Search results for: early intensive behavioral intervention

Authors: Rosa S. Wong, Keith T. S. Tung, Frederick K. Ho, Winnie W. Y. Tso, King-wa Fu, Nirmala Rao, Patrick Ip

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As technology advances, exposures in early childhood are no longer confined to stimulations in the surrounding physical environments. Children nowadays are also subject to influences from the digital world. In particular, early access to game consoles can cause risks to child development, especially when the game is not developmentally appropriate for young children. Overstimulation is possible and could impair brain development. On the other hand, recreational parent-child activities, including outdoor activities and visits to museums, require child interaction with parents, which is beneficial for developing adaptive emotion regulation and social skills. Given the differences between these two types of exposures, this study investigated and compared the independent effects of early exposure to a game console and early play-based parent-child activities on children’s long-term psychosocial outcomes. This study used data from a subset of children (n=304, 142 male and 162 female) in the longitudinal cohort study, which studied the long-term impact of family socioeconomic status on child development. In 2012/13, we recruited a group of children at Kindergarten 3 (K3) randomly from Hong Kong local kindergartens and collected data regarding their duration of exposure to game console and recreational parent-child activities at that time. In 2018/19, we re-surveyed the parents of these children who were matriculated as Form 1 (F1) students (ages ranging from 11 to 13 years) in secondary schools and asked the parents to rate their children’s psychosocial problems in F1. Linear regressions were conducted to examine the associations between early exposures and adolescent psychosocial problems with and without adjustment for child gender and K3 family socioeconomic status. On average, K3 children spent about 42 minutes on a game console every day and had 2-3 recreational activities with their parents every week. Univariate analyses showed that more time spent on game consoles at K3 was associated with more psychosocial difficulties in F1 particularly more externalizing problems. The effect of early exposure to game console on externalizing behavior remained significant (B=0.59, 95%CI: 0.15 to 1.03, p=0.009) after adjusting for recreational parent-child activities and child gender. For recreational parent-child activities at K3, its effect on overall psychosocial difficulties became insignificant after adjusting for early exposure to game consoles and child gender. However, it was found to have significant protective effect on externalizing problems (B=-0.65, 95%CI: -1.23 to -0.07, p=0.028) even after adjusting for the confounders. Early exposure to game consoles has negative impact on children’s psychosocial health, whereas play-based parent-child activities can foster positive psychosocial outcomes. More efforts should be directed to propagate the risks and benefits of these activities and urge the parents and caregivers to replace child-alone screen time with parent-child play time in daily routine.

Keywords: early childhood, electronic device, parenting, psychosocial wellbeing

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Authors: Undiyaundeye Florence Atube, Ugar Innocent A.

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Young children are active learners who use all their senses to build concepts and ideas from their experiences. The process of learning, the content and the outcomes, is vital for young children. They need time to explore whether they are satisfied with what is learnt. Of all levels of education, early childhood education is considered to be most critical for the social, emotional, cognitive and physical development. For this reason, the teachers for early years need to play a significant role in the teaching and learning process through the provision of a friendly environment in the school. A case study approach was used in this study. The information was gathered through various methods like class observation, field notes, documents analysis, group processes, and semi structured interviews. The group processes participants and interviewees were taken from some stakeholders such as parents, students, teachers, and head teachers from public schools, to have a broad and comprehensive analysis, informal interaction with different stakeholders and self-reflection was used to clarify aspects of varying issues and findings. The teachers’ roles in developing a child friendly environment in personal capacity to learning were found to improve a pupils learning ability. Prior to early child development education, learning experiences and pedagogical content knowledge played a vital role in engaging teachers in developing their thinking and teaching practice. Children can be helped to develop independent self-control and self-reliance with careful planning and development of the child’s experience with sensitive and appropriate interaction by the educator to propel eagerness to learn through the provision of a friendly environment.

Keywords: child friendly environment, early childhood, education and development, teaching, learning and the curriculum

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Authors: Shweta Jha, Digambar Darekar, Krishna Kadam

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Major Depressive Disorder (MDD) is one of the most common of psychiatric disorders. It has a wide range of symptoms, aetiologies and risk factors, and these reasons make MDD affect not only the primary patient, but also their family, caregivers and associates; by negatively impacting their self dignity, economic condition and self-confidence. Thus, it is important to help individuals suffering from MDD learn adaptive mechanism and deal effectively with their environment, with that aim this study focused on a comparative therapeutic intervention using Behaviour Activation (BA), Rational Emotive Behaviour Therapy (REBT) and Waiting list control (WLC) for management of MDD. This study apart from enhancing personal skills will also help us understand which therapeutic method would be more beneficial in treating and prolonging relapse in patients with MDD in Indian population. Fifteen individuals following application of inclusion and exclusion criteria were selected as study samples. They were randomly assigned to three treatment groups. Ten sessions of therapy, forty-five minutes each according to the proposed sessions plan were conducted for each group. The individuals selected as samples were re–assessed after 2 months and 6 months post intervention. The overall result showed that individuals treated with BA and REBT showed more improvement in comparison to those in WLC.

Keywords: behaviour activation, major depressive disorder, rational emotive behaviour therapy, therapeutic intervention

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Authors: Tomas Makaras, Gintaras Svecevičius

