Search results for: clinical education

Authors: Humphrey Atwijukiire, Gladys Nakidde, Anne Tweheyo Otwine, Jane Kabami

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Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda Introduction: Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. This study explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Methods: We conducted 12 in-depth interviews using translated interview guide, and audio recorders. Participants were purposively enrolled in the study. The study was conducted at three public health facilities in Mbarara City. Data was analyzed using thematic content analysis. Approval for this research was obtained from Mbarara University Research Ethics Committee and administrative clearance from city clerk of Mbarara City. Results: The mean age of participants was 38 years. An equal number of males (six) and females participated. Most of them had at least secondary level education, only three had primary education. Experienced benefits of HIV serostatus disclosure included: social support and care; decisions regarding health, fertility, and child bearing; sharing information on HIV prevention and protection; positive living; and, ease of HIV disclosure. The challenges included: misunderstandings in the families. Conclusion: Socially, psychologically and financially PLWHIV have benefited from their negative partners. Health wise, they have been supported, and cared for, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

Keywords: discordant couples, disclosure, experiences, HIV

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Authors: G. C. Phiri, E. A. Heil, A. A. Kalimbira, E. Muehlhoff, C. Masangano, B. M. Mtimuni, J. Herrmann, M. B. Krawinkel, I. Jordan

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Background and objectives: High prevalence of undernutrition in Malawi is caused by poor complementary foods. Lack of knowledge of age appropriate food within the household might affect utilization of available resources. FAO-Malawi implemented nutrition education (NE) sessions in 200 villages in Kasungu and Mzimba districts from December 2012 to April 2013 targeting 15 caregivers per village of children aged 6-18 months, grandmothers, spouses and community leaders. Two trained volunteers per village facilitated 10 NE sessions on breastfeeding, food safety and hygiene and complementary feeding using locally available resources. This study assessed the reported dietary diversification practices of infant and young child after nutrition education and the factors that influenced adoption of the practice. Methodology: Questionnaire-based interviews with caregivers were conducted in 16 randomly selected villages (n=108) before training-(t1) and seven months after training-(t2). Knowledge score (KS) was calculated on the indicators breastfeeding, hygiene and complementary feeding. Count regression was performed using SPSS 22. Eight focus group discussions (FGDs) were separately conducted among caregivers and grandmothers in 4 villages. Content analysis was used to analyze FGDs data. Results: Following NE, caregivers' KS significantly increased (p<0.001) between t1 and t2 for breastfeeding (7.7 vs. 9.8, max=18), hygiene (3.8 vs. 5.9, max=7) and complementary feeding (10.2 vs. 16.2, max=26). Caregivers indicated that they stopped preparation of plain-refined maize meal porridge after they gained knowledge on dietary diversification of complementary foods. They learnt mushing and pounding of ingredients for enriched porridge. Whole-maize meal or potatoes were often enriched with vegetables, legumes, small fish or eggs and cooking oil. Children liked the taste of enriched porridge. Amount of enriched porridge consumed at each sitting increase among previously fussy-eater children. Meal frequency increased by including fruits as snacks in child’s diet. Grandmothers observed preparation of enriched porridge among the mothers using locally available foods. Grandmothers liked the taste of enriched porridge and not the greenish color of the porridge. Both grandmothers and mothers reported that children were playing independently after consuming enriched porridge and were strong and healthy. These motivated adoption of the practice. Conclusion: Increased knowledge and skill of preparation and utilisation of locally available foods promoted children’s dietary diversification. Children liking the enriched porridge motivated adoption of dietary diversification.

Keywords: behaviour change, complementary feeding, dietary diversification, IYCN

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Authors: Aregamalage Sujeewa Vijayanthi Polgampala, Fang Huang

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This study explores the genesis and development of concept mapping as a useful tool for science education and its effectiveness as technique for teaching and learning and evaluation for secondary science in schools and the role played by National College of Education science teachers. Concept maps, when carefully employed and executed serves as an integral part of teaching method and measure of effectiveness of teaching and tool for evaluation. Research has shown that science concept maps can have positive influence on student learning and motivation. The success of concept maps played in an instruction class depends on the type of theme selected, the development of learning outcomes, and the flexibility of instruction in providing library unit that is equipped with multimedia equipment where learners can interact. The study was restricted to 6 male and 9 female respondents' teachers in third-year internship pre service science teachers in Gampaha district Sri Lanka. Data were collected through 15 item questionnaire provided to learners and in depth interviews and class observations of 18 science classes. The two generated hypotheses for the study were rejected, while the results revealed that significant difference exists between factors influencing teachers' choice of concept maps, its usefulness and problems hindering the effectiveness of concept maps for teaching and learning process of secondary science in schools. It was examined that concept maps can be used as an effective measure to evaluate students understanding of concepts and misconceptions. Even the teacher trainees could not identify, key concept is on top, and subordinate concepts fall below. It is recommended that pre service science teacher trainees should be provided a thorough training using it as an evaluation instrument.

