Search results for: technical intervention
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4462

Search results for: technical intervention

3682 Zero Energy Buildings in Hot-Humid Tropical Climates: Boundaries of the Energy Optimization Grey Zone

Authors: Nakul V. Naphade, Sandra G. L. Persiani, Yew Wah Wong, Pramod S. Kamath, Avinash H. Anantharam, Hui Ling Aw, Yann Grynberg

Abstract:

Achieving zero-energy targets in existing buildings is known to be a difficult task requiring important cuts in the building energy consumption, which in many cases clash with the functional necessities of the building wherever the on-site energy generation is unable to match the overall energy consumption. Between the building’s consumption optimization limit and the energy, target stretches a case-specific optimization grey zone, which requires tailored intervention and enhanced user’s commitment. In the view of the future adoption of more stringent energy-efficiency targets in the context of hot-humid tropical climates, this study aims to define the energy optimization grey zone by assessing the energy-efficiency limit in the state-of-the-art typical mid- and high-rise full AC office buildings, through the integration of currently available technologies. Energy models of two code-compliant generic office-building typologies were developed as a baseline, a 20-storey ‘high-rise’ and a 7-storey ‘mid-rise’. Design iterations carried out on the energy models with advanced market ready technologies in lighting, envelope, plug load management and ACMV systems and controls, lead to a representative energy model of the current maximum technical potential. The simulations showed that ZEB targets could be achieved in fully AC buildings under an average of seven floors only by compromising on energy-intense facilities (as full AC, unlimited power-supply, standard user behaviour, etc.). This paper argues that drastic changes must be made in tropical buildings to span the energy optimization grey zone and achieve zero energy. Fully air-conditioned areas must be rethought, while smart technologies must be integrated with an aggressive involvement and motivation of the users to synchronize with the new system’s energy savings goal.

Keywords: energy simulation, office building, tropical climate, zero energy buildings

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3681 Acceptance and Feasibility of Delivering an Evidence-based Digital Intervention for Palliative Care Education

Authors: Areej Alosimi, Heather Wharrad, Katharine Whittingham

Abstract:

Palliative care is a crucial element in nursing, especially with the steep increase in non-communicable diseases. Providing education in palliative care can help elevate the standards of care and address the growing need for it. However, palliative care has not been introduced into nursing curricula, specifically in Saudi Arabia, evidenced by students' inadequate understanding of the subject. Digital learning has been identified as a persuasive and effective method to improve education. The study aims to assess the feasibility and accessibility of implementing digital learning in palliative care education in Saudi Arabia by investigating the potential of delivering palliative care nurse education via distance learning. The study will utilize a sequential exploratory mixed-method approach. Phase one will entail identifying needs, developing a web-based program in phase two, and intervention implementation with a pre-post-test in phase three. Semi-structured interviews will be conducted to explore participant perceptions and thoughts regarding the intervention. Data collection will incorporate questionnaires and interviews with nursing students. Data analysis will use SPSS to analyze quantitative measurements and NVivo to analyze qualitative aspects. The study aims to provide insights into the feasibility of implementing digital learning in palliative care education. The results will serve as a foundation to investigate the effectiveness of e-learning interventions in palliative care education among nursing students. This study addresses a crucial gap in palliative care education, especially in nursing curricula, and explores the potential of digital learning to improve education. The results have broad implications for nursing education and the growing need for palliative care globally. The study assesses the feasibility and accessibility of implementing digital learning in palliative care education in Saudi Arabia. The research investigates whether palliative care nurse education can be effectively delivered through distance learning to improve students' understanding of the subject. The study's findings will lay the groundwork for a larger investigation on the efficacy of e-learning interventions in improving palliative care education among nursing students. The study can potentially contribute to the overall advancement of nursing education and the growing need for palliative care.

Keywords: undergraduate nursing students, E-Learning, Palliative care education, Knowledge

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3680 Experience of Inpatient Life in Korean Complex Regional Pain Syndrome: A Phenomenological Study

Authors: Se-Hwa Park, En-Kyung Han, Jae-Young Lim, Hye-Jung Ahn

Abstract:

Purpose: The objective of this study is to provide basic data for understanding the substance of inpatient life with CRPS (Complex Regional Pain Syndrome) and developing efficient and effective nursing intervention. Methods: From September 2018 to November, we have interviewed 10 CRPS patients about inpatient experiences. To understand the implication of inpatient life experiences with CRPS and intrinsic structure, we have used the question: 'How about the inpatient experiences with CRPS'. For data analysis, the method suggested by Colaizzi was applied as a phenomenological method. Results: According to the analysis, the study participants' inpatient life process was structured in six categories: (a) breakthrough pain experience (b) the limitation of pain treatment, (c) worsen factors of pain during inpatient period, (d) treat method for pain, (e) positive experience for inpatient period, (f) requirements for medical team, family and people in hospital room. Conclusion: Inpatient with CRPS have experienced the breakthrough pain. They had expected immediate treatment for breakthrough pain, but they experienced severe pain because immediate treatment was not implemented. Pain-worsening factors which patients with CRPS are as follows: personal factors from negative emotions such as insomnia, stress, sensitive character, pain part touch or vibration stimulus on the bed, physical factors from high threshold or rapid speed during fast transfer, conflict with other people, climate factors such as humidity or low temperature, noise, smell, lack of space because of many visitors. Patients actively manage the pain committing into another tasks or diversion. And also, patients passively manage the pain, just suppress, give-up. They think positively about rehabilitation treatment. And they require the understanding and sympathy for other people, and emotional support, immediate intervention for medical team. Based on the results of this study, we suppose the guideline of systematic breakthrough pain management for the relaxation of sudden pain, using notice of informing caution for touch or vibration. And we need to develop non-medicine pain management nursing intervention.

