Search results for: inclusive health care

Authors: Y. N. Shashidhara, B. S. Shakuntala

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Introduction: Nursing practice is undergoing tremendous changes and challenges. In order to meet social challenges and needs, nursing practice must be research based. Research is needed to evaluate the effectiveness of nursing treatment modalities, to determine the impact of nursing care on the health of the patients or to test the theory of nursing practice. Objective of the study to explore the attitude of staff nurses on Nursing research and its utilization Methodology: The descriptive study design was adopted and 300 staff nurses were selected by systematic random sampling technique from eight hospitals. The attitude on nursing research was assessed by validated and reliable self-administered attitude scale which consists of 40 items. Results: The overall attitude mean score 130.2 (SD 11.5) regarding attitude on Nursing research and its utilization. Some of the findings are the majority of staff nurses (51% agreed and 18.3% strongly agreed) that they have all the motivation to use research findings if they get support. Nearly 25.3 percent of staff nurses agreed and 10.7 percent strongly agreed that they do not have time to conduct research. The majority of staff nurses 53.7 percent agreed that research will help in updating Nursing profession. Nearly 32.6 percent of staff nurses agreed and 20.5 percent strongly agreed that being able to use will make them better nurses. About 45.3 percent and 17.3 percent agreed and strongly agreed that knowledge gained through experience is more useful than research. Most (40%) of nurses agreed that thy do not have the authority to change the patient care practice. The majority of staff nurses (45.7 percent agreed and 13 percent strongly agreed) feel the research will consume their personal time. Majority, 50 percent of staff nurses agreed and 16.7 percent strongly agreed that to conduct and utilize research findings requires financial support. Majority 50 percent of staff nurses agreed and 12 percent strongly agreed that physicians will cooperate and value nursing research findings. Majority 67.3 percent of staff nurses had moderate positive and 32.7 percent of staff nurses had highly positive attitude towards Nursing research and its utilization. Conclusion: With this study we understanding that, the staff nurses have positive attitude regarding nursing research. If the nurses are supported and motivated for research utilization we can improve the patient care.

Keywords: nurses, attitude, nursing research, research utilization

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Authors: Joanna Bielecka-Prus

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In the view of increasing number of labour migrations associated with broadly understood economic crisis, many families experience migration separation. Currently, in the era of globalization, migration movements include an increasing number of families, more and more frequently a new type of family, a transnational family. Accordingly, the functions of the family, family practice of care, and the relationships between members of the group change especially in the case of female migration. Sociologists highlight the emotional aspects of migrants’ family lives: managing emotions, coping with guilt, loneliness and rejection. Not without significance is the fact that today's public discourse often represents migrant women in a negative light. On the one hand, consumption and expanding material resources are assessed positively, on the other hand, deficits emotional and devastation of family life in the transnational families appear. Opinions expressed by different environments: the media, the political environment, etc. do not always take into account the context of mobility and their different effects on family life. The paper will present the analysis of qualitative studies of Polish female migrants’ families left-behind (children, parents, caregivers N = 100) and their coping strategies in different situations in the event of migration separation. The main area of care deficit will be defined and it will be showed who and how help to solve the problems.

Keywords: care, children left behind, female migration, parents left behind

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Authors: Jesus D. Cortes Gil, Fernanda Ewerling, Leonardo Ferreira, Aluisio J. D. Barros

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Background: The sustainable development goals call for inclusive, equitable, and quality learning opportunities for all. This is especially important for children, to ensure they all develop to their full potential. We studied the prevalence and inequalities of suspected delay in child development in 63 low- and middle-income countries. Methods and Findings: We used the early child development module from national health surveys, which covers four developmental domains (physical, social-emotional, learning, literacy-numeracy) and provides a combined indicator (early child development index, ECDI) of whether children are on track. We calculated the age-adjusted prevalence of suspected delay at the country level and stratifying by wealth, urban/rural residence, sex of the child, and maternal education. We also calculated measures of absolute and relative inequality. We studied 330.613 children from 63 countries. The prevalence of suspected delay for the ECDI ranged from 3% in Barbados to 67% in Chad. For all countries together, 25% of the children were suspected of developmental delay. At regional level, the prevalence of delay ranged from 10% in Europe and Central Asia to 42% in West and Central Africa. The literacy-numeracy domain was by far the most challenging, with the highest proportions of delay. We observed very large inequalities, and most markedly for the literacy-numeracy domain. Conclusions: To date, our study presents the most comprehensive analysis of child development using an instrument especially developed for national health surveys. With a quarter of the children globally suspected of developmental delay, we face an immense challenge. The multifactorial aspect of early child development and the large gaps we found only add to the challenge of not leaving these children behind.

Keywords: child development, inequalities, global health, equity

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Authors: Muhammad Adamu Kwankwaso

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Early childhood is a critical period of rapid physical, cognitive and psycho-social development of a child. The quality of care and Education which a child receives at this crucial age will determine to a great extent the level of his/her physical and cognitive development in the future. In Nigeria, Early Childhood Care and Education (ECCE) is a fundamental aspect or form of Education for children between the age of 3-6. It was started after independence as pre-primary Education or early child development as contained in the 1977 National Policy on Education. The trends towards ECCE in Nigeria and the northwestern part of the country in particular keep up changing as in the case of other part of the world. The current trends are now towards expansions, inclusiveness, redefinition, early literacy, increased government participation and the unprecedented societal response and awareness towards the Education of the younger children. While all hands are on deck to ensure successful implementation of the ECCE programme, it is unfortunate that, ECCE is facing some challenges. This paper therefore, examines the trends in Early Childhood Care and Education and the major challenges in the north west of Nigeria. Some of the major challenges include, inadequate trained ECCE teachers, lack of unified curriculum, teacher pupil’s ratio, and the medium of instructions and inadequate infrastructural and teaching facilities respectively. To improve the situation the paper offered the following recommendations; establishment of more ECCE classes, enforcement for the use of mothers’ tongue or the languages of the immediate community as a medium of instructions, and adequate provision of infrastructural facilities and the unified curriculum across the northwestern States of Nigeria.

