Search results for: Helen Johanna Van Niekerk

Authors: Helen S. Ghali, Engy Serag, A. Samer Ezeldin

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In many countries, the construction industry relies heavily on outsourcing models in executing their projects and expanding their businesses to fit in the diverse market. Such extensive integration of subcontractors is becoming an influential factor in contractor’s cash flow management. Accordingly, subcontractors’ financial terms are important phenomena and pivotal components for the well-being of the contractor’s cash flow. The aim of this research is to study the contractor’s cash flow with respect to the owner and subcontractor’s payment management plans, considering variable advance payment, payment frequency, and lag and retention policies. The model is developed to provide contractors with a decision support tool that can assist in selecting the optimum subcontracting plan to minimize the contractor’s financing limits and optimize the profit values. The model is built using Microsoft Excel VBA coding, and the genetic algorithm is utilized as the optimization tool. Three objective functions are investigated, which are minimizing the highest negative overdraft value, minimizing the net present worth of overdraft, and maximizing the project net profit. The model is validated on a full-scale project which includes both self-performed and subcontracted work packages. The results show potential outputs in optimizing the contractor’s negative cash flow values and, in the meantime, assisting contractors in selecting suitable subcontractors to achieve the objective function.

Keywords: cash flow optimization, payment plan, procurement management, subcontracting plan

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Authors: Helen Pushkarskaya, David Tolin, Lital Ruderman, Ariel Kirshenbaum, J. MacLaren Kelly, Christopher Pittenger, Ifat Levy

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Obsessive-Compulsive Disorder (OCD) produces profound morbidity. Difficulties with decision making and intolerance of uncertainty are prominent clinical features of OCD. The nature and etiology of these deficits are poorly understood. We used a well-validated choice task, grounded in behavioral economic theory, to investigate differences in valuation and value-based choice during decision making under uncertainty in 20 unmedicated participants with OCD and 20 matched healthy controls. Participants’ choices were used to assess individual decision-making characteristics. Compared to controls, individuals with OCD were less consistent in their choices and less able to identify options that were unambiguously preferable. These differences correlated with symptom severity. OCD participants did not differ from controls in how they valued uncertain options when outcome probabilities were known (risk) but were more likely than controls to avoid uncertain options when these probabilities were imprecisely specified (ambiguity). These results suggest that the underlying neural mechanisms of valuation and value-based choices during decision-making are abnormal in OCD. Individuals with OCD show elevated intolerance of uncertainty, but only when outcome probabilities are themselves uncertain. Future research focused on the neural valuation network, which is implicated in value-based computations, may provide new neurocognitive insights into the pathophysiology of OCD. Deficits in decision-making processes may represent a target for therapeutic intervention.

Keywords: obsessive compulsive disorder, decision-making, uncertainty intolerance, risk aversion, ambiguity aversion, valuation

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Authors: Helen Dilman, Eyal Oz, Shmuel Hayun, Nahum Frage

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The conventional approach for manufacturing silicon carbide and boron carbide reaction bonded composites is based on infiltrating a ceramic porous preform with molten silicon. The relatively high melting temperature of the silicon infiltrating medium is a drawback of the process. The present contribution is concerned with an approach that allows obtaining reaction bonded composites by pressure-less infiltration at a significantly lower (850-1000oC) temperature range. This approach was applied for the fabrication of fully dense SiC/(Si-Al) and (SiC+B4C)/(Si-Al) composites. The key feature of the approach is based on using Si alloys with low melting temperature and the Mg-vapor atmosphere, under which an adequate wetting between ceramics and liquid alloys for the infiltration process is achieved. In the first set of the experiments ceramic performs compacted from multimodal SiC powders (with the green density of about 27 vol. %) without free carbon addition were infiltrated by Si-20%Al alloy at 950oC. In the second set, 19 vol. % of a fine boron carbide powder was added to SiC powders as a source of carbon. The green density of the SiC-B4C preforms was about 23-25 vol. %. In both cases, successful infiltration was achieved and the composites were fully dense. The density of the composites was about 3g/cm3. For the SiC based composites the hardness value was 750±150HV, Young modulus-280GPa and bending strength-240±30MPa. These values for (SiC-B4C)/(Si-Al) composites (1460±200HV, 317GPa and 360±20MPa) were significantly higher due to the formation of novel ceramics phases. Microstructural characteristics of the composites and their phase composition will be discussed.

Keywords: boron carbide, composites, infiltration, low temperatures, silicon carbide

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Authors: Julia Wong, Hua Beng Lim, Petrina Goh, Johanna Foo, Caleb Ng, Nurul ‘Aqilah Bte Mohd Taufek

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Animal-assisted therapy (AAT) utilizes human-animal interaction to achieve specific therapeutic goals, and its efficacy has been demonstrated across various settings overseas. The use of AAT in Singapore, however, is still limited. Ang Mo Kio-Thye Hua Kwan (AMKH) is one of the first community hospitals in Singapore to use AAT to complement its occupational therapy services with elderly patients. This study explored the perspectives of AMKH’s occupational therapists (OTs) in relation to AAT to understand barriers and enablers in implementing and practising AAT. We also examined how OTs at-large across practice settings perceive AAT. A mixed method design was used. 64 OTs at-large participated in on online survey, and 7 AMKH OTs were interviewed individually via Zoom. Survey results were analysed with descriptive and Mann-Whitney U tests. Interviews were thematically analysed. AMKH OTs perceived various benefits of AAT articulated in overseas studies in domains such as motivation and participation, emotional, social interaction, sensory tactile stimulation, and cognition. Interestingly, this perception was also supported by 67% of OTs who had responded to the survey, even though most of the OTs who had participated in the survey had no experience in AAT. Despite the perceived benefits of AAT, both OTs from AMKH and those at-large articulated concerns on risks pertaining to AAT (e.g., allergies, unexpected animal behaviour, infections, etc). However, AMKH OTs shared several ways to mitigate these risks, demonstrating their ability to develop a safe program. For e.g., volunteers and their dogs must meet specific recruitment criteria, stringent protocols are used to screen and match dogs with patients, and there are strict exclusion criteria for patients participating in AAT. AMKH OTs’ experience suggests that additional skills and knowledge are required to implement AAT, therefore, healthcare institutions should first consider improving their staff training and risk mitigation knowledge before implementing AAT. They can also refer to AMKH’s AAT protocols and those found in overseas studies, but institutions must adapt the protocols to fit their institutional settings and patients’ profiles.

