Search results for: normative interventions

Authors: Nahida Sultana

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Globally, an estimated 58 million people have chronic hepatitis C virus infection, with about 1.5 million new infections occurring per year. The hepatitis C virus is a blood-borne virus, and most infections occur through exposure to blood from unsafe injection practices, unsafe health care, unscreened blood transfusion, injection drug use, and sexual practices that lead to exposure to blood. Hepatitis C virus (HCV) causes chronic infections that mainly affect the liver leading to liver diseases. This study aimed to determine whether there is any significant association between HCV transmission risk factors in relation to genotypes in HCV-infected Bangladeshi patients. After quantification of HCV viral load, 36 samples were randomly selected for HCV genotyping and risk factor measurement. A greater proportion of genotype 1 (p > 0.05) patients (40%) underwent blood transfusion compared to patients (22.6%) with genotype 3 infections. More genotype 1 patient underwent surgery and invasive procedures (20%), and rather than those with genotype 3 patients (16.1%). The history of IDUs (25.8%) and sexual exposure (3.2%) are only prevalent in genotype 3 patients and absent in patients with genotype 1 (p >0.05). There was no significant statistical difference found in HCV transmission risk factors (blood transfusion, IDUs, Surgery& interventions, sexual transmission) between patients infected with genotypes 1 and 3. In HCV infection, genotype may have no relation to transmission risk factors among Bangladeshi patients.

Keywords: HCV genotype, alanine aminotransferase (ALT), HCV viral load, IDUs

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Authors: Rodrigo Coelho

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We believe that in the majority of the “recent production of public space", the overvaluation of the "image", of the "ephemeral" and of the "objectual", has come to determine the configuration of banal and (more or less) arbitrary "public spaces", mostly linked to a problem of “outdoor decoration”, reflecting a clear sign of uncertainty and arbitrariness about the meaning, the role and shape of public space and public art.This "inconsistency" which is essentially linked to the loss of urban, but also social, cultural and political, vocation of the disciplines that “shape” the urban space (but is also linked to the lack of urban and technical culture of techinicians and policy makers) converted a significant set of the recently built "public space" and “urban art” into diffuse and multi-referenced pieces, which generally shares the inability of confering to the urban space, civic, aesthetic, social and symbolic meanings. In this sense we consider it is essential to undertake a theoretical reflection on the values, the meaning(s) and the shape(s) that open space, and urban art may (or must) take in the current urban and cultural context, in order to redeem for public space its status of significant physical reference, able to embody a spatial and urban identity, and simultaneously enable the collective accession and appropriation of public space. Taking as reference public space interventions built in the last decade on the European context, we will seek to explore and defend the need of considering public space as a true place of exception, an exceptional support where the emphasis is placed on the quality of the experience, especially by the relations public space/urban art can established with the city, with nature and geography in a broad sense, referring us back to a close and inseparable and timeless relationship between nature and culture.

Keywords: art, city, nature, public space

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Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Amin Asadi Hieh, Majid Kazemnezhad

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This research was conducted with the aim of determining the effectiveness of sexual cognitive behavioral therapy on psychological performance and openness to experience in women. The type of research was experimental in the form of pre-test-post-test. The statistical population of this research was made up of all working and married women with membership in the researcher's Instagram social network who had problems in marital-sexual relationships (N=900). From the statistical community, which includes working and married women who are members of the researcher's Instagram social network who have problems in marital-sexual relationships, there are 30 people including two groups (15 people in the experimental group and 15 people in the control group) as available sampling and selected randomly. They were placed in two experimental and control groups. The anxiety, stress, and depression scale (DASS) and the Costa and McCree personality questionnaire were used to collect data, and the cognitive behavioral therapy protocol of Dr. Mehrnaz Ali Akbari was used for the treatment sessions. To analyze the data, the covariance test was used in the SPSS22 software environment. The results showed that sexual cognitive behavioral therapy has a positive and significant effect on psychological performance and openness to experience in women. Conclusion: It can be concluded that interventions such as cognitive-behavioral sex can be used to treat marital problems.

Keywords: sexual cognitive behavioral therapy, psychological function, openness to experience, women

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Authors: Fabiana Souza Orlandi, Izabel Cristina Chavez Gomes, Barbara Isabela De Paula Morais, Ana Carolina Ottaviani

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Chronic Kidney Disease (CKD) is considered a public health problem. Patients who present CKD in their more advanced stages usually present several biopsychosocial changes, which may include pain. Pain can be considered subjective and personal, and its perception is characterized as a multidimensional experience. The objective of this study was to evaluate the level and descriptors of pain of adults and elderly patients with chronic kidney disease, through the Multidimensional Pain Evaluation Scale (EMADOR). This is a descriptive cross-sectional study with a quantitative approach. The sample consisted of 100 subjects with CKD in hemodialysis treatment at a Renal Replacement Therapy Service in the interior of the state of São Paulo. Data were collected through an individual interview, using a Sociodemographic Characterization and Multidimensional Pain Evaluation Scale (EMADOR). All ethical precepts were respected. The majority of the respondents were men (61.0%), white (56.0%) and with a high school education (34.0%). Regarding the pain of the individuals, 89 patients reported pain, with Chronic Pain predominating (50.0%, n = 50), followed by Acute Pain (39.0%, n = 39). Of the subjects who presented acute pain most of the 89.0% described the pain felt as unbearable, and of those who presented chronic pain, 35.0% described the pain felt as painful, unbearable and uncomfortable. It was concluded that there was a significant presence of pain, being the chronic pain dominant in the studied population. Faced with such factors, the present study motivates researches in this population, in order to establish interventions with the objective of improving the quality of life of these individuals.

