Search results for: facilitators

Authors: Zhang Dongqing

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Concern for students' mental health and the application of intelligent advanced technologies are driving changes in teaching models. The traditional teacher-centered classroom is beginning to transform into a student-centered smart interactive learning environment. Nowadays, smart classrooms are compatible with constructivist learning. This theory emphasizes the role of teachers in the teaching process as helpers and facilitators of knowledge construction, and students learn by interacting with them. The spatial design of classrooms is closely related to the teaching model and should also be developed in the direction of smart classroom design. The goal is to explore the impact of smart classroom layout on student-centered teaching environment and teacher-student interaction under the guidance of constructivist learning theory, by combining the design process and feedback analysis of the smart transformation project on the campus of Tongji University in Shanghai. During the research process, the theoretical basis of constructivist learning was consolidated through literature research and case analysis. The integration and visual field analysis of the traditional and transformed indoor floor plans were conducted using space syntax tools. Finally, questionnaire surveys and interviews were used to collect data. The main conclusions are as followed: flexible spatial layouts can promote students' learning effects and mental health; the interactivity of smart classroom layouts is different and needs to be combined with different teaching models; the public areas of teaching buildings can also improve the interactive learning atmosphere by adding discussion space. This article provides a data-based research basis for improving students' learning effects and mental health, and provides a reference for future smart classroom design.

Keywords: spatial layout, smart classroom, space syntax, renovation, educational environment

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Authors: Marta Fonseca, Pedro Marvão, Beatriz Oliveira, Bruno Heleno, Pedro Carreiro-Martins, Nuno Neuparth, António Rendas

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Background: Concept maps (CMs) visually represent hierarchical connections among related ideas. They foster logical organization and clarify idea relationships, potentially aiding medical students in critical thinking (to think clearly and rationally about what to do or what to believe). However, there are inconsistent claims about the use of CMs in undergraduate medical education. Our three research questions are: 1) What studies have been published on concept mapping in undergraduate medical education? 2) What was the impact of CMs on students’ critical thinking? 3) How and why have these interventions had an educational impact? Methods: Eight databases were systematically searched (plus a manual and an additional search were conducted). After eliminating duplicate entries, titles, and abstracts, and full-texts were independently screened by two authors. Data extraction and quality assessment of the studies were independently performed by two authors. Qualitative and quantitative data were integrated using mixed-methods. The results were reported using the structured approach to the reporting in healthcare education of evidence synthesis statement and BEME guidance. Results: Thirty-nine studies were included from 26 journals (19 quantitative, 8 qualitative and 12 mixed-methods studies). CMs were considered as a tool to promote critical thinking, both in the perception of students and tutors, as well as in assessing students’ knowledge and/or skills. In addition to their role as facilitators of knowledge integration and critical thinking, CMs were considered both teaching and learning methods. Conclusions: CMs are teaching and learning tools which seem to help medical students develop critical thinking. This is due to the flexibility of the tool as a facilitator of knowledge integration, as a learning and teaching method. The wide range of contexts, purposes, and variations in how CMs and instruments to assess critical thinking are used increase our confidence that the positive effects are consistent.

Keywords: concept map, medical education, undergraduate, critical thinking, meaningful learning

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Authors: Hami-Ziniman Revital, Ashwall Rachelly

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The conflict resolution realm has developed tremendously during the last half-decade. Three main approaches should be mentioned: an Alternative Dispute Resolution (ADR) suggesting processes such as Arbitration or Interests-based Negotiation was developed as an answer to obligations and rights-based conflicts. The Pragmatic mediation approach focuses on the gap between interests and needs of disputants. The Transformative mediation approach focusses on relations and suits identity-based conflicts. In the current study, we examine the conflictual relations between religious and non-religious Jews in Israel and the impact of three transformative mechanisms: Inter-group recognition, In-group empowerment and Value-based reframing on the relations between the participants. The research was conducted during four facilitated joint mediation classes. A unique finding was found. Using both transformative mechanisms and the Contact Hypothesis criteria, we identify transformation in participants’ relations and a considerable change from anger, alienation, and suspiciousness to an increased understanding, affection and interpersonal concern towards the out-group members. Intergroup Recognition, In-group empowerment, and Values-based reframing were the skills discovered as the main enablers of the change in the relations and the research participants’ fostered mutual recognition of the out-group values and identity-based issues. We conclude this transformation was possible due to a constant intergroup contact, based on the Contact Hypothesis criteria. In addition, as Interests-based mediation uses “Reframing” as a skill to acknowledge both mutual and opposite needs of the disputants, we suggest the use of “Value-based Reframing” in intergroup identity-based conflicts, as a skill contributes to the empowerment and the recognition of both mutual and different out-group values. We offer to implement those insights and skills to assist conflict resolution facilitators in various intergroup identity-based conflicts resolution efforts and to establish further research and knowledge.

Keywords: empowerment, identity-based conflict, intergroup recognition, intergroup relations, mediation skills, multi-cultural society, reframing, value-based recognition

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Authors: Jennifer Hunter, Francisco Ramirez, Neil A. Nedley, Thania Solorio, Christian Freed, Erica Kinjo

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People who have autoimmune disease are often at an increased risk for psychological disorders such as anxiety. Untreated psychological conditions can affect the development of disease and can affect one’s general quality of life. In this study, it was hypothesized that an educational community-based intervention would be useful in decreasing the anxiety levels of participants with autoimmune disease. Programs, 2-hours long each, were held weekly over a period of eight weeks. During every meeting, a 45-minute DVD presentation by a skilled physician was shown, a small group discussion was guided by trained facilitators, and weekly practical assignments were given to each participant. The focus of the program was to educate participants about healthy lifestyle behaviors such as exercise, nutrition, sleep hygiene, helpful thought patterns etc., and to provide a group environment in which each participant was supported. Participants were assessed pre-post program for anxiety using the Depression and Anxiety Assessment Test (registration TX 7-398-022), a validated mental health test based on DSM-5 criteria and demographics. Anxiety scores were classified according to the DSM-5 criteria into 4 categories: none (0-6), mild (7-10), moderate (11-19) or severe (20 or more). Out of the participants who participated in programs conducted in the manner explained above (n=431), the average age was 54.9 (SD 16.6) and 81.9% were female. At baseline, the mean group anxiety level was 9.4 (SD 5.4). Within the baseline group, anxiety levels were as follows: none (21.1%), mild (22.0%), moderate (27.1%) and severe (29.7%). After the program, mean group anxiety decreased to 4.7 (SD 4.0). Post-program anxiety levels were as follows: none (54.8%), mild (27.1%), moderate (12.5%), severe (5.6%). The decrease in overall anxiety levels was significant t(431)=19.3 p<.001, 95% CI [0.815, 1.041]. It was concluded that the eight-week intensive was beneficial in decreasing the anxiety levels of participants. A long-term follow-up study would be beneficial in determining how lasting such improvements are especially since autoimmune diseases are often chronic. Additionally, future studies that utilize a control group would aid in establishing whether the improvements seen are due to the use of this specific lifestyle-educational program.

