Search results for: teachers’ professional competencies

Authors: Adi Sharabi, Dafna Marom-Golan

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Parents’ involvement in the care of their children with Autism Spectrum Disorder (ASD) and its beneficial effect on the children’s developmental and educational outcomes is well documented. At the same time, parents of children with ASD tend to experience greater psychological distress than parents of children with other developmental disabilities or with typical development. Positive social support is an important resource used by parents to reduce their psychological distress. The goal of the current research was to examine the contribution of formal and informal social support in explaining mothers’ and fathers’ involvement with their young children with ASD. The sample consisted of 107 parents who live in Israel (61 mothers and 46 fathers) of children aged between 2 and 7, all diagnosed with ASD and attending special kindergartens or special day care for children with ASD. Parental involvement and social support perception were assessed. Initial analysis focused on the relations between involvement, support, and demographic variables. In addition, analysis of variance (ANOVA) was conducted to test differences between mothers and fathers. Two hierarchical multiple regression analyses were performed to examine the predicted factors in the involvement model while controlling for group (mothers/fathers). Results indicate that mothers reported significantly higher levels of parenting involvement than fathers. Mothers reported higher levels of general involvement and all sub-types of involvement. For example, mothers reported that they were more interested in and have higher levels of attendance in their child’s educational program. They were also more collaborative in their child’s educational therapeutic program, and socialized with other parents of children from their child’s kindergarten than fathers. Mothers’ involvement was found to be related to their informal support (non-formal relatives). Findings also reveal significant differences between mothers and fathers on the formal support subscale measure of specializes services. Fathers, more than mothers, reported more specializes services support such as social workers or professional therapists. Separate hierarchical multiple regression analyses revealed a unique gender difference in the factors that explained parental involvement. Specifically, informal support only had a unique positive contribution in explaining mothers’, but not fathers’ involvement. This study highlights the central role of mothers in maintaining constant contact with the educational system and the professionals who help care for their child with ASD. At the same time, this research emphasizes the crucial role of both mothers and fathers in their child's development and well-being at every development stage, particularly in early development. Further, different kinds of social support seem to relate to the different kinds of parental involvement. It is in the best interest of educators and family therapists who work with families with children with ASD to support the cohesiveness of the family and the collaboration of the parents by understanding and respecting the way each member addresses the responsibilities of parenting a child with ASD, and her or his need for different types of social support.

Keywords: parental differences, parental involvement, social support, specialized support services

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Authors: Ammar Asma, Bouafia Nabiha, Ben Cheikh Asma, Ezzi Olfa, Mahjoub Mohamed, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Ventilator-associated pneumonia (VAP) is currently recognized as one of the most relevant causes of morbidity and mortality among intensive care unit (ICU) patients worldwide. Identifying modifiable risk factors for VAP could be helpful for future controlled interventional studies aiming at improving prevention of VAP. The purposes of this study were to determine the incidence and risk factors for VAP in in a Tunisian medical ICU. Materials / Methods: A retrospective case-control study design based on the prospective database collected over a 14-month period from September 15th, 2015 through November 15th, 2016 in an 8-bed medical ICU. Patients under ventilation for over 48 h were included. The number of cases was estimated by Epi-info Software with the power of statistical test equal to 90 %. Each case patient was successfully matched to two controls according to the length of mechanical ventilation (MV) before VAP for cases and the total length of MV in controls. VAP in the ICU was defined according to American Thoracic Society; Infectious Diseases Society of America guidelines. Early onset or late-onset VAP were defined whether the infectious process occurred within or after 96 h of ICU admission. Patients’ risk factors, causes of admission, comorbidities and respiratory specimens collected were reviewed. Univariate and multivariate analyses were performed to determine variables associated with VAP with a p-value < 0.05. Results: During the period study, a total of 169 patients under mechanical ventilation were considered, 34 patients (20.11%) developed at least one episode of VAP in the ICU. The incidence rate for VAP was 14.88/1000 ventilation days. Among these cases, 9 (26.5 %) were early-onset VAP and 25 (73.5 %) were late-onset VAP. It was a certain diagnosis in 66.7% of cases. Tracheal aspiration was positive in 80% of cases. Multi-drug resistant Acinerobacter baumanii was the most common species detected in cases; 67.64% (n=23). The rate of mortality out of cases was 88.23% (n= 30). In univariate analysis, the patients with VAP were statistically more likely to suffer from cardiovascular diseases (p=0.035) and prolonged duration of sedation (p=0.009) and tracheostomy (p=0.001), they also had a higher number of re-intubation (p=0.017) and a longer total time of intubation (p=0.012). Multivariate analysis showed that cardiovascular diseases (OR= 4.44; 95% IC= [1.3 - 14]; p=0.016), tracheostomy (OR= 4.2; 95% IC= [1.16 -15.12]; p= 0.028) and prolonged duration of sedation (OR=1.21; 95% IC= [1.07, 1.36]; p=0.002) were independent risk factors for the development of VAP. Conclusion: VAP constitutes a therapeutic challenge in an ICU setting, therefore; strategies that effectively prevent VAP are needed. An infection control-training program intended to all professional heath care in this unit insisting on bundles and elaboration of procedures are planned to reduce effectively incidence rate of VAP.

Keywords: case control study, intensive care unit, risk factors, ventilator associated pneumonia

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Authors: Lik Hang Gary Wong

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Background: Practice learning is crucial for preparing the healthcare profession to meet the real challenge upon graduation. Students are required to demonstrate their competence in managing interpersonal challenges, such as teamwork with other professionals and communicating well with the service users, during the placement. Such competence precedes clinical practice, and it may eventually affect students' actual performance in a clinical context. Unfortunately, there were limited studies investigating how such competence affects students' performance in practice learning. Objectives: The aim of this study is to investigate how self-rated interpersonal competence affects students' actual performance during clinical placement. Methods: 40 occupational therapy students from Hong Kong were recruited in this study. Prior to the clinical placement (level two or above), they completed an online survey that included the Interpersonal Communication Competence Scale (ICCS) measuring self-perceived competence in interpersonal communication. Near the end of their placement, the clinical educator rated students’ performance with the Student Practice Evaluation Form - Revised edition (SPEF-R). The SPEF-R measures the eight core competency domains required for an entry-level occupational therapist. This study adopted the cross-sectional observational design. Pearson correlation and multiple regression are conducted to examine the relationship between students' interpersonal communication competence and their actual performance in clinical placement. Results: The ICCS total scores were significantly correlated with all the SPEF-R domains, with correlation coefficient r ranging from 0.39 to 0.51. The strongest association was found with the co-worker communication domain (r = 0.51, p < 0.01), followed by the information gathering domain (r = 0.50, p < 0.01). Regarding the ICCS total scores as the independent variable and the rating in various SPEF-R domains as the dependent variables in the multiple regression analyses, the interpersonal competence measures were identified as a significant predictor of the co-worker communication (R² = 0.33, β = 0.014, SE = 0.006, p = 0.026), information gathering (R² = 0.27, β = 0.018, SE = 0.007, p = 0.011), and service provision (R² = 0.17, β = 0.017, SE = 0.007, p = 0.020). Moreover, some specific communication skills appeared to be especially important to clinical practice. For example, immediacy, which means whether the students were readily approachable on all social occasions, correlated with all the SPEF-R domains, with r-values ranging from 0.45 to 0.33. Other sub-skills, such as empathy, interaction management, and supportiveness, were also found to be significantly correlated to most of the SPEF-R domains. Meanwhile, the ICCS scores correlated differently with the co-worker communication domain (r = 0.51, p < 0.01) and the communication with the service user domain (r = 0.39, p < 0.05). It suggested that different communication skill sets would be required for different interpersonal contexts within the workplace. Conclusion: Students' self-perceived interpersonal communication competence could predict their actual performance during clinical placement. Moreover, some specific communication skills were more important to the co-worker communication but not to the daily interaction with the service users. There were implications on how to better prepare the students to meet the future challenge upon graduation.

