Search results for: nutrition intervention

Authors: Mohua Chatterjee, Rajib De

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Introduction: Bone Marrow Transplant (BMT) is often performed to treat patients with various types of leukemia. A majority of these patients develop complications like chronic musculoskeletal GVHD post-BMT where patients get scleroderma, pain and restricted range of motion of joints of hand. If not treated early, it may cause permanent deformity of hand. This study was done to find the effectiveness of physiotherapy in hand dysfunction caused due to chronic musculoskeletal GVHD of leukemia patients after BMT. Methodology: 23 patients diagnosed with leukemia and having musculoskeletal GVHD were treated with a set of exercises including active exercises and stretching. The outcome was measured by Cochin Hand Function Scale (CHFS) at baseline and after four weeks of intervention. Results: Two patients were not able to carry out exercises beyond two weeks due to relapse of disease and one patient defaulted. It was found that all the patients who received physiotherapy had significant improvement in hand function. Mean CHFS decreased from 63.67 to 27.43 (P value < 0.001) indicating improvement in hand function after four weeks of physiotherapy. Conclusion: Early intervention of physiotherapy is effective in reducing hand dysfunction of leukemia patients with musculoskeletal GVHD post-BMT.

Keywords: bone marrow transplant, hand dysfunction, leukemia, musculoskeletal graft versus host disease, physiotherapy

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Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

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Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

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Authors: V. Viliene, V. Sasyte, A. Raceviciute-Stupeliene, R. Gruzauskas

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In horse nutrition, the most suitable cereal for their rations composition could be defined as oats and barley. Oats have high nutritive value because it provides more protein, fiber, iron and zinc than other whole grains, has good taste, and an activity of stimulating metabolic changes in the body. Another cereal – barley is very similar to oats as a feed except for some characteristics that affect how it is used; however, barley is lower in fiber than oats and is classified as a "heavy" feed. The value of oats and barley grain, first of all is dependent on its composition. Near-infrared spectroscopy (NIRS) has long been considered and used as a significant method in component and quality analysis and as an emerging technology for authenticity applications for cereal quality control. This paper presents the chemical and amino acid composition of different varieties of barley and oats, also digestible energy of different cereals for horses. Ten different spring barley (n = 5) and oats (n = 5) varieties, grown in one location in Lithuania, were assayed for their chemical composition (dry matter, crude protein, crude fat, crude ash, crude fiber, starch) and amino acids content, digestible amino acids and amino acids digestibility. Also, the grains digestible energy for horses was calculated. The oats and barley samples reflectance spectra were measured by means of NIRS using Foss-Tecator DS2500 equipment. The chemical components: fat, crude protein, starch and fiber differed statistically (P<0.05) between the oats and barley varieties. The highest total amino acid content between oats was determined in variety Flamingsprofi (4.56 g/kg) and the lowest – variety Circle (3.57 g/kg), and between barley - respectively in varieties Publican (3.50 g/kg) and Sebastian (3.11 g/kg). The different varieties of oats digestible amino acid content varied from 3.11 g/kg to 4.07 g/kg; barley different varieties varied from 2.59 g/kg to 2.94 g/kg. The average amino acids digestibility of oats varied from 74.4% (Liz) to 95.6% (Fen) and in barley - from 75.8 % (Tre) to 89.6% (Fen). The amount of digestible energy in the analyzed varieties of oats and barley was an average compound 13.74 MJ/kg DM and 14.85 MJ/kg DM, respectively. An analysis of the results showed that different varieties of oats compared with barley are preferable for horse nutrition according to the crude fat, crude fiber, ash and separate amino acids content, but the analyzed barley varieties dominated the higher amounts of crude protein, the digestible Liz amount and higher DE content, and thus, could be recommended for making feed formulation for horses combining oats and barley, taking into account the chemical composition of using cereal varieties.

Keywords: barley, digestive energy, horses, nutritional value, oats

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Authors: Ogbonna Olelewe

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This quality improvement project seeks to address the background and significance of promoting antidepressant (AD) medication adherence to reduce depression symptoms in patients diagnosed with major depression. This project aims to substantiate using daily encrypted short message service (SMS) text reminders to take prescribed antidepressant medications with the goal of increasing medication adherence to reduce depression scores in patients diagnosed with major depression, thereby preventing relapses and increasing remission rates. Depression symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) scale. The PHQ-9 provides a total score of depression symptoms from mild to severe, ranging from 0 to 27. A -pretest/post-test design was used, with a convenience sample size of 35 adult patients aged 18 years old to 45 years old, diagnosed with MDD, and prescribed at least one antidepressant for one year or more. Pre- and post-test PHQ-9 scores were conducted to compare depression scores before and after the four-week intervention period. The results indicated improved post-intervention PHQ-9 scores, improved AD medication adherence, and a significant reduction in depression symptoms.

Keywords: major depressive disorder, antidepressants, short message services, text reminders, Medication adherence/non-adherence, Patient Health Questionnaire 9

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Authors: Tracie Catlett

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Students enrolled in high-achieving schools are under tremendous pressure to perform at high levels inside and outside the classroom. Achievement pressure is a prevalent source of stress for students enrolled in high-achieving schools, and female students in particular experience a higher frequency and higher levels of stress compared to their male peers. The practice of mindfulness in a school setting is one tool that has been linked to improved self-regulation of emotions, increased positive emotions, and stress reduction. A mixed methods randomized pretest-posttest no-treatment control trial, evaluated the effects of a six-session mindfulness intervention taught during a regularly scheduled life skills period in an independent day school, one type of high-achieving school. Twenty-nine students in Grades 10 and 11 were randomized by class where Grade 11 students were in the intervention group (n = 14) and Grade 10 students were in the control group (n = 15). Findings from the study produced mixed results. There was no evidence that the mindfulness program reduced participants’ stress levels and negative emotions. In fact, contrary to what was expected, students enrolled in the intervention group experienced higher levels of stress and increased negative emotions at posttreatment when compared to pretreatment. Neither the within-group nor the between-groups changes in stress level were statistically significant, p > .05, and the between-groups effect size was small, d = .2. The study found evidence that the mindfulness program may have had a positive impact on students’ ability to regulate their emotions. The within-group comparison and the between-groups comparison at posttreatment found that students in the mindfulness course experienced statistically significant improvement in the in their ability to regulate their emotions at posttreatment, p = .009 < .05 and p =. 034 < .05, respectively. The between-groups effect size was medium, d =.7, suggesting that the positive differences in emotion regulation difficulties were substantial and have practical implications. The analysis of gender differences as they relate to stress and emotions revealed that female students perceive higher levels of stress and report experiencing stress more often than males. There were no gender differences when analyzing sources of stress experienced by the student participants. Both females and males experience regular achievement pressures related to their school performance and worry about their future, college acceptance, grades, and parental expectations. Females reported an increased awareness of their stress and actively engaged in practicing mindfulness to manage their stress. Students in the treatment group expressed that the practice of mindfulness resulted in feelings of relaxation and calmness.