Keywords: concept maps, evaluation, learning science, misconceptions

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Authors: N. Tal-Alon, O. Shapira-Lishchinsky

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Disability disclosure is one of the most complicated dilemmas that people with invisible disabilities face. There are only a few research studies that have focused on the difficulties and dilemmas of teachers who have different disabilities. In addition, there are currently no research studies focusing specifically on the different aspects of disability disclosure, which are unique to teachers. This research has, therefore, broadened the knowledge base and understanding of the dilemma of disability disclosure among teachers with invisible physical disabilities. In addition, it has shed light on the ways this issue is perceived by different groups: the perspective of school principals, the perspective of colleagues, and the perspective of teachers with physical disabilities themselves. The study sample included 12 teachers with invisible physical disabilities, 10 school principals who employ at least one teacher with an invisible physical disability, and 10 professional colleagues of at least one teacher with an invisible physical disability. This particular research study was conducted using a qualitative approach through the Narralizer computer program based on a series of in-depth interviews. The data analysis was carried out by grouping major points of interest into specific categories and sub-categories. The findings of this research suggest that teachers with disabilities struggle with the dilemma of whether or not to reveal their disability to the school staff and to their students. It was found that there were considerable differences between the issues that faculty members considered regarding this dilemma and the ones that teachers with disabilities considered. While the principals and professional colleagues focused solely on their own interests, the teachers with a disability emphasized more on the ways that they might have a positive influence on their students, as well as their own individual interests. In addition, school principals on a whole tended to view negatively the option of disclosing the disability to the students and were often critical towards teachers who concealed their disability from the school staff. The importance of this research is in its potential to influence policy decisions that can be implemented by the Ministry of Education regarding the support system for teachers with invisible physical disabilities.

Keywords: education, employment, invisible disabilities, teachers

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Authors: James D. Beauchemin

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This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

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Authors: Elena G. Diryugina, Maria A. Dovger, Maria V. Lunkina, Alexandra A. Ianchenko

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The personality development and well-being of children have become important focuses of school education and indicators of its quality. The studies show that academic success depends more on personality and motivation than on intelligence and giftedness. Those personality resources that help a person to maintain well-being both here and now and in the future constitute their personality potential. The development of schoolchildrens' personality potential can help them meet the challenges of the modern world and achieve new educational goals. At the same time, it is noted that the pedagogical factor is one of the most significant in relation to schoolchildrens' success and well-being. What is important for teachers to develop in order to make their students feel more competent and maintain well-being? As part of the Developmental Environment Programme of the Charitable Foundation ‘Investment in the Future’, a longitudinal study of the personality potential and well-being of educators and schoolchildren was conducted from 2018 to 2023. More than 2,500 teachers and over 4,000 students from Russia took part. It was found that behind a teacher's communication style, an important construct that influences the motivation of schoolchildren and the satisfaction of their basic psychological needs, is the personal potential of that teacher. Their personality potential correlates with the social-emotional development of schoolchildren in junior grades. A teacher's communication style with adolescents contributes to their academic motivation, self-esteem and satisfaction with life and learning. In addition, child well-being cannot be promoted in isolation from attention to the psychological well-being of teachers. Their social well-being and engagement are higher when they are included in professional learning communities. The results will be helpful for both positive education researchers and practitioners to identify an approach to child personality development and well-being that is achieved primarily through the personality development and well-being of school staff members and mostly teachers.

Keywords: Personality development, personality potential, schoolchildren, teaching style, well-being

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Authors: Bianca Price, Jennifer Stokes

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Academic and social support systems are critical for students in enabling education; these support systems have the potential to enhance the student experience whilst also serving a vital role for student retention. In the context of international moves toward widening university participation, Australia has developed enabling programs designed to support underrepresented students to access to higher education. The purpose of this study is to examine the effectiveness of a mentor program based within an enabling course. This study evaluates how the mentor program supports new students to develop social networks, improve retention, and increase satisfaction with the student experience. Guided by Social Learning Theory (SLT), this study highlights the benefits that can be achieved when students engage in peer-to-peer based mentoring for both social and learning support. Whilst traditional peer mentoring programs are heavily based on face-to-face contact, the present study explores the difference between mentors who provide face-to-face mentoring, in comparison with mentoring that takes place through the virtual space, specifically via a virtual community in the shape of a Facebook group. This paper explores the differences between these two methods of mentoring within an enabling program. The first method involves traditional face-to-face mentoring that is provided by alumni students who willingly return to the learning community to provide social support and guidance for new students. The second method requires alumni mentor students to voluntarily join a Facebook group that is specifically designed for enabling students. Using this virtual space, alumni students provide advice, support and social commentary on how to be successful within an enabling program. Whilst vastly different methods, both of these mentoring approaches provide students with the support tools needed to enhance their student experience and improve transition into University. To evaluate the impact of each mode, this study uses mixed methods including a focus group with mentors, in-depth interviews, as well as engaging in netnography of the Facebook group ‘Wall’. Netnography is an innovative qualitative research method used to interpret information that is available online to better understand and identify the needs and influences that affect the users of the online space. Through examining the data, this research will reflect upon best practice for engaging students in enabling programs. Findings support the applicability of having both face-to-face and online mentoring available for students to assist enabling students to make a positive transition into University undergraduate studies.

Keywords: enabling education, mentoring, netnography, social learning theory

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Authors: Teodora Mocan, Lucian Mocan, Cornel Iancu, Flaviu A. Tabaran, Bartos Dana, Matea Cristian

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Antimicrobial resistance, which threatens the efficacy of the existing antibiotics represents a worldwide public health issue. At the current time, vancomycin is the only responsive treatment although has significant cytotoxicity, is partially effective and it is poorly retained by infected tissues. From a clinical point of view, attractive alternative approaches for treating such Meticillin-Resistant Staphylococcus Aureus (MRSA) strains would be using agents that cause physical damage to the bacteria. Modular nanopharmaceuticals systems are being designed to address all of these multifunctional capabilities for the ideal bacterial treatment, with the ability to mix and match appropriate functions. Here we present a novel method of selective laser photothermal ablation of MRSA bacteria mediated by gold nanoparticles bound to PBP antibody against PBP protein located on the MRSA surface.

