Search results for: evidence based nursing
30204 Psychometric Validation of Czech Version of Spiritual Needs Assessment for Patients: The First Part of Research
Authors: Lucie Mrackova, Helena Kisvetrova
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Spirituality is an integral part of human life. In a secular environment, spiritual needs are often overlooked, especially in acute nursing care. Spiritual needs assessment for patients (SNAP), which also exists in the Czech version (SNAP-CZ), can be used for objective evaluation. The aim of this study was to measure the psychometric properties of SNAP-CZ and to find correlations between SNAP-CZ and sociodemographic and clinical variables. A cross-sectional study with tools assessing spiritual needs (SNAP-CZ), anxiety (Beck Anxiety Inventory; BAI), depression (Beck Depression Inventory; BDI), pain (Visual Analogue Scale; VAS), self-sufficiency (Barthel Index; BI); cognitive function (Montreal Cognitive Test; MoCa) and selected socio-demographic data was performed. The psychometric properties of SNAP-CZ were tested using factor analysis, reliability and validity tests, and correlations between the questionnaire and sociodemographic data and clinical variables. Internal consistency was established with Cronbach’s alfa for the overall score, respective domains, and individual items. Reliability was assessed by test-retest by Interclass correlation coefficient (ICC). Data for correlation analysis were processed according to Pearson's correlation coefficient. The study included 172 trauma patients (the mean age = 40.6 ± 12.1 years) who experienced polytrauma or severe monotrauma. There were a total of 106 (61.6%) male subjects, 140 (81.4%) respondents identified themselves as non-believers. The full-scale Cronbach's alpha was 0.907. The test-retest showed the reliability of the individual domains in the range of 0.924 to 0.960 ICC. Factor analysis resulted in a three-factor solution (psychosocial needs (alfa = 0.788), spiritual needs (alfa = 0.886) and religious needs (alfa = 0.841)). Correlation analysis using Pearson's correlation coefficient showed that the domain of psychosocial needs significantly correlated only with gender (r = 0.178, p = 0.020). Males had a statistically significant lower average value in this domain (mean = 12.5) compared to females (mean = 13.8). The domain of spiritual needs significantly correlated with gender (r = 0.199, p = 0.009), social status (r = 0.156, p = 0.043), faith (r = -0.250, p = 0.001), anxiety (r = 0.194, p = 0.011) and depression (r = 0.155, p = 0.044). The domain of religious needs significantly correlated with age (r = 0,208, p = 0,007), education (r = -0,161, p = 0,035), faith (r = -0,575, p < 0,0001) and depression (r = 0,179, p = 0,019). Overall, the whole SNAP scale significantly correlated with gender (r = 0.219, p = 0.004), social status (r = 0.175, p = 0.023), faith (r = -0.334, p <0.0001), anxiety (r = 0.177, p = 0.022) and depression (r = 0.173, p = 0.025). The results of this study corroborate the reliability of the SNAP-CZ and support its future use in the nursing care of trauma patients in a secular society. Acknowledgment: The study was supported by grant nr. IGA_FZV_2020_003.Keywords: acute nursing care, assessment of spiritual needs, patient, psychometric validation, spirituality
Procedia PDF Downloads 10430203 Assessment of Dietary Intake of Pregnant Women
Authors: Tuleshova Gulnara, Abduldayeva Aigul
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The goal is based on the studying the prevalence of micronutrient deficiencies among children and women of reproductive age to develop evidence-based recommendations aimed at improving the effectiveness of programs to prevent micronutrient deficiency. Subject: In our study we used a representative, random sample, carried out with the cluster method in the precinct of the principle areas of medical care for children 5 years of old. If the site has at least 60 children under 5 years of old, each second child was sampled, and if more than 60 children - each third child (first child selected by random sampling). The total number of investigated persons was within 80-86 women of reproductive age and children - within 80-92 people. Results: The studies found that the average prevalence of anemia among children aged 6-59 months was 35.2%, with the most susceptible to iron deficiency anemia in infants aged 6-23 months (53.3%). The prevalence of anemia among non-pregnant women was 39.0% among pregnant women - 43.8%. In children, the prevalence of folate deficiency was the highest (27.6%). Among non-pregnant women, frequent prevalence of folic acid deficiency was 37.0%. The prevalence of vitamin A deficiency was higher among children living in Astana (37.4%) compared with the medium-republican level (23.2%).Keywords: nutrition, pregnant women, micronutrients, macronutrients
Procedia PDF Downloads 61630202 Improving Self-Administered Medication Adherence for Older Adults: A Systematic Review
Authors: Mathumalar Loganathan, Lina Syazana, Bryony Dean Franklin
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Background: The therapeutic benefit of self-administered medication for long-term use is limited by an average 50% non-adherence rate. Patient forgetfulness is a common factor in unintentional non-adherence. With a growing ageing population, strategies to improve self-administration of medication adherence are essential. Our aim was to review systematically the effects of interventions to optimise self-administration of medication. Method: Database searched were MEDLINE, EMBASE, PsynINFO, CINAHL from 1980 to 31 October 2013. Search terms included were ‘self-administration’, ‘self-care’, ‘medication adherence’, and ‘intervention’. Two independent reviewers undertook screening and methodological quality assessment, using the Downs and Black rating scale. Results: The search strategy retrieved 6 studies that met the inclusion and exclusion criteria. Three intervention strategies were identified: self-administration medication programme (SAMP), nursing education and medication packaging (pill calendar). A nursing education programme focused on improving patients’ behavioural self-management of drug prescribing. This was the most studied area and three studies highlighting an improvement in self-administration of medication. Conclusion: Results are mixed and there is no one interventional strategy that has proved to be effective. Nevertheless, self-administration of medication programme seems to show most promise. A multi-faceted approach and clearer policy guideline are likely to be required to improve prescribing for these vulnerable patients. Mixed results were found for SAMP. Medication packaging (pill calendar) was evaluated in one study showing a significant improvement in self-administration of medication. A meta-analysis could not be performed due to heterogeneity in the outcome measures.Keywords: self-administered medication, intervention, prescribing, older patients
Procedia PDF Downloads 32330201 The Organizational Commitment of the Public Enterprises in Thailand
Authors: Routsukol Sunalai
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The purpose of this study is to examine the impact of public enterprise reform policy on the attributes of organizational commitments in the public energy enterprises in Thailand. It compares three structural types of public energy enterprises: Totally state-owned public enterprises (type I), partially transformed public enterprises (type II), and totally transformed public enterprises (type III), based on the degree of state partially transformed public enterprises (type II), and totally transformed public enterprises (type III),based on the degree of reformed organizations, by analyzing the presence of the desirable attributes of organizational commitment as perceived by employees. Findings indicate that there are statistically significant differences in the level of some dimensions of organizational commitment (affective commitment and normative commitment) between the three types of public energy enterprises. The lack of a structural type difference holds for only continuance commitment. The results also indicate empirical evidence concerning the causal relationship between the antecedents and including organizational commitment also.Keywords: management control, organizational commitment, public enterprises in Thailand, public enterprise reform