Keywords: pain, chronic kidney disease, dialysis, evaluation

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Authors: Ziyun Li, Jiudi Zhong, June Zhang

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Background: The diagnosis and treatment of lung cancer lead to varying degrees of psychological and social maladjustment among patients with lung cancer. Understanding psychosocial adjustment (PA) and its influencing factors in young and middle-aged lung cancer patients is essential to help them return to society and lead a normal life. Objectives: This study aims to examine the mediating role of resilience in the association between stigma and psychosocial adjustment among young and middle-aged patients with lung cancer. Methods: A total of 235 patients with lung cancer were recruited from a tertiary grade A cancer center in southern China and investigated using a self-designed general information questionnaire, Psychosocial Adjustment to Illness Scale Self-Report, Social Impact Scale, and Conner-Davidson Resilience Scale. Results: The mean score of PA was (32.61±14.75), and its influencing factors included treatment modalities, stigma, and resilience. The total effect of stigma on PA was significant (total effect=0.418, SE=0.045, 95%CI [0.310-0.497]), and a positive indirect effect was identified for stigma on PA via resilience (indirect effect=0.143, SE=0.041, 95% CI [0.075-0.236]). Conclusion: Stigma and resilience are significantly associated with PA, and resilience is also a mediating variable between stigma and PA. This study suggests that individualized interventions can be made to improve the PA by alleviating their stigma, or by enhancing their resilience in young and middle-aged lung cancer patients.

Keywords: psychosocial adjustment, lung cancer, cancer caring, nursing, young and middle-aged

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Authors: Rawan Masarwa, Merav Ben Natan, Yaron Berkovich

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Background: Hip fracture repair surgery carries a certain mortality risk, yet evidence suggests that orthopedic surgeons often refrain from discussing this issue with patients prior to surgery. Aim: This study aims to examine whether orthopedic surgeons address the issue of one-year post-surgery mortality before hip fracture repair surgery and to explore the factors influencing this decision. Method: The study uses a cross-sectional design, administering validated digital questionnaires to 150 orthopedic surgeons. Results: A minority of orthopedic surgeons reported consistently informing patients about the risk of mortality in the year following hip fracture surgery. The primary reasons for not discussing this risk were a desire to avoid frightening patients, time constraints, and concerns about undermining patient hope. Surgeons reported a medium-high level of perceived self-efficacy, with higher self-efficacy linked to a reduced likelihood of discussing one-year mortality risk. In contrast, older age and holding a specialist status in orthopedic surgery were associated with a higher likelihood of discussing this risk with patients. Conclusions: The findings suggest a need for interventions to address communication barriers and ensure consistent provision of essential information to patients undergoing hip fracture surgery. Additionally, they emphasize the importance of considering individual factors such as self-efficacy, age, and expertise in developing strategies to enhance patient-provider communication in orthopedic care settings.

Keywords: orthopedic surgeons, hip fracture surgery, mortality risk communication, patient information

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Authors: Rajeshwari Biradar

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Background: The anecdotal evidences indicate that utilization of HIV services especially in Government facilities is affected by stigma and discrimination among HIV positive female sex workers (FSWs) in Karnataka. To our knowledge, there is no quantitative study on this issue. In this study an attempt is made to examine these aspects among positive FSWs exposed to prevention programs. Methods: This is a cross‐ sectional quantitative survey of HIV positive FSWs in the 3 districts of northern Karnataka using a structured questionnaire. The list of HIV Positive FSWs was organized by stratification, and 607 positive FSWs were selected using a systematic random selection. The data were analyzed using both bivariate and multivariate statistical techniques. Results: Half of the sex workers (52%) are traditional (devadasi, dedicated to the temple), 22% are widowed and the mean age is 33 years. The FSWs practice sex work on an average 13 days a month with 2.3 clients per day and was in sex work for about 13 years. Almost all of them (97%) used condom with the clients they had on the last day of sex work. About 74% were ever registered in the ART center and 47% of them reported being ever on ART, of which 6% dropped out. Multivariate results support the hypothesis that the interventions addressing stigma and discrimination enabled accessing health services in the government facilities (AOR=1.37; p=0.17). Conclusions: Based on the results of the study, programs addressing stigma, discrimination and positive prevention can be implemented in places where government health services are not utilized by HIV positive FSWs. However, the study may be limited by the fact that majority of the FSWs entered into sex work through the traditional devadasi system, which may not be the case in other parts of India.

Keywords: sex work, HIV/AIDS, female sex workers, health

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Authors: Yuliya Lipshits-Braziler

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For many young adults, career decision making is a difficult and complex process that may lead to indecision. Indecision is frequently associated with great psychological distress and low levels of well-being. One important resource for dealing with indecision is career decision self-efficacy (CDSE), which refers to people’s beliefs about their ability to successfully accomplish certain tasks involved in career choice. Drawing from Social Cognitive Theory, it has been hypothesized that CDSE correlates with (a) people’s likelihood to engage in or avoid career decision making tasks, (b) the amount of effort put into the decision making process, (c) the people’s persistence in decision making efforts when faced with difficulties, and (d) the eventual success in arriving at career decisions. Based on these assumptions, the present study examines the associations between the CDSE and 14 strategies for coping with career indecision among young adults. Using the structural equation modeling (SEM), the results showed that CDSE is positively associated with the use of productive coping strategies, such as information-seeking, problem-solving, positive thinking, and self-regulation. In addition, CDSE was negatively associated with nonproductive coping strategies, such as avoidance, isolation, ruminative thinking, and blaming others. Contrary to our expectations, CDSE was not significantly correlated with instrumental help-seeking, while it was negatively correlated with emotional help-seeking. The results of this study can be used to facilitate the development of interventions aiming to reinforce young adults’ career decision making self-efficacy, which may provide them with a basis for overcoming career indecision more effectively.

