Search results for: midwife-led counseling
206 Multi-Modality Brain Stimulation: A Treatment Protocol for Tinnitus
Authors: Prajakta Patil, Yash Huzurbazar, Abhijeet Shinde
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Aim: To develop a treatment protocol for the management of tinnitus through multi-modality brain stimulation. Methodology: Present study included 33 adults with unilateral (31 subjects) and bilateral (2 subjects) chronic tinnitus with and/or without hearing loss independent of their etiology. The Treatment protocol included 5 consecutive sessions with follow-up of 6 months. Each session was divided into 3 parts: • Pre-treatment: a) Informed consent b) Pitch and loudness matching. • Treatment: Bimanual paper pen task with tinnitus masking for 30 minutes. • Post-treatment: a) Pitch and loudness matching b) Directive counseling and obtaining feedback. Paper-pen task is to be performed bimanually that included carrying out two different writing activities in different context. The level of difficulty of the activities was increased in successive sessions. Narrowband noise of a frequency same as that of tinnitus was presented at 10 dBSL of tinnitus for 30 minutes simultaneously in the ear with tinnitus. Result: The perception of tinnitus was no longer present in 4 subjects while in remaining subjects it reduced to an intensity that its perception no longer troubled them without causing residual facilitation. In all subjects, the intensity of tinnitus decreased by an extent of 45 dB at an average. However, in few subjects, the intensity of tinnitus also decreased by more than 45 dB. The approach resulted in statistically significant reductions in Tinnitus Functional Index and Tinnitus Handicap Inventory scores. The results correlate with pre and post treatment score of Tinnitus Handicap Inventory that dropped from 90% to 0%. Discussion: Brain mapping(qEEG) Studies report that there is multiple parallel overlapping of neural subnetworks in the non-auditory areas of the brain which exhibits abnormal, constant and spontaneous neural activity involved in the perception of tinnitus with each subnetwork and area reflecting a specific aspect of tinnitus percept. The paper pen task and directive counseling are designed and delivered respectively in a way that is assumed to induce normal, rhythmically constant and premeditated neural activity and mask the abnormal, constant and spontaneous neural activity in the above-mentioned subnetworks and the specific non-auditory area. Counseling was focused on breaking the vicious cycle causing and maintaining the presence of tinnitus. Diverting auditory attention alone is insufficient to reduce the perception of tinnitus. Conscious awareness of tinnitus can be suppressed when individuals engage in cognitively demanding tasks of non-auditory nature as the paper pen task used in the present study. To carry out this task selective, divided, sustained, simultaneous and split attention act cumulatively. Bimanual paper pen task represents a top-down activity which underlies brain’s ability to selectively attend to the bimanual written activity as a relevant stimulus and to ignore tinnitus that is the irrelevant stimuli in the present study. Conclusion: The study suggests that this novel treatment approach is cost effective, time saving and efficient to vanish the tinnitus or to reduce the intensity of tinnitus to a negligible level and thereby eliminating the negative reactions towards tinnitus.Keywords: multi-modality brain stimulation, neural subnetworks, non-auditory areas, paper-pen task, top-down activity
Procedia PDF Downloads 147205 Sickle Cell Disease: Review of Managements in Pregnancy and the Outcome in Ampang Hospital, Selangor
Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan
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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.Keywords: anaemia, haemoglobinopathies, pregnancy, sickle cell disease
Procedia PDF Downloads 258204 Exclusive Breast Feeding Practices in Bangladesh
Authors: Md. Ashikur Rahman
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Optimal breastfeeding practice is essential to reducing childhood morbidity and mortality and helps to achieve Millennium Development Goal (MDG). A cross-sectional study was conducted in a rural area in Dhaka district to explore the barrier to optimal breastfeeding practices. The population of this study constitutes all nursing mothers having children aged 0-6 months, and they were selected purposively. The study adopted a structured and in-depth interview procedure consisting of open and closed-ended questions. Four hundred rural nursing mothers constituted the sample of the structured interview, while 15 were involved in the in-depth interview. Among the respondent's majority (67%) were in the age group 17-25 years, with a mean age of 24.44 years. Most (39.5%) of the mothers were housewives with a secondary level of education (46.5%). About 32% of mothers started breastfeeding within one hour after birth. But delayed initiation was reported in 31.5% of mothers, whereas 36.8% of mothers forgot the exact time of initiation of breastfeeding. The main reason not to practice colostrum was mothers tried to breastfeed, but there was no milk, stated 13.8% of mothers. In addition, about one-third (34.3%) of the respondents practiced pre-lacteal feeding, and among them, 12.8% introduced sugar with water. Reasons given by the mothers for bottle-feeding was that baby was not satisfied with breast milk only; 22.0% of mothers indicated this cause. The main influence to take formula milk by their mother and mothers-in-law was stated by 18.8% of mothers. Some mothers stated that major constraints to EBF were the perception of not having enough milk (25.5 %) and babies crying seems to be hungry (8.8%). One-third of the mothers (31.5%) felt uncomfortable during breastfeeding. Access to antenatal and postnatal counseling in the study area also was a key obstacle to optimal breastfeeding practices. In a qualitative survey, some mothers believed that there was no difference between breast milk and formula milk. Colostrum feeding, pre-lacteal feeding, early initiation of breastfeeding, and exclusive breastfeeding were strongly associated with family type, family member, birth order, religion, husbands' occupation, delivery attendants and delivery type, postnatal care, and health care facilities. To reduce the barriers to the successful practice of exclusive breastfeeding, there is a need for a grass-roots approach to educating and counseling nursing mothers with identifying factors influencing or discouraging the optimal practice.Keywords: exclusive, breast feeding, practices, Bangladesh
Procedia PDF Downloads 93203 Educational Psychologists in Instructional and Mentoring Contexts: The Significance of Multicultural Competence
Authors: Yassir Semmar
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During the past two decades, the topic of multicultural competence has gained much attention in the psychology field, most notably in the clinical and counseling specializations. While higher education institutions have been placing a premium on sensitizing their faculty, staff, and student bodies to various diversity and multicultural issues, little emphasis has been directed towards mandating multicultural training for graduate learners in the educational psychology specialty. Given the increasingly diverse student population, it is imperative for educational psychologists to become multiculturally competent particularly in instructional and mentoring contexts. Strategies and conditions for attaining multicultural competence are discussed.Keywords: multicultural competence, instruction, pedagogical practices, mentoring