Keywords: early childhood care, education, trends, challenges

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Authors: Kamel Abdelaziz Mohamed

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Intoduction:Inadequate knowledge about obstetric admission and infrequent dealing with the obstetric patients in ICU results in high mortality and morbidity. Aim of the work:To evaluate the indications, course, severity of illness, and outcome of obstetric patients admitted to the intensive care unit (ICU). Patients and Methods: We collected baseline data and acute physiology and chronic health evaluation II (APACHE II) scores. ICU mortality was the primary outcome. Results: Seventy obstetric patients were admitted to the ICU over 3 years, 36 of these patients (51.4 %) were admitted during the antepartum period. The primary obstetric indication for ICU admission was pregnancy-induced hypertension (22 patients, 31.4%), followed by sepsis (8 patients, 11.4%) as the leading non-obstetric admission. The mean APACHE II score was 19.6. The predicted mortality rate based on the APACHE II score was 22%, however, only 4 maternal deaths (5.7%) were among the obstetric patients admitted to the ICU. Conclusion: Evaluation of obstetric patients by (APACHE II) scores showed higher predicted mortality rate, however the overall mortality was lower. Regular follow up, together with early detection of complications and prompt ICU admission necessitating proper management by specialized team can improve mortality.

Keywords: obstetric, complication, postpartum, sepsis

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Authors: Denisa Denglerova, Radim Sip

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Academic sources as well as international agreements and national documents define inclusion in terms of several criteria: equal opportunities, fulfilling individual needs, development of human resources, community participation. In order for these criteria to be met, the community must be cohesive. Community cohesion, which is a relatively new concept, is not determined by homogeneity, but by the acceptance of diversity among the community members and utilisation of its positive potential. This brings us to a central category of inclusion - appreciating diversity and using it to a positive effect. However, school diversity is a real phenomenon, which schools need to tackle more and more often. This is also indicated by the number of publications focused on diversity in schools. These sources present recent analyses of using identity as a tool of coping with the demands of a diversified society. The aim of this study is to identify and describe in detail the processes taking place in selected schools, which contribute to their pro-inclusive character. The research is designed around a multiple case study of three pro-inclusive schools. Paradigmatically speaking, the research is rooted in situational epistemology. This is also related to the overall framework of interpretation, for which we are going to use innovative methods of situational analysis. In terms of specific research outcomes this will manifest itself in replacing the idea of “objective theory” by the idea of “detailed cartography of a social world”. The cartographic approach directs both the logic of data collection and the choice of methods of their analysis and interpretation. The research results include detection of the following sensitive concepts: Key persons. All participants can contribute to promoting an inclusion-friendly environment; however, some do so with greater motivation than others. These could include school management, teachers with a strong vision of equality, or school counsellors. They have a significant effect on the transformation of the school, and are themselves deeply convinced that inclusion is necessary. Accordingly, they select suitable co-workers; they also inspire some of the other co-workers to make changes, leading by example. Employees with strongly opposing views gradually leave the school, and new members of staff are introduced to the concept of inclusion and openness from the beginning. Manifestations of school openness in working with diversity on all important levels. By this we mean positive manipulation with diversity both in the relationships between “traditional” school participants (directors, teachers, pupils) and school-parent relationships, or relationships between schools and the broader community, in terms of teaching methods as well as ways how the school culture affects the school environment. Other important detected concepts significantly helping to form a pro-inclusive environment in the school are individual and parallel classes; freedom and responsibility of both pupils and teachers, manifested on the didactic level by tendencies towards an open curriculum; ways of asserting discipline in the school environment.

Keywords: inclusion, diversity, education, sensitive concept, situational analysis

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Authors: Kenny Chi Man Chui

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Background: In Chinese culture, the traditional equivalent term for English dementia is chi dai zheng, which, whether translated as ‘insanity’ or ‘idiocy’ carries a sharply negative connotation. In fact, even though the traditional name for dementia has evolved, from chi dai zheng to shi zhi zheng, nao tui hua zheng or ren zhi zhang ai zheng, educating the population about more respectful terms for the condition and promoting a positive understanding about people with dementia in society have proven to be time-intensive endeavors. By extension, the use of such terms promotes the perception that people with dementia undergo a ‘total loss of self’ or experience a ‘living death’ or ‘social death’. Both in Asia and elsewhere, the appropriate nomenclature for dementia remains controversial, and different medical and healthcare professionals in Hong Kong have taken various stances on how to refer to the condition there. Indeed, how this negative perception affects the interaction between people with dementia and the surrounding others? Methodology: Qualitative research with the concept of postmodernism, interpretivism, and Foucauldian theory was adopted as frameworks in applying participatory observations, in-depth interviews, and other qualitative methods. First, ten people with dementia—one man and nine women—living in two residential care homes in Hong Kong were interviewed, as were ten members of the care staff, all of whom were women. Next, to coach the staff in understanding the feelings and self-perceptions of people with dementia, two reflective training sessions were provided. Afterward, to assess the impact of the training sessions on the staff, two focus groups were held. Findings: The findings revealed that residents with dementia did not perceive themselves as being ‘demented’ and were confused by not getting responses from the others. From the understanding of care staff, they perceived the residents as being ‘demented’, desolate troublemakers. They described people with dementia as ‘naughty children’ who should be controlled and be punished while treated them as ‘psychiatric patients’ who could be ignored and be mute. “Psychosocial restraint” happened regarding the discrepancy of perception between people with dementia and the care staff. People with dementia did not think that their confusion of memory was related to dementia or, frankly speaking, they did not know what dementia was. When others treated them as ‘demented patients, the residents with mild to moderate dementia fiercely rejected that designation and reported a host of negative feelings, hence the fluctuations of mood and emotion noted by the care staff. Conclusion: As the findings revealed, the people with dementia were also discontent with the care arrangements in the care homes, felt abandoned by others and worried about bothering others. Their shifting emotional states and moods were treated as the Behavioral and Psychological symptoms of Dementia (BPSD), which nothing can do reported by the care staff in the residential care homes. People with dementia become social withdrawal or isolated in daily living, which should be alert and be changed by the social work professionals about the occurrence of “psychosocial restraint” in dementia care.