Procedia PDF Downloads 29030200 The Lacuna in Understanding of Forensic Science amongst Law Practitioners in India
Authors: Poulomi Bhadra, Manjushree Palit, Sanjeev P. Sahni
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Forensic science uses all branches of science for criminal investigation and trial and has increasingly emerged as an important tool in the administration of justice. However, the growth and development of this field in India has not been as rapid or widespread as compared to the more developed Western countries. For successful administration of justice, it is important that all agencies involved in law enforcement adopt an inter-professional approach towards forensic science, which is presently lacking. In light of the alarmingly high average acquittal rate in India, this study aims to examine the lack of understanding and appreciation of the importance and scope of forensic evidence and expert opinions amongst law professionals such as lawyers and judges. Based on a study of trial court cases from Delhi and surrounding areas, the study underline the areas in forensics where the criminal justice system has noticeably erred. Using this information, the authors examine the extent of forensic understanding amongst legal professionals and attempt to conclusively identify the areas in which they need further appraisal. A cross-sectional study done using a structured questionnaire was conducted amongst law professionals across age, gender, type and years of experience in court, to determine their understanding of DNA, fingerprints and other interdisciplinary scientific materials used as forensic evidence. In our study, we understand the levels of understanding amongst lawyers with regards to DNA and fingerprint evidence, and how it affects trial outcomes. We also aim to understand the factors that prevent credible and advanced awareness amongst legal personnel, amongst others. The survey identified the areas in modern and advanced forensics, such as forensic entomology, anthropology, cybercrime etc., in which Indian legal professionals are yet to attain a functional understanding. It also brings to light, what is commonly termed as the ‘CSI-effect’ in the Western courtrooms, and provides scope to study the existence of this phenomenon and its effects on the Indian courts and their judgements. This study highlighted the prevalence of unchallenged expert testimony presented by the prosecution in criminal trials and impressed upon the judicial system the need for independent analysis and evaluation of the scientist’s data and/or testimony by the defense. Overall, this study aims to define a clearer and rigid understanding of why legal professionals should have basic understanding of the interdisciplinary nature of forensic sciences. Based on the aforementioned findings, the author suggests various measures by which judges and lawyers might obtain an extensive knowledge of the advances and promising potentialities of forensic science. This includes promoting a forensic curriculum in legal studies at Bachelor’s and Master’s level as well as in mid-career professional courses. Formation of forensic-legal consultancies, in consultation with the Department of Justice, will not only assist in training police, military and law personnel but will also encourage legal research in this field. These suggestions also aim to bridge the communication gap that presently exists between law practitioners, forensic scientists and the general community’s awareness of the criminal justice system.Keywords: forensic science, Indian legal professionals, interdisciplinary awareness, legal education
Procedia PDF Downloads 34130199 Relationship Quality, Value Creation Practices and Brand Loyalty in Virtual Communities: Evidence from Facebook Communities
Authors: Zoya Khan, Amina Muzaffar
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Social media based brand communities are communities that are developed around a brand. In the highly globalized world of today, Facebook is undoubtedly being regarded and has been widely recognized as a trendy and well-accepted medium of marketing. By means of a Facebook fan page, organizations can effectually create, enhance, and sustain customer-brand relationship. In this article, we explore whether brand communities based on social media (a special type of online brand communities) have positive effects on the main community elements and value creation practices in the communities as well as on brand trust and brand loyalty. A survey was conducted and 201 valid responses were used for analysis. The results of structural equation modeling show that brand communities established on social media have positive effects on value creation practices. Brand use, impression management practices and brand identification has an impact on brand trust and this brand trust then further leads to brand loyalty.Keywords: relationship quality, impression management practices, brand identification, brand trust, brand loyalty
Procedia PDF Downloads 47430198 High-Risk Gene Variant Profiling Models Ethnic Disparities in Diabetes Vulnerability
Authors: Jianhua Zhang, Weiping Chen, Guanjie Chen, Jason Flannick, Emma Fikse, Glenda Smerin, Yanqin Yang, Yulong Li, John A. Hanover, William F. Simonds
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Ethnic disparities in many diseases are well recognized and reflect the consequences of genetic, behavior, and environmental factors. However, direct scientific evidence connecting the ethnic genetic variations and the disease disparities has been elusive, which may have led to the ethnic inequalities in large scale genetic studies. Through the genome-wide analysis of data representing 185,934 subjects, including 14,955 from our own studies of the African America Diabetes Mellitus, we discovered sets of genetic variants either unique to or conserved in all ethnicities. We further developed a quantitative gene function-based high-risk variant index (hrVI) of 20,428 genes to establish profiles that strongly correlate with the subjects' self-identified ethnicities. With respect to the ability to detect human essential and pathogenic genes, the hrVI analysis method is both comparable with and complementary to the well-known genetic analysis methods, pLI and VIRlof. Application of the ethnicity-specific hrVI analysis to the type 2 diabetes mellitus (T2DM) national repository, containing 20,791 cases and 24,440 controls, identified 114 candidate T2DM-associated genes, 8.8-fold greater than that of ethnicity-blind analysis. All the genes identified are defined as either pathogenic or likely-pathogenic in ClinVar database, with 33.3% diabetes-associated and 54.4% obesity-associated genes. These results demonstrate the utility of hrVI analysis and provide the first genetic evidence by clustering patterns of how genetic variations among ethnicities may impede the discovery of diabetes and foreseeably other disease-associated genes.Keywords: diabetes-associated genes, ethnic health disparities, high-risk variant index, hrVI, T2DM
Procedia PDF Downloads 13730197 Test of Capital Account Monetary Model of Floating Exchange Rate Determination: Further Evidence from Selected African Countries
