Search results for: emergency (999) call
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1575

Search results for: emergency (999) call

555 Clinical Features of Acute Aortic Dissection Patients Initially Diagnosed with ST-Segment Elevation Myocardial Infarction

Authors: Min Jee Lee, Young Sun Park, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Jae Ho Lee, Yoon Seon Lee, Kyung Soo Lim, Won Young Kim

Abstract:

Background: Acute myocardial infarction (AMI) concomitant with acute aortic syndrome (AAS) is rare but prompt recognition of concomitant AAS is crucial, especially in patients with ST-segment elevation myocardial infarction (STEMI) because misdiagnosis with early thrombolytic or anticoagulant treatment may result in catastrophic consequences. Objectives: This study investigated the clinical features of patients of STEMI concomitant with AAS that may lead to the diagnostic clue. Method: Between 1 January 2010 and 31 December 2014, 22 patients who were the initial diagnosis of acute coronary syndrome (AMI and unstable angina) and AAS (aortic dissection, intramural hematoma and ruptured thoracic aneurysm) in our emergency department were reviewed. Among these, we excluded 10 patients who were transferred from other hospital and 4 patients with non-STEMI, leaving a total of 8 patients of STEMI concomitant with AAS for analysis. Result: The mean age of study patients was 57.5±16.31 years and five patients were Standford type A and three patients were type B aortic dissection. Six patients had ST-segment elevation in anterior leads and two patients had in inferior leads. Most of the patients had acute onset, severe chest pain but no patients had dissecting nature chest pain. Serum troponin I was elevated in three patients but all patients had D-dimer elevation. Aortic regurgitation or regional wall motion abnormality was founded in four patients. However, widened mediastinum was seen in all study patients. Conclusion: When patients with STEMI have elevated D-dimer and widened mediastinum, concomitant AAS may have to be suspected.

Keywords: aortic dissection, myocardial infarction, ST-segment, d-dimer

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554 Sterilization Incident Analysis by the Association of Litigation and Risk Management Method

Authors: Souhir Chelly, Asma Ben Cheikh, Hela Ghali, Salwa Khefacha, Lamine Dhidah, Mohamed Ben Rejeb, Houyem Said Latiri

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The hospital risk management department is firstly involved in the methodological analysis of grade zero sterilization incidents. The system is based on a subsequent analysis process in compliance with the ongoing requirements of the Haute Autorité de santé (HAS) for a reactive approach to risk, allowing to identify failures and start the appropriate preventive and corrective measures. The use of the association of litigation and risk management (ALARM) method makes easier the grade zero analysis and brings to light the team or institutional, organizational, temporal, individual factors representative of undesirable effects. Two main factors come out again from this analysis, pre-disinfection step of the emergency block unsupervised instrumentalist intern was poorly done since she did not remove the battery from micro air motor. At the sterilization unit, the worker who was not supervised by the nurse did the conditioning of the motor without having checked it if it still contained the battery. The main cause is that the management of human resources was inadequate at both levels, the instrumental trainee in the block who was not supervised by his supervisor and the worker of the sterilization unit who was not supervised by the responsible nurse. There is a lack of research help, advice, and collaboration. The difficulties encountered during this type of analysis are multiple. The first is based on its necessary acceptance by the various actors of care involved, which should not perceive it as a tool leading to individual punishment, but rather as a means to improve their practices.

Keywords: ALARM (Association of Litigation and Risk Management Method), incident, risk management, sterilization

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553 Ipsilateral Heterotopic Ossification in the Knee and Shoulder Post Long COVID-19

Authors: Raheel Shakoor Siddiqui, Calvin Mathias, Manikandar Srinivas Cheruvu, Bobin Varghese

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A 58 year old gentleman presented to accident and emergency at the district general hospital with worsening shortness of breath and a non-productive cough over a period of five days. He was initially admitted under the medical team for suspicion of SARS-CoV-2 (COVID-19) pneumonitis. Subsequently, upon deterioration of observations and a positive COVID-19 PCR, he was taken to intensive care for invasive mechanical ventilation. He required frequent proning, inotropic support and was intubated for thirty-three days. After successful extubation, he developed myopathy with a limited range of motion to his right knee and right shoulder. Plain film imaging of these limbs demonstrated an unusual formation of heterotopic ossification without any precipitating trauma or surgery. Current literature demonstrates limited case series portraying heterotopic ossification post-COVID-19. There has been negligible evidence of heterotopic ossification in the ipsilateral knee and shoulder post-prolonged immobility secondary to a critical illness. Physiotherapy and rehabilitation are post-intensive care can be prolonged due to the formation of heterotopic ossification around joints. Prolonged hospital stays may lead to a higher risk of developing infections of the chest, urine and pressure sores. This raises the question of whether a severe systemic inflammatory immune response from the SARS-CoV-2 virus results in histopathological processes leading to the formation of heterotopic ossification not previously seen, requiring prolonged physiotherapy.

Keywords: orthopaedics, rehabilitation, physiotherapy, heterotopic ossification, COVID-19

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552 Urban Sustainable Development with Flood Crisis Management Approach

Authors: Ali Liaghat, Navid Tavanpour, Nima Tavanpour

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An increase in population and prevalence of urbanity have led plan makers and decision makers put effort into sustainable development of cities at national and local levels. One of the important issues in urban development is compliance with safety issues in cities. Despite natural disasters and unexpected events such as floods, earthquakes, hurricanes, fires, etc., urban development should be regarded as an axiom, or else any form of construction and development is not safe, because it will greatly harm economic growth and development and pose an obstacle to achieving sustainable development, plus a loss to lives and finances of people. Therefore, in line with urban development, it is necessary to identify particular environmental and local issues as determinants and pay attention to them at the top of everything, in that we can call it a good action and factor in urban sustainable developments. Physical structure of each city represents how it has developed or its development shaped and what incidents, changes, natural disasters it has undergone over time. Since any form of development plan should be in accordance with the previous situations of cities, disregarding it, unfortunately, can escalate into uncontrolled urban development, non-resistant and unstable construction against earthquake or invasion of river areas, destruction of agricultural lands or vegetation, periodic floods over time. It has been viewed as serious threats to developing cities, and typically caused destruction of bed and other urban facilities as well as damages to lives and finances. In addition, uncontrolled development has caused cities to look ugly in terms of urban façade, and off and on such unplanned measures caused the country to face countless losses, and it not only vitiates expenses incurred, but it will also impose additional costs of reconstruction, i.e. it is unsustainable development. Thus, in this paper, in addition to a discussion about necessity for a profound attitude toward this subject and making long-term plans, programs for organizing river and its surrounding area, creating open and green urban spaces, retrofitting and flood preventing are presented for sustainable safety and development of cities along with a critique of successful countries.

