Search results for: intervention study

Authors: Mirzaii Khadigeh

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Background and objectives: Sexual health education is an important part of health promotion services. The major role of sex education is on mothers’ shoulders. So, they have to be equipped with enough knowledge, attitude and self-efficacy for teens’ education. The present study aimed to determine the effect of team-learning and multimedia software on mothers’ knowledge, attitudes and self-efficacy in sexual health education to 12-14-year-old sons in Mashhad in 1395. Materials and methods: In this research, two experimental and one control group were employed using random sampling, which was done on 132 mothers of high school pupils. They were randomly assigned into experimental and control groups. The data were collected using demographic information and a researcher-constructed questionnaire to investigate the mothers’ knowledge, attitude, and self-efficacy and DASS21(The Depression, Anxiety and Stress Scale). They were run after confirming their reliability and validity. Intervention for the multimedia group was in the form of four CDs- each for 45 minutes- that were given to the mothers each week. At the end of the fourth week, a question-and-answer session was administered for 60 minutes. The team-learning group received intervention once a week (totally four weeks). Two weeks later, the data were collected and analyzed via Chi-square, Fisher, Kruskal-Wallis and ANOVA. Findings: Knowledge, attitude and self-efficacy of mothers in sexual health before the intervention did not have any significant differences (p >0.05). At the end of the study, the difference between the scores of the knowledge, attitude and self-efficacy in the three groups was meaningfully different (p < 0/001), but the difference between the two groups of multimedia and team-learning was not significant (p> 0.05 ). Discussion and conclusion: The result reported the efficacy of both team-leaning and multimedia software, which implies that the multimedia software training method was as effective as team-learning training one on the knowledge, attitude and self-efficacy of mothers. But, the multimedia training method is highly advised due to its availability, flexibility, and interest.

Keywords: training one on the knowledge, attitude, self-efficacy of mothers, boys

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Authors: Justina Ijeoma Ezebuwa, Catherine C. Ikewuchi, Eka B. Essien, Francis C. Anacletus

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Iron deficiency anemia (IDA) is a significant problem in Nigeria, especially in children under five. Intervention options for treating anemia in under-five children have also been the subject of research. This study aims to synthesize the evidence on dietary interventions for managing iron deficiency anemia in under-five children in Nigeria. This study uses a systematic review method to collect relevant studies to answer the research questions and a narrative synthesis to analyze and synthesize the findings of this study. Cochrane, PubMed, and ScienceDirect databases were thoroughly searched, and five (5) articles were selected for this study. The results show that dietary interventions, such as daily multi-nutrient fortified dairy-based drinks, biofortified (yellow/ white) cassava rich in pro-vitamin A, iron supplementation in foods, and ready-to-use therapeutic food (RUTF) may be relevant to the management of iron deficiency anemia in under-five children in Nigeria. The study also shows that daily multi-nutrient fortified dairy-based drinks may be more effective, feasible, and culturally acceptable for managing anemia in under-5 children in Nigeria. In addition, daily multi-nutrient fortified dairy-based drinks and ready-to-use therapeutic food (RUTF) were reported to have the potential to improve the growth, cognitive development, and overall health outcomes of under-five children with iron deficiency anemia in Nigeria. Recommendations for future studies in this research area and for public health practitioners and policymakers were provided.

Keywords: dietary intervention, iron deficiency anemia, under-five children, Nigeria

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Authors: Reena Aggarwal

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Wall art is a manifestation of the human mind and an absorbing form of cultural expression. Solapur wall hanging making art reflects cultural values, regional sensibilities, beliefs, and identity and helps to preserve the many different communities. The tango of warp and weft in many ways than one tells the story of civilization itself. Solapur wall hanging is a poem in multicolor, written with the warp and weft having long, rich, and complex history with indigenous design vocabularies made by the Padmasali communities. The wall-hanging weaving of Solapur has remained unaltered for years, from being very basic and monochrome having landscapes and portraits catering only to the local market, thereby becoming a potential family income generation tool. The study focuses on the need for contemporization of the Solapur wall hanging and also deliberates on the fact that wherever the culture of native people has been aided by intervention, in nearly every case, the quality of their craft has began to be enhanced. The study also found the underlying reason for diminishing sales to a declining market, low sales, lack of innovation in design, and product development. Keeping in mind that the artisans of Solapur have heroically always hold on to their ancient beliefs and practices, which give them strength and identity, and a sense of pride, an intervention program was developed with an objective of widening the market and help artisans have a sustaining income which include urban consumers and create designs suitable for the urban market. The process of defining and measuring the advantages of design intervention was achieved by using qualitative research methods. An ethnographic research methodology was adopted, which includes six months of close interface with artisans from ten families engaged in making of wall hanging in Solapur. Design solutions were proposed in terms of product diversification and design extensions of the existing product line for increased variety. A collection of contemporary wall arts (wall decor) and room dividers were designed and developed.

Keywords: wall hanging, Solapur, contemporization, traditional, sustainable

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Authors: Jonathan W. Z. Lim, Vrizlynn L. L. Thing

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Cybercrimes are on the rise, in part due to technological advancements, as well as increased avenues of exploitation. Sophisticated threat actors are leveraging on such advancements to execute their malicious intentions. The increase in cybercrimes is prevalent, and it seems unlikely that they can be easily eradicated. A more serious concern is that the community may come to accept the notion that this will become the trend. As such, the key question revolves around how we can reduce cybercrime in this evolving landscape. In our paper, we propose to build a systematic framework through the lens of a cyber threat actor. We explore the motivation factors behind the crimes and the crime stages of the threat actors. We then formulate intervention plans so as to discourage the act of committing malicious cyber activities and also aim to integrate ex-cyber offenders back into society.

