Search results for: community and hospital approach

Authors: David Oluwole Moses, Odeyemi Adebowale Toba, Olawale Adetunji Kola

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Candida auris, an emerging fungus, has been reported in more than 30 countries around the world since its first detection in 2009. Due to its several virulence factors, resistance to antifungals, and persistence in hospital settings, Candida auris has been reported to cause treatment-failure infections. This study was therefore carried out to determine the incidence of Candida auris in a tertiary hospital in Ekiti State, Nigeria. In this study, a total of 115 samples were screened for Candida species using cultural and molecular methods. The carriage of virulence factors and antifungal resistance among C. auris was detected using standard microbiological methods. Candida species isolated from the samples were 15 (30.0%) in clinical samples and 22 (33.85%) in hospital equipment screened. Non-albicans Candida accounted for 3 (20%) and 8 (36.36%) among the isolates from the clinical samples and equipment, respectively. Only five of the non-albicans Candida isolates were C. auris. All the isolates produced biofilm, gelatinase, and hemolysin, while none produced germ tubes. Two of the isolates were resistant to all the antifungals tested. Also, all the isolates were resistant to fluconazole and itraconazole. Nystatin appeared to be the most effective among the tested antifungals. The isolation of Candida auris is being reported for the second time in Nigeria, further confirming that the fungus has spread beyond Lagos and Ibadan, where it was first reported. The extent of the spread of the nosocomial fungus needed to be further investigated and curtailed in Nigeria before its outbreak in healthcare facilities.

Keywords: candida auris, virulence factors, antifungals, pathogen, hospital, infection

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Authors: Alan Silva, Carla Cipolla

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The increase of life expectancy in the world is a current challenge for governments, demanding solutions towards elderly people. In this context, service design and age-friendly design appear as an approach to create solutions which favor active aging by social inclusion and better life quality. In essence, the age-friendly design aims to include elderly people in the democratic process of creation in order to strengthen the participation and empowerment of them through intellectual, social, civic, recreational, cultural and spiritual activities. All of these activities aim to provide resilience to this segment by granting access to the reserves needed for adaptation and growth in the face of life's challenges. On that approach, the following research brings an overview of the actions related to the integration and social qualification of the elderly people, considering a suburban area of Rio de Janeiro. Based on Design Thinking presented by Brown (2009), this research has a qualitative-exploratory approach demanding certain necessities and actions, which are collected through observation and interviews about the daily life of the elderly community individuals searching for information about personal capacitation and social integration of the studied population. Subsequently, a critical analysis is done on this overview, pointing out the potentialities and limitations of these actions. At the end of the research, a well-being map of solutions classified as physical, mental and social is created, also indicating which current services are relevant and which activities can be transformed into services to that community. In conclusion, the contribution of this research is the construction of a map of solutions that provides resilience to the studied public and favors the concept of active aging in society. From this map of solutions, it is possible to discriminate what are the resources necessary for the solutions to be operationalized and their journeys with the users of the elderly segment.

Keywords: resilience, age-friendly design, service design, active aging

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Authors: Lin Zhang

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The fear of leprosy has been longstanding throughout the human history. In an era where isolation is practiced as a means of epidemic prevention, the leprosy rehabilitation group has itself become an isolated community with an entrenched metaphor. In the process of new mediatization of the leprosy isolation community, what are the relations among media literacy, the leprosy internalized stigma and social support? To address the question, the “portrait” of leprosy rehabilitation group is re-delineated through two field studies in the “post-leprosy age” in 2012 and 2020, respectively. Taking an isolation community on Si’an Leprosy Island in Dongguan City, Guangdong Province, China as the study object, it is found that new media promotes the dissolution of segregation effect of the leprosy isolation community and the cultivation of opinion leaders by breaking spatial, psychological and social segregation and by building a community of village affairs and public space in the following way: the cured patients with high new media literacy, especially those who use WeChat and other applications and largely rely on new media for information, have a low level of leprosy internalized stigma and a high level of social support, and they are often the opinion leaders inside their community; on the contrary, the cured patients with low new media literacy, a high level of leprosy internalized stigma and a low level of social support are often the followers inside their community. Such effects of dissolution and construction are reflected not only in the vertical differentiation of the same individual at different times, but also in the horizontal differentiation between different individuals at the same time.