Keywords: achievement pressure, adolescents, emotion regulation, emotions, high-achieving schools, independent schools, mindfulness, negative affect, positive affect, stress

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Authors: Dana Zelicha

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A 6-week mindfulness programme was launched to improve the well being and performance of 20 managers (including the supervisor) of an international corporation in London. A unique assessment methodology was customised to the organisation’s needs, measuring four parameters: prioritising skills, listening skills, mindfulness levels and happiness levels. All parameters showed significant improvements (p < 0.01) post intervention, with a remarkable increase in listening skills and mindfulness levels. Although corporate mindfulness programmes have proven to be effective, the challenge remains the low engagement levels at home and the implementation of these tools beyond the scope of the intervention. This study has offered an innovative approach to enforce home engagement levels, which yielded promising results. The programme launched with a 2-day introduction intervention, which was followed by a 6-week training course (1 day a week; 2 hours each). Participants learned all basic principles of mindfulness such as mindfulness meditations, Mindfulness Based Stress Reduction (MBSR) techniques and Mindfulness Based Cognitive Therapy (MBCT) practices to incorporate into their professional and personal lives. The programme contained experiential mindfulness meditations and innovative mindfulness tools (OWBA-MT) created by OWBA - The Well Being Agency. Exercises included Mindful Meetings, Unitasking and Mindful Feedback. All sessions concluded with guided discussions and group reflections. One fundamental element of this programme was engagement level outside of the workshop. In the office, participants connected with a mindfulness buddy - a team member in the group with whom they could find support throughout the programme. At home, participants completed online daily mindfulness forms that varied according to weekly themes. These customised forms gave participants the opportunity to reflect on whether they made time for daily mindfulness practice, and to facilitate a sense of continuity and responsibility. At the end of the programme, the most engaged team member was crowned the ‘mindful maven’ and received a special gift. The four parameters were measured using online self-reported questionnaires, including the Listening Skills Inventory (LSI), Mindfulness Attention Awareness Scale (MAAS), Time Management Behaviour Scale (TMBS) and a modified version of the Oxford Happiness Questionnaire (OHQ). Pre-intervention questionnaires were collected at the start of the programme, and post-intervention data was collected 4-weeks following completion. Quantitative analysis using paired T-tests of means showed significant improvements, with a 23% increase in listening skills, a 22% improvement in mindfulness levels, a 12% increase in prioritising skills, and an 11% improvement in happiness levels. Participant testimonials exhibited high levels of satisfaction and the overall results indicate that the mindfulness programme substantially impacted the team. These results suggest that 6-week mindfulness programmes can improve employees’ capacities to listen and work well with others, to effectively manage time and to experience enhanced satisfaction both at work and in life. Limitations noteworthy to consider include the afterglow effect and lack of generalisability, as this study was conducted on a small and fairly homogenous sample.

Keywords: corporate mindfulness, listening skills, organisational well being, prioritising skills, mindful leadership

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Authors: Elham Abbas Aljaaly, Nahlaa Abdulwahab Khalifa

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The active method of disease prevention is seen as the most affordable and sustainable action to deal with risks of non-communicable diseases such as obesity. This eight-week project aimed to pilot the feasibility and acceptability of a school-based programme, which is proposed to prevent and modify overweight status and possible related risk factors among student girls 'at the intermediate level' in Jeddah city. The programme was conducted through comprehensible approach targeting physical environment and school policies (nutritional/exercise/behavioural approach). The programme was designed to cultivate the personal and environmental awareness in schools for girls. This was applied by promoting healthy eating and physical activity through policies, physical education, healthier options for school canteens, and the creation of school health teams. The prevention programme was applied on 68 students (who agreed to participate) from grades 7th, 8th and 9th. A pre and post assessment questionnaire was employed on 66 students. The questionnaires were designed to obtain information on students' knowledge about health, nutrition and physical activity. Survey questions included information about nutrients, food consumption patterns, food intake and lifestyle. Physical education included training sessions for new opportunities for physical activities to be performed during school or after school hours. A running competition 'to enhance students’ performance for physical activities' was also conducted during the school visit. A visit to the school canteen was conducted to check, observe, record and assess all available food/beverage items and meals. The assessment method was a subjective method for the type of food/beverages if high in saturated fat, salt and sugar (HFSS) or non-HFSS. The school canteen administrators were encouraged to provide healthy food/beverage items and a sample healthy canteen was provided for implementation. Two healthy options were introduced to the school canteen. A follow up for students’ preferences for the introduced options and the purchasing power were assessed. Thirty-eight percent of young girls (n=26) were not participating in any form of physical activities inside or outside school. Skipping breakfast was stated by 42% (n=28) of students with no daily consumption (19%, n=13) for fruit/vegetables. Significant changes were noticed in students’ (n=66) overall responses to the pre and post questions (P value=.001). All students had participated in the conducted running competition sessions and reported satisfaction and enjoyment about the sessions. No absence was reported by the research team for attending physical education and activity sessions throughout the delivered programme. The purchasing power of the introduced healthy options of 'Salad and oatmeal' was increased to 18% in 8 weeks at the school canteen, and slightly affected the purchase for other less healthy options. The piloted programme indorsed better health and nutrition knowledge, healthy eating and lifestyle attitude, which could help young girls to obtain sustainable changes. It is expected that the outcomes of the programme will be a cornerstone for the futuristic national study that will assist policy makers and participants to build a knowledgeable health promotion scenario and make sure that school students have access to healthy foods, physical exercise and healthy lifestyle.

Keywords: adolescents, diet, exercise, behaviours, overweight/obesity, prevention-intervention programme, Saudi Arabia, schoolgirls

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Authors: Mildred Moreno Villanueva

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Public space is essential to strengthen the social and urban fabric and the social cohesion; there lies the importance of its study. Hence, the aim of this paper is to analyze the quality of public space in the XXI century in both quantitative and qualitative terms. In this article, the concept of public space includes open spaces such as parks, public squares and walking areas. To make this analysis we take Mexico City as the case study. It has a population of nearly 9 million inhabitants and it is composed of sixteen boroughs. For this analysis, we consider both, existing public spaces and the government intervention for building and improvement of new and existent public spaces. Results show that on the one hand, quantitatively there is not an equitable distribution of public spaces because of both, the growth of the city itself, as well as for the absence of political will to create public spaces. Another factor is the evolution of this city, which has been growing merely in a 'patched pattern', where public space has played no role at all with a total absence of urban design. On the other hand, qualitatively, even the boroughs with the most public spaces have not shown interest in making these spaces qualitatively inclusive and open to the general population aiming for integration. Therefore, urban projects that privatize public space seem to be the rule, rather than a rehabilitation effort of the existent public spaces. Hence, state intervention should reinforce its role as an agent of social change acting in the benefit of the majority of the inhabitants with the promotion of more inclusive public spaces.

