Search results for: homoparental families

Authors: Joyce Fernandez

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This study examined the effects of critical incident stress debriefing and other related interventions on the psychological recovery of earthquake survivors. It is a mixed experimental and qualitative study using post-test only control group design and focus group discussion. After the conduct of critical incident stress debriefing activities and other related interventions in the form of counseling and psychiatric treatment to the survivors of a 6.9 magnitude earthquake, a post-test measuring the level of psychological recovery was given to randomized participants categorized as intervention and control groups. Using the traumatic assessment and belief scale as instrument for the quantitative aspect in order to gauge recovery in the psychological need areas of safety, trust, esteem, intimacy and control, the findings are the following: Intervention group participants have relatively better adjustment along the five psychological need areas compared to the control group participants; there is no significant difference in the psychological recovery among female and male participants of the invention and control groups and; there are significant differences between intervention and control groups in the psychological need areas of self-safety, self-trust, other-trust, self-esteem, and self-intimacy. Using a guided interview for the qualitative data, the themes derived are the following. Safety: The world is an unsafe place to live because of the calamities. Trust: Trust and dependence are anchored on the family. Esteem: Participants are having confused self-worth. Intimacy: Participants are thriving on attachment with their family. Control: Participants have unaltered desire to help but feeling restricted because of personal and logistical concerns.As an outcome of the study a Psychosocial Care Program for Individuals, Families and Communities Affected by Disaster and Trauma was proposed.

Keywords: critical incident stress debriefing, earthquake survivors, psychological recovery, related interventions

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Authors: María José Benitez Jimenez

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This study seeks to make clear the importance of family reunification in order to establish consolidated habits of coexistence of immigrants, directly favoring the relationship of the family nucleus and indirectly the social integration of foreigners. In addition to the theoretical analysis of the subject, information has been reviewed by the National Institute of Statistics and Reports of Spanish organizations that compile data on immigrants and specifically on family reunification. The Spanish regulations on foreigners include the right of foreigners legally residing in Spain to regroup their families. The general conditions required to exercise this right are having legally resided in Spain for one year and having obtained authorization to reside for one more year. There are exceptions to the requirement of having resided for one year in our country. Article 39 of the Spanish Constitution, although it does not express what is to be understood as a family, does refer to the fact that ‘the public authorities ensure the social, economic and legal protection of the family’. Therefore for the Spanish State, the family institution, in a broad sense, enjoys a privileged treatment that is revealed in the Supreme Norm and that reflects the interest of our society to address the relationships that subjects have in their immediate environment. Although we are aware of the reluctant position of the Spanish Constitutional Court to consider as a fundamental right the right to family life despite being enshrined in Article 8 of the European Convention on Human Rights, it is questionable whether access to authorization for family reunification should be more uniform in terms of requirements related to nationality, employment or training of applicants in order to have an egalitarian character. The requirement of having resided one year in Spain to be able to request successful family reunification seems dispensable because if foreigners can obviate this requirement by having a certain status, its abolition would be feasible by equating all situations and benefiting foreigners in general. The achievement of this proposal would help to strengthen the family life of immigrants from the beginning of their life in Spain.

Keywords: family, immigrants, social integration, reunification

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Authors: F. O. Arimoro, F. N. Okonkwo, R. B. Ikomi

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The environmental determinants structuring species richness has been generating interest recently but we still lack an understanding of these patterns in various regions (e.g. Afrotropical), and how seasons help to structure these patterns. Our aim was to assessed the environmental drivers importance in regulating species richness and community structure of fish species. The lchthyofauna assemblage of Warri River, Niger Delta area of Nigeria was studied between August 2013 and July 2014. A total of 1152 individuals representing 43 species in 23 families and 30 genera were caught. Of the 43 species recorded, 67.4%, 53.5% and 67.4% of the species occurred in Stations 1, 2 and 3 respectively. Eight taxa representing 18.6% of the total abundance were ubiquitous. The claroteid, Chrysichthys walkeri and the cichlid, Chromidotilapia guentheri were the most dominant species accounting for 19.2% and 6.0% respectively of the total catch. The species richness and general diversity were relatively higher in station 1 although Jaccard similarity index revealed that stations 1 and 3 were significantly similar while station 2 showed complete dissimilarity with stations 1 and 3. Canonical correspondence analysis indicated that dissolved oxygen, electrical conductivity, total nitrogen, Biochemical Oxygen demand and temperature were important variables structuring the overall fish assemblages. The presence of appreciable number of juveniles in this water body suggests that the Warri River is a breeding and nursery ground for fish species particularly those of brackish origin. These findings indicate that the water body is still useful as a good fishing ground for the rural communities and every effort should be put in place to ensure its protection and conservation for the production of healthy fish.

Keywords: Chrysichthys walkeri, fish communities, mangrove ecosystem, physicochemical parameters, Warri River

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Authors: Mariana Anaya Villafana

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The sudden change of a significant percentage of the Latino community in the United States elections towards a Republican political orientation was reflected during the 2016 presidential election. This moment represented a radical change that is happening inside the Latino community in the United States, the support they have given to Trump's campaign only demonstrates their support for new anti-immigration regulations and conservative values, which are causing a division of ideologies inside the Latino community. One of the main goals of the following research is to understand the whole phenomenon 'Why would people join their own oppressor?' Align themselves with the politics that prevent many of their relatives to come to the United States and made the assimilation process difficult for their parents. It is important to prove that a change in the identity has happened, through the use of power relations and the attachment to the desired object. A group of Hispanics/Latinos have decided to vote for Trump in order to belong to a society that hasn’t been able to fully include them within it, an action that can result on the non-intentional harm of the values and aims of the rest of the Latino/Hispanic community. In order to understand their new political beliefs, it is necessary to use the method of discourse analysis to comprehend those comments and interviews that are published on web sites such as: 'Latinos for Trump' and 'GOP Hispanic Division'. Among the results that the research has shown, the notion of the 'American Dream' can be considered as a determinant object for the construction of a new identity that is rooted in hard work and legality. One that is proud of the Latino heritage but still wants to maintain the boundaries between legality and illegality in relation to the immigrants. This discourse results on a contradiction to most of the cases because they mention that their families came to the U.S. as immigrants; the only difference is that they work hard to obtain legal citizenship.

