Search results for: junior secondary school education

Authors: Pinn Tsin Isabel Yee

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With the advent of internet technologies, students are increasingly turning toward social media and cross-platform messaging apps such as WhatsApp, Line, and WeChat to support their teaching and learning processes. Although each messaging app has varying features, WhatsApp remains one of the most popular cross-platform apps that allow for fast, simple, secure messaging and free calls anytime, anywhere. With a plethora of advantages, students could easily assimilate WhatsApp as a supportive technology in their learning process. There could be peer to peer learning, and a teacher will be able to share knowledge digitally via the creation of WhatsApp groups. Content analysis techniques were utilized to analyze data collected by closed-ended question forms. Studies demonstrated that 98.8% of college students (n=80) from the Monash University foundation year agreed that the employment of WhatsApp groups was helpful as a learning tool. Approximately 71.3% disagreed that notifications and alerts from the WhatsApp group were disruptions in their studies. Students commented that they could silence the notifications and hence, it would not disturb their flow of thoughts. In fact, an overwhelming majority of students (95.0%) found it enjoyable to participate in WhatsApp groups for educational purposes. It was a common perception that some students felt pressured to post a reply in such groups, but data analysis showed that 72.5% of students did not feel pressured to comment or reply. It was good that 93.8% of students felt satisfactory if their posts were not responded to speedily, but was eventually attended to. Generally, 97.5% of students found it useful if their teachers provided their handphone numbers to be added to a WhatsApp group. If a teacher posts an explanation or a mathematical working in the group, all students would be able to view the post together, as opposed to individual students asking their teacher a similar question. On whether students preferred using Facebook as a learning tool, there was a 50-50 divide in the replies from the respondents as 51.3% of students liked WhatsApp, while 48.8% preferred Facebook as a supportive technology in teaching and learning. Taken altogether, the utilization of WhatsApp groups as a supportive technology in teaching and learning should be implemented in all classes to continuously engage our generation Y students in the ever-changing digital landscape.-

Keywords: education, learning, messaging app, technology, WhatsApp groups

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Authors: Mehravar Javid, Sadrieh Khajavi Mazanderani, Kelly Gleischman, Zoe Andris

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The present study was conducted with the aim of investigating the effectiveness of transactional analysis group training on self-knowledge and Its dimensions (self, child, and adult) in counselors working in public and private high schools in Tehran. Counseling has become an important job for society, and there is a need for consultants in organizations. Providing better and more efficient counseling is one of the goals of the education system. The personal characteristics of counselors are important for the success of the therapy. In TA, humans have three ego states, which are named parent, adult, and child, and the main concept in the transactional analysis is self-state, which means a stable feeling and pattern of thinking related to behavioral patterns. Self-knowledge, considered a prerequisite to effective communication, fosters psychological growth, and recognizing it, is pivotal for emotional development, leading to profound insights. The research sample included 30 working counselors (22 women and 8 men) in the academic year 2019-2020 who achieved the lowest scores on the self-knowledge questionnaire. The research method was quasi-experimental with a control group (15 people in the experimental group and 15 people in the control group). The research tool was a self-awareness questionnaire with 29 questions and three subscales (child, parent, and adult Ego state). The experimental group was exposed to transactional analysis training for 10 once-weekly 2-hour sessions; the questionnaire was implemented in both groups (post-test). Multivariate covariance analysis was used to analyze the data. The data showed that the level of self-awareness of counselors who received transactional analysis training is higher than that of counselors who did not receive any training (p<0.01). The result obtained from this analysis shows that transactional analysis training is an effective therapy for enhancing self-knowledge and its subscales (Adult ego state, Parent ego state, and Child ego state). Teaching transactional analysis increases self-knowledge, and self-realization and helps people to achieve independence and remove irresponsibility to improve intra-personal and interpersonal relationships.

Keywords: ego state, group, transactional analysis, self-knowledge

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Authors: Maria Dora Horvath, Norbert Buzas, Zsanett Tesch

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Diabetes management poses many unique challenges for children and their parents. The use of a diabetes management device should not be one of these challenges as the purpose of these devices is to make the management more convenient. The objective of our study was to examine how demographical, psychological and diabetes-related factors determine the choices parents make regarding their child’s diabetes management technologies and how they perceive advanced devices. We conducted the study using an online questionnaire with 318 parents (mostly mothers). The questions of the survey were about demographical, diabetes-related and psychological factors (diabetes management problems, diabetes management competence). In addition, we asked the parents opinions about advanced diabetes management devices. We expanded our data with semi-structured in-depth interviews. 61 % of the participants Self-Monitored Blood Glucose (SMBG), and 39 % used a Continuous Glucose Monitoring System (CGM). Considering insulin administration, 58 % used Multiple Daily Insulin Injections (MDII) and 42 % used Continuous Subcutaneous Insulin Infusion (CSII). Parents who used diverse combinations of diabetes management devices showed significant differences in age (parents’ and child’s), the monthly cost of diabetes, the duration of diabetes, the highest level of education and average monthly household income. CGM users perceived diabetes management problems significantly more severe than SMBG users and CSII users felt significantly more competent in diabetes management than MDII users. Avoiding CGM use due to lack of financial resources was determined by diagnosis duration. While avoiding its use by the cause of the child rejecting, it was determined by the child’s age and diabetes competence. Using MDII instead of CSII because of the child’s rejection was determined by the monthly cost of diabetes and child’s age. We conducted a complex empirical study in which we examined perceptions and experiences of advanced and less advanced diabetes management technologies comprehensively. Our study highlights the factors that fundamentally influence parents’ motivations and choices about diabetes management technologies. These results could contribute to developing diabetes management technologies more suitable for children living with type 1 diabetes and their parents.

Keywords: advanced diabetes management technologies, children living with type 1 diabetes, diabetes management, motivation, parents

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Authors: Ntandoni Gloria Biyela

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During traditional times, there were no formal institutions of learning as they are today, where children attend classes to acquire or develop knowledge. This does not mean that there was no learning in indigenous African societies. Grandparents used to tell their grandchildren stories or teach them educational games around the fireplace, which this study refers to as a ‘traditional classroom’. A story recreated in symbolic or allegorical way, forms a base for a society’s beliefs, customs, accepted norms and language learning. Through folklore narratives, a society develops its own self awareness and education. So narrative characters, especially animals may be mythical products of the pre-literate folklore world and thus show the closeness that the Zulu society had with the wildlife. Oral cultures strive to create new facets of meaning by the use of animal metaphors to reflect the relationship of humans with the animal realm and to contribute to the language learning or literature in cross-cultural studies. Although animal metaphors are widespread in Zulu language because of the Zulu nation’s traditional closeness to wildlife, little field-research has been conducted on the social behavior of animals on the way in which their characteristics were transferred with precision to depictions of King Shaka’s behavior and activities during the amalgamation of Nguni clans into a Zulu kingdom. This study attempts to fill the gap by using first-hand interviews with local informants in areas traditionally linked to the king in KwaZulu-Natal province, South Africa. Departing from the conceptual metaphor theory, the study concentrates on King Shaka’s praise-poems in which the praise-poet describes his physical and dispositional characteristics through bold animal metaphors of the ‘Big Five’; namely, the lion, the leopard, the buffalo, the rhinoceros and the elephant, which are often referred to as Zulu royal favorites. These metaphors are still learnt by young and old in the 21st century because they reflect the responsibilities, status, and integrity of the king and the respect in which he is held by his people. They also project the crescendo growth of the Zulu nation, which, through the fulfillment of his ambitions, grew from a small clan to a mighty kingdom.