Keywords: flood, sustainable development, urbanisation, urban management

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551 Measuring Flood Risk concerning with the Flood Protection Embankment in Big Flooding Events of Dhaka Metropolitan Zone

Authors: Marju Ben Sayed, Shigeko Haruyama

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Among all kinds of natural disaster, the flood is a common feature in rapidly urbanizing Dhaka city. In this research, assessment of flood risk of Dhaka metropolitan area has been investigated by using an integrated approach of GIS, remote sensing and socio-economic data. The purpose of the study is to measure the flooding risk concerning with the flood protection embankment in big flooding events (1988, 1998 and 2004) and urbanization of Dhaka metropolitan zone. In this research, we considered the Dhaka city into two parts; East Dhaka (outside the flood protection embankment) and West Dhaka (inside the flood protection embankment). Using statistical data, we explored the socio-economic status of the study area population by comparing the density of population, land price and income level. We have drawn the cross section profile of the flood protection embankment into three different points for realizing the flooding risk in the study area, especially in the big flooding year (1988, 1998 and 2004). According to the physical condition of the study area, the land use/land cover map has been classified into five classes. Comparing with each land cover unit, historical weather station data and the socio-economic data, the flooding risk has been evaluated. Moreover, we compared between DEM data and each land cover units to find out the relationship with flood. It is expected that, this study could contribute to effective flood forecasting, relief and emergency management for a future flood event in Dhaka city.

Keywords: land use, land cover change, socio-economic, Dhaka city, GIS, flood

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550 Stakeholders Perceptions of the Linkage between Reproductive Rights and Environmental Sustainability: Environmental Mainstreaming, Injustice and Population Reductionism

Authors: Celine Delacroix

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Analyses of global emission scenarios demonstrate that slowing population growth could lead to substantial emissions reductions and play an important role to avoid dangerous climate change. For this reason, the advancement of individual reproductive rights might represent a valid climate change mitigation and adaptation option. With this focus, we reflected on population ethics and the ethical dilemmas associated with environmental degradation and climate change. We conducted a mixed-methods qualitative data study consisting of an online survey followed by in-depth interviews with stakeholders of the reproductive health and rights and environmental sustainability movements to capture the ways in which the linkages between family planning, population growth, and environmental sustainability are perceived by these actors. We found that the multi-layered marginalization of this issue resulted in two processes, the polarization of opinions and its eschewal from the public fora through population reductionism. Our results indicate that stakeholders of the reproductive rights and environmental sustainability movements find that population size and family planning influence environmental sustainability and overwhelmingly find that the reproductive health and rights ideological framework should be integrated in a wider sustainability frame reflecting environmental considerations. This position, whilst majoritarily shared by all participants, was more likely to be adopted by stakeholders of the environmental sustainability sector than those from the reproductive health and rights sector. We conclude that these processes, taken in the context of a context of a climate emergency, threaten to weaken the reproductive health and rights movement.

Keywords: environmental sustainability, family planning, population growth, population ethics, reproductive rights

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549 Realising the Socio-Economic Rights of Refugees Under Human Rights Law: A Case Study of South Africa

Authors: Taguekou Kenfack Alexie

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For a long time, refugee protection has constituted one of the main concerns of the international community as a whole and for the South African government in particular.The focus of this paper is on the challenges refugees face in accessing their rights in South Africa. In particular, it analyses the legal framework for the protection of the socio economic rights of refugees under international law, regional and domestic law and the extent to which the rights have been realized. The main hypothesis of the study centered on the fact that the social protection of refugees in South Africa is in conformity with international standards. To test this hypothesis, the qualitative research method was applied. Refugee related legal instruments were analyzed as well as academic publications, organizational reports and internet sources. The data analyzed revealed that there has been enormous progress in meeting international standards in the areas of education, emergency relief and assistance, protection of women and refugee children. The results also indicated that much remain to be desired in such areas as nutrition, shelter, health care, freedom of movement and very importantly, employment and social security. The paper also seeks to address the obstacles which prevent the proper treatment of refugees and to make recommendations as how the South African government can better regulate the treatment of refugees living in its territory.Recommendations include the amendment of the legal instruments that provide the normative framework for protection and improvement of protection policies to reflect the changing dynamics.

Keywords: international community, refugee, socioeconomic rights, social protection

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548 Ballistics of Main Seat Ejection Cartridges for Aircraft Application

Authors: B. A. Parate, K. D. Deodhar, V. K. Dixit, V. V. Rao

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This article outlines the ballistics of main seat ejection cartridges for aircraft application. The ballistics of main seat ejection cartridges plays a vital role during the ejection of the pilot in an emergency. The ballistic parameters such as maximum pressure, time is taken to reach the maximum pressure, and time required to reach half the maximum pressure contributes to the spinal injury of the pilot. Therefore, the evaluations of these parameters are very critical during various stages of development. Elaborate testing was carried out for main seat ejection cartridges on seat ejection tower (SET) at different operating temperatures considering physiological limits. As these trials are cumbersome in nature, a vented vessel (VV) testing facility was devised to lay down the performance parameters at hot and cold temperature conditions. Single base (SB) propellant having hepta-tubular configuration is selected as the main filling. Gun powder plays the role of a booster based on ballistic requirements. The evaluation methodology of various performance parameters of main seat ejection cartridges is explained in this paper. Physiological parameters such as maximum seat ejection velocity, acceleration, and rate of rising of acceleration are also experimentally determined on seat ejection tower. All the parameters are observed well within physiological limits. This paper addresses the internal ballistic of main seat ejection cartridges, propellant selection, its calculation, and evaluation of various performance parameters for an aircraft application.