Keywords: populism, identity, Latino Community, migration

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Authors: Gabrielle Veloso, Melanie Porter, Kelsie Boulton, Adam Guastella

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The aim of the current systematic review was to examine child and parent factors and their associations with parent sensitivity towards children with Autism Spectrum Disorder (ASD). Eight bibliographic databases were used to identify peer-reviewed journal articles examining these associations via quantitative analyses, with parent sensitivity measured via validated and reliable observation coding systems. Thirty-one studies were finalized as having met full criteria for inclusion. The review found agreement across studies that parent sensitivity was positively associated with the child’s initiations and responsiveness toward their parent, with more frequent parent-directed behaviors providing greater opportunity for parents to act and react in sensitive manner. There was also substantial evidence that parent sensitivity predicted later growth in child language ability and child social skills. Other factors such as child attachment, parent insightfulness toward their child, and parent resolution of the diagnosis were also identified across a number of studies as being positively associated with parent sensitivity, however, interpretations of these findings were limited by the absence of covariates identified in the literature as explaining much of the variance in parent sensitivity. With respect to non-significant associations, the literature reliably found that parents showed sensitivity toward their child with ASD, regardless of child age, ASD symptomology, concurrent child social skills, and concurrent child cognitive abilities. The robust associations found in this review and their potential explanations can serve as a jump off point in identifying an understanding protective and risk factors for families of children with ASD. With regard to future directions in research, assessment of the studies’ methodological quality identified points for improvement with respect to the measurement of parent sensitivity, as well as the consideration of several important methodological confounds that may be controlled for in statistical analyses.

Keywords: ASD, autism, parenting, parent sensitivity

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Authors: Yushen Dai, Tao Deng, Miaoying Chen, Baoqin Huang, Yan Ji, Yongshen Feng, Shaofei Liu, Dongmei Zhong, Tao Zhang, Lifeng Zhang

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Background: Detection and diagnosis are prerequisites for early interventions in the care of children with Autism Spectrum Disorder (ASD). However, few studies have focused on this topic. Aim: This study aims to characterize the timing from symptom detection to intervention in children with ASD and to identify the potential predictors of early detection, diagnosis, and intervention. Methods and procedures: A cross-sectional survey was conducted with 314 parents of children with ASD in Guangzhou, China. Outcomes and Results: This study found that most children (76.24%) were diagnosed within one year after detection, and 25.8% of them did not receive the intervention after diagnosis. Predictors to ASD diagnosis included ASD-related symptoms identified at a younger age, more serious symptoms, and initial symptoms with abnormal development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with the social deficit, sensory anomalies, and without language impairment, parents as the primary caregivers, family with lower income and less social support utilization increased the odds of the time lag between detection and diagnosis. Children whose fathers had a lower level of education were less likely to receive the intervention. Conclusions and Implications: The study described the time for detection, diagnosis, and interventions of children with ASD. Findings suggest that the ASD-related symptoms, the timing at which symptoms first become a concern, primary caregivers’ roles, father’s educational level, and the family economic status should be considered when offering support to improve early detection, diagnosis, and intervention. Helping children and their families take full advantage of support is also important.

Keywords: autism spectrum disorder, child, detection, diagnosis, intervention, social support

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Authors: Boudraa Wahiba, Chettibi Farah, Lahlah Naouel, Bouslama Zihad, Houhamdi Moussa

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The marsh of Boussedra (55 ha) is a peri-urban wetland, located in the city of El - Bouni, wilaya of Annaba (North-east of the Algeria). This city hosts every year, 53 species of waterfowl, belonging to 15 different families, of which the most represented family is the Anatidae with almost 12 species. The Glossy ibis (Plegadis falcinellus) is the only representative of the family of the threskiornithidae. After a total absence for almost a decade, this species has established in North Africa and started breeding since 2000. The Glossy ibis (plegadis falcinellus), breeds with low numbers in distant areas. At the wetland of Boussedra, the population of this species was observed with numbers approaching 160 individuals. During the breeding season of 2014 (between march and july), this species bred in mixed heronries (Cattle egret Bubulcus ibis , Little egret Egretta garzetta, The black-crowned night heron Nycticorax nycticorax , Squacco heron Ardeola ralloides and Little bittern Ixobrychus minutus), where a total of 120 nests were counted. This represents the largest colony observed in North Africa. The reproduction of the studied species took place on a Tamaricaceae (Tamarix gallica), where more than 2000 nest were constructed. During this breeding season, we have monitored the colony's installation and evolution and tried to characterize the reproduction, at the urban water plan of Boussedra (measurements of nests, measurements of eggs and monitoring the growing rate and weight gaining of the chicks, since their birth until their flight).

Keywords: glossy ibis, reproduction, peri-urban wetland, mixed heronry, Boussedra, Algeria

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Authors: Huda Al-Awisi, Mohammed Al-Azri, Samira Al-Rasbi, Mansour Al-Moundhri

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Cancer diagnosis is invariably a profound and catastrophic life-changing experience for individuals and their families. It has been found that cancer patients and survivors are distressed with the fragility of their life and their mortality. Based on the literature, cancer patients /survivors value their spiritual experience and connecting with unknown power either related to religious belief or not as an important coping mechanism. Health care professionals including nurses are expected to provide spiritual care for cancer patients as holistic care. Yet, nurses face many challenges in providing such care mainly due to lack of clear definition of spirituality. This study aims to explore coping mechanisms of Omani women diagnosed with breast cancer throughout their cancer journey including spirituality using a qualitative approach. A purposive sample of 19 Omani women diagnosed with breast cancer at different stages of cancer treatment modalities were interviewed. Interviews were tape recorded and transcribed verbatim. The framework approach was used to analyze the data. One main theme related to spirituality was identified and called “The power of faith”. For the majority of participants, faith in God (the will of God) was most important in coping with all stages of their breast cancer experience. Some participants thought that the breast cancer is a test from God which they have to accept. Participants also expressed acceptance of death as the eventual end and reward from God. This belief gives them the strength to cope with cancer and seek medical treatment. In conclusion, women participated in this study believed faith in God imposed spiritual power for them to cope with cancer. They connected spirituality with religious beliefs. Therefore, regardless of nurses’ faith in spirituality, the spiritual care needs to be tailored and provided according to each patient individual need.

