Search results for: individuals with disabilities education act

Authors: Elzbieta Sikorska-Simmons

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Dementia is a progressive terminal disease. Despite this recognition, research shows that most family caregivers do not know it, and it is unclear how this knowledge affects the quality of patient care. The aim of this qualitative study of 20 family caregivers for patients with advanced dementia is to examine how the caregiver's knowledge about dementia affects the quality of patient care in the context of healthcare decision-making, advanced care planning, and access to adequate support systems. Knowledge about dementia implies family caregivers' understanding of dementia trajectories, common symptoms/complications, and alternative treatment options (e.g., comfort feeding versus tube feeding). Data were collected in semi-structured interviews with 20 family caregivers. The interviews were conducted in person by the author and designed to elicit rich descriptions of family caregivers' experiences with healthcare decision-making and the management of common symptoms/complications of end-stage dementia as patient healthcare proxies. The study findings suggest that caregivers who recognize that dementia is a terminal disease are less likely to opt for life-extending treatments during the advanced stages. They are also more likely to seek palliative/hospice care, and consequently, they are better able to avoid unnecessary hospitalizations or medical procedures. For example, those who know that dementia is a terminal disease tend to opt for "comfort feeding" rather than "tube feeding" in managing the swallowing difficulties that accompany advanced dementia. In the context of advance care planning, family caregivers who know that dementia is a terminal disease tend to have more meaningful advance directives (e.g., Power of Attorney and Do Not Resuscitate orders). They are better prepared to anticipate common problems and pursue treatments that foster the best quality of patient life and care. Greater knowledge about advanced dementia helps them make more informed decisions that focus on enhancing the quality of patient life rather than just survival. In addition, those who know that dementia is a terminal disease are more likely to establish adequate support systems to help them cope with the complex demands of caregiving. For example, they are more likely to seek dementia-oriented primary care programs that offer house visits or respite services. Based on the study findings, knowledge about dementia as a terminal disease is critical in the optimal management of patient care needs and the establishment of adequate support systems. More research is needed to better understand what caregivers need to know to better prepare them for the complex demands of dementia caregiving.

Keywords: dementia education, family caregiver, management of dementia, quality of care

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Authors: Jarot Mahendra

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The primary objective of this paper is to provide a view in the interpretation of the revitalization of heritage buildings. This objective is achieved by analyzing the concept of interpretation that is oriented in the perspective of law, urban spatial planning, and stakeholder perspective, and then develops the theoretical framework of interpretation in the cultural resources management through issues of identity, heritage as a process, and authenticity in heritage. The revitalization of heritage buildings with the interpretation of these three issues is that interpretation can be used as a communication process to express the meaning and relation of heritage to the community so as to avoid the conflict that will arise and develop as a result of different perspectives of stakeholders. Using case studies in Indonesia, this study focuses on the revitalization of heritage sites in the National Gallery of Indonesia (GNI). GNI is a cultural institution that uses several historical buildings that have been designated as heritage and have not been designated as a heritage according to the regulations applicable in Indonesia, in carrying out its function as the center of Indonesian art development and art museums. The revitalization of heritage buildings is taken as a step to meet space needs in running the current GNI function. In the revitalization master plan, there are physical interventions on the building of heritage and the removal of some historic buildings which will then be built new buildings at that location. The research matrix was used to map out the main elements of the study (the concept of GNI revitalization, heritage as identity, heritage as a process, and authenticity in the heritage). Expert interviews and document studies are the main tools used in collecting data. Qualitative data is then analyzed through content analysis and template analysis. This study identifies the significance of historic buildings (heritage buildings and buildings not defined as heritage) as an important value of history, architecture, education, and culture. The significance becomes the basis for revisiting the revitalization master plan which is then reviewed according to applicable regulations and the spatial layout of Jakarta. The interpretation that is built is (1) GNI is one of the elements of the embodiment of the National Cultural Center in the context of the region, where there are National Monument, National Museum and National Library in the same area, so the heritage not only gives identity to the past culture but the culture of current community; (2) The heritage should be seen as a dynamic cultural process towards the cultural change of community, where heritage must develop along with the urban development, so that the heritage buildings can remain alive and side by side with modern buildings but still observe the principles of preservation of heritage; (3) The authenticity of heritage should be able to balance the cultural heritage conservation approach with urban development, where authenticity can serve as a 'Value Transmitter' so that authenticity can be used to evaluate, preserve and manage heritage buildings by considering tangible and intangible aspects.

Keywords: authenticity, culture process, identity, interpretation, revitalization

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Authors: Eda Üstünel, Seval Karacabey

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The students, who are enrolled in German Preparatory Language Programme at the School of Foreign Languages, Muğla Sıtkı Koçman University, Turkey, learn German as a foreign language for two semesters in an academic year. Although the language programme is a skills-based one, the students lack German speaking skills due to their fear of making language mistakes while speaking in German. This problem of incompetency in German speaking skills exists also in their four-year departmental study at the Faculty of Education. In order to address this problem we design German speaking activities, which are extra-curricular activities. With the help of these activities, we aim to lead Turkish students of German language to speak in the target language, to improve their speaking skills in the target language and to create a stress-free atmosphere and a meaningful learning environment to communicate in the target language. In order to achieve these aims, an ERASMUS+ exchange staff (a German trainee teacher of German as a foreign language), who is from Schwabisch Gmünd University, Germany, conducted out-of-class German speaking activities once a week for three weeks in total. Each speaking activity is lasted for one and a half hour per week. 7 volunteered students of German preparatory language programme attended the speaking activity for three weeks. The activity took place at a cafe in the university campus, that’s the reason, we call it as an out-of-class activity. The content of speaking activity is not related to the topics studied at the units of coursebook, that’s the reason, we call this activity as extra-curricular one. For data collection, three tools are used. A questionnaire, which is an adapted version of Sabo’s questionnaire, is applied to seven volunteers. An interview session is then held with each student on individual basis. The interview questions are developed so as to ask students to expand their answers that are given at the questionnaires. The German trainee teacher wrote fieldnotes, in which the teacher described the activity in the light of her thoughts about what went well and which areas were needed to be improved. The results of questionnaires show that six out of seven students note that such an acitivity must be conducted by a native speaker of German. Four out of seven students emphasize that they like the way that the activities are designed in a learner-centred fashion. All of the students point out that they feel motivated to talk to the trainee teacher in German. Six out of seven students note that the opportunity to communicate in German with the teacher and the peers enable them to improve their speaking skills, the use of grammatical rules and the use of vocabulary.

