Search results for: supporting family wellness through the disability experience

Authors: Jude Harrison

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Child protection is a complex and sensitive practice. The core responsibility is the care and protection of children and young people who have been subject to or who are at risk from abuse and neglect. The work involves investigating allegations of harm, preparing for and making representations to the legal system, and case planning and management across a continuum of complicated care interventions. Professionals’ learning for child protection practice is evident in a range of literature investigating multiple learning processes such as university preparation, student placements, professional supervision, training, and other post-qualifying professional development experiences at work. There is, however, very limited research into how caseworkers learn in and through their daily practice. Little is known, therefore, about how learning at work unfolds for caseworkers, the dimensions in which it can be understood or the ways in which it can be best facilitated and supported. Compounding this, much of the current child protection learning literature reflects an orthodox conception of learning as mentalistic and individualised, in which knowledge is typically understood as abstract theory or as technical skill or competency. This presentation outlines key findings from a PhD research study that explored learning at work for statutory child protection caseworkers from an alternative interpretation of learning using a practice theory approach. Practice theory offers an interpretation of learning as performative and grounded in situated experience. The findings of the study show that casework practice is both a mode and site of learning. The study was ethnographic in design based and followed 17 child protection caseworkers via in-depth interviews, observations and participant reflective journaling. Inductive and abductive analysis was used to organise and interpret the data and expand analysis, leading to themes. Key findings show learning to be a sociomaterial property of doing; the social ontological character of learning; and teleoaffectivity as a feature of learning. The findings contribute to theoretical and practical understandings of learning and practice in child protection, child welfare and the professional learning literature more broadly. The findings have potential to contribute to policy directions at state, territory and national levels to enhance child protection practice and systems.

Keywords: adiult learning, workplace learning, child welfare, sociomaterial, practice theory

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Authors: Andrew Green, Jiaming Liu, Kellathur Srinivasan, Raymond Chua

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Introduction: The size of Singapore’s online health product (HP) market (e-commerce) is largely unknown. However, it is recognized that a large majority comes from overseas and thus, unregulated. As buying HP from unauthorized sources significantly compromises public health safety, understanding e-commerce users’ demographics and their perceptions on online HP purchasing becomes a pivotal first step to form a basis for recommendations in Singapore’s pharmacovigilance efforts. Objective: To assess the prevalence of online HP purchasing behaviour among Singaporean e-commerce users. Methodology: This is a cross-sectional study targeting Singaporean e-commerce users recruited from various local websites and online forums. Participants were not randomized into study arms but instead stratified by random sampling method based on participants’ age. A self-administered anonymous questionnaire was used to explore participants' demographics, online HP purchasing behaviour, knowledge and attitude. The association of different variables with online HP purchasing behaviour was analysed using logistic regression statistics. Main outcome measures: Prevalence of HP e-commerce users in Singapore (%) and variables that contribute to the prevalence (adjusted prevalent ratio). Results: The study recruited 372 complete and valid responses. The prevalence of online HP consumers among e-commerce users in Singapore is estimated to be 55.9% (1.7 million consumers). Online purchasing of complementary HP (46.9%) was the most prevalent, followed by medical devices (21.6%) and Western medicine (20.5%). Multivariate analysis showed that age is an independent variable that correlates with the likelihood of buying HP online. The prevalence of HP e-commerce users is highest in the 35-44 age group (64.1%) and lowest among the 16-24 age group (36.4%). The most bought HP through the internet are vitamins and minerals (21.5%), non-herbal (15.9%), herbal (13.9%), weight loss (8.7%) and sports (8.4%) supplements. While the top 3 products are distributed equally between the genders, there is a skew towards female respondents (12.4% in females vs. 4.9% in males) for weight loss supplements and towards males (13.2% in males vs. 3.7% in females) for sports supplements. Even though online consumers are in the younger age brackets, our study found that up to 72.0% of HP bought online are bought for others (buyer’s family and/or friends). Multivariate analysis showed a statistically significant association between purchasing HP through online means and the perceptions that 'internet is safe' (adjusted Prevalence Ratio=1.15, CI 1.03-1.28), 'buying HP online is time saving' (PR=1.17, CI 1.01-1.36), and 'recognition of HP brand' (PR=1.21 CI 1.06-1.40). Conclusions: This study has provided prevalence data for online HP market in Singapore, and has allowed the country’s regulatory body to formulate a targeted pharmacovigilance approach to this growing problem.

Keywords: e-commerce, pharmaceuticals, pharmacovigilance, Singapore

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Authors: Jane E. Souyave, Judith Bower

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This study is an ongoing collaborative project between the University of Central Lancashire and the Alzheimer’s Society to design and test the idea of using interactive tools for a person living with dementia and their carers. It is hoped that the tools will fulfill the possible needs of engagement and interaction as dementia progresses, therefore enhancing wellbeing and improving quality of life for the person with dementia and their carers. The project was informed by Kitwood’s five psychological needs for producing wellbeing and explored evidence that fidgeting is often seen as a form of agitation and a negative symptom of dementia. Although therapy for agitation may be well established, there is a lack of appropriate items aimed at people in the later stage of dementia, that are not childlike or medical in their aesthetic. Individuals may fidget in a particular way and the tools in the Fidget Widget Toolkit have been designed to encourage repetitive movements of the hand, specifically to address the abilities of people with relatively advanced dementia. As an intervention, these tools provided a new approach that had not been tested in dementia care. Prototypes were created through an iterative design process and tested with a number of people with dementia and their carers, using quantitative and qualitative methods. Dementia Care Mapping was used to evaluate the impact of the intervention in group settings. Cohen Mansfield’s Agitation Inventory was used to record the daily use and interest of the intervention for people in their usual place of residence. The results informed the design of a new set of devices to promote safe, stigma free fidgeting as a positive experience, meaningful activity and enhance wellbeing for people in the later stage of dementia. The outcomes addressed the needs of individuals by reducing agitation and restlessness through helping them to connect, engage and act independently, providing the means of doing something for themselves that they were able to do. The next stage will be to explore the commercial feasibility of the Fidget Widget Toolkit so that it can be introduced as good practice and innovation in dementia care. It could be used by care homes, with carers and their families to support wellbeing and lead the way in providing some positive experiences and person-centred approaches that are lacking in the later stage of dementia.