Keywords: segregation, the leprosy rehabilitation group, new mediatization, digital empowerment, opinion leaders

Procedia PDF Downloads 172

Authors: B. A. N. Madubashini, S. Anojan, S. Thurka, N. M. C. J. Nawasinghe, G. A. S. Milanga, W. M. I. S. Weerakoon, I. D. N. Ihalahewage

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Evidence-based health promotional approaches are known to be successful ways of reducing tobacco consumption in a rural village. Hence tobacco prevention is essential in improving lives of people, and community-based approaches are considered as effective. This community-based health promotion intervention implemented to reduce high consumption of tobacco in a rural area in Sri Lanka. This intervention was conducted in a rural village of Sri Lanka. In the beginning, facilitation discussions conducted with community members to identify determinants leading to tobacco consumption among villagers. Intervention was planed based on those determinants. Community actions through small active groups to demote smoking were generated. Children groups displayed cigarette buds collected around common places such as temple to community gatherings including funeral welfare society elaborating the cost and the money spent on cigarettes. A till (expenditure box) was introduced, and smokers in family were encouraged to put money on a cigarette to it when they decide to smoke instead. This way they could monitor potential savings if quit. Children groups introduced a tool 'Engalanthe puthata (for overseas son)' to shops. Shop owners agreed to add a pebble to a box whenever they sell a cigarette. The money spent on cigarettes in that shop was calculated regularly, and that was considered as money sent to tobacco company overseas, so to the son of the company owner. This was useful to encourage quitting and to stop selling cigarette in the shops. All four shops in the community volunteered to stop selling cigarettes. Eleven percent of users quitted smoking and 37% users reduced smoking. Child empowerment was high, and 60% of children had shown their disapproval on smoking publicly at least once. Similar community-based health promotion intervention can be used to generate community actions leading to reduction of tobacco consumption.

Keywords: cigarette, community, empowerment, health promotion, intervention

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Authors: L. Korpinen, T. Kava, I. Salmi

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This study aimed to describe the operating model of obstructive sleep apnea. Due to the large number of patients, the role of nurses in the diagnosis and treatment of sleep apnea was important. Pulmonary physicians met only a minority of the patients. The sleep apnea study in 2018 included about 800 patients, of which about 28% were normal and 180 patients were classified as severe (apnea-hypopnea index [AHI] over 30). The operating model has proven to be workable and appropriate. The patients understand well that they may not be referred to a pulmonary doctor. However, specialized medical follow-up on professional drivers continues every year.

Keywords: sleep, apnea patient, operating model, hospital

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Authors: Akshita Gaba, Ria P. Dey, Sanya Karotiya, Smrijanee Dash, Soni Gupta

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This research paper explores the significance of environmental awareness and community outreach initiatives undertaken by the Speak Up World Foundation; a non-profit organization founded in 2021. The study delves into the historical context of environmental issues, identifies the driving factors contributing to environmental degradation, and outlines tasks undertaken by the foundation to promote environmental consciousness. The paper also highlights the impact of these efforts on the community and emphasizes the need for continued dedication to ensure sustainable coexistence with our environment.

Keywords: environment, social service, organization, degradation, survey

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Authors: Seung Chul Lee, Jooyeong Kim, Ki Ok Ahn, Juok Park

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Background: Injuries caused by motorcycle crashes are one of the major public health burdens leading to high mortality, functional disability. The risk of death among motorcyclists is 30 times greater than that among car drivers, with head injuries the leading cause of death. The motorcycle helmet is crucial protective equipment for motorcyclists. Aims: This study aimed to measure the protective effect of motorcycle helmet use on intracranial injury and mortality and to compare the preventive effect in drivers and passengers. Methods: This is a cross-sessional study based on the Emergency Department (ED)–based Injury In-depth Surveillance (EDIIS) database from 23 EDs in Korea. All of the trauma patients injured in motorcycle crashes between January 1, 2013 and December 31, 2016 were eligible, excluding cases with unknown helmet use and outcomes. The primary and secondary outcomes were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders. Using interaction models, we compared the protective effect of helmet use on outcomes across driving status (driver and passenger). Results: Among 17,791 eligible patients, 10,668 (60.0%) patients were wearing helmets at the time of the crash, 2,128 (12.0%) patients had intracranial injuries and 331 (1.9%) patients had in-hospital death. 16,381 (92.1%) patients were drivers and 1410 (7.9%) patients were passengers. 62.6% of drivers and 29.1% of passengers were wearing helmets at the time of the crash. Compared to un-helmeted group, the helmeted group was less likely to have an intracranial injury(8.0% vs. 17.9%, AOR: 0.43 (0.39-0.48)) and in-hospital mortality (1.0% vs. 3.2%, AOR: 0.29 (0.22-0.37)).In the interaction model, AORs (95% CIs) of helmet use for intracranial injury were 0.42 (0.38-0.47) in drivers and 0.61(0.41-0.90) in passengers, respectively. There was a significant preventive effect of helmet use on in-hospital mortality in drivers (AOR: 0.26(0.21–0.34)). Discussion and conclusions: Wearing helmets in motorcycle crashes reduced intracranial injuries and in-hospital mortality. The preventive effect of motorcycle helmet use on intracranial injury was stronger in drivers than in passengers. There was a significant preventive effect of helmet use on in-hospital mortality in driver but not in passengers. Public health efforts to increase motorcycle helmet use are needed to reduce health burden from injuries caused by motorcycle crashes.