Keywords: MRSA, laser, nanoparticle, antibody

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Authors: S. I. Mwasha, Z. Robinson, M. Musgrave

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Communities, especially in the global south, have been reported to have low adaptive capacity to cope with climate change impacts. As an attempt to improve adaptive capacity, most studies have focused on understanding the access of the household resources which can contribute to resilience against changes. However, little attention has been shown in uncovering how the household resources could be used and their implications to resilience against weather related shocks. By using a case study qualitative study, this project analyzed the trends in livelihoods practices and their implication to social equity. The study was done in three different villages within Kilimanjaro region. Each in different agro ecological zone. Two focus group discussions in two agro-ecological zones were done, one for women and another one for men except in the third zone where focus group participant were combined together (due to unforeseen circumstances). In the focus group discussion, several participatory rural appraisal tools were used to understand trend in crops and animal production and the use in which it is made: climate trends, soil fertility, trees and other livelihoods resources. Data were analyzed using thematic network analysis. Using an amalgam of magnitude (to note weather comments made were positive or negative) and descriptive coding (to note the topic), six basic themes were identified under social equity: individual ownership, family ownership, love and respect, women no education, women access to education as well as women access to loans. The results implied that despite mum and dad in the family providing labor in the agro pastoral activities, there were separations on who own what, as well as individual obligations in the family. Dad owned mostly income creating crops and mum, food crops. therefore, men controlled the economy which made some of them become arrogant and spend money to meet their interests sometimes not taking care of the family. Separation in ownership was reported to contribute to conflicts in the household as well as causing controversy on the use income is spent. Men were reported to use income to promote matriarchy system. However, as women were capacitated through access to education and loans they become closer to their husband and get access to own and plan the income together for the interest of the family. Joint ownership and planning on the household resources were reported to be important if families have to better adapt to climate change. The aim of this study is not to show women empowerment and joint ownership and planning as only remedy for low adaptive capacity. There is the need to understand other practices that either directly or indirectly impacts environmental integrity, food security and economic development for household resilience against changing climate.

Keywords: adaptive capacity, climate change, resilience, women empowerment

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Authors: Mehwish Azam, Muhammad Imran, Humaira Jabeen, Sumreen Begum, Rashida Qasim

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Background: Metabolic syndrome is a cluster of metabolic risk factors including obesity, glucose intolerance, insulin resistance, dyslipidemia and hypertension. Metabolic syndrome in obese and type 2 diabetic subjects increases the risk of cardiovascular diseases (CVD). Globally, the prevalence of metabolic syndrome ranges from 10%-50% and in Pakistan ranges from 18%-46%. The objective of the present study is to estimate the prevalence of metabolic syndrome (MS) in obese type 2 diabetic subjects by using International Diabetes Federation (IDF) and National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) definitions. Methods: Obese type 2 diabetic subjects and normal healthy subjects of both genders were selected from diabetic clinics and hospitals of various localities of Karachi, Pakistan. The frequency of metabolic syndrome was estimated by the proposed definitions of IDF and NCEP-ATP III. Results: The prevalence of metabolic syndrome using International Diabetes Federation (IDF) definition in obese type 2 diabetic subjects was 85.7%. It is significantly higher (p<0.05) in females (47.1%) as compared to males (38.6%). While, using National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) definition the overall prevalence of metabolic syndrome in obese type 2 diabetic subjects was 75.7%, the prevalence is significantly higher (p<0.05) in females (45.7%) than males (30.0%). Conclusion: It is concluded that, the overall prevalence of metabolic syndrome is increasing significantly in obese type 2 diabetic subjects by using IDF and NCEP–ATP III definitions. Therefore, it is need to initiate the preventive measures by arranging public awareness programmes to highlight the significance of a healthy lifestyle and emphasis should be given to reduce weight, increase physical activity, and increase intake of healthy low-glycemic-index foods.

Keywords: metabolic syndrome, diabetes mellitus, obesity, IDF, NCEP-ATP III

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Authors: Dorothy Ebere Adimora

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The study investigated the predictive power of home environment and peer pressure on disruptive behaviour and risky sexual behaviour of Secondary School Class Two Adolescents in Enugu State, Nigeria. The design of the study is a cross sectional survey of correlational study. The study was carried out in the six Education zones in Enugu state, Nigeria. Enugu State is divided into six education zones, namely Agbani, Awgu, Enugu, Nsukka, Obollo-Afor and Udi. The population for the study was all the 31,680 senior secondary class two adolescents in 285 secondary schools in Enugu State, Nigeria in 2014/2015 academic session. The target population was students in SSS.2 senior secondary class two. They constitute one-sixth of the entire student population in the state. The sample of the study was 528, a multi stage sampling technique was employed to draw the sample. Four research questions and four null hypotheses guided the study. The instruments for data collection were an interview session and a structured questionnaire of four clusters, they are; home environment, peer pressure, risky sexual behaviour and disruptive behaviour disorder questionnaires. The instruments were validated by 3 experts, two in psychology and one in measurement and Evaluation in Faculty of Education, University of Nigeria, Nsukka. The reliability coefficient of the instruments was ascertained by subjection to field trial. The adolescents were asked to complete the questionnaire on their home environment, peer pressure, disruptive behaviour disorder and risky sexual behaviours. The risky sexual behaviours were ascertained based on interview conducted on their actual sexual practice within the past 12 months. The research questions were analyzed using Pearson r and R-square, while the hypotheses were tested using ANOVA and multiple regression analysis at 0.05 level of significance. The results of this survey revealed that the adolescents are sexually active in very young ages. The mean age at sexual debut for the adolescents covered in this survey is a pointer to the fact that some of them started engaging in sexual activities long ago. It was also found that the adolescents engage in disruptive behaviour as a result of their poor home environment factors and association with negative peers. Based on the findings, it was recommended that the adolescents should be exposed to enhanced home environment such as parents’ responsiveness, organization of the environment, availability of appropriate learning materials, opportunities for daily stimulation and to offer a proper guidance to these adolescents to avoid negative peer influence which could result in risky sexual behaviour and disruptive behaviour disorder.

