Search results for: Infant and Young Children Feeding

Authors: Lisseth Rojas Barreto, Carlos Muñoz Hernández

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The COVID-19 pandemic led to many abrupt changes, including a prolonged lockdown, which brought about work and personal challenges to the population worldwide. Among the most affected populations are women who are workers and housewives at the same time, and especially those who are also parenting. These women were faced with the challenge to perform their usual varied roles during the lockdown from the same physical space, which inevitably had strong repercussions for each of them. This paper will present some results of a research study whose main objective was to examine the possible effects that the COVID-19 pandemic lockdown may have caused in the work, social, family, and personal environments of female English teachers who are also housewives and, by extension in the teaching and learning processes that they lead. Participants included five female English language teachers of a public foreign language school, they are all married, and two of them have children. Similarly, we examined some of the coping strategies these teachers used to tackle the pandemic-related challenges in their different roles, especially those used for their language teaching role; coping strategies are understood as a repertoire of behaviors in response to incidents that can be stressful for the subject, possible challenging events or situations that involve emotions with behaviors and decision-making of people which are used in order to find a meaning or positive result (Lazarus &Folkman, 1986) Following a qualitative-case study design, we gathered the data through a survey and a focus group interview with the participant teachers who work at a public language school in southern Colombia. Preliminary findings indicate that the circumstances that emerged as a result of the pandemic lockdown affected the participants in different ways, including financial, personal, family, health, and work-related issues. Among the strategies that participants found valuable to deal with the novel circumstances, we can highlight the reorganization of the household and work tasks and the increased awareness of time management for the household, work, and leisure. Additionally, we were able to evidence that the participants faced the circumstances with a positive view. Finally, in order to cope with their teaching duties, some participants acknowledged their lack of computer or technology literacy in order to deliver their classes online, which made them find support from their students or more knowledgeable peers to cope with it. Others indicated that they used strategies such as self-learning in order to get acquainted and be able to use the different technological tools and web-based platforms available.

Keywords: coping strategies, language teaching, female teachers, pandemic lockdown

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Authors: Hatice Akbıyık, Hülya Gökmen Özel, Nagehan Emiralioğlu, Elmas Ebru Güneş Yalçın, Deniz Doğru Ersöz, Hayriye Uğur Özçelik, Nural Kiper

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Background: Dietary recommendations in cystic fibrosis (CF) are based on the need to compensate for the increased energy needs of infection, the increased energy cost of breathing and the losses, incurred from malabsorption. Studies in CF indicate that dietary recommendations for CF patients can be difficult to achieve Aim: The aim of this study was to evaluate the energy and nutrient intakes and to compare in accordance with CF dietary guidelines in CF. Methods: One-hundred sixty patients with CF, aged between 2 to 20 years (mean±SD= 7.4±4.8 years) attending Hacettepe University, Faculty of Medicine, Department of Pediatric Pulmonary Diseases were included. Energy and nutrient intakes from foods and enteral products were calculated using a-24-hour dietary recall method with BEBIS 7.2 programme. Percentages of energy and nutrient intakes were compared in accordance with CF dietary guidelines. Patients or/and parents completed a questionnaire showing mealtime problems, usage of alternative therapies and type of nutrition. Statistical analyses were done using SPSS 16.0 programme. Results: It was obtained that 14.5% and 46.9% of the total energy intake were from proteins and carbohydrates, respectively. The actual contribution of total, saturated, monounsaturated and polyunsaturated fats to the total caloric intake was 37.5%, 14.3%, 14.9%, 9.9%, respectively. It was found that 87.7% of energy, 85% of protein 91.7% of carbohydrate, 81.1% of fat intakes were met, when compared CF recommended intakes of 120% RDA. Additionally 67%, 69.5%, 68.2% and 68.9% of the subjects did not achieve CF recommended intakes of 120% RDA for energy, protein, carbohydrate and fat, respectively. Patients with CF had low intakes for age for almost all vitamins and minerals, although supplementation was given. Especially most patients did not achieve the minimum recommended vitamin K intake of 120% RDA. The percentage meeting 120% RDA was 75.9% for vitamin K. It was shown that 41% of the patients had mealtime problems and they skipped the breakfast. Moreover 25.4% of the patients used alternative products outside the standard treatment (such as omega-3, ginger, turmeric, local honey). It was also showed that 60.8% of patients were using enteral products in addition to normal foods, the remaining patients were on only normal foods. Conclusion: The aims of improving nutritional status in children are to achieve normal weight gain and growth; optimize vitamin and mineral status; and slow the rate of clinical decline. In this study although enteral products were used in patients with CF, it was found that energy and nutrient requirements were unable to meet. Because dietary assessment is essential to identify the need for earlier nutritional intervention, in each visit patients need to be referred to CF specialist dietitian.

Keywords: cystic fibrosis, energy and nutrient intakes, mealtime problems, malabsorbtion

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Authors: Junali Deka

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“Pictures speak more than a thousand words”. It is the power of image which can have multiple meanings the way it is read by the viewers. This research article is an outcome of the extensive study of the phenomenon of‘selfie culture’ and dire need of self-constructed virtual identity among youths. In the recent times, there has been a revolutionary change in the concept of photography in terms of both techniques and applications. The popularity of ‘self-portraits’ mainly depend on the temporal space and time created on social networking sites like Facebook, Instagram. With reference to Stuart’s Hall encoding and decoding process, the article studies the behavior of the users who post photographs online. The photographic messages (Roland Barthes) are interpreted differently by different viewers. The notion of ‘self’, ‘self-love and practice of looking (Marita Sturken) and ways of seeing (John Berger) got new definition and dimensional together. After Oscars Night, show host Ellen DeGeneres’s selfie created the most buzz and hype in the social media. The term was judged the word of 2013, and has earned its place in the dictionary. “In November 2013, the word "selfie" was announced as being the "word of the year" by the Oxford English Dictionary. By the end of 2012, Time magazine considered selfie one of the "top 10 buzzwords" of that year; although selfies had existed long before, it was in 2012 that the term "really hit the big time an Australian origin. The present study was carried to understand the concept of ‘selfie-bug’ and the phenomenon it has created among youth (especially students) at large in developing a pseudo-image of its own. The topic was relevant and gave a platform to discuss about the cultural, psychological and sociological implications of selfie in the age of digital technology. At the first level, content analysis of the primary and secondary sources including newspapers articles and online resources was carried out followed by a small online survey conducted with the help of questionnaire to find out the student’s view on selfie and its social and psychological effects. The newspapers reports and online resources confirmed that selfie is a new trend in the digital media and it has redefined the notion of beauty and self-love. The Facebook and Instagram are the major platforms used to express one-self and creation of virtual identity. The findings clearly reflected the active participation of female students in comparison to male students. The study of the photographs of few selected respondents revealed the difference of attitude and image building among male and female users. The study underlines some basic questions about the desire of reconstruction of identity among young generation, such as - are they becoming culturally narcissist; responsible factors for cultural, social and moral changes in the society, psychological and technological effects caused by Smartphone as well, culminating into a big question mark whether the selfie is a social signifier of identity construction.

Keywords: Culture, Narcissist, Photographs, Selfie

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Authors: Motaz Alsolaim

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Nowadays, the challenges of running a start-up can be very complex and are perhaps more difficult than at any other time in the past. Changes in technology, manufacturing innovation, and product development, combined with intense competition and market regulations are factors that have put pressure on classic ways of managing firms, thereby forcing change. As a result, the rate of closure, exit or discontinuation of start-ups and young businesses is very high. Despite the essential role of small firms in an economy, they still tend to face obstacles that exert a negative influence on their performance and rate of survival. In fact, it is not easy to determine with any certainty the reasons why small firms fail. For this reason, failure itself is not clearly defined, and its exact causes are hard to diagnose. In this current study, therefore, the barriers to survival will be covered more broadly, especially personal/entrepreneurial, enterprise and environmental factors with regard to various possible reasons for this failure, in order to determine the best solutions and make appropriate recommendations. Methodology: It could be argued that mixed methods might help to improve entrepreneurship research addressing challenges emphasis in previous studies and to achieve the triangulation. Calls for the combined use of quantitative and qualitative research were also made in the entrepreneurship field since entrepreneurship is a multi-faceted area of research. Therefore, explanatory sequential mixed method was used, using questionnaire online survey for entrepreneurs, followed by semi-structure interview. Collecting over 750 surveys and accepting 296 valid surveys, after that 13 interviews from government official seniors, businessmen successful entrepreneurs, and non-successful entrepreneurs. Findings: The first phase findings ( quantitative) shows the obstacles to survive; starting from the personal/ entrepreneurial factors such as; past work experience, lack of skills and interest, are positive factors, while; gender, age and education level of the owner are negative factors. Internal factors such as lack of marketing research and weak business planning are positive. The environmental factors; in economic perspectives; difficulty to find labors, in socio-cultural perspectives; Social restriction and traditions found to be a negative factors. In other hand, from the political perspective; cost of compliance and insufficient government plans found to be a positive factors for small business failure. From infrastructure perspective; lack of skills labor, high level of bureaucracy and lack of information are positive factors. Conclusion: This paper serves to enrich the understanding of failure factors in MENA region more precisely in SA, by minimizing the probability of failure in small-micro entrepreneurial start-up in SA, in the light of the Saudi government’s Vision 2030 plan.

