Search results for: comprehensive emergency care and life support
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18528

Search results for: comprehensive emergency care and life support

14028 Selection of Solid Waste Landfill Site Using Geographical Information System (GIS)

Authors: Fatih Iscan, Ceren Yagci

Abstract:

Rapid population growth, urbanization and industrialization are known as the most important factors of environment problems. Elimination and management of solid wastes are also within the most important environment problems. One of the main problems in solid waste management is the selection of the best site for elimination of solid wastes. Lately, Geographical Information System (GIS) has been used for easing selection of landfill area. GIS has the ability of imitating necessary economical, environmental and political limitations. They play an important role for the site selection of landfill area as a decision support tool. In this study; map layers will be studied for minimum effect of environmental, social and cultural factors and maximum effect for engineering/economical factors for site selection of landfill areas and using GIS for an decision support mechanism in solid waste landfill areas site selection will be presented in Aksaray/TURKEY city, Güzelyurt district practice.

Keywords: GIS, landfill, solid waste, spatial analysis

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14027 Control of the Sustainability of Decorative Topping for Bakery in Order to Extend the Shelf-Life of the Product

Authors: Radovan Čobanović, Milica Rankov Šicar

Abstract:

In the modern bakery various supplements are used to attract more customers. Analyzed sample decorative toppings are consisted of flax seeds, corn grits, oatmeal, wheat flakes, sesame seeds, sunflower seeds, soybean sprouts are used as decoration for the bread. Our goal was to extend the product shelf life based on the analysis. According to the plan of sustainability it was defined that sample which already had expired shelf life had to be stored for 5 months at 25°C and analyzed every month from the day of reception until spoilage occurs. Samples were subjected to sensory analysis (appearance, odor, taste, color, and consistency), microbiological analysis (Salmonella spp., Bacillus cereus, Enterobacteriaceae and moulds) and chemistry analysis (free fatty acids (as oleic), peroxide number, water content and degree of acidity). All analyses were tested according: sensory analysis ISO 6658, Salmonella spp ISO 6579, Bacillus cereus ISO 7932, Enterobacteriaceae ISO 21528-2 and moulds ISO 21527-1, free fatty acids (as oleic) ISO 660, peroxide number ISO 3960, water content and degree of acidity Serbian ordinance on the methods of chemical analysis. After five months of storage, there had been the first changes concerning of sensory properties of the product. In the sample were visible worms and creations which look like spider nets linking seeds and cereal. The sample had smell on rancid and pungent. The results of microbiological analysis showed that Salmonella spp was not detected, Enterobacteriaceae were < 10 cfu/g during all 5 months but in fifth month Bacillus cereus and moulds occurred 700 cfu/g and 1500 cfu/g respectively. Chemical analyzes showed that the water content did not exceed a maximum of 14%. The content of free fatty acids ranged from 3.06 to 3.26%, degree of acidity from 3.69 to 4.9. With increasing degree of acidity the degradation of the sample and the activity of microorganisms was increased which led to the formation of acid reaction which is accompanied by the appearance of unpleasant odor and taste. Based on the obtained results it can be concluded that this product can have longer shelf life for four months than shelf life which is already defined because there are no changes that could have influence on decision of customers when purchase of this product is concerned.

Keywords: bakery products, extension of shelf life, sensory and chemical and microbiological analyses, sustainability

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14026 The Traveling Behavior and Needs for Tourist Support Facilities of Inbound Tourists Visiting Ratanakosin Island

Authors: Sakul Jariyachamsit

Abstract:

The objectives of this research were to study the behaviour of inbound tourist who visited Ratanakosin Island and to study their needs concerning support facilities. The independent variables included gender, age, levels of education, occupation, and income while the dependent variables were classified into two groups: tourists’ behaviour variables and tourists’ need of supporting facilities. A simple random sampling method was utilized to get 225 respondents. The majority of respondents were both male and female in the same proportion but most were between 21-30 years old. Most were married with a graduated degree. The average income of the respondents was between $20,000-30,000. The findings revealed that the majority of respondents came to Thailand for the first time and spent about 8 days in Thailand and preferred to travel in small groups. Their decision to come to Thailand was influenced by word of mouth. When they first thought of Thailand, they thought of Thai food. In terms of the needs for tourists around the Ratanakosin Island, and ranked in importance, are as follows: a tourist centre, somebody who can speak English, a trustable agency, police patrol, and the availability of maps and brochures.

Keywords: Rattanakosin Island, tourist, travelling behaviour, media engineering

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14025 A Qualitative Exploration of the Sexual and Reproductive Health Practices of Adolescent Mothers from Indigenous Populations in Ratanak Kiri Province, Cambodia

Authors: Bridget J. Kenny, Elizabeth Hoban, Jo Williams

Abstract:

Adolescent pregnancy presents a significant public health challenge for Cambodia. Despite declines in the overall fertility rate, the adolescent fertility rate is increasing. Adolescent pregnancy is particularly problematic in the Northeast provinces of Ratanak Kiri and Mondul Kiri where 34 percent of girls aged between 15 and 19 have begun childbearing; this is almost three times Cambodia’s national average of 12 percent. Language, cultural and geographic barriers have restricted qualitative exploration of the sexual and reproductive health (SRH) challenges that face indigenous adolescents in Northeast Cambodia. The current study sought to address this gap by exploring the SRH practices of adolescent mothers from indigenous populations in Ratanak Kiri Province. Twenty-two adolescent mothers, aged between 15 and 19, were recruited from seven indigenous villages in Ratanak Kiri Province and asked to participate in a combined body mapping exercise and semi-structured interview. Participants were given a large piece of paper (59.4 x 84.1 cm) with the outline of a female body and asked to draw the female reproductive organs onto the ‘body map’. Participants were encouraged to explain what they had drawn with the purpose of evoking conversation about their reproductive bodies. Adolescent mothers were then invited to participate in a semi-structured interview to further expand on topics of SRH. The qualitative approach offered an excellent avenue to explore the unique SRH challenges that face indigenous adolescents in rural Cambodia. In particular, the use of visual data collection methods reduced the language and cultural barriers that have previously restricted or prevented qualitative exploration of this population group. Thematic analysis yielded six major themes: (1) understanding of the female reproductive body, (2) contraceptive knowledge, (3) contraceptive use, (4) barriers to contraceptive use, (5) sexual practices, (6) contact with healthcare facilities. Participants could name several modern contraceptive methods and knew where they could access family planning services. However, adolescent mothers explained that they gained this knowledge during antenatal care visits and consequently participants had limited SRH knowledge, including contraceptive awareness, at the time of sexual initiation. Fear of the perceived side effects of modern contraception, including infertility, provided an additional barrier to contraceptive use for indigenous adolescents. Participants did not cite cost or geographic isolation as barriers to accessing SRH services. Child marriage and early sexual initiation were also identified as important factors contributing to the high prevalence of adolescent pregnancy in this population group. The findings support the Ministry of Education, Youth and Sports' (MoEYS) recent introduction of SRH education into the primary and secondary school curriculum but suggest indigenous girls in rural Cambodia require additional sources of SRH information. Results indicate adolescent girls’ first point of contact with healthcare facilities occurs after they become pregnant. Promotion of an effective continuum of care by increasing access to healthcare services during the pre-pregnancy period is suggested as a means of providing adolescents girls with an additional avenue to acquire SRH information.