Keywords: animal-assisted therapy, dog-assisted therapy, occupational therapy, complementary therapy

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Authors: Johanna Bapela, Heino Heyman, Marion Meyer

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Regardless of the significant advances accomplished in reducing the burden of malaria and other tropical diseases in recent years, malaria remains a major cause of mortality in endemic countries. This is especially the case in sub-Saharan Africa where 99% of the estimated global malaria deaths occurs on an annual basis. The emergence of resistant Plasmodium species and the lack of diversified chemotherapeutic agents provide the rationale for bioprospecting for antiplasmodial scaffolds. Crude extracts from twenty indigenous antimalarial plant species were screened for antimalarial activity and then subjected to 1H NMR-based metabolomic analysis. Ten plant extracts exhibited significant in vitro antiplasmodial activity (IC50 ≤ 5 µg/ml). The Principal Component Analysis (PCA) of the acquired 1H NMR spectra could not separate the analyzed plant extracts according to the detected antiplasmodial bioactivity. Application of supervised Orthogonal Projections to Latent Structures–Discriminant Analysis (OPLS-DA) to the 1H NMR profiles resulted in a discrimination pattern that could be correlated to bioactivity. A contribution plot generated from the OPLS-DA scoring plot illustrated the classes of compounds responsible for the observed grouping. Given the preliminary in vitro results, Tabernaemontana elegans Stapf. (Apocynaceae) and Vangueria infausta Burch. subsp. infausta (Rubiaceae) were subjected to further phytochemical investigations. Two indole alkaloids, dregamine and tabernaemontanine possessing antiplasmodial activity were isolated from T. elegans. Two compounds were isolated from V. infausta subsp. infausta and identified as friedelin (IC50 = 3.01 µg/ml) and morindolide (IC50 = 18.5 µg/ml). While these compounds have been previously identified, this is the first account of their occurrence in the genus Vangueria and their antiplasmodial activity. Based on the results of the study, metabolomics can be used to globally identify classes of plant secondary metabolites that are responsible for antiplasmodial activity.

Keywords: ethnopharmacology, Malaria, medicinal plants, metabolomics

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Authors: Helen Johnson-Egemba

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This paper will discuss the current effectiveness of music therapy for a range of conditions, such as depression and anxiety. Indeed, traditional forms of therapy have often been effective in treating various mental and physical health conditions. However, they are not with their limitations. Music therapy, on the other hand, is a non-invasive and cost-effective alternative that can produce similar or even better results. Music therapy can produce longer-lasting results. The research also highlights the underlying mechanisms of traditional music therapy, such as its complementary treatment. A systematic review of existing literature was conducted to gather relevant studies and establish a comprehensive understanding of the topic. Various research methods, including experimental studies, qualitative research, surveys, were utilized to explore the therapeutic potential of traditional music interventions. The findings reveal that traditional music therapy shows promise in managing anxiety and depression symptoms, with positive outcomes impacting brain activity, emotions, and stress regulation. The outcomes of this study contribute to evidence-based practice, providing insights for clinicians and therapists to incorporate traditional music therapy into their treatment approaches. Furthermore, the research promotes awareness and acceptance of traditional music as a legitimate and effective therapeutic intervention for anxiety and depression, potentially enhancing access to alternative and complementary treatment options. Overall, this study demonstrates the potential benefits of traditional music therapy in addressing anxiety and depression, offering valuable implications for mental health care and improving the well-being of individuals struggling with these conditions.

Keywords: anxiety, effectiveness, depression, traditional music, therapy, treatment

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Authors: Aseel Hatif Jassam, Hadeel Hatif Jassam

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The paper discusses the phallocentric discourse that is challenged by women in general and of women of color in particular in spite of the simultaneity of oppression due to race, class, and gender in the diaspora. Therefore, the paper gives a brief account of women's experience in the light of postcolonial feminist theory. The paper also cast light on the theories of Luce Irigaray and Helen Cixous, two Feminist theorists who support and advise women to have their own discourse to challenge the infectious patriarchal sentence advocated by Sigmund Freud and Harold Bloom's model of literary history. Black women authors like BuchiEmecheta as well as her alter ego Adah, a Nigerian-born girl and the protagonist of her semi-autobiographical novel, Second Class Citizen, suffer from this phallocentric and oppressive sentence and displacement as they migrate from Nigeria, a former British colony where they feel marginalized to North London with the hope of realizing their dreams. Yet, in the British diaspora, they get culturally shocked and continue to suffer from further marginalization due to class and race and are insulted and interiorized ironically by their patriarchal husbands who try to put an end to their dreams of authorship. With the phallocentric belief that women aren't capable of self-representation in the background of their mindsets, the violent Sylvester Onwordi and Francis Obi, the husbands of both Emecheta and Adah, respectively have practiced oppression on them by burning their own authoritative voice, represented by the novels they write while they are struggling with their economically atrocious living experience in the British diaspora.

Keywords: authorship, British diaspora, discourse, phallocentric, patriarchy

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Authors: Helen Yetunde Omoboye, Adebukola Adenike Adedeji, Israel Funso Adeniyi

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This study of the biodiversity, community structure, and production capacity of the zooplankton community is an aspect of bio-monitoring of the aquatic ecosystem. Samples were selected horizontally and vertically from Esa-Odo Reservoir using improvised Meyer’s water sampler. Planktonic samples were collected at two months intervals for two years. Net and total plankton were sampled by filtration and sedimentation methods. Planktonic samples were preserved as 5% formalin and 1% Lugol’s solution. Measurement, enumeration, and scaled pictures of the recorded zooplankton were taken using a photomicrograph. The taxonomic composition of zooplankton biota was determined using identification keys. Eighty three (83) species of zooplankton recorded in this study belong to 4 groups: Rotifera, Cladocera, Copepoda, and Insecta. Rotifera was the most represented group (61.21%). Horizontally, 24 species with the highest mean abundance characterized the lacustrine; while 12 species and 10 species were unique to the transition and riverine zones, respectively. Vertically, most species had their mean abundance decreased from the surface to the bottom of the reservoir. A total of nine (9), two (2), and one (1) species were peculiar to the surface, bottom and mid-depth, respectively. Zooplankton was most abundant during the dry season. In conclusion, Esa-Odo Reservoir comprised highly diversified zooplankton fauna with great potential to support a rich aquatic community and fishery production. The reservoir can be classified as fairly clean based on the abundance of the rotifer group. However, the lake should be subjected to regular proper monitoring because of the presence of some pollution tolerant copepod species identified among the zooplankton fauna.