Keywords: crime motivations, crime prevention, cybercrime, ex-cyber criminals

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Authors: Jane E. Souyave, Judith Bower

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This study is an ongoing collaborative project between the University of Central Lancashire and the Alzheimer’s Society to design and test the idea of using interactive tools for a person living with dementia and their carers. It is hoped that the tools will fulfill the possible needs of engagement and interaction as dementia progresses, therefore enhancing wellbeing and improving quality of life for the person with dementia and their carers. The project was informed by Kitwood’s five psychological needs for producing wellbeing and explored evidence that fidgeting is often seen as a form of agitation and a negative symptom of dementia. Although therapy for agitation may be well established, there is a lack of appropriate items aimed at people in the later stage of dementia, that are not childlike or medical in their aesthetic. Individuals may fidget in a particular way and the tools in the Fidget Widget Toolkit have been designed to encourage repetitive movements of the hand, specifically to address the abilities of people with relatively advanced dementia. As an intervention, these tools provided a new approach that had not been tested in dementia care. Prototypes were created through an iterative design process and tested with a number of people with dementia and their carers, using quantitative and qualitative methods. Dementia Care Mapping was used to evaluate the impact of the intervention in group settings. Cohen Mansfield’s Agitation Inventory was used to record the daily use and interest of the intervention for people in their usual place of residence. The results informed the design of a new set of devices to promote safe, stigma free fidgeting as a positive experience, meaningful activity and enhance wellbeing for people in the later stage of dementia. The outcomes addressed the needs of individuals by reducing agitation and restlessness through helping them to connect, engage and act independently, providing the means of doing something for themselves that they were able to do. The next stage will be to explore the commercial feasibility of the Fidget Widget Toolkit so that it can be introduced as good practice and innovation in dementia care. It could be used by care homes, with carers and their families to support wellbeing and lead the way in providing some positive experiences and person-centred approaches that are lacking in the later stage of dementia.

Keywords: dementia, design, fidgeting, healthcare, positive moments, quality of life, wellbeing

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Authors: Yunfan Jiang

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In response to an identified gap in available treatment programmes for high-risk offenders with multiple criminogenic needs and guided by emerging literature in the field of correctional rehabilitation, Singapore Prison Service (SPS) developed the Integrated Criminogenic Programme (ICP) in 2012. This evidence-informed psychological programme was designed to address all seven dynamic criminogenic needs (from the Central 8) of high-risk offenders by applying concepts from rehabilitation and psychological theories such as Risk-Need-Responsivity, Good Lives Model, narrative identity, and motivational interviewing. This programme also encompasses a 6-month community maintenance component for the purpose of providing structured step-down support in the aftercare setting. These sessions provide participants the opportunity for knowledge reinforcement and application of skills attained in-care. A quantitative evaluation of the ICP showed that the intervention group had statistically significant improvements across time in most self-report measures of criminal attitudes, substance use attitudes, and psychosocial functioning. This was congruent with qualitative data from participants saying that the ICP had the most impact on their criminal thinking patterns and management of behaviours in high-risk situations. Results from the comparison group showed no difference in their criminal attitudes, even though they reported statistically significant improvements across time in their substance use attitudes and some self-report measures of psychosocial functioning. The programme’s efficacy was also apparent in the lower rates of recidivism and relapse within 12 months for the intervention group. The management of staff issues arising from the development and implementation of an innovative high-intensity psychological programme such as the ICP will also be discussed.

Keywords: evaluation, forensic psychology, intervention programme, offender rehabilitation

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Authors: Varsha Tol, Laila Garda, Neelam Bhardwaj, Malata Usar

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In India, differently- abled girls suffer from a “dual stigma” of being female and physically challenged. The general consensus is that they are incapable of standing on their own two feet. It was observed that these girls do not have access to educational programs as most hostels do not keep them after the tenth grade. They are forced to return to a life of poverty and are often considered a liability by their families. Higher education is completely ignored. Parents focus on finding a husband and passing on their ‘burden’ to someone else. An innovative, intervention for differently-abled adolescent girls with the express purpose of mainstreaming them into society was started by Helplife. The objective was to enrich the lives of these differently abled adolescent girls through precise research, focused intervention and professionalism. This programme addresses physical, mental and social rehabilitation of the girls who come from impoverished backgrounds. These adolescents are reached by word of mouth, snowball technique and through the network of the NGO. Applications are invited from potential candidates which are scrutinized by a panel of experts. Selection criteria include her disability, socio-economic status, and desire and drive to make a difference in her own life. The six main areas of intervention are accommodation, education, health, professional courses, counseling and recreational activities. Each girl on an average resides in Helplife for a period of 2-3 years. Analysis of qualitative data collected at various time points indicates holistic development of character. A quality of life questionnaire showed a significant improvement in scores at three different time points in 75% of the current population under intervention i.e. 19 girls. Till date, 25 girls have successfully passed out from the intervention program completing their graduation/post-graduation. Currently, we have 19 differently abled girls housed in three flats in Pune district of Maharashtra. Out of which 14 girls are pursuing their graduation or post-graduation. Six of the girls are working in jobs in various sectors. In conclusion it may be noted with adequate support and guidance the sky is the limit. This journey of 12 years has been a learning for us with ups and downs modifying the intervention at every step. Helplife has a belief of impacting positively, individual lives of differently abled girls in order to empower them in a holistic manner. The intervention has a positive impact on differently abled girls. They serve as role models to other differently abled girls indicating that this is a road map to success by getting empowered to live with full potential and get integrated in the society in a dignified way.

Keywords: differently-abled, dual-stigma, empowerment, youth

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Authors: Muhammad Saqib Manzoor, Camille Dickson-Deane, Prashan Karunaratne

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Cobb-Douglas production (utility) function is a fundamental function widely used in economics teaching and research. The key reason is the function's characteristics to describe the actual production using inputs like labour and capital. The characteristics of the function like returns to scale, marginal, and diminishing marginal productivities are covered in the introductory units in both microeconomics and macroeconomics with a 2-dimensional static visualisation of the function. However, less insight is provided regarding three-dimensional surface, changes in the curvature properties due to returns to scale, the linkage of the short-run production function with its long-run counterpart and marginal productivities, the level curves, and the constraint optimisation. Since (freshman) learners have diverse prior knowledge and cognitive skills, the existing “one size fits all” approach is not very helpful. The aim of this study is to bridge this gap by introducing technological intervention with interactive animations of the three-dimensional surface and sequential unveiling of the characteristics mentioned above using Python software. A small classroom intervention has helped students enhance their analytical and visualisation skills towards active and authentic learning of this topic. However, to authenticate the strength of our approach, a quasi-Delphi study will be conducted to ask domain-specific experts, “What value to the learning process in economics is there using a 2-dimensional static visualisation compared to using a 3-dimensional dynamic visualisation?’ Here three perspectives of the intervention were reviewed by a panel comprising of novice students, experienced students, novice instructors, and experienced instructors in an effort to determine the learnings from each type of visualisations within a specific domain of knowledge. The value of this approach is key to suggesting different pedagogical methods which can enhance learning outcomes.