Keywords: small business barriers, start-up business, entrepreneurship, Saudi Arabia

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Authors: Young Ik Suh, Tywan G. Martin

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Bundling strategy is a common marketing practice today. In the past decades, both academicians and practitioners have increasingly emphasized the strategic importance of bundling in today’s markets. The reason for increased interest in bundling strategy is that they normally believe that it can significantly increase profits on organization’s sales over time and it is convenient for the customer. However, little efforts has been made on ticket bundling and purchase considerations in hedonic and utilitarian options in sport consumer behavior context. Consumers often face choices between utilitarian and hedonic alternatives in decision making. When consumers purchase certain products, they are only interested in the functional dimensions, which are called utilitarian dimensions. On the other hand, others focus more on hedonic features such as fun, excitement, and pleasure. Thus, the current research examines how utilitarian and hedonic consumption can vary in typical ticket purchasing process. The purpose of this research is to understand the following two research themes: (1) the differential effect of discount framing on ticket bundling: utilitarian and hedonic options and (2) moderating effect of team identification on ticket bundling. In order to test the research hypotheses, an experimental study using a two-way ANOVA, 3 (team identification: low, medium, and high) X 2 (discount frame: ticket bundle sales with utilitarian product, and hedonic product), with mixed factorial design will be conducted to determine whether there is a statistical significance between purchasing intentions of two discount frames of ticket bundle sales within different team identification levels. To compare mean differences among the two different settings, we will create two conditions of ticket bundles: (1) offering a discount on a ticket ($5 off) if they would purchase it along with utilitarian product (e.g., iPhone8 case, t-shirt, cap), and (2) offering a discount on a ticket ($5 off) if they would purchase it along with hedonic product (e.g., pizza, drink, fans featured on big screen). The findings of the current ticket bundling study are expected to have many theoretical and practical contributions and implications by extending the research and literature pertaining to the relationship between team identification and sport consumer behavior. Specifically, this study can provide a reliable and valid framework to understanding the role of team identification as a moderator on behavioral intentions such as purchase intentions. From an academic perspective, the study will be the first known attempt to understand consumer reactions toward different discount frames related to ticket bundling. Even though the game ticket itself is the major commodity of sport event attendance and significantly related to teams’ revenue streams, most recent ticket pricing research has been done in terms of economic or cost-oriented pricing and not from a consumer psychological perspective. For sport practitioners, this study will also provide significant implications. The result will imply that sport marketers may need to develop two different ticketing promotions for loyal fan and non-loyal fans. Since loyal fans concern ticket price than tie-in products when they see ticket bundle sales, advertising campaign should be more focused on discounting ticket price.

Keywords: ticket bundling, hedonic, utilitarian, team identification

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Authors: Kelly Jaunzems

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Social media is a powerful instrument of communication, enabling the presentation of information in multiple forms and modes, amplifying the interactions between people, organisations, and stakeholders, and increasing the range of communication channels available. Younger generations are highly engaged with social media and more likely to use this channel than any other to seek information. Given this, it may appear extraordinary that occupational safety and health professionals have yet to seriously engage with social media for communicating safety messages to younger audiences who, in many industries, might be statistically more likely to encounter more workplace harm or injury. Millennials, defined as those born between 1981-2000, have distinctive characteristics that also impact their interaction patterns rendering many traditional occupational safety and health communication channels sub-optimal or near obsolete. Used to immediate responses, 280-character communication, shares, likes, and visual imagery, millennials struggle to take seriously the low-tech, top-down communication channels such as safety noticeboards, toolbox meetings, and passive tick-box online inductions favoured by traditional OSH professionals. This paper draws upon well-established communication findings, which argue that it is important to know a target audience and reach them using their preferred communication pathways, particularly if the aim is to impact attitudes and behaviours. Health practitioners have adopted social media as a communication channel with great success, yet safety practitioners have failed to follow this lead. Using a digital ethnography approach, this paper examines seven organisations’ Facebook posts from two one-month periods one year apart, one in 2018 and one in 2019. Each of the years informs organisation-based case studies. Comparing, contrasting, and drawing upon these case studies, the paper discusses and evaluates the (non) use of social media communication of safety information in terms of user engagement, shareability, and overall appeal. The success of health practitioners’ use of social media provides a compelling template for the implementation of social media into organisations’ safety communication strategies. Highly visible content such as that found on social media allows an organization to become more responsive and engage in two-way conversations with their audience, creating more engaged and participatory conversations around safety. Further, using social media to address younger audiences with a range of tonal qualities (for example, the use of humour) can achieve cut through in a way that grim statistics fail to do. On the basis of 18 months of interviews, filed work, and data analysis, the paper concludes with recommendations for communicating safety information via social media. It proposes exploration of the social media communication formula that, when utilised by safety practitioners, may create an effective social media presence. It is anticipated that such social media use will increase engagement, expand the number of followers and reduce the likelihood and severity of safety-related incidents. The tools offered may provide a path for safety practitioners to reach a disengaged generation of workers to build a cohesive and inclusive conversation around ways to keep people safe at work.

Keywords: social media, workplace safety, communication strategies, young workers

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Authors: Ismail Bamidele Afolabi, Abdulmujeeb Babatunde Aremu, Lawal Abdurraheem Maidoki, Nnodimele Onuigbo Atulomah

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Background: Hepatitis B virus infection remains a significant global public health challenge with infectivity as well as the potential for transmission more than 50 to 100 times that of HIV. Annually, global HBV-related mortality is linked primarily to cirrhosis and liver carcinoma. The ever-increasing endemicity of HBV among children under-5-years, owing to vertical transmission and its lingering chronicity in developing countries, will hamper the global efforts concertedly endorsed towards eliminating viral hepatitis as a global public health threat by 2030. Objective: This study assessed information motivation behavioral skills model constructs as predictors of HBV infection prevention practices among consenting expectant mothers attending antenatal care in Central Uganda as a focal point of intervention towards breaking materno-foetal transmission of HBV. Methods: A cross-sectional study with a quantitative data collection approach based on the constructs of the IMB model was used to capture data on the study variables among 385 randomly selected pregnant women between September and October 2020. Data derived from the quantitative instrument were transformed into weighted aggregate scores using SPSS version 26. ANOVA and regression analysis were done to ascertain the study hypotheses with a significance level set as (p ≤ 0.05). Results: Relatively 60% of the respondents were aged between 18 and 28. Expectant mothers with secondary education (42.3%) were predominant. Furthermore, an average but inadequate knowledge (X ̅=5.97±6.61; B=0.57; p<.001), incorrect perception (X ̅=17.10±18.31; B=0.97; p=.014), and good behavioral skills (X ̅=12.39±13.37; B=0.56; p<.001) for adopting prevention practices all statistically predicted the unsatisfactory level of prevention practices (X ̅=15.03±16.20) among the study respondents as measured on rating scales of 12, 33, 21 and 30 respectively. Conclusion: Evidence from this study corroborates the imperativeness of IMB constructs in reducing the burden of HBV infection in developing countries. Therefore, the inadequate HBV knowledge and misperception among obstetric populations necessitate personalized health education during antenatal visits and subsequent health campaigns in order to inform better prevention practices and, in turn, reduce the lingering chronicity of HBV infection in developing countries.

