Search results for: family care team

Authors: Ndagi Salihu

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Corporate governance mechanisms are the control measures for ensuring that all the interests groups are equally represented and management are working towards wealth creation in the interest of all. Therefore, there are many empirical studies during the last three decades on corporate governance and firm performance. However, little is known about the effects of family ownership on the relationship between corporate governance and firm performance, especially in the developing economy like Nigeria. This limit our understanding of the unique governance dynamics of family ownership with regards firm performance. This study examined the impact of family ownership on the relationship between governance mechanisms and financial performance of publicly listed companies in Nigeria. The study adopted quantitative research methodology using correlational ex-post factor design and secondary data from annual reports and accounts of a sample of 23 listed companies for a period of 5 years (2014-2018). The explanatory variables are the board size, board composition, board financial expertise, and board audit committee attributes. Financial performance is proxy by Return on Assets (ROA) and Return on Equity (ROE). Multiple panel regression technique of data analysis was employed in the analysis, and the study found that family ownership has a significant positive effect on the relationships between corporate governance mechanisms and financial performance of publicly listed firms in Nigeria. This finding is the same for both the ROA and ROE. However, the findings indicate that board size, board financial expertise, and board audit committee attributes have a significant positive impact on the ROA and ROE of the sample firms after the moderation. Moreover, board composition has significant positive effect on financial performance of the sample listed firms in terms of ROA and ROE. The study concludes that the use of family ownership in the control of firms in Nigeria could improve performance by reducing the opportunistic actions managers as well as agency problems. The study recommends that publicly listed companies in Nigeria should allow significant family ownership of equities and participation in management.

Keywords: profitability, board characteristics, agency theory, stakeholders

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Authors: Nagendra P. Luitel, Mark J. D. Jordans

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Globally, there is a significant gap between the number of individuals in need of mental health care and those who actually receive treatment. The evidence is accumulating that mental health services can be delivered effectively by primary health care workers through community-based programs and task-sharing approaches. Changing the role of specialist mental health workers from service delivery to building clinical capacity of the primary health care (PHC) workers could help in reducing treatment gap in low and middle-income countries (LMICs). We developed a comprehensive mental health care plan in 2012 and evaluated its feasibility and effectiveness over the past three years. Initially, a mixed method formative study was conducted for the development of mental health care plan (MHCP). Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from beneficiaries (n=135) during the pilot-testing phase. Repeated community survey (N=2040); facility detection survey (N=4704) and the cohort study (N=576) were conducted for evaluation of the MHCP. The resulting MHCP consists of twelve packages divided over the community, health facility, and healthcare organization platforms. Detection of mental health problems increased significantly after introducing MHCP. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Currently, MHCP has been implemented in the entire Chitwan district where over 1400 people (438 people with depression, 406 people with psychosis, 181 people with epilepsy, 360 people with alcohol use disorder and 51 others) have received mental health services from trained health workers. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers, high drop-out rates and continue the supply of medicines. The results indicated that involvement of PHC workers in detection and management of mental health problems is an effective strategy to minimize treatment gap on mental health care in Nepal.

Keywords: mental health, Nepal, primary care, treatment gap

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Authors: Markandeya Kunchi

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Usability testing (UT) is one of the vital steps in the User-centred design (UCD) process when designing a product. In an e-commerce ecosystem, UT becomes primary as new products, features, and services are launched very frequently. And, there are losses attached to the company if an unusable and inefficient product is put out to market and is rejected by customers. This paper tries to answer why UT is important in the product life-cycle of an E-commerce ecosystem. Secondary user research was conducted to find out work patterns, development methods, type of stakeholders, and technology constraints, etc. of a typical E-commerce company. Qualitative user interviews were conducted with product managers and designers to find out the structure, project planning, product management method and role of the design team in a mid-level company. The paper tries to address the usual apprehensions of the company to inculcate UT within the team. As well, it stresses upon factors like monetary resources, lack of usability expert, narrow timelines, and lack of understanding of higher management as some primary reasons. Outsourcing UT to vendors is also very prevalent with mid-level e-commerce companies, but it has its own severe repercussions like very little team involvement, huge cost, misinterpretation of the findings, elongated timelines, and lack of empathy towards the customer, etc. The shortfalls of the unavailability of a UT process in place within the team and conducting UT through vendors are bad user experiences for customers while interacting with the product, badly designed products which are neither useful and nor utilitarian. As a result, companies see dipping conversions rates in apps and websites, huge bounce rates and increased uninstall rates. Thus, there was a need for a more lean UT system in place which could solve all these issues for the company. This paper highlights on optimizing the UT process with a collaborative method. The degree of optimization and structure of collaborative method is the highlight of this paper. Collaborative method of UT is one in which the centralised design team of the company takes for conducting and analysing the UT. The UT is usually a formative kind where designers take findings into account and uses in the ideation process. The success of collaborative method of UT is due to its ability to sync with the product management method employed by the company or team. The collaborative methods focus on engaging various teams (design, marketing, product, administration, IT, etc.) each with its own defined roles and responsibility in conducting a smooth UT with users In-house. The paper finally highlights the positive results of collaborative UT method after conducting more than 100 In-lab interviews with users across the different lines of businesses. Some of which are the improvement of interaction between stakeholders and the design team, empathy towards users, improved design iteration, better sanity check of design solutions, optimization of time and money, effective and efficient design solution. The future scope of collaborative UT is to make this method leaner, by reducing the number of days to complete the entire project starting from planning between teams to publishing the UT report.

Keywords: collaborative method, e-commerce, product management method, usability testing

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Authors: Tiantian Feng

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There is a dearth of research on the literary circle as a teaching strategy in English as a Foreign Language (EFL) classes in Chinese colleges and universities and even fewer empirical studies on its impacts. In this one-quarter, design-based project, the researcher aims to increase students’ engagement, cooperation, and, on top of that, reading comprehension performance by utilizing a researcher-developed, adapted reading circle model in an EFL reading course at a Chinese college. The model also integrated team-based learning and portfolio assessment, with an emphasis on the specialization of individual responsibilities, contributions, and outcomes in reading projects, with the goal of addressing current issues in EFL classes at Chinese colleges, such as passive learning, test orientation, ineffective and uncooperative teamwork, and lack of dynamics. In this quasi-experimental research, two groups of students enrolled in the course were invited to participate in four in-class team projects, with the intervention class following the adapted literature circle model and team members rotating as Leader, Coordinator, Brain trust, and Reporter. The researcher/instructor used a sequential explanatory mixed-methods approach to quantitatively analyze the final grades for the pre-and post-tests, as well as individual scores for team projects and will code students' artifacts in the next step, with the results to be reported in a subsequent paper(s). Initial analysis showed that both groups saw an increase in final grades, but the intervention group enjoyed a more significant boost, suggesting that the adapted reading circle model is effective in improving students’ reading comprehension performance. This research not only closes the empirical research gap of literature circles in college EFL classes in China but also adds to the pool of effective ways to optimize reading comprehension performance and class performance in college EFL classes.

