Search results for: psychological survey

Authors: S. Sakhri

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Background: The use of Zoledronic acid (ZA) is an established place in the treatment of malignant tumors with a predilection for the skeleton of interest (in particular metastasis). Although the main target of Zoledronic acid was osteoclasts, there are preclinical data suggest that Zoledronic acid may have an antitumor effect on cells other than osteoclasts, including tumor cells. Antitumor activity, including the inhibition of tumor cell growth and the induction of apoptosis of tumor cells, inhibition of tumor cell adhesion and invasion, and anti-angiogenic effects have been demonstrated. Methods. From (2012 to 2014), 438 patients were included respondents the inclusion criteria, respectively. This is a prospective study over a 4 year period. Of all patients (N=438), 432 received neoadjuvant chemotherapy with Zoledronic acid. The primary end point was the pathologic complete response in advancer breast cancer stage. The secondary end point is to evaluate Clinical response according to RECIST criteria; estimate the bone density before and at the end of chemotherapy in women with locally advanced breast cancer, Toxicity Evaluation and Overall survival using Kaplan-Meier and log test. Result: The Objective response rate was 97% after (C4) with 3% stabilizations and 99, 3% of which 0.7% C8 after stabilization. The clinical complete response was 28% after C4 respectively, and 46.8% after C8, the pathologic complete response rate was 40.13% according to the classification Sataloff. We observed that the pathologic complete response rate was the most raised in the group including Her2 (luminal Her2 and Her2) the lowest in the triple negative group as classified by Sataloff. We found that the pCR is significantly higher in the age group (35-50 years) with 53.17%. Those who have more than 50 years in 2nd place with 27.7% and the lower in young woman 35 years pCR was 19%, not statistically significant, -The pCR was also in favor of the menopausal group in 51, 4%, and 48, 55% for non-menopausal women. The average duration of overall survival was also significantly in the subgroup (Luminal -Her2, Her2) compared with triple negative. It is 47.18 months in the luminal group vs. 38.95 in the triple negative group. -Was observed in our study a difference in quality of life between (C1) was the admission of the patient, and after (C8), we found an increase in general signs and a deterioration in the psychological state C1, in contrast to the C8 these general signs and mental status improves, up to 12, and 24 months. Conclusion The results of this study suggest that the addition of ZA to néoadjuvant CT has potential anti-cancer benefit in patients (Luminal -Her2, Her2) compared with triple negative with or without menopause status.

Keywords: HER2+, RH+, breast cancer, tyrosine kinase

Procedia PDF Downloads 193

Authors: Japhet N. Mwambusi

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High tropical forests deforestation for solid wood furniture industry is among of climate change contributing agents. This pressure indirectly is caused by furniture joints failure due to poor gluing technology based on improper use of different glues to different wood species which lead to low quality and weak wood-glue joints. This study was carried in order to run performance tests of wood glues on different wood species used in wood workshops: Morogoro Tanzania whereby three popular wood species of C. lusitanica, T. glandis and E. maidenii were tested against five glues of Woodfix, Bullbond, Ponal, Fevicol and Coral found in the market. The findings were necessary on developing a guideline for proper glue selection for a particular wood species joining. Random sampling was employed to interview carpenters while conducting a survey on the background of carpenters like their education level and to determine factors that influence their glues choice. Monsanto Tensiometer was used to determine bonding strength of identified wood glues to different wood species in use under British Standard of testing wood shear strength (BS EN 205) procedures. Data obtained from interviewing carpenters were analyzed through Statistical Package of Social Science software (SPSS) to allow the comparison of different data while laboratory data were compiled, related and compared by the use of MS Excel worksheet software as well as Analysis of Variance (ANOVA). Results revealed that among all five wood glues tested in the laboratory to three different wood species, Coral performed much better with the average shear strength 4.18 N/mm², 3.23 N/mm² and 5.42 N/mm² for Cypress, Teak and Eucalyptus respectively. This displays that for a strong joint to be formed to all tree wood species for soft wood and hard wood, Coral has a first priority in use. The developed table of guideline from this research can be useful to carpenters on proper glue selection to a particular wood species so as to meet glue-bond strength. This will secure furniture market as well as reduce pressure to the forests for furniture production because of the strong existing furniture due to their strong joints. Indeed, this can be a good strategy on reducing climate change speed in tropics which result from high deforestation of trees for furniture production.

Keywords: climate change, deforestation, gluing technology, joint failure, wood-glue, wood species

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Authors: Chahrazed Salhi, Ayoub Zeroual, Yasmina Hamitouche

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Soil water erosion poses a significant threat to the watersheds in Algeria today. The degradation of storage capacity in large dams over the past two decades, primarily due to erosion, necessitates a comprehensive understanding of the factors that contribute to soil erosion. The Isser watershed, located in the Northwestern region of Algeria, faces additional challenges such as recurrent droughts and the presence of delicate marl and clay outcrops, which amplify its susceptibility to water erosion. This study aims to employ advanced techniques such as Geographic Information Systems (GIS) and Remote Sensing (RS), in conjunction with the Canonical Correlation Analysis (CCA) method and Soil Water Assessment Tool (SWAT) model, to predict specific erosion patterns and analyze the key factors influencing erosion in the Isser basin. To accomplish this, an array of data sources including rainfall, climatic, hydrometric, land use, soil, digital elevation, and satellite data were utilized. The application of the SWAT model to the Isser basin yielded an average annual soil loss of approximately 16 t/ha/year. Particularly high erosion rates, exceeding 12 T/ha/year, were observed in the central and southern parts of the basin, encompassing 41% of the total basin area. Through Canonical Correlation Analysis, it was determined that vegetation cover and topography exerted the most substantial influence on erosion. Consequently, the study identified significant and spatially heterogeneous erosion throughout the study area. The impact of land topography on soil loss was found to be directly proportional, while vegetation cover exhibited an inverse proportional relationship. Modeling specific erosion for the Ladrat dam sub-basin estimated a rate of around 39 T/ha/year, thus accounting for the recorded capacity loss of 17.80% compared to the bathymetric survey conducted in 2019. The findings of this research provide valuable decision-support tools for soil conservation managers, empowering them to make informed decisions regarding soil conservation measures.

Keywords: Isser watershed, RS, CCA, SWAT, vegetation cover, topography

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Authors: Samson Munn, Virginia H. Kim, Huija Chen, Sean Maldonado, Michelle Kim, Paul Koscheski, Babak N. Kalantari, Gregory Eckel, Albert Lee