Keywords: animal, indigenous, learning, metaphor

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Authors: Park Eri, Sklad Marcin, Tsirogianni Stavroula

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In a world where there is increasing exchange and movement of populations groups, and interconnectedness, there are plenty of opportunities for mutual cultural enrichment. However, in everyday life, relations among different cultural groups do not go that smoothly often resulting in discrimination, inequalities and violence. The increasing differentiation of roles, values and worldviews raise a lot of tensions and dilemmas for the state and people -especially in western liberal societies- about issues of acceptance, fairness, justice, autonomy, plurality, freedom, equality and cohesion. Cultural diversity requires a deeper understanding of the roots, meaning and consequences of group differences. We argue, that a psychology from the standpoint of the subject needs to be developed further according to new societal needs. This means within a globalised society, issues regarding the construction of the other as another have become of utmost importance. In constructing the other human beings construct their ideal and possible worlds and meanings about their lives and their significance by drawing on a set of cultural norms, beliefs and values embedded in the different contexts whereby they find themselves in. In this article, we are describing a series of exercises developed in collaboration with University students in the Netherlands that have been piloted with undergraduate 2nd year University Psychology students. These exercises aimed at making tangible and obvious how students apply different moral principles and norms to regulate relationships, which are linked to hegemonic ideological forces. The exercises were in the form of thought experiments that included 8 moral dilemmas, inspired by the moral foundations theory, that touched on different moral principles. The moral dilemmas were built onto each other in incremental steps: from a very tangible/hands-on level to more challenging and demanding ones which require to step into pre-existing networks on knowledge and discourses. After the execution of every dilemma, a discussion followed, which is focused on building links between the ‘theme of the exercise’ and participants’ own lives experiences. In this paper, we provide an evaluation of the methodology used through a discursive analysis of the discussion between the students and the teacher.

Keywords: citizenship, moral dilemmas, social justice, education

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Authors: Oluwasina Folajinmi, Kate Ssamulla, Penninah Lutung, Daniel Reijer

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Background: Despite of well-verified benefits of anti-retroviral therapy (ART) in prolonging life expectancy being lost to follow-up (LTFU) presents a challenge to the success of ART programs in resource limited countries like Nigeria. In several studies of ART programs in developing countries, researchers have reported that there has been a high rate of LTFU among patients receiving care and treatment at ART treatment centers. This study seeks to determine the cause of LTFU among HIV clients. Method: A descriptive cross sectional study focused on a population of 9,280 persons living with HIV/AIDS who were enrolled in nine treatment centers in Nigeria (both pre-ART and ART patients were included). Out of the total population, 1752 (18.9%) were found to be LTFU. Of this group we randomly selected 1200 clients (68.5%) their d patients’ information was generated through a database. Data on demographics and CD4 counts, causes of LTFU were analyzed and summarized. Results: Out of 1200 LTFU clients selected, 462 (38.5%) were on ART; 341 clients (73.8%) had CD4 level < 500cell/µL and 738 (61.5%) on pre-ART had CD4 level >500/µL. In our records we found telephone number for 675 (56.1%) of these clients. 675 (56.1%) were owners of a phone. The majority of the client’s 731 (60.9%) were living at not more than 25km away from the ART center. A majority were females (926 or 77.2%) while 274 (22.8%) were male. 675 (56.1%) clients were reported traced via telephone and home address. 326 (27.2%) of clients phone numbers were not reachable; 173 (14.4%) of telephone numbers were incomplete. 71 (5.9%) had relocated due to communal crises and expert client trackers reported that some patient could not afford transportation to ART centers. Conclusion: This study shows that, low health education levels, poverty, relocations and lack of reliable phone contact were major predictors of LTFU. Periodic updates of home addresses, telephone contacts including at least two next of kin, phone text messages and home visits may improve follow up. Early and consistent tracking of missed appointments is crucial. Creation of more ART decentralized centres are needed to avoid long distances.

Keywords: anti-retroviral therapy, HIV/AIDS, predictors, lost to follow up

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Authors: Adepeju Simon-Oke, Olatunji Odeyemi, Mobolanle Oniya

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Urinary tract infection has become the most common bacterial infections in humans, both at the community and hospital settings; it has been reported in all age groups and in both sexes. This study was carried out in order to determine and evaluate the prevalence, current drug susceptibility pattern of the isolated organisms and identify the associated risk factors of UTIs among the pregnant women in Akure, Ondo State, Nigeria. A cross-sectional study was conducted on the urine of pregnant women, and socio-demographic information of the women was collected. A total of 300 clean midstream urine samples were collected, and a general urine microscopic examination and culture were carried out, the Microbact identification system was used to identify gram-negative bacteria. Out of the 300 urine samples cultured, 183(61.0%) yielded significant growth of urinary pathogens while 117(39.0%) yielded either insignificant growth or no growth of any urinary pathogen. Prevalence of UTI was significantly associated with the type of toilet used, symptoms of UTI, and previous history of urinary tract infection (p<0.05). Escherichia coli 58(31.7%) was the dominant pathogen isolated, and the least isolated uropathogens were Citrobacter freudii and Providencia retgerri 2(1.1%) respectively. Gram-negative bacteria showed 77.6%, 67.9%, and 61.2% susceptibility to ciprofloxacin, augmentin, and chloramphenicol, respectively. Resistance against septrin, chloramphenicol, sparfloxacin, amoxicillin, augmentin, gentamycin, pefloxacin, trivid, and streptomycin was observed in the range of 23.1 to 70.1%. Gram-positive uropathogens isolated showed high resistance to amoxicillin (68.4%) and high susceptibility to the remaining nine antibiotics in the range 65.8% to 89.5%. This study justifies that pregnant women are at high risk of UTI. Therefore screening of pregnant women during antenatal clinics should be considered very important to avoid complications. Health education with regular antenatal and personal hygiene is recommended as precautionary measures to UTI.