Keywords: career decision self-efficacy, career indecision, coping strategies, career counseling

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Authors: S. Fantin

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This study is the result of the legal research on cybersecurity and data protection within the EUNITY (Cybersecurity and Privacy Dialogue between Europe and Japan) project, aimed at fostering the dialogue between the European Union and Japan. Based on the research undertaken therein, the author offers an outline of the main asymmetries in the laws governing such fields in the two regions. The research is a comparative analysis of the two legal frameworks, taking into account specific provisions, ratio legis and policy initiatives. Recent doctrine was taken into account, too, as well as empirical interviews with EU and Japanese stakeholders and project partners. With respect to the protection of personal data, the European Union has recently reformed its legal framework with a package which includes a regulation (General Data Protection Regulation), and a directive (Directive 680 on personal data processing in the law enforcement domain). In turn, the Japanese law under scrutiny for this study has been the Act on Protection of Personal Information. Based on a comparative analysis, some asymmetries arise. The main ones refer to the definition of personal information and the scope of the two frameworks. Furthermore, the rights of the data subjects are differently articulated in the two regions, while the nature of sanctions take two opposite approaches. Regarding the cybersecurity framework, the situation looks similarly misaligned. Japan’s main text of reference is the Basic Cybersecurity Act, while the European Union has a more fragmented legal structure (to name a few, Network and Information Security Directive, Critical Infrastructure Directive and Directive on the Attacks at Information Systems). On an relevant note, unlike a more industry-oriented European approach, the concept of cyber hygiene seems to be neatly embedded in the Japanese legal framework, with a number of provisions that alleviate operators’ liability by turning such a burden into a set of recommendations to be primarily observed by citizens. With respect to the reasons to fill such normative gaps, these are mostly grounded on three basis. Firstly, the cross-border nature of cybercrime brings to consider both magnitude of the issue and its regulatory stance globally. Secondly, empirical findings from the EUNITY project showed how recent data breaches and cyber-attacks had shared implications between Europe and Japan. Thirdly, the geopolitical context is currently going through the direction of bringing the two regions to significant agreements from a trade standpoint, but also from a data protection perspective (with an imminent signature by both parts of a so-called ‘Adequacy Decision’). The research conducted in this study reveals two asymmetric legal frameworks on cyber security and data protection. With a view to the future challenges presented by the strengthening of the collaboration between the two regions and the trans-national fashion of cybercrime, it is urged that solutions are found to fill in such gaps, in order to allow European Union and Japan to wisely increment their partnership.

Keywords: cybersecurity, data protection, European Union, Japan

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Authors: Safwat Mohamed, Rasha Metawi, Hadeel Khalil, Hussein Kamal

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This paper discusses and reveals the manufacturing techniques of the leather scale armour of Tutankhamun. This armour was in critical condition and went under many conservation procedures as it suffered from some serious deterioration aspects including fragmentation. In addition, its original shape was lost, the leather scales were found scattered in the box and separated from the linen basis, and hence its outlines were blurred and incomprehensible. In view of this, the leather scale armour of Tutankhamun was desperate for urgent conservation and reconstruction interventions. Documentation measures were done before conservation. Several re-treatable conservation procedures were applied seeking for stabilizing the armour and reaching sustainable condition. The conservation treatments included many investigations and analyses that helped in revealing materials and techniques of making the armour. The leather scale armour of Tutankhamun consisted of leather scales attached to a linen support. This linen support consisted of several layers. Howard Carter assumed that the linen support consisted of 6 layers. The undertaken conservation treatments helped in revealing the actual number of layers of the linen support as well as in reaching the most sustainable condition. This paper views the importance of the conservation procedures, which were recently carried out on Tutankhamun’s leather scale armour, in identifying and revealing all materials and techniques used in its manufacturing. The collected data about manufacturing techniques were used in making a replica of the leather scale armour with the same methods and materials.

Keywords: leather scales armours, conservation, manufacturing techniques, Tutankhamun, producing a replica

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Authors: Gina Cynthia Raphita Hasibuan

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The housing sector in Indonesia is in critical condition where majority of low-income citizens live in substandard dwellings, and the number housing backlog is increasing every year. The housing problem becomes more urgent when the term 'sustainability' is considered, and sustainable affordable housing is yet to gain its successful implementation. Global urbanization develops fastest in developing countries like Indonesia where informal settlements are rapidly escalating, hence, making sustainable affordable housing strategies very critical in this context. The problem in developing countries like Indonesia lies on the institutional capacity of newly-established local governments having greater power to determine a development policy but apparently still lacking institutional capability and coordination with the central government and collaborative governance are still not established yet. The concept of upgrading informal settlements are seen changed over time and inconsistent. Despite much research on theme such as sustainable housing concept within Indonesian context, there has been a dearth of research examining the role of collaborative governance, as the current approach still shows fragmented approach between the stakeholders and the lack of community participation as the end user, and thus this research attempts to fill the gap on the aforementioned problems. By using case study with multi-methods conducted in Jakarta, this research has an overall aim to critically assess the role of collaborative governance in addressing sustainable affordable housing in Indonesia and to understand informal settlements and interventions in Indonesia rather than imposing a framework from western perspectives.