Keywords: ballistics of seat ejection, ejection seat, gas generator, gun propulsion, main seat ejection cartridges, maximum pressure, performance parameters, propellant, progressive burning and vented vessel

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547 On Cloud Computing: A Review of the Features

Authors: Assem Abdel Hamed Mousa

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The Internet of Things probably already influences your life. And if it doesn’t, it soon will, say computer scientists; Ubiquitous computing names the third wave in computing, just now beginning. First were mainframes, each shared by lots of people. Now we are in the personal computing era, person and machine staring uneasily at each other across the desktop. Next comes ubiquitous computing, or the age of calm technology, when technology recedes into the background of our lives. Alan Kay of Apple calls this "Third Paradigm" computing. Ubiquitous computing is essentially the term for human interaction with computers in virtually everything. Ubiquitous computing is roughly the opposite of virtual reality. Where virtual reality puts people inside a computer-generated world, ubiquitous computing forces the computer to live out here in the world with people. Virtual reality is primarily a horse power problem; ubiquitous computing is a very difficult integration of human factors, computer science, engineering, and social sciences. The approach: Activate the world. Provide hundreds of wireless computing devices per person per office, of all scales (from 1" displays to wall sized). This has required new work in operating systems, user interfaces, networks, wireless, displays, and many other areas. We call our work "ubiquitous computing". This is different from PDA's, dynabooks, or information at your fingertips. It is invisible; everywhere computing that does not live on a personal device of any sort, but is in the woodwork everywhere. The initial incarnation of ubiquitous computing was in the form of "tabs", "pads", and "boards" built at Xerox PARC, 1988-1994. Several papers describe this work, and there are web pages for the Tabs and for the Boards (which are a commercial product now): Ubiquitous computing will drastically reduce the cost of digital devices and tasks for the average consumer. With labor intensive components such as processors and hard drives stored in the remote data centers powering the cloud , and with pooled resources giving individual consumers the benefits of economies of scale, monthly fees similar to a cable bill for services that feed into a consumer’s phone.

Keywords: internet, cloud computing, ubiquitous computing, big data

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546 Concurrent Validity of Synchronous Tele-Audiology Hearing Screening

Authors: Thidilweli Denga, Bessie Malila, Lucretia Petersen

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The Coronavirus Disease of 2019 (COVID-19) pandemic should be taken as a wake-up call on the importance of hearing health care considering amongst other things the electronic methods of communication used. The World Health Organization (WHO) estimated that by 2050, there will be more than 2.5 billion people living with hearing loss. These numbers show that more people will need rehabilitation services. Studies have shown that most people living with hearing loss reside in Low-Middle Income Countries (LIMC). Innovative technological solutions such as digital health interventions that can be used to deliver hearing health services to remote areas now exist. Tele-audiology implementation can potentially enable the delivery of hearing loss services to rural and remote areas. This study aimed to establish the concurrent validity of the tele-audiology practice in school-based hearing screening. The study employed a cross-sectional design with a within-group comparison. The portable KUDUwave Audiometer was used to conduct hearing screening from 50 participants (n=50). In phase I of the study, the audiologist conducted on-site hearing screening, while the synchronous remote hearing screening (tele-audiology) using a 5G network was done in phase II. On-site hearing screening results were obtained for the first 25 participants (aged between 5-6 years). The second half started with the synchronous tele-audiology model to avoid order-effect. Repeated sample t-tests compared threshold results obtained in the left and right ears for onsite and remote screening. There was a good correspondence between the two methods with a threshold average within ±5 dB (decibels). The synchronous tele-audiology model has the potential to reduce the audiologists' case overload, while at the same time reaching populations that lack access due to distance, and shortage of hearing professionals in their areas of reach. With reliable and broadband connectivity, tele-audiology delivers the same service quality as the conventional method while reducing the travel costs of audiologists.

Keywords: hearing screening, low-resource communities, portable audiometer, tele-audiology

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545 Multi-Elemental Analysis Using Inductively Coupled Plasma Mass Spectrometry for the Geographical Origin Discrimination of Greek Giant Beans “Gigantes Elefantes”

Authors: Eleni C. Mazarakioti, Anastasios Zotos, Anna-Akrivi Thomatou, Efthimios Kokkotos, Achilleas Kontogeorgos, Athanasios Ladavos, Angelos Patakas

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“Gigantes Elefantes” is a particularly dynamic crop of giant beans cultivated in western Macedonia (Greece). This variety of large beans growing in this area and specifically in the regions of Prespes and Kastoria is a protected designation of origin (PDO) species with high nutritional quality. Mislabeling of geographical origin and blending with unidentified samples are common fraudulent practices in Greek food market with financial and possible health consequences. In the last decades, multi-elemental composition analysis has been used in identifying the geographical origin of foods and agricultural products. In an attempt to discriminate the authenticity of Greek beans, multi-elemental analysis (Ag, Al, As, B, Ba, Be, Ca, Cd, Co, Cr, Cs, Cu, Fe, Ga, Ge, K, Li, Mg, Mn, Mo, Na, Nb, Ni, P, Pb, Rb, Re, Se, Sr, Ta, Ti, Tl, U, V, W, Zn, Zr) was performed by inductively coupled plasma mass spectrometry (ICP-MS) on 320 samples of beans, originated from Greece (Prespes and Kastoria), China and Poland. All samples were collected during the autumn of 2021. The obtained data were analysed by principal component analysis (PCA), an unsupervised statistical method, which allows for to reduce of the dimensionality of the enormous datasets. Statistical analysis revealed a clear separation of beans that had been cultivated in Greece compared with those from China and Poland. An adequate discrimination of geographical origin between bean samples originating from the two Greece regions, Prespes and Kastoria, was also evident. Our results suggest that multi-elemental analysis combined with the appropriate multivariate statistical method could be a useful tool for bean’s geographical authentication. Acknowledgment: This research has been financed by the Public Investment Programme/General Secretariat for Research and Innovation, under the call “YPOERGO 3, code 2018SE01300000: project title: ‘Elaboration and implementation of methodology for authenticity and geographical origin assessment of agricultural products.