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In terms of screening mammography quality, neither the portion of reports that advise call-back imaging that should be bilateral versus unilateral nor how much the unilateral call-backs may appropriately diverge from 50–50 (left versus right) is known. Many factors may affect detection laterality: display arrangement, reflections preferentially striking one display location, hanging protocols, seating positions with respect to others and displays, visual field cuts, health, etc. The call-back bilateral fraction may reflect radiologist experience (not in our data) or confidence level. Thus, laterality and bilaterality of call-backs advised in screening mammography reports could be worthy quality metrics. Here, laterality data did not reveal a concern until drilling down to individuals. Bilateral screening mammogram report recommendations by five breast imaging, attending radiologists at Harbor-UCLA Medical Center (Torrance, California) 9/1/15--8/31/16 and 9/1/16--8/31/17 were retrospectively reviewed. Recommended call-backs for bilateral versus unilateral, and for left versus right, findings were counted. Chi-square (χ²) statistic was applied. Year 1: of 2,665 bilateral screening mammograms, reports of 556 (20.9%) recommended call-back, of which 99 (17.8% of the 556) were for bilateral findings. Of the 457 unilateral recommendations, 222 (48.6%) regarded the left breast. Year 2: of 2,106 bilateral screening mammograms, reports of 439 (20.8%) recommended call-back, of which 65 (14.8% of the 439) were for bilateral findings. Of the 374 unilateral recommendations, 182 (48.7%) regarded the left breast. Individual ranges of call-backs that were bilateral were 13.2–23.3%, 10.2–22.5%, and 13.6–17.9%, by year(s) 1, 2, and 1+2, respectively; these ranges were unrelated to experience level; the two-year mean was 15.8% (SD=1.9%). The lowest χ² p value of the group's sidedness disparities years 1, 2, and 1+2 was > 0.4. Regarding four individual radiologists, the lowest p value was 0.42. However, the fifth radiologist disfavored the left, with p values of 0.21, 0.19, and 0.07, respectively; that radiologist had the greatest number of years of experience. There was a concerning, 93% likelihood that bias against left breast findings evidenced by one of our radiologists was not random. Notably, very soon after the period under review, he retired, presented with leukemia, and died. We call for research to be done, particularly by large departments with many radiologists, of two possible, new, quality metrics in screening mammography: laterality and bilaterality. (Images, patient outcomes, report validity, and radiologist psychological confidence levels were not assessed. No intervention nor subsequent data collection was conducted. This uncomplicated collection of data and simple appraisal were not designed, nor had there been any intention to develop or contribute, to generalizable knowledge (per U.S. DHHS 45 CFR, part 46)).

Keywords: mammography, screening mammography, quality, quality metrics, laterality

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Authors: Grace Adebo

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Rural Farmers-herdsmen conflicts have resulted in a large number of causalities in many parts of Nigeria. Herds of cattle have died, while farmers recorded inestimable losses of their crops and harvests. The overall consequences have impacted negatively on food security across the country. There are divided opinions by scholars, agricultural experts and conflict analysts on the root causes of the conflicts and why traditional institutional interventions are ineffective in resolving the crisis. The study, therefore, aims to investigate the fundamentality of the conflicts’ causes in Southwest Nigeria and the correlates between traditional institutional authorities’ intervention and farmers-herdsmen conflicts in Southwest Nigeria. A structured interview schedule and focus group discussion were employed to elicit information from 180 farmers and 48 herdsmen selected through a multistage sampling procedure from the conflict zones in Southwest Nigeria. Collected data were analyzed using frequency counts, percentages, means and the Relative Importance Index (RII). The study found that climate change effects, farmland encroachment, crop damage, theft, and competition for land and water resources and pollution were the root causes of the violent herders-rural farmer’s clashes. The quest for wealth acquisition by some traditional rulers and some notable individuals in the conflict neighborhoods, occasioned tribal-mix herds possession and, thus undermining local institutional interventions and perverting justice through weak conflict resolution strategies, therefore, fueling further conflicts. Most farmers in the conflict zones have abandoned their farms for fear of death. This coupled with physical, social, economic and psychological consequences have deepened food insecurity and impaired the economic conditions of the herdsmen and the farmers. Currently, there are no mutually established mediation mechanisms as most states are opposed to the enactment of grazing laws to protect territorial encroachments of lands and subsequent multiplication of the herdsmen. It is suggested that government and Non-Governmental Organisation (NGOs) should encourage a functional stakeholder's forum for sustainable conflict resolution and establish a compensation scheme for losses incurred while extension agents are equipped with knowledge on conflict management strategies for peace attainment with the envisioned goal of achieving sustainable livelihoods and food security in Southwest Nigeria.

Keywords: conflict resolution, food security, herdsmen-farmers conflict, sustainable livelihoods, traditional institutions

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Authors: Sneha Manjunath

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Architecture is a continuous process of evolution that keeps changing and evolving through time and gives rise to various design solutions based on the purpose of change and the present function of the space. This evolution in design has been happening for a long time and hence a variety of climate-responsive, context-responsive and human-responsive developments in habitats are witnessed. India has been one of the hot spots for the conservation of heritage and architecture. Buildings ranging from Indus-valley civilization to modern contemporary dwellings have all evolved in one or the other way. Various historical sites such as Hampi in Karnataka, Taj Mahal in Agra and various temples in Southern India are identified and preserved under the Archeological Survey of India. The main objective of such preservation is to help in protecting, preserving and keeping it intact for the future. Study of such heritage-rich buildings and building techniques helps us in understanding the psychology, lifestyle and socio-cultural impacts it had on the complete urban fabric that developed in a region. It also gives an insight into the occupation, economic status and religious beliefs that gave rise to a pattern in an urban form that was more inclusive and appropriate as per the need of the users. Today’s generation draws various inspirations from history with respect to space planning, building services such as lighting, ventilation and sanitation systems and elevation treatments. It is important to know and understand the importance of certain urban planning techniques used to develop ancient towns or cities in a radial pattern, square pattern, or checkered pattern depending on the need of the administrative set-up of the respective town or city. It is believed that every element of design undergoes evolution and it is important for a designer to know, respect and develop the same for the future so as to acknowledge and conserve every aspect of heritage that has been a backbone in urban form generation even today. Hampi in the Karnataka state of India is a very good example of how the monuments and dwellings from 14th Century still stand strong. Temples from North India, such as Kedarnath Temple, survived heavy floods because of their building techniques. Such building materials and construction techniques are to be revived and reused for a better perspective towards space planning in urbanized cities.

Keywords: architecture, urban form, heritage, town planning

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Authors: Monika Szpringer, Aneta Pawlinska

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Adverse childhood experiences are linked to various types of health and adapt problems at different stages of life. They include various types of abuse, neglect, and dysfunctional environment. They have an unfavorable impact on the development of a child and his future functioning in society. Adolescents who were exposed to bad treatment may suffer from health problems during adulthood, like chronic diseases, psychological disorders, drug addiction, and suicide attempts. Objective: The aim of the project is to assess the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs. Material And Methods: The research was carried out in the period from March to December 2018 in Mazowieckie, Świętokrzyskie, Łódzkie, and Lubelskie Voivodship. The group consisted of 600 people aged 16-18 (M=16,58; SD=0, 78), men (63,2%) aged 16-18 (M=16,60;SD= 0,78) and women (35,5%) aged 16-18 (M16,55;SD=0,79). Participants included residents from Youth Educational Centers and Youth Sociotherapy Centers. Each participant filled in Author's Questionnaire, Adverse Childhood Questionnaire, then Courtland Emotional Control Scale-CECS and Generalized Self Efficacy Scale-GSES. Results and conclusions: The most common adverse experiences, according to teenagers, were family abuse, divorce/separation/parent's death, overuse of alcohol or drugs by an inmate, and emotional neglect. Adolescents who suffered from five to twelve adverse experiences had a higher level of depression's control. Adverse childhood experiences have an importance for the level of anger and depression's control among teenagers taking drugs. The greatest importance of the level of anger's control has emotional neglect. A higher level of emotional neglect is linked to a lower ability to control anger. The greatest importance of the level of depression's control has physical abuse and emotional neglect. The higher physical abuse during childhood, and the higher frequency of emotional neglect, the bigger the depression's control. The sense of efficacy in the group of people who suffered from one to four adverse experiences is close to the sense of efficacy that suffered people from five to twelve adverse experiences. The most important factor lowering the sense of one's efficacy was the intensification of sexual abuse. It was confirmed that the intensification and frequency of adverse childhood experiences were higher among women than men. Women also characterized lower anger control and greater depression's control. The authors’ own analyses confirmed the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs.