Keywords: interpersonal competence, clinical education, healthcare professional education, occupational therapy, occupational therapy students

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Authors: Mohamed El Fares Djellatou, Fracoise Filion

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The Ashukin program that means bridge in Naskapi or Atikamekw language, has been designed to offer a partnership between nursing students and an indigenous community. The students design a health promotion project tailored to the needs of the community. The issues of intimidation in primary school and cyber-dependence in high school were some concerns in a rural Atikamekw community. The goal of the project was to have a conversation with indigenous youths, aged 10-16 years old, on the challenges presented by intimidation and cyber dependence as well as promoting healthy relationships online and within the community. Methods: Multiple progressive inquiry questions (PIQs) were used to assess the feasibility and importance of this project for the Atikamekw nation, and to determine a plan to follow. The theoretical foundations to guide the conception of the project were the Population Health Promotion Model (PHPM), the First Nations Holistic Lifelong Learning Model, and the Medicine Wheel. A broad array of social determinants of health were addressed, including healthy childhood development, personal health practices, and coping skills, and education. The youths were encouraged to participate in interactive educational sessions, using PowerPoint presentations and pamphlets as the main effective strategies. Additional tools such as cultural artworks and physical activities were introduced to strengthen the inter-relational and team spirit within the Indigenous population. A quality assurance tool (QAT) was developed specifically to determine the appropriateness of these health promotion tools. Improvements were guided by the feedback issued by the indigenous schools’ teachers and social workers who filled the QATs. Post educational sessions, quantitative results have shown that 93.48% of primary school students were able to identify the different types of intimidation, 72.65% recognized more than two strategies, and 52.1% were able to list at least four resources to diffuse intimidation. On the other hand, around 75% of the adolescents were able to name at least three negative effects, and 50% listed three strategies to reduce cyber-dependence. This project was meant to create a bridge with the First Nation through health promotion, a population that is known to be disadvantaged due to systemic health inequity and disparities. Culturally safe care was proposed to deal with the two identified priority issues, and an educational toolkit was given to both schools to ensure the sustainability of the project. The project was self-financed through fundraising activities, and it yielded better results than expected.

Keywords: indigenous, first nation, bullying, cyber-dependence, internet addiction, intimidation, youth, adolescents, school, community nursing, health promotion

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Authors: Cristina Felipeto, Catherine Bore, Eduardo Calil

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This work aims to analyze and compare the punctuation marks (PM) in school texts of Brazilian and French students and the comments on these PM made spontaneously by the students during the ongoing text. Assuming textual genetics as an investigative field within a dialogical and enunciative approach, we defined a common methodological design in two 1st year classrooms (7 years old) of the primary school, one classroom in Brazil (Maceio) and the other one in France (Paris). Through a multimodal capture system of writing processes in real time and space (Ramos System), we recorded the collaborative writing proposal in dyads in each of the classrooms. This system preserves the classroom’s ecological characteristics and provides a video recording synchronized with dialogues, gestures and facial expressions of the students, the stroke of the pen’s ink on the sheet of paper and the movement of the teacher and students in the classroom. The multimodal register of the writing process allowed access to the text in progress and the comments made by the students on what was being written. In each proposed text production, teachers organized their students in dyads and requested that they should talk, combine and write a fictional narrative. We selected a Dyad of Brazilian students (BD) and another Dyad of French students (FD) and we have filmed 6 proposals for each of the dyads. The proposals were collected during the 2nd Term of 2013 (Brazil) and 2014 (France). In 6 texts written by the BD there were identified 39 PMs and 825 written words (on average, a PM every 23 words): Of these 39 PMs, 27 were highlighted orally and commented by either student. In the texts written by the FD there were identified 48 PMs and 258 written words (on average, 1 PM every 5 words): Of these 48 PM, 39 were commented by the French students. Unlike what the studies on punctuation acquisition point out, the PM that occurred the most were hyphens (BD) and commas (FD). Despite the significant difference between the types and quantities of PM in the written texts, the recognition of the need for writing PM in the text in progress and the comments have some common characteristics: i) the writing of the PM was not anticipated in relation to the text in progress, then they were added after the end of a sentence or after the finished text itself; ii) the need to add punctuation marks in the text came after one of the students had ‘remembered’ that a particular sign was needed; iii) most of the PM inscribed were not related to their linguistic functions, but the graphic-visual feature of the text; iv) the comments justify or explain the PM, indicating metalinguistic reflections made by the students. Our results indicate how the comments of the BD and FD express the dialogic and subjective nature of knowledge acquisition. Our study suggests that the initial learning of PM depends more on its graphic features and interactional conditions than on its linguistic functions.

Keywords: collaborative writing, erasure, graphic marks, learning, metalinguistic awareness, textual genesis

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Authors: E. Rommes, Els Toonen, Rahil Roodsaz, Suborna Camellia, Farhana Alam, Saad Khan, Jhalok Ranjon Talukder, Tanveer Hassan, Syeda Farjana Ahmed, Sabina Faiz Rashid

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In Bangladesh, a country in which adults (both parents and teachers) find it particularly hard to speak with youth about sexuality, adolescents seem to struggle with various insecurities about their sexual feelings, thoughts, behavior and physical characteristics. On the basis of a large number of interviews and focus groups with rural and urban Bangla adolescent girls and boys of lower and middle class as part of the large-scale three-year project ‘Breaking the Shame’, we have identified ten sexual themes or ‘myths’ that youth struggle with most. These encompass amongst others beliefs and insecurities on masturbation, discharge, same-sex behavior and feelings, the effects of watching porn and gender norms. We argue that the Internet is a particularly suitable medium to ‘debunk’ those myths, as youth can consult it anonymously and privately and so avoid social shame. Moreover, amongst the myths, we have identified two kinds which may need different debunking techniques. One kind of myth concerns scientifically uncontested, generally biological related information, such as the effects of having sex with a pregnant woman, questions on the effects of a penile or vaginal discharge or questions on the effects of masturbation. The second kind of myths concerns more diverse information sources and deals with e.g. religious or culturally specific norms, such as on the meaning and existence of homosexuality or gender appropriate norms of behavior in Bangladesh. For addressing both kinds of myths, expert information including a wealth of references to information resources needs to be provided, which the Internet is very suitable for. For the second kind of myths, adolescents also need to learn how to deal with sometimes conflicting norms and information sources, and they need to develop and reflect on their own opinions as part of their identity formation. On the basis of a literature review, we thus distinguish general information needs from identity formation needs, which includes the need to be able to relate information and opinions to one’s own opinions and situation. Hence, we argue that youth not only need abstract expert information to be able to debunk sexual myths, but also the option to discuss this information with other adolescents and compare their own situation and opinions with other peers, who in that way serve as ‘warm experts’ for each other. In this paper, we will describe the outcomes of our qualitative study above. In addition, we will present our findings of an intervention by presenting youth with general, uncontested information on the Internet with additional peer discussion options to compare the debunking effects on different kinds of myths.

Keywords: peer discussion, intervention, sexual myths, shame

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Authors: Sakinah Idris, Femke Ten Hoeve, Kirstin Greaves-Lord

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Background: Social skills interventions are considered to be efficacious if social skills are improved as a result of an intervention. Nevertheless, the objective assessment of social skills is hindered by a lack of sensitive and validated measures. To measure the change in social skills after an intervention, questionnaires reported by parents, clinicians and/or teachers are commonly used. Observations are the most ecologically valid method of assessing improvements in social skills after an intervention. For this purpose, The Program for the Educational and Enrichment of Relational Skills (PEERS) was developed for adolescents, in order to teach them the age-appropriate skills needed to participate in society. It is an evidence-based intervention for adolescents with ASD that taught ecologically valid social skills techniques. Objectives: The current study aims to describe the development and psychometric evaluation of the Dutch Contextual Assessment of Social Skills (CASS), an observational outcome measure of social skills for adolescents with Autism Spectrum Disorder (ASD). Methods: 64 adolescents (M = 14.68, SD = 1.41, 71% boys) with ASD performed the CASS before and after a social skills intervention (i.e. PEERS or the active control condition). Each adolescent completed a 3-minute conversation with a confederate. The conversation was prompt as a natural introduction between two-unfamiliar, similar ages, opposite-sex peers who meet for the first time. The adolescent and the confederate completed a brief questionnaire about the conversation (Conversation Rating Scale). Results: Results indicated sufficient psychometric properties. The Dutch CASS has a high level of internal consistency (Cronbach's α coefficients = 0.84). Data supported the convergent validity (i.e., significant correlated with the Social Skills Improvement System (SSiS). The Dutch CASS did not significantly correlate with the autistic mannerism subscale from Social Responsiveness Scale (SRS), thus proved the divergent validity. Based on scorings made by raters who were kept blind to the time points, reliable change index was computed to assess the change in social skills. With regard to the content validity, only the learning objectives of the first two meetings of PEERS about conversational skills relatively matched with rating domains of the CASS. Due to this underrepresentation, we found an existing observational measure (TOPICC) that covers some of the other learning objectives of PEERS. TOPICC covers 22% of the learning objectives of PEERS about conversational skills, meanwhile, CASS is 45%. Unfortunately, 33% of the learning objectives of PEERS was not covered by CASS or TOPICC. Conclusion: Recommendations are made to improve the psychometric properties and content validity of the Dutch CASS.