Keywords: breast cancer, spiritual, religion, coping, diagnosis, oman, women

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Authors: Minhui Chiu

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According to relevant studies, clinical nurses have high work pressure and relatively high job adaptation needs. The nurses who work in oncology wards have more adaptation needs when they face repeating hospitalization patients. The aims of this study were to investigate the job stress adaptation and related factors of nurses in oncology wards and to understand the predictors of job stress adaptation needs. Convenience sampling was used in this study. The nurses in the oncology specialist ward of a regional teaching hospital in southern Taiwan were selected as the research objects. A cross-sectional survey was conducted using a structured questionnaire, random sampling, and the questionnaires were filled out by the participating nurses. A total of 68 people were tested, and 65 valid questionnaires (95.6%). One basic data questionnaire and nurses’ job stress adaptation needs questionnaire were used. The data was archived with Microsoft Excel, and statistical analysis was performed with JMP12.0. The results showed that the average age was 28.8 (±6.7) years old, most of them were women, 62 (95.38%), and the average clinical experience in the hospital was 5.7 years (±5.9), and 62 (95.38%) were university graduates. 39 people (60.0%) had no work experience. 39 people (60.0%) liked nursing work very much, and 23 people (35.3%) just “liked”. 47 (72.3%) people were supported to be oncology nurses by their families. The nurses' job stress adaptation needs were 119.75 points (±17.24). The t-test and variance analysis of the impact of nurses' job pressure adaptation needs were carried out. The results showed that the score of college graduates was 121.10 (±16.39), which was significantly higher than that of master graduates 96.67 (±22.81), and the degree of liking for nursing work also reached a Significant difference. These two variables are important predictors of job adaptation needs, and the R Square is 24.15%. Conclusion: Increasing the love of clinical nurses in nursing and encouraging university graduation to have positive effects on job pressure adaptation needs and can be used as a reference for the management of human resources hospitals for oncology nurses.

Keywords: oncology nurse, job stress, job stress adaptation needs, manpower

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Authors: Waqas Shafqat Chattha, Muhammad Iqbal, Amir Shakeel

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Transcriptional factors are proteins that play a vital role in regulating the transcription of target genes in different biological processes and are being widely studied in different plant species. In the current era of genomics, plant genomes sequencing has directed to the genome-wide identification, analyses and categorization of diverse transcription factor families and hence provide key insights into their structural as well as functional diversity. The DNA-binding with One Finger (DOF) proteins belongs to C2-C2-type zinc finger protein family. DOF proteins are plant-specific transcription factors implicated in diverse functions including seed maturation and germination, phytohormone signalling, light-mediated gene regulation, cotton-fiber elongation and responses of the plant to biotic as well as abiotic stresses. In this context, a genome-wide in-silico analysis of DOF TF family in diploid cotton species i.e. Gossypium raimondii has enabled us to identify 55 non-redundant genes encoding DOF proteins renamed as GrDofs (Gossypium raimondii Dof). Gene distribution studies have shown that all of the GrDof genes are unevenly distributed across 12 out of 13 G. raimondii chromosomes. The gene structure analysis illustrated that 34 out of 55 GrDof genes are intron-less while remaining 21 genes have a single intron. Protein sequence-based phylogenetic analysis of putative 55 GrDOFs has divided these proteins into 5 major groups with various paralogous gene pairs. Molecular evolutionary studies aided with the conserved domain as well as gene structure analysis suggested that segmental duplications were the principal contributors for the expansion of Dof genes in G. raimondii.

Keywords: diploid cotton , G. raimondii, phylogenetic analysis, transcription factor

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Authors: Jorge Martinez, Brandon Roberts, Holly Payton Toca

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Background: Therapeutic hypothermia (TH) is the international standard of care for all comatose patients after cardiac arrest, but criticism focuses on poor outcomes. We sought to develop criteria to identify American urban patients more likely to benefit from TH. Methods: Retrospective chart review of 107 consecutive adults undergoing TH in downtown New Orleans from 2010-2014 yielded records for 99 patients with all 44 survivors or families contacted up to four years. Results: 69 males and 38 females with a mean age of 60.2 showed 63 dead (58%) and 44 survivors (42%). Presenting cardiac rhythm was divided into shockable (Pulseless Ventricular Tachycardia, Ventricular Fibrillation) and non-shockable (Pulseless Electrical Activity, Asystole). Presenting in shockable rhythms with ROSC <20 minutes were 21 patients with 15 (71%) survivors (p=.001). Time >20 minutes until ROSC in shockable rhythms had 5 patients with 3 survivors (78%, p=0.001). Presenting in non-shockable rhythms with ROSC <20 minutes were 54 patients with 18 survivors (33%, p=.001). ROSC >20 minutes in non-shockable rhythms had 19 patients with 2 survivors (8%, p=.001). Survivors of shockable rhythms showed 19 (100%) living post TH. 15 survivors (79%, n=19, p=.001) had CPC score 1 or 2 with 4 survivors (21%, n=19) having a CPC score of 3. A total of 25 survived non-shockable rhythm. Acute survival of patients with non-shockable rhythm showed 18 expired <72 hours (72%, n=25) with long-term survival of 4 patients (5%, n=74) and CPC scores of 1 or 2 (p=.001). Interestingly, patients with time to ROSC <20 minutes exhibiting more than one loss of sustained ROSC showed 100% mortality (p=.001). Patients presenting with shockable >20 minutes ROSC had overall survival of 70% (p=.001), but those undergoing >3 cardiac rhythm changes had 100% mortality (p=.001). Conclusion: Patients presenting with shockable rhythms undergoing TH had overall acute survival of 70% followed by long-term survival of 100% after 4 years. In contrast, patients presenting with non-shockable rhythm had long-term survival of 5%. TH is not recommended for patients presenting with non-shockable rhythm and requiring greater than 20 minutes for restoration of ROSC.