Keywords: literature circle, EFL teaching, college english reading, reading comprehension

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Authors: Josiah O. Carter, Charlotte Hayden, Elizabeth Arthurs

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Background: During the COVID-19 pandemic, hospital management policies have changed frequently and rapidly. This has created novel challenges in keeping the workforce abreast of these changes to enable them to deliver safe and effective care. Traditional communication methods, e.g. email, do not keep pace with the rapidly changing environment in the hospital, resulting in inaccurate, irrelevant, or outdated information being communicated, resulting in inefficiencies in patient care. Methods: The creation of a WhatsApp messaging group within the medical division at the Bristol Royal Infirmary has enabled senior clinicians and the hospital management team to update the medical workforce in real-time. It has two primary functions: (1) To enable dissemination of a concise, important operational summary. This comprises information on bed status and infection control procedural changes. It is fed directly from a daily critical incident briefing (2) To facilitate a monthly scheduled question and answer (Q&A) session for junior doctors to clarify issues with clinical directors, rota, and management staff. Additional ad-hoc updates are sent out for time-critical information; otherwise, it mainly functions as a broadcast-only group to prevent important information from being lost amongst other communication. All junior doctors within the medical division were invited to join the group. At present, the group comprises 131 participants, of which 10 are administrative staff (rota coordinators, management staff & clinical directors); the remaining 121 are junior clinicians working within the medical division. An electronic survey via Microsoft forms was sent out to junior doctors via the WhatsApp group and via email to assess its utilisation and effectiveness with the aim of quality improvements. Results: Of the 121 group participants, 19 completed the questionnaire (response rate 15.7%). Of these, 16/19 (84.2%) used it regularly, and 12/19 (63.2%) rated it as the most useful source for reliable updates relating to the hospital response to the COVID-19 pandemic, whereas only 2/19 (10.5%) found the trust intranet and the trust COVID-19 operational email update most useful. Respondents rated the WhatsApp group more useful as an information source (mean score 7.7/10) than as a means of providing feedback to management staff (mean score 6.3/10). Qualitative feedback suggested information around ward closures and changes to COVID cohorting, along with updates on staffing issues, were most useful. Respondents also noted the Q&A sessions were an efficient way of relaying feedback about management decisions but that it would be preferable if these sessions could be delivered more frequently. Discussion: During the current global COVID-19 pandemic, there is an increased need for rapid dissemination of critical information within NHS trusts; this includes communication between junior doctors, managers, and senior clinicians. The versatility of WhatsApp permits a variety of functions allowing for regular updates, the dissemination of time-critical information, and enables conversing and feedback. The project has demonstrated that reserved and well-managed use of a WhatsApp group is a welcome, efficient and practical means of communication between the senior management team and the junior medical workforce.

Keywords: communication, COVID-19, hospital management, WhatsApp

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Authors: Shiksha Thakur, Rashmi Jain

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Maternal health is the most crucial element in the primary health care delivery system of any healthy society. We aware that the maternal health situation in India has been a cause of concern for us, in spite of the rapidly progressing socio-economic environment overall. India has realized impressive gains in Mother & Child survival over the last two decades. MMR as per 2012-2013 in India is 167 as per MMR bulletin, though there are variations between states in the Country. In 2013, an estimated 2,89,000 women worldwide died from complications arising from pregnancy & childbirth. In view of the above facts, a study was conducted in Indore to analyse the maternal health status among urban slums and non-slums women.

Keywords: antenatal care, postnatal care, JSY, maternal health, child health, reproductive health

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Authors: Elizabeth Hartney, Keith Borkowsky, Jo Axe, Doug Hamilton

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The aim of this research is to develop a grounded theory of educational leadership development, using an approach to initiating and maintaining professional growth in school principals and vice principals termed generative dialogue. The research was conducted in a relatively affluent, urban school district in Western Canada. Generative dialogue interviews were conducted by a team of consultants, and anonymous data in the form of handwritten notes were voluntarily submitted to the research team. The data were transcribed and analyzed using grounded theory. The results indicate that a key focus of educational leadership development is focused on navigating relationships within the school setting and that the generative dialogue process is helpful for principals and vice principals to explore how they might do this. Applicability and limitations of the study are addressed.

Keywords: generative dialogue, school principals, grounded theory, leadership development

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Authors: Esha Thakkar, Ina Liu, Kalynn Hosea, Shana Katz, Katie Marks, Sarah Hall, Cat Liu, Suzanne Harris

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Purpose: Inequities in mental healthcare accessibility are cited as an international public health concern by the World Health Organization (WHO) and National Alliance on Mental Illness (NAMI). These disparities are further exacerbated in racial and ethnic minority groups and are especially concerning in health professional training settings such as Doctor of Pharmacy (PharmD) programs and postgraduate residency training where mental illness rates are high. The purpose of the study was to determine baseline access to culturally sensitive mental healthcare and how to improve such access and communication for racially and ethnically minoritized pharmacy students and residents at one school of pharmacy and a partnering academic medical center in the United States. Methods: This IRB-exempt study included 60-minute focus groups conducted in person or online from November 2021 to February 2022. Eligible participants included PharmD students in their first (P1), second (P2), third (P3), or fourth year (P4) or pharmacy residents completing a postgraduate year 1 (PGY1) or PGY2 who identify as Black, Indigenous, or Person of Color (BIPOC). There were four core theme questions asked during the focus groups to lead the discussion, specifically on the core themes of personal barriers, identities, areas that are working well, and areas for improvement. Participant responses were transcribed and analyzed using an open coding system with two individual reviews, followed by collaborative and intentional discussion and, as needed, an external audit of the coding by a third research team member to reach a consensus on themes. Results: This study enrolled 26 participants, with eight P1, five P2, seven P3, two P4, and four resident participants. Within the four core themes of barriers, identities, areas working well, and areas for improvement, emerging subthemes included: lack of time, access to resources, and stigma under barriers; lack of representation, cultural and family stigma, and gender identities for identity barriers; supportive faculty, sense of community and culture supporting paid time off for areas going well; and wellness days, reduced workload and diversity of the workforce in areas of improvement. Subthemes sometimes varied within a core theme depending on the participant year. Conclusions: There is a gap in the literature in addressing barriers and disparities in mental health access for pharmacy trainees who identify as BIPOC. We identified key findings in regards to barriers, identities, areas going well and areas for improvement that can inform the School and the Residency Program in two priority initiatives of well-being and diversity equity and inclusion in creating actionable recommendations for trainees, program directors, and employers of our institutions, and also has the potential to provide insight for other organizations about the structures influencing access to culturally sensitive care in BIPOC trainees. These findings can inform organizations on how to continue building on communication with those who identify as BIPOC and improve access to care.