Keywords: autism spectrum disorder, observational, PEERS, social skills

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Authors: Natalie Preville, Carlos Joel Mejia-Olivares

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In the UK, since the early 1950s when the NHS was founded, international staff in the NHS have played an important role. Currently, they represent 16% of the workforce within the NHS in the UK. Furthermore, to address the shortfalls in nursing staff, international recruitment programs have been essential to reduce the gaps in the UK nursing workforce over the last two decades. The NHS Long Term Plan (2019) aims to have a significant reduction of nursing vacancies to 5% by 2028. However, in 2021 and 2022, Workforce Race Equality Standards (WRES) reports stated that there is inequitable Career Progression (CP) among Internationally Recruited (IR) nurses as compared to British counterparts. In addition, there is sufficient literature exploring the motives and lived experiences of IR nurses, which underpins the findings. Therefore, the overall aim of this report is to conduct a scoping project to understand the experiences of the IR nurses who joined the NHS in the South East of England within the last 5 years. Methodology- This document is based on the data from a survey developed by Royal Berkshire NHS Foundation Trust using Microsoft forms and consisted of 23 questions divided into four themes, staff background, career experience, career progression and future career plans within Royal Berkshire NHS Foundation Trust. The descriptive analysis provided the initial analysis of the quantitative data. As a result, 44 responses were collected and evaluated by utilising Microsoft excel. Key findings: Career experiences; 72% of respondents felt that their current role was a good fit, and in a subsequent question, the main reason cited was having “relevant skills”. This indicates that, for the most part, the prior experience of IR nurses is a large factor in their placement, which is viewed positively; the next step is to effectively apply similar relevance in aligning prior experience with career progression opportunities. Moreover, 67% of respondents feel valued by the department/team, which is a great reflection of the values of the Trust being demonstrated towards IR Nurses. However, further studies may be necessary to explore the reasons why the remaining 33% may not feel valued; this can include having a better understanding of cultural perceptions of value. Perceived Barriers: Although 37% of respondents had been promoted since commencing employment with the Trust, the data indicates that there is still room for CP opportunities, as it is the leading barrier reported by the respondents. Secondly, the growing mix of cultures within the nursing workforce gives the appearance of inclusion. However, this is not the experience of some IR nurses. Conclusion statemen: Survey results indicate that this NHS Trust has an excellent foundation to integrate international nurses into their workforce with scope for career progression in a reasonable timeframe. However, it would be recommendable to include fast-tracking career promotions by recognizing previous studies and professional experience. Further exploration of staff career experiences and goals may provide additional useful data for future planning.

Keywords: career progression, International nurses, perceived barriers, staff survey

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Authors: Young Ik Suh, Sanghak Lee, Tywan G. Martin

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An increasing number of athletes, across all sports, are moving from their home countries to play in foreign countries. The migration of athletes, coaches, managers, and administrators within and between nations is an important aspect of the social and cultural changes taking place in modern, global sports. It is especially important to understand the context of these migrations as they are critical factors in the successful development of sports policies. In previous decades, efforts have been made to understand the motives of migrating athletes from a variety of sports, including rugby, cricket, baseball, and soccer. These studies focused on the athletes’ motivations, experiences as migrants, and recruit process. However, few studies have been conducted in order to understand athletes’ constraints of migration. The concept of constraints in leisure studies refers to the barriers that exist between an individual’s desire for participation and an individual’s real participation. The study of constraints is not a new topic in the fields of sports and recreation. In addition to understanding the motives that drive athletes to work or play in foreign countries, it is also important to recognize that negative dimensions exist that stop some athletes from migrating. Furthermore, little research has explored what makes athletes consider playing in small and unknown volleyball markets, such as the Korean Volleyball League (V-League). The V-League is a professional men’s and women’s volleyball league, started in 2005. It consists of seven men’s clubs, and six women’s clubs and each team has one foreign player. In addition, several limitations are placed on the foreign players, such as on height, position, and salary to play in the V-League. Thus, the main focus of the present research is to understand why foreign athletes (e.g., European, American, Brazil, etc.) are attracted to the V-League, which has a smaller market compared to its neighbors (i.e., China, Japan, and The Philippines). In addition, the current study seeks to identify the negative factors that prevent athletes from playing in the V-League. The participants for this study will be foreign volleyball players participating in the V-League. The investigators will provide a brief introduction to this study and inform the potential participants that they can choose whether to participate in this study. In terms of theoretical saturation, at least 12 participants are generally an adequate number to reach saturation, if they belong to a relatively homogenous group based on culture and ethnicity. This study utilizes a qualitative approach in order to understand the migration experiences foreign volleyball athletes playing in the V-League. The proposed study represents ongoing research to support work conducted by the investigators to understand the possible motivations and constraints for foreign volleyball players playing in the V-League. In addition, significant contributions to scholarship in the field of sports, psychology, and coaching studies will be an outcome of this study along with additions to the body of knowledge in several disciplines, including psychology, sociology, and social work.

Keywords: athletes’ migration, motivation, constraints, volleyball

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Authors: Melissa Dorsey

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Moral distress and compassion fatigue plague nurses in the Cardiothoracic Intensive Care Unit (CTICU) and cause an unnecessary level of turnover. Dueling Burnout describes an initiative that was implemented in the CTICU to reduce the level of burnout the nurses endure by encouraging dual roles with collaborating departments. Purpose: Critical care nurses are plagued by burnout, moral distress, and compassion fatigue due to the intensity of care provided. The purpose of the dual role program was to decrease these issues by providing relief from the intensity of the critical care environment while maintaining full-time employment. Relevance/Significance: Burnout, moral distress, and compassion fatigue are leading causes of Cardiothoracic Critical Care (CTCU) turnover. A contributing factor to burnout is the workload related to serving as a preceptor for a constant influx of new nurses (RN). As a result of these factors, the CTICU averages 17% nursing turnover/year. The cost, unit disruption, and, most importantly, distress of the clinical nurses required an innovative approach to create an improved work environment and experience. Strategies/Implementation/Methods: In May 2018, a dual role pilot was initiated for nurses. The dual role constitutes .6 full-time equivalent hours (FTE) worked in CTICU in combination with .3 FTE worked in the Emergency Department (ED). ED nurses who expressed an interest in cross-training to CTICU were also offered the dual role opportunity. The initial hypothesis was that full-time employees would benefit from a change in clinical setting leading to increased engagement and job satisfaction. The dual role also presents an opportunity for professional development through the expansion of clinical skills in another specialty. Success of the pilot led to extending the dual role to areas beyond the ED. Evaluation/Outcomes/Results: The number of dual role clinical nurses has grown to 22. From the dual role cohort, only one has transferred out of CTICU. This is a 5% turnover rate for this group of nurses as compared to the average turnover rate of 17%. A role satisfaction survey conducted with the dual role cohort found that because of working in a dual role, 76.5% decreased their intent to leave, 100% decreased their level of burnout, and 100% reported an increase in overall job satisfaction. Nurses reported the ability to develop skills that are transferable between departments. Respondents emphasized the appreciation gained from working in multiple environments; the dual role served to transform their care. Conclusions/Implications: Dual role is an effective strategy to retain experienced nurses, decrease burnout and turnover, improve collaboration, and provide flexibility to meet staffing needs. The dual role offers RNs an expansion of skills, relief from high acuity and orientee demands, while improving job satisfaction.