Keywords: psychosocial restraint, qualitative research, social work with dementitude, voice of people with dementia

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Authors: Ying-Lun Tseng Chiu-Ying Chen

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Taiwan's Mental Health Act was amended at the end of 2022; they added regulations regarding refusing compulsory treatment by patients with mental illnesses. In addition, not only by an examination committee, the judge must also assess the patient's need for compulsory treatment. Additionally, the maximum of compulsory hospitalization has been reduced from an unlimited period to a maximum of 60 days. They aim to promote the healthcare autonomy of individuals with mental illnesses in Taiwan and prevent their silenced voice in medical decision-making while they still possess rationality. Furthermore, they plan to use community support and social care networks to replace the current practice of compulsory treatment in Taiwan. This study uses qualitative research methodology, utilizing interview guidelines to inquire about the experiences of Taiwanese who have undergone compulsory hospitalization, compulsory community treatment, and compulsory medical care. The interviews aimed to explore their feelings when they were subjected to compulsory medical intervention, the inside of their illness, their opinions after treatments, and whether alternative medical interventions proposed by them were considered. Additionally, participants also asked about their personal life history and their support networks in their lives. We collected 12 Taiwanese who had experienced compulsory medical interventions and were interviewed 14 times. The findings indicated that participants still possessed rationality during the onset of their illness. However, when they have other treatments to replace compulsory medical, they sometimes diverge from those of the doctors and their families. Finally, doctors prefer their professional judgment and patients' families' option. Therefore, Taiwanese mental health patients' power of decision-making still needs to improve. Because this research uses qualitative research, so difficult to find participants, and the sample size rate was smaller than Taiwan's population, it may have biases in the analysis. So, Taiwan still has significant progress in enhancing the decision-making rights of participants in the study.

Keywords: medical decision making, compulsory treatment, medical ethics, mental health act

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Authors: Ekaterina Malova

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Type 1 diabetes (T1D) is a chronic illness requiring immense lifestyle changes to reduce the chance of life-threatening complications. Moving to a college may be the first time for a young adult with T1D to take responsibility for all the aspects of their diabetes care. In addition, people with T1D constantly face stigmatization and discrimination as a result of their health condition, which puts additional pressure on young adults with T1D. Hence, omissions in diabetes self-care often occur during the time of transition to college when both the social and physical environment of young adults changes drastically and contribute to the fact that emerging young adults remain one of the age groups with the highest hemoglobin levels and poorest diabetes control. However, despite potential severe health risks caused by a lack of proper diabetes self-care, little is known about the experiences of emerging adults embarking on a higher education journey as this population. Thus, young adults with type 1 diabetes are a 'forgotten group,' meaning that their experiences are rarely addressed by researchers. Given that self-disclosure and information-seeking can be challenging for individuals with stigmatized illnesses, online platforms like YouTube have become a popular medium of self-disclosure and information-seeking for people living with T1D. Thus, this study aims to provide an analysis of experiences that college students with T1D choose to share with the general public online and explore the nature of information being communicated by college students with T1D to the online community in personal narratives posted on YouTube. A systematic approach was used to retrieve a video sample by searching YouTube with keywords 'type 1 diabetes' and 'college,' with results ordered by relevance. A total of 18 videos were saved. Video lengths ranged from 2 to 28 minutes. The data were coded using NVivo. Video transcripts were coded and analyzed utilizing the thematic analysis method. Three key themes emerged from thematic analysis: 1) Advice, 2) Personal experience, and 3) Things I wish everyone knew about T1D. In addition, Theme 1 was divided into subtopics to differentiate between the most common types of advice: 1) Overcoming stigma and b) Seeking social support. The identified themes indicate that two groups of the population can potentially benefit from watching students’ video testimonies: 1) lay public and 2) other students with T1D. Given that students in the videos reported a lack of T1D education in the lay public, such video narratives can serve important educational purposes and reduce health stigma, while perceived similarity and identification with students in the videos may facilitate the transition of health information to other individuals with T1D and positively affect their diabetes routine. Thus, online video narratives can potentially serve both educational and persuasive purposes, empowering students with T1D to stay in control of T1D while succeeding academically.

Keywords: type 1 diabetes, college students, health communication, transition period

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Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

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Authors: Yu-Chuan Huang

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Introduction: There is a higher mortality rate for unplanned transfer to intensive care units. It also needs a longer length of stay and makes the intensive care unit beds cannot be effectively used. It affects the immediate medical treatment of critically ill patients, resulting in a drop in the quality of medical care. Purpose: The purpose of this study was using SOFA and APACHEII score to analyze the mortality rate of the cases transferred from ED to ICU. According to the score that should be provide an appropriate care as early as possible. Methods: This study was a descriptive experimental design. The sample size was estimated at 220 to reach a power of 0.8 for detecting a medium effect size of 0.30, with a 0.05 significance level, using G-power. Considering an estimated follow-up loss, the required sample size was estimated as 242 participants. Data were calculated by medical system of SOFA and APACHEII score that cases transferred from ED to ICU in 2016. Results: There were 233 participants meet the study. The medical records showed 33 participants’ mortality. Age and sex with QSOFA , SOFA and sex with APACHEII showed p>0.05. Age with APCHHII in ED and ICU showed r=0.150, 0,268 (p < 0.001**). The score with mortality risk showed: ED QSOFA is r=0.235 (p < 0.001**), exp(B)=1.685(p = 0.007); ICU SOFA 0.78 (p < 0.001**), exp(B)=1.205(p < 0.001). APACHII in ED and ICU showed r= 0.253, 0.286 (p < 0.001**), exp(B) = 1.041,1.073(p = 0.017,0.001). For SOFA, a cutoff score of above 15 points was identified as a predictor of the 95% mortality risk. Conclusions: The SOFA and APACHE II were calculated based on initial laboratory data in the Emergency Department, and during the first 24 hours of ICU admission. In conclusion, the SOFA and APACHII score is significantly associated with mortality and strongly predicting mortality. Early predictors of morbidity and mortality, which we can according the predicting score, and provide patients with a detail assessment and proper care, thereby reducing mortality and length of stay.