Keywords: exclusion, inclusion, Mexico City, public space

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Authors: Jung Yoon Kim

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Introduction: Wounds inevitably cause patients to experience discomfort, distress, and consequentially reduced quality of life due to entailed pain, maceration, and foul odor. The dressing has been a universal wound care method in which wounds are covered and protected, and an optimum environment for healing is provided. This study aimed to investigate Korean nurses’ level of awareness of pain and skin tearing in wound beds and/or peri-wound skin at dressing change. Methods: A descriptive study was performed. Convenience sampling was employed, and registered nurses were recruited from attendees of continuing education program. A total of 399 participants (RN) completed the questionnaire. Data were collected from September to November 2022. Results: Many of them perceived skin tearing and wound-related pain associated with dressing changes, but most of them did not assess and record pain and skin tearing at dressing change. More than half of the respondents reported that they did not provide nursing intervention to prevent pain and skin tearing. Many of them reported that a systematic educational program for preventing pain and skin tearing at dressing changes was needed. Discussion: Many of the respondents were aware of pain and skin tearing at dressing change but did not take any further necessary measures, including nursing intervention, for the most appropriate, systematic pain and skin tearing management. Therefore, this study suggested that a systematic and comprehensive educational program for Korean healthcare professionals needs to be developed and implemented in Korea’s hospital settings.

Keywords: skin tearing, pain, dressing change, nurses

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Authors: Jennifer Hunter, Francisco Ramirez, Neil A. Nedley, Thania Solorio, Christian Freed, Erica Kinjo

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People who have autoimmune disease are often at an increased risk for psychological disorders such as anxiety. Untreated psychological conditions can affect the development of disease and can affect one’s general quality of life. In this study, it was hypothesized that an educational community-based intervention would be useful in decreasing the anxiety levels of participants with autoimmune disease. Programs, 2-hours long each, were held weekly over a period of eight weeks. During every meeting, a 45-minute DVD presentation by a skilled physician was shown, a small group discussion was guided by trained facilitators, and weekly practical assignments were given to each participant. The focus of the program was to educate participants about healthy lifestyle behaviors such as exercise, nutrition, sleep hygiene, helpful thought patterns etc., and to provide a group environment in which each participant was supported. Participants were assessed pre-post program for anxiety using the Depression and Anxiety Assessment Test (registration TX 7-398-022), a validated mental health test based on DSM-5 criteria and demographics. Anxiety scores were classified according to the DSM-5 criteria into 4 categories: none (0-6), mild (7-10), moderate (11-19) or severe (20 or more). Out of the participants who participated in programs conducted in the manner explained above (n=431), the average age was 54.9 (SD 16.6) and 81.9% were female. At baseline, the mean group anxiety level was 9.4 (SD 5.4). Within the baseline group, anxiety levels were as follows: none (21.1%), mild (22.0%), moderate (27.1%) and severe (29.7%). After the program, mean group anxiety decreased to 4.7 (SD 4.0). Post-program anxiety levels were as follows: none (54.8%), mild (27.1%), moderate (12.5%), severe (5.6%). The decrease in overall anxiety levels was significant t(431)=19.3 p<.001, 95% CI [0.815, 1.041]. It was concluded that the eight-week intensive was beneficial in decreasing the anxiety levels of participants. A long-term follow-up study would be beneficial in determining how lasting such improvements are especially since autoimmune diseases are often chronic. Additionally, future studies that utilize a control group would aid in establishing whether the improvements seen are due to the use of this specific lifestyle-educational program.

Keywords: anxiety, auto-immune disease, community-based educational program, lifestyle

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Authors: Rebecca S. Hock, Cyralene P. Bryce, Kevin Williams, Arielle G. Rabinowitz, Janina R. Galler

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Background: Findings have been mixed regarding whether offspring of parents who were abused or neglected as children have a greater risk of experiencing abuse or neglect themselves. In addition, many studies on this topic are restricted to physical abuse and take place in a limited number of countries, representing a small segment of the world's population. Methods: We examined relationships between childhood maltreatment history assessed in a subset (N=68) of the original longitudinal birth cohort (G1) of the Barbados Nutrition Study and their now-adult offspring (G2) (N=111) using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We used Pearson correlations to assess relationships between parent and offspring CTQ-SF total and subscale scores (physical, emotional, and sexual abuse; physical and emotional neglect). Next, we ran multiple regression analyses, using the parental CTQ-SF total score and the parental Sexual Abuse score as primary predictors separately in our models of G2 CTQ-SF (total and subscale scores). Results: G1 total CTQ-SF scores were correlated with G2 offspring Emotional Neglect and total scores. G1 Sexual Abuse history was significantly correlated with G2 Emotional Abuse, Sexual Abuse, Emotional Neglect, and Total Score. In fully-adjusted regression models, parental (G1) total CTQ-SF scores remained significantly associated with G2 offspring reports of Emotional Neglect, and parental (G1) Sexual Abuse was associated with offspring (G2) reports of Emotional Abuse, Physical Abuse, Emotional Neglect, and overall CTQ-SF scores. Conclusions: Our findings support a link between parental exposure to childhood maltreatment and their offspring's self-reported exposure to childhood maltreatment. Of note, there was not an exact correspondence between the subcategory of maltreatment experienced from one generation to the next. Compared with other subcategories, G1 Sexual Abuse history was the most likely to predict G2 offspring maltreatment. Further studies are needed to delineate underlying mechanisms and to develop intervention strategies aimed at preventing intergenerational transmission.

Keywords: trauma, family, adolescents, intergenerational trauma, child abuse, child neglect, global mental health, North America

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Authors: Siti Rahmah Fitrianti, Mela Milani

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Inadequate of water intake has negative effects on the health of the body, which can cause kidney failure and death. One of the factors that can affect someone intake of water is level of knowledge about the importance of water intake itself. A good knowledge of the daily water intake can increase the awareness of daily needed of water intake. Therefore, researchers initiated a study on the relationship of water intake to the level of knowledge related with water intake in food workers, at “Puspa” Hospital. Type of this research is quantitative research with cross-sectional approach. The research data was collected by measuring the independent and dependent variable at a time. This study took place in the food production unit of Nutrition Installation in "Puspa" Hospital, Jakarta in October 2016. The population target in this study were workers in food production unit aged 30-64 years. The instrument was a questionnaire question regarding water intake and 24 hours food recall. The result is 78.6% of respondents have less knowledge about the importance of water intake. Meanwhile, as many as 85.7% of respondents have adequate water intake. Tested by Chi-Square test, showed that no significant relationship between water intake with the level of knowledge related to water intake in workers of food production unit. Adequate intake of water in food workers commonly may be not caused by the level of knowledge related to water intake, but it may be cause of work environment factor which has a high temperature.