Procedia PDF Downloads 442202 Effects of Group Cognitive Restructuring and Rational Emotive Behavioral Therapy on Psychological Distress of Awaiting-Trial Inmates in Correctional Centers in North-West, Nigeria
Authors: Muhammad Shafi’U Adamu
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This study examined the effects of two groups of Cognitive Behavioral Therapies (CBT) which, includes Cognitive Restructuring (CB) and Rational Emotive Behavioral Therapy (REBT), on the Psychological Distress of awaiting-trial Inmates in Correctional Centers in North-West Nigeria. The study had four specific objectives, four research questions, and four null hypotheses. The study used a quasi-experimental design that involved pre-test and post-test. The population comprised of all 7,962 awaiting-trial inmates in correctional centers in North-west Nigeria. 131 awaiting trial inmates from three intact Correctional Centers were randomly selected using the census technique. The respondents were sampled and randomly put into 3 groups (CR, REBT and Control). Kessler Psychological Distress Scale (K10) was adapted for data collection in the study. The instrument was validated by experts and subjected to a pilot study using Cronbach's Alpha with a reliability coefficient of 0.772. Each group received treatment for 8 consecutive weeks (60 minutes/week). Data collected from the field were subjected to descriptive statistics of mean, standard deviation and mean difference to answer the research questions. Inferential statistics of ANOVA and independent sample t-test were used to test the null hypotheses at P≤ 0.05 level of significance. Results in the study revealed that there was no significant difference among the pre-treatment mean scores of experimental and control groups. Statistical evidence also showed a significant difference among the mean scores of the three groups, and thus, results of the Post Hoc multiple-comparison test indicated the posttreatment reduction of psychological distress in the awaiting-trial inmates. Documented output also showed a significant difference between the post-treatment psychologically distressed mean scores of male and female awaiting-trial inmates, but there was no difference in those exposed to REBT. The research recommends that a standardized structured CBT counseling technique treatment should be designed for correctional centers across Nigeria, and CBT counseling techniques could be used in the treatment of PD in both correctional and clinical settings.Keywords: awaiting-trial inmates, cognitive restructuring, correctional centers, rational emotive behavioral therapy
Procedia PDF Downloads 75201 Diagnosis and Management of Obesity Among South Asians: A Paradigm
Authors: Deepa Vasudevan, Thomas Northrup, Angela Stotts, Michelle Klawans
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To date, we have conducted three studies on this subject. The research done to date is through three studies. The initial study was to document that modified criteria independently identified higher numbers of overweight/obese South Asian Indians. The second study was to document physician knowledge of appropriate diagnosis of obesity among South Asian Indians. The final study was an intervention to evaluate the efficacy of a training module on improving physician diagnosis and counseling of overweight/obese Asian patients.Keywords: South Asian Indians, obesity, physicians, BMI and waist circumference
Procedia PDF Downloads 407200 Environmental /Occupational Factors and Seasonality of Birth- Male Infertility
Authors: C. Lalitha, R. Sayee, D. Apoorva
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Reproductive failure or infertility may be due to several factors that are not limited to one sex. It remains a common problem causing significant psychological distress to those affected individuals and who are increasingly seeking medical advice. Male infertility means inability to induce conception in normal woman within a year. The etiological factors associated with male infertility are anatomical, developmental, seminal, hormonal, immunological and environmental factors. The paper was aimed to highlight the environmental factors and its association to male infertility and seasonality of birth and its influence. The data was collected from the 75 male patients referred with infertility for karyotyping and counseling. Their age ranged from 21 to 45 years. It is opined that certain occupations are preferentially associated with male infertility.Keywords: environmental, occupational, seasonal, male infertility
Procedia PDF Downloads 267199 Barriers and Facilitators of Community Based Mental Health Intervention (CMHI) in Rural Bangladesh: Findings from a Descriptive Study
Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Sazzad Chowdhury, Sadia Chowdhury
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Access to mental health services in Bangladesh is a tale of urban privilege and rural struggle. Mental health services in the country are primarily centered in urban medical hospitals, with only 260 psychiatrists for a population of more than 162 million, while rural populations face far more severe and daunting challenges. In alignment with the World Health Organization's perspective on mental health as a basic human right and a crucial component for personal, community, and socioeconomic development; SAJIDA Foundation a value driven non-government organization in Bangladesh has introduced a Community Based Mental Health (CMHI) program to fill critical gaps in mental health care, providing accessible and affordable community-based services to protect and promote mental health, offering support for those grappling with mental health conditions. The CMHI programme is being implemented in 3 districts in Bangladesh, 2 of them are remote and most climate vulnerable areas targeting total 6,797 individual. The intervention plan involves a screening of all participants using a 10-point vulnerability assessment tool to identify vulnerable individuals. The assumption underlying this is that individuals assessed as vulnerable is primarily due to biological, psychological, social and economic factors and they are at an increased risk of developing common mental health issues. Those identified as vulnerable with high risk and emergency conditions will receive Mental Health First Aid (MHFA) and undergo further screening with GHQ-12 to be identified as cases and non-cases. The identified cases are then referred to community lay counsellors with basic training and knowledge in providing 4-6 sessions on problem solving or behavior activation. In situations where no improvement occurs post lay counselling or for individuals with severe mental health conditions, a referral process will be initiated, directing individuals to ensure appropriate mental health care. In our presentation, it will present the findings from 6-month pilot implementation focusing on the community-based screening versus outcome of the lay counseling session and barriers and facilitators of implementing community based mental health care in a resource constraint country like Bangladesh.Keywords: community-based mental health, lay counseling, rural bangladesh, treatment gap