Keywords: dementia, design, fidgeting, healthcare, positive moments, quality of life, wellbeing

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Authors: Srećko Favro, Dora Mužinić

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The eastern coast of the Adriatic Sea has been a significant part of the most important traffic corridors since Antiquity due to its position as the deepest indented bay of the Mediterranean and numerous bays on the coast and is-lands. The central place throughout history was occupied by the central part - Split-Dalmatia County, with its center in Antica in Salona and later in Split. Nowadays, in addition to its traffic and economic importance, this area is also important for tourism, an area where Croatia develops its economy and realizing its economic growth. Nautical tourism is the most important form of the tourist economic sector that uses the geographical features of the Croatian Adriatic water area and achieves the greatest growth based on tour-ist trends in the world (coronavirus - separation from the masses, adventure tourism - own arrangements) and thus opens up the possibility of develop-ment for other parts of the tourist economy. This will be described in the ex-ample of the business of the Split-Dalmatia County shipping company from Krilo Jesenice, which operates as a mini-cruising service provider, the lead-ing form of cruising in Croatia. The advantages that this type of tourism provides to travelers in terms of customized itineraries, high-quality services, an intimate atmosphere, and a unique experience through familiarization with local culture and tradition will be considered. Through direct primary research and analysis of available secondary research data, an attempt will be made to show how traditional Croatian mini cruisers manage to stand out in a competitive tourist environment. Their impact on the local economy, sus-tainability, and environmental protection will be considered, as well as how they are integrated into the tourist offer of other destinations in Croatia. In addition, the challenges and opportunities that arise in the maintenance and development of traditional Croatian mini cruisers will be discussed, includ-ing issues such as infrastructure, staff training, and market trends.

Keywords: croatia, adriatic, cruising, nautical tourism, mini cruise

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Authors: Tanjil Sowgat, Shamim Kobir

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World is now experiencing the consequences of climate change such as increased heat stress due to high temperature rise. In the context of changing climate, this study intends to find out the planning interventions necessary to adapt to the current heat stress in the planned residential areas of Khulna city. To carry out the study Sonadanga residential area (phase I) of Khulna city has been taken as the study site. This residential neighbourhood covering an area of 30 acres has 206 residential plots. The study area comprises twelve access roads, one park, one playfield, one water body and two street furniture’s. This study conducts visual analysis covering green, open space, water body, footpath, drainage and street trees and furniture and questionnaire survey deals with socio-economic, housing tenancy, experience of heat stress and urban design interventions. It finds that the current state that accelerates the heat stress condition such as lack of street trees and inadequate shading, maximum uses are not within ten minutes walking distance, no footpath for the pedestrians and lack of well-maintained street furniture. It proposes that to adapt to the heat stress pedestrian facilities, buffer sidewalk with landscaping, street trees and open spaces, soft scape, natural and man-made water bodies, green roofing could be effective urban design interventions. There are evidences of limited number of heat stress adaptive planned residential area. Since current sub-division planning practice focuses on rigid land use allocation, it partly addresses the climatic concerns through creating open space and street trees. To better respond to adapt to the heat stress, urban design considerations in the context of sub-division practice would bring more benefits.

Keywords: climate change, urban design, adaptation, heat stress, water-logging

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Authors: Maryam Jabeen

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In recent times, there has been a notable surge in attention towards diverse literacy concepts such as media literacy, information literacy, and digital literacy. These concepts have garnered escalating interest, spurring the emergence of novel approaches, particularly in the aftermath of the Covid-19 crisis. However, amidst discussions of crises, the domain of crisis literacy remains largely uncharted within academic exploration. Crisis literacy, also referred to as disaster literacy, denotes an individual's aptitude to not only comprehend but also effectively apply information, enabling well-informed decision-making and adherence to instructions about disaster mitigation, preparedness, response, and recovery. This theoretical and descriptive study seeks to transcend foundational literacy concepts, underscoring the urgency for an in-depth exploration of crisis literacy and its interplay with the realm of media communication. Given the profound impact of the pandemic experience and the looming uncertainty of potential future crises, there arises a pressing need to elevate crisis literacy, or disaster literacy, towards heightened autonomy and active involvement within the spheres of critical disaster preparedness, recovery initiatives, and media communication domains. This research paper is part of my ongoing Ph.D. research study, which explores on a broader level the Encoding and decoding of media communications in relation to crisis literacy. The primary objective of this research paper is to expound upon a descriptive, theoretical research endeavor delving into this domain. The emphasis lies in highlighting the paramount significance of media communications in literacy of crisis, coupled with an accentuated focus on its role in providing information to marginalized populations amidst crises. In conclusion, this research bridges the gap in crisis literacy correlation to media communications exploration, advocating for a comprehensive understanding of its dynamics and its symbiotic relationship with media communications. It intends to foster a heightened sense of crisis literacy, particularly within marginalized communities, catalyzing proactive participation in disaster preparedness, recovery processes, and adept media interactions.

Keywords: covid-19, crisis literacy, crisis, marginalized, media and communications, pandemic, vulnerable people

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Authors: Le Jiang, Chua Jinxing

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Introduction: The recent outbreak of Ebola virus disease in the west Africa has drawn global concern. With a high fatality rate and direct human-to-human transmission, it has spread between countries and caused great damages for patients and family who are affected. Being the designated hospital to manage epidemic outbreak in Singapore, Tan Tock Seng Hospital (TTSH) is facing great challenges in preparation and managing of potential outbreak of emerging infectious disease such as Ebola virus disease. Aim: We conducted an infection control drill in TTSH emergency department to assess the readiness of healthcare and allied health workers in managing suspected Ebola patients. It also helps to review current Ebola clinical protocol and work instruction to ensure more smooth and safe practice in managing Ebola patients in TTSH emergency department. Result: General preparedness level of staffs involved in managing Ebola virus disease in TTSH emergency department is not adequate. Knowledge deficits of staffs on Ebola personal protective equipment gowning and degowning process increase the risk of potential cross contamination in patient care. Loopholes are also found in current clinical protocol, such as unclear instructions and inaccurate information, which need to be revised to promote better staff performance in patient management. Logistic issues such as equipment dysfunction and inadequate supplies can lead to ineffective communication among teams and causing harm to patients in emergency situation. Conclusion: The infection control drill identified the need for more well-structured and clear clinical protocols to be in place to promote participants performance. In addition to quality protocols and guidelines, systemic training and annual refresher for all staffs in the emergency department are essential to prepare staffs for the outbreak of Ebola virus disease. Collaboration and communication with allied health staffs are also crucial for smooth delivery of patient care and minimising the potential human suffering, properties loss or injuries caused by disease. Therefore, more clinical drills with collaboration among various departments involved are recommended to be conducted in the future to monitor and assess readiness of TTSH emergency department in managing Ebola virus disease.