Keywords: Learning a Foreign Language, Speaking Skills, Teaching German as a Foreign Language, Turkish Learners of German Language

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Authors: Giorgi Sulashvili, Vladimer Kekenadze, Olga Khutsishvili, Bela Khotenashvili, Tsiuri Phkhakadze, Besarion Tsikhelashvili

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The article dealt with the South Caucasus is a complex economic policy, which consists of strands: The process of deepening economic integration in the South Caucasus region; deepening economic integration with the EU in the framework of "Neighbourhood policy with Europe" and in line with the Maastricht criteria; the development of bilateral trade and economic relations with many countries of the world community; the development of sufficient conditions for the integration of the South Caucasus region in the world to enter the market. According to the author, to determine the place of Georgia in the regional policy of the South Caucasus, it is necessary to consider two views about Georgia: The first is the view of Georgia, as a part of global economic and political processes and the second look at Georgia, as a country located in the geo-economic and geopolitical space of the South Caucasus. Such approaches reveal the place of Georgia in two dimensions; in the global and regional economies. In the countries of South Caucasus, the tourism has been developing fast and has a great social and economic importance. Tourism influences deeply on the social and economic growth of the regions of the country. Tourism development formulates thousand new jobs, fixes the positions of small and middle businesses, ensures the development of the education and culture of the population. In the countries of South Caucasus, the Tourist Industry can be specified as the intersectoral complex, which consists of travel transport and it’s technical service network, tourist enterprises which are specialized in various types, wide network services. Tourists have a chance to enjoy all of these services. At the transitional stage of shifting to the market economy, tourism is among the priorities in the development of the national economy of our country. It is true that the Georgian tourism faces a range of problems at present, but its recognition and the necessity for its development may be considered as a fact. Besides, we would underline that the revitalization of the Georgian tourism is not only the question of time. This area can bring a lot of benefits as to private firms, as to specific countries. It also has many negative effects were conducted fundamental research and studies to consider both, positive and negative impacts of tourism. In the future such decisions will be taken that will bring, the maximum benefit at minimum cost, in order for tourism to take its place in Georgia it is necessary to understand the role of the tourism sector in the economic structure.

Keywords: transitional stage, national economy, Georgian tourism, positive and negative impacts

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Authors: Lee Cahaner, Nissim Leon

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The segregation of populations is one of the main axes in the research of urban geography, which refers to the spatial and functional relationships between settlements. In Israel, this phenomenon has its unique expression in the spatial processes concerning the ultra-orthodox population. This population holds a set of interactions within itself as well as with the non-orthodox surrounding population because of historical and contemporary motivations on its which strength depends on its homogeneousness and separation. Its demographic growth rate and the internal social processes that the ultra-orthodox society undergoes create a new image of the ultra-orthodox concentration and its location in the Israeli space. The goals of the present study have also been defined with the express intention of filling the scholarly vacuum noted above: firstly, to discuss the development of the Israeli ultra-Orthodox sector’s hierarchical and spatial structure as of 2015, in light of the principles and mechanisms that guide it and vis-à-vis the general population’s hierarchical locality system; secondly, to map Israel’s ultra-Orthodox population, with attention to its physical boundaries, its subdivisions (Hassidic, Lithuanian, Sephardic) and the geographical and demographic processes that have characterized it in recent years; and thirdly, to shed light on the interactions between ultra-Orthodox localities via several different parameters, e.g. migration, education, transportation, employment, consumerism and community services. In order to understand the changes in ultra-Orthodox geographic distribution and the social processes that these changes have generated, a number of research activities were conducted during the course of this study− notably, gathering and assembling material from earlier academic studies, newspaper advertisements, state and private archives; in-depth interviews with major figures in the ultra-Orthodox community and others who come into contact with it; tours of the core areas of ultra-Orthodox settlement; and gathering quantitative and qualitative data from the statistical reports of governmental and other bodies. In addition, a multi-participant (2400-respondent) quantitative survey was conducted among residents of the new ultra-Orthodox cities, designed to elucidate the attributes and spatial attitudes of the residents− as a means of tracing and understanding this new settlement pattern within ultra-Orthodox space. A major portion of the quantitative and qualitative material was processed to form a system of maps that visually describe the distribution of Israel’s ultra-Orthodox population.

Keywords: migration, new cities, segregation, ultra-orthodox

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Authors: Barakat Adebisi Raji

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In the workplace, Artificial Intelligence has, in recent years, emerged as a transformative technology that revolutionizes how organizations operate and perform tasks. It is a technology that has a significant impact on transportation, manufacturing, education, cyber security, robotics, agriculture, healthcare, and so many other organizations. By harnessing AI technology, workplaces can enhance productivity, streamline processes, and make more informed decisions. Given the potential of AI to change the way we work and its impact on the labor market in years to come, employers understand that it entails legal challenges and risks despite the advantages inherent in it. Therefore, as AI continues to integrate into various aspects of the workplace, understanding the legal and ethical implications becomes paramount. Also central to this study is the question of who is held liable where AI makes any defaults; the person (company) who created the AI, the person who programmed the AI algorithm or the person who uses the AI? Thus, the aim of this paper is to provide a detailed overview of how AI-related liabilities are addressed under each legal tradition and shed light on potential areas of accord and divergence between the two legal cultures. The objectives of this paper are to (i) examine the ability of Common law and Islamic law to accommodate the issues and damage caused by AI in the workplace and the legality of compensation for such injury sustained; (ii) to discuss the extent to which AI can be described as a legal personality to bear responsibility: (iii) examine the similarities and disparities between Common Law and Islamic Jurisprudence on the liability of AI in the workplace. The methodology adopted in this work was qualitative, and the method was purely a doctrinal research method where information is gathered from the primary and secondary sources of law, such as comprehensive materials found in journal articles, expert-authored books and online news sources. Comparative legal method was also used to juxtapose the approach of Islam and Common Law. The paper concludes that since AI, in its current legal state, is not recognized as a legal entity, operators or manufacturers of AI should be held liable for any damage that arises, and the determination of who bears the responsibility should be dependent on the circumstances surrounding each scenario. The study recommends the granting of legal personality to AI systems, the establishment of legal rights and liabilities for AI, the establishment of a holistic Islamic virtue-based AI ethics framework, and the consideration of Islamic ethics.

