Search results for: health care professional
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12125

Search results for: health care professional

11465 The Shape of the Sculptor: Exploring Psychologist’s Perceptions of a Model of Parenting Ability to Guide Intervention in Child Custody Evaluations in South Africa

Authors: Anthony R. Townsend, Robyn L. Fasser

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This research project provides an interpretative phenomenological analysis of a proposed conceptual model of parenting ability that has been designed to offer recommendations to guide intervention in child custody evaluations in South Africa. A recent review of the literature on child custody evaluations reveals that while there have been significant and valuable shifts in the capacity of the legal system aided by mental health professionals in understanding children and family dynamics, there remains a conceptual gap regarding the nature of parenting ability. With a view to addressing this paucity of a theoretical basis for considering parenting ability, this research project reviews a dimensional model for the assessment of parenting ability by conceiving parenting ability as a combination of good parenting and parental fitness. This model serves as a conceptual framework to guide child-custody evaluation and refine intervention in such cases to better meet the best interests of the child in a manner that bridges the professional gap between parties, legal entities, and mental health professionals. Using a model of good parenting as a point of theoretical departure, this model incorporates both intra-psychic and interpersonal attributes and behaviours of parents to form an impression of parenting ability and identify areas for potential enhancement. This research, therefore, hopes to achieve the following: (1) to provide nuanced descriptions of parents’ parenting ability; (2) to describe parents’ parenting potential; (3) to provide a parenting assessment tool for investigators in forensic family matters that will enable more useful recommendations and interventions; (4) to develop a language of consensus for investigators, attorneys, judges and parents, in forensic family matters, as to what comprises parenting ability and how this can be assessed; and (5) that all of the aforementioned will serve to advance the best interests of the children involved in such litigious matters. The evaluative promise and post-assessment prospects of this model are illustrated through three interlinking data sets: (1) the results of interviews with South African psychologists about the model, (2) retrospective analysis of care and contact evaluation reports using the model to determine if different conclusions or more specific recommendations are generated with its use and (3) the results of an interview with a psychologist who piloted this model by using it in care and contact evaluation.

Keywords: alienation, attachment, best interests of the child, care and contact evaluation, children’s act (38 of 2005), child custody evaluation, civil forensics, gatekeeping, good parenting, good-enough parenting, health professions council of South Africa, family law, forensic mental healthcare practitioners, parental fitness, parenting ability, parent management training, parenting plan, problem-determined system, psychotherapy, support of other child-parent relationship, voice of the child

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11464 The Cost of Non-Communicable Diseases in the European Union: A Projection towards the Future

Authors: Desiree Vandenberghe, Johan Albrecht

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Non-communicable diseases (NCDs) are responsible for the vast majority of deaths in the European Union (EU) and represent a large share of total health care spending. A future increase in this health and financial burden is likely to be driven by population ageing, lifestyle changes and technological advances in medicine. Without adequate prevention measures, this burden can severely threaten population health and economic development. To tackle this challenge, a correct assessment of the current burden of NCDs is required, as well as a projection of potential increases of this burden. The contribution of this paper is to offer perspective on the evolution of the NCD burden towards the future and to give an indication of the potential of prevention policy. A Non-Homogenous, Semi-Markov model for the EU was constructed, which allowed for a projection of the cost burden for the four main NCDs (cancer, cardiovascular disease, chronic respiratory disease and diabetes mellitus) towards 2030 and 2050. This simulation is done based on multiple baseline scenarios that vary in demand and supply factors such as health status, population structure, and technological advances. Finally, in order to assess the potential of preventive measures to curb the cost explosion of NCDs, a simulation is executed which includes increased efforts for preventive health care measures. According to the Markov model, by 2030 and 2050, total costs (direct and indirect costs) in the EU could increase by 30.1% and 44.1% respectively, compared to 2015 levels. An ambitious prevention policy framework for NCDs will be required if the EU wants to meet this challenge of rising costs. To conclude, significant cost increases due to Non-Communicable Diseases are likely to occur due to demographic and lifestyle changes. Nevertheless, an ambitious prevention program throughout the EU can aid in making this cost burden manageable for future generations.

Keywords: non-communicable diseases, preventive health care, health policy, Markov model, scenario analysis

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11463 Factors Affecting on Mid-Career Training for Arab Journalists, United Arab Emirates Case Study

Authors: Maha Abdulmajeed, Nagwa Fahmy

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Improving journalism practice in the UAE requires a clear understanding of the mid-career training environment; what Arab journalists’ think about the professional training available to them, what training needs they have and still not achieved, and what factors they think it could help to improve the mid-career training outcomes. This research paper examines the validity and effectiveness of mid-career professional journalistic training in the UAE. The research focuses on Arab journalists’ perceptions and attitudes towards professional training, and the state of journalistic training courses available to them, in comparison to modern trends of professional training. The two main objectives of this paper are to examine how different factors affect the effectiveness of the mid-career training offered to Arab Journalists in UAE, whether they are institutional factories, socio-economic factors, personal factors, etc. Then, to suggest a practical roadmap to improve the mid-career journalism training in the UAE. The research methodology combines qualitative and quantitative approaches. As researchers conduct in-depth interviews with a sample of Arab journalists in the UAE, Media outlets in UAE encompass private and governmental entities, with media products in Arabic and/or English, online and/or offline as well. Besides, content analysis will be applied to the available online and offline journalistic training courses offered to Arab journalists’ in UAE along the past three years. Research outcomes are expected to be helpful and practical to improve professional training in the UAE and to determine comprehensive and concrete criteria to provide up-to-date professional training, and to evaluate its validity. Results and research outcomes can help to better understand the current status of mid-career journalistic training in the UAE, to evaluate it based on studying both; the targeted trainees and the up-to-date journalistic training trends.

Keywords: Arab journalists, Arab journalism culture, journalism practice, journalism and technology

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11462 A Theoretical Framework on International Voluntary Health Networks

Authors: Benet Reid, Nina Laurie, Matt Baillie-Smith

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Trans-national and tropical medicine, historically associated with colonial power and missionary activity, is now central to discourses of global health and development, thrust into mainstream media by events like the 2014 Ebola crisis and enshrined in the Sustainable Development Goals. Research in this area remains primarily the province of health professional disciplines, and tends to be framed within a simple North-to-South model of development. The continued role of voluntary work in this field is bound up with a rhetoric of partnering and partnership. We propose, instead, the idea of International Voluntary Health Networks (IVHNs) as a means to de-centre global-North institutions in these debates. Drawing on our empirical work with IVHNs in countries both North and South, we explore geographical and sociological theories for mapping the multiple spatial and conceptual dynamics of power manifested in these phenomena. We make a radical break from conventional views of health as a de-politicised symptom or corollary of social development. In studying health work as it crosses between cultures and contexts, we demonstrate the inextricably political nature of health and health work everywhere.