Keywords: breakthrough pain, CRPS, complex regional pain syndrome, inpatient life experiences, phenomenological method

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3679 General Mood and Emotional Regulation as Predictors of Bullying Behaviors among Adolescent Males: Basis for a Proposed Bullying Intervention Program

Authors: Angelyn Del Mundo

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Bullying cases are a proliferating issue that schools need to address. This calls for a challenge in providing effective measures to reduce bullying. The study aimed to determine which among the socio-emotional aspects of adolescent males could predict bullying. The respondents of the study were the grades 10 and 11 level and the selection of the respondents was based on the names listed by the teachers and guidance counselors through the Student Nomination Questionnaire. The Bullying Survey Questionnaire Checklist was answered by the respondents to be able to identify their most observed bullying behavior. On the other hand, the level of their mental ability was measured through the use of Otis-Lennon School Ability Test, while their socio-emotional aspects was is classified into 2 contexts: emotional intelligence and personality traits which were determined with the use of Bar-On Emotional Quotient Inventory: Youth Version (BarOn EQ-i:YV) and the Five-Factor Personality Inventory-Children (FFPI-C). Results indicated that majority of the respondents have average level of mental ability and socio-emotional aspects. However, many students have low to markedly low level interpersonal scale. Furthermore, general mood and emotional regulation were found as predictors of bullying behaviors. These findings became the basis for a proposed bullying intervention program.

Keywords: bullying, emotional intelligence, mental ability, personality traits

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3678 Stress and Dysfunctional Eating Behavior in COVID-19 Pandemic: A Gender Perspective

Authors: Vanshika Chutani, Priya Bhatnagar

Abstract:

The pandemic has brought us to a standpoint where stress as a physical, cognitive, and behavioral construct is inevitable. The current research provides an overview of the relationship between stress and dysfunctional eating behavior during the challenging time of the COVID-19 pandemic. The present paper also aims to highlight the gender-specific differences in perception of stress and its correlation with dysfunctional eating behavior in the COVID-19 pandemic. Perceived Stress Scale-10 (PSS) and Adult Eating Behavior questionnaire (AEBQ) were used on a heterogeneous sample between 20-40 years. The research was conducted on 50 participants, 25 male, and 25 female. Quantitative analysis was done with SPSS 22.0. The results of the investigation revealed a significant difference in stress level, t(48)=2.01, p<0.01, with women (M=22.24. SD=5.23) having a higher stress level than men (M=19.04, SD=4.89). There was no significant difference in dysfunctional eating behavior between males and females. There was a significant positive correlation between stress and dysfunctional eating behavior in females, whereas, in males, there was no significant positive correlation between stress and dysfunctional eating behavior. The research extrapolates that the pandemic led to elevated stress levels in both genders and gender differences existed, and males & females responded differently on dysfunctional eating behavior. The research has also outlined intervention to help individuals cope with stress and dysfunctional eating behavior. The findings of the research propose the execution of different intervention programs and psychological first aid to help individuals who are predisposed to develop eating disorders.

Keywords: stress, dysfunctional eating behavior, gender-specific differences, COVID-19

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3677 Investigating Income Diversification Strategies into Off-Farm Activities Among Rural Households in Ethiopia

Authors: Kibret Berhanu Getinet

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Off-farm income diversification by farm rural households has gained the attention of researchers and policymakers due to the fact that agriculture failed to meet the needs of people in developing countries like Ethiopia. The objective of this study was to investigate income diversification strategies into off-farm activities among rural households in Hawassa Zuria Woreda, Sidama National Regional State, Ethiopia. The study used primary and secondary data sources for the primary data collection questionnaire employed as a data collection instrument. A multistage sampling technique was used to collect data from a total of 197 sample households from four kebeles of the study area. Descriptive statistics, as well as econometrics methods of data analysis, were employed. The descriptive statistics result indicates that the majority of sample rural households (68.53 %) have engaged in off-farm income diversification activities while the remaining 31.47% of households did not participate in the diversification in the study area. The choice of participants among the strategies indicates that 6.60% of respondents participated in off-farm wage employment, 30.46% participated in off-farm self-employment, and about 31.47% of them participated in both off-farm wage employment. The study revealed that the share of off-farm income in total annual earnings of households was about 48.457%, and thus, the off-farm diversification significantly contributes to the rural household income. Moreover, binary and multinomial logistic regression models were employed to identify factors that affect the participation and the choices of the off-farm income diversification strategies, respectively. The binary logit model result indicated that agro-ecological zone, education status of the households, available technical skills of the household, household saving, total livestock owned by the households, access to electricity, road access and being married of household head were significant and positively affected the chance of diversification in off-farm activities while the on-farm income of households is negatively affected the chance of diversification. Similarly, the multinomial logistic regression model estimate revealed that agroecological zone, on-farm income, available technical skills, household savings, and access to electricity are positively related and significantly influenced the household’s choice of employment into off-farm wage employment. The off-farm self-employment diversification choice is significantly influenced by on-farm income, available technical skills, household savings, total livestock owned, and access to electricity. Moreover, the result showed that the factors that affect the choice of farm households to engage in both off-farm wage and self-employment are ecological zone, education status, on-farm income, available technical skills, household own saving, market access, total livestock owned, access to electricity and road access. Thus, due attention should be given to addressing the demographic, socio-economic, and institutional constraints to strengthen off-farm income diversification strategies to improve the income of rural households.

Keywords: off-farm, incoem, diversification, logit model

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3676 Artificial Intelligence Impact on Strategic Stability

Authors: Darius Jakimavicius

Abstract:

Artificial intelligence is the subject of intense debate in the international arena, identified both as a technological breakthrough and as a component of the strategic stability effect. Both the kinetic and non-kinetic development of AI and its application in the national strategies of the great powers may trigger a change in the security situation. Artificial intelligence is generally faster, more capable and more efficient than humans, and there is a temptation to transfer decision-making and control responsibilities to artificial intelligence. Artificial intelligence, which, once activated, can select and act on targets without further intervention by a human operator, blurs the boundary between human or robot (machine) warfare, or perhaps human and robot together. Artificial intelligence acts as a force multiplier that speeds up decision-making and reaction times on the battlefield. The role of humans is increasingly moving away from direct decision-making and away from command and control processes involving the use of force. It is worth noting that the autonomy and precision of AI systems make the process of strategic stability more complex. Deterrence theory is currently in a phase of development in which deterrence is undergoing further strain and crisis due to the complexity of the evolving models enabled by artificial intelligence. Based on the concept of strategic stability and deterrence theory, it is appropriate to develop further research on the development and impact of AI in order to assess AI from both a scientific and technical perspective: to capture a new niche in the scientific literature and academic terminology, to clarify the conditions for deterrence, and to identify the potential uses, impacts and possibly quantities of AI. The research problem is the impact of artificial intelligence developed by great powers on strategic stability. This thesis seeks to assess the impact of AI on strategic stability and deterrence principles, with human exclusion from the decision-making and control loop as a key axis. The interaction between AI and human actions and interests can determine fundamental changes in great powers' defense and deterrence, and the development and application of AI-based great powers strategies can lead to a change in strategic stability.

