Search results for: family nursing

Authors: Jamil Lane, Jason Freeman

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Background: The role of interpersonal relationships is vital predictors of adolescents’ eating habits, exercise activity, and health problems including obesity. The effect of interpersonal relationships (i.e. family, friends, and intimate partners) on individual health behaviors and development have gained considerable attention during the past 10 years. Teenagers eating habits and exercise activities are established through a dynamic course involving internal and external factors such as food preferences, body weight perception, and parental and peer influence. When conceptualizing one’s interpersonal relationships, it is important to understand that how one relates to others is shaped by their culture. East-Asian culture has been characterized as collectivistic, which describes the significant role intergroup relationships play in their construction of the self. Cultures found in North America, on the other hand, can be characterized as individualistic, meaning that these cultures encourage individuals to prioritize their interest over the needs and want of their compatriots. Individuals from collectivistic cultures typically have stronger boundaries between in-group and out-group membership, whereas those from individualistic cultures see themselves as distinct and separate from strangers as well as family or friends. Objective: The purpose of this study is to examine the effect of collectivism and individualism on interpersonal relationships that shapes eating patterns and physical activity among Asian-American and European-American adolescents. Design/Methods: Analyses were based on data from the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents in the United States who were surveyed from 1994 through 2008. This data will be used to examine interpersonal relationship factors that shape dietary intake and physical activity patterns within the Asian-American and European-American population in the United States. Factors relating to relationship strength, eating, and exercise behaviors were reported by participants in this first wave of data collection (1995). We plan to analyze our data using intragroup comparisons among those who identified as 'Asian-American' (n = 270) and 'White or European American' (n = 4,294) among the domains of positivity of peer influence and level of physical activity / healthy eating. Further, intergroup comparisons of these relationships will be made to extricate how the role positive peer influence in maintaining healthy eating and exercise habits differs with cultural variation. Results: We hypothesize that East-Asian participants with a higher degree of positivity in their peer and family relationships will experience a significantly greater rise in healthy eating and exercise behaviors than European-American participants with similar degrees of relationship positivity.

Keywords: interpersonal relationships, eating patterns, physical activity, adolescent health

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Authors: A. Dean, M. Pitcher, L. Storer, K. Shanahan, I. Rio, B. Mann

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Purpose: Breast cancer survivors are at risk of specific physical and psycho-social issues, such as arm swelling, fatigue, and depression. Firstly, we investigate symptoms reported by Australia breast cancer survivors upon completion of definitive treatment. Secondly, we evaluate the appropriateness and effectiveness of a multi-centre pilot program nurse-led clinic to identify these issues and make timely referrals to available services. Methods: Patients post-definitive treatment (excluding ongoing hormonal therapy) for early breast cancer or ductal carcinoma in situ were invited to participate. An hour long appointment with a breast care nurse (BCN) was scheduled. In preparation, patients completed validated quality-of-life surveys (FACT-B, Menopause Rating Scale, Distress Thermometer). During the appointment, issues identified in the surveys were addressed and referrals to appropriate services arranged. Results: 183 of 274 (67%) eligible patients attended a nurse-led clinic. Mean age 56.8 years (range 29-87 years), 181/183 women, 105/183 post-menopausal. 96 (55%) participants reported significant level of distress; 31 (18%) participants reported extreme distress or depression. Distress stemmed from a lack of energy (56/175); poor quality of sleep (50/176); inability to work or participate in household activities (35/172) and problems with sex life (28/89). 166 referrals were offered; 94% of patients accepted the referrals. 65% responded to a follow-up survey: the majority of women either strongly agreed or agreed that the BCN was overwhelmingly supportive, helpful in making referrals, and compassionate towards them. 39% reported making lifestyle changes as a result of the BCN. Conclusion: Breast cancer survivors experience a unique set of challenges, including low mood, difficulty sleeping, problems with sex life and fear of disease recurrence. The nurse-led clinic model is an appropriate and effective method to ensure physical and psycho-social issues are identified and managed in a timely manner. This model empowers breast cancer survivors with information about their diagnosis and available services.

Keywords: early breast cancer, survivorship, breast care nursing, oncology nursing and cancer care

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Authors: Rayanne Branco Dos Santos Lima, Lorena Pinheiro Barbosa, Kamila Ferreira Lima, Victor Manuel Tegoma Ruiz, Monyka Brito Lima Dos Santos, Maria Wendiane Gueiros Gaspar, Luzia Camila Coelho Ferreira, Leandro Cardozo Dos Santos Brito, Deyse Maria Alves Rocha

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Introduction: The lack of regulation of the baby's sleep-wake pattern in the first years of life affects the health of thousands of women. Maternal sleep deprivation can trigger or aggravate psychosomatic problems such as depression, anxiety and stress that can directly influence maternal safety, with consequences for the baby's and mother's sleep. Such conditions can affect the family's quality of life and child development. Objective: To correlate maternal security with maternal state anxiety scores and the mother's and baby's total sleep time. Method: Cross-sectional study carried out with 96 mothers of babies aged 10 to 24 months, accompanied by nursing professionals linked to a Federal University in Northeast Brazil. Study variables were maternal security, maternal state anxiety scores, infant latency and sleep time, and total nocturnal sleep time of mother and infant. Maternal safety was calculated using a four-point Likert scale (1=not at all safe, 2=somewhat safe, 3=very safe, 4=completely safe). Maternal anxiety was measured by State-Trait Anxiety Inventory, state-anxiety subscale whose scores vary from 20 to 80 points, and the higher the score, the higher the anxiety levels. Scores below 33 are considered mild; from 33 to 49, moderate and above 49, high. As for the total nocturnal sleep time, values between 7-9 hours of sleep were considered adequate for mothers, and values between 9-12 hours for the baby, according to the guidelines of the National Sleep Foundation. For the sleep latency time, a time equal to or less than 20 min was considered adequate. It is noteworthy that the latency time and the time of night sleep of the mother and the baby were obtained by the mother's subjective report. To correlate the data, Spearman's correlation was used in the statistical package R version 3.6.3. Results: 96 women and babies participated, aged 22 to 38 years (mean 30.8) and 10 to 24 months (mean 14.7), respectively. The average of maternal security was 2.89 (unsafe); Mean maternal state anxiety scores were 43.75 (moderate anxiety). The babies' average sleep latency time was 39.6 min (>20 min). The mean sleep times of the mother and baby were, respectively, 6h and 42min and 8h and 19min, both less than the recommended nocturnal sleep time. Maternal security was positively correlated with maternal state anxiety scores (rh=266, p=0.009) and negatively correlated with infant sleep latency (rh= -0.30. P=0.003). Baby sleep time was positively correlated with maternal sleep time. (rh 0.46, p<0.001). Conclusion: The more secure the mothers considered themselves, the higher the anxiety scores and the shorter the baby's sleep latency. Also, the longer the baby sleeps, the longer the mother sleeps. Thus, interventions are needed to promote the quality and efficiency of sleep for both mother and baby.