Procedia PDF Downloads 43198 Psychoeducation to Prevent Spread of HIV Among Men Who Have Sex with Men in Surabaya City
Authors: Christina Albertina Ludwinia Parung, I Gusti Ayu Maya Vratasti
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Sexual transmission of HIV among Men who have Sex with Men (MSM) is believed to be one of the sources of the AIDS epidemic. Nowadays, government, communities, and NGOs are taking action to prevent its spread by assisting and educating groups of MSM in their countries. This assistance involves experts in many fields of study, including psychology. In the field of psychology, psychoeducation is believed to be one of the ways to assist the MSM groups. Just like in other countries, this psychoeducation assistance is also needed in Indonesia, where MSM groups are found in many cities within. Surabaya, as the second largest and densely populated city in Indonesia, is known to have a big number of MSM population. In September to December 2020, the author and a colleague conducted a mentoring effort to the MSM community at the MSM community gathering location called Gang Pattaya, in the city of Surabaya. The existence of this community is disguised by the general public, but is well known by NGOs. Community members do MSM out of their liking, although some do it in exchange for money. However, safety factors, such as using condoms for MSM, are not a priority for this community. They do MSM whether they receive a reward or not, just out of a boost of pleasure. There is no attempt to find out the health of the partner once they are attracted to each other. In general, they do not know whether they are infected with HIV. Most of them feel healthy and since they do not show any symptoms, they think it is not necessary to get tested. In the mentoring process, the researchers conduct psychoeducation, which begins with an approach to certain individuals so that they are comfortable with the researchers’ presence, then increasing awareness of safe sex behavior for HIV prevention for groups in the form of counseling using the Theory of Reasoned Action (TRA) approach. Counseling is carried out in various forms including roleplay, games, and seminars. The number of participants was 11 people, varying from 19-47 years old. Pretest related to knowledge of safe sex was carried out before conducting the intervention and post-test after the intervention. The normality test used is the Shapiro-Wilk analysis. Different tests on the data obtained were carried out using the non-parametric Wilcoxon Signed Ranks Test. None of the participants had lower post-test knowledge scores than the pre-test. Prestest and post test for safer sex behavior showed 2 participants with safer sex behavior did not change. Both belong to the senior group, while other participants have an improvement in their safer sex behavior. These findings suggest that intervention programs for MSM as an effort to reduce HIV transmission should pay attention to affective and cognitive coping strategies.Keywords: HIV, men who have sex with men, psychoeducation, psychology health, safer sex behavior, theory of reasoned action
Procedia PDF Downloads 139197 Familiarity with Nursing and Description of Nurses Duties
Authors: Narges Solaymani
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medical training of patients. Nursing is a very important profession in the societies of the world. Although in the past, all caregivers of the sick and disabled were called nurses, nowadays, a nurse is a person who has a university education in this field. There are nurses in bachelor's, master's, and doctoral degrees in nursing. New courses have been launched in the master's degree based on duty-oriented nurses. A nurse cannot have an independent treatment center but is a member of the treatment team in established treatment centers such as hospitals, clinics, or offices. Nurses can establish counseling centers and provide nursing services at home. According to the standards, the number of nurses should be three times the number of doctors or twice the number of hospital beds, or there should be three nurses for every thousand people. Also, international standards show that in the internal and surgical department, every 4 to 6 patients should have a nurse.Keywords: Nurse, Intensive Care, CPR, Bandage
Procedia PDF Downloads 74196 The Impact of COVID-19 on Women’s Health in Bangladesh
Authors: Dil Ware Alam, Faiza Zebeen, Sumaya Binte Masud
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COVID-19) has impacted the whole world, including Bangladesh. The epidemic has reduced access to health care, particularly for women, creating challenges for an increasingly disadvantaged population. Women's health and well-being in Bangladesh are susceptible to a rise in domestic violence and need to be addressed quickly. The planet has been greatly influenced by Coronavirus disease 2019 (COVID-19), and Bangladesh is no difference. The pandemic has resulted in a decline in the availability of health care, notably for women's health problems, leading to an increase in difficulties for an increasingly marginalized group. Maternity care, maternal health programs, medical interventions, nutritional counseling and mental health care, are not discussed, and women's health and well-being in Bangladesh is vulnerable with a spike in domestic violence and needs to be resolved urgently.Keywords: Covid-19, mental health, reproductive health, Bangladesh
Procedia PDF Downloads 167195 The Relationship between Romantic Relationship Beliefs and Ego Identity Process
Authors: Betül Demirbağ, Nesrin Demir
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As a developmental period, early adulthood has a vital role in romantic relationships in young adult's life. lt's known that in this period, satisfaction of individual needs such as affiliation is essential for well-functioning and to be succeeded in sequent developmental task. Romantic relationships have an expected association with attachment style. But it's needed to get more information about indicators of romantic relationships in different cultural backgrounds. in this research it's aimed to investigate whether there is a relationship between romantic relationship beliefs and Ego identity status and also other possible indicators such as gender, age, socioeconomic status. Participants were undergraduate students training in various programs in Education Faculty in Adiyaman University. As data collection tool, Romantic Relationship Beliefs scale and Ego Identity Process Questionnaire which was adapted into Turkish were used. Results were discussed in the relevant literature.Keywords: ego identity, romantic relationships, university counseling
Procedia PDF Downloads 559194 Using Dynamic Bayesian Networks to Characterize and Predict Job Placement
Authors: Xupin Zhang, Maria Caterina Bramati, Enrest Fokoue