Keywords: pregnant women, prevalence, risk factor, UTIs

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Authors: Jonas Sanon

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The valorization of research is becoming a transversal instrument linking different sectors (academic, public and industrial). The practice of valorization seems to impact innovation techniques within companies where, there is often the implementation of industrial conventions of training through research (CIFRE), continuous training programs for employees, collaborations and partnerships around joint research and R&D laboratories focused on the needs of companies to improve or develop more efficient innovations. Furthermore, many public initiatives to support innovation and technology transfer have been developed at the international, European and national levels, with significant budget allocations. Thus, in the context of this work, we tried to analyze the way in which research transfer structures are evaluated within the Saclay ecosystem. In fact, the University-Paris-Saclay is one of the best French universities; it is made up of 10 university components, more than 275 laboratories and is in partnership with the largest French research centers This work mainly focused on how evaluations affected research transfer structures, how evaluations were conducted, and what the managers of research transfer structures thought about assessments. Thus, with the aid of the conducted interviews, it appears that the evaluations do not have a significant impact on the qualitative aspect of research and innovation, but is rather present a directive aspect to allow the structures to benefit or not from the financial resources to develop certain research work, sometimes directed and influenced by the market, some researchers might try to accentuate their research and experimentation work on themes that are not necessarily their areas of interest, but just to comply with the calls for proposed thematic projects. The field studies also outline the primary indicators used to assess the effectiveness of valorization structures as "the number of start-ups generated, the license agreements signed, the structure's patent portfolio, and the innovations of items developed from public research.". Finally, after mapping the actors, it became clear that the ecosystem of the University of Paris-Saclay benefits from a richness allowing it to better value its research in relation to the three categories of actors it has (internal, external and transversal), united and linked by a relationship of proximity of sharing and endowed with a real opportunity to innovate openly.

Keywords: research valorization, technology transfer, innovation, evaluation, impacts and performances, innovation policy

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Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng

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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.

Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work

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Authors: Wondmnew Derebe Yohannis

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Farming irrigation plays a crucial role in rural development strategies, impacting both annual household income and livelihood. This research aims to evaluate the factors influencing irrigation participation and assess the impact of small-scale irrigation on rural households' annual income. The study collected data from 287 farmers in the Dahana district of northern Ethiopia. The research investigates the driving forces behind farmers' decisions to adopt small-scale irrigation and its effect on annual income gain. The findings reveal that several factors positively influence the probability of adoption, including access to credit, cultivated land size, livestock holding, extension contact, and the education level of the household head. Conversely, the distance to local markets and water schemes negatively affects the likelihood of adoption. To understand the differences in annual income between farm households that adopted irrigation and those that did not, a simultaneous equations model with endogenous switching regression is estimated. This accounts for the heterogeneity in the adoption decision and unobservable characteristics of farmers and their farms. The analysis compares the expected income gain under actual and counterfactual scenarios, considering whether the farm household adopted irrigation or not. The study reveals that the group of farm households that adopted irrigation has distinct characteristics compared to those that did not adopt it. Furthermore, the research demonstrates that the adoption of irrigation practices leads to an increase in annual income. Interestingly, the impact of small-scale irrigation on annual income is greater for the farm households that actually adopted irrigation compared to those in the counterfactual scenario where they did not adopt. Based on the findings, the researcher concludes that small-scale irrigation is a practical solution for meeting household financial needs in the study area. It is recommended that investments in small-scale irrigation continue to further improve the livelihoods of rural farming communities by enhancing annual income gains.

Keywords: small-scale irrigation, income, rural farm households, endogenous switching regression, user, non-user

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Authors: Hanaa Sameen Ameen Bajilan

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Human rights should be protected and promoted without regard to race, ethnicity, religion, political philosophy, or sexual orientation, following our firm convictions. Thus, any infringement of these rights or disdain for; any use of violence against women undermines the principles and human values of equality and endangers the entire society, including its potential to live in peace and to make growth and development. This paper represents the condition of the new Iraqi women regarding issues such as the gender wage gap, education, health, and violence against women. The study aims to determine the impact of traditions and customs on the legal position of Iraqi women. First, it seeks to assess the effects of culture as a historical agency on the legal status of Iraqi women. Second, the influence of cultural developments in the later part of the twentieth century on Iraqi women's legal standing, and third, the importance of cultural variety as a progressive cultural component in women's legal position. Finally, the study highlights the representation of women in Iraq: Gender wage Gap, Women's liberation between culture and law, and the role of women within Iraqi society based on an Iraqi novel named (Orange Light) in Arabic: برتقالو ضو. in her book, the Iraqi writer Nadia Al-Abru succeeds in portraying the post-war society's devotion to the sexual, emotional and mental marginalization of women in terms of the value of attendance. Since the study of Iraqi women's literature in Arabic-English translation is a new avenue of research that contributes to all three areas, this investigation aims to establish critical lines of engagement between contemporary Iraqi women's literature in English translation and feminist translation conceptual frameworks, and this is accomplished by first focusing on why analyzing Iraqi women writers' novels in Arabic-English translation is a timeline of inquiry that contributes to existing and emerging knowledge fields concerning Iraqi women writers' contemporary critical contexts and scholarship on Arab women's literature in Arabic-English translation.

Keywords: women in İraq, equality, violence, gender wage gap, Nadia Al-Abru, (orange light), women's liberation, İraqi women's literature,

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Authors: Fiza Azam, Sahar Zia, Fatima Nazir Ali, Aysha Hanif

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Health is a fundamental human right, and a healthy population is essential for the prosperity and sustainable development of any country. This research is aligned with United Nations' Goal 3: Good Health and Well-being. It aims to assess and rank key health indicators across selected South Asian countries. The study focuses on urban areas in these nations, drawing on data from the World Bank’s primary collection of relevant indicators and specific health determinants outlined by the World Health Organization (WHO). These determinants include the physical environment, income and social status, education, social support networks, and personal behavior. To evaluate disparities in urban health across the region, the Urban Health Index (UHI) developed by Georgia State University, USA, is employed, followed by a mapping technique including visualization through a choropleth map to identify the pattern of spatial variations in our key variables, such as socioeconomic indicators across the region. This index serves as a comparative tool to rank health outcomes, where higher UHI values indicate better health conditions. The findings reveal notable disparities across South Asia. Afghanistan, with the lowest UHI score of 0.0423, ranks first, indicating the least favorable urban health conditions. Pakistan follows with a UHI score of 0.1190. Bangladesh and India rank third and fourth with UHI scores of 0.3099 and 0.3250, respectively. The Maldives and Sri Lanka rank fifth and sixth, with UHI scores of 0.3432 and 0.3495. Bhutan is ranked seventh with a score of 0.4750. Nepal, with a UHI score of 0.5012, ranks eighth, indicating the best urban health conditions among the countries studied. The findings of this research are crucial for addressing health disparities, improving living conditions, and enhancing social well-being in the region. These insights can inform policy measures aimed at reducing inequalities and promoting sustainable urban health in South Asia.