Keywords: artificial inteligence, strategic stability, deterrence theory, decision making loop

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3675 Effect of Science Learning Module in Filipino on Content Mastery and Conceptual Understanding of Grade 9 Students

Authors: Roly B. Bayo-Ang

Abstract:

This research investigated the effect of science intervention modules in Filipino and in English on mastery of content (MOC) and conceptual understanding of Grade 9 students in Chemistry. Analysis of content mastery scores revealed a significant difference in the mean scores of the control and experimental group, t (46) = -2.14, p < 0.05. The experimental group achieved an MPS of > 75% in three of the five lessons while none in the control group. Analysis of the pretest and posttest scores of the control group in the test for conceptual understanding (TCU) showed no significant difference, t (18), =1.44, p > 0.05, while pretest and posttest scores of experimental group revealed significant difference, t (29) = -5.08, p < 0.05. Comparison of posttest scores of control and experimental group revealed no significant difference t (42) =1.67, p > 0.05. Performance in TCU and MOC of the control group are not significantly correlated, r (17) =.307, p > 0.05; but significantly correlated, r (27) =.571, p < 0.05, for the experimental group. The intervention module in Filipino promotes conceptual understanding and mastery of content than the module in English.

Keywords: action research, conceptual understanding, mastery of content, Filipino module

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3674 Peripheral Inflammation and Neurodegeneration; A Potential for Therapeutic Intervention in Alzheimer’s Disease, Parkinson’s Disease, and Amyotrophic Lateral Sclerosis

Authors: Lourdes Hanna, Edward Poluyi, Chibuikem Ikwuegbuenyi, Eghosa Morgan, Grace Imaguezegie

Abstract:

Background: Degeneration of the central nervous system (CNS), also known as neurodegeneration, describes an age-associated progressive loss of the structure and function of neuronal materials, leading to functional and mental impairments. Main body: Neuroinflammation contributes to the continuous worsening of neurodegenerative states which are characterised by functional and mental impairments due to the progressive loss of the structure and function of neu-ronal materials. Some of the most common neurodegenerative diseases include Alzheimer’s disease (AD), Parkinson’s disease (PD) and amyotrophic lateral sclerosis (ALS). Whilst neuroinflammation is a key contributor to the progression of such disease states, it is not the single cause as there are multiple factors which contribute. Theoretically, non-steroidal anti-inflammatory drugs (NSAIDs) have potential to target neuroinflammation to reduce the severity of disease states. Whilst some animal models investigating the effects of NSAIDs on the risk of neurodegenerative diseases have shown a beneficial effect, this is not the same finding. Conclusion: Further investigation using more advanced research methods is required to better understand neuroinflammatory pathways and understand if there is still a potential window for NSAID efficacy.

Keywords: intervention, central nervous system, neurodegeneration, neuroinflammation

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3673 Effects of High-Intensity Interval Training versus Traditional Rehabilitation Exercises on Functional Outcomes in Patients with Knee Osteoarthritis: A Randomized Controlled Trial

Authors: Ahmed Torad

Abstract:

Background: Knee osteoarthritis (OA) is a prevalent musculoskeletal condition characterized by pain and functional impairment. While various rehabilitation approaches have been employed, the effectiveness of high-intensity interval training (HIIT) compared to traditional rehabilitation exercises remains unclear. Objective: This randomized controlled trial aimed to compare the effects of HIIT and traditional rehabilitation exercises on pain reduction, functional improvement, and quality of life in individuals with knee OA. Methods: A total of 120 participants diagnosed with knee OA were randomly allocated into two groups: the HIIT group (n=60) and the traditional rehabilitation group (n=60). The HIIT group participated in a 12-week supervised program consisting of high-intensity interval exercises, while the traditional rehabilitation group followed a conventional physiotherapy regimen. Outcome measures included visual analog scale (VAS) pain scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form-36 Health Survey (SF-36) at baseline and after the intervention period. Results: Both groups showed significant improvements in pain scores, functional outcomes (WOMAC), and quality of life (SF-36) after 12 weeks of intervention. However, the HIIT group demonstrated superior pain reduction (p<0.001), functional improvement (p<0.001), and physical health-related quality of life (p=0.002) compared to the traditional rehabilitation group. No significant differences were observed in mental health-related quality of life between the two groups. Conclusion: High-intensity interval training appears to be a more effective rehabilitation approach than traditional exercises for individuals with knee osteoarthritis, resulting in greater pain reduction, improved function, and enhanced physical health-related quality of life. These findings suggest that HIIT may represent a promising intervention strategy for managing knee OA and enhancing the overall well-being of affected individuals.

Keywords: knee osteoarthritis, high-intensity interval training, traditional rehabilitation exercises, randomized controlled trial, pain reduction, functional improvement, quality of life

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3672 Barriers to Health Promotion Advice Delivered by Paramedics and Emergency Department Nurses – Promoted Study

Authors: B. Schofield, F. Gul, S. McClean, R. Hoskins, R. Terry, U. Rolfe, A. Gibson, S. Voss, J. Benger

Abstract:

Aim: The aim of this study is to determine whether and how health promotion activities are undertaken by paramedics and emergency department nurses and investigate ways of overcoming potential barriers. Background: Paramedics and emergency department nurses are uniquely placed to reach millions of people and could use these contacts as positive opportunities to help people improve their health by identifying people with risk factors and provide information, brief interventions, and signposting to locally provided services. These interventions can be carried out when the opportunity arises, typically take no more than a few minutes, have a low financial cost and can be a highly efficient method of health promotion. Methodology: Three NHS Emergency Departments and four Ambulance Trusts in England were recruited to the study. A link to an online survey was distributed to paramedics and emergency department nurses at participating sites. Staff were invited to participate in virtual semi-structured interviews. Patients seen, treated, and discharged at the participating sites were invited to virtual semistructured interviews. Findings: A total of 331 survey responses were received, 21 virtual semi-structured staff interviews and 11 patient interviews were completed. Staff reported lack of time to prioritise, lack of knowledge, resources, and confidence as barriers. Receptiveness of patients guided their decision to undertake health promotion activities. They reported a desire to learn how to undertake health promotion conversations. Emergency department nurses felt more supported than paramedics by their organisations to undertake health promotion activities. Patients were not aware of health promotion activities and reported fear and lack of privacy as barriers. Conclusions: These results will guide the development of an intervention to support the provision of health promotion by staff in urgent and emergency care settings. The components of the intervention will be mapped to a framework which will consider the needs of staff working within these settings, patients they treat, and organisational issues and practices related to the implementation of such an intervention.