Keywords: behavioral skills, HBV infection, knowledge, perception, pregnant women, prevention practices

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Authors: Carlos Minguez, Christian F. Sagbay, Erika E. Ordoñez

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Guinea pigs (Cavia porcellus) play prominent roles as experimental models for medical research and as pets. However, in developing countries like South America, the Philippines, and sub-Saharan Africa, the meat of guinea pigs is an economic source of animal protein for the poor and malnourished humans because guinea pigs are mainly fed with forage and do not compete directly with human beings for food resources, such as corn or wheat. To achieve efficient production of guinea pigs, it is essential to provide insurance against vitamin C deficiency. The objective of this research was to investigate the effect of the partial replacement of alfalfa with fresh citrus pulp (Citrus sinensis) in a diet of guinea pigs on the growth performance, slaughter traits and mortality during the fattening period (between 20 and 74 days of age). A total of 300 guinea pigs were housed in collective cages of about ten animals (2 x 1 x 0.4 m) and were distributed into two completely randomized groups. Guinea pigs in both groups were fed ad libitum, with a standard commercial pellet diet (10 MJ of digestible energy/kg, 17% crude protein, 11% crude fiber, and 4.5% crude fat). Control group was supplied with fresh alfalfa as forage. In the treatment group, 30% of alfalfa was replaced by fresh citrus pulp. Growth traits, including body weight (BW), average daily gain (ADG), feed intake (FI), and feed conversion ratio (FCR), were measured weekly. On day 74, the animals were slaughtered, and slaughter traits, including live weight at slaughter (LWS), full gastrointestinal tract weight (FGTW), hot carcass weight (with head; HCW), cold carcass weight (with head; CCW), drip loss percentage (DLP) and dressing out carcass yield percentage (DCY), were evaluated. Contrasts between groups were obtained by calculated generalized least squares values. Mortality was evaluated by Fisher's exact test due to low numbers in some cells. In the first week, there were significant differences in the growth traits BW, ADG, FI, and FCR, which were superior in control group. These differences may have been due to the origin of the young guinea pigs, which, before weaning, were all raised without fresh citrus pulp, and they were not familiarized with the new supplement. In the second week, treatment group had significantly increased ADG compared with control group, which may have been the result of a process of compensatory growth. During subsequent weeks, no significant differences were observed between animals raised in the two groups. Neither were any significant differences observed across the total fattening period. No significant differences in slaughter traits or mortality rate were observed between animals from the two groups. In conclusion, although there were no significant differences in growth performance, slaughter traits, or mortality, the use of fresh citrus pulp is recommended. Fresh citrus pulp is a by-product of orange juice industry and it is cheap or free. Forage made with fresh citrus pulp could reduce about of 30 % the quantity of alfalfa in guinea pig for meat and as consequence, reduce the production costs.

Keywords: fresh citrus, growth, Guinea pig, mortality

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Authors: Marc Toutain, Pascale Leconte, Antoine Gauthier

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Introduction: Eating Disorders (ED), such as anorexia, bulimia, and binge eating, are psychiatric illnesses that mostly affect young people. The main symptoms concern eating (restriction, excessive food intake) and weight control behaviors (laxatives, vomiting). Psychological comorbidities (depression, executive function disorders, etc.) and problematic behaviors toward physical activity (PA) are commonly associated with ED. Acquaintances on ED risk factors are still lacking, and more community sample studies are needed to improve prevention and early detection. To our knowledge, studies are needed to specifically investigate the link between ED risk level, PA, and psychological risk factors in a community sample of adolescents. The aim of this study is to assess the relation between ED risk level, exercise (type, frequency, and motivations for engaging in exercise), and psychological factors based on the Jacobi risk factors model. We suppose that a high risk of ED will be associated with the practice of high caloric cost PA, motivations oriented to weight and shape control, and psychological disturbances. Method: An online survey destined for students has been sent to several middle schools and colleges in northwest France. This survey combined several questionnaires, the Eating Attitude Test-26 assessing ED risk; the Exercise Motivation Inventory–2 assessing motivations toward PA; the Hospital Anxiety and Depression Scale assessing anxiety and depression, the Contour Drawing Rating Scale; and the Body Esteem Scale assessing body dissatisfaction, Rosenberg Self-esteem Scale assessing self-esteem, the Exercise Dependence Scale-Revised assessing PA dependence, the Multidimensional Assessment of Interoceptive Awareness assessing interoceptive awareness and the Frost Multidimensional Perfectionism Scale assessing perfectionism. Machine learning analysis will be performed in order to constitute groups with a tree-based model clustering method, extract risk profile(s) with a bootstrap method comparison, and predict ED risk with a prediction method based on a decision tree-based model. Expected results: 1044 complete records have already been collected, and the survey will be closed at the end of May 2022. Records will be analyzed with a clustering method and a bootstrap method in order to reveal risk profile(s). Furthermore, a predictive tree decision method will be done to extract an accurate predictive model of ED risk. This analysis will confirm typical main risk factors and will give more data on presumed strong risk factors such as exercise motivations and interoceptive deficit. Furthermore, it will enlighten particular risk profiles with a strong level of proof and greatly contribute to improving the early detection of ED and contribute to a better understanding of ED risk factors.

Keywords: eating disorders, risk factors, physical activity, machine learning

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Authors: Abdullah Mohammadi

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Years of prolong war in Afghanistan has led to one of the largest refugee and migrant populations in the contemporary world. During this continuous unrest which began in 1970s (by military coup, Marxist revolution and the subsequent invasion of USSR), over one-third of the population migrated to neighboring countries, especially Pakistan and Iran. After the Soviet Army withdrawal in 1989, a new wave of conflicts emerged between rival Afghan groups and this led to new refugees. Taliban period, also, created its own refugees. During all these years, I.R. of Iran has been one of the main destinations of Afghan refugees and migrants. At first, due to the political situation after Islamic Revolution, Iran government didn’t restrict the entry of Afghan refugees. Those who came first in Iran received ID cards and had access to education and healthcare services. But in 1990s, due to economic and social concerns, Iran’s policy towards Afghan refugees and migrants changed. The government has tried to identify and register Afghans in Iran and limit their access to some services and jobs. Unfortunately, there are few studies on Afghan refugees and migrants’ situation in Iran and we have a dim and vague picture of them. Of the few studies done on this group, none of them focus on the illegal Afghan migrants’ situation in Iran. Here, we tried to study the social and economic aspects of illegal Afghan migrants’ living in Iran. In doing so, we interviewed 24 illegal Afghan migrants in Iran. The method applied for analyzing the data is thematic analysis. For the interviews, we chose family heads (17 men and 7 women). According to the findings, illegal Afghan migrants’ socio-economic situation in Iran is very undesirable. Its main cause is the marginalization of this group which is resulted from government policies towards Afghan migrants. Most of the illegal Afghan migrants work in unskilled and inferior jobs and live in rent houses on the margins of cities and villages. None of them could buy a house or vehicle due to law. Based on their income, they form one of the lowest, unprivileged groups in the society. Socially, they face many problems in their everyday life: social insecurity, harassment and violence, misuse of their situation by police and people, lack of education opportunity, etc. In general, we may conclude that illegal Afghan migrant have little adaptation with Iran’s society. They face severe limitations compared to legal migrants and refugees and have no opportunity for upward social mobility. However, they have managed some strategies to face these difficulties including: seeking financial and emotional helps from family and friendship networks, sending one of the family members to third country (mostly to European countries), establishing self-administered schools for children (schools which are illegal and run by Afghan educated youth).

Keywords: illegal Afghan migrants, marginalization, social insecurity, upward social mobility

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Authors: Cristina Fernandez, Felix Amparano, John Tumberger, Stephani Stancil, Sarah Hampl, Brooke Sweeney, Amy R. Beck, Helena H Laroche, Jared Tucker, Eileen Chaves, Sara Gould, Matthew Lindquist, Lora Edwards, Renee Arensberg, Meredith Dreyer, Jazmine Cedeno, Alleen Cummins, Jennifer Lisondra, Katie Cox, Kelsey Dean, Rachel Perera, Nicholas A. Clark

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Background: Adolescents with obesity are at higher risk of disordered eating than the general population. Detection of eating disorders (ED) is difficult. Screening questionnaires may aid in early detection of ED. Our team’s prior efforts focused on increasing ED screening rates to ≥90% using a validated 10-question adolescent binge eating disorder screening questionnaire (ADO-BED). This aim was achieved. We then aimed to improve treatment plan initiation of patients ≥12 years of age who screen positive for BED within our WMC from 33% to 70% within 12 months. Methods: Our WMC is within a tertiary-care, free-standing children’s hospital. A3, an improvement framework, was used. A multidisciplinary team (physicians, nurses, registered dietitians, psychologists, and exercise physiologists) was created. The outcome measure was documentation of treatment plan initiation of those who screen positive (goal 70%). The process measure was ADO-BED screening rate of WMC patients (goal ≥90%). Plan-Do-Study-Act (PDSA) cycle 1 included provider education on current literature and treatment plan initiation based upon ADO-BED responses. PDSA 2 involved increasing documentation of treatment plan and retrain process to providers. Pre-defined treatment plans were: 1) repeat screen in 3-6 months, 2) resources provided only, or 3) comprehensive multidisciplinary weight management team evaluation. Run charts monitored impact over time. Results: Within 9 months, 166 patients were seen in WMC. Process measure showed sustained performance above goal (mean 98%). Outcome measure showed special cause improvement from mean of 33% to 100% (n=31). Of treatment plans provided, 45% received Plan 1, 4% Plan 2, and 46% Plan 3. Conclusion: Through a multidisciplinary improvement team approach, we maintained sustained ADO-BED screening performance, and, prior to our 12-month timeline, achieved our project aim. Our efforts may serve as a model for other multidisciplinary WMCs. Next steps may include expanding project scope to other WM programs.