Keywords: development, global health, power, volunteering

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11461 Cultural Competence and Healthcare Challenges of Migrants in South Wales United Kingdom

Authors: Qirat Naz, Abasiokpon Udoakah

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In developed countries, global migration is diversifying. The minority ethnic population, including refugees and asylum seekers who, fled their home countries due to war, terrorism, oppression, or natural disasters, and returning home is dangerous for them. They need sanctuary and peaceful environment in host countries. They begin the process of acculturation, in which a person adopts the social mores and behavioral patterns of the dominant culture, yet they still have unique multicultural needs that the dominant society fails to address. The aim of this research is to provide a holistic understanding of the living experiences of a minority population, particularly migrants, including asylum seekers and refugees, in the health and social care system of South Wales. The purpose of this study is to investigate three research objectives: the multicultural health care needs of minorities, as well as the barriers to seeking health and social care facilities. There are Welsh policies for promoting cultural competence in the health and social care sectors; this research will explore the implications and impact of these policies on the target population. This research study will be conducted using qualitative research methods, tools, and techniques. This research is an inductive approach to coming up with a grounded theory. The sample will be divided into two groups: migrants and professionals providing any kind of services to migrants; each group will contain 30 participants. Interpretive phenomenological analysis would be utilized during the process of coding and developing the main themes of this research. The positionality of the researcher would be minimized by unloaded and open-ended questions, researcher’s work experience in research, continuous evaluation of her positionality, daily base reflection of fieldwork and seeking the help of male and female gatekeepers. The research findings would be based on emic perspective, and by documenting the emic perspective of minorities, this research will contribute to the knowledge of appropriate channels, including organizations, academics, and policymakers, to discover possible solutions and coping mechanisms to deal with the challenges and meet the multicultural demands of minorities. This research will provide a more in-depth understanding of minorities and will help to promote the diversity of health and social care in South Wales.

Keywords: migration, migrants, cultural competence, cultural barriers, healthcare challenges

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11460 Medical and Surgical Nursing Care

Authors: Nassim Salmi

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Postoperative mobilization is an important part of fundamental care. Increased mobilization has a positive effect on recovery, but immobilization is still a challenge in postoperative care. Aims: To report how the establishment of a national nursing database was used to measure postoperative mobilization in patients undergoing surgery for ovarian cancer. Mobilization was defined as at least 3 hours out of bed on postoperative day 1, with the goal set at achieving this in 60% of patients. Clinical nurses on 4400 patients with ovarian cancer performed data entry. Findings: 46.7% of patients met the goal for mobilization on the first postoperative day, but variations in duration and type of mobilization were observed. Of those mobilized, 51.8% had been walking in the hallway. A national nursing database creates opportunities to optimize fundamental care. By comparing nursing data with oncological, surgical, and pathology data, it became possible to study mobilization in relation to cancer stage, comorbidity, treatment, and extent of surgery.

Keywords: postoperative care, gynecology, nursing documentation, database

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11459 Personal Characteristics and Personality Traits as Predictors of Compassion Fatigue among Counselors from Dominican Schools in the Philippines

Authors: Neil Jordan M. Uy, Fe Pelilia V. Hernandez

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A counselor is always regarded as a professional who embodies the willingness to help others through the process of counseling. He is knowledgeable and skillful of the different theories, tools, and techniques that are useful in aiding the client to cope with their dilemmas. The negative experiences of the clients that are shared during the counseling session can affect the professional counselor. Compassion fatigue, a professional impairment, is characterized by the decline of one’s productivity and the feeling of anxiety and stress brought about as the counselor empathizes, listens, and cares for others. This descriptive type of research aimed to explore variables that are predictors of compassion fatigue utilizing three research instruments; Demographic Profile Sheet, Professional Quality of Life Scale, and Neo-Pi-R. The 52 respondents of this study were counselors from the different Dominican schools in the Philippines. Generally, the counselors have low level of compassion fatigue across personal characteristics (age, gender, years of service, highest educational attainment, and professional status) and personality traits (extraversion, agreeableness, conscientiousness, openness, and neuroticism). ANOVA validated the findings of this that among the personal characteristics and personality traits, extraversion with f-value of 3.944 and p-value of 0.026, and conscientiousness, with f-value of 4.125 and p-value of 0.022 were found to have significant difference in the level of compassion fatigue. A very significant difference was observed with neuroticism with f-value of 6.878 and p-value 0.002. Among the personal characteristics and personal characteristics, only neuroticism was found to predict compassion fatigue. The computed r2 value of 0.204 using multiple regression analysis suggests that 20.4 percent of compassion fatigue can be predicted by neuroticism. The predicting power of neuroticism can be computed from the regression model Y=0.156x+26.464; where x is the number of neuroticism.

Keywords: big five personality traits, compassion fatigue, counselors, professional quality of life scale

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11458 Suicide Wrongful Death: Standard of Care Problems Involving the Inaccurate Discernment of Lethal Risk When Focusing on the Elicitation of Suicide Ideation

Authors: Bill D. Geis

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Suicide wrongful death forensic cases are the fastest rising tort in mental health law. It is estimated that suicide-related cases have accounted for 15% of U.S. malpractice claims since 2006. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from U.S. state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. Research in recent years, however, has indicated that the majority of persons who end their lives do not say they are suicidal at their last medical or psychiatric contact. Near-term risk assessment—that goes beyond verbalized suicide ideation—is needed. Our previous research employed structural equation modeling to predict lethal suicide risk--eight negative thought patterns (feeling like a burden on others, hopelessness, self-hatred, etc.) mediated by nine transdiagnostic clinical factors (mental torment, insomnia, substance abuse, PTSD intrusions, etc.) were combined to predict acute lethal suicide risk. This structural equation model, the Lethal Suicide Risk Pattern (LSRP), Acute model, had excellent goodness-of-fit [χ2(df) = 94.25(47)***, CFI = .98, RMSEA = .05, .90CI = .03-.06, p(RMSEA = .05) = .63. AIC = 340.25, ***p < .001.]. A further SEQ analysis was completed for this paper, adding a measure of Acute Suicide Ideation to the previous SEQ. Acceptable prediction model fit was no longer achieved [χ2(df) = 3.571, CFI > .953, RMSEA = .075, .90% CI = .065-.085, AIC = 529.550].This finding suggests that, in this additional study, immediate verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The LSRP and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training. Without this training, the standard of care for suicide assessment is out of sync with current research—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: forensic evaluation, standard of care, suicide, suicide assessment, wrongful death