Keywords: adolescent pregnancy, contraceptive use, family planning, sexual and reproductive health

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14024 Development of an Instructional Model for Health Education Based On Social Cognitive Theory and Strategic Life Planning to Enhance Self-Regulation and Learning Achievement of Lower Secondary School Students

Authors: Adisorn Bansong, Walai Isarankura Na Ayudhaya, Aumporn Makanong

Abstract:

A Development of an Instructional Model for Health Education was the aim to develop and study the effectiveness of an instructional model for health education to enhance self-regulation and learning achievement of lower secondary school students. It was the Quasi-Experimental Designs, used a Single-group Interrupted Time-series Designs, conducted by 2 phases: 1. To develop an instructional model based on Social Cognitive Theory and Strategic Life Planning. 2. To trial and evaluate effectiveness of an instructional model. The results as the following: i. An Instructional Model for Health Education consists of five main components: a) Attention b) Forethought c) Tactic Planning d) Execution and e) Reflection. ii. After an Instructional Model for Health Education has used for a semester trial, found the 4.07 percent of sample’s Self-Regulation higher and learning achievement on post-test were significantly higher than pre-test at .05 levels (p = .033, .000).

Keywords: social cognitive theory, strategic life planning, self-regulation, learning achievement

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14023 Combining the Production of Radiopharmaceuticals with the Department of Radionuclide Diagnostics

Authors: Umedov Mekhroz, Griaznova Svetlana

Abstract:

In connection with the growth of oncological diseases, the design of centers for diagnostics and the production of radiopharmaceuticals is the most relevant area of healthcare facilities. The design of new nuclear medicine centers should be carried out from the standpoint of solving the following tasks: the availability of medical care, functionality, environmental friendliness, sustainable development, improving the safety of drugs, the use of which requires special care, reducing the rate of environmental pollution, ensuring comfortable conditions for the internal microclimate, adaptability. The purpose of this article is to substantiate architectural and planning solutions, formulate recommendations and principles for the design of nuclear medicine centers and determine the connections between the production and medical functions of a building. The advantages of combining the production of radiopharmaceuticals and the department of medical care: less radiation activity is accumulated, the cost of the final product is lower, and there is no need to hire a transport company with a special license for transportation. A medical imaging department is a structural unit of a medical institution in which diagnostic procedures are carried out in order to gain an idea of the internal structure of various organs of the body for clinical analysis. Depending on the needs of a particular institution, the department may include various rooms that provide medical imaging using radiography, ultrasound diagnostics, and the phenomenon of nuclear magnetic resonance. The production of radiopharmaceuticals is an object intended for the production of a pharmaceutical substance containing a radionuclide and intended for introduction into the human body or laboratory animal for the purpose of diagnosis, evaluation of the effectiveness of treatment, or for biomedical research. The research methodology includes the following subjects: study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research; An integrated approach to the study of existing international experience of PET / CT scan centers and the production of radiopharmaceuticals; Elaboration of graphical analysis and diagrams based on the system analysis of the processed information; Identification of methods and principles of functional zoning of nuclear medicine centers. The result of the research is the identification of the design principles of nuclear medicine centers with the functions of the production of radiopharmaceuticals and the department of medical imaging. This research will be applied to the design and construction of healthcare facilities in the field of nuclear medicine.

Keywords: architectural planning solutions, functional zoning, nuclear medicine, PET/CT scan, production of radiopharmaceuticals, radiotherapy

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14022 An Experimental Test of the Effects of Acute and Chronic Stress on Maternal Sensitivity

Authors: Mindy A. Brown, Emma E. Reardon, Jennifer Isenhour, Sheila E. Crowell, K. Lee Raby, Elisabeth Conradt

Abstract:

The positive impact of maternal sensitivity on infant social and emotional development is well-known, as is the notion that stress may impair a mother’s ability to provide sensitive care for her infant. However, individual differences in susceptibility to parenting-related stress are less understood. This study explores how chronic prenatal stress moderates the effect of acute stressors on maternal sensitivity. Data were gathered from 110 mothers and their 7-month-old infants. Mothers were exposed to either an acute stress task or a control task, after which they engaged in the still-face paradigm, a face-to-face interaction where maternal sensitivity was measured. Chronic maternal stress was assessed using the UCLA Life Stress Interview during the third trimester of pregnancy. The results revealed that among mothers exposed to the stress condition, those with higher chronic stress levels in the previous six months displayed significantly lower sensitivity during the still-face paradigm compared to those with lower chronic stress. Notably, past stress levels had no effect on maternal sensitivity in the control condition. These findings suggest a moderating effect of chronic stress on maternal caregiving behavior, with higher prenatal stress diminishing a mother’s ability to cope with acute parenting-related stressors in the present. The mechanisms behind this may involve changes in stress reactivity pathways, such as the hypothalamic-pituitary-adrenal (HPA) axis or altered emotion regulation strategies developed in response to chronic stress. Understanding these pathways could guide targeted interventions for mothers who may be more vulnerable to stress, improving caregiving outcomes.

Keywords: acute stress, maternal stress, prenatal stress, still-face paradigm

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14021 Protective Effect of Essential Oil from Chamaecyparis obtusa on Anxiety-Related Behaviors and Cytokine Abnormalities Induced by Early Life Stress

Authors: Hae Jeong Park, Joo-Ho Chung

Abstract:

In this study, the effect of essential oil from Chamaecyparis obtuse (EOCO) on early life stress using maternal separation (MS) rats was investigated. Anxiety-related behaviors were examined in MS rats using the elevated plus-maze (EPM) test. The changes of gene expressions by EOCO in the hippocampus of MS rats were analyzed using a microarray method. Rats in the MS groups were separated from their respective mothers from postnatal day (pnd) 14 to 28. Rats in the EOCO-treated groups were exposed to EOCO for 1 h or 2 h by inhalation from pnd 21 to 28. The EOCO-treated MS rats showed decreased anxiety-related behaviors compared to the MS rats in the EPM test. In the microarray analysis, EOCO downregulated the expressions of cytokine genes such as Ccl2, Il6, Cxcl10, Ccl19, and Il1rl in the hippocampus of MS rats, and it was also confirmed through RT-PCR. In particular, the expressions of Ccl2 and Il6 were predominantly decreased by EOCO in the hippocampus of MS rats. Interestingly, their protein expressions were also reduced by EOCO in MS rats. These results indicate that EOCO decreases MS-induced anxiety-related behaviors, and modulate cytokines, particularly Ccl2 and Il6, in the hippocampus of MS rats.

