Search results for: prevention focus

Authors: Colleen McMillan, Alice Schmidt-Hanbidge, Beth Archer-Kuhn, Heather Boynton, Judith Hughes

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It is well known that social work students enter the profession with higher scores of adverse childhood experiences (ACE). Add to that the fact that COVID-19 has forced higher education institutions to shift to online teaching and learning, where students, faculty and field educators in social work education have reported increased stressors as well as posing challenges in developing relationships with students and being able to identify mental health challenges including those related to trauma. This multi-institutional project included three Canadian post-secondary institutions at five sites (the University of Waterloo, the University of Calgary and the University of Manitoba) and partners; Desire To Learn (D2L), The Centre for Teaching Excellence at the University of Waterloo and the Taylor Institute for Teaching and Learning. A sequential mixed method research design was used. Survey data was collected from students, faculty and field education staff from the 3 universities using the Qualtrics Insight Platform, followed by virtual focus group data with students to provide greater clarity to the quantitative data. Survey data was analyzed using SPSS software, while focus group data was transcribed verbatim and organized with N-Vivo 12. Thematic analysis used line-by-line coding and constant comparative methods within and across focus groups. The following three objectives of the study were achieved: 1) Establish a Canadian baseline on trauma informed pedagogy and student experiences of trauma informed teaching in the online higher education environment during a pandemic; 2) Identify and document educator and student experiences of online learning regarding the ability to process trauma experiences; and, 3) Transfer the findings into a trauma informed pedagogical model for Social Work as a first step toward developing a universal trauma informed teaching model. The trauma informed pedagogy model would be presented in relation to the study findings.

Keywords: trauma informed pedagogy, higher education, social work, mental health

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Authors: Lodgaard Eirin, Myklebust Odd, Eleftheriadis Ragnhild

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Continuous improvement is becoming increasingly a prerequisite for manufacturing companies to remain competitive in a global market. In addition, future survival and success will depend on the ability to manage the forthcoming digitalization transformation in the industry 4.0 era. Industry 4.0 promises substantially increased operational effectiveness, were all equipment are equipped with integrated processing and communication capabilities. Subsequently, the interplay of human and technology will evolve and influence the range of worker tasks and demands. Taking into account these changes, the concept of continuous improvement must evolve accordingly. Based on a case study from manufacturing industry, the purpose of this paper is to point out what the concept of continuous improvement will meet and has to take into considering when entering the 4th industrial revolution. In the past, continuous improvement has the focus on a culture of sustained improvement targeting the elimination of waste in all systems and processes of an organization by involving everyone. Today, it has to be evolved into the forthcoming digital transformation and the increased interplay of human and digital communication system to reach its full potential. One main findings of this study, is how digital communication systems will act as an enabler to strengthen the continuous improvement process, by moving from collaboration within individual teams to interconnection of teams along the product value chain. For academics and practitioners, it will help them to identify and prioritize their steps towards an industry 4.0 implementation integrated with focus on continuous improvement.

Keywords: continuous improvement, digital communication system, human-machine-interaction, industry 4.0, team perfomance

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Authors: Dominika Pihikova, Stefan Belicky, Tomas Bertok, Roman Sokol, Petra Kubanikova, Jan Tkac

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Since aberrant glycosylation is frequently accompanied by both physiological and pathological processes in a human body (cancer, AIDS, inflammatory diseases, etc.), the analysis of tumor-associated glycan patterns have a great potential for the development of novel diagnostic approaches. Moreover, altered glycoforms may assist as a suitable tool for the specificity and sensitivity enhancement in early-stage prostate cancer diagnosis. In this paper we discuss the construction and optimization of ultrasensitive sandwich biosensor platform employing lectin as glycan-binding protein. We focus on the immunoassay development, reduction of non-specific interactions and final glycoprofiling of human serum samples including both prostate cancer (PCa) patients and healthy controls. The fabricated biosensor was measured by label-free electrochemical impedance spectroscopy (EIS) with further lectin microarray verification. Furthermore, we analyzed different biosensor interfaces with atomic force microscopy (AFM) in nanomechanical mapping mode showing a significant differences in the altitude. These preliminary results revealing an elevated content of α-2,3 linked sialic acid in PCa patients comparing with healthy controls. All these experiments are important step towards development of point-of-care devices and discovery of novel glyco-biomarkers applicable in cancer diagnosis.

Keywords: biosensor, glycan, lectin, prostate cancer

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Authors: P. H. G. J. Pushpakumara, Andrew Dawson

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Introduction: Deliberate self harm (DSH) is a major public health problem globally. Suicide rates of Sri Lanka are being among the highest national rates in the world, since 1950. Previous DSH is the most important independent predictor of repetition. The estimated 1 year non-fatal repeat self-harm rate was 16.3%. Asian countries had considerably lower rate, 10.0%. Objectives: To calculate incidence of deliberate self-poisoning (DSP) and suicides, repetition rate of DSP in Kurunegala District (KD). To determine the pattern of repeated DSP in KD. Methods: Study had two components. In the first component, demographic and event related details of, DSP admission in 46 hospitals and suicides in 28 police stations of KD were collected for 3 years from January 2011. Demographic details of cohort of DSP patients admitted to above hospitals in 2011 were linked with hospital admissions and police records of next two years period from the index admission. Records were screened for links with high sensitivity using the computer then did manual matching which would have been much more specific. In the second component, randomly selected DSP patients (n=438), who admitted to main referral centre which receives 60% of DSP cases of the district, were interviewed to assess life-time repetition. Results: There were 16,993 DSP admissions and 1078 suicides for the three year period. Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011, 2012 and 2013. Average male to female ratio for suicide incidences was 5.5. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population. Male incidences were slightly greater than the female incidences, male: female ratio was 1.1:1. Highest age standardized male and female incidence was reported in 20-24 years age group, 769.6/100,000, and 15-19 years age group 1304.0/100,000. Male to female ratio of the incidence increased with the age. There were 318 (179 male and 139 female) patients attempted DSH within two years. Female repetitive patients were ounger compared to the males, p < 0.0001, median age: males 28 and females 19 years. 290 (91.2%) had only one repetitive attempt, 24 (7.5%) had two, 3 (0.9%) had three and one (0.3%) had four in that period. One year repetition rate was 5.6 and two year repetition rate was 7.9%. Average intervals between indexed events and first repetitive DSP events were 246.8 (SD:223.4) and 238.5 (SD:207.0) days among males and females. One fifth of first repetitive events occurred within first two weeks in both males and females. Around 50% of males and females had the second event within 28 weeks. Within the first year of the indexed event, around 70% had the second event. First repetitive event was fatal for 28 (8.8%) individuals. Ages of those who died, mean 49.7 years (SD:15.3), were significantly higher compared to those who had non-fatal outcome, p<0.0001. 9.5% had life time history of DSH attempts. Conclusions: Both, DSP and suicide incidences were very high in KD. However, repetition rates were lesser compared regional values. Prevention of repetition alone may not produce significant impact on prevention of DSH.