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11457 From a Top Sport Event to a Sporting Activity

Authors: Helge Rupprich, Elke Knisel

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In a time of mediazation and reduced physical movement, it is important to change passivity (akinesa) into physical activity to improve health. The approach is to encourage children, junior athletes, recreational athletes, and semi-professional athletes to do sports while attending a top sport event. The concept has the slogan: get out off your seat and move! A top sport event of a series of professional beach volleyball tournaments with 330.000 life viewers, 13,70 million cumulative reach viewers and 215,13 million advertising contacts is used as framework for different sports didactic approaches, social integrative approaches and migration valuations. An important aim is to use the big radiant power of the top sport event to extract active participants from the viewers of the top sport event. Even if it is the goal to improve physical activity, it is necessary to differentiate between the didactic approaches. The first approach contains psycho motoric exercises with children (N=158) between two and five years which was used in the project ‘largest sandbox of the city’. The second approach is social integration and promotion of activity of students (N=54) in the form of a student beach volleyball tournament. The third approach is activity in companies. It is based on the idea of health motivation of employees (N=62) in a big beach volleyball tournament. Fourth approach is to improve the sports leisure time activities of recreational athletes (N=292) in different beach volleyball tournaments. Fifthly approach is to build a foreign friendly measure which is implemented in junior athlete training with the French and German junior national team (N=16). Sixthly approach is to give semi professional athletes a tournament to develop their relation to active life. Seventh approach is social integration for disadvantaged people (N=123) in form of training with professional athletes. The top sport beach volleyball tournament had 80 athletes (N=80) and 34.000 viewers. In sum 785 athletes (N=785) did sports in 13 days. Over 34.000 viewers where counted in the first three days of top sport event. The project was evaluated positively by the City of Dresden, Politics of Saxony and the participants and will be continued in Dresden and expanded for the season 2015 in Jena.

Keywords: beach volleyball, event, sports didactic, sports project

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11456 Psychological Factors of Readiness of Defectologists to Professional Development: On the Example of Choosing an Educational Environment

Authors: Inna V. Krotova

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The study pays special attention to the definition of the psychological potential of a specialist-defectologist, which determines his desire to increase the level of his or her professional competence. The group included participants of the educational environment – an additional professional program 'Technologies of psychological and pedagogical assistance for children with complex developmental disabilities' implemented by the department of defectology and clinical psychology of the KFU jointly with the Support Fund for the Deafblind people 'Co-Unity'. The purpose of our study was to identify the psychological aspects of the readiness of the specialist-defectologist to his or her professional development. The study assessed the indicators of psychological preparedness, and its four components were taken into account: motivational, cognitive, emotional and volitional. We used valid and standardized tests during the study. As a result of the factor analysis of data received (from Extraction Method: Principal Component Analysis, Rotation Method: Varimax with Kaiser Normalization, Rotation converged in 12 iterations), there were identified three factors with maximum factor load from 24 indices, and their correlation coefficients with other indicators were taken into account at the level of reliability p ≤ 0.001 and p ≤ 0.01. Thus the system making factor was determined – it’s a 'motivation to achieve success'; it formed a correlation galaxy with two other factors: 'general internality' and 'internality in the field of achievements', as well as with such psychological indicators as 'internality in the field of family relations', 'internality in the field of interpersonal relations 'and 'low self-control-high self-control' (the names of the scales used is the same as names in the analysis methods. In conclusion of the article, we present some proposals to take into account the psychological model of readiness of specialists-defectologists for their professional development, to stimulate the growth of their professional competence. The study has practical value for all providers of special education and organizations that have their own specialists-defectologists, teachers-defectologists, teachers for correctional and ergotherapeutic activities, specialists working in the field of correctional-pedagogical activity (speech therapists) to people with special needs who need true professional support.

Keywords: psychological readiness, defectologist, professional development, psychological factors, special education, professional competence, innovative educational environment

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11455 Method of Nursing Education: History Review

Authors: Cristina Maria Mendoza Sanchez, Maria Angeles Navarro Perán

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Introduction: Nursing as a profession, from its initial formation and after its development in practice, has been built and identified mainly from its technical competence and professionalization within the positivist approach of the XIX century that provides a conception of the disease built on the basis of to the biomedical paradigm, where the care provided is more focused on the physiological processes and the disease than on the suffering person understood as a whole. The main issue that is in need of study here is a review of the nursing profession's history to get to know how the nursing profession was before the XIX century. It is unclear if there were organizations or people with knowledge about looking after others or if many people survived by chance. The holistic care, in which the appearance of the disease directly affects all its dimensions: physical, emotional, cognitive, social and spiritual. It is not a concept from the 21st century. It is common practice, most probably since established life in this world, with the final purpose of covering all these perspectives through quality care. Objective: In this paper, we describe and analyze the history of education in nursing learning in terms of reviewing and analysing theoretical foundations of clinical teaching and learning in nursing, with the final purpose of determining and describing the development of the nursing profession along the history. Method: We have done a descriptive systematic review study, doing a systematically searched of manuscripts and articles in the following health science databases: Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL. The selection of articles has been made according to PRISMA criteria, doing a critical reading of the full text using the CASPe method. A compliment to this, we have read a range of historical and contemporary sources to support the review, such as manuals of Florence Nightingale and John of God as primary manuscripts to establish the origin of modern nursing and her professionalization. We have considered and applied ethical considerations of data processing. Results: After applying inclusion and exclusion criteria in our search, in Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL, we have obtained 51 research articles. We have analyzed them in such a way that we have distinguished them by year of publication and the type of study. With the articles obtained, we can see the importance of our background as a profession before modern times in public health and as a review of our past to face challenges in the near future. Discussion: The important influence of key figures other than Nightingale has been overlooked and it emerges that nursing management and development of the professional body has a longer and more complex history than is generally accepted. Conclusions: There is a paucity of studies on the subject of the review to be able to extract very precise evidence and recommendations about nursing before modern times. But even so, as more representative data, an increase in research about nursing history has been observed. In light of the aspects analyzed, the need for new research in the history of nursing emerges from this perspective; in order to germinate studies of the historical construction of care before the XIX century and theories created then. We can assure that pieces of knowledge and ways of care were taught before the XIX century, but they were not called theories, as these concepts were created in modern times.

