Search results for: patient's family

Authors: Temitope O. Tokosi, Visvanathan Naicker

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Patient health records contain sensitive information for which an electronic patient record (EPR) system can safely secure and transmit amongst clinicians for use in improving health delivery. Clinician’s use of the behaviour of these systems is under scrutiny to assess their attributes towards health technology. South Africa (SA) clinicians responded to a pilot study survey to assess their understanding of EPR, what attributes are important towards technology use and more importantly streamlining the survey for a larger study. Descriptive statistics using mean scores was used because of the small sample size of 11 clinicians who completed the survey. Nine (9) constructs comprising 62 items were used and a Cronbach alpha score of 0.883 was obtained. Limitations and discussions conclude the study.

Keywords: EPR, clinicians, pilot study, South Africa

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Authors: Masoud Abbasalipour

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In this study, the impact of family status on individuals, involving factors such as parents' literacy level, family size, individuals' blood group, and susceptibility to addiction, was investigated. Statistical tests were employed to scrutinize the relationships among these specified factors. The statistical population of the study consisted of 338 samples divided into two groups: individuals with addiction and those without addiction in the city of Amol. The addicted group was selected from individuals visiting the substance abuse treatment center in Amol, and the non-addicted group was randomly selected from individuals in urban and rural areas. The Chi-square test was used to examine the presence or absence of relationships among the variables, and Kramer's V test was employed to determine the strength of the relationship between them. Excel software facilitated the initial entry of data, and SPSS software was utilized for the desired statistical tests. The research results indicated a significant relationship between the variable of parents' education level and individuals' addiction. The analysis showed that the education level of their parents was significantly lower compared to non-addicted individuals. However, the variables of the number of family members and blood group did not significantly impact individuals' susceptibility to addiction.

Keywords: addiction, blood group, parents' literacy level, family status

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Authors: Mohd Sarfaraz

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The objective of this study is to investigate the work-life balance and job satisfaction among women employees in a hospital in India. It is believed that balancing a successful career with a family life or personal life can be challenging. WLB impacts on persons' satisfaction in their work and personal life roles. For this purpose, a questionnaire is developed with 22 items. The data collected from women employees who are working in a hospital in Aligarh, India. The constructs considered in this study include WLB and job satisfaction. The demographic and organisational variables considered in the study are genders, age and tenure of the job. Factors of WLB are flexible working conditions, work-life balance programs, and employee intention to change/leave a job, work pressure/stress and long working hours. This paper examines the relationship between work-family conflict, policies, and job and life satisfaction. Appropriate statistical tool using SPSS will be applied to achieve the objective. The anxiety over work-life balance is progressively becoming a common talk, especially for female employees.Increasing demands from the work and family domains represent a high strain for employees which even lead to the health problems among employees. Although it is believed that work-family role strain is more common among women employees. Therefore, the study will focus on these issues of WLB and job satisfaction among female professionals.

Keywords: work-life balance, job satisfaction, work- family conflict, health

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Authors: Silvia Maria Moya

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After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.

Keywords: mental health, nursing, deinstitutionalization, professional space

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Authors: Sorayya Kazemi, Hamed Kharrati, Mehdi Abedinpour Fallah

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This paper presents the design and implementation of a novel electric pressure-sensitive toothbrush, capable of measuring the forces applied to the head of the brush. The developed device is used for gum recession measurement. In particular, the percentage of gum recession is measured by a Programmable Automation controller (PAC). Moreover, the brushing forces are measured by a Force Sensing Resistor (FSR) sensor. These forces are analog inputs of PAC. According to the applied forces during patient’s brushing and the patient’s percentage of gum recession, dentist sets the standard force range. The instrument alarms when the patient applies a force over the set range.

Keywords: gum recession, force sensing resistor, controller, toothbrush

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Authors: Thapa Sirjana, Clifton R. Emery

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This paper examines the family order and Informal Social Control (ISC) by the extended families as a protective factor against Child Maltreatment. The findings are discussed using the main effects and the interaction effects of family order and informal social control by the extended families. The findings suggest that IPV mothers are associated with child abuse and child neglect. The children are neglected in the home more and physical abuse occurs in the case, if mothers are abused by their husbands. The mother’s difficulties of being abused may lead them to neglect their children. The findings suggest that ‘family order’ is a significant protective factor against child maltreatment. The results suggest that if the family order is neither too high nor too low than that can play a role as a protective factor. Soft type of ISC is significantly associated with child maltreatment. This study suggests that the soft type of ISC by the extended families is a helpful approach to develop child protection in both the countries. This study is analyzed the data collected from Seoul and Kathmandu families and neighborhood study (SKFNS). Random probability cluster sample of married or partnered women in 20 Kathmandu wards and in Seoul 34 dongs were selected using probability proportional to size (PPS) sampling. Overall, the study is to make a comparative study of Korea and Nepal and examine how the cultural differences and similarities associate with the child maltreatment.