Keywords: nursing retention, burnout, pandemic, strategic staffing, leadership

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Authors: Gebreselassie Sebhatleab

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According to the Global Peace Index report (GPI, 2023), global peacefulness has deteriorated by more than 0.42%. Old and new conflicts, COVID-19, and political and cultural polarization are the main drivers of conflicts in the world. The 2022 was the deadliest year for armed conflict in the history of the GPI. In Ethiopia, over half a million people died in the Tigray war, which was the largest conflict death event since the 1994 Rwandan genocide. In total, 84 countries recorded an improvement, while 79 countries recorded a deterioration in peacefulness across the globe. The Russia-Ukraine war and its consequences were the main drivers of the deterioration in peacefulness globally. Both Russia and Ukraine are now ranked amongst the ten least peaceful countries, and Ukraine had the largest deterioration of any country in the 2023 GPI. In the same year, the global impact of violence on the economy was 17 percent, which was equivalent to 10.9% of global GDP. Besides, the brutal conflict in Tigray started in November. 2020 claimed more than half a million lives lost and displaced nearly 3 million people, along with widespread human rights violations and sexual violence has left deep damage on the population. The displaced people are still unable to return home because the western, southern and Eastern parts of Tigray are occupied by Eritrean and Amhara forces, despite the Pretoria Agreement. Currently, armed conflicts in Amhara in the Oromya regions are intensified, and human rights violations are being reported in both regions. Meanwhile, protests have been held by war-injured TDF members, IDPs and teachers in the Tigray region. Hence, the general objective of this project is to explore the challenges of peace-building processes in the border woredas of the Eastern Zone of the Tigray Region. Methodologically, the project will employ exploratory qualitative research designs to gather and analyze qualitative data. A purposive sampling technique will be applied to gather pertinent information from the key stakeholders. Open-ended interview questions will be prepared to gather relevant information about the challenges and perceptions of peacebuilding in the study area. Data will be analyzed using qualitative methods such as content analysis, narrative analysis and phenomenological analysis to deeply investigate the challenges of peace-building in the study woredas. Findings of this research project will be employed for program intervention to promote sustainable peace in the study area.

Keywords: peace building, conflcit and violence, political instability, insecurity

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Authors: Jacqueline A. G. Sachett, Cláudia S. Nogueira, Diana C. P. Lima, Jessica T. S. Oliveira, Guilherme K. M. Salazar, Lílian K. Aguiar

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The Polo Amazon Telehealth offers several tools for professionals working in Primary Health Care as a second formative opinion, teleconsulting and training between the different areas, whether medicine, dentistry, nursing, physiotherapy, among others. These activities have a monthly schedule of free access to the municipalities of Amazonas registered. With this premise, and in partnership with the University of the State of Amazonas (UEA), is promoting the practice of the triad; teaching-research-extension in order to collaborate with the enrichment and acquisition of knowledge through educational practices carried out through teleconferences. Therefore, nursing is to join efforts and inserts as a collaborator of this project running, contributing to the education and training of these professionals who are part of the health system in full Amazon. The aim of this study is to report the experience of academic of Amazonas State University nursing course, about the experience in the extension project underway in Polo Telemedicine Amazon. This was a descriptive study, the experience report type, about the experience of nursing academic UEA, by extension 'Telenursing: teleconsulting and second formative opinion for FHS professionals in the state of Amazonas' project, held in Polo Telemedicine Amazon, through an agreement with the UEA and funded by the Foundation of Amazonas Research from July / 2012 to July / 2016. Initially developed active search of members of the Family Health Strategy professionals, in order to provide training and training teams to use the virtual clinic, as well as the virtual environment is the focus of this tool design. The election period was an aggravating factor for the implementation of teleconsulting proposal, due to change of managers in each municipality, requiring the stoppage until they assume their positions. From this definition, we established the need for new training. The first video conference took place on 03.14.2013 for learning and training in the use of Virtual Learning Environment and Virtual Clinic, with the participation of municipalities of Novo Aripuanã, São Paulo de Olivença and Manacapuru. During the whole project was carried out literature about what is being done and produced at the national level about the subject. By the time the telenursing project has received twenty-five (25) consultancy requests. The consultants sent by nursing professionals, all have been answered to date. Faced with the lived experience, particularly in video conferencing, face to cause difficulties issues, such as the fluctuation in the number of participants in activities, difficulty of participants to reconcile the opening hours of the units with the schedule of video conferencing, transmission difficulties and changes schedule. It was concluded that the establishment of connection between the Telehealth points is one of the main factors for the implementation of Telenursing and that this feature is still new for nursing. However, effective training and updating, may provide to these professional category subsidies to quality health care in the Amazon.

Keywords: Amazon, teleconsulting, telehealth, telenursing

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Authors: László L. Lippai

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In addition to the fact that mental health bears great significance to a particular individual, it can also be regarded as an organizational, community and societal resource. Within the Szeged Health Promotion Research Group, we conducted mental health surveys on two levels: The inhabitants of a medium-sized Hungarian town and students of a Hungarian university with a relatively big headcount were requested to participate in surveys whose goals were to define local government priorities and organization-level health promotion programmes, respectively. To facilitate professional decision-making, we defined three, pragmatically relevant, groups of the target population: the mentally healthy, the vulnerable and the endangered. In order to determine which group a person actually belongs to, we designed a simple and quick measurement tool, which could even be utilised as a smoothing method, the Mental State Questionnaire validity of the above three categories was verified by analysis of variance against psychological quality of life variables. We demonstrate the pragmatic significance of our method via the analyses of the scores of our two mental health surveys. On town level, during our representative survey in Hódmezővásárhely (N=1839), we found that 38.7% of the participants was mentally healthy, 35.3% was vulnerable, while 16.3% was considered as endangered. We were able to identify groups that were in a dramatic state in terms of mental health. For example, such a group consisted of men aged 45 to 64 with only primary education qualification and the ratios of the mentally healthy, vulnerable and endangered were 4.5, 45.5 and 50%, respectively. It was also astonishing to see to what a little extent qualification prevailed as a protective factor in the case of women. Based on our data, the female group aged 18 to 44 with primary education—of whom 20.3% was mentally healthy, 42.4% vulnerable and 37.3% was endangered—as well as the female group aged 45 to 64 with university or college degree—of whom 25% was mentally healthy, 51.3 vulnerable and 23.8% endangered—are to be handled as priority intervention target groups in a similarly difficult position. On organizational level, our survey involving the students of the University of Szeged, N=1565, provided data to prepare a strategy of mental health promotion for a university with a headcount exceeding 20,000. When developing an organizational strategy, it was important to gather information to estimate the proportions of target groups in which mental health promotion methods; for example, life management skills development, detection, psychological consultancy, psychotherapy, would be applied. Our scores show that 46.8% of the student participants were mentally healthy, 42.1% were vulnerable and 11.1% were endangered. These data convey relevant information as to the allocation of organizational resources within a university with a considerable headcount. In conclusion, The Mental State Questionnaire, as a valid smoothing method, is adequate to describe a community in a plain and informative way in the terms of mental health. The application of the method can promote the preparation, design and implementation of mental health promotion interventions. 

Keywords: health promotion, mental health promotion, mental state questionnaire, psychological well-being

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Authors: Alba Ballester Ciuró, Marc Pares Franzi

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While coming decades are likely to see a higher flood risk in Europe and greater socio-economic damages, traditional flood risk management has become inefficient. In response to that, new approaches such as capacity building and public participation have recently been incorporated in natural hazards mitigation policy (i.e. Sendai Framework for Action, Intergovernmental Panel on Climate Change reports and EU Floods Directive). By integrating capacity building and public participation, we present a research concerning the promotion of participatory social capacity building actions for flood risk mitigation at the local level. Social capacities have been defined as the resources and abilities available at individual and collective level that can be used to anticipate, respond to, cope with, recover from and adapt to external stressors. Social capacity building is understood as a process of identifying communities’ social capacities and of applying collaborative strategies to improve them. This paper presents a proposal of systematization of participatory social capacity building process for flood risk mitigation, and its implementation in a high risk of flooding area in the Ebro river basin: Ribera Alta del Ebro. To develop this process, we designed and tested a tool that allows measuring and building five types of social capacities: knowledge, motivation, networks, participation and finance. The tool implementation has allowed us to assess social capacities in the area. Upon the results of the assessment we have developed a co-decision process with stakeholders and flood risk management authorities on which participatory activities could be employed to improve social capacities for flood risk mitigation. Based on the results of this process, and focused on the weaker social capacities, we developed a set of participatory actions in the area oriented to general public and stakeholders: informative sessions on flood risk management plan and flood insurances, interpretative river descents on flood risk management (with journalists, teachers, and general public), interpretative visit to the floodplain, workshop on agricultural insurance, deliberative workshop on project funding, deliberative workshops in schools on flood risk management (playing with a flood risk model). The combination of obtaining data through a mixed-methods approach of qualitative inquiry and quantitative surveys, as well as action research through co-decision processes and pilot participatory activities, show us the significant impact of public participation on social capacity building for flood risk mitigation and contributes to the understanding of which main factors intervene in this process.