Keywords: anxiety, auto-immune disease, community-based educational program, lifestyle

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Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant

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Comprehensive and compassionate palliative care and support requires an integrated system of care that draws on formal health and social service providers working together with community and informal networks to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the community supports, services, and informal networks that health care professionals and social service providers rely on to allow their patients to die in their homes and communities. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers that arise as health care and social service providers attempt to build networks of care for patients with life limiting illnesses and families. Three main findings emerged: First, the variability that arises due to systemic barriers in accessing and providing care; second, the exceptionally challenging workload that providers are facing as they work to address complex social care needs (housing, disability, food security), along with escalating palliative care needs; and, finally, the lack of structural support that providers and informal care networks receive. Conclusion: These findings will facilitate and build stronger person-centred/relationship-centred principles and practices between providers, patients, community, and informal care networks by highlighting the systemic barriers to accessing and providing person-centred care. Further, they will have important implications for future partnerships in integrated care delivery programs and initiatives, community policies, education programs, and provincial and national palliative care strategies.

Keywords: public health palliative care, palliative care nursing, care networks, informal care, integrated health care

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Authors: Gali Pesin, Yuliya Lipshits-Braziler, Sima Amram-Vaknin, Moshe Tatar

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The present study introduces four different patterns of seeking and providing help online among adolescents: (I) ‘Transceivers’ - adolescents who both seek as well as provide help online; (II) ‘Receivers’ - adolescents who seek help online, yet don’t provide it; (III) ‘Transmitters’ - adolescents who provide help online, yet don’t seek it; and (IV) ‘Idles’ - adolescents who refrain from seeking and providing help online. The study examined differences in seeking and providing help online between possible combinations of the four patterns, as well as gender differences within each pattern. Data was collected from 528 adolescents in Israel (59% were girls). Findings revealed that Transceivers are the largest group (45%) in this study, with higher representation of girls (65%). These adolescents seek help mainly around social difficulties, and they turn to peers who are both known and unknown to them. In addition, their preferred way to seek and provide help is through social network sites. Moreover, they often accept and give others emotional support. Receivers are the smallest group (5%) in this study. They turn to both known and unknown professionals more often than to friends and family. In addition, they seek help mostly around health and nutrition issues, and they usually receive instrumental support. For Receivers, the most important factor for seeking help online is anonymity, and the least important factor is familiarity with the help giver. Transmitters represent 16% of the adolescents in this study, with a greater representation of boys (52%). Their main reason to refrain from seeking help online is self-reliance. Nevertheless, these adolescents provide help to others online, mainly to those known to them through posting or responding to posts on social network sites. Idles represent 34% of the adolescents in this study. They refrain from seeking help online mainly due to their preference to seek help face to face, and due to their lack of trust in the internet or those using it. Idles and Transmitters are willing to seek help online mostly from friends and family. In addition, they are willing seek help online mainly regarding questions concerning military or civil service. They consider the most important facilitators for seeking help online as confidentiality and reliability. The present study’s main contribution is exploring the role of providing online help in understanding the adolescent behavior of seeking help online. In addition, the results of the present study have practical implications for the work of mental health providers, such as counseling psychologists and online mental health support.

Keywords: adolescents, counseling, online help-seeking, online help-providing

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Authors: Narash Narasimman, Calvin Leong Jia Jun, Raksha Karthik, Paul Englert

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Background: Project Grit, a 12-week youth resilience program implemented by Impart and Spartans Boxing Club, aimed to help at-risk adolescents develop resilience through psychoeducation and mental health techniques for dealing with everyday stressors and adversity. The programme consists of two parts-1.5 hours of group therapy followed by 1 hour of boxing. Due to the novelty of the study, 6 male participants, aged 13 to 18, were recruited to participate in the study. Aim: This case study aims to examine the effectiveness of Project Grit in building resilience among at-risk adolescents. Methods: A case study design was employed to capture the complexity and uniqueness of the intervention, without oversimplifying or generalizing it. A 15-year-old male participant with a history of behavioural challenges, delinquency and gang involvement was selected for the study. Teacher, parent and child versions of the Strengths and Difficulties Questionnaire (SDQ) were administered to the facilitators, parents and participants respectively before and after the programme. Relevant themes from the qualitative interviews will be discussed. Results: Scores from all raters revealed improvements in most domains of the SDQ. Total difficulties scores across all raters improved from “very high” to “close to average”. High interrater reliability was observed (κ= .81). The participant reported learning methods to effectively deal with his everyday concerns using healthy coping strategies, developing a supportive social network, and building on his self efficacy. Themes from the subject’s report concurred with the improvement in SDQ scores. Conclusions: The findings suggest that Project Grit is a promising intervention for promoting resilience among at-risk adolescents. The teleological behaviourism framework and the combination of sports engagement and future orientation may be particularly effective in fostering resilience among this population. Further studies need to be conducted with a larger sample size to further validate the effectiveness of Project Grit.

Keywords: resilience, project grit, adolescents, at-risk, boxing, future orientation

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Authors: Oloruntegbe Kunle Oke, Alake Ese Monica, Odutuyi Olubu Musili

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This research explores the differing effectiveness of cascade and cluster models in professional development programs for educators in Ondo State, Nigeria. The cascade model emphasizes a top-down approach, where training is cascaded from expert trainers to lower levels of teachers. In contrast, the cluster model, a bottom-up approach, fosters collaborative learning among teachers within specific clusters. Through a review of the literature and empirical studies of the implementations of the former in two academic sessions followed by the cluster model in another two, the study examined their effectiveness on teacher development, productivity and students’ achievements. The study also drew a comparative analysis of the strengths and weaknesses associated with each model, considering factors such as scalability, cost-effectiveness, adaptability in various contexts, and sustainability. 2500 teachers from Ondo State Primary Schools participated in the cascade with intensive training in five zones for a week each in two academic sessions. On the other hand, 1,980 and 1,663 teachers in 52 and 34 clusters, respectively, were in the first and the following session. The programs were designed for one week of rigorous training of teachers by facilitators in the former while the latter was made up of four components: sit-in-observation, need-based assessment workshop, pre-cluster and the actual cluster meetings in addition to sensitization, and took place one day a week for ten weeks. Validated Cluster Impact Survey Instruments, CISI and Teacher’s Assessment Questionnaire (TAQ) were administered to ascertain the effectiveness of the models during and after implementation. The findings from the literature detailed specific effectiveness, strengths and limitations of each approach, especially the potential for inconsistencies and resistance to change. Findings from the data collected revealed the superiority of the cluster model. Response to TAQ equally showed content knowledge and skill update in both but were more sustained in the cluster model. Overall, the study contributes to the ongoing discourse on effective strategies for improving teacher training and enhancing student outcomes, offering practical recommendations for the development and implementation of future professional development projects.