Keywords: child maltreatment, intimate partner violence, informal social control and family order Seoul, Kathmandu

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Authors: Raveena Naz

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The concept of ‘Corporate Social Responsibility’ (CSR) has often relied on firms thinking beyond their economic interest despite the larger debate of shareholder versus stakeholder interest. India gave legal recognition to CSR in the Companies Act, 2013 which promises better corporate governance. CSR in India is believed to be different for two reasons: the dominance of family business and the history of practice of social responsibility as a form of philanthropy (mainly among the family business). This paper problematises the actual structure of business houses in India and the role of CSR in India. When the law identifies each company as a separate business entity, the economics of institutions emphasizes the ‘business group’ consisting of a plethora of firms as the institutional organization of business. The capital owned or controlled by the family group is spread across the firms through the interholding (interlocked holding) structures. This creates peculiar implications for CSR legislation in India. The legislation sets criteria for individual firms to undertake liability of mandatory CSR if they are above a certain threshold. Within this framework, the largest family firms which are all part of family owned business groups top the CSR expenditure list. The interholding structures, common managers, auditors and series of related party transactions among these firms help the family to run the business as a ‘family business’ even when the shares are issued to the public. This kind of governance structure allows family owned business group to show mandatory compliance of CSR even when they actually spend much less than what is prescribed by law. This aspect of the family firms is not addressed by the CSR legislation in particular or corporate governance legislation in general in India. The paper illustrates this with an empirical study of one of the largest family owned business group in India which is well acclaimed for its CSR activities. The individual companies under the business group are identified, shareholding patterns explored, related party transactions investigated, common managing authorities are identified; and assets, liabilities and profit/loss accounting practices are analysed. The data has been mainly collected from mandatory disclosures in the annual reports and financial statements of the companies within the business group accessed from the official website of the ultimate controlling authority. The paper demonstrates how the business group through these series of shareholding network reduces its legally mandated CSR liability. The paper thus indicates the inadequacy of CSR legislation in India because the unit of compliance is an individual firm and it assumes that each firm is independent and only connected to each other through market dealings. The law does not recognize the inter-connections of firms in corporate governance structures of family owned business group and hence is inadequate in its design to effect the threshold level of CSR expenditure. This is the central argument of the paper.

Keywords: business group, corporate governance, corporate social responsibility, family firm

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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Authors: Rachel Ashwell, Sally Millett

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Introduction: Adequate post-operative pain relief is a key priority in the delivery of caesarean sections. This improves patient experience, reduces morbidity and enables optimal mother-infant interaction. Recommendations outlined in the NICE guidelines for caesarean section (CS) include offering peri-operative intrathecal/epidural diamorphine and post-operative opioid analgesics; offering non-steroidal anti-inflammatory drugs (NSAIDs) unless contraindicated and taking hourly observations for 12 hours following intrathecal diamorphine. Method: This audit assessed the provision of post-CS analgesia in 29 women over a two-week period. Indicators used were the use of intrathecal/epidural opioids, use of post-operative opioids and NSAIDs, frequency of observations and patient satisfaction with pain management on post-operative days 1 and 2. Results: All women received intrathecal/epidural diamorphine, 97% were prescribed post-operative opioids and all were prescribed NSAIDs unless contraindicated. Hourly observations were not maintained for 12 hours following intrathecal diamorphine. 97% of women were satisfied with their pain management on post-operative day 1 whereas only 75% were satisfied on day 2. Discussion: This service meets the proposed standards for the provision of post-operative analgesia, achieving high levels of patient satisfaction 1 day after CS. However, patient satisfaction levels are significantly lower on post-operative day 2, which may be due to reduced frequency of observations. The lack of an official audit standard for patient satisfaction on postoperative day 2 may result in reduced incentive to prioritise pain management at this stage.