Keywords: food production unit, food workers, level of knowledge, water intake

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Authors: Zeineb Yousse, Fakher Kharrat

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Mosaic is a part of a broad universal cultural heritage; sometimes it represents a rather essential source for the researches on the everyday life of some of the previous civilizations. Tunisia has one of the finest and largest collections of mosaics in the world, which is essentially exhibited in the Museums of Bardo and Sousse. Restored and reconstituted, they bear witnesses to hard work. Our paper deals with the discipline of conservation of Roman mosaics based on the proceedings of the workshop of the Museum of Sousse. Thus, we highlight two main objectives. In the first place, it is a question of revealing the techniques adopted by professionals to handle mosaics and to which school of conservation these techniques belong. In the second place, we are going to interpret the works initiated to preserve the archaeological heritage in order to protect it in present time and transmit it to future generations. To this end, we paid attention to four Roman mosaics currently exhibited in the Museum of Sousse. These Mosaics show different voids or gaps at the level of their surfaces and the method used to fill these gaps seems to be interesting to analyze. These mosaics are known under the names of: Orpheus Charming the Animals, Gladiator and Bears, Stud farm of Sorothus and finally Head of Medusa. The study on the conservation passes through two chained phases. We start with a small historical overview in order to gather information related to the original location, the date of its composition as well as the description of its image. Afterward, the intervention process is analyzed by handling three complementary elements which are: diagnosis of the existing state, the study of the medium processing and the study of the processing of the tesselatum surface which includes the pictorial composition of the mosaic. Furthermore, we have implemented an evaluation matrix with six operating principles allowing the assessment of the appropriateness of the intervention. These principles are the following: minimal intervention, reversibility, compatibility, visibility, durability, authenticity and enhancement. Various accumulated outcomes are pointing out the techniques used to fill the gaps as well as the level of compliance with the principles of conservation. Accordingly, the conservation of mosaics in Tunisia is a practice that combines various techniques without really arguing about the choice of a particular theory.

Keywords: conservation, matrix, museum of Sousse, operating particular theory, principles, Roman mosaics

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Authors: Dyego Ramos Henrique, Viviane Pimentel, Katia Souto, Ana Valéria Mendonça, Andrea Gallassi

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Socioeconomic inequalities in Brazil have accentuated the aggravations of poverty among the most vulnerable populations, among which are the quilombola communities. The objective was to reflect on a situation of food and nutritional security in two Brazilian quilombola communities. The data were collected by means of reports of experience through the production of talk wheels in two quilombola communities (Itamatatiua and Mesquita), located in the cities of Alcântara and Cidade Ocidental. Access to health services and health promotion actions were still incipient in the quilombola communities visited. The perceptions of the participants of the quilombolas revealed that there are still repressed demands that have rendered the fulfillment of the principles of equity, universality and integrality, both for access to health and for access and availability of food. They recognize in governmental instances a socioeconomic-cultural valorization and nutritional qualities intrinsic to the foods produced by them. Although they have been used as communities of quilombolas live and their level of access to services and programs, dealing with quilombola communities does not mean dealing with 'isolated groups or a strictly homogeneous population.' It demands a great need of attention in relation to the access and availability of food, besides overcoming barriers that made it an unfeasible valuation of social, economic and cultural precepts, intrinsic to the thought about food and nutritional security in Brazilian quilombos.

Keywords: access to services, food and nutrition security, health promotion, quilombo population

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Authors: Pavel Svoboda, Oldřich Müller

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The paper contains a screening of the opinions of helping professional workers working in a home for seniors with individuals with neurocognitive disorders and compares them with the opinions of a younger generation of students who are just preparing for this work. The authors carried out a comparative questionnaire survey with both target groups, focusing on the analysis and comparison of possible differences in their knowledge in the field of care for elderly people with neurocognitive disorders. Specifically, they focused on knowledge and experience with approaches, methods and tools applicable within the framework of music therapy interventions, as they are understood in practice in comparison with the theoretical knowledge of secondary school students focused on social work. The questionnaire was mainly aimed at assessing the knowledge of the possibilities of effective memory stimulation of the elderly and their communication skills using the means of music. The conducted investigation was based on the research of studies dealing with so-called non-pharmacological approaches to the given clientele; for professional caregivers, it followed music therapy lessons, which the authors regularly implemented from the beginning of 2022. Its results will, among other things, serve as the basis for an upcoming study with a scoping design review.

Keywords: neurocognitive disorders, seniors, music therapy intervention, melody, rhythm, text, memory stimulation, communication skills

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Authors: V. Moser-Siegmeth, M. C. Gambal, M. Jelovcak, B. Prytek, I. Swietalsky, D. Würzl, C. Fida, V. Mühlegger

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Adaptability is the capacity to adjust without great difficulty to changing circumstances. Within our project, we aimed to detect whether older people living within a long-term care hospital lose the ability to adapt. Theoretical concepts are contradictory in their statements. There is also lack of evidence in the literature how the adaptability of older people changes over the time. Following research questions were generated: Are older residents of a long-term care facility able to adapt to changes within their daily routine? How long does it take for older people to adapt? The study was designed as a convergent parallel mixed method intervention study, carried out within a four-month period and took place within seven wards of a long-term care hospital. As a planned intervention, a change of meal-times was established. The inhabitants were surveyed with qualitative interviews and quantitative questionnaires and diaries before, during and after the intervention. In addition, a survey of the nursing staff was carried out in order to detect changes of the people they care for and how long it took them to adapt. Quantitative data was analysed with SPSS, qualitative data with a summarizing content analysis. The average age of the involved residents was 82 years, the average length of stay 45 months. The adaptation to new situations does not cause problems for older residents. 47% of the residents state that their everyday life has not changed by changing the meal times. 24% indicate ‘neither nor’ and only 18% respond that their daily life has changed considerably due to the changeover. The diaries of the residents, which were conducted over the entire period of investigation showed no changes with regard to increased or reduced activity. With regard to sleep quality, assessed with the Pittsburgh sleep quality index, there is little change in sleep behaviour compared to the two survey periods (pre-phase to follow-up phase) in the cross-table. The subjective sleep quality of the residents is not affected. The nursing staff points out that, with good information in advance, changes are not a problem. The ability to adapt to changes does not deteriorate with age or by moving into a long-term care facility. It only takes a few days to get used to new situations. This can be confirmed by the nursing staff. Although there are different determinants like the health status that might make an adjustment to new situations more difficult. In connection with the limitations, the small sample size of the quantitative data collection must be emphasized. Furthermore, the extent to which the quantitative and qualitative sample represents the total population, since only residents without cognitive impairments of selected units participated. The majority of the residents has cognitive impairments. It is important to discuss whether and how well the diary method is suitable for older people to examine their daily structure.