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Understanding the career placement of graduates from the university is crucial for both the qualities of education and ultimate satisfaction of students. In this research, we adapt the capabilities of dynamic Bayesian networks to characterize and predict students’ job placement using data from various universities. We also provide elements of the estimation of the indicator (score) of the strength of the network. The research focuses on overall findings as well as specific student groups including international and STEM students and their insight on the career path and what changes need to be made. The derived Bayesian network has the potential to be used as a tool for simulating the career path for students and ultimately helps universities in both academic advising and career counseling.Keywords: dynamic bayesian networks, indicator estimation, job placement, social networks
Procedia PDF Downloads 379193 Buddhist Cognitive Behavioral Therapy to Address Depression Among Elderly Population: Multi-cultural Model of Buddhist Based Cognitive Behavioral Therapy to Address Depression Among Elderly Population
Authors: Ashoke Priyadarshana Premananda
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As per the suggestions of previously conducted research in Counseling Psychology, the necessity of forming culture- friendly approaches has been strongly emphasized by a number of scholars in the field. In response to that, Multicultural-model of Buddhist Based Cognitive Behavioral Therapy (MMBCBT) has been formed as a culture-friendly therapeutic approach to address psychological disturbances (depression) in late adulthood. Elderly population in the world is on the rise by leaps and bounds, and forming a culture-based therapeutic model which is blended with Buddhist teachings has been the major objective of the study. Buddhist teachings and cultural applications, which were mapped onto Cognitive Behavioral Therapy (CBT) in the West, ultimately resulted in MMBCBT. Therefore, MMBCBT is a blend of cultural therapeutic techniques and the essence of certain Buddhist teachings extracted from five crucial suttas, which include CBT principles. In the process of mapping, MeghiyaSutta, GirimānandaSutta, SallekhaSutta, DvedhāvitakkaSutta, and Vitakka- SaṇṭhānaSutta have been taken into consideration mainly because of their cognitive behavioral content. The practical components of Vitakka- Saṇṭhānasutta (Aññanimittapabbaṃ) and Sallekhasutta (SallekhaPariyāya and CittuppādaPariyāya) have been used in the model while mindfulness of breathing was also carried out with the participants. Basically, multi-cultural therapeutic approaches of MMBCBT aim at modifying behavior (behavioral modification), whereas the rest is centered to the cognitive restructuring process. Therefore, MMBCBT is endowed with Behavioral Therapy (BT) and Cognitive Therapy(CT). In order to find out the validation of MMBCBT as a newly formed approach, it was then followed by mixed research (quantitative and qualitative research) with a sample selected from the elderly population following the purposive sampling technique. 40 individuals were selected from three elderly homes as per the purposive sampling technique. Elderly people identified to be depressed via Geriatric Depression Scale underwent MMBCBT for two weeks continuously while action research was being conducted simultaneously. Additionally, a Focus Group interview was carried out to support the action research. As per the research findings, people who identified depressed prior to the exposure to MMBCBT were found to be showing positive changes after they were exposed to the model. “Paired Sample t test” showed that the Multicultural Model of Buddhist based Cognitive Behavioral Therapy reduced depression of elderly people (The mean value (x̄) of the sample (level of depression) before the model was 10.7 whereas the mean value after the model was 7.5.). Most importantly, MMBCBT has been found to be effectively used with people from all walks of life despite religious diversities.Keywords: buddhist psychotherapy, cognitive behavioral therapy in buddhism, counseling in cultural context, gerontology, and buddhism
Procedia PDF Downloads 108192 Level of Awareness of Genetic Counselling in Benue State Nigeria: Its Advocacy on the Inheritance of Sickle Cell Disease
Authors: Agi Sunday
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A descriptive analysis of reported cases of sickle cell disease and the level of awareness about genetic counselling in 30 hospitals were carried out. Additionally, 150 individuals between ages 16-45 were randomly selected for evaluation of genetic counselling awareness. The main tools for this study were questionnaires which were taken to hospitals, and individuals completed the others. The numbers of reported cases of sickle cell disease recorded in private, public and teaching hospitals were 14 and 57; 143 and 89; 272 and 57 for the periods of 1995-2000 and 2001-2005, respectively. A general informal genetic counselling took place mostly in the hospitals visited. 122 (86%) individuals had the knowledge of genetic disease and only 43 (30.3%) individuals have been exposed to genetic counselling. 64% of individuals agreed that genetic counselling would help in the prevention of genetic disease.Keywords: sickle disease, genetic counseling, genetic testing, advocacy
Procedia PDF Downloads 389191 The Most Effective Interventions to Prevent Childhood Obesity
Authors: Sarah-Anne Schumann, Chintan Shah, Sandeep Ponniah, Syeachia Dennis
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Effective interventions to prevent childhood obesity include limiting sugar-sweetened beverage intake (SOR: B, longitudinal study), school and home based strategies to reduce total screen time and increase physical activity, behavioral and dietary counseling, and support for parents and families (SOR: A, meta-analysis of randomized and non-randomized controlled trials). Risk factors for childhood obesity include maternal pre-pregnancy weight, high infant birth weight, early infant rapid weight gain and maternal smoking during pregnancy which may provide opportunities to intervene and prevent childhood obesity (SOR: B, meta-analysis of observational studies).Keywords: childhood, obesity, prevent obesity, interventions to prevent obesity
Procedia PDF Downloads 445190 From Stigma to Solutions: Harnessing Innovation and Local Wisdom to Tackle Harms Associated with Menstrual Seclusion (Chhaupadi) in Nepal
Authors: Sara E. Baumann, Megan A. Rabin, Mary Hawk, Bhimsen Devkota, Kajol Upadhyaya, Guna Raj Shrestha, Brigit Joseph, Annika Agarwal, Jessica G. Burke
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In Nepal, prevailing sociocultural norms associated with menstruation prompt adherence to stringent rules that limit participation in daily activities. Chhaupadi is a specific menstrual tradition in Nepal in which women and girls segregate themselves and follow a series of restrictions during menstruation. Despite having numerous physical and mental health implications, extant interventions have yet to sustainably address the harms associated with chhaupadi. In this study, the authors describe insights garnered from a collaboration with community members in Dailekh district, who formulated their own approaches to mitigate the adverse facets of chhaupadi. Envisaged as an entry point to improve women’s menstrual health experiences, this investigation employed an approach that uses Human-centered Design and a community-engaged approach. The authors conducted a four-day design workshop which unfolded in two phases: The Discovery Phase, to uncover chhaupadi context and key stakeholders, and the Design Phase, to design contextually relevant interventions. Diverse community-members, including