Keywords: adolescences, adverse childhood experiences, coping with emotions, drugs

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Authors: K. Ismail, A. Ali, R. C. Hasan, I. Khalil, Z. Bachok, N. M. Said, A. M. Muslim, M. S. Che Din, W. S. Chong

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The marine ecosystem in Malaysia holds invaluable potential in terms of economics, food security, pharmaceuticals components and protection from natural hazards. Although exploration of oil and gas industry and fisheries are active within Malaysian waters, knowledge of the seascape and ecological functioning of benthic habitats is still extremely poor in the marine parks around Malaysia due to the lack of detailed seafloor information. Consequently, it is difficult to manage marine resources effectively, protect ecologically important areas and set legislation to safeguard the marine parks. The limited baseline data hinders scientific linkage to support effective marine spatial management in Malaysia. This became the main driver behind the first seabed mapping effort at the national level. Taman Laut Labuan (TLL) is located to the west coast of Sabah and to the east of South China Sea. The total area of TLL is approximately 158.15 km2, comprises of three islands namely Pulau Kuraman, Rusukan Besar and Rusukan Kecil and is characterised by shallow fringing reef with few submerged shallow reef. The unfamiliar rocky shorelines limit the survey of multibeam echosounder to area with depth more than 10 m. Whereas, singlebeam and side scan sonar systems were used to acquire the data for area with depth less than 10 m. By integrating data from multibeam bathymetry and backscatter with singlebeam bathymetry and side sonar images, we produce a substrate map and coral coverage map for the TLL using i) marine landscape mapping technique and ii) RSOBIA ArcGIS toolbar (developed by T. Le Bas). We take the initiative to explore the ability of aerial drone and satellite image (WorldView-3) to derive the depths and substrate type within the intertidal and subtidal zone where it is not accessible via acoustic mapping. Although the coverage was limited, the outcome showed a promising technique to be incorporated towards establishing a guideline to facilitate a standard practice for efficient marine spatial management in Malaysia.

Keywords: habitat mapping, marine spatial management, South China Sea, National seabed mapping

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Authors: Michal Almagor, Rivka Tuval-Mashiach

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This presentation will explore the main processes identified in women writing group, as an interdisciplinary field with personal and social effects. It is based on the initial findings of a Ph.D. research focus on the intersection of group processes with the element of writing, in the context of gender. Writing as a therapeutic mean has been recognized and found to be highly effective. Additionally, a substantial amount of research reveals the psychological impact of group processes. However, the combination of writing and groups as a therapeutic tool was hardly investigated; this is the contribution of this research. In the following qualitative-phenomenological study, the experiences of eight women participating in a 10-sessions structured writing group were investigated. We used the meetings transcripts, semi-structured interviews, and the texts to analyze and understand the experience of participating in the group. The two significant findings revealed were spiral intersubjectivity and archaic level of semiotic language. We realized that the content and the process are interwoven; participants are writing, reading and discussing their texts in a group setting that enhanced self-dialogue between the participants and their own narratives and texts, as well as dialogue with others. This process includes working through otherness within and between while discovering and creating a multiplicity of narratives. A movement of increasing shared circles from the personal to the group and to the social-cultural environment was identified, forming what we termed as spiral intersubjectivity. An additional layer of findings was revealed while we listened to the resonance of the group-texts, and discourse; during this process, we could trace the semiotic level in addition to the symbolic one. We were witness to the dominant presence of the body, and primal sensuality, expressed by rhythm, sound and movements, signs of pre-verbal language. Those findings led us to a new understanding of the semiotic function as a way to express the fullness of women experience and the enabling role of writing in reviving what was repressed. The poetic language serves as a bridge between the symbolic and the semiotic. Re-reading the group materials, exposed another layer of expression, an old-new language. This approach suggests a feminine expression of subjective experience with personal and social importance. It is a subversive move, encouraging women to write themselves, as a craft that every woman can use, giving voice to the silent and hidden, and experiencing the power of performing 'my story'. We suggest that women writing group is an efficient, powerful yet welcoming way to raise the awareness of researchers and clinicians, and more importantly of the participants, to the uniqueness of the feminine experience, and to gender-sensitive curative approaches.

Keywords: group, intersubjectivity, semiotic, writing

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Authors: Ann Rousseau, Steven Eggermont

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The current study sought to explain pre-adolescents’ differential susceptibility to the internalization of mediated appearance ideals, using a three-wave panel survey of preadolescent girls and boys (N = 973, Mage = 11.14). Based on the premises of objectification theory and sexual script theory, we proposed a double role for pubertal timing and cross-sex interactions in preadolescents’ media internalization. More specifically, we expected pubertal timing and cross-sex interactions to (a) trigger higher levels of media internalization, directly and indirectly via body surveillance, and (b) positively moderate the relationship between objectifying media exposure and girls’ and boys’ media internalization. A first cross-lagged model tested whether the pubertal timing and cross-sex interactions could trigger preadolescents media internalization and body surveillance. Structural equation analysis indicated that pubertal timing (Wave1) positively predicted body surveillance and media internalization (both Wave3). Cross-sex involvement (Wave1) was positively linked to media internalization (Wave2), but body surveillance (Wave2) was not associated with cross-sex interactions. Results also showed a reciprocal interaction between media internalization (Wave 2 and 3) and body surveillance (Wave2 and 3). Multiple group analysis showed that the observed relationships did not vary by gender. A second moderated moderation model examined whether (a) the relationship between objectifying media exposure (television and magazines, both Wave1) and media internalization (Wave3) depended on pubertal timing (Wave1), and (b) the two-way interaction between objectifying media exposure (Wave1) and pubertal timing (Wave1) varied depending on cross-sex interactions (Wave1). Results revealed that cross-sex interactions functioned as a buffer against media internalization. For preadolescents who had fewer cross-sex interactions, early puberty (relative to peers) positively moderated the relationship between magazine exposure and the internalization of mediated appearance ideals. No significant relationships were found for television. Again, no gender difference could be observed. The present study suggests a double role for pubertal timing and cross-sex interactions in preadolescents media internalization, and indicate that early developers with few cross-sex experiences are particularly vulnerable for media internalization. Additionally, the current findings suggest that there is relative gender equity in magazines’ ability to cultivate media internalization among preadolescents.

Keywords: cross-sex interactions, media effects, objectification theory, pubertal timing

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Authors: Mohammad Mahbub Alam Talukder, Shahnewaz, Hasanat-E-Rabbi, Mohammed Nazrul Islam

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Road traffic accident is a global problem which is severe in the developing countries like Bangladesh. In consequence, in developing countries road trauma has now been recognized as an increasing public health hazards and economic burning issue. And after road traffic accidents the lack of management and economic costs related with health seeking behavior have a disproportionate impact on lower income groups, thus contributing to the persistence of poverty in conjunction with disability. This cross sectional study, carried out during July 2012 to June 2013, aimed to explore health seeking decision and culture of handling the road traffic accident related victims, as taken from experiences of the poor disabled people of slum dwellers of Dhaka city. The present study has been designed based on qualitative techniques such as in-depth interview and case studies. Additionally, a survey questionnaire was used to collect the demographic characteristics of the study population (n=150) and to select participants purposely for in-depth interview (n=50) and case study (n=30). Content analysis of qualitative data was done through theme coding and matrix analysis of case study was done to use relevant verbatim. Most of the time the health seeking decision totally depended on the surrounded people of the accidental place, their knowledge, awareness and remaining facility and capacity regarding proper management of the victims. However, most of the cases the victims did not get any early treatment and it took 2-12 hours to get even the first aid because of distance, shortage of money, lack of availability of getting the aid, lack of mass awareness etc. Under the reality of discriminated and unaffordable health service provision better treatment could not turn out due to economic inability of the poor victims. To avoid the severe trauma, treatment delay must be reduced by providing first aid within very short time and to do so, mass awareness campaign is necessary for handing the victims. Moreover, necessary measures should be taken to ensure cost free health service provision to treat the chronic disabled condition of the road traffic accident related poor victims.