Keywords: ebola, emergency department, infection control drill, Tan Tock Seng Hospital

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Authors: Mohammed Agbali, Claudia Trillo, Yusuf Arayici, Terrence Fernando

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The wide-spread adoption of the Smart City concept has introduced a new era of computing paradigm with opportunities for city administrators and stakeholders in various sectors to re-think the concept of urbanization and development of healthy cities. With the world population rapidly becoming urban-centric especially amongst the emerging economies, social innovation will assist greatly in deploying emerging technologies to address the development challenges in core sectors of the future cities. In this context, sustainable health-care delivery and improved quality of life of the people is considered at the heart of the healthy city agenda. This paper examines the Boston innovation landscape from the perspective of smart services and innovation ecosystem for sustainable development, especially in transportation and healthcare. It investigates the policy implementation process of the Healthy City agenda and eHealth economy innovation based on the experience of Massachusetts’s City of Boston initiatives. For this purpose, three emerging areas are emphasized, namely the eHealth concept, the innovation hubs, and the emerging technologies that drive innovation. This was carried out through empirical analysis on results of public sector and industry-wide interviews/survey about Boston’s current initiatives and the enabling environment. The paper highlights few potential research directions for service integration and social innovation for deploying emerging technologies in the healthy city agenda. The study therefore suggests the need to prioritize social innovation as an overarching strategy to build sustainable Smart Cities in order to avoid technology lock-in. Finally, it concludes that the Boston example of innovation economy is unique in view of the existing platforms for innovation and proper understanding of its dynamics, which is imperative in building smart and healthy cities where quality of life of the citizenry can be improved.

Keywords: computing paradigm, emerging technologies, equitable healthcare, healthy cities, open data, smart city, social innovation

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Authors: Rajkumar Ghosh, Ananya Mukhopadhyay

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This scientific paper presents a thorough investigation into the integration of roof-mounted photovoltaic (PV) array systems and home rooftop rainwater collection systems in a remote community in Himachal Pradesh, India, with the goal of optimum utilization of natural resources for attaining sustainable living conditions by 2030. The study looks into the technical feasibility, environmental benefits, and socioeconomic impacts of this integrated method, emphasizing its ability to handle energy and water concerns in remote rural regions. This comprehensive method not only provides a sustainable source of electricity but also ensures a steady supply of clean water, promoting resilience and improving the quality of life for the village's residents. This research highlights the potential of such integrated systems in supporting sustainable conditions in rural areas through a combination of technical feasibility studies, economic analysis, and community interaction. There would be 20690 villages and 1.48 million homes (23.79% annual growth rate) in Himachal Pradesh if all residential buildings in the state had roof-mounted photovoltaic arrays to capture solar energy for power generation. The energy produced is utilized to power homes, lessening dependency on traditional fossil fuels. The same residential buildings housed domestic rooftop rainwater collection systems. Rainwater runoff from rooftops is collected and stored in tanks for use in a number of residential purposes, such as drinking, cooking, and irrigation. The gathered rainfall enhances the region's limited groundwater resources, easing the strain on local wells and aquifers. Although Himachal Pradesh of India is a Power state, the PV arrays have reduced the reliance of village on grid power and diesel generators by providing a steady source of electricity. Rooftop rainwater gathering has not only increased residential water supply but it has also lessened the burden on local groundwater resources. This helps to replenish groundwater and offers a more sustainable water supply for the town. The neighbourhood has saved money by utilizing renewable energy and rainwater gathering. Furthermore, lower fossil fuel consumption reduces greenhouse gas emissions, which helps to mitigate the effects of climate change. The integrated strategy of installing grid connected rooftop photovoltaic arrays and home rooftop rainwater collecting systems in Himachal Pradesh rural community demonstrates a feasible model for sustainable development. According to “Swaran Jayanti Energy Policy of Himachal Pradesh”, Himachal Pradesh is planned 10 GW from rooftop mode from Solar Power. Government of India provides 40% subsidy on solar panel of 1-3 kw and subsidy of Rs 6,000 per kw per year to encourage domestic consumers of Himachal Pradesh. This effort solves energy and water concerns, improves economic well-being, and helps to conserve the environment. Such integrated systems can serve as a model for sustainable development in rural areas not only in Himachal Pradesh, but also in other parts of the world where resource scarcity is a major concern. Long-term performance and scalability of such integrated systems should be the focus of future study. Efforts should also be made to duplicate this approach in other rural areas and examine its socioeconomic and environmental implications over time.

Keywords: renewable energy, photovoltaic arrays, rainwater harvesting, sustainability, rural development, Himachal Pradesh, India

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Authors: Angelika Kris D. Dalangin, Cesar B. Quicoy

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Rice farming is a major source of livelihood and employment in the Philippines, but it requires a substantial amount of capital. Capital may come from income (farm, non-farm, and off-farm), savings and credit. However, rice farmers suffer from lack of capital due to high costs of inputs and low productivity. Capital insufficiency, coupled with low productivity, hindered them to meet their basic household and production needs. Hence, they resorted to borrowing money, mostly from informal lenders who charge very high interest rates. As another source of capital, savings can help rice farmers meet their basic needs for both the household and the farm. However, information is inadequate whether the farmers save or not, as well as, why they do not depend on savings to augment their lack of capital. Thus, it is worth analyzing how rice farmers saved. The study revealed, using the actual savings which is the difference between the household income and expenditure, that about three-fourths (72%) of the total number of farmers interviewed are savers. However, when they were asked whether they are savers or not, more than half of them considered themselves as non-savers. This gap shows that there are many farmers who think that they do not have savings at all; hence they continue to borrow money and do not depend on savings to augment their lack of capital. The study also identified the forms of savings, saving motives, and savings utilization among rice farmers. Results revealed that, for the past 12 months, most of the farmers saved cash at home for liquidity purposes while others deposited cash in banks and/or saved their money in the form of livestock. Among the most important reasons of farmers for saving are for daily household expenses, for building a house, for emergency purposes, for retirement, and for their next production. Furthermore, the study assessed the factors affecting the rice farmers’ savings behaviour using logistic regression. Results showed that the factors found to be significant were presence of non-farm income, per capita net farm income, and per capita household expense. The presence of non-farm income and per capita net farm income positively affects the farmers’ savings behaviour. On the other hand, per capita household expenses have negative effect. The effect, however, of per capita net farm income and household expenses is very negligible because of the very small chance that the farmer is a saver. Generally, income and expenditure were proved to be significant factors that affect the savings behaviour of the rice farmers. However, most farmers could not save regularly due to low farm income and high household and farm expenditures. Thus, it is highly recommended that government should develop programs or implement policies that will create more jobs for the farmers and their family members. In addition, programs and policies should be implemented to increase farm productivity and income.