Authors: Oloyede John Adebayo
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This paper tested a variant of the monetary model of exchange rate determination, called Frankel’s Capital Account Monetary Model (CAAM) based on Real Interest Rate Differential, on the floating exchange rate experiences of three developing countries of Africa; viz: Ghana, Nigeria and the Gambia. The study adopted the Auto regressive Instrumental Package (AIV) and Almon Polynomial Lag Procedure of regression analysis based on the assumption that the coefficients follow a third-order Polynomial with zero-end constraint. The results found some support for the CAAM hypothesis that exchange rate responds proportionately to changes in money supply, inversely to income and positively to interest rates and expected inflation differentials. On this basis, the study points the attention of monetary authorities and researchers to the relevance and usefulness of CAAM as appropriate tool and useful benchmark for analyzing the exchange rate behaviour of most developing countries.Keywords: exchange rate, monetary model, interest differentials, capital account
Procedia PDF Downloads 41330196 Moral Decision-Making in the Criminal Justice System: The Influence of Gruesome Descriptions
Authors: Michel Patiño-Sáenz, Martín Haissiner, Jorge Martínez-Cotrina, Daniel Pastor, Hernando Santamaría-García, Maria-Alejandra Tangarife, Agustin Ibáñez, Sandra Baez
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It has been shown that gruesome descriptions of harm can increase the punishment given to a transgressor. This biasing effect is mediated by negative emotions, which are elicited upon the presentation of gruesome descriptions. However, there is a lack of studies inquiring the influence of such descriptions on moral decision-making in people involved in the criminal justice system. Such populations are of special interest since they have experience dealing with gruesome evidence, but also formal education on how to assess evidence and gauge the appropriate punishment according to the law. Likewise, they are expected to be objective and rational when performing their duty, because their decisions can impact profoundly people`s lives. Considering these antecedents, the objective of this study was to explore the influence gruesome written descriptions on moral decision-making in this group of people. To that end, we recruited attorneys, judges and public prosecutors (Criminal justice group, CJ, n=30) whose field of specialty is criminal law. In addition, we included a control group of people who did not have a formal education in law (n=30), but who were paired in age and years of education with the CJ group. All participants completed an online, Spanish-adapted version of a moral decision-making task, which was previously reported in the literature and also standardized and validated in the Latin-American context. A series of text-based stories describing two characters, one inflicting harm on the other, were presented to participants. Transgressor's intentionality (accidental vs. intentional harm) and language (gruesome vs. plain) used to describe harm were manipulated employing a within-subjects and a between-subjects design, respectively. After reading each story, participants were asked to rate (a) the harmful action's moral adequacy, (b) the amount of punishment deserving the transgressor and (c) how damaging was his behavior. Results showed main effects of group, intentionality and type of language on all dependent measures. In both groups, intentional harmful actions were rated as significantly less morally adequate, were punished more severely and were deemed as more damaging. Moreover, control subjects deemed more damaging and punished more severely any type of action than the CJ group. In addition, there was an interaction between intentionality and group. People in the control group rated harmful actions as less morally adequate than the CJ group, but only when the action was accidental. Also, there was an interaction between intentionality and language on punishment ratings. Controls punished more when harm was described using gruesome language. However, that was not the case of people in the CJ group, who assigned the same amount of punishment in both conditions. In conclusion, participants with job experience in the criminal justice system or criminal law differ in the way they make moral decisions. Particularly, it seems that they are less sensitive to the biasing effect of gruesome evidence, which is probably explained by their formal education or their experience in dealing with such evidence. Nonetheless, more studies are needed to determine the impact this phenomenon has on the fulfillment of their duty.Keywords: criminal justice system, emotions, gruesome descriptions, intentionality, moral decision-making
Procedia PDF Downloads 18830195 Clothing as Cure: Dress as Moral Treatment in Psychiatry
Authors: Dorothy Chyung
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In the psychiatric interview, the mental status exam begins with an assessment of the patient's appearance, noting aspects such as grooming and hygiene. However, it is not well established whether further examination of a patient's attire can provide further useful information. The popular assumption is that those who are mentally unwell will manifest this in unusual clothing. In the moral treatment of the 19th century, proper clothing was also seen as a pivotal therapeutic concern. This project examines assumptions about clothing, both as a reflection of and treatment for psychopathology. The methodology considers the opinions expressed in 19th century art and journals, as well as asylum rules, in comparison to contemporary psychiatric practice and research evidence. Per moral treatment in the 19th century, self-discipline and a proper environment would cure insanity. Madness was evident in the opposite of these ideals—such as ragged or ‘improper’ clothing—and rules about attire delineated the most correct (i.e. sane) ways to dress. These rules applied not only for the patients but also for staff. Despite these ideals, accusations were made that asylums, in fact, dressed patients to look more mentally unwell and further removed patients’ agency. Current practice in psychiatric hospitals retains remnants of moral treatment. Patients are expected to dress ‘appropriately’ while retaining some choice to build self-esteem, with arguments about safety being used to justify the removal of choice. Meanwhile, staff is expected to dress professionally and as role models, based on the assumption that conservative dress is least pathological. Research on this subject is limited, and there is little evidence that discrete psychiatric diagnoses manifest in the particular dress, nor that conservative dress would result in a reduction in pathology. Dressing unusually has become a privilege granted only to those without association with mental illness.Keywords: fashion, history of psychiatry, medical humanities, mental health treatment
Procedia PDF Downloads 21930194 Improvement in Oral Health-Related Quality of Life of Adult Patients After Rehabilitation With Partial Dentures: A Systematic Review and Meta-Analysis
Authors: Adama NS Bah
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Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review
Procedia PDF Downloads 10730193 Artificial Intelligence-Based Chest X-Ray Test of COVID-19 Patients
Authors: Dhurgham Al-Karawi, Nisreen Polus, Shakir Al-Zaidi, Sabah Jassim
