Search results for: experience sampling methods
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 21142

Search results for: experience sampling methods

19912 Examining Fertility Desires and Reproductive Planning among Low-Income Black Fathers: A Mixed-Methods Approach

Authors: Adaobi Anakwe, Wilson Majee, Kari White, Rhonda BeLue

Abstract:

Background: Black men in the U.S. have overall poorer health, are more likely to experience unintended pregnancies, and have pregnancies (with their partner) at younger ages than other racial/ethnic groups. These factors increase the likelihood that pregnancies among Black fathers will occur at suboptimal paternal health. Although several community-based programs exist to support low-income Black fathers’ involvement with their families, little is known about the sexual and reproductive health, and family planning needs of fathers enrolled in these programs. The objective of this study was to quantitatively examine the relationship between Black fathers’ fertility desires and pregnancy prevention strategies and qualitatively explore the nuances of this relationship. Methods: A concurrent mixed-methods approach was used to survey 36 and interview 13 Black fathers from low-income backgrounds, who were participating in a community-based fatherhood program in a Midwestern urban area. Fathers in this study were ≥18 years old with at least one child. Differences between groups were compared using Fisher’s Exact tests and thematic analyses to examine the relationship between participants' fertility desires and reproductive planning practices. Results: Participants had a median age of 33 years, and 72% were non-residential biological parents. About 40% of men desired pregnancy, and 69% reported they or their partner always used contraception. In bivariate analysis, participants’ fertility desires were not associated with pregnancy prevention (p=0.251). Although most interview participants desired pregnancies, several factors contributed to their ability to plan for a pregnancy. Men felt that using contraception to prevent pregnancies was dependent on navigating trust with a partner. Health before pregnancy and financial stability were also important. Overall, participants thought that using an adult mindset, in which they considered the consequences of unprotected sex, was key to family planning. Conclusion: Black fathers may not desire pregnancy and consider a variety of factors, but this does not always result in active pregnancy prevention/contraceptive use. Community-based organizations already working with Black fathers can be leveraged to increase reproductive health awareness and facilitate reproductive planning for fathers.

Keywords: reproductive planning, reproductive health, preconception health, Black fathers, fertility desires, pregnancy

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19911 A Pilot Study Exploring Dog Owners’ Perceptions on Volunteering With Their Dogs in Animal-Assisted Therapy Program in Singapore

Authors: Julia Wong, Hua Beng Lim, Cheryl Ho, Gin Jen Gwee, Rachel Tay

Abstract:

In Singapore, a few hospitals and non-governmental social service agencies have been utilising animal-assisted therapy (AAT) in their practice in recent years, although the animals used (e.g., dogs, cats, and horses) and program modality may differ due to the different practice settings, client profiles, and intervention goals. This pilot study explores dog owners’ perceptions of AAT with a focus on examining the enablers and barriers towards volunteering with their dogs in AAT programs in Singapore. A qualitative, thematic analysis study was conducted using in-depth, semi-structured interviews with 16 dog owners. 3 of the dog owners had previous experience volunteering with their dogs serving elderly patients in a community hospital, while the rest of the dog owners had no previous experience volunteering with their dogs. The former group was recruited with the help of the hospital, while the latter group was recruited via word-of-mouth. Dog owners who had volunteering experiences in AAT program versus those who had none differed in their perceptions towards AAT. Dog owners who had volunteered with their dogs in an AAT program in a hospital felt that their volunteering experience were meaningful to patients and to themselves, as they were intrinsically motivated by the desire to serve the community. Those who had not volunteered were hesitant to volunteer with their dogs as they were not comfortable with strangers touching their dogs. They also felt that it would be a huge commitment in terms of time and money; most of them do not own a car as it is uneconomical, and pets are not allowed on Singapore’s public transport systems. This study is limited by its small sample size, and its findings are not generalisable. However, given that volunteers are an invaluable resource in healthcare settings, future studies can examine more stakeholders’ perceptions towards AAT.

Keywords: animal-assisted therapy, dog-assisted therapy, volunteers, complementary therapy

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19910 Artificial Intelligence in Duolingo

Authors: Elana Mahboub, Lamar Bakhurji, Hind Alhindi, Sara Alesayi

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Duolingo is a revolutionary language learning platform that offers an interactive and accessible learning experience. Its gamified approach makes language learning engaging and enjoyable, with a diverse range of languages available. The platform's adaptive learning system tailors lessons to individual proficiency levels, ensuring a personalized and efficient learning journey. The incorporation of multimedia elements enhances the learning experience and promotes practical language application. Duolingo's success is attributed to its mobile accessibility, offering basic access to language courses for free, with optional premium features for those seeking additional resources. Research shows positive outcomes for users, and the app's global impact extends beyond individual learning to formal language education initiatives. Duolingo is a transformative force in language education, breaking down barriers and making language learning an attainable goal for millions worldwide.

Keywords: duolingo, artificial intelligence, artificial intelligence in duolingo, benefit of artificial intelligence

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19909 Integration of an Innovative Complementary Approach Inspired by Clinical Hypnosis into Oncology Care: Nurses’ Perception of Comfort Talk

Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

Abstract:

Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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19908 Language Errors Used in “The Space between Us” Movie and Their Effects on Translation Quality: Translation Study toward Discourse Analysis Approach

Authors: Mochamad Nuruz Zaman, Mangatur Rudolf Nababan, M. A. Djatmika

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Both society and education areas teach to have good communication for building the interpersonal skills up. Everyone has the capacity to understand something new, either well comprehension or worst understanding. Worst understanding makes the language errors when the interactions are done by someone in the first meeting, and they do not know before it because of distance area. “The Space between Us” movie delivers the love-adventure story between Mars Boy and Earth Girl. They are so many missing conversations because of the different climate and environment. As the moviegoer also must be focused on the subtitle in order to enjoy well the movie. Furthermore, Indonesia subtitle and English conversation on the movie still have overlapping understanding in the translation. Translation hereby consists of source language -SL- (English conversation) and target language -TL- (Indonesia subtitle). These research gap above is formulated in research question by how the language errors happened in that movie and their effects on translation quality which is deepest analyzed by translation study toward discourse analysis approach. The research goal is to expand the language errors and their translation qualities in order to create a good atmosphere in movie media. The research is studied by embedded research in qualitative design. The research locations consist of setting, participant, and event as focused determined boundary. Sources of datum are “The Space between Us” movie and informant (translation quality rater). The sampling is criterion-based sampling (purposive sampling). Data collection techniques use content analysis and questioner. Data validation applies data source and method triangulation. Data analysis delivers domain, taxonomy, componential, and cultural theme analysis. Data findings on the language errors happened in the movie are referential, register, society, textual, receptive, expressive, individual, group, analogical, transfer, local, and global errors. Data discussions on their effects to translation quality are concentrated by translation techniques on their data findings; they are amplification, borrowing, description, discursive creation, established equivalent, generalization, literal, modulation, particularization, reduction, substitution, and transposition.