Keywords: affordable housing, collaborative governance, sustainability, urban planning

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Authors: Claire Baudry, Jessica Pearson, Laura-Emilie Savage, George Tarbulsy

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Over the last fifty years, maternal sensitivity and child development among vulnerable families have been a priority for researchers. For this reason, attachment-based interventions have been implemented and been shown to be effective in enhancing child development. Most of the time, child outcomes are measured shortly after the intervention. Objectives: The goal of the study was to investigate the effects of an attachment-based intervention on child development shortly after the intervention ended and one-year post-intervention. Methods: Over the seventy-two mother-child dyads referred by Child Protective Services in the province of Québec, Canada, forty-two were included in this study: 24 dyads who received 6 to 8 intervention sessions and 18 dyads who did not. Intervention and none intervention dyads were matched for the following variables: duration of child protective services, the reason for involvement with child protection, age, sex, and family status. Internalizing and externalizing behaviors were measured 3 and 12 months after the end of the intervention when the average age of children were respectively 45 and 54 months old. Findings: Independent-sample t-tests were conducted to compare scores between the two groups and the two data collection times. In general, on differences observed between the two groups three months after the intervention ended, just a few of them were still present nine months later. Conclusions: This first set of analyses suggests that the effects of attachment-based intervention observed three months following the intervention are not lasting for most of them. Those results inform us of the importance of considering the possibility to offer more attachment-based intervention sessions for those highly vulnerable families.

Keywords: attachment-based intervention, child behaviors, child protective services, highly vulnerable families

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Authors: Tracey Estriplet-Adams

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This paper focuses on the influence of maternal-fetal bonding by examining attachment theory, psycho-social-cultural influences/adaptations, and maternal well-being. A systematic review methodology was used to synthesize research results to summarize current evidence that can contribute to evidence-based practices. It explores the relationship between attachment styles, prenatal attachment, and perceptions of maternal-infant bonding/attachment six weeks postpartum. It also examines the protective factors of maternal-fetal attachment development. The research explores Bowlby's attachment theory and its relevance to maternal-fetal bonding with a Black Feminist Theory lens. Additionally, it discusses the impact of perceived stress, social support, and ecological models on maternal-fetal attachment. The relationship between maternal well-being, maternal-fetal attachment, and early postpartum bonding is reviewed. Moreover, the paper specifically addresses black mothers and maternal-fetal bonding, exploring the intersectionality of race, ethnicity, class, geographic location, cultural identities, and immigration status. It considers the role of familial and partner support, as well as the relationship between maternal attachment style and maternal-fetal bonding, within the framework of attachment theory and black feminist theory. Therefore, it is imperative to center Black women's voices in research, policy, and healthcare practices. Black women are experts in their own experiences and advocate for their autonomy in decision-making regarding maternal-fetal health. By amplifying their voices, we can ensure that interventions are grounded in their lived experiences.

Keywords: maternal-fetal bonding, infant well-being, maternal-infant attachment, black mothers

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Authors: Shadi Kanan, Ghada Shahrour, Barbara Broome, Donna Bernert, Muntaha Alibrahim, Dana Hansen

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Coronary artery disease is responsible for over 7 million deaths a year worldwide. In developing countries, such as Jordan, the incidence of coronary artery disease exceeds that of developed countries. One contributing factor to this disparity is decreased physical activity among the population, for reasons related to specific cultural and religious values. Using the theory of planned behaviour, the purpose of this study was to investigate the intentions of Jordanian patients with coronary artery disease regarding physical activity. A total of 109 patients with coronary artery disease were recruited for this cross-sectional study from King Abdullah University Hospital in Jordan. A 15-item questionnaire based on the theory of planned behaviour was used to assess participants’ attitudes, subjective norms, perceived behavioural control and intentions towards engagement in physical activity. Perceived behavioural control was found to have the strongest significant relationship with participants’ intentions to engage in physical activity. Barriers to physical activity included lack of time, lack of support from family or friends, and feelings of exhaustion. Lifestyle interventions for patients with coronary artery disease should focus on fostering a sense of control over the environment to encourage patients to engage in physical activity.

Keywords: coronary artery disease, perceived behavioural control, subjective norms, theory of planned behaviour

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Authors: Mihail Nagea, Olivera Lupescu, Elena Taina Avramescu, Cristina Patru

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Classical education of orthopedic surgeons involves lectures, self study, workshops and cadaver dissections, and sometimes supervised practical training within surgery, which quite seldom gives the young surgeons the feeling of being unable to apply what they have learned especially in surgical practice. The purpose of this paper is to present a different approach from the classical one, which enhances the practical skills of the orthopedic trainees and prepare them for future practice. The paper presents the content of the research project 2015-1-RO01-KA202-015230, ERASMUS+ VET ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery’ which, using e learning as a basic tool , delivers to the trainees not only courses, but especially practical information through videos and case scenarios including gait analysis in order to build patient focused therapeutic plans, adapted to the characteristics of each patient. The outcome of this project is to enhance the practical skills in orthopedic surgery and the results are evaluated following the answers to the questionnaires, but especially the reactions within the case scenarios. The participants will thus follow the idea that any mistake within solving the cases might represent a failure of treating a real patient. This modern approach, besides using interactivity to evaluate the theoretical and practical knowledge of the trainee, increases the sense of responsibility, as well as the ability to react properly in real cases.

Keywords: interdisciplinary approach, gait analysis, orthopedic surgery, vocational training

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Authors: Yi-Fung Lin, Yuan-Mei Liao

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Background: Pain is common among patients with cancer and is also one of the most disturbing symptoms. As this suffering is subjective, if patients proactively participate in their pain self-management, pain could be alleviated effectively. However, not everyone can carry out self-management very well because human behavior is a product of the cognition process. In this process, we can see that "self-efficacy" plays an essential role in affecting human behaviors. Methods: We used the eight steps of concept analysis proposed by Walker and Avant to clarify the concept of “self-efficacy for cancer pain management.” A comprehensive literature review was conducted for relevant publications that were published during the period of 1977 to 2021. We used several keywords, including self-efficacy, self-management, concept analysis, conceptual framework, and cancer pain, to search the following databases: PubMed, CINAHL, Web of Science, and Embase. Results: We identified three defining attributes for the concept of self-efficacy for cancer pain management, including pain management abilities, confidence, and continuous pain monitoring, and recognized six skills related to pain management abilities: problem-solving, decision-making, resource utilization, forming partnerships between medical professionals and patients, planning actions, and self-regulation. Five antecedents for the concept of self-efficacy for cancer pain management were identified: pain experience, existing cancer pain, pain-related knowledge, a belief in pain management, and physical/mental state. Consequences related to self-efficacy for cancer pain management were achievement of pain self-management, well pain control, satisfying quality of life, and containing motivation. Conclusions: This analysis provides researchers with a clearer understanding of the concept of “self-efficacy for cancer pain management.” The findings presented here provide a foundation for future research and nursing interventions to enhance self-efficacy for cancer pain management.