Keywords: emergency service, hospital, nursing, allied health personnel, emergency medical services, health promotion

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3671 Industrial Ergonomics Improvement at a Refrigerator Manufacturing Company in Iran: An Approach on Interventional Ergonomics

Authors: Hassan S. Naeini

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Nowadays a lot of people are working in several sorts of industrial sectors in which there are some risk factors which threaten human being especially in developing countries. One of the main problems which effect on workers’ health refers to Ergonomics. Ergonomics as multidisciplinary science concerns workers’ health and safety in terms of somatic and mental concepts. Surely ergonomics interventions and improvement make a better condition for workers and change the quality of working life to better condition. In this study, one of the factories in Iran which is producing some kinds of small and medium size of refrigerators was chosen as the sample. The preliminary ergonomics observation of the mentioned factory showed that there are some risk factors in terms of ergonomics aspects, so an ergonomic intervention was defined, then some ergonomic assessment methods such as NMQ,OWAS, and Environmental Ergonomic Assessment were used. Also Anthropometric measurement was done. This study shows that there are some workstations and plants which suffer some degrees of ergonomic problems. Considering with the gathered data, illumination, noise control and workstation design in metal workstation are known as the priority actions. Some parts of the mentioned interventions are ongoing actions. it seems that the mentioned intervention and workstations design make a better condition for workers, because ergonomics make a safer and more sustainable environments for human being.

Keywords: anthropometry, ergonomics, health, NMQ, OWAS

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3670 Use of Life Cycle Data for State-Oriented Maintenance

Authors: Maximilian Winkens, Matthias Goerke

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The state-oriented maintenance enables the preventive intervention before the failure of a component and guarantees avoidance of expensive breakdowns. Because the timing of the maintenance is defined by the component’s state, the remaining service life can be exhausted to the limit. The basic requirement for the state-oriented maintenance is the ability to define the component’s state. New potential for this is offered by gentelligent components. They are developed at the Corporative Research Centre 653 of the German Research Foundation (DFG). Because of their sensory ability they enable the registration of stresses during the component’s use. The data is gathered and evaluated. The methodology developed determines the current state of the gentelligent component based on the gathered data. This article presents this methodology as well as current research. The main focus of the current scientific work is to improve the quality of the state determination based on the life-cycle data analysis. The methodology developed until now evaluates the data of the usage phase and based on it predicts the timing of the gentelligent component’s failure. The real failure timing though, deviate from the predicted one because the effects from the production phase aren’t considered. The goal of the current research is to develop a methodology for state determination which considers both production and usage data.

Keywords: state-oriented maintenance, life-cycle data, gentelligent component, preventive intervention

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3669 Testing the Effectiveness of a Peer Facilitated Body Project Interventions Among Body Dissatisfied Young Women in China: A Randomized Control Trial

Authors: Todd Jackson

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In this randomized control trial, we tested the effectiveness of a peer-facilitated version of the Body Project (BP) intervention among body-dissatisfied young women in China. Participants were randomly assigned to a peer-facilitator BP condition (N = 94) versus an educational video minimal intervention control condition (N = 89). Questionnaire measures of two primary outcomes (i.e., disordered eating and body dissatisfaction) and six secondary outcomes (thin-ideal internalization, pressure to be thin, negative affect, body surveillance, body shame, body appreciation and interest in cosmetic surgery) were administered at a pre-treatment baseline, a post-treatment assessment, and at a 12-month follow-up. A series of 2 (Group) x 2 (Time) analyses of variance indicated women in the peer-facilitated BP condition reported significant improvements in primary outcome measures of disordered eating and body dissatisfaction compared to women in the educational video control condition following treatment and at the 12-month follow-up. Furthermore, women in the peer-facilitated BP condition reported significant improvements in measures of body surveillance, body shame and body appreciation) compared to educational video controls that extended to the 12-month follow-up. Finally, although women in the peer-facilitated BP condition showed significant post-treatment improvements in thin-ideal internalization, negative affect, perceived pressure to be thin, and interest in cosmetic surgery compared to video controls, these differences were no longer statistically significant at the 12-month follow-up. In conclusion, findings supported the overall effectiveness of a peer-facilitated group version of the BP as an intervention for reducing disordered eating and several associated risk factors among at-risk young women in China.

Keywords: body project, disordered eating, body dissatisfaction, risk factors, prevention, China

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3668 Quality in Healthcare: An Autism-Friendly Hospital Emergency Waiting Room

Authors: Elena Bellini, Daniele Mugnaini, Michele Boschetto

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People with an Autistic Spectrum Disorder and an Intellectual Disability who need to attend a Hospital Emergency Waiting Room frequently present high levels of discomfort and challenging behaviors due to stress-related hyperarousal, sensory sensitivity, novelty-anxiety, communication and self-regulation difficulties. Increased agitation and acting out also disturb the diagnostic and therapeutic processes, and the emergency room climate. Architectural design disciplines aimed at reducing distress in hospitals or creating autism-friendly environments are called for to find effective answers to this particular need. A growing number of researchers are considering the physical environment as an important point of intervention for people with autism. It has been shown that providing the right setting can help enhance confidence and self-esteem and can have a profound impact on their health and wellbeing. Environmental psychology has evaluated the perceived quality of care, looking at the design of hospital rooms, paths and circulation, waiting rooms, services and devices. Furthermore, many studies have investigated the influence of the hospital environment on patients, in terms of stress-reduction and therapeutic intervention’ speed, but also on health professionals and their work. Several services around the world are organizing autism-friendly hospital environments which involve the architecture and the specific staff training. In Italy, the association Spes contra spem has promoted and published, in 2013, the ‘Chart of disabled people in the hospital’. It stipulates that disabled people should have equal rights to accessible and high-quality care. There are a few Italian examples of therapeutic programmes for autistic people as the Dama project in Milan and the recent experience of Children and Autism Foundation in Pordenone. Careggi’s Emergency Waiting Room in Florence has been built to satisfy this challenge. This project of research comes from a collaboration between the technical staff of Careggi Hospital, the Center for autism PAMAPI and some architects expert in the sensory environment. The methodology of focus group involved architects, psychologists and professionals through a transdisciplinary research, centered on the links between the spatial characteristics and clinical state of people with ASD. The relationship between architectural space and quality of life is studied to pay maximum attention to users’ needs and to support the medical staff in their work by a specific program of training. The result of this research is a sum of criteria used to design the emergency waiting room, that will be illustrated. A protected room, with a clear space design, maximizes comprehension and predictability. The multisensory environment is thought to help sensory integration and relaxation. Visual communication through Ipad allows an anticipated understanding of medical procedures, and a specific technological system supports requests, choices and self-determination in order to fit sensory stimulation to personal preferences, especially for hypo and hypersensitive people. All these characteristics should ensure a better regulation of the arousal, less behavior problems, improving treatment accessibility, safety, and effectiveness. First results about patient-satisfaction levels will be presented.

