Search results for: early intervention services

Authors: Esmaeil Sarikhani

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Objectives: Considering the importance of introducing new methods of improving self-compassion and compassion to the others in nursing students, this study intends to evaluate the effect of self-compassion training on nursing students. Methods: This is a field trial study in which 52 nursing interns from Isfahan University of Medical Sciences were selected using convenience sampling method and divided in two experimental and control groups. The sampling was done during two phases: before and after the intervention. The intervention consisted of eight sessions over eight weeks of self-compassion training. The data were collected using the self-compassion standard questionnaire with 26 questions before and after the intervention. Data were then analyzed by the SPSS18 software and independent and paired T-tests, and also Chi-square and Mann-Whitney tests. Results: The results obtained from the independent t-test showed that the mean score of self-compassion and its components in the experimental group was significantly increased compared to the control group (p < 0.001). Comparing the groups, the mean overall score difference of self-compassion and its components had also a statistically significant change after the intervention (p < 0.001). Conclusion: Self-compassion training program, leads to improving nursing students' self-compassion. As it seems, this method can be used as an important training course in order to improve compassion of nursing students to themselves and the others.

Keywords: self-compassion, student, nursing students, field trial

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Authors: Ogunnaiya Racheal Taiwo

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Children's formative years are crucial to their growth; it is, therefore, necessary for all the stakeholders to ensure that the pupils have an enabling quality of life which is essential for realizing their potential. For children to live and grow, they need a secure home, nutritious food, good health care, and quality education. This paper, therefore, investigates the implications of a depressed economy on the classroom learning of Nigerian children as it is clear that Nigeria is currently experiencing the worst economic depression in several decades, which affects a substantial proportion of children. The study is qualitative research, and it adopts a phenomenological approach where the experiences of respondents are examined qualitatively. Three senatorial districts in Oyo State were considered, and 50 teachers, both male, and female were chosen from each senatorial district for an interview through conversational key informants' interviews. The interviewees were recorded, transcribed, and presented using thematic analysis. Findings showed that more children have dropped out since the beginning of the year than in previous years. It was also recorded that learning has become challenging as children now find it harder to acquire learning materials. It was recommended that the government should reimburse early childhood schools to lessen the effect of the inability to purchase materials and pay school fees. It was also recommended that an intervention be made to approach and resolve issues associated with out-of-school children.

Keywords: childhood, classroom, education, depressed economy, poverty

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Authors: Hsin-Yu Lin, Ching-Hsia Hung

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Obstructive sleep apnea (OSA) is characterized by a complete or partial obstruction of the upper airway during sleep. The vulnerable sites of upper airway collapses are consequences of sleep state-dependent reductions in tone in specific pharyngeal dilators. Clinical examinations reveal multilevel collapses of the upper airway among the patients with OSA. Therefore, an anatomically-based oropharyngeal rehabilitation should comprise a multilevel approach, including retropalatal, retroglossal, hypopharyngeal, temporomandibular, and facial levels, all of which involve different muscle groups and contribute to multifunctional interaction and coordination, such as swallowing, breathing, and phonation. The purpose of the study was to exam the effects of this rehabilitation program with a multilevel approach. In this study, fifteen subjects with newly diagnosed moderate or severe OSA (Apnea-Hypopnea-Index≥15) were randomized into an intervention group and control group. The intervention group (N=8) underwent a 12-week-intervention of a hospital-based rehabilitation program, while the control group (N=7) was kept on the waiting list. The 12-week-intervention comprised an anatomically based multilevel approach. The primary outcome was Polysomnography (PSG) data, and the secondary outcome was oropharyngeal and respiratory muscle function. In the intervention group, Apnea-Hypopnea-Index significantly improved (46.96±19.45 versus 32.78±10.78 events/h, p=0.017) compared with control group (35.77±17.49 versus 42.96±17.32 events/h, p=0.043). While the control group remained no change, the intervention group demonstrated other PSG outcomes significantly improvement, including arousal index (46.04±18.9 versus 32.98±8.35/h, p=0.035), mean SpO2 (92.88±2.1 versus 94.13±1.46%, p=0.039). Besides, the intervention group demonstrated significant improvement in oropharyngeal and respiratory muscle function compared to the control group. This anatomically-based oropharyngeal rehabilitation with a multilevel approach can be proven as a non-invasive therapy for patients with OSA.

Keywords: obstructive sleep apnea, upper airway, oropharyngeal rehabilitation, multilevel approach

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Authors: Leoba Nyathi, Augustine K. Tugli, Takalani G. Tshitangano

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Use of health care services is an effective way of improving maternal and child health outcomes, especially in the rural areas. The study aimed to find out the perceptions of women on factors that affect the utilisation of antenatal care services (ANC) in Mangwe Rural District, Zimbabwe. The study was conducted in Mabunga village which is situated in Mangwe Rural District, Matabeleland South Province, Zimbabwe. A qualitative approach using explorative and descriptive design was adopted for the study. A sample of ten women were chosen from the target population by means of convenience sampling and data was collected through semi-structured interviews. Interviews and discussions were audio-taped, transcribed and coded into themes and subthemes. The study results showed that access factors, socio-cultural factors, demographic factors, quality of care and knowledge about antenatal care services were the major factors affecting utilisation of ANC services in Mangwe Rural District. It was discovered that the geographical location of the village to the health care centres has a great impact on utilisation of services. All the women did not initiate ANC services as recommended and they also did not adhere to the number of times they were supposed to visit the health care centres. The findings concluded that women have the knowledge about ANC and they all attended at least once during their last pregnancy. However, inconsistencies in attendance were shown due to access, socio-cultural and demographic factors.