Keywords: geographical origin, authenticity, multi-elemental analysis, beans, ICP-MS, PCA

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544 The Impact of Diabetes Mellitus on Skin and Soft Tissue Infections

Authors: Stephanie Cheng, Benjamin Poh, Vivyan Tay, Sachin Mathur

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Aim: Diabetes mellitus (DM) is a worldwide pandemic affecting 500 million people. It is known to be associated with increased susceptibility to soft tissue infections (STI). Despite being a major public health burden, the literature relating the effects of DM and the presentation, severity and healing of STIs in general surgical patients remain limited. Methods: We conducted a retrospective review of all patients admitted with STI in a tertiary teaching hospital over a 12-month period. Patient demographics and surgical outcomes were collected and analyzed. Results: During the study period, 1059 patients were admitted for STIs, of which 936 (88%) required surgical intervention. Diabetic patients were presented with a higher body-mass index (BMI) (28 vs 26), larger abscess size (24 vs 14 cm²) and a longer length of stay (LOS)(4.4 days vs 2.9 days). They also underwent a higher proportion of wide debridement as well as application of negative pressure wound therapy (NPWT) (42% vs 35%). More diabetic patients underwent subsequent re-operation within the same sitting (8 vs 4). There were no differences in re-admission rates within 30 days nor subsequent abscess formation in those followed for 6 months. Conclusion: The incidence of STIs among DM patients represents a significant disease burden; surgeons should consider intensive patient counseling and partnering with primary care providers in order to help reduce the incidence of future STI admissions based on lifestyle modification and glucose control.

Keywords: general surgery, emergency general surgery, acute care surgery, soft tissue infections, diabetes mellitus

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543 Management of Fitness-For-Duty for Human Error Prevention in Nuclear Power Plants

Authors: Hyeon-Kyo Lim, Tong-Il Jang, Yong-Hee Lee

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For the past several decades, not a few researchers have warned that even a trivial human error may result in unexpected accidents, especially in Nuclear Power Plants. To prevent accidents in Nuclear Power Plants, it is quite indispensable to make any factors under the effective control that may raise the possibility of human errors for accident prevention. This study aimed to develop a risk management program, especially in the sense that guaranteeing Fitness-for-Duty (FFD) of human beings working in Nuclear Power Plants. Throughout a literal survey, it was found that work stress and fatigue are major psychophysical factors requiring sophisticated management. A set of major management factors related to work stress and fatigue was through repetitive literal surveys and classified into several categories. To maintain the fitness of human workers, a 4-level – individual worker, team, staff within plants, and external professional - approach was adopted for FFD management program. Moreover, the program was arranged to envelop the whole employment cycle from selection and screening of workers, job allocation, and job rotation. Also, a managerial care program was introduced for employee assistance based on the concept of Employee Assistance Program (EAP). The developed program was reviewed with repetition by ex-operators in nuclear power plants, and assessed in the affirmative. As a whole, responses implied additional treatment to guarantee high performance of human workers not only in normal operations but also in emergency situations. Consequently, the program is under administrative modification for practical application.

Keywords: fitness-for-duty (FFD), human error, work stress, fatigue, Employee-Assistance-Program (EAP)

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542 Dietary Habits and Cardiovascular Risk factors Among the Patients of the Coronary Artery Disease: A Case Control Study

Authors: Muhammad Kamran Hanif Khan, Fahad Mushtaq

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Globally, the death rate from cardiovascular disease has risen over the past 20 years, but especially in low and middle-income countries (LMICS), reports the World Health Organization (WHO). Around 17.5 million deaths, or 31% of all deaths worldwide in 2012, were attributed to CVD, 80% of which occurred in low- and middle-income nations, and eighty five percent of all worldwide disability is attributable to cardiovascular disease. This study assessed the dietary habit and Cardiovascular Risk factors among the patients of coronary artery disease against matched controls. The research was a case-control study. Sample size for this case-control study was 410 CAD cases and 410 healthy controls. The case-control ratio was 1:1. Patients diagnosed with coronary artery disease were recruited from the outpatient departments and emergency rooms of four hospitals in Pakistan. The ages of people who were diagnosed with coronary artery disease were not significantly different from (mean 57.97 7.39 years) the healthy controls (mean 57.12 6.73 years). In order to determine the relationship between food consumption and the two binary outcomes, logistic regression analysis was carried out. Chicken (0.340 (0.245-0.47), p-value 0.0001), beef (0.38 (0.254-0.56), p-value 0.0001), eggs (0.297 (0.208-0.426), p-value 0.0001), and junk food (0.249 (0.167-0.372), p-value 0.0001)) were protective, while yogurt consumption more than twice weekly was risk. Conclusion: In conclusion, poor dietary habits are closely linked to the risk of CAD. Investigations based on dietary trends offer vital and practical knowledge about societal patterns.

Keywords: dietary habbits, cardiovasculardisease, CVD risk factors, hypercholesterolemia

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541 Big Data and Cardiovascular Healthcare Management: Recent Advances, Future Potential and Pitfalls

Authors: Maariyah Irfan

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Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

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540 The Teaching and Learning Process and Information and Communication Technologies from the Remote Perspective

Authors: Rosiris Maturo Domingues, Patricia Luissa Masmo, Cibele Cavalheiro Neves, Juliana Dalla Martha Rodriguez

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This article reports the experience of the pedagogical consultants responsible for the curriculum development of Senac São Paulo courses when facing the emergency need to maintain the pedagogical process in their schools in the face of the Covid-19 pandemic. The urgent adjustment to distance education resulted in the improvement of the process and the adoption of new teaching and learning strategies mediated by technologies. The processes for preparing and providing guidelines for professional education courses were also readjusted. Thus, a bank of teaching-learning strategies linked to digital resources was developed, categorized, and identified by their didactic-pedagogical potential, having as an intersection didactic planning based on learning objectives based on Bloom's taxonomy (revised), given its convergence with the competency approach adopted by Senac. Methodologically, a relationship was established between connectivity and digital networks and digital evolution in school environments, culminating in new paradigms and processes of educational communication and new trends in teaching and learning. As a result, teachers adhered to the use of digital tools in their practices, transposing face-to-face classroom methodologies and practices to online media, whose criticism was the use of ICTs in an instrumental way, reducing methodologies and practices to teaching only transmissive. There was recognition of the insertion of technology as a facilitator of the educational process in a non-palliative way and the development of a web curriculum, now and fully, carried out in contexts of ubiquity.