Keywords: Caesarean section, analgesia, postoperative care, patient satisfaction

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Authors: Chukwunonso Igboamalu, Daprim Ogaji

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Background: With the limited number of trained health care providers in Nigeria, patent and proprietary medicine vendors (PPMVs) are inevitable and highly needed especially in the rural areas for the supply of drugs in treating minor illnesses. These vendors serve as a crucial link between the healthcare system and the community, aiding in the distribution of medications and healthcare information, particularly in areas with limited hospital infrastructure. Objectives: The study set to measure the participants’ knowledge, attitude and patient referral practice and any association of their characteristics with patient referral. Methodology: This cross-sectional descriptive survey was conducted among PPMVs in Obio-Akpor LGA of Rivers State. Data was collected using a self-administered structured questionnaire and analysed using SPSS version 25. Results: The study showed that 18.3% had adequate knowledge, 62.4% had moderate knowledge and 19.2% had poor knowledge. Attitude was moderate among 73.4% of the study participants with only 13% showing adequate attitude. In reporting their referral practice, 34% showed poor referral practice, 58% reported moderate practice and only 8% showed adequate practice. Conclusion: Various facilitators as well as barriers to patient referral were highlighted by the respondents. This study indicated that while attitude and practice were moderate among respondents, the percentage of PPMVs with the adequate knowledge of patient referral was high. To enhance the effectiveness of patient referrals, addressing barriers to referral and promoting education and training for PPMVs are critical steps forward.

Keywords: knowledge, attitude, practice, barriers, facilitators, patent medicine vendor, referral

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Authors: D. L. David, J. A. Wahedi, Q. T. Zaku

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A study was conducted at River Mayo Ranewo and River Lau, Taraba State Nigeria. The two rivers empty into the Upper Benue Basin. A visual encounter survey was conducted within the two wetlands from June to August, 2014. The fish record was based entirely on landings of fishermen, number of canoes that land fish was counted, types of nets and baits used on each sampling day. Fish were sorted into taxonomic groups, identified to family/species level, counted and weighed in groups. The relative species abundance was determined by dividing the number of species from a site by the total number of species from all tributaries/sites. Fish was preserved in 2% formaldehyde solution and taken to the laboratory, where they were identified. Shannon-Weiner index of species diversity indicated that the diversity was highest at River Mayo Ranewo than River Lau. In the result showed at River Mayo Ranewo, the family Mochokidae recorded the highest (23.15%), followed by Mormyridae (2.64%) and the least was the family Lepidosirenidae (0.04%). While at River Lau the family Mochokidae recorded the highest occurrence of (24.1%), followed by Bagridae (20.20%), and then Mormyridae, which also was the second highest in River Lau, with 18.46% occurrence. There was no occurrence of Malapteruridae and Osteoglossidae (0%) in River Lau, but the least occurrence was the family Gymnarchidae (0.04%). These results indicated that the fish composition were not significantly (p ≤ 0.05) different based on t-test.

Keywords: conservation, diversity index, Lau, Mayo Ranewo, wetlands

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Authors: Thevaranchany Sivaskaran

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Women entrepreneurs are the key players in the society and their contributions is highly highlighted to enhance economic stability in the country. In Sri Lanka, especially in North and East provinces people badly affected by war. Most of them are widows and women headed families. Due to this changing environment, Educational opportunities, and the support of NGO’s Most of the women have started their business and become entrepreneurs. Even though existing family setup and social setup entrepreneurial women are overburdened and difficult to balance their business and family roles. The research has been conducted on the experiences of women entrepreneurs with the family role support and work-life balance within the small and micro- enterprise sector in Jaffna, Srilanka. This study aims to identify that what extent the role of family support will be the tool to balancing work and life effectively and, secondly, the main challenges they face in achieving work-life balance. This is done by drawing on literatures including those on work-life balance, small-and micro enterprises, and entrepreneurship theories. To find out this objective, the data were collected from 50 entrepreneurs among the members of Jaffna women chamber in each GS division basis (cluster random sampling). A qualitative methodological technique and semi-structured interviews were used to collect the data for the case study on these entrepreneurs. The results indicate that the majority of entrepreneurs do not enjoy a sense of work-life balance because most of them are women headed family and they need to work hard to generate financial profit for the benefit of family. The motivation for them to work in this way is to provide basic needs. Results confirmed for others that support of husbands is very important. Mostly, emotional support (belief and empowerment) is exposed; however, getting financial contribution seems to be highly appreciated. More responsibilities which spouses were ready to take over regarding the home responsibilities (that is, childcare) should also not be neglected in the system of support to their entrepreneurial wives. Although, more important for all, women with children appreciated other members and spouses help and assistance to a higher extent. Results showed that majority of women who started their own business feel that in the first year of ope-ration the emotional support of family members was more important.