Keywords: intracranial injury, helmet, mortality, motorcycle crashes

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Authors: Thanaporn Chaimongkol

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The objective of this research was aimed to examine the factors that influence the development of community leadership strategies to further develop the career regarding the Benjarong pottery products in eight upper central provinces, Thailand. The sample included (1) 1200 Benjarong pottery operators, (2) 30 involved representatives at both the policy level and support, and (3) OTOP network of 24 people. In this quantitative study, investigating data was conducted on individual session basis. The research instruments used included questionnaires and interview. The results showed that the components of the development of the community leadership strategies for career development of the Benjarong pottery products in eight upper central provinces were high overall; the Five Competitive Forces were of the highest average, followed by bargaining power of suppliers, and McKinsey 7's framework, respectively; where the highest average was strategy.

Keywords: community leadership, strategy development, Benjarong Pottery, 8 upper central provinces

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Authors: Anchana Sooksomchitra

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This study aims to explore and compare the current condition of community radio stations in Phutthamonthon district, Nakhon Pathom province, Thailand, as well as the challenges they are facing. Qualitative research tools including in-depth interviews; documentary analysis; focus group interviews; and observation, are used to examine the content, programming, and management structure of three community radio stations currently in operation within the district. Research findings indicate that the management and operational approaches adopted by the two non-profit stations included in the study, Salaya Pattana and Voice of Dhamma, are more structured and effective than that of the for-profit Tune Radio. Salaya Pattana – backed by the Faculty of Engineering, Mahidol University, and the charity-funded Voice of Dhamma, are comparatively free from political and commercial influence, and able to provide more relevant and consistent community-oriented content to meet the real demand of the audience. Tune Radio, on the other hand, has to rely solely on financial support from political factions and business groups, which heavily influence its content.

Keywords: radio broadcasting, programming, management, community radio, Thailand

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Authors: Mahmoud Abdel Hameed Shahin

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Job demands that are incompatible with an employee's skills, resources, or needs cause unpleasant emotional and physical reactions known as job stress. Nurses offer care in hospital emergency rooms all around the world, and since they operate in such a dynamic and unpredictable setting, they are constantly under pressure. It has been discovered that job stress has harmful impacts on nurses' health as well as their capacity to handle the demands of their jobs. The purpose of this study was to evaluate the level of job stress experienced by the emergency department nurses at King Fahad Specialist Hospital in Buraidah City, Saudi Arabia. In October 2021, a cross-sectional descriptive study was conducted. 80 nurses were conveniently selected for the study, the bulk of them worked at King Fahad Specialist Hospital's emergency department. An electronic questionnaire with a sociodemographic data sheet and a job stress scale was given to the participating nurses after ethical approval was received from the Ministry of Health's representative bodies. Using SPSS Version 26, both descriptive and inferential statistics were employed to analyze and tabulate the acquired data. According to the findings, the factors that contributed to the most job stress in the clinical setting were having an excessive amount of work to do and working under arbitrary deadlines, whereas the factors that contributed to the least stress were receiving the proper recognition or rewards for good work. In the emergency room of King Fahad Specialist Hospital, nurses had a moderate level of stress (M=3.32 ± 0.567/5). Based on their experience, emergency nurses' levels of job stress varied greatly, with nurses with less than a year of experience notably experiencing the lowest levels of job stress. The amount of job stress did not differ significantly based on the emergency nurses' age, nationality, gender, marital status, position, or level of education. The causes and impact of stress on emergency nurses should be identified and alleviated by hospitals through the implementation of interventional programs.