Keywords: flood risk management, public participation, risk reduction, social capacities, vulnerability assessment

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Authors: Ine Huybrechts, Anja Declercq, Emily Verté, Peter Raeymaeckers, Sibyl Anthierens

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Goal-oriented care is a concept gaining increased interest as an approach to go towards more coordinated and integrated primary care. It places patients’ personal life goals at the core of health care support, hereby shifting the focus from “what’s the matter with this patient” to “what matters to this patient.” In Flanders/Belgium, various primary care providers, health and social care organizations and governmental bodies have picked up this concept and have initiated actions to facilitate this approach. The implementation of goal-oriented care not only happens on the micro-level, but it also requires efforts on the meso- and macro-level. Within implementation research, there is a growing recognition that the context in which an intervention takes place strongly relates to its implementation outcomes. However, when investigating contextual variables, the external context and its impact on implementation processes is often overlooked. This study aims to explore how we can better identify and understand the external context and how it relates to the mechanism of change within the implementation process of goal-oriented care in Flanders/Belgium. Results can be used to support and guide initiatives to introduce innovative approaches such as goal-oriented care inside an organization or in the broader primary care landscape. We have conducted qualitative research, performing in-depth interviews with n=23 respondents who have affinity with the implementation of goal-oriented care within their professional function. This lead to in-depth insights from a wide range of actors, with meso-level and/or macro-level perspectives on the implementation of goal-oriented care. This means that we have interviewed actors that are not only involved with initiatives to implement goal-oriented care, but also actors that actively give form to the external context in which goal-oriented care is implemented. Data were collected using a semi-structured interview guide, audio recorded, and analyzed first inductively and then deductively using various theories and concepts that derive from organizational research. Our preliminary findings suggest t Our findings can contribute to further define actions needed for sustainable implementation of goal-oriented primary care. It gives insights in the dynamics between contextual variables and implementation efforts, hereby indicating towards those contextual variables that can be further shaped to facilitate the implementation of an innovation such as goal-oriented care. hat organizational theories can help understand the mechanism of change of implementation processes with a macro-level perspective. Institutional theories, contingency theories, resources dependency theories and others can expose the mechanism of change for an innovation such as goal-oriented care. Our findings can contribute to further define actions needed for sustainable implementation of goal-oriented primary care. It gives insights in the dynamics between contextual variables and implementation efforts, hereby indicating towards those contextual variables that can be further shaped to facilitate the implementation of an innovation such as goal-oriented care.

Keywords: goal-oriented care, implementation processes, organizational theories, person-centered care, implementation research

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Authors: Katherine O'Grady-Bray

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For some deaf children, reading books can be a challenge. Frank Barnes School (FBS) provides guided reading time with Teachers of the Deaf, in which they read books with deaf children using a bilingual approach. The vocabulary and context of the story is explained to deaf children in BSL so they develop skills bridging English and BSL languages. However, the success of this practice is only achieved if the person is fluent in both languages. FBS piloted a scheme to convert an Oxford Reading Tree (ORT) book into an e-book that can be read using tablets. Deaf readers at FBS have access to both languages (BSL and English) during lessons and outside the classroom. The pupils receive guided reading sessions with a Teacher of the Deaf every morning, these one to one sessions give pupils the opportunity to learn how to bridge both languages e.g. how to translate English to BSL and vice versa. Generally, due to our pupils’ lack of access to incidental learning, gaining new information about the world around them is limited. This highlights the importance of quality time to scaffold their language development. In some cases, there is a shortfall of parental support at home due to poor communication skills or an unawareness of how to interact with deaf children. Some families have a limited knowledge of sign language or simply don’t have the required learning environment and strategies needed for language development with deaf children. As the majority of our pupils’ preferred language is BSL we use that to teach reading and writing English. If this is not mirrored at home, there is limited opportunity for joint reading sessions. Development of the e-Book required planning and technical development. The overall production took time as video footage needed to be shot and then edited individually for each page. There were various technical considerations such as having an appropriate background colour so not to draw attention away from the signer. Appointing a signer with the required high level of BSL was essential. The language and pace of the sign language was an important consideration as it was required to match the age and reading level of the book. When translating English text to BSL, careful consideration was given to the nonlinear nature of BSL and the differences in language structure and syntax. The e-book was produced using Apple’s ‘iBook Author’ software which allowed video footage of the signer to be embedded on pages opposite the text and illustration. This enabled BSL translation of the content of the text and inferences of the story. An interpreter was used to directly ‘voice over’ the signer rather than the actual text. The aim behind the structure and layout of the e-book is to allow parents to ‘read’ with their deaf child which helps to develop both languages. From observations, the use of e-books has given pupils confidence and motivation with their reading, developing skills bridging both BSL and English languages and more effective reading time with parents.

Keywords: bilingual book, e-book, BSL and English, bilingual e-book

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Authors: Aline V. Arroteia, Gustavo G. Do Amaral, Simone Z. Kikuti, Norberto C. S. Moura, Silvio B. Melhado

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Despite the significant advances made by the construction industry in recent years, the crystalized absence of integration between the design and construction phases is still an evident and costly problem in building construction. Globally, the construction industry has sought to adopt collaborative practices through new technologies to mitigate impacts of this fragmented process and to optimize its production. In this new technological business environment, professionals are required to develop new methodologies based on the notion of collaboration and integration of information throughout the building lifecycle. This scenario also represents the industry’s reality in developing nations, and the increasing need for overall efficiency has demanded new educational alternatives at the undergraduate and post-graduate levels. In countries like Brazil, it is the common understanding that Architecture, Engineering and Building Construction educational programs are being required to review the traditional design pedagogical processes to promote a comprehensive notion about integration and simultaneity between the phases of the project. In this context, the coherent inclusion of computation design to all segments of the educational programs of construction related professionals represents a significant research topic that, in fact, can affect the industry practice. Thus, the main objective of the present study was to comparatively measure the effectiveness of the Building Information Modeling courses offered by the University of Sao Paulo, the most important academic institution in Brazil, at the Schools of Architecture and Civil Engineering and the courses offered in well recognized BIM research institutions, such as the School of Design in the College of Architecture of the Georgia Institute of Technology, USA, to evaluate the dissemination of BIM knowledge amongst students in post graduate level. The qualitative research methodology was developed based on the analysis of the program and activities proposed by two BIM courses offered in each of the above-mentioned institutions, which were used as case studies. The data collection instruments were a student questionnaire, semi-structured interviews, participatory evaluation and pedagogical practices. The found results have detected a broad heterogeneity of the students regarding their professional experience, hours dedicated to training, and especially in relation to their general knowledge of BIM technology and its applications. The research observed that BIM is mostly understood as an operational tool and not as methodological project development approach, relevant to the whole building life cycle. The present research offers in its conclusion an assessment about the importance of the incorporation of BIM, with efficiency and in its totality, as a teaching method in undergraduate and graduate courses in the Brazilian architecture, engineering and building construction schools.

Keywords: building information modeling (BIM), BIM education, BIM process, design teaching

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Authors: Kuo-Kai Lin, Po-Lun Chang

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Background: The Emergency Care Research Institute released a list for the top 10 medical technology hazards in 2017, with the following hazard topping the list: ‘infusion errors can be deadly if simple safety steps are overlooked.’ In addition, hospitals use various assessment items to evaluate the safety of their medical equipment, confirming the importance of medical equipment safety. In recent years, the topic of patient safety has garnered increasing attention. Accordingly, various agencies have established patient safety-related committees to coordinate, collect, and analyze information regarding abnormal events associated with medical practice. Activities to promote and improve employee training have been introduced to diminish the recurrence of medical malpractice. Objective: To allow nursing personnel to acquire the skills needed to operate common medical equipment and update and review such skills whenever necessary to elevate medical care quality and reduce patient injuries caused by medical equipment operation errors. Method: In this study, a quasi-experimental design was adopted and nurses from a regional teaching hospital were selected as the study sample. Online videos instructing the operation method of common medical equipment were made and quick response codes were designed for the nursing personnel to quickly access the videos when necessary. Senior nursing supervisors and equipment experts were invited to formulate a ‘Scale-based Questionnaire for Assessing Nursing Personnel’s Operational Knowledge of Common Medical Equipment’ to evaluate the nursing personnel’s literacy regarding the operation of the medical equipment. From March to October 2017, an employee training on medical equipment operation and a practice course (simulation course) were implemented, after which the effectiveness of the training and practice course were assessed. Results: Prior to and after the training and practice course, the 66 participating nurses scored 58 and 87 on ‘operational knowledge of common medical equipment,’ respectively (showing a significant statistical difference; t = -9.407, p < .001); 53.5 and 86.3 on ‘operational knowledge of 12-lead electrocardiography’ (z = -2.087, p < .01), respectively; 40 and 79.5 on ‘operational knowledge of cardiac defibrillators’ (z = -3.849, p < .001), respectively; 90 and 98 on ‘operational knowledge of Abbott pumps’ (z = -1.841, p = 0.066), respectively; and 8.7 and 13.7 on ‘perceived competence’ (showing a significant statistical difference; t = -2.77, p < .05). In the participating hospital, medical equipment operation errors were observed in both 2016 and 2017. However, since the implementation of the intervention, medical equipment operation errors have not yet been observed up to October 2017, which can be regarded as the secondary outcome of this study. Conclusion: In this study, innovative teaching strategies were adopted to effectively enhance the professional literacy and skills of nursing personnel in operating medical equipment. The training and practice course also elevated the nursing personnel’s related literacy and perceived competence of operating medical equipment. The nursing personnel was thus able to accurately operate the medical equipment and avoid operational errors that might jeopardize patient safety.