Keywords: deliberate self-harm, incidence, repetition, Sri Lanka, suicide

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Authors: Azadeh Mohajer Milani

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Urbanization constitutes an irreversible global trend, presenting myriad challenges such as heightened energy consumption, pollution, congestion, and the depletion of natural resources. Today's urban landscapes have emerged as focal points for economic, social, and environmental challenges, underscoring the pressing need for sustainable development. This article delves into the realm of sustainable urban development, concentrating on the pivotal role played by integrated green spaces as an optimal solution to address environmental concerns within cities. The study utilizes Tehran as a case study. Our findings underscore the imperative of preserving and expanding green spaces in urban areas, coupled with the establishment of well-designed ecological networks, to enhance environmental quality and elevate the sustainability of cities. Notably, Tehran's urban green spaces exhibit a disjointed design, lacking a cohesive network to connect various patches and corridors, resulting in significant environmental impacts. The results emphasize the necessity of a balanced and proportional distribution of urban green spaces and the creation of a cohesive patch-corridor-matrix network tailored to the ecological and social needs of residents. This approach is crucial for fostering a more sustainable and livable urban environment for all species, with a specific focus on humans.

Keywords: ecology, sustainable urban development, sustainable landscape, urban green space network

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Authors: Assile Abou Diab, Shadi Najjar

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Fiber-reinforcement is an effective soil improvement technique for applications involving the prevention of shallow failures on the slope face and the repair of existing slope failures. A typical application is the stabilization of cohesionless infinite slopes. The objective of this paper is to present a probabilistic, reliability-based methodology (based on Monte Carlo simulations) for the design of a practical fiber-reinforced cohesionless infinite slope, taking into consideration the impact of various sources of uncertainty. Recommendations are made regarding the required factors of safety that need to be used to achieve a given target reliability level. These factors of safety could differ from the traditional deterministic factor of safety.

Keywords: factor of safety, fiber reinforcement, infinite slope, reliability-based design, uncertainty

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Authors: Rebecca Pryce, Nijole Bernaitis, Andrew K. Davey, Shailendra Anoopkumar-Dukie

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Background: Warfarin is an oral anticoagulant widely used in the prevention of strokes in patients with atrial fibrillation (AF) and in the treatment and prevention of deep vein thrombosis (DVT). Regular monitoring of Internationalised Normalised Ratio (INR) is required to ensure therapeutic benefit with time in therapeutic range (TTR) used to measure warfarin control. A number of factors influence TTR including diet, concurrent illness, and drug interactions. Extensive literature exists regarding the effect of conventional medicines on warfarin control, but documented interactions relating to complementary medicines are limited. It has been postulated that fish oil and krill oil supplementation may affect warfarin due to their association with bleeding events. However, to date little is known as to whether fish and krill oil significantly alter the incidence of bleeding with warfarin or impact on warfarin control. Aim:To assess the influence of fish oil and krill oil supplementation on warfarin control in AF and DVT patients by determining the influence of these supplements on TTR and bleeding events. Methods:A retrospective cohort analysis was conducted utilising patient information from a large private pathology practice in Queensland. AF and DVT patients receiving warfarin management by the pathology practice were identified and their TTR calculated using the Rosendaal method. Concurrent medications were analysed and patients taking no other interacting medicines were identified and divided according to users of fish oil and krill oil supplements and those taking no supplements. Study variables included TTR and the incidence of bleeding with exclusion criteria being less than 30 days of treatment with warfarin. Subject characteristics were reported as the mean and standard deviation for continuous data and number and percentages for nominal or categorical data. Data was analysed using GraphPad InStat Version 3 with a p value of <0.05 considered to be statistically significant. Results:Of the 2081 patients assessed for inclusion into this study, a total of 573 warfarin users met the inclusion criteria. Of these, 416 (72.6%) patients were AF patients and 157 (27.4%) DVT patients and overall there were 316 (55.1%) male and 257 (44.9%) female patients. 145 patients were included in the fish oil/krill oil group (supplement) and 428 were included in the control group. The mean TTR of supplement users was 86.9% and for the control group 84.7% with no significant difference between these groups. Control patients experienced 1.6 times the number of minor bleeds per person compared to supplement patients and 1.2 times the number of major bleeds per person. However, this was not statistically significant nor was the comparison between thrombotic events. Conclusion: No significant difference was found between supplement and control patients in terms of mean TTR, the number of bleeds and thrombotic events. Fish oil and krill oil supplements when used concurrently with warfarin do not significantly affect warfarin control as measured by TTR and bleeding incidence.

Keywords: atrial fibrillation, deep vein thormbosis, fish oil, krill oil, warfarin

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Authors: Basman Abdul Jabbar

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The researchers aimed to improve the importance of the good posture without any divisions & deformities. The importance of research lied in the discovery posture deformities early so easily treated before its transformation into advanced abnormalities difficult to treat and may need surgical intervention. Research problem was noting that some previous studies were based on the discovery of posture deformities, which was dependent on the (self-evaluation) which this type did not have accuracy to discover deformities. The Samples were (500) schoolchildren aged (9-11 years, males) at Baghdad al Karak. They were students at primary schools. The measure included all posture deformities. The researcher used video camera to analyze the posture deformities according to biomechanical variables by Kinovea software for motion analysis. The researcher recommended the need to use accurate scientific methods for early detection of posture deformities in children which contribute to the prevention and reduction of distortions.