Keywords: urban health index, health disparities, sustainable development, South Asia, World Health Organization, United Nations, living conditions, public health

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Authors: Afshan Golriz

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This paper addresses the nuances in the relationship between the rural community of Volcan, Costa Rica, and the presence of multinational pineapple giant Pineapple Development Corporation (PINDECO). The paper analyzes the continuous negotiation between the need for environmental protection in the face of pineapple monoculture and the socioeconomic dependencies of the community on the company. Drawing on eight years of ethnographic work in Volcan de Buenos Aires and relying on intergenerational interviews that document oral histories, this article provides a socio-historical account of the economic and environmental impact of the presence of PINDECO in the southern zone of the country. The paper draws on interviews and in-depth participant observation, conducted by the author in intermittent periods over eight years. The research sheds light on the tensions between the village and PINDECO, as simultaneous acceptance of and opposition to the company persist by different stakeholders in the region. In doing so, this paper examines the strikingly powerful affinity toward the company and the community's regard for PINDECO as the town patriarch despite social and environmental injustices. In demonstrating these tensions, the author problematizes the practice of conducting foreign environmental research in developing countries, and more importantly, proposing changes to environmental conservation and socioeconomic structures without understanding community reliance on the presence of corporations such as PINDECO and the threats that changes to existing structures could pose to community members' livelihoods. In complicating these common western academic practices, the author takes an anti-colonial approach to environmental research, refusing the assumption that the affinity toward the company by the community of Volcan is rooted in ignorance, lack of education, or lack of interest in environmental conservation. The author instead highlights local knowledge and agency, demonstrating the many ways in which the community itself is producing knowledge and taking action. Through this paper, common assumptions regarding the agency of such communities are contested, and the grassroots environmental initiatives of Volcan, Costa Rica are brought to life.

Keywords: environmental conservation, grassroots movements, local knowledge, agricultural multinational

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Authors: Bendes Ákos

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Digital evidence will be the most widely used type of evidence in the future. With the development of the modern world, more and more new types of crimes have evolved and transformed. For this reason, it is extremely important to examine these types of crimes in order to get a comprehensive picture of them, with which we can help the authorities work. In 1865, with early technologies, people were able to forge a picture of a quality that is not even recognized today. With the help of today's technology, authorities receive a lot of false evidence. Officials are not able to process such a large amount of data, nor do they have the necessary technical knowledge to get a real picture of the authenticity of the given evidence. The digital world has many dangers. Unfortunately, we live in an age where we must protect everything digitally: our phones, our computers, our cars, and all the smart devices that are present in our personal lives and this is not only a burden on us, since companies, state and public utilities institutions are also forced to do so. The training of specialists and experts is essential so that the authorities can manage the incoming digital evidence at some level. When analyzing evidence, it is important to be able to examine it from the moment it is created. Establishing authenticity is a very important issue during official procedures. After the proper acquisition of the evidence, it is essential to store it safely and use it professionally. After the proper acquisition of the evidence, it is essential to store it safely and use it professionally. Otherwise, they will not have sufficient probative value and in case of doubt, the court will always decide in favor of the defendant. One of the most common problems in the world of digital data and evidence is doubt, which is why it is extremely important to examine the above-mentioned problems. The most effective way to avoid digital crimes is to prevent them, for which proper education and knowledge are essential. The aim is to present the dangers inherent in the digital world and the new types of digital crimes. After the comparison of the Hungarian investigative techniques with international practice, modernizing proposals will be given. A sufficiently stable yet flexible legislation is needed that can monitor the rapid changes in the world and not regulate afterward but rather provide an appropriate framework. It is also important to be able to distinguish between digital and digitalized evidence, as the degree of probative force differs greatly. The aim of the research is to promote effective international cooperation and uniform legal regulation in the world of digital crimes.

Keywords: digital crime, digital law, cyber crime, international cooperation, new crimes, skepticism

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Authors: Zeiler M., Stadler D., Schmaderer C.

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Over the years of dialysis treatment, most patients experience significant weight loss. The primary emphasis in earlier research was the underlying mechanism of protein energy wasting and the subsequent malnutrition inflammation syndrome. In the interest to provide an effective and rapid solution for the patients, the aim of this study is identifying individual influences of their assumed reduced dietary intake, such as nausea, appetite loss and taste changes, and to determine whether the patients adhere to their nutrition guidelines. A prospective, controlled study with 38 end-stage renal disease patients was performed using a questionnaire to reflect their diet within the last 12 months. Thereby, the daily intake for the most important macro-and micronutrients was calculated to be compared with the individual KDQOI-guideline value, as well as controls matched in age and gender. The majority of the study population did not report symptoms commonly associated with dialysis, such as nausea or inappetence, and denied any change in dietary behavior since receiving renal replacement therapy. The patients’ daily intake of energy (3080kcal ± 1266) and protein (89,9g [53,4-142,0]) did not differ significantly from the controls (energy intake: 3233kcal ± 1046, p=0,597; protein intake: 103,7g [90,1-125,5], p=0,120). The average difference to the individual calculated KDQOI-guideline was +176,0kcal ± 1156 (p=0,357) for energy intake and -1,75g ± 45,9 (p=0,491) for protein intake. However, there was an observed imbalance in the distribution of macronutrients, with a preference for fats over proteins. The patients’ daily intake of sodium (5,4g [ 2,95-10,1]) was higher than in the controls (4,1g [2,04-5,99], p= 0,058) whereas both values for potassium (3,7g ± 1,84) and phosphorous (1,79g ± 0,91) went significantly below the controls’ values (potassium intake: 4,89g ± 1,74, p=0,014; phosphorous intake: 2,04g ± 0,64, p=0,038). Thus, the values exceeded the calculated KDQOI-recommendation by + 3,3g [0,63-7,90] (p<0,001) for sodium, +1,49g ± 1,84 (p<0,001) for potassium and +0,89g ± 0,91 (p<0,001) for phosphorous. Contrary to the assumption, the patients did not under-eat. Nevertheless, their diets did not align with the recommended values. These findings highlight the need for intervention and education among patients and that regular dietary monitoring could prevent unhealthy nutrition habits. The elaboration of individual references instead of standardized guidelines could increase the compliance to the advised diet so that interdisciplinary comorbidities do not develop or worsen.