Keywords: emergency nurses, job pressure, Qassim, Saudi Arabia, job stress

Procedia PDF Downloads 179

Authors: Aneta Nitsch-Osuch, Damian Okrucinski, Magdalena Dawgialło, Izabela Gołębiak, Ernest Kuchar

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The Hospital Antibiotic Policy (HAP) should be implemented to rationalize the antibiotic use and to decrease the risk of spreading of spreading of resistant bacteria. The aim of our study was to describe the antibiotic consumption patterns at the single oncosurgery ward before and after implementation of the HAP. We conducted a retrospective analysis of the antibiotic use at the Oncosurgery Ward in Warsaw (Poland) in years 2011-2016. Calculations were based on daily defined doses (DDDs), DDDs/100 hospitalizations and DDDs/100 person-days, drug utilization rates (DU 90% and DU 100%) were also analysed. After implementation of the HAP, the total antibiotic consumption increased (365.35 DDD in 2011 vs. 1359,22 DDD in 2016). The significant change was observed in antibiotic consumption patterns: the use of amoxicillin clavulanate and carbapenems or glycopeptides decreased significantly (p < 0,05), while the use of ciprofloxacin and aminoglycosides increased (p < 0,05). The DU100% rate varied from 6 in 2011 to 12 in 2016; while DU 90% rate varied from 2 in 2011 to 3-5 in 2013-2016. Although the implementation of the HAP did not result in the decreased total antibiotic consumption, it provided favorable changes in the antibiotic consumption patterns.

Keywords: antibiotics, hospital, policy, stewardship

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Authors: Kanyarat Bussaban, Siriporn Poolsuwan

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This study is conducted with the objective to prove how the distorted distribution of welfare affects the quality of school-age children lives differently in the case of an urban community in Bangkok. 334 samples are households from Suan Oi and Ratchapatubtim communities. The study of sample communities found the difference between two community areas that are close. The people of Suan Oi community are economically better off people than the people of the Ratchapatubtim community. They share the benefits of using most services except the welfare of a child’s education. The resulting analysis of the variability in quality of life of the school age children indicate that heads of the households are women looking for quality of life benefits when the compulsory school age is less. A study of the two communities suggests that the inequality in income distribution currently affects the quality of life of school-age children.

Keywords: inequality, income distribution, quality of school-age children lives, welfare state

Procedia PDF Downloads 367

Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

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Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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Authors: Neveen Ali-Saleh Darawsha

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Exposure to community violence (CV) is alarmingly high and emphasizes negative consequences. The present study examines the rates and consequences of exposure to community violence, among Palestinian adolescents from Israel, age ranged 14-18. Specifically, it examines whether exposure to community violence is indirectly related to academic achievement through internalizing and externalizing symptoms among adolescents; and whether the indirect effects of exposure to CV and academic achievements will differ when the parents have different levels of psychological well-being. Method: Semi systematic random sample of 760 Palestinian adolescents in Israel, (320 boys, and 440 girls) filled out a self-administration questionnaire. Most of the adolescents had witnessed community violence during the last year and during their lifetime, and more than one third had directly experienced such violence during lifetime compared with 19.6% during the last year. Structural equation modeling was used to examine the indirect effects of exposure to CV and academic achievement. Results revealed that externalizing symptoms mediated the association between exposure to CV and academic achievement. There were no indirect effects through internalizing symptoms. Moreover, parental psychological well-being moderated the indirect effects between externalizing symptoms and academic achievements. Conclusion: Findings highlight the importance of targeting externalizing symptoms for adolescents that could improve their behaviors and also their academic achievements as well. limitations of the study, implications for the practice and recommendations for future research are discussed.

Keywords: community violence, witnessing violence, direct personal experiencing, academic achievement, psychological well-being, Palestinian adolescents

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Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

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Authors: Mogens Saberi

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The following article focuses on a new seismic design approach for Denmark. Denmark is located in a low seismic zone and up till now a general and very simplified approach has been used to accommodate the effect of seismic loading. The current used method is presented and it is found that the approach is on the unsafe side for many building types in Denmark. The damages during time due to earth quake is presented and a seismic map for Denmark is developed and presented. Furthermore, a new design approach is suggested and compared to the existing one. The new approach is relatively simple but captures the effect of seismic loading more realistic than the existing one. The new approach is believed to the incorporated in the Danish Deign Code for building structures.