Keywords: mental health, disparities, minorities, wellbeing, identity, communication, barriers

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Authors: Celeste Lawson

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Learning to embrace and value teamwork assessment at a university level is critical for students, as graduates enter a real-world working environment where teamwork is likely to occur virtually. Student disdain for teamwork exercises is an area often overlooked or disregarded by academics. This research explored the implementation of an online teamwork assessment approach at a regional Australian university with a significant cohort of Distance Education students. Students had disliked teamwork for three reasons: it was not relevant to their study, the grading was unfair amongst team members, and managing the task was challenging in a virtual environment. Teamwork assessment was modified so that the task was an authentic task that could occur in real-world practice; team selection was based on the task topic rather than randomly; grading was based on the individual’s contribution to the task, and students were provided virtual team management skills as part of a the assessment. In this way, management of the team became an output of the task itself. Data was gathered over three years from student satisfaction surveys, failure rates, attrition figures, and unsolicited student comments. In one unit where this approach was adopted (Advanced Public Relations), student satisfaction increased from 3.6 (out of 5) in 2012 to 4.6 in 2016, with positive comments made about the teamwork approach. The attrition rate for another unit (Public Relations and the Media) reduced from 20.7% in 2012 to 2.2% in 2015. In 2012, criticism of teamwork assessment made up 50% of negative student feedback in Public Relations and the Media. By 2015, following the successful implementation of the teamwork assessment approach, only 12.5% of negative comments on the student satisfaction survey were critical of teamwork, while 33% of positive comments related to a positive teamwork experience. In 2016, students explicitly nominated teamwork as the best part of this unit. The approach is transferable to other disciplines and was adopted by other academics within the institution with similar results.

Keywords: assessment, distance education, teamwork, virtual

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Authors: Akriti Kafle Baral, Ruixing Zhang, Dzifa K Lalit, Manthar M Alli

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Introduction: Hemodialysis is the most common type of dialysis globally approximately million are reported to receive this type of dialysis. Psychosocial issues in hemodialysis are the psychological and socioeconomic burdens emanating from the initiation and course of treatment and have the potential for gross deterioration in the quality of life and general well-being of patients. Understanding the psychosocial issues and needs of patients undergoing hemodialysis could pave the way for comprehensive support and therapies designed to reduce stress, improve social support, and foster mental resilience. Objectives: The aim of this study was to explore the psychosocial issues and support needs of patients undergoing hemodialysis at a tertiary care center in Nepal. Methods: A qualitative descriptive study was conducted among 20 purposefully selected patients attending hemodialysis treatment at Pokhara Academy of Health Sciences, Nepal. Data was analyzed via thematic analysis. Results: The study resulted in three major themes which included Emotional, psychological, and spiritual struggles, Social and economic impacts, and Support and information needs. Moreover, 16 sub-themes emerged which are Frustration with daily life, Constant fear of death, Thoughts of self-harm, Perceived Burden on Family, Sense of Divine Punishment, Sense of Unfairness, Fear about future uncertainties, Social avoidance, Social stigmatization, Loss of employment, Financial strain, Transportation challenges, Need for early, clear and comprehensive information, Need for support and reassurance from family, Support through peer connections, and Reassurance from healthcare providers. Conclusion: The findings of this study indicate that patients undergoing hemodialysis in Nepal experience numerous hardships and multifaceted struggles that require support from different dimensions. Establishing robust support systems that include family involvement, peer networks, and effective communication from healthcare professionals can significantly mitigate feelings of anxiety and isolation.

Keywords: hemodialysis, psychosocial issues, support needs, chronic kidney disease, end stage renal disease, Nepal

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Authors: Tiago Sigal Linhares, Ana Amélia Nascimento da Silva Bones, Juliana Miola, McArthur Alexander Barrow, Airton Tetelbom Stein

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Introduction: As a result of increased globalization and changing migration trends, it is expected that a significant portion of People Living with HIV/AIDS (PLWHA) will change their place of residence over time. In order to provide better health care, monitor the HIV epidemic and plan urban public health care and policies, there is a growing need to formulate a strategy for monitoring PLWHA care, location and migration patterns. The Porto Alegre District is characterized by a high prevalence of PLWHA and is considered one of the epicenters of HIV epidemic in Latin America. Objectives: The aim of this study is to create a digital and easily editable map in order to create a visual representation of the location of PLWHA and to monitor their migration within the city and the country in an effort to promote longitudinal care. Methods: This Experience Report used Google Maps Map Creator to generate an active digital map showing the location and changes in residence of 165 PLWHA who received care at two Primary Health Care (PHC) clinics, which attended an estimated population of five thousand patients, in downtown Porto Alegre over the last four years. Their current addresses were discovered in the unified Brazilian health care system digital records (e-SUS) and updated on the map. Results: A digital map with PLWHA current residence location was created. It was possible to demonstrate visually areas with a large concentration of PLWHA and the migration of the population within the city as wells as other cities, regions and states. Conclusions: An easily reproducible and free map could aid in PLWHA monitoring, urban public health planning, target interventions and situational diagnosis. Moreover, a visual representation of PLWHA location and migration could help bring more attention and investments to areas with geographic inequities or higher prevalence of PLWHA. It also enables notification of local PHC units of monitored patients inside their area, which are in clinical risk or with treatment abandonment through active case findings, improving the care of PLWHA.