Keywords: zooplankton, spatial, temporal, abundance, biodiversity, reservoir

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Authors: Kyra Kannen, Sonja D. Roelen, Sebastian Schnieder, Jarek Krajewski, Steffen Holsteg, André Karger, Johanna Askeridis, Celina Slawik, Philip Mildner, Jens Piesk, Ruslan David, Holger Kürten, Benjamin Oster, Robert Malzan, Mike Ludemann

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Virtual Reality (VR) is increasingly recognized for its potential in transforming mental disorder treatment, offering advantages such as cost-effectiveness, time efficiency, accessibility, reduced stigma, and scalability. While the application of VR in the context of anxiety disorders has been extensively evaluated and demonstrated to be effective, the utilization of VR as a therapeutic treatment for depression remains under-investigated. Our goal is to pioneer immersive VR therapy modules for treating major depression, alongside a web-based system for home use. We develop a modular digital therapy platform grounded in psychodynamic therapy interventions which addresses stress reduction, exploration of social situations and relationship support, social skill training, avoidance behavior analysis, and psychoeducation. In addition, an automated depression monitoring system, based on acoustic voice analysis, is implemented in the form of a speech-based diary to track the affective state of the user and depression severity. The use of immersive VR facilitates patient immersion into complex and realistic interpersonal interactions with high emotional engagement, which may contribute to positive treatment acceptance and satisfaction. In a proof-of-concept study, 45 depressed patients were assigned to VR or web-platform modules, evaluating user experience, usability and additional metrics including depression severity, mindfulness, interpersonal problems, and treatment satisfaction. The findings provide valuable insights into the effectiveness and user-friendliness of VR and web modules for depression therapy and contribute to the refinement of more tailored digital interventions to improve mental health.

Keywords: virtual reality therapy, digital health, depression, psychotherapy

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Authors: Naeim Akbari Shahkhosravi, Reza Kakavand, Helen M. S. Davies, Amin Komeili

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Equine locomotion and performance are significantly affected by hoof health. One of the most critical diseases of the hoof is laminitis, which can lead to horse lameness in a severe condition. This disease exhibits the mechanical properties degradation of the laminar junction tissue within the hoof. Therefore, it is essential to investigate the biomechanics of the hoof, focusing specifically on excessive and cumulatively accumulated stresses within the laminar junction tissue. For this aim, the current study generated a novel equine hoof Finite Element (FE) model under dynamic physiological loading conditions and employing a hyperelastic material model. Associated tissues of the equine hoof were segmented from computed tomography scans of an equine forelimb, including the navicular bone, third phalanx, sole, frog, laminar junction, digital cushion, and medial- dorsal- lateral wall areas. The inner tissues were connected based on the hoof anatomy, and the hoof was under a dynamic loading over cyclic strides at the trot. The strain distribution on the hoof wall of the model was compared with the published in vivo strain measurements to validate the model. Then the validated model was used to study the development of laminitis. The ultimate stress tolerated by the laminar junction before rupture was considered as a stress threshold. The tissue damage was simulated through iterative reduction of the tissue’s mechanical properties in the presence of excessive maximum principal stresses. The findings of this investigation revealed how damage initiates from the medial and lateral sides of the tissue and propagates through the hoof dorsal area.

Keywords: horse hoof, laminitis, finite element model, continuous damage

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Authors: Johanna Gamboa-Kroesen

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School connectedness, or the sense of belonging at school, is a critical factor in adolescent health, academic achievement, and socioemotional well-being. In educational research, the construct of the psychological sense of school membership is often referred to as school engagement, school bonding, or school attachment. While current research recognizes school connectedness as integral to a child’s mental health and academic success, many schools have yet to develop adequate interventions to promote a child’s overall sense of belonging at school. However, prior researches in music education indicates that, among other benefits, music classrooms may provide an environment where students feel they belong. While studies indicates that music learning environments, specifically performing ensemble learning environments, instill a sense of school connectedness and, more broadly, contribute to a student’s socio-emotional development, there has been inadequate research on how the actions of music teachers contribute to this phenomenon. The purpose of this study was to examine the relationship between school connectedness and music learning environments with middle school music students enrolled in a school-based music ensemble. In addition, the study aimed to provide a descriptive analysis of the instructional practices that music teachers use to promote an inclusive environment in their classrooms and an overall sense of belonging in their students. Using 191 student surveys of school membership, student reflective writings, 5 teacher interviews, and 10 classroom observations, this study examined the relationship between 7th and 8th-grade student-reported levels of connectedness within their school-based music ensemble and teacher instructional practice. The study found that students reported high levels of positive school membership within their music classes. Students who participate in school-based orchestra ensembles reported a positive change in emotional state during music instruction. In addition, evidence in this study found that music teachers use instructional practices to build connectedness through de-emphasizing competition and strengthening a student’s sense of relational value within their music learning experience. The findings offer implications for future music teacher instruction to create environments of inclusion, strengthen student-teacher relationships, and promote strategies that enhance student connection to school.

Keywords: music education, belonging, instructional practice, school connectedness

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Authors: Johanna Perdomo, Riki Lamont, Edmund Pickering, Naomi C. Paxton, Maria A. Woodruff

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Background: Tissue Engineering (TE) has combined advanced materials, such as biomaterials, to create affordable scaffolds and dynamic systems to generate stimulation of seeded cells on these scaffolds, improving and maintaining the cellular growth process in a cell culture. However, Few TE skin products have been clinically translated, and more research is required to produce highly biomimetic skin substitutes that mimic the native elasticity of skin in a controlled manner. Therefore, this work will be focused on the fabrication of a novel mechanical system to enhance the TE treatment approaches for the reparation of damaged tissue skin. Aims: To archive this, a soft robotic device will be created to emulate different deformation of skin stress. The design of this soft robot will allow the attachment of scaffolds, which will then be mechanically actuated. This will provide a novel and highly adaptable platform for dynamic cell culture. Methods: Novel, low-cost soft robot is fabricated via 3D printed moulds and silicone. A low cost, electro-mechanical device was constructed to actuate the soft robot through the controlled combination of positive and negative air pressure to control the different state of movements. Mechanical tests were conducted to assess the performance and calibration of each electronic component. Similarly, pressure-displacement test was performed on scaffolds, which were attached to the soft robot, applying various mechanical loading regimes. Lastly, digital image correlation test was performed to obtain strain distributions over the soft robot’s surface. Results: The control system can control and stabilise positive pressure changes for long hours. Similarly, pressure-displacement test demonstrated that scaffolds with 5µm of diameter and wavy geometry can displace at 100%, applying a maximum pressure of 1.5 PSI. Lastly, during the inflation state, the displacement of silicone was measured using DIC method, and this showed a parameter of 4.78 mm and strain of 0.0652. Discussion And Conclusion: The developed soft robot system provides a novel and low-cost platform for the dynamic actuation of tissue scaffolds with a target towards dynamic cell culture.