Keywords: parenting, peer group, adolescents, sexuality, conduct disorder

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Authors: Wee Akina Sia Seng Lee, Shabeshan Rengasamy, Lim Boon Hooi, Chandrakalavaratharajoo, Mohd Ibrahim K. Azeez

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This study was conducted to examine the effectiveness of Teaching Games For Understanding (TGFU) in improving the hockey tactical skills and state self-confidence among 16-year-old students. Two hundred fifty nine (259) school students were selected for the study based on the intact sampling method. One class was used as the control group (Boys=60, Girls=70), while another as the treatment group (Boys=60, Girls=69) underwent intervention with TGFU in physical education class conducted twice a week for four weeks. The Games Performance Assessment Instrument was used to observe the hockey tactical skills and The State Self-Confidence Inventory was used to determine the state of self-confidence among the students. After four weeks, ANCOVA analysis indicated the treatment groups had significant improvement in hockey tactical skills with F (1, 118) =313.37, p < .05 for school boys, and F (1, 136) =92.62, p < .05 for school girls. The Mann Whitney U test also showed the treatment groups had significant improvement in state self-confidence with U=428.50, z= -7.22, p < .05, r=.06 for school boys. ANCOVA analysis also showed the treatment group had significant improvement in state self-confidence with F (1, 136) =74.40, p < .05 for school girls. This indicates that TGFU in a 40 minute physical education class conducted twice a week for four weeks can significantly improve the hockey tactical skills and state self-confidence among 16-year-old students. The findings give new knowledge to PE teachers to implement the TGFU method as it enhances the hockey tactical skills and state self-confidence among 16-year-old students. Some recommendation was suggested for future research.

Keywords: Teaching Games For Understanding (TGFU), traditional teaching, hockey tactical skills, state self-confidence

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Authors: Arfaoui Emna, Nouira Mariem

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Background and aims: Breastfeeding is the reference feeding for a child, especially during the first months of life. It is not widespread in many countries due to many factors. There has been a decline in exclusive breastfeeding (EB) practice, particularly in the middle- and low-income countries, i.e., Tunisia. The aim of our study was to describe the knowledge, attitudes, and practice of a sample of Tunisian mothers toward breastfeeding. Methods: It was a descriptive cross-sectional study conducted during the year 2022 over a period of two months in three health structures in the north of Tunisia among mothers of infants aged 2 to 18 months. Levels of mothers’ knowledge (low/moderate/high) were determined using a score ranging from 0 to 11 points. EB was defined as the proportion of infants who were exclusively breastfed during the first six months of life. Results: A total of 180 women with a mean age of 33±4.9 years were included. The average knowledge score was equal to 6.4 ±1.5 points, with extremes ranging from 3 to 11 points. Most of the respondents had a moderate knowledge level (44.4%). More than half of surveyed mothers (66.1%) thought that breastfeeding deforms breasts, and 16.7% thought that breastfeeding is specific to women who do not work. Breastfeeding experience during the first week of life was considered difficult in 70% of cases. The prevalence of EB up to 6 months of age was equal to 16.4% [10.8-23.2]. The main reported obstacles during breastfeeding practice were having an insufficient quantity of breast milk (18.3%) and child difficulties with sucking (12.8%), and having pain in the breast while breastfeeding (12.80%). Conclusion: Our results highlighted the insufficient level of knowledge and a low prevalence of EB in our study population. Improving mothers’ knowledge and promoting EB practice is needed. Implementing health education strategies involving healthcare workers, who represent a main actor in education and breastfeeding promotion, is very important to reach a satisfactory frequency for EB.

Keywords: breastfeeding, practices, knowledge, Tunisia

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Authors: Wael El-Deeb

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The present study aimed to investigate the diagnostic importance of acute phase proteins in urinary tract infection (UTI) in cattle. We describe the clinical, bacteriological and biochemical findings in 99 lactating cows. Blood and urine samples from diseased (n=84) and control healthy cows (n=15) were submitted to laboratory investigations. The urine analysis revealed hematuria and pyuria in UTI group. The isolated bacteria were E.coli (43/84) Corynebacterium spp, (31/84), Proteus spp. (6/84) and Streptococcus spp (4/84). The concentrations of Haptoglobin (Hp), serum amyloid A (SAA), α1-Acid glycoprotein (AGP), fibrinogen (Fb), total protein, albumen, and globulin were higher in cows with UTI when compared to healthy ones. Fifty-one of 84 cows with UTI were successfully treated. The levels of Hp, SAA, AGP, total protein, and globulin were associated with the odds of treatment failure. Conclusively, acute phase proteins could be used as diagnostic and prognostic biomarkers in cows with UTI.

Keywords: cows, urinary, infections, haptoglobin, serum Amyloid A

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Authors: Ayesha Sohail, Khadija Maqbool, Anila Asif, Haroon Ahmad

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The field of tissue engineering is an active area of research. Bone tissue engineering helps to resolve the clinical problems of critical size and non-healing defects by the creation of man-made bone tissue. We will design and validate an efficient numerical model, which will simulate the effective diffusivity in bone tissue engineering. Our numerical model will be based on the finite element analysis of the diffusion-reaction equations. It will have the ability to optimize the diffusivity, even at multi-scale, with the variation of time. It will also have a special feature, with which we will not only be able to predict the oxygen, glucose and cell density dynamics, more accurately, but will also sort the issues arising due to anisotropy. We will fix these problems with the help of modifying the governing equations, by selecting appropriate spatio-temporal finite element schemes, by adaptive grid refinement strategy and by transient analysis.