Keywords: health care, medical public health, theoretical and conceptual innovations, urban public health

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Authors: Beryl Rene R. Lopez, Lesley Anne M. Lipat, Rhogene Barbette C. Lirio, Laurice Joy H. Llanes, Karl Philippe M. Llapitan, Einstein James R. Lopez, Socorro S. GuanHing

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Background: Measles remain as one of the most common childhood diseases despite the availability of the vaccine that is safe and cost-effective. Because of morbidity and mortality associated with the recent measles outbreak in the Philippines, there is an increasing concern from the health care professionals. Objective: The purpose of this study is to determine the relationship between the compliance of Filipino mothers to measles vaccination and their health beliefs when grouped according to the given socio-demographic factors using a researcher-made questionnaire. Research Methodology: This research utilized the descriptive-correlational research design. With the use of purposive sampling technique, the study involved 200 Filipino mothers aged 18 years old and above excluding those who are healthcare professionals with children aged 2-3 years old with either urban or rural as their settlements. Pre-testing was done prior to the actual data gathering. A questionnaire composed of 26 items involving socio-demographic, compliance, and health beliefs was distributed to the sample population. Statistical analysis was done with the use of Exploratory Factor Analysis (EFA) for the first research question and Structural Equation Model (SEM) for the second research question. Results: Four dimensions were generated with the use of EFA namely: Vulnerability-Oriented Beliefs (VOB), Knowledge-Oriented Beliefs (KOB), Accessibility-Oriented Beliefs (AOB), and Outcomes-Oriented Beliefs (OOB). These were then correlated with the mothers’ socio-demographic factors (age, educational attainment, the area of residence, the number of children, and family income) and their compliance to the measles vaccination schedule. Results showed significant and direct relationships between area of residence and compliance, family income and compliance, KOB and compliance, education and KOB, KOB and VOB, KOB and OOB, AOB and KOB, AOB and OOB, AOB and VOB, and lastly, OOB and VOB. Conclusion: The Knowledge – Oriented Belief dimension greatly influence compliance to measles vaccination. Other determinants of compliance like the area of residence, educational attainment, and family income significantly increase the Filipino mothers’ likelihood of compliance to measles vaccination, which have implications to health education.

Keywords: socio-demographic, health beliefs, compliance, measles vaccination

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Authors: Shazia Almas, Jaffar Iqbal, Nazia Almas

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In most of the South Asian countries like Pakistan medical profession is one the most valued and respectful professions yet being a medical professional requires an enormous amount of responsibilities and work overload at the same time which possibly can be in contrast with family role of a doctor. Job and family are two primary spheres of a person's life no matter whatever the profession one adopts and the type of family one is running. There is a bi-directional relationship between job and family. The type and nature of work, time schedules, working shifts in medical profession are very demanding in the countries like Pakistan where number of patients is far more higher than the number of doctors available. The work life also have significant impact on family life and vice versa. Because of the sensitivity and interdependency of these relations, today’s overarching and competing demands remain dissatisfactory. The main objective of the current research is to investigate how interpersonal relationships affect work and work affects interpersonal relationships of medical professionals. In line with identifying these facts, the current study aimed to examine the predictive role of psychological capital (self-efficacy, hope, optimism, and resilience), in organizational outcome (job satisfaction) and personal outcome (family satisfaction) amongst male and medical professionals. A total of 350 participants from public and private sector hospitals of Pakistan were recruited through simple random and stratified sampling techniques, with age ranges from 26-50 years. The questionnaire including established and certified self-report measures of Psychological Capital Questionnaire, Job Satisfaction, and Family Satisfaction were adopted to collect the data. The reliability and validity of mentioned instruments were established through Cronbach’s alpha and factor analyses (exploratory and confirmatory) respectively using Structural Equation Modeling (SEM) by AMOS. The proposed hypotheses were tested using Pearson’s Correlation and Regression analyses for predicting effect whereas, t-Test was deployed to verify the difference between male and female health professionals. The results revealed that self-efficacy and optimism predicted job satisfaction while, self-efficacy, hope, and resilience predicted family satisfaction. Moreover, the results depicted significant gender differences in job satisfaction where females were higher on job satisfaction as compared to male medical professionals but no significant differences were observed in levels of family satisfaction between both genders. The study has implications for social, organizational and work policy designers. The study also paves for more researches with positive psychological approach to promote work-family harmony.

Keywords: family satisfaction, job satisfaction, medical professionals, psychological capital

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Authors: Jo, Eui Chang, Shin, Heekang, Mun, A. Young , Kim, Hong Kyu

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Regarding change on population and family structure in Korea after the 1980s, there has been a rapid change of low fertility, graying and increase of single household that cannot be found in any other parts of the world. With the result of total population residence by the National Statistical Office, Korea will hold 52,160,065 people in 2030 and reduction is predicted and from 2025 people above the age of 65 will take 20% of the total population, which means the entry of a super aging society. Also, average number in a family will be 2.71 in 2015 and decrease to 2.33 in 2035. On the other hand, proportion of single and two person household will be 53.7% in 2015 and it will increase up to 68.4% in 2035. Old population will increase greatly, single and two person household will take 2/3 of the total households. Delphi research was processed in 3 steps on 40 professionals about the importance and changing factors of residential environment of apartment followed by the change of population structure. For interior plan, space variety, variability, safety, convenient installation, eco-friendly installation, and IT installation were important factors for construction plan, plan on aged and single households, convenient installation, safety installation, eco-friendly installation for subdivision plan, education/child care facility, parks/gymnasium facility, community facility, and accessibility of transportation were predicted as important factors.