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Landfill waste is a common problem as it has an economic and environmental impact even if it is closed. Landfill waste contains a high density of various persistent compounds such as heavy metals, organic and inorganic materials. As persistent compounds are slowly-degradable or even non-degradable in the environment, they often produce sublethal or even lethal effects on aquatic organisms. The aims of the present study were to estimate sublethal effects of the Kairiai landfill (WGS: 55°55‘46.74“, 23°23‘28.4“) leachate on the locomotor activity of rainbow trout Oncorhynchus mykiss juveniles using the original system package developed in our laboratory for automated monitoring, recording and analysis of aquatic organisms’ activity, and to determine patterns of fish behavioral response to sublethal effects of leachate. Four different concentrations of leachate were chosen: 0.125; 0.25; 0.5 and 1.0 mL/L (0.0025; 0.005; 0.01 and 0.002 as part of 96-hour LC50, respectively). Locomotor activity was measured after 5, 10 and 30 minutes of exposure during 1-minute test-periods of each fish (7 fish per treatment). The threshold-effect-concentration amounted to 0.18 mL/L (0.0036 parts of 96-hour LC50). This concentration was found to be even 2.8-fold lower than the concentration generally assumed to be “safe” for fish. At higher concentrations, the landfill leachate solution elicited behavioral response of test fish to sublethal levels of pollutants. The ability of the rainbow trout to detect and avoid contaminants occurred after 5 minutes of exposure. The intensity of locomotor activity reached a peak within 10 minutes, evidently decreasing after 30 minutes. This could be explained by the physiological and biochemical adaptation of fish to altered environmental conditions. It has been established that the locomotor activity of juvenile trout depends on leachate concentration and exposure duration. Modeling of these parameters showed that the activity of juveniles increased at higher leachate concentrations, but slightly decreased with the increasing exposure duration. Experiment results confirm that the behavior of rainbow trout juveniles is a sensitive and rapid biomarker that can be used in combination with the system for fish behavior monitoring, registration and analysis to determine sublethal concentrations of pollutants in ambient water. Further research should be focused on software improvement aimed to include more parameters of aquatic organisms’ behavior and to investigate the most rapid and appropriate behavioral responses in different species. In practice, this study could be the basis for the development and creation of biological early-warning systems (BEWS).

Keywords: fish behavior biomarker, landfill leachate, locomotor activity, rainbow trout juveniles, sublethal effects

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Authors: Angelina Tarabokija

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This study looks into how cognitive behavioral training (CBT) techniques affect collegiate track and field athletes' anxiety related to performance, with a focus on distance runners. The goal of the research is to discover whether consistent use of cognitive behavioral therapy (CBT) methods, such as progressive muscle relaxation, yoga (Y-CBT), visualization, relaxed breathing, and meditation, can reduce performance anxiety and improve sports performance. Six runners from the Rider Track & Field team, aged eighteen to twenty-three, participated in the quantitative research design used in the technique. Prior to employing CBT techniques every day for two weeks, including before competitions or on race day, participants conducted baseline assessments using the Sport Anxiety Scale-2 (SAS-2). The SAS-2 was used in post-competition evaluations to track alterations in performance anxiety. The findings show that participants' total trait anxiety levels significantly decreased after utilizing CBT techniques for one week. However, after two weeks, a few participants' anxiety levels slightly increased, pointing to the need for more research and regular practice. The study indicates that CBT approaches can effectively reduce performance anxiety and increase athletic performance in collegiate track and field athletes, despite constraints related to participant motivation and potential confounding variables. Future areas for research could entail examining the precise impacts of worry, interruption of attention, and bodily anxiety on performance, as well as adding more controls. Overall, by providing insights into evidence-based strategies to maximize mental states and athletic performance in collegiate athletes, this study advances the area of sports psychology.

Keywords: cognitive behavioral training, performance, athletes, anxiety, well-being, SAS-2, Sport, trait anxiety, somatic anxiety

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Authors: Habtamu Wolde Engudai

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Background: Sedation can be provided to facilitate a procedure or to stabilize patients admitted in pediatric intensive care unit (PICU). Sedation is often necessary to maintain optimal care for critically ill children requiring mechanical ventilation. However, if sedation is too deep or too light, it has its own adverse effects, and hence, it is important to monitor the level of sedation and maintain an optimal level. Objectives: The objective is to assess the level of sedation and associated factors among intubated critically ill children admitted to PICU of JUMC, Jimma. Methods: A prospective observation study was conducted in the PICU of JUMC in September 2021 in 105 patients who were going to be admitted to the PICU aged less than 14 and with GCS >8. Data was collected by residents and nurses working in PICU. Data entry was done by Epi data manager (version 4.6.0.2). Statistical analysis and the creation of charts is going to be performed using SPSS version 26. Data was presented as mean, percentage and standard deviation. The assumption of logistic regression and the result of the assumption will be checked. To find potential predictors, bi-variable logistic regression was used for each predictor and outcome variable. A p value of <0.05 was considered as statistically significant. Finally, findings have been presented using figures, AOR, percentages, and a summary table. Result: in this study, 105 critically ill children had been involved who were started on continuous or intermittent forms of sedative drugs. Sedation level was assessed using a comfort scale three times per day. Based on this observation, we got a 44.8% level of suboptimal sedation at the baseline, a 36.2% level of suboptimal sedation at eight hours, and a 24.8% level of suboptimal sedation at sixteen hours. There is a significant association between suboptimal sedation and duration of stay with mechanical ventilation and the rate of unplanned extubation, which was shown by P < 0.05 using the Hosmer-Lemeshow test of goodness of fit (p> 0.44).

Keywords: level of sedation, critically ill children, Pediatric intensive care unit, Jimma university

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Authors: Rivindu Nethmin Bandara Menik Hitihamy Mudiyanselage, Matthias Hank Haeusler, Ben Doherty

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Investors and clients in the Architectural, Engineering and Construction industry find it difficult to understand complex datasets and reports with little to no graphic representation. The stakeholders examined in this paper include designers, design clients and end-users. Communicating embodied carbon information graphically and concisely can aid with decision support early in a building's life cycle. It is essential to create a common visualisation approach as the level of knowledge about embodied carbon varies between stakeholders. The tool, designed in conjunction with Bates Smart, condenses Tally Life Cycle Assessment data to a carbon hot-spotting visualisation, highlighting the sections with the highest amounts of embodied carbon. This allows stakeholders at every stage of a given project to have a better understanding of the carbon implications with minimal effort. It further allows stakeholders to differentiate building elements by their carbon values, which enables the evaluation of the cost-effectiveness of the selected materials at an early stage. To examine and build a decision-support tool, an action-design research methodology of cycles of iterations was used along with precedents of embodied carbon visualising tools. Accordingly, the importance of visualisation and Building Information Modelling are also explored to understand the best format for relaying these results.