Keywords: sleep, anxiety, infant, mother-child relations

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Authors: Bernardino Vinoya, Cassandra D. Batton, Samantha Gayle M. Bonavente, Johnson O. Canoza, Lhea Flynn B. Capones, Camille S. Dispo, Johanna Neilvin T. Dontogan, Louise Angelica C. Lipana, Charlene Pearl P. Navalta, Rechelle Vhen W. Payo-os, Mary Reyna D. Ridao, Rushnol Jade P. Tupac, Pauline B. Sol

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Parenting is preparing children for life as productive adults and discipline strategies are needed to achieve it like non-aggressive, psychologically aggressive and physical discipline. The effects of disciplinary strategies on children are well explored as evidenced by existing studies, local and international laws and active international organizations which are all brimmed towards child protection but status quo shows a profound scarcity of studies engaged in the effects of disciplining the child on the parent. To know the deeper unexplored reasons and untold stories of the parent, mainly the lived experiences of parents in disciplining their children. Design is descriptive phenomelogical. Participants were chosen using snowball purposive sampling. Data were collected through interview with the general question, “Ano ang mga karanasan ninyo sa pagdidisiplina ng inyong anak (What are your experiences when disciplining your child?)”, followed with unstructured questions. Collaizi method was used in analyzing data. Data collected was verified through focused group discussion. Results show three main themes: Reason, Disciplinary Strategy, and Aftermath. The use of disciplinary strategy is influenced by the experiences of the parent, the triggers like the child’s misbehavior and parental desires or wishes for the child. Disciplinary strategy can either be physical punishment or verbal. Parent’s generally used both when children disrespects or disobeys. Parents also experience both positive and negative effects on their physical, social, emotional aspects after disciplining their children. As a result, parents use coping mechanisms to maintain ego stability. Disciplining a child is a cyclical process. Parents, just like the child will also experience both positive and negative outcomes after using different disciplinary strategies. Future researchers can replicate study or use triangulation in multi-site qualitative and quantitative studies, professors can teach findings on parents in the concepts of pediatric nursing and apply the findings in the clinical area particularly when dealing with families.

Keywords: parents, disciplinary strategy, parental effects, pediatric nursing

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Authors: Akemi Nasu, Keiko Matsumoto

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Rehabilitation for cancer requires setting up individual goals for each patient and an approach that properly fits the stage of cancer when putting into practice. In order to cope with the daily changes in the patients' condition, the establishment of a good cooperative relationship between the nurses and the physiotherapists, occupational therapists, and speech-language-hearing therapists (therapists) becomes essential. This study will focus on the present situation of the cooperation between nurses and therapists, especially the speech-language-hearing therapists, and aim to elucidate what develops there. A semi-structured interview was conducted targeted at a physical therapist having practical experience in working in collaboration with nurses. The contents of the interview were transcribed and converted to data, and the data was encoded and categorized with sequentially increasing degrees of abstraction to conduct a qualitative explorative factor analysis of the data. When providing ethical explanations, particular care was taken to ensure that participants would not be subjected to any disadvantages as a result of participating in the study. In addition, they were also informed that their privacy would be ensured and that they have the right to decline to participate in the study. In addition, they were also informed that the results of the study would be announced publicly at an applicable nursing academic conference. This study has been approved following application to the ethical committee of the university with which the researchers are affiliated. The survey participant is a female speech-language-hearing therapist in her forties. As a result of the analysis, 6 categories were extracted consisting of 'measures to address appetite and aspiration pneumonia prevention', 'limitation of the care a therapist alone could provide', 'the all-inclusive patient- supportive care provided by nurses', 'expand the beneficial cooperation with nurses', 'providing education for nurses on the swallowing function utilizing videofluoroscopic examination of swallowing', 'enhancement of communication including conferences'. In order to improve the team performance, and for the teamwork competency necessary for the provision of safer care, mutual support is essential. As for the cooperation between nurses and therapists, this survey indicates that the maturing of the cooperation between professionals in order to improve nursing professionals' knowledge and enhance communication will lead to an improvement in the quality of the rehabilitation for cancer.

Keywords: cancer rehabilitation, nurses, speech-language-hearing therapists, interprofessional work

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Authors: Rakesh Mishra

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India’s Demography has always amazed the world because of its unprecedented outcomes in the presence of multifaceted socioeconomic and geographical characteristics. Being the first one to implement family panning in 1952, it occupies 2nd largest population of the world, with some of its state like Uttar Pradesh contributing 5th largest population to the world population surpassing Brazil. Being the one with higher in number it is more prone to the demographic disparity persisting into its territories brought upon by the inequalities in availability, accessibility and attainability of socioeconomic and various other resources. Fifth goal of Millennium Development Goal emphasis to improve maternal and child health across the world as Children’s development is very important for the overall development of society and the best way to develop national human resources is to take care of children. The target is to reduce the infant deaths by three quarters between 1990 and 2015. Child health status depends on the care and delivery by trained personnel, particularly through institutional facilities which is further associated with the status of the mother. However, delivery in institutional facilities and delivery by skilled personnel are rising slowly in India. The main objective of the present study is to measure the child health status on based on the educational and occupational background of the women in India. Study indicates that women education plays a very crucial role in deciding the health of the new born care and access to family planning, but the women autonomy indicates to have mixed results in different states of India. It is observed that rural women are 1.61 times more likely to exclusive breastfed their children compared to urban women. With respect to Hindu category, women belonging to other religious community were 21 percent less likely to exclusive breastfed their child. Taking scheduled caste as reference category, the odds of exclusive breastfeeding is found to be decreasing in comparison to other castes, and it is found to be significant among general category. Women of high education status have higher odds of using family planning methods in most of the southern states of India. By and large, girls and boys are about equally undernourished. Under nutrition is generally lower for first births than for subsequent births and consistently increases with increasing birth order for all measures of nutritional status. It is to be noted that at age 12-23 months, when many children are being weaned from breast milk, 30 percent of children are severely stunted and around 21 percent are severely underweight. So, this paper presents the evidence on the patterns of prevailing child health status in India and its states with reference to the mother socioeconomics and biological characteristics and examines trends in these, and discusses plausible explanations.

Keywords: immunization, exclusive breastfeeding, under five mortality, binary logistic regression, ordinal regression and life table

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Authors: Soheila Rabiepoor, Elham Sadeghi

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Introduction: Divorce is both a personal and a social issue. Nowadays, due to various factors such as rapid social, economical, and cultural changes, the family structure has undergone many rough changes, out of 3 marriages 2 of them lead to divorce. One of the factors affecting the incidence of divorce and relationship problems between couples is the sexual and marital behaviors. There are several different reasons to suspect that pornography might affect divorce in either a positive or a negative way. Therefore this study evaluated the sexual health of divorce-asking in Urmia, Iran. Methods: This was a cross-sectional descriptive study and was conducted on 71 married women of Urmia, Iran in 2016. Participants were applicants of divorce (referred to divorce center) who were selected by using convenient sampling method. Data gathering tool included the scales for measuring demographic, sexual health (sexual satisfaction and function), and researcher made pornography questions. Data were analyzed based on the SPSS 16 software. P-values less than 0.05 were considered significant. Results: Investigation of demographic features showed that age average of studied samples was 28.98 ± 7.44, with a marriage duration average 8.12 ± 6.53 years (min 1 year/ max 28 years). Most of their education was at diploma (45.1%). 69 % of the women declared their income and expenditure as equal. Nearly 42% of women and 59% of their partner had watched sexual pornography clips. 45.5% of participants reported that they compared own sexual relationship with sexual pornography clips. In the other hand, sexual satisfaction total score was 51.50 ± 17.92. The mean total sexual function score was 16.62 ± 10.58. According to these findings, most of women were experienced sexual dissatisfaction and dysfunction. Conclusions: The results of the study indicated that who had low sexual satisfaction score, had higher rate of watching pornography clips. Based on current study, paying attention to family education and counseling programs especially in the sexual field will be more fruitful.