Keywords: cancer pain, concept analysis, self-efficacy, self-management

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Authors: Mohammed Alateeq, Abdulaziz Alrshoud

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Objectives: To examine the attitude and practice of family physicians in giving smoking cessation advice at King Abdul-Aziz Medical City for National Guard, Riyadh. Methods: Cross sectional study using validated self-reported questionnaire that distributed to all family physicians and primary health care doctors at the four main family medicine and primary health care centers, KAMC, Riyadh. Results: 73 physicians are contributed in this study. 28 (38.4%) physicians were from (KASHM ALAN) clinic, 26 (35.6%) physicians were from (UM ALHAMAM) Clinic. 13 (17.8%) physicians were from (ISKAN) clinic. 6 (8.2%) physicians were from the Employee Health Clinic. 73 (100%) of the target population agreed that giving brief smoking cessation advice is part of their duties. 67 (91.7%) agreed that Presence of hospital guidelines and special clinics for smoking cessation will encourage them to provide advice. Only 5 (6.84%) received training courses (1-4 weeks) in smoking cessation interventions. Conclusion: Most of the target population agreed that brief smoking cessation advice is part of their duties. Also, they agreed that Presence of hospital guidelines and special clinics for smoking cessation will encourage them to provide advice although most of them did not received a formal training in smoking cessation advice.

Keywords: advice, attitude, cessation, family physicians, smoking

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Authors: Marwa Abdussalam

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Breastfeeding is a unique emotional bond between a mother and their offspring. Though breastfeeding may be natural, it is not something mothers are born with; some still struggle to breastfeed their babies. Various factors can influence the breastfeeding experience, such as the mode of delivery, the mother’s health condition, proper latching, etc. In addition, psychological factors have been known to influence breastfeeding ability, duration, and milk supply. Some mothers struggle to breastfeed their babies because they perceive they have a low milk supply and or don’t have the ability to breastfeed their babies. Most of these perceptions result either from their own past experience or from the ‘comments’ of their caregivers. So, it is of utmost essential to understand such psychological factors affecting breastfeeding so that necessary steps can be taken to educate breastfeeding mothers. The study explored the role of psychological factors that affect breastfeeding. Data were collected from fifteen breastfeeding mothers using a semi-structured interview schedule. A total of 10 questions were included in the interview schedule. Questions were sequenced in a funnel pattern, beginning with open-ended questions and then moving on to close-ended questions. Data were analyzed using Braun and Clarke’s Thematic Analysis technique. This technique involves identifying the codes, generating themes, naming them, and finally reviewing them. Results indicated that breastfeeding self-efficacy perceived insufficient milk supply, and lack of knowledge were the psychological factors affecting breastfeeding. The results of this study can be used to help mothers who are struggling with breastfeeding by developing interventions aimed at improving breastfeeding self-efficacy.

Keywords: breastfeeding, breastfeeding self-efficacy, perceived insufficient milk supply, Thematic Analysis

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Authors: Mostafa Gabr, Rania Abdul Galil, Nihal Salim

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Various interventions are applied in cities with the aim to improve living and acoustic environmental conditions. Noise is one of the most influential and critical factors in the environment that has an effect on the QOL (quality of life) and urban environment. It ranks second among environmental pollution issues according to EEAA. Traffic noise is a major source of noise. Noise barriers are one of the physical techniques in landscape design used to reduce the impact of noise pollution in urban areas. Roadways noise pollution can be best controlled by a noise barrier. The aim of this paper is to consider all facets of sustainability when designing a comfortable acoustic environment in roadways, through different strategies related to planning and the design process. The study focuses on the relation between the design of noise barriers as a landscape noise mitigation installation and their materiality in so far as it influences the sustainability of the open space and the acceptability of users. According to previous studies, design of noise barrier mainly depends on cost as a decisive factor. This study asserts that environmental and socioeconomic costs associated are equally important. Hence, the paper presents a strategy for sustainable soundscape design. It builds a framework focusing on materiality considering the environmental and socioeconomic impact of noise barriers shaping urban open space around the road ways, and the different academic and market positions on noise barrier types and materials. Finally, it concludes with a matrix of the relation between the noise barrier design consideration and the three pillars of sustainability (social, economic and environmental).

Keywords: traffic noise level, acoustic sustainability, noise barrier, noise reduction, noise control, acoustical level

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Authors: M. V. Shivaani, P. K. Jain, Surendra S. Yadav

