Search results for: extension health professionals

Authors: E. Nakamachi, S. Tanaka, K. Yamamoto, Y. Morita

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In this study, we developed a three-dimensional (3D) direct current electric field (DCEF) stimulation bio-reactor for axonal outgrowth enhancement to generate the neural network of the central nervous system (CNS). By using our newly developed 3D DCEF stimulation bio-reactor, we cultured the rat pheochromocytoma cells (PC12) and investigated the effects on the axonal extension enhancement and network generation. Firstly, we designed and fabricated a 3D bio-reactor, which can load DCEF stimulation on PC12 cells embedded in the collagen gel as extracellular environment. The connection between the electrolyte and the medium using salt bridges for DCEF stimulation was introduced to avoid the cell death by the toxicity of metal ion. The distance between the salt bridges was adopted as the design variable to optimize a structure for uniform DCEF stimulation, where the finite element (FE) analyses results were used. Uniform DCEF strength and electric flux vector direction in the PC12 cells embedded in collagen gel were examined through measurements of the fabricated 3D bio-reactor chamber. Measurement results of DCEF strength in the bio-reactor showed a good agreement with FE results. In addition, the perfusion system was attached to maintain pH 7.2 ~ 7.6 of the medium because pH change was caused by DCEF stimulation loading. Secondly, we disseminated PC12 cells in collagen gel and carried out 3D culture. Finally, we measured the morphology of PC12 cell bodies and neurites by the multiphoton excitation fluorescence microscope (MPM). The effectiveness of DCEF stimulation to enhance the axonal outgrowth and the neural network generation was investigated. We confirmed that both an increase of mean axonal length and axogenesis rate of PC12, which have been exposed 5 mV/mm for 6 hours a day for 4 days in the bioreactor. We found following conclusions in our study. 1) Design and fabrication of DCEF stimulation bio-reactor capable of 3D culture nerve cell were completed. A uniform electric field strength of average value of 17 mV/mm within the 1.2% error range was confirmed by using FE analyses, after the structure determination through the optimization process. In addition, we attached a perfusion system capable of suppressing the pH change of the culture solution due to DCEF stimulation loading. 2) Evaluation of DCEF stimulation effects on PC12 cell activity was executed. The 3D culture of PC 12 was carried out adopting the embedding culture method using collagen gel as a scaffold for four days under the condition of 5.0 mV/mm and 10mV/mm. There was a significant effect on the enhancement of axonal extension, as 11.3% increase in an average length, and the increase of axogenesis rate. On the other hand, no effects on the orientation of axon against the DCEF flux direction was observed. Further, the network generation was enhanced to connect longer distance between the target neighbor cells by DCEF stimulation.

Keywords: PC12, DCEF stimulation, 3D bio-reactor, axonal extension, neural network generation

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Authors: Laila Vivas

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Fossil Health is proposed as a value-concept to describe the hegemonic health paradigms that underpin health enactment. Such representation is justified by Foucaldian and related ideas on biopower and biosocialities, calling for the politicization of health and signalling the importance of narratives. This approach, hence, enables contemplating health paradigms as reflexive or co-constitutive of health itself or, in other words, conceiving health as a verb. Fossil health is a symbolic representation, influenced by Andreas Malm’s concept of fossil capitalism, that integrates environment and health as non-dichotomic areas. Fossil Health sustains that current notions of human and non-human health revolve around fossil fuel dependencies. Moreover, addressing disequilibria from established health ideals involves fossil-fixes. Fossil Health, therefore, represents causes and consequences of a health conception that has the agency to contribute to the functioning of a particular structural eco-social model. Moreover, within current capitalist relations, Fossil Health expands its meaning to cover not only fossil implications but also other dominant paradigms of the capitalist system that are (re)produced through health paradigms, such as the burgeoning of technoscience and biomedicalization, privatization of health, expertization of health, or the imposing of standards of uniformity. Overall, Fossil Health is a comprehensive approach to environment and health, where understanding hegemonic health paradigms means understanding our (human-non-human) nature paradigms and the structuring effect these narratives convey.

Keywords: fossil health, environment, paradigm, capitalism

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Authors: Matthew Sedgwick

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Introduction: Social media continues to grow in popularity and Instagram is one of the largest platforms available. It provides an invaluable method of communication between health care professionals and patients. Both patients and dentists can benefit from seeing clinical cases posted by other members of the profession. It can prompt discussion about how the outcome was achieved and showcases what is possible with the right techniques and planning. This study aimed to identify what people were posting about the topic ‘veneers’ and inform health care professionals as to what content had the most engagement and make recommendations as to how to improve the quality of social media posts. Design: 150 consecutive posts for the search term ‘veneers’ were analyzed retrospectively between 21st October 2021 to 31st October 2021. Non-English language posts duplicated posts, and posts not about dental veneers were excluded. After exclusions were applied, 80 posts were included in the study for analysis. The content of the posts was analyzed and coded and the main themes were identified. The number of comments, likes and views were also recorded for each post. Results: The themes were: before and after treatment, cost, dental training courses, treatment process and trial smiles. Dentists were the most common posters of content (82.5%) and it was interesting to note that there were no patients who posted about treatment in this sample. The main type of media was photographs (93.75%) compared to video (6.25%). Videos had an average of 45,541 views and more comments and likes than the average for photographs. The average number of comments and likes per post were 20.88 and 761.58, respectively. Conclusion: Before and after photographs were the most common finding as this is how dentists showcase their work. The study showed that videos showing the treatment process had more engagement than photographs. Dentists should consider making video posts showing the patient journey, including before and after veneer treatment, as this can result in more potential patients and colleagues viewing the content. Video content could help dentists distinguish their posts from others as it can also be used across other platforms such as TikTok or Facebook reaching a wider audience. More informative posts about how the result has shown are achieved required, including potential costs. This will help increase transparency regarding this treatment method, including the financial and potential biological cost to teeth. As a result, this will improve patient understanding and become an invaluable adjunct in informed consent.