Keywords: adaptability, intervention study, mixed methods, nursing home residents

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Authors: Phan Hong, David Lishner, Matthew Hanson

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Sixty-five children across four school research sites participated in the present experiment, which was designed to examine whether mindfulness promotes eating enjoyment and diverse eating behaviors in preschool- and early elementary-age children. Children, ages 3-9 years old, were randomly assigned to a 4-week mindfulness intervention condition or a 4-week exposure, control condition. Each week for four days, children received one of four different foods (celery, cauliflower, kidney beans, or garbanzo beans). Children either received instructions to mindfully engage with the food or were given the food and allowed to eat without mindfulness prompts from the researchers. Following the eating exercise, they recorded the amount eaten and rated their enjoyment level. Across all sessions, researchers modeled eating behaviors for the children by eating all the offered food. Results suggested that a brief mindfulness intervention promoted more diverse eating behaviors and more overall food consumption of typically not preferred and unfamiliar foods (celery, cauliflower, and garbanzo beans), compared with an exposure, control condition in preschool children and elementary-age children. However, food enjoyment ratings did not significantly differ between the two conditions for any of the foods. Implications of the finding for addressing eating behavior of young children are considered.

Keywords: children, control trial, eating behavior, eating enjoyment, mindfulness, schools

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Authors: Tracie Catlett

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Students enrolled in high-achieving schools are under tremendous pressure to perform at high levels inside and outside the classroom. Achievement pressure is a prevalent source of stress for students enrolled in high-achieving schools, and female students, in particular, experience a higher frequency and higher levels of stress compared to their male peers. The practice of mindfulness in a school setting is one tool that has been linked to improved self-regulation of emotions, increased positive emotions, and stress reduction. A mixed methods randomized pretest-posttest no-treatment control trial evaluated the effects of a six-session mindfulness intervention taught during a regularly scheduled life skills period in an independent day school, one type of high-achieving school. Twenty-nine students in Grades 10 and 11 were randomized by class, where Grade 11 students were in the intervention group (n = 14) and Grade 10 students were in the control group (n = 15). Findings from the study produced mixed results. There was no evidence that the mindfulness program reduced participants’ stress levels and negative emotions. In fact, contrary to what was expected, students enrolled in the intervention group experienced higher levels of stress and increased negative emotions at posttreatment when compared to pretreatment. Neither the within-group nor the between-groups changes in stress level were statistically significant, p > .05, and the between-groups effect size was small, d = .2. The study found evidence that the mindfulness program may have had a positive impact on students’ ability to regulate their emotions. The within-group comparison and the between-groups comparison at posttreatment found that students in the mindfulness course experienced statistically significant improvement in the in their ability to regulate their emotions at posttreatment, p = .009 < .05 and p =. 034 < .05, respectively. The between-groups effect size was medium, d =.7, suggesting that the positive differences in emotion regulation difficulties were substantial and have practical implications. The analysis of gender differences, as they relate to stress and emotions, revealed that female students perceive higher levels of stress and report experiencing stress more often than males. There were no gender differences when analyzing sources of stress experienced by the student participants. Both females and males experience regular achievement pressures related to their school performance and worry about their future, college acceptance, grades, and parental expectations. Females reported an increased awareness of their stress and actively engaged in practicing mindfulness to manage their stress. Students in the treatment group expressed that the practice of mindfulness resulted in feelings of relaxation and calmness.

Keywords: achievement pressure, adolescents, emotion regulation, emotions, high-achieving schools, independent schools, mindfulness, negative affect, positive affect, stress

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Authors: Maryam Mousavi Nik, Sara Pasandian

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The aim of the current research was to determine the effectiveness of Cognitive-Behavioral Group Therapy (G-CBT) on stress, illness anxiety and obsessions-compulsion caused by the coronavirus crisis in adolescents (14-18-Year-olds) in Tehran, Iran. This research was carried out in the form of a semi-experimental study with a control group and in the framework of a pre-test and post-test design for both experimental and control groups. The statistical population of this research consisted of all high schools in Tehran in 2022. The sample size includes 32 Adolescents (14-18-Year-olds) who were selected using a cluster sampling method, and then they were randomly replaced in two experimental (n=16) and control (n=16) groups. In this research, an adolescent stress questionnaire (ASQ-N) with an emphasis on the impact of Coronavirus, Coronavirus disease anxiety (CDAS) and The Children's Yale-Brown Obsessive Compulsive Symptom Scale (CY-BOCS) emphasis on the Coronavirus were used, and group therapy intervention with The cognitive-behavioral approach was conducted for 8 sessions of 90 minutes in the experimental group. The research data were analyzed by Multivariate analysis of covariance (MANCOVA) and covariance (ANCVA) tests. The results of multivariate covariance analysis showed that group therapy intervention with a cognitive-behavioral approach had a significant effect on at least one of the variables of stress, illness anxiety and obsession-compulsion at the level (P<0.01, F=94.772) in the post-test stage. Also, the results of covariance analysis of one variable showed that group therapy intervention with a cognitive-behavioral approach in the level of (P<0.01, F=106.377) stress, in the level of (P<0.01, F=48.147) disease anxiety and in the level (P>0.01, F=17.033) of obsession-compulsion had a significant effect in the post-test stage. The results showed that The treatment with GCBT can be effective in decreasing stress, illness anxiety and obsessions and compulsion caused by the coronavirus crisis in Adolescents (15-20-Year-olds) and may be considered as an alternative to either individual cognitive-behavioral therapy or medication.