Keywords: discourse analysis, language errors, The Space between Us movie, translation techniques, translation quality instruments

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19907 A Case Study of Psycho-Social Status of Rohingya Women Refugees Settled in Delhi

Authors: Fizza Saghir

Abstract:

Rohingyas are an ethnic minority of predominantly Buddhist-Myanmar. Living in ghettos in Rakhine, one of the poorest states of Myanmar, for decades, they have been marginalized, discriminated, deprived of the basic amenities and have faced ghastly violations of their rights- politically, socially, economically and culturally. In 2012, in violence that, erupted between ethnic Rakhine Buddhists and Rohingya Muslims, hundreds of Rohingyas were slayed and many more displaced. The state does not recognize them as ‘citizens’ and the military and police have constantly persecuted and pushed them to either migrate to other countries like India, Bangladesh or else die of deprivation. Amidst the deadly violence, Rohingya women are the most vulnerable. Many of them have faced sexual abuse and gender-based violence. Minimalistic to insignificant studies have been done on the plight of Rohingya women refugees in context of India. Thus, this paper focuses on psycho-social status of Rohingya women refugees settled in Delhi, India. The research study used both quantitative and qualitative methods. It was explorative in nature and used non-probability sampling, purposive sampling, in particular. A sample size of 30 Rohingya women refugees was interviewed out of the universe of 45 Rohingya refugee families living in Kalindi Kunj Refugee Camp of Delhi. Case studies were developed. The paper explores the psychological and social status of the respondents along with a deep understanding of their issues and concerns. Moreover, it assesses the impact of violence and migration on respondents. It was found that Rohingya women refugees are deeply and severely affected by a violent past, an insecure present and an uncertain future. Major problems they face in Delhi, India are finding employment, lack of identity cards to avail government services, language barrier, lack of health and education facilities. All they desire is peace and shelter in India. Besides, recommendations and suggestions have been given to various stakeholders of the forced mass migration of Rohingya refugees which includes, Government of Myanmar, Government of India, other bordering nations of Myanmar, international NGOs and media and the Rohingya community, itself. Only an immediate, peaceful and continuous dialogue process can help resolve the issue of exodus of Rohingyas. Countries, including India, must come together to help the Rohingyas who are in need of urgent humanitarian aid and assistance.

Keywords: dialogue process, ethnic minority, forced mass migration, impact of violence and migration, psycho-social status, Rohingya women refugees, sexual abuse

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19906 Partially Knowing of Least Support Orthogonal Matching Pursuit (PKLS-OMP) for Recovering Signal

Authors: Israa Sh. Tawfic, Sema Koc Kayhan

Abstract:

Given a large sparse signal, great wishes are to reconstruct the signal precisely and accurately from lease number of measurements as possible as it could. Although this seems possible by theory, the difficulty is in built an algorithm to perform the accuracy and efficiency of reconstructing. This paper proposes a new proved method to reconstruct sparse signal depend on using new method called Least Support Matching Pursuit (LS-OMP) merge it with the theory of Partial Knowing Support (PSK) given new method called Partially Knowing of Least Support Orthogonal Matching Pursuit (PKLS-OMP). The new methods depend on the greedy algorithm to compute the support which depends on the number of iterations. So to make it faster, the PKLS-OMP adds the idea of partial knowing support of its algorithm. It shows the efficiency, simplicity, and accuracy to get back the original signal if the sampling matrix satisfies the Restricted Isometry Property (RIP). Simulation results also show that it outperforms many algorithms especially for compressible signals.

Keywords: compressed sensing, lest support orthogonal matching pursuit, partial knowing support, restricted isometry property, signal reconstruction

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19905 Socioeconomic Status and Use of Web-Based Information Resources by Public Polytechnic Students in Southwestern Nigeria

Authors: John Adeboye Oyeboade, Pius Olatunji Olaojo, Kuburay Folashade Yusuf, John Oluwaseye Adebayo

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Web-based Information Resources (WBIR) are increasingly becoming essential tools for students to accomplish academic tasks. Preliminary observation revealed that many polytechnic libraries in Southwestern Nigeria do not subscribe or renew subscriptions to WBIR academic databases, and students use free-based electronic resources. Hence, this study was carried out to investigate socioeconomic status and use of WBIR by public polytechnic students in Southwestern Nigeria. Six public polytechnics out of the 16 offerings of Higher National Diploma (HND) programs were selected by stratified random sampling to reflect federal and state polytechnics. A proportionate size sampling technique was used to select 1,463 HND students. The instruments used were Socioeconomic status (SeS) (α=0.81) and WBIR used for Academic Tasks (α=0.98) scales. Data were analyzed using descriptive statistics and Pearson’s product-moment correlation at a 0.05 level of significance. Students’ SeS ( =79.10) was moderate. Online reference sources ( =3.97), Web 2.0 ( =3.50), and social media ( =3.00) were regularly used WBIR. WBIR use ( =53.34) was moderate. The students used WBIR for project writing ( =3.46) and class assignments ( =3.42). The Students’ SeS (r=0.59) had significant relationships with WBIR use. Socioeconomic status directly influenced the use of WBIR for academic tasks. Management of polytechnics should provide WBIR subscriptions for students’ use in the polytechnic e-libraries.