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The management of COVID-19 patients based on chest imaging is emerging as an essential tool for evaluating the spread of the pandemic which has gripped the global community. It has already been used to monitor the situation of COVID-19 patients who have issues in respiratory status. There has been increase to use chest imaging for medical triage of patients who are showing moderate-severe clinical COVID-19 features, this is due to the fast dispersal of the pandemic to all continents and communities. This article demonstrates the development of machine learning techniques for the test of COVID-19 patients using Chest X-Ray (CXR) images in nearly real-time, to distinguish the COVID-19 infection with a significantly high level of accuracy. The testing performance has covered a combination of different datasets of CXR images of positive COVID-19 patients, patients with viral and bacterial infections, also, people with a clear chest. The proposed AI scheme successfully distinguishes CXR scans of COVID-19 infected patients from CXR scans of viral and bacterial based pneumonia as well as normal cases with an average accuracy of 94.43%, sensitivity 95%, and specificity 93.86%. Predicted decisions would be supported by visual evidence to help clinicians speed up the initial assessment process of new suspected cases, especially in a resource-constrained environment.Keywords: COVID-19, chest x-ray scan, artificial intelligence, texture analysis, local binary pattern transform, Gabor filter
Procedia PDF Downloads 14530192 O.MG- It’s a Cyber-Enabled Fraud
Authors: Damola O. Lawal, David W. Gresty, Diane E. Gan, Louise Hewitt
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This paper investigates the feasibility of using a programmable USB such as the O.MG Cable to perform a file tampering attack. Here, the O.MG Cable, an apparently harmless mobile device charger, is used in an unauthorized way to alter the content of a file (accounts record-January_Contributions.xlsx). The aim is to determine if a forensics analyst can reliably determine who has altered the target file; the O.MG Cable or the user of the machine. This work highlights some of the traces of the O.MG Cable left behind on the target computer itself, such as the Product ID (PID) and Vendor ID (ID). Also discussed is the O.MG Cable’s behavior during the experiments. We determine if a forensics analyst could identify if any evidence has been left behind by the programmable device on the target file once it has been removed from the computer to establish if the analyst would be able to link the traces left by the O.MG Cable to the file tampering. It was discovered that the forensic analyst might mistake the actions of the O.MG Cable for the computer users. Experiments carried out in this work could further the discussion as to whether an innocent user could be punished for the unauthorized changes made by a programmable device.Keywords: O.MG cable, programmable USB, file tampering attack, digital evidence credibility, miscarriage of justice, cyber fraud
Procedia PDF Downloads 15930191 A Transformational Ecology Model of School Based Universal Mental Health Development
Authors: Cheryl M. Bowen
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Understanding that children thrive in a multi-systems approach to mental health development, a growing number of schools often promote school-based positive youth development however, there is scant empirical evidence investigating effective school-based “wraparound” mental health services for low income, Latinx children and their families. This 10-month case study utilizes a sample of 281 low-income, Latinx parents and their children, and 23 K-5th grade teachers living in northern California to test the hypothesis that a school-based mental health program can strengthen students’ developmental asset attainment and positively impact the school environment. The study utilized triangulated data to ascertain the effects of two program levels - (a) mental health and (b) positive child development services. All services were site-based and meant to target a wide variety of families. Findings from the study report that the universal mental health program increased the developmental asset attainment in 5 out of 8 thriving indicators thus transforming the child within his/her environment. Data collected from the administrative referral report demonstrate that the project also positively impacted the school climate. Parents and teachers felt more connected to the school, and referrals were down for discipline (35%), academics (66%), and suspensions (51%). The study concludes that a transformational ecology model of positive child development is the most effective means to nurture connections to all socializing agencies in a child’s ecosystem.Keywords: case study, child development, positive youth development, developmental assets, ecological systems theory
Procedia PDF Downloads 7630190 Environmental Degradation of Natural Resources in Broghil National Park in the High Mountains of Pakistan – Empirical Evidence From Local Community and Geoinformatics
Authors: Siddique Ullah Baig, Alisha Manzoor
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The remotest, mountainous, and icy Broghil Valley is a high-profile protected area as a national park, which hosts one of the highest altitude permanent human settlements on the earth. This park hosts a distributed but diverse range of habitats. Due to a lack of infrastructures, higher altitudes, and harsh environmental conditions, poverty-stricken inhabitants mostly rely on its resources, causing ecological dis-balance. This study aims to investigate the environmental degradation of natural resources of the park based on empirical evidence from stakeholders and geoinformatics. The result shows that one-fourth of the park is a gently undulating basin dotted with water bodies / grass, and agricultural land and three fourth is entirely rugged with steep mountains and glaciers. There are virtually no forests as the arid cold tundra climate and high altitude prevent tree growth. Rapid three-decadal land cover changes have led to ecological disequilibrium of the park, narrowing the traditional diverse food base, decreasing the resilience of biodiversity and local livelihoods as crop-land has shifted towards fallow, alpine-grass to peat-land and snow/glacial ice area to bare-soil/rocks. The local community believes in exploiting whatever vegetation or organic material is available for use as food, fodder, and fuel. The permanent presence of the community and limited cost-effective options in the park will be a challenge forever to maintain undisturbed natural processes as the objective of a national park.Keywords: Broghil National Park, natural resources, environmental degradation, land cover
Procedia PDF Downloads 6730189 Development of an Omaha System-Based Remote Intervention Program for Work-Related Musculoskeletal Disorders (WMSDs) Among Front-Line Nurses
Authors: Tianqiao Zhang, Ye Tian, Yanliang Yin, Yichao Tian, Suzhai Tian, Weige Sun, Shuhui Gong, Limei Tang, Ruoliang Tang