Keywords: embodied carbon, visualisation, summarisation, data filtering, early-stage decision-making, materiality

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Authors: N. Dunleavy, E. Lovemore, K. Siljeur, D. Jackson, M. Hendricks, M. Hoosain, N. Plastow, S. Marais

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Background: The work requirements of sewing machine operators cause physical and emotional strain. Past ergonomic interventions have been provided to alleviate physical concerns; however, a holistic, multimodal intervention was needed to improve these factors. Aim: The study aimed to examine the effect of an occupational therapy programme on sewing machine operators’ pain, mental health, and productivity within a factory in the South African context. Methods: A pilot randomised control trial was conducted with 22 sewing machine operators within a single factory. Stratified randomisation was used to determine the experimental (EG) and control groups (CG), using measures for pain intensity, level of depression (mental health), and productivity rates as stratification variables. The EG received the multimodal intervention, incorporating education, seating adaptations, and mental health intervention. In three months, the CG will receive the same intervention. Pre- and post-intervention testing have occurred with upcoming three- and six-month follow-ups. Results: Immediate results indicate a statistically significant decrease in pain in both experimental and control groups; no change in productivity scores and depression between the two groups. This may be attributed to external factors. The values for depression further showed no statistical significance between the two groups and within pre-and post-test results. The Statistical Program for Social Sciences (SPSS) version-24 was used as the data analysis testing, where all the tests will be evaluated at a 5% significance level. Contribution of research: The research adds to the body of knowledge informing the Occupational Therapy role in work settings, providing evidence on the effectiveness of workplace-based multimodal interventions. Conclusion: The study provides initial data on the effectiveness of a pilot randomised control trial on pain and mental health in South Africa. Results indicated no quantitative change between the experimental and control groups; however, qualitative data suggest a clinical significance of the findings.

Keywords: ergonomics programme, occupational therapy, sewing machine operators, workplace-based multimodal interventions

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Authors: Yumei Han, Naiqing Song, Xiaoping Yang, Yuping Han

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This study explores the conceptualization of key competencies that children are expected to develop in three year preschools (age 3-6) and the assessment practices of such key competencies in China. Assessment of children development has been put into the central place of early childhood education quality evaluation system in China. In the context of students key competencies development centered education reform in China, defining and selecting key competencies of children in preschools are of great significance in that they would lay a solid foundation for children’s lifelong learning path, and they would lead to curriculum and instruction reform, teacher development reform as well as quality evaluation reform in the early childhood education area. Based on sense making theory and framework, this study adopted multiple stakeholders’ (early childhood educators, parents, evaluation administrators, scholars in the early childhood education field) perspectives and grass root voices to conceptualize and operationalize key competencies for children in preschools in Southwest China. On the ground of children development theories, Chinese and international literature related to children development and key competencies, and key competencies frameworks by UNESCO, OECD and other nations, the authors designed a two-phase sequential mixed method study to address three main questions: (a) How is early childhood key competency defined or labeled from literature and from different stakeholders’ views? (b) Based on the definitions explicated in the literature and the surveys on different stakeholders, what domains and components are regarded to constitute the key competency framework of children in three-year preschools in China? (c) How have early childhood key competencies been assessed and measured, and how such assessment and measurement contribute to enhancing early childhood development quality? On the first phase, a series of focus group surveys were conducted among different types of stakeholders around the research questions. Moreover, on the second phase, based on the coding of the participants’ answers, together with literature synthesis findings, a questionnaire survey was designed and conducted to select most commonly expected components of preschool children’s key competencies. Semi-structured open questions were also included in the questionnaire for the participants to add on competencies beyond the checklist. Rudimentary findings show agreeable concerns on the significance and necessity of conceptualization and assessment of key competencies for children in preschools, and a key competencies framework composed of 7 domains and 25 indicators was constructed. Meanwhile, the findings also show issues in the current assessment practices of children’s competencies, such as lack of effective assessment tools, lack of teacher capacity in applying the tools to evaluating children and advancing children development accordingly. Finally, the authors put forth suggestions and implications for China and international communities in terms of restructuring early childhood key competencies framework, and promoting child development centered reform in early childhood education quality evaluation and development.

Keywords: assessment, conceptualization, early childhood education quality in China, key competencies

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Authors: Opara Monica Onyinyechi, Ahmad Iqmer Nashriq Mohd Nazan, Suriani Ismail

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Introduction: Global estimates of malaria indicate that at least 3.3 billion people are at risk of being infected with malaria and 1.2 billion are at high risk. The review investigates the effectiveness of health education strategies to increase the level of malaria knowledge and ITN ownership among the populations of sub-Sahara African countries. Methods: A literature search was conducted using Science direct, CINAHL, PubMed, Prisma, Pico, Cochrane library and PsycINFO databases to retrieve articles published between 2000 until 2020. Eleven studies that reported on malaria prevention and intervention using health education strategies conducted in sub-Saharan Africa were included in the final review. Results: Four studies used educational interventions to teach appropriate ITN strategies and promote ITN usage. Two others focused on improving knowledge of malaria transmission, prevention, treatment, and its signs and symptoms. The remaining five studies assessed both ITN use and malaria knowledge. Of these, 10 were eligible for meta-analysis. On average, health education interventions significantly increase the odds of a person in the intervention group to report better malaria knowledge (odds ratio 1.30, 95% CI: 1.00 to 1.70, P= 0.05) and higher ITN ownership (odds ratio 1.53, 95% CI: 1.02 to 2.29, P= 0.004) compared to those in the control group. The odds of ITN ownership also substantially increases when the intervention was based on a theory or model (odds ratio 5.27, 95% CI: 3.24 to 8.58, P= 0.05). Conclusion: Our review highlights the various health education strategies used in sub-Saharan Africa to curb malaria over the past two decades. Meta-analysis findings show that health education intervention is moderately effective in improving malaria knowledge and ITN ownership and has contributed to the effort of global malaria strategy.