Keywords: accident, injury, disabled, qualitative, slum

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Authors: Kangrij Roeksiripat

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Street vending is one of the informal economy activities which considered significance to Thai people in the economic and the day-to-day social life. It had been believed that the street vendor is a group of the poor and uneducated people. With the increasing numbers of the street vendor occupying space on public sidewalks especially in central business districts, it becomes unclear whether street vending continues as a solution to unemployment for access labors. This research attempts to study and analyze types of street vendors in Bangkok under the informal economy framework. The debate on the heterogeneous informal economy has categorized into four schools; the dualism, the structuralism, the legalism and the voluntarism. The examination also embodies with market concept with Porter’s Five Forces of Competitive Position Model analysis and the interviews with the street vendors in three case study areas: Inner zone (Pathumwan district - the sidewalk on the opposite side of Siam Paragon mall), Middle zone (Ramkhamhaeng district - the sidewalk on the opposite side of Ramkhamhaeng University) and Outer zone (Minburi district- the sidewalk of Sriburanukit Road). The result indicates that most of street vendors in Siam square are voluntarily choose to make a living in vending on a sidewalk and tend to take it as a long-term occupation even though they can be in formal wage employment. Moreover, average income and positive attitude towards self-employed are the important factors that drive them to operate street vending businesses. Meanwhile, street vending is often a family enterprise in Ramkhamhaeng area and most vendors do not wish to transform their businesses into the formal sectors. Whereas the survey conducted in Sriburankit Road reveals that almost all of street vendors migrated from other provinces and were previously paid as the unskilled workers in formal sectors. They moved to informal trades because of the uncertainty of employment in the mainstream sectors and the inconsistent income with knowledge support of friends and relatives from the same hometown. In particular, the result reveals a common pattern that street vending is the very first occupation of some group of vendors and they will continue to engage in this activity. Thus, it is important for the government to design optimal policy which not only integrating informal workers into the formal economy but also monitoring the enforcement of regulations on the modern informal economy.

Keywords: informal economy, sidewalks, street vendors, occupation

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Authors: F. O Anugom

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The general functions of the university amongst other things include teaching, research and community service. Universities are recognized as the apex of learning, accumulating and imparting knowledge and skills of all kinds to students to enable them to be productive, earn their living and to make optimum contributions to national development. This is equivalent to the production of human capital in the form of high level manpower needed to administer the educational society, be useful to the society and manage the economy. Quality has become a matter of major importance for university education in Nigeria. Accreditation is the systematic review of educational programs to ensure that acceptable standards of education, scholarship and infrastructure are being maintained. Accreditation ensures that institution maintain quality. The process is designed to determine whether or not an institution has met or exceeded the published standards for accreditation, and whether it is achieving its mission and stated purposes. Ensuring quality assurance in accreditation process falls in the hands of university management which justified the need for this study. This study examined accreditation and quality assurance: the management imperative. Three research questions and three hypotheses guided the study. The design was a correlation survey with a population of 2,893 university administrators out of which 578 Heads of department and Dean of faculties were sampled. The instrument for data collection was titled Programme Accreditation Exercise scale with high levels of reliability. The research questions were answered with Pearson ‘r’ statistics. T-test statistics was used to test the hypotheses. It was found among others that the quality of accredited programme depends on the level of funding of universities in Nigeria. It was also indicated that quality of programme accreditation and physical facilities of universities in Nigeria have high relationship. But it was also revealed that programme accreditation is positively related to staffing in Nigerian universities. Based on the findings of the study, the researcher recommend that academic administrators should be included in the team of those who ensure quality programs in the universities. Private sector partnership should be encouraged to fund programs to ensure quality of programme in the universities. Independent agencies should be engaged to monitor the activities of accreditation teams to avoid bias.

Keywords: accreditation, quality assurance, national universities commission , physical facilities, staffing

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Authors: Mbuotidem Brendan, Nathanael Afolabi

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Teenage pregnancy is a major health concern because of its association with high morbidity and mortality for both mother and child. In 2013, 23% of women in Nigeria, aged 15 - 19 yr have begun childbearing: 17% have had a child and 5% are pregnant with their first child. Reported differences across locations have been attributed to factors such as educational attainment and exposure to mass media. This study therefore seeks to determine the difference in the level of exposure among teenage mothers and older women of reproductive age in Nigeria. Over 12,000 women of reproductive age (18 – 49 yr) were interviewed across 8 states from the Northern and Southern region of Nigeria. The women were further segregated into two groups of 0 (women aged 18 – 20 yr who had children of their own) and 1 (women of reproductive age excluding teenage mothers). Data was collected via structured questionnaires on mobile devices using the open data kit platform. Initial data formatting and recoding was done using STATA 13 package. Initial analysis was also conducted using SPSS version 21 and the data points were mapped on QuantumGIS package. From the results of analyzed data obtained from the studied states, there were various mean ages of first births across the supported states. Though Akwa Ibom had one of the oldest mean ages (21.2 yr) at first birth and the lowest fertility rate of 3.9 births/woman according to the National Demographic Health Survey 2013, Akwa Ibom had the highest rate of teenage pregnancy (18.2%) across the respondents. Based on education, the respondents that had completed secondary school education (56.9%) made up the greatest cohorts of the teenage parents. This is counter indicative of the initial thinking that there is an inverse relationship between level of education and teenage pregnancy. Akwa Ibom, Bauchi and Delta states are states where respondents felt that contraceptive use is dangerous to health and they were the top 4 states that had a large proportion of teenage mothers. Similarly, across the states examined, all the women of reproductive age felt they could convince their spouses to use contraceptives, as using family planning does not cause women to be promiscuous. This study thus reveals that across the states studied, there was no marked variation in the perception of family planning between teenage parents and women of reproductive age. The study also highlights the need for future planning and exposure to family planning messages at secondary school level.