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Introduction: Healthcare workers, especially the nurses all over the world, are highly vulnerable to work-related musculoskeletal disorders (WMSDs), experiencing high rates of neck, shoulder, and low back injuries, due to the unfavorable working conditions. To reduce WMSDs among nursing personnel, many workplace interventions have been developed and implemented. Unfortunately, the ongoing Covid-19 (SARS-CoV-2) pandemic has posed great challenges to the ergonomic practices and interventions in healthcare facilities, particularly the hospitals, since current Covid-19 mitigation measures, such as social distancing and working remotely, has substantially minimized in-person gatherings and trainings. On the other hand, hospitals throughout the world have been short-staffed, resulting in disturbance of shift scheduling and more importantly, the increased job demand among the available caregivers, particularly the doctors and nurses. With the latest development in communication technology, remote intervention measures have been developed as an alternative, without the necessity of in-person meetings. The Omaha System (OS) is a standardized classification system for nursing practices, including a problem classification system, an intervention system, and an outcome evaluation system. This paper describes the development of an OS-based ergonomic intervention program. Methods: First, a comprehensive literature search was performed among worldwide electronic databases, including PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), between journal inception to May 2020, resulting in a total of 1,418 scientific articles. After two independent screening processes, the final knowledge pool included eleven randomized controlled trial studies to develop the draft of the intervention program with Omaha intervention subsystem as the framework. After the determination of sample size needed for statistical power and the potential loss to follow-up, a total of 94 nurses from eight clinical departments agreed to provide written, informed consent to participate in the study, which were subsequently assigned into two random groups (i.e., intervention vs. control). A subgroup of twelve nurses were randomly selected to participate in a semi-structured interview, during which their general understanding and awareness of musculoskeletal disorders and potential interventions was assessed. Then, the first draft was modified to reflect the findings from these interviews. Meanwhile, the tentative program schedule was also assessed. Next, two rounds of consultation were conducted among experts in nursing management, occupational health, psychology, and rehabilitation, to further adjust and finalize the intervention program. The control group had access to all the information and exercise modules at baseline, while an interdisciplinary research team was formed and supervised the implementation of the on-line intervention program through multiple social media groups. Outcome measures of this comparative study included biomechanical load assessed by the Quick Exposure Check and stresses due to awkward body postures. Results and Discussion: Modification to the draft included (1) supplementing traditional Chinese medicine practices, (2) adding the use of assistive patient handling equipment, and (3) revising the on-line training method. Information module should be once a week, lasting about 20 to 30 minutes, for a total of 6 weeks, while the exercise module should be 5 times a week, each lasting about 15 to 20 minutes, for a total of 6 weeks.Keywords: ergonomic interventions, musculoskeletal disorders (MSDs), omaha system, nurses, Covid-19
Procedia PDF Downloads 18230188 Evaluation of Classification Algorithms for Diagnosis of Asthma in Iranian Patients
Authors: Taha SamadSoltani, Peyman Rezaei Hachesu, Marjan GhaziSaeedi, Maryam Zolnoori
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Introduction: Data mining defined as a process to find patterns and relationships along data in the database to build predictive models. Application of data mining extended in vast sectors such as the healthcare services. Medical data mining aims to solve real-world problems in the diagnosis and treatment of diseases. This method applies various techniques and algorithms which have different accuracy and precision. The purpose of this study was to apply knowledge discovery and data mining techniques for the diagnosis of asthma based on patient symptoms and history. Method: Data mining includes several steps and decisions should be made by the user which starts by creation of an understanding of the scope and application of previous knowledge in this area and identifying KD process from the point of view of the stakeholders and finished by acting on discovered knowledge using knowledge conducting, integrating knowledge with other systems and knowledge documenting and reporting.in this study a stepwise methodology followed to achieve a logical outcome. Results: Sensitivity, Specifity and Accuracy of KNN, SVM, Naïve bayes, NN, Classification tree and CN2 algorithms and related similar studies was evaluated and ROC curves were plotted to show the performance of the system. Conclusion: The results show that we can accurately diagnose asthma, approximately ninety percent, based on the demographical and clinical data. The study also showed that the methods based on pattern discovery and data mining have a higher sensitivity compared to expert and knowledge-based systems. On the other hand, medical guidelines and evidence-based medicine should be base of diagnostics methods, therefore recommended to machine learning algorithms used in combination with knowledge-based algorithms.Keywords: asthma, datamining, classification, machine learning
Procedia PDF Downloads 44730187 Effect of Humor on Pain and Anxiety in Patients with Rheumatoi̇d Arthri̇ti̇s: A Prospective, Randomized Controlled Study
Authors: Burcu Babadağ Savaş, Nihal Orlu, Güler Balcı Alparslan, Ertuğrul Çolak, Cengiz Korkmaz
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Introduction/objectives: We aimed to investigate the effect of humor on pain and state anxiety in patients with rheumatoid arthritis (RA) receiving biologic intravenous (IV) infusion therapy. Method: The study sample consisted of 36 patients who met the classification criteria for RA and inclusion criteria in a rheumatology outpatient clinic at a university hospital between September 2020 and November 2021. Two sample groups were formed: the intervention group (watching a comedy movie) (n=18) and the control group (n=18). The intervention group consisted of the patient watching a comedy movie of his/her choice from an archive created by the researchers during the biological IV infusion therapy (approximately 90-120 minutes). The data collection instruments used before and after the test were the descriptive identification form, the visual analog scale (VAS), and the state anxiety scale. Results: The mean VAS scores of patients in the intervention group were 5.05 ± 2.01 in the pre-test and 2.61 ± 1.91 in the post-test. The mean state anxiety scores of patients in the intervention group were 45.94 ± 9.97 in the pre-test and 34.22 ± 6.57 in the post-test. Thus, patients who watched comedy movies during biologic IV infusion therapy in the infusion center had a greater reduction in pain scores than the control group and the effect size was small. Although there was a decrease in state anxiety scores in both groups, there was no significant difference between groups and the effect size was not relevant. Conclusions: During IV infusion therapy, watching comedy movies is recommended as a nursing care intervention for reducing pain in patients with RA in cooperation with other health professionals.Keywords: watching comedy movie, humor, pain, anxiety, nursing, care
Procedia PDF Downloads 13930186 Impact of Geomagnetic Variation over Sub-Auroral Ionospheric Region during High Solar Activity Year 2014
Authors: Arun Kumar Singh, Rupesh M. Das, Shailendra Saini