Keywords: technologies, education, teaching-learning strategies, Bloom taxonomy

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539 Impact of Environmental Rule of Law towards Positive Environmental Outcomes in Nigeria

Authors: Kate N. Okeke

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The ever-growing needs of man requiring satisfaction have pushed him strongly towards industrialization which has and is still leaving environmental degradation and its attendant negative impacts in its wake. It is, therefore, not surprising that the enjoyment of fundamental rights like food supply, security of lives and property, freedom of worship, health and education have been drastically affected by such degradation. In recognition of the imperative need to protect the environment and human rights, many global instruments and constitutions have recognized the right to a healthy and sustainable environment. Some environmental advocates and quite a number of literatures on the subject matter call for the recognition of environmental rights via rule of law as a vital means of achieving positive outcomes on the subject matter. However, although there are numerous countries with constitutional environmental provisions, most of them such as Nigeria, have shown poor environmental performance. A notable problem is the fact that the constitution which recognizes environmental rights appears in its other provisions to contradict its provisions by making enforceability of the environmental rights unattainable. While adopting a descriptive, analytical, comparative and explanatory study design in reviewing a successful positive environmental outcome via the rule of law, this article argues that rule of law on a balance of scale, weighs more than just environmental rights recognition and therefore should receive more attention by environmental lawyers and advocates. This is because with rule of law, members of a society are sure of getting the most out of the environmental rights existing in their legal system. Members of Niger-Delta communities of Nigeria will benefit from the environmental rights existing in Nigeria. They are exposed to environmental degradation and pollution with effects such as acidic rainfall, pollution of farmlands and clean water sources. These and many more are consequences of oil and gas exploration. It will also pave way for solving the violence between cattle herdsmen and farmers in the Middle Belt and other regions of Nigeria. Their clashes are over natural resource control. Having seen that environmental rule of law is vital to sustainable development, this paper aims to contribute to discussions on how best the vehicle of rule law can be driven towards achieving positive environmental outcomes. This will be in reliance on other enforceable provisions in the Nigerian Constitution. Other domesticated international instruments will also be considered to attain sustainable environment and development.

Keywords: environment, rule of law, constitution, sustainability

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538 Understanding of Malaysian Community Disaster Resilience: Australian Scorecard Adaptation

Authors: Salizar Mohamed Ludin, Mohd Khairul Hasyimi Firdaus, Paul Arbon

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Purpose: This paper aims to develop Malaysian Government and community-level critical thinking, planning and action for improving community disaster resilience by reporting Phase 1, Part 1 of a larger community disaster resilience measurement study about adapting the Torrens Resilience Institute Australian Community Disaster Resilience Scorecard to the Malaysian context. Methodology: Pparticipatory action research encouraged key people involved in managing the six most affected areas in the 2014 flooding of Kelantan in Malaysia’s north-east to participate in discussions about adapting and self-testing the Australian Community Disaster Resilience Scorecard to measure and improve their communities’ disaster resilience. Findings: Communities need to strengthen their disaster resilience through better communication, cross-community cooperation, maximizing opportunities to compare their plans, actions and reactions with those reported in research publications, and aligning their community disaster management with reported best practice internationally while acknowledging the need to adapt such practice to local contexts. Research implications: There is a need for a Malaysia-wide, simple-to-use, standardized disaster resilience scorecard to improve the quality, quantity and capability of healthcare and emergency services’ preparedness, and to facilitate urgent reallocation of aid. Value: This study is the first of its kind in Malaysia. The resulting community disaster resilience guideline based on participants’ feedback about the Kelantan floods and scorecard self-testing has the potential for further adaptation to suit contexts across Malaysia, as well as demonstrating how the scorecard can be adapted for international use.

Keywords: community disaster resilience, CDR Scorecard, participatory action research, flooding, Malaysia

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537 Determinants of Teenage Pregnancy: The Case of School Adolescents of Arba Minch Town, Southern Ethiopia

Authors: Aleme Mekuria, Samuel Mathewos

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Background: Teenage pregnancy has long been a worldwide social, economic and educational concern for the developed, developing and underdeveloped countries. Studies on adolescent sexuality and pregnancy are very limited in our country. Therefore, this study aims at assessing the prevalence of teenage pregnancy and its determinants among school adolescents of Arba Minch town. Methods: Institution- based, cross-sectional study was conducted from 20-30 March 2014. Systematic sampling technique was used to select a total of 578 students from four schools of the town. Data were collected by trained data collectors using a pre-tested, self-administered structured questionnaire. The analysis was made using the software SPSS version 20.0 statistical packages. Multivariate logistic regression was used to identify the predictors of teenage pregnancy. Results: The prevalence of teenage pregnancy among school adolescents of Arba Minch town was 7.7%. Being grade11(AOR=4.6;95%CI:1.4,9.3) and grade12 student (AOR=5.8;95% CI:1.3,14.4), not knowing the correct time to take emergency contraceptives(AOR=3.3;95%CI:1.4,7.4), substance use(AOR=3.1;95%CI:1.1,8.8), living with either of biological parents (AOR=3.3;95%CI:1.1,8.7) and poor parent-daughter interaction (AOR=3.1;95%CI:1.1,8.7) were found to be significant predictors of teenage pregnancy. Conclusion: This study revealed a high level of teenage pregnancy among school adolescents of Arba Minch town. A significant number of adolescent female school students were at risk of facing the challenges of teenage pregnancy in the study area. School-based reproductive health education and strong parent-daughter relationships should be strengthened.

Keywords: adolescent, Arba minch, risk factors, school, southern Ethiopia, teenage pregnancy

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536 Towards a Critical Disentanglement of the ‘Religion’ Nexus in the Global East

Authors: Daan F. Oostveen

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‘Religion’ as a term is not native to the Global East. The concept ‘religion’ is both understood in its meaning of ‘religious traditions’, commonly referring to the ‘World Religions’ and in its adjective meaning ‘the religious’ or ‘religiosity’ as a separate domain of human culture, commonly contrasted to the secular. Though neither of these understandings are native to the historical worldviews of East Asia, their development in modern Western scholarship has had an enormous impact on the self-understanding of cultural diversity in the Global East as well. One example is the identification and therefore elevation to the status of World Religion of ‘Buddhism’ which connected formerly dispersed religious practices throughout the Global East and subsumed them under this powerful label. On the other hand, we see how popular religiosity, shamanism and hybrid cultural expressions have become excluded from genuine religion; this had an immense impact on the sense of legitimacy of these practices, which became sometimes labeled as superstition are rejected as magic. Our theoretical frameworks on religion in the Global East do not always consider the complex power dynamics between religious actors, both elites and lay expressions of religion in everyday life, governments and religious studies scholars. In order to get a clear image of how religiosity functions in the context of the Global East, we have to take into account these power dynamics. What is important in particular is the issue of religious identity or absence of religious identity. The self-understanding of religious actors in the Global East is often very different from what scholars of religion observe. Religious practice, from an etic perspective, is often unrelated to religious identification from an emic perspective. But we also witness the rise of Christian churches in the Global East, in which religious identity and belonging does play a pivotal role. Finally, religion in the Global East has since the beginning of the 20th Century been conceptualized as the ‘other’ or republicanism or Marxist-Maoist ideology. It is important not to deny the key role of colonial thinking in the process of religion formation in the Global East. In this paper, it is argued that religious realities constituted emerging as a result from our theory of religion, and that these religious realities in turn inform our theory. Therefore, the relationship between phenomenology of religion and theory of religion can never be disentangled. In fact, we have to acknowledge that our conceptualizations of religious diversity are always already influenced by our valuation of those cultural expressions that we have come to call ‘religious’.