Keywords: agricultural economics, agricultural finance, binary logistic regression, logit, Philippines, Quezon, rice farmers, savings, savings behaviour

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Authors: Hossam Ali-Hassan, Michael Bliemel

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This poster reflects upon our experiences using INNOV8, IBM’s Business Process Management (BPM) simulation game, in online MBA and undergraduate MIS classes over a period of 2 years. The game is designed to gives both business and information technology players a better understanding of how effective BPM impacts an entire business ecosystem. The game includes three different scenarios: Smarter Traffic, which is used to evaluate existing traffic patterns and re-route traffic based on incoming metrics; Smarter Customer Service where players develop more efficient ways to respond to customers in a call centre environment; and Smarter Supply Chains where players balance supply and demand and reduce environmental impact in a traditional supply chain model. We use the game as an experiential learning tool, where students have to act as managers making real time changes to business processes to meet changing business demands and environments. The students learn how information technology (IT) and information systems (IS) can be used to intelligently solve different problems and how computer simulations can be used to test different scenarios or models based on business decisions without having to actually make the potentially costly and/or disruptive changes to business processes. Moreover, when students play the three different scenarios, they quickly see how practical process improvements can help meet profitability, customer satisfaction and environmental goals while addressing real problems faced by municipalities and businesses today. After spending approximately two hours in the game, students reflect on their experience from it to apply several BPM principles that were presented in their textbook through the use of a structured set of assignment questions. For each final scenario students submit a screenshot of their solution followed by one paragraph explaining what criteria you were trying to optimize, and why they picked their input variables. In this poster we outline the course and the module’s learning objectives where we used the game to place this into context. We illustrate key features of the INNOV8 Simulation Game, and describe how we used them to reinforce theoretical concepts. The poster will also illustrate examples from the simulation, assignment, and learning outcomes.

Keywords: experiential learning, business process management, BPM, INNOV8, simulation, game

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Authors: Kimberley Kennedy

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The major findings of this study discuss the importance of understanding and applying Systems thinking concepts to ensure an effective Project-Based Learning environment. A pilot project study of a major pedagogical change was conducted over a five year period with the goal to give students real world, hands-on learning experiences and the opportunity to apply what they had learned over the past two years of their business program. The first two weeks of the fifteen week semester utilized teaching methods of lectures, guest speakers and design thinking workshops to prepare students for the project work. For the remaining thirteen weeks of the semester, the students worked with actual business owners and clients on projects and challenges. The first three years of the five year study focused on student feedback to ensure a quality learning experience and continuous improvement process was developed. The final two years of the study, examined the conceptual understanding and perception of learning and teaching by faculty using Project-Based Learning pedagogy as compared to lectures and more traditional teaching methods was performed. Relevant literature was reviewed and data collected from program faculty participants who completed pre-and post-semester interviews and surveys over a two year period. Systems thinking concepts were applied to better understand the challenges for faculty using Project-Based Learning pedagogy as compared to more traditional teaching methods. Factors such as instructor and student fatigue, motivation, quality of work and enthusiasm were explored to better understand how to provide faculty with effective support and resources when using Project-Based Learning pedagogy as the main teaching method. This study provides value by presenting generalizable, foundational knowledge by offering suggestions for practical solutions to assure student and teacher engagement in Project-Based Learning courses.

Keywords: continuous improvement, project-based learning, systems thinking, teacher engagement

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Authors: Bilge Afşar, Zeynep Karaçor, Burcu Guvenek

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The aim of this study is to examine and analyze the effect of macroeconomic policies on foreign trade. In the study, the effect of the macroeconomic policies applied in Turkey after 2001 on foreign trade was scrutinized carrying out a survey study in the sample of the province Konya. In the survey study, the survey was administered to a total of 209 exporter firms, which are the members of Konya Chamber of Commerce. While 51 of the firms, to which the survey was administered, exported below $ 100,000, 158 of them are the firms exporting above $ 100,000. Survey was realized in the way of face to face interview with the firms in the rate of 79%. 47% of the institutions forming the mass were reached. In forming survey questionnaire, in general, 5-point Likert scale was used. In order to assess the study results, SPSS 15 package program was utilized. In the survey, foreign trade activities of the firms in Konya were analyzed; and the problems they face, while performing foreign trade, and those needing to be carried out for increasing foreign trade volume of Konya were revealed by determining how and at what degree they were affected from the macroeconomic policies applied. Thus, foreign trade structure and state of the province Konya were attempted to be analyzed. In the survey study, it emerges that although the problems Konya faces in foreign trade overlap with the problems across Turkey, the province Konya seems to be affected relatively less from the last crisis with its equity capital in either trade or other areas. Until the year 2008, while Konya is in a position of the province continuously increasing its export, also with the effect of global crisis, in 2009, a fall was seen in the amount of export. The results emerging in the survey study also confirm this case. In parallel with demand inadequacy and recession all over the world, firms experience trouble. However, again according to our survey result, foreign market weight of firms shifted from EU countries to Russia, East Bloc, and Middle East countries. This prevented Konya from negative affecting from EU crisis at maximum level. That is, Russian and Middle East market express significance for Konya. That market is diversified, and being relatively rid of dependence to EU is extremely important in terms of Konya export.

Keywords: economy, foreign trade, economic crise, macro economic politicies

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Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

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Despite the existence of different dental specialties, the dentist-patient relationship is unique, in the very fact that the treatment is performed by one doctor and the patient identifies the malpractice presented as part of that doctor's practice; this is in complete contrast to cases of medical treatments where the patient can be presented to a team of doctors, to treat a specific pathology. The rules of dental ethics are almost the same as the rules of medical ethics. The appearance of dental malpractice affects exactly this two-party relationship, created on the basis of professionalism, without deviations in this direction, between the dentist and the patient, but with very narrow individual boundaries, compared to cases of medical malpractice. Main text: Malpractice can have different reasons for its appearance, starting from professional negligence, but also from the lack of professional knowledge of the dentist who undertakes the dental treatment. It should always be seen in perspective that we are not talking about the individual - the dentist who goes to work with the intention of harming their patients. Malpractice can also be a consequence of the impossibility, for anatomical or physiological reasons of the tooth under dental treatment, to realize the predetermined dental treatment plan. On the other hand, the dentist himself is an individual who can be affected by health conditions, or have vices that affect the systemic health of the dentist as an individual, which in these conditions can cause malpractice. So, depending on the reason that led to the appearance of malpractice, the method of treatment from a legal point of view also varies, for the dentist who committed the malpractice, evaluating the latter if the malpractice came under the conditions of applying the rules of dental ethics. Conclusions: The deviation from the predetermined dental plan is the minimum sign of malpractice and the latter should not be definitively related only to cases of difficult dental treatments. The identification of the reason for the appearance of malpractice is the initial element, which makes the difference in the way of its treatment, from a legal point of view, and the involvement of the dentist in the assessment of the malpractice committed, must be based on the legislation in force, which must be said to have their specific changes in different states. Malpractice should be referred to, or included in the lectures or in the continuing education of professionals, because it serves as a method of obtaining professional experience in order not to repeat the same thing several times, by different professionals.