Keywords: cascade model, cluster model, teachers’ development, productivity, students’ achievement

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Authors: Siobhan Hegarty, Michael Bloomfield, Kim Entholt, Dorothy Williams, Helen Kennerley

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Complex Post-Traumatic Stress Disorder (CPTSD) confers greater risk of poor outcomes than does Post-Traumatic Stress Disorder (PTSD). Despite this, the current treatment guidelines for CPTSD aim to reduce only the ‘core’ symptoms of re-experiencing, hyper-vigilance and avoidance, while not addressing the Disturbances of Self Organisation (DSO) symptoms that distinguish this novel diagnosis from PTSD. The Recovering from Child Abuse Programme (RCAP) is a group protocol, based on the principles of cognitive behavioural therapy (CBT). Preliminary evidence suggests the program is effective at reducing DSO symptoms. This pilot study is the first to investigate the potential effectiveness of the RCAP for the specific treatment of CPTSD. This study was conducted as a service evaluation in a secondary care, traumatic stress service. Treatment was delivered once a week, in two-hour sessions, to ten existing female CPTSD patients of the service, who had experienced sexual abuse in childhood. The programme was administered by two therapists and two additional facilitators, following the RCAP protocol manual. Symptom severity was measured before the administration of therapy and was tracked across a range of measures (International Trauma Questionnaire; Patient Health Questionnaire; Community Assessment of Psychic Experience; Work and Social Adjustment Scale) at five time points, over the course of treatment. Qualitative appraisal of the programme was gathered via weekly feedback forms and from audio-taped recordings of verbal feedback given during group sessions. Preliminary results suggest the programme causes a slight reduction in CPTSD and depressive symptom severity and preliminary qualitative analysis suggests that the RCAP is both helpful and acceptable to group members. Final results and conclusions will follow completed thematic analysis of results.

Keywords: Child sexual abuse, Cognitive behavioural therapy, Complex post-traumatic stress disorder, Recovering from child abuse programme

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Authors: Jerry D. Johnson, Jason A. LaFrance, Matthew A. Ohlson, Shane C. Shope

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The public school system is the largest employer and most impactful factor in the local economy for many rural communities in the United States. The relationship between the school system and the community is symbiotic—they thrive together or decline together. Understanding the perceptions of rural school superintendents (the titular head of the local school district) with regard to rural development is foundational to understanding how the school and community interact and collaborate in key areas like economic development, community development, and workforce development. To investigate those perceptions as they manifest among superintendents in thriving rural communities, a collective case study was designed and conducted to disclose and characterize superintendent perceptions about rural development in three diverse rural settings in the U.S.: Florida, Kansas, and Ohio. Appreciative Inquiry (AI) served as the conceptual framework and supported a focus on identifying and describing assets and strategies/activities that helped explain the positive results in the communities of interest. Implementation of a criterion-based purposive sampling process (using extant data and a nomination process to identify rural superintendents in communities with vibrant economies and recognized the contribution by the schools in rural development) resulted in two superintendents from each of these state settings who participated in semi-structured interviews. Interview transcripts and relevant extant documents were coded and analyzed to produce individual cases with representative themes, after which a cross-case analysis was conducted to generate overarching themes. The overarching themes were then scrutinized and tested through the application of appropriate credibility techniques to promote the trustworthiness of the results. Findings include the importance of building and maintaining relationships that extend beyond the immediate collaboration activity, the importance of collaboration skills, intentionality of practice, and organizational systems/structures as facilitators/affordances. The results offer potential guidance for leveraging the potential for public schools to contribute to their rural development in the communities they serve.

Keywords: collaboration, leadership, rural development, rural schools

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Authors: Hani Malik

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Background: Clinician burnout is a growing phenomenon in current health systems worldwide. Increasing emotional exhaustion, depersonalisation, and reduced personal accomplishment threaten the effective delivery of healthcare. This can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in clinicians. Objectives: To conduct a scoping review and identify high-quality studies on mindfulness practice in clinician burnout, synthesize themes that emerge from these studies, and discuss the implications of the results to healthcare leadership and innovation. Methodology: A focused scoping review was carried out to investigate the effects of mindfulness practice on clinician burnout. High-ranking journals were targeted to analyse high-quality studies and synthesize common themes in the literature. Studies conducted on current, practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Grey literature and studies conducted only on allied health personnel were excluded from this review. Analysis:31 studies were included in this scoping review. Mindfulness practice was found to decrease emotional exhaustion and depersonalisation while improving mood, responses to stress, and vigour. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged which include: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to clinician mindfulness practice. Conclusion: Mindfulness had widely been reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate clinician leader will play a crucial role in addressing gaps in current practice, prioritise staff mental health, and provide a supportive platform for innovation.

Keywords: mindfulness practice, clinician burnout, healthcare leadership, COVID-19

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Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Razia Sultana, Md. Faroque Miah

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Mental health remains a significant global public health challenge, profoundly affecting millions worldwide. In Bangladesh, the situation is dire, with the National Mental Health Survey 2018-19 indicating that 19% of adults suffer from any kind of mental disorders, including severe mental disorder of around 2%. Despite these high prevalence rates, there is a substantial treatment gap in low- and middle-income countries, including Bangladesh, where up to 92% of individuals with mental illnesses do not receive adequate care. This gap is exacerbated by social barriers such as stigma, discrimination, social exclusion, poverty, homelessness, and human rights violations. To address these challenges, the SAJIDA Foundation launched the Proshanti in November 2022. Proshanti is a community based supportive housing intervention designed to provide cost-effective, sustainable, long-term care for individuals with chronic mental illnesses. It aims to rehabilitate participants by improving their mental health, quality of life, and equipping them with skills necessary for independent living and social mobility. Currently, Proshanti operates seven houses in Manikganj and Habiganj districts of Bangladesh, accommodating up to 40 individuals. Over a two-year period, individuals have received personalized support from trained personal assistants and care coordinators, regular health checkups, and opportunities for vocational training and community engagement. In this presentation, we will present the outcome of such intervention on individual’s functionality, quality of life and psychological health generated from 24 months of journey. Additionally, a qualitative approach will be employed to understand the facilitators and barriers of program implementation. The Proshanti program represents a promising model for addressing the significant mental health treatment gap in Bangladesh at the community level. Our findings will provide crucial insights into the program's feasibility, effectiveness, and the factors influencing its implementation, potentially guiding future mental health interventions in similar contexts.