Keywords: antenatal care services, women, utilisation, affect, factors, perceptions

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Authors: Caroline Labib

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This paper reports on a qualitative study exploring the approaches teachers used to integrate computers or smart tablets into their program planning. Their aim was to integrate ICT into children’s play, thereby supporting children’s learning and development. Data was collected in preschool settings in Melbourne in 2016. Interviews with teachers, observations of teacher interactions with children and copies of teachers’ planning and observation documents informed the study. The paper looks closely at findings from two early childhood settings and focuses on exploring the differing approaches two EC teachers have adopted when integrating iPad or computers into their settings. Data analysis revealed three key approaches which have been labelled: free digital play, guided digital play and teacher-led digital use. Importantly, teacher decisions were influenced by the interplay between the opportunities that the ICT tools offered, the teachers’ prior knowledge and experience about ICT and children’s learning needs and contexts. This paper is a snapshot of two early childhood settings, and further research will encompass data from six more early childhood settings in Victoria with the aim of exploring a wide range of motivating factors for early childhood teachers trying to integrate ICT into their programs.

Keywords: early childhood education (ECE), digital play, information and communication technologies (ICT), play, and teachers' interaction approaches

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Authors: Rahimah Saimin

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Previous research has shown that young children can learn from educational television programmes, videos or other technological media. However, the blending of any of these with traditional printed-based text appears to be omitted. Repeated viewing is an important factor in children's ability to comprehend the content or plot. The present study combined videos with traditional printed-based text and required repeated viewing and is original and distinctive. The first study was a pilot study to explore whether the intervention is implementable in ordinary classrooms. The second study explored whether the curricular embedding is important or whether the video with curricular embedding is effective. The third study explored the effect of “dosage”, i.e. whether a longer/ more intense intervention has a proportionately greater effect on outcomes. Both measured outcomes (comprehension, word sounds, and early word recognition) and unmeasured outcomes (engagement to reading traditional printed-based texts or/and multimodal texts) were obtained from this study. Observation indicated degree of engagement in reading. The theoretical framework was multimodality theory combined with Piaget’s and Vygotsky’s learning theories. An experimental design was used with 4-5-year-old children in nursery schools and primary schools. Six links to video clips exploring non-fiction science content were provided to teachers. The first session is whole-class and subsequent sessions small-group. The teacher then engaged the children in dialogue using supplementary materials. About half of each class was selected randomly for pre-post assessments. Two assessments were used the British Picture Vocabulary Scale (BPVSIII) and the York Assessment of Reading for Comprehension (YARC): Early Reading. Different programme fidelity means were deployed- observations, teacher self-reports attendance logs and post-delivery interviews. Data collection is in progress and results will be available shortly. If this multiphase study show effectiveness in one or other application, then teachers will have other tools which they can use to enhance vocabulary, letter knowledge and word reading. This would be a valuable addition to their repertoire.

Keywords: language skills, literacy skills, multimodality, video

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Authors: Nijat S. İmamverdiyev

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The transition to renewable energy sources has become a critical component of global efforts to mitigate climate change and promote sustainable development. However, the deployment of renewable energy technologies can also have significant impacts on ecosystems and the services they provide, such as carbon sequestration, soil fertility, water quality, and biodiversity. It also highlights the potential co-benefits of renewable energy deployment for ecosystem services, such as reducing greenhouse gas emissions and improving air and water quality. Renewable energy sources, such as wind, solar, hydro, and biomass, are increasingly being used to meet the world's energy needs due to their environmentally friendly nature and the desire to reduce greenhouse gas emissions. However, the expansion of renewable energy infrastructure can also impact ecosystem services, which are the benefits that humans derive from nature, such as clean water, air, and food. This geographical assessment aims to evaluate the relationship between renewable energy infrastructure and ecosystem services. Here, also explores potential solutions to mitigate the negative effects of renewable energy infrastructure on ecosystem services, such as the use of ecological compensation measures, biodiversity-friendly design of renewable energy infrastructure, and stakeholder involvement in decision-making processes.

Keywords: renewable energy, solar energy, climate change, energy production

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Authors: Emine Yılmaz Bolat

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Early childhood is a very important period in terms of identifying and developing early skills and abilities. It is likely that the child's development will be in the same direction in the future. This study was conducted with 26 children for the purpose of examining pictures of children of five years old. In the survey, children were asked to draw a picture with pastel dyes. The drawings were collected and evaluated by the researcher. At the end of the research, it was found that the children used the yellow color (N = 17, 16,34%) and the least gray color (N = 1, 0,96%). When the features of children's pictures are examined, the children's paintings have been found to have hierarchy, transparency, completion, the use of vivid colors, and the presence of vertical and horizontal painting lines.

Keywords: early childhood, kindergarten, pictures of children, features of pictures

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Authors: Aleksandra Bogdanovic, Milicat Tošić Radev, Tatjana Stefanovic Stanojevic

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The aim behind this study was to first analyze the nature and the extent of childhood trauma and existing maladaptive outcomes (internalized and externalized problems and dissociation) among adolescents in the foster system and then analyze the possibility of using traumatic experiences to predict the aforementioned outcomes of childhood trauma. The sample consists of 121 respondents, children, and youths in the care of child protective services, without adequate parental care, residing in temporary foster care families on the territory of Serbia, aged between 11 and 18. The respondents filled out the Childhood Trauma Questionnaire – CTQ, Relationship Questionaire – Clinical version RQ-CV, the Dissociative experience scale for adolescents, A-DES and the Child behavior checklist – youth self-report. The results of the analyses have indicated that physical and emotional neglect are the most frequent forms of maltreatment in early childhood, with a relatively high prevalence of the other individual forms of trauma. Early childhood trauma statistically significantly predicted all the analyzed maladaptive outcomes, explaining approximately 20% of the variance of internalized and externalized problems and dissociation. Recommendations are given for future studies.