Keywords: public polytechnic students, polytechnic libraries, socioeconomic status, Web-based information resources

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19904 Patients' Satisfaction about Private Sector Primary Care Nurses in Sri Lanka

Authors: N. R. N. Mendis, S. N. Silva

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Introduction: Patient satisfaction of services provided by primary care health services depends on many factors. One key factor in this depends on is the nursing services received in primary care. Since majority of the primary care in Sri Lanka is provided by the private sector, it is important to assess patient satisfaction on this. Objective: To assess the satisfaction among the public on nurses working in dispensaries in Sri Lanka. Methods: A descriptive study was done on 200 individual selected using convenient sampling among dispensaries in Gampaha district, Sri Lanka. Results: 59.3% of the sample had long term illnesses or disabilities and all of them preferred speaking to a nurse. 70.9% of the sample used to make appointments with nurses while 57.8% out of them were comfortable in discussing their health concerns. 98.9 % agreed that they get individual attention by the nurses. Majority of the sample that is 34.2% spends around 20 minutes with the nurse without even making any pay. Significantly, the whole sample believes that the nurses are professional and admits that the care given is of high quality. All 100% of the sample said that the nurses could understand their concerns while 93.5% admitted that it was very useful in their recovery. Conclusions: Majority of the public were very much satisfied with the nurses and their practice at the dispensaries.

Keywords: health education, nurses practices, patient satisfaction, primary care

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19903 A Survey on the Supervision Experience of Full-Time Intern Counseling Psychologist

Authors: Szu-Fan Chen, Cheng-Tseng Lin, Ting-Chia Lien

Abstract:

This study mainly focuses on understanding the current supervision experience of full-time intern counseling psychologists in Taiwan. This study took 197 full-time intern counseling psychologists as the research subjects, including 146 women (74%) and 51 men (26%). In terms of internship sites, the largest number of internships are in school sites (59%), followed by community sites (30%), and fewer in medical fields or corporate sites (only 11%). In addition, a survey was conducted on whether the subjects had full-time jobs before full-time internship. 42% did not have full-time workers, and 48% had full-time workers. However, among those who had full-time workers, 28% were engaged in work related to psychological counseling. 20% are engaged in work unrelated to psychological counseling. In the sample of this study, each person interviewed on average 2.68 internship institutions in total, and the current internship unit is the 2.29th institution interviewed. All (100%) full-time intern psychologists have entered into individual internship contracts with internship institutions. In terms of professional supervisor candidates, a total of 178 (90%) supervisors were appointed by internal personnel of the institution, and a total of 19 (10%) were hired as supervisors from outside the institution. Regarding the form of supervision, it is mostly conducted through individual supervision (98%), and up to 60% is conducted through discussion of written/oral case reports. In terms of supervision satisfaction, 47% were very satisfied, 28% were satisfied, 18% were OK, and 6% were dissatisfied. It is worth noting that the results of this study show that full-time intern counseling psychologists said that they are under pressure to accept supervision (30%). It is recommended that the internship system should standardize the qualification review and evaluation of internship institutions to facilitate institutional control. Furthermore, the personal difficulties of full-time intern psychologists need to be discussed with the internship institution and supervisor from time to time to jointly assist them in completing their professional studies stably and successfully. Finally, it is recommended that future researchers can use the interview method provided by the author to strengthen their understanding of the supervision experience of full-time intern counseling psychologists, so that in the future, this study can provide relevant specific and feasible suggestions for counseling practitioners and future researchers' reference.

Keywords: full-time intern counseling psychologist, supervision experience, full-time intership, supervision

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19902 Cloud-Based Dynamic Routing with Feedback in Formal Methods

Authors: Jawid Ahmad Baktash, Mursal Dawodi, Tomokazu Nagata

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With the rapid growth of Cloud Computing, Formal Methods became a good choice for the refinement of message specification and verification for Dynamic Routing in Cloud Computing. Cloud-based Dynamic Routing is becoming increasingly popular. We propose feedback in Formal Methods for Dynamic Routing and Cloud Computing; the model and topologies show how to send messages from index zero to all others formally. The responsibility of proper verification becomes crucial with Dynamic Routing in the cloud. Formal Methods can play an essential role in the routing and development of Networks, and the testing of distributed systems. Event-B is a formal technique that consists of describing the problem rigorously and introduces solutions or details in the refinement steps. Event-B is a variant of B, designed for developing distributed systems and message passing of the dynamic routing. In Event-B and formal methods, the events consist of guarded actions occurring spontaneously rather than being invoked.

Keywords: cloud, dynamic routing, formal method, Pro-B, event-B

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19901 The Role of Family’s Emotional Climate and Emotional Expression Style in Academic Well-Being of Students with Military Parent

Authors: Ala Rakhshandeh, Zahra Ashkar, Solmaz Dehghani Dolatabadi, Hossein Bayat

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The present study has been conducted to investigate the role of family emotional climate and emotional expression style in the academic well-being of students with military parents. Children, including 280 female students of Shahriar police officers, were selected by random sampling method, and they have been investigated through Alfred B. Hillburn's family emotional climate questionnaire (1964), King and Ammon's emotional expression questionnaire (1990), and Pitrinen, Sweeney, and Falto's academic well-being questionnaire (2014). The data were analyzed using statistical methods of correlation coefficient and stepwise multiple regression under the SPSS23 program. The results reveal that the variables of family emotional climate and emotional expression can explain 36.4% of the variance in academic well-being. This finding reveals that with an increase of standard deviation on the scores of family emotional climate and emotional expression, 0.513 and 0.155 standard deviations are added to the scores of academic well-being, respectively. The emotional climate of the family has a superior distinctive role in predicting the educational well-being of female students. Thus, the emotional climate of the family and the style of emotional expression play a meaningful role in the academic well-being of students with the military parent.