Keywords: content analysis, dental veneers, Instagram, social media

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Authors: Kathleen Canul

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Bullying is on the rise according to several recent studies. Workplace bullying has garnered less attention than other forms yet incidence rates range from 35-45%. The consequences of being bullied at work are broad, ranging from physiological to psychological to occupational. As the bullying progresses, employees begin to exhibit physical and psychological symptoms. Blood pressure rises, along with other cardiac related concerns. For men, covert coping with job unfairness was associated with a four-fold risk of heart attack and death. Gastrointestinal distress, headaches, muscle tension, sleep disorders and exhaustion are also common. Workplace bullying appears to contribute to the risk of subsequent psychotropic medication, as well. Emotionally, anxiety and depression increase along with lowered self-esteem and problems concentrating on the duties of the job. In an attempt to cope, individuals may succumb to unhealthy practices involving food, alcohol and other drugs. Patterns of bullying vary by gender, race, and ethnicity, as well as sexual orientation, with women, ethnic minorities and LGBTQ employees reporting higher rates of bullying in the workplace. Not only is this an issue of inequity on the job, but also a problem of health disparities as there are few mental health professionals confident and competent in dealing with workplace bullying issues, and the lack of culturally competent clinicians exacerbates this inequality in receiving adequate care. Alone, the topic of workplace bullying is not unique; however, the diverse experiences of underrepresented groups who disproportionately are affected on the job and suffer untreated, health related concerns represent a significant and emerging problem requiring attention. Conference participants who have experienced, witnessed or help those bullied on the job would benefit most from this review of the literature on the consequences of bullying experienced by diverse and underrepresented groups in the workplace.

Keywords: bullying, ethnic minorities, health disparities, workplace conflict

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Authors: Budi Purnomo, Karen M. Fernandez

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The creation of an ASEAN Community in 2015 is definitely one thing to look forward to. Integration may have birth pains in the beginning but at the end of the day, there are many opportunities that each member-state can take advantage that will benefit the people of ASEAN. Once fully integrated in 2015, ASEAN-certified tourism professionals who pass the common competency standards may find employment in various divisions of labor that are common across various sectors of tourism in member countries. At present, there are six labor divisions where tourism professionals may find employment in ASEAN member countries: namely Front Office; Housekeeping; Food Production; Food and Beverage Services (for Hotel Services); Travel Agency; and Tour Operations (for Travel Services Division). The study attempts to assess the readiness of Indonesian and Filipino students prospective skilled and educated tourism labors to work in ASEAN member countries by 2015. The data sources are obtained from a researcher-designed questionnaire and in-depth interview to reveal the interest of Indonesian and Filipino students to work in other ASEAN member states. The questionnaires were distributed to 240 third and fourth year students who are currently enrolled at the leading tourism institutes/universities in Indonesia and Philippines. The findings of the study will reveal the fulfillment of the requirements to work in ASEAN member-states, the comparison of existing tourism management curricula of Indonesia and Philippines to the Common ASEAN Curriculum (CATC) and Regional Qualifications Framework and Skills Recognition System (RQFSRS) which supports the policies of the Ministry of Tourism and Creative Economy of the Republic of Indonesia and the Department of Tourism and Department of Labor and Employment of the Republic of the Philippines.

Keywords: ASEAN economic community, prospective skilled and educated tourism labors, tourism labor movement, ASEAN certified-tourism professionals

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Authors: Sideri Katerina, Chanania Eleni

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The reasons why people remain unvaccinated, especially health workers, are complex. In Greece, 2 percent of health workers (around 7,000) remain unvaccinated, despite the fact that for this group of people vaccination against COVID-19 is mandatory. In April 2022, the Greek health minister repeated that unvaccinated health care workers will remain suspended from their jobs ‘for as long as the pandemic lasts,’ explaining that the suspension of the workers in question was ‘entirely their choice’ and that health professionals who do not believe in vaccines ‘do not believe in their own science.’ Although policy circles around the world often link vaccine hesitancy to ignorance of science or misinformation, various recently published qualitative studies show that vaccine hesitancy is the result of a combination of factors, which include distrust towards elites and the system of innovation and distrust towards government. In a similar spirit, some commentators warn that labeling hesitancy as “anti-science” is bad politics. In this paper, we worked within the tradition of STS taking the view that people draw upon personal associations to enact and express civic concern with an issue, the enactment of public concern involves the articulation of threats to actors’ way of life, personal values, relationships, lived experiences, broader societal values and institutional structures. To this effect, we have conducted 27 in depth interviews with unvaccinated Greek health workers and we are in the process of conducting 20 more interviews. We have so far found that rather than a question of believing in ‘facts’ vaccine hesitancy reflects deep distrust towards those charged with the making of decisions and pharmaceutical companies and that emotions (rather than rational thinking) play a crucial role in the formation of attitudes and the making of decisions. We need to dig deeper so as to understand the causes of distrust towards technical government and the ways in which public(s) conceive of and want to be part in the politics of innovation. We particularly address the question of the effectiveness of mandatory vaccination of health workers and whether such top-down regulatory measures further polarize society, to finally discuss alternative regulatory approaches and governance structures.

Keywords: vaccine hesitancy, innovation, trust in vaccines, sociology of vaccines, attitude drivers towards scientific information, governance