Keywords: biomechanics, children, deformities, posture

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Authors: Bai-Chen Xie, Biao Li

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With the deepening of international exchanges and investment, the international comparison of power grid firms has become the focus of regulatory authorities. Ignoring the differences in the economic environment, resource endowment, technology, and other aspects of different countries or regions may lead to efficiency bias. Based on the Meta-frontier model, this paper divides China and Japan into two groups by using the data of China and Japan from 2006 to 2020. While preserving the differences between the two countries, it analyzes and compares the efficiency of the transmission and distribution industries of the two countries. Combined with the four-component stochastic frontier model, the efficiency is divided into transient and persistent efficiency. We found that there are obvious differences between the transmission and distribution sectors in China and Japan. On the one hand, the inefficiency of the two countries is mostly caused by long-term and structural problems. The key to improve the efficiency of the two countries is to focus more on solving long-term and structural problems. On the other hand, the long-term and structural problems that cause the inefficiency of the two countries are not the same. Quality factors have different effects on the efficiency of the two countries, and this different effect is captured by the common frontier model but is offset in the overall model. Based on these findings, this paper proposes some targeted policy recommendations.

Keywords: transmission and distribution industries, transient efficiency, persistent efficiency, meta-frontier, international comparison

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Authors: Josiane Yaguibou, Ngoy Kishimba, Issiaka V. Coulibaly, Sabrina Pestilli, Falinirina Razanalison, Hantanirina V. Andremanisa

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Background In Madagascar modern contraceptive prevalence rate increased from 18% in 2003 to 43% in 2021. Anecdotal evidence suggests that increased use and frequent stock out in public health facilities of male condoms and medroxyprogesterone acetate (MPA) can be related to diverted use of these products. This study analyzed the use of contraceptives and mode of utilization (correct or diverted) at the community level in the period 2019-2023 in Madagascar. Methodology: The study included a literature review, a quantitative survey combined with a qualitative study. It was carried out in 10 regions out of the 23 of the country. Eight regions (Bongolava, Vakinakaratra, Italy, Hautre Matsiatra, Betsiboka, Diana, Sofia and Anosy) were selected based on a study that showed existence of medroxyprogesterone acetate in pigs (MPA). The remaining 2 regions were selected due to high mCPR (Atsimo Andrefana) and to ensure coverage of all geographical zones in the country (Alaotra Mangoro). Sample random method was used, and the sample size was identified at 300 individuals per region. Zonal distribution is based on the urbanization rate for the region. 6 focus group discussions were organized in 3 regions, equally distributed between rural and urban areas. Key findings: Overall, 67% of those surveyed or their partner are currently using contraception. Injectables (MPA) are the most popular choice (33%), followed by implants and male condoms, 12% and 9%, respectively. The majority of respondents use condoms to prevent unwanted pregnancy but also to prevent STDs. Still, 43% of respondents use condoms for other purposes, reaching 52% of respondents in urban areas and 71,2% in the age group 15-18. Diverted use includes hair growth (18.9%), as a toy (18.8%), cleaning the screen of electronic devices (10 %), cleaning shoes (3.1%) and for skincare (1.6%). Injectables are the preferred method of contraception both in rural areas (35%) and urban areas (21.2%). However, diverted use of injectables was confirmed by 4% of the respondents, ranging from 3 % in rural areas to 12% in urban. The diverted use of injectables in pig rearing was to avoid pregnancy and facilitate pig’s growth. Program Implications: The study confirmed the diverted use of some contraceptives. The misuse of male condoms is among the causes of stockouts of products in public health facilities, limiting their availability for pregnancy and STDs prevention. The misuse of injectables in pigs rearing needs to be further studied to learn the full extent of the misuse and eventual implications for meat consumption. The study highlights the importance of including messages on the correct use of products during sensibilization activities. In particular, messages need to address the anecdotal and false effects of male condoms, especially amongst young people. For misuse of injectables is critical to sensibilize farmers and veterinaries on possible negative effects for humans.

Keywords: diverted use, injectables, male condoms, sensibilization

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Authors: Ioanna Koumi

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The aim of the intervention presented is to show the positive effects a mindfulness programme can have on the behaviour of preschoolers (years 4-6). The programme was implemented as part of the psychologist's work in 5 preschool units on the Greek island of Chios. Classroom-based activities of mindfulness were shown and practiced in 5 sessions, in collaboration with teachers, in order to make preschoolers aware of how their brain affects their behaviour, as well as of how they can have more positive behaviours, especially in instances of negative feelings. The outcomes of the intervention were assessed via questionnaire completion before and after the sessions by the teachers, as well as focus groups procedures with students, teachers, and parents. Implications of how mindfulness programmes can also be implemented at home are further discussed. School year in which the programme is being implemented: 2022-23 Intervention method: based on basic mindfulness theory and practice, the 220 students (age 4-6) in 11 classes of the 5 preschools that participated were given lessons of how to become aware of their states of focusing, regulation, attention, emotional situation, as well as body and social situations. Furthermore, the preschoolers were encouraged to make more mindful choices when it came to negative situations and emotions. Assessment method: The school as a caring community Profile II – Questionnaire completed by 20 preschool teachers prior to and after the intervention, Focus group sessions with teachers, students, parents at the end of the intervention Results: the assessment will be completed in May 2023.

Keywords: preschool, mindfulness training, self-awareness, social-emotional development

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Authors: Anette Hay, Zama Simamane

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Capacity-building and integration of practical activities is one of the key SDGs of the 2030 Agenda for Sustainable Development. This paper will focus on SDG# 17 – “the means of implementation” - and the role of systems thinking in practice (STiP) in supporting both competence and SDG implementation capability in teacher education curricula at North-West University, South Africa. The “Environmental Management for Sustainability” module (EDTM 312), which is compulsory for all students enrolled in the education program at North-West University, will be used as a case study. There is a need for higher education to implement and practically integrate SDG goals into their curricula, and one way to achieve this is through the development of competencies. Education for Sustainable Development (ESD) has the potential to offer approaches that can be useful in the development of capacity-building activities to foster sustainability. The methodological approach adopted is based on a participatory paradigm followed by two cycles and reflection. This paper focuses on systems thinking in practice demonstrating how students apply and reflect on competencies to situations and how praxis captures the actual experiences. The results of this research indicated how to re-orientate the EDTM 312 curriculum to include an environmental justice focus. This research shares practical knowledge of systems thinking as a sustainability competency.