Keywords: divorce-asking, pornography, sexual satisfaction, sexual function, women

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Authors: Ali Kassem, Yhea Kishik, Ali Hassan, Mohamed Abdelwahab

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Introduction: Accelerated coronary and peripheral vascular atherosclerosis is one of the most common and chronic complications of diabetes mellitus. A recent aspect of coronary artery disease in this condition is its silent nature. The aim of the work: Detection of the prevalence of silent myocardial ischemia (SMI) in Upper Egypt type 2 diabetic males and to select male diabetic population who should be screened for SMI. Patients and methods: 100 type 2 diabetic male patients with a negative history of angina or anginal equivalent symptoms and 30 healthy control were included. Full medical history and thorough clinical examination were done for all participants. Fasting and post prandial blood glucose level, lipid profile, (HbA1c), microalbuminuria, and C-reactive protein were done for all participants Resting ECG, trans-thoracic echocardiography, treadmill exercise ECG, myocardial perfusion imaging were done for all participants and patients positive for one or more NITs were subjected for coronary angiography. Results Twenty nine patients (29%) were positive for one or more NITs in the patients group compared to only one case (3.3%) in the controls. After coronary angiography, 20 patients were positive for significant coronary artery stenosis in the patients group, while it was refused to be done by the patient in the controls. There were statistical significant difference between the two groups regarding, hypertension, dyslipidemia and obesity, family history of DM and IHD with higher levels of microalbuminuria, C-reactive protein, total lipids in patient group versus controls According to coronary angiography, patients were subdivided into two subgroups, 20 positive for SMI (positive for coronary angiography) and 80 negative for SMI (negative for coronary angiography). No statistical difference regarding family history of DM and type of diabetic therapy was found between the two subgroups. Yet, smoking, hypertension, obesity, dyslipidemia and family history of IHD were significantly higher in diabetics positive versus those negative for SMI. 90% of patients in subgroup positive for SMI had two or more cardiac risk factors while only two patients had one cardiac risk factor (10%). Uncontrolled DM was detected more in patients positive for SMI. Diabetic complications were more prevalent in patients positive for SMI versus those negative for SMI. Most of the patients positive for SMI have DM more than 5 years duration. Resting ECG and resting Echo detected only 6 and 11 cases, respectively, of the 20 positive cases in group positive for SMI compared to treadmill exercise ECG and myocardial perfusion imaging that detected 16 and 18 cases respectively, Conclusion: Type 2 diabetic male patients should be screened for detection of SMI when aged above 50 years old, diabetes duration is more than 5 years, presence of two or more cardiac risk factors and/or patients suffering from one or more of the chronic diabetic complications. CRP, is an important parameter for selection of type 2 diabetic male patients who should be screened for SMI. Non invasive cardiac tests are reliable for screening of SMI in these patients in our locality.

Keywords: C-reactive protein, Silent myocardial ischemia, Stress tests, type 2 DM

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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Authors: Tomasz Holecki, Hanna Dobrowolska

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In the Polish health care system, nurses and midwives are obliged to regularly update their professional knowledge. It is all regulated by the Law on the nurse and midwife’s profession and the code of ethics. The professional self-governing body (County Chamber of Nurses and Midwives) is obliged to organize ongoing training for them so that maintaining accessibility and availability to the high quality of educational services could be possible at all levels of post-graduate education. The aim of this study is an analysis of post-graduate education organized by the County Chamber of Nurses and Midwives in the city of Katowice, Poland, as a professional self-governing body operating in the area of Silesian province inhabited by almost 5 million citizens which bring together more than 30 thousand professionally active nurses and midwives. In the years 2000-2017, the self-government of nurses and midwives trained over 50,000 people. The education and supervision system over the labour of nurses and midwives establishes exercising control by a self-governing body. In practice, this means that conducting activities aimed at creating legal regulations and organizational conditions, as well as the practical implementation of courses, belongs to the professional self-government of nurses and midwives. The most of specialization courses that were provided from their own funds came from membership fees. The biggest group was participants of specializations in the fields of cardiac, anesthesia, and preventive nursing. The smallest group of people participated in such specializations as neonatal, emergency, and obstetrics nursing. The most popular specialist courses were in the fields of the electrocardiogram and cardiopulmonary resuscitation, whereas the least popular were the ones in the fields of protective vaccinations of neonates. So-called 'soft training-courses' in the fields of improvement of social skills and management were also provided. The research shows that a vast majority of nurses and midwives are interested in raising their professional qualifications. Specialist courses and selected fields of qualification courses received the most concrete attention. In light of conducted research, one can assert that cooperation inside the community of nurses and midwives provides access to high-quality education and training services regularly used by a wide circle of them. The presented results exemplify a level of real interest in specialist and qualification training-courses and also show sources of financing them.

Keywords: nurses and midwives, ongoing training, postgraduate education, specialist training-courses

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Authors: Hugo Reis, Isabel Rabiais

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The main purpose of the present study is to understand the nurse’s responsibility in preventing the septic shock in an oncological patient with febrile neutropenia submitted to chemotherapy. In order to do it, an integrative review of literature has been conducted. In the research done in many databases, it was concluded that only 7 out of 5202 articles compiled the entire inclusion standard present in the strict protocol of research, being this made up by all different methodologies. On the research done in the 7 articles it has resulted 8 text macro-units associated to different nursing interventions: ‘Health Education’; ‘Prophylactic Therapy Administration’; ‘Scales Utilization’; ‘Patient Evaluation’; ‘Environment Control’; ‘Performance of Diagnostic Auxiliary Exams’; ‘Protocol Enforcement/Procedure Guidelines’; ‘Antibiotic Therapy Administration’. Concerning the prevalence/result’s division there can be identified many conclusions: the macro-units ‘Patient Evaluation’, ‘Performance of Diagnostic Auxiliary Exams’, and ‘Antibiotic Therapy Administration’ present themselves to be the most prevalent in the research – 6 in 7 occurrences (approximately 85.7%). Next, the macro-unit ‘Protocol Enforcement/Procedure Guidelines’ presents itself as an important expression unit – being part of 5 out of the 7 analyzed studies (approximately 71.4%). The macro-unit ‘Health Education’, seems to be in the same way, an important expression unit – 4 out of the 7 (or approximately 57%). The macro-unit ‘Scales Utilization’, represents a minor part in the research done – it’s in only 2 out of the 7 cases (approximately 28.6%). On the other hand, the macro-units ‘Prophylactic Therapy Administration’ and ‘Environment Control’ are the two categories with fewer results in the research - 1 out of the 7 cases, the same as approximately 14.3% of the research results. Every research done to the macro-unit ‘Antibiotic Therapy Administration’ agreed to refer that the intervention should be strictly done, in a period of time less than one hour after diagnosing the fever, with the purpose of controlling the quick spread of infection – minimizing its seriousness. Identifying these interventions contributes, concluding that, to adopt strategies in order to prevent the phenomenon that represents a daily scenario responsible for the cost´s increase in health institutions, being at the same time responsible for the high morbidity rates and mortality increase associated with this specific group of patients.