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

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

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

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Authors: Paivi Hietanen

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At family with children, divorce is a risk for a child to lose the relationship to the parent with whom the child doesn't live. A child has the right to the get care from both parents after the divorce. Even though your ex-spouse isn’t longer your companion, to the child he or she is still unique as a parent and parents must cooperate and support their child in the new family situation. To divorcee, it's necessary to understand the difference between the intimate relationship that ends and parenthood that continues. Cooperative parenting takes a lot of effort and flexibility for the parents to make joint custody work well. It is vital that parents get help to understand the situation from child points of view. When parent is facing divorce, and all the emotions that it brings along, can the child easily be forgotten. To help children, we must help parents to understand, that a relationship can end, parenthood cannot. As professionals, we should help the parents to see the significance and value of both parents to the child and try to support and protect parenthood-relationship between parents. The Federation of Mother and Child Homes and Shelters have developed group models to work with parents during or after divorce. These support groups are led by professionals, but peer support is also used. These support groups have been held over 10 years and there are found from 20 different cities in Finland. Eroneuvo event (divorce advice) service is intended for parents who are considering or have already divorced. The Vanhemman neuvo (parents' council) is a peer support group that helps parents with post-divorce parenting issues. From these groups, parents receive information and peer support for matters related to divorcing and how to support the child and do co-parenting. At the groups and in given information for divorced parents, is used a method called the 'Irreversible triangle'. It's a way to picture the intimate relationship and parenthood after the divorce and what is the difference between these two things. 'Irreversible triangle' is used to help parents and professionals to understand, what happens if a child loses the relationship to the other parent or if parents co-parenting doesn't work well. From the largely collected feedback, group members tell that they feel themselves relieved after taking part of the group. Parents also experience that talking with other parents helps to survive. Group members learn to co-operate with the other parent, and they'll also learn to see the best interest of the child after the divorce. Parents would highly recommend these groups to other parents.

Keywords: child's right, co-parenting, parenthood after the divorce, peer support

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Authors: Anthony R. Townsend, Robyn L. Fasser

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This research project provides an interpretative phenomenological analysis of a proposed conceptual model of parenting ability that has been designed to offer recommendations to guide intervention in child custody evaluations in South Africa. A recent review of the literature on child custody evaluations reveals that while there have been significant and valuable shifts in the capacity of the legal system aided by mental health professionals in understanding children and family dynamics, there remains a conceptual gap regarding the nature of parenting ability. With a view to addressing this paucity of a theoretical basis for considering parenting ability, this research project reviews a dimensional model for the assessment of parenting ability by conceiving parenting ability as a combination of good parenting and parental fitness. This model serves as a conceptual framework to guide child-custody evaluation and refine intervention in such cases to better meet the best interests of the child in a manner that bridges the professional gap between parties, legal entities, and mental health professionals. Using a model of good parenting as a point of theoretical departure, this model incorporates both intra-psychic and interpersonal attributes and behaviours of parents to form an impression of parenting ability and identify areas for potential enhancement. This research, therefore, hopes to achieve the following: (1) to provide nuanced descriptions of parents’ parenting ability; (2) to describe parents’ parenting potential; (3) to provide a parenting assessment tool for investigators in forensic family matters that will enable more useful recommendations and interventions; (4) to develop a language of consensus for investigators, attorneys, judges and parents, in forensic family matters, as to what comprises parenting ability and how this can be assessed; and (5) that all of the aforementioned will serve to advance the best interests of the children involved in such litigious matters. The evaluative promise and post-assessment prospects of this model are illustrated through three interlinking data sets: (1) the results of interviews with South African psychologists about the model, (2) retrospective analysis of care and contact evaluation reports using the model to determine if different conclusions or more specific recommendations are generated with its use and (3) the results of an interview with a psychologist who piloted this model by using it in care and contact evaluation.

Keywords: alienation, attachment, best interests of the child, care and contact evaluation, children’s act (38 of 2005), child custody evaluation, civil forensics, gatekeeping, good parenting, good-enough parenting, health professions council of South Africa, family law, forensic mental healthcare practitioners, parental fitness, parenting ability, parent management training, parenting plan, problem-determined system, psychotherapy, support of other child-parent relationship, voice of the child

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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A core challenge of physician assistant education is preparing professionals for lifelong learning. While this conventionally has encompassed scientific advances, students must also embrace new care delivery models and technologies. Telemedicine, the provision of care via two-way audio and video, is an example of a technological advance reforming health care. During a three-semester sequence of Hospital Community Experiences, physician assistant students were assigned experiences with Answer Health on Demand, a telemedicine collaborative. Preceding the experiences, the agency lectured on the application of telemedicine. Students were then introduced to the technology and partnered with a provider. Prior to observing the patient-provider interaction, patient consent was obtained. Afterwards, students completed a reflection paper on lessons learned and the potential impact of telemedicine on their careers. Thematic analysis was completed on the students’ reflection papers (n=13). Preceding the lecture and experience, over 75% of students (10/13) were unaware of telemedicine. Several stated they were 'skeptical' about the effectiveness of 'impersonal' health care appointments. After the experience, all students remarked that telemedicine will play a large role in the future of healthcare and will provide benefits by improving access in rural areas, decreasing wait time, and saving cost. More importantly, 30% of students (4/13) commented that telemedicine is a technology they can see themselves using in their future practice. Initial results indicate that collaborative interaction between students and telemedicine providers enhanced student learning and exposed students to technological advances in the delivery of care. Further, results indicate that students perceived telemedicine more favorably as a viable delivery method after the experience.

Keywords: collaboration, physician assistant education, teaching innovative health care delivery method, telemedicine

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Authors: Elaheh Ezami, Behzad Mohammadian, Elham Aznab

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Health service design will need to change due to bringing in new digital health tools. This highlights the importance of innovation in adopting Health Information Technology (HIT). It can be argued that innovation in the health sector correlates with entrepreneurship. Various reasons exist for health entrepreneurs to advocate increased investment in HIT to compensate for shortcomings in the health sector and improve the quality of healthcare. Furthermore, every innovative program presents challenges and motivations for entrepreneurs that may distract or encourage the adoption of technology. Our study used a systematic literature review to identify relevant articles that defined the frustrations and promotions of using health information technology in organizations or enterprises. A meta-analysis of the articles was conducted to identify the factors driving or pulling entrepreneurs to use HIT.

Keywords: health information technology, health entrepreneurship, health enterprise, health entrepreneurs' innovation

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Authors: Gabriela Smeckova

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The entire world is becoming more and more diverse. The reasons why people migrate are different and unique for each family /individual. Professionals delivering services (including speech-language pathologists) must be prepared to work with clients coming from different cultural and/or linguistic backgrounds. Well-educated speech-language pathologists will consider many factors when delivering services. Some of them will be discussed during the presentation (language spoken, beliefs about health care and disabilities, reasons for immigration, etc.). The communication styles of the client can be different than the styles of the speech-language pathologist. The goal is to become culturally responsive in service delivery.