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The present work is an attempt to evaluate the sub-auroral ionospheric behavior under changing space weather conditions especially during high solar activity year 2014. In view of this, the GPS TEC along with Ionosonde data over Indian permanent scientific base 'Maitri', Antarctica (70°46′00″ S, 11°43′56″ E) has been utilized. The results suggested that the nature of ionospheric responses to the geomagnetic disturbances mainly depended upon the status of high latitudinal electro-dynamic processes along with the season of occurrence. Fortunately, in this study, both negative and positive ionospheric impact to the geomagnetic disturbances has been observed in a single year but in different seasons. The study reveals that the combination of equator-ward plasma transportation along with ionospheric compositional changes causes a negative ionospheric impact during summer and equinox seasons. However, the combination of pole-ward contraction of the oval region along with particle precipitation may lead to exhibiting positive ionospheric response during the winter season. Other than this, some Ionosonde based new experimental evidence also provided clear evidence of particle precipitation deep up to the low altitudinal ionospheric heights, i.e., up to E-layer by the sudden and strong appearance of E-layer at 100 km altitudes. The sudden appearance of E-layer along with a decrease in F-layer electron density suggested the dominance of NO⁺ over O⁺ at a considered region under geomagnetic disturbed condition. The strengthening of E-layer is responsible for modification of auroral electrojet and field-aligned current system. The present study provided a good scientific insight on sub-auroral ionospheric to the changing space weather condition.Keywords: high latitude ionosphere, space weather, geomagnetic storms, sub-storm
Procedia PDF Downloads 16930185 Application of Cloud Based Healthcare Information System through a Smart Card in Kingdom of Saudi Arabia
Authors: Wasmi Woishi
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Smart card technology is a secure and safe technology that is expanding its capabilities day by day in terms of holding important information without alteration. It is readily available, and its ease of portability makes it more efficient in terms of its usage. The smart card is in use by many industries such as financial, insurance, governmental industries, personal identification, to name a few. Smart card technology is popular for its wide familiarity, adaptability, accessibility, benefits, and portability. This research aims to find out the perception toward the application of a cloud-based healthcare system through a smart card in KSA. The research has compiled the countries using a smart card or smart healthcare card and indicated the potential benefits of implementing smart healthcare cards. 120 participants from Riyadh city were surveyed by the means of a closed-ended questionnaire. Data were analyzed through SPSS. This research extends the research body in the healthcare system. Empirical evidence regarding smart healthcare cards is scarce and hence undertaken in this study. The study provides a useful insight into collecting, storing, analyzing, manipulating, and accessibility of medical information regarding smart healthcare cards. Research findings can help achieve KSA's Vision 2030 goals in terms of the digitalization of healthcare systems in improving its efficiency and effectiveness in storing and accessing healthcare data.Keywords: smart card technology, healthcare using smart cards, smart healthcare cards, KSA healthcare information system, cloud-based healthcare cards
Procedia PDF Downloads 16230184 Political Leadership: Bane of African Development
Authors: Samaila Liman Gamba
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This paper discussed the importance of good governance and its impact on the socio-economic and political development of African countries and, conversely, its underdevelopment and consequent stagnation. The study employed the use of quantitative and descriptive methods of collecting secondary data. The system analysis approach was also adopted as the theoretical framework. It is a global system, but it is also used to analyze the place of regions and single states within it. The study showed that political leadership in Africa based on empirical observation and documented evidence since the hard-won political independence from colonial Europe has become one of Africa’s sources of problems confronting the states and their resources became the primary purpose of political contestation and the establishment of a political culture based on ethnicity and authoritarian pattern of governance. The solution is for African leaders to learn and imbibe the leadership qualities of the late Nelson Mandela, Nyerere and Kwame Nkrumah, who carried their citizens along and were devoid of ethnicity and personal aggrandizement. They sacrificed their lives for their countrymen and fought against imperialism and are counted as patriots.Keywords: political leadership, African development, constitutional democracy, power and resource control
Procedia PDF Downloads 6130183 Clinical Prediction Rules for Using Open Kinetic Chain Exercise in Treatment of Knee Osteoarthritis
Authors: Mohamed Aly, Aliaa Rehan Youssef, Emad Sawerees, Mounir Guirgis
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Relevance: Osteoarthritis (OA) is the most common degenerative disease seen in all populations. It causes disability and substantial socioeconomic burden. Evidence supports that exercise are the most effective conservative treatment for patients with OA. Therapists experience and clinical judgment play major role in exercise prescription and scientific evidence for this regard is lacking. The development of clinical prediction rules to identify patients who are most likely benefit from exercise may help solving this dilemma. Purpose: This study investigated whether body mass index and functional ability at baseline can predict patients’ response to a selected exercise program. Approach: Fifty-six patients, aged 35 to 65 years, completed an exercise program consisting of open kinetic chain strengthening and passive stretching exercises. The program was given for 3 sessions per week, 45 minutes per session, for 6 weeks Evaluation: At baseline and post treatment, pain severity was assessed using the numerical pain rating scale, whereas functional ability was being assessed by step test (ST), time up and go test (TUG) and 50 feet time walk test (50 FTW). After completing the program, global rate of change (GROC) score of greater than 4 was used to categorize patients as successful and non-successful. Thirty-eight patients (68%) had successful response to the intervention. Logistic regression showed that BMI and 50 FTW test were the only significant predictors. Based on the results, patients with BMI less than 34.71 kg/m2 and 50 FTW test less than 25.64 sec are 68% to 89% more likely to benefit from the exercise program. Conclusions: Clinicians should consider the described strengthening and flexibility exercise program for patents with BMI less than 34.7 Kg/m2 and 50 FTW faster than 25.6 seconds. The validity of these predictors should be investigated for other exercise.Keywords: clinical prediction rule, knee osteoarthritis, physical therapy exercises, validity
Procedia PDF Downloads 42330182 Religious and Architectural Transformations of Kourion in Cyprus between the 1st and 6th Centuries AD. The Case of Trypiti Bay and its Topographical Relationships to Coastal Sanctuaries
Authors: Argyroula Argyrou
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The purpose of my current research, of which this paper form’s part, is to explore the architectural and religious transformations of Trypiti Bay in the region of Kourion, Cyprus, between the 1st and 6th centuries AD. This research aims to explore and analyse three different stages in the religious and architectural transformations of the ancient port, with evidence supporting these transformations from the main city of Kourion and the Sanctuary of Apollo Hylates between the 1st and 6th centuries. In addition, the research is using historical and archaeological comparisons with coastal sites in the Levant, North Africa, Lebanon, and Europe in an attempt to identify a pattern of development in the religious topography of Kourion and how these contributed to change in the use and symbolism of Trypiti bay as an important passageway to religious sanctuaries in the vicinity of the coast. The construction of Trypiti Bay has been proven, according to archaeological and historical evidence, gathered throughout Kourion’s fieldwork and archival research, that it served as a natural port for cargos that needed to be protected from the strong west winds of the area. The construction of Trypiti Bay is believed to be unique to the island as no similar structure has yet been discovered.Keywords: architecture, heritage, perservation, transformation, unique