Keywords: AI, health- care, agriculture, cyber security, common law, Shari'ah

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Authors: Qi En Han, Si En Wai, Eugene Quek

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As one of the two Academic Medical Centres (AMCs) in Singapore, SingHealth Duke-NUS AMC strives to improve patients’ lives through excellent clinical care, research and education. These efforts are enhanced with the establishment of Academic Clinical Programmes (ACPs). Each ACP brings together specialists in a particular discipline from different institutions to maximize the power of shared knowledge and resources. Initiated by Surgery ACP, the student research mentorship programme is a programme designed to facilitate engagement between medical students and the surgical faculty. The programme offers mentors not only the opportunity to supervise research but also to nurture future clinician scientists. In turn, medical students acquire valuable research experience which may be useful in their future careers. The programme typically lasts one year, depending on the students’ commitment. Surgery ACP matches students’ research interests with the mentor's area of expertise whenever possible. Surgery ACP organizes informal tea sessions to bring students and prospective mentors together. Once a match is made, the pair is required to submit a project proposal which includes the title, proposed start and end dates, ethical and biosafety considerations and project details. The mentees either think of their own research question with guidance from the mentors or join an existing project. The mentees may participate in data collection, data analysis, manuscript writing and conference presentation. The progress of each research project is monitored through half-yearly progress report. The mentees report problems encountered or changes made to existing proposal on top of the progress made. A total of 18 mentors were successfully paired with 36 mentees since 2013. Currently, there are 23 on-going and 13 completed projects. The mentees are encouraged to present their projects at conferences and to publish in peer-reviewed journals. Six mentees have presented their completed projects at local or international conferences and one mentee has her work published. To further support student research, Surgery ACP organized a Research Day in 2015 to recognize their research efforts and to showcase their wide-range of research. Surgery ACP recognizes that early exposure of medical students to research is important in developing them into clinician scientists. As interest in research take time to develop and are usually realized during various research attachments, it is crucial that programmes such as the student research mentorship programme exist. Surgery ACP will continue to build on this programme.

Keywords: academic clinical programme, clinician scientist, medical student, mentoring

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Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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Authors: Amy L. Smith

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This study investigates the impact of student authenticity while engaging in academic exploration of students' sense of belonging, autonomy, and persistence. Research questions include: How does incorporating authenticity in first-year academic exploration courses impact; 1) first-year students’ sense of belonging, autonomy, and persistence? 2) first-year students’ sense of belonging, autonomy, and persistence during the first and last halves of the fall semester? 3) first-year students’ sense of belonging, autonomy, and persistence among various student demographics? First-year students completed a Likert-like survey at the conclusion of eight weeks (first and last eight weeks/fall semester) academic exploration courses. Course redesign included grounding the curriculum and instruction with student authenticity and creating opportunities for students to explore, define, and reflect upon their authenticity during academic exploration. Surveys were administered at the conclusion of these eight week courses (first and last eight weeks/fall semester). Data analysis included an entropy balancing matching method and t-tests. Research findings indicate integrating authenticity into academic exploration courses for first-year students has a positive impact on students' autonomy and persistence. There is a significant difference between authenticity and first-year students' autonomy (p = 0.00) and persistence (p = 0.01). Academic exploration courses with the underpinnings of authenticity are more effective in the second half of the fall semester. There is a significant difference between an academic exploration course grounding the curriculum and instruction in authenticity offered M8A (first half, fall semester) and M8B (second half, fall semester) (p = 0); M8B courses illustrate an increase of students' sense of belonging, autonomy, and persistence. Integrating authenticity into academic exploration courses for first-year students has a positive impact on varying student demographics (p = 0.00). There is a significant difference between authenticity and low-income (p = 0.04), first-generation (p = 0.00), Caucasian (p = 0.02), and American Indian/Alaskan Native (p = 0.05) first-year students' sense of belonging, autonomy, and persistence. Academic exploration courses embedded in authenticity helps develop first-year students’ sense of belonging, autonomy, and persistence, which are effective traits of college students. As first-year students engage in content courses, professors can empower students to have greater engagement in their learning process by relating content to students' authenticity and helping students think critically about how content is authentic to them — how students' authenticity relates to the content, how students can take their content expertise into the future in ways that, to the student, authentically contribute to the greater good. A broader conversation within higher education needs to include 1) designing courses that allow students to develop and reflect upon their authenticity/to formulate answers to the questions: who am I, who am I becoming, and how will I move my authentic self forward; and 2) a discussion of how to shift from the university shaping students to the university facilitating the process of students shaping themselves.

Keywords: authenticity, first-year experience, sense of belonging, autonomy, persistence

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Authors: Marian Emmanuel Okon

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Introduction: The Niger Delta region of Nigeria has a vast reserve of oil and gas, which has globally positioned the nation as the sixth largest exporter of crude oil. Production rapidly rose following oil discovery. In most oil producing nations of the world, the wealth generated from oil production and export has propelled economic advancement, enabling the development of industries and other relevant infrastructures. Therefore, it can be assumed that majority of the oil resource such as Nigeria’s, has the potential to improve the health of the population via job creation and derived revenues. However, the health benefits of this economic development might be offset by the environmental consequences of oil exploitation and production. Objective: This research aims to evaluate the balance between the health benefits of oil-led economic development and harmful environmental consequences of crude oil exploitation in Nigeria. Study Design: A pathway has been designed to guide data search and this study. The model created will assess the relationship between oil-led economic development and population health development via job creation, improvement of education, development of infrastructure and other forms of development as well as through harmful environmental consequences from oil activities. Data/Emerging Findings: Diverse potentially suitable datasets which are at different geographical scales have been identified, obtained or applied for and the dataset from the World Bank has been the most thoroughly explored. This large dataset contains information that would enable the longitudinal assessment of both the health benefits and harms from oil exploitation in Nigeria as well as identify the disparities that exist between the communities, states and regions. However, these data do not extend far back enough in time to capture the start of crude oil production. Thus, it is possible that the maximum economic benefits and health harms could be missed. To deal with this shortcoming, the potential for a comparative study with countries like United Kingdom, Morocco and Cote D’ivoire has also been taken into consideration, so as to evaluate the differences between these countries as well as identify the areas of improvement in Nigeria’s environmental and health policies. Notwithstanding, these data have shown some differences in each country’s economic, environmental and health state over time as well as a corresponding summary statistics. Conclusion: In theory, the beneficial effects of oil exploitation to the health of the population may be substantial as large swaths of the ‘wider determinants’ of population heath are influenced by the wealth of a nation. However, if uncontrolled, the consequences from environmental pollution and degradation may outweigh these benefits. Thus, there is a need to address this, in order to improve environmental and population health in Nigeria.

Keywords: environmental pollution, health benefits, oil-led economic development, petroleum exploitation

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Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli

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Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.