Keywords: SOFA, APACHEII, mortality, ICU

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Authors: Rana Praween Kumar

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Preterm-low birth weight delivery is a major cause of infant morbidity and mortality in developing countries and has been linked to poor periodontal health during pregnancy. Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory oral diseases. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. This study is intended to investigate predisposing and enabling factors as determinants of oral health indicators in pregnancy as well as the association between periodontal problems during pregnancy with age and socio economic status of the individual. A community –based prospective cohort study will be conducted in Jamshedpur, Jharkhand, India among pregnant women using completed interviews and a full mouth oral clinical examination using the CPITN (Community Periodontal Index of Treatment Need) and OHI-S (Simplified Oral Hygiene) indices with adequate sample size and informed consent to the patient following proper inclusion and exclusion criteria. Multiple logistic regression analyses will be used to identify independent determinants of periodontal problems and use of dental services during pregnancy. Analysis of covariance (ANCOVA) will be used to investigate the relationship between periodontal problems with the age and socioeconomic status. The result will help in proper monitoring of periodontal health during pregnancy encouraging the delivery of healthy child and the maintenance of proper health of the mother.

Keywords: infant, periodontal problems, pregnancy, pre-term-low birth weight delivery

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Authors: Ghulam Mustafa Halepota, Zaib Dahar

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Background: Low acceptance of FP services, particularly in hard to reach areas where geographic, economic, or social barriers limit-service uptake. Moreover, limited resources appeared to be a reflection of dismal contraceptive use in Pakistan. People’s Primary Health Care Initiative (PPHI) is a Public Private Partnership Program of Government of Sindh which aims to improve maternal child health through accessible family planning services in far flung areas. In 2015 PPHI launched special family planning camps to have achieved a rapid improvement in CPR. On quarterly basis, these camps focus on Long Acting Reversible Contraceptives (LARC). These camps are arranged at 250 BHU Plus (24/7 MCHCs). The Organization manages 1140 primary health care facilities all over Sindh province and focuses on maternal, newborn and child health which includes antenatal care, labor/delivery, postnatal care, family planning, immunization, nutrition, BEmONC, CEmONC, diagnostic laboratories, ambulance services. Under the FPRH program, the organization launched special family planning camps in far flung areas to achieve a rapid improvement in CPR-committed to FP 2020 goal. Objective: To assess the performance of special FP camps for the improvement of long acting reversible contraceptive in hard to reach areas. Methodology: Outreach camps are organized on quarterly basis in 250 BHUs and maternal and child health centers (available-24/7). Using observational study design, the study reports 2 years data of special FP camps conducted in 23 various districts of Sindh during April 2015-April 2017. These special camps served a range of modern contraceptive methods including IUCDs, implants, condoms, pills, and injections. Moreover, 125 male medical officers are trained across Sindh in LARC and 554 female have been trained in implants and IUCD insertions. MSI Impact calculator was used to determine health and demographic impact of services. Results: This intervention has brought exceptional results, and the response has been overwhelming in time. Total 2048 special camps during 2015 till April 2017 have been carried out. 231796 MWRAs visited camps 91% opted modern FP, of which 45% opted Implants, 6% selected IUCDs from LARC (long term reversible contraceptive) from short term, 17% opted injectable 18% choose pills, and 12% used condoms. This intervention created a high contraceptive impact in rural Sindh an estimated 125048 FP users have been created, of this 111846 LARC users and 13498 are SARC users, through this intervention an estimated 55774 unintended pregnancies, 36299 live births, 9394, 80 maternal deaths, 926 and 6077 unsafe abortion have been averted. Moreover, the intervention created an economic impact and saved 2,409,563 direct health expenditure on each woman with reproductive age. Conclusion: Special FP Camps along with routine services is an effective and acceptable model for increase in provision of long-acting and permanent methods in hard to reach areas. This innovative approach by PHHI-Sindh has also been adopted in other provinces of Pakistan.

Keywords: inequalities, special camps, family planning services, hard to reach areas

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Authors: Daniel Faraj, Arabella Raupach, Charlotte Hespe, Helen Wilcox, Kristie-Lee Anning

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Aim: International child sponsorship programs comprise a considerable proportion of global aid accessible to the general population. Team Philippines (TP), a healthcare and welfare initiative run in association with the University of Notre Dame Sydney since 2013, leads a holistic sponsorship program for thirty children from Calauan, Philippines. To date, empirical research has not been performed on the overall success and impact of the TP child sponsorship program. As such, this study aims to evaluate its effectiveness in improving pediatric outcomes. Methods: Study cohorts comprised thirty sponsored and twenty-nine age- and gender-matched non-sponsored children. Data were extracted from the TP Medical Director database and lifestyle questionnaires for July-November 2019. Outcome measures included anthropometry, markers of medical health, dental health, exercise, and diet. Statistical analyses were performed in SPSS. Results: Sponsorship resulted in fewer medical diagnoses and prescription medications, superior dental health, and improved diet. Further, sponsored children may show a clinically significant trend toward improved physical health. Sponsorship did not affect growth and development metrics or levels of physical activity. Conclusions: The TP child sponsorship program significantly impacts positive pediatric health outcomes in the Calauan community. The strength of the program lies in its holistic, sustainable, and community-based model, which is enabled by effective international child sponsorship. This study further supports the relationship between supporting early livelihood and improved health in the pediatric population.