Keywords: dental ethics, malpractice, negligence, legal basis, continuing education, dental treatments

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Authors: Timma Reddy, Srikonda Ramesh

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India has been traditionally vulnerable to natural disasters such as Floods, droughts, cyclones, earthquakes and landslides. It has become a recurrent phenomenon as observed in last five decades. The survey indicates that about 60% of the landmass is prone to earthquakes of various intensities; over 40 million hectares is prone to floods; about 8% of the total area is prone to cyclones and 68% of the area is susceptible to drought. Climate change is likely to be perceived through experience of extreme weather events. There is growing societal concern about climate change, given the potential impacts of associated natural hazards such as cyclones, flooding, earthquakes, landslides etc, hence it is essential and crucial to strengthening our settlements to respond to such calamities. So, the research paper focus is to analyze the effective planning strategy/mechanism to integrate disaster mitigation measures in coastal regions in general and Capital Region of Andhra Pradesh in particular. The basic hypothesis is to govern the appropriate special planning considerations would facilitate to have organized way of protective life and properties from natural disasters. And further to integrate the infrastructure planning with conscious direction would provide an effective mitigations measures. It has been planned and analyzed to Vijayawada city with conscious land use planning with reference to space syntax trajectory in accordance to required social infrastructure such as health facilities, institution areas and recreational and other open spaces. It has been identified that the geographically ideal location with reference to the population densities based on GIS tools the properness strategies can be effectively integrated to protect the life and to save the properties by means of reducing the damage/impact of natural disasters in general earth quake/cyclones or floods in particularly.

Keywords: modular, trajectories, social infrastructure, evidence based syntax, drills and equipments, GIS, geographical micro zoning, high resolution satellite image

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

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Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: advanced palliative aquatics care, magnetic field therapy, medical device, research design

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Authors: Şenay Güngör, Emre Elbaşi, Beyda Sadikoğlu, Utku Eren Bağci, Ömer Uzunel

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One of the first places that comes to mind when it comes to tourism in Turkey is the Cappadocia Region. Due to its rich geological and geomorphological heritage, Cappadocia is one of the most visited destinations in the world. In fact, in the first half of 2023, the number of international tourists visiting Cappadocia exceeded 2 million. Considering that the economy of the Cappadocia region is largely based on tourism, it is understood that the quality and technology integration levels of the touristic services offered in the region are of great importance. In this context; as a result of the observations made in Kızılçukur, Meskendir, Güllüdere 1 and Güllüdere 2 valleys, where the important hiking routes of the Cappadocia Region are located, it has been observed that the digital level of the routes is insufficient. It has been observed that the telephone networks in the area are very low or have completely lost their signal strength. In addition, it was determined that the materials such as maps and brochures used by tourism agencies to introduce the valleys are simple and incomplete. It is thought that this situation negatively affects the tourists' orientation and touristic experience in the field. Eliminating these deficiencies identified in the field, improving the digital level of the above-mentioned hiking routes and increasing the added value in destinations are among the main objectives of our study. Within the scope of the study, a mobile application that can work both online and offline on hiking routes has been prepared. 3D modeling of Kızılçukur, Meskendir, Güllüdere 1 and Güllüdere 2 valleys were made using Geographical Information Systems (GIS). In addition, a website has been created to enable tourists to easily access all the above-mentioned information, visuals and technological applications related to the routes. As it is known, the effective use of information and communication technologies in touristic regions not only increases the satisfaction levels of tourists, but also positively affects the attraction of qualified tourists to the region. When the tangible and intangible outputs of this study are evaluated, it is thought that it will serve the social and economic development of the region and set an example for the digital transformation of other routes in the region.

Keywords: nevşehir, cappadocia, cappadocia valleys, trekking route

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Authors: Louise Reyntjens

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In response to Islamic-inspired terrorism and the growing trend of foreign fighters, European governments are increasingly relying on the deprivation of citizenship as a security tool. This development fits within a broader securitization of immigration, where the terrorist threat is perceived as emanating from abroad. As a result, immigration law became more and more ‘securitized’. The European migration crisis has reinforced this trend. This research evaluates the deprivation of citizenship from a human rights perspective. For this, the author selected four European countries for a comparative study: Belgium, France, the United Kingdom and Sweden. All these countries face similar social and security issues, vitalizing (the debate on) deprivation of citizenship as a counterterrorism tool. Yet, they adopt a very different approach on this: The United Kingdom positions itself on the repressive side of the spectrum. Sweden on the other hand, also ‘securitized’ its immigration policy after the recent terrorist hit in Stockholm but remains on the tolerant side of the spectrum. Belgium and France are situated in between. This contribution evaluates the deprivation of citizenship in Belgium. Belgian law has provided the possibility to strip someone of their Belgian citizenship since 1919. However, the provision long remained a dead letter. The 2015 Charlie Hebdo attacks in Paris sparked a series of legislative changes, elevating the deprivation measure to a key security tool in Belgian law. Yet, the measure raises profound human rights issues. Firstly, it infringes the right to private and family life. As provided by Article 8 (2) European Court of Human Right (ECHR), this right can be limited if necessary for national security and public safety. Serious questions can however be raised about the necessity for the national security of depriving an individual of its citizenship. Behavior giving rise to this measure will generally be governed by criminal law. From a security perspective, criminal detention will thus already provide in removing the individual from society. Moreover, simply stripping an individual of its citizenship and deporting them constitutes a failure of criminal law’s responsibility to prosecute criminal behavior. Deprivation of citizenship is also discriminatory, because it differentiates, without a legitimate reason, between those liable to deprivation and those who are not. It thereby installs a secondary class of citizens, violating the European Court of Human Right’s principle that no distinction can be tolerated between children on the basis of the status of their parents. If followed by expulsion, deprivation also seriously jeopardizes the right to life and prohibition of torture. This contribution explores the human rights consequences of citizenship deprivation as a security tool in Belgium. It also offers a critical view on its efficacy for protecting national security.