Keywords: mental health, community based supportive housing, treatment gap, bangladesh

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Authors: Sheillah Hlamalani Mboweni, Lufuno Makhado

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Background: The increasing number of people who tested HIV positive and who demand antiretroviral therapy (ART) prompted the National Department of Health to adopt WHO recommendations of task shifting where Professional Nurses(PNs) initiate ART rather than doctors in the hospital. This resulted in the decentralization of services to primary health care(PHC), generating a need to capacitate PNs on NIMART. After years of training, the impact of NIMART was assessed where it was established that even though there was an increased number who accessed ART, the quality of care is of serious concern. The study aims to answer the following question: What are the challenges influencing NIMART implementation in primary health care. Objectives: This study explores challenges influencing NIMART training and implementation and makes recommendations to improve patient and HIV program outcomes. Methods: A qualitative explorative program evaluation research design. The study was conducted in the rural districts of North West province. Purposive sampling was used to sample PNs trained on NIMART. FGDs were used to collect data with 6-9 participants and data was analysed using ATLAS ti. Results: Five FGDs, n=28 PNs and three program managers were interviewed. The study results revealed two themes: inadequacy in NIMART training and the health care system challenges. Conclusion: The deficiency in NIMART training and health care system challenges is a public health concern as it compromises the quality of HIV management resulting in poor patients’ outcomes and retard the goal of ending the HIV epidemic. These should be dealt with decisively by all stakeholders. Recommendations: The national department of health should improve NIMART training and HIV management: standardization of NIMART training curriculum through the involvement of all relevant stakeholders skilled facilitators, the introduction of pre-service NIMART training in institutions of higher learning, support of PNs by district and program managers, plan on how to deal with the shortage of staff, negative attitude to ensure compliance to guidelines. There is a need to develop a conceptual framework that provides guidance and strengthens NIMART implementation in PHC facilities.

Keywords: antiretroviral therapy, nurse initiated management of retroviral therapy, primary health care, professional nurses

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Authors: Felix Golla

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In an era where technology increasingly intersects with education, the potential of chatbots and ChatGPT agents in enhancing student learning experiences in higher education is both significant and timely. This study explores the integration of these AI-driven tools in educational settings, emphasizing their design and functionality to meet the specific needs of students. Recognizing the gap in literature concerning student-centered AI applications in education, this research offers valuable insights into the role and efficacy of chatbots and ChatGPT agents as educational tools. Employing qualitative research methodologies, the study involved conducting semi-structured interviews with university students. These interviews were designed to gather in-depth insights into the students' experiences and expectations regarding the use of AI in learning environments. The High-Performance Cycle Model, renowned for its focus on goal setting and motivation, served as the theoretical framework guiding the analysis. This model helped in systematically categorizing and interpreting the data, revealing the nuanced perceptions and preferences of students regarding AI tools in education. The major findings of the study indicate a strong preference among students for chatbots and ChatGPT agents that offer personalized interaction, adaptive learning support, and regular, constructive feedback. These features were deemed essential for enhancing student engagement, motivation, and overall learning outcomes. Furthermore, the study revealed that students perceive these AI tools not just as passive sources of information but as active facilitators in the learning process, capable of adapting to individual learning styles and needs. In conclusion, this study underscores the transformative potential of chatbots and ChatGPT agents in higher education. It highlights the need for these AI tools to be designed with a student-centered approach, ensuring their alignment with educational objectives and student preferences. The findings contribute to the evolving discourse on AI in education, suggesting a paradigm shift towards more interactive, responsive, and personalized learning experiences. This research not only informs educators and technologists about the desirable features of educational chatbots but also opens avenues for future studies to explore the long-term impact of AI integration in academic curricula.

Keywords: chatbot design in education, high-performance cycle model application, qualitative research in AI, student-centered learning technologies

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Authors: Elisabeth Unterfrauner, Christian Voigt

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Since the foundation of the first Fab Lab by the Massachusetts Institute of Technology about 17 years ago, the Maker movement has spread globally with the foundation of maker spaces and Fab Labs worldwide. In these workshops, citizens have access to digital fabrication technologies such as 3D printers and laser cutters to develop and test their own ideas and prototypes, which makes it an attractive place for start-up companies. Know-How is shared not only in the physical space but also online in diverse communities. According to the Horizon report, the Maker movement, however, will also have an impact on educational settings in the following years. The European project ‘DOIT - Entrepreneurial skills for young social innovators in an open digital world’ has incorporated key elements of making to develop an early entrepreneurial education program for children between the age of six and 16. The Maker pedagogy builds on constructive learning approaches, learning by doing principles, learning in collaborative and interdisciplinary teams and learning through trial and error where mistakes are acknowledged as learning opportunities. The DOIT program consists of seven consecutive elements. It starts with a motivation phase where students get motivated by envisioning the scope of their possibilities. The second step is about Co-design: Students are asked to collect and select potential ideas for innovations. In the Co-creation phase students gather in teams and develop first prototypes of their ideas. In the iteration phase, the prototype is continuously improved and in the next step, in the reflection phase, feedback on the prototypes is exchanged between the teams. In the last two steps, scaling and reaching out, the robustness of the prototype is tested with a bigger group of users outside of the educational setting and finally students will share their projects with a wider public. The DOIT program involves 1,000 children in two pilot phases at 11 pilot sites in ten different European countries. The comprehensive evaluation design is based on a mixed method approach with a theoretical backbone on Lackeus’ model of entrepreneurship education, which distinguishes between entrepreneurial attitudes, entrepreneurial skills and entrepreneurial knowledge. A pre-post-test with quantitative measures as well as qualitative data from interviews with facilitators, students and workshop protocols will reveal the effectiveness of the program. The evaluation results will be presented at the conference.

Keywords: early entrepreneurial education, Fab Lab, maker education, Maker movement

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Authors: Dounyazad Sour

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This research examines international doctoral students’ reflections on their journey and experiences of studying for a PhD in the UK. Since the early 1990s, the international students’ number in the UK has increased. The significant contribution of these international students to the cultural and academic diversity of the UK universities’ doctoral programmes is widely acknowledged. The substantial fees these students bring to British Higher Education institutions is also much appreciated. The rationale for undertaking this study grew from personal experience of studying in the UK. Through membership in different groups both online and, when regulations permitted it, face to face social groups, it quickly became apparent that among all students, there were both shared and individual experiences of struggles and triumphs. This insight led to the decision to investigate these matters in greater detail. This in-depth qualitative interpretative study, inspired by a phenomenological approach, offers fresh insights into academic, social and cultural experiences of international PhD students in the UK. Data collection was carried out in the UK over a period of three months, deploying focus groups, individual semi-structured interviews, and images selected by participants that represent their feelings towards their experiences. The ten participants are attending different UK universities, studying a range of disciplines and have diverse backgrounds. Interviews and discussions took place in the participants' preferred languages; Arabic, English and French. The analysis shows that the participants had experienced two types of shock: negative and positive. Negative shocks, which have seen considerable attention in the field of international students’ experiences, relate to unexpected incidents that happened to the participants in relation to their interactions with others: people from different backgrounds and people from the same background. This impacted their experience negatively through experiencing feelings of anxiety, stress, low self-esteem and xenophobia, all these hindering factors contribute to make international students struggle to adapt to the new environment. Positive shocks, which have remained largely under-researched in the field of international students’ experiences, refer to all the positive occurrences that participants experienced. For instance, a shop assistant saying: “do you need any help, honey?” which brought a sense of belonging, feeling home, safety, and satisfaction to the respondents, and made their experiences less challenging. This investigation will offer insights into the PhD international students’ experiences and shed new light on the shocks that can work as facilitators, rather than as inhibitors.