Keywords: cobb-douglas production function, quasi-Delphi method, effective teaching and learning, 3D-visualisations

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Authors: Rukiye Pinar Boluktas

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According to 2015 statistics, in Turkey, 46% of older people live alone in their homes, 55% have poor health perceptions, 18% face poverty, and 43% are unhappy. Prevalence of depression is between 14% and 20%. In 2013, rate of suicide was 6.5. However, the most of older people prefer to live in their community although they are lonely, they face poverty, and face limitations as a result of chronic diseases and disabilities. Community based care for older people is also encouraged by Ministry of Health as it is more cost-effective. Music therapy is a simple, effective, safe, and nonpharmacologic intervention that may be used to decrease depression and to improve cognition, and health related quality of life (HRQOL). In Turkish culture, music is typically described as ‘food for soul’. This study aimed to investigate the effect of Turkish classical music songs in 32 community dwelling older people. Participants were received interventions two or three times per week, 50-60 min per session, for 8 weeks at a day health center. Each intervention session started listening music for 15-20 min to get remember songs, then followed singing songs as a group. Participants were assessed at baseline (week 0), and two follow-up at month 1 and month 2. Compared to baseline, at two follow-up, we observed that cognition improved, depression decreased, and SF-36 scores, including 8 domains and two summary scores increased. We conclude that an intervention comprising listening and singing Turkish classical music improve cognition, depression and HRQOL in older people.

Keywords: cognitive function, depression, elderly, quality of life, Turkish classical music

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Authors: Seyed Ebrahim Hosseini, Shahbaz Pervez

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As people go through aging, maintenance and improvement of the quality of life become more important for them. To know the role of smartphone technology and communications applications on quality of life, a sample group of old people living in Dar-Iran was selected for a quasi-experimental study. The participants were registered senior inhabitants from public health centers in Dar, Iran in 2022. The number of participants was 39. Participants were randomly categorized into intervention and control groups. A validated Persian version of the Control, Autonomy, Self-realisation, Pleasure scale (CASP-19) scale questionnaire was provided for them which answers were used for the quality of life assessment. The paired t-test between pre-and post-test (t= -8.45, p<.00), post-and follow-up-test (t= -2.12, p=.01), and pre-test and the follow-up test (t= -8.27, p<.00) in the intervention group revealed a considerable mean difference. Based on the results of paired t-test for the control group, this was not significant between pre-test and post-test (t= 1.26, p=.15), post-test and follow-up test (t= .33, p=.67) and pre-test and follow-up test (t= 1.85, p=.08) for quality of life. Considering the educational training associated with it, this study aimed at helping families and aging field practitioners to understand the essentiality of modern communication technology teaching in promoting a greater life quality of the elderly’s community.

Keywords: Iranian elderly, quality of life, smartphone, social applications, CASP-19

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Authors: Reynald Contreras, Shaina Marie Bho, Kate Roan Dela Cruz, Marvin Dela Cruz

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This study was conducted with the aim of determining the skill level of grade ten (Grade 10) students in writing a reflective essay in selected secondary schools of Valenzuela. This research used descriptive and qualitative-quantitative research methods to systematically and accurately describe the level of writing skills of students and used a convenient sampling technique in selecting forty (40) students in grade ten. (Grade 10) at Polo, Wawang Pulo, and Arkong Batong high schools with a total of one hundred and twenty (120) students to assess the written reflective essay using modified rubrics developed based on 6+1 writing traits by Ruth Culham. According to the findings of the study, students at Polo and Wawang Pulo National high schools have low levels of writing skills that need to be developed or are not proficient. Meanwhile, Arkong Bato National High School has achieved a high degree of writing proficiency. Based on the study's findings, the researchers devised a suggested curriculum mapping for the suggested activity or intervention activity that would aid in the development and cultivation of the writing skills of children in grade ten (Grade 10).

Keywords: writing skills, reflective essay, intervention activity, 6+1 writing traits, modified rubrics

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Authors: Genesis F. Dela Cruz, Liza C. Costa

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The study is concerned with the Risk factors of dropping out among Grade VII students for SY 2012-2013. A total of 87 Grade VII Students-At-Risk-of-Dropping Out (SARDOs) were involved in this study. The descriptive survey method was used in this study. A 50-item questionnaire was used in data gathering. Expert validation was done to determine the validity and reliability of the instrument. The study used Chi Square, Kruskal Wallis Test and Mann Whitney Test in the statistical treatment of data. The study revealed that the respondents are within the standard age limit for Grade VII students in the Philippines which is 13 years old. Males more than females usually becomes SARDOs. SARDOs come from low economic status and complete families contrary to the common belief that they came from single-parent families. The study also showed that parent’s involvement in educating their children on family-related factors contributed to the very good perception on the family related factors. Based on age, there are no significant differences in their perception of the four major recognized risk factors for dropping out among all ages. There are no significant differences in their perception of the family, individual and community related factors for dropping out based on sex. However, females have a more favorable perception when it comes to school related factors. No significant differences in their perception of dropping out were also noted when they are classified according to distance of school from home. The respondents do not differ in their perception on family, individual and community related factors when they are classified according to type of family. When surveyed regarding the respondents’ reason for being absent, it was found out that laziness and being late are the two major reasons. Respondents also perceived remedial and tutorial classes as school-initiated intervention measure to prevent school disengagement or dropping out.

Keywords: drop-out, guidance and counseling, school initiated intervention, students at risk of dropping out

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Authors: Helyeh Doutaghi

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In 2005, the doctrine of Responsibility to Protect (R2P) was created by the UN Member States agreeing to not only to have the primary responsibility to protect their civilians from genocide, war crimes, crimes against humanity and ethnic cleansing, but also to be responsible towards those civilians whose State was found manifestly failing in that regard. This paper will assess the doctrine of R2P and will argue that R2P too, just like humanitarian intervention, suffers from a lack of legal basis and political will to implement it. Or better said, it is being selectively used by the hegemon’s power to achieve its political will. In doing so, the origin and development shall be explained. Furthermore, it will be submitted that R2P has failed to achieve its purpose due to the unresolved Security Council’s deadlock. Lastly, the concept of legal morality entailed in R2P and its use in real life cases since 2005 will be examined.