Keywords: obesity, pediatrics, clinic, eating disorder

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Authors: Nuzhat Sharmin

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Human being is the most integral part of the nature and responsible for maintaining ecological balance both in rural and urban areas. But unfortunately, we are not doing our job with a holistic approach. The rapid growth of urbanization is making human life more isolated from greenery. Nowadays modern urban living involves sensory deprivation and overloaded stress. In many cities and towns of the world are expanding unabated in the name of urbanization and industrialization and in fact becoming jungles of concrete. Dhaka is one of the examples of such cities where open and green spaces are decreasing because of accommodating the overflow of population. This review paper has been prepared based on interviewing 30 teenagers, both male and female in Dhaka city. There were 12 open-ended questions in the questionnaire. For the literature review information had been gathered from scholarly papers published in various peer-reviewed journals. Some information was collected from the newspapers and some from fellow colleagues working around the world. Ideally about 25% of an urban area should be kept open or with parks, fields and/or plants and vegetation. But currently Dhaka has only about 10-12% open space and these also are being filled up rapidly. Old Dhaka has only about 5% open space while the new Dhaka has about 12%. Dhaka is now one of the most populated cities in the world. Accommodating this huge influx of people Dhaka is continuously losing its open space. As a result, children and teenagers are losing their interest in playing games and making friends, rather they are mostly occupied by television, gadgets and social media. It has been known from the interview that only 28% of teenagers regularly play. But the majority of them have to play on the street and rooftop for the lack of open space. On an average they are occupied with electronic devices for 8.3 hours/day. 64% of them has chronic diseases and often visit doctors. Most shockingly 35% of them claimed for not having any friends. Green space offers relief from stress. Areas of natural environment in towns and cities are theoretically seen providing setting for recovery and recuperation from anxiety and strains of the urban environment. Good quality green spaces encourage people to walk, run, cycle and play. Green spaces improve air quality and reduce noise, while trees and shrubbery help to filter out dust and pollutants. Relaxation, contemplation and passive recreation are essential to stress management. All city governments that are losing its open spaces should immediately pay attention to this aesthetic issue for the benefit of urban people. All kinds of development must be sustainable both for human being and nature.

Keywords: greenery, health, human, urban

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Authors: Pratap Chandra Pati, Prabina Rajib, Parama Barai

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The traditional finance theory neglects the role of sentiment factor in asset pricing. However, the behavioral approach to asset-pricing based on noise trader model and limit to arbitrage includes investor sentiment as a priced risk factor in the assist pricing model. Investor sentiment affects stock more that are vulnerable to speculation, hard to value and risky to arbitrage. It includes small stocks, high volatility stocks, growth stocks, distressed stocks, young stocks and non-dividend-paying stocks. Since the introduction of Chicago Board Options Exchange (CBOE) volatility index (VIX) in 1993, it is used as a measure of future volatility in the stock market and also as a measure of investor sentiment. CBOE VIX index, in particular, is often referred to as the ‘investors’ fear gauge’ by public media and prior literature. The upward spikes in the volatility index are associated with bouts of market turmoil and uncertainty. High levels of the volatility index indicate fear, anxiety and pessimistic expectations of investors about the stock market. On the contrary, low levels of the volatility index reflect confident and optimistic attitude of investors. Based on the above discussions, we investigate whether market-wide fear levels measured volatility index is priced factor in the standard asset pricing model for the Indian stock market. First, we investigate the performance and validity of Fama and French three-factor model and Carhart four-factor model in the Indian stock market. Second, we explore whether India volatility index as a proxy for fearful market-based sentiment indicators affect the cross section of stock returns after controlling for well-established risk factors such as market excess return, size, book-to-market, and momentum. Asset pricing tests are performed using monthly data on CNX 500 index constituent stocks listed on the National stock exchange of India Limited (NSE) over the sample period that extends from January 2008 to March 2017. To examine whether India volatility index, as an indicator of fear sentiment, is a priced risk factor, changes in India VIX is included as an explanatory variable in the Fama-French three-factor model as well as Carhart four-factor model. For the empirical testing, we use three different sets of test portfolios used as the dependent variable in the in asset pricing regressions. The first portfolio set is the 4x4 sorts on the size and B/M ratio. The second portfolio set is the 4x4 sort on the size and sensitivity beta of change in IVIX. The third portfolio set is the 2x3x2 independent triple-sorting on size, B/M and sensitivity beta of change in IVIX. We find evidence that size, value and momentum factors continue to exist in Indian stock market. However, VIX index does not constitute a priced risk factor in the cross-section of returns. The inseparability of volatility and jump risk in the VIX is a possible explanation of the current findings in the study.

Keywords: India VIX, Fama-French model, Carhart four-factor model, asset pricing

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Authors: Keiko Yamauchi, Motoyuki Nakao, Yoko Ishihara

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The increase in the number of women with breast cancer in Japan has required hospitals to provide a higher quality of medicine so that patients are satisfied with the treatment they receive. However, patients’ satisfaction following breast cancer treatment has not been sufficiently studied. Hence, we investigated the factors influencing patient satisfaction following breast cancer treatment among Japanese women. These women underwent either breast-conserving surgery (BCS) (n = 380) or total mastectomy (TM) (n = 247). In March 2016, we conducted a cross-sectional internet survey of Japanese women with breast cancer in Japan. We assessed the following factors: socioeconomic status, cancer-related information, the role of medical decision-making, the degree of satisfaction regarding the treatments received, and the regret arising from the medical decision-making processes. We performed logistic regression analyses with the following dependent variables: extreme satisfaction with the treatments received, and regret regarding the medical decision-making process. For both types of surgery, the odds ratio (OR) of being extremely satisfied with the cancer treatment was significantly higher among patients who did not have any regrets compared to patients who had. Also, the OR tended to be higher among patients who chose to play a wanted role in the medical decision-making process, compared with patients who did not. In the BCS group, the OR of being extremely satisfied with the treatment was higher if, at diagnosis, the patient’s youngest child was older than 19 years, compared with patients with no children. The OR was also higher if patient considered the stage and characteristics of their cancer significant. The OR of being extremely satisfied with the treatments was lower among patients who were not employed on full-time basis, and among patients who considered the second medical opinions and medical expenses to be significant. These associations were not observed in the TM group. The OR of having regrets regarding the medical decision-making process was higher among patients who chose to play a role in the decision-making process as they preferred, and was also higher in patients who were employed on either a part-time or contractual basis. For both types of surgery, the OR was higher among patients who considered a second medical opinion to be significant. Regardless of surgical type, regret regarding the medical decision-making process decreases treatment satisfaction. Patients who received breast-conserving surgery were more likely to have regrets concerning the medical decision-making process if they could not play a role in the process as they preferred. In addition, factors associated with the satisfaction with treatment in BCS group but not TM group included the second medical opinion, medical expenses, employment status, and age of the youngest child at diagnosis.

Keywords: medical decision making, breast-conserving surgery, total mastectomy, Japanese

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Authors: Kitoholi V. Zhimo

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Unlike the cases of cases of homosexuals, haemophilic and or drug users in USA, France, Africa and other countries, in India the first case of HIV/AIDS was detected in heterosexual female sex workers (FSW) in Chennai in 1986. This image played an important role in understanding HIV/AIDS scenario in the country. Similar to popular and dominant metaphors on HIV/AIDS such as ‘gay plague’, ‘new cancer’, ‘lethal disease’, ‘slim disease’, ‘foreign disease’, ‘junkie disease’, etc. around the world, the social construction of the virus was largely attributed to women in India. It was established that women particularly sex workers are ‘carrier’ and ‘transmitter’ of virus and were categorised as High Risk Groups (HRG’s) alongside homosexuals, transgenders and injecting drug users. Recent literature reveals growing rate of HIV infection among housewives since 1997 which revolutionised public health scenario in India. This means shift from high risk group to general public through ‘bridge population’ encompassing long distance truckers and migrant labours who at the expense of their nature of work and mobility comes in contact with HRG’s and transmit the virus to the general public especially women who are confined to the domestic space. As HIV epidemic expands, married women in monogamous relationship/marriage stand highly susceptible to infection with limited control, right and access over their sexual and reproductive health and planning. In context of Nagaland, a small state in North-eastern part of India HIV/AIDS transmission through injecting drug use dominated the early scene of the epidemic. However, paradigm shift occurred with declining trend of HIV prevalence among injecting drug users (IDU’s) over the past years with the introduction of Opioid Substitution Therapy (OST) and easy access/availability of syringes and injecting needles. Reflection on statistical data reveals that out of 36 states and union territories in India, the position of Nagaland in HIV prevalence among IDU’s has significantly dropped down from 6th position in 2003 to 16th position in 2017. The present face of virus in Nagaland is defined by (hetero) sexual mode of transmission which accounts for about 91% of as reported by Nagaland state AIDS control society (NSACS) in 2016 wherein young and married woman were found to be most affected leading to feminization of HIV/AIDS epidemic in the state. Thus, not only is HIV epidemic feminised but emerged victim to domestic violence which is more often accepted as normal part of heterosexual relationship. In the backdrop of these understanding, the present paper based on ethnographic fieldwork explores the plight, lived experiences and images of HIV+ve women with regard to sexual and reproductive rights against the backdrop of patriarchal system in Nagaland.