those with lived experience practicing chhaupadi, developed five intervention concepts: 1) harnessing Female Community Health Volunteers as role models, for counseling, and raising awareness; 2) focusing on mothers and mother’s groups to instigate behavioral shifts; 3) engaging the broader community in behavior change efforts; 4) empowering fathers to effect change in their homes through counseling and education; and 5) training and emboldening youth to advocate for positive change through advocacy in their schools and homes. This research underscores the importance of employing multi-level approaches tailored to specific stakeholder groups, given Nepal’s rich cultural diversity. The engagement of Female Community Health Volunteers emerged as a promising yet underexplored intervention concept for chhaupadi, warranting broader implementation. Crucially, it is also imperative for interventions to prioritize tackling deleterious aspects of the chhaupadi tradition, emphasizing safety considerations, all while acknowledging chhaupadi’s entrenched cultural history; for some, there are positive aspects of the tradition that women and girls wish to preserve.Keywords: human-centered design, menstrual health, Nepal, community-engagement, intervention development, women's health, rural health
Procedia PDF Downloads 62189 A Mixed-Method Study Exploring Expressive Writing as a Brief Intervention Targeting Mental Health and Wellbeing in Higher Education Students: A Focus on the Qualitative Findings
Authors: Deborah Bailey-Rodriguez, Maria Paula Valdivieso Rueda, Gemma Reynolds
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In recent years, the mental health of Higher Education (HE) students has been a growing concern. This has been further exacerbated by the stresses associated with the Covid-19 pandemic, placing students at even greater risk of developing mental health issues. Support available to students in HE tends to follow an established and traditional route. The demands for counseling services have grown, not only with the increase in student numbers but with the number of students seeking support for mental health issues, with 94% of HE institutions recently reporting an increase in the need for counseling services. One way of improving the well-being and mental health of HE students is through the use of brief interventions, such as expressive writing (EW). This intervention involves encouraging individuals to write continuously for at least 15-20 minutes for three to five sessions (often on consecutive days) about their deepest thoughts and feelings to explore significant personal experiences in a meaningful way. Given the brevity, simplicity and cost-effectiveness of EW, this intervention has considerable potential as an intervention for HE populations. The current study, therefore, employed a mixed-methods design to explore the effectiveness of EW in reducing anxiety, general stress, academic stress and depression in HE students while improving well-being. HE students at MDX were randomly assigned to one of three conditions: (1) The UniExp-EW group was required to write about their emotions and thoughts about any stressors they have faced that are directly relevant to their university experience (2) The NonUniExp-EW group was required to write about their emotions and thoughts about any stressors that are NOT directly relevant to their university experience, and (3) The Control group were required to write about how they spent their weekend, with no reference to thoughts or emotions, and without thinking about university. Participants were required to carry out the EW intervention for 15 minutes per day for four consecutive days. Baseline mental health and well-being measures were taken before the intervention via a battery of standardized questionnaires. Following completion of the intervention on day four, participants were required to complete the questionnaires a second time and again one week later. Participants were also invited to attend focus groups to discuss their experience of the intervention. This will allow an in-depth investigation into students’ perceptions of EW as an effective intervention to determine whether they would choose to use this intervention in the future. Preliminary findings will be discussed at the conference as well as a discussion of the important implications of the findings. The study is fundamental because if EW is an effective intervention for improving mental health and well-being in HE students, its brevity and simplicity mean it can be easily implemented and can be freely available to students. Improving the mental health and well-being of HE students can have knock-on implications for improving academic skills and career development.Keywords: expressive writing, higher education, psychology in education, mixed-methods, mental health, academic stress
Procedia PDF Downloads 69188 Rapid Situation Assessment of Family Planning in Pakistan: Exploring Barriers and Realizing Opportunities
Authors: Waqas Abrar
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Background: Pakistan is confronted with a formidable challenge to increase uptake of modern contraceptive methods. USAID, through its flagship Maternal and Child Survival Program (MCSP), in Pakistan is determined to support provincial Departments of Health and Population Welfare to increase the country's contraceptive prevalence rates (CPR) in Sindh, Punjab and Balochistan to achieve FP2020 goals. To inform program design and planning, a Rapid Situation Assessment (RSA) of family planning was carried out in Rawalpindi and Lahore districts in Punjab and Karachi district in Sindh. Methodology: The methodology consisted of comprehensive desk review of available literature and used a qualitative approach comprising of in-depth interviews (IDIs) and focus group discussions (FGDs). FGDs were conducted with community women, men, and mothers-in-law whereas IDIs were conducted with health facility in-charges/chiefs, healthcare providers, and community health workers. Results: Some of the oft-quoted reasons captured during desk review included poor quality of care at public sector facilities, affordability and accessibility in rural communities and providers' technical incompetence. Moreover, providers had inadequate knowledge of contraceptive methods and lacked counseling techniques; thereby, leading to dissatisfied clients and hence, discontinuation of contraceptive methods. These dissatisfied clients spread the myths and misconceptions about contraceptives in their respective communities which seriously damages community-level family planning efforts. Private providers were found reluctant to insert Intrauterine Contraceptive Devices (IUCDs) due to inadequate knowledge vis-à-vis post insertion issues/side effects. FGDs and IDIs unveiled multi-faceted reasons for poor contraceptives uptake. It was found that low education and socio-economic levels lead to low contraceptives uptake and mostly uneducated women rely on condoms provided by Lady Health Workers (LHWs). Providers had little or no knowledge about postpartum family planning or lactational amenorrhea. At community level family planning counseling sessions organized by LHWs and Male Mobilizers do not sensitize community men on permissibility of contraception in Islam. Many women attributed their physical ailments to the use of contraceptives. Lack of in-service training, job-aids and