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Risk management has been gaining extensive focus from international organizations like Committee of Sponsoring Organizations and Financial Stability Board, and, the foundation of such an effective and efficient risk management system lies in a strong risk governance structure. In view of this, an attempt (perhaps a first of its kind) has been made to develop a risk governance index, which could be used as proxy for quality of risk governance structures. The index (normative framework) is based on eleven variables, namely, size of board, board diversity in terms of gender, proportion of executive directors, executive/non-executive status of chairperson, proportion of independent directors, CEO duality, chief risk officer (CRO), risk management committee, mandatory committees, voluntary committees and existence/non-existence of whistle blower policy. These variables are scored on a scale of 1 to 5 with the exception of the variables, namely, status of chairperson and CEO duality (which have been scored on a dichotomous scale with the score of 3 or 5). In case there is a legal/statutory requirement in respect of above-mentioned variables and there is a non-compliance with such requirement a score of one has been envisaged. Though there is no legal requirement, for the larger part of study, in context of CRO, risk management committee and whistle blower policy, still a score of 1 has been assigned in the event of their non-existence. Recognizing the importance of these variables in context of risk governance structure and the fact that the study basically focuses on risk governance, the absence of these variables has been equated to non-compliance with a legal/statutory requirement. Therefore, based on this the minimum score is 15 and the maximum possible is 55. In addition, an attempt has been made to explore the determinants of this index. For this purpose, the sample consists of non-financial companies (429) that constitute S&P CNX500 index. The study covers a 10 years period from April 1, 2005 to March 31, 2015. Given the panel nature of data, Hausman test was applied, and it suggested that fixed effects regression would be appropriate. The results indicate that age and size of firms have significant positive impact on its risk governance structures. Further, post-recession period (2009-2015) has witnessed significant improvement in quality of governance structures. In contrast, profitability (positive relationship), leverage (negative relationship) and growth (negative relationship) do not have significant impact on quality of risk governance structures. The value of rho indicates that about 77.74% variation in risk governance structures is due to firm specific factors. Given the fact that each firm is unique in terms of its risk exposure, risk culture, risk appetite, and risk tolerance levels, it appears reasonable to assume that the specific conditions and circumstances that a company is beset with, could be the biggest determinants of its risk governance structures. Given the recommendations put forth in the paper (particularly for regulators and companies), the study is expected to be of immense utility in an important yet neglected aspect of risk management.

Keywords: corporate governance, ERM, risk governance, risk management

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Authors: Gladys Maame Akua Setordzie

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Decision on one’s future career is said to have both beneficial and detrimental effects on one’s mental health, social and economic standing later in life, making it an important developmental problem for young people. In this light, the study’s overarching goal was to assess how different personality traits serve as a determinant of career decision-making difficulties experienced by university students in Ghana. Specifically, for the purpose of shaping the future of individualized career counselling support, the study investigated whether the “Big Five” personality traits influenced the difficulties students at the University of Ghana encounter while making career decisions. Cross-sectional survey design using a stratified random sampling technique, sampled 494 undergraduate students from the University of Ghana, who completed the Big Five Questionnaire and the Career Decision-making Difficulties Questionnaire. Hierarchical multiple regression analyses indicated that neuroticism, consciousness, and openness, accounted for a significant proportion of the variance in career decision-making difficulties. This study provides empirical evidence to support the idea that neuroticism is not necessarily a negative emotion when it comes to career decisionmaking, as has been suggested in previous studies, but rather it allows students to perform better in career decision-making. These results suggests that personality traits play a significant role in the career decision-making process of students of the University of Ghana. Therefore, a better understanding of how different personal and interpersonal factors impact career indecision in students could help career counsellors develop more focused vocational and career guidance interventions.

Keywords: career decision-making difficulties, dysfunctional career beliefs, personality traits, young people

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Authors: Ibrahim Nadeem, Mohammed Rahman, Yasser Ad-Dab’Bagh, Mahmood Akhtar

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Depression is one of the most prevalent mental illnesses and is often associated with various other medical disorders. In this review, we aim to evaluate existing systematic reviews that investigate the use of probiotics as a treatment for depressive symptoms. Five online databases were searched for relevant studies up to December 2017. Systematic reviews that included randomized controlled trials assessing the efficacy of probiotics in the treatment of depressive symptoms were included. Seven systematic reviews met the inclusion criteria. Three of these reviews conducted meta-analyses, out of which, two found probiotics to significantly improve depressive symptoms in the sample population. Two meta-analyses conducted subgroup analysis based on health status, and both found probiotics to significantly decrease depressive symptoms in patients with major depressive disorder, but only one review found it to significantly decrease in healthy patients. Another subgroup analysis was conducted based on age, and found probiotics to produce significant effects on subjects under the age of 60, but close to no effect on patients over the age of 65. Out of the four reviews that conducted qualitative analysis, three reviews concluded that probiotics have the potential to be used as a treatment. Due to the differences in clinical trials, a definitive effect of probiotics on depressive symptoms cannot be concluded. Nonetheless, probiotics seem to produce a significant therapeutic effect for subjects with pre-existing depressive symptoms. Further studies are warranted for definitive conclusions.

Keywords: depression, gut-brain axis, gut microbiota, probiotic, psychobiotic

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Authors: Samson F. Agberotimi, Rachel B. Asagba, Choja Oduaran

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Disturbing rate of use of different substances such as cannabis, alcohol, as well as pharmaceutical drugs among Nigerian youth in recent times has been affirmed in the literature. There is, however, a paucity of literature addressing the pattern of usage of such drugs, especially for clinical relevance and intervention planning. The present study investigated the prevalence and pattern of drug usage among youth in Ogbomoso, Nigeria. A cross-sectional survey involving 92 purposively selected participants comprising of 82 males and 10 females aged between 15 and 24 years was conducted. A measure of drug involvement and demographic characteristics was administered to the participants. Descriptive analysis was done using the SPSS v.21. Cannabis (79.4%), alcohol (77.2%), codeine (70.7%), tobacco (65.2%) and tramadol (47.8%) are the five most frequently used substances. However, the majority of the users of tobacco (68.3%) and alcohol (62.0%) are casual users indicating a mild level of use of the substances among the participants. On the other hand, 49.2% of the codeine users, 27.3% of the tramadol users, and 21.9% of the cannabis users reported harmful/intensive levels of use. Furthermore, the results revealed individuals at the pathological level of use as 28.8% for cannabis, 25.0% for tramadol, and 21.6% for codeine, and thus require clinical/therapeutic intervention. In conclusion, cannabis remains the most frequently used substance among youths. However, there appears to be a shift from the use of conventional psychoactive substances to pharmaceutical/prescription drugs such as codeine and tramadol. The findings of this study raised the need for both preventive and therapeutic interventions addressing the problem of substance use disorder among youth in contemporary society.