Keywords: global east, religion, religious belonging, secularity

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535 Communication and Management of Incidental Pathology in a Cohort of 1,214 Consecutive Appendicectomies

Authors: Matheesha Herath, Ned Kinnear, Bridget Heijkoop, Eliza Bramwell, Alannah Frazetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, James Moore

Abstract:

Background: Important incidental pathology requiring further action is commonly found during appendicectomy, macro- and microscopically. It is unknown whether the acute surgical unit (ASU) model affects the management and disclosure of these findings. Methods: An ASU model was introduced at our institution on 01/08/2012. In this retrospective cohort study, all patients undergoing appendicectomy 2.5 years before (traditional group) or after (ASU group) this date were compared. The primary outcomes were rates of appropriate management of the incidental findings and communication of the findings to the patient and to their general practitioner (GP). Results: 1,214 patients underwent emergency appendicectomy; 465 in the traditional group and 749 in the ASU group. 80 (6.6%) patients (25 and 55 in each respective period) had important incidental findings. There were 24 patients with benign polyps, 15 with neuro-endocrine tumour, 11 with endometriosis, 8 with pelvic inflammatory disease, 8 Enterobius vermicularis infection, 7 with low grade mucinous cystadenoma, 3 with inflammatory bowel disease, 2 with diverticulitis, 2 with tubo-ovarian mass, 1 with secondary appendiceal malignancy and none with primary appendiceal adenocarcinoma. One patient had dual pathologies. There was no difference between the traditional and ASU group with regards to communication of the findings to the patient (p=0.44) and their GP (p=0.27), and there was no difference in the rates of appropriate management (p=0.21). Conclusions: The introduction of an ASU model did not change rates of surgeon-to-patient and surgeon-to-GP communication nor affect rates of appropriate management of important incidental pathology during an appendectomy.

Keywords: acute care surgery, appendicitis, appendicectomy, incidental

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534 The Cost of Healthcare among Malaysian Community-Dwelling Elderly with Dementia

Authors: Roshanim Koris, Norashidah Mohamed Nor, Sharifah Azizah Haron, Normaz Wana Ismail, Syed Mohamed Aljunid Syed Junid, Amrizal Muhammad Nur, Asrul Akmal Shafie, Suraya Yusuff, Namaitijiang Maimaiti

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An ageing population has huge implications for virtually every aspect of Malaysian societies. The elderly consume a greater volume of healthcare facilities not because they are older, but because of they are sick. The chronic comorbidities and deterioration of cognitive ability would lead the elderly’s health to become worst. This study aims to provide a comprehensive estimate of the direct and indirect costs of health care used in a nationally representative sample of community-dwelling elderly with dementia and as well as the determinants of healthcare cost. A survey using multi-stage random sampling techniques recruited a final sample of 2274 elderly people (60 years and above) in the state of Johor, Perak, Selangor and Kelantan. Mini Mental State Examination (MMSE) score was used to measure the cognitive capability among the elderly. Only the elderly with a score less than 19 marks were selected for further analysis and were classified as dementia. By using a two-part model findings also indicate household income and education level are variables that strongly significantly influence the healthcare cost among elderly with dementia. A number of visits and admission are also significantly affect healthcare expenditure. The comorbidity that highly influences healthcare cost is cancer and seeking the treatment in private facilities is also significantly affected the healthcare cost among the demented elderly. The level of dementia severity is not significant in determining the cost. This study is expected to attract the government's attention and act as a wake-up call for them to be more concerned about the elderly who are at high risk of having chronic comorbidities and cognitive problems by providing more appropriate health and social care facilities. The comorbidities are one of the factor that could cause dementia among elderly. It is hoped that this study will promote the issues of dementia as a priority in public health and social care in Malaysia.

Keywords: ageing population, dementia, elderly, healthcare cost, healthcare utiliztion

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533 Seismic Vulnerability Assessment of Masonry Buildings in Seismic Prone Regions: The Case of Annaba City, Algeria

Authors: Allaeddine Athmani, Abdelhacine Gouasmia, Tiago Ferreira, Romeu Vicente

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Seismic vulnerability assessment of masonry buildings is a fundamental issue even for moderate to low seismic hazard regions. This fact is even more important when dealing with old structures such as those located in Annaba city (Algeria), which the majority of dates back to the French colonial era from 1830. This category of buildings is in high risk due to their highly degradation state, heterogeneous materials and intrusive modifications to structural and non-structural elements. Furthermore, they are usually shelter a dense population, which is exposed to such risk. In order to undertake a suitable seismic risk mitigation strategies and reinforcement process for such structures, it is essential to estimate their seismic resistance capacity at a large scale. In this sense, two seismic vulnerability index methods and damage estimation have been adapted and applied to a pilot-scale building area located in the moderate seismic hazard region of Annaba city: The first one based on the EMS-98 building typologies, and the second one derived from the Italian GNDT approach. To perform this task, the authors took the advantage of an existing data survey previously performed for other purposes. The results obtained from the application of the two methods were integrated and compared using a geographic information system tool (GIS), with the ultimate goal of supporting the city council of Annaba for the implementation of risk mitigation and emergency planning strategies.