Keywords: change of population structure, super-graying, change of residential environment of apartment, single household, interior plan, construction plan, subdivision plan, Delphi research

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Authors: Isabelle Gobatto

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Based on an anthropological approach, this paper explores the medical profession and the construction of medical practices by considering the multiform articulations between structural poverty and the production of care from a low-resource francophone West African country, Burkina Faso. This country is considered in its exemplary dimension of culturally differentiated countries of the African continent that share the same situation of structural poverty. The objective is to expose the effects of structural poverty on the ways of constructing professional knowledge and thinking about the sense of the medical profession. If doctors are trained to have the same capacities in South and West countries, which are to treat and save lives whatever the cultural contexts of the practice of medicine, the ways of investing their role and of dealing with this context of action fracture the homogenization of the medical profession. In the line of anthropology of biomedicine, this paper outlines the complex effects of structural poverty on health care, care relations, and the moral economy of doctors. The materials analyzed are based on an ethnography including two temporalities located thirty years apart (1990-1994 and 2020-2021), based on long-term observations of care practices conducted in healthcare institutions, interviews coupled with the life histories of physicians. The findings reveal that disabilities faced by doctors to deliver care are interpreted as policy gaps, but they are also considered by physicians as constitutive of the social and cultural characteristics of patients, making their capacities and incapacities in terms of accompanying caregivers in the production of care. These perceptions have effects on know-how, structured around the need to act even when diagnoses are not made so as not to see patients desert health structures if the costs of care are too high for them. But these interpretations of highly individualizing dimensions of these difficulties place part of the blame on patients for the difficulties in using learned knowledge and delivering effective care. These situations challenge the ethics of caregivers but also of ethnologists. Firstly because the interpretations of disabilities prevent caregivers from considering vulnerabilities of care as constituting a common condition shared with their patients in these health systems, affecting them in an identical way although in different places in the production of care. Correlatively, these results underline that these professional conceptions prevent the emergence of a figure of victim, which could be shared between patients and caregivers who, together, undergo working and care conditions at the limit of the acceptable. This dimension directly involves politics. Secondly, structural poverty and its effects on care challenge the ethics of the anthropologist who observes caregivers producing, without intent to arm, experiences of care marked by an ordinary violence, by not giving them the care they need. It is worth asking how anthropologists could get doctors to think in this light in west-African societies.

Keywords: Africa, care, ethics, poverty

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Authors: A. Bouabid, B. Bielenberg, S. Ainane, N. Pasha

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In this paper, a team of faculty members of the Petroleum Institute in Abu Dhabi, UAE representing six different courses across General Engineering (ENGR), Communication (COMM), and Design (STPS) worked together to establish a clear developmental progression of learning outcomes and performance indicators for targeted knowledge, areas of competency, and skills for the first three semesters of the Bachelor of Sciences in Engineering curriculum. The sequences of courses studied in this project were ENGR/COMM, COMM/STPS, and ENGR/STPS. For each course’s nine areas of knowledge, competency, and skills, the research team reviewed the existing learning outcomes and related performance indicators with a focus on identifying linkages across disciplines as well as within the courses of a discipline. The team reviewed existing performance indicators for developmental progression from semester to semester for same discipline related courses (vertical alignment) and for different discipline courses within the same semester (horizontal alignment). The results of this work have led to recommendations for modifications of the initial indicators when incoherence was identified, and/or for new indicators based on best practices (identified through literature searches) when gaps were identified. It also led to recommendations for modifications of the level of emphasis within each course to ensure developmental progression. The exercise has led to a revised Sequence Performance Indicator Mapping for the knowledge, skills, and competencies across the six core courses.

Keywords: curriculum alignment, horizontal and vertical progression, performance indicators, skill level

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Authors: Jui Chen Wu, Ming Yi Hsu

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Background and Purpose: Shift work of nursing staff is inevitable in hospital to provide continuing medical care. However, shift work is considered as a health hazard that may cause physical and psychological problems. Serious workplace fatigue of nursing shift work might impact on family, social and work life, moreover, causes serious reduction of quality of medical care, or even malpractice. This study aims to explore relationships among nursing staff’s shift, workplace fatigue and quality of working life. Method: Structured questionnaires were used in this study to explore relationships among shift work, workplace fatigue and quality of working life in nursing staffs. We recruited 590 nursing staffs in different Community Teaching hospitals in Taiwan. Data analysed by descriptive statistics, single sample t-test, single factor analysis, Pearson correlation coefficient and hierarchical regression, etc. Results: The overall workplace fatigue score is 50.59 points. In further analysis, the score of personal burnout, work-related burnout, over-commitment and client-related burnout are 57.86, 53.83, 45.95 and 44.71. The basic attributes of nursing staff are significantly different from those of workplace fatigue with different ages, licenses, sleeping quality, self-conscious health status, number of care patients of chronic diseases and number of care people in the obstetric ward. The shift variables revealed no significant influence on workplace fatigue during the hierarchical regression analysis. About the analysis on nursing staff’s basic attributes and shift on the quality of working life, descriptive results show that the overall quality of working life of nursing staff is 3.23 points. Comparing the average score of the six aspects, the ranked average score are 3.47 (SD= .43) in interrelationship, 3.40 (SD= .46) in self-actualisation, 3.30 (SD= .40) in self-efficacy, 3.15 (SD= .38) in vocational concept, 3.07 (SD= .37) in work aspects, and 3.02 (SD= .56) in organization aspects. The basic attributes of nursing staff are significantly different from quality of working life in different marriage situations, education level, years of nursing work, occupation area, sleep quality, self-conscious health status and number of care in medical ward. There are significant differences between shift mode and shift rate with the quality of working life. The results of the hierarchical regression analysis reveal that one of the shifts variables 'shift mode' which does affect staff’s quality of working life. The workplace fatigue is negatively correlated with the quality of working life, and the over-commitment in the workplace fatigue is positively related to the vocational concept of the quality of working life. According to the regression analysis of nursing staff’s basic attributes, shift mode, workplace fatigue and quality of working life related shift, the results show that the workplace fatigue has a significant impact on nursing staff’s quality of working life. Conclusion: According to our study, shift work is correlated with workplace fatigue in nursing staffs. This results work as important reference for human resources management in hospitals to establishing a more positive and healthy work arrangement policy.

Keywords: nursing staff, shift, workplace fatigue, quality of working life

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Authors: Nipon Sasithornsaowapa

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This research aims to study the impact of personality and family status on women executives’ career success of the primary education department of Thailand. The independent variable includes three factors, namely family status, personality, and knowledge-skill-experience, while the dependent variable is the career success. The population of this study includes 2,179 female management officials in the department of primary education. A total of 400 female managers is interviewed and utilized as a sample group. A questionnaire is developed and used as a research tool for data collection. Content analysis is performed to get the quantitative data. Descriptive statistics in this research is conducted by SPSS program. The findings revealed that personality and family status of samples have an influence on the overall career success of women executives in terms of their objective career success. However, in terms of specific factors of personality or family status, it is found that there is no relevance of each factor on the women executives’ career success. It can be concluded that the factor affecting the women executives’ career success is subjective career success including the happiness and enjoyment with the job not factor concerning materials. Their success is the result of each individual working experience. However, their personal characteristics do not affect their success.