Keywords: anxiety-related behavior, Chamaecyparis obtuse, cytokine gene, early-life stress, maternal separation

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14020 Effect of Nutrition Education on the Control and Function of Insulin-Dependent Diabetes Patients

Authors: Rahil Sahragard, Mahmoud Hatami, Rostam Bahadori Khalili

Abstract:

Diabetes is one of the most important health problems in the world and a chronic disease requiring continuous care and therefore, it is necessary for patients to undergo self-care and nutrition education. This study was conducted to evaluate the effect of nutrition education on the metabolic control of diabetic patients in Tehran in 2015. An experimental study was conducted on 100 patients who had previously been approved by a specialist physician for diabetes and at least one year after their onset. At first, patients without any knowledge of the educational program were selected as sample and from them a checklist containing demographic and specific information about diabetes was filled and were taken three fasting blood glucose and three times fasting blood glucose (5 p.m.) Then, the patients received face-to-face training in the same conditions for 2 weeks in a Mehregan hospital of Tehran, and received 3 months of training, while they were fully monitored and during this time, samples that had a cold or blood pressure-related disease or were admitted to the hospital were excluded from the study. After the end of the study, the checklist was filled again and 3 fasting blood glucose and 3 fasting blood glucose samples were taken, the results were statistically analyzed by MC Nemar's statistical test. The research findings were performed on 100 patients 41.7% male and 58.3% women, the range of age was between 22 and 60 years old, with a duration of diabetes ranging from 1 to 15 years. Abnormal fasting blood glucose from 95% to 48.3% (P <0.0001) and non-fasting blood glucose decreased from 91.6% to 71.2% (P <0.001). Research has shown that training on blood glucose control has been successful, therefore, it is recommended that more research is done in the field of education to help patients with diabetes more comfortable.

Keywords: nutrition education, diabetes, function, insulin, chronic, metabolic control

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14019 Modeling of Building a Conceptual Scheme for Multimodal Freight Transportation Information System

Authors: Gia Surguladze, Nino Topuria, Lily Petriashvili, Giorgi Surguladze

Abstract:

Modeling of building processes of a multimodal freight transportation support information system is discussed based on modern CASE technologies. Functional efficiencies of ports in the eastern part of the Black Sea are analyzed taking into account their ecological, seasonal, resource usage parameters. By resources, we mean capacities of berths, cranes, automotive transport, as well as work crews and neighbouring airports. For the purpose of designing database of computer support system for Managerial (Logistics) function, using Object-Role Modeling (ORM) tool (NORMA – Natural ORM Architecture) is proposed, after which Entity Relationship Model (ERM) is generated in automated process. The software is developed based on Process-Oriented and Service-Oriented architecture, in Visual Studio.NET environment.

Keywords: seaport resources, business-processes, multimodal transportation, CASE technology, object-role model, entity relationship model, SOA

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14018 Structural Performance of a Bridge Pier on Dubious Deep Foundation

Authors: Víctor Cecilio, Roberto Gómez, J. Alberto Escobar, Héctor Guerrero

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The study of the structural behavior of a support/pier of an elevated viaduct in Mexico City is presented. Detection of foundation piles with uncertain integrity prompted the review of possible situations that could jeopardy the structural safety of the pier. The objective of this paper is to evaluate the structural conditions of the support, taking into account the type of anomaly reported and the depth at which it is located, the position of the pile with uncertain integrity in the foundation system, the stratigraphy of the surrounding soil and the geometry and structural characteristics of the pier. To carry out the above, dynamic analysis, spectral modal, and step-by-step, with elastic and inelastic material models, were performed. Results were evaluated in accordance with the standards used for the design of the original structural project and with the Construction Regulations for Mexico’s Federal District (RCDF-2017, 2017). Comments on the response of the analyzed models are issued, and the conclusions are presented from a structural point of view.

Keywords: dynamic analysis, inelastic models, dubious foundation, bridge pier

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14017 Burnout in the Resident Physician and a Simple Means of Improvement

Authors: Jacob Dangerfield, Jacob Pollard, Jennifer DeCou

Abstract:

Introduction: Burnout, anxiety, and depression are three conditions that are prevalent in medical providers. This is especially the case in the field of anesthesia, which has a high number of providers suffering from burnout and burnout syndrome. A major contributor to this issue is isolation in the workplace, with a perceived lack of peer support as a major risk factor for burnout. Two organizational interventions that can be done to help improve this issue are small group sessions and providing affordable mental health services. Per American College of Graduate Medical Education (ACGME) Guidelines, these affordable mental health services are a requirement of all residency programs, but for a variety of reasons, many residents do not access them. As physicians, we are often not good at asking for help. With this in mind, we hypothesized that carrying out small group resiliency sessions facilitated by Graduate Medical Education (GME) Wellness Counselors would improve both resident peer support as well as the likelihood that a resident will reach out to GME Wellness in a time of need. Methods: We held small group resiliency sessions with the GME Wellness Mental Health Professionals during protected didactic time. These sessions were small groups, including the members of one’s class (i.e., first-year residents on their own), and were facilitated by 1-2 mental health professionals. After these sessions, we surveyed residents who attended using a short Google Forms survey and using a 5-point Likert Scale, asked residents about some outcomes from the session. A “strongly agree” or “agree” was considered a positive response. Results: Results from our survey showed that the resident sessions had multiple positive outcomes. This survey was sent to 29 residents, and we had a 62% response rate. We found out through this survey that these small group sessions had a perceived positive impact on resident personal well-being, increased perceived peer support from classmates, and made residents more likely to reach out to GME Wellness in the future. Perceived positive impact on well-being was found in 83% of resident respondents, improved perceived peer support in 83% of respondents, and 78% of resident respondents stated that this session increased their likelihood of reaching out to mental health professionals. Conclusions: Through this study, we can conclude that our hypothesis was correct in that Small Group Resiliency Sessions that are facilitated by GME Wellness Counselors improve both resident peer support as well as the likelihood a resident reaches out to these mental health professionals in time of need. We believe these findings are very important as they address two important factors that can aid in decreasing a provider’s risk of experiencing burnout. Through this simple means, we believe other residency programs can help the well-being of their residents, and together, we can decrease the number of cases of burnout in anesthesia.