Keywords: malaria, health education, insecticide treated nets, sub-Saharan Africa, meta-analysis

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Authors: Matthias Grünke

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In this single-case study, we evaluated the effects of a self-graphing intervention to help students improve their reading fluency. Our participant was a 10-year-old girl with a suspected learning disability in reading. We applied an ABAB reversal design to test the efficacy of our approach. The dependent measure was the number of correctly read words from a children’s book within five minutes. Our participant recorded her daily performance using a simple line diagram. Results indicate that her reading rate improved simultaneously with the intervention and dropped as soon as the treatment was suspended. The findings give reasons for optimism that our simple strategy can be a very effective tool in supporting students with learning disabilities to boost their reading fluency.

Keywords: single-case study, learning disabilities, elementary education, reading problems, reading fluency

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Authors: Katharina Kargel, Frederic Vobbe

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Sexualized violence against children and adolescents using digital media poses particular challenges for practitioners with a focus on crisis intervention (social work, psychotherapy, law enforcement). The technical delimitation of violence increases the burden on those affected and increases the complexity of interdisciplinary cooperation. Urgently needed recommendations for practical action do not yet exist in Germany. Funded by the Federal Ministry of Education and Research, these recommendations for action are being developed in the HUMAN project together with science and practice. The presentation introduces the participatory approach of the HUMAN project. We discuss the application-oriented, casuistic approach of the project and present its results using the example of concrete case-based recommendations for Action. The participants will be presented with concrete prototypical case studies from the project, which will be used to illustrate quality criteria for crisis intervention in cases of sexualized violence using digital media. On the basis of case analyses, focus group interviews and interviews with victims of violence, we present the six central challenges of sexualized violence with the use of digital media, namely: • Diffusion (Ambiguities regarding the extent and significance of violence) , • Transcendence (Space and time independence of the dynamics of violence, omnipresence), • omnipresent anxiety (considering diffusion and transcendence), • being haunted (repeated confrontation with digital memories of violence or the perpetrator), • disparity (conflicts of interpretative power between those affected and the social environment) • simultaneity (of all other factors). We point out generalizable principles with which these challenges can be dealt with professionally. Dealing professionally with sexualized violence using digital media requires a stronger networking of professional actors. A clear distinction must be made between their own mission and the mission of the network partners. Those affected by violence must be shown options for crisis intervention in the context of the aid networks. The different competencies and the professional mission of the offers of help are to be made transparent. The necessity of technical possibilities for deleting abuse images beyond criminal prosecution will be discussed. Those affected are stabilized by multimodal strategies such as a combination of rational emotive therapy, legal support and technical assistance.

Keywords: sexualized violence, intervention, digital media, children and youth

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Authors: Magdalena Chrabąszcz, Teresa Wolniewicz, Cezary Maciejewski, Joanna Czuwara

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BACKGROUND: Dermoscopy is a clinical tool known to improve the early detection of melanoma and other malignancies of the skin. Over the past few years melanoma has grown into a disease of socio-economic importance due to the increasing incidence and persistently high mortality rates. Early diagnosis remains the best method to reduce melanoma and non-melanoma skin cancer– related mortality and morbidity. Dermoscopy is a noninvasive technique that consists of viewing pigmented skin lesions through a hand-held lens. This simple procedure increases melanoma diagnostic accuracy by up to 35%. Dermoscopy is currently the standard for clinical differential diagnosis of cutaneous melanoma and for qualifying lesion for the excision biopsy. Like any clinical tool, training is required for effective use. The introduction of small and handy dermoscopes contributed significantly to the switch of dermatoscopy toward a first-level useful tool. Non-dermatologist physicians are well positioned for opportunistic melanoma detection; however, education in the skin cancer examination is limited during medical school and traditionally lecture-based. AIM: The aim of this randomized study was to determine whether the adjunct of dermoscopy to the standard fourth year medical curriculum improves the ability of medical students to distinguish between benign and malignant lesions and assess acceptability and satisfaction with the intervention. METHODS: We performed a prospective study in 2 cohorts of fourth-year medical students at Medical University of Warsaw. Groups having dermatology course, were randomly assigned to:  cohort A: with limited access to dermatoscopy from their teacher only – 1 dermatoscope for 15 people  Cohort B: with a full access to use dermatoscopy during their clinical classes:1 dermatoscope for 4 people available constantly plus 15-minute dermoscopy tutorial. Students in both study arms got an image-based test of 10 lesions to assess ability to differentiate benign from malignant lesions and postintervention survey collecting minimal background information, attitudes about the skin cancer examination and course satisfaction. RESULTS: The cohort B had higher scores than the cohort A in recognition of nonmelanocytic (P < 0.05) and melanocytic (P <0.05) lesions. Medical students who have a possibility to use dermatoscope by themselves have also a higher satisfaction rates after the dermatology course than the group with limited access to this diagnostic tool. Moreover according to our results they were more motivated to learn dermatoscopy and use it in their future everyday clinical practice. LIMITATIONS: There were limited participants. Further study of the application on clinical practice is still needed. CONCLUSION: Although the use of dermatoscope in dermatology as a specialty is widely accepted, sufficiently validated clinical tools for the examination of potentially malignant skin lesions are lacking in general practice. Introducing medical students to dermoscopy in their fourth year curricula of medical school may improve their ability to differentiate benign from malignant lesions. It can can also encourage students to use dermatoscopy in their future practice which can significantly improve early recognition of malignant lesions and thus decrease melanoma mortality.

Keywords: dermatoscopy, early detection of melanoma, medical education, skin cancer

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Authors: M. C. Arcuri, L. Gai, F. Ielasi

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Italian Central Guarantee Fund (CGF) has the purpose to facilitate Small and Medium-sized Enterprises (SMEs)’ access to credit. The aim of the paper is to study the evaluation method adopted by the CGF with regard to SMEs requiring its intervention. This is even more important in the light of the recent CGF reform. We analyse an initial sample of more than 500.000 guarantees from 2012 to 2018. We distinguish between a counter-guarantee delivered to a mutual guarantee institution and a guarantee directly delivered to a bank. We investigate the impact of variables related to the operations and the SMEs on Altman Z’’-score and the score consistent with CGF methodology. We verify that the type of intervention affects the scores and the initial condition changes with the new assessment criterions. 