Keywords: accessibility of care, autism-friendly architecture, personalized therapeutic process, sensory environment

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3667 Morality in Actual Behavior: The Moderation Effect of Identification with the Ingroup and Religion on Norm Compliance

Authors: Shauma L. Tamba

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This study examined whether morality is the most important aspect in actual behavior. The prediction was that people tend to behave in line with moral (as compared to competence) norms, especially when such norms are presented by their ingroup. The actual behavior that was tested was support for a military intervention without a mandate from the UN. In addition, this study also examined whether identification with the ingroup and religion moderated the effect of group and norm on support for the norm that was prescribed by their ingroup. The prediction was that those who identified themselves higher with the ingroup moral would show a higher support for the norm. Furthermore, the prediction was also that those who have religion would show a higher support for the norm in the ingroup moral rather than competence. In an online survey, participants were asked to read a scenario in which a military intervention without a mandate was framed as either the moral (but stupid) or smart (but immoral) thing to do by members of their own (ingroup) or another (outgroup) society. This study found that when people identified themselves with the smart (but immoral) norm, they showed a higher support for the norm. However, when people identified themselves with the moral (but stupid) norm, they tend to show a lesser support towards the norm. Most of the results in the study did not support the predictions. Possible explanations and implications are discussed.

Keywords: morality, competence, ingroup identification, religion, group norm

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3666 Course Outcomes to Programme Outcomes Mapping: A Methodology Based on Key Elements

Authors: Twarakavi Venkata Suresh Kumar, Sailaja Kumar, B. Eswara Reddy

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In a world of tremendous technical developments, effective and efficient higher education has always been a major challenge. The rising number of educational institutions have made it mandatory for healthy competitions among the institutions. To evaluate the qualitative competence of these educations institutions in engineering and technology and related disciplines, an efficient assessment technique in internal and external quality has to be followed. To achieve this, the curriculum is to be developed into courses, and each course has to be presented in the form teaching lesson plan consisting of topics and session outcome known as Course Outcomes (COs), that easily map into different Programme Outcomes (POs). The major objective of these methodologies is to provide quality technical education to its students. Detailed clear weightage in CO-PO mapping helps in proper measurable COs and to devise the POs attainment is an important issue. This ensures in assisting the achievement of the POs with proper weightage to POs, and also improves the successive curriculum development. In this paper, we presented a methodology for mapping CO and PO considering the key elements supported by each PO. This approach is useful in evaluating the attainment of POs which is based on the attainment of COs using the existing data from students' marks taken from various test items. Such direct assessment tools are used to measure the degree to which each student has achieved each course learning outcome by the completion of the course. Hence, these results are also useful in measuring the PO attainment for improving the programme vision and mission.

Keywords: attainment, course outcomes, programme outcomes, educational institutions

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3665 Assessing the Impact of Pharmacist-Led Medication Therapy Management on Treatment Adherence and Clinical Outcomes in Cancer Patients: A Prospective Intervention Study

Authors: Omer Ibrahim Abdallh Omer

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Cancer patients often face complex medication regimens, leading to challenges in treatment adherence and clinical outcomes. Pharmacist-led medication therapy management (MTM) has emerged as a potential solution to optimize medication use and improve patient outcomes in oncology settings. In this prospective intervention study, we aimed to evaluate the impact of pharmacist-led MTM on treatment adherence and clinical outcomes among cancer patients. Participants were randomized to receive either pharmacist-led MTM or standard care, with assessments conducted at baseline and follow-up visits. Pharmacist interventions included medication reconciliation, adherence counseling, and personalized care plans. Our findings reveal that pharmacist-led MTM significantly improved medication adherence rates and clinical outcomes compared to standard care. Patients receiving pharmacist interventions reported higher satisfaction levels and perceived value in pharmacist involvement in their cancer care. These results underscore the critical role of pharmacists in optimizing medication therapy and enhancing patient-centered care in oncology settings. Integration of pharmacist-led MTM into routine cancer care pathways holds promise for improving treatment outcomes and quality of life for cancer patients.

Keywords: cancer, medications adherence, medication therapy management, pharmacist

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3664 Implementation Research on the Singapore Physical Activity and Nutrition Program: A Mixed-Method Evaluation

Authors: Elaine Wong

Abstract:

Introduction: The Singapore Physical Activity and Nutrition Study (SPANS) aimed to assess the effects of a community-based intervention on physical activity (PA) and nutrition behaviours as well as chronic disease risk factors for Singaporean women aged above 50 years. This article examines the participation, dose, fidelity, reach, satisfaction and reasons for completion and non-completion of the SPANS. Methods: The SPANS program integrated constructs of Social Cognitive Theory (SCT) and is composed of PA activities; nutrition workshops; dietary counselling coupled with motivational interviewing (MI) through phone calls; and text messages promoting healthy behaviours. Printed educational resources and health incentives were provided to participants. Data were collected via a mixed-method design strategy from a sample of 295 intervention participants. Quantitative data were collected using self-completed survey (n = 209); qualitative data were collected via research assistants’ notes, post feedback sessions and exit interviews with program completers (n = 13) and non-completers (n = 12). Results: Majority of participants reported high ‘satisfactory to excellent’ ratings for the program pace, suitability of interest and overall program (96.2-99.5%). Likewise, similar ratings for clarity of presentation; presentation skills, approachability, knowledge; and overall rating of trainers and program ambassadors were achieved (98.6-100%). Phone dietary counselling had the highest level of participation (72%) at less than or equal to 75% attendance rate followed by nutrition workshops (65%) and PA classes (60%). Attrition rate of the program was 19%; major reasons for withdrawal were personal commitments, relocation and health issues. All participants found the program resources to be colourful, informative and practical for their own reference. Reasons for program completion and maintenance were: desired health benefits; social bonding opportunities and to learn more about PA and nutrition. Conclusions: Process evaluation serves as an appropriate tool to identify recruitment challenges, effective intervention strategies and to ensure program fidelity. Program participants were satisfied with the educational resources, program components and delivery strategies implemented by the trainers and program ambassadors. The combination of printed materials and intervention components, when guided by the SCT and MI, were supportive in encouraging and reinforcing lifestyle behavioural changes. Mixed method evaluation approaches are integral processes to pinpoint barriers, motivators, improvements and effective program components in optimising the health status of Singaporean women.