Keywords: low seismicity, new design approach, earthquakes, Denmark

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Authors: Mariko Hara, Mari Aoki, Takako Ito, Masao Sugita

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Social distancing measures due to the COVID-19 crisis had a severe impact on music and art practices based in community settings. They had to re-think how to connect with their dispersed community using online tools. As the social distancing continues, there is an urgent need to investigate the possibilities of online community music and art practices. Are they sustainable actions that can have positive impacts on the community and the quality of lives of people over time? The Online Lindgren Café (hereafter ‘OLC’) is a monthly online literature event which started in June 2020. In the OLC, up to 14 members meet online to discuss the works of Astrid Lindgren and similar authors. Members come from various places in Japan and Norway, with a variety of expertise from music therapy, music education, psychotherapy, music sociology, storytelling, and theatre, and their family members join them. In these meetings, music and arts activities emerged in response to interests among the members. The resources and experiences of the members helped to develop these activities further. This paper first introduces one of the music and art activities in one specific event, a collaborative picture book-making with music, which was initiated and led by the second author. The third author chose the music, and the activity itself was recorded. This is followed by the description of a reflecting event, where the recording of the collaborative picture book-making activity was shared to facilitate further creations (drawings, haiku, and fabric weaving) as well as group reflections on the trajectories of the Online Lindgren Café. Finally, we will discuss the preliminary findings using the data collected at the reflecting event. Key findings suggest that the resource-driven approach of the OLC leveled the relationships among the intergenerational, multi-cultural, and interdisciplinary members. This enabled the members to set aside their professional and/or predominant identities, which allowed them to discover their own and others’ resources. The relaxed, unstructured, and liminal phenomenon at OLC can be regarded as a form of communitas, where members gain a sense of liberation and belonging in a different way from in-person communications. Participation from one’s home, as well as a video conferencing function that allowed the members to position themselves among the other participants in equal-sized windows, seems to have enabled members to feel safe to express themselves openly at the same time feel a sense of belonging. Furthermore, in the OLC, music and arts activities acted to inclusively connect and re-connect dispersed, intergenerational members with each other. For instance, in a music and drawing activity, music acted as a means for each member to engage in their own ‘drawing space’ while still feeling connected with the others. The positive experiences from these activities inspired the members to use similar approaches outside of the OLC. The finding suggests that, because of its resource-driven approach supported by the music and arts activities, the OLC could be developed further as a permeable and sustainable action even after any current social distancing measures are lifted.

Keywords: communitas, COVID-19, musical affordances, online community of practices, resource-driven approach

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Authors: Gelila Tamyalew, Asres Abitie

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Community Pharmacists (CPs) have a significant part in consumer choice in the rational use of LMPPs. The opinion of pharmacists regarding branded and generic medications can offer a perception of the potential obstacles that might have to be overcome to advance generic medicine utilization. Many factors affect CPs' attitudes negatively toward LMPPs. Therefore, the current study assessed factors that can affect CPs' attitudes toward LMPPs. In the regression analysis of variables, three variables were associated with CPs' attitudes toward LMPPs. These are; maximum educational status, professional status, and year of experience in community pharmacy practice. Moreover, lack of belief in LMPPs, substitution agreement with the prescriber, cost-effectiveness of LMPPs, and consumer preference/demand were the most influencing reasons for the selection of LMPPs. In conclusion, the attitude of CPs seems suboptimal that requires an intervention to optimize LMPP utilization.

Keywords: locally manufactured pharmaceutical products, attitude, community pharmacist, Ethiopia

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Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

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The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

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Authors: Hadjer Messabih

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The M’zab architecture has preserved its identity that was able to endure for centuries conserving practically the same way of life and the same building techniques since the 11th century. Even more, the newly built ksar Tafilelt is also designed to meet the local tradition. In 1996, a community led project was initiated to build a “new ksar” named Tafilelt based on a traditional form of community-led cooperative housing. It is a unique experience in the field of community housing that reproduces traditional architectural patterns while addressing contemporary ways of life with their expected modern comfort. This research is based on the hypothesis that the process of producing ksar Tafilelt is culturally responsive to a conservative community that was characterized by certain values which were transmitted to this ksar manifesting as cultural continuity. It aims at investigating what type of cultural continuity manifests itself in the co-production of ksar Tafilelt and the way the settlement and its houses are produced and inhabited, as well as the new emerging values and adaptive transition in social relations. The research methodology is based on a combination of questionnaires, in depth interviews, photography, and site visit to record and demonstrate how these buildings respond to peoples’ needs. Post Occupancy Evaluation (POE) is also employed in order to understand the lessons that can be learned from this project. Finally, this study proves that the cultural continuity that was transmitted from the Ibadi community is sill manifested in ksar Tafilelt, which provided strong religious bonds and a strong sense of community. The research findings have resulted in a number of lessons and principles that can be learnt from the project of ksar Tafilelt which can inform future practices of housing provision and design in Algeria and other countries.