Keywords: child health, public health, health status disparities, healthcare disparities, social determinants of health, morbidity, community health services, culturally competent care, medically underserved areas, population health management, Philippines

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Authors: Khitam Ibrahem Shlash Mohammad

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Background: Postnatal depression is a focus of considerable research attention, but little is known about the pattern of stress across this period. Objective: to investigate the prevalence of stress after childbirth for Jordanian women and identify associated risk factors. Method: Design: A descriptive cross-sectional study. Participants were recruited six to eight weeks postpartum, provided personal, social and obstetric information, and completed the stress subscale of Depression Anxiety and Stress Scale (DASS-S), the Maternity Social Support Scale (MSSS), and Perceived Self-Efficacy Scale (PSES). Setting: maternal and child health care clinics in four health care centres in Maan city in Southern Jordan. Participants: Arabic speaking women (n = 324) between the ages of 18 and 45 years, six to eight weeks postpartum, primiparous or multiparous at low risk for obstetric complications. Data collection took place between October 2015 and January 2016. Ethical clearance was obtained prior to data collection. Results: The prevalence of postpartum stress among Jordanian women was 39.8 %. A regression analysis revealed that occupation, low social support, financial problems, difficult marital relationships, difficult relationship with family-in-law, giving birth to a female baby, difficult childbirth, and low self-efficacy were associated with postpartum stress. Conclusions and implications for practice: Jordanian women need support during pregnancy, during and after childbirth. Postpartum emotional support and assessment of symptoms of stress need to be incorporated into routine practice. The opportunity for open discussion along with increased awareness and clarification of common misconceptions about postpartum stress is necessary.

Keywords: prevalence, postpartum, stress, Jordanian women

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Authors: Emily Hickmann, Peggy Richter, Maren Kaehlig, Hannes Schlieter

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Patient engagement is a cornerstone of high-quality care and essential for patients with chronic diseases to achieve improved health outcomes. Through digital transformation, possibilities to engage patients in their personal healthcare have multiplied. However, the exploitation of this potential is still lagging. To support the transmission of patient engagement theory into practice, this paper’s objective is to give a state-of-the-art overview of patient engagement tools and methods. A systematic literature review was conducted. Overall, 56 tools and methods were extracted and synthesized according to the four attributes of patient engagement, i.e., personalization, access, commitment, and therapeutic alliance. The results are discussed in terms of their potential to be implemented in digital health solutions under consideration of the “computers are social actors” (CASA) paradigm. It is concluded that digital health can catalyze patient engagement in practice, and a broad future research agenda is formulated.

Keywords: chronic diseases, digitalization, patient-centeredness, patient empowerment, patient engagement

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Authors: Jessica Chukwuyem Molua, Collins O Molua

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The effective dose of selected health care workers who are constantly exposed to X-ray radiation was measured using thermoluminescence dosimeters (TLD) placed over the lead apron at the chest region in all categories of medical personnel investigated. To measure radiation in all the selected hospitals to ascertain the exposure of x-ray machines at exactly 1m from the primary source. The work was carried out within a year in each of the selected centers. The personnel examination records containing the type of examination each day, peak tube voltage, tube current, and exposure time, including the actual number of films used, were obtained. A total of 40personel were examined in government hospital Agbor, 21 in central hospital Owa Alero and 18 in Okonye hospital The method used here has also been used by other researchers. Findings showed that the results obtained from the three hospitals investigated in this work were found to conform with the recommendations of the National Commission on radiological and protection {NCRP} 70 and 116 protocols. The Radiologist in the three study areas has the highest dose level, but of particular note is the dosage of the radiologist in Okonye hospital. This, as observed, is because the protective shielding parameters were inadequate and this could result in severe health consequences over time.

Keywords: radiology, health, Agbor, Owa

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Authors: Aikaterini Tavoulari, Mike Richardson

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Objective: This abstract presents a multisensory participatory design project, inspired by a deafblind PhD student's ambition to climb Mount Everest. The project aims to explore accessible routes for filmmaking and video content creation, catering to the needs of individuals with hearing and sight loss. By engaging participants from the Southwest area of England, recruited through multiple networks, the project seeks to gather qualitative data and insights to inform the development of inclusive media practices. Design: It will be a community-based participatory research design. The workshop will feature various stations that stimulate different senses, such as scent, touch, sight, hearing as well as movement. Participants will have the opportunity to engage with these multisensory experiences, providing valuable feedback on their effectiveness and potential for enhancing accessibility in filmmaking and video content. Methods: Brief semi-structured interviews will be conducted to collect qualitative data, allowing participants to share their perspectives, challenges, and suggestions for improvement. The participatory design approach emphasizes the importance of involving the target audience in the creative process. By actively engaging individuals with hearing and sight loss, the project aims to ensure that their needs and preferences are central to the development of accessible filmmaking techniques and video content. This collaborative effort seeks to bridge the gap between content creators and diverse audiences, fostering a more inclusive media landscape. Results: The findings from this study will contribute to the growing body of research on accessible filmmaking and video content creation. Via inductive thematic analysis of the qualitative data collected through interviews and observations, the researchers aim to identify key themes, challenges, and opportunities for creating engaging and inclusive media experiences for deafblind audiences. The insights will inform the development of best practices and guidelines for accessible filmmaking, empowering content creators to produce more inclusive and immersive video content. Conclusion: The abstract targets the hybrid International Conference for Disability and Diversity in Canada (January 2025), as this platform provides an excellent opportunity to share the outcomes of the project with a global audience of researchers, practitioners, and advocates working towards inclusivity and accessibility in various disability domains. By presenting this research at the conference in person, the authors aim to contribute to the ongoing discourse on disability and diversity, highlighting the importance of multisensory experiences and participatory design in creating accessible media content for the deafblind community and the community with sensory impairments more broadly.