Keywords: adolescent, family planning, mass media, teenage mothers

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Authors: Maria E. Laconi, Kyla D. Scherr, Mary A. Jamieson

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Human populations in urban environments have rapidly grown in recent decades. Consequently, the intensity of land-use and development has also increased in many urban and peri-urban environments. Some cities, such as Detroit, Michigan, USA, have embraced urban agriculture and local food production. Little is known, however, about how the local and landscape scale environmental factors influence crop productivity on urban farms. Our study aims to evaluate factors influencing the productivity of strawberries on community farms and gardens in the Detroit metropolitan area. Strawberries are one of few fruits that can provide an abundant harvest just after the first season of being planted, which is ideal for urban gardeners in developed areas. In the spring of 2016, we planted six different strawberry cultivars (three everbearing and three June bearing varieties) at five farm sites in Wayne and Oakland County (six replicate plants per cultivar per site). We surveyed flower and fruit phenology and production for everbearing varieties weekly (flowers for June bearing varieties were removed to enhance productivity in the coming growing season). Additionally, we conducted one initial 36hr pollinator survey in mid-September during peak fruit production and characterized local and landscape scale land-cover data. Preliminary results and observations from this first year of our study revealed that strawberry production varied significantly by site. Specifically, productivity at our most northern site appeared to suffer from delayed phenology and early frost damage to ripening strawberries. Bee abundance and diversity also differed among farms, though further surveys are needed to adequately inventory the pollinator community. Finally, strawberry cultivars demonstrated significant differences in the number and size of fruits produced. We plan to continue this study in the coming years, increasing the number of sites surveyed and number of pollinator sampling events. Our study aims to inform strategies for enhancing crop productivity on urban and peri-urban farms.

Keywords: insect pollination, strawberry productivity, sustainable agriculture, urban gardening

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Authors: Fizza Saghir

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Rohingyas are an ethnic minority of predominantly Buddhist-Myanmar. Living in ghettos in Rakhine, one of the poorest states of Myanmar, for decades, they have been marginalized, discriminated, deprived of the basic amenities and have faced ghastly violations of their rights- politically, socially, economically and culturally. In 2012, in violence that, erupted between ethnic Rakhine Buddhists and Rohingya Muslims, hundreds of Rohingyas were slayed and many more displaced. The state does not recognize them as ‘citizens’ and the military and police have constantly persecuted and pushed them to either migrate to other countries like India, Bangladesh or else die of deprivation. Amidst the deadly violence, Rohingya women are the most vulnerable. Many of them have faced sexual abuse and gender-based violence. Minimalistic to insignificant studies have been done on the plight of Rohingya women refugees in context of India. Thus, this paper focuses on psycho-social status of Rohingya women refugees settled in Delhi, India. The research study used both quantitative and qualitative methods. It was explorative in nature and used non-probability sampling, purposive sampling, in particular. A sample size of 30 Rohingya women refugees was interviewed out of the universe of 45 Rohingya refugee families living in Kalindi Kunj Refugee Camp of Delhi. Case studies were developed. The paper explores the psychological and social status of the respondents along with a deep understanding of their issues and concerns. Moreover, it assesses the impact of violence and migration on respondents. It was found that Rohingya women refugees are deeply and severely affected by a violent past, an insecure present and an uncertain future. Major problems they face in Delhi, India are finding employment, lack of identity cards to avail government services, language barrier, lack of health and education facilities. All they desire is peace and shelter in India. Besides, recommendations and suggestions have been given to various stakeholders of the forced mass migration of Rohingya refugees which includes, Government of Myanmar, Government of India, other bordering nations of Myanmar, international NGOs and media and the Rohingya community, itself. Only an immediate, peaceful and continuous dialogue process can help resolve the issue of exodus of Rohingyas. Countries, including India, must come together to help the Rohingyas who are in need of urgent humanitarian aid and assistance.

Keywords: dialogue process, ethnic minority, forced mass migration, impact of violence and migration, psycho-social status, Rohingya women refugees, sexual abuse

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Authors: Narayan Prasad Adhikari

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In Nepal, the crop residues have often been considered as one of the potential sources of energy to cope with prevailing energy crisis. However, the lack of systematic studies about production and various other competent uses of crop production is the main obstacle to evaluate net potential of the residues for energy production. Under this background, this study aims to assess the net annual availability of crop residues for energy production by undertaking three different districts with the representation of country’s three major regions of lowland, hill, and mountain. The five major cereal crops of paddy, wheat, maize, millet, and barley are considered for the analysis. The analysis is based upon two modes of household surveys. The first mode of survey is conducted to total of 240 households to obtain key information about crop harvesting and livestock management throughout a year. Similarly, the quantification of main crops along with the respective residues on fixed land is carried out to 45 households during second mode. The range of area of such fixed land is varied from 50 to 100 m2. The measurements have been done in air dry basis. The quantity for competitive uses of respective crop residues is measured on the basis of respondents’ feedback. There are four major competitive uses of crop residues at household which are building material, burning, selling, and livestock fodder. The results reveal that the net annual available crop residues per household are 4663 kg, 2513 kg, and 1731 kg in lowland, hill, and mountain respectively. Of total production of crop residues, the shares of dedicated fodder crop residues (except maize stalk and maize cob) are 94 %, 62 %, and 89 % in lowland, hill, and mountain respectively and of which the corresponding shares of fodder are 87 %, 91 %, and 82 %. The annual percapita energy equivalent from net available crop residues in lowland, hill, and mountain are 2.49 GJ, 3.42 GJ, and 0.44 GJ which represent 30 %, 33 %, and 3 % of total annual energy consumption respectively whereas the corresponding current shares of crop residues are only 23 %, 8 %, and 1 %. Hence, even utmost exploitation of available crop residues can hardly contribute to one third of energy consumption at household level in lowland, and hill whereas this is limited to particularly negligible in mountain. Moreover, further analysis has also been done to evaluate district wise supply-demand context of dedicated fodder crop residues on the basis of presence of livestock. The high deficit of fodder crop residues in hill and mountain is observed where the issue of energy generation from these residues will be ludicrous. As a contrary, the annual production of such residues for livestock fodder in lowland meets annual demand with modest surplus even if entire fodder to be derived from the residues throughout a year and thus there seems to be further potential to utilize the surplus residues for energy generation.

Keywords: crop residues, hill, lowland, mountain

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Authors: Kim Jin-OK, Lee Jin-Eui, Han Seung-Hoon, Kim Nam-Jo

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This study aimed to analyze the effect of the motivation of Chinese tourists to visit North Korea on their decision making process. Chinese tourists account for a considerable portion of foreign tourists in the world, while North Korea is the favorite tourist attraction of Chinese tourists. The motivation to visit North Korea was divided into three factors: the redness, which is the modern cultural heritage of Communism based on the red tourism accounting for the significant portion of domestic tourism, the novelty of the special environment of North Korean society, and the convenience of tour to North Korea in terms of geographical distance and policy of China. Red tourism refers to visiting the places of revolutionary events, monuments, artifacts and the residences of previous communist leaders, and other places related to the past Chinese Communist Party. As a revolutionary tourism, red tourism has recently been taking place in the old communist countries to recall their memories on the revolutionary places in China, as well as in North Korea, Vietnam, Cambodia, Russia, Bulgaria, Cuba, etc. In order to examine the effect of the segmented motivations on the revisit intention of Chinese tourists who have experienced a tour to North Korea, this study employed the model of goal-directed behavior, a model developed by adding a variable of emotion to the theory of planned behavior, which has a strong explanatory power on the decision making process of people in social science. For achieving the aim of the study, the data was collected through the survey in Dandong, China against Chinese tourists who have visited North Korea. The results of this study found that not only the novelty of North Korea, but also the redness, which accounts for the largest proportion in the domestic tourism, are significantly affecting overseas tour of Chinese tourists at this time point where overseas tour of Chinese tourists continue to increase. The results, therefore, suggest that the old communist countries, including those in Asia, need an emotional promotion strategy that stimulates nostalgia by focusing on the redness of the modern cultural heritage of Communism to attract Chinese tourists.