Keywords: banks, default risk, Italian guarantee fund, mutual guarantee institutions

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Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

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The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

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Authors: Ghorbanali Mohammadi

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Background: Due to the widespread outbreak of the COVID-19 virus, a large number of people become infected with the disease every day and go to hospitals. The acute condition of this disease has caused the death of many people. Since all the stages of treatment for these people happen in the hospitals, nurses are at the forefront of the fight against this virus. This causes nurses to suffer from physical and mental health problems. Methods: Physical and mental problems in nurses were assessed using the Depression, Anxiety and Stress Scale (DASS-42) of Lovibond (1995) and the Nordic Questionnaire. Results: 90 nurses from emergency, intensive care, and coronary care units were examined, and a total of 180 questionnaires were collected and evaluated. It was found that 37.78%, 47.78%, and 21.11% of nurses have symptoms of depression, anxiety, and stress, respectively. 40% of the nurses had physical problems. In total, 65.17% of them were involved in one or more mental or physical illnesses. Conclusions: Of the three units surveyed, the nurses in intensive care, emergency room, and coronary care units worked more than ten hours a day. Examining the interaction of physical and mental health problems indicated that physical problems can aggravate mental problems.

Keywords: depression anxiety and stress scale of Lovibond, nordic questionnaire, mental health of nurses, physical health problems in nurses

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Authors: Danuvasin Charoen

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This research investigates cluster development in the area called the Greater Mekong Subregion (GMS), which consists of Thailand, the People’s Republic of China (PRC), the Yunnan Province and Guangxi Zhuang Autonomous Region, Myanmar, the Lao People’s Democratic Republic (Lao PDR), Cambodia, and Vietnam. The study utilized Porter’s competitiveness theory and the cluster mapping approach to analyze the competitiveness of the region. The data collection consists of interviews, focus groups, and the analysis of secondary data. The findings identify some evidence of cluster development in the GMS; however, there is no clear indication of collaboration among the components in the clusters. GMS clusters tend to be stand-alone. The clusters in Vietnam, Lao PDR, Myanmar, and Cambodia tend to be labor intensive, whereas the clusters in Thailand and the PRC (Yunnan) have the potential to successfully develop into innovative clusters. The collaboration and integration among the clusters in the GMS area are promising, though it could take a long time. The most likely relationship between the GMS countries could be, for example, suppliers of the low-end, labor-intensive products will be located in the low income countries such as Myanmar, Lao PDR, and Cambodia, and these countries will be providing input materials for innovative clusters in the middle income countries such as Thailand and the PRC.

Keywords: cluster, GMS, competitiveness, development

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Authors: Rhea Kapoor

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Fractal dimension provides a way to characterize non-geometric shapes like those found in nature. The purpose of this research is to estimate Minkowski fractal dimension of human lung images for early detection of lung cancer. Lung cancer is the leading cause of death among all types of cancer and an early histopathological analysis will help reduce deaths primarily due to late diagnosis. A Python application program, PathoPy2.0, was developed for analyzing medical images in pixelated format and estimating Minkowski fractal dimension using a new box-counting algorithm that allows windowing of images for more accurate calculation in the suspected areas of cancerous growth. Benchmark geometric fractals were used to validate the accuracy of the program and changes in fractal dimension of lung images to indicate the presence of issues in the lung. The accuracy of the program for the benchmark examples was between 93-99% of known values of the fractal dimensions. Fractal dimension values were then calculated for lung images, from National Cancer Institute, taken over time to correctly detect the presence of cancerous growth. For example, as the fractal dimension for a given lung increased from 1.19 to 1.27 due to cancerous growth, it represents a significant change in fractal dimension which lies between 1 and 2 for 2-D images. Based on the results obtained on many lung test cases, it was concluded that fractal dimension of human lungs can be used to diagnose lung cancer early. The ideas behind PathoPy2.0 can also be applied to study patterns in the electrical activity of the human brain and DNA matching.

Keywords: fractals, histopathological analysis, image processing, lung cancer, Minkowski dimension

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Authors: Delies L. Alejo

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This study explores the psychosocial influences of Spinal Cord Injury (SCI) on patients in the Philippine Orthopedic Center Hospital in the Philippines, examining their social functioning and proposing interventions for reintegration. Quantitative data were collected through surveys using a concurrent triangulation research design, while qualitative insights were obtained via interviews. Findings revealed significant psychosocial challenges among SCI patients, impacting relationships, family dynamics, work, friendships, parenting, education, and self-care. Demographic profiles indicated variations in psychosocial functioning. The study underscores the importance of tailored interventions for SCI patients based on age, marital status, gender, education, and occupation. Triangulation of data enhanced understanding, revealing four themes: ‘Resilient Navigation of Intimacy and Connection,’ ‘Family Dynamics and Care Challenges,’ ‘Occupational Hurdles and Work Engagement,’ and ‘Social and Community Integration Obstacles.’ The study proposes a holistic intervention plan, addressing emotional challenges, creating support networks, implementing vocational rehabilitation, promoting community engagement, and sustaining collaboration with healthcare professionals.