Keywords: stress, disease anxiety, obsession-compulsion, coronavirus (Covid-19) crisis, and cognitive-behavioral therapy

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Authors: Susan K. Steele-Moses, Aimee Badeaux

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Introduction: Nurse anesthesia education places high demands on students, creating stress and anxiety that can impact their success. Framed in Watson’s caring theory, the research question posed for this study was: What is the effect of a mindfulness application on the perceived stress and anxiety of nurse anesthesia students. Methods: A quantitative comparative research design was used to determine the effect of a mindfulness meditation application, Mindshift, on SRNA’s perceived stress and anxiety over time. The stress and anxiety subscales of the Depression Anxiety Stress Scale 21 (DASS-21) were used to measure the effectiveness of the intervention. After the IRB approval was obtained the 2024, 2025, and 2026 SRNA cohorts were invited to participate in the study (N = 56). Thirty-six students agreed to participate, completed the electronic informed consent, and the electronic DASS-21 baseline measure (64.3%). The Mindshift app was downloaded from the app store onto their personal device and the mindfulness meditation exercises were integrated into their daily routine. The stress and anxiety subscale of the DASS-21 was repeated at 1-month, 3-months, and 6-months, with 31 students completing all measures (86.1%). The difference over time was computed using a repeated measures ANCOVA. Results: Instrument reliability and validity was reconfirmed (Stress: α = .890; Anxiety: α = .788; χ2 = 232.898, p < .001). There was no difference in the student’s stress over time (F = 2.62, p = .079, η2 = .086). When the intervention was considered stress decreased at the 3- month (F = 4.497, p = .014, η2 .138) and 6-month (F = 7.998, p < .001, η2 = .222) intervals. Post-hoc analysis revealed no change between baseline and 1-month (p = .245) but improved from 1-month to 3-months (p = .014), 1-month to 6-months (p < .001), and 3-months to 6- months (p = .007). There was no difference in the student’s anxiety over time (F = .326, p = .683, η2 = .011) or at the three-month interval (F = .647 , p = .488, η2 .024), but anxiety decreased at the six-month interval (F = 4.686, p = .004, η2 = .143). Post-hoc analysis revealed no change between baseline and 1-month (p = .261) or 1-month to 3-months (p = .132). However the student’s anxiety significantly improved from 1-month to 6-months ( p < .001), and 3-months to 6-month (p = .014). Discussion: The mindfulness intervention reduced perceived stress and anxiety levels over time. The gradual decline in stress and the delayed improvement in anxiety suggest that continuous interventions are needed to achieve positive results. It is recommended that mindfulness meditation techniques are integrated into the curriculum highlighting the importance of longitudinal interventions.

Keywords: nurse anesthesia, nursing education, innovation in education, stress, anxiety

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Authors: Omer Zvi Shaked, Amir Tirosh

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Type 1 Diabetes (T1DM) is an incurable chronic illness with no known preventive measures. Excess to insulin therapy can lead to hypoglycemia with neuro-glycogenic symptoms such as shakiness, nausea, sweating, irritability, fatigue, excessive thirst or hunger, weakness, seizure, and coma. Severe Hypoglycemia (SH) is also considered a most aversive event since it may put patients at risk for injury and death, which matches the criteria of a traumatic event. SH has a ranging prevalence of 20%, which makes it a primary medical Issue. One of the results of SH is an intense emotional fear reaction resembling the form of post-traumatic stress symptoms (PTS), causing many patients to avoid insulin therapy and social activities in order to avoid the possibility of hypoglycemia. As a result, they are at risk for irreversible health deterioration and medical complications. Fear of Hypoglycemia (FOH) is, therefore, a major disturbance for T1DM patients. FOH differs from prevalent post-traumatic stress reactions to other forms of traumatic events since the threat to life continuously exists in the patient's body. That is, it is highly probable that orthodox interventions may not be sufficient for helping patients after SH to regain healthy social function and proper medical treatment. Accordingly, the current presentation will demonstrate the results of a study conducted among T1DM patients after SH. The study was designed in two stages. First, a preliminary qualitative phenomenological study among ten patients after SH was conducted. Analysis revealed that after SH, patients confuse between stress symptoms and Hypoglycemia symptoms, divide life before and after the event, report a constant sense of fear, a loss of freedom, a significant decrease in social functioning, a catastrophic thinking pattern, a dichotomous split between the self and the body, and internalization of illness identity, a loss of internal locus of control, a damaged self-representation, and severe loneliness for never being understood by others. The second stage was a two steps study of intervention among five patients after SH. The first part of the intervention included three months of therapeutic 3rd wave CBT therapy. The contents of the therapeutic process were: acceptance of fear and tolerance to stress; cognitive de-fusion combined with emotional self-regulation; the adoption of an active position relying on personal values; and self-compassion. Then, the intervention included a one-week practical real-time 24/7 support by trained medical personnel, alongside a gradual exposure to increased insulin therapy in a protected environment. The results of the intervention are a decrease in stress symptoms, increased social functioning, increased well-being, and decreased avoidance of medical treatment. The presentation will discuss the unique emotional state of T1DM patients after SH. Then, the presentation will discuss the effectiveness of the intervention for patients with chronic conditions after a traumatic event. The presentation will make evident the unique situation of illness-related PTSD. The presentation will also demonstrate the requirement for multi-professional collaboration between social work and medical care for populations with chronic medical conditions. Limitations of the study and recommendations for further research will be discussed.

Keywords: type 1 diabetes, chronic illness, post-traumatic stress, illness-related PTSD

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Authors: Ali Saghaei, Negar Ghotbeddin, Ebrahim Rajabzadeh Ghatrami, Milad Maniat

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The use of herbs as natural additives in fish diets are used to enhance the efficiency and safety systems. The use of herbs, garlic, due to the structure and composition of it has beneficial role in human nutrition and animal nutrition. This study was conducted evaluate the effect different levels of garlic (Allium sativum) powder on the some serum biochemical parameters of Oscar fish (Astronotus ocellatus). Fish were divided into four groups fed on diets containing garlic in different levels; 5 g kg˗1, 10 g kg-1, 20 g kg-1, 30 g kg-1 diet and the control group diet was without garlic. A total number of 300 fish was used and Triplicate groups of Oscar fish with initial weight of 12.43±0.24 g were hand-fed to visual satiation at three meals per day. The experiment extended for two months. Total Protein (TP), Albumin (ALB), Globulin (GLB) and Albumin/Globulin (A/G) ratio, were determined. Based on the results, no significant differences were seen among treatments and control groups during the experimental period for TP, ALB, GLB, and A/G ratio (p > 0.05). Although, the highest amount of serum total protein and globulin levels were observed in diet containing 10 g kg-1 of garlic. Also, the highest value of albumin and A/G were observed in diet containing 20 g kg-1 of garlic, but there were no significant difference with other treatments. The results of this study show that addition of garlic Allium sativum to fish diet can improve fish health.