Keywords: Ogbomoso, pattern of drug use, prevalence of drug use, youth

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Authors: Aisha M. Memon, Arabella Bhutto, Zahid A. Memon, Adnan Pitafi

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This study aims to identify the existing and non-existing elements in the entrepreneurial ecosystem which include finance, institutions, laws and regulations, human capital, culture, and markets, to measure the level of effectiveness of existing elements and to develop recommendations for improving the ecosystem to facilitate the women entrepreneurs in Jamshoro, Pakistan. The nature of this study is qualitative. Data were drawn from 25 in-depth, semi-structured interviews and a focus group discussion with women entrepreneurs in rural Jamshoro, Pakistan. The findings show the lack of awareness and knowledge among women entrepreneurs about available financial resources, lack of knowledge about laws, an absence of familial and societal support for women in accessing the entrepreneurial ecosystem, the absence of business and innovation enablers in rural areas, communication gaps, and unskilled human capital. The study found that institutions like non-for-profit organizations are playing an active role in the growth of women entrepreneurs. The existing entrepreneurial ecosystem in Jamshoro can be improved through culturally sensitive coordinated approach, interventions aimed at increasing awareness about the resources, promoting an understanding about the laws and regulations, making business enablers more effective, establishing public-private partnerships, and providing the women entrepreneurs easy access to market and financial resources.

Keywords: entrepreneurship, entrepreneurship ecosystem, Pakistan, women entrepreneurs

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Authors: Bara Yousef

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The development of independency and functional participation is an important therapeutic goal for many children with cerebral palsy,They was many therapeutic approach have been used for treatment those children like neurodevelopment treatment, balance training strengthening and stretching exercise. More recently, therapy for children with cerebral palsy has focused on achieving functional goals using task-oriented interventions and summer camping model, which focus on activities that relevant and meaningful to the child, to learn more efficient and effective motor skills. We explore the effectiveness of using functional rehabilitation comparing with regular rehabilitation among 40 Saudi children with cerebral palsy in pediatric unit at Sultan Bin Abdul Aziz Humanitarian City-Ksa ,where 20 children randomly assign in control group who received rehabilitation based on regular therapy approach and other 20 children assign on experiment group who received rehabilitation based on functional therapy approach with an average of 45min OT treatment and 45 min PT treatment- daily within a period of 6 week. Our finding reported that children in experiment group has improved in gross motor function with an average from 49.4 to 57.6 based on GMFM 66 as primary outcome measure and improved in WeeFIM with an average from 52 to 62 while children in control group has improved with an average from 48.4 to 53.7 in GMFM and from 53 to and 58 in WeeFIM. Consequently, there has been growing interest in determining the effects of functional training programs as promising approach for these children.

Keywords: Cerebral Palsy (CP), gross motor function measure (GMFM66), pediatric Functional Independent Measure (WeeFIM), rehabilitation, disability

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Authors: Eileen K. Africa, Karel J. van Deventer

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Neuro-typical children develop the motor skills necessary to play, do schoolwork and interact with others. However, this is not observed in children who have learning or behavioural problems. Children with Autism Spectrum Disorder (ASD) are often referred to as clumsy because their body parts do not work well together in a sequence. Physical Activity (PA) has shown to be beneficial to the general population, therefore, providing children with ASD opportunities to take part in PA programmes, could prove to be beneficial in many ways and should be investigated. The purpose of this study was to design a specialised group intervention programme, to attempt to improve gross motor skills of selected children diagnosed with ASD between the ages of eight and 13 years. A government school for ASD learners was recruited to take part in this study, and a sample of convenience (N=7) was selected. Children in the experimental group (n=4) participated in a 12-week group intervention programme twice per week, while the control group continued with their normal daily routine. The Movement Assessment Battery for Children-Second Edition (MABC-2), was administered pre- and post-test to determine the children’s gross motor proficiency and to determine if the group intervention programme had an effect on the gross motor skills of the experimental group. Statistically significant improvements were observed in total motor skill proficiency (p < 0.05), of the experimental group. These results demonstrate the importance of gross motor skills interventions for children diagnosed with ASD. Future research should include more participants to ensure that the results can be generalised.

Keywords: autism spectrum disorder, children, gross motor skills, group intervention programme

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Authors: Dwarika P. Shrestha, Dipendra Gurung, Rushma Shrestha, Inger Rosdahl

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Introduction: Skin diseases are one of the most common health problems in Nepal. The objectives of this study are to determine the prevalence of skin diseases and impact on quality of life in rural areas in Nepal. Materials and methods: A house-to-house survey was conducted, to obtain socio-demographic data and identify individuals with skin diseases, followed by health camps, where the villagers were examined. A pilot study was conducted in one village, which was then extended to 10 villages in 4 districts. To assess the impact on quality of life, the villagers were interviewed with Skin Disease Disability Index. This is a questionnaire developed and validated by the authors for use in Nepal. Results: In the pilot study, the overall prevalence of skin diseases was 20.1% (645/3207). In the additional 10 villages with 7348 (3651/3787 m/f) inhabitants, 1862 (721/1141 m/f, mean age 31.4 years) had one or more skin diseases. The overall prevalence of skin diseases was 25%. The most common skin disease categories were eczemas (13.7%, percentage among all inhabitants) pigment disorders (6.8%), fungal infections (4.9%), nevi (3.7%) and urticaria (2.9%). These five most common skin disease categories comprise 71% of all skin diseases seen in the study. The mean skin disease disability index score was 13.7, indicating very large impact on the quality of life. Conclusions: This population-based study shows that skin diseases are very common in the rural areas of Nepal and have significant impact on quality of life. Targeted intervention at the primary health care level should help to reduce the health burden due to skin diseases.