Keywords: compliance, dialysis, end-stage renal disease, KDQOI, malnutrition, nutrition guidelines, questionnaire, salt intake

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Authors: Ammal M. Metwally, Walaa A. Basha, Ghada A. Abdel-Latif, Amira S. El Rifay

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Introduction: Improving breastfeeding practices does not always link to interventions relying on improving nutrition awareness and education alone but needs cultural and behavioral insights. Aim: Our study provided educational intervention through the use of the social marketing (SM) approach, which was respectable to societal norms allowing more conscious choices by mothers to achieve the maximum potential of physical growth of their infants. This study evaluated the effectiveness of the used approach for improving breastfeeding practices and the physical growth of infants aged up to 2 years. Methodology: A quasi-experimental intervention design with a posttest-only control design was done over three years duration to motivate mothers’ voluntary behavioral change toward breastfeeding promotion using SM principles: product, price, place, and promotion. The interventions targeted 464 pregnant women in their last trimester, mothers of children up to 2 years, and 1454 women in their childbearing period. Results: Most mothers showed increased awareness about the benefits of breastfeeding and became interested in breastfeeding their children outside the house using the breastfeeding cover (Gawn). Breastfeeding initiation, exclusive breastfeeding under six months, frequency of breastfeeding per day, and percentage of children who continued breastfeeding till two years were significantly increased (from 30%, 23 %, 56%, and 32% to 62 %, 47.3 %, 69 %, and 43.5 %). With the attention of the nutritional educational sessions three or more times, the majority of indicators had the most significant improvement. The females who recorded underweight results over males during the first two years of life significantly improved after the intervention (from 53.8 % to 15.4%, respectively). At the same time, females that were found to be obese before the intervention (7.7 %) became no longer obese. Conclusions: Nutritional interventions that are based on the use SM approach showed improvement for the majority of the key performance indicators. Although they doubled their value before the intervention, the majority were still modest (below 50 %). With sustained use of the SM approach, infants will achieve their maximum potential for physical growth by providing economically disadvantaged mothers with breastfeeding support.

Keywords: social marketing approach, early breastfeeding initiation, exclusive breastfeeding, responsiveness to cues of hunger and satiety, physical growth of infants

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Authors: Ali Kharazi, Hassanali Aghajani, Hesami Azizi

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Tourism entrepreneurship is a growing field that has the potential to create new opportunities for sustainable development. The purpose of this study is to identify and classify the entrepreneurial opportunities in the blind tourism industry in Khuzestan Province of Iran that can be created through the operation of blinds’ tours. This study used a mixed methods approach. The qualitative data was collected through semi-structured interviews with 15 tourist guides and tourism activists, while the quantitative data was collected through a questionnaire survey of 40 blind people who had participated in blinds’ tours. The findings of this study suggest that there are a number of entrepreneurial opportunities in the blind tourism industry in Khuzestan Province, including (1) developing and providing accessible tourism services, such as tours, accommodations, restaurants, and transportation, (2) creating and marketing blind-friendly tourism products and experiences (3) training and educating tourism professionals on how to provide accessible and inclusive tourism services. This study contributes to the theoretical understanding of tourism entrepreneurship by providing insights into the entrepreneurial opportunities in the blind tourism industry. The findings of this study can be used to develop policies and programs that support the development of the blind tourism industry. The qualitative data were analyzed using content analysis. The quantitative data were analyzed using descriptive statistics and inferential statistics. This study examines the entrepreneurial opportunities within the blind tourism industry in Khuzestan Province, Iran. In addition, Khuzestan province has made relatively good development in the field of blinds’ tourism. Blind tourists have become loyal customers of blinds’ tours, which has increased their self-confidence and social participation. Tourist guides and centers of tourism services are interested in participating in blinds’ tours more than before, and even other parts outside the tourism field have encouraged sponsorship. Education had a great impact on the quality of tourism services, especially for the blind. It has played a significant role in improving the quality of tourism services for the blind. However, the quality and quantity of infrastructure should be increased in different sectors of tourism services to foster future growth. These opportunities can be used to create new businesses and jobs and to promote sustainable development in the region.

Keywords: entrepreneurship, tourism, blind, sustainable development, Khuzestan

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Authors: Tony Feng, Rea Thomson, Kathryn Greenslade, Ross Medine, Jennifer Easterbrook, Calum Arthur, Matilda Powell-bowns

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There are clear guidelines on taking group and screen samples (G&S) for elective arthroplasty and major trauma. However, there is limited guidance on blood grouping for other trauma patients. The purpose of this study was to review the level of blood grouping at a major trauma centre and validate a protocol that limits the expensive processing of G&S samples. After reviewing the national guidance on transfusion samples in orthopaedic patients, data was prospectively collected for all orthopaedic admissions in the Royal Infirmary of Edinburgh between January to February 2023. The cause of admission, number of G&S samples processed on arrival and need for red cells was collected using the hospital blood bank. A new protocol was devised based on a multidisciplinary meeting which limited the requirement for G&S samples only to presentations in “category X”, including neck-of-femur fractures (NOFs), pelvic fractures and major trauma. A re-audit was completed between April and May after departmental education and institution of this protocol. 759 patients were admitted under orthopaedics in the major trauma centre across two separate months. 47% of patients were admitted with presentations falling in category X (354/759) and patients in this category accounted for 88% (92/104) of those requiring post-operative red cell transfusions. Of these, 51% were attributed to NOFs (47/92). In the initial audit, 50% of trauma patients outwith category X had samples sent (116/230), estimated to cost £3800. Of these 230 patients, 3% required post-operative transfusions (7/230). In the re-audit, 23% of patients outwith category X had samples sent (40/173), estimated to cost £1400, of which 3% (5/173) required transfusions. None of the transfusions in these patients in either audit were related to their operation and the protocol achieved an estimated cost saving of £2400 over one month. This study highlights the importance of sending samples for patients with certain categories of orthopaedic trauma (category X) due to the high demand for post-operative transfusions. However, the absence of transfusion requirements in other presentations suggests over-testing. While implementation of the new protocol has markedly reduced over-testing, additional interventions are required to reduce this further.

Keywords: blood transfusion, quality improvement, orthopaedics, trauma

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Authors: Edoghogho Ogbeifun, Charles Mbohwa, J. H. C. Pretorius

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Effective infrastructure development scheme planned and executed has positive influence on the quantity of available stock of infrastructure to meet the immediate and expansion needs of an organization, as well as contribute to the overall economic development of a nation, community or the local entity where the infrastructure is hosted. It is noteworthy, however, that infrastructure development scheme spans a long time frame, usually longer than the political life of the administration that initiates the scheme. In the majority of circumstances, execution may start and achieve different levels of completion; at best, only limited numbers are completed and put into functional use during the life of the administration that initiated the infrastructure scheme. When there is a change in leadership, many of the uncompleted projects are usually abandoned. The new administration repeats the circle of its predecessors and develops another set of infrastructure scheme which will suffer similar fate as the ones developed by their predecessors; thus doting the landscape with many uncompleted projects, which leads to infrastructure deficit. These circle will continue unless each succeeding leader sees governance as single continuum. Therefore, infrastructure projects not completed by one administration should be continued by succeeding administration, in order to increase the stock of relevant infrastructure available for the smooth operations organization and enhance the needed developments, as well as reduce the negative effects of infrastructure deficit. The single case study of qualitative research method was adopted to investigate the actions of the administration of three successive Vice-Chancellors, in a higher education institution in Nigeria, over a longitudinal period of twelve years. This is with a view to exploring the effects of each administration on the development and execution of infrastructure projects, with particular interest on abandoned projects. The findings revealed that although two of Vice-Chancellors were committed to infrastructure upgrade, they executed more new projects than completing abandoned ones, while the current leader has shown more pragmatism in completing abandoned projects alongside constructing new ones; thus demonstrating the importance of the continuity of governance. In this regard, there is a steady increase in the stock of infrastructure to accommodate the expansion of existing academic programmes, host new ones as well as reduce the negative effects of infrastructure deficit caused by abandoned projects.