Keywords: trauma, maladaptive outcomes, disorganization, dissociation

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Authors: Jang-Hwan Jo

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The supply management of ecosystem services of local forests is an essential issue as it is linked to the ecological welfare of local residents. This study aims to estimate the supply, trade-offs, and synergies of local forest regulating ecosystem services using a land cover classification map (LCCM) and a forest types map (FTM). Rigorous literature reviews and Expert Delphi analysis were conducted using the detailed variables of 1:5,000 LCCM and FTM. Land-use scoring method and Getis-Ord Gi* Analysis were utilized on detailed variables to propose a method for estimating supply, trade-offs, and synergies of the local forest regulating ecosystem services. The analysis revealed that the rank order (1st to 5th) of supply of regulating ecosystem services was Erosion prevention, Air quality regulation, Heat island mitigation, Water quality regulation, and Carbon storage. When analyzing the correlation between defined services of the entire city, almost all services showed a synergistic effect. However, when analyzing locally, trade-off effects (Heat island mitigation – Air quality regulation, Water quality regulation – Air quality regulation) appeared in the eastern and northwestern forest areas. This suggests the need to consider not only the synergy and trade-offs of the entire forest between specific ecosystem services but also the synergy and trade-offs of local areas in managing the regulating ecosystem services of local forests. The study result can provide primary data for the stakeholders to determine the initial conditions of the planning stage when discussing the establishment of policies related to the adjustment of the supply of regulating ecosystem services of the forests with limited access. Moreover, the study result can also help refine the estimation of the supply of the regulating ecosystem services with the availability of other forms of data.

Keywords: ecosystem service, getis ord gi* analysis, land use scoring method, regional forest, regulating service, synergies, trade-offs

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Authors: Andres Manuel Garcia Lamparte, Rocio Losada Iglesias, Marcos BoullóN Magan, David Miranda Barros

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The biodiversity strategy of the European Union for 2030, mentions climate change as one of the key factors for biodiversity loss and considers green infrastructure as one of the solutions to this problem. In this line, the European Commission has developed a green infrastructure strategy which commits members states to consider green infrastructure in their territorial planning. This green infrastructure is aimed at granting the provision of a wide number of ecosystem services to support biodiversity and human well-being by countering the effects of climate change. Yet, there are not too many tools available to delimit green infrastructure. The available ones consider the potential of the territory to provide ecosystem services. However, these methods usually aggregate several maps of ecosystem services potential without considering possible trade-offs. This can lead to excluding areas with a high potential for providing ecosystem services which have many trade-offs with other ecosystem services. In order to tackle this problem, a methodology is proposed to consider ecosystem services trade-offs in the objective function of a simulated annealing algorithm aimed at delimiting green infrastructure multifunctional buffer areas. To this end, the provision potential maps of the regulating ecosystem services considered to delimit the multifunctional buffer areas are clustered in groups, so that ecosystem services that create trade-offs are excluded in each group. The normalized provision potential maps of the ecosystem services in each group are added to obtain a potential map per group which is normalized again. Then the potential maps for each group are combined in a raster map that shows the highest provision potential value in each cell. The combined map is then used in the objective function of the simulated annealing algorithm. The algorithm is run both using the proposed methodology and considering the ecosystem services individually. The results are analyzed with spatial statistics and landscape metrics to check the number of ecosystem services that the delimited areas produce, as well as their regularity and compactness. It has been observed that the proposed methodology increases the number of ecosystem services produced by delimited areas, improving their multifunctionality and increasing their effectiveness in preventing climate change impacts.

Keywords: ecosystem services trade-offs, green infrastructure delineation, multifunctional buffer areas, climate change

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Authors: Oentoeng Wahjoe

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Liberalisation of air transportation practically is known as open sky policy. In the practice, the liberalisation of air transportation is divided into two group of services, i.e.: air transportation services, for passengers and goods (air service) which is categorized as hard rights and supporting services of the air transportation services (ancillary services) which is categorized as soft rights. The research in this paper focused in air transportation services for passengers and goods, consists of nine freedom of the air. The impact of the policy such as the Agreement regarding ASEAN open sky policy, is the readiness of Indonesian air transportation companies to compete with foreign air transportation companies. The goverment of Indonesia has to regulate the implementation of ASEAN Open Sky Policy to be projected in order to comply with national development, i.e. the function of air law in national development. The policy has been implemented by enact or amend the existing law as air law that regulate flight lines, the following provisions: To regulate flight line for foreign airlines to open flight lines in Indonesia region which may not or have not land and sea transportation. The regulation is intended to supprot mobility of humans, goods and services that may fulfil the needs of the people of Indonesia, which materially and spiritually and the development of the region. The regulation of flight lines of foreign air transportation for region of tourism, industrial and trade centre. The regulation is intended to support the national economic development of Indonesia.

Keywords: transport, liberalization, impact, Indonesian air service

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Authors: Nazlı Üstünes Demirhan

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International norms are subject to pressures of change through contestation during the course of their lifetimes. The nature of the contestation is one of the factors that are likely to have a determinative role in the direction of this change towards a stronger or weaker norm. This paper aims to understand the relation between the legality of contestation and the direction of change in norm strength. Based on a multidimensional norm strength conceptualization, it is hypothesized that use of legal logic and rhetoric of argumentation would have a positive influence for norm strength, whereas non-legal nature of contestation would lack this and weaken the norm. In order to show this, the evolution of the human protection norm between 1999 and 2018 will be examined with reference to two major contestation periods; Kosovo intervention of 1999, which led to the development of R2P doctrine, and Libya intervention of 2011, which is followed by the demise of the norm. The comparative analysis will be conducted through process tracing method with a document analysis on the Security Council meeting minutes, resolutions, and press releases. This study aims to contribute to the norm contestation literature with the introduction of legal process analysis. It also relates to further questions in IR/IL nexus, relating to the value added of norm legality as well as the politics of legalization.