Keywords: HIV/AIDS, monogamy, Nagaland, sex worker disease, women

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Authors: Anne Nattembo

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Cervical cancer remains a major public health problem in developing countries, especially in Africa. Effective cervical cancer prevention communication requires identification of behaviors, attitudes and increasing awareness of a given population; thus this study focused on investigating awareness, attitudes, and behavior among female university students towards cervical cancer messages. The study objectives sought to investigate the communication behavior of young adults towards cervical cancer, to understand female students recognition of cervical cancer as a problem, to identify the frames related to cervical cancer and their impact towards audience communication and participation behaviors, to identify the factors that influence behavioral intentions and level of involvement towards cervical cancer services and to make recommendations on how to improve cervical cancer communication towards female university students. The researcher obtained data using semi-structured interviews and focus group discussions targeting 90 respondents. The semi-structured in-depth interviews were carried out through one-on-one discussions basis using a set of prepared questions among 53 respondents. All interviews were audio-tape recorded. Each interview was directly typed into Microsoft Word. 4 focus group discussions were conducted with a total of 37 respondents; 2 female only groups with 10 respondents in one and 9 respondents in another, 1 mixed with 12 participants 5 of whom were male, and 1 male only group with 6 participants. The key findings show that the participants preferred to receive and access cervical cancer information from doctors although they were mainly receiving information from the radio. In regards to the type of public the respondents represent, majority of the respondents were non-publics in the sense that they did not have knowledge about cervical cancer, had low levels of involvement and had high constraint recognition their cervical cancer knowledge levels. The researcher identified the most salient audience frames among female university students towards cervical cancer and these included; death, loss, and fear. These frames did not necessarily make cervical cancer an issue of concern among the female university students but rather an issue they distanced themselves from as they did not perceive it as a risk. The study also identified the constraints respondents face in responding to cervical cancer campaign calls-to-action which included; stigma, lack of knowledge and access to services as well as lack of recommendation from doctors. In regards to sex differences, females had more knowledge about cervical cancer than the males. In conclusion the study highlights the importance of interpersonal communication in risk or health communication with a focus on health providers proactively sharing cervical cancer prevention information with their patients. Health provider’s involvement in cervical cancer is very important in influencing behavior and compliance of cervical cancer calls-to-action. The study also provides recommendations for designing effective cervical cancer campaigns that will positively impact on the audience such as packaging cervical cancer messages that also target the males as a way of increasing their involvement and more campaigns to increase awareness of cervical cancer as well as designing positive framed messages to counter the negative audience frames towards cervical cancer.

Keywords: cervical cancer communication, health communication, university students, risk communication

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Authors: E. V. Fakhrutdinova, Y. S. Kolesnikova, E. A. Karasik, V. M. Zagidullina

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Poverty as the social and economic phenomenon exists in any society and represents a many-sided problem. In this sense it is universal and for many centuries serves as a research objects for scientists. Special attention to a problem of poverty in Russia is caused, first of all, by the critical growth of inequality and by scales of expansion of poverty, considerable decrease in the level and quality of life of the population, decrease in availability of education during the period of reforming. The expansion of poverty on the working members of society, youth, which has to provide reproduction of the population is alarming. As poverty is the reason of weakening of national security of the country, degradation of the population, decline in the quality of the human capital, complication of a demographic situation, strengthening of social contradictions in society, so far as the reduction of poverty, so, the increase in production. Poverty: the characteristic of an economic situation of the individual or social group at which they can't satisfy certain minimum requirements necessary for life, preservations of working capacity and reproduction. Poverty became one of the critical factors expelling people from the system of the institutional interactions reducing social space in which their relations were building breaking their social identity. Complication of the problem of poverty in modern society happened due to penetration of the related relations into many spheres of life. It is known that negative consequences of poverty display not only at the personal level of the poor person, but also at the level of interpersonal social interactions, decline in the quality and level of development of the human capital, and also at social and economic system in general. We conducted a research on the influence of education on the change of poverty level of the population. We consider education as a resource for an increase of the income and social mobility. Dependence of the income of the population on the level of education, availability of education (level of education and quality of education) on the level of income of families is found. Differentiation of quality and number of educational services for children depending on the level of the income of families is revealed. Influence of a factor of poverty on the availability of education is also studied. We consider expenses on education as the limiter of access to education. We consider education as a factor of fixation and aggravation of a property inequality. In the solution of problems of poverty the defining condition is the state regulation of social and economic development by means of creation of the effective institutional environment. The state has to develop measures for an increase of availability of various services to all categories of citizens, in particular services of health care and education, especially for poor citizens enters. The special attention regarding an increase of availability of education services has to be paid to creation of system of social elevators.

Keywords: poverty, education, human capital, quality of life

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Authors: Arun Perumbilavil Anand

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It may no longer be just anecdotal that every twelfth person in Kerala is a migrant worker from outside the state. For the past few years, the state has been witnessing large inflow of migrants from other states of India, which emerged as a result of demographic transition and Gulf emigration. Initially, the migrants were from the neighbouring states but, at a later period, the state started getting migrants from the distant parts of the country. Currently, migrants have turned to be a decisive force in the state and their increasing numbers have already started creating turbulences in the state. Over the past years, the increasing involvement of migrants in unlawful and criminal activities have generated apprehensions on their presence in the state. Moreover, at present, the Kerala society is not just hosting the first generation migrants, but there has been an increase in the second generation migrants making the situations more complex and diverse. In such a paradigm, the study ponders into the issues of migrants concerning their assimilation and well-being in the host society. Also, the study looks into the factors that impede the assimilation process, along with the perceptions of the migrants about the host society and the people. The study also tries to bring out the differences in the levels of assimilation among the migrants along the lines of religion, caste, state of origin, gender, stay duration and education. Methodology: The study is based on the empirical findings obtained out of the primary survey conducted on migrants employed in the Kanjikode industrial area of Kerala. The samples were selected through purposive sampling and the study employed techniques like observation, questionnaire and in-depth interviews. The findings are based on interviews conducted with 100 migrants. Findings and Conclusion: The study was an attempt of its kind in addressing the issues of assimilation and integration of interstate migrants working in the Kerala. As mentioned, the study could bring out differences in the levels of assimilation along the lines of different characteristics. The study could also locate the importance, and the role played by the peer groups and neighborhoods in accelerating the process of assimilation among the migrants. As an extension, the study also looked at the assimilation and educational issues of the migrant children living in Kerala, and it found that the place of birth, age at entry and the peer group plays a pivotal role in the assimilation process. The study through its findings recommends the need for incorporating the concept of inclusive education into the state educational system by giving due emphasis to the needs of the marginalized. The study points out that owing to the existing demographic conditions, the state will inevitably have to depend on migrant labor in future. Moreover, in such a paradigm, the host community and the government should strive to create a conducive environment for the proper assimilation of the migrants and which in turn can be an impetus for the fulfilment of the needs of both the migrants and the state.

Keywords: assimilation, integration, Kerala, migrant workers, well-being

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Authors: Nada Abdelsadig Moahamed Saied

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Female Genital Mutilation (FGM) and other similar traditional cultural practices pose a significant problem for Sudanese society. Such actions are severe and seriously detrimental to people's health since they are based on false social perceptions. To address these problems, numerous institutions and organizations were compelled to act rapidly. Female circumcision, or FGM, is one of the riskiest practices. It is referred to as the excision of the genitalia. Any surgeries involving the total or partial removal of the external female genitalia for non-medical reasons fall under this category. The results of FGM can vary depending on the kind and degree of the operation. These can be categorized as short-term, mid-term, or long-term issues. Infections, including the Human, blood, discomfort, and difficulty urinating are the immediate effects. FGM is defined by the World Health Organization (WHO) as practices that purposefully damage or modify female genital organs for non-medical purposes. It often takes place between the ages of one and fifteen. The girl's right to decide on important choices affecting her sexual and reproductive health is violated because the act is usually performed without her consent and frequently against her will. UNICEF, the United Nations International Children's Emergency Fund, aggressively combats the issue of FGM in Sudan. Numerous programs were started by NGOs to stop the practice. To our knowledge, no scientific study has been conducted to evaluate the effects of such social marketing techniques on simulating and comprehending society’s feelings surrounding FGM. This study proposes the development of a structural equation model aiming to determine the impact of awareness programs on people’s intentions to adopt the behavior of abandoning FGM based on theoretical models of behavior change. The model incorporates all the relevant factors that contribute to FGM and possible strategic actions to tackle this problem. The theoretical backdrop for FGM is presented in the next section, which also explains the practice's history, justifications, and potential treatments. The methodology section that follows describes the structural equation model. The proposed model, which compiles all the pertinent elements into a single image, is presented in the fourth part. Finally, conclusions are reached, and suggestions for further research are made.

