Search results for: critical care transition program
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13441

Search results for: critical care transition program

12721 Solution to Riemann Hypothesis Critical Strip Zone Using Non-Linear Complex Variable Functions

Authors: Manojkumar Sabanayagam

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The Riemann hypothesis is an unsolved millennium problem and the search for a solution to the Riemann hypothesis is to study the pattern of prime number distribution. The scope of this paper is to identify the solution for the critical strip and the critical line axis, which has the non-trivial zero solutions using complex plane functions. The Riemann graphical plot is constructed using a linear complex variable function (X+iY) and is applicable only when X>1. But the investigation shows that complex variable behavior has two zones. The first zone is the transformation zone, where the definition of the complex plane should be a non-linear variable which is the critical strip zone in the graph (X=0 to 1). The second zone is the transformed zone (X>1) defined using linear variables conventionally. This paper deals with the Non-linear function in the transformation zone derived using cosine and sinusoidal time lag w.r.t imaginary number ‘i’. The alternate complex variable (Cosθ+i Sinθ) is used to understand the variables in the critical strip zone. It is concluded that the non-trivial zeros present in the Real part 0.5 are because the linear function is not the correct approach in the critical strip. This paper provides the solution to Reimann's hypothesis.

Keywords: Reimann hypothesis, critical strip, complex plane, transformation zone

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12720 Thai Student Ability on Speexx Language Training Program

Authors: Toby Gibbs, Glen Craigie, Suwaree Yordchim

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Using the Speexx Online Language Training Program with Thai students has allowed us to evaluate their learning comprehension and track their progression through the English language program. Speexx sets the standard for excellence and innovation in web-based language training and online coaching services. The program is designed to improve the business communication skills of language learners for Thai students. Speexx consists of English lessons, exercises, tests, web boards, and supplementary lessons to help students practice English. The sample groups are 191 Thai sophomores studying Business English with the department of Humanities and Social Science. The data was received by standard deviation (S.D.) value from questionnaires and samples provided from the Speexx training program. The results found that most Thai sophomores fail the Speexx training program due to their learning comprehension of the English language is below average. With persisted efforts on new training methods, the success of the Speexx Language Training Program can break through the cultural barriers and help future students adopt English as a second language. The Speexx results revealed four main factors affecting the success as follows: 1) Future English training should be pursued in applied Speexx development. 2) Thai students didn’t see the benefit of having an Online Language Training Program. 3) There is a great need to educate the next generation of learners on the benefits of Speexx within the community. 4) A great majority of Thai Sophomores didn't know what Speexx was. A guideline for self-reliance planning consisted of four aspects: 1) Development planning: by arranging groups to further improve English abilities with the Speexx Language Training program and encourage using Speexx every day. Local communities need to develop awareness of the usefulness of Speexx and share the value of using the program among family and friends. 2) Humanities and Social Science staff should develop skills using this Online Language Training Program to expand on the benefits of Speexx within their departments. 3) Further research should be pursued on the Thai Students progression with Speexx and how it helps them improve their language skills with Business English. 4) University’s and Language centers should focus on using Speexx to encourage learning for any language, not just English.

Keywords: ability, comprehension, sophomore, speexx

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12719 Structure of the Working Time of Nurses in Emergency Departments in Polish Hospitals

Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: emergency nurses, nursing care, workload, work sampling

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12718 “Congratulations, I Am Sorry for Your Loss”. A Qualitative Study to Help Healthcare Providers Search for Words When a Baby Dies

Authors: Liesbeth Van Kelst, Jozefiene Jansens

Abstract:

Background: All care providers within mother and child care are confronted, at some point in their career, with the care for parents who (will) lose or have lost a baby. Obtaining the correct attitude and communicating well during these difficult moments are aspects that many healthcare provides continue to struggle with. Parents still encounter well-intentioned but inappropriate communication from healthcare providers. Aim: To study how communication, both verbal and non-verbal, around the death of a baby during pregnancy, birth, or in the first ten days postnatal was experienced by parents and healthcare providers. Methods: A qualitative study using grounded theory principles was conducted. Data were collected through 22 individual face-to-face in-depth interviews with parents who had lost a baby (n = 12) and intramural caregivers, such as midwives, nurses, gynecologists and neonatologists (n=10). In the first phase, data were analyzed within each group separately (parents and healthcare providers) and in the second phase, findings from both groups were compared and analyzed according to meta-synthesis principles. Results: The themes that emerged from the data demonstrated congruent experiences between the group of the parents and the health care providers. Both strengths and weaknesses in current care were named and suggestions for appropriate communication were formulated. Conclusion: Since most health care providers only occasionally care for parents with a deceased baby, a communication tool can optimize communication between healthcare professionals and parents who lose a baby. This is very important as the words which are said at this difficult period last a lifetime in the heads of parents.

Keywords: communication, death, perinatal loss, stillbirth

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12717 Clinical Staff Perceptions of the Quality of End-of-Life Care in an Acute Private Hospital: A Mixed Methods Design