Keywords: vision impairment, hearing impairment, deafblindness, accessibility, filmmaking

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Authors: James Boag

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The needs of people with a diagnosis of dementia and their carers and families are physical, psychosocial, and psychological and begin at the time of diagnosis. There is frequently a lack of emotional support and counselling. Care- giving support is required from the presentation of the first symptoms of dementia until death. Alzheimer's disease begins decades before the clinical symptoms begin to appear, and in many cases, it remains undiagnosed, or diagnosed too late for any possible interventions to have any effect. However, if an incorrect diagnosis is given, it may result in a person being treated, without effect, for a type of dementia they do not have and delaying the interventions they should have received. Being diagnosed with dementia can cause emotional distress to the person, and physical and emotional support is needed, which will become more important as the disease progresses. The severity of the patient's dementia and their symptoms has a bearing of the impact on the carer and the support needed. A lack of insight and /or a denial of the diagnosis, grief, reacting to anticipated future losses, and coping methods to maximise the disease outcome, are things that should be addressed. Because of the stigma, it is important for carers not to lose contact with family and others because social isolation leads to depression and burnout. The impact on a carer's well- being and quality of life can be influenced by the severity of the illness, its type of dementia, its symptoms, healthcare support, financial and social status, career, age, health, residential setting, and relationship to the patient. Carer burnout due to lack of support leads to people diagnosed with dementia being put into residential care prematurely. Often dementia is not recognised as a terminal illness, limiting the ability of the person diagnosed with dementia and their carers to work on advance care planning and getting access to palliative and other support. Many carers have been satisfied with the physical support they were given in their everyday life, however, it was agreed that there was an immense unmet need for psychosocial support, especially after diagnosis and approaching end of life. Providing continuity and coordination of care is important. Training is necessary for providers to understand that every case is different, and they should understand the complexities. Grief, the emotional response to loss, is suffered during the progression of the disease and long afterwards, and carers should continue to be supported after the death of the person they were caring for.

Keywords: dementia, caring, challenges, needs

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Authors: Joshua W. Edefo, Shafiul Azam, Murray D. Smith

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Introduction: In April 2022, the Welsh Government introduced the six goals for urgent and emergency care programs. One of these goals was to provide access to clinically safe alternatives, leading to the establishment of the Same Day Emergency Care (SDEC) program. The SDEC initiative aims to offer viable options that maintain patient safety while avoiding unnecessary hospital stays. The aim of the study is to determine the duration of patient stay in SDEC and compare it with that of Emergency department (ED) stay to ascertain if one of the objectives of SDEC is achieved. Methods: Patient stays and attendance datasets were constructed from Withybush SDEC and ED patient records. These records were provided by Hywel Dda University Health Board Informatics. Some hypothetical pathways were identified, notably SDEC visits involving a single attendance and ED visits then immediately transferred to SDEC. Descriptive statistics were used to summarise the data, and hypothesis tests for mean differences used the student t-test. Propensity scoring was employed to match a set of ED patient stays to SDEC patient stays which were then used to determine the average treatment effect (ATE) to compare durations of stay in SDEC with ED. Regression methods were used to model the natural logarithm of the duration of SDEC attendance, and the level of statistical significance was set to 0.05. Results: SDEC visits involving a single attendance (170 of 384; 44.3%) is the most frequently observed pathway with patient length of stay at 256 minutes (95%CI 237.4 - 275.1). The next most frequently observed pathway of patient stay was SDEC attendance after presenting to ED (80 of 384; 20.8%) and gave the length of stay of 440 minutes (95%CI 351.6 - 529.2). Time spent in this pathway significantly increased by 184 minutes (95%CI 118.0 - 250.2, support for no difference p<0.001) compared to the most seen pathway. When SDEC data were compared with ED, the estimate for the ATE from SDEC single attendance was -272 minutes (95%CI -334.1 - -210.5; p<0.001), while that of ED then SDEC pathway was -50.6 min (95%CI -182.7-81.5; p=0.453). Conclusion: When patients are admitted to SDEC and successfully discharged, their stays are significantly shorter, approximately 4.5 hours, compared to patients who spend their entire stay in the Emergency Department. That difference vanishes when the patient stay includes a period spent previously in ED before transfer to SDEC.

Keywords: attendance, emergency-department, patient-stay, same-day-emergency-care

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Authors: Chinwe Okpoko, Vivian Atasie

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One of the leading causes of death amongst women of child-bearing age in southeast Nigeria is pregnancy. Women in the reproductive age group die at a higher rate than men of the same age bracket. Furthermore, most maternal deaths occur among poor women who live in rural communities, and who generally fall within the low socio-economic group in society. Failure of policy makers and the media to create the strategic awareness and communication that conform with the sensibilities of this group account, in part, for the persistence of this malaise. Family planning (FP) is an essential component of safe motherhood, which is designed to ensure that women receive high-quality care to achieve an optimum level of health of mother and infant. The aim is to control the number of children a woman can give birth to and prevent maternal and child mortality and morbidity. This is what sustainable development goal (SDG) health target of World Health Organization (WHO) also strives to achieve. FP programmes reduce exposure to the risks of child-bearing. Indeed, most maternal deaths in the developing world can be prevented by fully investing simultaneously in FP and maternal and new-born care. Given the intrinsic value of communication in health care delivery, it is vital to adopt the most efficacious means of awareness creation and communication amongst rural women in FP. In a country where over 50% of her population resides in rural areas with attendant low-level profile standard of living, the need to communicate health information like FP through indigenous channels becomes pertinent. Interpersonal communication amongst family, friends, religious groups and other associations, is an efficacious means of communicating social issues in rural Africa. Communication in informal settings identifies with the values and social context of the recipients. This study therefore sought to determine the place of interpersonal communication on the knowledge of rural women on FP and how it influences uptake of FP. Descriptive survey design was used in the study, with interviewer administered questionnaire constituting the instrument for data collection. The questionnaire was administered on 385 women from rural communities in southeast Nigeria. The results show that majority (58.5%) of the respondents agreed that interpersonal communication helps women understand how to plan their family size. Many rural women (82%) prefer the short term natural method to the more effective modern contraceptive methods (38.1%). Husbands’ approval of FP, as indicated in the Mean response of 2.56, is a major factor that accounts for the adoption of FP messages among rural women. Socio-demographic data also reveal that educational attainment and/or exposure influenced women’s acceptance or otherwise of FP messages. The study, therefore, recommends amongst others, the targeting of husbands in subsequent FP communication interventions, since they play major role on contraceptive usage.