Keywords: process evaluation, Singapore, older adults, lifestyle changes, program challenges

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3663 Domain-Specific Languages Evaluation: A Literature Review and Experience Report

Authors: Sofia Meacham

Abstract:

In this abstract paper, the Domain-Specific Languages (DSL) evaluation will be presented based on existing literature and years of experience developing DSLs for several domains. The domains we worked on ranged from AI, business applications, and finances/accounting to health. In general, DSLs have been utilised in many domains to provide tailored and efficient solutions to address specific problems. Although they are a reputable method among highly technical circles and have also been used by non-technical experts with success, according to our knowledge, there isn’t a commonly accepted method for evaluating them. There are some methods that define criteria that are adaptations from the general software engineering quality criteria. Other literature focuses on the DSL usability aspect of evaluation and applies methods such as Human-Computer Interaction (HCI) and goal modeling. All these approaches are either hard to introduce, such as the goal modeling, or seem to ignore the domain-specific focus of the DSLs. From our experience, the DSLs have domain-specificity in their core, and consequently, the methods to evaluate them should also include domain-specific criteria in their core. The domain-specific criteria would require synergy between the domain experts and the DSL developers in the same way that DSLs cannot be developed without domain-experts involvement. Methods from agile and other software engineering practices, such as co-creation workshops, should be further emphasised and explored to facilitate this direction. Concluding, our latest experience and plans for DSLs evaluation will be presented and open for discussion.

Keywords: domain-specific languages, DSL evaluation, DSL usability, DSL quality metrics

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3662 Health Promotion Program on Prevention of Zoonotic Diseases among Aborigines in Peninsular Malaysia

Authors: Siti Fatimah Kader Maideen, Abdul Rashid, Nur Indah Ahmad

Abstract:

Introduction: Indigenous people have an increased risk of contracting zoonotic infections due to their practices. Similarly, the aborigines in Peninsular Malaysia, the Orang Asli, have a higher risk too. This study aimed to empower the Jahai children on the prevention of zoonotic infections by implementing a health promotion intervention program. Methods: A non-experimental pre and post-test interventional study was conducted among the indigenous primary school children aged between nine and 12 years in Perak, Malaysia. A structured questionnaire was used to assess the pre-and post-knowledge and attitudes towards zoonotic infections and hand hygiene practice. This is followed by three sessions of the health promotion program. Ethical approval was obtained prior to the data collection. Data were analysed using SPSS software. Results: The knowledge on whether diseases can spread from animals to humans, transmission via saliva and faeces, types of organisms that can infect, and signs and symptoms increased significantly between pre and post. Significant improvements were observed in the attitude and practices too. Conclusion: The intervention program demonstrated improvement in the knowledge, attitude, and practice among the children. The continuous program needs to be conducted for a sustainable outcome.

Keywords: health promotion, zoonotic infections, aborigines, knowledge, practice

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3661 The Impact of Resource-oriented Music Listening on Oversea Dispatch Employees Work Stress Relief

Authors: Wei Yaming

Abstract:

Objective: In order to compare the stress of employees sent overseas with (GRAS) before and after, we used the resource-oriented music listening intervention in this study. We also collected pertinent experimental data. Methods: The experiment involved 47 employees who were sent abroad by the Chinese side. They completed the stress scale test and documented it before the intervention. They tested for stress after five interventions and performed one-on-one interviews. Quantitative data and SPSS software were used to analyze relationships between stress reduction and resource-oriented music listening, as well as Pearson's correlation, multiple regression levels, and ANOVA. For the qualitative analysis, content analysis of one-on-one interviews was performed. Results: A comparison of data from before and after demonstrates how resource-focused music listening activities can lessen and relieve stress in remote workers. In the qualitative study, stress is broken down into six categories: relationship stress, health stress, emotional stress, and frustration stress. External pressures include work pressure and cultural stress. And it has been determined that listening to music that is resource-oriented can better ease internal stress (health, emotion, and dissatisfaction). Conclusion: The Guide Resource-oriented Music Listening (GROML) Program appears to have had some effect on the participants' stress levels. The resources that the participants encountered while listening to music are bravery, calm, letting go, and relaxing.

Keywords: resource-oriented, music listening, oversea dispatch employees, work stress

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3660 Effects of Transtheoretical Model in Obese and Overweight Women Nutritional Behavior Change and Lose Weight

Authors: Abdmohammad Mousavi, Mohsen Shams, Mehdi Akbartabar Toori, Ali Mousavizadeh, Mohammad Ali Morowatisharifabad

Abstract:

The effectiveness of Transtheoretical Model (TTM) on nutritional behavior change and lose weight has been subject to questions by some studies. The objective of this study was to determine the effect of nutritional behavior change and lose weight interventions based on TTM in obese and overweight women. This experimental study that was a 8 months trial nutritional behavior change and weight loss program based on TTM with two conditions and pre–post intervention measurements weight mean. 299 obese and overweight 20-44 years old women were selected from two health centers include training (142) and control (157) groups in Yasuj, a city in south west of Iran. Data were analyzed using paired T-test and One–Way ANOVA tests. In baseline, adherence with nutritional healthy behavior in training group(9.4%) compare with control(38.8%) were different significantly(p=.003), weight mean of training(Mean=78.02 kg, SD=11.67) compared with control group(Mean=77.23 kg, SD=10.25) were not (P=.66). In post test, adherence with nutritional healthy behavior in training group(70.1%) compare with control (37.4%) were different significantly (p=.000), weight mean of training (Mean=74.65 kg, SD=10.93, p=.000) compare with pre test were different significantly and control (Mean=77.43 kg, SD=10.43, p=.411) were not. The training group has lost 3.37 kg weight, whereas the control group has increased .2 kg weight. These results supported the applicability of the TTM for women weight lose intervention.