Information, Education and Communications (IEC) materials at facilities seriously comprise the quality of care in effective family planning service delivery. This is further compounded by frequent stock-outs of contraceptives at public healthcare facilities, poor data quality, false reporting, lack of data verification systems and follow-up. Conclusions: Some key conclusions from this assessment included capacity building of healthcare providers on long acting reversible contraceptives (LARCs) which give women contraception for a longer period. Secondly, capacity building of healthcare providers on postpartum family planning is an enormous challenge that can be best addressed through institutionalization. Thirdly, Providers should be equipped with counseling skills and techniques including inculcation of pros and cons of all contraceptive methods. Fourthly, printed materials such as job-aids and Information, Education and Communications (IEC) materials should be disseminated among healthcare providers and clients. These concluding statements helped MCSP to make informed decisions with regard to setting broad objectives of project and were duly approved by USAID.Keywords: capacity building, contraceptive prevalence rate, family planning, Institutionalization, Pakistan, postpartum care, postpartum family planning services
Procedia PDF Downloads 153187 Working Effectively with Muslim Communities in the West
Authors: Lisa Tribuzio
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This paper explores the complexity of working with Muslim communities in Australia. It will draw upon the notions of belonging, social inclusion and effective community programming to engage Muslim communities in Western environments given the current global political climate. Factors taken into consideration for effective engagement include: family engagement, considering key practices such as Ramadan, fasting and prayer and food requirements, gender relations, core values around faith and spirituality, considering attitudes towards self disclosure in a counseling setting and the notion of Us and Them in the media and systems and its effect on minority communities. It will explore recent research in the field from Australian researchers as well as recommendations from United Nations in working with Muslim communities. It will also explore current practice models applied in Australia in engaging effectively with diverse communities and addressing racism and discrimination in innovative ways.Keywords: Muslim, cultural diversity, social inclusion, racism
Procedia PDF Downloads 420186 The Development of the Self-concept Scale for Elders in Taiwan
Authors: Ting-Chia Lien, Tzu-Yin Yen, Szu-Fan Chen, Tai-chun Kuo, Hung-Tse Lin, Yi-Chen Chung, Hock-Sen Gwee
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The purpose of this study was to explore the result of the survey by developing “Self-Concept Scale for Elders”, which could provide community counseling and guidance institution for practical application. The sample of this study consisted of 332 elders in Taiwan (male: 33.4%; female: 66.6%). The mean age of participants was 65-98 years. The measurements applied in this study is “Self-Concept Scale for Elders”. After item and factor analyses, the preliminary version of the Self-Concept Scale for Elders was revised to the final version. The results were summarized as follows: 1) There were 10 items in Self-Concept Scale for Elders. 2) The variance explained for the scale accounted for 77.15%, with corrected item-total correlations Cronbach’s alpha=0.87. 3) The content validity, criterion validity and construct validity have been found to be satisfactory. Based on the findings, the implication and suggestions are offered for reference regarding counselor education and future research.Keywords: self-concept, elder, development scale, applied psychology
Procedia PDF Downloads 570185 Effect of Timing and Contributing Factors for Early Language Intervention in Toddlers with Repaired Cleft Lip and Palate
Authors: Pushpavathi M., Kavya V., Akshatha V.
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Introduction: Cleft lip and palate (CLP) is a congenital condition which hinders effectual communication due to associated speech and language difficulties. Expressive language delay (ELD) is a feature seen in this population which is influenced by factors such as type and severity of CLP, age at surgical and linguistic intervention and also the type and intensity of speech and language therapy (SLT). Since CLP is the most common congenital abnormality seen in Indian children, early intervention is a necessity which plays a critical role in enhancing their speech and language skills. The interaction between the timing of intervention and factors which contribute to effective intervention by caregivers is an area which needs to be explored. Objectives: The present study attempts to determine the effect of timing of intervention on the contributing maternal factors for effective linguistic intervention in toddlers with repaired CLP with respect to the awareness, home training patterns, speech and non-speech behaviors of the mothers. Participants: Thirty six toddlers in the age range of 1 to 4 years diagnosed as ELD secondary to repaired CLP, along with their mothers served as participants. Group I (Early Intervention Group, EIG) included 19 mother-child pairs who came to seek SLT soon after corrective surgery and group II (Delayed Intervention Group, DIG) included 16 mother-child pairs who received SLT after the age of 3 years. Further, the groups were divided into group A, and group B. Group ‘A’ received SLT for 60 sessions by Speech Language Pathologist (SLP), while Group B received SLT for 30 sessions by SLP and 30 sessions only by mother without supervision of SLP. Method: The mothers were enrolled for the Early Language Intervention Program and following this, their awareness about CLP was assessed through the Parental awareness questionnaire. The quality of home training was assessed through Mohite’s Inventory. Subsequently, the speech and non-speech behaviors of the mothers were assessed using a Mother’s behavioral checklist. Detailed counseling and orientation was done to the mothers, and SLT was initiated for toddlers. After 60 sessions of intensive SLT, the questionnaire and checklists were re-administered to find out the changes in scores between the pre- and posttest measurements. Results: The scores obtained under different domains in the awareness questionnaire, Mohite’s inventory and Mothers behavior checklist were tabulated and subjected to statistical analysis. Since the data did not follow normal distribution (i.e. p > 0.05), Mann-Whitney U test was conducted which revealed that there was no significant difference between groups I and II as well as groups A and B. Further, Wilcoxon Signed Rank test revealed that mothers had better awareness regarding issues related to CLP and improved home-training abilities post-orientation (p ≤ 0.05). A statistically significant difference was also noted for speech and non-speech behaviors of the mothers (p ≤ 0.05). Conclusions: Extensive orientation and counseling helped mothers of both EI and DI groups to improve their knowledge about CLP. Intensive SLT using focused stimulation and a parent-implemented approach enabled them to carry out the intervention in an effectual manner.Keywords: awareness, cleft lip and palate, early language intervention program, home training, orientation, timing of intervention