Keywords: soft robot, tissue engineering, mechanical stimulation, dynamic cell culture, bioreactor

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Authors: Helen Huang, Francisco Javier Quesada Ocet, Blanca Quesada Oce, Javier Jimenez Bello, Victor Palanca Gil, Alba Cervero Rubio, Ana Paya Chaume, Alejandro Herreros-Pomares, Fernando Vidal-Vanaclocha, Rafael Paya Serrano, Aurelio Quesada Dorador, Monica Soliman

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Background: Cancer favors both the pro-inflammatory state and autonomic dysfunction, two important mechanisms in the genesis of AF. Atrial remodeling might be caused as a result of paraneoplastic conditions or the result of direct expression of neoplasia. Here, we hypothesize that cancer, through inflammatory mediators, may favor the appearance of AF and patients with the first episode of AF could have a higher risk of developing cancer. Method: Data was collected from patients who attended the emergency department of our hospital for the first episode of AF, diagnosed electrocardiographically, between 2010-2015 (n = 712). The minimum follow-up was 2 years, recording the appearance of cancer, total mortality, recurrences of AF and other events. Patients who developed cancer and those who did not during the 2 years after the onset of AF were compared, as well as with the incidence of cancer in Spain in 2012. Results: After 2 years, 35 patients (4.91%) were diagnosed with cancer, with an annual incidence of 2.45%. Hematological neoplasms were the most frequent (34.28%). The cancer group was older (76.68 +/-12.75 years vs 74.16 +/-12.71; p <0.05) and had fewer typical symptoms (palpitations) (33.38% vs 14.28% , p <0.05). The incidence of cancer in Spain during 2012 was 0.46%, much lower than our sample. When comparing the incidence by age, these differences were maintained both in those over 65 years of age and in those under 65 years of age (2.17% vs. 0.28%; 0.28% vs. 0.18% respectively). Discussion: Therefore, a high incidence of cancer in patients with the first episode of AF was observed (the annual incidence of 2.45% after the onset of AF is 6.1 times that of the general population). After the evaluation of patients with AF in their first detected episode, surveillance of the appearance of cancer should be considered in clinical practice.

Keywords: cancer, cardiovascular outcomes, atrial fibrillation, inflammation

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Authors: Sa`ad M. Ismail, Hung-Hsun Yen, Christina M. Murray, Helen M. S. Davies

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The lumbosacral junction (where the 7th lumbar vertebra (L7) articulates with the sacrum) is a clinically important area in the dog. The 7th lumbar vertebra (L7) is normally shorter than other lumbar vertebrae, and it has been reported that variations in the L7 length may be associated with other abnormal anatomical findings. These variations included the reduction or absence of the portion of the median sacral crest. In this study, 53 greyhound cadavers were placed in right lateral recumbency, and two lateral radiographs were taken of the lumbosacral region for each greyhound. The length of the 6th lumbar (L6) vertebra and L7 were measured using radiographic measurement software and was defined to be the mean of three lines drawn from the caudal to the cranial edge of the L6 and L7 vertebrae (a dorsal, middle, and ventral line) between specific landmarks. Sacrocaudal fusion was found in 41.5% of the greyhounds. The mean values of the length of L6, L7, and the ratio of the L6/L7 length of the greyhounds with sacrocaudal fusion were all greater than those with standard sacrums (three sacral vertebrae). There was a significant difference (P < 0.05) in the mean values of the length of L7 between the greyhounds without sacrocaudal fusion (mean = 29.64, SD ± 2.07) and those with sacrocaudal fusion (mean = 30.86, SD ± 1.80), but, there was no significant difference in the mean value of the length of the L6 measurement. Among different types of sacrocaudal fusion, the longest L7 was found in greyhounds with sacrum type D, intermediate length in those with sacrum type B, and the shortest was found in those with sacrums type C, and the mean values of the ratio of the L6/L7 were 1.11 (SD ± 0.043), 1.15, (SD ± 0.025), and 1.15 (SD ± 0.011) for the types B, C, and D respectively. No significant differences in the mean values of the length of L6 or L7 were found among the different types of sacrocaudal fusion. The occurrence of sacrocaudal fusion might affect direct anatomically connected structures such as the L7. The variation in the length of L7 between greyhounds with sacrocaudal fusion and those without may reflect the possible sequences of the process of fusion. Variations in the length of the L7 vertebra in greyhounds may be associated with the occurrence of sacrocaudal fusion. The variation in the vertebral length may affect the alignment and biomechanical properties of the sacrum and may alter the loading. We concluded that any variations in the sacrum anatomical features might change the function of the sacrum or the surrounding anatomical structures.

Keywords: biomechanics, Greyhound, sacrocaudal fusion, locomotion, 6th Lumbar (L6) Vertebra, 7th Lumbar (L7) Vertebra, ratio of the L6/L7 length

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Authors: Helen K. Buteme, Rebecca Axelsson-Robertson, Moses L. Joloba, Henry W. Boom, Gunilla Kallenius, Markus Maeurer

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Background: The Ugandan population is heavily affected by infectious diseases and Human leukocyte antigen (HLA) diversity plays a crucial role in the host-pathogen interaction and affects the rates of disease acquisition and outcome. The identification of HLA class 1 alleles and determining which alleles are associated with tuberculosis (TB) outcomes would help in screening individuals in TB endemic areas for susceptibility to TB and to predict resistance or progression to TB which would inevitably lead to better clinical management of TB. Aims: To be able to determine the HLA class 1 phenotype distribution in a Ugandan TB cohort and to establish the relationship between these phenotypes and active and latent TB. Methods: Blood samples were drawn from 32 HIV negative individuals with active TB and 45 HIV negative individuals with latent MTB infection. DNA was extracted from the blood samples and the DNA samples HLA typed by the polymerase chain reaction-sequence specific primer method. The allelic frequencies were determined by direct count. Results: HLA-A*02, A*01, A*74, A*30, B*15, B*58, C*07, C*03 and C*04 were the dominant phenotypes in this Ugandan cohort. There were differences in the distribution of HLA types between the individuals with active TB and the individuals with LTBI with only HLA-A*03 allele showing a statistically significant difference (p=0.0136). However, after FDR computation the corresponding q-value is above the expected proportion of false discoveries (q-value 0.2176). Key findings: We identified a number of HLA class I alleles in a population from Central Uganda which will enable us to carry out a functional characterization of CD8+ T-cell mediated immune responses to MTB. Our results also suggest that there may be a positive association between the HLA-A*03 allele and TB implying that individuals with the HLA-A*03 allele are at a higher risk of developing active TB.