Keywords: assessment, education, nurse, triage

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Authors: María de los Ángeles Cerda González, Itzel Arriaga Hurtado, Pascacio José Martínez Pichardo

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In México, the recognition of refugee condition is a fundamental right which, as host State, has the obligation of respect, protect, and fulfill to the foreigners – where we can find the figure of immigrants in irregular situation-, that cannot return to their country of origin for humanitarian reasons. The recognition of the refugee condition as a fundamental right in the Mexican law system proceeds under these situations: 1. The immigrant applies for the refugee condition, even without the necessary proving elements to accredit the humanitarian character of his departure from his country of origin. 2. The immigrant does not apply for the recognition of refugee because he does not know he has the right to, even if he has the profile to apply for. 3. The immigrant who applies fulfills the requirements of the administrative procedure and has access to the refugee recognition. Of the three situations above, only the last one is contemplated for the national indexes of the status refugee; and the first two prove the inefficiency of the governmental system viewed from its lack of sensibility consequence of the no education in human rights matter and which results in the legal vulnerability of the immigrants in irregular situation because they do not have access to the procuration and administration of justice. In the aim of determining the causes and consequences of the no recognition of the refugee status, this investigation was structured from a systemic analysis which objective is to show the advances in Central American humanitarian emergency investigation, the Mexican States actions to protect, respect and fulfil the fundamental right of refugee of immigrants in irregular situation and the social and legal vulnerabilities suffered by Central Americans in Mexico. Therefore, to achieve the deduction of the legal nature of the humanitarian emergency from the Human Rights as a branch of the International Public Law, a conceptual framework is structured using the inductive deductive method. The problem statement is made from a legal framework to approach a theoretical scheme under the theory of social systems, from the analysis of the lack of communication of the governmental and normative subsystems of the Mexican legal system relative to the process undertaken by the Central American immigrants to achieve the recognition of the refugee status as a human right. Accordingly, is determined that fulfilling the obligations of the State referent to grant the right of the recognition of the refugee condition, would mean a guideline for a new stage in Mexican Law, because it would enlarge the constitutional benefits to everyone whose right to the recognition of refugee has been denied an as consequence, a great advance in human rights matter would be achieved.

Keywords: central American immigrants in irregular situation, humanitarian emergency, human rights, refugee

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Authors: Alice D. Dioquino, Olivia N. Buzon, Emilio F. Aguinaldo, Ruel Avila, Erwin R. Callo, Cristy Ocampo, Malvin R. Tabajen, Marla C. Papango, Marilou M. Ubina, Josephine Tondo, Cromwell L. Valeriano

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The main purpose of this study was to develop, evaluate and validate courseware on Selected Topics in Mathematics, Science, and the English Language. Specifically, it aimed to: 1. Identify the appropriate Instructional Systems Design (ISD) model in the development of the courseware material; 2. Assess the courseware material according to its: a. Content Characteristics; b. Instructional Characteristics; and c. Technical Characteristics 3. Find out if there is a significant difference in the performance of students before and after using the tutorial CAI. This research is developmental as well as a one group pretest-posttest design. The study had two phases. Phase I includes the needs analysis, writing of lessons and storyboard by the respective experts in each field. Phase II includes the digitization or the actual development of the courseware by the faculty of the ICT department. In this phase it adapted an instructional systems design (ISD) model which is the ADDIE model. ADDIE stands for Analysis, Design, Development, Implementation and Evaluation. Formative evaluation was conducted simultaneously with the different phases to detect and remedy any bugs in the courseware along the areas of content, instructional and technical characteristics. The expected output are the digitized lessons in Algebra, Biology, Chemistry, Physics and Communication Arts in English. Students and some IT experts validated the CAI material using the Evaluation Form by Wong & Wong. They validated the CAI materials as Highly Acceptable with an overall mean rating of 4.527and standard deviation of 0 which means that they were one in the ratings they have given the CAI materials. A mean gain was recorded and computing the t-test for dependent samples it showed that there were significant differences in the mean achievement of the students before and after the treatment (using CAI). The identified ISD model used in the development of the tutorial courseware was the ADDIE model. The quantitative analyses of data based on ratings given by the respondents’ shows that the tutorial courseware possess the characteristics and or qualities of a very good computer-based courseware. The ratings given by the different evaluators with regard to content, instructional, and technical aspects of the Tutorial Courseware are in conformity towards being excellent. Students performed better in mathematics, biology chemistry, physics and the English Communication Arts after they were exposed to the tutorial courseware.

Keywords: CAI, tutorial courseware, Instructional Systems Design (ISD) Model, education

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Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

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Authors: Lo Kai Chung

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Fathers in the family of disabled children play a crucial role in fostering child development. Previous studies addressing emotions of father involvement in rearing children with special needs have been rare. With reference to the cultural orientation and masculine idea of Chinese fathers, shame and guilt are probable causal emotions that affect fathers’ psycho-behavioral reactions and, thus, father involvement. Based on the findings of our earlier qualitative studies, the current study aims to develop and validate a multi-item scale of guilt or shame and explore their relations with and fatherhood in families with children with special needs. A model is proposed to understand the roles that shame and guilt play in affecting fathers’ involvement in their family system. The severity and type of the child’s special needs are regarded as independent variables affecting the father’s emotional responses – shame and guilt. It is hypothesized that shame and guilt, under the influence of masculinity, lead to avoidance and compensation, respectively, which subsequently decrease and increase father involvement with children with special needs. A cross-sectional online questionnaire survey of fathers with children with special needs recruited by convenience sampling was conducted. Potential participants were reached by bulk emails, related groups on the Internet and education/social services providers. Totally 537 valid sets of online questionnaires were collected from fathers of children with special needs. EFA on the items pool of shame and guilt was performed, resulting in an x-item single-factor solution and y-item single-factor solution, respectively. Further path model analysis revealed that shame and guilt, under the influence of masculinity, showed differential avoidance and compensation responses and resulted in a decrease and increase in father involvement with special needs children. Demographic and key confounding variables were controlled in the analysis. The shame and guilt scales developed show good psychometric properties. Furthermore, they showed significant differential impacts, under the influence of masculinity, on avoidance and compensation behaviours, consequently resulting in a decrease/increase in father involvement in the expected directions. The findings have important theoretical and practical implications. At the community and policy level, the findings inform the design of strategies for strengthening the role of men in families with special needs children.