Keywords: international students, PhD journey, phenomenological approach, positive shock

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Authors: Lynnette Lyzwinski, Liam Caffery, Matthew Bambling, Sisira Edirippulige

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Introduction: A novel method of delivering mindfulness interventions for populations at risk of weight gain and stress-related eating, in particular, college students, is through mHealth. While there have been qualitative studies on mHealth for weight loss, there has not been a study on mHealth for weight loss using mindfulness that has explored student perspectives on a student centred mindfulness app and mindfulness-based text messages for eating and stress. Student perspective data will provide valuable information for creating a specific purpose weight management app and mindfulness-based text messages (for the Mindfulness App study). Methods: A qualitative focus group study was undertaken at St Lucia campus at the University of Queensland in March 2017. Students over the age of 18 were eligible to participate. Interviews were audiotaped and transcribed. One week following the focus group, students were sent sample mindfulness-based text messages based on their responses. Students provided written feedback via email. Data were analysed using N Vivo software. Results: The key themes in a future mindfulness-based app are a simple design interface, a focus on education/practical tips, and real-life practical exercises. Social media should be avoided. Key themes surrounding barriers include the perceived difficulty of mindfulness and a lack of proper guidance or knowledge. The mindfulness-based text messages were received positively. Key themes were creating messages with practical tips about how to be mindful and how to integrate mindful reflection of both one’s body and environment while on campus. Other themes including creating positive, inspirational messages. There was lack of agreement on the ideal timing for messages. Discussion: This is the first study that explored student perspectives on a mindfulness-app and mindfulness-based text messages for stress and weight management as a pre-trial study for the Mindfulness App trial for stress, lifestyle, and weight in students. It is important to consider maximizing the potential facilitators of use and minimize potential identified barriers when developing and designing a future mHealth mindfulness-based intervention tailored to the student consumer. Conclusion: Future mHealth studies may consider integrating mindfulness-based text messages in their interventions for weight and stress as this is a novel feature that appears to be acceptable for participants. The results of this focus group provide the basis to develop content for a specific purpose student app for weight management.

Keywords: mindfulness, college students, mHealth, weight loss

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Authors: Ioannis Souris

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In this paper, we would like to present how we taught German through playwriting and analyze the usefulness of this method for teaching languages and cultivating a sense of political agency in students and teachers alike. Last academic year, we worked at the German Saturday School in Greenwich, London. This school offers Saturday German lessons to children whose parents are German, living in London. The lessons are two hours long, and the children’s level of German varies according to how often or how much German is spoken at home or how often the families visit Germany (as well as other factors which will be discussed in more detail in the paper). The directors of the school provide teachers with learning material and course books, but they strongly encourage individual input on lesson structure and methods of teaching German. The class we taught consisted of six eight-to-nine-year-olds. Midway into the academic year, we ran out of teaching material, and we, therefore, decided to write a play. In the paper, we would like to explore the process we followed in creating or writing this play and how this encouraged the children to collaborate and exercise their skills in writing, storytelling, speaking, and opinion-sharing. We want to examine the impact this project had on the children who wrote and performed the play, the wider community of the Saturday school, and the development of our language teaching practice. We found, for instance, that some students, who were quiet or shy, became very open and outspoken in the process of writing and performing the play. They took the initiative and led the process, putting us, their teachers, in the role of simple observers or facilitators. When we showed the play in front of the school, the other children and teachers, as audience members, also became part of the process as they commented on the plot, language, and characters and gave feedback on further development. In the paper, we will discuss how this teaching project fits into recent developments in the research of creativity and the teaching of languages and how engagement with creative approaches to teaching has the potential to question and subvert traditional notions of ‘lesson’, ‘teacher’, and ‘student’. From the moment a questioning of norms takes place, we inadvertently raise questions about politics, agency, and resistance. We will conclude the paper with a definition of what we mean by ‘political agency’ within the context of our teaching project and education, in general, and why inspiring creativity and imagination within teaching can be considered a political act. Finally, our aim in this paper will be to propose the possibility of analyzing teaching languages through creativity and political agency theories.

Keywords: innovation in language teaching and learning, language acquisition and learning, language curriculum development, language education

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Authors: Harry B. Santoso, Lia Sadita, Firlia Sandyta, Musa Alfatih, Nove Spalo, Nu'man Naufal, Nuryahya P. Utomo, Putu A. Paramatha, Rezka Aufar Leonandya, Tommy Anugrah, Aulia Chairunisa, M. Fadly Uzzaki, Riandy D. Banimahendra

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The numbers of Internet active users in Indonesia reach out over 88.1 million, where 48% of them are daily active users. Seeing these numbers, it is the best opportunity for IT companies to grow their business, especially e-Commerce. In fact, the growth of e-Commerce companies in Indonesia is proportional with internet daily active users. This phenomenon shows that competition happening among the e-Commerce companies is raising high. It triggers many e-Commerce companies to improve their services. The authors hypothesized that one of the best ways to improve the services is by improving their usability. So, the authors had done a study to evaluate and find out ways to improve usability of those e-Commerce websites. The authors chose four e-Commerce websites which each of them has different business focus and profiles. Each company is labeled as A, B, C, and D. Company A is a fashion-based e-Commerce services with two-million desktop visits Indonesia. Company B is an international online shopping mall for everyday appliances with 48,3-million desktop visits in Indonesia. Company C is a localized online shopping mall with 3,2-million desktop visits in Indonesia. Company D is an online shopping mall with one-million desktop visits in Indonesia. Writers used popular web traffic analytics platform to gain the numbers. There are some approaches to evaluate the usability of e-Commerce websites. In this study, the authors used usability testing method supported by the User Experience Questionnaire. This method involved the user in interacting directly with the services provided by the e-Commerce company. This study was conducted within two months including preparation, data collection, data analysis, and reporting. We used a pair of computers, a screen-capture video application named Smartboard, and User Experience Questionnaire. A team was built to conduct this study. They consisted of one supervisor, two assistants, four facilitators and four observers. For each e-Commerce, three users aged 17-25 years old were invited to do five task scenarios. Data collected in this study included demographic information of the users, usability testing results, and users’ responses to the questionnaire. Some findings were revealed from the usability testing and the questionnaire. Compared to the other three companies, Company D had the least score for the experiences. One of the most painful issues figured out by the authors from the evaluation was most users claimed feeling confused by user interfaces in these e-Commerce websites. We believe that this study will help e-Commerce companies to improve their services and business in the future.