Keywords: emotional climate, family, emotional expression style, academic well-being

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19900 Difficulties for Implementation of Telenursing: An Experience Report

Authors: Jacqueline A. G. Sachett, Cláudia S. Nogueira, Diana C. P. Lima, Jessica T. S. Oliveira, Guilherme K. M. Salazar, Lílian K. Aguiar

Abstract:

The Polo Amazon Telehealth offers several tools for professionals working in Primary Health Care as a second formative opinion, teleconsulting and training between the different areas, whether medicine, dentistry, nursing, physiotherapy, among others. These activities have a monthly schedule of free access to the municipalities of Amazonas registered. With this premise, and in partnership with the University of the State of Amazonas (UEA), is promoting the practice of the triad; teaching-research-extension in order to collaborate with the enrichment and acquisition of knowledge through educational practices carried out through teleconferences. Therefore, nursing is to join efforts and inserts as a collaborator of this project running, contributing to the education and training of these professionals who are part of the health system in full Amazon. The aim of this study is to report the experience of academic of Amazonas State University nursing course, about the experience in the extension project underway in Polo Telemedicine Amazon. This was a descriptive study, the experience report type, about the experience of nursing academic UEA, by extension 'Telenursing: teleconsulting and second formative opinion for FHS professionals in the state of Amazonas' project, held in Polo Telemedicine Amazon, through an agreement with the UEA and funded by the Foundation of Amazonas Research from July / 2012 to July / 2016. Initially developed active search of members of the Family Health Strategy professionals, in order to provide training and training teams to use the virtual clinic, as well as the virtual environment is the focus of this tool design. The election period was an aggravating factor for the implementation of teleconsulting proposal, due to change of managers in each municipality, requiring the stoppage until they assume their positions. From this definition, we established the need for new training. The first video conference took place on 03.14.2013 for learning and training in the use of Virtual Learning Environment and Virtual Clinic, with the participation of municipalities of Novo Aripuanã, São Paulo de Olivença and Manacapuru. During the whole project was carried out literature about what is being done and produced at the national level about the subject. By the time the telenursing project has received twenty-five (25) consultancy requests. The consultants sent by nursing professionals, all have been answered to date. Faced with the lived experience, particularly in video conferencing, face to cause difficulties issues, such as the fluctuation in the number of participants in activities, difficulty of participants to reconcile the opening hours of the units with the schedule of video conferencing, transmission difficulties and changes schedule. It was concluded that the establishment of connection between the Telehealth points is one of the main factors for the implementation of Telenursing and that this feature is still new for nursing. However, effective training and updating, may provide to these professional category subsidies to quality health care in the Amazon.

Keywords: Amazon, teleconsulting, telehealth, telenursing

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19899 An Audit on Tracheal Tube Cuff Pressure Check and Monitoring during Current Practice

Authors: Mahmoud Hassanin, Roshan Thawale, Kiran Yelamati

Abstract:

Background: During current practice, intraoperative regular endotracheal cuff pressure monitoring is not routine, despite the significant number of clinicians interested in checking it after intubation to ensure a good seal and adequate ventilation. Aims and objectives: to highlight that the current practice has no guidance related to regular intra-operative monitoring of the endotracheal tube cuff pressure, which can improve patient safety and post-operative experience. Methods: local department survey was done targeting anaesthetists' current practice, measuring their knowledge and problem awareness to improve patient satisfaction and change the current approach. Results: The participants were not using the manometer, despite their interest in ensuring that the cuff pressure was high enough and there was a proper seal. More than 50% of the participant don't know the ideal range of the endotracheal tube cuff pressure range, and 32% don't know whether it is available or not in the theatre. Despite the previous finding, 100% of the participants used different methods to ensure adequate cuff pressure. The collected data revealed that at least 26% of the participant confirmed that they had seen patients having post-intubation complications. Conclusion: There is an increasing importance placed on quality assurance. Clinical practice varies widely among practitioners, with the only consistency being the omission of cuff manometers during routine intra-operative management, despite their proven benefit and efficacy. Encourage the anaesthetists and ODPs to use cuff pressure manometers. The availability of portable pressure manometers can help to maintain safe cuff pressures in patients requiring endotracheal intubation.

Keywords: endotracheal cuff pressure, intra-operative monitoring, current practice, patient satisfaction

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19898 Students’ Attitudes towards Reading as a Determinant of Performance in O’ Level English in Oyo State Secondary Schools, Nigeria

Authors: Adebimpe Olubunmi Adebanjo

Abstract:

This study observed students’ attitudes towards reading as a determinant of performance in O’ Level English in Oyo state secondary schools. Random sampling technique was used to select two schools from each of the five geo-political zones of the state while stratified sampling technique was used to select twenty students from each of the ten schools. A researcher designed questionnaire was used to gather information on students’ attitudes while a prepared test based on O’ Level syllabus was stapled to each of the questionnaire to ascertain their level of achievement in O’ Level English. The Percentage, Mean, Standard Deviation, Chi-square and Pearson Contingency Coefficient were used to answer and test the research questions and hypotheses raised. The findings showed that the general attitude of students towards reading was ambivalent; the general level of achievement was also low. The findings also revealed that there was a significant difference in the attitudes of students to reading on the basis of gender and home background. Students from educated homes also had better attitudes towards reading than their counterparts from illiterate homes. The findings also showed that there was a significant relationship between students’ attitudes to reading and their performance in O’ Level English. Students with positive attitude to reading had better grades in O’ Level English than students with ambivalent and negative attitudes. Based on the findings, it was recommended that students should change their attitudes to reading; the school and the home were also advised to always encourage students to read.

Keywords: positive, ambivalent, negative attitudes, o' level English

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19897 Morphological and Property Rights Control of Plot Pattern in Urban Regeneration: Case Inspiration from Germany and the United States

Authors: Nan Wu, Peng Liu

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As a morphological element reflecting the land property rights structure, the plot pattern plays a crucial role in shaping the form and quality of the built environment. Therefore, it is one of the core control elements of urban regeneration. As China's urban development mode is shifting from growth-based development to urban regeneration, it is urgent to explore a more refined way for the planning control of the plot pattern, which further promotes the optimization of urban form and land property structure. European and American countries such as Germany and the United States began to deal with the planning control of plot patterns in urban regeneration earlier and established relatively mature methods and mechanisms. Therefore, this paper summarizes two typical scenarios of plot pattern regeneration in old cities in China: the first one is "limited scale plot pattern rezoning", which mainly deals with the regeneration scenario of tearing down the old and building the new, and the focus of its control is to establish an adaptive plot pattern rezoning methodology and mechanism; The second is "localized parcel regeneration under the existing property rights," which mainly deals with the renewal scenario of alteration and addition, and its control focuses on the establishment of control rules for individual plot regeneration. For the two typical plot pattern regeneration scenarios, Germany (Berlin) and the United States (New York) are selected as two international cases with reference significance, and the framework of plot pattern form and property rights control elements of urban regeneration is established from four latitudes, namely, the overall operation mode, form control methods, property rights control methods, and effective implementation prerequisites, so as to compare and analyze the plot pattern control methods of the two countries under different land systems and regeneration backgrounds. Among them, the German construction planning system has formed a more complete technical methodology for block-scale rezoning, and together with the overall urban design, it has created a practical example in the critical redevelopment of the inner city of Berlin. In the United States (New York), the zoning method establishes fine zoning regulations and rules for adjusting development rights based on the morphological indicators plots so as to realize effective control over the regeneration of local plots under the existing property rights pattern. On the basis of summarizing the international experience, we put forward the proposal of plot pattern and property rights control for the organic regeneration of old cities in China.