Keywords: HLA, phenotype, tuberculosis, Uganda

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Authors: Bernardino Vinoya, Cassandra D. Batton, Samantha Gayle M. Bonavente, Johnson O. Canoza, Lhea Flynn B. Capones, Camille S. Dispo, Johanna Neilvin T. Dontogan, Louise Angelica C. Lipana, Charlene Pearl P. Navalta, Rechelle Vhen W. Payo-os, Mary Reyna D. Ridao, Rushnol Jade P. Tupac, Pauline B. Sol

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Parenting is preparing children for life as productive adults and discipline strategies are needed to achieve it like non-aggressive, psychologically aggressive and physical discipline. The effects of disciplinary strategies on children are well explored as evidenced by existing studies, local and international laws and active international organizations which are all brimmed towards child protection but status quo shows a profound scarcity of studies engaged in the effects of disciplining the child on the parent. To know the deeper unexplored reasons and untold stories of the parent, mainly the lived experiences of parents in disciplining their children. Design is descriptive phenomelogical. Participants were chosen using snowball purposive sampling. Data were collected through interview with the general question, “Ano ang mga karanasan ninyo sa pagdidisiplina ng inyong anak (What are your experiences when disciplining your child?)”, followed with unstructured questions. Collaizi method was used in analyzing data. Data collected was verified through focused group discussion. Results show three main themes: Reason, Disciplinary Strategy, and Aftermath. The use of disciplinary strategy is influenced by the experiences of the parent, the triggers like the child’s misbehavior and parental desires or wishes for the child. Disciplinary strategy can either be physical punishment or verbal. Parent’s generally used both when children disrespects or disobeys. Parents also experience both positive and negative effects on their physical, social, emotional aspects after disciplining their children. As a result, parents use coping mechanisms to maintain ego stability. Disciplining a child is a cyclical process. Parents, just like the child will also experience both positive and negative outcomes after using different disciplinary strategies. Future researchers can replicate study or use triangulation in multi-site qualitative and quantitative studies, professors can teach findings on parents in the concepts of pediatric nursing and apply the findings in the clinical area particularly when dealing with families.

Keywords: parents, disciplinary strategy, parental effects, pediatric nursing

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Authors: Johanna Lindstrom, Jacob Mickelsson

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Changes in the current media environment are transforming peoples’ everyday media consumption patterns all over the world. Digital media have become a natural, almost unavoidable, part of everyday lives of humans. While this has led to many positive consequences, there is also a growing concern for harmful effects. This paper contributes to knowledge about “the dark side” of media use by considering the topic of media addiction and subsequent coping strategies among young adults. The paper draws on a longitudinal media diary study conducted among young university students between the years 2013 and 2021. A total of 1029 diaries have been collected (approximately 100 each year), aiming at capturing the students’ everyday media behavior. In this paper, reflective narratives in the diaries have been analyzed, aiming at answering the following questions: Which of their own media behaviors do the students perceive as particularly destructive, addictive or problematic? How do they cope with such behaviors? Results from the study indicate a noticeable increase in reflections on addictive media behavior over the years. For example, compared to earlier years, the amount of such reflections significantly started to increase in the diaries in 2016 and 2017, and this trend has continued ever since. Furthermore, the nature of these reflections has changed, displaying a growing concern for one’s own excessive media use and general wellbeing. Media addiction seems particularly difficult to cope with as digital media is literally everywhere and media use in general is described as consistent and habitual, in terms of regularly repeated routines that are fragmented but performed continuously and often unintentionally throughout the day. Reflections on “the dark side” of everyday media consumption become particularly prominent in times of the Covid -19 pandemic. However, this trend was noticeable well before the pandemic started. The study also identifies a countertrend regarding reflections on how to deal and cope with problematic media behavioral patterns. This countertrend portrays a general development of increased awareness of factors that may trigger compulsive behavior and how to avoid or handle such trigger points. The countertrend is particularly evident in recent years, despite the ongoing pandemic and subsequent increases in time spent using media. Addictive media behavior may lead to severe consequences for students’ learning processes and general well-being. Increased awareness of this growing trend and coping strategies are needed on an individual as well as a broader educational level.

Keywords: coping strategies, media addiction, media behavior, well-being

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Authors: Denise Levy, Helen J. Khoury

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Nuclear technology is a controversial issue among a great share of the Brazilian population. Misinformation and common wrong beliefs confuse public’s perceptions and the scientific community is expected to offer a wider perspective on the benefits and risks resulting from ionizing radiation in everyday life. Attentive to the need of new approaches between science and society, the Nuclear Energy Museum, in northeast Brazil, is an initiative created to communicate the growing impact of the beneficial applications of nuclear technology in medicine, industry, agriculture and electric power generation. Providing accessible scientific information, the museum offers a rich learning environment, making use of different educational strategies, such as films, interactive panels and multimedia learning tools, which not only increase the enjoyment of visitors, but also maximize their learning potential. Developed according to modern active learning instructional strategies, multimedia materials are designed to present the increasingly role of nuclear science in modern life, transforming science education into a meaningful learning experience. In year 2016, nine different interactive computer-based activities were developed, presenting curiosities about ionizing radiation in different landmarks around the world, such as radiocarbon dating works in Egypt, nuclear power generation in France and X-radiography of famous paintings in Italy. Feedback surveys have reported a high level of visitors’ satisfaction, proving the high quality experience in learning nuclear science at the museum. The Nuclear Energy Museum is the first and, up to the present time, the only permanent museum in Brazil devoted entirely to nuclear science.

Keywords: nuclear technology, multimedia learning tools, science museum, society and education

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Authors: Yetunde M. Dairo, Johnny Collett, Helen Dawes

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Background and Aim: Engagement with physical activity (PA) research is poor among adults with intellectual disabilities (ID), particularly in those from residential homes. This study explored why, by asking managers of residential homes, adults with ID and their carers. Methods: Participants: A convenient sample of 23 individuals from two UK local authorities, including a group of ID residential home managers, adults with ID and their support staff. Procedures: A) Residential home managers (n=6) were asked questions about their willingness to allow their residents to participate in PA research; B) eleven adults with ID and their support workers (n=6) were asked questions about their willingness to accept 7-day accelerometer monitoring and/or the International Physical Activity Questionnaire-short version (IPAQ-s) as PA measures. The IPAQ-s was administered by the researcher and they were each provided with samples of accelerometers to try on. Results: A) Five out of six managers said that the burden of wearing the accelerometer for seven days would be too high for the people they support, the majority of whom might be unable to express their wishes. They also said they would be unwilling to act as proxy respondents for the same reason. Additionally, they cited time pressure, understaffing, and reluctance to spend time on the research paperwork as further reasons for non-participation. B) All 11 individuals with ID completed the IPAQ-s while only three accepted the accelerometer, one of whom was deemed inappropriate to wear it. Reasons for rejecting accelerometers included statements from participants of: ‘too expensive’, ‘too heavy’, ‘uncomfortable’, and two people said they would not want to wear it for more than one day. All adults with ID (11) and their support workers (6) provided information about their physical activity levels through the IPAQ-s. Conclusions: Care home managers are a barrier to research participation. However, adults with ID would be happy for the IPAQ-s as a PA measure, but less so for the 7-day accelerometer monitoring. In order to improve participation in this population, the choice of PA measure is considered important. Moreover, there is a need for studies exploring how best to engage ID residential home managers in PA research.