Keywords: family planning, interpersonal communication, interpersonal interaction, traditional communication

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Authors: Lukman Abiodun Nafiu

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This study examines the impact evaluation of vaccination against eight-child-killer diseases on under-five children mortality at Mbale District. It was driven by three specific objectives which are to determine the proportion of under-five children mortality due to the eight-child-killer diseases to the total under-five children mortality; establish the cause-effect relationship between the eight-child-killer diseases and under-five children mortality; as well as establish the dependence of under-five children mortality in the location at Mbale District. A community based cross-sectional and longitudinal (panel) study design involving both quantitative and qualitative (focus group discussion and in-depth interview) approaches was employed over a period of 36 months. Multi-stage cluster design involving Health Sub-District (HSD), Forms of Ownership (FOO) and Health Facilities Centres (HFC) as the first, second and third stages respectively was used. Data was collected regarding the eight-child-killer diseases namely: measles, pneumonia, pertussis (whooping cough), diphtheria, poliomyelitis (polio), tetanus, haemophilus influenza, rotavirus gastroenteritis and mortality regarding immunized and non-immunized children aged 0-59 months. We monitored the children over a period of 24 months. The study used a sample of 384 children out of all the registered children for each year at Mbale Referral Hospital and other Primary Health Care Centres (HCIV, HCIII and HCII) at Mbale District between 2015 and 2019. These children were followed from birth to their current state (living or dead). The data collected in this study was analysed using cross tabulation and the chi-square test. The study concluded that majority of mothers at Mbale district took their children for immunization and thus reducing the occurrence of under-five children mortality. Overall, 2.3%, 4.6%, 3.1%, 5.4%, 1.5%, 3.8%, 0.0% and 0.0% of under-five children had polio, tetanus, diphtheria, measles, pertussis, pneumonia, haemophilus influenzae and rotavirus gastroenteritis respectively across all the sub counties at Mbale district during the period considered. Also, different locations (sub counties) do not have significant influence on the occurrence of these eight-child-killer diseases among the under-five children at Mbale district. Therefore, the study recommended that government and agencies should continue to work together to implement measures of vaccination programs and increasing access to basic health care with a continuous improvement on the social interventions to progress child survival.

Keywords: Diseases, Mortality, Children, Vaccination

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Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton

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Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.

Keywords: adolescent, binge eating, mental illness, obesity

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Authors: Gabriela Sardinha Pacheco

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In a context of elderly population growth, the need to provide high quality infrastructure and services to these people becomes even more evident. The act of designing a space dedicated to elderly people goes beyond the concept of well-being and reaches to a point of evaluating and changing the way which society sees this part of the population as well as how it can build a relationship with energy efficiency. In this context, the care facilities for elderly have an extremely important role to provide this infrastructure to the population. A common issue is that, for many times, these facilities face financial issues, and the full operation of the establishment can be impacted. The intention of this work is to develop a project in which the energy efficiency measures can be lived daily and that the residents of the institution can participate actively, directly, or indirectly in the construction of this relationship. The use of energy efficiency strategies should become a natural process when thinking about buildings as it is an essential step to provide increased well-being, climate change mitigation, and cost reduction.

Keywords: energy efficiency, environmental comfort, long-term care facility, well-being

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Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

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Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

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Authors: E. Ielegems, J. Herssens, J. Vanrie

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Designers require knowledge and data about a diversity of users throughout the design process to create inclusive design solutions which are usable, understandable and desirable by everyone. Besides understanding users’ needs and expectations, the ways in which users perceive and experience the built environment contain valuable knowledge for architects. Since users’ perceptions and experiences are mainly tacit by nature, they are much more difficult to express in words and therefore more difficult to externalise. Nevertheless, literature confirms the importance of articulating embodied knowledge from users throughout the design process. Hence, more insight is needed into the ways architects can build knowledge on Universal Design through direct user contact. In a project called ‘light up for all’ architecture students are asked to design a light switch and socket, elegant, usable and understandable to the greatest extent possible by everyone. Two workshops with user/experts are organised in the first stages of the design process in which students could gain insight into users’ experiences through direct contact. Three data collection techniques are used to analyse the teams’ design processes. First, students were asked to keep a design diary, reporting design activities, personal experiences, and thoughts about users throughout the design process. Second, one of the authors observed workshops taking field notes. Finally, focus groups are conducted with the design teams after the design process was finished. By means of analysing collected qualitative data, we first identify different design aspects that make the teams’ proposals more inclusive than standard design solutions. For this paper, we specifically focus on aspects that externalise embodied user knowledge from users’ experiences. Subsequently, we look at designers’ approaches to learn about these specific aspects throughout the design process. Results show that in some situations, designers perceive contradicting knowledge between observations and verbal conversations, which shows the value of direct user contact. Additionally, findings give indications on values and limitations of working with selected prototypes as ‘boundary objects’ when externalising users’ experiences. These insights may help researchers to better understand designers’ process of eliciting embodied user knowledge. This way, research can offer more effective support to architects, which may result in better incorporating users’ experiences so that the built environment gradually can become more inclusive for all.

Keywords: universal design, architecture, design process, embodied user knowledge

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Authors: Sherin Kamal Zaki Kallini

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The ratification of an global human rights prison instrument affords signatory States with an opportunity to count on a hard and fast of obligations and rights for the gain of their residents, imparting expanded possibilities, possibilities, and manner to access an improved best of existence – to be, to appear, and to become. developed countries commonly experience cultural, political, social, monetary, prison, and regulatory alterations in reaction to this transition. In a methodologically proactive technique, mechanisms undergo a visible and understandable manner of qualitative and quantitative exchange. Conversely, in countries undergoing improvement, the response to such ratification varies. some display high quality coverage modifications, whilst others stay stagnant or regress. Cameroon falls into the second one category, no matter efforts, as it legally prohibits 50% of its populace with disabilities from obtaining the reputation of a person with a incapacity. The overarching goal of this communique is to spotlight those deficiencies and their adverse outcomes on various components of existence, fostering recognition among beneficiaries and advocating for extra inclusive alterations within the united states. Our task employs a popular and participatory methodological approach by related to beneficiaries and their groups in its training. it is also inclusive, representing the diversity of disabilities and tasty natural and criminal folks from numerous backgrounds. active consultations occur at all tiers of the sports. anticipated consequences include raising focus globally among countries, worldwide cooperation businesses, NGOs, and other inclusive improvement actors. We are looking for their support for nearby advocacy efforts to absolutely enforce the United countries convention on the Rights of persons with Disabilities (CRPD). concurrently, we hope they specific harmony with the sufferers in Cameroon who have been left behind and endorse legal reforms to align domestic and global rules with the promotion and safety of incapacity rights.