Keywords: anesthesiology, burnout, wellness, depression, residents, trainees, mental health

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14016 Trend Analysis of the Effectiveness of Diabetes Health Coaching in Taiwan

Authors: Ching-Ling Lin, Li-Chi Huang, Yao-Tsung Chang, Ruey-Yu Chen, Shwu-Huey Yang

Abstract:

Introduction & Purpose: Diabetes and its related complications always been a major part of medical cost in Taiwan. To patient with diabetes, self-management blood sugar, improving a healthy lifestyle are the most important thing to avoid getting worse. The aim of this study was to explore the trend of the changing in blood glucose within intervention and followed-up periods of patients who participated in the health coaching program between 2017 and 2020. Design & Methods: The data was combined from two diabetes health coaching program. The intervention group had health coaching and usual care for 6 months, whereas the control had usual care only. The main outcome variables were HbA1c level at baseline, 3, 6, 9, and 12 months. Results: In total, the data were available for 99 patients in the coaching intervention group and for 88 patients in the control group, the dropout rate during the follow-up period is about 18%. Of 187 participants, 54% were female, mean age was 61.5 years (SD=10.19), only 32.1% had a bachelor’s degree or higher, and the mean duration of diabetes treatment at Cathay General Hospital was 9.9 years. Within 12 months, the intervention group had a significant decrease of 0.65% (SD=1.05) in HbA1c level, and a non-significant decrease of 0.13%(SD=0.96) was observed in the control group. The figure showed the effect was the most significant in the first three months of the intervention and can be maintained for up to six months after the intervention was over. The HbA1c values of the two groups at each follow-up point are significantly different. In addition, there were non-significant correlation between HbA1c and gender, age, and educational level. Conclusion: Health coaching might be an effective way to enhance self-management for patients with diabetes and improving their blood sugar control in Taiwan.

Keywords: diabetes, health coaching, HbA1c, self-management

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14015 Productive Engagements and Psychological Wellbeing of Older Adults; An Analysis of HRS Dataset

Authors: Mohammad Didar Hossain

Abstract:

Background/Purpose: The purpose of this study was to examine the associations between productive engagements and the psychological well-being of older adults in the U.S by analyzing cross-sectional data from a secondary dataset. Specifically, this paper analyzed the associations of 4 different types of productive engagements, including current work status, caregiving to the family members, volunteering and religious strengths with the psychological well-being as an outcome variable. Methods: Data and sample: The study used the data from the Health and Retirement Study (HRS). The HRS is a nationally representative prospective longitudinal cohort study that has been conducting biennial surveys since 1992 to community-dwelling individuals 50 years of age or older on diverse issues. This analysis was based on the 2016 wave (cross-sectional) of the HRS dataset and the data collection period was April 2016 through August 2017. The samples were recruited from a multistage, national area-clustered probability sampling frame. Measures: Four different variables were considered as the predicting variables in this analysis. Firstly, current working status was a binary variable that measured by 0=Yes and 1= No. The second and third variables were respectively caregiving and volunteering, and both of them were measured by; 0=Regularly, 1= Irregularly. Finally, find in strength was measured by 0= Agree and 1= Disagree. Outcome (Wellbeing) variable was measured by 0= High level of well-being, 1= Low level of well-being. Control variables including age were measured in years, education in the categories of 0=Low level of education, 1= Higher level of education and sex r in the categories 0=male, 1= female. Analysis and Results: Besides the descriptive statistics, binary logistic regression analyses were applied to examine the association between independent and dependent variables. The results showed that among the four independent variables, three of them including working status (OR: .392, p<.001), volunteering (OR: .471, p<.003) and strengths in religion (OR .588, p<.003), were significantly associated with psychological well-being while controlling for age, gender and education factors. Also, no significant association was found between the caregiving engagement of older adults and their psychological well-being outcome. Conclusions and Implications: The findings of this study are mostly consistent with the previous studies except for the caregiving engagements and their impact on older adults’ well-being outcomes. Therefore, the findings support the proactive initiatives from different micro to macro levels to facilitate opportunities for productive engagements for the older adults, and all of these may ultimately benefit their psychological well-being and life satisfaction in later life.

Keywords: productive engagements, older adults, psychological wellbeing, productive aging

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14014 Improving Effectiveness of Students' Learning during Clinical Rotations at a Teaching Hospital in Rwanda

Authors: Nanyombi Lubimbi, Josette Niyokindi

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Background: As in many other developing countries in Africa, Rwanda suffers from a chronic shortage of skilled Health Care professionals including Clinical Instructors. This shortage negatively affects the clinical instruction quality therefore impacting student-learning outcomes. Due to poor clinical supervision, it is often noted that students have no structure or consistent guidance in their learning process. The Clinical Educators and the Rwandan counterparts identified the need to create a favorable environment for learning. Description: During orientation the expectations of the student learning process, collaboration of the clinical instructors with the nurses and Clinical Educators is outlined. The ward managers facilitate structured learning by helping the students identify a maximum of two patients using the school’s objectives to guide the appropriate selection of patients. Throughout the day, Clinical Educators with collaboration of Clinical Instructors when present conduct an ongoing assessment of learning and provide feedback to the students. Post-conference is provided once or twice a week to practice critical thinking skills of patient cases that they have been taking care of during the day. Lessons Learned: The students are found to be more confident with knowledge and skills gained during rotations. Clinical facility evaluations completed by students at the end of their rotations highlight the student’s satisfaction and recommendation for continuation of structured learning. Conclusion: Based on the satisfaction of both students and Clinical Instructors, we have identified need for structured learning during clinical rotations. We acknowledge that more evidence-based practice is necessary to effectively address the needs of nursing and midwifery students throughout the country.

Keywords: Rwanda, clinical rotation, structured learning, critical thinking skills, post-conference

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14013 Multi-Criteria Decision Support System for Modeling of Civic Facilities Using GIS Applications: A Case Study of F-11, Islamabad

Authors: Asma Shaheen Hashmi, Omer Riaz, Khalid Mahmood, Fahad Ullah, Tanveer Ahmad

Abstract:

The urban landscapes are being change with the population growth and advancements in new technologies. The urban sprawl pattern and utilizes are related to the local socioeconomic and physical condition. Urban policy decisions are executed mostly through spatial planning. A decision support system (DSS) is very powerful tool which provides flexible knowledge base method for urban planning. An application was developed using geographical information system (GIS) for urban planning. A scenario based DSS was developed to integrate the hierarchical muti-criteria data of different aspects of urban landscape. These were physical environment, the dumping site, spatial distribution of road network, gas and water supply lines, and urban watershed management, selection criteria for new residential, recreational, commercial and industrial sites. The model provided a framework to incorporate the sustainable future development. The data can be entered dynamically by planners according to the appropriate criteria for the management of urban landscapes.