Keywords: education for sustainable development, environmental justice competencies, sustainable development goals, systems thinking in practice

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Authors: Samar Alharbi, Yota Dimitriadi

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The literature on educational technology in Saudi Arabia reveals female learners’ unwillingness to study fully online courses in higher education despite the fact that Saudi universities have offered a variety of online degree programmes to undergraduate students in many regions of the country. The root causes keeping female students from successfully learning in online environments are limited social interaction, lack of motivation and difficulty with the use of e-learning platforms. E-immediacy remains an important method of online teaching to enhance students’ interaction and support their online learning. This study explored Saudi female students’ perceptions, as well as the experiences of lecturers’ immediacy behaviours in online environments, who participate in fully online courses using Blackboard at a Saudi university. Data were collected through interviews with focus groups. The three focus groups included five to seven students each. The female participants were asked about lecturers’ e-immediacy behaviours and which e-immediacy behaviours were important for an effective learning environment. A thematic analysis of the data revealed three main themes: the encouragement of student interaction, the incorporation of social media and addressing the needs of students. These findings provide lecturers with insights into instructional designs and strategies that can be adopted in using e-immediacy in effective ways, thus improving female learners’ interactions as well as their online learning experiences.

Keywords: e-learning, female students, higher education, immediacy

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Authors: Cheyenne Johnson, Samantha Robinson, Christina Chant, Ann M. Mitchell, Carol Price, Carmel Clancy, Adam Searby, Deborah S. Finnell

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Introduction: Substance use along the continuum from at-risk use to a substance use disorder (SUD) contributes substantially to the burden of disease and related harms worldwide. There is a growing body of literature that highlights the lack of substance use related content in nursing curricula. Furthermore, there is also a lack of consensus on key competencies necessary for entry-level nurses. Globally, there is a lack of established nursing competencies related to prevention, health promotion, harm reduction and treatment of at-risk substance use and SUDs. At a critical time in public health, this gap in nursing curricula contributes to a lack of preparation for entry-level nurses to support people along the continuum of substance use. Thus, in practice, early opportunities for screening, support, and interventions may be missed. To address this gap, an international committee was convened to develop international entry-level nursing competencies specifying the knowledge, skills, and abilities that all nurses should possess in order to address the continuum of substance use. Methodology: An international steering committee, including representation from Canada, United States, United Kingdom, and Australia was established to lead this work over a one-year time period. The steering committee conducted a scoping review, undertaken to examine nursing competency frameworks, and to inform a competency structure that would guide this work. The next steps were to outline key competency areas and establish leaders for working groups to develop the competencies. In addition, a larger international committee was gathered to contribute to competency working groups, review the collective work and concur on the final document. Findings: A comprehensive framework was developed with competencies covering a wide spectrum of substance use across the lifespan and in the context of prevention, health promotion, harm reduction and treatment, including special populations. The development of this competency-based framework meets an identified need to provide guidance for universities, health authorities, policy makers, nursing regulators and other organizations that provide and support nursing education which focuses on care for patients and families with at-risk substance use and SUDs. Conclusion: Utilizing these global competencies as expected outcomes of an educational and skill building curricula for entry-level nurses holds great promise for incorporating evidence-informed training in the care and management of people across the continuum of substance use.

Keywords: addiction nursing, addiction nursing curriculum, competencies, substance use

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Authors: Mikko Hänninen

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This paper explores the effect online retail platforms have on customer behavior and retail patronage through an inductive multi-case study. Existing research on retail platforms and ecosystems generally focus on competition between platform members and most papers maintain a managerial perspective with customers seen mainly as merely one stakeholder of the value-exchange relationship. It is proposed that retail platforms change the nature of customer relationships compared to traditional brick-and-mortar or e-commerce retailers. With online retail platforms such as Alibaba, Amazon and Rakuten gaining increasing traction with their platform based business models, the purpose of this paper is to define retail platforms and look at how leading retail platforms are able to create value for their customers, in order to foster meaningful customer’ relationships. An analysis is conducted on the major global retail platforms with a focus specifically on understanding the tools in place for creating customer value in order to show how retail platforms create and maintain customer relationships for fostering customer loyalty. The results describe the opportunities and challenges retailers face when competing against platform based businesses and outline the advantages as well as disadvantages that platforms bring to individual consumers. Based on the inductive case research approach, five theoretical propositions on consumer behavior in online retail platforms are developed that also form the basis of further research with this research making both a practical as well as theoretical contribution to platform research streams.

Keywords: retail, platform, ecosystem, e-commerce, loyalty

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Authors: Thanduxolo Nomngcoyiya, Simon M. Kang’ethe

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The aim of this article is to explore whether a relationship exists between traditional male circumcision mishaps and level of education in the Eastern Cape, South Africa, exemplified by an empirical case study. The study used qualitative paradigm; was exploratory in nature and used case study design that was descriptive and exploratory; and entailed interviewing twenty-eight (28) research participants comprising of eleven (11) newly initiated men and their families on one-on-one in-depth interviews, twelve (12) traditional nurses and community members in focus group discussions; and five (5) society key informants on key informant method. An interview guide served as a data collection instrument for focus group discussions, key informant method and in-depth interviews with unstructured open-ended questions. Findings indicated an array of traditional male circumcision (TMC) gaps, some of which were indicative of a relationship between the mishaps and level of education: the phenomenon of schooling became secondary in newly initiated men’s lives; TMC mishaps became a drawback towards the newly initiated men’s education progression; the newly initiated men are sacrificed at the altar of culture, and TMC mishaps ushered in socioeconomic setback to the newly initiated men. The study suggested that: TMC be developmental; TMC as a cultural endeavor be educational and human rights friendly; and the need to identify and integrate all other players with diverse specialties.