Keywords: cardiac rhythm changes, Pulseless Electrical Activity (PEA), Therapeutic Hypothermia (TH)

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Authors: Nessa-Amie T. Peñaflor, Antonio Cinto

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This is a descriptive research on the level of math anxiety and mathematics misconceptions in algebra. This research is composed of four parts: (1) analysis of the level of anxiety of the respondents; (2) analysis of the common mathematical misconceptions in algebra; (3) relationship of socio-demographic profile in math anxiety and mathematical misconceptions and (4) analysis of the relationship of math anxiety and misconceptions in algebra. Through the demographic profile questionnaire it was found out that most of the respondents were female. Majority had ages that ranged from 13-15. Most of them had parents who finished secondary education. The biggest portion of Grade Seven students where from families with annual family income ranging from PhP 100, 000 to PhP 299, 999. Most of them came from public school. Mathematics Anxiety Scale for Secondary and Senior Secondary School Students (MAS) and set of 10 open-ended algebraic expressions and polynomials were also administered to determine the anxiety level and the common misconceptions in algebra. Data analysis revealed that respondents had high anxiety in mathematics. Likewise, the common mathematical misconceptions of the Grade Seven students were: combining unlike terms; multiplying the base and exponents; regarding the variable x as 0; squaring the first and second terms only in product of two binomials; wrong meaning attached to brackets; writing the terms next to each other but not simplifying in using the FOIL Method; writing the literal coefficient even if the numerical coefficient is 0; and dividing the denominator by the numerator when the numerical coefficient in the numerator is smaller than the numerical coefficient of the denominator. Results of the study show that the socio-demographic characteristics were not related to mathematics anxiety and misconceptions. Furthermore, students from higher section had high anxiety than those students on the lower section. Thus, belonging to higher or lower section may affect the mathematical misconceptions of the respondents.

Keywords: algebra, grade 7 math, math anxiety, math misconceptions

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Authors: Homer Hermes De Dios, Dewoowoogen Baclayon

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The community assemblages of reef fishes was conducted in ten marine sanctuaries and ten non-marine sanctuary areas in Sogod Bay, Southern Leyte, Philippines from 2014-2015. A total of 223 species belonging to 39 families of reef fishes in Sogod Bay were recorded. Family Pomacentridae (e.g. damsel fishes) has the highest number of species (42), followed by Labridae or wrasses (27), Chaetodonthidae or butterfly fish (22), Scaridae or parrotfishes (17), and Acanthuridae (surgeonfishes) and Pomacanthidae (angelfishes) both with 10 species. Two of the recorded fish species were included in the IUCN Red List, wherein one is near threatened (Chlorurus bowersi) and the other is endangered species (Cheilinus undulatus). The mean total fish biomass (target + indicator + major or other fish) in MPA was significantly higher (13,468 g/500m2 or equivalent to 26.94 mt/km2) than Non-MPA with 7,408 g/500m2 or 15,216mt/km2 in Non-MPA. The mean total fish biomass in MPAs in Sogod Bay can be categorized as high (21-40 mt/km2) with minimal fishing and medium or slightly moderately fished (11-20 mt/km2) in Non-MPAs. The mean (±SE) biomass of target fishes was significantly higher in MPA than Non-MPA and differ significantly across two depths. The target fish biomass was significantly higher in Limasawa Marine Sanctuary (13,569 g/500m2) followed by Lungsodaan Marine Sanctuary in Padre Burgos (11,884 g/500m2) and the lowest was found in San Isidro (735 g/500m2). The mean total fish density (target + indicator + major or other fish) did not differ between Marine Protected area (607.912 fishes/500m2 or 1215.824 fishes/1000m2) and 525.937 fishes/500m2 in non-Marine Protected Area and can be categorized as moderate (667-2267mt/km2). The mean density of target fishes was significantly (p=0.022) higher in deeper areas (12-15m) than in shallow areas but did not differ significantly between MPAs and Non-MPA. No significant difference of the biomass and density for indicator and other fishes in MPAs and Non-MPAs.

Keywords: abundance, density, species richness, target fish, coral reef management

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Authors: Ayşe Defne Öz, Özlem Bozkurt

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Alzheimer's Disease (AD) is counted as one of the most important global health problems and the main cause of dementia. The term dementia refers to a wide spectrum of disorders characterized by global, chronic, and generally irreversible cognitive deterioration. It is estimated that %60 % to 80 of the cases of dementia are because of AD. Alzheimer's is a slowly progressive brain disease. The reason for AD is unknown to the author's best knowledge, yet it is one of the topics that is most researched. AD shows the histopathologically abnormal accumulation of the protein beta-amyloid (plague) outside neurons and twisted strands of the protein tau (tangles) inside neurons in the brain. These changes are accompanied by damage to the brain tissue and the death of neurons. AD causes people to have difficulty remembering names or conversations. Some of the later symptoms are difficulty in talking and walking. Alzheimer's Disease is elevated by the illness and mortality of COVID-19. COVID-19 has affected many lives globally and had profound effects on human lives. COVID-19 is caused by SARS-CoV-2, which is a virus that attacks the respiratory and central nervous system and has neuroinvasive potential. More than %80 of COVID-19 patients have ageusia or anosmia, representing the pathognomic features of the disease. Patients with dementia are frail, and with the COVID-19 pandemic, including isolation, cognitive decline may exacerbate. Furthermore, patients with AD can be unable to follow the directions, such as covering their mouth and nose while coughing and can live in nursing homes which makes them more open to being infected. As COVID-19 is highly infectious and its management requires isolation and quarantine, the need for caregivers for AD management conflicts with that of COVID-19 and adds an extra burden on AD patients, caregivers, families, society, and the economy. Due to the entry of SARS-CoV-2 into the central nervous system, inflammation caused by COVID-19, prolonged hospitalization, and delirium, it has been reported that COVID-19 causes many neurological disorders and predisposition to AD.