Procedia PDF Downloads 122184 Familiarity with Nursing and Description of Nurses Duties
Authors: Narges Solaymani
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Definition of Nurse: Nurse: A person who is educated and skilled in the field of scientific principles and professional skills of health care, treatment, and medical training of patients. Nursing is a very important profession in the societies of the world. Although in the past, all caregivers of the sick and disabled were called nurses, nowadays, a nurse is a person who has a university education in this field. There are nurses in bachelor's, master's, and doctoral degrees in nursing. New courses have been launched in the master's degree based on duty-oriented nurses. A nurse cannot have an independent treatment center but is a member of the treatment team in established treatment centers such as hospitals, clinics, or offices. Nurses can establish counseling centers and provide nursing services at home. According to the standards, the number of nurses should be three times the number of doctors or twice the number of hospital beds, or there should be three nurses for every thousand people. Also, international standards show that in the internal and surgical department, every 4 to 6 patients should have a nurse.Keywords: nurse, intensive care, CPR, bandage
Procedia PDF Downloads 68183 Nutrition Support Practices and Nutritional Status of Adolescents Receiving Antiretroviral Therapy in Selected Hospitals in Ethiopia
Authors: Meless Gebrie Bore, Lin Perry, Xiaoyue Xu, Andargachew Kassa, Marilyn Cruickshank
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Background: Adolescents living with HIV (ALHIV) in Ethiopia face significant health challenges, particularly related to nutrition, which is essential for optimizing antiretroviral therapy (ART) outcomes. This population is vulnerable to nutritional deficiencies due to increased energy demands and the adverse effects of HIV, alongside rapid growth and low socio-economic status. Despite advances in ART, research on nutritional care for ALHIV in Ethiopia is limited. Integrated nutritional interventions are critical for improving health outcomes, yet comprehensive guidance is lacking. This study aimed to evaluate healthcare workers' practices in ART clinics, assess the nutritional status of ALHIV, and provide recommendations for enhancing nutritional care. Method: Cross-sectional surveys were conducted, recruiting 44 healthcare professionals and 384 ALHIV across ten public hospitals in Addis Ababa and Oromia regions. Participants were selected using purposive sampling for healthcare workers and proportionate random sampling for ALHIV engaged in ART services. Data was collected using a pre-tested structured questionnaire with quantitative and qualitative components facilitated by trained healthcare workers through the Kobo Toolbox program. Results: Findings revealed that while most healthcare workers conducted basic nutritional assessments, more sensitive methods were rarely used. Only 36.4% assessed dietary intake and 27.3% evaluated food security. Nutrition counseling was limited, with only 38.6% providing such services regularly. Health Care worker participants expressed dissatisfaction with the integration of nutrition services due to a lack of training and resources. Nutritional assessments revealed that 24.2% of ALHIV were classified as thin, 21.7% as stunted, and 34.9% as malnourished based on mid-upper arm circumference, with 19.4% experiencing severe acute malnutrition. These results highlight the urgent need and opportunities to improve nutritional support tailored to ALHIV-specific needs. Conclusion and Recommendations: Study findings identified evidence of substantial nutritional deficits and critical gaps in nutritional care for ALHIV in Ethiopian ART clinics. While basic assessment and counseling were generally practiced, limited use of more sensitive methods and inadequate integration of nutrition services hindered care effectiveness. To improve health outcomes, it is essential to enhance training for healthcare workers, develop standardized nutrition guidelines, and allocate resources effectively. Conducting further research with large, diverse samples and integrating comprehensive nutritional care alongside ART services will enable better matching of the nutritional needs of this vulnerable population.Keywords: adolescents living with HIV(ALHIV), antiretroviral therapy (ART), HIV, Ethiopia, malnutrition, nutritional support, stunting, thinness
Procedia PDF Downloads 10182 A Study on How Newlyweds Handle the Difference with Parents on Wedding Arrangements and Its Implication for Services in Hong Kong
Authors: K. M. Yuen
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This research examined the literature review of wedding preparation’s challenges and its developmental tasks of family transition under family life cycle. Five interviewees were invited to share their experiences on the differences with their parents in regard to wedding preparations and coping strategies. Some coping strategies and processes were highlighted for facilitating the family to achieve the developmental tasks during the wedding preparation. However, those coping strategies and processes may only act as the step and the behavior, while “concern towards parents” was found to be the essential element behind these behaviors. In addition to pre-marital counseling, a developmental group was suggested to develop under the framework of family life cycle and its related coping strategies on working with the newlyweds who encountered intergenerational differences in regard to their wedding preparations.Keywords: wedding preparation, difference, parents, family life cycle, developmental tasks, coping strategies, process
Procedia PDF Downloads 339181 An eHealth Intervention Using Accelerometer- Smart Phone-App Technology to Promote Physical Activity and Health among Employees in a Military Setting
Authors: Emilia Pietiläinen, Heikki Kyröläinen, Tommi Vasankari, Matti Santtila, Tiina Luukkaala, Kai Parkkola
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Working in the military sets special demands on physical fitness, however, reduced physical activity levels among employees in the Finnish Defence Forces (FDF), a trend also being seen among the working-age population in Finland, is leading to reduced physical fitness levels and increased risk of cardiovascular and metabolic diseases, something which also increases human resource costs. Therefore, the aim of the present study was to develop an eHealth intervention using accelerometer- smartphone app feedback technique, telephone counseling and physical activity recordings to increase physical activity of the personnel and thereby improve their health. Specific aims were to reduce stress, improve quality of sleep and mental and physical performance, ability to work and reduce sick leave absences. Employees from six military brigades around Finland were invited to participate in the study, and finally, 260 voluntary participants were included (66 women, 194 men). The participants were randomized into intervention (156) and control groups (104). The eHealth intervention group used accelerometers measuring daily physical activity and duration and quality of sleep for six months. The accelerometers