Keywords: scaffolds, porosity, diffusion, transient analysis

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Authors: Kamaljeet Kaur, Vinod Kumari, Jatesh Kathpalia, Bas Kaur

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A gender bias towards girl child is pervasive across the world. It is seen in all the strata of the society and manifests in various forms. However nature and extent of these inequalities are not uniform. Generally these inequalities are more prevalent in patriarchal society. Despite emerging and increasing opportunities for women, there are still inequalities between men and women in each and every sphere like education, health, economy, polity and social sphere. Patriarchal ideology as a cultural norm enforces gender construction which is oriented toward hierarchical relations between the sexes and neglect of women in Indian society. Discrimination to girls may also vary by their age and be restricted to the birth order and sex composition of her elder surviving siblings. The present study was conducted to know the gender discrimination among rural children in India. The respondents were selected from three generations as per AICRP age group viz, 18-30 years (3rd generation), 31-60 years (2nd generation) and above 60 years (1st generation). A total sample size was 600 respondents from different villages of two districts of Haryana state comprising of half males and half females. Data were collected using personal interview schedule and analysed by SPSS software. Among the total births 46.35 per cent were girl child and 53.64 % were male child. Dropout rate was more in female children as compared to male children i.e. near about one third (31.09%) female children dropped school followed by 21.17 % male children. It was quite surprising that near about two-third (61.16%) female children and more than half (59.22%) of the male children dropped school. Cooking was mainly performed by adult female with overall mean scores 2.0 and ranked first which was followed by female child (1.7 mean scores) clearly indicating that cooking was the activity performed mainly by females while activity related to purchase of fruits and vegetable, cereals and pulses was mainly done by adult male. First preference was given to male child for serving of costly and special food. Regarding professional aspiration of children of the respondents’ families, it was observed that 20.10% of the male children wanted to become engineer, whereas only 3.89 % female children wanted to become engineer. Ratio of male children was high in both generations irrespective of the districts. School dropouts were more in case of female in both the 1st and 2 nd generations. The main reasons of school dropout were lack of interest, lack of resources and early marriage in both the generations. Female enrolment was more in faculty of arts, whereas in case of male percentage it was more in faculty of non-medical and medical which showed that female children were getting traditional type of education. It is suggested to provide equal opportunities to girls and boys in home as well as outside the home for smooth functioning of society.

Keywords: gender biasness, male child, female child, education, home

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Authors: Matthias Haenisch, Katharina Hermann, Marc Godau, Verena Weidner

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Over the past two decades, international music education has been characterized by a growing interest in informal learning for formal contexts and a "compositional turn" that has moved from closed to open forms of composing. This change occurs under social and technological conditions that permeate 21st-century musical practices. This forms the background of Musical Communities in the (Post)Digital Age (MusCoDA), a four-year joint research project of the University of Erfurt (UE) and the University of Education Karlsruhe (PHK), funded by the German Federal Ministry of Education and Research (BMBF). Both explore songwriting processes as an example of collective creativity in (post)digital communities, one in formal and the other in informal learning contexts. Collective songwriting will be studied from a network perspective, that will allow us to view boundaries between both online and offline as well as formal and informal or hybrid contexts as permeable and to reconstruct musical learning practices. By comparing these songwriting processes, possibilities for a pedagogical-didactic interweaving of different educational worlds are highlighted. Therefore, the subproject of the University of Erfurt investigates school music lessons with the help of interviews, videography, and network maps by analyzing new digital pedagogical and didactic possibilities. In the first step, the international literature on songwriting in the music classroom was examined for design development. The analysis focused on the question of which methods and practices are circulating in the current literature. Results from this stage of the project form the basis for the first instructional design that will help teachers in planning regular music classes and subsequently reconstruct musical learning practices under these conditions. In analyzing the literature, we noticed certain structural methods and concepts that recur, such as the Building Blocks method and the pre-structuring of the songwriting process. From these findings, we developed a deck of cards that both captures the current state of research and serves as a method for design development. With this deck of cards, both teachers and students themselves can plan their individual songwriting lessons by independently selecting and arranging topic, structure, and action cards. In terms of science communication, music educators' interactions with the card game provide us with essential insights for developing the first design. The overall goal of MusCoDA is to develop an empirical model of collective musical creativity and learning and an instructional design for teaching music in the postdigital age.

Keywords: card game, collective songwriting, community of practice, network, postdigital

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Authors: L. R. Valencia Pérez, J. M. Peña Aguilar, A. Lamadrid Álvarez, A. Pastrana Palma, H. F. Valencia Pérez, M. Vivanco Vargas