Keywords: nutritional behavior, Transtheoretical Model, weight lose, women

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3659 Optimization of Technical and Technological Solutions for the Development of Offshore Hydrocarbon Fields in the Kaliningrad Region

Authors: Pavel Shcherban, Viktoria Ivanova, Alexander Neprokin, Vladislav Golovanov

Abstract:

Currently, LLC «Lukoil-Kaliningradmorneft» is implementing a comprehensive program for the development of offshore fields of the Kaliningrad region. This is largely associated with the depletion of the resource base of land in the region, as well as the positive results of geological investigation surrounding the Baltic Sea area and the data on the volume of hydrocarbon recovery from a single offshore field are working on the Kaliningrad region – D-6 «Kravtsovskoye».The article analyzes the main stages of the LLC «Lukoil-Kaliningradmorneft»’s development program for the development of the hydrocarbon resources of the region's shelf and suggests an optimization algorithm that allows managing a multi-criteria process of development of shelf deposits. The algorithm is formed on the basis of the problem of sequential decision making, which is a section of dynamic programming. Application of the algorithm during the consolidation of the initial data, the elaboration of project documentation, the further exploration and development of offshore fields will allow to optimize the complex of technical and technological solutions and increase the economic efficiency of the field development project implemented by LLC «Lukoil-Kaliningradmorneft».

Keywords: offshore fields of hydrocarbons of the Baltic Sea, development of offshore oil and gas fields, optimization of the field development scheme, solution of multicriteria tasks in oil and gas complex, quality management in oil and gas complex

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3658 Concept Mapping to Reach Consensus on an Antibiotic Smart Use Strategy Model to Promote and Support Appropriate Antibiotic Prescribing in a Hospital, Thailand

Authors: Phenphak Horadee, Rodchares Hanrinth, Saithip Suttiruksa

Abstract:

Inappropriate use of antibiotics has happened in several hospitals, Thailand. Drug use evaluation (DUE) is one strategy to overcome this difficulty. However, most community hospitals still encounter incomplete evaluation resulting overuse of antibiotics with high cost. Consequently, drug-resistant bacteria have been rising due to inappropriate antibiotic use. The aim of this study was to involve stakeholders in conceptualizing, developing, and prioritizing a feasible intervention strategy to promote and support appropriate antibiotic prescribing in a community hospital, Thailand. Study antibiotics included four antibiotics such as Meropenem, Piperacillin/tazobactam, Amoxicillin/clavulanic acid, and Vancomycin. The study was conducted for the 1-year period between March 1, 2018, and March 31, 2019, in a community hospital in the northeastern part of Thailand. Concept mapping was used in a purposive sample, including doctors (one was an administrator), pharmacists, and nurses who involving drug use evaluation of antibiotics. In-depth interviews for each participant and survey research were conducted to seek the problems for inappropriate use of antibiotics based on drug use evaluation system. Seventy-seven percent of DUE reported appropriate antibiotic prescribing, which still did not reach the goal of 80 percent appropriateness. Meropenem led other antibiotics for inappropriate prescribing. The causes of the unsuccessful DUE program were classified into three themes such as personnel, lack of public relation and communication, and unsupported policy and impractical regulations. During the first meeting, stakeholders (n = 21) expressed the generation of interventions. During the second meeting, participants who were almost the same group of people in the first meeting (n = 21) were requested to independently rate the feasibility and importance of each idea and to categorize them into relevant clusters to facilitate multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the idealist, cluster list, point map, point rating map, cluster map, and cluster rating map. All of these were distributed to participants (n = 21) during the third meeting to reach consensus on an intervention model. The final proposed intervention strategy included 29 feasible and crucial interventions in seven clusters: development of information technology system, establishing policy and taking it into the action plan, proactive public relations of the policy, action plan and workflow, in cooperation of multidisciplinary teams in drug use evaluation, work review and evaluation with performance reporting, promoting and developing professional and clinical skill for staff with training programs, and developing practical drug use evaluation guideline for antibiotics. These interventions are relevant and fit to several intervention strategies for antibiotic stewardship program in many international organizations such as participation of the multidisciplinary team, developing information technology to support antibiotic smart use, and communication. These interventions were prioritized for implementation over a 1-year period. Once the possibility of each activity or plan is set up, the proposed program could be applied and integrated into hospital policy after evaluating plans. Effectiveness of each intervention could be promoted to other community hospitals to promote and support antibiotic smart use.

Keywords: antibiotic, concept mapping, drug use evaluation, multidisciplinary teams

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3657 Standalone Docking Station with Combined Charging Methods for Agricultural Mobile Robots

Authors: Leonor Varandas, Pedro D. Gaspar, Martim L. Aguiar

Abstract:

One of the biggest concerns in the field of agriculture is around the energy efficiency of robots that will perform agriculture’s activity and their charging methods. In this paper, two different charging methods for agricultural standalone docking stations are shown that will take into account various variants as field size and its irregularities, work’s nature to which the robot will perform, deadlines that have to be respected, among others. Its features also are dependent on the orchard, season, battery type and its technical specifications and cost. First charging base method focuses on wireless charging, presenting more benefits for small field. The second charging base method relies on battery replacement being more suitable for large fields, thus avoiding the robot stop for recharge. Existing many methods to charge a battery, the CC CV was considered the most appropriate for either simplicity or effectiveness. The choice of the battery for agricultural purposes is if most importance. While the most common battery used is Li-ion battery, this study also discusses the use of graphene-based new type of batteries with 45% over capacity to the Li-ion one. A Battery Management Systems (BMS) is applied for battery balancing. All these approaches combined showed to be a promising method to improve a lot of technical agricultural work, not just in terms of plantation and harvesting but also about every technique to prevent harmful events like plagues and weeds or even to reduce crop time and cost.