Keywords: emotions, father involvement, guilt, shame, special needs

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Authors: Rosemary E. Huntriss, Lucy Jones

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Obesity and excess weight continue to be significant health problems in England. Traditional weight management programmes offer face-to-face support or group education. Remote care is recognised as a viable means of support; however, its effectiveness has not previously been evaluated in a tier 3 weight management setting. This service evaluation explored the effectiveness of online coaching, telephone support, and face-to-face support as optional management strategies within a tier 3 weight management programme. Outcome data were collected for adults with a BMI ≥ 45 or ≥ 40 with complex comorbidity who were referred to a Tier 3 weight management programme from January 2018 and had been discharged before October 2018. Following an initial 45-minute consultation with a specialist weight management dietitian, patients were offered a choice of follow-up support in the form of online coaching supported by an app (8 x 15 minutes coaching), face-to-face or telephone appointments (4 x 30 minutes). All patients were invited to a final 30-minute face-to-face assessment. The planned intervention time was between 12 and 24 weeks. Patients were offered access to adjunct face-to-face or telephone psychological support. One hundred and thirty-nine patients were referred into the programme from January 2018 and discharged before October 2018. One hundred and twenty-four patients (89%) attended their initial assessment. Out of those who attended their initial assessment, 110 patients (88.0%) completed more than half of the programme and 77 patients (61.6%) completed all sessions. The average length of the completed programme (all sessions) was 17.2 (SD 4.2) weeks. Eighty-five (68.5%) patients were coached online, 28 (22.6%) patients were supported face-to-face support, and 11 (8.9%) chose telephone support. Two patients changed from online coaching to face-to-face support due to personal preference and were included in the face-to-face group for analysis. For those with data available (n=106), average weight loss across the programme was 4.85 (SD 3.49)%; average weight loss was 4.70 (SD 3.19)% for online coaching, 4.83 (SD 4.13)% for face-to-face support, and 6.28 (SD 4.15)% for telephone support. There was no significant difference between weight loss achieved with face-to-face vs. online coaching (4.83 (SD 4.13)% vs 4.70 (SD 3.19) (p=0.87) or face-to-face vs. remote support (online coaching and telephone support combined) (4.83 (SD 4.13)% vs 4.85 (SD 3.30)%) (p=0.98). Remote support has been shown to be as effective as face-to-face support provided by a dietitian in the short-term within a tier 3 weight management setting. The completion rates were high compared with another tier 3 weight management services suggesting that offering remote support as an option may improve completion rates within a weight management service.

Keywords: dietitian, digital health, obesity, weight management

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Authors: Joanna Błach, Anna Doś, Maria Gorczyńska, Monika Wieczorek-Kosmala

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Financial innovations can be regarded as the cause and the effect of the evolution of the financial system. Most of financial innovations are created by various financial institutions for their own purposes and needs. However, due to their diversity, financial innovations can be also applied by various business entities (other than financial institutions). This paper focuses on the potential application of financial innovations by non-financial companies. It is assumed that financial innovations may be effectively applied in all fields of corporate financial decisions integrating financial management with the risk management process. Appropriate application of financial innovations may enhance the development of the company and increase its value by improving its financial situation and reducing the level of risk. On the other hand, misused financial innovations may become the source of extra risk for the company threatening its further operation. The main objective of the paper is to identify the major types of financial innovations offered to non-financial companies by the banking system in Poland. It also aims at identifying the main factors determining the creation of financial innovations in the banking system in Poland and indicating future directions of their development. This paper consists of conceptual and empirical part. Conceptual part based on theoretical study is focused on the determinants of the process of financial innovations and their application by the non-financial companies. Theoretical study is followed by the empirical research based on the analysis of the actual offer of the 20 biggest banks operating in Poland with regard to financial innovations offered to SMEs and large corporations. These innovations are classified according to the main functions of the integrated financial management, such as: Financing, investment, working capital management and risk management. Empirical study has proved that the biggest banks operating in the Polish market offer to their business customers many types and classes of financial innovations. This offer appears vast and adequate to the needs and purposes of the Polish non-financial companies. It was observed that financial innovations pertained to financing decisions dominate in the banks’ offer. However, due to high diversification of the offered financial innovations, business customers may effectively apply them in all fields and areas of integrated financial management. It should be underlined, that the banks’ offer is highly dispersed, which may limit the implementation of financial innovations in the corporate finance. It would be also recommended for the banks operating in the Polish market to intensify the education campaign aiming at increasing knowledge about financial innovations among business customers.

Keywords: banking products and services, banking sector in Poland, corporate financial management, financial innovations, theory of innovation

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Authors: Areti Angeliki Veroniki, Sofia Tsokani, Evangelos Paraskevaidis, Dimitris Mavridis

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The plethora of diagnostic test accuracy (DTA) studies has led to the increased use of systematic reviews and meta-analysis of DTA studies. Clinicians and healthcare professionals often consult DTA meta-analyses to make informed decisions regarding the optimum test to choose and use for a given setting. For example, the human papilloma virus (HPV) DNA, mRNA, and cytology can be used for the cervical intraepithelial neoplasia grade 2+ (CIN2+) diagnosis. But which test is the most accurate? Studies directly comparing test accuracy are not always available, and comparisons between multiple tests create a network of DTA studies that can be synthesized through a network meta-analysis of diagnostic tests (DTA-NMA). The aim is to summarize the DTA-NMA methods for at least three index tests presented in the methodological literature. We illustrate the application of the methods using a real data set for the comparative accuracy of HPV DNA, HPV mRNA, and cytology tests for cervical cancer. A search was conducted in PubMed, Web of Science, and Scopus from inception until the end of July 2019 to identify full-text research articles that describe a DTA-NMA method for three or more index tests. Since the joint classification of the results from one index against the results of another index test amongst those with the target condition and amongst those without the target condition are rarely reported in DTA studies, only methods requiring the 2x2 tables of the results of each index test against the reference standard were included. Studies of any design published in English were eligible for inclusion. Relevant unpublished material was also included. Ten relevant studies were finally included to evaluate their methodology. DTA-NMA methods that have been presented in the literature together with their advantages and disadvantages are described. In addition, using 37 studies for cervical cancer obtained from a published Cochrane review as a case study, an application of the identified DTA-NMA methods to determine the most promising test (in terms of sensitivity and specificity) for use as the best screening test to detect CIN2+ is presented. As a conclusion, different approaches for the comparative DTA meta-analysis of multiple tests may conclude to different results and hence may influence decision-making. Acknowledgment: This research is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning 2014-2020» in the context of the project “Extension of Network Meta-Analysis for the Comparison of Diagnostic Tests ” (MIS 5047640).