Keywords: intellectual disability, physical activity measurement, research engagement, research participation

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Authors: Helen Pluut, Remus Ilies, Nikos Dimotakis, Maral Darouei

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This study aims to examine recovery from work as an important daily activity with implications for workplace behavior. Building on affective events theory and the stressor-detachment model as frameworks, this paper proposes and tests a comprehensive within-individual model that uncovers the role of recovery processes at home in linking workplace demands (e.g., workload) and stressors (e.g., workplace incivility) to next-day organizational citizenship behaviors (OCBs). Our sample consisted of 126 full-time employees in a large Midwestern University. For a period of 16 working days, these employees were asked to fill out 3 electronic surveys while at work. The first survey (sent out in the morning) measured self-reported sleep quality, recovery experiences the previous day at home, and momentary effect. The second survey (sent out close to the end of the workday) measured job demands and stressors as well as OCBs, while the third survey in the evening assessed job strain. Data were analyzed using Hierarchical Linear Modeling (HLM). Results indicated that job demands and stressors at work made it difficult to unwind properly at home and have a good night’s sleep, which had repercussions for next day’s morning effect, which, in turn, influenced OCBs. It can be concluded that processes of recovery are vital to an individual’s daily effective functioning and behavior at work, but recovery may become impaired after a hard day’s work. Thus, our study sheds light on the potentially persistent nature of strain experienced as a result of work and points to the importance of recovery processes to enable individuals to avoid such cross-day spillover. Our paper will discuss this implication for theory and practice as well as potential directions for future research.

Keywords: affect, job demands, organizational citizenship behavior, recovery, strain

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Authors: Hassen Mohammed, Michelle Clarke, Helen Marshall

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Maternal immunization is an effective strategy to protect pregnant women and their offspring from vaccine-preventable diseases. Despite the recommendation of maternal influenza and more recently pertussis immunization in Australia, uptake of these vaccines has been suboptimal. Monitoring the impact of the current funded vaccine programs for pregnant women is limited. The study aimed to assess the impact of the funded program and determine factors associated with vaccine uptake in pregnant women. This observational prospective study was undertaken between November 2014 and July 2016 at the Women’s and Children’s Hospital in South Australia (WCH). Demographic details and vaccination history from South Australian pregnant women who attended the WCH were reviewed. A standardized self-reported survey was conducted in antenatal care with a follow up telephone interview at 8-10 weeks post-delivery. A midwife delivered immunization program for pregnant women in antenatal clinic commenced in April 2015. Of the 180 pregnant women who completed the survey questionnaire, 75.5% and 80.5 % received maternal influenza and pertussis vaccines respectively. First-time mothers had twice the odds of having received influenza vaccine during pregnancy than multiparous women (OR 2.4; CI 1.14 - 4.94; p= 0.021). The proportion of women who received pertussis vaccine during pregnancy, following the introduction of the midwife delivered pertussis vaccination program (140/155, 90.3%) was significantly higher compared with women who received maternal pertussis vaccination prior to the introduction of the program (5/22, 23.7%, p < 0.001). The odds of women receiving maternal pertussis vaccine following the implementation of the midwife delivered program were 31 times higher than women who delivered babies prior to the program (OR 31.7, CI 10.24- 98.27; p < 0.001). High uptake of influenza and pertussis vaccines during pregnancy can be attained with health care provider recommendation and inclusion of maternal immunization as part of standard antenatal care.

Keywords: influenza, maternal immunization, pertussis, provider recommendation

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Authors: Helen L. Hein, Joachim Schwarte

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As a pillar of sustainable development, ecology has become an important milestone in research community, especially due to global challenges like climate change. The ecological performance of products can be scientifically conducted with life cycle assessments. In the construction sector, significant amounts of CO₂ emissions are assigned to the energy used for building heating purposes. Therefore, sustainable construction materials for insulating purposes are substantial, whereby aerogels have been explored intensively in the last years due to their low thermal conductivity. Therefore, the WALL-ACE project aims to develop an aerogel-based thermal insulating plaster that would achieve minor thermal conductivities. But as in the early stage of development phases, a lot of information is still missing or not yet accessible, the ecological performance of innovative products bases increasingly on uncertain data that can lead to significant deviations in the results. To be able to predict realistically how meaningful the results are and how viable the developed products may be with regard to their corresponding respective market, these deviations however have to be considered. Therefore, a classification method is presented in this study, which may allow comparing the ecological performance of modern products with already established and competitive materials. In order to achieve this, an alternative calculation method was used that allows computing with lower and upper bounds to consider all possible values without precise data. The life cycle analysis of the considered products was conducted with an interval arithmetic based calculation method. The results lead to the conclusion that the interval solutions describing the possible environmental impacts are so wide that the result usability is limited. Nevertheless, a further optimization in reducing environmental impacts of aerogels seems to be needed to become more competitive in the future.

Keywords: aerogel-based, insulating material, early development phase, interval arithmetic

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Authors: Sa'ad M. Ismail, Hung-Hsun Yen, Christina M. Murray, Helen M. S. Davies

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In the dog, the median sacral crest is formed by the fusion of three sacral spinous processes. In greyhounds with standard sacrums, this fusion in the median sacral crest consists of the fusion of three sacral spinous processes while it consists of four in greyhounds with sacrocaudal fusion. In the present study, variations in the angulation of the first sacral spinous process in association with different types of sacrocaudal fusion in the greyhound were investigated. Sacrums were collected from 207 greyhounds (102 sacrums; type A (unfused) and 105 with different types of sacrocaudal fusion; types: B, C and D). Sacrums were cleaned by boiling and dried and then were placed on their ventral surface on a flat surface and photographed from the left side using a digital camera at a fixed distance. The first sacral spinous process angle (1st SPA) was defined as the angle formed between the cranial border of the cranial ridge of the first sacral spinous process and the line extending across the most dorsal surface points of the spinous processes of the S1, S2, and S3. Image-Pro Express Version 5.0 imaging software was used to draw and measure the angles. Two photographs were taken for each sacrum and two repeat measurements were also taken of each angle. The mean value of the 1st SPA in greyhounds with sacrocaudal fusion was less (98.99°, SD ± 11, n = 105) than those in greyhounds with standard sacrums (99.77°, SD ± 9.18, n = 102) but was not significantly different (P < 0.05). Among greyhounds with different types of sacrocaudal fusion the mean value of the 1st SPA was as follows: type B; 97.73°, SD ± 10.94, n = 39, type C: 101.42°, SD ± 10.51, n = 52, and type D: 94.22°, SD ± 11.30, n = 12. For all types of fusion these angles were significantly different from each other (P < 0.05). Comparing the mean value of the1st SPA in standard sacrums (Type A) with that for each type of fusion separately showed that the only significantly different angulation (P < 0.05) was between standard sacrums and sacrums with sacrocaudal fusion sacrum type D (only body fusion between the S1 and Ca1). Different types of sacrocaudal fusion were associated with variations in the angle of the first sacral spinous process. These variations may affect the alignment and biomechanics of the sacral area and the pattern of movement and/or the force produced by both hind limbs to the cranial parts of the body and may alter the loading of other parts of the body. We concluded that any variations in the sacrum anatomical features might change the function of the sacrum or surrounding anatomical structures during movement.