Keywords: urban, GIS, spatial, criteria

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14012 Sensitivity Parameter Analysis of Negative Moment Dynamic Load Allowance of Continuous T-Girder Bridge

Authors: Fan Yang, Ye-Lu Wang, Yang Zhao

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The dynamic load allowance, as an application result of the vehicle-bridge coupled vibration theory, is an important parameter for bridge design and evaluation. Based on the coupled vehicle-bridge vibration theory, the current work establishes a full girder model of a dynamic load allowance, selects a planar five-degree-of-freedom three-axis vehicle model, solves the coupled vehicle-bridge dynamic response using the APDL language in the spatial finite element program ANSYS, selects the pivot point 2 sections as the representative of the negative moment section, and analyzes the effects of parameters such as travel speed, unevenness, vehicle frequency, span diameter, span number and forced displacement of the support on the negative moment dynamic load allowance through orthogonal tests. The influence of parameters such as vehicle speed, unevenness, vehicle frequency, span diameter, span number, and forced displacement of the support on the negative moment dynamic load allowance is analyzed by orthogonal tests, and the influence law of each influencing parameter is summarized. It is found that the effects of vehicle frequency, unevenness, and speed on the negative moment dynamic load allowance are significant, among which vehicle frequency has the greatest effect on the negative moment dynamic load allowance; the effects of span number and span diameter on the negative moment dynamic load allowance are relatively small; the effects of forced displacement of the support on the negative moment dynamic load allowance are negligible.

Keywords: continuous T-girder bridge, dynamic load allowance, sensitivity analysis, vehicle-bridge coupling

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14011 Effects of Virtual Reality on Relieving Postoperative Pain in Surgical Patients: A Systematic Review and Meta-Analysis

Authors: Lingyu Ding, Hongxia Hua, Hanfei Zhu, Jinling Lu, Qin Xu

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Background: Postoperative pain is a prevalent problem leading to many adverse outcomes in surgical patients. Virtual reality (VR) is an emerging non-pharmacological method of postoperative pain relief, but the effects of it are not clear. This review aimed to explore the effects of VR on relieving postoperative pain. Methods: We searched PubMed, Embase, Web of Science, and other databases from inception to November 2019 to get the eligible studies. Meta-analyses were conducted to compare VR and usual care for relieving postoperative pain. Subgroup analyses and sensitivity analyses were performed to explain the heterogeneity. Results: Overall, 8 randomized control trials (RCTs) enrolling 723 participants were included. Our results demonstrated that the patients receiving the VR intervention had lower postoperative pain scores than those receiving the usual care. One subgroup analysis revealed that VR could relieve postoperative pain both in minor surgery and major surgery. Another subgroup analysis demonstrated a significant reduction in postoperative pain among patients receiving VR during the intraoperative and the postoperative periods. However, there was no significant postoperative pain relief when receiving VR during the preoperative period. Additionally, significant improvements in postoperative satisfaction were reported in two studies. However, another two studies included found that VR could not affect physiological parameters related to pain. Conclusion: Applying VR can relieve postoperative pain effectively. The type of surgery and timing of using VR are the main sources of heterogeneity. More rigorous studies about the relationship between VR and postoperative pain relief will be needed.

Keywords: meta-analysis, postoperative pain, systematic review, virtual reality

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14010 Academic Achievement in Argentinean College Students: Major Findings in Psychological Assessment

Authors: F. Uriel, M. M. Fernandez Liporace

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In the last decade, academic achievement in higher education has become a topic of agenda in Argentina, regarding the high figures of adjustment problems, academic failure and dropout, and the low graduation rates in the context of massive classes and traditional teaching methods. Psychological variables, such as perceived social support, academic motivation and learning styles and strategies have much to offer since their measurement by tests allows a proper diagnose of their influence on academic achievement. Framed in a major research, several studies analysed multiple samples, totalizing 5135 students attending Argentinean public universities. The first goal was aimed at the identification of statistically significant differences in psychological variables -perceived social support, learning styles, learning strategies, and academic motivation- by age, gender, and degree of academic advance (freshmen versus sophomores). Thus, an inferential group differences study for each psychological dependent variable was developed by means of student’s T tests, given the features of data distribution. The second goal, aimed at examining associations between the four psychological variables on the one hand, and academic achievement on the other, was responded by correlational studies, calculating Pearson’s coefficients, employing grades as the quantitative indicator of academic achievement. The positive and significant results that were obtained led to the formulation of different predictive models of academic achievement which had to be tested in terms of adjustment and predictive power. These models took the four psychological variables above mentioned as predictors, using regression equations, examining predictors individually, in groups of two, and together, analysing indirect effects as well, and adding the degree of academic advance and gender, which had shown their importance within the first goal’s findings. The most relevant results were: first, gender showed no influence on any dependent variable. Second, only good achievers perceived high social support from teachers, and male students were prone to perceive less social support. Third, freshmen exhibited a pragmatic learning style, preferring unstructured environments, the use of examples and simultaneous-visual processing in learning, whereas sophomores manifest an assimilative learning style, choosing sequential and analytic processing modes. Despite these features, freshmen have to deal with abstract contents and sophomores, with practical learning situations due to study programs in force. Fifth, no differences in academic motivation were found between freshmen and sophomores. However, the latter employ a higher number of more efficient learning strategies. Sixth, freshmen low achievers lack intrinsic motivation. Seventh, models testing showed that social support, learning styles and academic motivation influence learning strategies, which affect academic achievement in freshmen, particularly males; only learning styles influence achievement in sophomores of both genders with direct effects. These findings led to conclude that educational psychologists, education specialists, teachers, and universities must plan urgent and major changes. These must be applied in renewed and better study programs, syllabi and classes, as well as tutoring and training systems. Such developments should be targeted to the support and empowerment of students in their academic pathways, and therefore to the upgrade of learning quality, especially in the case of freshmen, male freshmen, and low achievers.

Keywords: academic achievement, academic motivation, coping, learning strategies, learning styles, perceived social support

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14009 Willingness and Attitude towards Organ Donation of Nurses in Taiwan

Authors: ShuYing Chung, Minchuan Huang, Iping Chen

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Taking the medical staff in an emergency ward of a medical center in Central Taiwan as the research object, the questionnaire data were collected by anonymous and voluntary reporting methods with structured questionnaire to explore the actual situation, willingness and attitude of organ donation. Only 80 valid questionnaires were collected. Among the 8 questions, the average correct rate was 5.9 + 1.2, and the correct rate was 73.13%. The willingness of organ donation that 7.5% of the people are not willing; 92.5% of the people are willing, of which 62.5% have considered but have not yet decided; 21.3% are willing but have not signed the consent of organ donation; They have signed the consent of organ donation 8.7%. The average total score (standard deviation) of attitude towards organ donation was 36.2. There is no significant difference between the demographic variables and the awareness and willingness of organ donation, but there is a significant correlation between the marital status and the attitude of organ donation.