Keywords: nursing history, nursing theory, Saint John of God, Florence Nightingale, learning, nursing education

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11454 Delegation or Assignment: Registered Nurses’ Ambiguity in Interpreting Their Scope of Practice in Long Term Care Settings

Authors: D. Mulligan, D. Casey

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Introductory Statement: Delegation is when a registered nurse (RN) transfers a task or activity that is normally within their scope of practice to another person (delegatee). RN delegation is common practice with unregistered staff, e.g., student nurses and health care assistants (HCAs). As the role of the HCA is increasingly embedded as a direct care and support role, especially in long-term residential care for older adults, there is RN uncertainty as to their role as a delegator. The assignment is when a task is transferred to a person that is within the role specification of the delegatee. RNs in long-term care (LTC) for older people are increasingly working in teams where there are less RNs and more HCAs providing direct care to the residents. The RN is responsible and accountable for their decision to delegate and assign tasks to HCAs. In an interpretive, multiple case studies to explore how delegation of tasks by RNs to HCAs occurred in long-term care settings in Ireland the importance of the RN understanding their scope of practice emerged. Methodology: Focus group interviews and individual interviews were undertaken as part of a multiple case study. Both cases, anonymized as Case A and Case B, were within the public health service in Ireland. The case study sites were long-term care settings for older adults located in different social care divisions, and in different geographical areas. Four focus group interviews with staff nurses and three individual interviews with CNMs were undertaken. The interactive data analysis approach was the analytical framework used, with within-case and cross-case analysis. The theoretical lens of organizational role theory, applying the role episode model (REM), was used to understand, interpret, and explain the findings. Study Findings: RNs and CNMs understood the role of the nurse regulator and the scope of practice. RNs understood that the RN was accountable for the care and support provided to residents. However, RNs and CNM2s could not describe delegation in the context of their scope of practice. In both cases, the RNs did not have a standardized process for assessing HCA competence to undertake nursing tasks or interventions. RNs did not routinely supervise HCAs. Tasks were assigned and not delegated. There were differences between the cases in relation to understanding which nursing tasks required delegation. HCAs in Case A undertook clinical vital sign assessments and documentation. HCAs in Case B did not routinely undertake these activities. Delegation and assignment were influenced by the organizational factors, e.g., model of care, absence of delegation policies, inadequate RN education on delegation, and a lack of RN and HCA role clarity. Concluding Statement: Nurse staffing levels and skill mix in long-term care settings continue to change with more HCAs providing more direct care and support. With decreasing RN staffing levels RNs will be required to delegate and assign more direct care to HCAs. There is a requirement to distinguish between RN assignment and delegation at policy, regulation, and organizational levels.

Keywords: assignment, delegation, registered nurse, scope of practice

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11453 Evaluating the Knowledge and Skill of Final Year Pharmacy Students in Maternal and Child Health at a University in South Africa

Authors: E. O. Egieyeh, N. Butler, R. Coetzee, M. Van Huyssteen, A. Bheekie

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Background: High rate of maternal and child mortality is a global concern. Nationally, it constitutes one of South Africa’s quadruple burdens of diseases. Pharmacists have a crucial role in maternal and child health care delivery and as such should be equipped with adequate knowledge and skill required to contribute to maternal and child well-being. The International Pharmaceutical Federation statement of policy (2013) outlines pharmacist-led interventions in accordance with the World Health Organisation’s interventions in maternal, new-born and child health care. The South African Pharmacy Council’s guideline on Good Pharmacy Practice (2010) also stipulates the minimum standards required to participate in reproductive, maternal and child care. Pharmacy schools are obliged to train pharmacy students to meet priority health needs of the population so that graduates are ‘fit for purpose’. The purpose of the study is to evaluate the knowledge and skill of final year pharmacy students at a university in South Africa to determine their preparedness to contribute effectively to maternal and child health care. Method: A quantitative, descriptive, non-randomized baseline study was conducted among the final year students at the School of Pharmacy. Data was collected using a questionnaire designed in sections to assess knowledge of contraception, maternal and child health directed at the primary care level and framed within the scope of practice required of an entry-level generalist pharmacist. Participants’ skill in infant growth assessment was assessed in a section of the questionnaire in a written format. Participants ticked the topics they had been exposed to on a curriculum content assessment tool which was not graded. A pilot study examined the clarity and suitability of question items, and duration to complete the questionnaire. A score of 50% in each section of the questionnaire indicated a pass. The questionnaire was delivered in campus lecture venue. Results: Of the 102 students in final year, 53 (52%) students consented to participate in the study. Only 13.2% of participants scored above 50% in each section. Forty five (85%) participants scored above 50% in the contraception section while 40 (75%) scored less than 50% in the skills assessment. Less than half (45.3%) of the participants had a total score above 50%. Being a parent or working part-time as pharmacist assistance did not have any influence on the performance of the participants. Evaluation of participants’ curriculum content exposure showed differences in exposure to the various topics. Exposure to contraception teaching received the most recognition. Conclusion: Maternal and child health curriculum content should be reviewed at the university to enhance the knowledge and skill of pharmacy graduates.

Keywords: final year pharmacy students, knowledge and skill, maternal and child health, South Africa

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11452 Big Data and Cardiovascular Healthcare Management: Recent Advances, Future Potential and Pitfalls

Authors: Maariyah Irfan

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Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

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11451 Kiira EV Project Transition from Student to Professional Team through Project-Based Skills Development

Authors: Doreen Orishaba, Paul Isaac Musasizi, Richard Madanda, Sandy Stevens Tickodri-Togboa

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The world of academia tends to be a very insular place. Consequently, scholars who successfully completed their undergraduate and graduate studies are unpleasantly surprised at how challenging the transition to corporate life can get. This is a global trend even as the students who juggle work with attending some of the most demanding and best graduate programs may not easily adjust to and confirm to the professionalism required for corporate management of the industry. This paper explores the trends in the transition of Kiira EV Project from a predominantly student team to a professional team of a national pride program through mentorship and apprenticeship. The core disciplines within the Kiira EV Project include Electrical and Electronics Engineering, Mechanical Engineering, and Industrial Design.