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This work proposes a Cooperation-Competitive (Coopetitive) approach that allows coordinated work among the Secretary of Public Education (SEP), the Autonomous University of Querétaro (UAQ) and government funds from National Council for Science and Technology (CONACYT) or some other international organizations. To work on an overall knowledge transfer strategy with e-learning over the Cloud, where experts in junior high and high school education, working in multidisciplinary teams, perform analysis, evaluation, design, production, validation and knowledge transfer at large scale using a Cloud Computing platform. Allowing teachers and students to have all the information required to ensure a homologated nationally knowledge of topics such as mathematics, statistics, chemistry, history, ethics, civism, etc. This work will start with a pilot test in Spanish and initially in two regional dialects Otomí and Náhuatl. Otomí has more than 285,000 speaking indigenes in Queretaro and Mexico´s central region. Náhuatl is number one indigenous dialect spoken in Mexico with more than 1,550,000 indigenes. The phase one of the project takes into account negotiations with indigenous tribes from different regions, and the Information and Communication technologies to deliver the knowledge to the indigenous schools in their native dialect. The methodology includes the following main milestones: Identification of the indigenous areas where Otomí and Náhuatl are the spoken dialects, research with the SEP the location of actual indigenous schools, analysis and inventory or current schools conditions, negotiation with tribe chiefs, analysis of the technological communication requirements to reach the indigenous communities, identification and inventory of local teachers technology knowledge, selection of a pilot topic, analysis of actual student competence with traditional education system, identification of local translators, design of the e-learning platform, design of the multimedia resources and storage strategy for “Cloud Computing”, translation of the topic to both dialects, Indigenous teachers training, pilot test, course release, project follow up, analysis of student requirements for the new technological platform, definition of a new and improved proposal with greater reach in topics and regions. Importance of phase one of the project is multiple, it includes the proposal of a working technological scheme, focusing in the cultural impact in Mexico so that indigenous tribes can improve their knowledge about new forms of crop improvement, home storage technologies, proven home remedies for common diseases, ways of preparing foods containing major nutrients, disclose strengths and weaknesses of each region, communicating through cloud computing platforms offering regional products and opening communication spaces for inter-indigenous cultural exchange.

Keywords: Mexicans indigenous tribes, education, knowledge transfer, cloud computing, otomi, Náhuatl, language

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Authors: Haya Salah, Srinivas Sharan

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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.

Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time

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Authors: Kanchan Negi

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Background: Modern and urban occupational culture have driven demands for people to work long hours and weekends and take work to home at times. Research on the health effects of these exhaustive temporal work patterns is scant or contradictory. This study examines the relationship between work patterns and wellbeing in a sample of women living in the metropolitan hub of Delhi. Method: This study is based on the data collected from 360 currently married women between age 29 and 49 years, working in the urban capital hub of India, i.e., Delhi. The women interviewed were professionals from the education, health, banking and information and technology (IT) sector. Bivariate analysis was done to study the characteristics of the sample. Logistic regression analysis was used to estimate the physical and psychological wellbeing across occupational characteristics. Results: Most of the working women were below age 35 years; around 30% of women worked in the education sector, 23% in health, 21% in banking and 26% in the IT sector. Over 55% of women were employed in the private sector and only 36% were permanent employees. Nearly 30% of women worked for more than the standard 8 hours a day. The findings from logistic regression showed that compared to women working in the education sector, those who worked in the banking and IT sector more likely to have physical and psychological health issues (OR 2.07-4.37, CI 1.17-4.37); women who bear dual burden of responsibilities had higher odds of physical and psychological health issues than women who did not (OR 1.19-1.85 CI 0.96-2.92). Women who worked for more than 8 hours a day (OR 1.15, CI 1.01-1.30) and those who worked for more than five days a week (OR 1.25, CI 1.05-1.35) were more likely to have physical health issues than women who worked for 6-8 hours a day and five days e week, respectively. Also, not having flexible work timings and compensatory holidays increased the odds of having physical and psychological health issues among working women (OR 1.17-1.29, CI 1.01-1.47). Women who worked in the private sector, those employed temporarily and who worked in the non-conducive environments were more likely to have psychological health issues as compared to women in the public sector, permanent employees and those who worked in a conducive environment, respectively (OR 1.33-1.67, CI 1.09-2.91). Women who did not have poor work-life balance had reduced the odds of psychological health issues than women with poor work-life balance (OR 0.46, CI 0.25-0.84). Conclusion: Poor wellbeing significantly linked to strenuous and rigid work patterns, suggesting that modern and urban work culture may contribute to the poor wellbeing of working women. Noticing the recent decline in female workforce participation in Delhi, schemes like Flexi-timings, compensatory holidays, work-from-home and daycare facilities for young ones must be welcomed; these policies already exist in some private sector firms, and the public sectors companies should also adopt such changes to ease the dual burden as homemaker and career maker. This could encourage women in the urban areas to readily take up the jobs with less juggle to manage home and work.

Keywords: occupational characteristics, urban India, well-being, working women

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Authors: Afef Dridi, Salah Mezlini

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Since experimental devices cannot calculate stress and deformation of complex structures. The Finite Element Method FEM has been widely used in several fields of research. One of these fields is orthodontics. The advantage of using such a method is the use of an accurate and non invasive method that allows us to have a sufficient data about the physiological reactions can happening in soft tissues. Most of researches done in this field were interested in the study of stresses and deformations induced by orthodontic apparatus in soft tissues (alveolar tissues). Only few studies were interested in the distribution of stress and strain in the orthodontic brackets. These studies, although they tried to be as close as possible to real conditions, their models did not reproduce the clinical cases. For this reason, the model generated by our research is the closest one to reality. In this study, a numerical model was developed to explore the stress and strain distribution under the application of real conditions. A comparison between different material properties was also done.