Keywords: career success, women executives, primary education, knowledge-skill-experience

Procedia PDF Downloads 481

Authors: K. Pankaj, R. K. Chaudhary, B. P. Mishra, S. Kochar

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Introduction: Consultation-Liaison psychiatry is a branch of psychiatry that includes clinical service, teaching and research. A consultation-liaison psychiatrist plays a role in having an expert opinion and linking the patients to other medical professionals and the patient’s bio-psycho-social aspects that may be leading to his/her symptoms. Consultation-Liaison psychiatry has been recognised as 'The guardian of the holistic approach to the patient', underlining its pre-eminent role in the management of patients who are admitted in a tertiary care hospital. Aims/ Objectives: The aim of the study was to analyse the utilization of psychiatric services and reasons for referrals in a tertiary care hospital. Materials and Methods: The study was done in a tertiary care hospital. The study included all the cases referred from different Inpatient wards to the psychiatry department for consultation. The study was conducted on 300 patients over a 3 month period. International classification of diseases 10 was used to diagnose the referred cases. Results: The majority of the referral was from the Medical Intensive care unit (22%) followed by general medical wards (18.66%). Majority of the referral was taken for altered sensorium (24.66%), followed by low mood or unexplained medical symptoms (21%). Majority of the referrals had a diagnosis of alcohol withdrawal syndrome (21%) as per International classification of diseases criteria, followed by unipolar Depression and Anxiety disorder (~ 14%), followed by Schizophrenia (5%) and Polysubstance abuse (2.6%). Conclusions: Our study concludes the importance of utilization of consultation-liaison psychiatric services. Also, the study signifies the need for sensitization of our colleagues regarding psychiatric sign and symptoms from time to time and seek psychiatric consult timely to decrease morbidity.

Keywords: consultation-liaison, psychiatry, referral, tertiary care hospital

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Authors: Jevonte Abioye, Dylan Savary

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The aim of this research is to present a disaggregated geostatistical analysis of the subnational provincial trends of child mortality variation in Zimbabwe from a child health policy perspective. Soon after gaining independence in 1980, the government embarked on efforts towards promoting equitable health care, namely through the provision of primary health care. Government intervention programmes brought hope and promise, but achieving equity in primary health care coverage was hindered by previous existing disparities in maternal health care disproportionately concentrated in urban settings to the detriment of rural communities. The article highlights policies and programs adopted by the government during the millennium development goals period between 1990-2015 as a response to the inequities that characterised the country’s maternal health care. A longitudinal comparative method for a spatial variation on child mortality rates across provinces is developed based on geostatistical analysis. Cross-sectional and time-series data was extracted from the World Health Organisation (WHO) global health observatory data repository, demographic health survey reports, and previous academic and technical publications. Results suggest that although health care policy was uniform across provinces, not all provinces received the same antenatal and perinatal services. Accordingly, provincial rates of child mortality growth between 1994 and 2015 varied significantly. Evidence on the trends of child mortality rates and maternal health policies in Zimbabwe can be valuable for public child health policy planning and public service delivery design both in Zimbabwe and across developing countries pursuing the sustainable development agenda.

Keywords: antenatal care, perinatal care, infant mortality rate, neonatal mortality rate, under-five mortality rate, millennium development goals, sustainable development agenda

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Authors: Young Ik Suh, Tywan G. Martin

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Bundling strategy is a common marketing practice today. In the past decades, both academicians and practitioners have increasingly emphasized the strategic importance of bundling in today’s markets. The reason for increased interest in bundling strategy is that they normally believe that it can significantly increase profits on organization’s sales over time and it is convenient for the customer. However, little efforts has been made on ticket bundling and purchase considerations in hedonic and utilitarian options in sport consumer behavior context. Consumers often face choices between utilitarian and hedonic alternatives in decision making. When consumers purchase certain products, they are only interested in the functional dimensions, which are called utilitarian dimensions. On the other hand, others focus more on hedonic features such as fun, excitement, and pleasure. Thus, the current research examines how utilitarian and hedonic consumption can vary in typical ticket purchasing process. The purpose of this research is to understand the following two research themes: (1) the differential effect of discount framing on ticket bundling: utilitarian and hedonic options and (2) moderating effect of team identification on ticket bundling. In order to test the research hypotheses, an experimental study using a two-way ANOVA, 3 (team identification: low, medium, and high) X 2 (discount frame: ticket bundle sales with utilitarian product, and hedonic product), with mixed factorial design will be conducted to determine whether there is a statistical significance between purchasing intentions of two discount frames of ticket bundle sales within different team identification levels. To compare mean differences among the two different settings, we will create two conditions of ticket bundles: (1) offering a discount on a ticket ($5 off) if they would purchase it along with utilitarian product (e.g., iPhone8 case, t-shirt, cap), and (2) offering a discount on a ticket ($5 off) if they would purchase it along with hedonic product (e.g., pizza, drink, fans featured on big screen). The findings of the current ticket bundling study are expected to have many theoretical and practical contributions and implications by extending the research and literature pertaining to the relationship between team identification and sport consumer behavior. Specifically, this study can provide a reliable and valid framework to understanding the role of team identification as a moderator on behavioral intentions such as purchase intentions. From an academic perspective, the study will be the first known attempt to understand consumer reactions toward different discount frames related to ticket bundling. Even though the game ticket itself is the major commodity of sport event attendance and significantly related to teams’ revenue streams, most recent ticket pricing research has been done in terms of economic or cost-oriented pricing and not from a consumer psychological perspective. For sport practitioners, this study will also provide significant implications. The result will imply that sport marketers may need to develop two different ticketing promotions for loyal fan and non-loyal fans. Since loyal fans concern ticket price than tie-in products when they see ticket bundle sales, advertising campaign should be more focused on discounting ticket price.

Keywords: ticket bundling, hedonic, utilitarian, team identification

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Authors: Rajendra Kumar Kanojia

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Treatment of fracture both bones of leg following trauma is done intially at nearby primary health care center.primary management for shock,pain,control of bleeding,plaster application. These are treated for primay fixation of fracture, debridment of wound. Then, they were refered to tertiary care where they were again and planned for further treatment. This leads to loss of lot of time, money, job, etc.