Keywords: mentorship, apprenticeship, professional, development

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11450 Fostering Teacher Professional Well-being: Understanding the Impact of School Administration Leadership and Other Factors

Authors: Monika Simkute-Bukante

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Teachers significantly influence student achievements, personal development, and academic success. Consequently, they are subject to heightened expectations and scrutiny from governments, school administrations, parents, and even students. Increasing responsibilities and pressures impact teachers’ professional well-being, contributing to a global trend of increased teacher turnover and shortages due to stress and heavy workloads. Given the critical role of teachers in educating young people, it is essential to implement strategies to retain them. School administrations are pivotal in creating an environment conducive to optimal performance. However, there remains a gap in understanding how school administration leadership impacts teachers' professional well-being and its potential for improvement. This research aims to define teacher professional well-being, identify its attributes, and explore the factors influencing it, with a particular focus on the role of school administration. Employing the concept analysis method, this study reviews scholarly publications from 2019 to 2024 to articulate the components of teacher professional well-being. The findings highlight key attributes of teacher well-being, including self-efficacy, work engagement, job satisfaction, relationships with colleagues and students, support from administration, work autonomy, school climate, time pressure, workload, resilience, stress, burnout, and turnover intentions. The analysis demonstrates that school administration leadership directly affects these aspects by providing support in challenging situations, empowering teachers, offering recognition, facilitating open communication, and ensuring autonomy at work. In conclusion, the research shows that teachers' professional well-being is heavily dependent on relationships with school administration, colleagues, and students, as well as the overall school climate. It suggests that by enhancing these elements, school leaders can significantly improve teacher professional well-being. Recommendations are made for developing strategies to support these relationships, thereby fostering an environment that enhances teacher retention and effectiveness.

Keywords: concept analysis, teacher professional well-being, school administration leadership, well-being factors

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11449 Determining Face-Validity for a Set of Preventable Drug-Related Morbidity Indicators Developed for Primary Healthcare in South Africa

Authors: D. Velayadum, P. Sthandiwe , N. Maharaj, T. Munien, S. Ndamase, G. Zulu, S. Xulu, F. Oosthuizen

Abstract:

Introduction and aims of the study: It is the responsibility of the pharmacist to manage drug-related problems in order to ensure the greatest benefit to the patient. In order to prevent drug-related morbidity, pharmacists should be aware of medicines that may contribute to certain drug-related problems due to their pharmacological action. In an attempt to assist healthcare practitioners to prevent drug-related morbidity (PDRM), indicators for prevention have been designed. There are currently no indicators available for primary health care in developing countries like South Africa, where the majority of the population access primary health care. There is, therefore, a need to develop such indicators, specifically with the aim of assisting healthcare practitioners in primary health care. Methods: A literature study was conducted to compile a comprehensive list of PDRM indicators as developed internationally using the search engines Google Scholar and PubMed. MESH term used to retrieve suitable articles was 'preventable drug-related morbidity indicators'. The comprehensive list of PDRM indicators obtained from the literature study was further evaluated for face validity. Face validity was done in duplicate by 2 sets of independent researchers to ensure 1) no duplication of indicators when compiling a single list, 2) inclusion of only medication available in primary healthcare, and 3) inclusion of medication currently available in South Africa. Results: The list of indicators, compiled from PDRM indicators in the USA, UK, Portugal, Australia, India, and Canada contained 324 PDRM. 184 of these indicators were found to be duplicates, and the duplications were omitted, leaving a final list of 140. The 140 PDRM indicators were evaluated for face-validity, and 97 were accepted as relevant to primary health care in South Africa. 43 indicators did not comply with the criteria and were omitted from the final list. Conclusion: This study is a first step in compiling a list of PDRM indicators for South Africa. It is important to take cognizance to the fact the health systems differ vastly internationally, and it is, therefore, important to develop country-specific indicators.

Keywords: drug-related morbidity, primary healthcare, South Africa, developing countries

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11448 Data Model to Predict Customize Skin Care Product Using Biosensor

Authors: Ashi Gautam, Isha Shukla, Akhil Seghal

Abstract:

Biosensors are analytical devices that use a biological sensing element to detect and measure a specific chemical substance or biomolecule in a sample. These devices are widely used in various fields, including medical diagnostics, environmental monitoring, and food analysis, due to their high specificity, sensitivity, and selectivity. In this research paper, a machine learning model is proposed for predicting the suitability of skin care products based on biosensor readings. The proposed model takes in features extracted from biosensor readings, such as biomarker concentration, skin hydration level, inflammation presence, sensitivity, and free radicals, and outputs the most appropriate skin care product for an individual. This model is trained on a dataset of biosensor readings and corresponding skin care product information. The model's performance is evaluated using several metrics, including accuracy, precision, recall, and F1 score. The aim of this research is to develop a personalised skin care product recommendation system using biosensor data. By leveraging the power of machine learning, the proposed model can accurately predict the most suitable skin care product for an individual based on their biosensor readings. This is particularly useful in the skin care industry, where personalised recommendations can lead to better outcomes for consumers. The developed model is based on supervised learning, which means that it is trained on a labeled dataset of biosensor readings and corresponding skin care product information. The model uses these labeled data to learn patterns and relationships between the biosensor readings and skin care products. Once trained, the model can predict the most suitable skin care product for an individual based on their biosensor readings. The results of this study show that the proposed machine learning model can accurately predict the most appropriate skin care product for an individual based on their biosensor readings. The evaluation metrics used in this study demonstrate the effectiveness of the model in predicting skin care products. This model has significant potential for practical use in the skin care industry for personalised skin care product recommendations. The proposed machine learning model for predicting the suitability of skin care products based on biosensor readings is a promising development in the skin care industry. The model's ability to accurately predict the most appropriate skin care product for an individual based on their biosensor readings can lead to better outcomes for consumers. Further research can be done to improve the model's accuracy and effectiveness.