Keywords: culture, education for all, EFA, millennium development goals, traditional male circumcision

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Authors: Diana Kwok

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Introduction: There is a rising concern on the educational needs of school guidance teachers, counselors, and sex educators to work effectively with students from multicultural groups, such as racial minorities, gender minorities, sexual minorities, and disability groups etc., and to respect cultural diversities. A specialized training model, the multicultural framework based on contact theory is recognized as necessary training model for professional training programs. Methodology: While the major focus of this project is on improving teaching and learning in teacher training courses within the department of Special Education and Counselling, it specifically aims to enhance the cultural competence of 102 participants enrolled in counseling and sexuality education courses by integrating the following teaching and learning strategies: 1) Panel presentation; 2) Case studies; 3) Experiential learning. Data sources from the participants consisted of the following: (a) questionnaires (MCKAS and ATLG) administered in classes; (b) weekly reflective journals, and c) focus group interviews with panel members. The focus group interviews with panel members were documented. Qualitatively, the weekly reflections were content analyzed. The presentation in this specific conference put focus on themes we found from qualitative content analysis of weekly reflective journals from 102 participants. Findings: Content analysis had found the following preliminary emergent themes: Theme I) Cultural knowledge and challenges to personal limitation. Students had gained a new perspective that specific cultural knowledge involved unique values and worldview. Awareness of limitation of counsellors is very important after actively acquiring the cultural knowledge. Theme 2 - Observation, engagement and active learning. Through the sharing and case studies, as well as visits to the communities, students recognized that observation and listening to the needs of cultural group members were the essential steps before taking any intervention steps. Theme 3 - Curiosity and desire for further inter-group dialogue. All students expressed their desire, curiosity, and motivation to have further inter-group dialogue in their future work settings. Theme 4: Experience with teaching and learning strategies. Students shared their perspectives on how teaching and learning strategies had facilitated their acquisition of cultural competence. Results of this analysis suggests that diverse teaching and learning strategies based on contact perspective had stimulated their curiosity to re-examine their values and motivated them to acquire cultural knowledge relevant to the cultural groups. Acknowledgment: The teaching and learning project was funded by the Teaching and Development Grant, Hong Kong Institute of Education (Project Number T0142).

Keywords: cultural competence, Chinese teacher students, teaching and learning, contacts

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Authors: Nuray Gökçek Karaca

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This study aims to examine the application of occupational health and safety supervision in Turkey and EU countries in terms of legal regulations. The results of research reveal that occupational health and safety supervision in EU countries, whatever the understanding of welfare state, is effectively carried out and almost all legal regulations on this subject are consistent with the EU directives. On the other hand, there are serious problems in applications, not legal regulations, of occupational health and safety supervision in Turkey by the side of EU countries. Indeed, Turkey has modern regulations on occupational health and safety supervision whereas there are several problems such as ignoring prevention policy on occupational health and safety supervision, understanding of monotype inspector, problems resulting from this understanding and dispersed structure of occupational health and safety organizations in workplaces. As a result, Turkey needs to carry out effective supervision mechanisms.

Keywords: legal rules, occupational health and safety, inspection, supervision, legislation

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Authors: Champika Amarasinghe

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Introduction: Covid 19 pandemic was badly hit to the Sri Lankan economy during the year 2021. More than 65% of the Sri Lankan work force is engaged with small and medium scale businesses which no doubt that they had to struggle for their survival and business continuity during the pandemic. Objective: To assess the association of adherence to the new norms during the Covid 19 pandemic and maintenance of healthy working environmental conditions for business continuity. A cross sectional study was carried out to assess the OSH status and adequacy of Covid 19 preventive strategies among the 200 SME’S in selected two districts in Sri Lanka. These two districts were selected considering the highest availability of SME’s. Sample size was calculated, and probability propionate to size was used to select the SME’s which were registered with the small and medium scale development authority. An interviewer administrated questionnaire was used to collect the data, and OSH risk assessment was carried out by a team of experts to assess the OSH status in these industries. Results: According to the findings, more than 90% of the employees in these industries had a moderate awareness related to COVID 19 disease and preventive strategies such as the importance of Mask use, hand sainting practices, and distance maintenance, but the only forty percent of them were adhered to implementation of these practices. Furthermore, only thirty five percent of the employees and employers in these SME’s new the reasons behind the new norms, which may be the reason for reluctance to implement these strategies and reluctance to adhering to the new norms in this sector. The OSH risk assessment findings revealed that the working environmental organization while maintaining the distance between two employees was poor due to the inadequacy of space in these entities. More than fifty five percent of the SME’s had proper ventilation and lighting facilities. More than eighty five percent of these SME’s had poor electrical safety measures. Furthermore, eighty two percent of them had not maintained fire safety measures. Eighty five percent of them were exposed to heigh noise levels and chemicals where they were not using any personal protectives nor any other engineering controls were not imposed. Floor conditions were poor, and they were not maintaining the occupational accident nor occupational disease diseases. Conclusions: Based on the findings, proper awareness sessions were carried out by NIOSH. Six physical training sessions and continues online trainings were carried out to overcome these issues, which made a drastic change in their working environments and ended up with hundred percent implementation of the Covid 19 preventive strategies, which intern improved the worker participation in the businesses. Reduced absentees and improved business opportunities, and continued their businesses without any interruption during the third episode of Covid 19 in Sri Lanka.

Keywords: working environment, Covid 19, occupational diseases, occupational accidents

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Authors: Elkington S. Mnguni

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Water and sanitation services in South Africa are characterized by both achievements and challenges. After the end of apartheid in 1994 the newly elected government faced the challenge of eradicating backlogs with respect to access to basic services, including water and sanitation. Capital investment made in the development of new water and sanitation infrastructure to provide basic services to previously disadvantaged communities has grown, to a certain extent, at the expense of investment in the operation and maintenance of new and existing infrastructure. Challenges resulting from aging infrastructure and poor plant performance highlight the need for investing in the maintenance, rehabilitation, and replacement of existing infrastructure to optimize the return on investment. Advanced water infrastructure asset management (IAM) is key to achieving adequate levels of service, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution and associated risks. Against this backdrop, this paper presents an appraisal of water and sanitation IAM systems in South Africa’s three utilities, being metropolitan cities in the Gauteng Province. About a quarter of the national population lives in the three rapidly urbanizing cities of Johannesburg, Ekurhuleni and Tshwane, located in a semi-arid region. A literature review has been done and field visits to some of the utility facilities are being conducted. Semi-structured interviews will be conducted with the three utilities. The following critical factors are being analysed in terms of compliance with the national Water Services IAM Strategy (2011) and other applicable legislation: asset registers; capacity of assets; current and predicted demand; funding availability / budget allocations; plans: operation & maintenance, renewal & replacement, and risk management; no-drop status (non-revenue water levels); blue drop status (water quality); green drop status (effluent quality); and skills availability. Some of the key challenges identified in the literature review include: funding constraints, Skills shortage, and wastewater treatment plants operating beyond their design capacities. These challenges will be verified during field visits and research interviews. Gaps between literature and practice will be identified and relevant recommendations made if necessary. The objective of this study is to contribute to the resolution of the challenges brought about by the backlogs in the operation and maintenance of water and sanitation assets in the country in general, and in the three cities in particular, thus improving the sustainability thereof.