Keywords: fracture both bones leg, non-union, ilizarov, cost

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Authors: Mohammad Naeem Lakanwall

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Background:The thyroid gland, located just below the vocal cord on each side of and anterior to the trachea, is one of the main endocrine glands. Its normal weight is 15 to 20 grams in adults. The thyroid secretes two most important hormones, thyroxine and triiodothyronine, usually called T4 and T3, respectively. These hormones greatly increase the metabolic rate of the body. In addition to T3 and T4, the thyroid gland secrets calcitonin as well which is a significant hormone for calcium metabolism. Objective: The aim of this study is to estimate the proportion of and to identify factors associated with thyroid dysfunction among individuals coming to a tertiary care facility in Kabul, Afghanistan. Material and Methods: An analytical cross-sectional study design was conducted from July to Sep 2018. Blood samples were obtained, serum TSH levels were measured, and the patients were divided into three diagnostic categories according to their serum TSH concentrations. 1) Hypothyroidism 2) Hyperthyroidism 3) Normal thyroid Results: A total of 127 individuals were part of the sample for the final analysis. The majority of study participants (77%) were females. A large number of the participants (92%) did not have a family history of thyroid dysfunction and the majority of the female participants, (85%) were not pregnant in the last two years. Furthermore, 98% of participants, were non-smokers. Conclusion: The findings of the current study showed a high prevalence of thyroid dysfunctions in individuals coming to FMIC for thyroid functions tests. The findings also indicated that aging and smoking are the factors associated with thyroid dysfunctions. Further studies are needed to find out the prevalence of and factors associated with thyroid dysfunctions.

Keywords: Afghanistan, Kabul, hypothyroidism, hyperthyroidism, triiodothyronine, thyroxine

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Authors: Yi-Fung Lin, Shiow-Ching Shun, Wen-Yu Hu

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Background: A skill mix model is regarded as one of the most effective methods of reducing nursing shortages, as well as easing nursing staff workloads and labor costs. Although this model shows several benefits for the health workforce, the relationship between the optimal model of skill mix and the patient mortality rate remains to be discovered. Objectives: This review aimed to explore the relationship between the skill mix model and patient mortality rate in acute care hospitals. Data Sources: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases and researchers retrieved studies published between January 1986 and March 2022. Review methods: Two independent reviewers screened the titles and abstracts based on selection criteria, extracted the data, and performed critical appraisals using the STROBE checklist of each included study. The studies focused on adult patients in acute care hospitals, and the skill mix model and patient mortality rate were included in the analysis. Results: Six included studies were conducted in the USA, Canada, Italy, Taiwan, and European countries (Belgium, England, Finland, Ireland, Spain, and Switzerland), including patients in medical, surgical, and intensive care units. There were both nurses and nursing assistants in their skill mix team. This main finding is that three studies (324,592 participants) show evidence of fewer mortality rates associated with hospitals with a higher percentage of registered nurse staff (range percentage of registered nurse staff 36.1%-100%), but three articles (1,122,270 participants) did not find the same result (range of percentage of registered nurse staff 46%-96%). However, based on appraisal findings, those showing a significant association all meet good quality standards, but only one-third of their counterparts. Conclusions: In light of the limited amount and quality of published research in this review, it is prudent to treat the findings with caution. Although the evidence is not insufficient certainty to draw conclusions about the relationship between nurse staffing level and patients' mortality, this review lights the direction of relevant studies in the future. The limitation of this article is the variation in skill mix models among countries and institutions, making it impossible to do a meta-analysis to compare them further.

Keywords: nurse staffing level, nursing assistants, mortality, skill mix

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Authors: E. Vazquez-Santacruz, M. Gamboa-Zuniga

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In this paper, we show a methodology for bodies classification in lying state using HOG descriptors and pressures sensors positioned in a matrix form (14 x 32 sensors) on the surface where bodies lie down. it will be done in real time. Our system is embedded in a care robot that can assist the elderly patient and medical staff around to get a better quality of life in and out of hospitals. Due to current technology a limited number of sensors is used, wich results in low-resolution data array, that will be used as image of 14 x 32 pixels. Our work considers the problem of human posture classification with few information (sensors), applying digital process to expand the original data of the sensors and so get more significant data for the classification, however, this is done with low-cost algorithms to ensure the real-time execution.

Keywords: real-time classification, sensors, robots, health care, elderly patients, artificial intelligence

Procedia PDF Downloads 866

Authors: V. Emery David Jr., J. Wenchao, D. Mmereki, Y. John, F. Heriniaina

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Healthcare waste management continues to present an array of challenges for developing countries, and Liberia is of no exception. There is insufficient information available regarding the generation, handling, and disposal of health care waste. This face serves as an impediment to healthcare management schemes. The specific objective of this study is to present an evaluation of the current health care management practices in Liberia. It also presented procedures, techniques used, methods of handling, transportation, and disposal methods of wastes as well as the quantity and composition of health care waste. This study was conducted as an investigative case study, covering three different health care facilities; a hospital, a health center, and a clinic in Monrovia, Montserrado County. The average waste generation was found to be 0-7kg per day at the clinic and health center and 8-15kg per/day at the hospital. The composition of the waste includes hazardous and non-hazardous waste i.e. plastic, papers, sharps, and pathological elements etc. Nevertheless, the investigation showed that the healthcare waste generated by the surveyed healthcare facilities were not properly handled because of insufficient guidelines for separate collection, and classification, and adequate methods for storage and proper disposal of generated wastes. This therefore indicates that there is a need for improvement within the healthcare waste management system to improve the existing situation.