Keywords: spinal cord injury, psychosocial influences, social functioning, concurrent triangulation, intervention plan

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Authors: Bonnie R. Brammall, Rhonda M. Garad, Helena J. Teede, Cheryce L. Harrison

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Introduction: Reproductive aged women are at high-risk for accelerated weight gain and obesity development, with pregnancy recognised as a critical contributory life phase. Healthy lifestyle interventions during the preconception and antenatal period improve maternal and infant health outcomes. Yet, interventions from preconception through to postpartum and translation and implementation into real-world healthcare settings remain limited. OptimalMe is a randomised, hybrid implementation effectiveness study of evidence-based healthy lifestyle intervention. Here, we report engagement, acceptability of the intervention during preconception, and self-reported behaviour change outcomes as a result of the preconception phase of the intervention. Methods: Reproductive aged women who upgraded their private health insurance to include pregnancy and birth cover, signalling a pregnancy intention, were invited to participate. Women received access to an online portal with preconception health and lifestyle modules, goal-setting and behaviour change tools, monthly SMS messages, and two coaching sessions (randomised to video or phone) prior to pregnancy. Results: Overall n=527 expressed interest in participating. Of these, n=33 did not meet inclusion criteria, n=8 were not contactable for eligibility screening, and n=177 failed to engage after the screening, leaving n=309 who were enrolled in OptimalMe and randomised to intervention delivery method. Engagement with coaching sessions dropped by 25% for session two, with no difference between intervention groups. Women had a mean (SD) age of 31.7 (4.3) years and, at baseline, a self-reported mean BMI of 25.7 (6.1) kg/m², with 55.8% (n=172) of a healthy BMI. Behaviour was sub-optimal with infrequent self-weighing (38.1%), alcohol consumption prevalent (57.1%), sub-optimal pre-pregnancy supplementation (61.5%), and incomplete medical screening. Post-intervention 73.2% of women reported engagement with a GP for preconception care and improved lifestyle behaviour (85.5%), since starting OptimalMe. Direct pre-and-post comparison of individual participant data showed that of 322 points of potential change (up-to-date cervical screening, elimination of high-risk behaviours [alcohol, drugs, smoking], uptake of preconception supplements and improved weighing habits) 158 (49.1%) points of change were achieved. Health coaching sessions were found to improve accountability and confidence, yet further personalisation and support were desired. Engagement with video and phone sessions was comparable, having similar impacts on behaviour change, and both methods were well accepted and increased women's accountability. Conclusion: A low-intensity digital health and lifestyle program with embedded health coaching can improve the uptake of preconception care and lead to self-reported behaviour change. This is the first program of its kind to reach an otherwise healthy population of women planning a pregnancy. Women who were otherwise healthy showed divergence from preconception health and lifestyle objectives and benefited from the intervention. OptimalMe shows promising results for population-based behaviour change interventions that can improve preconception lifestyle habits and increase engagement with clinical health care for pregnancy preparation.

Keywords: preconception, pregnancy, preventative health, weight gain prevention, self-management, behaviour change, digital health, telehealth, intervention, women's health

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Authors: Samanta Tiague, Igor Michel Gachig

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The practice of inclusive education within general education classrooms is becoming more prevalent in Cameroon. In this context, quality Education is an important driver of the development agenda in this era of global sustainable development. This requires that the Cameroon’s educational system be strategically restructured to provide every citizen with the needed quality education for sustainable development. This study thus examined the need for the restructuring of the Cameroon educational system towards inclusive education as a target of the Sustainable Development Goal #4 (Ensure Quality Education), from a critical disability theory perspective. Special focus was on the education of children with visual impairment in the early childhood classroom. This study is suggesting a model design of responsive and contextual inclusive education policies, and the provision of quality human, material and financial educational resources to support the improvement of curriculums and inclusive instructional strategies. This paper is therefore designed as a basic starting point for early childhood educators with limited to no experience in working with students having visual impairments. Ultimately, this work represents a contribution to early childhood educators toward understanding visual impairment challenges and innovative practices to approach accessibility in a meaningful way to students in Cameroon. This is important to achieve quality education due to the peculiar nature of the educational needs of children with visual impairment, toward attainment of the global sustainable development agenda.

Keywords: early childhood educators, inclusive education, sustainable development, visual impairment

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Authors: Cristina Costa-Lobo, Carla B. Vestena, Filomena E. Ponte

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Creativity and intelligence are concepts that have aroused very expressive interest in the field of educational sciences and the field of psychological science since the middle of the last century since they have a great impact on the potential and well-being of individuals. However, due to progress in cognitive and positive psychology, there has been a growing interest in the psychoeducational domain of intelligence and creativity in the last decade. In this theoretical work, are analyzed comparatively the theoretical models that relate the intelligence and the creativity, are analyzed several psychoeducational intervention programs that have been implemented with a view to the promotion of creativity and signal possibilities, realities and ironies around the psychological evaluation of intelligence and creativity. In order to reach a broad perspective on creativity, the evidence is presented that points the need to evaluate different psychological domains. The psychoeducational intervention programs addressed have, with a common characteristic, the full stimulation of the creative potential of the participants, assumed as a highly valued capacity at the present time. The results point to the systematize that all interventions in the ambit of creativity have two guiding principles: all individuals can be creative, and creativity is a capacity that can be stimulated. This work refers to the importance of stimulus creativity in educational contexts, to the usefulness and pertinence of the creation, the implementation, and monitoring of flexible curricula, adapted to the educational needs of students, promoting a collaborative work among teachers, parents, students, psychologists, managers and educational administrators.

Keywords: creativity, intelligence, psychoeducational intervention programs, psychological evaluation, educational contexts