Keywords: responsibility to protect, humanitarian intervention, United Nations, legitimacy, legality

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Authors: Wendi Dunham, Kimberly Floyd

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The constructivist approach to learning is a theoretical orientation that posits that individuals create their own understanding and knowledge of the world through their experiences and interactions. This approach emphasizes that learning is an active process and that individuals are not passive recipients when constructing their understanding of their world. When used concurrently with trauma-informed practices, a constructivist approach can inform the development of a framework for students and teachers that supports their social, emotional, and mental health in addition to enabling academic success. This framework can be applied to teachers and students. When applied to teachers, it can be used to achieve purposeful coping mechanisms through restorative justice and dispositional mindfulness. When applied to students, the framework can implement proactive, student-based practices such as Response to Intervention (RtI) and the 4 Rs to connect resiliency and intervention to academic learning. Using a constructivist, trauma-informed framework can provide students with a greater sense of control and agency over their trauma experiences and impart confidence in achieving school success.

Keywords: trauma, trauma informed practices in education, constructivist theory framework, school responses to trauma, trauma informed supports for teachers, trauma informed strategies for students, restorative justice, mindfulness, response to intervention, the 4 R's, resiliency

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Authors: Alexandria Carey, Angela Starkweather, Ann Horgas, Hwayoung Cho, Jason Beneciuk

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Background/Significance: Over 3.4 million acute axial low back pain (aLBP) cases are treated annually in the United States (US) emergency departments (ED). ED patients with aLBP receive varying verbal and written discharge routine care (RC), leading to ineffective patient self-management. Ineffective self-management increase chronic low back pain (cLPB) transition risks, a chief cause of worldwide disability, with associated costs >$60 million annually. This research addresses this significant problem by evaluating an ED digital pain self-management intervention (EDPSI) focused on improving self-management through improved knowledge retainment, skills, and self-efficacy (confidence) (KSC) thus reducing aLBP to cLBP transition in ED patients discharged with aLBP. The research has significant potential to increase self-efficacy, one of the most potent mechanisms of behavior change and improve health outcomes. Focusing on accessibility and usability, the intervention may reduce discharge disparities in aLBP self-management, especially with low health literacy. Study Questions: This research will answer the following questions: 1) Will an EDPSI focused on improving KSC progress patient self-management behaviors and health status?; 2) Is the EDPSI sustainable to improve pain severity, interference, and pain recurrence?; 3) Will an EDPSI reduce aLBP to cLBP transition in patients discharged with aLBP? Aims: The pilot randomized-controlled trial (RCT) study’s objectives assess the effects of a 12-week digital self-management discharge tool in patients with aLBP. We aim to 1) Primarily assess the feasibility [recruitment, enrollment, and retention], and [intervention] acceptability, and sustainability of EDPSI on participant’s pain self-management; 2) Determine the effectiveness and sustainability of EDPSI on pain severity/interference among participants. 3) Explore patient preferences, health literacy, and changes among participants experiencing the transition to cLBP. We anticipate that EDPSI intervention will increase likelihood of achieving self-management milestones and significantly improve pain-related symptoms in aLBP. Methods: The study uses a two-group pilot RCT to enroll 30 individuals who have been seen in the ED with aLBP. Participants are randomized into RC (n=15) or RC + EDPSI (n=15) and receive follow-up surveys for 12-weeks post-intervention. EDPSI innovative content focuses on 1) highlighting discharge education; 2) provides self-management treatment options; 3) actor demonstration of ergonomics, range of motion movements, safety, and sleep; 4) complementary alternative medicine (CAM) options including acupuncture, yoga, and Pilates; 5) combination therapies including thermal application, spinal manipulation, and PT treatments. The intervention group receives Booster sessions via Zoom to assess and reinforce their knowledge retention of techniques and provide return demonstration reinforcing ergonomics, in weeks two and eight. Outcome Measures: All participants are followed for 12-weeks, assessing pain severity/ interference using the Brief Pain Inventory short-form (BPI-sf) survey, self-management (measuring KSC) using the short 13-item Patient Activation Measure (PAM), and self-efficacy using the Pain Self-Efficacy Questionnaire (PSEQ) weeks 1, 6, and 12. Feasibility is measured by recruitment, enrollment, and retention percentages. Acceptability and education satisfaction are measured using the Education-Preference and Satisfaction Questionnaire (EPSQ) post-intervention. Self-management sustainment is measured including PSEQ, PAM, and patient satisfaction and healthcare utilization (PSHU) requesting patient overall satisfaction, additional healthcare utilization, and pain management related to continued back pain or complications post-injury.

Keywords: digital, pain self-management, education, tool

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Authors: A. Abbou, V. Makis, N. Salari

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We study the condition-based maintenance (CBM) problem of a system subject to stochastic deterioration. The system is composed of three units (or modules): (i) Module 1 deterioration follows a Markov process with two operational states and one failure state. The operational states are partially observable through periodic condition monitoring. (ii) Module 2 deterioration follows a Gamma process with a known failure threshold. The deterioration level of this module is fully observable through periodic inspections. (iii) Only the operating age information is available of Module 3. The lifetime of this module has a general distribution. A CBM policy prescribes when to initiate a maintenance intervention and which modules to repair during intervention. Our objective is to determine the optimal CBM policy minimizing the long-run expected average cost of operating the system. This is achieved by formulating a Markov decision process (MDP) and developing the value iteration algorithm for solving the MDP. We provide numerical examples illustrating the cost-effectiveness of the optimal CBM policy through a comparison with heuristic policies commonly found in the literature.

Keywords: reliability, maintenance optimization, Markov decision process, heuristics

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Authors: Bu Kyung Park

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Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.

Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis

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Authors: Heena Akbar, Winnie Niumata, Danielle Gallegos

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Type 2 diabetes is a significant public health problem for Māori and Pasifika communities in Queensland, who are experiencing a higher burden of morbidity and mortality from the condition. Despite this higher burden, there are few initiatives that are culturally tailored to improve prevention and management. Modification of personal behaviors through women’s wellness programs aimed at early intervention has been shown to reduce the risk of developing complications in established type 2 diabetes and may reduce hospitalization rates from preventable complications related to this disease. The 24-week Pasifika Women’s Diabetes Wellness Program (PWDWP) was culturally co-designed and co-developed with Māori and Pasifika women with type 2 diabetes through a community-academia partnership in Queensland. Underpinned by Social Cognitive Theory and the Indigenous Pacific Health frameworks to include family culture & spirituality and integrating a collectivist and whānau (family) centered approach to self-care, the program takes into consideration the cultural shame associated with acknowledging the disease and tailors the interventions using talanoa (storytelling or conversation in a relational context) as the key strategy to come to a shared meaning for behavior change. The pilot trial is a 12-week intervention followed by a 12-week follow-up period conducted with 50 women with type 2 diabetes, 25 women who will receive the intervention and 25 women who will receive usual care. The pilot program provides in-person and virtual access to culturally supported prevention and self-management of Māori and Pasifika women with type 2 diabetes with the aim to improve healthy lifestyles and reduce late hospital presentations from diabetes-related complications for better diabetes-related outcomes. This study will test and evaluate the effectiveness of the PWDWP pilot trial in partnership with Māori & Pasifika community organizations and key stakeholders for improved glycated hemoglobin (HbA1c) levels associated with poor management of type 2 diabetes.

Keywords: culturally co-designed intervention, Indigenous methodology, Māori and Pasifika communities, type 2 diabetes self-management

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Authors: Selvia Arokiya Mary

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Introduction: Worldwide, breast cancer comprises 10.4% of all cancer incidence among women. In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths). Many women who undergo breast surgery suffer from ill-defined pain syndromes. STATEMENT OF THE PROBLEM: A study to assess the effectiveness of twin therapeutic approaches on certain bio-physiological parameters in breast cancer patients after breast surgery at selected hospital, Chennai. Objectives: This study is to 1. assess the level of certain biophysiological parameters in women after mastectomy. 2. assess the effectiveness of twin therapeutic approaches on certain biophysiological parameters in women after mastectomy. 3. correlate the practice of twin therapeutic approaches with certain biophysiological parameters. 4. associate the selected demographic variables with certain biophysiological parameters in women after mastectomy Research Design and Method: Pre experimental research design was used. Fifty women were selected by using convenient sampling technique at government general hospital, Chennai. Results: The Level of pain shows, in the study group 49(98%) of them had moderate in the pre test and after the intervention all of them had mild pain in the post test. In relation to level of shoulder function before the intervention shows that in the study group 49(98%) of them had movement towards gravity and after intervention 24 (48%) of them had movement against gravity maximum resistance. There was a significant reduction in pain and shoulder stiffness level at a ‘P’ level of < 0.001. There was a negative correlation between the pranayama practice and the level of pain, there was a positive correlation between the arm exercise practice and the level of shoulder function. There was no significant association between demographic and clinical variables with the level of pain and shoulder function in the study. Hypothesis: There is a significant difference in level of pain and shoulder function among women following breast surgery who receive pranayama & arm exercise programme. The pranayama had effect in terms of reduction of pain, arm exercise programme had effect in prevention of arm stiffness among post operative women following breast surgery. Thus the stated hypothesis was accepted. Conclusion: On the basis of the findings of the present study there was Advancing age related to increasing risk of breast cancer, level of pain also the type of surgery was associated with level of pain and shoulder function, There fore it is to be concluded that the study participants may get benefited by practice of pranayama and arm exercise program.

Keywords: biophysiological parameters breast surgery, lumpectomy , mastectomy, radical mastectomy, twin therapeutic approach, pranayama, arm exercise

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Authors: Vesile Unver, Tulay Basak, Hatice Ayhan, Ilknur Cinar, Emine Iyigun, Nuran Tosun

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The aim of this study is to analyze the effects of the hybrid simulation. In this simulation, types standardized patients and task trainers are employed simultaneously. For instance, in order to teach the IV activities standardized patients and IV arm models are used. The study was designed as a quasi-experimental research. Before the implementation an ethical permission was taken from the local ethical commission and administrative permission was granted from the nursing school. The universe of the study included second-grade nursing students (n=77). The participants were selected through simple random sample technique and total of 39 nursing students were included. The views of the participants were collected through a feedback form with 12 items. The form was developed by the authors and “Patient intervention self-confidence/competence scale”. Participants reported advantages of the hybrid simulation practice. Such advantages include the following: developing connections between the simulated scenario and real life situations in clinical conditions; recognition of the need for learning more about clinical practice. They all stated that the implementation was very useful for them. They also added three major gains; improvement of critical thinking skills (94.7%) and the skill of making decisions (97.3%); and feeling as if a nurse (92.1%). In regard to the mean scores of the participants in the patient intervention self-confidence/competence scale, it was found that the total mean score for the scale was 75.23±7.76. The findings obtained in the study suggest that the hybrid simulation has positive effects on the integration of theoretical and practical activities before clinical activities for the nursing students.

Keywords: hybrid simulation, clinical practice, nursing education, nursing students

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Authors: Bohsiu Wu

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This study compares the differences in social dynamics between rural and urban areas in California to explain homicides involving family members. It is hypothesized that rural homicides are better explained by social isolation and lack of intervention resources, whereas urban homicides are attributed to social disadvantage factors. Several critical social dynamics including social isolation, social disadvantages, acculturation, and intervention resources were entered in a hierarchical linear model (HLM) to examine whether county-level factors affect how each specific dynamic performs at the ZIP code level, a proxy measure for communities. Homicide data are from the Supplementary Homicide Report for all 58 counties in California from 1997 to 1999. Predictors at both the county and ZIP code levels are derived from the 2000 US census. Preliminary results from a HLM analysis show that social isolation is a significant but moderate predictor to explain rural family homicide and various social disadvantage factors are significant factors accounting for urban family homicide. Acculturation has little impact. Rurality and urbanity appear to interact with various social dynamics in explaining family homicide. The implications for prevention at both the county and community level as well as directions for future study on the differences between rural and urban locales are explored in the paper.