Keywords: plot pattern, urban regeneration, urban morphology, property rights, regulatory planning

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19896 Location and Group Specific Differences in Human-Macaque Interactions in Singapore: Implications for Conflict Management

Authors: Srikantan L. Jayasri, James Gan

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The changes in Singapore’s land use, natural preference of long-tailed macaques (Macaca fascicularis) to live in forest edges and their adaptability has led to interface between humans and macaques. Studies have shown that two-third of human-macaque interactions in Singapore were related to human food. We aimed to assess differences among macaques groups in their dependence on human food and interaction with humans as indicators of the level of interface. Field observations using instantaneous scan sampling and all occurrence ad-lib sampling were carried out for 23 macaque groups over 28 days recording 71.5 hours of observations. Data on macaque behaviour, demography, frequency, and nature of human-macaque interactions were collected. None of the groups were found to completely rely on human food source. Of the 23 groups, 40% of them were directly or indirectly provisioned by humans. One-third of the groups observed engaged in some form of interactions with the humans. Three groups that were directly fed by humans contributed to 83% of the total human-macaque interactions observed during the study. Our study indicated that interactions between humans and macaques exist in specific groups and in those fed by humans regularly. Although feeding monkeys is illegal in Singapore, such incidents seem to persist in specific locations. We emphasize the importance of group and location-specific assessment of the existing human-wildlife interactions. Conflict management strategies developed should be location specific to address the cause of interactions.

Keywords: primates, Southeast Asia, wildlife management, Singapore

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19895 Need for Shariah Screening of Companies in Nigeria: Lessons from Other Jurisdictions

Authors: Aishat Abdul-Qadir Zubair

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Background: The absence of Shari’ah screening methodology for companies in Nigeria has further engineered the uncertainty surrounding the acceptability of investing in certain companies by people professing the religion of Islam due to the nature of the activities carried out by these companies. There are some existing shariah screening indices in other jurisdictions whose criteria can be used to check if a company or business is shariah-compliant or not. Examples such as FTSE, DJIM, Standard and Poor to mention just a few. What these indices have tried to do is to ensure that there are benchmarks to check with before investing in companies that carry out mixed activities in their business, wherein some are halal and others may be haram. Purpose: There have been numerous studies on the need to adopt certain screening methodologies as well as call for new methods in screening companies for shariah compliance in order to suit the investments needs of Muslims in other jurisdictions. It is, however, unclear how suitable these methodologies will be to Nigeria. This paper, therefore, seeks to address this gap to consider an appropriate screening methodology to be employed in Nigeria, drawing from the experience of other jurisdictions. Methods: This study employs a triangulation of both quantitative and qualitative methods to analyze the need for Shari’ah screening of companies in Nigeria. The qualitative method is used by way of ijtihad, and this study tries to apply some Islamic Principles of Maqasid al-shari’ah as well as Qawaid al-Fiqiyyah to analyze activities of companies in order to ensure that they are indeed Shari’ah compliant. In addition, using the quantitative data gathered from the interview survey, the perspective of the investors with regards to the need for Shari’ah screening of companies in Nigeria is further analyzed. Results: The result of the study shows that there is a lack of awareness from the teeming Muslim population in Nigeria on the need for Shari’ah screening of companies in Nigeria. The result further shows that there is the need to take into cognizance the peculiar nature of company activities in Nigeria before any particular Shari’ah screening methodology is adopted and setting the necessary benchmarks. Conclusion and Implications: The study concludes that there is the need to ensure that the conscious Muslims in Nigeria screen companies for Shari’ah compliance so that they can easily identify the companies to invest in. The paper, therefore, recommends that the Nigerian government need to come up with a screening methodology that will suit the peculiar nature of companies in Nigeria. The study thus has a direct implication on the Investment regulatory bodies in Nigeria such as the Securities and Exchange Commission (SEC), Central Bank of Nigeria (CBN) as well as the investor Muslims.

Keywords: Shari'ah screening, Muslims, investors, companies

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19894 Gap Analysis of Service Quality: The Veterinary Teaching Hospital, University of Peradeniya, Sri Lanka

Authors: Preethi Sudarshanie Dassanayake, R. A. Sudath Weerasiri

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Objective: The objective of this study were to find out highest expectation and perception,highest gap between perception and expectation of service quality, and to find out such gaps between perception and expectation with regard to service quality dimensions were whether statistically significant. Methodology: This study carried out at the Out Patient Department (OPD) of the Veterinary Teaching Hospital (VTH), University of Peradeniya. Modified version of SERVQUAL with 22-pairs of items regarding expectation and perception of service quality in dimensions of tangible, reliability, responsiveness, assurance and empathy were included in Part 1 and the Part 2 of the questionnaire consisted of questions regarding socio-demographic factors. Sample size was 200 and sampling procedure was Systematic Random Sampling. Customers above 18 years of age, able to read, write and understand Sinhala or English language, visits more than twice in last six months and who willing to respond were selected. Findings: The analysis revealed customers expectations of service higher than the perceived for all 22- items of the SERVQUAL. This high expectation suggests that there is sufficient room for further improvement of service quality in all five dimensions. Originality/Value of the Paper: This study gave a new insight for poorly researched area of veterinary health service quality in Sri Lankan context. It provides hospital administrators and policy makers to develop strategies for further improvement of service quality according to customers' view.