Keywords: angulation of first sacral spinous process, biomechanics, greyhound, locomotion, sacrocaudal fusion

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Authors: Johanna Sagner, María José Sandoval

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At the early stages of adolescence, young people, regardless of a disability or not, start to establish closer friendship ties. Unlike previous developmental phases, these ties are rather reciprocal, more committed, and require more time. Friendship ties during adolescence allow the development of social and personal skills, specifically the skills to start constructing identity. In an inclusive context that incorporates young people with a disability, friendship among peers also takes place. Nonetheless, the relation is shaped, among others, by the alterity construction about the other with disability. Research about peers’ relation between young people with and without disability in an inclusive context has shown that the relation tends to become a helper-helpee relation, where those with a disability are seen as people in need. Prejudices about the others’ condition or distancing from the other because of his/hers disability are common. In this sense, the helper-helpee relation, as a non-reciprocal and protective relation, will not promote friendship between classmates, but a rather asymmetric alterity. Our research is an explorative case study that wants to know how the relation between peers is shaped within a different inclusive program, were also the integrated group has special educational needs. Therefore, we analyze from a qualitative and quantitative approach the data of an inverted inclusive program. This is a unique case of a special public school for visual disability in Germany that includes young people from a mainstream school who had learning difficulties. For the research, we analyze data from interviews, focal interviews and open-ended questions with an interpretative phenomenological analysis approach. The questionnaires include a five point Likert scale, for which we calculate the acceptance rate. The findings show that the alterity relation between pupils is less asymmetrical and represents a rather horizontal alterity. The helper-helpee relation is marked by exchange, since both groups have special educational needs and therefore, those with visual disability and those with learning difficulties help each other indistinctly. Friendship is more present among classmates. The horizontal alterity peers’ relation is influenced by a sort of tie, where none of the groups need more or less help than other groups. Both groups identify that they themselves and the other have special needs. The axiological axe of alterity is not of superiority or inferiority, recognizing each other’s differences and otherness. Another influential factor relates with the amount of time they spend together, since the program does not have a resource room or a teacher who teaches parallel lessons. Two probable causes for that rather equal peer relation might be the constellation of fewer pupils per classroom and the differentiated lessons taught by teachers with a special educational formation.

Keywords: alterity, disability, inverted inclusion, peers’ relation

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Authors: Natasha Botha, Gary Corderely, Helen M. Inglis

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With the move to cleaner energy applications the transport industry is working towards on-board hydrogen, or compressed natural gas-fuelled vehicles. A popular method for storage is to use composite overwrapped pressure vessels (COPV) because of their high strength to weight ratios. The proper design of these COPVs are according to international standards; this study aims to provide a preliminary design for a 350 Bar Type IV COPV (i.e. a polymer liner with a composite overwrap). Netting analysis, a popular analytical approach, is used as a first step to generate an initial design concept for the composite winding. This design is further improved upon by following the American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel standards, Section X: Fibre-reinforced composite pressure vessels. A design program based on these two approaches is developed using Python. A numerical model of a burst test simulation is developed based on the two approaches and compared. The results indicate that the netting analysis provides a good preliminary design, while the ASME-based design is more robust and accurate as it includes a better approximation of the material behaviour. Netting analysis is an easy method to follow when considering an initial concept design for the composite winding when not all the material characteristics are known. Once these characteristics have been fully defined with experimental testing, an ASME-based design should always be followed to ensure that all designs conform to international standards and practices. Future work entails more detailed numerical testing of the design for improvement, this will include the boss design. Once finalised prototype manufacturing and experimental testing will be conducted, and the results used to improve on the COPV design.

Keywords: composite overwrapped pressure vessel, netting analysis, design, American Society of Mechanical Engineers section x, fiber-reinforced, hydrogen storage

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Authors: Shrawan Baghel, Helen Cathcart, Biall J. O'Reilly

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Amorphous drug formulations have great potential to enhance solubility and thus bioavailability of BCS class II drugs. However, the higher free energy and molecular mobility of the amorphous form lowers the activation energy barrier for crystallization and thermodynamically drives it towards the crystalline state which makes them unstable. Accurate determination of the crystallization tendency/kinetics is the key to the successful design and development of such systems. In this study, dipyridamole (DPM) and cinnarizine (CNZ) has been selected as model compounds. Thermodynamic fragility (m_T) is measured from the heat capacity change at the glass transition temperature (Tg) whereas dynamic fragility (m_D) is evaluated using methods based on extrapolation of configurational entropy to zero 〖(m〗_(D_CE )), and heating rate dependence of Tg 〖(m〗_(D_Tg)). The mean relaxation time of amorphous drugs was calculated from Vogel-Tammann-Fulcher (VTF) equation. Furthermore, the correlation between fragility and glass forming ability (GFA) of model drugs has been established and the relevance of these parameters to crystallization of amorphous drugs is also assessed. Moreover, the crystallization kinetics of model drugs under isothermal conditions has been studied using Johnson-Mehl-Avrami (JMA) approach to determine the Avrami constant ‘n’ which provides an insight into the mechanism of crystallization. To further probe into the crystallization mechanism, the non-isothermal crystallization kinetics of model systems was also analysed by statistically fitting the crystallization data to 15 different kinetic models and the relevance of model-free kinetic approach has been established. In addition, the crystallization mechanism for DPM and CNZ at each extent of transformation has been predicted. The calculated fragility, glass forming ability (GFA) and crystallization kinetics is found to be in good correlation with the stability prediction of amorphous solid dispersions. Thus, this research work involves a multidisciplinary approach to establish fragility, GFA and crystallization kinetics as stability predictors for amorphous drug formulations.