Keywords: febrile neutropenia, oncology nursing, patient, septic shock

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Authors: Anna Triwijayati, Etsa Astridya Setiyati, Titik Desi Harsoyo

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Culture is the important determinant of human behavior and desire. Culture influences the consumer through the norms and values established by the society in which they live and reflect it. The cultural values of Javanese society certainly have united in the Javanese society behavior in consumption. This research is expected to give big enough theoretical benefits in the findings of cultural value in consumption in Javanese society. These can be an incentive in finding the local cultural value in many tribes in Indonesia, so one time, the local cultural value in Indonesia about consumption can be fundamental part in education and consumption practice in Indonesia. The approach used in this research is non positivist research or is known as qualitative approach. The method or type of research used in this research is ethnomethodology. The collection data is done in Central Java region. The research subject or informant is determined by the purposive technique by certain criteria determined by the researcher. The data is collected by deep interview and observation. Before the data analysis, the researcher does the storing method data stage and implements the data validity procedures. Then, the data is analyzed by the theme and interactive analysis technique. The Javanese Mataraman society has such consumption values such as has to be sufficient, be careful, economical, submit to the one who creates the life, the way life flow, and the present problem is thought in the present also. In the financial management for consumption, the consumer should have the simple life principles, has to be sufficient, has to be able to eat, has to be able to self-press, well-managed/diligent/accurate/careful, the open or transparent management, has the struggle effort, like to self-sacrifice and think about the future. The meaning of consumption value in family is centered to the submission and full-trust to God. These consumption values are applied in consumer behavior in self, family, investment and credit need in short term and long term perspective.

Keywords: values, consumer, consumption, Javanese Mataraman, ethnomethodology

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Authors: Magdalena Suárez-Ortega, M. Fe. Sánchez-García

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This paper focuses on the analysis of the motivations that lead people to undertake and consolidate their business. It is addressed from the framework of planned behavior theory, which recognizes the importance of the social environment and cultural values, both in the decision to undertake business and in business consolidation. Similarly, it is also based on theories of career development, which emphasize the importance of career management competencies and their connections to other vital aspects of people, including their roles within their families and other personal activities. This connects directly with the impact of entrepreneurship on the career and the professional-personal project of each individual. This study is part of the project titled Career Design and Talent Management (Ministry of Economy and Competitiveness of Spain, State Plan 2013-2016 Excellence Ref. EDU2013-45704-P). The aim of the study is to identify and describe entrepreneurial competencies and motivational profiles in a sample of 248 Spanish entrepreneurs, considering the consolidated profile and the profile in transition (n = 248).In order to obtain the information, the Questionnaire of Motivation and conditioners of the entrepreneurial career (MCEC) has been applied. This consists of 67 items and includes four scales (E1-Conflicts in conciliation, E2-Satisfaction in the career path, E3-Motivations to undertake, E4-Guidance Needs). Cluster analysis (mixed method, combining k-means clustering with a hierarchical method) was carried out, characterizing the groups profiles according to the categorical variables (chi square, p = 0.05), and the quantitative variables (ANOVA). The results have allowed us to characterize three motivational profiles relevant to the motivation, the degree of conciliation between personal and professional life, and the degree of conflict in conciliation, levels of career satisfaction and orientation needs (in the entrepreneurial project and life-career). The first profile is formed by extrinsically motivated entrepreneurs, professionally satisfied and without conflict of vital roles. The second profile acts with intrinsic motivation and also associated with family models, and although it shows satisfaction with their professional career, it finds a high conflict in their family and professional life. The third is composed of entrepreneurs with high extrinsic motivation, professional dissatisfaction and at the same time, feel the conflict in their professional life by the effect of personal roles. Ultimately, the analysis has allowed us to line the kinds of entrepreneurs to different levels of motivation, satisfaction, needs and articulation in professional and personal life, showing characterizations associated with the use of time for leisure, and the care of the family. Associations related to gender, age, activity sector, environment (rural, urban, virtual), and the use of time for domestic tasks are not identified. The model obtained and its implications for the design of training actions and orientation to entrepreneurs is also discussed.

Keywords: motivation, entrepreneurial career, guidance needs, life-work balance, job satisfaction, assessment

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Authors: J. Lamilla-Monje, C. Solano-Puerto, L. Franco-Lara

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Trees play an essential role in cities due to their ability to provide multiple ecosystem goods and services. Bogota trees are threatened by factors such as pests, pathogens, contamination, among others. Among the pathogens, phytoplasmas are a potential risk for urban trees, generating symptoms that affect the ecosystem services that these trees provide in Bogota, an example of this is the affectation of Q. humboldtii by phytoplasmas, these bacteria are transmitted for insects of the order Hemiptera, this is why the objective of this work was to know if the climatic variables (humidity, precipitation, and temperature) and environmental variables (PM10 and PM2.5) could be related to the distribution of the Oak Quercus entomofauna and specifically with the phytoplasma vector insects in Bogota. For this study, the sampling points were distributed in areas of the city with contrasting variables in two types of locations: parks and streets. A total of 68 trees were sampled in which the associated insects were collected using two methodologies: jameo and agitation traps. The results show that insects of the order Hemiptera were the most abundant, including a total of 1682 individuals represented by 29 morphotypes, within this order individuals from eight families were collected (Aphidae, Aradidae, Berytidae, Cicadellidae, Issidae, Membracidae, Miridae, and Psyllidae), finding as possible vectors the families Cicadellidae, Membracidae, and Psyllidae with 959, 8 and 14 individuals respectively. Within the Cicadellidae family, 21 morphotypes were found, being reported as vectors in the literature: Amplicephalus, Exitianus atratus, Haldorus sp., Xestocephalus desertorum, Idiocerinae sp., Scaphytopius sp., the Membracidae family was represented by two morphotypes and the Psyllidae by one. Results that suggest that there is no correlation between climatic and environmental variables with the diversity of insects associated with oak. Knowing the vector insects of phytoplasmas in oak trees will complete the pathosystem and generate effective vector control.