Authors: Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray

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Current literature demonstrates that most Australians receive end-of-life care in a hospital setting, despite most hoping to die within their own home. The necessity for high quality end-of-life care has been emphasised by the Australian Commission on Safety and Quality in Health Care and the National Safety and Quality in Health Services Standards depict the requirement for comprehensive care at the end of life (Action 5.20), reinforcing the obligation for continual organisational assessment to determine if these standards are suitably achieved. Limited research exploring clinical staff perspectives of end-of-life care delivery has been conducted within an Australian private health context. This study aimed to investigate clinical staff member perceptions of end-of-life care delivery at a private hospital in Western Australia. The study comprised of a multi-faceted mixed-methods methodology, part of a larger study. Data was obtained from clinical staff utilising surveys and focus groups. A total of 133 questionnaires were completed by clinical staff, including registered nurses (61.4%), enrolled nurses (22.7%), allied health professionals (9.9%), non-palliative care consultants (3.8%) and junior doctors (2.2%). A total of 14.7% of respondents were palliative care ward staff members. Additionally, seven staff focus groups were conducted with physicians (n=3), nurses (n=26) and allied health professionals including social workers (n=1), dietitians (n=2), physiotherapists (n=5) and speech pathologists (n=3). Key findings from the surveys highlighted that the majority of staff agreed it was part of their role to talk to doctors about the care of patients who they thought may be dying, and recognised the importance of communication, appropriate training and support for clinical staff to provide quality end-of-life care. Thematic analysis of the qualitative data generated three key themes: creating the setting which highlighted the importance of adequate resourcing and conducive physical environments for end-of-life care and to support staff and families; planning and care delivery which emphasised the necessity for collaboration between staff, families and patients to develop care plans and treatment directives; and collaborating in end-of-life care, with effective communication and teamwork leading to achievable care delivery expectations. These findings contribute to health professionals better understanding of end-of-life care provision and the importance of collaborating with patients and families in care delivery. It is crucial that health care providers implement strategies to overcome gaps in care, so quality end-of-life care is provided. Findings from this study have been translated into practice, with the development and implementation of resources, training opportunities, support networks and guidelines for the delivery of quality end-of-life care.

Keywords: clinical staff, end-of-life care, mixed-methods, private hospital.

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12716 The Influence of Married Women's Adult Children Care Burden and Stress on Depression: Testing the Moderated Mediating Effect of Satisfaction with Husbands’ Sharing of the Care

Authors: Soo-Bi Lee, Jun Young Jeong, Zehgn Lin, Chenminxi

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Background: In South Korea, a problematic phenomenon has recently arisen whereby adult children continue to receive parentalcaregivingin some cases. These phenomena has been shown to affect the mental health of mothers. Study Goals: The purposes of this study are to verify whether the mediating effects of stress on the relationship between a woman’s care burden for their adult children and depression are moderated by their satisfaction about their husbands’ sharing of the caregiving. Methodology: This study analyzed 3,053 married women with adult children using the most recent data from the “Korean Longitudinal Survey of Women & Families 7th(2018)" conducted at the national level. The analysis was conducted using the SPSS Process Macro Model 7 to verify the moderated mediating effects and subsequently confirm their significance based on the bootstrapping method. Results and Implications: (1) Stress was identified a mediating factor in the relationship between the care burden for adult children and depression; and (2) the mediating effects of stress on depression from the burden of caring for adult children are modulated by the woman's satisfaction with her husband’s sharing of the care burden. In other words, the higher the caring burden of adult children, the higher the mother's stress, which increases depression. At this time, the higher the their satisfaction with the husband's share of care in the path of mother's care burden and stress, the lower the mother's stress and, ultimately, the depression be alleviated. Conclusion: Programs that promote the mental health of married women heavily with the caring burden for their adult children, as well as those that improve social awareness regarding husbands' sharing of the care burden, should be implemented. Also, social welfare policy alternatives are needed at the national level to reduce the caring burden caused by adult children.

Keywords: married women, adult children care burden, stress, depression, satisfaction with husbands sharing of the care

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12715 Multicenter Baseline Survey to Outline Antimicrobial Prescribing Practices at Six Public Sectortertiary Care Hospitals in a Low Middle Income Country

Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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12714 A Randomised Controlled Trial on the Nurse-Led Smartphone-Based Self-Management Programme for Type 2 Diabetes Patients with Poor Glycemic Control

Authors: Wenru Wang

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Over the past decades, Asia has emerged as the ‘diabetes epicentre’ in the world due to rapid economic development, urbanization and nutrition transition. There is an urgent need to develop more effective and cost-effective care management strategies in response to this rising diabetes epidemic. This study aims to develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes among type 2 diabetes patients with poor glycemic control in Singapore. We proposed a randomized controlled trial with pre- and repeated post-tests control group design. A total of 128 type 2 diabetes patients with poor glycemic control will be recruited from the diabetes clinic of an acute public hospital in Singapore through convenience sampling. Study participants will be either randomly allocated to the experimental group or control group. Outcome measures used will include the 10-item General Self-Efficacy Scale, 11-item Revised Summary of Diabetes Self-care Activities, and 19-item Diabetes-Dependent Quality of Life. Data will be collected at 3-time points: baseline, three months and six months from the baseline, respectively. It is expected that this programme will be an alternative offered to diabetes patients to master their self-care management skills, in addition to the existing diabetes service provided in diabetes clinics in Singapore hospitals. Also, the self-supporting and less resource-intensive nature of this programme, through the use of smartphone app as a mode of intervention delivery, will greatly reduce nurses’ direct contact time with patients and allow more time to be allocated to those who require more attention. The study has been registered with clinicaltrials.gov. The trial registration number is NCT03088475.