Keywords: humanitarian intervention, legality, norm contestation, norm dynamics, norm strength, responsibility to protect

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Authors: Nasim Hashemi, Abbas Sheikhtaheri

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Telemedicine is the use of telecommunication and information technologies to provide health care services that would often not be consistently available in distant rural communities to people at these remote areas. Teleophthalmology is a branch of telemedicine that delivers eye care through digital medical equipment and telecommunications technology. Thus, teleophthalmology can overcome geographical barriers and improve quality, access, and affordability of eye health care services. Since teleophthalmology has been widespread applied in recent years, the aim of this study was to determine the different applications of teleophthalmology in the world. To this end, three bibliographic databases (Medline, ScienceDirect, Scopus) were comprehensively searched with these keywords: eye care, eye health care, primary eye care, diagnosis, detection, and screening of different eye diseases in conjunction with telemedicine, telehealth, teleophthalmology, e-services, and information technology. All types of papers were included in the study with no time restriction. We conducted the search strategies until 2015. Finally 70 articles were surveyed. We classified the results based on the’type of eye problems covered’ and ‘the type of telemedicine services’. Based on the review, from the ‘perspective of health care levels’, there are three level for eye health care as primary, secondary and tertiary eye care. From the ‘perspective of eye care services’, the main application of teleophthalmology in primary eye care was related to the diagnosis of different eye diseases such as diabetic retinopathy, macular edema, strabismus and aged related macular degeneration. The main application of teleophthalmology in secondary and tertiary eye care was related to the screening of eye problems i.e. diabetic retinopathy, astigmatism, glaucoma screening. Teleconsultation between health care providers and ophthalmologists and also education and training sessions for patients were other types of teleophthalmology in world. Real time, store–forward and hybrid methods were the main forms of the communication from the perspective of ‘teleophthalmology mode’ which is used based on IT infrastructure between sending and receiving centers. In aspect of specialists, early detection of serious aged-related ophthalmic disease in population, screening of eye disease processes, consultation in an emergency cases and comprehensive eye examination were the most important benefits of teleophthalmology. Cost-effectiveness of teleophthalmology projects resulted from reducing transportation and accommodation cost, access to affordable eye care services and receiving specialist opinions were also the main advantages of teleophthalmology for patients. Teleophthalmology brings valuable secondary and tertiary care to remote areas. So, applying teleophthalmology for detection, treatment and screening purposes and expanding its use in new applications such as eye surgery will be a key tool to promote public health and integrating eye care to primary health care.

Keywords: applications, telehealth, telemedicine, teleophthalmology

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Authors: B. J. Kim, K. W. Nam, S. J. Lee

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Traditional social network services provide users with more information than is needed, and it is not easy to verify the authenticity of the information. This paper proposes a system that can only post messages where users are located to enhance the reliability of social networking services. The proposed system implements a Google Map API to post postings on the map and to read postings within a range of distances from the users’ location. The proposed system will only provide alerts, memories, and information about locations within a given range depending on the users' current location, providing reliable information that they believe will be necessary in real time. It is expected that the proposed system will be able to meet the real demands of users and create a more reliable social network services environment.

Keywords: social network, location, reliability, posting

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Authors: Sushila Pareek, Divya Shekhawat

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Music has been shown as a therapeutic agent in depression, anxiety, and stress. A pilot study was carried out to see the therapeutic effects of Indian classical instrumental Raga Todi on depression, anxiety, and stress. 50 individuals diagnosed with depression, anxiety, and stress with DSM-V were taken for the study. Subjects were randomly divided into two groups: the experimental group and the control group. The experimental group received the instrumental raga Todi whereas the other control group didn't receive any intervention. DASS-21 was used on the baseline and after the intervention to measure depression, anxiety, and stress. The result indicates that anxiety, stress, and depression level was reduced after listening to the raga desi Todi. It was concluded that raga desi Todi is an effective intervention for reducing depression, anxiety, and stress.

Keywords: raga, anxiety, stress, depression, DASS-21, mental health

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Authors: Adela Penesova, Zofia Radikova, Boris Bajer, Andrea Havranova, Miroslav Vlcek

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Background: The aim of our study was to compare the effect of intensified lifestyle intervention on insulin resistance (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and Fibroblast growth factor (FGF) 21 after 8 weeks of lifestyle intervention. Methods: A group of 43 obese patients (13M/30F; 43.0±12.4 years; BMI (body mass index) 31.2±6.3 kg/m2 participated in a weight loss interventional program (NCT02325804) following an 8-week hypocaloric diet (-30% energy expenditure) and physical activity 150 minutes/week. Insulin sensitivity was evaluated according to the homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity indices according to Matsuda and Cederholm were calculated (ISImat and ISIced). Plasma ALT, AST, Fetuin-A, FGF 21, and physical fitness were measured. Results: The average reduction of body weight was 6.8±4.9 kg (0-15 kg; p=0.0006), accompanied with a significant reduction of body fat amount of fat mass (p=0.03), and waist circumference (p=0.02). Insulin sensitivity has been improved (IR HOMA 2.71±3.90 vs 1.24±0.83; p=0.01; ISIMat 6.64±4.38 vs 8.93±5.36 p ≤ 0.001). Total, LDL cholesterol, and triglycerides decreased (p=0.05, p=0.04, p=0.04, respectively). Physical fitness significantly improved after intervention (as measure VO2 max (maximal oxygen uptake) (p ≤ 0.001). ALT decreased significantly (0.44±0.26 vs post 0.33±0.18 ukat/l, p=0.004); however, AST not (pre 0.40±0.15 vs 0.35±0.09 ukat/l, p=0.07). Hepatokine Fetuin-A significantly decreased after intervention (43.1±10.8 vs 32.6±8.6 ng/ml, p < 0.001); however, FGF 21 levels tended to decrease (146±152 vs 132±164 pg/ml, p=0.07). Conclusion: 8-weeks of diet and physical activity intervention program in obese otherwise healthy subjects led to an improvement of insulin resistance parameters and liver marker profiles, as well as increased physical fitness. This study was supported by grants APVV 15-0228; VEGA 2/0161/16.