Keywords: vector insects, diversity, phytoplasmas, Cicadellidae

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Authors: Yiu K. C. Jacky, Tang S. K. Eric, W. Y. Tsang, C. Y. Li, C. K. Leung

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Objectives : (1) To enhance the competence of nurses on using IPMOE for drug administration; (2) To ensure the transition on implementation of IPMOE in safer and smooth way hospital-wide. Methodology: (1) Well-structured Governance: To make provision for IPMOE implementation, multidisciplinary governance structure at Corporate and Local levels are well established. (2) Staff Engagement: A series of staff engagement events were conducted including Staff Forum, IPMOE Hospital Visit, Kick-off Ceremony and establishment of IPMOE Webpage for familiarizing the forthcoming implementation with frontline staff. (3) Well-organized training program: from Workshop to Workplace Two different IPMOE training programs were tailor-made which aimed at introducing the core features of administration module. Fifty-five identical training classes and six train-the-trainer workshops were organized at 2-3Q 2015. Lending Scheme on IPMOE hardware for hands-on practicing was launched and further extended the training from workshop to workplace. (4) Standard Guidelines and Workflow: the related workflow and guidelines are developed which facilitates users to acquire the competence towards IPMOE and fully familiarize with the standardized contingency plan. (5) Facilities and Equipment: The installations of IPMOE hardware were promptly arranged for rollout. Besides, IPMOE training venue was well-established for staff training. (6) Risk Management Strategy: UCH Medication Safety Forum is organized in December 2015 for sharing “Tricks & Tips” on IPMOE which further disseminate at webpage for arousal of medication safety. Hospital-wide annual audit on drug administration was planned to figure out the compliance and deliberate the rooms for improvement. Results: Through the comprehensive training plan, over 1,000 UCH nurses attended the training program with positive feedback. They agreed that their competence on using IPMOE was enhanced. By the end of November 2015, 28 wards (over 1,000 Inpatient-bed) involving departments of M&G, SUR, O&T and O&G have been successfully rolled out IPMOE in 5-month. A smooth and safe transition of implementation of IPMOE was achieved. Eventually, we all get prepared for embedding IPMOE into daily nursing and work altogether for medication safety at UCH.

Keywords: drug administration, inpatient medication order entry system, medication safety, nursing informatics

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Authors: Boubacar Niang, Denis Raulin

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This paper presents the design of a dedicated board for learning and programming with ATMEL AVR new generation micro controller’s family. This board designed as a "shield" for the Arduino Uno allows us to focus on the design and programming of basic micro controller functionalities in high level language with a considerable time saving because of dealing with additional components is not required.

Keywords: Arduino, microcontroller, programming, language

Procedia PDF Downloads 567

Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis

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The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.

Keywords: psychiatric disorders, refugees, war survivors, war trauma

Procedia PDF Downloads 181

Authors: Karl Kingsley

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Many mechanisms are involved in the control of cellular differentiation and growth, which are often dysregulated in many cancers. Many distinct pathways are involved in these mechanisms of control, including deoxyribonuclease (DNA) methyltransferase and histone deacetylase (HDAC) activation that controls both genetic and epigenetic modifications and micro ribonucleic acid (RNA) expression. Less is known about the expression of DNA methyltransferase (DNMT) and HDAC in oral cancers and the effect on microRNA expression. The primary objective of this study was to evaluate the expression of DNMT and HDAC family members in oral cancer and the concomitant expression of cancer-associated microRNAs. Using commercially available oral cancers, including squamous cell carcinoma (SCC)-4, SCC-9, SCC-15, and SCC-25, RNA was extracted and screened for DNMT, HDAC, and microRNA expression using highly-specific primers and quantitative polymerase chain reaction (qPCR). These data revealed low or absent expression of DNMT-1, which is associated with cellular differentiation but increased expression of DNMT-3a and DNMT-3b in all SCC cell lines compared with normal non-cancerous cell controls. In addition, no expression of HDAC1 and HDAC2 expression was found among the normal, non-cancerous cells but was highly expressed in each of the SCC cell lines examined. Differential expression of oncogenic and cancer-associated microRNAs was also observed among the SCC cell lines, including miR-21, miR-133, miR-149, miR-155, miR-365, and miR-720. These findings also appeared to vary according to observed growth rates among these cells. These data may be the first to demonstrate the expression and association between HDAC and DNMT3 family members among oral cancers. In addition, the differential expression of these epigenetic modifiers may be associated with the expression of specific microRNAs in these cancers, which have not previously been observed to the best of the author's knowledge. In addition, some associations and relationships may exist between the expression of these biomarkers and the rates of growth and proliferation, which may suggest that these expression patterns might represent potentially useful biomarkers to determine tumor aggressiveness and other phenotypic behaviors among oral cancers.

Keywords: oral cancer, DNA methyltransferase, histone deacetylase, microRNA

Procedia PDF Downloads 117

Authors: Sandra Maria Cerqueira Da Silva

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In Brazil, women are the majority of the country's population. They have advanced in terms of years of education and professional training. However, this has not prevented the differences in the labor market from being sustained, particularly the wage gap and inequalities concerning the access to command positions and promotions, i.e., in the gender relations and treatment. One of the conditions which constitute a barrier to career advancement is the necessary support chain to support women when they are in the labor market. Therefore, the purpose of this research is to demonstrate, describe, and criticize some of the current conformations of support chains and how these compete to promote the phenomenon known as glass ceiling in the country. However, this support may come even from inside a woman's own home, with a fairer division of household activities between men and women. Such behavior can free an entire network of women within the same family. In addition, it can serve as pressure to structure better conditions for women as a whole, improving the living conditions of the poor population. This can occur through programs and projects for qualification and retraining of adult women. In answer to the question that guides this study, it is concluded that a family support system is critical to the success of women in management positions. To meet this demand, one of the ways could be the development of specific gender policies by the public authorities, in accordance with the emerging global economic policies, in order to provide and structure the necessary support. This would respond to feminist manifestations - which should go on pointing needs – although the legislative assembly should also propose ideas to change this picture. This is a qualitative research, with a poststructuralist approach, featuring a cutout corpus of three interviews carried out with women holding leadership positions in the academia. Questions related to this very discussion are many. New studies could address points as the promotion of qualification and expansion of skills of women in subaltern condition. There is also need to investigate possible support systems, considering the inequalities and local economic conditions.

Keywords: gender and labor market, glass ceiling, post-structuralism, support chain

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Authors: Krizette Ladera

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Fathers are there not only to provide the financial stability of a family but a father is also there to provide the love and support that usually people would see as the mother’s responsibility. To describe the lived experiences and how fathers make sense of their lived experiences with their children who have cerebral palsy is the main objective of the study. A qualitative research using a thematic analysis was used for the study. The qualitative research focused on the personal narratives, self-report and expression of the participant’s memory in terms of how they tell their stories. The interpretative phenomenological analysis was used to focus on the experience of the participants on how they will describe their experiences, and to also add on that the IPA will also attempt to describe and explain the meaning of human experiences using interview, specifically on the father who have a child that suffers from cerebral palsy. For the sampling technique, the snowball technique was used to gather participants from the referral of other participants. The five non-randomly selected fathers will be served as the participants for the research. A self-made interview with an open-ended question was used as the research instrument; it includes profiling of the respondent as well as their experiences in taking care of their child that suffers from cerebral palsy. In analyzing a data, the researcher used the thematic analysis where in the interview was made into a transcript, then it was organized and divided themes. After that, the relations of each themes, was identified and it was later documented and translated into written text format using thematic grouping. Finally, the researcher analyzed each data according to its themes and put it in a table to be presented in the result section of the study And as for the result of the study, the researcher was able to come up with the four (4) main themes that most of the participants experienced and those are: The experiences in finding out about the condition of the Child, disclosing the condition of the child to the family and its emotional effect, The experiences of living the day of day realities in providing the physical, financial, emotional and a well balanced environment to the child, and the religious perspectives of the fathers. Along with those four (4) themes comes the subtheme which explains the themes in a more detailed explanation.