Keywords: visco-hyperelasticity, FEM, orthodontic treatment, inverse method

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Authors: Mathilde Blondon, Salla Aicha Dieng, Catherine Pfister

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In a paradoxical way, teenagers nowadays seem to use suicidal attempts to elaborate on their trauma abuses and regain some kind of control in their lives. As their behavior becomes life-threatening, the hospital offers a variety of expertise to address their need, with Child Protective Services also joining in, to a point when teenagers could have a feeling of losing control of their lives, which results in them making more suicidal attempts. Our goal here is to walk with these foster teenagers long enough to step therapy up first, then as their mental health is restored enough to step the therapy down in a way that is secure and will give them their life back. This would prevent them from making suicidal attempts to get a feeling of control over their life. We’ll present a clinical case of a 14-year-old girl named Sofia, who was suffering from parental deprivation, an identity disorder, and severe depression disorder. Our intervention took place in January 2024, after Sofia had undergone four hospitalizations, including a two-month period in a specialized clinic. In a stepping-up effort, a substantial setting has been built around Sofia. She was coming three days a week to therapeutic activities at the Child Psychiatry Day Hospital, she had one psychotherapy session a week at the Medical-Psychological Center, and she was meeting with the Adolescent Psychiatrist on a regular basis. However, her suicidal attempts frequency continued to increase to the point when she couldn’t stay more than four days outside the hospital unit without harming herself and being brought back to the Emergency Unit. We were all stuck in some kind of medical deadlock, writing to clinics that had no room for her while social workers were calling foster homes that wouldn’t even accept her either. At some point, a clinical decision was made by the psychiatrist to stop what appeared to be a global movement of traumatic repetition, which involved Sofia’s family, the medical team and the social workers as one. This decision to step therapy down created a surprise and put an end to the cycle. It provided a new path, a new solution where Sofia could securely settle without being unfaithful to her family. Her suicidal attempts stopped for four weeks. She had one relapse, then didn’t make another attempt so far. There is a fine line between too little and too much, a pathway with the right amount of care and support. We believe it is not a steady line but rather a path up and down the hill. It’s about building up this moment when medication and mental processes have improved the subject’s condition enough to allow the medical team to step therapy down and give more control back to the subject. These needed variations used to come from a change of hospital or medical team. Stepped care avoids any breaking of bonds and appears to be decisive in stopping teenagers’ suicidal attempts.

Keywords: child protection, adolescent psychiatry, teenager suicidal attempt, foster teenagers, parental deprivation, stepped care

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Authors: Mohammed A. Al-Ajmi, Reem S. Al-Kandari

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This study is concerned with the behavior of engineering students in Kuwait University which became a concern due to the global issues of education in all levels. A survey has been conducted to identify academic and societal issues that affect the engineering student performance through. The study is drawing major conclusions with regard to private tutoring and the online availability of textbooks’ solution manuals.

Keywords: solution manual, engineering, textbook, ethics

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Authors: Said Rashid Aal Abdulsallam

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The purpose of this paper is to measure ISO 9001:2008 effectiveness and determines its impact on the performance dimensions in terms of service quality, operational performance and customer satisfaction from the perspectives of both service providers and receivers. The paper is based on an empirical study carried out on all the ISO 9001:2008 certified departments in the Ministry of Education in the Sultanate of Oman. Data were obtained from the certified departments and their equivalent clients through two structured online questionnaires. Exploratory factor analyses are applied to extract the underlying factors of the indicators of ISO 9001 objectives and performance dimensions. Multiple linear regression analyses are also applied in order to determine the impact of ISO 9001 effectiveness on the performance dimensions of the certified departments. The study sample includes all the ISO 9001 certified departments in the Ministry of Education. The study instruments used target both the service providers as well as the service receivers with the purpose of alleviating the subjective nature of the data collected from the service providers who may be biased in favour of ISO 9001 quality management system or their performance. The findings of the study verify the effectiveness of the application of ISO 9001:2008 quality management system. Additionally, the study reveals that the ISO 9001 certified departments have achieved the ISO 9001 the standard's objectives including prevention of nonconformities, continuous improvement and customer satisfaction focus at different rates. The study also proves that there is a significant relation between the achievement of the ISO 9001 standard objectives and the operational performance of the departments. Even though the operational performance service quality of the ISO 9001 certified departments has substantially improved from the perspective of the departments, the customer satisfaction has not notably increased from the perspective of the service receivers.

Keywords: iso 9001, customer satisfaction, operational performance, public organization, quality management

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Authors: Shreya Saxena

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Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

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Authors: Natcha Lueangapapong, Chariya Chuthapisith, Lunliya Thampratankul

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Background: There is a need to find an appropriate tool to help healthcare providers determine sleep problems in children for early diagnosis and management. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) is a parent-reported sleep questionnaire that has good psychometric properties and can be used in the context of Asian culture, which is likely suitable for Thai children. Objectives: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep disorders in preschoolers. Methods: After approval by the original developer, the cross-cultural adaptation process of JSQ-P was performed, including forward translation, reconciliation, backward translation, and final approval of the Thai version of JSQ-P (TH-JSQ-P) by the original creator. This study was conducted between March 2021 and February 2022. The TH-JSQ-P was completed by 2,613 guardians whose children were aged 2-6 years twice in 10-14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). Face validity, content validity, structural validity, construct validity (discriminant validity), criterion validity and predictive validity were assessed. The sensitivity and specificity of the TH-JSQ-P were also measured by using a total JSQ-P score cutoff point 84, recommended by the original JSQ-P and each subscale score among the clinical samples of obstructive sleep apnea syndrome. Results: Internal consistency reliability, evaluated by Cronbach’s α coefficient, showed acceptable reliability in all subscales of JSQ-P. It also had good test-retest reliability, as the intraclass correlation coefficient (ICC) for all items ranged between 0.42-0.84. The content validity was acceptable. For structural validity, our results indicated that the final factor solution for the Th-JSQ-P was comparable to the original JSQ-P. For construct validity, age group was one of the clinical parameters associated with some sleep problems. In detail, parasomnias, insomnia, daytime excessive sleepiness and sleep habits significantly decreased when the children got older; on the other hand, insufficient sleep was significantly increased with age. For criterion validity, all subscales showed a correlation with the Epworth Sleepiness Scale (r = -0.049-0.349). In predictive validity, the Epworth Sleepiness Scale was significantly a strong factor that correlated to sleep problems in all subscales of JSQ-P except in the subscale of sleep habit. The sensitivity and specificity of the total JSQ-P score were 0.72 and 0.66, respectively. Conclusion: The Thai version of JSQ-P has good internal consistency reliability and test-retest reliability. It passed 6 validity tests, and this can be used to evaluate sleep problems in preschool children in Thailand. Furthermore, it has satisfactory general psychometric properties and good reliability and validity. The data collected in examining the sensitivity of the Thai version revealed that the JSQ-P could detect differences in sleep problems among children with obstructive sleep apnea syndrome. This confirmed that the measure is sensitive and can be used to discriminate sleep problems among different children.