Keywords: obesity, diet, exercice, insulin sensitivity

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Authors: Abeer Alkhwaldi, Mumtaz Kamala

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On the inception of the third millennium, there is much evidence that cloud technologies have become the strategic trend for many governments not only developed countries (e.g., UK, Japan, and USA), but also developing countries (e.g. Malaysia and the Middle East region), who have launched cloud computing movements for enhanced standardization of IT resources, cost reduction, and more efficient public services. Therefore, cloud-based e-government services considered as one of the high priorities for government agencies in Jordan. Although of their phenomenal evolution, government cloud-services still suffering from the adoption challenges of e-government initiatives (e.g. technological, human-aspects, social, and financial) which need to be considered carefully by governments contemplating its implementation. This paper presents a pilot study to investigate the citizens' perception of the extent in which these challenges affect the acceptance and use of cloud computing in Jordanian public sector. Based on the data analysis collected using online survey some important challenges were identified. The results can help to guide successful acceptance of cloud-based e-government services in Jordan.

Keywords: challenges, cloud computing, e-government, acceptance, Jordan

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Authors: Hector Liu, Chih-Ming Tsai

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Consumer behaviors in the subscription of over-the-top (OTT) media services have substantially changed because of the COVID-19 pandemic; hence, this study aims to determine the factors affecting subscription intentions. The increased usage of OTT media, particularly in the lockdowns during the COVID-19 pandemic, has intensified the competition between both global and local streaming providers. While studies have discussed antecedents accounting for this change, they have paid limited attention to the psychological factors that shape consumer behavior in using OTT services. Given the changes in consumers’ psychological states during the pandemic, this study seeks to fill the research gap by integrating the expectancy-value model to provide insights into the key gratifications that consumers seek and obtain and that have affected their subscription to OTT services. This study proposes a theoretical model and assesses this framework on data collected from 1,068 OTT service users in Taiwan. The results strengthen the literature by indicating a clear growth in the popularity and subscription of OTT services because of the COVID-19 lockdowns as well as factors such as perceived quality and satisfaction, which influence behavioral intentions for OTT services. Most crucially, however, OTT viewers who acquired a sense of belonging, a sense of being accompanied, and a sense of reduction in anxiety due to being quarantined and in lockdown show a higher tendency to continue their subscriptions to their OTT services of choice during the pandemic. With consumer behavior trends forever changed by the COVID-19 pandemic, the implications from this study provide OTT service platforms with an opportunity to capitalize on their current and potential customers’ changing desires, demands, and factors for a continued subscription.

Keywords: consumer behavior, COVID-19, expectancy-value model, OTT media services

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Authors: Marie-Claude Richard, Amelie Bolduc-Mokhtar, Mathieu Parent

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People who have experienced maltreatment in childhood subsequently face many parenting issues of their own, in particular when it comes to distancing themselves from the abusive behaviors they were exposed and had access to positive role models. Few studies have explored the factors explaining the ability to break the generational cycle of child maltreatment. However, deeper knowledge of the factors associated with intergenerational discontinuity could facilitate the development of innovative interventions and increase the preventive potential of existing programs. This poster presentation will be about a better understanding of the intergenerational transmission of maltreatment (IGTM) from the perspective of both youth protection workers and parents receiving child protection services. The data used to meet this goal were collected from a group interview with eight youth protection workers whose caseloads involved IGTM situations and through semi-structured interviews with four parents with a history of child protection services and who were currently receiving such services for at least one of their children. In the view of the youth protection workers, the IGTM refers to everything that is transmitted and not transmitted from one generation to the next within a family. The study participants painted quite a bleak portrait of the families affected by IGTM. However, three main avenues of intervention were mentioned by the participants: working within the network, favoring long-term interventions and being empathic. The results also show that the mothers were in a trajectory of intergenerational discontinuity in child maltreatment. Support from their families and friends as well as from formal support services brought out some possible explanatory factors for intergenerational discontinuity in child maltreatment. From a prevention perspective, developing meaningful and trusting relationships seems a source of resilience for parents who were placed in the care of the child protection system as children. The small number of participants limits the generalizability of these results. The difficulty of recruiting parents is a substantial challenge regarding gaining knowledge on the intergenerational transmission of child maltreatment. Future studies should examine this question and seek to develop effective strategies to help recruit study participants.

Keywords: child maltreatment, intergenerational transmission, prevention, qualitative data

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Authors: Araceli Martinez Ortiz, Gillian Bayne, Solomon Abraham

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This paper describes research led by faculty from three American universities and four Ethiopian universities on the delivery of professional leadership development for early-career female Ethiopian university instructors in the Science, Technology, Engineering, and Mathematics (STEM) fields. The objective was to carry out a case study focused on the impact of an innovative intervention program designed to assist in the empowerment and leadership development related to teaching effectiveness, scholarly activity participation, and professional service participation by female instructors. This research was conducted utilizing a case study methodology for the weeklong intervention and a survey to capture the voices of the leadership program participants. The data regarding insights into the challenges and opportunities for women in these fields is presented. The research effort project expands upon existing linkages between universities to support professional development and research effort in this region of the world. Findings indicate the positive reception of this kind of professional development by the participating women. Survey data also reflects the particular cultural challenges professional women in STEM education face in Ethiopia as well as the global challenges of balancing family expectations with career development.