Keywords: Alzheimer's disease, COVID-19, dementia, SARS-CoV-2

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Authors: Meha Singla, Shankhadeep Chaudhuri, Yadunandan Batchu

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Rental Housing is a more cost effective and flexible housing solution for the low income families than home-ownership. While India is undergoing a new industrial metamorphosis with multiple government initiatives that emphasise on the growth of manufacturing sector through policy frameworks and corridor development proposals, there is going to be a huge influx of low-income working population to the upcoming urban centres. As per stats, about 70 per cent of the housing demand at these centres fall into the affordable segment. And in the midst of this rapid urbanisation and huge immigration of young population, there is a lack of proper rental housing framework in the country. A large number of immigrants will be unable to support home-ownership thereby leading to proliferation of slums in urban centres. As a result, there is a dire need for immediate articulation of a comprehensive rental housing policy and affordable housing initiatives. In this paper, CommonFloor attempts to analyse successful rental housing case studies of the world followed by establishing a correlation between the gap in urban rental housing stock and the per capita income statistics to devise rental housing affordability specific to major Indian cities (Delhi, Mumbai, Bangalore, Chennai). Further, with the corroboration of market price trends, it will try to locate feasible micro-markets for immediate rental housing action. Final research findings will provide key data points thereby helping to design the approach for efficient utilisation of unsold residential inventory in the country in order to compensate the rental housing deficiency. This data set is believed to express viable model(s) of the rental housing approach for the government and private participants.

Keywords: housing prices, migration of population, real estate, rental housing, rental markets, residential property market, urbanisation

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Authors: C. V. Nnamani, O. L. Adedeji

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The contemporary global economic meltdown has devastating effect on the Nigerian’s economy and its frantic search for alternative source of national revenue aside from oil and gas has become imperative for economic emancipation for Nigerians. Apicultural entrepreneurship could provide a source of livelihood if the basic knowledge of those plant genetic resources needed by bees is made available. A palynological evaluation of those palynotaxa which honey bees forage for pollen and nectar was carried out after standard acetolysis method. Results showed that the honey samples were highly diversified and rich in honey plants. A total of 9544.3 honey pollen, consisting of 39 honey plants belonging to 21 plant families and distributed within 38 genera were identified excluding 238 unidentified pollen grains. Data from the analysis equally revealed that Elaeis guineensis Jacq, Anacardium occidentale L, Diospyros mespiliformis Hochist xe ADC, Alchornea cordifolia Muell, Arg, Daniella oliveri (Rolfe) Hutch & Dalz, Irvingia wombolu Okafor ex Baill, Treculia africana Decne, Nauclea latifolia Smith and Crossopteryx febrifuga Afzil ex Benth were the predominant honey plants. It provided a guide to the optimal utilization of floral resources by honeybees in these regions, showing the opportunity and amazing potentials for apiculture entrepreneurship of these palytaxa. Most of these plants are rare, threatened and endangered. It calls for urgent conservation techniques and step by all players. Critical awareness creation to ensure farmers knowledge of these palynotaxa to ensure proper understanding and attendance boost from them as economic empowerment is needed.

Keywords: palynotaxa, acetolysis, enterprise, livelihood, Nigeria

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Authors: Timothy Scheinert, Eliza Wright

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Background: Link Health is a Boston-based non-profit leveraging in-person and digital platforms to promote health equity. Its primary aim is to financially support low-income individuals through enrollment in federal benefit programs. This study examines the monetary impact of enrollment in several benefit programs. Methodologies: Approximately 17,000 individuals have been screened for eligibility via digital outreach, community events, and in-person clinics. Enrollment and financial distributions are evaluated across programs, including the Affordable Connectivity Program (ACP), Lifeline, LIHEAP, Transitional Aid to Families with Dependent Children (TAFDC), and the Supplemental Nutrition Assistance Program (SNAP). Major Findings: A total of 1,895 individuals have successfully applied, collectively distributing an estimated $1,288,152.00 in aid. The largest contributors to this sum include: ACP: 1,149 enrollments, $413,640 distributed annually. Child Care Financial Assistance (CCFA): 15 enrollments, $240,000 distributed annually. Lifeline: 602 enrollments, $66,822 distributed annually. LIHEAP: 25 enrollments, $48,750 distributed annually. SNAP: 41 enrollments, $123,000 distributed annually. TAFDC: 21 enrollments, $341,760 distributed annually. Conclusions: These results highlight the role of targeted outreach and effective enrollment processes in promoting access to federal benefit programs. High enrollment rates in ACP and Lifeline demonstrate a considerable need for affordable broadband and internet services. Programs like CCFA and TAFDC, despite lower enrollment numbers, provide sizable support per individual. This analysis advocates for continued funding of federal benefit programs. Future efforts can be made to develop screening tools that identify eligibility for multiple programs and reduce the complexity of enrollment.

Keywords: benefits, childcare, connectivity, equity, nutrition

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Authors: Shruti Govindarajan

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In-utero gene editing with CRISPR-Cas9 opens up new possibilities for treating genetic disorders during pregnancy while still in mother’s womb. By targeting genetic mutations in the early stages of fetal development, this approach could potentially prevent severe conditions—like cystic fibrosis, sickle cell anemia, and muscular dystrophy—from causing harm. CRISPR-Cas9, which allows precise DNA edits, could be delivered into fetal cells through vectors such as adeno-associated viruses (AAVs) or nanoparticles, correcting disease-causing mutations and possibly offering lifelong relief from these disorders. For families facing severe genetic diagnoses, in-utero gene editing could provide a transformative option. However, technical challenges remain, including ensuring that gene editing only targets the intended cells and verifying long-term safety. Ethical considerations are also at the forefront of this technology. The editing of a fetus's genes brings up difficult questions about consent, especially since these genetic changes will affect the child’s entire life without their input. There's also concern over possible unintended side effects, or changes passed down to future generations. Moreover, if used beyond therapeutic purposes, this technology could be misused for ‘enhancements,’ like selecting for certain physical or cognitive traits, raising concerns about inequality and social pressures. In this way, in-utero gene editing brings both exciting potential and complex moral questions. As research progresses, addressing these scientific and ethical concerns will be key to ensuring that this technology is used responsibly, prioritizing safety, fairness, and a focus on alleviating genetic disease. A cautious and inclusive approach, along with clear regulations, will be essential to realizing the benefits of in-utero gene editing while protecting against unintended consequences.