Keywords: biosensors, data model, machine learning, skin care

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11447 The Implementation of a Nurse-Driven Palliative Care Trigger Tool

Authors: Sawyer Spurry

Abstract:

Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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11446 A Bayesian Approach for Health Workforce Planning in Portugal

Authors: Diana F. Lopes, Jorge Simoes, José Martins, Eduardo Castro

Abstract:

Health professionals are the keystone of any health system, by delivering health services to the population. Given the time and cost involved in training new health professionals, the planning process of the health workforce is particularly important as it ensures a proper balance between the supply and demand of these professionals and it plays a central role on the Health 2020 policy. In the past 40 years, the planning of the health workforce in Portugal has been conducted in a reactive way lacking a prospective vision based on an integrated, comprehensive and valid analysis. This situation may compromise not only the productivity and the overall socio-economic development but the quality of the healthcare services delivered to patients. This is even more critical given the expected shortage of the health workforce in the future. Furthermore, Portugal is facing an aging context of some professional classes (physicians and nurses). In 2015, 54% of physicians in Portugal were over 50 years old, and 30% of all members were over 60 years old. This phenomenon associated to an increasing emigration of young health professionals and a change in the citizens’ illness profiles and expectations must be considered when planning resources in healthcare. The perspective of sudden retirement of large groups of professionals in a short time is also a major problem to address. Another challenge to embrace is the health workforce imbalances, in which Portugal has one of the lowest nurse to physician ratio, 1.5, below the European Region and the OECD averages (2.2 and 2.8, respectively). Within the scope of the HEALTH 2040 project – which aims to estimate the ‘Future needs of human health resources in Portugal till 2040’ – the present study intends to get a comprehensive dynamic approach of the problem, by (i) estimating the needs of physicians and nurses in Portugal, by specialties and by quinquenium till 2040; (ii) identifying the training needs of physicians and nurses, in medium and long term, till 2040, and (iii) estimating the number of students that must be admitted into medicine and nursing training systems, each year, considering the different categories of specialties. The development of such approach is significantly more critical in the context of limited budget resources and changing health care needs. In this context, this study presents the drivers of the healthcare needs’ evolution (such as the demographic and technological evolution, the future expectations of the users of the health systems) and it proposes a Bayesian methodology, combining the best available data with experts opinion, to model such evolution. Preliminary results considering different plausible scenarios are presented. The proposed methodology will be integrated in a user-friendly decision support system so it can be used by politicians, with the potential to measure the impact of health policies, both at the regional and the national level.

Keywords: bayesian estimation, health economics, health workforce planning, human health resources planning

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11445 A Case Study on Indian Translation Ecosystem of Point-Of-Care Solutions

Authors: Tripta Dixit, Smita Sahu, William Selvamurthy, Sadhana Srivastava

Abstract:

The translation of healthcare technologies is an expensive, complex affair, current healthcare challenges in Asian countries and their efforts to meet Millennium Development Goals (MDGs), necessitates continuous technology advancement to save countless lives, improve the quality of life and for socio-economic development. India’s consistently improving global innovation index (57) demonstrates its innovation potential, but access to health care is asymmetric and lacks priority in India. Therefore, there is utmost need of a robust translation system for point-of-care (POC) solutions, inexpensive, low-maintenance, reliable, and easy-to-use diagnostic technologies. Few cases of POC technologies viz. Elisa based diagnostic kits for regional viral disease, a device for detection of cancerous lesions were studied to understand the process and challenges involved in their translation. Accordingly, the entire translation ecosystem was summarized proposing a nexus of various actors such as technology developer, technology transferor technology receiver, funding entities, government/regulatory bodies and their effect on translation of different medical technologies. This study highlights the role and concerns pertaining to these actors for POC such as unsystematic and unvalidated research roadmap, low profit preposition, unfocused approach of up-scaling, low market acceptability and multiple window regulatory framework, etc. This provides an opportunity to devise solutions to overcome problem areas in translation path.

Keywords: healthcare technologies, point-of-care solutions, public health, translation

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11444 Innovation of Teaching Methods in Vocational Education with Popularity Development Process

Authors: Hong Zeng

Abstract:

In the process of popularization of higher education, it is necessary to innovate teaching methods in order to make the students cultivated suitable for the needs of social development. This paper discusses the limitations and shortcomings of the traditional teaching method of teaching approach to a person's aptitude, personality, and interest and introduces the new teaching method of teaching approach to a person's personality. The teaching approach to a person's personality is a target teaching method that aims to develop students' potential and cultivate professional talents. Therefore, teachers should be professional and can adopt modern teaching methods from the Internet so that students can clearly understand the course and the knowledge structure. Finally, the students using new teaching methods can enhance their motivation to study and quickly acquire professional skills.

Keywords: higher education, personality, target education, student-centered

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11443 Acceptance and Feasibility of Delivering an Evidence-based Digital Intervention for Palliative Care Education

Authors: Areej Alosimi, Heather Wharrad, Katharine Whittingham

Abstract:

Palliative care is a crucial element in nursing, especially with the steep increase in non-communicable diseases. Providing education in palliative care can help elevate the standards of care and address the growing need for it. However, palliative care has not been introduced into nursing curricula, specifically in Saudi Arabia, evidenced by students' inadequate understanding of the subject. Digital learning has been identified as a persuasive and effective method to improve education. The study aims to assess the feasibility and accessibility of implementing digital learning in palliative care education in Saudi Arabia by investigating the potential of delivering palliative care nurse education via distance learning. The study will utilize a sequential exploratory mixed-method approach. Phase one will entail identifying needs, developing a web-based program in phase two, and intervention implementation with a pre-post-test in phase three. Semi-structured interviews will be conducted to explore participant perceptions and thoughts regarding the intervention. Data collection will incorporate questionnaires and interviews with nursing students. Data analysis will use SPSS to analyze quantitative measurements and NVivo to analyze qualitative aspects. The study aims to provide insights into the feasibility of implementing digital learning in palliative care education. The results will serve as a foundation to investigate the effectiveness of e-learning interventions in palliative care education among nursing students. This study addresses a crucial gap in palliative care education, especially in nursing curricula, and explores the potential of digital learning to improve education. The results have broad implications for nursing education and the growing need for palliative care globally. The study assesses the feasibility and accessibility of implementing digital learning in palliative care education in Saudi Arabia. The research investigates whether palliative care nurse education can be effectively delivered through distance learning to improve students' understanding of the subject. The study's findings will lay the groundwork for a larger investigation on the efficacy of e-learning interventions in improving palliative care education among nursing students. The study can potentially contribute to the overall advancement of nursing education and the growing need for palliative care.