Keywords: asset management, backlogs, levels of service, sustainability, water and sanitation infrastructure

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Authors: Prince S. Campbell, Janine B. Adams, Melusi Thwala, Opeoluwa Oyedele, Paula E. Melariri

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Schistosomiasis, often known as bilharzia, is a parasitic water-borne disease caused by trematode flatworms of the genus Schistosoma. Schistosomiasis infection and prevention have been found to be influenced by a range of socio-cultural risk factors, including human characteristics (e.g., gender, age, education, knowledge, attitude, and practices), as well as environmental and economic elements. Lack of awareness of the disease may also contribute to an individual's tendency to participate in behaviours or activities that heighten their susceptibility to infection. The current study assessed the community knowledge, attitude and practices (KAP) on schistosomiasis and implemented an educational intervention following pre-test interviews. A cross-sectional quasi-experimental research design was used in this quantitative study. Pre- and post-intervention interview format surveys were conducted using a structured questionnaire, targeting individuals aged 18–65 years residing within 5 km of select water bodies. The questionnaire contained 54 close-ended questions about schistosomiasis causes, transmission, and clinical symptoms and the participants were interviewed face-to-face in their homes. Data was captured on Question Pro and analyzed using Microsoft Office Excel 365 (2019) and R (version 4.3.1) software. Overall, 380 individuals completed the pre and post-intervention assessments; 194 and 185 were males (51.1%) and females (48.7%), respectively. A notable 91.3% of participants did not know about schistosomiasis in the pre-intervention phase; however, the mean post-intervention test score (9.4 ± 1.4) for knowledge among participants was higher than the pre-intervention test score (2.2 ± 2.1) indicating a good and improved knowledge of schistosomiasis among the participants. Furthermore, the paired samples t-test results demonstrated that the increase in knowledge levels was statistically significant (p<0.001). Also, the post-intervention improvement of both practice (p<0.001) and attitude (p<0.001) levels was statistically significant. A positive correlation (r=0.23, p<0.001) was found between knowledge and attitude in the pre-intervention stage. Knowledgeable participants had a more positive attitude towards obtaining medical assistance and disease prevention. Moreover, attitudes and practices correlated negatively (r=-0.13, p=0.013) post-intervention; hence, those with positive attitudes did not engage in risky water-related practices, which was the desired outcome. The educational intervention had a favourable impact on the KAP of the study population as the majority were able to recall the disease aetiology, symptoms, transmission pattern, and preventative measures three months post-intervention. Nevertheless, previous research has suggested that participants were unable to recall information about the disease following the intervention. Consequently, research should prioritize behavioural modification strategies that may result in a more persistent outcome in terms of the participants' knowledge, which could ultimately contribute to the development of long-term positive attitudes and practices.

Keywords: educational intervention, knowledge, attitudes and practices, schistosomiasis

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Authors: David Kramsky, Barbora Vegrichtova

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The prison facility is generally considered as an environment having a corrective purpose. Besides the social sense of remedy, prison is also an environment that potentially determines and affects socially dangerous behavior. The authors, based on long-term empirical research, present the significant indicators that are directly related to the transformation of personality attitudes, motivations and behavior associating with a process of radicalization. One of the most significant symptoms of radicalization is a particular social moral decision making. Individuals in the radicalism process primarily prefer utilitarian manners of decision-making more than personal aspects like empathy for others. The authors will present the method of social moral profiling of the subject in radicalization process as an effective prevention system reducing security risks in society.

Keywords: indicators, moral decision, radicalism, social profile

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Authors: Raudone Lina, Raudonis Raimondas, Liaudanskas Mindaugas, Pukalskas Audrius, Viskelis Pranas, Janulis Valdimaras

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Human health fortification, its protection and disease prophylaxis are the main problems of the health care systems. Plant origin materials and their preparations are applied for the prevention of the common diseases. Oxidative stress takes part in the pathogenesis of many autoimmune, neurodegenerative, tumor and ageing processes. The antioxidants are able to protect the human body from the free radicals and to stop the progression of numerous chronic diseases. The research of plant origin materials is relevant for the search of natural antioxidants. A group of compounds that gained scientific attention due to antioxidant properties and effects on human health are phenolic compounds. Phenolic compounds are widely abundant in various parts of plants, i.e. leaves, stems, roots, flowers and fruits. Most commonly consumed fruits all over the world are apples. It is very important to analyze the antioxidant activity of apples as they are extensively used in the prevention of various diseases. The aim of this study was to determine the antioxidant profiles of Malus domestica Borkh fruit cultivars (Aldas, Auksis, Connel Red, Ligol, Lodel, Rajka) and to identify the phenolic compounds with potent contribution to antioxidant activity. Nineteen constituents were identified in apple cultivars using ultra high performance liquid chromatography coupled to quadruple and time-of-flight mass spectrometers (UPLC–QTOF–MS). Phytochemical profile was constituted of phenolic acids, procyanidins, quercetin derivatives and dihydrochalcones. Reducing and radical scavenging activities of individual constituents were determined using high performance liquid chromatography (HPLC) coupled to post-column FRAP and ABTS assay, respectively. Significant differences of total radical scavenging and reducing activity (expressed as trolox equivalents, TE µmol/g) were determined between the investigated cultivars. Chlorogenic acid and complex of procyanidins were the main contributors to antioxidant activity determining up to 35 % and 55 % of total TE values, respectively. Determined phenolic composition and antioxidant activity significantly depend on apple cultivars. It is important to determine the individual compounds that are significant for antioxidant activity and that could be investigated in vivo systems. The identification of the antioxidants provides information for the further research of standardized extracts that could be used for pharmaceutical preparations with specific phenolic traits.