Keywords: in-utero gene editing, CRISPR, bioethics, genetic disorder

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Authors: Rojan Afrouz

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Introduction: The immigration is a complex process of transitioning and transformation. Immigrants are more likely to come from the patriarchal and hierarchical society with traditional gender roles and women’s stereotypes. Changing the perception of women’s gender roles may result in challenges between women and their family and community. In this article, Afghan women’s perspectives on gender roles and stereotypes have been investigated as well as their experience of changes in the new context of Australia. Australian initiatives of challenging gender roles have provided the opportunities for Afghan women to emancipate from the traditional gender roles and pursue the value of gender equality. In this process, they may face many challenges in intersectional levels within their family, community and wider society which is a complex conflate of oppressive factors that may not be addressed easily and straightforward. Methods: This qualitative study has been conducted among Afghan women who have lived in Australia less than ten years. Semi-structured interviews either face to face or by phone have been used to collect data for this study. The interviews have been audio-recorded and transcribed verbatim. Nvivo software has been used for data analysis. Findings: Many participants mentioned that they had been taught that a good Afghan woman is devoted, obedient and loyal to their family and community. They believed that for many Afghan families, Afghan women's natural place was inside the home as a housewife, mother, daughter involving so many responsibilities and expectation of making sacrifices. Many women stated that their attitudes toward gender roles and their feeling of being a woman had been changed since they came to Australia although the process of change for women was complex and diverse. Some had to deal with conflicts with their stereotypes, traditional gender roles as well as strong disagreement with their family and community. Conclusion: Moving to a different country with more gender equality is an opportunity for Afghan women to change their perceptions of gender roles and stereotypes. However, challenging traditional stereotypes and gender roles in the new context is a complex process comprising intersectional levels.

Keywords: stereotypes, gender role, immigration, Afghan women

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Authors: Shaista Meghani, Rozina Karmaliani, Khairulnissa Ajani, Shireen Shahzad, Nadeem Ullah Khan

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Background: The concept of Family Presence During Resuscitation (FPDR) is gradually gaining recognition in western countries, however, it is rarely considered in South Asian countries including Pakistan. Over time, patients’ and families’ rights have gained recognition and healthcare has progressed to become more patient-family centered. Objectives: The objective of this study was to evaluate the impact of an educational program on the Knowledge, Attitude, and Practices (KAP) of healthcare professionals (HCPs) towards FPDR in Emergency Department (ED), at a tertiary care setting, in Karachi, Pakistan. Methods: This was a Pre-test and Post-test study design. A convenient universal sampling was done, and all ED nurses and physicians with more than one year of experience were eligible. The intervention included one-hour training sessions for physicians (three sessions) and nurses (eight sessions), The KAP of nurses and physicians were assessed immediately after (post-test I), and two weeks(post-test II) after the intervention using a pretested questionnaire. Results: The findings of the study revealed that the mean scores of knowledge and attitude of HCPs at both time points were statistically significant (p-value=<0.001), however, an insignificant difference was found on practice of FPDR (p-value=>0.05). Conclusion: The study findings recommend that the educational program on FPDR for HCPs needs to be offered on an ongoing basis. Moreover, training modules need to be developed for the staff, and formal guidelines need to be proposed for FPDR, through a multidisciplinary team approach.

Keywords: family presence, cardiopulmonary resuscitation, attitude, education, practices, health care professionals

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Authors: Ebru Ergi̇n, Funda Kutlu

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Emerging adulthood is a developmental period and the formation of identity is crucial task of emerging adults in this period. In this frame, the main aim of the study was to compare college students and full-time workers on emerging adulthood dimensions and identity statuses in relation to some demographic variables in Turkey. The participants of the study were university students studying in Ankara and the employees working full-time in Ankara and Bursa. The mean age of the sample was 20.84 (sd=1.84), ranging from 18 to 25. The measurement instruments of the study were Inventory of Dimensions of Emerging Adulthood and Extended Objective Measure of Ego Identity Status (EOMEIS-II). The participants’ data (N=313) were analyzed to test the research questions and hypotheses of the study. A series of MANOVA were performed to test the group differences for some demographic characteristics (such as: employee/student, male/female, living with family/living apart from family) on scores of emerging adulthood dimensions and identity status. The results of the MANOVAs indicated that students, females and participants who live apart from their families had higher scores on emerging adulthood dimensions. The results of the identity status scores differences depending on the demographic characteristic pointed out that there were a significant group differences for identity foreclosure identity scores between employees and students. Employees’ foreclosure identity scores were higher than students. Furthermore, the identity scores were differed significantly according to gender of the participants. Male participants had higher scores in moratorium and foreclosure identity and female participants have higher achievement identity scores than males. Also, the participants who live with their family scored higher in foreclosure identity and the participants who live apart from their family scored higher in identity achievement status.

Keywords: college students, emerging adulthood, full-time employees, identity statuses

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Authors: Rony Reátegui, Cesar Chácara, Benjamin Castañeda, Rafael Aguilar

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Nowadays, heritage building information modeling (HBIM) is considered an efficient tool to represent and manage information of cultural heritage (CH). The basis of this tool relies on a 3D model generally obtained from a cloud-to-BIM procedure. There are different methods to create an HBIM model that goes from manual modeling based on the point cloud to the automatic detection of shapes and the creation of objects. The selection of these methods depends on the desired level of development (LOD), level of information (LOI), grade of generation (GOG), as well as on the availability of commercial software. This paper presents the 3D modeling of a stone masonry chapel using Recap Pro, Revit, and Dynamo interface following a three-step methodology. The first step consists of the manual modeling of simple structural (e.g., regular walls, columns, floors, wall openings, etc.) and architectural (e.g., cornices, moldings, and other minor details) elements using the point cloud as reference. Then, Dynamo is used for generative modeling of complex structural elements such as vaults, infills, and domes. Finally, semantic information (e.g., materials, typology, state of conservation, etc.) and pathologies are added within the HBIM model as text parameters and generic models families, respectively. The application of this methodology allows the documentation of CH following a relatively simple to apply process that ensures adequate LOD, LOI, and GOG levels. In addition, the easy implementation of the method as well as the fact of using only one BIM software with its respective plugin for the scan-to-BIM modeling process means that this methodology can be adopted by a larger number of users with intermediate knowledge and limited resources since the BIM software used has a free student license.