Keywords: culture, cultural competence, culturallly responsive practices, speech-language pathologist, cultural and linguistical variables, communication styles

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Authors: Tien-Hui Chiang, Q. Zhou

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For structural-functionalism, one set of the common traits of traditional professionals, such as medical practitioners and engineers, can be viewed as the criteria for evaluating whether a given occupation has the right of claiming its professional status or not. Under the influence of this professionalism, teaching practitioners have devoted themselves to acquiring this right as evidenced by the fact that initial training has been extended to even the level of postgraduate. However, for interactionalists, professionalism adopts a predetermined assumption so that it ignores the dynamic nature of social development, which is able to regulate the professional status of a given occupation. Such an interactive approach highlights the concept of professionalization. Furthermore, Marxists argue that structural-functionalists have ignored the impact of proletarianization on the white collar. While professionals gradually lose their control over their practices, the title of profession functions as a self-regulated icon that prevents them from collaborating with the working class and, in turn, creates the ideology of de-politicization sustaining the interests of the ruling class. This article adopts a theoretical analysis on these contradictory arguments. It argues that these criticisms neglect the influence of the institutionalized value system on social operation, which is the core element in sustaining the notion of the profession.

Keywords: teaching profession, professionalism, professionalization, proletarianialization, institutionalized value system

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Authors: Cathy Basterfield

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Issue: To engage in one’s own health care, health professionals need to be aware of an individual’s specific skills and abilities for best communication. One of the most discussed is health literacy. One of the assumed skills and abilities for adults is an individuals’ health literacy. Background: A review of publicly available health content appears to assume all adult readers will have a broad and full capacity to read at a high level of literacy, often at a post-school education level. Health information writers and clinicians need to recognise one critical area for why there may be little or no change in a person’s behaviour, or no-shows to appointments. Perhaps unintentionally, they are miscommunicating with the majority of the adult population. Health information contains many literacy domains. It usually includes technical medical terms or jargon. Many fact sheets and other information require scientific literacy with or without specific numerical literacy. It may include graphs, percentages, timing, distance, or weights. Each additional word or concept in these domains decreases the readers' ability to meaningfully read, understand and know what to do with the information. An attempt to begin to read the heading where long or unfamiliar words are used will reduce the readers' motivation to attempt to read. Critically people who have low literacy are overwhelmed when pages are covered with lots of words. People attending a health environment may be unwell or anxious about a diagnosis. These make it harder to read, understand and know what to do with the information. But access to health information must consider an even wider range of adults, including those with poor school attainment, migrants, and refugees. It is also homeless people, people with mental health illnesses, or people who are ageing. People with low literacy also may include people with lifelong disabilities, people with acquired disabilities, people who read English as a second (or third) language, people who are Deaf, or people who are vision impaired. Outcome: This paper will discuss Easy English, which is developed for adults. It uses the audiences’ everyday words, short sentences, short words, and no jargon. It uses concrete language and concrete, specific images to support the text. It has been developed in Australia since the mid-2000s. This paper will showcase various projects in the health domain which use Easy English to improve the understanding and functional use of written information for the large numbers of adults in our communities who do not have the health literacy to manage a range of day to day reading tasks. See examples from consent forms, fact sheets and choice options, instructions, and other functional documents, where Easy English has been developed. This paper will ask individuals to reflect on their own work practice and consider what written information must be available in Easy English. It does not matter how cutting-edge a new treatment is; when adults can not read or understand what it is about and the positive and negative outcomes, they are less likely to be engaged in their own health journey.

Keywords: health literacy, inclusion, Easy English, communication

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Authors: Mohammad Abdul Momin, Sekender Ali, Mahbubul Alam, Rafiquel Islam, Mohammad Mizanul Haque Kazal

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Improved high-yielding modern rice varieties can reduce hunger and food insecurity in Bangladesh. However, lower adoption and higher adoption gap of modern rice varieties are the main concerns of rice researchers, extension specialists, and legislators. This study attempts to determine the adoption status and adoption gap of 10 selected BRRI-released Boro rice varieties to assess some selected socio-economic characteristics of the rice farmers and to explore the contribution of the selected socio-economic characteristics of farmers to their adoption gap of selected BRRI-released Boro varieties. Necessary data were collected from 03 September to 31 December 2021 using a well-structured pre-tested interview schedule from 371 randomly selected farmers covering 12 agricultural blocks of four Upazilas under Cumilla, Mymensingh, Tangail, and Bogura districts. The study revealed that most (73.05%) of the rice farmers had high adoption and low adoption gap; 23.72% had moderate adoption and adoption gap; and the rest 3.23% of respondents’ farmers had low adoption and high adoption gap of BRRI-released Boro rice varieties. Overall adoption and adoption gap of BRRI-released Bororice varieties were 77.02% and 22.98%, respectively. Based on the descending order of the Adoption Index, BRRI dhan29 ranked 1st, followed by BRRI dhan28. The adoption indices of these two top-ranked varieties were 38.84 and 30.43, respectively, which were much higher than others. Third to ninth ranked varieties were BRRI dhan58, BRRI dhan89, BRRI dhan88, BRRI dhan50, BRRI dhan74, BRRI dhan81, and BRRI dhan63. Reverse-ranked orders were observed based on the descending order of the Adoption Gap Index (AGI). Stepwise multiple regression analysis indicated that ‘knowledge on BRRI-released Boro rice varieties’, ‘extension contacts’, ‘rice farming profitability’, ‘rice farming experience’, and ‘satisfaction on BRRI-releasedBoro rice varieties’ of the farmers had a significant negative contribution to their adoption gap, i.e., positive contribution to their adoption of BRRI-released Boro rice varieties. The study concluded that policy interventions should be taken to improve farmers’ knowledge of BRRI-releasedBoro rice varieties by increasing extension contact to all the lower and higher experienced farmers to make them profitable and satisfied to increase adoption and decrease the adoption gap of BRRI-released Boro rice varieties. These issues also urge policy interventions for the rethinking of current dissemination tactics to ensure the widespread adoption of newly released modern Boro rice varieties at the farm level.