Procedia PDF Downloads 11230181 Common Soccer Injuries and Its Risk Factors: A Systematic Review
Authors: C. Brandt, R. Christopher, N. Damons
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Background: Soccer is one of the most common sports in the world. It is associated with a significant chance of injury either during training or during the course of an actual match. Studies on the epidemiology of soccer injuries have been widely conducted, but methodological appraisal is lacking to make evidence-based decisions. Objectives: The purpose of this study was to conduct a systematic review of common injuries in soccer and their risk factors. Methods: A systematic review was performed based on the Joanna Briggs Institute procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed, and grey literature were searched. The quality of selected studies was rated, and data extracted and tabulated. Plot data analysis was done, and incidence rates and odds ratios were calculated, with their respective 95% confidence intervals. I² statistic was used to determine the proportion of variation across studies. Results: The search yielded 62 studies, of which 21 were screened for inclusion. A total of 16 studies were included for the analysis, ten for qualitative and six for quantitative analysis. The included studies had, on average, a low risk of bias and good methodological quality. The heterogeneity amongst the pooled studies was, however, statistically significant (χ²-p value < 0.001). The pooled results indicated a high incidence of soccer injuries at an incidence rate of 6.83 per 1000 hours of play. The pooled results also showed significant evidence of risk factors and the likelihood of injury occurrence in relation to these risk factors (OR=1.12 95% CI 1.07; 1.17). Conclusion: Although multiple studies are available on the epidemiology of soccer injuries and risk factors, only a limited number of studies were of sound methodology to be included in a review. There was also significant heterogeneity amongst the studies. The incidence rate of common soccer injuries was found to be 6.83 per 1000 hours of play. This incidence rate is lower than the values reported by the majority of previous studies on the occurrence of common soccer injuries. The types of common soccer injuries found by this review support the soccer injuries pattern reported in existing literature as muscle strain and ligament sprain of varying severity, especially in the lower limbs. The risk factors that emerged from this systematic review are predominantly intrinsic risk factors. The risk factors increase the risk of traumatic and overuse injuries of the lower extremities such as hamstrings and groin strains, knee and ankle sprains, and contusion.Keywords: incidence, prevalence, risk factors, soccer injuries
Procedia PDF Downloads 18330180 The Relationship between Organizational Culture and Application of Management Accounting Innovation: Evidence from Iran
Authors: Zohreh Hajiha
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Culture affects the ability of the organization in expressing and achieving the goals. Organizational culture influences the selection of instruments applied in the management of organizations. All the instruments applied in organizations to control, promote and create innovations are influenced by organizational culture. This research studies organizational culture based on the cultural model of Muijen and its relationship with applying management accounting innovations in Iranian listed firms. Management accounting innovations of this study include activity-based costing, activity-based management, balanced scorecard, target costing, standard costing, quality costing, Kaizen costing and dimensions of organizational culture include support orientation, innovation orientation, rules orientation and goal orientation. 105 questionnaires were sent to financial executives of production companies and 73 questionnaires were returned. The findings show that there is a significant difference between organizational culture of firms that have applied management accounting innovations and those which have used these innovations less. Also, dimensions of support orientation and culture goal orientation are the highest in groups that apply management accounting innovations. The findings suggest that proper organization culture could promote the use od management accounting tools in Iranian firms.Keywords: organizational culture, innovation, management accounting, muijen model
Procedia PDF Downloads 36030179 Analysis of Causality between Economic Growth and Carbon Emissions: The Case of Mexico 1971-2011
Authors: Mario Gómez, José Carlos Rodríguez
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This paper analyzes the Environmental Kuznets Curve (EKC) hypothesis to test the causality relationship between economic activity, trade openness and carbon dioxide emissions in Mexico (1971-2011). The results achieved in this research show that there are three long-run relationships between production, trade openness, energy consumption and carbon dioxide emissions. The EKC hypothesis was not verified in this research. Indeed, it was found evidence of a short-term unidirectional causality from GDP and GDP squared to carbon dioxide emissions, from GDP, GDP squared and TO to EC, and bidirectional causality between TO and GDP. Finally, it was found evidence of long-term unidirectional causality from all variables to carbon emissions. These results suggest that a reduction in energy consumption, economic activity, or an increase in trade openness would reduce pollution.Keywords: causality, cointegration, energy consumption, economic growth, environmental Kuznets curve
Procedia PDF Downloads 35130178 The Adoption of Process Management for Accounting Information Systems in Thailand
Authors: Manirath Wongsim
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Information Quality (IQ) has become a critical, strategic issue in Accounting Information Systems (AIS) adoption. In order to implement AIS adoption successfully, it is important to consider the quality of information use throughout the adoption process, which seriously impacts the effectiveness of AIS adoption practice and the optimization of AIS adoption decisions. There is a growing need for research to provide insights into issues and solutions related to IQ in AIS adoption. The need for an integrated approach to improve IQ in AIS adoption, as well as the unique characteristics of accounting data, demands an AIS adoption specific IQ framework. This research aims to explore ways of managing information quality and AIS adoption to investigate the relationship between the IQ issues and AIS adoption process. This study has led to the development of a framework for understanding IQ management in AIS adoption. This research was done on 44 respondents as ten organisations from manufacturing firms in Thailand. The findings of the research’s empirical evidence suggest that IQ dimensions in AIS adoption to provide assistance in all process of decision making. This research provides empirical evidence that information quality of AIS adoption affect decision making and suggests that these variables should be considered in adopting AIS in order to improve the effectiveness of AIS.Keywords: information quality, information quality dimensions, accounting information systems, accounting information system adoption