Keywords: agricultural mobile robot, charging methods, battery replacement method, wireless charging method

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3656 Stigmatising AIDS: A Content Analysis on HIV/AIDS-Related News Articles Published in Three Major Philippine Broadsheet

Authors: L. Dinco John Christian, C. Ramos Camille, C. Reyes Maria Eloisa

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HIV/AIDS has been dubbed as one of the most stigmatised diseases of the recent century. Nelson Mandela pointed out that PLWHA (People Living With HIV/AIDS) are not killed by the disease, but by the stigma surrounding it. Despite the numerous studies on HIV/AIDS Stigmatisation globally, little is known about how evident and how powerful the media can be in framing the views of the readers when it comes to print in the Philippine context. This study dealt with a quantitative content analysis of HIV/AIDS-related news articles published by the top three broadsheets such as Philippine Daily Inquirer, Manila Bulletin and the Philippine Star in the span of one year. The HIV/AIDS-related news articles were collected and subjected to coding according to their tones, stigmatising statements/terminologies and news prominence. An analysis of the results had supported the researchers’ objectives (1) that there are different tones of HIV/AIDS-related news articles, (2) that there is a significant relation between the Stigmatizing Statements/Terminologies and the tone and that the (3) technical properties of HIV/AIDS related news articles determine the news prominence. Results revealed that despite the fact that the broadsheets were overtly reporting HIV/AIDS in Anti-Stigma-toned articles, they were covertly suggesting Stigma by the use of Stigmatising statements/terminologies present in it rather than plainly disseminating current medical knowledge about the transmission and treatments of the disease; the technical properties of the HIV/AIDS related news articles determined its prominence.

Keywords: HIV, AIDS, newspaper, content analysis

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3655 Change through Stillness: Mindfulness Meditation as an Intervention for Men with Self-Perceived Problematic Pornography Use

Authors: Luke Sniewski, Pante Farvid, Phil Carter, Rita Csako

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Background and Aims: Self-Perceived Problematic Porn Use (SPPPU) refers to individuals who identify as or perceive themselves to be addicted to porn. These individuals feel they are unable to regulate their porn consumption and experience adverse consequences as a result of their use in everyday life. To the author’s best knowledge, this research represents the first study to intervene with pornography use with mindfulness meditation, and aims to investigate the experiences and challenges of men with SPPPU as they engage in a mindfulness meditation intervention. As meditation is commonly characterized by sitting and observing one’s internal experience with non-reaction and acceptance, the study’s principal hypothesis was that consistent practice of meditation would develop the participant’s capacity to respond to cravings, urges, and unwanted thoughts in less reactive, more productive ways. Method: This 12-mixed method research utilised Single Case Experimental Design (SCED) methodology, with a standard AB design. Each participant was randomly assigned to an initial baseline time period between 2 to 5 weeks before learning the meditation technique and practicing it for the remainder of the 12-week study. The pilot study included 3 participants, while the intervention study included 12. The meditation technique used for the study involved a 15-minute guided breathing exercise in the morning, along with a 15-minute guided concentration meditation in the evening. Results: At the time of submission, only pilot study results were available. Results from the pilot study indicate an improved capacity for self-awareness of the uncomfortable mental and emotional states that drove their participants’ pornography use. Statistically significant reductions were also observed in daily porn use, total weekly time spent viewing porn, as well as lowered Pornography Craving Questionnaire (PCQ) and Problematic Pornography Use Scale (PPUS) scores. Conclusion: Pilot study results suggest that meditation could serve as a complementary tool for health professionals to provide clients in conjunction with therapeutic interventions. Study limitations, directions for future research, and clinical implications to be discussed as well.

Keywords: meditation, behavioural change, pornography, mindfulness

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3654 The Effect of Physical Therapy on Triceps Surae Myofascial Trigger Point

Authors: M. Simon, O. Peillon, R. Seijas, P. Alvarez, A. Pérez-Bellmunt

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Introduction: Myofascial trigger points (MTrPs) are defined as hyperirritable areas within taut bands of skeletal muscle and classified as either active or latent. Although they could be present in any muscle, the triceps surae is one of the most affected of the lower limb. The aim of this study was described which treatments are more used and their principal results. Study design: We performed a systematic literature search using strategies for the concepts of “Trigger Points and Gastrocnemius and Soleus not Trapezius” in Medline. Articles were screened by authors and included if they contained a rehabilitation intervention of MTrPs in healthy subjects or patients. Results: The treatments used were mostly invasive interventions and only a small part of the studies used non-invasive treatments. The methodology (time o type of intervention, characteristics of treatment, etc.) used in these treatments were frequently undefined. Overall, examination variables varied significantly among the included studies, but they were improving their parameters when the MTrPs were treated. Conclusions: There are a high variety of physical therapy treatments to improve the symptomatology of MTrPs when affect triceps surae muscle. Even so, not a single study analyzing the skeletal muscle contractile parameters (as maximal displacement or delay time) change with MTrPS therapy has been found. The treatments have to better specificity the methodology used in the futures investigation.

Keywords: fascia, myofascial trigger points, physical therapy, triceps surae

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3653 Girls, Justice, and Advocacy: Using Arts-Based Public Health Strategies to Challenge Gender Inequities in Juvenile Justice

Authors: Tasha L. Golden

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Girls in the U.S. juvenile justice system are most often arrested for truancy, drug use, or running from home, all of which are symptoms of abuse. In fact, some have called this 'The Sexual Abuse to Prison Pipeline.' Such abuse has consequences for girls' health, education, employment, and parenting, often resulting in significant health disparities. Yet when arrested, girls rarely encounter services designed to meet their unique needs. Instead, they are expected to cope with a system that was historically designed for males. In fact, even literature advocating for increased gender equity frequently fails to include girls’ voices and firsthand accounts. In response to these combined injustices, public health researchers launched a trauma-informed creative writing intervention in a southern juvenile detention facility. The program was designed to improve the health of detained girls, while also establishing innovative methods of both data collection and social justice advocacy. Girls’ poems and letters were collected and coded, adding rich qualitative data to traditional survey responses. In addition, as part of the intervention, these poems are regularly published by international literary publisher Sarabande Books—and distributed to judges, city leaders, attorneys, state representatives, and more. By utilizing a creative medium, girls generated substantial civic engagement with their concerns—thus expanding their influence and improving policy advocacy efforts. Researchers hypothesized that having access to their communities and policy makers would provide its own health benefits for incarcerated girls: cultivating self-esteem, locus of control, and a sense of leadership. This paper discusses the establishment of this intervention, examines findings from its evaluation, and includes several girls’ poems as exemplars. Grounded in social science regarding expressive writing, stigma, muted group theory, and health promotion, the paper theorizes about the application of arts-based advocacy efforts to other social justice endeavors.

Keywords: advocacy, public health, social justice, women’s health

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