Keywords: model of goal-directed behavior, modern cultural heritage, North Korea, red tourism

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Authors: Rana Alkhamra

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Background: Child's earliest experiences with books and stories during the first years of his life are strongly linked with the development of his early language and literacy skills. Interacting in routine learning activities, such as shared book reading, storytelling, and teaching about the letters of the alphabet make a critical foundation for early learning, language growth and emergent literacy. Aim: The current study explores family and preschool early interactive literacy practices in families and preschools (nursery and kindergarten) in Jordan. It highlights the importance of early interactive literacy activities on child language and literacy growth and development. Methods: This is a cross sectional study that surveyed 243 Jordanian families. The survey investigated literacy routine practices, largely shared books reading, at home and at preschool; child speech and language development; and family demographics. Results: Around 92.5% of the families read books and stories to their children, as frequently as 1-2 times weekly or monthly (75%). Only 19.6% read books on daily basis. Many families reported preferring story-telling (97%). Despite that families acknowledged the importance of early literacy activities, on language, reading and writing, cognitive, and academic development, 45% asked for education and training pertaining to specific ways and ideas to help their young children develop language and literacy skills. About 69% of the families reported reading books and stories to their children for 15 minutes a day, while 71.2% indicated having their children watch television for 3 to > 6 hours a day. At preschool, only 52.8% of the teachers were reported to read books and stories. Factors like parent education, monthly income, living inside (33.6%) or outside (66.4%) the capital city of Amman significantly (p < 0.05) affected child early literacy interactive activities whether at home or at preschool. Conclusion: Early language and literacy skills depend largely on the opportunities and experiences provided to children in the home and in preschool environment. Family literacy programs can play an important role in bridging the gap in early literacy experiences for families that need help. Also, speech therapists can work in collaboration with families and educators to ensure that young children have high quality and sufficient opportunities to participate in early literacy activities both at home and in preschool environments.

Keywords: literacy, interactive activities, language, practices, family, preschool, Jordan

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Authors: Reka Zsuzsanna Mathe

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The globalization and the Europeanization have significantly contributed to a change in the role of the nation-states. The global economic crisis, the climate changes, and the recent refugee crisis, are just a few among many challenges that cannot be effectively addressed by the traditional role of the nation-states. One of the main roles of the states is to solve collective action problems, however due to their changing roles; apparently this is getting more and more difficult. Depending on political culture, collective action problems are solved either through cooperation or conflict. The political culture of Central and Eastern European (CEE) countries is marked by low civic participation and by a weak civil society. In this type of culture collective action problems are likely to be induced through conflict, rather than the democratic process of dialogue and any type of social change is probably to be introduced by social movements. Several studies have been conducted on the social movements of the CEE countries, yet, it is still not clear if the most significant social movements of the region tend to choose rather the cooperative or the conflictual way as action strategy. This study differentiates between a national and a European action field, having different social orders. The actors of the two fields are the broadly understood civil society members, conceptualized as social movements. This research tries to answer the following questions: a) What are the norms that best characterize the CEE countries’ social order? b) What type of actors would prefer a change and in which areas? c) Is there a significant difference between the main actors active in the national versus the European field? The main hypotheses are that there are conflicting norms defining the national and the European action field, and there is a significant difference between the action strategies adopted by social movements acting in the two different fields. In mapping the social order, the study uses data provided by the European Social Survey. Big data of the Global Data on Events, Location and Tone (GDELT) database offers information regarding the main social movements and their preferred type of action. The unit of the analysis is the so called ‘Visegrad 4’ countries: Poland, Czech Republic, Slovakia and Hungary and the research uses data starting from 2005 (after the European accession of these four countries) until May, 2017. According to the data, the main hypotheses were confirmed.

Keywords: big data, Central and Eastern Europe, civil society, GDELT, social movements

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Authors: Mark Morgan, Christine Li, Shuangyu Xu, Jenny McCarty

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The National Wild and Scenic Rivers System was created by the U.S. Congress in 1968 (Public Law 90-542; 16 U.S.C. 1271 et seq.) to preserve outstanding natural, cultural, and recreational values of some U.S. rivers in a free-flowing condition for the enjoyment of present and future generations. This Act is notable for safeguarding the special character of these rivers while supporting management action that encourages public participation for co-creating river protection goals and strategies. This is not an easy task. To meet the challenges of modern ecosystem management, federal resource agencies must address many legal, environmental, economic, political, and social issues. The U.S. Forest Service manages a 44-mile section of the Eleven Point National Scenic River (EPR) in southern Missouri, mainly for outdoor recreation purposes. About half of the acreage is in private lands, while the remainder flows through the Mark Twain National Forest. Private land along the river is managed by scenic easements to ensure protection of scenic values and natural resources, without public access. A portion of the EPR lies adjacent to a 16,500-acre tract known as the Irish Wilderness. The spring-fed river has steep bluffs, deep pools, clear water, and a slow current, making it an ideal setting for outdoor enthusiasts. A 10-month visitor study was conducted at five access points along the EPR during 2019 so the US Forest Service could update their river management plan. A mail-back survey was administered to 560 on-site visitors, yielding a response rate of 53%. Although different types of visitors use the EPR, boating and fishing were the predominant forms of outdoor recreation. Some river use was from locals, but other visitors came from farther away. Formulating unbiased policies for outdoor recreation is difficult because managers must assign relative values to recreational activities and travel distance. Because policymaking is a subjective process, management decisions can affect user groups in different ways (i.e., boaters vs. fishers; proximate vs. distal visitors), as seen through a GIS analysis.

Keywords: activity selection, forest recreation, policy, travel distance

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Authors: Estibe Dagne Mekonnen

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In recent years, the prevalence of undernourishment was 30 percent for sub-Saharan Africa, compared with 16 percent for Asia and the Pacific (Ali, 2011). In Ethiopia, almost 40 percent of the total population in the country and 57 percent of Addis Ababa population lives below the international poverty line of US$ 1.25 per day (UNICEF, 2009). This study aims to analyze the determinant of household food secrity in Addis Ababa city administration. Primary data were collected from a survey of 256 households in the selected sub-city, namely Addis Ketema, Arada, and Kolfe Keranio, in the year 2022. Both Purposive and multi-stage cluster random sampling procedures were employed to select study areas and respondents. Descriptive statistics and order logistic regression model were used to test the formulated hypotheses. The result reveals that out of the total sampled households, 25% them were food secured, 13% were mildly food insecure, 26% were moderately food insecure and 36% were severely food insecure. The study indicates that household family size, house ownership, household income, household food source, household asset possession, household awareness on inflation, household access to social protection program, household access to credit and saving and household access to training and supervision on food security have a positive and significant effect on the likelihood of household food security status. However, marital status of household head, employment sector of household head, dependency ratio and household’s nonfood expenditure has a negative and significant influence on household food security status. The study finally suggests that the government in collaboration with financial institutions and NGO should work on sustaining household food security by creating awareness, providing credit, facilitate rural-urban linkage between producer and consumer and work on urban infrastructure improvement. Moreover, the governments also work closely and monitor consumer good suppliers, if possible find a way to subsidize consumable goods to more insecure households and make them to be food secured. Last but not least, keeping this country’s peace will play a crucial role to sustain food security.