Keywords: family support, work life balance, women entrepreneurs, Jaffna District, Sri Lanka

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Authors: Lateef Bamidele

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Over the years, radiographic examinations are the most used diagnostic tools in the Nigerian health care system, but most diagnostic examinations carried out do not have records of patient doses. Lack of adequate information on patient doses has been a major hindrance in quantifying the radiological risk associated with radiographic examinations. This study aimed at estimating dose–area product (DAP) of patient examined in X-Ray units in selected hospitals in Southern Nigeria. The standard projections selected are chest posterior-anterior (PA), abdomen anterior-posterior (AP), pelvis AP, pelvis lateral (LAT), skull AP/PA, skull LAT, lumbar spine AP, lumbar spine, LAT. Measurement of entrance surface dose (ESD) was carried out using thermoluminescent dosimeter (TLD). Measured ESDs were converted into DAP using the beam area of patients. The results show that the mean DAP ranged from 0.17 to 18.35 Gycm². The results obtained in this study when compared with those of NRPB-HPE were found to be higher. These are an indication of non optimization of operational conditions.

Keywords: dose–area product, radiographic examinations, patient doses, optimization

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Authors: Zeinabossadat Hosseini, Fateme Qorbani

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The universal community has suffered from the lack of a sustainable and prosperous civilization in the world, and human distance from religious doctrines exposes the civilization of society to decline and collapse. To build a sustainable Islamic civilization, it is essential to understand and strengthen the core foundations of this subject. Islam, which claims to be integral in ensuring human prosperity and the creation of a new Islamic civilization, it can only develop this civilization if it has the necessary foundations. On the other hand, the family is one of the most important and effective foundations for effective individual and community life, and according to the influential role of the family on human behavioral and cognitive domains, it is impossible to define and explain the development of Islamic civilization without regard to the family category. The family can be effective in this important matter through its direct and indirect role in the education of individuals, and its members have the highest interaction and impact on each other. Development of the teachings of Islam in the form of verses and traditions can guide people towards the Islamic lifestyle and thus Islamic civilization and the Pure life (Tayyibah life-Al-Nahl/97). This article provides a descriptive-analytical approach to the conclusion that modern Islamic civilization promises the prosperity of the world and the hereafter. It will bring peace and prosperity to the world as well as advancement, fight against poverty, unity, and solidarity of Muslims, preservation of human dignity, as well as the growth of spirituality. It can also be deduced that the foundations of Islamic civilization in Qur'anic Tayyibah life and in today's term, the Islamic lifestyle, can be identified and implemented in the family structure, And the components of this blissful life can be found in this focus. The Tayyibah life will be realized by relying on the right faith and practice, paying attention to the rulings, divine command mentioned in the verses, as well as the traditions, altruism, nurturing a commitment to the community.

Keywords: family, development of modern Islamic civilization, quranic lifestyle, Tayyibah life

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Authors: Adel Hashlan

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Parent and family engagement plays a crucial role in supporting the success of students with special needs in educational settings. This paper explores the significance of parental involvement in special education, examining its impact on academic achievement, social-emotional development, and overall well-being. Drawing on a review of current literature and empirical research, the paper highlights the benefits of meaningful collaboration between educators, parents, and families in promoting positive outcomes for students with diverse learning needs. The abstract begins by establishing the importance of parent and family engagement in special education, emphasizing its multifaceted impact on student success. It then outlines the key components of effective parent and family involvement initiatives, including communication strategies, collaboration frameworks, and partnership-building approaches. Additionally, the abstract addresses common barriers to parental involvement and explores strategies for overcoming these challenges, such as cultural responsiveness, accessibility, and empowerment. Furthermore, the abstract discusses the implications of parent and family engagement for educational policy and practice, emphasizing the need for systemic support and resource allocation to facilitate meaningful partnerships between schools and families. It concludes by underscoring the importance of ongoing research and professional development efforts to enhance the effectiveness of parent and family engagement initiatives in special education and maximize the potential for student achievement and well-being. Overall, this paper contributes to the growing body of literature on parent and family engagement in special education, providing insights into best practices, challenges, and opportunities for fostering collaborative partnerships that support the diverse needs of students with disabilities.

Keywords: special education, autism, parent, school

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Authors: Mohamad Reza Khodabakhsh

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The present study investigated the effectiveness of attachment-based family therapy on maladaptive schemas and depressive symptoms of adolescence. This study was a quasi-experimental study, and a pre-test and post-test design with a control group were used. In this study, the study population included all adolescence. The sample consisted of 30 adolescents who were selected by the available sampling method. Then they were randomly divided into experimental (n = 15) and control (n = 15) groups. Data were collected in this study using the Beck Depression Inventory (1974) and the short form of Young's early maladaptive schema questionnaire (1988). After taking the pre-test, group implementation of family therapy based on attachment style was presented for 11 sessions of two and a half hours for two months in the experimental group. At the end of the sessions, both groups were retested, and the data were analyzed using analysis of covariance in SPSS-22 software. The results showed that attachment-based family therapy led to a significant reduction in maladaptive schemas, including emotional deprivation, rejection/abandonment, mistrust/abuse, social isolation, disability/shame, dependence/inadequacy, vulnerability/trauma, and depressive symptoms were compared to the control group. It can be concluded that this treatment has an effect on maladaptive schemas and symptoms of depression.