Keywords: Ethiopian women, STEM leadership, professional development, gender equity

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Authors: Annis Lai Chu Fung

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While aggression had high stability throughout developmental stages and across generations, it should be the top priority of researchers and frontline helping professionals to develop prevention and intervention programme for aggressive children and children at risk of developing aggressive behaviours. Although there is a substantial amount of anti-bullying programmes, they gave disappointingly small effect sizes. The neglectful practical significance could be attributed to the overly simplistic categorisation of individuals involved as bullies or victims. In the past three decades, the distinction between reactive and proactive aggression has been well-proved. As children displaying reactively aggressive behaviours have distinct social-information processing pattern with those showing proactively aggressive behaviours, it is critical to identify the unique needs of the two subtypes accordingly when designing an intervention. The onset of reactive aggression and proactive aggression was observed at earliest in 4.4 and 6.8 years old respectively. Such findings called for a differential early intervention targeting these high-risk children. However, to the best of the author’s knowledge, the author was the first to establish an evidence-based intervention programme against reactive and proactive aggression. With the largest samples in the world, the author, in the past 10 years, explored three different approaches and their effectiveness against aggression quantitatively and qualitatively with longitudinal design. The three approaches presented are (a) cognitive-behavioral approach, (b) moral education, with Chinese marital arts and ethics as the medium, and (c) bioneurological measures (omega-3 supplementation). The studies adopted a multi-informant approach with repeated measures before and after the intervention, and follow-up assessment. Participants were recruited from primary and secondary schools in Hong Kong. In the cognitive-behavioral approach, 66 reactive aggressors and 63 proactive aggressors, aged from 11 to 17, were identified from 10,096 secondary-school children with questionnaire and subsequent structured interview. Participants underwent 10 group sessions specifically designed for each subtype of aggressor. Results revealed significant declines in aggression levels from the baseline to the follow-up assessment after 1 year. In moral education through the Chinese martial arts, 315 high-risk aggressive children, aged 6 to 12 years, were selected from 3,511 primary-school children and randomly assigned into four types of 10-session intervention group, namely martial-skills-only, martial-ethics-only, both martial-skills-and-ethics, and physical fitness (placebo). Results showed only the martial-skills-and-ethics group had a significant reduction in aggression after treatment and 6 months after treatment comparing with the placebo group. In the bioneurological approach, 218 children, aged from 8 to 17, were randomly assigned to the omega-3 supplement group and the placebo group. Results revealed that compared with the placebo group, the omega-3 supplement group had significant declines in aggression levels at the 6-month follow-up assessment. All three approaches were effective in reducing proactive and reactive aggression. Traditionally, intervention programmes against aggressive behaviour often adapted the cognitive and/or behavioural approach. However, cognitive-behavioural approach for children was recently challenged by its demanding requirement of cognitive ability. Traditional cognitive interventions may not be as beneficial to an older population as in young children. The present study offered an insightful perspective in aggression reduction measures.

Keywords: intervention, outcome effectiveness, proactive aggression, reactive aggression

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Authors: Esabelle Lo Yan Yam, Pheak Chhoun, Sovannary Tuot, Emily Lancsar, Siyan Yi

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Persons living with HIV (PLHIV) need lifelong antiretroviral treatment (ART) to keep their viral load suppressed to an undetectable level, maintain a healthy immune system, and reduce the risk of transmitting HIV to others. However, many factors affect PLHIV's adherence to ART, including access to antiretrovirals (ARV), stigma, lack of social support, and the burden of seeking lifelong care. Community-based care has been shown to be instrumental in the experience of PLHIV in many countries, including Cambodia. In this study based in Cambodia, a community-based ART delivery (CAD) intervention involving community action workers (CAWs) who are PLHIVs was introduced. These workers collect pre-packaged ARVs from the ART clinics and dispense them to PLHIVs in the communities. The quasi-experimental study involved approximately 2000 stable PLHIV in the intervention arm and another 2000 PLHIV in the control arm (receiving usual care). A cost-effectiveness analysis is currently conducted to complement the clinical effectiveness of the CAD intervention on the care continuum and treatment outcomes for stable PLHIV, as well as the operational effectiveness in increasing the efficiency of the ART clinics and the health system. The analysis will consider health system and societal perspectives based on primary outcomes, including retention in care, viral load suppression, and adherence to ART. Additionally, a consultation with the National Centre for HIV/AIDS, Dermatology, and STD under the Cambodia Ministry of Health will be done to discuss the conduct of a budget impact analysis that can quantify the financial impact on the government's budget when adopting the CAD intervention at the provincial and national levels. The budget impact analysis will take into consideration various scaling-up scenarios for the interventions in the country. The research will assess the cost-effectiveness of the CAD intervention to support national stakeholders in Cambodia to make an informed decision on the adoption and scaling up of the intervention in Cambodia. The results are currently being analyzed and will be available at the time of the conference.