Keywords: abandoned projects, continuity of governance, infrastructure development scheme, long time frame

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Authors: Mauro Callejas-Cuervo, Andrea Catherine Alarcon-Aldana, Lorena Paola Castillo-Guerra

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The software industry requires highly-trained professionals, capable of developing the roles integrated in the cycle of software development. That is why a large part of the task is the responsibility of higher education institutions; often through a curriculum established to orientate the academic development of the students. It is so that nowadays there are different models that support proposals for the improvement of the curricula for the area of Software Engineering, such as ACM, IEEE, ABET, Swebok, of which the last stands out, given that it manages and organises the knowledge of Software Engineering and offers a vision of theoretical and practical aspects. Moreover, it has been applied by different universities in the pursuit of achieving coverage in delivering the different topics and increasing the professional quality of future graduates. This research presents the structure of teaching and learning guides from the objectives of training and methodological strategies immersed in the levels of learning of Bloom’s taxonomy with which it is intended to improve the delivery of the topics in the area of Requirements Engineering. Said guides were implemented and validated in a course of Requirements Engineering of the Systems and Computer Engineering programme in the Universidad Pedagógica y Tecnológica de Colombia (Pedagogical and Technological University of Colombia) using a four stage methodology: definition of the evaluation model, implementation of the guides, guide evaluation, and analysis of the results. After the collection and analysis of the data, the results show that in six out of the seven topics proposed in the Swebok guide, the percentage of students who obtained total marks within the 'High grade' level, that is between 4.0 and 4.6 (on a scale of 0.0 to 5.0), was higher than the percentage of students who obtained marks within the 'Acceptable' range of 3.0 to 3.9. In 86% of the topics and the strategies proposed, the teaching and learning guides facilitated the comprehension, analysis, and articulation of the concepts and processes of the students. In addition, they mainly indicate that the guides strengthened the argumentative and interpretative competencies, while the remaining 14% denotes the need to reinforce the strategies regarding the propositive competence, given that it presented the lowest average.

Keywords: pedagogic guide, pedagogic strategies, requirements engineering, Swebok, teaching-learning process

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Authors: Biback Das

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New Public Management, a phenomenal tool, which is used to enforcing in public administration in different country’s to enhance the capacities. Since the 1980s, New Public Management (NPM) is primarily focusing to modernize the public sector. From the initial period, many developed countries such as UK, New Zealand, Australia, and the USA are applied in their administration to modernize. Almost 1990s, it has been applied in many developing countries. This study can describe the real situations of NPM based administration. Bangladesh Government has taken many projects to reform the public sector under NPM. Even many Development Agencies like UN, UNDP, World Bank, Asian Development Bank and so on, along with many developed countries also invested and prescribed to take NPM based reform that can to restructure the public sector so that it can maximize the efforts to provide the better service. This study examines using many factors that effects work on Public Administration in Bangladesh and also assessing its endeavor to adopt in it. Although Government has taken such initiatives to implement NPM originated reform, it’s not effectively been implemented to bring positive change about as per NPM objectives. This study mainly examines some initiatives in Bangladesh that have the influence of NPM as well as some drawbacks that can’t help the satisfaction of these initiatives. This article help to identify the efforts of many development agencies providing a fund to enhance the NPM based projects with their specific conditions that are prescribed by them helping to get fund. Therefore, to establish effective public management or to follow NPM model, Bangladesh need having an institutional framework, sound rule of law, proper structure, effective civil service system, appropriate checks, and balances to restructure the public sector help along with donor agencies ad implement in it. Bangladesh Government has applied its recent days to enhance the capabilities in its Public Administration. Moreover, this study mainly identifies how the designing strategies, program formulating, its implementation in various sector such as education, health sector etc. and how to reduce the backdrop the during problem by smooth functioning. This paper is also assessing the influence of many projects like PPP (Public-Private and Partnership) to work along with private organizations for smooth service delivery. Accordingly, this paper briefly reviews how it applies in a global context following the taken many initiatives and the consequences of Bangladesh context.

Keywords: new public management, capacity building, conditionalities, service delivery, public-private-partnership

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Authors: L. Nathaniel-Wurie

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The Sellick manoeuvre a.k.a the application of cricoid force (CF), was first described by Brian Sellick in 1961. CF is the application of digital pressure against the cricoid cartilage with the intention of posterior force causing oesophageal compression against the vertebrae. This is designed to prevent passive regurgitation of gastric contents, which is a major cause of morbidity and mortality during emergency airway management inside and outside of the hospital. To the authors knowledge, there is no universally standardised training modality and, therefore, no reliable way to examine if there are appropriate outcomes. If force is not measured during training, how can one surmise that appropriate, accurate, or precise amounts of force are being used routinely. Poor homogeneity in teaching and untested outcomes will correlate with reduced efficacy and increased adverse effects. For this study, the accuracy of force delivery in trained professionals was tested, and outcomes contrasted against a novice control and a novice study group. In this study, 20 operating department practitioners were tested (with a mean experience of 5.3years of performing CF). Subsequent contrast with 40 novice students who were randomised into one of two arms. ‘Arm A’ were explained the procedure, then shown the procedure then asked to perform CF with the corresponding force measurement being taken three times. Arm B had the same process as arm A then before being tested, they had 10, and 30 Newtons applied to their hands to increase intuitive understanding of what the required force equated to, then were asked to apply the equivalent amount of force against a visible force metre and asked to hold that force for 20 seconds which allowed direct visualisation and correction of any over or under estimation. Following this, Arm B were then asked to perform the manoeuvre, and the force generated measured three times. This study shows that there is a wide distribution of force produced by trained professionals and novices performing the procedure for the first time. Our methodology for teaching the manoeuvre shows an improved accuracy, precision, and homogeneity within the group when compared to novices and even outperforms trained practitioners. In conclusion, if this methodology is adopted, it may correlate with higher clinical outcomes, less adverse events, and more successful airway management in critical medical scenarios.