Keywords: undergraduate nursing students, E-Learning, Palliative care education, Knowledge

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11442 Knowledge and Capabilities of Primary Caregivers in Providing Quality Care for Elderly Patients with Post- Operative Hip Fracture, Songklanagarind Hospital

Authors: Manee Hasap, Mongkolchai Hasap, Tasanee Nasae

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The purpose of this study was to evaluate the primary caregivers’ knowledge and capabilities for providing quality care to be hospitalized post-hip fracture surgery elderly patients. The theoretical framework of the study was derived from the concepts of dependent care agency in Orem’s Self-Care theory, and family care provision for the elderly and chronically ill patients. 59 subjects were purposively selected. The subjects were primary caregivers of post-operated hip fracture elderly patients who had been admitted to the Orthopaedic Ward of Songklanagarind Hospital. Demographic data of the caregivers and patients were collected by non-participant observation using the evaluation and recording forms. The reliability of caregivers’ knowledge measurement (0.86) was obtained by KR-20 and that of caregivers’ capabilities for post-operative care evaluation form (0.97) obtained from 2 observers by interrater reliability. The data were analyzed using descriptive statistic, which were frequency, percentage, mean, and standard deviation. The result of this study indicated that elderly patients with post-hip fracture surgery had many pre-discharge self care limitations. Approximately, 75% of the caregivers had knowledge to respond to patient’s essential needs at a high level, while the rest (25%) had this knowledge a moderate level. For observation, 57.63% of the subjects had capabilities in care practice at a moderate level; 28.81% had capabilities in care practice at a high level, while 13.56% had at a low level. The result of this study can be used as basic information for patients and caregivers capabilities developing plan especially, providing patients’ activities, accident surveillance and complications prevention for a good life quality of elderly patients after hip surgery both hospitalization and rehabilitation at home.

Keywords: care givers’ knowledge, care givers’ capabilities, elderly hip fracture patients, patients

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11441 Organizational Culture of a Public and a Private Hospital in Brazil

Authors: Fernanda Ludmilla Rossi Rocha, Thamiris Cavazzani Vegro, Silvia Helena Henriques Camelo, Carmen Silvia Gabriel, Andrea Bernardes

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Introduction: Organizations are cultural, symbolic and imaginary systems composed by values and norms. These values and norms represent the organizational culture, which determines the behavior of the workers, guides the work practices and impacts the quality of care and the safety culture of health services worldwide. Objective: To analyze the organizational culture of a public and a private hospital in Brazil. Method: Descriptive study with quantitative approach developed in a public and in a private hospital of Brazil. Sample was composed by 281 nursing workers, of which 73 nurses and 208 nursing auxiliaries and technicians. The data collection instrument comprised the Brazilian Instrument for Assessing Organizational Culture. Data were collected from March to December 2013. Results: At the public hospital, the results showed an average score of 2.85 for the values concerning cooperative professionalism (CP); 3.02 for values related to hierarchical rigidity and the centralization of power (HR); 2.23 for individualistic professionalism and competition at work (IP); 2.22 for values related to satisfaction, well-being and motivation of workers (SW); 3.47 for external integration (EI); 2.03 for rewarding and training practices (RT); 2.75 for practices related to the promotion of interpersonal relationships (IR) About the private hospital, the results showed an average score of 3.24 for the CP; 2.83 for HR; 2.69 for IP; 2.71 for SW; 3.73 for EI; 2.56 for RT; 2.83 for IR at the hospital. Discussion: The analysis of organizational values of the studied hospitals shows that workers find the existence of hierarchical rigidity and the centralization of power in the institutions; believed there was cooperation at workplace, though they perceived individualism and competition; believed that values associated with the workers’ well-being, satisfaction and motivation were seldom acknowledged by the hospital; believed in the adoption of strategic planning actions within the institution, but considered interpersonal relationship promotion, continuous education and the rewarding of workers to be little valued by the institution. Conclusion: This work context can lead to professional dissatisfaction, compromising the quality of care and contributing to the occurrence of occupational diseases.

Keywords: nursing management, organizational culture, quality of care, interpersonal relationships

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11440 Being Your Own First Responder: A Training to Identify and Respond to Mental Health

Authors: Joe Voshall, Leigha Shoup

Abstract:

In 2022, the Ohio Peace Officer Training Council and the Attorney General required officers to complete a minimum of 24 hours of continued professional training for the year. Much of the training was based on Mental Health or similarly related topics. This includes Officer Wellness and Officer Mental Health. It is becoming clearer that the stigma of Officer / First Responder Mental Health is a topic that is becoming more prevalently faced. To assist officers and first responders in facing mental health issues, we are developing new training. This training will aid in recognizing mental health-related issues in officers/first responders and citizens, as well as further using the same information to better respond and interact with one another and the public. In general, society has many varying views of mental health, much of which is largely over-sensationalized by television, movies, and other forms of entertainment. There has also been a stigma in law enforcement / first responders related to mental health and being weak as a result of on-the-job-related trauma-induced struggles. It is our hope this new training will assist officers and first responders in not only positively facing and addressing their mental health but using their own experience and education to recognize signs and symptoms of mental health within individuals in the community. Further, we hope that through this recognition, officers and first responders can use their experiences and more in-depth understanding to better interact within the field and with the public. Through recognition and better understanding of mental health issues and more positive interaction with the public, additional achievements are likely to result. This includes in the removal of bias and stigma for everyone.

Keywords: law enforcement, mental health, officer related mental health, trauma

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11439 Trauma System in England: An Overview and Future Directions

Authors: Raheel Shakoor Siddiqui, Sanjay Narayana Murthy, Manikandar Srinivas Cheruvu, Kash Akhtar

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Major trauma is a dynamic public health epidemic that is continuously evolving. Major trauma care services rely on multi-disciplinary team input involving highly trained pre and in-hospital critical care teams. Pre-hospital critical care teams (PHCCTs), major trauma centres (MTCs), trauma units, and rehabilitation facilities all form an efficient and organised trauma system. England comprises 27 MTCs funded by the National Health Service (NHS). Major trauma care entails enhanced resuscitation protocols coupled with the expertise of dedicated trauma teams and rapid radiological imaging to improve trauma outcomes. Literature reports a change in the demographic of major trauma as elderly patients (silver trauma) with injuries sustained from a fall of 2 metres or less commonly present to services. Evidence of an increasing population age with multiple comorbidities necessitates treatment within the first hour of injury (golden hour) to improve trauma survival outcomes. Staffing and funding pressures within the NHS have subsequently led to a shortfall of available physician-led PHCCTs. Thus, there is a strong emphasis on targeted research and funding to appropriately deploy resources to deprived areas. This review article will discuss the current English trauma system whilst critically appraising present challenges, identifying insufficiencies, and recommending aims for an improved future trauma system in England.