Keywords: attachment-based family therapy, maladaptive schemas, depressive symptoms, adolescence

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Authors: Jia Liu

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This article explores the shifting nature of physician-patient relationship in mainland China. Specifically, it takes the physician-patient relationship during the barefoot doctor program in 1968-1978, the marketization of healthcare services in 1978-2002, and the healthcare reform in 2003-2020 as three typical historical periods, illustrating how the nature of the physician-patient relationship has changed over time in mainland China. Drawing on recent jurisprudential literature that emphasizes the roles and functions done by and through obligation rather than right, it explores how the obligations of physicians and patients along with the implementation of informed consent, marketization of the healthcare system, and the basic healthcare reform have affected their relationship. One key feature of this article is that it analyzes the ways in which commodification and decommodification of healthcare have defined and in many different ways have determined the expectations and practices of physicians and patients, which illustrates how the trust between physicians and patients threatens to collapse and the bond between the citizen and the state fails to be firmly established in the mainland Chinese healthcare context. It also pays special attention to the role played by law and legal institutions—for instance, the implementation of informed consent and the liability law—in being complicit in facilitating the decoupling of the practices of physicians and patients from their ethical senses of obligation and undermining the bond (the trust relationship) between them.

Keywords: healthcare, marketization, physician-patient relationship, sense of obligation

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Authors: Matjaž Divjak, Simon Zelič, Aleš Holobar

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We present a dedicated video-based monitoring system for quantification of patient’s attention to visual feedback during robot assisted gait rehabilitation. Two different approaches for eye gaze and head pose tracking are tested and compared. Several metrics for assessment of patient’s attention are also presented. Experimental results with healthy volunteers demonstrate that unobtrusive video-based gaze tracking during the robot-assisted gait rehabilitation is possible and is sufficiently robust for quantification of patient’s attention and assessment of compliance with the rehabilitation therapy.

Keywords: video-based attention monitoring, gaze estimation, stroke rehabilitation, user compliance

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Authors: Sophia Shi

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Acute kidney injury (AKI) is the sudden onset of kidney damage in which the kidneys cannot filter waste from the blood, requiring emergency hospitalization. AKI patient mortality rate is high in the ICU and is virtually impossible for doctors to predict because it is so unexpected. Currently, there is no hybrid model predicting AKI that takes advantage of two types of data. De-identified patient data from the MIMIC-III database and de-identified kidney images and corresponding patient records from the Beijing Hospital of the Ministry of Health were collected. Using data features including serum creatinine among others, two numeric models using MIMIC and Beijing Hospital data were built, and with the hospital ultrasounds, an image-only model was built. Convolutional neural networks (CNN) were used, VGG and Resnet for numeric data and Resnet for image data, and they were combined into a hybrid model by concatenating feature maps of both types of models to create a new input. This input enters another CNN block and then two fully connected layers, ending in a binary output after running through Softmax and additional code. The hybrid model successfully predicted AKI and the highest AUROC of the model was 0.953, achieving an accuracy of 90% and F1-score of 0.91. This model can be implemented into urgent clinical settings such as the ICU and aid doctors by assessing the risk of AKI shortly after the patient’s admission to the ICU, so that doctors can take preventative measures and diminish mortality risks and severe kidney damage.

Keywords: Acute kidney injury, Convolutional neural network, Hybrid deep learning, Patient record data, ResNet, Ultrasound kidney images, VGG

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Authors: Maria Luz Macasinag

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This study aims to determine and to examine critically successful family-owned higher educational institutions towards identifying the attributes and practices that may likely have led to their success. This research is confined to private, non-sectarian, family-owned higher institutions of learning that have been operating for more than fifty years, had only one founder and had at least two transitions in terms of generation. The criteria for selecting family-owned universities to be part of the cases under investigation include institutions (1) with increasing enrollment over the past five years, with level III accreditation status, (3) with good performance in the Board examinations in most of its programs and (4) with high employability of graduates. The study uses the multiple case study method. A model based on the cross-case analysis of the attributes and practices of all the case studies of successful family- owned higher institutions of learning is the output. The paper provides insights to current and future school owners and administrators in the management of their institutions for competitiveness, sustainability and advancement. This research encourages the evaluation of how the ideas that may lead to the success of schools owned by families in developing a sense of community, a reciprocal relationship among colleagues, the students and other stakeholders will result to the attainment of the vision and mission of the school. The study is beneficial to entrepreneurs and to business students whose know-how may provide insights that would be helpful in guiding prospective school owners. The commission on higher education and the Department of Education stand to benefit from this academic paper for the guidance that they provide to family-owned educational institutions. Banks and other financial institutions may find valuable ideas from this academic paper for the purpose of providing financial assistance to colleges and universities that are family-owned. Researchers in the field of educational management and administration may be able to extract from this study related topics for future research.