Keywords: type 2 diabetes, poor glycaemic control, nurse-led, smartphone-based, self-management, health-relevant outcomes

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12713 External Program Evaluation: Impacts and Changes on Government-Assisted Refugee Mothers

Authors: Akiko Ohta, Masahiro Minami, Yusra Qadir, Jennifer York

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The Home Instruction for Parents of Preschool Youngsters (HIPPY) is a home instruction program for mothers of children 3 to 5 years old. Using role-play as a method of teaching, the participating mothers work with their home visitors and learn how to deliver the HIPPY curriculum to their children. Applying HIPPY, Reviving Hope and Home for High-risk Refugee Mothers Program (RHH) was created to provide more personalized peer support and to respond to ongoing settlement challenges for isolated and vulnerable Government Assisted Refugee (GAR) mothers. GARs often have greater needs and vulnerabilities than other refugee groups. While the support is available, they often face various challenges and barriers in starting their new lives in Canada, such as inadequate housing, low first-language literacy levels, low competency in English or French, and social isolation. The pilot project was operated by Mothers Matter Centre (MMC) from January 2019 to March 2021 in partnership with the Immigrant Services Society of BC (ISSofBC). The formative evaluation was conducted by a research team at Simon Fraser University. In order to provide more suitable support for GAR mothers, RHH intended to offer more flexibility in HIPPY delivery, supported by a home visitor, to meet the need of refugee mothers facing various conditions and challenges; to have a pool of financial resources to be used for the RHH families when necessitated during the program period; to have another designated staff member, called a community navigator, assigned to facilitate the support system for the RHH families in their settlement; to have a portable device available for each RHH mother to navigate settlement support resources; and to provide other variations of the HIPPY curriculum as an option for the RHH mothers, including a curriculum targeting pre-HIPPY age children. Reflections on each program component was collected from RHH mothers and staff members of MMC and ISSofBC, including frontline workers and management staff, through individual interviews and focus group discussions. Each of the RHH program components was analyzed and evaluated by applying Moore’s four domains framework to identify key information and generate new knowledge (data). To capture RHH mothers’ program experience more in depth based on their own reflections, the photovoice method was used. Some photos taken by the mothers will be shared to illustrate their RHH experience as part of their life stories. Over the period of the program, this evaluation observed how RHH mothers became more confident in various domains, such as communicating with others, taking public transportations alone, and teaching their own child(ren). One of the major factors behind the success was their home visitors’ flexibility and creativity to create a more meaningful and tailored approach for each mother, depending on her background and personal situation. The role of the community navigator was tested out and improved during the program period. The community navigators took the key role to assess the needs of the RHH families and connect them with community resources. Both the home visitors and community navigators were immigrant mothers themselves and owing to their dedicated care for the RHH mothers; they were able to gain trust and work closely and efficiently with RHH mothers.

Keywords: refugee mothers, settlement support, program evaluation, Canada

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12712 [Keynote Speech]: An Overview on the Effectiveness of Critical Thinking on Knowledge

Authors: Solehah Yaacob

Abstract:

The study focuses on revisiting the effectiveness of Critical Thinking in human mind capability as a major faculty in human life. The tool used as a measurement of this knowledge ability consists of several processes including experience and education background. To emphasize the `Overview` concept, the researcher highlights two major aspects of philosophical approach, they are; Divine Revelation Concept and Modern Scientific Theory. The research compares between the both parties to introduce the Divine Revelation into Modern Scientific theory. An analytical and critical study of the both concepts become the methodology of the discussion.

Keywords: critical thinking, knowledge, intellectual, language

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12711 Principles and Guidance for the Last Days of Life: Te Ara Whakapiri

Authors: Tania Chalton

Abstract:

In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.

Keywords: end of life, guidelines, New Zealand, palliative care

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12710 Nursing Experience in Improving Physical and Mental Well-Being of a Patient with Premature Menopause Osteoporosis and Sarcopenia in Nursing-Led Multi-Discipline Care

Authors: Huang Chiung Chiu

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This article is about the nursing experience of assisting an outpatient with premature menopause, osteoporosis and sarcopenia through a multi-discipline care model. The nursing period is from September 22nd, 2020, to December 7th, 2020, collecting data through interviews with the patient, observation, and physical assessment. It was found that the main health problems were insufficient nutrition, less physical need, insomnia, and potentially dangerous falls. As an outpatient nurse, the author observed that in recent years, the age group of women with premature menopause, osteoporosis and sarcopenia had shifted downward. Integrated multi-disciplinary interventions were provided upon the initial diagnosis of osteoporosis and sarcopenia. Under the outpatient care setting, the collaborative team works between the doctors, nutritionists, osteoporosis educators, rehabilitates, physical therapists and other specialized teams were applied to provide individualized, integrated multi-disciplinary care. Through empathy and the establishment of attentive care, companionship and trust, we discussed care plans and treatment guidelines with the case, providing accurate, complete disease information and feedback education to strengthen the patient’s knowledge and motivation for exercise. Nursing guidance regarding the dietary nutrition and adjustment of daily routine was provided to increase the self-care ability, improve the health problems of muscle weakness and insomnia, and prevent falls. For patients with postmenopausal osteoporosis and sarcopenia, it is recommended that the nurses coordinate the multi-discipline integrated care model, adjust patients’ lifestyle and diet, and establish a regular exercise plan so that the cases can be evaluated holistically to improve the quality of care and physical and mental comfort.

Keywords: multi-discipline care model, premature menopause, osteoporosis, sarcopenia, insomnia

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12709 Reflections on Ten Years of Preparing Graduate Students for the Professoriate at an American Research University

Authors: Samuel Olugbenga King

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Using a reflective analysis tool to provide both local and global perspectives, this study focuses on the longitudinal evaluation of the Graduate Student Development (GSD) initiative, the Preparing Future Faculty (PFF) program. The reflection process involves examining the past and present to identify challenges, and culminates in the creation of an action plan to address barriers to further growth and teaching development of graduate students, thus positively impacting student experience. The outcomes of the reflective critique of the PFF program indicate that lack of mentoring as well as inadequate feedback and funding are barriers that need to be addressed to positively impact the graduate student experience. Consequently, interventions, such as peer and student evaluations, and alumni surveys are highlighted as pragmatic modes of addressing the inadequate feedback and mentoring barriers. However, funding remains an ongoing challenge. This article is a contribution to the literature on the use of critical reflection approaches to investigate and evaluate specific programming that focuses on enhancing the graduate student experience and development.