Keywords: Cambodia, community intervention, economic evaluation, global health, HIV/AIDs, implementation research

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Authors: Catherine Bradshaw

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Educators often report difficulty managing behavior problems and other mental health concerns that students display at school. These concerns also interfere with the learning process and can create distraction for teachers and other students. As such, schools play an important role in both preventing and intervening with students who experience these types of challenges. A number of models have been proposed to serve as a framework for delivering prevention and early intervention services in schools. One such model is called Positive Behavioral Interventions and Supports (PBIS), which has been scaled-up to over 26,000 schools in the U.S. and many other countries worldwide. PBIS aims to improve a range of student outcomes through early detection of and intervention related to behavioral and mental health symptoms. PBIS blends and applies social learning, behavioral, and organizational theories to prevent disruptive behavior and enhance the school’s organizational health. PBIS focuses on creating and sustaining tier 1 (universal), tier 2 (selective), and tier 3 (individual) systems of support. Most schools using PBIS have focused on the core elements of the tier 1 supports, which includes the following critical features. The formation of a PBIS team within the school to lead implementation. Identification and training of a behavioral support ‘coach’, who serves as a on-site technical assistance provider. Many of the individuals identified to serve as a PBIS coach are also trained as a school psychologist or guidance counselor; coaches typically have prior PBIS experience and are trained to conduct functional behavioral assessments. The PBIS team also identifies a set of three to five positive behavioral expectations that are implemented for all students and by all staff school-wide (e.g., ‘be respectful, responsible, and ready to learn’); these expectations are posted in all settings across the school, including in the classroom, cafeteria, playground etc. All school staff define and teach the school-wide behavioral expectations to all students and review them regularly. Finally, PBIS schools develop or adopt a school-wide system to reward or reinforce students who demonstrate those 3-5 positive behavioral expectations. Staff and administrators create an agreed upon system for responding to behavioral violations that include definitions about what constitutes a classroom-managed vs. an office-managed discipline problem. Finally, a formal system is developed to collect, analyze, and use disciplinary data (e.g., office discipline referrals) to inform decision-making. This presentation provides a brief overview of PBIS and reports findings from a series of four U.S. based longitudinal randomized controlled trials (RCTs) documenting the impacts of PBIS on school climate, discipline problems, bullying, and academic achievement. The four RCTs include 80 elementary, 40 middle, and 58 high schools and results indicate a broad range of impacts on multiple student and school-wide outcomes. The session will highlight lessons learned regarding PBIS implementation and scale-up. We also review the ways in which PBIS can help educators and school leaders engage in data-based decision-making and share data with other decision-makers and stakeholders (e.g., students, parents, community members), with the overarching goal of increasing use of evidence-based programs in schools.

Keywords: positive behavioral interventions and supports, mental health, randomized trials, school-based prevention

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Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

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Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

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Authors: Amberly Brigden, Ali Heawood, Emma C. Anderson, Richard Morris, Esther Crawley

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Background: Paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is characterised by persistent, disabling fatigue. Health services see patients below the age of 12. This age group experience high levels of disability, with low levels of school attendance, high levels of fatigue, anxiety, functional disability and pain. CFS/ME interventions have been developed for adolescents, but the developmental needs of younger children suggest treatment should be tailored to this age group. Little is known about how intervention should be delivered to this age group, and further work is needed to explore this. Qualitative research aids patient-centered design of health intervention. Methods: Five to 11-year-olds and their parents were recruited from a specialist CFS/ME service. Semi-structured interviews explored the families’ experience of the condition and perspectives on treatment. Interactive and arts-based methods were used. Interviews were audio-recorded, transcribed and analysed thematically. Qualitative Results: 14 parents and 7 children were interviewed. Early analysis of the interviews revealed the importance of the social-ecological setting of the child, which led to themes being developed in the context of Systems Theory. Theme one relates to the level of the child, theme two the family system, theme three the organisational and societal systems, and theme four cuts-across all levels. Theme1: The child’s capacity to describe, understand and manage their condition. Younger children struggled to describe their internal experiences, such as physical symptoms. Parents felt younger children did not understand some concepts of CFS/ME and did not have the capabilities to monitor and self-regulate their behaviour, as required by treatment. A spectrum of abilities was described; older children (10-11-year-olds) were more involved in clinical sessions and had more responsibility for self-management. Theme2: Parents’ responsibility for managing their child’s condition. Parents took responsibility for regulating their child’s behaviour in accordance with the treatment programme. They structured their child’s environment, gave direct instructions to their child, and communicated the needs of their child to others involved in care. Parents wanted their child to experience a 'normal' childhood and took steps to shield their child from medicalization, including diagnostic labels and clinical discussions. Theme3: Parental isolation and the role of organisational and societal systems. Parents felt unsupported in their role of managing the condition and felt negative responses from primary care health services and schools were underpinned by a lack of awareness and knowledge about CFS/ME in younger children. This sometimes led to a protracted time to diagnosis. Parents felt that schools have the potential important role in managing the child’s condition. Theme4: Complexity and uncertainty. Many parents valued specialist treatment (which included activity management, physiotherapy, sleep management, dietary advice, medical management and psychological support), but felt it needed to account for the complexity of the condition in younger children. Some parents expressed uncertainty about the diagnosis and the treatment programme. Conclusions: Interventions for younger children need to consider the 'systems' (family, organisational and societal) involved in the child’s care. Future research will include interviews with clinicians and schools supporting younger children with CFS/ME.

Keywords: chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), pediatric, qualitative, treatment

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Authors: Ali Babajanzade, Hossein Bozorgian

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Cognitive load plays an important role in learning in general and L2 listening comprehension in particular. This study is an attempt to investigate the effect of metacognitive strategy intervention through dialogic interaction (MSIDI) on L2 listeners’ cognitive load. A mixed-method design with 50 participants of male and female Iranian lower-intermediate learners between 20 to 25 years of age was used. An experimental group (n=25) received weekly interventions based on metacognitive strategy intervention through dialogic interaction for ten sessions. The second group, which was control (n=25), had the same listening samples with the regular procedure without a metacognitive intervention program in each session. The study used three different instruments: a) a modified version of the cognitive load questionnaire, b) digit span tests, and c) focused group interviews to investigate listeners’ level of cognitive load throughout the process. Results testified not only improvements in listening comprehension in MSIDI but a radical shift of cognitive load rate within this group. In other words, listeners experienced a lower level of cognitive load in MSIDI in comparison with their peers in the control group.