Keywords: clinical psychology, organ donation, doctors affecting psychological disorders, commitment

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14008 An Integrated Approach to Cultural Heritage Management in the Indian Context

Authors: T. Lakshmi Priya

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With the widening definition of heritage, the challenges of heritage management has become more complex . Today heritage not only includes significant monuments but comprises historic areas / sites, historic cities, cultural landscapes, and living heritage sites. There is a need for a comprehensive understanding of the values associated with these heritage resources, which will enable their protection and management. These diverse cultural resources are managed by multiple agencies having their own way of operating in the heritage sites. An Integrated approach to management of these cultural resources ensures its sustainability for the future generation. This paper outlines the importance of an integrated approach for the management and protection of complex heritage sites in India by examining four case studies. The methodology for this study is based on secondary research and primary surveys conducted during the preparation of the conservation management plansfor the various sites. The primary survey included basic documentation, inventorying, and community surveys. Red Fort located in the city of Delhi is one of the most significant forts built in 1639 by the Mughal Emperor Shahjahan. This fort is a national icon and stands testimony to the various historical events . It is on the ramparts of Red Fort that the national flag was unfurled on 15th August 1947, when India became independent, which continues even today. Management of this complex fort necessitated the need for an integrated approach, where in the needs of the official and non official stakeholders were addressed. The understanding of the inherent values and significance of this site was arrived through a systematic methodology of inventorying and mapping of information. Hampi, located in southern part of India, is a living heritage site inscribed in the World Heritage list in 1986. The site comprises of settlements, built heritage structures, traditional water systems, forest, agricultural fields and the remains of the metropolis of the 16th century Vijayanagar empire. As Hampi is a living heritage site having traditional systems of management and practices, the aim has been to include these practices in the current management so that there is continuity in belief, thought and practice. The existing national, regional and local planning instruments have been examined and the local concerns have been addressed.A comprehensive understanding of the site, achieved through an integrated model, is being translated to an action plan which safeguards the inherent values of the site. This paper also examines the case of the 20th century heritage building of National Archives of India, Delhi and protection of a 12th century Tomb of Sultan Ghari located in south Delhi. A comprehensive understanding of the site, lead to the delineation of the Archaeological Park of Sultan Ghari, in the current Master Plan for Delhi, for the protection of the tomb and the settlement around it. Through this study it is concluded that the approach of Integrated Conservation has enabled decision making that sustains the values of these complex heritage sites in Indian context.

Keywords: conservation, integrated, management, approach

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14007 Multicenter Baseline Survey to Outline Antimicrobial Prescribing Practices at Six Public Sectortertiary Care Hospitals in a Low Middle Income Country

Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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14006 The Impact of Sensory Overload on Students on the Autism Spectrum in Italian Inclusive Classrooms: Teachers' Perspectives and Training Needs

Authors: Paola Molteni, Luigi d’Alonzo

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Background: Sensory issues are now considered one of the key aspects in defining and diagnosing autism, changing the perspectives on behavioural analysis and intervention in mainstream educational services. However, Italian teachers’ training is yet not specific on the topic of autism and its sensory-related effects and this research investigates the teacher’s capability in understanding the student’s needs and his/her challenging behaviours considering sensory perceptions. Objectives: The research aims to analyse mainstream schools teachers’ awareness on students’ sensory perceptions and how this affects classroom inclusion and learning process. The research questions are: i) Are teachers able to identify student’s sensory issues?; ii) Are trained teachers more able to identify sensory problems then untrained ones?; iii) What is the impact of sensory issues on inclusion in mainstream classrooms?; iv) What should teachers know about autistic sensory dimensions? Methods: This research was designed as a pilot study that involves a multi-methods approach, including action and collaborative research methodology. The designed research allows the researcher to catch the complexity of a province school district (from kindergarten to high school) through a deep detailed analysis of selected aspects. The researcher explored the questions described above through 133 questionnaires and 6 focus groups. The qualitative and quantitative data collected during the research were analysed using the Interpretative Phenomenological Analysis (IPA). Results: Mainstream schools teachers are not able to confidently recognise sensory issues of children included in the classroom. The research underlines: how professionals with no specific training on autism are not able to recognise sensory problems in students on the spectrum; how hearing and sight issues have higher impact on classroom inclusion and student’s learning process; how a lack of understanding is often followed by misinterpretations of the impact of sensory issues and challenging behaviours. Conclusions: As this research has shown, promoting and enhancing the importance of understanding sensory issues related to autism is fundamental to enable mainstream schools teachers to define educational and life-long plans able to properly answer the student’s needs and support his/her real inclusion in the classroom. This study is a good example of how the educational research can meet and help the daily practice in working with people on the autism spectrum and support the training design for mainstream school teachers: the emerging need of designed preparation on sensory issues is fundamental to be considered when planning school district in-service training programmes, specifically declined for inclusive services.

Keywords: autism spectrum condition, scholastic inclusion, sensory overload, teacher's training

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14005 Interdisciplinary Method Development - A Way to Realize the Full Potential of Textile Resources

Authors: Nynne Nørup, Julie Helles Eriksen, Rikke M. Moalem, Else Skjold

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Despite a growing focus on the high environmental impact of textiles, textile waste is only recently considered as part of the waste field. Consequently, there is a general lack of knowledge and data within this field. Particularly the lack of a common perception of textiles generates several problems e.g., to recognize the full material potential the fraction contains, which is cruel if the textile must enter the circular economy. This study aims to qualify a method to make the resources in textile waste visible in a way that makes it possible to move them as high up in the waste hierarchy as possible. Textiles are complex and cover many different types of products, fibers and combinations of fibers and production methods. In garments alone, there is a great variety, even when narrowing it to only undergarments. However, textile waste is often reduced to one fraction, assessed solely by quantity, and compared to quantities of other waste fractions. Disregarding the complexity and reducing textiles to a single fraction that covers everything made of textiles increase the risk of neglecting the value of the materials, both with regards to their properties and economical. Instead of trying to fit textile waste into the current primarily linear waste system where volume is a key part of the business models, this study focused on integrating textile waste as a resource in the design and production phase. The study combined interdisciplinary methods for determining replacement rates used in Life Cycle Assessments and Mass Flow Analysis methods with the designer’s toolbox to hereby activate the properties of textile waste in a way that can unleash its potential optimally. It was hypothesized that by activating Denmark's tradition for design and high level of craftsmanship, it is possible to find solutions that can be used today and create circular resource models that reduce the use of virgin fibers. Through waste samples, case studies, and testing of various design approaches, this study explored how to functionalize the method so that the product after the end-use is kept as a material and only then processed at fiber level to obtain the best environmental utilization. The study showed that the designers' ability to decode the properties of the materials and understanding of craftsmanship were decisive for how well the materials could be utilized today. The later in the life cycle the textiles appeared as waste, the more demanding the description of the materials to be sufficient, especially if to achieve the best possible use of the resources and thus a higher replacement rate. In addition, it also required adaptation in relation to the current production because the materials often varied more. The study found good indications that part of the solution is to use geodata i.e., where in the life cycle the materials were discarded. An important conclusion is that a fully developed method can help support better utilization of textile resources. However, it stills requires a better understanding of materials by the designers, as well as structural changes in business and society.