Keywords: prevalence and pattern of skin diseases, impact on quality of life, rural Nepal, interventions

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Authors: A. Kulprasutidilok

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In order to address the social factors of elderly health care, researcher and community members have turned to more inclusive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received increased attention as the academic and public health communities struggle to address the persistent problems of disparities in the use of health care and health outcomes for several over the past decade. As Thailand becomes an ageing society, health services and proper care systems specifically for the elderly group need to be prepared and well established. The purpose of this assignment was to study the health problems and was to explore the process of community participation in elderly health care. Participants in this study were member of elderly group of Paisanee Ramintra 65 community in Bangkok, Thailand. The results indicated two important components of community participation process in elderly health care: 1) a process to develop community participation in elderly health care, and 2) outcomes resulting from such process. The development of community participation consisted of four processes. As for the outcomes of the community participation development process, they consisted of elderly in the community got jointly and formulated a group, which strengthened the project because of collaborative supervision among themselves. Moreover, inactive health care services have changed to being energetic and focus on health promotion rather than medical achievement and elderly association of community can perform health care activities for chronically illness through the achievement of this development; consequently, they increasingly gained access to physical, cognitive, and social activity.

Keywords: community-based participatory research, elderly, heath care, Thailand.

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Authors: Murat Durucu

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Glaucoma is a condition of irreversible blindness, early diagnosis and appropriate interventions to make the patients able to see longer time. In this study, it addressed that the importance of developing a decision support system for glaucoma diagnosis. Glaucoma occurs when pressure happens around the eyes it causes some damage to the optic nerves and deterioration of vision. There are different levels ranging blindness of glaucoma disease. The diagnosis at an early stage allows a chance for therapies that slows the progression of the disease. In recent years, imaging technology from Heidelberg Retinal Tomography (HRT), Stereoscopic Disc Photo (SDP) and Optical Coherence Tomography (OCT) have been used for the diagnosis of glaucoma. This better accuracy and faster imaging techniques in response technique of OCT have become the most common method used by experts. Although OCT images or HRT precision and quickness, especially in the early stages, there are still difficulties and mistakes are occurred in diagnosis of glaucoma. It is difficult to obtain objective results on diagnosis and placement process of the doctor's. It seems very important to develop an objective decision support system for diagnosis and level the glaucoma disease for patients. By using OCT images and pattern recognition systems, it is possible to develop a support system for doctors to make their decisions on glaucoma. Thus, in this recent study, we develop an evaluation and support system to the usage of doctors. Pattern recognition system based computer software would help the doctors to make an objective evaluation for their patients. It is intended that after development and evaluation processes of the software, the system is planning to be serve for the usage of doctors in different hospitals.

Keywords: decision support system, glaucoma, image processing, pattern recognition

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Authors: Thiago R. Pereira

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The philosophical hermeneutics is able to change the Brazilian Judiciary because of the understanding of the characteristics of the human being. It is impossible for humans, to be invested in the function of being a judge, making absolutely neutral decisions, but the philosophical hermeneutics can assist the judge making impartial decisions, based on the federal constitution. The normative legal positivism imagined a neutral judge, a judge able to try without any preconceived ideas, without allowing his/her background to influence him/her. When a judge arbitrates based on legal rules, the problem is smaller, but when there are no clear legal rules, and the judge must try based on principles, the risk of the decision is based on what they believe in. Solipsistically, this issue gains a huge dimension. Today, the Brazilian judiciary is independent, but there must be a greater knowledge of philosophy and the philosophy of law, partially because the bigger problem is the unpredictability of decisions made by the judiciary. Actually, when a lawsuit is filed, the result of this judgment is absolutely unpredictable. It is almost a gamble. There must be the slightest legal certainty and predictability of judicial decisions, so that people, with similar cases, may not receive opposite sentences. The relativism, since classical antiquity, believes in the possibility of multiple answers. Since the Greeks in in the sixth century before Christ, through the Germans in the eighteenth century, and even today, it has been established the constitution as the great law, the Groundnorm, and thus, the relativism of life can be greatly reduced when a hermeneut uses the Constitution as North interpretational, where all interpretation must act as the hermeneutic constitutional filter. For a current philosophy of law, that inside a legal system with a Federal Constitution, there is a single correct answer to a specific case. The challenge is how to find this right answer. The only answer to this question will be that we should use the constitutional principles. But in many cases, a collision between principles will take place, and to resolve this issue, the judge or the hermeneut will choose a solipsism way, using what they personally believe to be the right one. For obvious reasons, that conduct is not safe. Thus, a theory of decision is necessary to seek justice, and the hermeneutic philosophy and the linguistic turn will be necessary for one to find the right answer. In order to help this difficult mission, it will be necessary to use philosophical hermeneutics in order to find the right answer, which is the constitutionally most appropriate response. The constitutionally appropriate response will not always be the answer that individuals agree to, but we must put aside our preferences and defend the answer that the Constitution gives us. Therefore, the hermeneutics applied to Law, in search constitutionally appropriate response, should be the safest way to avoid judicial individual decisions. The aim of this paper is to present the science of law starting from the linguistic turn, the philosophical hermeneutics, moving away from legal positivism. The methodology used in this paper is qualitative, academic and theoretical, philosophical hermeneutics with the mission to conduct research proposing a new way of thinking about the science of law. The research sought to demonstrate the difficulty of the Brazilian courts to depart from the secular influence of legal positivism. Moreover, the research sought to demonstrate the need to think science of law within a contemporary perspective, where the linguistic turn, philosophical hermeneutics, will be the surest way to conduct the science of law in the present century.

Keywords: hermeneutic, right answer, solipsism, Brazilian judiciary

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