Keywords: cerebral palsy, children, fathers, lived experiences

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Authors: Sigrid James

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Purpose and Background: Despite a global policy push for deinstitutionalization, residential care for children and youth remains a relevant and highly utilized out-of-home care option in many countries, fulfilling functions of care and accommodation as well as education and treatment. While many youths are placed in residential care programs temporarily or during times of transition, some still spend years in programs that range from small group homes to large institutions. How residential care is used and what function it plays in child welfare systems is influenced by a range of factors. Among them are sociocultural and historical developments, available resources for child welfare, cultural notions about family, a lack of family-based placement alternatives as well as a belief that residential care can be beneficial to children. As part of a larger study that examined differences in residential care across 16 countries along a range of dimensions, this paper reports findings on utilization rates of residential care, i.e., the proportion of out out-of-home care dedicated to residential care relative to forms of family-based foster care. Method: Using an embedded multiple-case design study approach where a country represents a case, residential care in 16 countries was studied and compared. The comparison was focused on countries with developed social welfare systems and included Spain, Denmark, Germany, Ireland, the Netherlands, England, Scotland, Australia, Italy, Israel, Argentina, Portugal, Finland, France, the United States and Canada. Experts from each country systematically collected data on residential care based on a common matrix developed by the author. A range of sources were accessed depending on the information sought, including administrative data, government reports, research studies, etc. Utilization rates were mostly drawn from administrative data or government reports. While denominators may slightly differ, available data allowed for meaningful comparisons. Beyond descriptive data on utilization rates, analysis allowed to also capture trends in utilization (increasing, decreasing, stable) as well as the rate change. Results: Results indicate high variability in the utilization of residential care, covering the entire spectrum from a low of 7% to a high of 97%, with most countries falling somewhere in between. Three utilization categories were identified: high-users of residential care (Portugal, Argentina and Israel), medium-users (Denmark, France, Italy, Finland, Spain, Netherlands, Germany), and low-users (England, Scotland, Ireland, Canada, Australia, the United States). A number of countries experienced drastic reductions in residential care during the past few years (e.g. US), while others have seen stable rates (e.g., Portugal) or even increasing rates (e.g., Spain). Conclusions: Multiple contextual factors have to be considered when interpreting findings. For instance, countries with low residential care rates have, in most cases, undergone recent legislative changes to drastically reduce residential care. In medium-utilization countries, residential care reforms seem to be primarily focused on improving standards and, thus, the quality of care. High utilization countries generally face serious obstacles to implementing alternative family-based forms of out-of-home care. Cultural acceptance of residential or foster care and notions of professionalism also appear to play an important role in explaining variability in utilization.

Keywords: residential youth care, child welfare, case study, cross-national comparative research

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Authors: Rolland Epafras Fanggidae

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The impact of climate change such as natural disasters, crop failures, increasing crop pests, bad gisi on children and other impacts, will indirectly affect education, health, food safety, as well as the economy. The impact of climate change has put a man in a situation of vulnerability, which was powerless to meet the minimum requirements, it is in close contact with poverty. When talking about poverty, the most plausible is female. The role of women in Indonesia, particularly in East Nusa Tenggara in Domestic aktifity very central and dominant. This makes Indonesian woman can say "outstanding actor in the face of climate change mitigation and adaptation and applying local knowledge", but still ignored when women based on gender division of work entrusted role in domestic activities. Similarly, in public activity is an extension of the Domestic example, trading activity in the market lele / mama. Although men are also affected by climate change, but most feel is female. From the above problems, it can be said that Indonesia's commitment has not been followed by optimal empowerment of women's role in addressing climate change, it is necessary to learn to know how the role of women in the face of climate change impacts that hit on her role as a woman, a housewife or head of the family and will be input in order to determine how women find a solution to tackle the problem of climate change. This study focuses on the efforts made by women cope with the impacts of climate change, efforts by the government, empowerment model used in Playing the impact of climate change. The container with the formulation of the title "The Role of Women in Climate Change Impact in Kupang district". Where the assessment in use types Research mix Methods combination of quantitative research and qualitative research. While the location of the research conducted in Kupang regency, East Nusa Tenggara, namely: District of East Kupang is a district granary in Kupang district. Subdistrict West Kupang, especially Tablolong Village is the center of seaweed cultivation in Kupang district.

Keywords: climate change, women, women's roles, gender, family

Procedia PDF Downloads 277

Authors: Poonam Magu, Kumud Khanna, P. Seetharaman

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A kitchen is a major workplace in any home. A large variety of tasks, mainly related to meal preparation is performed here. The types of activities performed are varied and vast. In a way, it is the activities performed that determine the way the space within the kitchen is going to be utilised. A study was conducted in 510 Indian kitchens belonging to middle-income group families living in Delhi. It was conducted in three phases. In the first phase, 510 non-working homemakers were interviewed and questions pertaining to their personal characteristics, meal preparation and physical aspects related to the kitchen were asked. In the second phase, the technique of Path Process Chart was developed. Subsequently, a sub-sample of 50 homemakers was selected from the larger group. The activity of meal preparation was carried out by the homemakers themselves in their kitchens. A time and motion study was conducted using the technique of Path Process Chart. The results were analysed using the appropriate analysis sheets and conclusions were drawn. It was found that the entire kitchen and more specifically, the counter had been 'divided' into a number of workplaces. These workplaces were being used either for performing operations or for the purpose of storage. In many cases, it was used for both. On the whole, in 50 kitchens studied, 21 workplaces were identified which were used for performing operations related to meal preparation and 17 for storage It was also observed that almost the entire kitchen was used for the purpose of storage of some item or the other. The major workplaces where operations were performed were the range, workplaces to the right and left of range and sink and workplaces to the right or left of the sink. The same workplaces were also used for the purpose of storage. There were some workplaces outside the kitchen too, which were used for operations or storage. These were the dining table, courtyard or balcony, bedroom cupboard. On the whole, the range centre and the sink centre were found to be the two most important centres in an Indian kitchen belonging to urban middle-income group family.