Keywords: graduate student experience, longitudinal reflection, quality enhancement, teaching

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12708 The Effects of a Mathematics Remedial Program on Mathematics Success and Achievement among Beginning Mathematics Major Students: A Regression Discontinuity Analysis

Authors: Kuixi Du, Thomas J. Lipscomb

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The proficiency in Mathematics skills is fundamental to success in the STEM disciplines. In the US, beginning college students who are placed in remedial/developmental Mathematics courses frequently struggle to achieve academic success. Therefore, Mathematics remediation in college has become an important concern, and providing Mathematics remediation is a prevalent way to help the students who may not be fully prepared for college-level courses. Programs vary, however, and the effectiveness of a particular remedial Mathematics program must be empirically demonstrated. The purpose of this study was to apply the sharp regression discontinuity (RD) technique to determine the effectiveness of the Jack Leaps Summer (JLS) Mathematic remediation program in supporting improved Mathematics learning outcomes among newly admitted Mathematics students in the South Dakota State University. The researchers studied the newly admitted Fall 2019 cohort of Mathematics majors (n=423). The results indicated that students whose pretest score was lower than the cut-off point and who were assigned to the JLS program experienced significantly higher scores on the post-test (Math 101 final score). Based on these results, there is evidence that the JLS program is effective in meeting its primary objective.

Keywords: causal inference, mathematisc remedial program evaluation, quasi-experimental research design, regression discontinuity design, cohort studies

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12707 Construction Project Planning Using Fuzzy Critical Path Approach

Authors: Omar M. Aldenali

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Planning is one of the most important phases of the management science and network planning, which represents the project activities relationship. Critical path is one of the project management techniques used to plan and control the execution of a project activities. The objective of this paper is to implement a fuzzy logic approach to arrange network planning on construction projects. This method is used to finding out critical path in the fuzzy construction project network. The trapezoidal fuzzy numbers are used to represent the activity construction project times. A numerical example that represents a house construction project is introduced. The critical path method is implemented on the fuzzy construction network activities, and the results showed that this method significantly affects the completion time of the construction projects.

Keywords: construction project, critical path, fuzzy network project, planning

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12706 Knowledge, Perceptions, and Barriers of Preconception Care among Healthcare Workers in Nigeria

Authors: Taiwo Hassanat Bawa-Muhammad, Opeoluwa Hope Adegoke

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Introduction: This study aims to examine the knowledge and perceptions of preconception care among healthcare workers in Nigeria, recognizing its crucial role in ensuring safe pregnancies. Despite its significance, awareness of preconception care remains low in the country. The study seeks to assess the understanding of preconception services and identify the barriers that hinder their efficacy. Methods: Through semi-structured interviews, 129 healthcare workers across six states in Nigeria were interviewed between January and March 2023. The interviews explored the healthcare workers' knowledge of preconception care practices, the socio-cultural influences shaping decision-making, and the challenges that limit accessibility and utilization of preconception care services. Results: The findings reveal a limited knowledge of preconception care among healthcare workers, primarily due to inadequate information dissemination within the healthcare system. Additionally, cultural beliefs significantly influence perceptions surrounding preconception care. Furthermore, financial constraints, distance to healthcare facilities, and poor health infrastructure disproportionately restrict access to preconception services, particularly for vulnerable populations. The study also highlights insufficient skills and outdated training among healthcare workers regarding preconception guidance, primarily attributed to limited opportunities for professional development. Discussion: To improve preconception care in Nigeria, comprehensive education programs must be implemented, taking into account the societal influences that shape perceptions and behaviors. These programs should aim to dispel myths and promote evidence-based practices. Additionally, training healthcare workers and integrating preconception care services into primary care settings, with support from religious and community leaders, can help overcome barriers to access. Strategies should prioritize affordability while emphasizing the broader benefits of preconception care beyond fertility concerns alone. Lastly, widespread literacy campaigns utilizing trusted channels are crucial for effectively disseminating information and promoting the adoption of preconception practices in Nigeria.

Keywords: preconception care, knowledge, healthcare workers, Nigeria, barriers, education, training

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12705 Effectiveness of Breathing Training Program on Quality of Life and Depression Among Hemodialysis Patients: Quasi‐Experimental Study

Authors: Hayfa Almutary, Noof Eid Al Shammari

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Aim: The management of depression in patients undergoing hemodialysis remains challenging. The aim of this study was to evaluate the effectiveness of a breathing training program on quality of life and depression among patients on hemodialysis. Design: A one-group pretest-posttest quasi-experimental design was used. Methods: Data were collected from hemodialysis units at three dialysis centers. Initial baseline data were collected, and a breathing training program was implemented. The breathing training program included three types of breathing exercises. The impact of the intervention on outcomes was measured using both the Kidney Disease Quality of Life Short Version and the Beck Depression Inventory-Second Edition from the same participants. The participants were asked to perform the breathing training program three times a day for 30 days. Results: The mean age of the patients was 52.1 (SD:15.0), with nearly two-thirds of them being male (63.4%). Participants who were undergoing hemodialysis for 1–4 years constituted the largest number of the sample (46.3%), and 17.1% of participants had visited a psychiatric clinic 1-3 times. The results show that the breathing training program improved overall quality of life and reduced symptoms and problems. In addition, a significant decrease in the overall depression score was observed after implementing the intervention. Conclusions: The breathing training program is a non-pharmacological intervention that has proven visible effectiveness in hemodialysis. This study demonstrated that using breathing exercises reduced depression levels and improved quality of life. The integration of this intervention in dialysis units to manage psychological issues will offer a simple, safe, easy, and inexpensive intervention. Future research should compare the effectiveness of various breathing exercises in hemodialysis patients using longitudinal studies. Impact: As a safety precaution, nurses should initially use non-pharmacological interventions, such as a breathing training program, to treat depression in those undergoing hemodialysis.