Keywords: adoption, adoption gap, Boro, rice, BRRI, Bangladesh

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Authors: David Yartel

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Drawing on the current state of software engineering and information technology in Ghana, the study documents its significant contribution to the development of Ghanaian industries. The study focuses on the application of modern trends in technology and the barriers faced in the area of software engineering and information technology. A thorough analysis of a dozen of interviews with stakeholders in software engineering and information technology via interviews reveals how modern trends in software engineering pose challenges to the industry in Ghana. Results show that to meet the expectation of modern software engineering and information technology trends, stakeholders must have skilled professionals, adequate infrastructure, and enhanced support for technology startups. Again, individuals should be encouraged to pursue a career in software engineering and information technology, as it has the propensity to increase the efficiency and effectiveness of work-related activities. This study recommends that stakeholders in software engineering and technology industries should invest enough in training more professionals by collaborating with international institutions well-versed in the area by organizing frequent training and seminars. The government should also provide funding opportunities for small businesses in the technology sector to drive creativity and development in order to bring about growth and development.

Keywords: software engineering, information technology, Ghana, development

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Authors: Parya Salimitari, Farhad Tabatabai Ghomsheh, Siyamak Khorramymehr, Hossein Taghadosi, Mohammad Hossein Dashti

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The aim of this study was to evaluate the effect of heel height on the knee joint direction in Genu recurvatum patients compared to normal state. The test was performed on a patient with Genu recurvatum and a healthy person with similar and match biomechanical conditions. Subjects were tested under six different positions of shoes with heels 0, 1, 2, 3, 4 and 5 cm after marking during the gate. The results of the spatial temporal geometry obtained from Vicon Motion System (six-camera T10 model, Oxford Metrics Ltd., Oxford, UK), and were used to compute and analyze the kinematic results. In this study, we tried to determine the effect of shoe heel intervention on knee joint direction correction. The results indicate that the 1 cm heel has been optimized and significantly improved in knee joint flexion and flexion-extension angle so that the difference in knee flexion-extension angle between the patient and the healthy person at some stages of walking has reached zero (good posture). The 3 cm heel compared with the 0 cm heel has reduced the knee recurvatum index (KRI) by up to 21.74% in the patient (from 219.233 mm to 47.6714 mm). According to the findings of this study, it can be concluded that heel increase is effective in correcting knee joints in Genu recurvatum and the optimum heel height is 1 cm.

Keywords: joint alignment of knee, gait analysis, genu recurvatum, heel lift, kinematics, motion-analysis

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Authors: Huang Wei-Chi, Li Wei, Yu Tien-Chieh

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Medication adherence is crucial for treatment success. Adherence problem is common in patients with polypharmacy, especially in the geriatric population who are vulnerable to multiple chronic conditions but averagely less knowledgeable about diseases and medications. In order to help patients take medications appropriately and enhance the understanding of diseases or medications, a Line official account named e-Pharmacist was designed. The line is a popular freeware app with the highest penetration rate (95.7%) in Taiwan. The interface of e-Pharmacist is user-friendly for easy-to-read and convenient operating. Differ from other medication adherence apps, users just added e-Pharmacist as a LINE friend without installing any more apps and the drug lists were automatically downloaded from the personal electronic medical records with security permission. Over and above medication reminder, several additional capabilities were set up and engaged in the platform of e-Pharmacist including prescription refill reservation, laboratory examination consultation, medical appointment registration, and “Daily Health Log” where patients can record and track data of blood pressure/blood sugar and daily meals for self-health management as well as can share the important information to clinical professionals when seeking medical help. Additionally, a Line chatbot was utilized to provide tailored medicine information for the individual user. From July 2020 to March 2022, around 3000 patients added e-pharmacist as Line friends. Every day more than 1500 patients receive messages from e-pharmacist to notify them to take medicine. Thanks to the e-pharmacist alert system and Chatbot, the low-compliance patients (defined by Program on Adherence to Medication, PAM) significantly dropped from 36% to 6%, whereas the high-compliance patients dramatically increased from 13% to 77%. The user satisfaction is 98%. In brief, an e-pharmacist is not only a medication reminder but also a tailored personal assistant with value-added service for health management.

Keywords: e-pharmacist, self-health management, medication reminder, value-added service

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Authors: Aliya Moreira, Blake Duffy, Sam Kosinski, Kate Heckman, Erika Steensma

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Introduction: The One Health initiative promotes recognition of the interrelatedness between people, animals, plants, and their shared environment. The field of comparative medicine studies the similarities and differences between humans and animals for the purpose of advancing medical sciences. Currently, medical school education is narrowly focused on human anatomy and physiology, but as the COVID-19 pandemic has demonstrated, a holistic understanding of health requires comprehension of the interconnection between health and the lived environment. To prepare future physicians for unique challenges from emerging zoonoses to climate change, medical students can benefit from exposure to and experience with One Health and Comparative Medicine content. Methods: In January 2020, an elective course for medical students on One Health and Comparative Medicine was created to provide medical students with the background knowledge necessary to understand the applicability of animal and environmental health in medical research and practice. The 2-week course was continued in January 2021, with didactic and experiential activities taking place virtually due to the COVID-19 pandemic. In response to student feedback, lectures were added to expand instructional content on zoonotic and wildlife diseases for the second iteration of the course. Other didactic sessions included interprofessional lectures from 20 physicians, veterinarians, public health professionals, and basic science researchers. The first two cohorts of students were surveyed regarding One Health and Comparative Medicine concepts at the beginning and conclusion of the course. Results: 16 medical students have completed the comparative medicine course thus far, with 87.5% (n=14) completing pre-and post-course evaluations. 100% of student respondents indicated little to no exposure to comparative medicine or One Health concepts during medical school. Following the course, 100% of students felt familiar or very familiar with comparative medicine and One Health concepts. To assess course efficacy, questions were evaluated on a five-point Likert scale. 100% agreed or strongly agreed that learning Comparative Medicine and One Health topics augmented their medical education. 100% agreed or strongly agreed that a course covering this content should be regularly offered to medical students. Conclusions: Data from the student evaluation surveys demonstrate that the Comparative Medicine course was successful in increasing medical student knowledge of Comparative Medicine and One Health. Results also suggest that interprofessional training in One Health and Comparative Medicine is applicable and useful for medical trainees. Future iterations of this course could capitalize on the inherently interdisciplinary nature of these topics by enrolling students from veterinary and public health schools into a longitudinal course. Such recruitment may increase the course’s value by offering multidisciplinary student teams the opportunity to conduct research projects, thereby strengthening both the individual learning experience as well as sparking future interprofessional research ventures. Overall, these efforts to educate medical students in One Health topics should be reproducible at other institutions, preparing more future physicians for the diverse challenges they will encounter in practice.