Keywords: communities, family, HLM, homicide, rural, urban

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Authors: Chi H. Lin, Chi C. Lin, Chih L. Hsieh

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Motor Imagery (MI) alone or combined with action observation (AO) has been shown to enhance motor performance and skill learning. The most effective way to combine these techniques has received limited scientific scrutiny. In the present study, we examined the effects of simultaneous (i.e., observing an action whilst imagining carrying out the action concurrently), alternate (i.e., observing an action and then doing imagery related to that action consecutively) and synthesis (alternately perform action observation and imagery action and then perform observation and imagery action simultaneously) AOMI combinations on improving golf putting performance and learning. Participants, 45 university students who had no formal experience of using imagery for the study, were randomly allocated to one of four training groups: simultaneous action observation and motor imagery (S-AOMI), alternate action observation and motor imagery (A-AOMI), synthesis action observation and motor imagery (A-S-AOMI), and a control group. And it was applied 'Different Experimental Groups with Pre and Post Measured' designs. Participants underwent eighteen times of different interventions, which were happened three times a week and lasting for six weeks. We analyzed the information we received based on two-factor (group × times) mixed between and within analysis of variance to discuss the real effects on participants' golf putting performance and learning about different intervention methods of different types of combined action observation and motor imagery. After the intervention, we then used imagery questionnaire and journey to understand the condition and suggestion about different motor imagery and action observation intervention from the participants. The results revealed that the three experimental groups both are effective in putting performance and learning but not for the control group, and the A-S-AOMI group is significantly better effect than S-AOMI group on golf putting performance and learning. The results confirmed the effect of motor imagery combined with action observation on the performance and learning of golf putting. In particular, in the groups of synthesis, motor imagery, or action observation were alternately performed first and then performed motor imagery, and action observation simultaneously would have the best effectiveness.

Keywords: motor skill learning, motor imagery, action observation, simulation

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Authors: Samaneh Abedini, Diana Coholic

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The transition from adolescence into adulthood involves many changes that result in increased vulnerability to psychological challenges. This developmental stage can be especially stressful for female youth living in underserviced regions. If mental health problems are left untreated in socially marginalized youth, these challenges can extend into adulthood. We know that a lack of access to mental health services and supports can influence adolescents’ psycho-social development and well-being, while resilience and emotion regulation can help them cope with these challenges. Feasible therapeutic programs can play a significant role in assisting youth in developing these characteristics and skills. Mindfulness-Based Cognitive Therapy for Children (MBCT-C) and Holistic Art-Based Program (HAP) are two examples of mindfulness-based interventions (MBIs) that address emotion regulation, coping strategies, and resilience in marginalized youth. While each program’s beneficial effects have been documented, there is a lack of research comparing MBIs with youth, within underserviced geographical locations, and across different cultures. In this study, the sample was 42 female youth between the ages of 12 and 17 years from Iran. 42 female youth from the Elm o Honar High School, located in rural parts of Iran, Isfahan province, have been enrolled in the study. The participants were assigned to one of the MBIs (three MBCT-C experimental groups (n=20) and three HAP experimental groups (n=22)). All participants completed measures including the Child and Youth Resilience Measure-28 (CYRM-28), Child and Adolescent Mindfulness Measure (CAMM), and Difficulties in Emotion Regulation Scale (DERS) at baseline and post-intervention. At the end of intervention, the MBCT-C and HAP experimental groups showed significant changes in resilience and emotion regulation. However, the changes in resilience in HAP groups were not significant; the participants in MBCT-C experimental groups showed significant improvement in resilience. The study provided initial evidence that mindfulness-based intervention can be potentially beneficial for improving mental health status in marginalized Iranian female youth living in the middle east culture.

Keywords: benefits, female, marginalized, mindfulness, youth

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Authors: A. K. Aswathy, Asha Manoharan, Arya Manoharan

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The purpose of this study are to define the nature of oral sensory issues in children with autism spectrum disorder (ASD), identify important components of the assessment and treatment of this issues specific to this population, and delineate specific therapeutic techniques designed to improve assessment and treatment within therapeutic settings. Literature review and case example is used to define the predominant nature of the oral sensory issues that are experienced by some children on the autism spectrum. Characteristics of this complex disorder that can have an impact on feeding skill and behavior are also identified. These factors are then integrated to create assessment and intervention techniques that can be used in conjunction with traditional feeding approaches to facilitate improvements in eating as well as reducing oral apraxic component in this unique population. The complex nature of ASD and its many influences on feeding skills and behavior create the need for modification to both assessment and treatment approaches. Additional research is needed to create therapeutic protocols that can be used by speech-language pathologists to effectively assess and treat feeding and oro motor apraxic difficulties that are commonly encountered in children with ASD.

Keywords: autism, assessment, feeding, intervention, oral sensory issues, oral apraxia

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Authors: Osman Ali, Jeanne Kriek

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Introduction: The current instructional approach entrenched in memorizing does not assist conceptual understanding in science. Instructional approaches that encourage research, investigation, and experimentation, which depict how scientists work, should be encouraged. One such teaching strategy is problem-based learning (PBL). PBL has many advantages; enhanced self-directed learning and improved problem-solving and critical thinking skills. However, despite many advantages, PBL has challenges. Research confirmed is time-consuming and difficult to formulate ill-structured questions. Professional development interventions are needed for in-service educators to adopt the PBL strategy. The purposively selected educators had to implement PBL in their classrooms after the intervention to develop their practice and then reflect on the implementation. They had to indicate their achievements and challenges. This study differs from previous studies as the rural educators were subjected to implementing PBL in their classrooms and reflected on their experiences, beliefs, and attitudes regarding PBL. Theoretical Framework: The study reinforced Vygotskian sociocultural theory. According to Vygotsky, the development of a child's cognitive is sustained by the interaction between the child and more able peers in his immediate environment. The theory suggests that social interactions in small groups create an opportunity for learners to form concepts and skills on their own better than working individually. PBL emphasized learning in small groups. Research Methodology: An exploratory case study was employed. The reason is that the study was not necessarily for specific conclusive evidence. Non-probability purposive sampling was adopted to choose eight schools from 89 rural public schools. In each school, two educators were approached, teaching physical sciences in grades 10 and 11 (N = 16). The research instruments were questionnaires, interviews, and lesson observation protocol. Two open-ended questionnaires were developed before and after intervention and analyzed thematically. Three themes were identified. The semi-structured interviews and responses were coded and transcribed into three themes. Subsequently, the Reform Teaching Observation Protocol (RTOP) was adopted for lesson observation and was analyzed using five constructs. Results: Evidence from analyzing the questionnaires before and after the intervention shows that participants knew better what was required to develop an ill-structured problem during the implementation. Furthermore, indications from the interviews are that participants had positive views about the PBL strategy. They stated that they only act as facilitators, and learners’ problem-solving and critical thinking skills are enhanced. They suggested a change in curriculum to adopt the PBL strategy. However, most participants may not continue to apply the PBL strategy stating that it is time-consuming and difficult to complete the Annual Teaching Plan (ATP). They complained about materials and equipment and learners' readiness to work. Evidence from RTOP shows that after the intervention, participants learn to encourage exploration and use learners' questions and comments to determine the direction and focus of classroom discussions.