Keywords: FRAP, ABTS, antioxidant, phenolic, apples, chlorogenic acid

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Authors: Hakimullah Hakim, Chiharu Toyofuku, Mari Ota, Mayuko Suzuki, Miyuki Komura, Masashi Yamada, Md. Shahin Alam, Natthanan Sangsriratanakul, Dany Shoham, Kazuaki Takehara

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Disinfectants and their application are essential part of infection control strategies and enhancement of biosecurity at farms, worldwide. Alkaline agents are well known for their strong and long term antimicrobial capacities and most frequently are applied at farms for control and prevention of biological hazards. However, inadequate information regarding such materials’ capacities to inactivate pathogens and their improper applications fail farmers to achieve the mentioned goal. Thus, this requires attention to further evaluate their efficacies, under different conditions and in different ways. Here in this study we evaluated bactericidal efficacies of food additive grade of calcium hydroxide (FdCa(OH)2) powder derived from natural calcium carbonates obtained from limestone (Fine Co., Ltd., Tokyo, Japan), and bioceramic powder (BCX) derived from chicken feces at pH 13 (NMG environmental development Co., Ltd., Tokyo, Japan), for their efficacies to inactivate bacteria in feces. [Materials & Methods] Chicken feces were inoculated by 100 µl Escherichia coli and Salmonella Infantis in falcon tubes, individually, then FdCa(OH)2 or BCX powders were individually added to make final concentration of 0, 5, 10, 20 and 30% (w/w) in total weight of 0.5g, followed by properly mixing and incubating at room temperature for certain periods of time, in a dark place. Afterwards, 10 ml 1M Tris-HCl (pH 7.2) was added onto them to reduce their pH, in order to stop powders’ activities and to harvest the remained viable bacteria, whereas using normal medium or dW2 to recover bacteria increases the mixture pH, and as a result bacteria would be inactivated soon; therefore, the latter practice brings about incorrect and misleading results. Samples were then inoculated on DHL agar plates in order to calculate colony forming units (CFU)/ml of viable bacteria. [Results and Discussion] FdCa(OH)2 powder at 10% and 5% required 3 hr and 6 hr exposure times, respectively, while BCX powder at 20% concentrations required 6 hr exposure time to kill the mentioned bacteria in feces down to lower than detectable level (≤ 3.6 log10 CFU/ml). This study confirmed capacities of FdCa(OH)2 and BCX powders to inactivate bacteria in feces, and both materials are environment friendly materials, with no risk to human or animal’s health. This finding helps farmers to properly apply alkaline agents in appropriate concentrations and exposure times in their farms, in order to prevent and control infectious diseases outbreaks and to enhance biosecurity. Finally, this finding may help farmers to implement better strategies for infections control in their livestock farms.

Keywords: bacterial inactivation, bioceramic, biosecurity at livestock farms, chicken feces

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Authors: Era Dorihi Kale, Sabina Gero, Uly Agustine

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Asylum seekers are people who come to other countries to get asylum. In line with that, they also carry the culture and health behavior of their country, which is very different from the new country they currently live in. This situation raises problems, also in the health sector. The approach taken must also be a culturally sensitive approach, where the culture and habits of the refugee's home area are also valued so that the health services provided can be right on target. Some risk factors that already exist in this group are lack of activity, consumption of fast food, smoking, and stress levels that are quite high. Overall this condition will increase the risk of an increased incidence of cardiovascular disease. This research is a descriptive and experimental study. The purpose of this study is to identify health status and develop a culturally sensitive health promotion model, especially related to the risk of cardiovascular disease for asylum seekers in detention homes in the city of Kupang. This research was carried out in 3 stages, stage 1 was conducting a survey of health problems and the risk of asylum seeker cardiovascular disease, Stage 2 developed a health promotion model, and stage 3 conducted a testing model of health promotion carried out. There were 81 respondents involved in this study. The variables measured were: health status, risk of cardiovascular disease and, health promotion models. Method of data collection: Instruments (questionnaires) were distributed to respondents answered for anamnese health status; then, cardiovascular risk measurements were taken. After that, the preparation of information needs and the compilation of booklets on the prevention of cardiovascular disease is carried out. The compiled booklet was then translated into Farsi. After that, the booklet was tested. Respondent characteristics: average lived in Indonesia for 4.38 years, the majority were male (90.1%), and most were aged 15-34 years (90.1%). There are several diseases that are often suffered by asylum seekers, namely: gastritis, headaches, diarrhea, acute respiratory infections, skin allergies, sore throat, cough, and depression. The level of risk for asylum seekers experiencing cardiovascular problems is 4 high risk people, 6 moderate risk people, and 71 low risk people. This condition needs special attention because the number of people at risk is quite high when compared to the age group of refugees. This is very related to the level of stress experienced by the refugees. The health promotion model that can be used is the transactional stress and coping model, using Persian (oral) and English for written information. It is recommended for health practitioners who care for refugees to always pay attention to aspects of culture (especially language) as well as the psychological condition of asylum seekers to make it easier to conduct health care and promotion. As well for further research, it is recommended to conduct research, especially relating to the effect of psychological stress on the risk of cardiovascular disease in asylum seekers.

Keywords: asylum seekers, health status, cardiovascular disease, health promotion

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Authors: Seree Klaengair, Sunpetch Angkititrakul, Dusadee Phongaran, Chaiyaporn Soikum

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The objectives of this study is to determine the prevalence and antimicrobial resistance pattern of Salmonella spp. isolated from chickens at slaughterhouses in northeast of Thailand. During 2015-2016, all samples were isolated and identified by ISO 6579:2002. A total of 604 samples of rectal swab were collected and isolated for the presence of Salmonella. Salmonella was detected in 109 of 604 (18.05%) samples. The most prevalent serovars were Salmonella Kentucky (22.94%), Give (20.18%) and Typhimurium (7.34%). In this study, 66.97% of the isolates were resistant to at least one antimicrobial drug and 38.39% were multidrug resistant. The highest resistances were found in nalidixic acid (49.54%), ampicillin (30.28%), tetracycline (27.52%), amoxicillin (26.61%), ciprofloxacin (23.85) and norfloxacin (19.27%). The results showed high prevalence of Salmonella spp. in chickens and antimicrobial resistance patterns. Prevention and control of Salmonella contamination in chickens should be consumer healthy.