Keywords: social marketing, policy-making, behavioral change, female genital mutilation, culture

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Authors: Chia-Ching Sun, Li-Yin Chien, Chun-Ting Hsiao

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Background: Appropriate gestation weight gain benefits pregnant women and their children; however, excessive weight gain could raise the risk of adverse health outcomes and chronicle diseases. Nevertheless, there is currently limited evidence on the effect of physical activities on pregnant women’s gestational weight gain. Purpose: This study aimed to explore the correlation between the level of physical activity and gestation weight gain during the second and third trimester of pregnancy. Methods: This longitudinal study enrolled 800 healthy pregnant women aged over 20 from six hospitals in northern Taiwan. Structured questionnaires were used to collect data twice for each participant during 14-27 and 28-40 weeks of gestation. Variables included demographic data, maternal health history, and lifestyle. The International Physical Activity Questionnaire-short form was used to measure the level of physical activity from walking and of moderate-intensity and vigorous-intensity before and during pregnancy. Weight recorded at prenatal checkups were used to calculate average weight gain in each trimester of pregnancy. T-tests, ANOVA, chi-squared tests, and multivariable logistic regression models were applied to determine the predicting factors for weight gain during the second and third trimester. Result: Participants who had achieved recommended physical activity level (150 minutes of moderate physical activity or 75 minutes of vigorous physical activity a week) before pregnancy (aOR=1.85, 95% CI=1.27-2.67) or who achieved recommended walking level (150 minutes a week) during the second trimester of pregnancy (aOR=1.43, 95% CI= 1.00-2.04) gained significantly more weight during the second trimester. Compared with those who did not reach recommended level of moderate-intensity physical activity (150 minutes a week), women who had reached that during the second trimester were more likely to be in the less than recommended weight gain group than in the recommended weight gain group (aOR=2.06, CI=1.06-4.00). However, there was no significant correlation between physical activity level and weight gain in the third trimester. Other predicting factors of excessive weight gain included education level which showed a negative correlation (aOR=0.38, CI=0.17-0.88), whereas overweight and obesity before pregnancy showed a positive correlation (OR=3.97, CI=1.23-12.78). Conclusions/implications for practice: Participants who had achieved recommended physical activity level before pregnancy significantly reduced exercise during pregnancy and gained excessive weight during the second trimester. However, women who engaged in the practice of physical activity as recommended could effectively control weight gain in the third trimester. Healthcare professionals could suggest that pregnant women who exercise maintain their pre-pregnancy level of physical activity, given activities requiring physical contact or causing falls are avoided. For those who do not exercise, health professionals should encourage them to gradually increase the level of physical activity. Health promotion strategies related to weight control and physical activity level achievement should be given to women before pregnancy.

Keywords: pregnant woman, physical activity, gestation weight gain, obesity, overweight

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Authors: Jiayue Guo, Lili You

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Background: Children and adolescent health are crucial for both personal well-being and the nation's future health landscape. Health Literacy (HL) is important in enabling adolescents to self-manage their health, a fundamental step towards health empowerment. However, there are limited tools for assessing HL among elementary and junior high school students. This study aims to construct and validate a test-based HL scale for Chinese students, offering a scientific reference for cross-cultural HL tool development. Methods: We conducted a cross-sectional online survey. Participants were recruited from a stratified cluster random sampling method, a total of 4189 Chinese in-school primary and secondary students. The development of the scale was completed by defining the concept of HL, establishing the item indicator system, screening items (7 health content dimensions), and evaluating reliability and validity. Delphi method expert consultation was used to screen items, the Rasch model was conducted for quality analysis, and Cronbach’s alpha coefficient was used to examine the internal consistency. Results: We developed four versions of the HL scale, each with a total score of 100, encompassing seven key health areas: hygiene, nutrition, physical activity, mental health, disease prevention, safety awareness, and digital health literacy. Each version measures four dimensions of health competencies: knowledge, skills, motivation, and behavior. After the second round of expert consultation, the average importance score of each item by experts is 4.5–5.0, and the coefficient of variation is 0.000–0.174. The knowledge and skills dimensions are judgment-based and multiple-choice questions, with the Rasch model confirming unidimensionality at a 5.7% residual variance. The behavioral and motivational dimensions, measured with scale-type items, demonstrated internal consistency via Cronbach's alpha and strong inter-item correlation with KMO values of 0.924 and 0.787, respectively. Bartlett's test of sphericity, with p-values <0.001, further substantiates the scale's reliability. Conclusions: The new test-based scale, designed to evaluate competencies within a multifaceted framework, aligns with current international adolescent literacy theories and China's health education policies, focusing not only on knowledge acquisition but also on the application of health-related thinking and behaviors. The scale can be used as a comprehensive tool for HL evaluation and a reference for other countries.

Keywords: adolescent health, Chinese, health literacy, rasch model, scale development

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Authors: Dercan Gencbas, Hatice Bebis, Sue Moorhead

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In the nursing process, many of the nursing classification systems were created to be used in international. From these, NANDA-I, Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). In this direction, the main objective of this study is to establish a model for caregivers in hospitals and communities in Turkey and to ensure that nursing outputs are assessed by NOC-based measures. There are many scales to measure Urinary Incontinence (UI), which is very common in children, in old age, vaginal birth, NOC scales are ideal for use in the nursing process for comprehensive and holistic assessment, with surveys available. For this reason, the purpose of this study is to evaluate the validity of the NOC outputs and indicators used for UI NANDA-I. This research is a methodological study. In addition to the validity of scale indicators in the study, how much they will contribute to recovery after the nursing intervention was assessed by experts. Scope validations have been applied and calculated according to Fehring 1987 work model. According to this, nursing inclusion criteria and scores were determined. For example, if experts have at least four years of clinical experience, their score was 4 points or have at least one year of the nursing classification system, their score was 1 point. The experts were a publication experience about nursing classification, their score was 1 point, or have a doctoral degree in nursing, their score was 2 points. If the expert has a master degree, their score was 1 point. Total of 55 experts rated Fehring as a “senior degree” with a score of 90 according to the expert scoring. The nursing interventions to be applied were asked to what extent these indicators would contribute to recovery. For coverage validity tailored to Fehring's model, each NOC and NOC indicator from specialists was asked to score between 1-5. Score for the significance of indicators was from 1=no precaution to 5=very important. After the expert opinion, these weighted scores obtained for each NOC and NOC indicator were classified as 0.8 critical, 0.8 > 0.5 complements, > 0.5 are excluded. In the NANDA-I / NOC / NIC system (guideline), 5 NOCs proposed for nursing diagnoses for UI were proposed. These outputs are; Urinary Continence, Urinary Elimination, Tissue Integrity, Self CareToileting, Medication Response. After the scales are translated into Turkish, the weighted average of the scores obtained from specialists for the coverage of all 5 NOCs and the contribution of nursing initiatives exceeded 0.8. After the opinions of the experts, 79 of the 82 indicators were calculated as critical, 3 of the indicators were calculated as supplemental. Because of 0.5 > was not obtained, no substance was removed. All NOC outputs were identified as valid and usable scales in Turkey. In this study, five NOC outcomes were verified for the evaluation of the output of individuals who have received nursing knowledge of UI and variant types. Nurses in Turkey can benefit from the outputs of the NOC scale to perform the care of the elderly incontinence.