Keywords: community-led cooperative housing, conservative community, cultural continuity, post occupancy evaluation

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Authors: Crispin Rakibu Mbamba

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Twenty-two years after the adoption of the United Nation Trafficking Protocol, evidence suggest that child trafficking continues to rise. Community level factors, like poverty which creates the conditions for children’s vulnerability is key to the rise in trafficking cases in Ghana. Albeit, growing evidence suggestthat despite the vulnerabilities, communities have the capacity to prevent and address child trafficking issues. This study contributes to this positive agenda by exploring the ways in which communities (and the key actors) in Ghana contribute to child trafficking interventions.The study objective is explored through in-depth interviews with practitioners (including social workers) from an organization working in trafficking hotspots in Ghana. Interviews wereanalyzed thematically with the help of HyperRESEARCH software. From the in-depth interviews, three themes were identified as the ways in which communities are involved in child trafficking interventions: 1) engagement of community leaders, 2) community-led anti-trafficking committees and 3) knowledge about trafficking. Albeit the cultural differences, evidence on the instrumental role of community chiefs and leaders provide important learning on how to harness trafficking intervention measures and ensure better child protection practices. Based on the findings, we recommend the need to intensify trafficking awareness campaigns in rural communities where education is lacking to contribute to United Nations (UN) promoting Just, Peaceful and Inclusive societies’ mandate.

Keywords: child trafficking, community interventions, knowledge on trafficking, human trafficking intervention

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Authors: K. Lalhmingsangi, U. K. Sahoo

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Non-Timber Forest Products represent one of the key sources of income and subsistence to the fringe communities living in rural areas. A study was conducted for the assessment of NTFP within the community forest of five villages under Thenzawl forest division. Participatory Rural Appraisal (PRA), questionnaire, field exercise, discussion and interview with the first hand NTFP exploiter and sellers was adopted for the field study. Fuel wood, medicinal plants, fodder, wild vegetables, fruits, broom grass, thatch grass, bamboo pole and cane species are the main NTFP harvested from the community forest. Among all the NTFPs, the highest percentage of household involvement was found in fuel wood, i.e. 53% of household and least in medicinal plants 5%. They harvest for their own consumption as well as for selling to the market to meet their needs. Edible food and fruits are sold to the market and it was estimated that 300 (Rs/hh/yr) was earned by each household through the selling of this NTFP from the community forest alone. No marketing channels are linked with fuelwood, medicinal plants and fodder since they harvest only for their own consumption.

Keywords: community forest, subsistence, non-timber forest products, Thenzawl Forest Division

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Authors: P. Daniels, T. Adonis, P. September-Brown, R. Comalie

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The community engagement unit at the University of the Western Cape was tasked with establishing a community engagement database. The database would store information of all community engagement projects related to the university. The wealth of knowledge obtained from the various disciplines would be used to facilitate interdisciplinary collaboration within the university, as well as facilitating community university partnership opportunities. The purpose of this qualitative study was to explore electronic data collection through the development of a database. Two types of electronic data collection platforms were used, namely online questionnaire and email. The semi structured questionnaire was used to collect data related to community engagement projects from different faculties and departments at the university. There are many benefits for using an electronic data collection platform, such as reduction of costs and time, ease in reaching large numbers of potential respondents, and the possibility of providing anonymity to participants. Despite all the advantages of using the electronic platform, there were as many challenges, as depicted in our findings. The findings suggest that certain barriers existed by using an electronic platform for data collection, even though it was in an academic environment, where knowledge and resources were in abundance. One of the challenges experienced in this process was the lack of dissemination of information via email to staff within faculties. The actual online software used for the questionnaire had its own limitations, such as only being able to access the questionnaire from the same electronic device. In a few cases, academics only completed the questionnaire after a telephonic prompt or face to face meeting about "Is higher education in South Africa ready to embrace electronic platform in data collection?"