Keywords: cognitive load theory, human mental functioning, metacognitive theory, listening comprehension, sociocultural theory

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: Elisabetta Ceretti, Silvia Bonizzoni, Alberto Bonetti, Milena Villarini, Marco Verani, Maria Antonella De Donno, Sara Bonetta, Umberto Gelatti

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Introduction: Air pollution is a global problem. In 2013, the International Agency for Research on Cancer (IARC) classified air pollution and particulate matter as carcinogenic to human. The study of the health effects of air pollution in children is very important because they are a high-risk group in terms of the health effects of air pollution and early exposure during childhood can increase the risk of developing chronic diseases in adulthood. The MAPEC_LIFE (Monitoring Air Pollution Effects on Children for supporting public health policy) is a project founded by EU Life+ Programme which intends to evaluate the associations between air pollution and early biological effects in children and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children. Methods: The study was carried out on 6-8-year-old children living in five Italian towns in two different seasons. Two biomarkers of early biological effects, primary DNA damage detected with the comet assay and frequency of micronuclei, were investigated in buccal cells of children. Details of children diseases, socio-economic status, exposures to other pollutants and life-style were collected using a questionnaire administered to children’s parents. Child exposure to urban air pollution was assessed by analysing PM0.5 samples collected in the school areas for PAHs and nitro-PAHs concentration, lung toxicity and in vitro genotoxicity on bacterial and human cells. Data on the chemical features of the urban air during the study period were obtained from the Regional Agency for Environmental Protection. The project created also the opportunity to approach the issue of air pollution with the children, trying to raise their awareness on air quality, its health effects and some healthy behaviors by means of an educational intervention in the schools. Results: 1315 children were recruited for the study and participate in the first sampling campaign in the five towns. The second campaign, on the same children, is still ongoing. The preliminary results of the tests on buccal mucosa cells of children will be presented during the conference as well as the preliminary data about the chemical composition and the toxicity and genotoxicity features of PM0.5 samples. The educational package was tested on 250 children of the primary school and showed to be very useful, improving children knowledge about air pollution and its effects and stimulating their interest. Conclusions: The associations between levels of air pollutants, air mutagenicity and biomarkers of early effects will be investigated. A tentative model to calculate the global absolute risk of having early biological effects for air pollution and other variables together will be proposed and may be useful to support policy-making and community interventions to protect children from possible health effects of air pollutants.

Keywords: air pollution exposure, biomarkers of early effects, children, public health policy

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Authors: Aboli Gore, Aritra Das, Sunil Sonthalia, Tanmay Mahapatra, Sridhar Srikantiah, Hemant Shah

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AMANAT is an initiative, taken in collaboration with the Government of Bihar, aimed at improving the Quality of Maternal and Neonatal care services at Bihar’s public health facilities – those offering either the Basic Emergency Obstetric and Neonatal care (BEmONC) or Comprehensive Emergency Obstetric and Neonatal care (CEmONC) services. The effectiveness of this program is evaluated by conducting cross-sectional assessments at the concerned facilities prior to (baseline) and following completion (endline) of intervention. Direct Observation of Delivery (DOD) methodology is employed for carrying out the baseline and endline assessments – through which key obstetric and neonatal care practices among the Health Care Providers (especially the nurses) are assessed quantitatively by specially trained nursing professionals. Assessment of vitals prior to delivery improved during all three phases of BEmONC and all four phases of CEmONC training with statistically significant improvement noted in: i) pulse measurement in BEmONC phase 2 (9% to 68%), 3 (4% to 57%) & 4 (14% to 59%) and CEmONC phase 2 (7% to 72%) and 3 (0% to 64%); ii) blood pressure measurement in BEmONC phase 2 (27% to 84%), 3 (21% to 76%) & 4 (36% to 71%) and CEmONC phase 2 (23% to 76%) and 3 (2% to 70%); iii) fetal heart rate measurement in BEmONC phase 2 (10% to 72%), 3 (11% to 77%) & 4 (13% to 64%) and CEmONC phase 1 (24% to 38%), 2 (14% to 82%) and 3 (1% to 73%); and iv) abdominal examination in BEmONC phase 2 (14% to 59%), 3 (3% to 59%) & 4 (6% to 56%) and CEmONC phase 1 (0% to 24%), 2 (7% to 62%) & 3 (0% to 62%). Regarding infection control, wearing of apron, mask and cap by the delivery conductors improved significantly in all BEmONC phases. Similarly, the practice of handwashing improved in all BEmONC and CEmONC phases. Even on disaggregation, the handwashing showed significant improvement in all phases but CEmONC phase-4. Not only the positive practices related to handwashing improved but also negative practices such as turning off the tap with bare hands declined significantly in the aforementioned phases. Significant decline was also noted in negative maternal care practices such as application of fundal pressure for hastening the delivery process and administration of oxytocin prior to delivery. One of the notable achievement of AMANAT is an improvement in active management of the third stage of labor (AMTSL). The overall AMTSL (including administration of oxytocin or other uterotonics uterotonic in proper dose, route and time along with controlled cord traction and uterine massage) improved in all phases of BEmONC and CEmONC mentoring. Another key area of improvement, across phases, was in proper cutting/clamping of the umbilical cord. AMANAT mentoring also led to improvement in important immediate newborn care practices such as initiation of skin-to-skin care and timely initiation of breastfeeding. The next phase of the mentoring program seeks to institutionalize mentoring across the state that could potentially perpetuate improvement with minimal external intervention.

Keywords: capacity building, nurse-mentoring, quality of care, pregnancy, newborn care

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