Keywords: e-commerce, evaluation, usability testing, user experience

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Authors: Rangika Perera, Shyamani Hettiarachchi, Fran Hagstrom

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Dyslexia is the most common reading reading-related difficulty among the school school-aged population and currently, 5-10% are showing the features of dyslexia in Sri Lanka. As there is an insufficient number of speech and language pathologists in the country and few speech and language pathologists working in government mainstream school settings, these children who are at risk of dyslexia are not receiving enough quality early intervention services to develop their reading skills. As teachers are the key professionals who are directly working with these children, using them as the primary facilitators to improve their reading skills will be the most effective approach. This study aimed to identify the efficacy of a two and half a day of intensive training provided to fifteen mainstream government school teachers of grade two classes. The goal of the training was to enhance their knowledge of dyslexia and provide full classroom skills training that could be used to support the development of the students’ reading competencies. A closed closed-ended multiple choice questionnaire was given to these teachers pre and -post-training to measure teachers’ knowledge of dyslexia, the areas in which these children needed additional support, and the best strategies to facilitate reading competencies. The data revealed that the teachers’ knowledge in all areas was significantly poorer prior to the training and that there was a clear improvement in all areas after the training. The gain in target areas of teaching skills selected to improve the reading skills of children was evaluated through peer feedback. Teachers were assigned to three groups and expected to model how they were going to introduce the skills in recommended areas using researcher developed, validated and reliability reliability-tested materials and the strategies which were introduced during the training within the given tasks. Peers and the primary investigator rated teachers’ performances and gave feedback on organizational skills, presentation skills of materials, clarity of instruction, and appropriateness of vocabulary. After modifying their skills according to the feedback the teachers received, they were expected to modify and represent the same tasks to the group the following day. Their skills were re-evaluated by the peers and primary investigator using the same rubrics to measure the improvement. The findings revealed a significant improvement in their teaching skills development. The data analysis of both knowledge and skills gains of the teachers was carried out using quantitative descriptive data analysis. The overall findings of the study yielded promising results that support intensive training as a method for improving teachers’ knowledge and teaching skill development for use with children in a whole class intervention setting who are at risk of dyslexia.

Keywords: Dyslexia, knowledge, teaching skills, training program

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Authors: Tereza Hruskova

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200 million people globally experience serious mental health problems, and only one third seek professional help, and help-seeking is described as a last resort. Adolescents and young adults have a high prevalence of mental illness. Mental stigma is a key element in the decision to seek help and is divided into (i) self-stigma (self-stigmatization), including internal beliefs, low self-esteem, and lower quality of life, and (ii) public stigma (social stigma) containing stereotypes, beliefs and society's disapproval of help-seeking having a negative effect on help-seeking and our attitudes. Previous research has mainly focused on examining the construct of help seeking, avoidance, and delaying separately and trying to find out why people do not seek help in time and what obstacles stand in the way. Barriers are not static and may change over time and the stage of help-seeking. Attitudes are closely related to self-stigma and social stigma and predict whether a person will seek help. Barriers (stigmatization, a sense of humiliation, insufficient recognition of the problem, preferences, solving it alone, and distrust of a professional) and facilitators (previous experience with mental problems, social support, and help from others) are factors influencing help-seeking. The current research on the Czech population of young adults responds to the gap between a person with mental health problems and actually seeking professional help. The aim of the study is to describe in detail the individual constructs and factors, to understand the person seeking help, and to define possible obstacles on this path of seeking help. A sample of approximately 250 participants (age 18-35) would take part in the online questionnaire, conducted in May-June 2023, and would be administered a demographic questionnaire and four scales measuring attitudes (Attitudes Toward Seeking Professional Psychological Help – Short form), barriers (Barrier to Help Seeking Scale), self-stigma (Self Stigma of Seeking Help) and stigmatization (Perceptions of Stigmatization by Others for seeking help). Firstly, all four scales would be translated into the Czech language. The aim is (I) to determine the validity and reliability of the Czech translation of the scales, (II) to examine the factors of the scales on the Czech population and compare them retrospectively with the results of reliability and validity from the original language of the scales and (III) to examine the connections between attitudes towards seeking, avoidance or delaying the search for professional psychological help due to the demographic and individual differences of the participants, barriers, self-stigmatization and social stigmatization. We expect to carry out the first study on the given topic in the Czech Republic, to identify and better understand the factors leading to the avoidance of seeking professional help and to reveal the relationships between stigmatization, attitudes and barriers leading to the avoidance or postponement of seeking professional help. The belief is to find out whether the Czech population of young adults differs from the data found on the foreign population in individual constructs, as cultural differences in individual countries were found.

Keywords: mental health, stigma, problems, seeking psychological help

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Authors: Bu Kyung Park

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Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.

Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis

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Authors: Gracie Tredget, Raymond McGrath, Karen Ang, Julie Williams, Nick Sevdalis, Fiona Gaughran, Jorge Aria de la Torre, Ioannis Bakolis, Andy Healey, Zarnie Khadjesari, Euan Sadler, Natalia Stepan

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Background: Preventable physical health problems have been found to increase morbidity rates amongst adults living with serious mental illness (SMI). Community mental health clinicians have a role in identifying, and preventing physical health problems worsening, and supporting primary care services to administer routine physical health checks for their patients. However, little is known about how mental health staff perceive and approach their role when providing physical healthcare amongst patients with SMI, or the impact these attitudes have on routine practice. Methods: The present study involves a prospective service evaluation specific to Adult Community Mental Health Services at South London and Maudsley NHS Foundation Trust (SLaM). A qualitative methodology will use semi-structured interviews, focus groups and observations to explore attitudes, perceptions and experiences of staff, patients, and carers (n=64) towards physical healthcare, and barriers or facilitators that impact upon it. 1South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK 2 Centre for Implementation Science, King’s College London, London, SE5 8AF, UK 3 Psychosis Studies, King's College London, London, SE5 8AF, UK 4 Department of Biostatistics and Health Informatics, King’s College London, London, SE5 8AF, UK 5 Kings Health Economics, King's College London, London, SE5 8AF, UK 6 Behavioural and Implementation Science (BIS) research group, University of East Anglia, Norwich, UK 7 Department of Nursing, Midwifery and Health, University of Southampton, Southampton, UK 8 Mind and Body Programme, King’s Health Partners, Guy’s Hospital, London, SE1 9RT *[email protected] Analysis: Data from across qualitative tasks will be synthesised using Framework Analysis methodologies. Staff, patients, and carers will be invited to participate in co-development of recommendations that can improve routine physical healthcare within Adult Community Mental Health Teams at SLaM. Results: Data collection is underway at present. At the time of the conference, early findings will be available to discuss. Conclusions: An integrated approach to mind and body care is needed to reduce preventable deaths amongst people with SMI. This evaluation will seek to provide a framework that better equips staff to approach physical healthcare within a mental health setting.