Keywords: breathing training program, depression, exercise, quality of life, hemodialysis

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12704 Application of an Educational Program for Al Jouf University Students regarding Scientific Writing and Presentation Skills

Authors: Fatma Abdel Moneim Al Tawil

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This study was undertaken to evaluate an educational program regarding scientific writing and presentation skills among university students. This interventional study used a one-group, pretest/posttest design and was conducted in Al Jouf University among four colleges in Saudi Arabia. Baseline students’ assessment was conducted for developing educational program. Interventional, one group, pretest/posttest study was designed to evaluate the effectiveness of the educational program. Three parts evaluation sheet with total scores of 30 was used for 113 students for the development of the program and 52 students for test pretest phase. Wilcoxon signed ranks showed statistically significant improvement in the combined overall program skills score from a median of 56.7 pre to a median of 86.7 post, (z = 6.231, p < 0.001). When compared to preprogram intervention, post interventions 51.9 % of students achieve excellent performance. While pre intervention no students (0.0 %) achieve this score. Regarding to scientific writing skills, Wilcoxon signed ranks showed statistically significant improvement in the score from a median of 60 pre to a median of 90 post, (z = 6.122, p < 0.001). None of students had excellent performance changed to 73.1%. Regarding to oral presentation skills, Wilcoxon signed ranks showed statistically significant improvement in the score from a median of 50 pre to a median of 80 post, (z = 6.153, p < 0.001). None of students had excellent performance changed to 48.1%. Such educational program needs to be incorporated into classroom delivery of the students’ curriculum. Scientific writing skills book needed to be developed to be recommended as a basic educational strategy for all university faculties.

Keywords: scientific writing, presentation skills, university students, educational program

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12703 Qualitative Data Analysis for Health Care Services

Authors: Taner Ersoz, Filiz Ersoz

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This study was designed enable application of multivariate technique in the interpretation of categorical data for measuring health care services satisfaction in Turkey. The data was collected from a total of 17726 respondents. The establishment of the sample group and collection of the data were carried out by a joint team from The Ministry of Health and Turkish Statistical Institute (Turk Stat) of Turkey. The multiple correspondence analysis (MCA) was used on the data of 2882 respondents who answered the questionnaire in full. The multiple correspondence analysis indicated that, in the evaluation of health services females, public employees, younger and more highly educated individuals were more concerned and complainant than males, private sector employees, older and less educated individuals. Overall 53 % of the respondents were pleased with the improvements in health care services in the past three years. This study demonstrates the public consciousness in health services and health care satisfaction in Turkey. It was found that most the respondents were pleased with the improvements in health care services over the past three years. Awareness of health service quality increases with education levels. Older individuals and males would appear to have lower expectancies in health services.

Keywords: multiple correspondence analysis, multivariate categorical data, health care services, health satisfaction survey

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12702 Outcome Evaluation of a Blended-Learning Mental Health Training Course in South African Public Health Facilities

Authors: F. Slaven, M. Uys, Y. Erasmus

Abstract:

The South African National Mental Health Education Programme (SANMHEP) was a National Department of Health (NDoH) initiative to strengthen mental health services in South Africa in collaboration with the Foundation for Professional Development (FPD), SANOFI and the various provincial departments of health. The programme was implemented against the backdrop of a number of challenges in the management of mental health in the country related to staff shortages and infrastructure, the intersection of mental health with the growing burden of non-communicable diseases and various forms of violence, and challenges around substance abuse and its relationship with mental health. The Mental Health Care Act (No. 17 of 2002) prescribes that mental health should be integrated into general health services including primary, secondary and tertiary levels to improve access to services and reduce stigma associated with mental illness. In order for the provisions of the Act to become a reality, and for the journey of mental health patients through the system to improve, sufficient and skilled health care providers are critical. SANMHEP specifically targeted Medical Doctors and Professional Nurses working within the facilities that are listed to conduct 72-hour assessments, as well as District Hospitals. The aim of the programme was to improve the clinical diagnosis and management of mental disorders/conditions and the understanding of and compliance with the Mental Health Care Act and related Regulations and Guidelines in the care, treatment and rehabilitation of mental health care users. The course used a blended-learning approach and trained 1 120 health care providers through 36 workshops between February and November 2019. Of those trained, 689 (61.52%) were Professional Nurses, 337 (30.09%) were Medical Doctors, and 91 (8.13%) indicated their occupation as ‘other’ (of these more than half were psychologists). The pre- and post-evaluation of the face-to-face training sessions indicated a marked improvement in knowledge and confidence level scores (both clinical and legislative) in the care, treatment and rehabilitation of mental health care users by participants in all the training sessions. There was a marked improvement in the knowledge and confidence of participants in performing certain mental health activities (on average the ratings increased by 2.72; or 27%) and in managing certain mental health conditions (on average the ratings increased by 2.55; or 25%). The course also required that participants obtain 70% or higher in their formal assessments as part of the online component. The 337 participants who completed and passed the course scored 90% on average. This illustrates that when participants attempted and completed the course, they did very well. To further assess the effect of the course on the knowledge and behaviour of the trained mental health care practitioners a mixed-method outcome evaluation is currently underway consisting of a survey with participants three months after completion, follow-up interviews with participants, and key informant interviews with department of health officials and course facilitators. This will enable a more detailed assessment of the impact of the training on participants' perceived ability to manage and treat mental health patients.