Keywords: problem-solving, self-directed, critical thinking, intervention

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Authors: Jemma McGourty, Brid Delahunt, Fiona Hackett, Sharon Courtney, Richard English, Graham Russell, Sinéad O’Connor

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Fundamental Movement Skills (FMS) mastery is considered essential for children’s ongoing, meaningful engagement in Physical Activity (PA). There has been a dearth of Irish research on baseline FMS and their development by means of intervention in young primary school children. In addition, as children’s participation in PA is heavily influenced by both parents and teachers, it is imperative to understand their attitudes and perceptions towards PA participation and its’ promotion in children. The ‘Fun, Move, Play’ Project investigated the effect of a 6-week play based PA intervention on primary school children’s (aged 6-8 years) FMS while also exploring the attitudes and perceptions of their parents and teachers towards PA participation. The FMS intervention utilised a pre-post quasi-experimental design to determine the effect of a 6-week play based PA intervention (devised from the iCoach Kids Programme) on 176 primary school children’s FMS (N = 176: 90 girls and 86 boys; M = 7.2 years; SD = 0.48). Objective measures of 7 FMS (run, skip, vertical jump, static balance, stationary dribble, catch, kick) were made using a combination of the TGMD2 and Get Skilled, Get Active resources. One hundred parents (87 mothers; 13 fathers; M=36 years; SD=5.45) and 90 teachers (67 females; 23 males) completed surveys investigating their attitudes and perceptions towards PA participation. In addition, 19 of these parents and 9 of these teachers participated in semi-structured qualitative interviews to explore, in more depth, their views and perceptions of PA participation. Both the FMS data set and survey responses were analysed using SPSS version 23, using appropriate statistical analysis. A thematic analysis framework was used to analyse the qualitative findings. A significant improvement was observed in the children’s overall FMS score pre-post intervention (t = 16.67; df = 175; p < 0.001), while there were also significant improvements in each of the seven individual FMS measured in the children, pre-post intervention. Findings from the parent surveys and interviews indicated that parents had positive attitudes towards PA, viewed it as important and supported their child’s PA participation. However, a lack of knowledge regarding the amount and intensity of PA that children should participate in emerged as a recurrent finding. Also, there was a significant positive correlation between the PA levels of parents’ and their children (r = .41; n = 100; p < .001). Arising from the teachers’ surveys and interviews was a positive attitude towards PA and the impact that it has on a child’s health and well-being. They also reported feeling more confident teaching certain aspects of the PE curriculum (games and sports) compared to others (gymnastics, dance), where they appreciate working with specialist practitioners. Conclusion: A short-term PA intervention has a positive effect on children’s FMS. While parents are supportive of their child’s PA participation, there is a knowledge gap regarding National PA guidelines for children. Teachers appreciate the importance of PA in children, but face a number of challenges in its implementation and promotion.

Keywords: fundamental movement skills, parents attitudes to physical activity, short-term intervention, teachers attitudes to physical activity

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Authors: Sokkhey Phauk, Takeo Okazaki

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The challenging task in educational institutions is to maximize the high performance of students and minimize the failure rate of poor-performing students. An effective method to leverage this task is to know student learning patterns with highly influencing factors and get an early prediction of student learning outcomes at the timely stage for setting up policies for improvement. Educational data mining (EDM) is an emerging disciplinary field of data mining, statistics, and machine learning concerned with extracting useful knowledge and information for the sake of improvement and development in the education environment. The study is of this work is to propose techniques in EDM and integrate it into a web-based system for predicting poor-performing students. A comparative study of prediction models is conducted. Subsequently, high performing models are developed to get higher performance. The hybrid random forest (Hybrid RF) produces the most successful classification. For the context of intervention and improving the learning outcomes, a feature selection method MICHI, which is the combination of mutual information (MI) and chi-square (CHI) algorithms based on the ranked feature scores, is introduced to select a dominant feature set that improves the performance of prediction and uses the obtained dominant set as information for intervention. By using the proposed techniques of EDM, an academic performance prediction system (APPS) is subsequently developed for educational stockholders to get an early prediction of student learning outcomes for timely intervention. Experimental outcomes and evaluation surveys report the effectiveness and usefulness of the developed system. The system is used to help educational stakeholders and related individuals for intervening and improving student performance.

Keywords: academic performance prediction system, educational data mining, dominant factors, feature selection method, prediction model, student performance

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Authors: Christian Andrä, Pauline Hähner, Sebastian Ludyga