Keywords: cloud-to-BIM, cultural heritage, generative modeling, HBIM, parametric modeling, Revit

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Authors: Luisito L. Lacatan, Gian Carlo J. Bergonia, Felipe C. Buado III, Gerald L. Gono, Ron Mark V. Ortil, Calvin A. Yap

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This paper features the development of a Mobile Self-sustaining Electricity Generator for water distillation process with MCU- based wireless controller & indicator designed to solve the problem of scarcity of clean water. It is a fact that pure water is precious nowadays and its value is more precious to those who do not have or enjoy it. There are many water filtration products in existence today. However, none of these products fully satisfies the needs of families needing clean drinking water. All of the following products require either large sums of money or extensive maintenance, and some products do not even come with a guarantee of potable water. The proposed project was designed to alleviate the problem of scarcity of potable water in the country and part of the purpose was also to identify the problem or loopholes of the project such as the distance and speed required to produce electricity using a wheel and alternator, the required time for the heating element to heat up, the capacity of the battery to maintain the heat of the heating element and the time required for the boiler to produce a clean and potable water. The project has three parts. The first part included the researchers’ effort to plan every part of the project from the conversion of mechanical energy to electrical energy, from purifying water to potable drinking water to the controller and indicator of the project using microcontroller unit (MCU). This included identifying the problem encountered and any possible solution to prevent and avoid errors. Gathering and reviewing related studies about the project helped the researcher reduce and prevent any problems before they could be encountered. It also included the price and quantity of materials used to control the budget.

Keywords: mobile, self – sustaining, electricity generator, water distillation, wireless battery indicator, wireless water level indicator

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Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant

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Holistic and patient-centred palliative care and support require an integrated system of care that includes health and social service providers working together to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the benefits and challenges of mobilizing multidisciplinary care teams for health care professionals and social service providers. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed, and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers posed by multidisciplinary care teams. Three main findings emerged: First, the data highlighted the benefits of multidisciplinary care teams for both patient outcomes and quality of life and provider mental health; second, the data showed that the lack of a system-wide integrated communication system reduces the quality of patient care and increases provider stress while working in multidisciplinary care teams; finally, the data demonstrated the existence of implicit hierarchies between disciplines, this coupled with different disciplinary perspectives of palliative care provision can lead to friction and challenges within care teams. These findings will have important implications for the future of palliative care as they will help to facilitate and build stronger person-centred/relationship-centred palliative care practices by naming the challenges faced by multidisciplinary palliative care teams and providing examples of best practices.

Keywords: public health palliative care, palliative care nursing, care networks, integrated health care, palliative care approach, public health, multidisciplinary work, care teams

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Authors: Raees Khan, Mir A. Khan, Sheikh Z. Ul Abidin, Abdul S. Mumtaz

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In the present study, phytogeography and conservation status of gymnosperms of Pakistan were investigated. 44 gymnosperms species of 18 genera and 9 families were collected from 66 districts of the country. Among the 44 species, 20 species were native (wild) and 24 species were exotic (cultivated). Ephedra sarocarpa of Ephedraceae was not collected in this study from its distribution area and most probably it may be Nationally Extinct now from this area. Previously in Gymnosperms Flora of Pakistan 34 species was reported. 12 new gymnosperms species were recorded for the first time. Pinus wallichiana (40 districts), Cedrus deodara (39 districts) Pinus roxburghii (36 districts), Picea smithiana (36 districts) and Abies pindrow (34 districts) have the maximum ecological amplitude. Juniperus communis (17districts) and Juniperus excelsa (14 districts) were the widely distributed among the junipers. Ephedra foliata (23 districts), Ephedra gerardiana (20 districts) and Ephedra intermedia (19 districts) has the widest distribution range. Taxus fuana was also wider distribution range and recorded in 19 districts but its population was not very stable. These species was recorded to support local flora and fuana, especially endemics. PCORD version 5 clustered all gymnosperms species into 4 communities and all localities into 5 groups through cluster analyses. The Two Way Cluster Analyses of 66 districts (localities) resulted 4 various plant communities. The Gymnosperms in Pakistan are distributed in 3 floristic regions i.e. Western plains of the country, Northern and Western mountainous regions and Western Himalayas. The assessment of the National conservation status of these species, 10 species were found to be threatened, 6 species were endangered, 4 species were critically endangered and 1 species have become extinct (Ephedra sarcocarpa). The population of some species i.e. Taxus fuana, Ephedra gerardiana, Ephedra monosperma, Picea smithiana and Abies spectabilis is decreasing at an alarming rate.

Keywords: conservation status, gymnosperms, phytogeography, Pakistan

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Authors: Karun Karki

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The Lhotshampa are Bhutanese people of Nepali origin who have been in Bhutan since the early 1600s. A significant number of these people migrated to Bhutan in the nineteenth century. The 1958 Nationality Law of Bhutan granted citizenship to many Lhotshampa people; however, in the late 1970s, the government of Bhutan introduced a series of laws and policies intended for the socio-political and cultural exclusion of the Lhotshampa due to their ancestry. These exclusionary policies and ethnic and racial injustices not only removed the rights and citizenship of the Lhotshampa but also forcibly displaced thousands of families with no choice but to seek refuge in Nepal. In this context, racism becomes a biopolitical tool designed to govern and regulate populations in a way that determines who may live and who must die. The governance and the management of the population, what Stephan Scheel terms as biopolitical bordering, depends on boundaries between residents and non-residents, citizens and non-citizens, and emigrants and immigrants. Drawing on Foucault’s biopolitics and Mbembe’s necropolitics, this paper argues that the concept of racism should be examined within the context of political discourses because it is intertwined with the colonial project, enslavement, and diaspora. This paper critically explores ethnic and racial injustices the Lhotshampa people experienced and the ways in which they negotiated and resisted such injustices in their resettlement processes, including before displacement, in refugee camps, and after the third-country resettlement. Critical examination of these issues helps shed light on the notion of racial difference that justifies dehumanization, discrimination, and racist attitudes against the Lhotshampa people. The study's findings are critical in promoting human rights, social justice, and the health and well-being of the Lhotshampa community in the context of trauma and stressors in their resettlement processes.