Keywords: trauma, orthopaedics, major trauma, trauma system, trauma network

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11438 A Dimensional Approach to Family Involvement in Forensic Mental Health Settings - Prevention of the Systemic Replication of Abuse, Need for Accepted Falsehoods and Family Guilt and Shame

Authors: Katie E. Jennings

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The interactions between family dynamics and environmental factors with mental health vulnerability in individuals are well known and are a theme for on-going research and debate. The impact upon mental health issues and forensic issues on family dynamics, experience, and emotional wellbeing cannot be over-Emphasised. For forensic patients with diagnosed mental disorders, these relationships and environments may have also been functionally linked to the development and maintenance of those disorders; with significant adverse childhood experiences being a common feature of many Patient’s histories. Mental health hospitals remove the patient from their home environments and provide treatment outside of these relationships and often outside of the home area. There is, therefore, a major focus on Services ensuring that patients are able to build and maintain relationships with family and friends, requiring services to involve families in Patients' care and treatment wherever possible. There are standards set by Government and clinical bodies that require absolute demonstration of the inclusion of family and friends in all aspects of the care and treatment of forensic patients. For some patients and family members, this push to take on a “role” in care can be unhelpful, extremely stressful, and has constant implications for the potential delicate reparation of relationships. Based on work undertaken for over 20 years in forensic mental health settings, this paper explores the positive psychology approach to a dimensional model to family inclusion in mental health care that learns from family court work and allows for the maintenance of relationships to be at both proximal and Distil levels; to prevent the replication of abuse, decrease the need for falsehoods and assist the recovery of all. The model is based on allowing families to choose to not be involved or be involved in different ways if this is seen to be more helpful. It also allows patients to choose the level of potential involvement that they would find helpful, and for this to be reviewed at a timeframe agreed by all parties, rather than when the next survey is due or the patient has a significant care meeting. This paper is significant as there is a lack of research to support services to use a positive psychology approach to work in this area, the assumption that being asked to be involved must be positive for all seems naïve at best for this patient group. Work relating to the psychology of family can significantly contribute to the development of knowledge in this area. The development of a dimensional model will support choice within families and assist in the development of more honest and open relationships.

Keywords: family dynamics, forensic, mental disorder, positive psychology

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11437 Exploring Affordable Care Practs in Nigeria’s Health Insurance Discourse

Authors: Emmanuel Chinaguh, Kehinde Adeosun

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Nigerians die untimely, with 55.75 years of life expectancy, which is 17.45 below the world average of 73.2 (Worldometer, 2020). This is due, among other factors, to the country's limited access to high-quality healthcare. To increase access to good and affordable healthcare services, the National Health Insurance Authority (NHIA) Bill 2022 – which repealed the National Health Insurance Scheme Act 2004 – was passed into law. Applying Jacob Mey’s (2001) pragmatics act (pract) theory, this study explores how NHIA seeks to actualise these healthcare goals by characterising the general situational prototype or pragmemes and pragmatic acts in institutional communications. Data was sourced from the NHIA operational guidelines, which has 147 pages and four sections, and shared posters on NHIA Nigeria Twitter Handle with 14,200 followers. Digital humanities tools, like AntConc and Voyant, were engaged in the data analysis for text encoding and data visualisation. This study identifies these discourse tokens in the data: advertisement and programmes, standards and accreditation, records and information, and offences and penalties. Advertisement and programmes pract facilitating, propagating, prospecting, advising and informing; standards and accreditation, and records and information pract stating, informing and instructing; and offences and penalties pract stating and sanctioning. These practs combined to advance the goals of affordable care and universal accessibility to quality healthcare services. The pragmatic acts were marked by these pragmatic tools: shared situational knowledge (SSK), relevance (REL), reference (REF) and inference (INF). This paper adds to the understanding of health insurance discourse in Nigeria as a mediated social practice that promotes the health of Nigerians.

Keywords: affordable care, NHIA, Nigeria’s health insurance discourse, pragmatic acts.

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11436 Using Wearable Technology to Monitor Perinatal Health: Perspectives of Community Health Workers and Potential Use by Underserved Perinatal Women in California

Authors: Tamara Jimah, Priscilla Kehoe, Pamela Pimentel, Amir Rahmani, Nikil Dutt, Yuqing Guo

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Ensuring equitable access to maternal health care is critical for public health. Particularly for underserved women, community health workers (CHWs) have been invaluable in providing support through health education and strategies for improved maternal self-care management. Our research aimed to assess the acceptance of technology by CHWs and perinatal women to promote healthy pregnancy and postpartum wellness. This pilot study was conducted at a local community organization in Orange County, California, where CHWs play an important role in supporting low-income women through home visitations. Questionnaires were administered to 14 CHWs and 114 pregnant and postpartum women, literate in English and/or Spanish. CHWs tested two wearable devices (Galaxy watch and Oura ring) and shared their user experience, including potential reception by the perinatal women they served. In addition, perinatal women provided information on access to a smart phone and the internet, as well as their interest in using wearable devices to self-monitor personal health with guidance from a CHW. Over 85% of CHWs agreed that it was useful to track pregnancy with the smart watch and ring. The majority of perinatal women owned a smartphone (97.4%), had access to the internet (80%) and unlimited data plans (78%), expressed interest in using the smart wearable devices to self-monitor health, and were open to receiving guidance from a CHW (87%). Community health workers and perinatal women embraced the use of wearable technology to monitor maternal health. These preliminary findings have formed the basis of an ongoing research study that integrates CHW guidance and technology (i.e., smart watch, smart ring, and a mobile phone app) to promote self-efficacy and self-management among underserved perinatal women.

Keywords: community health workers, health promotion and education, health equity, maternal and child health, technology

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