Keywords: mental health, public health facilities, South Africa, training

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12701 Identifying Areas on the Pavement Where Rain Water Runoff Affects Motorcycle Behavior

Authors: Panagiotis Lemonakis, Theodoros Αlimonakis, George Kaliabetsos, Nikos Eliou

Abstract:

It is very well known that certain vertical and longitudinal slopes have to be assured in order to achieve adequate rainwater runoff from the pavement. The selection of longitudinal slopes, between the turning points of the vertical curves that meet the afore-mentioned requirement does not ensure adequate drainage because the same condition must also be applied at the transition curves. In this way none of the pavement edges’ slopes (as well as any other spot that lie on the pavement) will be opposite to the longitudinal slope of the rotation axis. Horizontal and vertical alignment must be properly combined in order to form a road which resultant slope does not take small values and hence, checks must be performed in every cross section and every chainage of the road. The present research investigates the rain water runoff from the road surface in order to identify the conditions under which, areas of inadequate drainage are being created, to analyze the rainwater behavior in such areas, to provide design examples of good and bad drainage zones and to track down certain motorcycle types which might encounter hazardous situations due to the presence of water film between the pavement and both of their tires resulting loss of traction. Moreover, it investigates the combination of longitudinal and cross slope values in critical pavement areas. It should be pointed out that the drainage gradient is analytically calculated for the whole road width and not just for an oblique slope per chainage (combination of longitudinal grade and cross slope). Lastly, various combinations of horizontal and vertical design are presented, indicating the crucial zones of bad pavement drainage. The key conclusion of the study is that any type of motorcycle will travel for some time inside the area of improper runoff for a certain time frame which depends on the speed and the trajectory that the rider chooses along the transition curve. Taking into account that on this section the rider will have to lean his motorcycle and hence reduce the contact area of his tire with the pavement it is apparent that any variations on the friction value due to the presence of a water film may lead to serious problems regarding his safety. The water runoff from the road pavement is improved when between reverse longitudinal slopes, crest instead of sag curve is chosen and particularly when its edges coincide with the edges of the horizontal curve. Lastly, the results of the investigation have shown that the variation of the longitudinal slope involves the vertical shift of the center of the poor water runoff area. The magnitude of this area increases as the length of the transition curve increases.

Keywords: drainage, motorcycle safety, superelevation, transition curves, vertical grade

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12700 Positive Parenting and Subjective Well-Being: Proposed Program for Parents of Gifted Children

Authors: Suzy Pereira, Alberto Rocha, Ana Almeida, Catarina Figueiredo, Helena Fonseca, Leonor Moreira, Carla Blum Vestena, Cristina Costa-Lobo

Abstract:

The socio-educational support to parents, through parental education intervention programs, is part of European social policies, aiming to respond to the needs of education, promotion of well-being and development of children and young people. The purpose of this research is to evaluate the impact of the Positive Parenting Program on the subjective well-being of the parents of gifted children. The Positive Parenting Program is authored and is conducted by the National Association of Study and Intervention in Giftedness, Portuguese Association. The central question to be explored in this research is: Does the promotion of positive parenting in parents of gifted children have a positive impact on the subjective well-being? The sample consisted of 30 parents, non-probabilistic sampling of convenience, of which 15 parents belong to the intervention group and the rest to the control group. One dimension will be evaluated - subjective well-being, through the PANAS questionnaire - before and after the sessions of this program. The aim is to contribute to the understanding of the process and results of the positive parenting program in parents of gifted children.

Keywords: positive parenting, subjective well-being, giftedness, parental education intervention programs

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12699 Clinical Nursing Experience in Managing a Uterine Cancer Patient with Psychogenic Shock During the Extracorporeal Membrane Oxygenation Weaning Process

Authors: Syue-Wen Lin

Abstract:

Objective: This article discusses the nursing experience of caring for a uterine cancer patient who experienced cardiogenic shock and was weaned off ECMO. The patient was placed on ECMO due to cardiogenic shock and initially struggled with anxiety caused by the physical discomfort from the disease and multiple medical devices, as well as the isolation in the ICU and restrictions on physical activity. Over time, the patient was able to wean off ECMO and perform daily activities and rehabilitation independently. Methods: The nursing period was from January 6 to January 9. Through observation, direct care, interviews, physical assessments, and case reviews, the intensive care team and bypass personnel conducted a comprehensive assessment using Gordon's 11 functional health patterns. The assessment identified three main nursing health problems: pain, anxiety, and decreased cardiac tissue perfusion. Results: The author consulted a psychologist to employ open communication techniques and empathetic care to build a trusting nurse-patient relationship. A patient-centered intensive cancer care plan was developed. Pain was assessed using a pain scale, and pain medications were adjusted in consultation with a pharmacist. Lavender essential oil therapy, light music, and pillows were used to distract and alleviate pain. The patient was encouraged to express feelings and family members were invited to increase visits and provide companionship to reduce the uncertainty caused by cancer and illness. Vital signs were closely monitored, and nursing interventions were provided to maintain adequate myocardial perfusion. Post-ECMO, the patient was encouraged to engage in rehabilitation and cardiopulmonary training. Conclusion: A key takeaway from the care process is the importance of observing not only the patient's vital signs but also their psychological state, especially when dealing with cancer patients on ECMO. The patient's greatest source of comfort was the presence of family, which helped alleviate anxiety. Healthcare providers play multiple critical roles as advocates, coordinators, educators, and counselors, listening to and accepting the patient’s emotional responses. The report aims to provide clinical cancer nurses with a reference to improve the quality of care and alleviate cancer-related discomfort.