Keywords: determinants, household, food security, order logit model, Addis Ababa

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Authors: Wing Chi Wong

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Globally, studying parents caring for children with attention deficit/ hyperactivity disorder (ADHD) is valuable in order to design measures in supporting those parents by health care providers and government. Such parents in Hong Kong seem to encounter detrimental stress and enormous difficulties which are exacerbated by the traditional Chinese culture, exclusion from social members and fiercely competitive educational system. However, seldom studies scrutinize this issue in Hong Kong. This article aims to review the literature regarding parents caring offsprings with ADHD in Hong Kong. Criteria were set for searching among published studies listed in various databases, including MEDLINE, CINCAHL, PsycINFO, ProQuest, Embase, Cochrane Library and Springer Link. Articles with words 'Attention Deficit Hyperactivity Disorder', 'parenting', 'parent', 'family', 'father', 'mother', 'care' in titles and abstracts were identified. Articles with all types of research designs and methods, regardless in English or Chinese, were included. They were limited to years between January 2008 and September 2018. Four relevant studies have resulted. Of them, two were exploratory studies, one was a qualitative study, and one was a survey. Samples were recruited from child psychiatric clinic, Child and Adolescent Mental Health Unit, or multiple family group therapy centres. Authors proclaimed that quality of life of those parents was usually low; particularly mothers perceived a higher stress than fathers; parenting barriers existed; conflicts were commonly raised in parent-child relationship resulting in probable maltreatment to children. Previous studies generally suggested the potential negative outcomes of parents caring children with ADHD. The types and effectiveness of interventions to those parents on relieving their tortures under Hong Kong context had not been explored and systematically evaluated. The scanty studies and existing understanding could not give a promising conclusion pertaining to the appropriate family intervention to parents living with children with ADHD. A stringent research design is necessary to establish evidence on the effectiveness of interventions for those families.

Keywords: attention deficit/ hyperactivity disorder, Hong Kong, parents, interventions

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Authors: Muhammad Arslan, Michael A. Kaminski, Bassam S. Tawabini, Fabrizio Frontalini

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We conducted a survey of living benthic foraminifera in a relatively unpolluted site of Bahrain in the Arabian Gulf, with the aim of determining the seasonal variability in their populations, as well as various environmental parameters that affect their distribution. The maximum standing crop was observed during winter, with highest population of rotaliids, followed by a peak in miliolids. The highest population is attributed to an increasing number juveniles observed along the depth transect. A strong correlation between sediment grain size and the foraminiferal population indicates that juveniles were most abundant on coarser sandy substrate and less abundant on fine substrate. In spring, the total living population decreased, and lowest values are observed in the summer. The population started to increase again in the autumn with highest juveniles/adult ratios. Moreover, results of relative abundance and species consistency show that Ammonia is found to be consistent from the shallowest to the deepest station, whereas miliolids start appearing in the deeper stations. The average numbers of Peneroplis and Elphidium also increases along the depth transect. Environmental characterization reveals that although the site is subjected to eutrophication caused by nitrates and sulfates, pollution caused by hydrocarbons and heavy metals is not significant. The assessment of 63 heavy metals showed that none of the metals had concentrations that exceed internationally accepted norms [the devised level of Effect Range-Low], with the exception of strontium. The lack of a significant environmental effect of heavy metals is confirmed by a Foraminiferal Deformities Index value of less than 2%. Likewise, no hydrocarbon contamination was detected in the water or sediment samples. Lastly, observations of cytoplasmic streaming and pseudopodial activity in Petri dishes suggest that the foraminiferal population is not stressed. We conclude that the site in Bahrain is not yet adversely affected by human development, and therefore can provide baseline information for future comparison and assessment of foraminiferal assemblages in contaminated zones of the Arabian Gulf.

Keywords: Arabian Gulf, benthic foraminifera, standing crop, Western Bahrain

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Authors: Bayarmaa Enkhbold, Kenichi Matsui

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Urban parks are important assets to every community in terms of providing space for health, cultural and leisure activities. However, Ulaanbaatar, the capital of Mongolia, faces a shortage of green spaces, particularly urban parks, due to overpopulation and haphazard growth. Therefore, in order to increase green space per person, the city government has planned to increase green space per person up to 20m² by 2020 and 30m² by 2030 by establishing more urban parks throughout the city. But this plan was estimated that it is highly unlikely to reach those goals according to the analysis of the present status of plan implementation because the current amount of green space per person is still 4m². In the past studies globally, city planners and scientists agree that it is highly improbable to develop urban parks and keep maintenance sustainably without reflecting community perceptions and their involvement in the park establishment. Therefore, this research aims to find the challenges which stymie urban park development in Ulaanbaatar city and recommend dealing with the problems. In order to reach the goal, communities’ perceptions about the current challenges and their necessity for urban parks were identified and determined whether they differentiated depending on two different types of residential areas (urban and suburban areas). It also attempted to investigate international good practices on how they deal with similar problems. The research methodology was based on a questionnaire survey among city residents, a document review regarding the involvement of stakeholders, and a literature review of relevant past studies. According to the residents’ perceptions, the biggest challenge was a lack of land availability and followed by a lack of proper policy, planning, management, and maintenance out of seven key challenges identified. The biggest community demand from the urban park was a playground for children and followed by recreation and relaxation out of six types of needs. Based on research findings, the study proposed several recommendations for enhancements as institutional and legal framework, park plan and management, supportive environment and monitoring, evaluation, and reporting.

Keywords: challenges of urban park planning and maintenance, community-based urban park establishment, community perceptions and participation, urban parks in Ulaanbaatar, Mongolia

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Authors: Magdalena Hasplova, Katerina Ivanova

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Perinatal palliative care is a relatively young and developing field that includes the care of a fetus or newborn with a life-threatening or limiting defect and his family. However, the training of midwives in perinatal palliative care is insufficient and midwives do not feel prepared for this aspect of their work. This fact can affect the barriers to communication with the mother or family of the endangered child. The main aim was to analyze the awareness of midwifery students on the issue of perinatal palliative care in the Czech Republic. Based on the analysis, draw attention to possible communication barriers that may be caused by insufficient information. The research was carried out using a qualitative method, the method of data collection was a semi-structured interview. Eleven female students took part in the research, and the respondents were selected using the Snowballing method. Some methods of grounded theory (open coding and category creation) were used to analyze the data. Based on the results of the research, questions were set in a questionnaire focused on communication barriers between mothers (family) and health care professionals in the care of newborns with life-threatening or limiting disabilities. Based on the analysis of data, categories 1 were determined. Knowledge of perinatal palliative care 2. Education 3. Practical experience 4. Readiness and concerns in the provision of perinatal palliative care 6. Supervision. The questions in the questionnaire were then derived taking into account the data obtained, and the operationalization of health literacy in the field of perinatal palliative care was performed. The analysis of the interviews revealed that the education of midwives in the Czech Republic in the issue of perinatal palliative care is not uniform. The research confirmed the insufficient knowledge and skills of midwifery students preparing to provide perinatal palliative care. Respondents reported feelings of unpreparedness in the areas of communication with a woman after perinatal loss, psychological support for a woman and her family, the care of a stillborn or dying child, or self-coping with death. The questions in the questionnaire then develop these areas. We assumed that by analyzing and interpreting the data obtained from our research, we will help to better understand the concerns and motivations of students in providing holistic perinatal palliative care. We came to the conclusion that it would be appropriate to set up a unified and comprehensive education on this issue in the Czech Republic. Healthcare professionals are in a unique position that can positively or negatively affect the intensity of perinatal loss. Already properly set up education of health professionals leads to overcoming barriers in communication between health professionals and the family, experiencing perinatal loss.