Keywords: medical equipment, digital teaching plan, simulation-based teaching plan, operational knowledge, patient safety

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Authors: R. F. Mesquita Brandão

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Act Local, Think Global is the name of a campaign implemented at Superior Institute of Engineering of Porto (ISEP), one of schools of Polytechnic of Porto, with the main objective of increase the sustainability of the campus. ISEP has a campus with 52.000 m2 and more than 7.000 students. The campaign started in 2019 and the results are very clear. In 2019 only 16% of the waste created in the campus was correctly separate for recycling and now almost 50% of waste goes to the correct waste container. Actions to reduce the energy consumption were implemented with significantly results. One of the major problems in the campus are the water leaks. To solve this problem was implemented a methodology for water monitoring during the night, a period of time where consumptions are normally low. If water consumption in the period is higher than a determinate value it may mean a water leak and an alarm is created to the maintenance teams. In terms of energy savings, some measurements were implemented to create savings in energy consumption and in equivalent CO₂ produced. In order to reduce the use of plastics in the campus, was implemented the prohibition of selling 33 cl plastic water bottles and in collaboration with the students association all meals served in the restaurants changed the water plastic bottle for a glass that can be refilled with water in the water dispensers. This measures created a reduction of use of more than 75.000 plastic bottles per year. In parallel was implemented the ISEP water glass bottle to be used in all scientific meetings and events. Has a way of involving all community in sustainability issues was developed and implemented a vertical garden in aquaponic system. In 2019, the first vertical garden without soil was installed inside a large campus building. The system occupies the entire exterior façade (3 floors) of the entrance to ISEP's G building. On each of these floors there is a planter with 42 positions available for plants. Lettuces, strawberries, peppers are examples of some vegetable produced that can be collected by the entire community. Associated to the vertical garden was developed a monitoring system were some parameters of the system are monitored. This project is under development because it will work in a stand-alone energy feeding, with the use of photovoltaic panels for production of energy necessities. All the system was, and still is, developed by students and teachers and is used in class projects of some ISEP courses. These and others measures implemented in the campus, will be more developed in the full paper, as well as all the results obtained, allowed ISEP to be the first Portuguese high school to obtain the certification “Coração Verde” (Green Heart), awarded by LIPOR, a Portuguese company with the mission of transform waste into new resources through the implementation of innovative and circular practices, generating and sharing value.

Keywords: aquaponics, energy efficiency, recycling, sustainability, waste separation

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Authors: Virginia Vettori, Chiara Lorini, Vieri Lastrucci, Giulia Di Pisa, Alessia De Blasi, Sara Giuggioli, Guglielmo Bonaccorsi

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The design of the Nutrition Literacy Assessment Instrument (NLit) responds to the need to provide a tool to adequately assess the construct of nutrition literacy (NL), which is strictly connected to the quality of the diet and nutritional health status. The NLit was originally developed and validated in the US context, and it was recently validated for Italian people too (NLit-IT), involving a sample of N = 74 adults. The results of the cross-cultural adaptation of the tool confirmed its validity since it was established that the level of NL contributed to predicting the level of adherence to the Mediterranean Diet (convergent validity). Additionally, results obtained proved that Internal Consistency and reliability of the NLit-IT were good (Cronbach’s alpha (ρT) = 0.78; 95% CI, 0.69–0.84; Intraclass Correlation Coefficient (ICC) = 0.68, 95% CI, 0.46–0.85). However, the Subscale 3 of the NLit-IT “Household Food Measurement” showed lower values of ρT and ICC (ρT = 0.27; 95% CI, 0.1–0.55; ICC = 0.19, 95% CI, 0.01–0.63) than the entire instrument. Subscale 3 includes nine items which are constituted by written questions and the corresponding pictures of the meals. In particular, items 2, 3, and 8 of Subscale 3 had the lowest level of correct answers. The purpose of the present study was to identify the factors that influenced the Internal Consistency and reliability of Subscale 3 of NLit-IT using the methodology of a focus group. A panel of seven experts was formed, involving professionals in the field of public health nutrition, dietetics, and health promotion and all of them were trained on the concepts of nutrition literacy and food appearance. A member of the group drove the discussion, which was oriented in the identification of the reasons for the low levels of reliability and Internal Consistency. The members of the group discussed the level of comprehension of the items and how they could be readapted. From the discussion, it emerges that the written questions were clear and easy to understand, but it was observed that the representations of the meal needed to be improved. Firstly, it has been decided to introduce a fork or a spoon as a reference dimension to better understand the dimension of the food portion (items 1, 4 and 8). Additionally, the flat plate of items 3 and 5 should be substituted with a soup plate because, in the Italian national context, it is common to eat pasta or rice on this kind of plate. Secondly, specific measures should be considered for some kind of foods such as the brick of yogurt instead of a cup of yogurt (items 1 and 4). Lastly, it has been decided to redo the photos of the meals basing on professional photographic techniques. In conclusion, we noted that the graphical representation of the items strictly influenced the level of participants’ comprehension of the questions; moreover, the research group agreed that the level of knowledge about nutrition and food portion size is low in the general population.

Keywords: nutritional literacy, cross cultural adaptation, misinformation, food design

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Authors: A. M. Andriano, M. Lombardi, A. Lopolito, M. Prosperi, A. Stasi, E. Iannuzzi

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In according to the scientific debate on the definition of Social Innovation (SI), the present paper identifies SI as new ideas (products, services, and models) that simultaneously meet social needs and create new social relationships or collaborations. This concept offers important tools to unravel the difficult condition for the agricultural sector in marginalized areas, characterized by the abandonment of activities, low level of farmer education, and low generational renewal, hampering new territorial strategies addressed at and integrated and sustainable development. Models of SI in agriculture, starting from bottom up approach or from the community, are considered to represent the driving force of an ecological and digital revolution. A system based on SI may be able to grasp and satisfy individual and social needs and to promote new forms of entrepreneurship. In this context, Vazapp ('Go Hoeing') is an emerging SI model in southern Italy that promotes solutions for satisfying needs of farmers and facilitates their relationships (creation of network). The Vazapp’s initiative, considered in this study, is the Contadinners ('Farmer’s dinners'), a dinner held at farmer’s house where stakeholders living in the surrounding area know each other and are able to build a network for possible future professional collaborations. The aim of the paper is to identify the evolution of farmers’ relationships, both quantitatively and qualitatively, because of the Contadinner’s initiative organized by Vazapp. To this end, the study adopts the Social Network Analysis (SNA) methodology by using UCINET (Version 6.667) software to analyze the relational structure. Data collection was realized through a questionnaire distributed to 387 participants in the twenty 'Contadinners', held from February 2016 to June 2018. The response rate to the survey was about 50% of farmers. The elaboration data was focused on different aspects, such as: a) the measurement of relational reciprocity among the farmers using the symmetrize method of answers; b) the measurement of the answer reliability using the dichotomize method; c) the description of evolution of social capital using the cohesion method; d) the clustering of the Contadinners' participants in followers and not-followers of Vazapp to evaluate its impact on the local social capital. The results concern the effectiveness of this initiative in generating trustworthy relationships within the rural area of southern Italy, typically affected by individualism and mistrust. The number of relationships represents the quantitative indicator to define the dimension of the network development; while the typologies of relationships (from simple friendship to formal collaborations, for branding new cooperation initiatives) represents the qualitative indicator that offers a diversified perspective of the network impact. From the analysis carried out, Vazapp’s initiative represents surely a virtuous SI model to catalyze the relationships within the rural areas and to develop entrepreneurship based on the real needs of the community.