Keywords: ECMO, uterine cancer, palliative care, Gordon's 11 functional health patterns

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12698 How to Integrate Sustainability in Technological Degrees: Robotics at UPC

Authors: Antoni Grau, Yolanda Bolea, Alberto Sanfeliu

Abstract:

Embedding Sustainability in technological curricula has become a crucial factor for educating engineers with competences in sustainability. The Technical University of Catalonia UPC, in 2008, designed the Sustainable Technology Excellence Program STEP 2015 in order to assure a successful Sustainability Embedding. This Program takes advantage of the opportunity that the redesign of all Bachelor and Master Degrees in Spain by 2010 under the European Higher Education Area framework offered. The STEP program goals are: to design compulsory courses in each degree; to develop the conceptual base and identify reference models in sustainability for all specialties at UPC; to create an internal interdisciplinary network of faculty from all the schools; to initiate new transdisciplinary research activities in technology-sustainability-education; to spread the know/how attained; to achieve international scientific excellence in technology-sustainability-education and to graduate the first engineers/architects of the new EHEA bachelors with sustainability as a generic competence. Specifically, in this paper authors explain their experience in leading the STEP program, and two examples are presented: Industrial Robotics subject and the curriculum for the School of Architecture.

Keywords: sustainability, curricula improvement, robotics, STEP program

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12697 Drinking Reduction Programs: Comparing the Effectiveness of Different Versions of the Programs

Authors: Justyna Śniadach, Barbara Bętkowska Korpała, Napoleon Waszkiewicz

Abstract:

The drinking reduction program is a relatively new form of therapy. A lot has changed in thinking about alcohol problems and effective ways to solve them. Until recently, alcohol consumers were divided into two groups: addicted and "normal" drinkers. In recent years, the existence of a large group of people who drink alcohol harmfully has been noticed: not addicted, but still drinking in a way that brings losses and harms to others. It turned out that most of the problems resulting from drinking alcohol are generated by people who drink harmfully and that showed that it is necessary to build a support system for these people aimed at reducing alcohol consumption. The Drinking Reduction Program currently has 3 versions. There is a Drinking Reduction Program in a standard form, where the patient works stationary, in the therapist's office. Another possibility is the patient's work on Online - Drinking Reduction Program with application in a remote form. Another possibility is the patient's work in Online- Drinking Reduction Program on-line but together with the therapist. In all of this program's exercises are based on the assumptions of behavioral-cognitive therapy and methods of motivational dialogue. The purpose of this research will be to compare three versions of Drinking Reduction Programs in terms of their effectiveness, psychological and sociological variables, as well as the level of motivation to change the drinking pattern.

Keywords: alcohol addiction, addiction therapy, drinking reduction programs, cognitive-behavioral therapy

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12696 Identification of Thermally Critical Zones Based on Inter Seasonal Variation in Temperature

Authors: Sakti Mandal

Abstract:

Varying distribution of land surface temperature in an urbanized environment is a globally addressed phenomenon. Usually has been noticed that criticality of surface temperature increases from the periphery to the urban centre. As the centre experiences maximum severity of heat throughout the year, it also represents most critical zone in terms of thermal condition. In this present study, an attempt has been taken to propose a quantitative approach of thermal critical zonation (TCZ) on the basis of seasonal temperature variation. Here the zonation is done by calculating thermal critical value (TCV). From the Landsat 8 thermal digital data of summer and winter seasons for the year 2014, the land surface temperature maps and thermally critical zonation has been prepared, and corresponding dataset has been computed to conduct the overall study of that particular study area. It is shown that TCZ can be clearly identified and analyzed by the help of inter-seasonal temperature range. The results of this study can be utilized effectively in future urban development and planning projects as well as a framework for implementing rules and regulations by the authorities for a sustainable urban development through an environmentally affable approach.

Keywords: thermal critical values (TCV), thermally critical zonation (TCZ), land surface temperature (LST), Landsat 8, Kolkata Municipal Corporation (KMC)

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12695 The Need for a More Defined Role for Psychologists in Adult Consultation Liaison Services in Hospital Settings

Authors: Ana Violante, Jodie Maccarrone, Maria Fimiani

Abstract:

In the United States, over 30 million people are hospitalized annually for conditions that require acute, 24-hour, supervised care. The experience of hospitalization can be traumatic, exposing the patient to loss of control, autonomy, and productivity. Furthermore, 40% of patients admitted to hospitals for general medical illness have a comorbid psychiatric diagnosis. Research suggests individuals admitted with psychiatric comorbidities experience poorer health outcomes, higher utilization rates and increased overall cost of care. Empirical work suggests hospital settings that include a consultation liaison (CL) service report reduced length of stay, lower costs per patient, improved medical staff and patient satisfaction and reduced readmission after 180 days. Despite the overall positive impact CL services can have on patient care, it is estimated that only 1% - 2.8% of hospital admits receive these services, and most research has been conducted by the field of psychiatry. Health psychologists could play an important role in increasing access to this valuable service, though the extent to which health psychologists participate in CL settings is not well known. Objective: Outline the preliminary findings from an empirical study to understand how many APPIC internship training programs offer adult consultation liaison rotations within inpatient hospital settings nationally, as well as describe the specific nature of these training experiences. Research Method/Design: Data was exported into Excel from the 2022-2023 APPIC Directory categorized as “health psychology” sites. It initially returned a total of 537 health training programs out 1518 total programs (35% of all APPIC programs). A full review included a quantitative and qualitative comprehensive review of the APPIC program summary, the site website, and program brochures. The quantitative review extracted the number of training positions; amount of stipend; location or state of program, patient, population, and rotation. The qualitative review examined the nature of the training experience. Results: 29 (5%) of all APPIC health psychology internship training programs (2%) respectively of all APPIC training internship programs offering internship CL training were identified. Of the 29 internship training programs, 16 were exclusively within a pediatric setting (55%), 11 were exclusively within an adult setting (38%), and two were a mix of pediatric and adult settings (7%). CL training sites were located to 19 states, offering a total of 153 positions nationally, with Florida containing the largest number of programs (4). Only six programs offered 12-month training opportunities while the rest offered CL as a major (6 month) to minor (3-4 month) rotation. The program’s stipend for CL training positions ranged from $25,000 to $62,400, with an average of $32,056. Conclusions: These preliminary findings suggest CL training and services are currently limited. Training opportunities that do exist are mostly limited to minor, short rotations and governed by psychiatry. Health psychologists are well-positioned to better define the role of psychology in consultation liaison services and enhance and formalize existing training protocols. Future research should explore in more detail empirical outcomes of CL services that employ psychology and delineate the contributions of psychology from psychiatry and other disciplines within an inpatient hospital setting.