Keywords: severe mental illness, physical healthcare, adult community mental health, nursing

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Authors: Fiona Jensen, Barb Goodwin, Nancy Kleiman, Rhonda Usunier

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Background: Clinical simulation is now a common component in many health profession curricula in preparation for clinical practice. In the Rady Faculty of Health Sciences (RFHS) college leads in simulation and interprofessional (IP) education, planned an eight hour simulated hospital day shift, where seventy students from six health professions across two campuses, learned with each other in a safe, realistic environment. Learning about interprofessional collaboration, an expected competency for many health professions upon graduation, was a primary focus of the simulation event. Method: Faculty representatives from the Colleges of Nursing, Medicine, Pharmacy and Rehabilitation Sciences (Physical Therapy, Occupation Therapy, Respiratory Therapy) and Pharmacy worked together to plan the IP event in a simulation facility in the College of Nursing. Each college provided a faculty mentor to guide the same profession students. Students were placed in interprofessional teams consisting of a nurse, physician, pharmacist, and then sharing respiratory, occupational, and physical therapists across the team depending on the needs of the patients. Eight patient scenarios were role played by health profession students, who had been provided with their patient’s story shortly before the event. Each team was guided by a facilitator. Results and Outcomes: On the morning of the event, all students gathered in a large group to meet mentors and facilitators and have a brief overview of the six competencies for effective collaboration and the session objectives. The students assuming their same profession roles were provided with their patient’s chart at the beginning of the shift, met with their team, and then completed professional specific assessments. Shortly into the shift, IP team rounds began, facilitated by the team facilitator. During the shift, each patient role-played a spontaneous health incident, which required collaboration between the IP team members for assessment and management. The afternoon concluded with team rounds, a collaborative management plan, and a facilitated de-brief. Conclusions: During the de-brief sessions, students responded to set questions related to the session learning objectives and expressed many positive learning moments. We believe that we have a sustainable simulation IP collaborative learning opportunity, which can be embedded into curricula, and has the capacity to grow to include more health profession faculties and students. Opportunities are being explored in the RFHS at the administrative level, to offer this event more frequently in the academic year to reach more students. In addition, a formally structured event evaluation tool would provide important feedback and inform the qualitative feedback to event organizers and the colleges about the significance of the simulation event to student learning.

Keywords: simulation, collaboration, teams, interprofessional

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Authors: Annika Freudenberger, Sin Sokhong

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In just a few years, the Face-to-Face Victory Gardens Project (F2F) in Cambodia has developed a high-impact project that has provided immediate and tangible benefits to local families. This has been accomplished with a relatively hands-off approach that relies on households’ own motivation and personal investments of time and resources -which is both unique and impressive in the landscape of NGO and government initiatives in the area. Households have been growing food both for their own consumption and to sell or exchange. Not all targeted beneficiaries are equally motivated and maximizing their involvement, but there is a clear subset of households -particularly those who serve as facilitators- whose circumstances have been transformed as a result of F2F. A number of household factors and contextual economic factors affect families’ income generation opportunities. All the households we spoke with became involved with F2F with the goal of selling some proportion of their produce (i.e., not exclusively for their own consumption). For some, this income is marginal and supplemental to their core household income; for others, it is substantial and transformative. Some engage directly with customers/buyers in their immediate community, while others sell in larger nearby markets, and others link up with intermediary vendors. All struggle, to a certain extent, to compete in a local economy flooded with cheap produce imported from large-scale growers in neighboring provinces, Thailand, and Vietnam, although households who grow and sell herbs and greens popular in Khmer cuisine have found a stronger local market. Some are content with the scale of their garden, the income they make, and the current level of effort required to maintain it; others would like to expand but are faced with land constraints and water management challenges. Households making a substantial income from selling their products have achieved success in different ways, making it difficult to pinpoint a clear “model” for replication. Within our small sample size of interviewees, it seems as though the families with a clear passion for their gardens and high motivation to work hard to bring their products to market have succeeded in doing so. Khmer greens and herbs have been the most successful; they are not high-value crops, but they are fairly easy to grow, and there is a constant demand. These crops are also not imported as much, so prices are more stable than those of crops such as long beans. Although we talked to a limited number of individuals, it also appears as though successful families either restricted their crops to those that would grow well in drought or flood conditions (depending on which they are affected by most); or benefit already from water management infrastructure such as water tanks which helps them diversify their crops and helps them build their resilience.

Keywords: food security, Victory Gardens, nutrition, Cambodia

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Authors: Estefanya Vazquez-Casaubon, Veroline Cauberghe, Dieneke Van de Sompel, Hayley Pearce

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Working together to reduce the anthropogenic impact should be a collective action, including effort within the household. In the matter, children are considered to have an important role in influencing the household to reduce the environmental impact through reversed socialization where children motivate and increase the concern of the parents towards environmental protection. Previous studies reveal that communication between parents and kids is key for effective reversed socialization. However, multiple barriers have been identified in the literature, such as the acceptance of the influence from the kids, the properties of the communication, among other factors. Based on the previous evidence, the present study aims to assess barriers and facilitators of communication at the household level that have an impact on reversed socialization. More precisely, the study examines how parents’ climate change coping strategy (problem-focused, meaning-focused, disregarding) influences the valence and the type of the communication related to climate change, and eventually the extent to which they report their beliefs and behaviours to be influenced by the pro-environmental perspectives of their children; i.e. reversed socialization. Via an online survey, 723 Belgian parents self-reported on communication about environmental protection and risk within their household (such as the frequency of exchange about topics related to climate change sourced from school, the household rules, imparting knowledge to the children, and outer factors like media or peer pressure, the emotional valence of the communication), their perceived socialization, and personal factors (coping mechanisms towards climate change). The results, using structural equation modelling, revealed that parents applying a problem-solving coping strategy related to climate change, appear to communicate more often in a positive than in a negative manner. Parents with a disregarding coping style towards climate change appear to communicate less often in a positive way within the household. Parents that cope via meaning-making of climate change showed to communicate less often in either a positive or negative way. Moreover, the perceived valence of the communication (positive or negative) influenced the frequency and type of household communication. Positive emotions increased the frequency of the communication overall. However, the direct effect of neither of the coping mechanisms on the reversed socialization was significant. High frequency of communication about the media, environmental views of the household members among other external topics had a positive impact on the perceived socialization, followed by discussions school-related; while parental instructing had a negative impact on the perceived socialization. Moreover, the frequency of communication was strongly affected by the perceived valence of the communication (positive or negative). The results go in line with previous evidence that a higher frequency of communication facilitates reversed socialization. Hence the results outstand how the coping mechanisms of the parents can be either a facilitator when they cope via problem-solving, while parents that disregard might avert frequent communication about climate change at the household.