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Authors: Irene H. Maralit

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Warning labels have been found to inform smokers about the health hazards of smoking, encourage smokers to quit, and prevent nonsmokers from starting to smoke. Warning labels on tobacco products are an ideal way of communicating with smokers. Since the intervention is delivered at the time of smoking, nearly all smokers are exposed to warning labels and pack-a-day smokers could be exposed to the warnings more than 7,000 times per year. Given the reach and frequency of exposure, the proponents want to know the effect of warning labels on smoking behavior. Its aims to identify the profile of the smokers associated with its behavioral variables that best describe the users’ perception. The behavioral variables are AVOID, THINK RISK and FORGO. This research study aims to determine if there is significant relationship between the effect of warning labels on cigarette package on Consumer behavior when grouped according to profile variable. The researcher used quota sampling to gather representative data through purposive means to determine the accurate representation of data needed in the study. Furthermore, the data was gathered through the use of a self-constructed questionnaire. The statistical method used were Frequency count, Chi square, multi regression, weighted mean and ANOVA to determine the scale and percentage of the three variables. After the analysis of data, results shows that most of the respondents belongs to age range 22–28 years old with percentage of 25.3%, majority are male with a total number of 134 with percentage of 89.3% and single with total number of 79 and percentage of 52.7%, mostly are high school graduates with total number of 59 and percentage of 39.3, with regards to occupation, skilled workers have the highest frequency of 37 with 24.7%, Majority of the income of the respondents falls under the range of Php 5,001-Php10,000 with 50.7%. And also with regards to the number of sticks consumed per day falls under 6–10 got the highest frequency with 33.3%. The respondents THINK RISK factor got the highest composite mean which is 2.79 with verbal interpretation of agree. It is followed by FORGO with 2.78 composite mean and a verbal interpretation of agree and AVOID variable with composite mean of 2.77 with agree as its verbal interpretation. In terms of significant relationship on the effects of cigarette label to consumer behavior when grouped according to profile variable, sex and occupation found to be significant.

Keywords: consumer behavior, smokers, warning labels, think risk avoid forgo

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Authors: Mario A. Maggioni, Domenico Rossignoli, Simona Beretta, Sara Balestri

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The paper presents the results of a Longitudinal Randomized Control Trial implemented in 2016 two State Prisons in California (USA). The subjects were randomly assigned to a 10-months program (GRIP, Guiding Rage Into Power) aiming at undoing the destructive behavioral patterns that lead to criminal actions by raising the individual’s 'mindfulness'. This study tests whether the participation to this program (treatment), based on strong relationships and mutual help, affects pro-social behavior of participants, in particular with reference to trust and inequality aversion. The research protocol entails the administration of two questionnaires including a set of behavioral situations ('games') - widely used in the relevant literature in the field - to 80 inmates, 42 treated (enrolled in the program) and 38 controls. The first questionnaire has been administered before treatment and randomization took place; the second questionnaire at the end of the program. The results of a Difference-in-Differences estimation procedure, show that trust significantly increases GRIP participants to compared to the control group. The result is robust to alternative estimation techniques and to the inclusion of a set of covariates to further control for idiosyncratic characteristics of the prisoners.

Keywords: behavioral economics, difference in differences, longitudinal study, pro-social preferences

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Authors: Silvia Franco, Marcos Sarasola

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The Faculty of Business Administration at the Catholic University of Uruguay is performing an important educational innovation, unique in the country. In preparing future professionals in companies, teamwork competence is very important. However, there is no often a systematic and specific training in the acquisition of this competence in undergraduate students. For this reason, we have designed and implemented an educational innovation through an intervention method to improve teamwork competence for undergraduate students of business studies. Students’ teams are integrated according to the complementary roles of Belbin; changes in teamwork competence during training period are measured with CCSAC tool; classroom methodology in the prio-border teamwork by Team-Based Learning. Methodology also integrates coaching and support team performance during the first two semesters.

Keywords: business students, teamwork, learning, competences

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Authors: Olusola Joseph Adesina, Abiodun Ezekiel Adesina

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Efforts at improving the falling standard of education in the country call for the need-based assessment of the primary tier of education in Nigeria. Teachers’ cluster meeting intervention is a step towards enhancing the teachers’ professional competency, efficient and effective pupils’ academic achievement and attitudinal development. The study thus determined the impact of the intervention on pupils’ achievement in Oyo State, Nigeria. Three research questions and four hypotheses guided the study. Pre-test, post-test control group, quasi-experimental design was adopted for the study. Eight intact classes from eight different schools were randomly selected into treatment and control groups. Two response instruments, pupils academic achievement test (PAAT; r = 0.87) and pupils attitude to lesson scale (PALS; r = 0.80) were used for data collection. Mean, standard deviation and analysis of covariance (ANCOVA) were used to analyse the collected data. The results showed that the teachers’ cluster meeting have significant impact on pupils academic achievement (F (1,327) =41.79; p<0.05) and attitudinal development (F (1,327) =26.01; p<0.05) in the core subjects of primary schools in Oyo State, Nigeria. The study therefore recommended among others that teachers’ cluster meeting should be sustained for teachers’ professional development and pupils’ upgradement in the State.

Keywords: teachers’ cluster meeting, pupils’ academic achievement, pupils’ attitudinal development, academic achievement

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Authors: Catarina Belchior, Catarina Martins, Sara Mendes, Ana Rita S. Valente, Elsa Marta Soares

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Introduction: The negative feelings and attitudes that a person who stutters can develop are extremely relevant when considering assessment and intervention in Speech and Language Therapy. This relates to the fact that the person who stutters can experience feelings such as shame, fear and negative beliefs when communicating. Considering the complexity and importance of integrating diverse aspects in stuttering intervention, it is central to identify those emotions as early as possible. Therefore, this research aimed to achieve the translation, adaptation to European Portuguese and to analyze the content validation of the Preschooler Awareness Stuttering Survey (Abbiati, Guitar & Hutchins, 2015), an instrument that allows the assessment of the impact of stuttering on preschool children who stutter considering feelings and attitudes. Methodology: Cross-sectional descriptive qualitative research. The following methodological procedures were followed: translation, back-translation, panel of experts and pilot study. This abstract describes the results of the first three phases of this process. The translation was accomplished by two Speech Language Therapists (SLT). Both professionals have more than five years of experience and are users of English language. One of them has a broad experience in the field of stuttering. Back-translation was conducted by two bilingual individuals without experience in health or any knowledge about the instrument. The panel of experts was composed by 3 different SLT, experts in the field of stuttering. Results and Discussion: In the translation and back-translation process it was possible to verify differences in semantic and idiomatic equivalences of several concepts and expressions, as well as the need to include new information to enhance the understanding of the application of the instrument. The meeting between the two translators and the researchers allowed the achievement of a consensus version that was used in back-translation. Considering adaptation and content validation, the main change made by the experts was the conceptual equivalence of the questions and answers of the instrument's sheets. Considering that in the translated consensus version the questions began with various nouns such as 'is' or 'the cow' and that the answers did not contain the adverb 'much' as in the original instrument, the panel agreed that it would be more appropriate if the questions all started with 'how' and that all the answers should present the adverb 'much'. This decision was made to ensure that the translate instrument would be similar to the original and so that the results obtained could be comparable between the original and the translated instrument. There was also elaborated one semantic equivalence between concepts. The panel of experts found that all other items and specificities of the instrument were adequate, concluding the adequacy of the instrument considering its objectives and its intended target population. Conclusion: This research aspires to diversify the existing validated resources in this scope, adding a new instrument that allows the assessment of preschool children who stutter. Consequently, it is hoped that this instrument will provide a real and reliable assessment that can lead to an appropriate therapeutic intervention according to the characteristics and needs of each child.