Keywords: airway, cricoid, medical education, sellick

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Authors: T. Northcut, A. Rai, N. Perkins

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Background: The COVID-19 pandemic has had a serious impact on academia in general and social work education in particular, changing permanently the way in which we approach educating students. The new reality of the pandemic coupled with the much-needed focus on racism across the country inspired and required educators to get creative with their teaching styles in order to disrupt the power imbalance in the classroom and attend to the multiple layers of needs of diverse students in precarious sociological and economic circumstances. This paper highlights research examining educators with distinctive positionalities and approaches to classroom instruction who use feminist and antiracist pedagogies while adapting to online teaching during the pandemic. Despite being feminist scholars, whose ideologies developed during different waves of feminism, our commitment to having student-led classrooms, liberation, and equity of all, and striving for social change, unified our feminist teaching pedagogies as well as provided interpersonal support. Methodology: Following a narrative qualitative inquiry methodology, the five authors of this paper came together to discuss our pedagogical styles and underlying values using Zoom in a series of six conversations. Narrative inquiry is an appropriate method to use when researchers are bound by common stories or personal experiences. The use of feminist pedagogy in the classroom before and during the pandemic guided the discussions. After six sessions, we reached the point of data saturation. All data from the dialogic process was recorded and transcribed. We used in vivo, narrative, and descriptive coding for the data analytic process. Results: Analysis of the data revealed several themes, which included (1) the influence of our positionalities as an intersection of race, sexual orientation, gender, and years of teaching experience in the classroom, (2) the meaning and variations between different liberatory pedagogical approaches, (3) the tensions between these approaches and institutional policies and practices, (4) the role of self-reflection in everyday teaching, (5) the distinctions between theory and practice and its utility for students, and (6) the challenges of applying a feminist-centered pedagogical approach during the pandemic while utilizing an online platform. As a collective, we discussed several challenges that limited the use of our feminist pedagogical approaches due to instruction through Zoom.

Keywords: feminist, pedagogy, COVID, zoom

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Authors: Anita Paddy, Millicent Obodai, Lebbaeus Asamani

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The management of sickle cell disease requires a multidisciplinary team for better outcomes. Thus, literature on the application of the biopsychosocial model for the management and explanation of chronic pain in sickle cell disease (SCD) and other chronic diseases abound. However, there is limited research on the use of the biopsychosocial model, together with a spiritual component (biopsychosocial-spiritual model). The study investigated the extent to which healthcare providers utilized the biopsychosocial-spiritual model in the management of chronic pain to improve the quality of life (QoL) of patients with SCD. This study employed the descriptive survey design involving a consecutive sampling of 261 patients with SCD who were between the ages of 18 to 79 years and were accessing hematological services at the Clinical Genetics Department of the Korle Bu Teaching Hospital. These patients willingly consented to participate in the study by appending their signatures. The theory of integrated quality of life, the gate control theory of pain and the biopsychosocial(spiritual) model were tested. An instrument for the biopsychosocial-spiritual model was developed, with a basis from the literature reviewed, while the World Health Organisation Quality of Life BREF (WHOQoLBref) and the spirituality rating scale were adapted and used for data collection. Data were analyzed using descriptive statistics (means, standard deviations, frequencies, and percentages) and partial least square structural equation modeling. The study revealed that healthcare providers had a great leaning toward the biological domain of the model compared to the other domains. Hence, participants’ QoL was not fully improved as suggested by the biopsychosocial(spiritual) model. Again, the QoL and spirituality of patients with SCD were quite high. A significant negative impact of spirituality on QoL was also found. Finally, the biosocial domain of the biopsychosocial-spiritual model was the most significant predictor of QoL. It was recommended that policymakers train healthcare providers to integrate the psychosocial-spiritual component in health services. Also, education on SCD and its resultant impact from the domains of the model should be intensified while health practitioners consider utilizing these components fully in the management of the condition.

Keywords: biopsychosocial (spritual), sickle cell disease, quality of life, healthcare, accra

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Authors: Raquel Vianna Duarte Cardoso, Eduarda Lobato Faria, José Jorge Boueri

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Rapid urbanization has transformed the global landscape, presenting significant challenges to public health. This article delves into the impact of urbanization on the spread of infectious diseases in cities and identifies crucial strategies to enhance urban community resilience. Massive urbanization over recent decades has created conducive environments for the rapid spread of diseases due to population density, mobility, and unequal living conditions. Urbanization has been observed to increase exposure to pathogens and foster conditions conducive to disease outbreaks, including seasonal flu, vector-borne diseases, and respiratory infections. In order to tackle these issues, a range of cross-disciplinary approaches are suggested. These encompass the enhancement of urban healthcare infrastructure, emphasizing the need for robust investments in hospitals, clinics, and healthcare systems to keep pace with the burgeoning healthcare requirements in urban environments. Moreover, the establishment of disease monitoring and surveillance mechanisms is indispensable, as it allows for the timely detection of outbreaks, enabling swift responses. Additionally, community engagement and education play a pivotal role in advocating for personal hygiene, vaccination, and preventive measures, thus playing a pivotal role in diminishing disease transmission. Lastly, the promotion of sustainable urban planning, which includes the creation of cities with green spaces, access to clean water, and proper sanitation, can significantly mitigate the risks associated with waterborne and vector-borne diseases. The article is based on a review of scientific literature, and it offers a comprehensive insight into the complexities of the relationship between urbanization and health. It places a strong emphasis on the urgent need for integrated approaches to improve urban resilience in the face of health challenges.

Keywords: infectious diseases dissemination, public health, urbanization impacts, urban resilience

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Authors: Lancer Scott

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Purpose: High quality clinical disaster medicine requires providers working collaboratively to care for multiple patients in chaotic environments; however, many providers lack adequate training. To address this deficit, we created a competency-based, 5-hour Emergency Preparedness Training (EPT) curriculum using didactics, small-group discussion, and kinetic learning. The goal was to evaluate the effect of a short course on improving provider knowledge, confidence and skills in disaster scenarios. Methods: Diverse groups of medical university students, health care professionals, and community members were enrolled between 2011 and 2014. The course consisted of didactic lectures, small group exercises, and two live, multi-patient mass casualty incident (MCI) scenarios. The outcome measures were based on core competencies and performance objectives developed by a curriculum task force and assessed via trained facilitator observation, pre- and post-testing, and a course evaluation. Results: 708 participants completed were trained between November 2011 and August 2014, including 49.9% physicians, 31.9% medical students, 7.2% nurses, and 11% various other healthcare professions. 100% of participants completed the pre-test and 71.9% completed the post-test, with average correct answers increasing from 39% to 60%. Following didactics, trainees met 73% and 96% of performance objectives for the two small group exercises and 68.5% and 61.1% of performance objectives for the two MCI scenarios. Average trainee self-assessment of both overall knowledge and skill with clinical disasters improved from 33/100 to 74/100 (overall knowledge) and 33/100 to 77/100 (overall skill). The course assessment was completed by 34.3% participants, of whom 91.5% highly recommended the course. Conclusion: A relatively short, intensive EPT course can improve the ability of a diverse group of disaster care providers to respond effectively to mass casualty scenarios.