Keywords: garlic (Allium sativum), serum, Oscar fish (Astronotus ocellatus), iran

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Authors: Zasha Romero, Roberto Trevino, Lin Wang, Elizabeth Alanis, Jesus Cuellar

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Background: There is a strong relationship between low cardiorespiratory fitness (CRF) and high adiposity levels. The purpose of this study was to assess the effects of the Bienestar/Neema Coordinated School Health Program (BN CSHP) on the CRF of preschool children. Methods: This is a randomized cluster trial conducted in preschools of two school districts located along the Texas-Mexico border. Of 48 eligible schools, 28 were randomly selected (intervention, n=14; control, n=14). Family demographics and household health characteristics were collected from parents. CRF, as measured by the Progressive Anaerobic Capacity Endurance Run (PACER) fitness test, was collected from the children. A generalized linear mixed model (GLMM) was used to analyze the data. Results: Family demographics, household health characteristics, and children’s weight, obesity prevalence, and sedentary activity were similar among both treatment groups. After adjusting for covariates, the number of laps run by children in the control group increased by 23% (CI: -5% to 60%) per each data collection period compared with 53% (CI: 7% to 119%) in the intervention group. Conclusions: Children in the BN CSHP, compared to those in the control group, had a significantly higher increase in their CRF. This finding is important because of the health benefits of CRF in children.

Keywords: coordinated school health program, cardiorespiratory fitness, obesity, border health, preschool, physical education, movement

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Authors: Funmilayo Abiola Opadoja, Samuel Olukayode Awotona

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Nursing services costing has been a major interest to nurses for a long period of time. Determination of nursing costing is germane in order to show the effectiveness of nursing practice in an improved and affordable health care delivery system. This has been a major concern of managers that have the mind of quality and affordable health services. The treatment or intervention should be considered as ‘product’ of nursing care and should provide an explainable term for billing. The study was non-experimental, descriptive and went about eliciting the views of nurses on costing nursing care at two public hospitals namely: University College Hospital and Adeoyo Maternity Teaching Hospital. The questionnaire was the instrument used in eliciting nurse’s response. It was administered randomly on 300 selected respondents across various wards within the hospitals. The data was collected and analysed using SPSS20.0 to generate frequency, and cross-tabulations to explore the statistical relationship between variables. The result shows that 89.2% of the respondents viewed costing of nursing care as an important issued to be looked into. The study concluded that nursing care costing is germane to enhancing the status and imagery of the nurses, it is essential because it would enhance the performance of nurses in discharging their duties. There is need to have a procedural manual agreed on by nursing practitioner on costing of each care given.

Keywords: costing, health care delivery system, intervention, nursing care, practitioner

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Authors: Jill Steel

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The interlinked issues of emotional wellbeing and attainment continue to dominate international educational discourse. Reading skills are particularly important to attainment in all areas of the curriculum, and illiteracy is associated with reduced wellbeing and life prospects, with serious ramifications for the wider economy and society. Research shows that reading attainment is influenced by reading motivation and frequency. Reading to Dogs (RTD) is increasingly applied to promote reading motivation and frequency in schools despite a paucity of empirical evidence, specifically examining the influence of RTD on emotional wellbeing and engagement with reading. This research aims to examine whether RTD is effective in promoting these positive outcomes among children aged eight to nine years. This study also aims to inform much needed regulation of the field and standards of practice, including both child and dog welfare. Therefore, ethical matters such as children’s inclusion and safety, as well as the rights and wellbeing of dogs infuse the study throughout. The methodological design is a mixed method longitudinal study. A UK wide questionnaire will be distributed to teachers between January and June 2020 to understand their perceptions of RTD. Following this, a randomised controlled trial (N = 100) will begin in August 2020 in two schools of a comparable demographic, with N= 50 in the intervention school, and N= 50 in a waiting list control school. Reading and wellbeing assessments will be conducted prior to and immediately post RTD, and four weeks after RTD to measure sustained changes. The reading assessments include New Group Reading Test, Motivation to Read Profile (Gambrell et al., 1995), as well as reading frequency and reading anxiety assessments specifically designed for the study. Wellbeing assessments include Goodman’s SDQ, (1997) and pupil self-reporting questionnaires specifically designed for the study. Child, class teacher, and parent questionnaires and interviews prior to, during and post RTD will be conducted to measure perceptions of the impact of RTD on mood and motivation towards reading. This study will make a substantial contribution to our understanding of the effectiveness of RTD and thus have consequences for the fields of education and anthrozoology.

Keywords: animal assisted intervention, reading to dogs, welfare, wellbeing

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Authors: Claire Xu, Welton Wang, Manasvi Pinnaka, Anqi Pan, Michael Han

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Hospitalizations account for one-third of the total health care spending in the US. Early risk detection and intervention can reduce this high cost and increase the satisfaction of both patients and physicians. Due to the lack of awareness of the potential arising risks in home environment, the opportunities for patients to seek early actions of clinical visits are dramatically reduced. This research aims to offer a highly personalized remote patients monitoring and risk assessment AI framework to identify the potentially preventable hospitalization for both acute as well as chronic diseases. A hybrid-AI framework is trained with data from clinical setting, patients surveys, as well as online databases. 20+ risk factors are analyzed ranging from activities, biometric info, demographic info, socio-economic info, hospitalization history, medication info, lifestyle info, etc. The AI model yields high performance of 87% accuracy and 88 sensitivity with 20+ features. This hybrid-AI framework is proven to be effective in identifying the potentially preventable hospitalization. Further, the high indicative features are identified by the models which guide us to a healthy lifestyle and early intervention suggestions.

Keywords: hospitalization prevention, machine learning, remote patient monitoring, risk prediction

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Authors: Mariam Azam, Sajjad Ur Rahman, Mukarram Bashir, Muhammad Tahir, Seemal Javaid, Jawad, Aoun Muhammad, Muhammad Zohaib, Hannan Khan

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Products of microbial origin are of great importance as they have proved their value in healthcare and nutrition, use of these microbial metabolites acquired from partially fermented soya hulls and wheat bran along with Saccharomyces cerevisiae (DL-22 S/N) substantiates to be a great source for an increase in the total milk production and quality yield.1×109 CFU/ml cells of Saccharomyces cerevisiae (DL-22 S/N) were further grown under in-vivo conditions for the assessment of quality milk production. Two groups with twelve cows, each having the same physical characteristics (Group A and Group B), were under study, Group A was daily fed with 12gm of biological metabolites and 22% protein-pelleted feed. On the other hand, the animals of Group B were provided with no metabolites in their feed. In thirty days of trial, improvement in the overall health, body score, milk protein, milk fat, yield, incidence rate of mastitis, ash, and solid not fat (SNF) was observed. The collected data showed that the average quality milk production was elevated up to 0.45 liter/h/d. However, a reduction in the milk fats up to 0.45% and uplift in the SNF value up to 0.53% of cow milk was also observed. At the same time, the incidence rate of mastitis recorded for the animals under trial was reduced to half, and improved non specific immunity was reported.