Keywords: medical education, interprofessional instruction, one health, comparative medicine

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Authors: L. E. Mphahama, A. Mushunje, A. Taruvinga

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Although broiler production does not generate any large incomes among the smallholder community, it represents the main source of livelihood and part of nutritional requirement. As a result, market for broiler meat is growing faster than that of any other meat products and is projected to continue growing in the coming decades. However, the implication is that a multitude of factors manipulates transformation of smallholder broiler farmers participating in the mainstream markets. From 217 smallholder broiler farmers, socio-economic and institutional factors in broiler farming were incorporated into Binary model to estimate the probability of broiler farmers’ participation in the mainstream markets within the Maseru district in Lesotho. Of the thirteen (13) predictor variables fitted into the model, six (6) variables (household size, number of years in broiler business, stock size, access to transport, access to extension services and access to market information) had significant coefficients while seven (7) variables (level of education, marital status, price of broilers, poultry association, access to contract, access to credit and access to storage) did not have a significant impact. It is recommended that smallholder broiler farmers organize themselves into cooperatives which will act as a vehicle through which they can access contracts and formal markets. These cooperatives will also enable easy training and workshops for broiler rearing and marketing/markets through extension visits.

Keywords: broiler chicken, mainstream market, Maseru district, participation, smallholder farmers

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Authors: Kalat P. Duniya

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A number of technologies expected to increase maize productivity have been introduced by several research programs at national and international level. To this end, the study sought to identify the factors influencing adoption intensity of certified maize varieties. The data used were obtained from a sample household survey of 406 maize farmers, conducted in the northern guinea savannah of Nigeria through multistage stratified sampling, structured questionnaire. A triple hurdle model was adopted to estimate the determinants of adoption intensity; considering awareness, adoption, and intensity as three separate stages. The result showed that the drivers of farmers’ awareness, adoption, and intensity of usage may not necessarily be the same, and where they are, not of the same magnitude and direction. However, factors which were found to be statistically significant were age, education, membership of association and frequency of extension advice. In addition, awareness and adoption of the technologies were likely to be increased with male respondents. Farmers that were members of either community organizations or cooperative organizations had a higher tendency of being aware and adopting certified maize seed varieties. It was also discovered that though some of the farmers were fully aware of the existence of some certified maize varieties, majority lacked detailed knowledge and technical know-how. There is a need for creation of awareness through an excellent trained extension and restructuring of the educational sector to improve on the adoption process as well as improve maize productivity in the country.

Keywords: adoption, awareness, maize farmers, Nigeria, regression

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Authors: Amy Darwin, Claire Blacklock

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Background: Existing literature about delivering evidence-based mental health and psychosocial support (MHPSS) in emergency settings is limited. It is difficult to monitor and evaluate the approach to MHPSS in informal refugee camps such as ‘The Jungle’ in Calais, where there are multiple service providers and where the majority of providers are volunteers. AIM: To identify experiences of MHPSS delivery by service providers in an informal camp environment in Calais, France and describe MHPSS barriers and opportunities in this type of setting. Method: Qualitative semi-structured interviews were conducted with 13 individuals from different organisations offering MHPSS in Calais and analysed using conventional content analysis. Results: Unsafe, uncertain and unsanitary conditions in the camp meant MHPSS was difficult to implement, and such conditions contributed to the poor mental health of the residents. The majority of MHPSS was offered by volunteers who lacked resources and training, and there was no overall official camp leadership which meant care was poorly coordinated and monitored. Strong relationships existed between volunteers and camp residents, but volunteers felt frustrated that they could not deliver the kind of MHPSS that they felt residents required. Conclusion: While long-term volunteers had built supportive relationships with camp residents, lack of central coordination and leadership of MHPSS services and limited access to trained professionals made implementation of MHPSS problematic. Similarly, the camp lacked the necessary infrastructure to meet residents’ basic needs. Formal recognition of the camp, and clear central leadership were identified as necessary steps to improving MHPSS delivery.

Keywords: calais, mental health, refugees, the jungle, MHPSS

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Authors: Wing Mui Winnie So, Tian Luo, Zeyu Han

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To fully explore and develop the potentials of gifted students systematically and strategically by providing them with opportunities to receive education at appropriate levels, schools in Hong Kong are encouraged to adopt the "Three-Tier Implementation Model" to plan and implement the school-based gifted education, with Level Three refers to the provision of learning opportunities for the exceptionally gifted students in the form of specialist training outside the school setting by post-secondary institutions, non-government organisations, professional bodies and technology enterprises. Due to the growing concern worldwide about low interest among students in pursuing STEM (Science, Technology, Engineering, and Mathematics) careers, cultivating and boosting STEM career interest has been an emerging research focus worldwide. Although numerous studies have explored its critical contributors, little research has examined the effectiveness of comprehensive interventions such as “Studying with STEM professional”. This study aims to examine the effect on gifted students’ career interest during their participation in an off-school support programme designed and supervised by a team of STEM educators and STEM professionals from a university. Gifted students were provided opportunities and tasks to experience STEM career topics that are not included in the school syllabus, and to experience how to think and work like a STEM professional in their learning. Participants involved 40 primary school students joining the intervention programme outside the normal school setting. Research methods included adopting the STEM career interest survey and drawing tasks supplemented with writing before and after the programme, as well as interviews before the end of the programme. The semi-structured interviews focused on students’ views regarding STEM professionals; what’s it like to learn with a STEM professional; what’s it like to work and think like a STEM professional; and students’ STEM identity and career interest. The changes in gifted students’ STEM career interest and its well-recognised significant contributors, for example, STEM stereotypes, self-efficacy for STEM activities, and STEM outcome expectation, were collectively examined from the pre- and post-survey using T-test. Thematic analysis was conducted for the interview records to explore how studying with STEM professional intervention can help students understand STEM careers; build STEM identity; as well as how to think and work like a STEM professional. Results indicated a significant difference in STEM career interest before and after the intervention. The influencing mechanism was also identified from the measurement of the related contributors and the analysis of drawings and interviews. The potential of off-school support programme supervised by STEM educators and professionals to develop gifted students’ STEM career interest is argued to be further unleashed in future research and practice.