Keywords: nursing outcomes, content validity, nursing diagnosis, urinary incontinence

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Authors: Gelareh Ghaderi

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the overall objective of this study is to develop two alternative plans of spatial and infrastructural development for the Netwerkstad Twente (Twente region) until 2040 and to assess the impacts of those two alternative plans. This region is located on the eastern border of the Netherlands, and it comprises of five municipalities. Based on the strengths and opportunities of the five municipalities of the Netwerkstad Twente, and in order develop the region internationally, strengthen the job market and retain skilled and knowledgeable young population, two alternative visions have been developed; environmental oriented vision, and economical oriented vision. Environmental oriented vision is based mostly on preserving beautiful landscapes. Twente would be recognized as an educational center, driven by green technologies and environment-friendly economy. Market-oriented vision is based on attracting and developing different economic activities in the region based on visions of the five cities of Netwerkstad Twente, in order to improve the competitiveness of the region in national and international scale. On the basis of the two developed visions and strategies for achieving the visions, land use and infrastructural development are modeled and assessed. Based on the SWOT analysis, criteria were formulated and employed in modeling the two contrasting land use visions by the year 2040. Land use modeling consists of determination of future land use demand, assessment of suitability land (Suitability analysis), and allocation of land uses on suitable land. Suitability analysis aims to determine the available supply of land for future development as well as assessing their suitability for specific type of land uses on the basis of the formulated set of criteria. Suitability analysis was operated using CommunityViz, a Planning Support System application for spatially explicit land suitability and allocation. Netwerkstad Twente has highly developed transportation infrastructure, consists of highways network, national road network, regional road network, street network, local road network, railway network and bike-path network. Based on the assumptions of speed limitations on different types of roads provided, infrastructure accessibility level of predicted land use parcels by four different transport modes is investigated. For evaluation of the two development scenarios, the Multi-criteria Evaluation (MCE) method is used. The first step was to determine criteria used for evaluation of each vision. All factors were categorized as economical, ecological and social. Results of Multi-criteria Evaluation show that Environmental oriented cities scenario has higher overall score. Environment-oriented scenario has impressive scores in relation to economical and ecological factors. This is due to the fact that a large percentage of housing tends towards compact housing. Twente region has immense potential, and the success of this project will define the Eastern part of The Netherlands and create a real competitive local economy with innovations and attractive environment as its backbone.

Keywords: economical oriented vision, environmental oriented vision, infrastructure, land use, multi criteria assesment, vision

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Authors: Richard Byrne, Emma Mulliner

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Smart cities are a vision for the future that is increasingly becoming a reality. While a key concept of the smart city is the ability to capture, communicate, and process data that has long been produced through day-to-day activities of the city, much of the assessment models in place neglect this fact to focus on ‘smartness’ concepts. Although it is true technology often provides the opportunity to capture and communicate data in more effective ways, there are also human processes involved that are just as important. The growing importance with regards to the use and ownership of data in society can be seen by all with companies such as Facebook and Google increasingly coming under the microscope, however, why is the same scrutiny not applied to cities? The research area is therefore of great importance to the future of our cities here and now, while the findings will be of just as great importance to our children in the future. This research aims to understand the influence data is having on organisations operating throughout the smart cities sector and employs a mixed-method research approach in order to best answer the following question: Would a data-based evaluation model for smart cities be more appropriate than a smart-based model in assessing the development of the smart city? A fully comprehensive literature review concluded that there was a requirement for a data-driven assessment model for smart cities. This was followed by a documentary analysis to understand the root source of data integration to the smart city. A content analysis of city data platforms enquired as to the alternative approaches employed by cities throughout the UK and draws on best practice from New York to compare and contrast. Grounded in theory, the research findings to this point formulated a qualitative analysis framework comprised of: the changing environment influenced by data, the value of data in the smart city, the data ecosystem of the smart city and organisational response to the data orientated environment. The framework was applied to analyse primary data collected through the form of interviews with both public and private organisations operating throughout the smart cities sector. The work to date represents the first stage of data collection that will be built upon by a quantitative research investigation into the feasibility of data network effects in the smart city. An analysis into the benefits of data interoperability supporting services to the smart city in the areas of health and transport will conclude the research to achieve the aim of inductively forming a framework that can be applied to future smart city policy. To conclude, the research recognises the influence of technological perspectives in the development of smart cities to date and highlights this as a challenge to introduce theory applied with a planning dimension. The primary researcher has utilised their experience working in the public sector throughout the investigation to reflect upon what is perceived as a gap in practice of where we are today, to where we need to be tomorrow.

Keywords: data, planning, policy development, smart cities

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Authors: Li Wang, Dan Shu, Shiguang Pang, Lixiu Wang, Bing Xiang Yang, Qian Liu

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Background: Cancer is one of the most severe diseases in childhood; long-term treatment and its side effects significantly impact the patient's physical, psychological, social functioning and quality of life while also placing substantial physical and psychological burdens on caregivers and families. Family resilience is crucial for children with cancer, helping them cope better with the disease and supporting the family in facing challenges together. As a family-level variable, family resilience requires information from multiple family members. However, to our best knowledge, there is currently no research investigating family resilience from both the perspectives of pediatric cancer patients and their caregivers. Therefore, this study aims to investigate the family resilience and quality of life of pediatric cancer patients from a patient–caregiver dyadic perspective. Methods: A total of 149 dyads of patients diagnosed with pediatric cancer patients and their principal caregivers were recruited from oncology departments of 4 tertiary hospitals in Wuhan and Taiyuan, China. All participants completed questionnaires that identified their demographic and clinical characteristics as well as assessed their family resilience and quality of life for both the patients and their caregivers. K-means cluster analysis was used to identify different clusters of family resilience based on the reports from patients and caregivers. Multivariate logistic regression and linear regression are used to analyze the factors influencing family resilience and quality of life, as well as the relationship between the two. Results: Three clusters of family resilience were identified: a cluster of high family resilience (HR), a cluster of low family resilience (LR), and a cluster of discrepant family resilience (DR). Most (67.1%) families fell into the cluster with low resilience. Characteristics such as the types of caregivers perceived social support of the patient were different among the three clusters. Compared to the LR group, families where the mother is the caregiver and where the patient has high social support are more likely to be assigned to the HR. The quality of life for caregivers was consistently highest in the HR cluster and lowest in the LR cluster. The patient's quality of life is not related to family resilience. In the linear regression analysis of the patient's quality of life, patients who are the first-born have higher quality of life, while those living with their parents have lower quality of life. The participants' characteristics were not associated with the quality of life for caregivers. Conclusions: In most families, family resilience was low. Families with maternal caregivers and patients receiving high levels of social support are more inclined to be higher levels of family resilience. Family resilience was linked to the quality of life of caregivers of pediatric cancer patients. The clinical implications of this findings suggest that healthcare and social support organizations should prioritize and support the participation of mothers in caregiving responsibilities. Furthermore, they should assist families in accessing social support to enhance family resilience. This study also emphasizes the importance of promoting family resilience for enhancing family health and happiness, as well as improving the quality of life for caregivers.

Keywords: pediatric cancer, cluster analysis, family resilience, quality of life

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Authors: Ma. Cecilia D. Licuan

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The pandemic situation continues to affect the lives of many people, including children with disabilities and their families, globally, especially in developing countries like the Philippines. The operations of health programs, industries, and economic sectors, as well as academic training institutions, are still challenged in terms of operations and delivery of services. The academic community of the Physical Therapy program is not spared by this circumstance. The restriction posted by the quarantine policies nearly terminated the onsite delivery of training programs for the senior internship level, which challenged the academic institutions to implement flexible learning programs to ensure the continuity of the instructional and learning processes with full consideration of safety and compliance to health protocols. This study aimed to develop a benchmark model that can be used by tertiary-level health institutions in the implementation of the Pediatric Senior Clinical Internship Training Program using Telerehabilitation. It is a descriptive-qualitative paper that utilized documentary analysis and focused on explaining the design, development, and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences (DLSMHSI-CRS) Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program covering the pandemic years spanning from the academic year 2020- 2021 to present anchored on needs analysis based on documentary reviews. Results of the study yielded the determination of the Pediatric Telerehabilitation Model; declaration of developed training program outcomes and thrusts and content; explanation of the process integral to the training program’s pedagogy in implementation; and the evaluation procedures conducted for the program. Since the study did not involve human participants, ethical considerations on the use of documents for review were done upon the endorsement of the management of the DLSMHSI-CRS to conduct the study. This paper presents the big picture of how a tertiary-level health sciences institution in the Philippines embraced the senior clinical internship challenges through the operations of its telerehabilitation program. It specifically presents the design, development and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program, which can serve as a benchmark model for other institutions as they continue to serve their stakeholders amidst the pandemic.