Keywords: community engagement, database, data collection, electronic platform, electronic tools, knowledge sharing, university

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Authors: Hayati Sari Hasibuan, Tresna P. Soemardi, Raldi H. Koestoer, Setyo S. Moersidik

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Facing the severe transportation system in daily basis, the government of Indonesia were searching an alternative solution to combat the acute traffic jam and the socio-economic negative effects and pollutions resulted. Transit-oriented development as a strategy in reformulating and restructuring of the urban land uses as well as the transport system will be implemented in many urban areas in Indonesia, especially in Jabodetabek. Jabodetabek is the greatest metropolitan area in Indonesia with 27.9 million inhabitants. The Jabodetabek is also the center of economic activity with gross domestic product around 22 percent of gross national product. This study aims to assess the potential of economic development and community change effects with implementing the transit oriented development. This study found that using transit oriented development as an alternative approach in reconstructing of urban land uses in metropolitan region will effect to the behaviour of urban mobilities, the housing choices, and the cost of transportation. The sustainable of socio-economic aspects resulting from the transit oriented development is the main focus of this paper. The challenge here is to explore the characteristics of transit oriented development that suitable for metropolitan region in developing country,which considering the uniqueness of nature and socio-cultural that shapes this urban.

Keywords: economic development, community change, restructuring, land use, transportation, environment

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Authors: Mochammad Thalut

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This essay discusses how educational leadership response the Muslims pupils’ problems and their expectation about education in the UK. As we know, the Muslims community in the country is increasing. However, the debate about educational leadership is still limited to the separation between religion and academic by westerns approach. It is found that there are four major problems of Muslims pupils that need to solve by the educational leader to provide social justice in education. Leader-teacher as an Islamic concept of the educational leader is an alternative approach that can be used by the educational leader to overcome the problems. In the end, it is strongly recommended to bring this issue to the leadership development program in the UK to give all aspiring heads understanding about Muslims expectation about education.

Keywords: Muslim, education, leadership, identity

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Authors: Chih-Yuan Weng

Abstract:

It may be a common sense that indigenous people in Taiwan, like their counterparts in the rest of the world, are generally more disadvantaged than other citizens in terms of all sorts of socioeconomic indicators. However, it has also been well-documented in the literature that there is always significant variation in the level of indigenous poverty, both among individuals and among tribes, which can be obscured by a national survey that does not take into account the heterogeneity, such as tribal locations, among indigenous people. Thus, using a Truku tribe in a remote county of Taiwan (i.e., Hualien County) as an example, this study aims at investigating whether and how the socioeconomic livelihood of the indigenous residents would be damaged by the remoteness of their tribal community.

Keywords: indigenous people, tribal community, poverty, socioeconomic livelihood, remoteness

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Authors: Emeshaw Damtew Zebene, Edom Seife, Hagos Tesfay, Gurja Belay

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Background: cancer incidence and mortality has grown rapidly throughout the world. Aging of the population, urbanization, physical inactivity, economic growth followed by smoking and drinking contributed a lot for the increased incidence of cancer all over the globe. Objective: the aim of this study was to assess a one-year trend of cancer patients who underwent curative/radical radiotherapy at radiotherapy center, Tikur Anbessa specialized hospital, Ethiopia. Methodology: We performed a prospective descriptive study of cancer patients treated with LINAC at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia, from April 2021- March 2022. A standardized questionnaire was used to collect sociodemographic and clinical characteristics of the patients. Descriptive statistics and chi-square results were generated using SPSS version 24. The level of significance was obtained at 0.05. Results: Sixty-four (64) curative/radical patients-44 females and 20 males were analyzed. Majority, 27(42.2%), of the patients age range from 45 to 64, and 45(70%) of them were urban residents where a group of higher gynecologic cancer was observed.78% of the patients were with locally advanced cancer, and 54(84.4%) of them had no awareness about cancer. Generally, head & neck cancer were found the most prevalent cancer 20(31.3%), and the leading cause of cancer among women was cervical cancer 17(38.6%), where about half 7(15.9%) of them were HIV positive. Conclusion: Our finding revealed that most of curative/radical patients presented at a locally advanced stage of the disease. Hence, maintaining the already available teletherapy machines and installing additional radiotherapy centers may help in treating the patients at the early stage of the disease. Since almost all of our study participants did not have information about cancer, awareness raising mechanisms should be done. Additionally, understanding differences in cancer incidence between urban and rural is important. Key words: Cancer, Curative/radical, Radiotherapy, Tikur Anbessa Specialized Hospital

Keywords: cancer, curative/radical, radiotherapy, tkur anbessa specialized hospital

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Authors: Mandlenkosi Richard Mphatheni