Keywords: expectation, perception, service quality, SERVQUAL, veterinary health care

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19893 Virtual Reality as a Method in Transformative Learning: A Strategy to Reduce Implicit Bias

Authors: Cory A. Logston

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It is imperative researchers continue to explore every transformative strategy to increase empathy and awareness of racial bias. Racism is a social and political concept that uses stereotypical ideology to highlight racial inequities. Everyone has biases they may not be aware of toward disparate out-groups. There is some form of racism in every profession; doctors, lawyers, and teachers are not immune. There have been numerous successful and unsuccessful strategies to motivate and transform an individual’s unconscious biased attitudes. One method designed to induce a transformative experience and identify implicit bias is virtual reality (VR). VR is a technology designed to transport the user to a three-dimensional environment. In a virtual reality simulation, the viewer is immersed in a realistic interactive video taking on the perspective of a Black man. The viewer as the character experiences discrimination in various life circumstances growing up as a child into adulthood. For instance, the prejudice felt in school, as an adolescent encountering the police and false accusations in the workplace. Current research suggests that an immersive VR simulation can enhance self-awareness and become a transformative learning experience. This study uses virtual reality immersion and transformative learning theory to create empathy and identify any unintentional racial bias. Participants, White teachers, will experience a VR immersion to create awareness and identify implicit biases regarding Black students. The desired outcome provides a springboard to reconceptualize their own implicit bias. Virtual reality is gaining traction in the research world and promises to be an effective tool in the transformative learning process.

Keywords: empathy, implicit bias, transformative learning, virtual reality

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19892 Project-Based Learning Application: Applying Systems Thinking Concepts to Assure Continuous Improvement

Authors: Kimberley Kennedy

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The major findings of this study discuss the importance of understanding and applying Systems thinking concepts to ensure an effective Project-Based Learning environment. A pilot project study of a major pedagogical change was conducted over a five year period with the goal to give students real world, hands-on learning experiences and the opportunity to apply what they had learned over the past two years of their business program. The first two weeks of the fifteen week semester utilized teaching methods of lectures, guest speakers and design thinking workshops to prepare students for the project work. For the remaining thirteen weeks of the semester, the students worked with actual business owners and clients on projects and challenges. The first three years of the five year study focused on student feedback to ensure a quality learning experience and continuous improvement process was developed. The final two years of the study, examined the conceptual understanding and perception of learning and teaching by faculty using Project-Based Learning pedagogy as compared to lectures and more traditional teaching methods was performed. Relevant literature was reviewed and data collected from program faculty participants who completed pre-and post-semester interviews and surveys over a two year period. Systems thinking concepts were applied to better understand the challenges for faculty using Project-Based Learning pedagogy as compared to more traditional teaching methods. Factors such as instructor and student fatigue, motivation, quality of work and enthusiasm were explored to better understand how to provide faculty with effective support and resources when using Project-Based Learning pedagogy as the main teaching method. This study provides value by presenting generalizable, foundational knowledge by offering suggestions for practical solutions to assure student and teacher engagement in Project-Based Learning courses.

Keywords: continuous improvement, project-based learning, systems thinking, teacher engagement

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19891 The Need for Sustaining Hope during Communication of Unfavourable News in the Care of Children with Palliative Care Needs: The Experience of Mothers and Health Professionals in Jordan

Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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A preliminary systematic review shows that health professionals experience a tension when communicating with the parents and family members of children with life-threatening and life-limiting conditions. On the one hand, they want to promote open and honest communication, while on the other, they are apprehensive about fostering an unrealistic sense of hope. Defining the boundaries between information that might offer reasonable hope versus that which results in false reassurance is challenging. Some healthcare providers worry that instilling a false sense of hope could motivate parents to seek continued aggressive treatment for their child, which in turn might cause the patient further unnecessary suffering. To date, there has been a lack of research in the Middle East regarding how healthcare providers do or should communicate bad news; in particular, the issue of hope in the field of paediatric palliative care has not been researched thoroughly. This study aims to explore, from the perspective of patients’ mothers, physicians, and nurses, the experience of communicating and receiving bad news in the care of children with palliative care needs. Data were collected using a collective qualitative case study approach across three paediatric units in a Jordanian hospital. Two data collection methods were employed: participant observation and semi-structured interviews. The overall number of cases was 15, with a total of 56 interviews with mothers (n=24), physicians (n=12), and nurses (n=20) completed, as well as 197 observational hours logged. The findings demonstrate that mothers wanted their doctors to provide them with hopeful information about the future progression of their child’s illness. Although some mothers asked their doctors to provide them with honest information regarding the condition of their child, they still considered a sense of hope to be essential for coping with caring for their child. According to mothers, hope was critical to treatment as it helped them to stay committed to the treatment and protected them to some extent from the extreme emotional suffering that would occur if they lost hope. The health professionals agreed with the mothers on the importance of hope, so long as it was congruent with the stage and severity of each patient’s disease. The findings of this study conclude that while parents typically insist on knowing all relevant information when their child is diagnosed with a severe illness, they considered hope to be an essential part of life, and they found it very difficult to handle suffering without any glimmer of it. This study finds that using negative terms has extremely adverse effects on the parents’ emotions. Hence, although the mothers asked the doctors to be as honest as they could, they still wanted the physicians to provide them with a positive message by communicating this information in a sensitive manner including hope.

Keywords: health professionals, children, communication, hope, information, mothers, palliative care

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19890 Reconceptualizing Human Trafficking: Revealings of the Experience of Ethiopian Migrant Returnees