Keywords: administration practices, attributes, family-owned schools, success factors

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Authors: Mark Andrew Tu, Raymond Olazo, Cybele Abad

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Cryptococcosis is an invasive infection most commonly found in patients who are immuno compromised. However, patients with this infection usually present with meningitis and rarely pulmonary infection in isolation. We present a case of a Filipino HIV patient who developed cryptococcal pneumonia without meningitis.

Keywords: Cryptococcal Pneumonia, HIV, Filipino, immune system

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Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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Authors: Shan Jiang

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Child aggression represents a significant global issue, with its familial determinants being crucial. Family is a vital context for child development, but prior research on the impact of parental assortative mating on child aggression is limited. This study investigates the effects of assortative mating on child aggression, elucidating the mediating mechanisms involved and examining gender-specific responses, within a substantial sample of 10,570 parents and their children, grades 1-6, in Hangzhou City, Zhejiang Province, China. The findings indicate that children exhibit a significant increase in aggressive behaviors when maternal income surpasses paternal income, contrasted with families where the father's income is higher. The study identifies family communication, co-parenting quality, and parental problem-solving strategies as significant mediators in the relationship between parental income/education differences and child aggression. This research contributes to understanding the parental influence on child behavior within the family system and offers valuable implications for child protection policy and intervention strategies.

Keywords: assortative mating, aggression, children, family

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Authors: Dina Hadad

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Women empowerment in the Arab world remains a central issue in the context of development and human rights. Akin to many societies around the globe, gender equality is yet to be achieved. This research will provide an introduction into the current legal stand of some Arab countries in terms of gender equality and women rights in the context of family law. It will look specifically into the recent family law in Kuwait and why many women consider it a positive step towards affirming their rights and their needs. Depending on comparative material from the area, the research argues that whilst some countries made efforts to promote women’s empowerment as a concept and practice throughout its policies, others have indeed some unique journeys that reflect organic and from within evolutions. Nonetheless, these efforts are yet to reflect a comprehensive structure that addresses women legal and political empowerment let alone social status. A contradiction in the realities of different Arab states is nothing new since the lack of comprehensive rights-based policy making in Arab countries has contributed to the disconnect between economic growth and development challenges.

Keywords: women empowerment, cultural challenges, gender equality, Islamic law, international standards, family law

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Authors: Ines Zemni, Maher Slimane, Jamel Ben Hassouna, Khaled Rahal

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Background: Neurofibromatosis type 1 (NF1) is a genetic disease, which is associated with an increased risk of developing different malignancies including breast cancer. The association between NF1 band breast sarcoma is a rare entity. Herein we present a 25-year-old woman with NF1 who had fibrosarcoma of the left breast. Case presentation: The patient has multiple thoraco-abdominal 'café au lait' spots. Clinical examination showed a lump of the left breast measuring 9 cm of diameter, which was noticed for 6 months. There was a left inguinal mass of 6 cm of diameter. The patient underwent first a left lumpectomy. Histopathological exam revealed a high-grade fibrosarcoma of the left breast measuring 7.5 cm. Three months later, the patient underwent a left mastectomy and excision of the inguinal mass, which was a neurofibroma. An adjuvant chemotherapy and radiation therapy were indicated, but not applied because of the timeout. The patient is now alive after a follow up of 6 years, with no loco-regional recurrence or metastasis. Conclusion: The relationship between NF1 and breast cancer need to be more clarified by further studies. Establishing a specific screening program of these patients may help to make an earlier diagnosis of breast cancer.

Keywords: neurofibromatosis, breast, sarcoma, cancer

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Authors: Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Caroline O. Laurence