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Authors: Gaston Bacquet

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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

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Authors: Emmanuel A. David, Rebecca O. Soremekun, Roseline I. Aderemi-Williams

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Background: The complexities involved in the management of diabetes mellitus require a multi-dimensional, multi-professional collaborative and continuous care by health care providers and a substantial self-care by the patients in order to achieve desired treatment outcomes. The effect of pharmacists’ care in the management of diabetes in resource-endowed nations is well documented in literature, but randomised-controlled assessment of the impact of pharmacist-led care among patients with diabetes in resource-limited settings like Nigeria and sub-Saharan Africa countries is scarce. Objective: To evaluate the impact of Pharmacist-led care on glycaemic control in patients with uncontrolled type 2 diabetes, using a randomised-controlled study design Methods: This study employed a prospective randomised controlled design, to assess the impact of pharmacist-led care on glycaemic control of 108 poorly controlled type 2 diabetic patients. A total of 200 clinically diagnosed type 2 diabetes patients were purposively selected using fasting blood glucose ≥ 7mmol/L and tested for long term glucose control using Glycated haemoglobin measure. One hundred and eight (108) patients with ≥ 7% Glycated haemoglobin were recruited for the study and assigned unique identification numbers. They were further randomly allocated to intervention and usual care groups using computer generated random numbers, with each group containing 54 subjects. Patients in the intervention group received pharmacist-structured intervention, including education, periodic phone calls, adherence counselling, referral and 6 months follow-up, while patients in usual care group only kept clinic appointments with their physicians. Data collected at baseline and six months included socio-demographic characteristics, fasting blood glucose, Glycated haemoglobin, blood pressure, lipid profile. With an intention to treat analysis, Mann-Whitney U test was used to compared median change from baseline in the primary outcome (Glycated haemoglobin) and secondary outcomes measure, effect size was computed and proportion of patients that reached target laboratory parameter were compared in both arms. Results: All enrolled participants (108) completed the study, 54 in each study. Mean age was 51±11.75 and majority were female (68.5%). Intervention patients had significant reduction in Glycated haemoglobin (-0.75%; P<0.001; η2 = 0.144), with greater proportion attaining target laboratory parameter after 6 months of care compared to usual care group (Glycated haemoglobin: 42.6% vs 20.8%; P=0.02). Furthermore, patients who received pharmacist-led care were about 3 times more likely to have better glucose control (AOR 2.718, 95%CI: 1.143-6.461) compared to usual care group. Conclusion: Pharmacist-led care significantly improved glucose control in patients with uncontrolled type 2 diabetes mellitus and should be integrated in the routine management of diabetes patients, especially in resource-limited settings.

Keywords: glycaemic control , pharmacist-led care, randomised-controlled trial , type 2 diabetes mellitus

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Authors: Anna Lower, Michal Lower, Robert Masztalski, Agnieszka Szumilas

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Contemporary cities are facing serious congestion and parking problems. In urban transport policy the introduction of the park and ride system (P&R) is an increasingly popular way of limiting vehicular traffic. The determining of P&R facilities location is a key aspect of the system. Criteria for assessing the quality of the selected location are formulated generally and descriptively. The research outsourced to specialists are expensive and time consuming. The most focus is on the examination of a few selected places. The practice has shown that the choice of the location of these sites in a intuitive way without a detailed analysis of all the circumstances, often gives negative results. Then the existing facilities are not used as expected. Methods of location as a research topic are also widely taken in the scientific literature. Built mathematical models often do not bring the problem comprehensively, e.g. assuming that the city is linear, developed along one important communications corridor. The paper presents a new method where the expert knowledge is applied to fuzzy inference model. With such a built system even a less experienced person could benefit from it, e.g. urban planners, officials. The analysis result is obtained in a very short time, so a large number of the proposed location can also be verified in a short time. The proposed method is intended for testing of car parks location in a city. The paper will show selected examples of locations of the P&R facilities in cities planning to introduce the P&R. The analysis of existing objects will also be shown in the paper and they will be confronted with the opinions of the system users, with particular emphasis on unpopular locations. The research are executed using the fuzzy inference model which was built and described in more detail in the earlier paper of the authors. The results of analyzes are compared to documents of P&R facilities location outsourced by the city and opinions of existing facilities users expressed on social networking sites. The research of existing facilities were conducted by means of the fuzzy model. The results are consistent with actual users feedback. The proposed method proves to be good, but does not require the involvement of a large experts team and large financial contributions for complicated research. The method also provides an opportunity to show the alternative location of P&R facilities. The performed studies show that the method has been confirmed. The method can be applied in urban planning of the P&R facilities location in relation to the accompanying functions. Although the results of the method are approximate, they are not worse than results of analysis of employed experts. The advantage of this method is ease of use, which simplifies the professional expert analysis. The ability of analyzing a large number of alternative locations gives a broader view on the problem. It is valuable that the arduous analysis of the team of people can be replaced by the model's calculation. According to the authors, the proposed method is also suitable for implementation on a GIS platform.

Keywords: fuzzy logic inference, park and ride system, P&R facilities, P&R location

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Authors: Andrea Fiorista

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The learning of prepositions is a quite problematic aspect in foreign language instruction, and Italian is certainly not an exception. In their prototypical function, prepositions express schematic relations of two entities in a highly abstract, typically image-schematic way. In other terms, prepositions assume concepts such as directionality, collocation of objects in space and time and, in Cognitive Linguistics’ terms, the position of a trajector with respect to a landmark. Learners of different native languages may conceptualize them differently, implying that they are supposed to operate a recategorization (or create new categories) fitting with the target language. However, most current Italian Foreign/Second Language handbooks and didactic grammars do not facilitate learners in carrying out the task, as they tend to provide partial and idiosyncratic descriptions, with the consequent learner’s effort to memorize them, most of the time without success. In their prototypical meaning, prepositions are used to specify precise topographical positions in the physical environment which become less and less accurate as they radiate out from what might be termed a concrete prototype. According to that, the present study aims to elaborate a cognitive and conceptually well-grounded analysis of some extensive uses of the Italian preposition a, in order to propose effective pedagogical solutions in the Teaching/Learning process. Image schemas, cognitive metaphors and embodiment represent efficient cognitive tools in a task like this. Actually, while learning the merely spatial use of the preposition a (e.g. Sono a Roma = I am in Rome; vado a Roma = I am going to Rome,…) is quite straightforward, it is more complex when a appears in constructions such as verbs of motion +a + infinitive (e.g. Vado a studiare = I am going to study), inchoative periphrasis (e.g. Tra poco mi metto a leggere = In a moment I will read), causative construction (e.g. Lui mi ha mandato a lavorare = He sent me to work). The study reports data from a teaching intervention of Focus on Form, in which a basic cognitive schema is used to facilitate both teachers and students to respectively explain/understand the extensive uses of a. The educational material employed translates Cognitive Linguistics’ theoretical assumptions, such as image schemas and cognitive metaphors, into simple images or proto-scenes easily comprehensible for learners. Illustrative material, indeed, is supposed to make metalinguistic contents more accessible. Moreover, the concept of embodiment is pedagogically applied through activities including motion and learners’ bodily involvement. It is expected that replacing rote learning with a methodology that gives grammatical elements a proper meaning, makes learning process more effective both in the short and long term.