transmitted the data to smartphone apps while giving feedback about daily physical activity and sleep. The intervention group participants were also encouraged to exercise for two hours a week during working hours, a benefit that was already offered to employees following existing FDF guidelines. To separate the exercise done during working hours from the accelerometer data, the intervention group marked this exercise into an exercise diary. The intervention group also participated in telephone counseling about their physical activity. On the other hand, the control group participants continued with their normal exercise routine without the accelerometer and feedback. They could utilize the benefit of being able to exercise during working hours, but they were not separately encouraged for it, nor was the exercise diary used. The participants were measured at baseline, after the entire intervention period, and six months after the end of the entire intervention. The measurements included accelerometer recordings, biochemical laboratory tests, body composition measurements, physical fitness tests, and a wide questionnaire focusing on sociodemographic factors, physical activity and health. In terms of results, the primary indicators of effectiveness are increased physical activity and fitness, improved health status, and reduced sick leave absences. The evaluation of the present scientific reach is based on the data collected during the baseline measurements. Maintenance of the studied outcomes is assessed by comparing the results of the control group measured at the baseline and a year follow-up. Results of the study are not yet available but will be presented at the conference. The present findings will help to develop an easy and cost-effective model to support the health and working capability of employees in the military and other workplaces.Keywords: accelerometer, health, mobile applications, physical activity, physical performance
Procedia PDF Downloads 196180 Quality of Life of Mothers of Adolescents with Attention-Deficit/Hyperactivity Disorder Based on Lazarus-Folkman's Coping
Authors: Simin Hosseinian, Roghieh Nooripour
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Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a major neuropsychiatric disorder diagnosis in children, adolescents. This study was aimed to investigate the quality of life of mothers of adolescents with ADHD based on Lazarus-Folkman's coping. Method: Due to this purpose, 120 mothers were selected with convenience sampling method that referred to counseling centers with their adolescents with ADHD for treatment of their adolescents and then they completed Iranian Quality of Life Questionnaire and The Ways of Coping Questionnaire (WCQ). Data were analyzed by the Pearson correlation and stepwise regression methods with SPSS-19. Results: The result showed that there was a positive significant relationship between quality of life and self-controlling and also a negative relationship between quality of life and accepting responsibility (p < 0.05). Conclusion: According to these findings, we can suggest suitable intervention for mothers who have adolescents with ADHD and enhance their quality of life.Keywords: ADHD, mother, adolescent, quality of life, Lazarus-Folkman
Procedia PDF Downloads 175179 The Prevalence of X-Chromosome Aneuploidy in Recurrent Pregnancy Loss
Authors: Rim Frikha, Nouha Bouayed, Afifa Sellami, Nozha Chakroun, Salima Douad, Leila Keskes, Tarek Rebai
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Recurrent pregnancy loss (RPL), classically defined as the occurrence of two or more failed pregnancies, is a serious reproductive problem, in which, chromosomal rearrangements in either carrier are a major cause; mainly the chromosome aneuploidy. This study was conducted to determine the frequency and contribution of X-chromosome aneuploidy in recurrent pregnancy loss. A retrospective study was carried out among 100 couples with more than 2 miscarriages, referred to our genetic counseling. In all the cases the detailed reproductive histories were taken. Chromosomal analysis was performed using RHG banding in peripheral blood. Of a total of 100 couples; 3 patients with a detected X-chromosome aneuploidy were identified with an overall frequency of 3%. Chromosome abnormalities are as below: a Turner syndrome with 45, X/46, XX mosaicism, a 47, XXX, and a Klinefelter syndrome with 46, XY/47, XXY. These data show a high incidence of X-chromosome aneuploidy; mainly with mosaicism; in RPL. Thus, couples with such chromosomal abnormality should be referred to a clinical geneticist with whom the option of pre-implantation genetic diagnosis in subsequent pregnancy should be discussed.Keywords: aneuploidy, genetic testing, recurrent pregnancy loss, X-chromosome
Procedia PDF Downloads 360178 Family Functionality in Mexican Children with Congenital and Non-Congenital Deafness
Authors: D. Estrella, A. Silva, R. Zapata, H. Rubio
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A total of 100 primary caregivers (mothers, fathers, grandparents) with at least one child or grandchild with a diagnosis of congenital bilateral profound deafness were assessed in order to evaluate the functionality of families with a deaf member, who was evaluated by specialists in audiology, molecular biology, genetics and psychology. After confirmation of the clinical diagnosis, DNA from the patients and parents were analyzed in search of the 35delG deletion of the GJB2 gene to determine who possessed the mutation. All primary caregivers were provided psychological support, regardless of whether or not they had the mutation, and prior and subsequent, the family APGAR test was applied. All parents, grandparents were informed of the results of the genetic analysis during the psychological intervention. The family APGAR, after psychological and genetic counseling, showed that 14% perceived their families as functional, 62% moderately functional and 24% dysfunctional. This shows the importance of psychological support in family functionality that has a direct impact on the quality of life of these families.Keywords: deafness, psychological support, family, adaptation to disability
Procedia PDF Downloads 424177 FMR1 Gene Carrier Screening for Premature Ovarian Insufficiency in Females: An Indian Scenario
Authors: Sarita Agarwal, Deepika Delsa Dean
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Like the task of transferring photo images to artistic images, image-to-image translation aims to translate the data to the imitated data which belongs to the target domain. Neural Style Transfer and CycleGAN are two well-known deep learning architectures used for photo image-to-art image transfer. However, studies involving these two models concentrate on one-to-one domain translation, not one-to-multi domains translation. Our study tries to investigate deep learning architectures, which can be controlled to yield multiple artistic style translation only by adding a conditional vector. We have expanded CycleGAN and constructed Conditional CycleGAN for 5 kinds of categories translation. Our study found that the architecture inserting conditional vector into the middle layer of the Generator could output multiple artistic images.Keywords: genetic counseling, FMR1 gene, fragile x-associated primary ovarian insufficiency, premutation
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