Keywords: Annaba city, EMS98 concept, GNDT method, old city center, seismic vulnerability index, unreinforced masonry buildings

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532 Reconceptualising Faculty Teaching Competence: The Role of Agency during the Pandemic

Authors: Ida Fatimawati Adi Badiozaman, Augustus Raymond Segar

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The Covid-19 pandemic transformed teaching contexts at an unprecedented level. Although studies have focused mainly on its impact on students, little is known about how emergency online teaching affects faculty members in higher education. Given that the pandemic has robbed teachers of opportunities for adequate preparation, it is vital to understand how teaching competencies were perceived in the crisis-response transition to online teaching and learning (OTL). Therefore, the study explores how academics perceive their readiness for OTL and what competencies were perceived to be central. Therefore, through a mixed-methods design, the study first explores through a survey how academics perceive their readiness for OTL and what competencies were perceived to be central. Emerging trends from the quantitative data of 330 academics (three public and three private Higher learning institutions) led to the formulation of interview guides for the subsequent qualitative phase. The authors use critical sensemaking (CSM) to analyse interviews with twenty-two teachers (n = 22) (three public; three private HEs) toward understanding the interconnected layers of influences they draw from as they make sense of their teaching competence. The sensemaking process reframed competence and readiness in that agentic competency emerged as crucial in shaping resilience and adaptability during the transition to OTL. The findings also highlight professional learningcriticalto teacher competence: course design, communication, time management, technological competence, and identity (re)construction. The findings highlight opportunities for strategic orientation to change during crisis. Implications for pedagogy and policy are discussed.

Keywords: online teaching, pedagogical competence, agentic competence, agency, technological competence

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531 Use of Galileo Advanced Features in Maritime Domain

Authors: Olivier Chaigneau, Damianos Oikonomidis, Marie-Cecile Delmas

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GAMBAS (Galileo Advanced features for the Maritime domain: Breakthrough Applications for Safety and security) is a project funded by the European Space Program Agency (EUSPA) aiming at identifying the search-and-rescue and ship security alert system needs for maritime users (including operators and fishing stakeholders) and developing operational concepts to answer these needs. The general objective of the GAMBAS project is to support the deployment of Galileo exclusive features in the maritime domain in order to improve safety and security at sea, detection of illegal activities and associated surveillance means, resilience to natural and human-induced emergency situations, and develop, integrate, demonstrate, standardize and disseminate these new associated capabilities. The project aims to demonstrate: improvement of the SAR (Search And Rescue) and SSAS (Ship Security Alert System) detection and response to maritime distress through the integration of new features into the beacon for SSAS in terms of cost optimization, user-friendly aspects, integration of Galileo and OS NMA (Open Service Navigation Message Authentication) reception for improved authenticated localization performance and reliability, and at sea triggering capabilities, optimization of the responsiveness of RCCs (Rescue Co-ordination Centre) towards the distress situations affecting vessels, the adaptation of the MCCs (Mission Control Center) and MEOLUT (Medium Earth Orbit Local User Terminal) to the data distribution of SSAS alerts.

Keywords: Galileo new advanced features, maritime, safety, security

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530 Dematerialized Beings in Katherine Dunn's Geek Love: A Corporeal and Ethical Study under Posthumanities

Authors: Anum Javed

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This study identifies the dynamical image of human body that continues its metamorphosis in the virtual field of reality. It calls attention to the ways where humans start co-evolving with other life forms; technology in particular and are striving to establish a realm outside the physical framework of matter. The problem exceeds the area of technological ethics by explicably and explanatorily entering the space of literary texts and criticism. Textual analysis of Geek Love (1989) by Katherine Dunn is adjoined with posthumanist perspectives of Pramod K. Nayar to beget psycho-somatic changes in man’s nature of being. It uncovers the meaning people give to their experiences in this budding social and cultural phenomena of material representation tied up with personal practices and technological innovations. It also observes an ethical, physical and psychological reassessment of man within the context of technological evolutions. The study indicates the elements that have rendered morphological freedom and new materialism in man’s consciousness. Moreover this work is inquisitive of what it means to be a human in this time of accelerating change where surgeries, implants, extensions, cloning and robotics have shaped a new sense of being. It attempts to go beyond individual’s body image and explores how objectifying media and culture have influenced people’s judgement of others on new material grounds. It further argues a decentring of the glorified image of man as an independent entity because of his energetic partnership with intelligent machines and external agents. The history of the future progress of technology is also mentioned. The methodology adopted is posthumanist techno-ethical textual analysis. This work necessitates a negotiating relationship between man and technology in order to achieve harmonic and balanced interconnected existence. The study concludes by recommending a call for an ethical set of codes to be cultivated for the techno-human habituation. Posthumanism ushers a strong need of adopting new ethics within the terminology of neo-materialist humanism.

Keywords: corporeality, dematerialism, human ethos, posthumanism

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529 The Teacher’s Role in Generating and Maintaining the Motivation of Adult Learners of English: A Mixed Methods Study in Hungarian Corporate Contexts

Authors: Csaba Kalman

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In spite of the existence of numerous second language (L2) motivation theories, the teacher’s role in motivating learners has remained an under-researched niche to this day. If we narrow down our focus on the teacher’s role on motivating adult learners of English in an English as a Foreign Language (EFL) context in corporate environments, empirical research is practically non-existent. This study fills the above research niche by exploring the most motivating aspects of the teacher’s personality, behaviour, and teaching practices that affect adult learners’ L2 motivation in corporate contexts in Hungary. The study was conducted in a wide range of industries in 18 organisations that employ over 250 people in Hungary. In order to triangulate the research, 21 human resources managers, 18 language teachers, and 466 adult learners of English were involved in the investigation by participating in interview studies, and quantitative questionnaire studies that measured ten scales related to the teacher’s role, as well as two criterion measure scales of intrinsic and extrinsic motivation. The qualitative data were analysed using a template organising style, while descriptive, inferential statistics, as well as multivariate statistical techniques, such as correlation and regression analyses, were used for analysing the quantitative data. The results showed that certain aspects of the teacher’s personality (thoroughness, enthusiasm, credibility, and flexibility), as well as preparedness, incorporating English for Specific Purposes (ESP) in the syllabus, and focusing on the present, proved to be the most salient aspects of the teacher’s motivating influence. The regression analyses conducted with the criterion measure scales revealed that 22% of the variance in learners’ intrinsic motivation could be explained by the teacher’s preparedness and appearance, and 23% of the variance in learners’ extrinsic motivation could be attributed to the teacher’s personal branding and incorporating ESP in the syllabus. The findings confirm the pivotal role teachers play in motivating L2 learners independent of the context they teach in; and, at the same time, call for further research so that we can better conceptualise the motivating influence of L2 teachers.