Keywords: colposcopy, diagnostic test, HPV, network meta-analysis

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

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Electronic devices have become an essential part of our lives. Various reports have highlighted the alarming usage of electronic devices at early ages and its long-term developmental consequences. More sedentary screen time was associated with increased adiposity, worse cognitive and motor development, and psychosocial health. Apart from the problems caused by children’s own screen time, parents today are often paying less attention to their children due to hand-held device. Some anecdotes suggest that distracted parenting has negative impact on parent-child relationship. This study examined whether distracted parenting detrimentally affected parent-child activities which may, in turn, impair children’s psychosocial health. In 2018/19, we recruited a cohort of preschoolers from 32 local kindergartens in Tin Shui Wai and Sham Shui Po for a 5-year programme aiming to build stronger foundations for children from disadvantaged backgrounds through an integrated support model involving medical, education and social service sectors. A comprehensive set of questionnaires were used to survey parents on their frequency of being distracted while parenting and their frequency of learning and recreational activities with children. Furthermore, they were asked to report children’s screen time amount and their psychosocial problems. Mediation analyses were performed to test the direct and indirect effects of electronic device-distracted parenting on children’s psychosocial problems. This study recruited 873 children (448 females and 425 males, average age: 3.42±0.35). Longer screen time was associated with more psychosocial difficulties (Adjusted B=0.37, 95%CI: 0.12 to 0.62, p=0.004). Children’s screen time positively correlated with electronic device-distracted parenting (r=0.369, p < 01). We also found that electronic device-distracted parenting was associated with more hyperactive/inattentive problems (Adjusted B=0.66, p < 0.01), fewer prosocial behavior (Adjusted B=-0.74, p < 0.01), and more emotional symptoms (Adjusted B=0.61, p < 0.001) in children. Further analyses showed that electronic device-distracted parenting exerted influences both directly and indirectly through parent-child interactions but to different extent depending upon the outcome under investigation (38.8% for hyperactivity/inattention, 31.3% for prosocial behavior, and 15.6% for emotional symptoms). We found that parents’ use of devices and children’s own screen time both have negative effects on children’s psychosocial health. It is important for parents to set “device-free times” each day so as to ensure enough relaxed downtime for connecting with children and responding to their needs.

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

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Authors: Sven Borén, Lisiana Nurhadi, Henrik Ny

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From a theoretical perspective, electric buses can be more sustainable and can be cheaper than fossil fuelled buses in city traffic. The authors have not found other studies based on actual urban public transport in Swedish winter climate. Further on, noise measurements from buses for the European market were found old. The aims of this follow-up study was therefore to test and possibly verify in a real-life environment how energy efficient and silent electric buses are, and then conclude on if electric buses are preferable to use in public transport. The Ebusco 2.0 electric bus, fitted with a 311 kWh battery pack, was used and the tests were carried out during November 2014-April 2015 in eight municipalities in the south of Sweden. Six tests took place in urban traffic and two took place in more of a rural traffic setting. The energy use for propulsion was measured via logging of the internal system in the bus and via an external charging meter. The average energy use turned out to be 8% less (0,96 kWh/km) than assumed in the earlier theoretical study. This rate allows for a 320 km range in public urban traffic. The interior of the bus was kept warm by a diesel heater (biodiesel will probably be used in a future operational traffic situation), which used 0,67 kWh/km in January. This verified that electric buses can be up to 25% cheaper when used in public transport in cities for about eight years. The noise was found to be lower, primarily during acceleration, than for buses with combustion engines in urban bus traffic. According to our surveys, most passengers and drivers appreciated the silent and comfortable ride and preferred electric buses rather than combustion engine buses. Bus operators and passenger transport executives were also positive to start using electric buses for public transport. The operators did however point out that procurement processes need to account for eventual risks regarding this new technology, along with personnel education. The study revealed that it is possible to establish a charging infrastructure for almost all studied bus lines. However, design of a charging infrastructure for each municipality requires further investigations, including electric grid capacity analysis, smart location of charging points, and tailored schedules to allow fast charging. In conclusion, electric buses proved to be a preferable alternative for all stakeholders involved in public bus transport in the studied municipalities. However, in order to electric buses to be a prominent support for sustainable development, they need to be charged either by stand-alone units or via an expansion of the electric grid, and the electricity should be made from new renewable sources.

Keywords: sustainability, electric, bus, noise, greencharge

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Authors: Warner Woodworth

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While the explosion of autocratic governments is growing globally, perhaps nowhere is it more obvious than in the United States since 2015. In that nation, democracy is increasingly caving to extreme Right-wing movements, especially after Donald Trump lost to Joe Biden in the 2020 election. Angered by that rejection, he and his support groups that foster extremism began an all-out assault on freedom, beginning with the attack on the US Capitol itself on January 6, 2021. Since then, following Trump’s two presidential impeachments, 34 felony convictions, 88 impending court cases by the Department of Justice, and crimes by some of his most ardent co-conspirators, the rule of law, traditional political values, and even the Constitution became threatened. Now, since his Nov. 5, 2024, campaign victory, the dark clouds of autocracies loom larger every day. To wit: Appointments to Trump’s cabinet are all extremists promising to eliminate major beneficiary citizen programs such as healthcare, civil rights, education, justice, and a massive move to drive millions of immigrants from the country. The political divide is at its highest extreme since the 1861 Civil War between North and South. Autocratization is manifest daily in fake news media, as well as traditional conspiracy organizations such as politically violent motorcycle gangs, the John Birch Society, Eagle Forum, and Anti-Constitutional Sheriffs and other law enforcement groups. Even worse is the expansion of violent groups such as the Proud Boys, Aryan Nations, Patriot Front, White Nationalists, Stormfront, Oath Keepers, Three Percenters, Ku Klux Klan, Moms for Liberty, American Nazi Party, Operation Homeland, Skinhead organizations, America First, Veterans on Patrol, hundreds of militia groups from coast to coast, and of course, hundreds more under the banner of Trump’s movement, ‘Make America Great Again.’ This paper will draw on the author’s decades of researching these groups and Trump's new authoritarian agenda. Qualitative data will include expert analysis from multiple academic disciplines as Americans, and the larger world seek to understand these dangerous U.S. trends and future prospects. The paper concludes by sharing the prospects of America’s future over the next four years, or longer if Trump’s vow to be a dictator is extended.