Authors: Waganesh Zeleke, Abebaw Minaye

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This study examined the act, means, and purpose of human trafficking in the case of Ethiopian migrant returnees from the Middle East and South Africa. Using a questionnaire survey data was gathered from 1078 returnees. Twelve focus group discussions were used to solicit detailed experience of returnee about the process of their 'unsafe' immigration. Both quantitative and qualitative analysis results revealed that against the mainstream thinking of human trafficking means such as forcing, coercing, abducting or threatening, traffickers used 'victims’ free will' means by providing false promises to and capitalizing on the vulnerability of migrants. The migrants’ living condition including unemployment, ambitious view to change their life, and low level of risk perception were found to be risk factors which made them vulnerable and target of the brokers and smugglers who served as a catalyst in the process of their 'unsafe' migration. Equal to the traffickers/brokers/agency, the migrants’ family, friends and Ethiopian embassies contributed to the deplorable situation of migrant workers. 64.4% of the returnees reported that their migration is self-initiated, and 20% reported peer pressure and 13.8 percent reported family pressure, and it is only 1.8% who reported having been pushed by brokers. The findings revealed that 69.5% of the returnees do not know about the lifestyle and culture of the host community before their leave. In a similar vein, 50.9% of the returnees reported that they do not know about the nature of the work they are to do and their responsibilities. Further, 81% of the returnees indicated that the pre-migration training they received was not enough in equipping them with the required skill. Despite the returnees experiences of various forms of abuse and exploitation in the journey and at the destination they still have a positive attitude for migration (t=9.7 mean of 18.85 with a test value of 15). The returnees evaluated the support provided by sending agencies and Ethiopian embassies in the destination to be poor. 51.8% of the migrants do not know the details of the contract they signed during migration. Close to 70% of the returnees expressed that they had not got any legal support from stakeholders when they faced problems. What is more is that despite all these 27.9% of the returnees indicated re-immigrating as their plan. Based on these findings on the context and experience of Ethiopian migrant returnees, implications for training, policy, research, and intervention are discussed.

Keywords: trafficking, migrant, returnee, Ethiopia, experience, reconceptualizing

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19889 Component Comparison of Polyaluminum Chloride Produced from Various Methods

Authors: Wen Po Cheng, Chia Yun Chung, Ruey Fang Yu, Chao Feng Chen

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The main objective of this research was to study the differences of aluminum hydrolytic products between two PACl preparation methods. These two methods were the acidification process of freshly formed amorphous Al(OH)3 and the conventional alkalization process of aluminum chloride solution. According to Ferron test and 27Al NMR analysis of those two PACl preparation procedures, the reaction rate constant (k) values and Al13 percentage of acid addition process at high basicity value were both lower than those values of the alkaline addition process. The results showed that the molecular structure and size distribution of the aluminum species in both preparing methods were suspected to be significantly different at high basicity value.

Keywords: polyaluminum chloride, Al13, amorphous aluminum hydroxide, Ferron test

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19888 Integrating Distributed Architectures in Highly Modular Reinforcement Learning Libraries

Authors: Albert Bou, Sebastian Dittert, Gianni de Fabritiis

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Advancing reinforcement learning (RL) requires tools that are flexible enough to easily prototype new methods while avoiding impractically slow experimental turnaround times. To match the first requirement, the most popular RL libraries advocate for highly modular agent composability, which facilitates experimentation and development. To solve challenging environments within reasonable time frames, scaling RL to large sampling and computing resources has proved a successful strategy. However, this capability has been so far difficult to combine with modularity. In this work, we explore design choices to allow agent composability both at a local and distributed level of execution. We propose a versatile approach that allows the definition of RL agents at different scales through independent, reusable components. We demonstrate experimentally that our design choices allow us to reproduce classical benchmarks, explore multiple distributed architectures, and solve novel and complex environments while giving full control to the user in the agent definition and training scheme definition. We believe this work can provide useful insights to the next generation of RL libraries.

Keywords: deep reinforcement learning, Python, PyTorch, distributed training, modularity, library

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19887 Socio-Motor Experience between Affectivity and Movement from Harry Potter to Lord of the Rings

Authors: Manuela Gamba, Niki Mandolesi

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Teenagers today have little knowledge about how to move or play together. The adults who are part of sports culture must find an effective way to foster this essential ability. Our research in Italy uses a 'holistic model' based on fantasy literature to explore the relationships between the game identities and self-identities of young people and the achievement of psycho-motor, emotional and social well-being in the realms of sport and education. Physical activity projects were carried out in schools and extra-curricular associations in Rome, combining outdoor activities and distance learning. This holistic and malleable game model is inspired by fantasy accounts of the journeys taken in The Lord of Rings and Harry Potter books. We know that many have a lot of resistance to the idea of using fantasy and play as a pedagogical tool, but the results obtained in this experience are surprising. Our interventions and investigations focused on promoting self-esteem, awareness, a sense of belonging, social integration, cooperation, well-being, and informed decision making: a basis for healthy and effective citizenship. For teenagers, creative thinking is the right stimulus to involve and compare the story of characters to their own journey through social and self-reflective identity analysis. We observed how important it is to engage students emotionally as well as cognitively and that enabling them to play with identity through relationships with peers. There is a need today for a multidisciplinary synthesis of analog and digital values, especially in response to recent distance-living experiences. There is a need for a global reconceptualization of free time and nature in the human experience.

Keywords: awareness, creativity, identity, play

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19886 Intensive Care Nursing Experience of a Lung Cancer Patient Receiving Palliative

Authors: Huang Wei-Yi

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Objective: This article explores the intensive care nursing experience of a terminal lung cancer patient who received palliative care after tracheal intubation. The patient was nearing death, and the family experienced sadness and grief as they faced the patient’s deteriorating condition and impending death. Methods: The patient was diagnosed with lung cancer in 2018 and received chemotherapy and radiation therapy with regular outpatient follow-ups. Due to brain metastasis and recent poor pain control and treatment outcomes, the patient was admitted to the intensive care unit (ICU), where the tracheal tube was removed, and palliative care was initiated. During the care period, a holistic assessment was conducted, addressing the physical, psychological, social, and spiritual aspects of care. Medical records were reviewed, interviews and family meetings were held, and a comprehensive assessment was carried out by the critical care team in collaboration with the palliative care team. The primary nursing issues identified included pain, ineffective breathing patterns, fear of death, and altered tissue perfusion. Results: Throughout the care process, the palliative care nurse, along with the family, utilized listening, caring, companionship, pain management, essential oil massage, distraction, and comfortable positioning to alleviate the patient’s pain and breathing difficulties. The use of Morphine 6mg in 0.9% N/S 50ml IV drip q6h reduced the FLACC pain score from 6 to 3. The patient’s respiratory rate improved from 28 breaths/min to 18-22 breaths/min, and sleep duration increased from 4 to 7 uninterrupted hours. The holistic palliative care approach, coupled with the involvement of the palliative care team, facilitated expressions of gratitude, apologies, and love between the patient and family. Visiting hours were extended, and with the nurse’s assistance, these moments were recorded and shared with the patient’s consent, providing cherished memories for the family. The patient’s end-of-life experience was thus improved, and the family was able to find peace. This case also served to promote the concept of palliative care, ensuring that more patients and families receive high-quality nursing care. Conclusion: When caring for terminal patients, collaboration with the palliative care team, including social workers, clergy, psychologists, and nutritionists, is essential. Involving the family in decision-making and providing opportunities for closeness and expressions of gratitude improve personalized care and enhance the patient's quality of life. Upon transferring to the ward, the patient’s hemodynamic stability was maintained, including SBP 110-130 mmHg, respiratory rate 20-22 breaths/min, and pain score <3. The patient was later discharged and transitioned to home hospice care for ongoing support.