Keywords: Belgium, counterterrorism strategies, deprivation of citizenship, human rights, immigration law

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Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

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Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

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Authors: D. M. Lewis, L. Frisby, U. Stead

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Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

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Authors: Muhammet Şahal, Oğuz Köklü

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As statistical thinking and problem-solving processes have become increasingly important, teachers need to be more rigorously prepared with statistical knowledge to teach their students effectively. This study examined preservice mathematics teachers' development of statistical investigation projects using data and exploratory data analysis tools, following a design-based research perspective and statistical investigation cycle. A total of 26 pre-service senior mathematics teachers from a public university in Turkiye participated in the study. They formed groups of 3-4 members voluntarily and worked on their statistical investigation projects for six weeks. The data sources were audio recordings of pre-service teachers' group discussions while working on their projects in class, whole-class video recordings, and each group’s weekly and final reports. As part of the study, we reviewed weekly reports, provided timely feedback specific to each group, and revised the following week's class work based on the groups’ needs and development in their project. We used content analysis to analyze groups’ audio and classroom video recordings. The participants encountered several difficulties, which included formulating a meaningful statistical question in the early phase of the investigation, securing the most suitable data collection strategy, and deciding on the data analysis method appropriate for their statistical questions. The data collection and organization processes were challenging for some groups and revealed the importance of comprehensive planning. Overall, preservice senior mathematics teachers were able to work on a statistical project that contained the formulation of a statistical question, planning, data collection, analysis, and reaching a conclusion holistically, even though they faced challenges because of their lack of experience. The study suggests that preservice senior mathematics teachers have the potential to apply statistical knowledge and techniques in a real-world context, and they could proceed with the project with the support of the researchers. We provided implications for the statistical education of teachers and future research.

Keywords: design-based study, pre-service mathematics teachers, statistical investigation projects, statistical model

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Authors: Renate Verkaik, Mieke Rijken, Hennie Boeije

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Elderly who are living alone and who are having one or more impairments are vulnerable for a loss of wellbeing and institutionalization. Physical exercise and social activities together with peers have the potential to make them more resilient. The Dutch program ‘More Resilience, Longer at Home’ initiated by FNO funded 126 local projects to stimulate vulnerable older citizens to participate in exercise and social activities, and as such to improve wellbeing and independent living. The program evaluation addressed the following questions: (1) what are the effects of the program on older (65+) participants exercise behavior, social activities and what is the relationship with wellbeing?, (2) which factors contribute to successful implementation of the projects and their outcomes? A mixed method approach was used. Effects on participants were assessed with a short survey, containing questions on exercise, social engagement, daily functioning, loneliness and life satisfaction. Results of the participants were compared with those of a reference group from the Dutch national population. Perceived influencing factors were investigated with a questionnaire for project leaders. This questionnaire was based on site visits and interviews with project leaders, volunteers and participating elderly. Preliminary results show that social engagement of the participating elderly rises significantly (p ≤ .05) as do their exercise levels and daily functioning. They experience less social loneliness, but not less emotional loneliness. Additionally, there is a positive association between daily functioning and life satisfaction and between exercise and life satisfaction. Perceived influencing factors that contribute to successful implementation of the projects can be categorized in 4 types: (1) characteristics of the activities; (2) profiles of the involved staff (professionals and volunteers), (3) characteristics of the organization, (4) the social political environment. Conclusions are that local projects have been successful in stimulating older citizens to participate in exercise and social activities. Multiple factors need to be addressed to ensure sustainability and scaling-up of the good practices.

Keywords: elderly living alone in the community, exercise and social activities, resilience, quality of life

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Authors: Toslim Uddin Khan, Jesmin Akter, Mohiuddin Ahmed

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Menstrual hygiene management (MHM) and personal health-care practice is a critical issue to prevent morbidity and other reproductive health complications among adolescent girls in Bangladesh. Inadequate access to water, sanitation and hygiene (WASH) facilities lead to unhealthy MHM practices that resulted in poor reproductive health outcomes. It is evident from different studies that superstitions and misconception are more common in rural communities that limit young girls’ access to and understanding of the menstrual hygiene and self care practices. The state-of-the-art approach of Social Marketing Company (SMC) is proved to be instrumental in delivering reinforcing health messages, making public health and hygiene products available at the door steps of the community through community mobilization programs in rural Bangladesh. School health program is one of the flagship interventions of SMC to equip adolescent girls and boys with correct knowledge of health and hygiene practices among themselves, their families and peers. In Bangladeshi culture, adolescent girls often feel shy to ask fathers or male family members about buying sanitary napkin from local pharmacy and they seem to be reluctant to seek help regarding their menstrual problems. A recent study reveals that 48% adolescent girls are using sanitary napkins while majority of them are unaware of menstrual hygiene practices in Bangladesh. Under school adolescent program, SMC organizes health education sessions for adolescent girls from grade seven to ten using enter-educate approach with special focus on sexual and reproductive health and menstrual hygiene issues including delaying marriage and first pregnancy. In addition, 2500 rural women entrepreneurs branded as community sales agents are also involved in disseminating health messages and selling priority health products including sanitary napkin at the household level. These women entrepreneurs are serving as a source of sustainable supply of the sanitary napkins for the rural adolescent girls and thereby they are earning profit margins on the sales they make. A recent study on the impact of adolescent program activities reveals that majority (71%) of the school adolescent girls are currently using sanitary napkins. Health education equips and empowers adolescent girls with accurate knowledge about menstrual hygiene practices and self-care as well. Therefore, engagement of female entrepreneurs in school adolescent health program at the community level is one of the promising ways to improve menstrual hygiene practices leading to increased use of sanitary napkin in rural and semi-rural communities in Bangladesh.