Keywords: American authoritarianism, trump, fascism, conspiracies, extremism

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Authors: Freya Willicks

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The society of the 21st century is characterized by dynamic and complexity, developments that also shape universities and university life. The Bologna reform, for example, has led to restructuring at many European universities. Today's university teachers, therefore, have to meet many expectations: Their tasks include not only teaching but also the general improvement of the quality of teaching, good research, the management of various projects or the development of their own personal skills. This requires a high degree of flexibility and openness to change. The resulting pressure can often lead to exhaustion. Coaching can be a way for university teachers to cope with these pressures because it gives them the opportunity to discuss stressful situations with a coach and self-reflect on them. As a result, more and more universities in Europe offer to coach to their teachers. An analysis of the services provided at universities in Germany, however, quickly reveals an immense disagreement with regard to the understanding of ‘coaching’. A variety of terms is used, such as coaching, counselling or supervision. In addition, each university defines its offer individually, from process-oriented consulting to expert consulting, from group training to individual coaching. The biographic backgrounds of those who coach are also very divergent, both external and internal coaches can be suitable. These findings lead to the following questions: Which structural characteristics for coaching at universities have been proven successful? What competencies should a good coach for university lecturers have? In order to answer these questions, a qualitative study was carried out. In a first step, qualitative semi-structured interviews (N = 14) were conducted, on the one hand with coaches for university teachers and on the other hand with university teachers who have been coached. In a second step, the interviews were transcribed and analyzed using Mayring's qualitative content analysis. The study shows how great the potential of coaching can be for university teachers, who otherwise have little opportunity to talk about their teaching in a private setting. According to the study, the coach should neither be a colleague nor a superior of the coachee but should take an independent perspective, as this is the only way for the coachee to openly reflect on himself/herself. In addition, the coach should be familiar with the university system, i.e., be an academic himself/herself. Otherwise, he/she cannot fully understand the complexity of the teaching situation and the role expectations. However, internal coaches do not necessarily have much coaching experience or explicit coaching competencies. They often come from the university's own didactics department, are experts in didactics, but do not necessarily have a certified coaching education. Therefore, it is important to develop structures and guidelines for internal coaches to support their coaching. In further analysis, such guidelines will be developed on the basis of these interviews.

Keywords: coaching, university coaching, university didactics, qualitative interviews

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Authors: Manavjit Singh Dhindsa, Ursula Das, Kshirasagar Naik, Marzia Zaman, Richard Purcell, Srinivas Sampalli, Abdul Mutakabbir, Chung-Horng Lung, Thambirajah Ravichandran

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These days, wildland fires, also known as forest fires, are more prevalent than ever. Wildfires have major repercussions that affect ecosystems, communities, and the environment in several ways. Wildfires lead to habitat destruction and biodiversity loss, affecting ecosystems and causing soil erosion. They also contribute to poor air quality by releasing smoke and pollutants that pose health risks, especially for individuals with respiratory conditions. Wildfires can damage infrastructure, disrupt communities, and cause economic losses. The economic impact of firefighting efforts, combined with their direct effects on forestry and agriculture, causes significant financial difficulties for the areas impacted. This research explores different forest fire spread models and presents a comprehensive review of various techniques and methodologies used in the field. A forest fire spread model is a computational or mathematical representation that is used to simulate and predict the behavior of a forest fire. By applying scientific concepts and data from empirical studies, these models attempt to capture the intricate dynamics of how a fire spreads, taking into consideration a variety of factors like weather patterns, topography, fuel types, and environmental conditions. These models assist authorities in understanding and forecasting the potential trajectory and intensity of a wildfire. Emphasizing the need for a comprehensive understanding of wildfire dynamics, this research explores the approaches, assumptions, and findings derived from various models. By using a comparison approach, a critical analysis is provided by identifying patterns, strengths, and weaknesses among these models. The purpose of the survey is to further wildfire research and management techniques. Decision-makers, researchers, and practitioners can benefit from the useful insights that are provided by synthesizing established information. Fire spread models provide insights into potential fire behavior, facilitating authorities to make informed decisions about evacuation activities, allocating resources for fire-fighting efforts, and planning for preventive actions. Wildfire spread models are also useful in post-wildfire mitigation strategies as they help in assessing the fire's severity, determining high-risk regions for post-fire dangers, and forecasting soil erosion trends. The analysis highlights the importance of customized modeling approaches for various circumstances and promotes our understanding of the way forest fires spread. Some of the known models in this field are Rothermel’s wildland fuel model, FARSITE, WRF-SFIRE, FIRETEC, FlamMap, FSPro, cellular automata model, and others. The key characteristics that these models consider include weather (includes factors such as wind speed and direction), topography (includes factors like landscape elevation), and fuel availability (includes factors like types of vegetation) among other factors. The models discussed are physics-based, data-driven, or hybrid models, also utilizing ML techniques like attention-based neural networks to enhance the performance of the model. In order to lessen the destructive effects of forest fires, this initiative aims to promote the development of more precise prediction tools and effective management techniques. The survey expands its scope to address the practical needs of numerous stakeholders. Access to enhanced early warning systems enables decision-makers to take prompt action. Emergency responders benefit from improved resource allocation strategies, strengthening the efficacy of firefighting efforts.

Keywords: artificial intelligence, deep learning, forest fire management, fire risk assessment, fire simulation, machine learning, remote sensing, wildfire modeling

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Authors: Rebecca-Lee Kuhnert, Ron Rapee

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Up to 15% of Australian youth will experience an emotional disorder, yet relatively few get the help they need. Schools provide an ideal environment through which we can identify young people who are struggling and provide them with appropriate help. Universal mental health screening is a method by which all young people in school can be quickly assessed for emotional disorders, after which identified youth can be linked to appropriate health services. Despite the obvious logic of this process, universal mental health screening has received little scientific evaluation and even less application in Australian schools. This study will develop methods for Australian education systems to help identify young people (aged 9-17 years old) who are struggling with existing and emerging emotional disorders. Prior to testing, a series of focus groups will be run to get feedback and input from young people, parents, teachers, and mental health professionals. They will be asked about their thoughts on school-based screening methods and and how to best help students at risk of emotional distress. Schools (n=91) across New South Wales, Australia will be randomised to do either immediate screening (in May 2021) or delayed screening (in February 2022). Students in immediate screening schools will complete a long online mental health screener consisting of standard emotional health questionnaires. Ultimately, this large set of items will be reduced to a small number of items to form the final brief screener. Students who score in the “at-risk” range on any measure of emotional health problems will be identified to schools and offered pathways to relevant help according to the most accepted and approved processes identified by the focus groups. Nine months later, the same process will occur among delayed screening schools. At this same time, students in the immediate screening schools will complete screening for a second time. This will allow a direct comparison of the emotional health and help-seeking between youth whose schools had engaged in the screening and pathways to care process (immediate) and those whose schools had not engaged in the process (delayed). It is hypothesised that there will be a significant increase in students who receive help from mental health support services after screening, compared with baseline. It is also predicted that all students will show significantly less emotional distress after screening and access to pathways of care. This study will be an important contribution to Australian youth mental health prevention and early intervention by determining whether school screening leads to a greater number of young people with emotional disorders getting the help that they need and improving their mental health outcomes.