Keywords: amorphous, fragility, glass forming ability, molecular mobility, mean relaxation time, crystallization kinetics, stability

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Authors: Manisha Massey, Mariette Berndsen, Helen McLaren

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The existing body of literature concerning the incidence, prevalence, and experiences of childhood sexual abuse (CSA) lacked cultural inclusivity, primarily reflecting Euro-centric perspectives. This study investigated and reviewed the existing literature to understand the experiences of women of color from South Asia, addressing the gap in understanding how culture and diversity impact CSA. While individualist cultures emphasize autonomy, collectivist societies prioritize interdependence. South Asia's diverse intersections, including gender, caste, religion, and class, have intensified child sexual exploitation, challenging assumed homogeneity and safety. Additionally, the power exploitation in the space of abuse and grooming supplementing with the prevalence of honor violence makes disclosures of sexual abuse for children daunting and unsafe in these cultures. This scoping review examined the connection between CSA, psychological trauma, re-traumatization, and shame among adult South Asian women from India, Pakistan, and Bangladesh. Despite distinct borders, these countries share historical, linguistic, and traditional ties. Following PRISMA guidelines, the review employed thematic analysis. Findings underscored cultural factors' influence on CSA incidence, help-seeking barriers, and treatment challenges. The pivotal role of shame (sharam) and honor (izzat) in disclosure and healing processes was highlighted. The study emphasized the need for culturally sensitive interventions while noting limited literature on re-traumatisation. Incorporating a culturally informed perspective, this research aims to decolonize trauma therapy by contributing to the CSA discourse, shedding light on its intricate interaction with trauma, shame, and healing among South Asian women.

Keywords: Childhood sexual abuse, decolonizing psychology, trauma, re-trauma, shame

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Authors: Helen Coronel, Will Brewer, Peggy Bergeron, Clarissa Hall, Victoria Casson

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Simulation-based training provides the nurse practitioner (NP) student with a safe and controlled environment in which they can practice a real-life scenario. This type of learning fosters critical thinking skills essential to practice. The expectation of this study was that students would have an increase in their competency and confidence after performing the simulation. Approximately 8.4% of Americans suffer from depression. The state of Alabama is ranked 47th out of 50 for access to mental health care. As a result of this significant shortage of mental health providers, primary care providers are frequently put in the position of screening for and treating mental health conditions, such as depression. Family nurse practitioners are often utilized as primary care providers, making their ability to assess, diagnose and treat these disorders a necessary skill. The expected outcome of this simulation is an increase in confidence, competency and the empowerment of the nurse practitioner student’s ability to assess, diagnose and treat a common mood disorder they may encounter in practice. The Kirkpatrick Module was applied for this study. A non-experimental design using descriptive statistical analysis was utilized. The simulation was based on a common psychiatric mood disorder frequently observed in primary care and mental health clinics. Students were asked to watch a voiceover power point presentation prior to their on-campus simulation. The presentation included training on the assessment, diagnosis, and treatment of a patient with depression. Prior to the simulation, the students completed a pre-test, then participated in the simulation, and completed a post-test when done. Apple iPads were utilized to access a simulated health record. Major findings of the study support an increase in students’ competency and confidence when assessing, diagnosing, and treating an adult patient with depression.

Keywords: advanced practice, nurse practitioner, simulation, primary care, depression

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Authors: Daniel Faraj, Arabella Raupach, Charlotte Hespe, Helen Wilcox, Kristie-Lee Anning

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Aim: International child sponsorship programs comprise a considerable proportion of global aid accessible to the general population. Team Philippines (TP), a healthcare and welfare initiative run in association with the University of Notre Dame Sydney since 2013, leads a holistic sponsorship program for thirty children from Calauan, Philippines. To date, empirical research has not been performed on the overall success and impact of the TP child sponsorship program. As such, this study aims to evaluate its effectiveness in improving pediatric outcomes. Methods: Study cohorts comprised thirty sponsored and twenty-nine age- and gender-matched non-sponsored children. Data were extracted from the TP Medical Director database and lifestyle questionnaires for July-November 2019. Outcome measures included anthropometry, markers of medical health, dental health, exercise, and diet. Statistical analyses were performed in SPSS. Results: Sponsorship resulted in fewer medical diagnoses and prescription medications, superior dental health, and improved diet. Further, sponsored children may show a clinically significant trend toward improved physical health. Sponsorship did not affect growth and development metrics or levels of physical activity. Conclusions: The TP child sponsorship program significantly impacts positive pediatric health outcomes in the Calauan community. The strength of the program lies in its holistic, sustainable, and community-based model, which is enabled by effective international child sponsorship. This study further supports the relationship between supporting early livelihood and improved health in the pediatric population.

Keywords: child health, public health, health status disparities, healthcare disparities, social determinants of health, morbidity, community health services, culturally competent care, medically underserved areas, population health management, Philippines

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Authors: Styliani Soulioti, Helen Fiddler

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The aim of this study was to investigate the approaches used by physiotherapists in the education of patients with chronic low back pain (cLBP) and the rationale that underpins their choice of approach. Therapeutic patient education (TPE) is considered to be an important aspect of modern physiotherapy practice, as it helps patients achieve better self-management and a better understanding of their problem. Previous studies have explored this subject, but the reasoning behind the choices physiotherapists make as educators has not been widely explored, thus making it difficult to understand areas that could be addressed in order to improve the application of TPE.A qualitative study design, guided by a constructivist epistemology was used in this research project. Semi-structured interviews were used to collect data from 7 physiotherapists. Inductive coding and thematic analysis were used, which allowed key themes to emerge. Data analysis revealed two overarching themes: 1) patient-centred versus therapist-centred educational approaches, and 2) behaviourist versus constructivist educational approaches. Physiotherapists appear to use a patient-centred-approach when they explore patients’ beliefs about cLBP and treatment expectations. However, treatment planning and goal-setting were guided by a therapist-centred approach, as physiotherapists appear to take on the role of the instructor/expert, whereas patients were viewed as students. Using a constructivist approach, physiotherapists aimed to provide guidance to patients by combining their professional knowledge with the patients’ individual knowledge, to help the patient better understand their problem, reflect upon it and find a possible solution. However, educating patients about scientific facts concerning cLBP followed a behaviourist approach, as an instructor/student relationship was observed and the learning content was predetermined and transmitted in a one-way manner. The results of this study suggest that a lack of consistency appears to exist in the educational approaches used by physiotherapists. Although patient-centeredness and constructivism appear to be the aims set by physiotherapists in order to optimise the education they provide, a student-teacher relationship appears to dominate when it comes to goal-setting and delivering scientific information.

Keywords: chronic low back pain, educational approaches, health education, patient education

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