Keywords: school adolescent program, social marketing, women entrepreneurs, menstrual hygiene management

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Authors: Ming-Jyh Chen, Wen-Ming Huang, Yi-Chu Liu, Li-Hui Yang

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Introduction: Social responsibility is the key to sustainable organizational development. Under the ground Green Health Hospital Declaration signed by our superintendent, we have launched comprehensive energy conservation management in medical services, the community, and the staff’s life. To execute environment-friendly promotion with robust strategies, we build up a low-carbon medical system and community with smart green public construction promotion as well as intensifying energy conservation education and communication. Purpose/Methods: With the support of the board and the superintendent, we construct an energy management team, commencing with an environment-friendly system, management, education, and ISO 50001 energy management system; we have ameliorated energy performance and energy efficiency and continuing. Results: In the year 2021, we have achieved multiple goals. The energy management system efficiently controls diesel, natural gas, and electricity usage. About 5% of the consumption is saved when compared to the numbers from 2018 and 2021. Our company develops intelligent services and promotes various paperless electronic operations to provide people with a vibrant and environmentally friendly lifestyle. The goal is to save 68.6% on printing and photocopying by reducing 35.15 million sheets of paper yearly. We strengthen the concept of environmental protection classification among colleagues. In the past two years, the amount of resource recycling has reached more than 650 tons, and the resource recycling rate has reached 70%. The annual growth rate of waste recycling is about 28 metric tons. Conclusions: To build a green medical system with “high efficacy, high value, low carbon, low reliance,” energy stewardship, economic prosperity, and social responsibility are our principles when it comes to formulation of energy conservation management strategies, converting limited sources to efficient usage, developing clean energy, and continuing with sustainable energy.

Keywords: energy efficiency, environmental education, green hospital, sustainable development

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Authors: Josephine K. Mule, Levi Obonyo

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Technology has changed human life over time. The COVID-19 pandemic has altered the work set-up, the school system, the shopping experience, church attendance, and even the way athletes train in Kenya. Although the use of technology to communicate and maintain interactions has been on the rise in the last 30 years, the uptake during the COVID-19 pandemic has been unprecedented. Traditionally, ‘paid’ work has been considered to take place outside the “home house” but COVID-19 has resulted in what is now being referred to as “the world’s largest work-from-home experiment” with up to 43 percent of employees working at least some of the time remotely. This study was conducted on 90 respondents from across remote work set-ups, school systems, merchants and customers of online shopping, church leaders and congregants and athletes, and their coaches. Data were collected by questionnaires and interviews that were conducted online. The data is based on the first three months since the first case of coronavirus was reported in Kenya. This study found that the use of technology is in the center of working remotely with work interactions being propelled on various online platforms including, Zoom, Microsoft Teams, and Google Meet, among others. The school system has also integrated the use of technology, including students defending their thesis/dissertations online and university graduations being conducted virtually. Kenya is known for its long-distance runners, due to the directives to reduce interactions; coaches have taken to providing their athletes with guidance on training on social media using applications such as WhatsApp. More local stores are now offering the shopping online option to their customers. Churches have also felt the brunt of the situation, especially because of the restrictions on crowds resulting in online services becoming more popular in 2020 than ever before. Artists, innovatively have started online musical concerts. The findings indicate that one of the outcomes in the Kenyan society that is evident as a result of the COVID-19 period is a population that is using technology more to communicate and get work done. Vices that have thrived in this season where the use of technology has increased, include the spreading of rumors on social media and cyberbullying. The place of technology seems to have been cemented by demand during this period.

Keywords: communication, coronavirus, COVID-19, Kenya, technology

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Authors: Navah Z. Ratzon, Anat Keren, Shlomit Y. Greenberg

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Car accidents are a problem worldwide. Adolescents’ involvement in car accidents is higher in comparison to the overall driving population. Researchers estimate the risk of accidents among adolescents with symptoms of attention-deficit/hyperactivity disorder (ADHD) to be 1.2 to 4 times higher than that of their peers. Individuals with ADHD exhibit unique patterns of eye movements and attentional shifts that play an important role in driving. In addition, deficiencies in cognitive and executive functions among adolescents with ADHD is likely to put them at greater risk for car accidents. Fifteen adolescents with ADHD and 17 matched controls participated in the study. Individuals from both groups attended local public schools and did not have a driver’s license. Participants’ mean age was 16.1 (SD=.23). As part of the experiment, they all completed a driving simulation session, while their eye movements were monitored. Data were recorded by an eye tracker: The entire driving session was recorded, registering the tester’s exact gaze position directly on the screen. Eye movements and simulator data were analyzed using Matlab (Mathworks, USA). Participants’ cognitive and metacognitive abilities were evaluated as well. No correlation was found between saccade properties, regions of interest, and simulator performance in either group, although participants with ADHD allocated more visual scan time (25%, SD = .13%) to a smaller segment of dashboard area, whereas controls scanned the monitor more evenly (15%, SD = .05%). The visual scan pattern found among participants with ADHD indicates a distinct pattern of engagement-disengagement of spatial attention compared to that of non-ADHD participants as well as lower attention flexibility, which likely affects driving. Additionally the lower the results on the cognitive tests, the worse driving performance was. None of the participants had prior driving experience, yet participants with ADHD distinctly demonstrated difficulties in scanning their surroundings, which may impair driving. This stresses the need to consider intervention programs, before driving lessons begin, to help adolescents with ADHD acquire proper driving habits, avoid typical driving errors, and achieve safer driving.

Keywords: ADHD, attentional shifting, driving simulator, eye movements

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Authors: Jolanta Uszko, Tomasz Wloch, Aneta Pirowska, Roman Nowobilski

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Introduction: Phantom phenomena are often reported by subjects who have undergone limb amputation. Mostly, patients feel the amputated part of the limb as if it was still attached to the body. Two types of phantom phenomena: painless (phantom sensation) and painful (phantom pain) were described. Triggers of phantom sensations and phantom pain, as well as fully effective treatment, have not been clearly described yet. Purpose: To assess the influence of psychosocial factors and some clinical conditions on the occurrence of phantom phenomena in amputee athletes. Subjects: 21 men (age: 31 years, SD = 7.5 years) after lower or upper extremity amputation, who regularly performed high-intensity sports (Amp Football Team Players) were included to the study. Method and equipment: In the research, the following method and tools were used: Questionnaire [Pirowska] adapted for athletes with disabilities, Numerical Rating Scale (NRS) - for phantom pain assessment, McGill Pain Assessment Questionnaire (short version), Beck's Depression Inventory (BDI), State Trait Anxiety Inventory (STAI): X-1 and X-2, shortened version of The World Health Organization Quality of Life (WHOQOLBREFF). Results: In the study group, the lower leg amputations with traumatic etiology were predominant. Phantom sensations were present in all subjects. Half of the respondents claimed to experience phantom sensations at least once a day, paroxysmally. There was a prevalence of phantom sensations characterized as incomplete, immobile limb. Phantom pain was reported by over 85% of respondents. The nature of phantom pain was frequently described as stabbing, squeezing, shooting, pulsing, tiring. There was a significant correlation between phantom pain intensity and anxiety, quality of life, depressive tendencies, perception of phantom pain as the obstacle in daily functioning and intensity of the limb pain before amputation. Conclusions: The etiology of phantom phenomena is complex. Psychological factors seem to have a significant influence on the intensity of the phantom pain. Particular attention should be paid to patients who complain about persistent limb pain before the amputation. These are patients with an increased risk of the phantom pain of relatively high intensity.