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The Constitution of the Republic of South Africa (Act 108 of 1996 section 28(1) (d)) states, ‘Every child has the right to be protected from maltreatment, neglect, abuse, and degradation’. Qualitative research studied perceptions of the selected sample. Objectives of the research were to determine factors that influence perpetrators of sexual violence to target children, the risk factors of child sexual abuse, the effects of child sexual abuse on the development of the child, and the community prevention measures to minimize the risks of child sexual abuse. The research aimed to understand perspective and experiences of the Ngangelizwe community members on the problem of sexual violence against children and the perpetrator’s perceived motive for sexually abusing children. Convenience non-probability sampling technique was adopted to select 20 participants within the Ngangelizwe Township at Mthatha. Thematic analyses were used to analyse data. It was found that sexual abuse of children affects severely child and parents, while the community reported to be trivially affected by the sexual abuse of a child. The research revealed ignorance of some forms of sexual violence, as the commonly known form of sexual violence was rape. Therefore, ignorance of community members regarding various forms of sexual abuse means that such acts are either ignored, tolerated, or even regarded as acceptable. It thus means that community members cannot reject any actions or behaviour if they themselves are ignorant of what constitutes sexual violence. This study recommends that communities should be educated about different sexual offenses.

Keywords: child sexual abuse, community, childhood attachment, adult attachment

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Authors: Delly C. Lestari, Linosefa, Ardiana Kusumaningrum, Andi Yasmon, Anis Karuniawati

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The objective of this study is to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mecA genes from screening isolates among intensive care unit (ICU) patients. All MRSA screening isolates from ICU’s patients of Cipto Mangunkusumo Hospital during 2011 and 2014 were included in this study. Identification and susceptibility test was performed using Vitek2 system (Biomereux®). PCR was conducted to characterize the SCCmec of S. aureus harboring the mecA gene on each isolate. Patient’s history of illness was traced through medical record. 24 isolates from 327 screening isolates were MRSA positive (7.3%). From PCR, we found 17 (70.8%) isolates carrying SCCmec type I, 3 (12.5%) isolates carrying SCCmec type III, and 2 (8.3%) isolates carrying SCCmec type IV. In conclusion, SCCmec type I is the most prevalent MRSA colonization among ICU patients in Cipto Mangunkusumo Hospital.

Keywords: MRSA, mecA genes, ICU, colonization

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Authors: Sharon Jackson White

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Purpose: Nurse practitioners (NPs) practicing within hospital medicine play a significant role in caring for patients who might benefit from palliative care (PC) services. Using the Theory of Planned Behavior, the purpose of this study was to examine the relationships among facilitators to referral, barriers to referral, self-efficacy with end-of-life discussions, history of referral, and referring to PC among NPs in hospital medicine. Hypotheses: 1) Perceived facilitators to referral will be associated with a higher history of referral and a higher number of referrals to PC. 2) Perceived barriers to referral will be associated with a lower history of referral and a lower number of referrals to PC. 3) Increased self-efficacy with end-of-life discussions will be associated with a higher history of referral and a higher number of referrals to PC. 4) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the history of referral to PC. 5) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the number of referrals to PC. Significance: Previous studies of referring patients to PC within the hospital setting care have focused on physician practices. Identifying factors that influence NPs referring hospitalized patients to PC is essential to ensure that patients have access to these important services. This study incorporates the SNRS mission of advancing nursing research through the dissemination of research findings and the promotion of nursing science. Methods: A cross-sectional, predictive correlational study was conducted. History of referral to PC, facilitators to referring to PC, barriers to referring to PC, self-efficacy in end-of-life discussions, and referral to PC were measured using the PC referral case study survey, facilitators and barriers to PC referral survey, and self-assessment with end-of-life discussions survey. Data were analyzed descriptively and with Pearson’s Correlation, Spearman’s Rho, point-biserial correlation, multiple regression, logistic regression, Chi-Square test, and the Mann-Whitney U test. Results: Only one facilitator (PC team being helpful with establishing goals of care) was significantly associated with referral to PC. Three variables were statistically significant in relation to the history of referring to PC: “Inclined to refer: PC can help decrease the length of stay in hospital”, “Most inclined to refer: Patients with serious illnesses and/or poor prognoses”, and “Giving bad news to a patient or family member”. No predictor variables contributed a significant variance in the number of referrals to PC for all three case studies. There were no statistically significant results showing a relationship between the history of referral and referral to PC. All five hypotheses were partially supported. Discussion: Findings from this study emphasize the need for further research on NPs who work in hospital settings and what factors influence their behaviors of referring to PC. Since there is an increase in NPs practicing within hospital settings, future studies should use a larger sample size and incorporate hospital medicine NPs and other types of NPs that work in hospitals.

Keywords: palliative care, nurse practitioners, hospital medicine, referral

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