Keywords: communication, parents’ coping mechanisms, environmental protection, household, perceived socialization

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Authors: Okunola Oluseye Ademola

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The study investigated various socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. The objectives are to examine the perception of people living with HIV/AIDS (PLWHA) of antiretroviral therapy (ART) in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, investigate the influence of socio-cultural factors on adherence of PLWHA to treatment regimen in the study area and assess the prevalence of adherence to ART among PLWHA in the study area. It was a cross-sectional where both qualitative and quantitative research methods were adopted. The participants were HIV diagnosed patients attending clinic at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife between the ages of 18 and 60 years. Also three healthcare delivery personnel working in the clinic were interviewed. Out of the 3007 patients receiving treatment, using Fischer’s formula of sampling technique, 336 patients living with HIV/AIDS were selected for the study. These participants had been on antiretroviral drugs for more than six months prior to the study and were selected using simple random sampling technique. Two focus group discussion sessions comprising of 10 male and 10 female living with HIV and currently on ART were conducted. These groups were purposively selected based on their being on ART for more than one year. Also in-depth interviews were conducted among three purposively selected healthcare givers (an experienced nurse, a doctor and a pharmacist) who are working in this clinic. All the participants were interviewed at the clinic on the various clinic days. Data were collected using a structured questionnaire, an interview guide and tape-recorder. The quantitative data were analysed using descriptive and inferential statistics. Content analysis was employed to analyse responses from IDI and FGD sessions. The findings from the study revealed a very positive perception to ART among PLWHA which was about 86.3% while the level of adherence to ART was 89.0% among the respondents. There was a very strong relationship between social and family supports and the degree of adherence to ART in the PLWHA. Nutrition, polygamy, difficulty in financing transportation fare to the clinic, unemployment, drug hawkers, religion, excuse duty from work and waking up very early were highlighted as socio-cultural barriers to adherence to ART. Fear of death, strong family support, religion belief, not seeking alternative treatment, absence of rituals and perceived improved health status were identified as very strong facilitators to adherence. The study concluded that to achieve a very optimal outcome in the management of HIV among PLWHA, various social and cultural contexts should be taken into consideration as this study was able to ascertain the influence of various socio-cultural factors militating and facilitating adherence to ART.

Keywords: ART, HIV, PLWHA, socio-cultural

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Authors: Thomas Turner

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Due to the Covid-19 pandemic alternative ways of delivering dental education were required. As a result, many institutions moved teaching online. The impact of this is poorly understood. Is online problem-based learning (PBL) and case-based learning (CBL) effective and is it suitable in the post-pandemic era? PBL and CBL are both types of interactive, group-based learning which are growing in popularity within many dental schools. PBL was first introduced in the 1960’s and can be defined as learning which occurs from collaborative work to resolve a problem. Whereas CBL encourages learning from clinical cases, encourages application of knowledge and helps prepare learners for clinical practice. To evaluate the use of online PBL and CBL. A literature search was conducted using the CINAHL, Embase, PubMed and Web of Science databases. Literature was also identified from reference lists. Studies were only included from dental education. Seven suitable studies were identified. One of the studies found a high learner and facilitator satisfaction rate with online CBL. Interestingly one study found learners preferred CBL over PBL within an online format. A study also found, that within the context of distance learning, learners preferred a hybrid curriculum including PBL over a traditional approach. A further study pointed to the limitations of PBL within an online format, such as reduced interaction, potentially hindering the development of communication skills and the increased time and technology support required. An audience response system was also developed for use within CBL and had a high satisfaction rate. Interestingly one study found achievement of learning outcomes was correlated with the number of student and staff inputs within an online format. Whereas another study found the quantity of learner interactions were important to group performance, however the quantity of facilitator interactions was not. This review identified generally favourable evidence for the benefits of online PBL and CBL. However, there is limited high quality evidence evaluating these teaching methods within dental education and there appears to be limited evidence comparing online and faceto-face versions of these sessions. The importance of the quantity of learner interactions is evident, however the importance of the quantity of facilitator interactions appears to be questionable. An element to this may be down to the quality of interactions, rather than just quantity. Limitations of online learning regarding technological issues and time required for a session are also highlighted, however as learners and facilitators get familiar with online formats, these may become less of an issue. It is also important learners are encouraged to interact and communicate during these sessions, to allow for the development of communication skills. Interestingly CBL appeared to be preferred to PBL in an online format. This may reflect the simpler nature of CBL, however further research is required to explore this finding. Online CBL and PBL appear promising, however further research is required before online formats of these sessions are widely adopted in the post-pandemic era.

Keywords: case-based learning, online, problem-based learning, remote, virtual

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Authors: F. Slaven, M. Uys, Y. Erasmus

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The South African National Mental Health Education Programme (SANMHEP) was a National Department of Health (NDoH) initiative to strengthen mental health services in South Africa in collaboration with the Foundation for Professional Development (FPD), SANOFI and the various provincial departments of health. The programme was implemented against the backdrop of a number of challenges in the management of mental health in the country related to staff shortages and infrastructure, the intersection of mental health with the growing burden of non-communicable diseases and various forms of violence, and challenges around substance abuse and its relationship with mental health. The Mental Health Care Act (No. 17 of 2002) prescribes that mental health should be integrated into general health services including primary, secondary and tertiary levels to improve access to services and reduce stigma associated with mental illness. In order for the provisions of the Act to become a reality, and for the journey of mental health patients through the system to improve, sufficient and skilled health care providers are critical. SANMHEP specifically targeted Medical Doctors and Professional Nurses working within the facilities that are listed to conduct 72-hour assessments, as well as District Hospitals. The aim of the programme was to improve the clinical diagnosis and management of mental disorders/conditions and the understanding of and compliance with the Mental Health Care Act and related Regulations and Guidelines in the care, treatment and rehabilitation of mental health care users. The course used a blended-learning approach and trained 1 120 health care providers through 36 workshops between February and November 2019. Of those trained, 689 (61.52%) were Professional Nurses, 337 (30.09%) were Medical Doctors, and 91 (8.13%) indicated their occupation as ‘other’ (of these more than half were psychologists). The pre- and post-evaluation of the face-to-face training sessions indicated a marked improvement in knowledge and confidence level scores (both clinical and legislative) in the care, treatment and rehabilitation of mental health care users by participants in all the training sessions. There was a marked improvement in the knowledge and confidence of participants in performing certain mental health activities (on average the ratings increased by 2.72; or 27%) and in managing certain mental health conditions (on average the ratings increased by 2.55; or 25%). The course also required that participants obtain 70% or higher in their formal assessments as part of the online component. The 337 participants who completed and passed the course scored 90% on average. This illustrates that when participants attempted and completed the course, they did very well. To further assess the effect of the course on the knowledge and behaviour of the trained mental health care practitioners a mixed-method outcome evaluation is currently underway consisting of a survey with participants three months after completion, follow-up interviews with participants, and key informant interviews with department of health officials and course facilitators. This will enable a more detailed assessment of the impact of the training on participants' perceived ability to manage and treat mental health patients.

Keywords: mental health, public health facilities, South Africa, training

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