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Introduction: Improving access to quality family planning services is the key to improving health of women and children. However, there is currently little evidence on the quality and scope of family planning services provided by private facilities, and this compares to the services provided in public facilities in Ethiopia. This is important, particularly in determining whether the government should further expand the roles of the private sector in the delivery of family planning facility. Methods: This study used the 2014 Ethiopian Services Provision Assessment Plus (ESPA+) survey dataset for comparing the structural aspects of quality of care in family planning services. The present analysis used a weighted sample of 1093 primary health care facilities (955 public and 138 private). This study employed logistic regression analysis to compare key structural variables between public and private facilities. While taking the structural variables as an outcome for comparison, the facility type (public vs private) were used as the key exposure of interest. Results: When comparing availability of basic amenities (infrastructure), public facilities were less likely to have functional cell phones (AOR=0.12; 95% CI: 0.07-0.21), and water supply (AOR=0.29; 95% CI: 0.15-0.58) than private facilities. However, public facilities were more likely to have staff available 24 hours in the facility (AOR=0.12; 95% CI: 0.07-0.21), providers having family planning related training in the past 24 months (AOR=4.4; 95% CI: 2.51, 7.64) and possessing guidelines/protocols (AOR= 3.1 95% CI: 1.87, 5.24) than private facilities. Moreover, comparing the availability of equipment, public facilities had higher odds of having pelvic model for IUD demonstration (AOR=2.60; 95% CI: 1.35, 5.01) and penile model for condom demonstration (AOR=2.51; 95% CI: 1.32, 4.78) than private facilities. Conclusion: The present study suggests that Ethiopian government needs to provide emphasis towards the private sector in terms of providing family planning guidelines and training on family planning services for their staff. It is also worthwhile for the public health facilities to allocate funding for improving the availability of basic amenities. Implications for policy and/ or practice: This study calls policy makers to design appropriate strategies in providing opportunities for training a health care providers working in private health facility.

Keywords: quality of care, family planning, public-private, Ethiopia

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Authors: Sascha Kraus, Wolfgang Hora, Philipp Stieg, Thomas Niemand, Ferdinand Thies, Matthias Filser

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In most countries, small and medium-sized enterprises (SME) are the backbone of the economy due to their impact on job creation, innovation and wealth creation. Moreover, the ongoing globalization makes it inevitable – even for SME that traditionally focused on their domestic markets – to internationalize their business activities to realize further growth and survive in international markets. Thus, internationalization has become one of the most common growth strategies for SME and has received increasing scholarly attention over the last two decades. One the downside internationalization can be also regarded as the most complex strategy that a firm can undertake. Particularly for family firms, that are often characterized by limited financial capital, a risk-averse nature and limited growth aspirations, it could be argued that family firms are more likely to face greater challenges when taking the pathway to internationalization. Especially the triangulation of family, ownership, and management (so-called ‘familiness’) manifests in a unique behavior and decision-making process which is often characterized by the importance given to noneconomic goals and distinguishes a family firm from other businesses. Taking this into account, the concept of socio-emotional wealth (SEW) has been evolved to describe the behavior of family firms. In order to investigate how different internal and external firm characteristics shape internationalization success of family firms, we drew on a sample consisting of 297 small and medium-sized family firms from Germany, Austria, Switzerland, and Liechtenstein. Thus, we include SEW as essential family firm characteristic and added the two major intra-organizational characteristics, entrepreneurial orientation (EO), absorptive capacity (AC) as well as collaboration intensity (CI) and relational knowledge (RK) as two major external network characteristics. Based on previous research we assume that these characteristics are important to explain internationalization success of family firm SME. Regarding the data analysis, we applied a Fuzzy Set Qualitative Comparative Analysis (fsQCA), an approach that allows identifying configurations of firm characteristics, specifically used to study complex causal relationships where traditional regression techniques reach their limits. Results indicate that several combinations of these family firm characteristics can lead to international success, with no permanently required key characteristic. Instead, there are many roads to walk down for family firms to achieve internationalization success. Consequently, our data states that family owned SME are heterogeneous and internationalization is a complex and dynamic process. Results further show that network related characteristics occur in all sets, thus represent an essential element in the internationalization process of family owned SME. The contribution of our study is twofold, as we investigate different forms of international expansion for family firms and how to improve them. First, we are able to broaden the understanding of the intersection between family firm and SME internationalization with respect to major intra-organizational and network-related variables. Second, from a practical perspective, we offer family firm owners a basis for setting up internal capabilities to achieve international success.

Keywords: entrepreneurial orientation, family firm, fsQCA, internationalization, socio-emotional wealth

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Authors: Michel T. Leger, Shawn Martin

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Leading an ecologically responsible lifestyle represents a difficult challenge. Though research in environmental education does point to an increase in the intention to act more responsibly towards the environment, this intent does not seem to translate to concrete ecological action. This mixed methods collective case study explores the adoption of ecological actions in the family, a context of socio-ecological transformation rarely examined in the scientific literature. More specifically, it takes into account the popular use of social media today to explore the potential role social media, namely Facebook, in promoting environmental action. In other words, for families who are intent on adopting an ecologically friendly lifestyle, could the use of Facebook positively affect the way family members relate to the environment and bring about real change in their daily household actions? To answer this question, twenty-one families living in an urban setting were recruited and then divided them into two distinct groups. The first group of families attempted to lower their household electrical bill as part of a private Facebook group, while the other aimed to do the same, but without the directed use of social media. For both groups, we recorded the amount of kilowatt-hours used during the project as well as the amount used for the same months the previous year, adjusting for temperature variations. Exit interviews were also conducted with each family in order to try to understand the processes of eco-citizenship development in the context of family. Results seem to suggest that both virtual social networks and one-on-one support can help to increase environmental awareness in participating family. Interestingly, families from the Facebook group seemed to demonstrate a higher degree of environmental engagement, and younger family members in this group were more active in the processes of collective behavioral change.