Keywords: disposal, healthcare waste, management, Montserrado County, Monrovia

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Authors: Mohammad S. Razai, Jan Williams, Rachel Nestel, Dermot Dalton

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Purpose: This descriptive qualitative study aimed to obtain parents recommendations for improving the notification process and communication of positive newborn screening result for cystic fibrosis (CF). Methods: Thematic analysis of semi-structured open-ended interviews with 11 parents of 7 children with confirmed diagnosis of CF between 2 months — 2 years of age. Results: Parents preferred face to face disclosure of positive NBS results by a pediatrician with CF professional qualification. They trusted a pediatrician more than any other professional in providing accurate, credible and comprehensive information about the diagnosis and its implications. Parents recommended that health professionals be knowledgeable and provide clear, succinct and understandable information. Providers should also explore parents concerns and acknowledge feelings and emotions. Most parents reported that they preferred to be notified immediately as soon as the results were available. Several parents preferred to be told once the diagnosis was certain. Most parents regarded open access to CF team as the most significant part of care coordination. In addition to health professionals, most parents used internet as an important source of information, interaction and exchange of experiences. Most parents also used social networking sites such as Facebook groups and smart phone apps. Conclusion: This study provides significant new evidence from parental perspective in emphasizing the pivotal role of good communication skills deployed by a knowledgeable CF specialist in person. Parents use of social media and internet has replaced some traditional methods of information exchange and may reduce the need for professional input for newly diagnosed CF patients.

Keywords: care coordination, cystic fibrosis, newborn screening, notification process, parental preferences, professional-paren communication

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Authors: Amanda Aliende da Matta

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This communication presents an aspect of phenomenon selection in an applied hermeneutic phenomenology study on care and vulnerability: the need to consider it as a situated universal. For that, we will first present the study and its methodology. Secondly, we will expose the need to understand phenomena as situation-defined, incorporating feminist thought. In an informatics class for 14 year olds, we explained the exercise: students have to make a 5 slide presentation about a topic of their choice. A does it on streetwear, B on Cristiano Ronaldo, C on Marvel, but J did it on Down Syndrome. Introducing it to the class, J explains the physical and cognitive differences caused by trisomy; when asked to explain it further, he says: "they are angels, teacher," and shows us a poster on his cellphone that says: if you laugh at a different child he will laugh with you because his innocence outweighs your ignorance. The anecdote shows, better than any theoretical explanation, something that some vulnerable people have; something beautiful and special but difficult to define. Let's call this something caring. The research has the main objective of accounting for the experience of caregiving in vulnerability, and it will be carried out with Applied Hermeneutic Phenomenology (AHP). The method's objective is to investigate the lived human experience in its pre-reflexive dimension to know its meaning structures. Contrary to other research methods, AHP does not produce theory about a specific context but seeks the meaning of the lived experience, in its characteristic of human experience. However, it is necessary that we understand care as defined in a concrete situation. We cannot start the research with an a priori definitive concept of care, or we would fall into the mistake of closing ourselves to only what we already know, as explained by Levinas. We incorporate, then, the notion of situated universals. Loyal to phenomenology, the definition of the phenomenon should start with an investigation of the word's etymology: the word cura, in its etymological root, means care. And care comes from the Latin word cogitātus/cōgĭto, which means "to pursue something in mind" and "to consider thoroughly." The verb cōgĭto, meanwhile, is composed of co- (altogether) and agitare (to deal with or think committedly about something, to concern oneself with) / ăgĭto (to set in motion, to move). Care, therefore, has in its origin a meditation on something, a concern about something, a verb that has a sense of action and movement. To care is to act out of concern for something/someone. This etymology, though, is not the final definition of the phenomenon, but only its skeleton. It needs to be embodied in the concrete situation to become a possible lived experience. And that means that the lived experience descriptions (LEDs) should be selected by taking into consideration how and if care was engendered in that concrete experience. Defining the phenomenon has to take into consideration situated knowledge.

Keywords: applied hermeneutic phenomenology, care ethics, hermeneutics, phenomenology, situated universalism

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Authors: Niveen M. Hassan-Abbas

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The COVID-19 pandemic created a range of stressors, among them difficulties related to work conditions, financial changes, lack of childcare, and confinement or isolation due to social distancing. Among families and married individuals, these stressors were often expressed in additional daily hassles, with an influence on mental health. This study examined two moderated mediation models based on Bodenmann’s systemic-transactional stress model. Specifically, the models tested the hypothesis that intra-dyadic stress mediates the association between extra-dyadic stress and mental health, while two measures of family functioning, cohesion, and flexibility, moderate the relationship between extra and intra-dyadic stress. Participants were 480 heterosexual married Palestinians from Israel who completed self-report questionnaires. The results showed partial mediation patterns supporting both models, indicating that family cohesion and flexibility weakened the mediating effect of intra-dyadic stress on the relationship between extra-dyadic stress and mental health. These findings increase our understanding of the variables that affected mental health during the pandemic and suggested that when faced with extra-dyadic stress, married individuals with good family environments are less likely to experience high levels of intra-dyadic stress, which is in turn associated with preserved mental health. Limitations and implications for planning interventions for couples and families during the pandemic are discussed.

Keywords: Palestinian families in Israel, COVID-19 pandemic, family cohesion and flexibility, extra-dyadic stress, intra-dyadic stress, mental health

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Authors: Jafar Ahmadi, Zhohreh Asiaban, Sedigheh Fabriki Ourang

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Brassinosteroids (BRs) regulate cell elongation, vascular differentiation, senescence and stress responses. BRs signal through the BES1/BZR1 family of transcription factors, which regulate hundreds of target genes involved in this pathway. In this research a comprehensive genome-wide analysis was carried out in BES1/BZR1 gene family in Arabidopsis thaliana, Cucumis sativus, Vitis vinifera, Glycin max, and Brachypodium distachyon. Specifications of the desired sequences, dot plot and hydropathy plot were analyzed in the protein and genome sequences of five plant species. The maximum amino acid length was attributed to protein sequence Brdic3g with 374aa and the minimum amino acid length was attributed to protein sequence Gm7g with 163aa. The maximum Instability index was attributed to protein sequence AT1G19350 equal with 79.99 and the minimum Instability index was attributed to protein sequence Gm5g equal with 33.22. Aliphatic index of these protein sequences ranged from 47.82 to 78.79 in Arabidopsis thaliana, 49.91 to 57.50 in Vitis vinifera, 55.09 to 82.43 in Glycin max, 54.09 to 54.28 in Brachypodium distachyon 55.36 to 56.83 in Cucumis sativus. Overall, data obtained from our investigation contributes a better understanding of the complexity of the BES1/BZR1 gene family and provides the first step towards directing future experimental designs to perform systematic analysis of the functions of the BES1/BZR1 gene family.

Keywords: BES1/BZR1, brassinosteroids, phylogenetic analysis, transcription factor

Procedia PDF Downloads 340