Keywords: cognitive approaches to language teaching, image schemas, embodiment, Italian as FL/SL

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Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care

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Authors: Tiffany Riggleman, Andrea Schultheis, Kalyn Jannace, Jerika Taylor, Michelle Nordstrom, Paul F. Pasquina

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Introduction: Posttraumatic Stress (PTS) and Posttraumatic Stress Disorder (PTSD) remain significant problems for military and veteran communities. Symptoms of PTSD often include poor sleep, intrusive thoughts, difficulty concentrating, and trouble with emotional regulation. Unfortunately, despite its high prevalence, service members diagnosed with PTSD often do not seek help, usually because of the perceived stigma surrounding behavioral health care. To help address these challenges, non-pharmacological, therapeutic approaches are being developed to help improve care and enhance compliance. The Service Dog Training Program (SDTP), which involves teaching patients how to train puppies to become mobility service dogs, has been successfully implemented into PTS/PTSD care programs with anecdotal reports of improved outcomes. This study was designed to assess the biopsychosocial effects of SDTP from military beneficiaries with PTS symptoms. Methods: Individuals between the ages of 18 and 65 with PTS symptom were recruited to participate in this prospective study. Each subject completes 4 weeks of baseline testing, followed by 6 weeks of active service dog training (twice per week for one hour sessions) with a professional service dog trainer. Outcome measures included the Posttraumatic Stress Checklist for the DSM-5 (PCL-5), Generalized Anxiety Disorder questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), social support/interaction, anthropometrics, blood/serum biomarkers, and qualitative interviews. Preliminary analysis of 17 participants examined mean scores on the GAD-7, PCL-5, and PHQ-9, pre- and post-SDTP, and changes were assessed using Wilcoxon Signed-Rank tests. Results: Post-SDTP, there was a statistically significant mean decrease in PCL-5 scores of 13.5 on an 80-point scale (p=0.03) and a significant mean decrease of 2.2 in PHQ-9 scores on a 27 point scale (p=0.04), suggestive of decreased PTSD and depression symptoms. While there was a decrease in mean GAD-7 scores post-SDTP, the difference was not significant (p=0.20). Recurring themes among results from the qualitative interviews include decreased pain, forgetting about stressors, improved sense of calm, increased confidence, improved communication, and establishing a connection with the service dog. Conclusion: Preliminary results of the first 17 participants in this study suggest that individuals who received SDTP had a statistically significant decrease in PTS symptom, as measured by the PCL-5 and PHQ-9. This ongoing study seeks to enroll a total of 156 military beneficiaries with PTS symptoms. Future analyses will include additional psychological outcomes, pain scores, blood/serum biomarkers, and other measures of the social aspects of PTSD, such as relationship satisfaction and sleep hygiene.

Keywords: post-concussive syndrome, posttraumatic stress, service dog, service dog training program, traumatic brain injury

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Authors: Kevin Baxter, Ron Grove, James Pitney, John Harrison, Ozlem Gumus

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The purpose of this research is to determine the mediating effect of effectiveness of the training provided by Northwestern University’s School of Police Staff and Command (SPSC), on the ability of law enforcement mid-level managers to learn transformational and authentic leadership traits. This study will also evaluate the leadership styles, of course, graduates compared to non-attendees using a static group comparison design. The Louisiana State Police pay approximately $40,000 in salary, tuition, housing, and meals for each state police lieutenant attending the 10-week program of the SPSC. This school lists the development of transformational leaders as an increasing element. Additionally, the SPSC curriculum addresses all four components of authentic leadership - self-awareness, transparency, ethical/moral, and balanced processing. Upon return to law enforcement in roles of mid-level management, there are questions as to whether or not students revert to an “autocratic” leadership style. Insufficient evidence exists to support claims for the effectiveness of management training or leadership development. Though it is widely recognized that transformational styles are beneficial to law enforcement, there is little evidence that suggests police leadership styles are changing. Police organizations continue to hold to a more transactional style (i.e., most senior police leaders remain autocrats). Additionally, research in the application of transformational, transactional, and laissez-faire leadership related to police organizations is minimal. The population of the study is law enforcement mid-level managers from various states within the United States who completed leadership training presented by the SPSC. The sample will be composed of 66 active law enforcement mid-level managers (lieutenants and captains) who have graduated from SPSC and 65 active law enforcement mid-level managers (lieutenants and captains) who have not attended SPSC. Participants will answer demographics questions, Multifactor Leadership Questionnaire, Authentic Leadership Questionnaire, and the Kirkpatrick Hybrid Evaluation Survey. Analysis from descriptive statistics, group comparison, one-way MANCOVA, and the Kirkpatrick Evaluation Model survey will be used to determine training effectiveness in the four levels of reaction, learning, behavior, and results. Independent variables are SPSC graduates (two groups: upper and lower) and no-SPSC attendees, and dependent variables are transformational and authentic leadership scores. SPSC graduates are expected to have higher MLQ scores for transformational leadership traits and higher ALQ scores for authentic leadership traits than SPSC non-attendees. We also expect the graduates to rate the efficacy of SPSC leadership training as high. This study will validate (or invalidate) the benefits, costs, and resources required for leadership development from a nationally recognized police leadership program, and it will also help fill the gap in the literature that exists between law enforcement professional development and transformational and authentic leadership styles.

Keywords: training effectiveness, transformational leadership, authentic leadership, law enforcement mid-level manager

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Authors: Noel Smith

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To achieve professional registration, UK social workers need to complete a programme of education and training which meets standards set down by central government. When it comes to practice, social work in local authorities must fulfil requirements of national legislation but there is considerable local variation in the organisation and delivery of services. This presentation discusses the on-going reform of social work education by central government in the context of research of social work services in a local authority. In doing so it highlights that the ‘direction of travel’ of the national reform of social work education seems at odds with the trajectory of development of local social work services. In terms of education reform, the presentation cites key government initiatives including the knowledge and skills requirements which have been published separately for, respectively, child and family social work and adult social work. Also relevant is the Government’s new ‘teaching partnership’ pilot which focuses exclusively on social work in local government, in isolation from social work in NGOs. In terms of research, the presentation discusses two studies undertaken by Professor Smith in Suffolk County Council, a local authority in the east of England. The first is an equality impact analysis of the introduction of a new model for the delivery of adult and community services in Suffolk. This is based on qualitative research with local government representatives and NGOs involved in social work with older people and people with disabilities. The second study is an on-going, mixed method evaluation of the introduction of a new model of social care for children and young people in Suffolk. This new model is based on the international ‘Signs of Safety’ approach, which is applied in this model to a wide range of services from early intervention to child protection. While both studies are localised, the service models they examine are good illustrations of the way services are developing nationally. Analysis of these studies suggest that, if services continue to develop as they currently are, then social workers will require particular skills which are not be adequately addressed in the Government’s plans for social work education. Two issues arise. First, education reform concentrates on social work within local government while increasingly local authorities are outsourcing service provision to NGOs, expecting greater community involvement in providing care, and integrating social care with health care services. Second, education reform focuses on the different skills required for working with older and disabled adults and working with children and families, to the point where potentially the profession would be fragmented into two different classes of social worker. In contrast, the development of adult and children’s services in local authorities re-asserts the importance of common social work skills relating to personalisation, prevention and community development. The presentation highlights the importance for social work education in the UK to be forward looking, in terms of the changing design of service delivery, and outward looking, in terms of lessons to be drawn from international social work.

Keywords: adult social work, children and families social work, European social work, social work education

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Authors: Mairo H. Ipadeola, Catherine James Atteng

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The term social inclusion refers to a process by which those disadvantaged in society can have access to fully participate in education like others. Student with special needs are expected to learn along with their peers within the some educational institutions which provide adequate access for all. There for, the study sort to understand the typical ways in which students with disabilities (SWD) were denied from fully participating as students in Kaduna Polytechnic. In doing this, two (2) objectives and research questions were raised. Firstly, to explore the attitudes of others towards students with disabilities in the institutions and secondly, to ascertain the extent of social participation and physical accessibility for students with disabilities (SWD) while in the institutions. Based on the objectives the paper postulated the research questions: what are the attitudes of management, teachers, and students towards students with special need in Kaduna Polytechnic and to what extent did the students with disabilities experience social participation and physical accessibility within Kaduna Polytechnic school environment? The study area was Kaduna Polytechnic. The study engaged the interview for the data collected which were transcribed and analyzed by thematic coding. The findings were categorized under themes, sub-themes, and codes. The findings revealed that the perception, behavior, and association experiences of students with disabilities within Kaduna Polytechnic were not encouraging. Their experiences were characterized by negative attitudes, feelings of rejection, neglect, and bullying. Data generated on social participation indicated that 71% of the respondents believed that learning, school activities, recreations, and student politics between SWD and the other student were in the direction of low / very low. All the respondents, particularly students with blindness and physical challenges faced difficulty with environmental and physical access above all within the school environment, classroom, walkways and ramps, Also, directions were none existent in most departments with physical access to classrooms, toilets, cafeterias, and school shops absent or very low (71% and 29% of the respondents). The conclusion was that the physical barriers limited the possibilities of social participation of SWD.The paper made some recommendations such as mass public enlightenment on radio and television to change the perception of society about people with disability. Also, the federal, state, and local governments enact building acts for fresh builders and adopted measures and time frames for existing public buildings to be made accessible for people with disabilities. All stakeholders should ensure that the five (5) percent budget set aside by State Universal Basic Education Board (SUBEB) and/or Tertiary Education Trust Fund (TETFUND) for the provision of specialized equipment and facilities for the student with special needs should be used prudently spent and monitored by the board.cm.

Keywords: social inclusion, students with disability, social participation, environmental/physical access

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