Keywords: midwife, perinatal loss, perinatal palliative care, communication, barriers, mothers, family

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Authors: Nurten Tasdemir, Busra Baloglu, Zeynep Cingoz, Can Demirel, Zeki Gezer, Barıs Efe

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Student nurses are increasingly exposed to technology in the workplace after graduation with the growing numbers of electric health records (EHRs), handheld computers, barcode scanner medication dispensing systems, and automatic capture of patient data such as vital signs. Internationally, electronic health records (EHRs) systems are being implemented and evaluated. Students will inevitably encounter EHRs in the clinical learning environment and their professional practice. Nursing students must develop competency in the use of EHR. Aim: The study aimed to examine nursing students’ experiences of learning to use electronic health records (EHR) in clinical placements. Method: This study adopted a descriptive approach. The study population consisted of second and third-year nursing students at the Zonguldak School of Health in the West Black Sea Region of Turkey; the study was conducted during the 2015–2016 academic year. The sample consisted of 315 (74.1% of 425 students) nursing students who volunteered to participate. The students, who were involved in clinical practice, were invited to participate in the study Data were collected by a questionnaire designed by the researchers based on the relevant literature. Data were analyzed descriptively using the Statistical Package for Social Sciences (SPSS) for Windows version 16.0. The data are presented as means, standard deviations, and percentages. Approval for the study was obtained from the Ethical Committee of the University (Reg. Number: 29/03/2016/112) and the director of Nursing Department. Findings: A total of 315 students enrolled in this study, for a response rate of 74.1%. The mean age of the sample was 22.24 ± 1.37 (min: 19, max: 32) years, and most participants (79.7%) were female. Most of the nursing students (82.3%) stated that they use information technologies in clinical practice. Nearly half of the students (42.5%) reported that they have not accessed to EHR system. In addition, 61.6% of the students reported that insufficient computers available in clinical placement. Of the students, 84.7% reported that they prefer to have patient information from EHR system, and 63.8% of them found more effective to preparation for the clinical reporting. Conclusion: This survey indicated that nursing students experience to learn about EHR systems in clinical placements. For more effective learning environment nursing education should prepare nursing students for EHR systems in their educational life.

Keywords: electronic health record, clinical placement, nursing student, nursing education

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Authors: Maria Wendy Mendoza-Solomo

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The study assessed the level of understanding of catholic doctrines in relation to the way of life of Ignatian graduates of Ateneo de Naga University (ADNU). It was conducted to find out if ADNU is successful in leading their students to a deeper moral understanding of the world centered on Jesus Christ through their curriculum, academic programs, activities and practices. This study further evaluated if their graduates live out their Catholic commitment to Christ in their current way of life. It also determined the factors that affected their level of understanding of Catholic doctrines and their current way of life. The descriptive, qualitative, evaluative and correlational analyses determined the level of understanding of the Catholic doctrines and the current way of life of 390 graduates. It also correlated the level of understanding to moral life and worship. The factors that affected the graduates’ level of understanding and their current way of life were measured. A researcher-made instrument was distributed to the respondents either using the traditional way or the online survey to reach out graduates across the globe. Major findings were (1) The weighted mean of graduates’ level of understanding of Catholic doctrines was 4.63. (2) Along moral life, 4.07 while along worship, 3.83. (3) The Catholic doctrines and moral life had Pearson r value of 0.79. The doctrines and worship, 0.87; and worship and moral life, 0.89. (4) The understanding of the doctrines was affected highly by the teacher factor with 4.09 mean. The moral life and worship were affected highly by the teacher and technological factors both ranked 1.5 (4.04). (5) Along Catholic doctrines, the teacher factor had 0.90 r value; and environmental, -0.40. Along moral life, teacher had r value of -0.30; technological (-0.92), socio-economic (-0.93), political (-0.83), and environmental (-0.90). Along worship, the teacher had 0.36 Pearson r value, technological and socio-economic (-0.78), political (-0.73) and environmental (-0.72). Major conclusions were: (1) Graduates had very high level of understanding of the Catholic doctrines as summarized in the Creed which is grounded in the Sacred Scriptures. (2) They live out this Catholic commitment to Christ by obeying the Commandments very extensively but needed more participation in religious and parish activities. They have overwhelming spirituality and religiosity in terms of receiving of sacraments and sacramental practices except reading the Bible and reflecting on its passages. (3) The graduates’ level of understanding of the Catholic doctrines had very strong correlation with their current way of life. (4) Teacher, socio-economic, technological, environmental, and political factors significantly affected their understanding of the Catholic doctrines and their current way of life. (5) The teacher factor had very strong relationship with the doctrines; technological and political, weak; environmental, moderate; and socio-economic, very weak relationship. The teacher factor had weak relationship but the other factors had very strong relationship with moral life and strong relationship with worship.

Keywords: Catholic doctrines, Ignatian graduates, relationship, way of life

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavoured to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learner. Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: medical education, clinical education, andragogy, pedagogy

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Authors: Huei Jiun Chen, Hui Mei Huan

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Introduction: Pain is an unpleasant experience for hospitalized patients that impacts both their physical and mental well-being. It is important to select appropriate pain assessment tools to ensure effective pain management. Therefore, it is suggested to use Verbal Rating Scale (VRS) instead for better assessment. The Wong-Baker FACES Pain Rating Scale(WBS) is a widely used pain assessment tool in Taiwan to help individuals communicate the intensity of their pain. However, in clinical practice, even when using various assessment tools to evaluate pain, Numeric Rating Scale-11 (NRS-11) is still commonly utilized to quantify the intensity of pain. The correlation between NRS and other pain assessment tools has not been extensively explored in Taiwan. Additionally, the influence of gender and education level on pain assessment among elderly individuals has not been extensively studied in Taiwan. The aim of this study is to investigate the correlation between pain assessment scales (NRS-11, VRS, WBS) in assessing pain intensity among elderly inpatients. The secondary objective of this study is to examine how gender and education level influence pain assessment among individuals, as well as to explore their preferences regarding pain assessment tools. Method: In this study, a questionnaire survey and purposive sampling were employed to recruit participants from a medical center located in central Taiwan. Participants were requested to assess their pain intensity in the past 24 hours using NRS-11, VRS, and WBS. Additionally, the study investigated their preferences for pain assessment tools. Result: A total of 252 participants were included in this study, with a mean age of 71.1 years (SD=6.2). Of these participants, 135 were male (53.6%), and 44.4% had a primary level or below education. Participants were asked to use NRS-11, VRS, and WBS to assess their current, maximum, and minimum pain intensity experienced in the past 24 hours. The findings indicated a significant correlation (p< .01) among all three pain assessment tools. No significant differences were observed in gender across the three pain assessment scales. For severe pain, there were significant differences in self-rated pain scales among the elderly participants with different education levels (F=3.08, p< .01; X²=17.25, X²=17.21, p< .01), but there were no significant differences observed for mild pain. Regarding preferences for pain assessment tools, 158 participants (62.7%) favored VRS, followed by WBS; gender and education level had no influence on their preferences. Conclusion: Most elderly participants prefer using VRS (Verbal Rating Scale) to self-reported their pain. The reason for this preference may be attributed to the verbal nature of VRS, as it is simple and easy to understand. Furthermore, it could be associated with the level of education among the elderly participants. The pain assessment using VRS demonstrated a significant correlation with NRS-11 and WBS, and gender was not found to have any influence on these assessment. Further research is needed to explore the effect of different education levels on self-reported pain intensity among elderly people in Taiwan.

Keywords: pain assessment, elderly, gender, education

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