Keywords: circular economy, development of sustainable processes, environmental impacts, environmental management of textiles, environmental sustainability through textile recycling, interdisciplinary method development, resource optimization, recycled textile materials and the evaluation of recycling, sustainability and recycling opportunities in the textile and apparel sector

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14004 A Comprehensive Approach to Scour Depth Estimation Through HEC-RAS 2D and Physical Modeling

Authors: Ashvinie Thembiliyagoda, Kasun De Silva, Nimal Wijayaratna

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The lowering of the riverbed level as a result of water erosion is termed as scouring. This phenomenon remarkably undermines the potential stability of the bridge pier, causing a threat of failure or collapse. The formation of vortices in the vicinity of bridges due to the obstruction caused by river flow is the main reason behind this pursuit. Scouring is aggravated by factors including high flow rates, bridge pier geometry, sediment configuration etc. Tackling scour-related problems when they become severe is more costly and disruptive compared to implementing preventive measures based on predicted scour depths. This paper presents a comprehensive investigation of the development of a numerical model that could reproduce the scouring effect around bridge piers and estimate the scour depth. The numerical model was developed for one selected bridge in Sri Lanka, the Kelanisiri Bridge. HEC-RAS two-dimensional (2D) modeling approach was utilized for the development of the model and was calibrated and validated with field data. To further enhance the reliability of the model, a physical model was developed, allowing for additional validation. Results from the numerical model were compared with those obtained from the physical model, revealing a strong correlation between the two methods and confirming the numerical model's accuracy in predicting scour depths. The findings from this study underscore the ability of the HEC-RAS two-dimensional modeling approach for the estimation of scour depth around bridge piers. The developed model is able to estimate the scour depth under varying flow conditions, and its flexibility allows it to be adapted for application to other bridges with similar hydraulic and geomorphological conditions, providing a robust tool for widespread use in scour estimation. The developed two-dimensional model not only offers reliable predictions for the case study bridge but also holds significant potential for broader implementation, contributing to the improved design and maintenance of bridge structures in diverse environments.

Keywords: piers, scouring, HEC-RAS, physical model

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14003 Comparison of Gestational Diabetes Influence on the Ultrastructure of Rectus Abdominis Muscle in Women and Rats

Authors: Giovana Vesentini, Fernanda Piculo, Gabriela Marini, Debora Damasceno, Angelica Barbosa, Selma Martheus, Marilza Rudge

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Problem statement: Skeletal muscle is highly adaptable, muscle fiber composition and size can respond to a variety of stimuli, such physiologic, as pregnancy, and metabolic abnormalities, as Diabetes mellitus. This study aimed to analyze the effects of pregnancy-associated diabetes on the rectus abdominis muscle (RA), and to compare this changes in rats and women. Methods: Female Wistar rats were maintained under controlled conditions and distributed in Pregnant (P) and Long-term mild pregnant diabetic (LTMd) (n=3 r/group). Diabetes in rats was induced by streptozotocin (100mg/Kg, sc) on the first day of life, for a hyperglycemic state between 120-300 mg/dL in adult life. Female rats were mated overnight, at day 21 of pregnancy were anesthetized, and killed for the harvesting of maternal RA. Pregnant women who attended the Diabetes Prenatal Care Clinic of Botucatu Medical School were distributed in Pregnant non-diabetic (Pnd) and Gestational Diabetic (GDM) (n=3 w/group). The diagnosis of GDM was established according to ADA’s criteria (2016). The harvesting of RA was during the cesarean section. Transversal cross-sections of the RA of both women and rats were analyzed by transmission electron microscopy. All procedures were approved by the Ethics Committee on Animal Experiments of the Botucatu Medical School (Protocol Number 1003/2013) and by the Botucatu Medical School Ethical Committee for Human Research in Medical Sciences (CAAE: 41570815.0.0000.5411). Results: The photomicrographs of the RA of rats revealed disorganized Z lines, thinning sarcomeres, and a usual quantity of intermyofibrillar mitochondria in the P group. The LTMd group showed swollen sarcoplasmic reticulum, dilated T tubes and areas with sarcomere disruption. The ultrastructural analysis of Pnd non-diabetic women in the RA showed well-organized myofibrils forming intact sarcomeres, organized Z lines and a normal distribution of intermyofibrillar mitochondria. The GDM group revealed increase in intermyofibrillar mitochondria, areas with sarcomere disruption and increased lipid droplets. Conclusion: Pregnancy and diabetes induce adaptations in the ultrastructure of the rectus abdominis muscle for both women and rats, changing the architectural design of these tissues. However, in rats these changes are more severe maybe because, besides the high blood glucose levels, the quadrupedal animal may suffer an excessive mechanical tension during pregnancy by gravity. Probably, these findings may suggest that these alterations are a risk factor that contributes to the development of muscle dysfunction in women with GDM and may motivate treatment strategies in these patients.