Keywords: kitchen, workplace, meal preparation, path process chart

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Authors: Ashimolowo Olubunmi

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Contraception use helps prevent pregnancy as well as health-related challenges, most especially among youths and girls. Our communities are bedeviled with many problems, including rape, defilement, neglect by the spouse, and intimate partner violence. Current interventions target only adults, with most facilities having youth and unfriendly adolescent services. To further support the need for this research, especially with our target beneficiaries, the partnership embarked on qualitative evidence-finding research through focus group discussions and in-depth-interview in Abeokuta and Ibadan (the capital cities of Ogun). The Focus Group Discussion (FGD) sessions were held in the state with adolescents (10-18 years) and young women (18-30 years). The result revealed that teenagers and youths who receive formal and sexual education on abstinence, and birth control methods, are likely to have healthier sexual behaviours through the promotion of abstinence and the use of condoms and other forms of contraceptives at their first intercourse, thereby protecting themselves against HIV/AIDs (Human Immunodeficiency Virus/Acquired immunodeficiency syndrome. The result further revealed that parents do not discuss issues around Adolescent and Sexual Reproductive Health (ASRH) with their adolescent girls, leading to gaps in knowledge of ASRH. Stakeholders’ involvement and trust are low. Respondents noted that there were few outreaches on ASRH and that youth-friendly adolescent centres are not common in the community. Respondents noted that there were few outreaches on ASRH organised within the community. Also, youth-friendly services were not common. There is a need to work with all stakeholders to promote those foundational life skills on pubertal changes, menstruation, and sexual life to prepare youths and girls for challenges ahead through sex education; we should work to institutionalize youth and adolescent-friendly Sexual and Reproductive Health (SRH) in our communities.

Keywords: contraception, family planning, focus group discussion, adolescents

Procedia PDF Downloads 54

Authors: A. Tamimi, S. Greatrex-White, A. Narayanasamy

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Background: Spirituality has been increasingly acknowledged in the nursing literature as an important element of holistic patient care. To date there have been numerous studies investigating the meaning of spirituality in Western cultures. Spirituality in Middle Eastern countries however remains under-researched. We will present a study which aimed to address this gap. Aim: The study aimed to explore how spirituality manifests in the lives of Jordanian End Stage Renal Failure (ESRF) patients. Methodology and Method: A hermeneutic phenomenological approach was adopted informed by the philosophy of Martin Heidegger. Participants (n=27) were recruited from four different dialysis units: in a public hospital, a private hospital, an educational hospital and a refugee’s hospital in Jordan. Data was collected through in-depth unstructured interviews. Data Analysis: Analysis was guided by the tenets of hermeneutic phenomenology namely: gaining immediate sense of what was said both during and after each interview, transcribing data verbatim, translating interviews into the English language, intensive reading and re-reading, seeking meaning units by line to line coding, developing situated structures (how spirituality was manifest in each text), developing a general structure from the individual situated structures (how the phenomenon ‘spirituality’ comes into being). Findings: Three major themes emerged from analysis: Religion, Relationships and Desperation. We will argue that a ‘secular’ concept of spirituality had no meaning for the participants in the study. Spirituality is fundamentally part of religion and vice versa. Discussion: The findings may have consequences for the use of spirituality in multi-cultural settings in Western countries. Additionally, findings highlighted an important emphasis on the practice of spirituality, often underestimated in previous literature for Arab-Muslim Jordanian patients. Conclusion: The study findings contribute to the existing gap in knowledge regarding how Arab-Muslim Jordanian ESRF patients experience spirituality during their illness. It provides valuable insights into the importance of spirituality for this patient group and suggests how nurses, educators and policy makers might help address ESRF patients’ spiritual needs and provide appropriate spiritual care. We suggest the findings may have relevance beyond the Jordanian context in educating nurses’ on the importance of appreciating the religious dimension of spirituality.

Keywords: spirituality, nursing, muslim, Jordan

Procedia PDF Downloads 435

Authors: A. Cervantes-Diaz, B. Sevilla-Moran, Manuel Alcami, Al Mokhtar Lamsabhi, J. L. Alonso-Prados, P. Sandin-España

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Profoxydim is a post-emergence herbicide belonging to the cyclohexanedione oxime family, used to control weeds in rice crops. The use of soil organic amendments has increased significantly in the last decades, and their effects on the behavior of many herbicides are still unknown. Additionally, it is known that photolysis is an important degradation process to be considered when evaluating the persistence of this family of herbicides in the environment. In this work, the photodegradation of profoxydim in an amended paddy soil-water system with alperujo compost was studied. Photodegradation experiments were carried out under laboratory conditions using simulated solar light (Suntest equipment) in order to evaluate the reaction kinetics of the active substance. The photochemical behavior of profoxydim was investigated in soil with and without alperujo amendment. Furthermore, due to the rice crop characteristics, profoxydim photodegradation in water in contact with these types of soils was also studied. Determination of profoxydim degradation kinetics was performed by High-Performance Liquid Chromatography with Diode-Array Detection (HPLC-DAD). Furthermore, we followed the evolution of resulting transformation by-products, and their tentative identification was achieved by mass spectrometry. All the experiments allowed us to fit the data of profoxydim photodegradation to a first-order kinetic. Photodegradation of profoxydim was very rapid in all cases. The half-lives in aqueous matrices were in the range of 86±0.3 to 103±0.5 min. The addition of alperujo amendment to the soil produced an increase in the half-life from 62±0.2 min (soil) to 75±0.3 min (amended soil). In addition, a comparison to other organic amendments was also performed. Results showed that the presence of the organic amendment retarded the photodegradation in paddy soil and water. Regarding degradation products, the main process involved was the cleavage of the oxime moiety giving rise to the formation of the corresponding imine compound.

Keywords: by-products, herbicide, organic amendment, photodegradation, profoxydim

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Authors: Nadia H. Mohammed, Anmar Al-Taie, Fadia H. Al-Sultany

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Although breast cancer prevalence continues to increase, mortality has been decreasing as a result of early detection and improvement in adjuvant systemic therapy. Nevertheless, this disease required further efforts to understand and identify the associated potential risk factors that could play a role in the prevalence of this malignancy among Iraqi women. The objective of this study was to assess the perception of certain predictive risk factors on the prevalence of breast cancer types among a sample of Iraqi women diagnosed with breast cancer. This was a retrospective observational study carried out at National Cancer Research Center in College of Medicine, Baghdad University from November 2017 to January 2018. Data of 100 patients with breast cancer whose biopsies examined in the National Cancer Research Center were included in this study. Data were collected to structure a detailed assessment regarding the patients’ demographic, medical and cancer records. The majority of study participants (94%) suffered from ductal breast cancer with mean age 49.57 years. Among those women, 48.9% were obese with body mass index (BMI) 35 kg/m². 68.1% of them had positive family history of breast cancer and 66% had low parity. 40.4% had stage II ductal breast cancer followed by 25.5% with stage III. It was found that 59.6% and 68.1% had positive oestrogen receptor sensitivity and positive human epidermal growth factor (HER2/neu) receptor sensitivity respectively. In regard to the impact of prediction of certain variables on the incidence of ductal breast cancer, positive family history of breast cancer (P < 0.0001), low parity (P< 0.0001), stage I and II breast cancer (P = 0.02) and positive HER2/neu status (P < 0.0001) were significant predictive factors among the study participants. The results from this study provide relevant evidence for a significant positive and potential association between certain risk factors and the prevalence of breast cancer among Iraqi women.