Keywords: adult learners, corporate contexts, motivation, teacher’s role

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528 Meditation and Insight Interpretation Using Quantum Circle Based-on Experiment and Quantum Relativity Formalism

Authors: Somnath Bhattachryya, Montree Bunruangses, Somchat Sonasang, Preecha Yupapin

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In this study and research on meditation and insight, the design and experiment with electronic circuits to manipulate the meditators' mental circles that call the chakras to have the same size is proposed. The shape of the circuit is 4-ports, called an add-drop multiplexer, that studies the meditation structure called the four-mindfulness foundation, then uses an AC power signal as an input instead of the meditation time function, where various behaviors with the method of re-filtering the signal (successive filtering), like eight noble paths. Start by inputting a signal at a frequency that causes the velocity of the wave on the perimeter of the circuit to cause particles to have the speed of light in a vacuum. The signal changes from electromagnetic waves and matter waves according to the velocity (frequency) until it reaches the point of the relativistic limit. The electromagnetic waves are transformed into photons with properties of wave-particle overcoming the limits of the speed of light. As for the matter wave, it will travel to the other side and cannot pass through the relativistic limit, called a shadow signal (echo) that can have power from increasing speed but cannot create speed faster than light or insight. In the experiment, the only the side where the velocity is positive, only where the speed above light or the corresponding frequency indicates intelligence. Other side(echo) can be done by changing the input signal to the other side of the circuit to get the same result. But there is no intelligence or speed beyond light. It is also used to study the stretching, contraction of time and wormholes that can be applied for teleporting, Bose-Einstein condensate and teleprinting, quantum telephone. The teleporting can happen throughout the system with wave-particle and echo, which is when the speed of the particle is faster than the stretching or contraction of time, the particle will submerge in the wormhole, when the destination and time are determined, will travel through the wormhole. In a wormhole, time can determine in the future and the past. The experimental results using the microstrip circuit have been found to be by the principle of quantum relativity, which can be further developed for both tools and meditation practitioners for quantum technology.

Keywords: quantu meditation, insight picture, quantum circuit, absolute time, teleportation

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527 The Admissibility of Evidence Obtained in Contravention of the Right to Privacy in a Criminal Trial: A Comparative Study of Poland and Germany

Authors: Konstancja Syller

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International law and European regulations remain hardly silent about the admissibility of evidence obtained illegally in a criminal trial. However, Article 6 of the European Convention on Human Rights guarantees the right to a fair trial, it does not normalise a proceeding status of specified sources or means of proof outright. Therefore, it is the preserve of national legislation and national law enforcement authorities to decide on this matter. In most countries, especially in Germany and Poland, a rather complex normative approach to the issue of proof obtained in violation of the right to privacy is evident, which pursues in practise to many interpretive doubts. In Germany the jurisprudence has a significant impact within the range of the matter mentioned above. The Constitutional Court and the Supreme Court of Germany protect the right to privacy quite firmly - they ruled on inadmissibility of obtaining a proof in the form of a diary or a journal as a protection measure of constitutional guaranteed right. At the same time, however, the Supreme Court is not very convinced with reference to the issue of whether materials collected as a result of an inspection, call recordings or listening to the premises, which were carried out in breach of law, can be used in a criminal trial. Generally speaking, German courts indicate a crucial importance of the principle of Truth and the principle of proportionality, which both enable a judgement to be made as to the possibility of using an evidence obtained unlawfully. Comparing, in Poland there is almost no jurisprudence of the Constitutional Tribunal relating directly to the issue of illegal evidence. It is somehow surprising, considering the doctrinal analysis of the admissibility of using such proof in a criminal trial is performed in relation to standards resulted from the Constitution. Moreover, a crucial de lega lata legal provision, which enables allowing a proof obtained in infringement of the provisions in respect of criminal proceedings or through a forbidden act, is widely criticised within the legal profession ant therefore many courts give it their own interpretation at odds with legislator’s intentions. The comparison of two civil law legal systems’ standards regarding to the admissibility of an evidence obtained in contravention of the right to privacy in a criminal trial, taking also into account EU legislation and judicature, is the conclusive aim of this article.

Keywords: criminal trial, evidence, Germany, right to privacy, Poland

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526 Postpartum Depression Screening and Referrals for Lower-Income Women in North Carolina, USA

Authors: Maren J. Coffman, Victoria C. Scott, J. Claire Schuch, Ashley N. Kelley, Jeri L. Ryan

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Postpartum Depression (PPD) is a leading cause of postpartum morbidity. PPD affects 7.1% of postpartum women and 19.2% of postpartum women when including minor depression. Lower-income women and ethnic minorities are more at risk for developing PPD and face multiple attitudinal and institutional barriers to receiving care. This study aims to identify PPD among low-income women and connect them to appropriate services in order to reduce the illness burden and enhance access to care. Screenings were conducted in two Women, Infants, and Children (WIC) clinics in the city of Charlotte, North Carolina, USA, from April 2017 to April 2018. WIC is a supplemental nutrition program that provides healthcare and nutrition to low-income pregnant women, breastfeeding women, and children under the age of 5. Additionally, a qualitative study was conducted to better understand the PPD continuum of care in order to identify opportunities for improvement. Mothers with infants were screened for depression risk using the PHQ-2. Mothers who scored ≥ 2 completed two additional standardized screening tools (PHQ-7, to complete the PHQ-9, and the Edinburgh) to assess depressive symptomatology. If indicated they may be suffering from depression, women were referred for case management services. Open-ended questions were used to understand treatment barriers. Four weeks after the initial survey, a follow-up telephone call was made to see if women had received care. Seven focus groups with WIC staff and managers, referral agency staff, local behavioral health professionals, and students examining the screenings, are being conducted March - April, 2018 to gather information related to current screening practices, referrals, follow up and treatment. Mothers (n = 231 as of February, 2018) were screened in English (65%) or Spanish (35%). According to preliminary results, 29% of mothers screened were at risk for postpartum depression (PHQ-2 ≥ 2). There were significant differences in preliminary screening results based on survey language (

Keywords: health disparities, maternal health, mental health, postpartum depression

Procedia PDF Downloads 173