Keywords: lhotshampa people, bhutanese refugees, racism, dehumanization, social justice, biopower, necropower

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Authors: J. C. Valenzuela-Tripodoro, P. Álvarez-Ruíz, M. A. Mateos-Camacho, M. Cera

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In 2004, it was introduced the concept of Roman domination in graphs. This concept was initially inspired and related to the defensive strategy of the Roman Empire. An undefended place is a city so that no legions are established on it, whereas a strong place is a city in which two legions are deployed. This situation may be modeled by labeling the vertices of a finite simple graph with labels {0, 1, 2}, satisfying the condition that any 0-vertex must be adjacent to, at least, a 2-vertex. Roman domination in graphs is a variant of classic domination. Clearly, the main aim is to obtain such labeling of the vertices of the graph with minimum cost, that is to say, having minimum weight (sum of all vertex labels). Formally, a function f: V (G) → {0, 1, 2} is a Roman dominating function (RDF) in the graph G = (V, E) if f(u) = 0 implies that f(v) = 2 for, at least, a vertex v which is adjacent to u. The weight of an RDF is the positive integer w(f)= ∑_(v∈V)▒〖f(v)〗. The Roman domination number, γ_R (G), is the minimum weight among all the Roman dominating functions? Obviously, the set of vertices with a positive label under an RDF f is a dominating set in the graph, and hence γ(G)≤γ_R (G). In this work, we start the study of a generalization of RDF in which we consider that any undefended place should be defended from a sudden attack by, at least, k legions. These legions can be deployed in the city or in any of its neighbours. A function f: V → {0, 1, . . . , k + 1} such that f(N[u]) ≥ k + |AN(u)| for all vertex u with f(u) < k, where AN(u) represents the set of active neighbours (i.e., with a positive label) of vertex u, is called a [k]-multiple Roman dominating functions and it is denoted by [k]-MRDF. The minimum weight of a [k]-MRDF in the graph G is the [k]-multiple Roman domination number ([k]-MRDN) of G, denoted by γ_[kR] (G). First, we prove that the [k]-multiple Roman domination decision problem is NP-complete even when restricted to bipartite and chordal graphs. A problem that had been resolved for other variants and wanted to be generalized. We know the difficulty of calculating the exact value of the [k]-MRD number, even for families of particular graphs. Here, we present several upper and lower bounds for the [k]-MRD number that permits us to estimate it with as much precision as possible. Finally, some graphs with the exact value of this parameter are characterized.

Keywords: multiple roman domination function, decision problem np-complete, bounds, exact values

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Authors: Rojan Afrouz

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The main aim of this study is understanding Afghan women’s perception of domestic violence and their experience of abuse by their family members. The voice of Afghan women has not been heard much particularly in Australia. Their families and communities have silenced some of them in the name of family honour and reputation, and others have not had the opportunity to talk about the issue. Although domestic violence is an issue in every country, research suggests that this is more likely to be considered acceptable behaviour in Afghanistan than elsewhere. Given the high public visibility of initiatives which aim to tackle domestic violence in Australia, it is entirely possible that Afghan women’s perceptions and beliefs about domestic violence will have changed since their arrival in this country. Thus, their understandings, perceptions and their experience of domestic violence have been investigated to improve the Afghan women’s situation in Australia. Methods: This qualitative study has been conducted among Afghan women who have lived in Australia less than ten years. Semi-structured interviews either face to face or by phone have been used to collect data for this study. The interviews have been audio-recorded and transcribed verbatim. Nvivo software has been used for data analysis. Findings: Participants’ definitions of domestic violence vary. They defined domestic violence in relation to their educational levels, their personal life and experience of domestic violence. Some women tended to change the definitions to be more relevant to their own life and experience. Many women had the knowledge of different domestic violence acts that have been distinguished as violent acts in Australia or other western countries. Some of the participants stated that they had the experience of domestic violence from their partner or one of the family members. Those who have been abused, their experiences were diverse and had been perpetrated by different family members. Majority of participants revealed the story of other women in their family and community that have been abused. Conclusion: Moving to Australia helped women to be aware of the issues and recognising that they are in the abusive relationships. However, intersecting multiple identities in a complex system of oppression, domination or discrimination makes the experience of domestic violence more complicated among Afghan community in Australia that cannot be addressed easily.

Keywords: domestic violence, intersectionality, immigration, afghan women

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Authors: Irene Carter, Roy Hanes, Judy MacDonald

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Considering that disability is universal and people with disabilities are part of all societies; that there is a connection between the disabled individual and the societal; and that it is society and social arrangements that disable people with impairments, contemporary disability discourse emphasizes the social model of disability to counter medical and rehabilitative models of disability. However, the social model does not go far enough in addressing the issues of oppression and inclusion. The authors indicate that the social model does not specifically or adequately denote the oppression of persons with disabilities, which is a central component of progressive social work practice with people with disabilities. The social model of disability does not go far enough in deconstructing disability and offering social workers, as well as people with disabilities a way of moving forward in terms of practice anchored in individual, familial and societal change. The social model of disability is expanded by incorporating principles of anti-oppression social work practice. Although the contextual analysis of the social model of disability is an important component there remains a need for social workers to provide service to individuals and their families, which will be illustrated through anti-oppressive practice (AOP). By applying an anti-oppressive model of practice to the above definitions, the authors not only deconstruct disability paradigms but illustrate how AOP offers a framework for social workers to engage with people with disabilities at the individual, familial and community levels of practice, promoting an emancipatory focus in working with people with disabilities. An anti- social- oppression social work model of disability connects the day-to-day hardships of people with disabilities to the direct consequence of oppression in the form of ableism. AOP theory finds many of its basic concepts within social-oppression theory and the social model of disability. It is often the case that practitioners, including social workers and psychologists, define people with disabilities’ as having or being a problem with the focus placed upon adjustment and coping. A case example will be used to illustrate how an AOP paradigm offers social work a more comprehensive and critical analysis and practice model for social work practice with and for people with disabilities than the traditional medical model, rehabilitative and social model approaches.

Keywords: anti-oppressive practice, disability, people with disabilities, social model of disability

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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