Keywords: sustainable development, human rights, the right to development, the human rights-based approach to development, environmental rights, economic development, social sustainability human rights protection, human rights violations, workers’ rights, justice, security.

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Authors: M. Khaledi Pour, P. Akbartehrani, M. Amini, M. Khani, M. Mohajeri Tehrani, R. Radi, B. Shokri

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Diabetic Foot Ulcer (DFU) is one of the costly severe complications of diabetes. Neuropathy and Peripheral Arterial Disease (PAD) due to diabetes are significant causes of this complication. In 10 years the patients with DFUs are twice as likely to die as patients without DFUs. Cold Atmospheric Plasma (CAP) is a promising tool for medical purposes. CAP generate reactive species at room temperature and are effective in killing bacteria and fibroblast proliferation. These CAP-based tools produce NO, which has bactericidal and angiogenesis properties. It also showed promising effects in the DFUs surface reduction and the time to wound closure. In this paper, we evaluated the effect of the Argon Plasma Jet (APJ) on the healing process of the Wagner Grade 2 DFUs in a randomized clinical trial. The 20 kHz sinusoidal voltage frequency derives the APJ. Patients (n=20) were randomly double-blinded assigned into two groups. These groups receive the standard care (SC, n=10) and the standard care with APJ treatment (SC+APJ, n=10) for five sessions in four weeks. The results showed that the APJ treatment along standard care could reduce the wound surface by 20 percent more than the standard care. Also, It showed a more influential role in controlling wound infection.

Keywords: argon plasma jet, cold atmospheric plasma, diabetes, diabetic foot ulcer

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Authors: Fiona Whittington-Walsh

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Including All Citizens Pathway (IACP) is addressing the systems wide discrimination that students with disabilities experience throughout the education system. IACP offers a wide, institutional support structure so that all students, including students with intellectual/developmental disabilities, are included and can succeed. The entire process from admissions, course selection, course instruction, graduation is designed to address systemic discrimination while supporting learners and faculty. The inclusive and accessible pedagogical model that is the foundation of IACP opens the doors of post-secondary education by making existing academic courses environments where all students can participate and succeed. IACP is about transforming teaching, not modifying, or adapting the curriculum or essential knowledge and skill sets that are required learning outcomes. Universal Design for Learning (UDL) principles are applied to instructional teaching strategies such as lectures, presentations, and assessment tools. Created in 2016 as a research pilot, IACP is one of the first fully inclusive for credit post-secondary options available. The pilot received numerous external and internal grants to support its initiative to investigate and assess the teaching strategies and techniques that support student learning of essential knowledge and skill sets. IACP pilot goals included: (1) provide a successful pilot as a model of inclusive and accessible pedagogy; (2) create a teacher’s guide to assist other instructors in transforming their teaching to reach a wide range of learners; (3) identify policy barriers located within the educational system; and (4) provide leadership and encouraging innovative and inclusive pedagogical practices. The pilot was a success and in 2020 the first cohort of students graduated with an exit credential that pre-exists IACP and consists of ten academic courses. The University has committed to continue IACP and has developed a sustainable model. Each new academic year a new cohort of IACP students starts their post-secondary educational journey, while two additional instructors are mentored with the pedagogy. The pedagogical foundation of IACP has far-reaching potential including, but not limited to, programs that offer services for international students whose first language is not English as well as influencing pedagogical reform in secondary and post-secondary education. IACP also supports universities in satisfying educational standards that are or will be included in accessibility/disability legislation. This session will present information about IACP, share examples of systems transformation, hear from students and instructors, and provide participatory experiential activities that demonstrate the transformative techniques. We will be drawing from the experiences of a recent course that explored research documenting the lived experiences of students with disabilities in post-secondary institutes in B.C (Whittington-Walsh). Students created theatrical scenes out of the data and presented it using Forum Theatre method. Forum Theatre was used to create conversations, challenge stereotypes, and build connections between ableism, disability justice, Indigeneity, and social policy.

Keywords: disability justice, inclusive education, pedagogical transformation, systems transformation

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Authors: Sujith Gunawardhana

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The circular economy is a system in which resources and energy are derived from renewable sources, utilized efficiently, recycled, and reused to reduce waste, reduce nonrenewable resource consumption, and mitigate negative environmental impacts. However, it poses moral questions about sustainability, the environment, and societal issues. Many societies face challenges when implementing the circular economy, as the concept is still young. The equitable distribution of the advantages and costs of circularity should be ensured during implementation, as some communities, particularly disadvantaged or marginalized ones, may suffer unfairly disproportionately from the harmful effects of production and recycling facilities. Prioritizing the health and safety of workers, communities, and the environment is essential, and strict rules must be implemented to guard against harm. However, most underdeveloped countries need a legal safeguard for this situation. The ultimate objective of the circular economy is to improve social, environmental, and economic performance, but its implementation also requires consideration of the ethics of care and non-epistemic values. Those are often hindered in underdeveloped countries, as the availability of infrastructure and technology, affordability, and legislative framework are poor. To achieve long-term success in the circular economy, evaluating implementation steps and considering health, safety, environmental, and social risks is crucial. To implement the circular economy, respect ethics of care and non-epistemic values. Adopt Kantian Ethics and control technology design to ensure equal benefits for all involved. Ethical gaps may lead underdeveloped countries to generate social pressure against the circular economy.

Keywords: circular economy, ethics, values, sustainability

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