Keywords: clinical disaster medicine, training, hospital preparedness, surge capacity, education, curriculum, research, performance, training, student, physicians, nurses, health care providers, health care

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Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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Authors: Angshuman Raha, Abesh Kumar Sanyal, Uttaran Bandyopadhyay, Kaushik Mallick, Kamalika Bhattacharyya, Subrata Gayen, Gaurab Nandi Das, Mohd. Ali, Kailash Chandra

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Indian Himalayan Region (IHR), due to its sheer latitudinal and altitudinal expanse, acts as a mixing ground for different zoogeographic faunal elements. The innumerable unique and distributional restricted rare species of IHR are constantly being threatened with extinction by the ongoing climate change scenario. Many of which might have faced extinction without even being noticed or discovered. Monitoring the community dynamics of a suitable taxon is indispensable to assess the effect of this global perturbation at micro-habitat level. Lepidoptera, particularly moths are suitable for this purpose due to their huge diversity and strict herbivorous nature. The present study aimed to collate scattered historical records of moths from IHR and spatially disseminate the same in Geographic Information System (GIS) domain. The study also intended to identify moth species with significant altitudinal shifts which could be prioritised for monitoring programme to assess the effect of climate change on biodiversity. A robust database on moths recorded from IHR was prepared from voluminous secondary literature and museum collections. Historical sampling points were transformed into richness grids which were spatially overlaid on altitude, annual precipitation and vegetation layers separately to show moth richness patterns along major environmental gradients. Primary samplings were done by setting standard light traps at 11 Protected Areas representing five Indian Himalayan biogeographic provinces. To identify significant altitudinal shifts, past and present altitudinal records of the identified species from primary samplings were compared. A consolidated list of 4107 species belonging to 1726 genera of 62 families of moths was prepared from a total of 10,685 historical records from IHR. Family-wise assemblage revealed Erebidae to be the most speciose family with 913 species under 348 genera, followed by Geometridae with 879 species under 309 genera and Noctuidae with 525 species under 207 genera. Among biogeographic provinces, Central Himalaya represented maximum records with 2248 species, followed by Western and North-western Himalaya with 1799 and 877 species, respectively. Spatial analysis revealed species richness was more or less uniform (up to 150 species record per cell) across IHR. Throughout IHR, the middle elevation zones between 1000-2000m encompassed high species richness. Temperate coniferous forest associated with 1500-2000mm rainfall zone showed maximum species richness. Total 752 species of moths were identified representing 23 families from the present sampling. 13 genera were identified which were restricted to specialized habitats of alpine meadows over 3500m. Five historical localities with high richness of >150 species were selected which could be considered for repeat sampling to assess climate change influence on moth assemblage. Of the 7 species exhibiting significant altitudinal ascend of >2000m, Trachea auriplena, Diphtherocome fasciata (Noctuidae) and Actias winbrechlini (Saturniidae) showed maximum range shift of >2500m, indicating intensive monitoring of these species. Great Himalayan National Park harbours most diverse assemblage of high-altitude restricted species and should be a priority site for habitat conservation. Among the 13 range restricted genera, Arichanna, Opisthograptis, Photoscotosia (Geometridae), Phlogophora, Anaplectoides and Paraxestia (Noctuidae) were dominant and require rigorous monitoring, as they are most susceptible to climatic perturbations.

Keywords: altitudinal shifts, climate change, historical records, Indian Himalayan region, Lepidoptera

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Authors: Goldie Lynn Diaz, Ma. Teresa Tricia G. Bautista, Elisabeth Engeljakob, Mary Glaze Rosal

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Introduction: Residents are expected to convey unfavorable news, discuss prognoses, and relieve suffering, and address do-not-resuscitate orders, yet some report a lack of competence in providing this type of care. Recognizing this need, Family Medicine residency programs are incorporating end-of-life care from symptom and pain control, counseling, and humanistic qualities as core proficiencies in training. Objective: This study determined the competency of Family Medicine Residents from various institutions in Metro Manila on rendering care for the dying. Materials and Methods: Trainees completed a Palliative Care Evaluation tool to assess their degree of confidence in patient and family interactions, patient management, and attitudes towards hospice care. Results: Remarkably, only a small fraction of participants were confident in performing independent management of terminal delirium and dyspnea. Fewer than 30% of residents can do the following without supervision: discuss medication effects and patient wishes after death, coping with pain, vomiting and constipation, and reacting to limited patient decision-making capacity. Half of the respondents had confidence in supporting the patient or family member when they become upset. Majority expressed confidence in many end-of-life care skills if supervision, coaching and consultation will be provided. Most trainees believed that pain medication should be given as needed to terminally ill patients. There was also uncertainty as to the most appropriate person to make end-of-life decisions. These attitudes may be influenced by personal beliefs rooted in cultural upbringing as well as by personal experiences with death in the family, which may also affect their participation and confidence in caring for the dying. Conclusion: Enhancing the quality and quantity of end-of-life care experiences during residency with sufficient supervision and role modeling may lead to knowledge and skill improvement to ensure quality of care. Fostering bedside learning opportunities during residency is an appropriate venue for teaching interventions in end-of-life care education.

Keywords: end of life care, geriatrics, palliative care, residency training skill

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Authors: Floriane Shala, Evangeline Wagner, Yichun Zhao

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Background: Proper educational training and support are proven to be major components of EHR (Electronic Health Record) implementation and use. However, the majority of health providers are not sufficiently trained in EHR use, leading to adverse events, errors, and decreased quality of care. In response to this, students studying Health Information Science, Public Health, Nursing, and Medicine should all gain a thorough understanding of EHR use at different levels for different purposes. The design of a usable and safe EHR system that accommodates the needs and workflows of different users, user groups, and disciplines is required for EHR learning to be efficient and effective. Objectives: This project builds several artifacts which seek to address both the educational and usability aspects of an educational EHR. The artifacts proposed are models for and examples of such an EHR with a configurable UI to be learned by students who need a background in EHR use during their degrees. Methods: Review literature and gather professional opinions from domain experts on usability, the use of workflow patterns, UI configurability and design, and the educational aspect of EHR use. Conduct interviews in a semi-casual virtual setting with open discussion in order to gain a deeper understanding of the principal aspects of EHR use in educational settings. Select a specific task and user group to illustrate how the proposed solution will function based on the current research. Develop three artifacts based on the available research, professional opinions, and prior knowledge of the topic. The artifacts capture the user task and user’s interactions with the EHR for learning. The first generic model provides a general understanding of the EHR system process. The second model is a specific example of performing the task of MRI ordering with a configurable UI. The third artifact includes UI mock-ups showcasing the models in a practical and visual way. Significance: Due to the lack of educational EHRs, medical professionals do not receive sufficient EHR training. Implementing an educational EHR with a usable and configurable interface to suit the needs of different user groups and disciplines will help facilitate EHR learning and training and ultimately improve the quality of patient care.

Keywords: education, EHR, usability, configurable

Procedia PDF Downloads 157