Keywords: pediatric physical therapy, telerehabilitation, clinical internship, pandemic

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Authors: Prajakta Khare

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There is a huge number of social enterprises operating in India, across all enterprise sizes and forms addressing diverse social issues. Some cases such as such as Aravind eye care, Narayana Hridalaya, SEWA have been studied extensively in management literature and are known cases in social entrepreneurship. But there are several smaller social enterprises in India that are not called so per se due to the lack of understanding of the concept. There is a lack of academic research on social entrepreneurship in India and the term ‘social entrepreneurship’ is not yet widely known in the country, even by people working in this field as was found by this study. The present study aims to identify the most prominent form of social enterprises in India, the profile of the entrepreneurs, challenges faced, the lessons (theory and practices) emerging from their functioning and finally the factors contributing to the enterprises’ success. This is a preliminary exploratory study using primary data from 30 social enterprises in India. The study used snow ball sampling and a qualitative analysis. Data was collected from founders of social enterprises through written structured questionnaires, open-ended interviews and field visits to enterprises. The sample covered enterprises across sectors such as environment, affordable education, children’s rights, rain water harvesting, women empowerment etc. The interview questions focused on founder’s background and motivation, qualifications, funding, challenges, founder’s understanding and perspectives on social entrepreneurship, government support, linkages with other organizations etc. apart from several others. The interviews were conducted across 3 languages - Hindi, Marathi, English and were then translated and transcribed. 50% of founders were women and 65% of the total founders were highly qualified with a MBA, PhD or MBBS. The most important challenge faced by these entrepreneurs is recruiting skilled people. When asked about their understanding of the term, founders had diverse perspectives. Also, their understandings about the term social enterprise and social entrepreneur were extremely varied. Some founders identified the terms with doing something good for the society, some thought that every business can be called a social enterprise. 35% of the founders were not aware of the term social entrepreneur/ social entrepreneurship. They said that they could identify themselves as social entrepreneurs after discussions with the researcher. The general perception in India is that ‘NGOs are corrupt’- fighting against this perception to secure funds is also another problem as pointed out by some founders. There are unique challenges that social entrepreneurs in India face, as the political, social, economic environment around them is rapidly changing; and getting adequate support from the government is a problem. The research in its subsequent stages aims to clarify existing, missing and new definitions of the term to provide deeper insights in the terminology and issues relating to Social Entrepreneurship in India.

Keywords: challenges, India, social entrepreneurship, social entrepreneurs

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Authors: Asrarul H. Jeelani

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Arsenic contamination of groundwater and its’ health implications in lower Gangetic plain of Indian states started reporting in the 1980s. The same period was declared as the first water decade (1981-1990) to achieve ‘water for all.’ To fulfill the aim, the Indian government, with the support of international agencies installed millions of hand-pumps through water resources development programs. The hand-pumps improve the accessibility if the groundwater, but over-extraction of it increases the chances of mixing of trivalent arsenic which is more toxic than pentavalent arsenic of dug well water in Gangetic plain and has different physical manifestations. Now after three decades, Bihar (middle Gangetic plain) is also facing arsenic contamination of groundwater and its’ health implications. Objective: This interdisciplinary research attempts to understand the health and social implications of arsenicosis among different castes in Haldi Chhapra village and to find the association of ramifications with water resources development. Methodology: The Study used concurrent quantitative dominant mix method (QUAN+qual). The researcher had employed household survey, social mapping, interviews, and participatory interactions. However, the researcher used secondary data for retrospective analysis of hand-pumps and implications of arsenicosis. Findings: The study found 88.5% (115) household have hand-pumps as a source of water however 13.8% uses purified supplied water bottle and 3.6% uses combinations of hand-pump, bottled water and dug well water for drinking purposes. Among the population, 3.65% of individuals have arsenicosis, and 2.72% of children between the age group of 5 to 15 years are affected. The caste variable has also emerged through quantitative as well as geophysical locations analysis as 5.44% of arsenicosis manifested individual belong to scheduled caste (SC), 3.89% to extremely backward caste (EBC), 2.57% to backward caste (BC) and 3% to other. Among three clusters of arsenic poisoned locations, two belong to SC and EBC. The village as arsenic affected is being discriminated, whereas the affected individual is also facing discrimination, isolation, stigma, and problem in getting married. The forceful intervention to install hand-pumps in the first water decades and later restructuring of the dug well destroyed a conventional method of dug well cleaning. Conclusion: The common manifestation of arsenicosis has increased by 1.3% within six years of span in the village. This raised the need for setting up a proper surveillance system in the village. It is imperative to consider the social structure for arsenic mitigation program as this research reveals caste as a significant factor. The health and social implications found in the study; retrospectively analyzed as the collateral impact of water resource development programs in the village.

Keywords: arsenicosis, caste, collateral impact, water resources

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Authors: Qiang Guo, Ruying Qi

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This project aims to trace the developmental patterns of a child's Mandarin and English from China to Australia from age 3; 03 till 5; 06. In childhood bilingual studies, there is an assumption that age 3 is the dividing line between simultaneous bilinguals and sequential bilinguals. Determining similarities and differences between Bilingual First Language Acquisition, Early Second Language Acquisition, and Second Language Acquisition is of great theoretical significance. Studies on Bilingual First Language Acquisition, hereafter, BFLA in the past three decades have shown that the grammatical development of bilingual children progresses through the same developmental trajectories as their monolingual counterparts. Cross-linguistic interaction does not show changes of the basic grammatical knowledge, even in the weaker language. While BFLA studies show consistent results under the conditions of adequate input and meaningful interactional context, the research findings of Early Second Language Acquisition (ESLA) have demonstrated that this cohort proceeds their early English differently from both BFLA and SLA. The different development could be attributed to the age of migration, input pattern, and their Environmental Languages (Lε). In the meantime, the dynamic relationship between the two languages is an issue to invite further attention. The present study attempts to fill this gap. The child in this case study started acquiring L1 Mandarin from birth in China, where the environmental language (Lε) coincided with L1 Mandarin. When she migrated to Australia at 3;06, where the environmental language (Lε) was L2 English, her Mandarin exposure was reduced. On the other hand, she received limited English input starting from 1; 02 in China, where the environmental language (Lε) was L1 Mandarin, a non-English environment. When she relocated to Australia at 3; 06, where the environmental language (Lε) coincided with L2 English, her English exposure significantly increased. The child’s linguistic profile provides an opportunity to explore: (1) What does the child’s English developmental route look like? (2) What does the L1 Mandarin developmental pattern look like in different environmental languages? (3) How do input and environmental language interact in shaping the bilingual child’s linguistic repertoire? In order to answer these questions, two linguistic areas are selected as the focus of the investigation, namely, subject realization and wh-questions. The chosen areas are contrastive in structure but perform the same semantic functions in the two linguistically distant languages and can serve as an ideal testing ground for exploring the developmental path in the two languages. The longitudinal case study adopts a combined approach of qualitative and quantitative analysis. Two years’ Mandarin and English data are examined, and comparisons are made with age-matched monolinguals in each language in CHILDES. To the author’s best knowledge, this study is the first of this kind examining a Mandarin-English bilingual child's bilingual development at a critical age, in different input patterns, and in different environmental languages (Lε). It also expands the scope of the theory of Lε, adding empirical evidence on the relationship between input and Lε in bilingual acquisition.

Keywords: bilingual development, age, input, environmental language (Le)

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Authors: Azyz Sharafy

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3D Text Toys is an innovative and creative approach that utilizes 3D text objects to enhance creativity, literacy, and basic learning in an enjoyable and gamified manner. By using 3D Text Toys, children can develop their creativity, visually learn words and texts, and apply their artistic talents within their creative abilities. This process incorporates haptic engagement with 2D and 3D texts, word building, and mechanical construction of everyday objects, thereby facilitating better word and text retention. The concept involves constructing visual objects made entirely out of 3D text/words, where each component of the object represents a word or text element. For instance, a bird can be recreated using words or text shaped like its wings, beak, legs, head, and body, resulting in a 3D representation of the bird purely composed of text. This can serve as an art piece or a learning tool in the form of a 3D text toy. These 3D text objects or toys can be crafted using natural materials such as leaves, twigs, strings, or ropes, or they can be made from various physical materials using traditional crafting tools. Digital versions of these objects can be created using 2D or 3D software on devices like phones, laptops, iPads, or computers. To transform digital designs into physical objects, computerized machines such as CNC routers, laser cutters, and 3D printers can be utilized. Once the parts are printed or cut out, students can assemble the 3D texts by gluing them together, resulting in natural or everyday 3D text objects. These objects can be painted to create artistic pieces or text toys, and the addition of wheels can transform them into moving toys. One of the significant advantages of this visual and creative object-based learning process is that students not only learn words but also derive enjoyment from the process of creating, painting, and playing with these objects. The ownership and creation process further enhances comprehension and word retention. Moreover, for individuals with learning disabilities such as dyslexia, ADD (Attention Deficit Disorder), or other learning difficulties, the visual and haptic approach of 3D Text Toys can serve as an additional creative and personalized learning aid. The application of 3D Text Toys extends to both the English language and any other global written language. The adaptation and creative application may vary depending on the country, space, and native written language. Furthermore, the implementation of this visual and haptic learning tool can be tailored to teach foreign languages based on age level and comprehension requirements. In summary, this creative, haptic, and visual approach has the potential to serve as a global literacy tool.

Keywords: 3D text toys, creative, artistic, visual learning for world literacy

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