Keywords: consultation liaison, health psychology, hospital setting, training

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12694 Growth Performance and Critical Supersaturation of Heterogeneous Condensation for High Concentration of Insoluble Sub-Micron Particles

Authors: Jie Yin, Jun Zhang

Abstract:

Measuring the growth performance and critical supersaturation of particle group have a high reference value for constructing a supersaturated water vapor environment that can improve the removal efficiency of the high-concentration particle group. The critical supersaturation and the variation of the growth performance with supersaturation for high-concentration particles were measured by a flow cloud chamber. Findings suggest that the influence of particle concentration on the growth performance will reduce with the increase of supersaturation. Reducing residence time and increasing particle concentration have similar effects on the growth performance of the high-concentration particle group. Increasing particle concentration and shortening residence time will increase the critical supersaturation of the particle group. The critical supersaturation required to activate a high-concentration particle group is lower than that of the single-particle when the minimum particle size in the particle group is the same as that of a single particle.

Keywords: sub-micron particles, heterogeneous condensation, critical supersaturation, nucleation

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12693 Transient Freshwater-Saltwater Transition-Zone Dynamics in Heterogeneous Coastal Aquifers

Authors: Antoifi Abdoulhalik, Ashraf Ahmed

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The ever growing threat of saltwater intrusion has prompted the need to further advance the understanding of underlying processes related to SWI for effective water resource management. While research efforts have mainly been focused on steady state analysis, studies on the transience of saltwater intrusion mechanism remain very scarce and studies considering transient SWI in heterogeneous medium are, as per our knowledge, simply inexistent. This study provides for the first time a quantitative analysis of the effect of both inland and coastal water level changes on the transition zone under transient conditions in layered coastal aquifer. In all, two sets of four experiments were completed, including a homogeneous case, and four layered cases: case LH and case HL presented were two bi-layered scenarios where a low K layer was set at the top and the bottom, respectively; case HLH and case LHL presented two stratified aquifers with High K–Low K–High K and Low K–High K– Low K pattern, respectively. Experimental automated image analysis technique was used here to quantify the main SWI parameters under high spatial and temporal resolution. The findings of this study provide an invaluable insight on the underlying processes responsible of transition zone dynamics in coastal aquifers. The results show that in all the investigated cases, the width of the transition zone remains almost unchanged throughout the saltwater intrusion process regardless of where the boundary change occurs. However, the results demonstrate that the width of the transition zone considerably increases during the retreat, with largest amplitude observed in cases LH and LHL, where a low K was set at the top of the system. In all the scenarios, the amplitude of widening was slightly smaller when the retreat was prompted by instantaneous drop of the saltwater level than when caused by inland freshwater rise, despite equivalent absolute head change magnitude. The magnitude of head change significantly caused larger widening during the saltwater wedge retreat, while having no impact during the intrusion phase.

Keywords: freshwater-saltwater transition-zone dynamics, heterogeneous coastal aquifers, laboratory experiments, transience seawater intrusion

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12692 Social Aspect of Energy Transition in Frankfurt

Authors: Aly Ahmed, Aber Kay Obwona, Mokrzecka Martyna, Piotrowska Małgorzata, Richardson Stephen

Abstract:

Frankfurt am Main, the fifth largest city in Germany, ranked at 15th place by the Global Financial Centers Index in 2014, and a finalist of European Green Capital, 214 is a crucial player in German Environmental Policy. Since 2012 the city Authorities have been working on implementing the plan, which assumed to reduce the energy consumption by 50%, and fully switch to renewable energy by the year 2050. To achieve this goal, the Municipality of Frankfurt has begun preparing the Master plan, which will be introduced to public by the end of 2015. A significant question when facing the starting of Master Plan public’s introduction was deciding which method should be used to increase the public engagement. In order to answer this question, the city and region authorities in the cooperation with Frankfurt’s Universities and Climate KIC, organized a two-week PhD scientific workshops, in which participated more than 30 students from numerous countries. The paper presented the outcome of the research and solution proposal of the winning team. Transitions theory tells, that to address challenges as complex as Climate Change and the Energiewende, using of new technologies and system to the public is not sufficient. Transition –by definition is a process, and in such a large scale (city and region transition) can be fulfilled only, when operates within a broad socio – technical system. Authors believe that only by close cooperation with city dwellers, as well as different stakeholders, the Transition in Frankfurt can be successful. The vital part is the strategy which will ensure the engagement, sense of ownership and broad support within Frankfurt society. Author proposal based therefore, on fostering the citizens engagement through a comprehensive, innovative communication strategy.

Keywords: city development, communication strategies, social transition, sustainability

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