Keywords: intensive care, lung cancer, palliative care, ICU

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19885 Factors Associated with Increase of Diabetic Foot Ulcers in Diabetic Patients in Nyahururu County Hospital

Authors: Daniel Wachira

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The study aims to determine factors contributing to increasing rates of DFU among DM patients attending clinics in Nyahururu County referral hospital, Lakipia County. The study objectives include;- To determine the demographic factors contributing to increased rates of DFU among DM patients, determining the sociocultural factors that contribute to increased rates of DFU among DM patients and determining the health facility factors contributing to increased rates of DFU among DM patients attending DM clinic at Nyahururu county referral hospital, Laikipia County. This study will adopt a descriptive cross-sectional study design. It involves the collection of data at a one-time point without follow-up. This method is fast and inexpensive, there is no loss to follow up as the data is collected at one time point and associations between variables can be determined. The study population includes all DM patients with or without DFU. The sampling technique that will be used is the probability sampling method, a simple random method of sampling will be used. The study will employ the use of questionnaires to collect the required information. Questionnaires will be a research administered questionnaires. The questionnaire developed was done in consultation with other research experts (supervisor) to ensure reliability. The questionnaire designed will be pre-tested by hand delivering them to a sample 10% of the sample size at J.M Kariuki Memorial hospital, Nyandarua county and thereafter collecting them dully filled followed by refining of errors to ensure it is valid for collection of data relevant for this study. Refining of errors on the questionnaires to ensure it was valid for collection of data relevant for this study. Data collection will begin after the approval of the project. Questionnaires will be administered only to the participants who met the selection criteria by the researcher and those who agreed to participate in the study to collect key information with regard to the objectives of the study. The study's authority will be obtained from the National Commission of Science and Technology and Innovation. Permission will also be obtained from the Nyahururu County referral hospital administration staff. The purpose of the study will be explained to the respondents in order to secure informed consent, and no names will be written on the questionnaires. All the information will be treated with maximum confidentiality by not disclosing who the respondent was and the information.

Keywords: diabetes, foot ulcer, social factors, hospital factors

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19884 Fighting COVID-19: Lessons and Experience from the World’s Largest Economies

Authors: Xiaowen Zhang, Wanda Luen-Wun Siu

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The paper reviews the insights gained in combating COVID-19 in the US, Japan, and China. After evaluation and investigation, we found that China’s and Japan’s experience of fighting COVID-19 is commendable. The Chinese government and the Japanese administration have implemented highly effective governance and public health course of action to fight COVID-19. Government-led epidemic control with a staunch belief in science can roll out effective pandemic control strategies. In contrast, the US failed to react to COVID-19 effectively. The relaxed public health measures of ending shutdowns prematurely were not working. When the US keeps business open after the spring shutdown, COVID-19 cases are soaring. Such experiences inform us effective governance and a mandatory and stricter approach can better curb a pandemic than milder measures in handling a public health emergency. And China and Japan, where collectivistic culture reins, can better maneuver a public health crisis with collective efforts.

Keywords: US, China, Japan, COVID-19

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19883 Experience in Caring for a Patient with Terminal Aortic Dissection of Lung Cancer and Paralysis of the Lower Limbs after Surgery

Authors: Pei-Shan Liang

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Objective: This article explores the care experience of a terminal lung cancer patient who developed lower limb paralysis after surgery for aortic dissection. The patient, diagnosed with aortic dissection during chemotherapy for lung cancer, faced post-surgical lower limb paralysis, leading to feelings of helplessness and hopelessness as they approached death with reduced mobility. Methods: The nursing period was from July 19 to July 27, during which the author, alongside the intensive care team and palliative care specialists, conducted a comprehensive assessment through observation, direct care, conversations, physical assessments, and medical record review. Gordon's eleven functional health patterns were used for a holistic evaluation, identifying four nursing health issues: "pain related to terminal lung cancer and invasive procedures," "decreased cardiac tissue perfusion due to hemodynamic instability," "impaired physical mobility related to lower limb paralysis," and "hopelessness due to the unpredictable prognosis of terminal lung cancer." Results: The medical team initially focused on symptom relief, administering Morphine 5mg in 0.9% N/S 50ml IVD q6h for pain management and continuing chemotherapy as prescribed. Open communication was employed to address the patient's physical, psychological, and spiritual concerns. Non-pharmacological interventions, including listening, caring, companionship, opioid medication, and distraction techniques like comfortable positioning and warm foot baths, were used to alleviate pain, reducing the pain score to 3 on the numeric rating scale and easing respiratory discomfort. The palliative care team was also involved, guiding the patient and family through the "Four Paths of Life," helping the patient achieve a good end-of-life experience and the family to experience a peaceful life. This process also served to promote the concept of palliative care, enabling more patients and families to receive high-quality and dignified care. The patient was encouraged to express inner anxiety through drawing or writing, which helped reduce the hopelessness caused by psychological distress and uncertainty about the disease's prognosis, as assessed by the Hospital Anxiety and Depression Scale, reaching a level of mild anxiety but acceptable without affecting sleep. Conclusion: What left a deep impression during the care process was the need for intensive care providers to consider the patient's psychological state, not just their physical condition, when the patient's situation changes. Family support and involvement often provide the greatest solace for the patient, emphasizing the importance of comfort and dignity. This includes oral care to maintain cleanliness and comfort, frequent repositioning to alleviate pressure and discomfort, and timely removal of invasive devices and unnecessary medications to avoid unnecessary suffering. The nursing process should also address the patient's psychological needs, offering comfort and support to ensure that they can face the end of life with peace and dignity.

Keywords: intensive care, lung cancer, aortic dissection, lower limb paralysis

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