Procedia PDF Downloads 46730177 Exploring Employee Experiences of Distributed Leadership in Consultancy SMEs
Authors: Mohamed Haffar, Ramdane Djebarni, Russell Evans
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Despite a growth in literature on distributed leadership, the majority of studies are centred on large public organisations particularly within the health and education sectors. The purpose of this study is to fill the gap in the literature by exploring employee experiences of distributed leadership within two commercial consultancy SME businesses in the UK and USA. The aim of the study informed an exploratory method of research to gather qualitative data drawn from semi-structured interviews involving a sample of employees in each organisation. A series of broad, open questions were used to explore the employees’ experiences; evidence of distributed leadership; and extant barriers and practices in each organisation. Whilst some of our findings aligned with patterns and practices in the existing literature, it importantly discovered some emergent themes that have not previously been recognised in the previous studies. Our investigation identified that whilst distributed leadership was in evidence in both organisations, the interviewees’ experience reported that it was sporadic and inconsistent. Moreover, non-client focused projects were reported to be less important and distributed leadership was found to be inconsistent or non-existent.Keywords: consultancy, distributed leadership, owner-manager, SME, entrepreneur
Procedia PDF Downloads 12330176 The Application of Patterned Injuries in Reconstruction of Motorcycle Accidents
Authors: Chun-Liang Wu, Kai-Ping Shaw, Cheng-Ping Yu, Wu-Chien Chien, Hsiao-Ting Chen, Shao-Huang Wu
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Objective: This study analyzed three criminal judicial cases. We applied the patterned injuries of the rider to demonstrate the facts of each accident, reconstruct the scenes, and pursue the truth. Methods: Case analysis, a method that collects evidence and reasons the results in judicial procedures, then the importance of the pattern of injury as evidence will be compared and evaluated. The patterned injuries analysis method is to compare the collision situation between an object and human body injuries to determine whether the characteristics can reproduce the unique pattern of injury. Result: Case 1: Two motorcycles, A and B, head-on collided; rider A dead, and rider B was accused. During the prosecutor’s investigation, the defendant learned that rider A had an 80 mm open wound on his neck. During the court trial, the defendant requested copies of the case file and found out that rider A had a large contusion on his chest wall, and the cause of death was traumatic hemothorax and abdominal wall contusion. The defendant compared all the evidence at the scene and determined that the injury was obviously not caused by the collision of the body or the motorcycle of rider B but that rider was out of control and injured himself when he crossed the double yellow line. In this case, the defendant was innocent in the High Court judgment in April 2022. Case 2: Motorcycles C and D head-on crashed, and rider C died of massive abdominal bleeding. The prosecutor decided that rider C was driving under the influence (DUI), but rider D was negligent and sued rider D. The defendant requested the copies’ file and found the special phenomenon that the front wheel of motorcycle C was turned left. The defendant’s injuries were a left facial bone fracture, a left femur fracture, and other injuries on the left side. The injuries were of human-vehicle separation and human-vehicle collision, which proved that rider C suddenly turned left when the two motorcycles approached, knocked down motorcycle D, and the defendant flew forward. Case 3: Motorcycle E and F’s rear end collided, the front rider E was sentenced to 3 months, and the rear rider F sued rider E for more than 7 million N.T. The defendant found in the copies’ file that the injury of rider F was the left tibial platform fracture, etc., and then proved that rider F made the collision with his left knee, causing motorcycle E to fall out of control. This evidence was accepted by the court and is still on trial. Conclusion: The application of patterned injuries in the reconstruction of a motorcycle accident could discover the truth and provide the basis for judicial justice. The cases and methods could be the reference for the policy of preventing traffic accident casualties.Keywords: judicial evidence, patterned injuries analysis, accident reconstruction, fatal motorcycle injuries
Procedia PDF Downloads 8530175 The People's Tribunal: Empowerment by Survivors for Survivors of Child Abuse
Authors: Alan Collins
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This study explains how The People’s Tribunal empowered survivors of child abuse. It examines how People’s tribunals can be effective mean of empowerment; the challenges of empowerment – expectation v. reality; the findings and how they reflect other inquiry findings; and the importance of listening and learning from survivors. UKCSAPT “The People’s Tribunal” was established by survivors of child sex abuse and members of civil society to investigate historic cases of institutional sex abuse. The independent inquiry, led by a panel of four judges, listened to evidence spanning four decades from survivors and experts. A common theme throughout these accounts showed that a series of institutional failures prevented abuse from being reported; and that there are clear links between children being rendered vulnerable by these failures and predatory abuse on an organised scale. It made a series of recommendations including the establishment of a permanent and open forum for victims to share experiences and give evidence, better links between mental health services and police investigations, and training for police and judiciary professionals on the effects of undisclosed sexual abuse. The main findings of the UKCSAPT report were:-There are clear links between children rendered vulnerable by institutional failures and predatory abuse on an organised scale, even if these links often remain obscure. -UK governmental institutions have failed to provide survivors with meaningful opportunities for either healing or justice. -The vital mental health needs of survivors are not being met and this undermines both their psychological recovery and access to justice. -Police and other authorities often lack the training to understand the complex reasons for the inability of survivors to immediately disclose a history of abuse. -Without far-reaching changes in institutional culture and practices, the sexual abuse of children will continue to be a significant scourge in the UK. The report also outlined a series of recommendations for improving reporting and mental health provision, and access to justice for victims were made, including: -A permanent, government-funded popular tribunal should be established to enable survivors to come forward and tell their stories. -Survivors giving evidence should be assigned an advocate to assist their access to justice. -Mental health services should be linked to police investigations to help victims disclose abuse. -Victims who fear reprisals should be provided with a channel though which to give evidence anonymously.Keywords: empowerment, survivors, sexual, abuse
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