Keywords: preschooler, questionnaire, validation, Thai version

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Authors: Abiodun Musbau Lawal, Benjamin Oladapo Olley

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Long Distance Truck Drivers (LDTDs) have been found to be a high-risk group in the spread of HIV/AIDS globally; perhaps, due to their high Sexual Risk Behaviours (SRBs). Interventions for reducing SRBs in trucking population have not been fully exploited. A quasi-experimental control group pretest-posttest design was used to assess the efficacy of psycho-education and behavioural skills training in reducing SRBs among LDTDs. Sixteen drivers rivers were randomly assigned into either experimental or control groups using balloting technique. A questionnaire was used as an instrument for data collection. Repeated measures t-test and independent t-test were used to test hypotheses. The intervention had a significant effect on the SRBs among LDTDs at post-test(t{7}=6.01, p<.01) and at followup (t{7}=6.42, p<.01). No significant difference in sexual risk behaviour of LDTDs at post-test and at follow-up stage. Similarly, intervention had significant effects on sexual risk behaviour at post-test (t {14}=- 4.69, p<.05) and at follow-up (t {14}= -9.56, p < .05) respectively. At post-test and follow-up stages, drivers in experimental group reported reduced SRBs than those in the control group. Drivers in an experimental group reported lower sexual risk behaviour a week after intervention as well as at three months follow-up than those in the control group. It is concluded that HIV/AIDS preventive intervention that provides the necessary informational and behavioural skills content can significantly impact long distance truck drivers sexual risk behaviours.

Keywords: HIV/AIDS interventions, long distance truck drivers, Nigeria, sexual risk behaviours

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Authors: Sara Bonetti

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The use of quantitative data to support policies and justify investments has become imperative in many fields including the field of education. However, the topic of data literacy has only marginally touched the early care and education (ECE) field. In California, within the ECE workforce, there is a group of professionals working in policy and advocacy that use quantitative data regularly and whose educational and professional experiences have been neglected by existing research. This study aimed at analyzing these experiences in accessing, using, and producing quantitative data. This study utilized semi-structured interviews to capture the differences in educational and professional backgrounds, policy contexts, and power relations. The participants were three key professionals from county-level organizations and one working at a State Department to allow for a broader perspective at systems level. The study followed Núñez’s multilevel model of intersectionality. The key in Núñez’s model is the intersection of multiple levels of analysis and influence, from the individual to the system level, and the identification of institutional power dynamics that perpetuate the marginalization of certain groups within society. In a similar manner, this study looked at the dynamic interaction of different influences at individual, organizational, and system levels that might intersect and affect ECE professionals’ experiences with quantitative data. At the individual level, an important element identified was the participants’ educational background, as it was possible to observe a relationship between that and their positionality, both with respect to working with data and also with respect to their power within an organization and at the policy table. For example, those with a background in child development were aware of how their formal education failed to train them in the skills that are necessary to work in policy and advocacy, and especially to work with quantitative data, compared to those with a background in administration and/or business. At the organizational level, the interviews showed a connection between the participants’ position within the organization and their organization’s position with respect to others and their degree of access to quantitative data. This in turn affected their sense of empowerment and agency in dealing with data, such as shaping what data is collected and available. These differences reflected on the interviewees’ perceptions and expectations for the ECE workforce. For example, one of the interviewees pointed out that many ECE professionals happen to use data out of the necessity of the moment. This lack of intentionality is a cause for, and at the same time translates into missed training opportunities. Another interviewee pointed out issues related to the professionalism of the ECE workforce by remarking the inadequacy of ECE students’ training in working with data. In conclusion, Núñez’s model helped understand the different elements that affect ECE professionals’ experiences with quantitative data. In particular, what was clear is that these professionals are not being provided with the necessary support and that we are not being intentional in creating data literacy skills for them, despite what is asked of them and their work.

Keywords: data literacy, early childhood professionals, intersectionality, quantitative data

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Authors: Elinor Bull, Faye Horsley

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Abstract Objective: The current study investigated if there was a difference in personality factors in prisoners who had a recorded history of firesetting and who had no recorded history of firesetting. Participants: Participants were 64 male prisoners in a Category B male prison. Participants who had set a fire were identified through the prisons data base, and prisoners who had not set a fire were selected at random. Method: The study used the International Personality Item Pool-50 to measure personality factors, and prisoners who had set a fire were identified through a range of sources accessible to the prison. Analytical evaluation was done by the Multivariate Kruskal Wallis and Mann-Whitney tests. Findings: There was a significant difference between the the firesetting and non-firesetting group in the scores of the personality factor of Contentiousness. Contentiousness was significantly lower in the firesetting sample compared to the non-firesetting sample. Conclusions: Implications for clinical practice and future research are discussed.

Keywords: firesetting, personality, arson, prison, prisoners

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Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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