Keywords: antimicrobial resistance, Salmonella spp., chicken, slaughterhouse

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Authors: Naziema Jappie

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South Africa is a diverse nation but with many challenges. The fundamental changes in the political, economic and educational domains in South Africa in the late 1990s affected the South African community profoundly. In higher education, experiences of discrimination and bias are detrimental to the sense of belonging of staff and students. It is therefore important to cultivate an appreciation of diversity and inclusion. To bridge common understandings with the reality of racial inequality, we must understand the ways in which senior and executive leadership at universities think about social justice issues relating to diversity and inclusion and contextualize these within the current post-democracy landscape. The position and status of social justice issues and initiatives in South African higher education is a slow process. The focus is to highlight how and to what extent initiatives or practices around campus diversity and inclusion have been considered and made part of the mainstream intellectual and academic conversations in South Africa. This involves an examination of the social and epistemological conditions of possibility for meaningful research and curriculum practices, staff and student recruitment, and student access and success in addressing the challenges posed by social diversity on campuses. Methodology: In this study, university senior and executive leadership were interviewed about their perceptions and advancement of social justice and examine the buffering effects of diverse and inclusive peer interactions and institutional commitment on the relationship between discrimination–bias and sense of belonging for staff and students at the institutions. The paper further explores diversity and inclusion initiatives at the three institutions using a Critical Race Theory approach in conjunction with a literature review on social justice with a special focus on diversity and inclusion. Findings: This paper draws on research findings that demonstrate the need to address social justice issues of diversity and inclusion in the SA higher education context. The reason for this is so that university leaders can live out their experiences and values as they work to transform students into being accountable and responsible. Documents were selected for review with the intent of illustrating how diversity and inclusion work being done across an institution can shape the experiences of previously disadvantaged persons at these institutions. The research has highlighted the need for institutional leaders to embody their own mission and vision as they frame social justice issues for the campus community. Finally, the paper provides recommendations to institutions for strengthening high-level diversity and inclusion programs/initiatives among staff, students and administrators. The conclusion stresses the importance of addressing the historical and current policies and practices that either facilitate or negate the goals of social justice, encouraging these privileged institutions to create internal committees or task forces that focus on racial and ethnic disparities in the institution.

Keywords: diversity, higher education, inclusion, social justice

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Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

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Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

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Authors: Pernille K. Christiansen, Mette Maria Skjøth, Line Lorenzen, Eva Draborg, Christina Anne Vinter, Trine Kjær, Mette Juel Rothmann

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Background and aims: Overweight and obesity are an increasing challenge on a global level. In Denmark, more than one-third of all pregnant women are overweight or obese, and many women exceed the gestational weight gain recommendations from the Institute of Medicine. Being overweight or obese, is associated with a higher risk of adverse maternal and fetal outcomes, including gestational diabetes and childhood obesity. Thus, it is important to focus on the women’s lifestyles between their pregnancies to lower the risk of gestational weight retention in the long run. The objective of this study was to explorer what barriers and challenges postpartum women experience with respect to healthy lifestyles during the postpartum period and to access whether an Information Technology based intervention might be a supportive tool to assist and motivate postpartum women to a healthy lifestyle. Materials and methods: The method is inspired by participatory design. A systematic text condensation was applied to semi-structured focus groups. Five focus group interviews were carried out with a total of 17 postpartum women and two interviews with a total of six health professionals. Participants were recruited through the municipality in Svendborg, Denmark, and at Odense University Hospital in Odense, Denmark, during a four-month period in early 2018. Results: From the women’s perspective, better assistance is needed from the health professionals to obtain or maintain a healthy lifestyle. The women need tools that inform and help them understand and prioritise their own health-related risks, and to motivate them to plan and take care of their own health. As the women use Information Technology on a daily basis, the solution could be delivered through Information Technology. Finally, there is room for engaging the partner more in the communication related to the baby and family’s lifestyle. Conclusion: Postpartum women need tools that inform and motivate a healthy lifestyle postpartum. The tools should allow access to high-quality information from health care professionals, when the information is needed, and also allow engagement from the partner. Finally, Information Technology is a potential tool for delivering tools.

Keywords: information technology, lifestyle, overweight, postpartum

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Authors: Virginia Guillén Cañas, Miren Agurtzane Ortiz-Jauregi, Sonia Ruiz De Azua, Naiara Ozamiz

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We want to focus on relationship of the communicational skills in several key aspects of medicine. The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes’ improvement and efficiency of health services. We define empathy as it as Sympathy and connection to others and capability to communicate this understanding. Some outcomes favoring empathy are female gender, younger age, and specialty choice. Third gender or third sex is a concept in which allows a person not to be categorized in a dual way but as a continuous variable, giving the choice of moving along it. This point of view recognizes three or more genders. The subject of Ethics and Clinical Communication is dedicated to sensitizing students about the importance and effectiveness of a good therapeutic relationship. We are also interested in other communicational aspects related to empathy as active listening, assertivity and basic and advanced Social Skills. Objectives: 1. To facilitate the approach of the student in the Medicine Degree to the reality of the medical profession 2. Analyze interesting outcome variables in communication 3. Interactive process to detect the areas of improvement in the learning process of the Physician throughout his professional career needs. Design: A comparative study with a cross-sectional approach was conducted in successive academic year cohorts of health professional students at a public Basque university. Four communicational aspects were evaluated through these questionnaires in Basque, Spanish and English: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. Types of interventions for improving skills: Interpersonal skills training intervention, Empathy intervention, Writing about experiential learning, Drama through role plays, Communicational skills training, Problem-based learning, Patient interviews ´videos, Empathy-focused training, Discussion. Results: It identified the need for a cross cultural adaptation and no gender distinction. The students enjoyed all the techniques in comparison to the usual master class. There was medium participation but these participative methodologies are not so usual in the university. According to empathy, men have a greater empathic capacity to fully understand women (p < 0.05) With regard to assertiveness there have been no differences between men and women in self-assertiveness but nevertheless women are more heteroassertive than men. Conclusions: These findings suggest that educational interventions with adequate feedback can be effective in maintaining and enhancing empathy in undergraduate medical students.

Keywords: physician's communicational skills, patient satisfaction, third gender, cross cultural adaptation

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