Keywords: children and young people, early intervention, mental health, mental health screening, prevention, school-based mental health

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Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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Authors: Bryan Jefry Sabillon, Arlex Molina Cedillo

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Currently, the raise in the demand of electrical energy as a consequence of the development of technology and population growth, as well as some projections made by ‘La Agencia Internacional de la Energía’ (AIE) and research institutes, reveal alarming data about the expected raise of it in the next few decades. Because of this, something should be made to raise the awareness of the rational and efficient usage of this resource. Because of the global concern of providing electrical energy to isolated areas, projects consisting of energy generation using renewable resources are commonly carried out. On a socioeconomically and cultural point of view, it can be foreseen a positive impact that would result for the society to have this resource. This article is focused on the great potential that Honduras shows, as a country that is looking forward to produce renewable energy due to the crisis that it’s living nowadays. Because of this, we present a detailed research that exhibits the main necessities that the rural communities are facing today, to allay the negative aspects due to the scarcity of electrical energy. We also discuss which should be the type of electrical generation method to be used, according to the disposition, geography, climate, and of course the accessibility of each area. Honduras is actually in the process of developing new methods for the generation of energy; therefore, it is of our concern to talk about renewable energy, the exploitation of which is a global trend. Right now the countries’ main energetic generation methods are: hydrological, thermic, wind, biomass and photovoltaic (this is one of the main sources of clean electrical generation). The use of these resources was possible partially due to the studies made by the organizations that focus on electrical energy and its demand, such as ‘La Cooperación Alemana’ (GIZ), ‘La Secretaria de Energía y Recursos Naturales’ (SERNA), and ‘El Banco Centroamericano de Integración Económica’ (BCIE), which eased the complete guide that is to be used in the protocol to be followed to carry out the three stages of this type of projects: 1) Licences and Permitions, 2) Fincancial Aspects and 3) The inscription for the Protocol in Kyoto. This article pretends to take the reader through the necessary information (according to the difficult accessibility that each zone might present), about the best option of electrical generation in zones that are totally isolated from the net, pretending to use renewable resources to generate electrical energy. We finally conclude that the usage of hybrid systems of generation of energy for small remote communities brings about a positive impact, not only because of the fact of providing electrical energy but also because of the improvements in education, health, sustainable agriculture and livestock, and of course the advances in the generation of energy which is the main concern of this whole article.

Keywords: energy, isolated, renewable, accessibility

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Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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Authors: Noreen Pulte

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Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.

Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags

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Authors: Richa Raje, Anumol Antony

Abstract:

Playing is the foremost stepping stone for childhood development. Play is an essential aspect of a child’s development and learning because it creates meaningful enduring environmental connections and increases children’s performance. The children’s proficiencies are ever varying in their course of growth. There is innovation in the activities, as it kindles the senses, surges the love for exploration, overcomes linguistic barriers and physiological development, which in turn allows them to find their own caliber, spontaneity, curiosity, cognitive skills, and creativity while learning during play. This paper aims to comprehend the learning in play which is the most essential underpinning aspect of the outdoor play area. It also assesses the trend of playgrounds design that is merely hammered with equipment's. It attempts to derive a relation between the natural environment and children’s activities and the emotions/senses that can be evoked in the process. One of the major concerns with our outdoor play is that it is limited to an area with a similar kind of equipment, thus making the play highly regimented and monotonous. This problem is often lead by the strict timetables of our education system that hardly accommodates play. Due to these reasons, the play areas remain neglected both in terms of design that allows learning and wellbeing. Poorly designed spaces fail to inspire the physical, emotional, social and psychological development of the young ones. Currently, the play space has been condensed to an enclosed playground, driveway or backyard which confines the children’s capability to leap the boundaries set for him. The paper emphasizes on study related to kids ranging from 5 to 11 years where the behaviors during their interactions in a playground are mapped and analyzed. The theory of affordance is applied to various outdoor play areas, in order to study and understand the children’s environment and how variedly they perceive and use them. A higher degree of affordance shall form the basis for designing the activities suitable in play spaces. It was observed during their play that, they choose certain spaces of interest majority being natural over other artificial equipment. The activities like rolling on the ground, jumping from a height, molding earth, hiding behind tree, etc. suggest that despite equipment they have an affinity towards nature. Therefore, we as designers need to take a cue from their behavior and practices to be able to design meaningful spaces for them, so the child gets the freedom to test their precincts.

Keywords: children, landscape design, learning environment, nature and play, outdoor play

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Authors: Chijioke Oliver Nwodoh, Jonah Ikechukwu Eze, Loretta Chika Ukwuaba, Ifeoma Ndubuisi, Ada Carol Nwaneri, Ijeoma Lewechi Okoronkwo

Abstract:

Presence of nursing workforce with unequal qualification and status in Nigeria has undermined the growth of nursing profession in the country. Upgrading of the existing basic and post-basic nursing schools to degree-awarding institutions in Nigeria is a way-forward to solving this inequality problem and Nigeria teaching hospitals are in vantage position for this project due to the already existing supportive structure and manpower in those hospitals. What the nurse trainers and the stakeholders of the teaching hospitals may hold for or against the upgrading is a determining factor for the upgrading project, but that is not clear and has not been investigated in Nigeria. The study investigated the perception of nurse trainers and stakeholders of teaching hospitals in Enugu State of Nigeria on the obstacles and ways-forward to upgrading nursing schools to degree-awarding institutions in Nigeria. The study specifically elicited what the subjects may view as obstacles to upgrading basic and post-basic nursing schools to degree-awarding institutions in Nigeria and ascertained their suggestions on the possible ways of overcoming the obstacles. By utilizing cross-sectional descriptive design and a purposive sampling procedure, 78 accessible subjects out of a total population of 87 were used for the study. The generated data from the subjects were analyzed using frequencies, percentages and mean for the research questions and Pearson’s chi-square for the hypotheses, with the aid of Statistical Package for Social Sciences Version 20.0. The result showed that lack of extant policy, fund, and disunity among policy makers and stakeholders of nursing profession are the main obstacles to the upgrading. However, the respondents did not see items like: stakeholders and nurse trainers of basic and post-basic schools of nursing; fear of admitting and producing poor quality nurses; and so forth, as obstacles to the upgrading project. Institution of the upgrading policy by Nursing and Midwifery Council of Nigeria, funding, awareness creation for the upgrading and unison among policy makers and stakeholders of nursing profession are the major possible ways to overcome the obstacles. The difference in the subjects’ perceptions between the two hospitals was found to be statistically insignificant (p > 0.05). It is recommended that the policy makers and stakeholders of nursing in Nigeria should unite and liaise with Federal Ministries of Health and Education for modalities and actualization of upgrading nursing schools to degree-awarding institutions in Nigeria.

Keywords: nurse trainers, obstacles, perception, stakeholders, teaching hospital, upgrading basic nursing schools, ways-forward

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