Keywords: gestational diabetes, muscle dysfunction, pregnancy, rectus abdominis

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14002 Retrospective Study of Positive Blood Cultures Carried out in the Microbiology Department of General Hospital of Ioannina in 2017

Authors: M. Gerasimou, S. Mantzoukis, P. Christodoulou, N. Varsamis, G. Kolliopoulou, N. Zotos

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Purpose: Microbial infection of the blood is a serious condition where bacteria invade the bloodstream and cause systemic disease. In such cases, blood cultures are performed. Blood cultures are a key diagnostic test for intensive care unit (ICU) patients. Material and method: The BacT/Alert system, which measures the production of carbon dioxide with metabolic organisms, is used. The positive result in the BacT/Alert system is followed by culture in the following selective media: Blood, Mac Conkey No 2, Chocolate, Mueller Hinton, Chapman and Sabaureaud agar. Gram staining method was used to differentiate bacterial species. The microorganisms were identified by biochemical techniques in the automated Microscan (Siemens) system and followed by a sensitivity test on the same system using the minimum inhibitory concentration MIC technique. The sensitivity test is verified by a Kirby Bauer-based test. Results: In 2017 the Laboratory of Microbiology received 3347 blood cultures. Of these, 170 came from the ICU. 116 found positive. Of these S. epidermidis was identified in 42, A. baumannii in 27, K. pneumoniae in 12 (4 of these KPC ‘Klebsiella pneumoniae carbapenemase’), S. hominis in 8, E. faecium in 7, E. faecalis in 5, P. aeruginosa in 3, C. albicans in 3, S. capitis in 2, K. oxytoca in 2, P. mirabilis in 2, E. coli in 1, S. intermidius in 1 and S. lugdunensis in 1. Conclusions: The study of epidemiological data and microbial resistance phenotypes is essential for the choice of therapeutic regimen for the early treatment and limitation of multivalent strains, while it is a crucial factor to solve diagnostic problems.

Keywords: blood culture, bloodstream, infection, intensive care unit

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14001 Effect of Media on Psycho-Social Interaction among the Children with Their Parents of Urban People in Dhaka

Authors: Nazma Sultana

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Social media has become an important part of our daily life. It has a significance influences on the people who use them in their daily life frequently. The number of people using social network sites has been increasing continuously. For this frequent utilization has started to affect our social life. This study examine whether the use of social network sites affects the psychosocial interaction between children and their parents. At first parents introduce their children to the internet and different type of device in their early childhood. Many parents use device for feeding their children by watching rhyme or cartoon. As a result children are habituate with it. In Bangladesh 70% people are heavy internet users. About 23 percent of them spend more than five hours on the social networking sites a day. Media are increasing pervasive in the lives of children-roughly the average child today spends nearly about 45 hours per week with media, compared with 17 hours with parents and 30 hours in school. According to a social learning theory, children & adolescents learn by observing & imitating what they see on screen particularly when these behaviors are realistic or are rewarded. The influence of the media on the psychosocial development of children is profound. Thus it is important for parents to provide guidance on age-appropriate use of all media, including television, radio, music, video games and the internet.

Keywords: social media, psychosocial, Technology, Parent, Social Relationship, Adolescents, Teenage, Youth

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14000 Interplay of Imaginary, Symbolic and Real In Shakespeare's Hamlet, Disturbance of Nature

Authors: Mahnaz Poorshahidi

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This article is a psychological reading of Shakespeare’s Hamlet applying Lacan’s ideas to work with a new look. Lacan entitled Hamlet ‘tragedy of desire’. He believes that Hamlet is caught up in the desire of his mother. So he is the universal symbol of all human beings, regardless of their sex, who desire their mother, but based on the rules of Nature and Father, this unity is impossible. Hamlet hesitates in fulfilling the task of revenge and the text says nothing about the reasons and motives behind it. However, this essay tries to answer the question and justify Hamlet’s hesitation. There is one question for the readers, which is why Hamlet appears to delay in killing his uncle, despite the fact that this is precisely what he seems to want to do. In 1958-59 Lacan delivered a series of lectures on Hamlet entitled ‘Desire and Its Interpretations’ and called it ‘tragedy of desire’. However, this article will have a new representation of Hamlet’s decision not to take revenge. The research demonstrates that Hamlet has passed through imaginary, symbolic and real stages, which are the natural process of life. Eliminating father means disturbing this natural process. This essay is going to conclude that killing Claudius can break the natural order of life. On the other hand, Claudius has also disturbed nature and is regretful about his deed. Hamlet’s ever-present speech ‘To be or not to be’ reflects his mental turmoil and disturbance of the natural life cycle: Nature.

Keywords: desire, father figure, lacan, nature

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13999 Academic Major, Gender, and Perceived Helpfulness Predict Help-Seeking Stigma

Authors: Tran Tran

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Mental health issues are prevalent among Vietnamese undergraduate students, and they are greatly exacerbated during the COVID-19 pandemic for this population. While there is empirical evidence supporting the effectiveness and efficiency of therapy on mental health issues among college students, the rates of Vietnamese college students seeking professional mental health services were alarmingly low. Multiple factors can prevent those in need from finding support. The Internalized Stigma Model posits that public stigma directly affects intentions to seek psychological help via self-stigma and attitudes toward seeking help. However, little research has focused on what factors can predict public stigma toward seeking professional psychological support, especially among this population. A potential predictor is academic majors since academic majors can influence undergraduate students' perceptions, attitudes, and intentions. A study suggested that students who have completed two or more psychology courses have a more positive attitude toward seeking care for mental health issues and reduced stigma, which might be attributed to increased mental health literacy. In addition, research has shown that women are more likely to utilize mental health services and have lower stigma than men. Finally, studies have also suggested that experience of mental health services can increase endorsement of perceived need and lower stigma. Thus, it is expected that perceived helpfulness from past service uses can reduce stigma. This study aims to address this gap in the literature and investigate which factors can predict public stigma, specifically academic major, gender, and perceived helpfulness, potentially suggesting an avenue of prevention and ultimately improving the well-being of Vietnamese college students. The sample includes 408 undergraduate students (Mage = 20.44; 80.88% female) Hanoi city, Vietnam. Participants completed a pen-and-paper questionnaire. Students completed the Stigma Scale for Receiving Psychological Help, which yielded a mean public stigma score. Participants also completed a measurement assessing their perceived helpfulness of their university’s counseling center, which included eight subscales: future self-development, learning issues, career counseling, medical and health issues, mental health issues, conflicts between teachers and students, conflicts between parents and students, and interpersonal relationships. Items were summed to create a composite perceived helpfulness score. Finally, participants provided demographic information. This included gender, which was dichotomized between female and other. Additionally, it included academic major, which was also similarly dichotomized between psychology and other (e.g., natural science, social science, and pedagogy & social work). Linear relationships between public stigma and gender, academic major, and perceived helpfulness were analyzed individually with a regression model. Findings suggested that academic major, gender, and perceived counseling center's helpfulness predicted stigma against seeking professional psychological help. Specifically, being a psychology major predicted lower levels of public stigma (β = -.25, p < .001). Additionally, gender female predicted lower levels of public stigma (β = -.11, p < .05). Lastly, higher levels of perceived helpfulness of the counseling center also predicted lower levels of public stigma (β = -.16, p < .01). The study’s results offer potential intervention avenues to help reduce stigma and increase well-being for Vietnamese college students.

Keywords: stigma, vietnamese college students, counseling services, help-seeking

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