Keywords: microbial metabolites, post-biotics, animal supplements, animal nutrition, proteins, animal production, fermentation

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Authors: Binu Sahayam

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HIV/AIDS epidemic is in its third decade and has become a virulent disease that threatens the world population. Many countless efforts had been made yet this has become a social and developmental concern. According to UNAIDS 2013 Report, In India around 2.4 million people are currently living with HIV and third in the infection rate. As every country is facing this health issue, this has become a social and developmental concern for India. In country like India, open discussion on sex and sexuality is not possible due to its conventional culture. Educational institution like schools and colleges can create awareness on sex education, life skill education, information on HIV and STD which is lacking. It is very clear that preventive knowledge remains low and this leads to increase in the HIV/AIDS infection rate. HIV/AIDS is a disease which is not curable but preventable, keeping this in mind religious leaders of various have come forward in addressing the issue of HIV/AIDS using various social strategies. The study has been focused on three main India religious teachings Hinduism, Christianity and Islam in addressing the issue of HIV/AIDS and its possible intervention in dealing with HIV/AIDS prevention. The study is important because it highlights the health issues, stigma discrimination, psychological disturbances and insecurity faced by the infected and affected persons. Therefore, this study privileges the role of religious leadership in the efforts and processes of preventing HIV/AIDS, caring and providing support to People living with HIV/AIDS and argues that intervention of religious leadership is an effective measure to confront many of the barriers associated with HIV/AIDS.

Keywords: HIV and AIDS, STDs, religion and religious organisation

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Authors: Neşe Alkan

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Purpose: The point that applied/clinical psychology, which is the practice and research discipline of the mental health field, has reached today can be summarized as the necessity of handling the psychological well-being of people from multiple perspectives and the goal of moving it to a higher level. Clients' subjective assessment of their own condition and wellbeing is an integral part of evidence-based interventions. There is a need for tools through which clients can evaluate the effectiveness of the psychotherapy/intervention performed with them and their contribution to the wellbeing and wellbeing of this process in a valid and reliable manner. The aim of this research is to meet this need, to test the reliability and validity of the index in Turkish, and explore its usability in the practices of both researchers and psychotherapists. Method: A total of 213 adults aged between 18-54, 69.5% working and 29.5% university students, were included in the study. Along with their demographic information, the participants were administered a set of scales: wellbeing, life satisfaction, spiritual satisfaction, shopping addiction, and loneliness, namely via an online platform. The construct validity of the wellbeing scale was tested with exploratory and confirmatory factor analyses, convergent and discriminant validity were tested with two-way full and partial correlation analyses and, measurement invariance was tested with one-way analysis of variance. Results: Factor analyzes showed that the scale consisted of six dimensions as it is in its original structure. The internal consistency of the scale was found to be Cronbach α = .82. Two-way correlation analyzes revealed that the wellbeing scale total score was positively correlated with general life satisfaction (r = .62) and spiritual satisfaction (r = .29), as expected. It was negatively correlated with loneliness (r = -.51) and shopping addiction (r = -.15). While the scale score did not vary by gender, previous illness, or nicotine addiction, it was found that the total wellbeing scale scores of the participants who had used antidepressant medication during the past year were lower than those who did not use antidepressant medication (F(1,204) = 7.713, p = .005). Conclusion: It has been concluded that the 12-item wellbeing scale consisting of six dimensions can be used in research and health sciences practices as a valid and reliable measurement tool. Further research which examines the reliability and validity of the scale in different widely used languages such as Spanish and Chinese is recommended.

Keywords: wellbeing, intervention effectiveness, reliability and validity, effectiveness

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Authors: Mary Farrell, Maria Soubra, Sandra Vega, Dorothy Kakraba, Joanne Fontanilla, Moira Kendra, Danielle Tonzola, Stephanie Chiu

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Pneumonia is the most common infectious cause of hospitalizations in the United States, with more than one million admissions annually and costs of $10 billion every year, making it the 8th leading cause of death. Aspiration pneumonia is an aggressive type of pneumonia that results from inhalation of oropharyngeal secretions and/or gastric contents and is preventable. The authors hypothesized that an evidence-based aspiration pneumonia clinical care pathway could reduce 30-day hospital readmissions and mortality rates, while improving the overall care of patients. We conducted a retrospective chart review on 979 patients discharged with aspiration pneumonia from January 2021 to December 2022 at Overlook Medical Center. The authors identified patients who were coded with aspiration pneumonia and/or stable sepsis. Secondarily, we identified 30-day readmission rates for aspiration pneumonia from a SNF. The Aspiration Pneumonia Clinical Care Pathway starts in the emergency department (ED) with the initiation of antimicrobials within 4 hours of admission and early recognition of aspiration. Once this is identified, a swallow test is initiated by the bedside nurse, and if the patient demonstrates dysphagia, they are maintained on strict nothing by mouth (NPO) followed by a speech and language pathologist (SLP) referral for an appropriate modified diet recommendation. Aspiration prevention techniques included the avoidance of straws, 45-degree positioning, no talking during meals, taking small bites, placement of the aspiration wrist band, and consuming meals out of the bed in a chair. Nursing education was conducted with a newly created online learning module about aspiration pneumonia. The authors identified 979 patients, with an average age of 73.5 years old, who were diagnosed with aspiration pneumonia on the index hospitalization. These patients were reviewed for a 30-day readmission for aspiration pneumonia or stable sepsis, and mortality rates from January 2021 to December 2022 at Overlook Medical Center (OMC). The 30-day readmission rates were significantly lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011). When evaluating the mortality rates in the pre and post intervention cohort the authors discovered the mortality rates were lower in the post intervention cohort (23.7% vs 22.4%, p = 0.61) Mortality among non-white (self-reported as non-white) patients were lower in the post intervention cohort (34.4% vs. 21.0% , p = 0.05). Patients who reported as a current smoker/vaper in the pre and post cohorts had increased mortality rates (5.9% vs 22%). There was a decrease in mortality for the male population but an increase in mortality for women in the pre and post cohorts (19% vs. 25%). The authors attributed this increase in mortality in the post intervention cohort to more active smokers, more former smokers, and more being admitted from a SNF. This research identified that implementation of an Aspiration Pneumonia Clinical Care Pathway showed a statistically significant decrease in readmission rates and mortality rates in non-whites. The 30-day readmission rates were lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011).

Keywords: aspiration pneumonia, mortality, quality improvement, 30-day pneumonia readmissions

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