Keywords: environmental education, family-based eco-citizenship, social media, case study

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Authors: Lemi Tolu

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Background: Postpartum family planning (PPFP) focuses on the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth. Objective: This study assesses the barriers to uptake of long-term and permanent family planning methods among immediate post-partum mothers at Saint Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. Methodology: An institution-based cross-sectional study was conducted from January 1 to June 30, 2017. The six months of study were used as strata, and systematic sampling used to select participants in each month. Post-partum mothers were interviewed using pretested structured questionnaires. Data entry and analysis were done using SPSS version 17. Bivariate and multivariable logistic regressions were fitted to identify determinants of post-partum family planning uptake. An OR with 95% CIs was calculated, and p values set at 005 were used to determine the statistical significance of associations. Results: Four hundred and twenty-two post-partum women were interviewed. Two hundred sixty-eight (63%) women received counselling on family planning, and 241 (66.8 %) got information about contraception. One hundred and fifty-two (45%) of the women accepted long-term and permanent contraception on their immediate postpartum period before discharge. Contraceptive counselling (OR = 2.13, 95% CI 1.004-3.331), getting information from the health facility (OR = 15.15, 95% CI 1.848-19.242), and partner support (OR = 1.367, 95% CI 1.175-2.771) were significantly associated with long-term and permanent contraception uptake. Conclusion: Postpartum counselling on family planning and provision of contraception information improve immediate postpartum FP acceptance, and, hence postpartum programs need to strengthen such services.

Keywords: contraception, immediate postpartum, long-term family planning, post-partum family planning

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Authors: Mariam Anwaar, Kiran B. Ahmad

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Borderline Personality Disorder (BPD) is an invasive presence of affect instability, disturbance in self-concept and attachment in relationships. The profound indicator is the dichotomous approach of the world in which the ego categorizes individuals, especially their significant others, into secure or threatful beings, leaving little room for a complex combination of characteristics in one person. This defense mechanism of splitting their world has been described through the explanatory model of unconscious conflict theorized by Sigmund Freud’s Electra Complex in the Phallic Stage. The central role is of the father with whom the daughter experiences penis envy, thus identifying with the mother’s characteristics to receive the father’s attention. However, Margret Mahler, an object relation theorist, elucidates the central role of the mother and that the split occurs during the pre-Electra complex stage. Amid the 14 and 24 months of the infant, it acknowledges the world away from the mother as they have developed milestones such as crawling. In such novelty, the infant crawls away from the mother creating a sense of independence (individuation). On the other hand, being distant causes anxiety, making them return to their original object of security (separation). In BPD, the separation-individuation stage is disrupted, due to contradictory actions of the caregiver, which results in splitting the object into negative and positive aspects, repressing the former and adhering to the latter for survival. Thus, with time, the ego distorts the reality into dichotomous categories, using the splitting defenses, and the mental representation of the self is distorted due to the internalization of the negative objects. The explanatory model was recognized in the case study of Fizza, at 21-year-old Pakistani female, residing in Karachi. Her marital status is single with an occupation being a dental student. Fizza lives in a nuclear family but is surrounded by her extended family as they all are in close vicinity. She came with the complaints of depressive symptoms for two-years along with self-harm due to severe family conflicts. Through the intervention of Dialectical Behavior Therapy (DBT), the self-harming actions were reduced, however, this libidinal energy transformed into claustrophobic symptoms and, along with this, Fizza has always experienced vivid dreams. A retrospective method of Jungian dream-analysis was applied to locate the origins of the splitting in the unconscious. The result was the revelation of a sexual harassment trauma at the age of six-years which was displaced in the form of self-harm. In addition to this, the presence of a conflict at the separation-individuation stage was detected during the dream-analysis, and it was the underlying explanation of the claustrophobic symptoms. This qualitative case study implicates the use of a patient’s subjective experiences, such as dreams, to journey through the spiral of the unconscious in order to not only detect repressed memories but to use them in psychotherapy as a means of healing the patient.

Keywords: borderline personality disorder, dream-analysis, Electra complex, separation-individuation, splitting, unconscious

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