Keywords: stuttering, assessment, feelings and attitudes, speech language therapy

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Authors: Erick C. Valverde, Wansu Lim

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Facial emotion recognition (FER) system has been recently developed for more advanced computer vision applications. The ability to identify human emotions would enable smart healthcare facility to diagnose mental health illnesses (e.g., depression and stress) as well as better human social interactions with smart technologies. The FER system involves two steps: 1) face detection task and 2) facial emotion recognition task. It classifies the human expression in various categories such as angry, disgust, fear, happy, sad, surprise, and neutral. This system requires intensive research to address issues with human diversity, various unique human expressions, and variety of human facial features due to age differences. These issues generally affect the ability of the FER system to detect human emotions with high accuracy. Early stage of FER systems used simple supervised classification task algorithms like K-nearest neighbors (KNN) and artificial neural networks (ANN). These conventional FER systems have issues with low accuracy due to its inefficiency to extract significant features of several human emotions. To increase the accuracy of FER systems, deep learning (DL)-based methods, like convolutional neural networks (CNN), are proposed. These methods can find more complex features in the human face by means of the deeper connections within its architectures. However, the inference speed and computational costs of a DL-based FER system is often disregarded in exchange for higher accuracy results. To cope with this drawback, an optimized DL-based FER system is proposed in this study.An extreme version of Inception V3, known as Xception model, is leveraged by applying different network optimization methods. Specifically, network pruning and quantization are used to enable lower computational costs and reduce memory usage, respectively. To support low resource requirements, a 68-landmark face detector from Dlib is used in the early step of the FER system.Furthermore, a DL compiler is utilized to incorporate advanced optimization techniques to the Xception model to improve the inference speed of the FER system. In comparison to VGG-Net and ResNet50, the proposed optimized DL-based FER system experimentally demonstrates the objectives of the network optimization methods used. As a result, the proposed approach can be used to create an efficient and real-time FER system.

Keywords: deep learning, face detection, facial emotion recognition, network optimization methods

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Authors: Vivian Khamis

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Exposure to war and forced migration have been widely linked to child subsequent adaptation. What remains sparse is research spanning multiple risk and protective factors and examining their unique and relative implications to difficulties in mental health among refugee girls. This study investigated the mechanisms through which posttraumatic stress disorder (PTSD), emotion dysregulation , neuroticism, and behavioral and emotional disorders in Syrian refugee girls is impacted by exposure to war traumas, age, and other risk and protective factors such as coping styles, family relationships, and school environment. The sample consisted of 539 Syrian refugee girls who ranged in age from 7 to 18 years attending public schools in various governorates in Lebanon and Jordan. Two school counselors carried out the interviews with children at school. Results indicated that war trauma, older age, and a combination of negative copying style associated with conflict in the family could lead to an overall state of emotion dysregulation, neuroticism, behavioral and emotional disorders, and PTSD in refugee girls. On the other hand, lapse of time since resettlement in host country, positive copying style, cohesion, and expressiveness in the family would lead to more positive mental health status, including lower levels of emotion dysregulation, neuroticism, behavioral and emotional disorders, and PTSD . Enhanced understanding of the mechanistic role of risk and protective factors in contributing to difficulties in mental health in refugee girls may contribute to the development of effective interventions to target the psychological effects of the refugee experience.

Keywords: refugee girls, PTSD, emotion dysregulation, neuroticism, behavioral and emotional disorders

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Authors: T. Goldstein, E. Serok, J. D. Kark

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Background and Aim: The prevalence of obesity is increasing worldwide and in Israel. To meet this challenge, our study tests a new educational approach through a controlled school-based trial to achieve an improvement in eating habits, aerobic activity, and reduced obesity in Grades 2-3. Methods and Design: A cluster randomized controlled trial allocated 4 elementary schools (3rd and 2nd-grade classes each) to intervention or control groups. This allocation was switched with the next cohort of children. Recruitment was in first grade, randomization at the beginning of second grade, evaluation of results at the end of second grade and the beginning of third grade — intervention: 5 joint parent-children classroom activities on health topics and 5 educational workshops for parents only. Alfred Adler's concepts were guiding principles. Subjects: Of 743 children in 23-second grade classes, parents provided informed consent for 508 (68%). Information of retention health habits continued for third grade. Additional parental approvals were required. Parents provided informed consent for third-grade follow-up for 432. Results: At the end of 2nd grade, the amount of aerobic activity increased in the intervention group in comparison with the control group, the difference being marginally statistically significant (p=0.061). There is a significant difference between the groups in the percentage of "no activity being done" reported at the end of second grade when in the experimental group, the percentage is lower than the control. There are differences between genders in the percentage of aerobic activity at the end of second grade (p=0.044) and in the third grade (p < 0.0001). Height increased significantly (p=0.030 ), and waist circumference declined significantly (p=0.021) in the intervention compared with the control group. There were no significant between-group differences in BMI and weight. Conclusion: There were encouraging changes in aerobic activity and in anthropometric measurements. To maintain changes over longer periods, refreshing these nutrition and activity themes annually in school using the model is required.

Keywords: aerobic activity, child obesity, Alfred Adler, schoolchildren

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