Keywords: amputation, phantom pain, phantom sensations, adaptive sports

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Authors: Anne Y. Faxer, Ellen Olausson, Jens Hagman, Ana Magazinius, Jenny J. Stier, Tommy Fransson, Oscar Enerback

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While electric vehicles (both battery electric vehicles and plug-in hybrids) have been on the market for around 6 years, they are still far from mainstream and the knowledge of them is still low among the public. This is likely one of the reasons that Sweden, having one of the highest penetrations of electric vehicles in Europe, still has a long way to go in reaching a fossil free vehicle fleet. Car dealerships are an important medium that connects consumers to vehicles, but somehow, their role in introducing electric vehicles has not yet been thoroughly studied. Research from other domains shows that salespeople can affect customer decisions in their choice of products. The aim of this study is to explore the role of car dealerships when it comes to promoting electric vehicles. The long-term goal is to understand how they could be a key in the effort of achieving a mass introduction of electric vehicles in Sweden. By emulating the customer’s experience, this study investigates the interaction between car salespeople and customers, particularly examining whether they present electric vehicles as viable options. Covert participatory observations were conducted for data collection from four different brands at in total twelve car dealers. The observers worked in pairs and played the role of a customer with needs that could be matched by an electric vehicle. The data was summarized in observation protocols and analyzed using thematic coding. The result shows that only one of twelve salespeople offered an electric vehicle as the first option. When environmental factors were brought up by the observers, the salespeople followed up with lower fuel consumption internal combustion engine vehicles rather than suggesting an electric vehicle. All salespeople possessed at least basic knowledge about electric vehicles but their interest of selling them were low in most cases. One of the reasons could be that the price of electric vehicles is usually higher. This could be inferred from the finding that salespeople tend to have a strong focus on price and economy in their dialogues with customers, regardless which type of car they were selling. In conclusion, the study suggests that car salespeople have the potential to help the market to achieve mass introduction of electric vehicles; however, their potential needs to be exploited further. To encourage salespeople to prioritize electric vehicles in the sales process, right incentives need to be in place.

Keywords: car dealerships, covert participatory observation, customer perspective , electric vehicle, market penetration

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Authors: Güler Duru Aşiret

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Introduction: Poor sleep quality is a common problem among the older people living in nursing homes. Our study aimed at assessing the effect of individual reminiscence therapy on the sleep quality of the elderly living in nursing homes. Methods: The study had 22 people in the intervention group and 24 people in the control group. The intervention group had reminiscence therapy once a week for 12 weeks in the form of individual sessions of 25-30 minutes. In our study, we first determined the dates suitable for the intervention group and researcher and planned the date and time of individual reminiscence therapies, which would take 12 weeks. While preparing this schedule, we considered subjects’ time schedules for their regular visits to health facilities and the arrival of their visitors. At this stage, the researcher informed the participants that their regular attendance in sessions would affect the intervention outcome. One topic was discussed every week. Weekly topics included: introduction in the first week; childhood and family life, school days, starting work and work life (a day at home for housewives), a fun day out of home, marriage (friendship for the singles), plants and animals they loved, babies and children, food and cooking, holidays and travelling, special days and celebrations, assessment and closure, in the following weeks respectively. The control group had no intervention. Study data was collected by using an introductory information form and the Pittsburgh Sleep Quality Index (PSQI). Results: In our study, participants’ average age was 76.02 ± 7.31. 58.7% of them were male and 84.8% were single. All of them had at least one chronic disease. 76.1% did not need help for performing their daily life activities. The length of stay in the institution was 6.32 ± 3.85 years. According to the participants’ descriptive characteristics, there was no difference between groups. While there was no statistically significant difference between the pretest PSQI median scores (p > 0.05) of both groups, PSQI median score had a statistically significant decrease after 12 weeks of reminiscence therapy (p < 0.05). There was no statistically significant change in the median scores of the subcomponents of sleep latency, sleep duration, sleep efficiency, sleep disturbance and use of sleep medication before and after reminiscence therapy. After the 12-weeks reminiscence therapy, there was a statistically significant change in the median scores for the PSQI subcomponents of subjective sleep quality (p<0.05). Conclusion: Our study found that reminiscence therapy increased the sleep quality of the elderly living in nursing homes. Acknowledgment: This study (project no 2017-037) was supported by the Scientific Research Projects Coordination Unit of Aksaray University. We thank the elderly subjects for their kind participation.

Keywords: nursing, older people, reminiscence therapy, sleep

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Authors: Moldir Makenova

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Alongside the implementation of trilingual education in schools, the Ministry of Education and Science of the Republic of Kazakhstan innovated the school curriculum in 2013 to include a Content and Language Integrated Learning (CLIL) approach. In this regard, some transition issues have arisen, such as unprepared teachers, a need for more awareness of the CLIL approach, and teaching resources. Some teachers view it as a challenge due to its combination of both content and language. This often creates anxiety among teachers who are knowledgeable about their subject areas in Kazakh or Russian but are deficient in delivering the subject’s content in English. Thus, with this new teaching approach, teachers encounter to choose the role of language and answer how language works in the CLIL classroom. This study aimed to explore how teachers experience the changing role of language in the curriculum and to find out what challenges teachers face related to CLIL implementation and how their language proficiency influences their teaching practices. A qualitative comparative case study was conducted in an X Lyceum and a mainstream school piloting CLIL. Data collection procedures were conducted via semi-structured interviews, classroom observations, and document analysis. Eight content teachers were chosen from these two schools as the target group of this study. Subject teachers, rather than language teachers, were chosen as the target group to grasp how the language-related issues in the new curriculum are interpreted by educators who do not necessarily identify themselves as language experts at the outset. The findings showed that mainstream teachers prioritize content over language because, as content teachers, the knowledge of content is more essential for them rather than the language. In contrast, most X Lyceum teachers balance language and content and additionally showed their preferences to support the ‘English language only' policy among 10-11 graders. Moreover, due to the low-level English proficiency, mainstream teachers did highlight the necessity of CLIL training and further collaboration with language teachers. This study will be beneficial for teachers and policy-makers to enable them to solve the issues mentioned above related to the implementation of CLIL. Larger-scale research conducted in the future would further inform its successful deployment country-wide.

Keywords: role of language, trilingual education, updated curriculum, teacher practices

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