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Introduction: In the recent past, discussions on the importance of physical activity for child development have contributed to a growing interest in executive functions, which refer to cognitive processes. By controlling, modulating and coordinating sub-processes, they make it possible to achieve superior goals. Major components include working memory, inhibition and cognitive flexibility. While executive functions can be trained easily in school children, there are still research deficits regarding the trainability during preschool age. Methodology: This quasi-experimental study with pre- and post-design analyzes 23 children [age: 5.0 (mean value) ± 0.7 (standard deviation)] from four different sports groups. The intervention group was made up of 13 children (IG: 4.9 ± 0.6), while the control group consisted of ten children (CG: 5.1 ± 0.9). Between pre-test and post-test, children from the intervention group participated special games that train executive functions (i.e., changing rules of the game, introduction of new stimuli in familiar games) for ten units of their weekly sports program. The sports program of the control group was not modified. A computer-based version of the Eriksen Flanker Task was employed in order to analyze the participants’ inhibition ability. In two rounds, the participants had to respond 50 times and as fast as possible to a certain target (direction of sight of a fish; the target was always placed in a central position between five fish). Congruent (all fish have the same direction of sight) and incongruent (central fish faces opposite direction) stimuli were used. Relevant parameters were response time and accuracy. The main objective was to investigate whether children from the intervention group show more improvement in the two parameters than the children from the control group. Major findings: The intervention group revealed significant improvements in congruent response time (pre: 1.34 s, post: 1.12 s, p<.01), while the control group did not show any statistically relevant difference (pre: 1.31 s, post: 1.24 s). Likewise, the comparison of incongruent response times indicates a comparable result (IG: pre: 1.44 s, post: 1.25 s, p<.05 vs. CG: pre: 1.38 s, post: 1.38 s). In terms of accuracy for congruent stimuli, the intervention group showed significant improvements (pre: 90.1 %, post: 95.9 %, p<.01). In contrast, no significant improvement was found for the control group (pre: 88.8 %, post: 92.9 %). Vice versa, the intervention group did not display any significant results for incongruent stimuli (pre: 74.9 %, post: 83.5 %), while the control group revealed a significant difference (pre: 68.9 %, post: 80.3 %, p<.01). The analysis of three out of four criteria demonstrates that children who took part in a special sports program improved more than children who did not. The contrary results for the last criterion could be caused by the control group’s low results from the pre-test. Conclusion: The findings illustrate that inhibition can be trained as early as in preschool age. The combination of familiar games with increased requirements for attention and control processes appears to be particularly suitable.

Keywords: executive functions, flanker task, inhibition, preschool children

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Authors: Renu Kumari

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State sovereignty refers to the ability and power of a state to be independent and not to have any interference of external actors in its internal affairs. This phenomenon has been accepted by International Law, which gives rights to the state to maintain its autonomy and territorial integrity without the interference of other actors. In of 1980’s and 1990’s the world has witnessed the worst case of human rights violence for instance, Rwanda genocide, the conflict in former Yugoslavia, Kosovo, Burundi, and Chad so and so forth. Though human rights violence is not a new phenomenon, it has been present all over the world in different time and space. But in 1990’s after the devastation of these conflicts and violence the world community came up with the notion of humanitarian intervention in which some states took the responsibility of protecting human rights violations and on the in order to protect they can intervene in the internal matters of a state specifically during civil war where state is unable to protect its people. Later on these so-called world community realized that intervention itself is a negative term that was criticized also therefore they came up with a different notion that sounded positive which known as responsibility to protect. In 2005 onwards, the notion of responsibility to protect accepted and recognized by the United Nations and states at a larger level. In the case of Syria on the name of responsibility to protect foreign interventions took place and due to the internal war Syrian people were already facing many problems, the government was not able to protect them. External invasion caused many devastating outcomes to the country. This paper is an attempt to analyze various dimensions of invasion of external affairs of a particular state and the status of sovereignty. Firstly, it lays out the notion of humanitarian intervention and then the responsibility to protect. Secondly, it looks in the case of Syria since 2011, the conflict of Syria. Thirdly it focuses on various efforts made by international organizations and other actors. Lastly, it looks why and how other actors intervene in the internal matter of Syria.

Keywords: state sovereignty, external actors, intervention, responsibility to protect

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Authors: Carmen W. H. Chan, Helen Y. L. Chan, Kai Chow Choi, Ka Ming Chow, Cecilia W. M. Kwan, Nancy H. Y. Ng, Jackie Robinson

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Introduction: In Hong Kong, a significant number of deaths occur in acute care wards, which requires nurses in these settings to provide end-of-life care and lead ACP implementation. However, nurses in these settings, in fact, have very low-level involvement in ACP discussions because of limited training in ACP conversations. Objective: This study aims to assess the impact of a multi-media experiential ACP (MEACP) training program, which is guided by the experiential learning model and theory of planned behaviour, on nurses' knowledge and confidence in assisting patients with ACP. Methodology: The study utilizes a cluster randomized controlled trial with a 12-week follow-up. Eligible nurses working in acute care hospital wards are randomly assigned at the ward level, in a 1:1 ratio, to either the control group (no ACP education) or the intervention group (4-week MEACP training program). The training programme includes training through a webpage and mobile application, as well as a face-to-face training workshop with enhanced lectures and role play, which is based on the Theory of Planned Behavior and Kolb's Experiential Learning Model. Questionnaires were distributed to assess nurses' knowledge (a 10-item true/false questionnaire) and level of confidence (five-point Likert scale) in ACP at baseline (T0), four weeks after the baseline assessment (T1), and 12 weeks after T1 (T2). In this interim report, data analysis was mainly descriptive in nature. Result: The interim report focuses on the preliminary results of 165 nurses at T0 (Control: 74, Intervention: 91) over a 5-month period, 69 nurses from the control group who completed the 4-week follow-up and 65 nurses from the intervention group who completed the 4-week MEACP training program at T1. The preliminary attrition rate is 6.8% and 28.6% for the control and intervention groups, respectively, as some nurses did not complete the whole set of online modules. At baseline, the two groups were generally homogeneous in terms of their years of nursing practice, weekly working hours, working title, and level of education, as well as ACP knowledge and confidence levels. The proportion of nurses who answered all ten knowledge questions correctly increased from 13.8% (T0) to 66.2% (T1) for the intervention group and from 13% (T0) to 20.3% (T1) for the control group. The nurses in the intervention group answered an average of 7.57 and 9.43 questions correctly at T0 and T1, respectively. They showed a greater improvement in the knowledge assessment at T1 with respect to T0 when compared with their counterparts in the control group (mean difference of change score, Δ=1.22). They also exhibited a greater gain in level of confidence at T1 compared to their colleagues in the control group (Δ=0.91). T2 data is yet available. Conclusion: The prevalence of nurses engaging in ACP and their level of knowledge about ACP in Hong Kong is low. The MEACP training program can enrich nurses by providing them with more knowledge about ACP and increasing their confidence in conducting ACP.

Keywords: advance directive, advance care planning, confidence, knowledge, multi-media experiential, randomised control trial

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