Keywords: gifted students, STEM career, STEM education, STEM professionals

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Authors: Zarish Jawad, Nikita Chugh, Karina Dadar

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Introduction: This paper aims to identify barriers indigenous women face in accessing prenatal care in Canada. It explores the differences in prenatal care received between indigenous and non-indigenous women. The objective is to look at changes or programs in Canada's healthcare system to reduce barriers to accessing safe prenatal care for indigenous women. Methods: A literature search of 12 papers was conducted using the following databases: PubMed, Medline, OVID, Google Scholar, and ScienceDirect. The studies included were written in English only, including indigenous females between the age of 19-35, and review articles were excluded. Participants in the studies examined did not have any severe underlying medical conditions for the duration of the study, and study designs included in the review are prospective cohort, cross-sectional, case report, and case-control studies. Results: Among all the barriers Indigenous women face in accessing prenatal care, the three most significant barriers Indigenous women face include a lack of culturally safe prenatal care, lack of services in the Indigenous community, proximity of prenatal facilities to Indigenous communities and costs of transportation. Discussion: The study found three significant barriers indigenous women face in accessing prenatal care in Canada; the geographical distribution of healthcare facilities, distrust between patients and healthcare professionals, and cultural sensitivity. Some of the suggested solutions include building more birthing and prenatal care facilities in rural areas for indigenous women, educating healthcare professionals on culturally sensitive healthcare, and involving indigenous people in the decision-making process to reduce distrust and power imbalances. Conclusion: The involvement of indigenous women and community leaders is important in making decisions regarding the implementation of effective healthcare and prenatal programs for indigenous women. However, further research is required to understand the effectiveness of the solutions and the barriers that make prenatal care less accessible for indigenous women in Canada.

Keywords: indigenous, maternal health, prenatal care, barriers

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Authors: Cinzia Russi, Chiyo Nishida

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Using data from online corpora (Spanish CREA, Italian CORIS), this paper examines the relatively understudied use of Spanish se and Italian si exemplified in (1) and (2), respectively. (1) El rojo es … el que se come a los demás. ‘The red (bottle) is the one that outshines/*eats the rest.’(2) … ebbe anche la saggezza di mangiarsi tutto il suo patrimonio. ‘… he even had the wisdom to squander/*eat all his estate.’ In these sentences, se/si accompanies the consumption verb comer/mangiare ‘to eat’, without which the sentences would not be interpreted appropriately. This se/si cannot readily be attributed to any of the multiple functions so far identified in the literature: reflexive, ergative, middle/passive, inherent, benefactive, and complete consumptive. In particular, this paper argues against the feasibility of a recent construction-based analysis of sentences like (1) and (2), which situates se/si within a prototype-based network of meanings all deriving from the central meaning of 'COMPLETE CONSUMPTION' (e.g., Alice se comió toda la torta/Alicesi è mangiata tutta la torta ‘John ate the whole cake’). Clearly, the empirical adequacy of such an account is undermined by the fact that the events depicted in the se/si-sentences at issue do not always entail complete consumption because they may lack an INCREMENTAL THEME, the distinguishing property of complete consumption. Alternatively, it is proposed that the sentences under analysis represent instances of verbal METAPHORICAL EXTENSION: se/si represents an explicit marker of this cognitive process, which has independently developed from the complete consumptive se/si, and the meaning extension is captured by the general tenets of Conceptual Metaphor Theory (CMT). Two conceptual domains, Source (DS) and target (DT), are related by similarity, assigning an appropriate metaphorical interpretation to DT. The domains paired here are comer/mangiare (DS) and comerse/mangiarsi (DT). The eating event (DS) involves (a) the physical process of xEATER grinding yFOOD-STUFF into pieces and swallowing it; and (b) the aspect of xEATER savoring yFOOD-STUFF and being nurtured by it. In the physical act of eating, xEATER has dominance and exercises his force over yFOOD-STUFF. This general sense of dominance and force is mapped onto DT and is manifested in the ways exemplified in (1) and (2), and many others. According to CMT, two other properties are observed in each pair of DS & DT. First, DS tends to be more physical and concrete and DT more abstract, and systematic mappings are established between constituent elements in DS and those in DT: xEATER corresponds to the element that destroys and yFOOD-STUFF to the element that is destroyed in DT, as exemplified in (1) and (2). Though the metaphorical extension marker se/si appears by far most frequently with comer/mangiare in the corpora, similar systematic mappings are observed in several other verb pairs, for example, jugar/giocare ‘to play (games)’ and jugarse/giocarsi ‘to jeopardize/risk (life, reputation, etc.)’, perder/perdere ‘to lose (an object)’ and perderse/perdersi ‘to miss out on (an event)’, etc. Thus, this study provides evidence that languages may indeed formally mark metaphor using means available to them.

Keywords: complete consumption value, conceptual metaphor, Italian si/Spanish se, metaphorical extension.