Keywords: Ductal Breast Cancer, Hormone Sensitivity, Iraq, Risk Factors

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Authors: Mohamed Mamdouh Al-Banna, Warda Youssef Mohamed Morsy, Hanaa Ali El-Feky, Ashraf Hussein Abdelmohsen

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Background: The mechanically ventilated patients need a special nursing care with continuous closed observation. The patients’ body mass index may affect their prognosis or outcomes. Aim of the study: to investigate the relationship between BMI and selected outcomes of critically ill mechanically ventilated patients. Research Design: A descriptive correlational research design was utilized Research questions: a) what is the BMI profile of mechanically ventilated patients admitted to critical care units over a period of six months? b) What is the relationship between body mass index and frequency of organ dysfunction, length of ICU stay, weaning from mechanical ventilation, and the mortality rate among adult critically ill mechanically ventilated patients? Setting: different intensive care units of Cairo University Hospitals. Sample: A convenience sample of 30 mechanically ventilated patients for at least 72 hours. Tools of data collection: Three tools were utilized to collect data pertinent to the current study: tool 1: patients’ sociodemographic and medical data sheet, tool 2: BURNS Wean Assessment Program (BWAP) checklist, tool 3: Sequential organ failure assessment (SOFA score) sheet. Results: The majority of the studied sample (77%) was males, and (26.7 %) of the studied sample were in the age group of 18-28 years old, and (26.7 %) were in the age group of 40-50 years old. Moreover, two thirds (66.7%) of the studied sample were within normal BMI. No significant statistical relationship between BMI category and ICU length of stay or the mortality rate among the studied sample, (X² = 11.31, P value = 0.79), (X² = 0.15, P value = 0.928) respectively. No significant statistical relationship between BMI category and the weaning trials from mechanical ventilation among the studied sample, (X² = 0.15, P value = 0.928). No significant statistical relationship was found between BMI category and the occurrence of organ dysfunction among the studied sample, (X² = 2.54, P value = 0.637). Conclusion: No relationship between the BMI categories and the selected patients’ outcomes (weaning from MV, length of ICU stay, occurrence of organ dysfunction, mortality rate). Recommendations: Replication of this study on a larger sample from different geographical locations in Arab Republic of Egypt, conducting farther studies to assess the effect of the quality of nursing care on the mechanically ventilated patients’ outcomes.

Keywords: mechanical ventilation, body mass index, outcomes of mechanically ventilated patient, organ failure

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Authors: Jaspinder Kaur, Jatinder Pal Singh

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Introduction- Delusional parasitosis is a rare psychotic illness characterized by a fixed belief of manifesting a parasite in a body when in reality, it was not. Also known as Ekbom syndrome or delusional infestations, or acarophobia. Although the patient has no primary skin pathology, but all skin findings were secondary to skin manipulation by the patient itself, which is why up to 90% of patients first seek consultation from a dermatologist. Most commonly, it was seen in older people with female to male ratio is 2:1. For treatment, the patient first need to be investigated to rule all other possible causes, as Delusional parasitosis can be caused by Vitamin B12 deficiency, pellagra, hepatic and renal disease, diabetes mellitus, multiple sclerosis, and leprosy. When all possible causes ruled out, psychiatric referral to be done. Rule out other psychiatric comorbidities, and treatment should be done accordingly. Patient with delusional parasitosis responds well to second generation antipsychotics and need to continuous medication over years, and relapse is likely if treatment is stopped. Case Presentation- A 79-year-old female, belonging to lower socio-economic status, presented with complaints of itching sensation with erythematous patches over the scalp and multiple scratch excoriations lesion over the scalp, face and neck from the past 7-8 months. She had a feeling of small insect crawling under her skin and scalp area. To reduce the itching and kill the insect, she would scratch and squeeze her skin repeatedly. When the family tried to give her explanation that there was no insect in her body, she would not get convinced, rather got angry and abuse family members for not believing her. Gradually, her sleep would remain disturbed, she would be seen awake at night, seen to be scratching her skin, pull her scalp hair, even squeeze out her healed lesions. She collected her skin debris, scalp hairs and look out for insect. Because of her continuous illness, the patient started to remain sad and had crying spells. Her appetite decreased. She became socially isolated and stopped doing her activities of daily living. Family member’s first consulted dermatologist, investigated thoroughly with routine investigations, autoimmune and malignancy workup. As all investigations were normal, following which patient was referred for psychiatric evaluation. The patient was started on Tablet Olanzapine 2.5 mg, gradually increased to 7.5 mg. Over 1 month, there was reduction in itching, skin pricking. Lesions were gradually healed, and the patient continued to take other dermatological medications and ointment and was in regular follow up with psychiatric liaison from past 2 months with 70-80 % improvement in her symptoms. Conclusion- Delusional parasitosis is a psychiatric disorder of insidious onset, seen commonly in middle and old age people. Both psychiatric and dermatology consultation liaison will help the patient for an early diagnosis and adequate treatment. If a primary psychiatric diagnosis, the patient respond well to second generation antipsychotics but always require a further evaluation and treatment management if it is secondary to some physical or other psychiatric comorbidity.

Keywords: delusional parasitosis, delusional infestations, rare, primary psychiatric diagnosis, antipsychotic agents

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Authors: Shuofen Hsu, Ya-Yi Chao, Chao-Wei Li

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This paper investigates the relationship between voluntary audit (hereafter, VA) of semi-annual consolidated financial statements decision and accounting conservatism. In general, there are four kinds of auditors' assurance services, which include audit, review, agreed-upon procedure and compliance engagements base on degree of assurance. The VA work by auditors may not only have the higher audit quality but an important signal of more reliable information than the review work. In Taiwan, The listed companies must prepare the semi-annual consolidated financial statements and with auditors' review before 2012, but some of the listed companies choose the assurance work from review to audit voluntarily. Due to the adoption of International Financial Reporting Standards, the listed companies were required to prepare the second quarterly consolidated financial statements which should be reviewed by auditors since 2013. This rule will change some of the assurance work from audit to review by auditors, and the information asymmetry maybe increased. To control the selection bias, we use two-stage model to test the relationship between VA decision and accounting conservatism. Our empirical results indicate that the VA decision and accounting conservatism have a significant positive relationship in firms with family-controlled. That is, firms with family-controlled are more likely to do VA and to prepare more conservative consolidated financial statements to reduce the information asymmetry, meaning that there is a complementary effect between VA and accounting conservatism for firms with more information asymmetry. But on the contrary, we find that the VA decision and accounting conservatism have a significant negative relationship in firms with professional managers-controlled, meaning that there is a substitution effect between VA and accounting conservatism for firms with less information asymmetry. Finally, the accounting conservatism of consolidated financial statements decrease after the adoption of IFRSs (International Financial Reporting Standards) in Taiwan. It means that the disclosure and transparency of consolidated financial statements had be improved.

Keywords: voluntary audit, accounting conservatism, audit quality, information asymmetry

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