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Authors: Ayşe Coban, Orhan Coban, Haldun Soydal, Sükrü Sürücü

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While health is a source of prosperity for individuals, it is also one of the most important determinants of economic growth for a country. Health, by increasing the productivity of labor, contributes to economic growth. Therefore, countries should give the necessary emphasis to health services. The primary aim of this study is to analyze the changes occurring in health services in Turkey by examining the developments in the sector. In this scope, the second aim of the study is to reveal the place of health expenditures in the Turkish economy. As a result of the analysis in the dataset, in which the 1999-2013 periods is considered, it was determined that some increase in health expenditures took place and that the increase in the share of health expenditures in GDP was too small. Furthermore, analysis of the results points out that in financing health expenditures, the public sector is prominent compared to the private sector.

Keywords: health, health service, health expenditures, Turkey

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Authors: Mara A. C. Lopes

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Hiring a second teacher to accompany deaf students inserted at Brazilian inclusive school system has raised questions about its role in the educational process of deaf students. Federal policies determine that deaf students inserted in regular education are accompanied by sign language interpreters, which leads to the understanding that the second teacher should assume this function. However, what those professionals do is to assume the function of teaching deaf student, instead of the classroom main teacher. Historical-Cultural Psychology was used as a reference for analysis, which aimed to identify the social function of the second teacher in the classroom. Two studies were accomplished in the public schools of Sao Paulo State: In Study 1, videotaped lectures provided by the Department of Education for collective reflection about the second teacher's role were examined, to identify the social meaning of that professional activity. Study 2 aimed to analyze the process of assigning personal sense to the teacher activity, considering the opinions of 21 professionals from Sao Paulo. Those teachers were interviewed individually with the support of a semi-structured interview. The analysis method utilized was: empirical description of data; development of categories, for reality abstraction; identifying the unit analysis; and return to reality, in order to explain it. Study 1 showed that the social meaning of the second teacher's activity is, also, to teach. However, Study 2 showed that this meaning is not shared among professionals of the school, so they understand that they must act as sign language interpreters. That comprehension causes a disruption between social meaning and the personal sense they attach to their activity. It also shows the need of both teachers at the classroom planning and executing activity together. On the contrary, a relationship of subordination of one teacher to another was identified, excluding the second teacher and the deaf student of the main activity. Results indicate that the second teacher, as a teacher, must take the responsibility for deaf student education, consciously, and to promote the full development of the subjects involved.

Keywords: deaf education, historical-cultural psychology, inclusion, teacher function

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Authors: Fatai Shola Afolabi

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The study identified and evaluates the causes of building failure and examined the effects of building failure with respect to cost in Lagos State, Nigeria. The method employed in the collection of data includes the administration of questionnaire to professionals in the construction industry and case studies for the sites. A purposive sampling technique was used for selecting the sites visited, and selecting the construction professionals. Descriptive statistical techniques such as frequency distribution and percentages and mean response analysis were used to analyze data. The study revealed that the major causes of building failures were bad design, faulty construction, over loading, non-possession of approved drawings, Possession of approved drawings but non-compliance, and the use of quarks. In the two case studies considered, the total direct loss to the building owners was thirty eight million three hundred and eight five thousand, seven hundred and twenty one naira (38,385,721) which is about One hundred and ninety four thousand, eighty hundred and fifty one dollars ($194,851) at one hundred and ninety seven naira to one US dollars, central bank Nigeria of exchange rate as at 14th March, 2015.

Keywords: building structures, building failure, building collapse, structural failure, cost, direct loss

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Authors: Berrin Şentürk

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In this study, due to the recurrence of bovine tuberculosis, in the same areas, the risk factors for the disease were determined and evaluated at the local level. This study was carried out in 32 farms where the disease was detected in the district and center of Samsun province in 2014. Predetermined risk factors, such as farm, environmental and economic risks, were investigated with the survey method. It was predetermined that risks in the three groups are similar to the risk variables of the disease on the global scale. These risk factors that increase the susceptibility of the infection must be understood by the herd owners. The risk-based contagious disease management system approach should be applied for bovine tuberculosis by farmers, animal health professionals and public and private sector decision makers.

Keywords: bovine tuberculosis, disease management, control, outbreak, risk analysis

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Authors: Christos E. Lampropoulos, Maria Konsta, Tamta Sirbilatze, Ifigenia Apostolou, Vicky Dradaki, Konstantina Panouria, Irini Dri, Christina Kordali, Vaggelis Lambas, Georgios Mavras

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Objectives: Full Mini Nutritional Assessment (MNA) questionnaire is one of the most useful tools in diagnosis of malnutrition in hospitalized patients, which is related to increased morbidity and mortality. The purpose of our study was to assess the nutritional status of elderly, hospitalized patients and examine the hypothesis that MNA may predict mortality and extension of hospitalization. Methods: One hundred fifty patients (78 men, 72 women, mean age 80±8.2) were included in this cross-sectional study. The following data were taken into account in analysis: anthropometric and laboratory data, physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, dietary habits, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission. The latter was compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and extended hospitalization respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 20% per each unit increase of full MNA score (OR=0.8, 95% CI 0.74-0.89, p < 0.0001). Patients who admitted due to cancer were 23 times more likely to die, compared to those with infection (OR=23, 95% CI 3.8-141.6, p=0.001). Similarly, patients who admitted due to stroke were 7 times more likely to die (OR=7, 95% CI 1.4-34.5, p=0.02), while these with all other causes of admission were less likely (OR=0.2, 95% CI 0.06-0.8, p=0.03), compared to patients with infection. According to multivariate linear regression analysis, each increase of unit of full MNA, decreased the admission duration on average 0.3 days (b:-0.3, 95% CI -0.45 - -0.15, p < 0.0001). Patients admitted due to cancer had on average 6.8 days higher extension of hospitalization, compared to those admitted for infection (b:6.8, 95% CI 3.2-10.3, p < 0.0001). Conclusion: Mortality and extension of hospitalization is significantly increased in elderly, malnourished patients. Full MNA score is a useful diagnostic tool of malnutrition.

Keywords: duration of admission, malnutrition, mini nutritional assessment score, prognostic factors for mortality

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