Search results for: perception of nursing care

Authors: Florence Roselle Adalin, Misha Louise Delariarte, Fabbette Laire Lagas, Sarah Emanuelle Mejia, Lika Mizukoshi, Irish Paullen Palomeno, Gibrianne Alistaire Ramos, Danica Pauline Ramos, Josefina Tuazon, Jo Leah Flores

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Pain, often a missed and undertreated symptom, affects the quality of life of individuals. Nurses are key players in providing effective pain management to decrease morbidity and mortality of patients in pain. Nurses’ knowledge and attitude on pain greatly affect their ability on assessment and management. The Pain Society of the Philippines recognized the inadequacy and inaccessibility of data on the knowledge, skills, and attitude of nurses on pain management in the country. This study may be the first of its kind in the county, giving it the potential to contribute greatly to nursing education and practice through providing valuable baseline data. Objectives: This study aims to describe the level of knowledge and attitude, and current practices of nurses on pain assessment and management; and determine the relationship of nurses’ knowledge and attitude with years of experience, training on pain management and clinical area of practice. Methodology: A survey research design was employed. Four hospitals were selected through purposive sampling. A total of 235 Medical-Surgical Unit and Intensive Care Unit (ICU) nurses participated in the study. The tool used is a combination of demographic survey, Nurses’ Knowledge and Attitude Survey Regarding Pain (NKASRP), Acute Pain Evidence Based Practice Questionnaire (APEBPQ) with self-report questions on non-pharmacologic pain management. The data obtained was analysed using descriptive statistics, two sample T-tests for clinical areas and training; and Pearson product correlation to identify relationship of level of knowledge and attitude with years of experience. Results and Analysis: The mean knowledge and attitude score of the nurses was 47.14%. Majority answered ‘most of the time’ or ‘all the time’ on 84.12% of practice items on pain assessment, implementation of non-pharmacologic interventions, evaluation and documentation. Three of 19 practice items describing morphine and opioid administration in special populations were only done ‘a little of the time’. Most utilized non-pharmacologic interventions were deep breathing exercises (79.66%), massage therapy (27.54%), and ice therapy (26.69%). There was no significant relationship between knowledge scores and years of clinical experience (p = 0.05, r= -0.09). Moreover, there was not enough evidence to show difference in nurses’ knowledge and attitude scores in relation to presence of training (p = 0.41) or areas (Medical-Surgical or ICU) of clinical practice (p = 0.53). Conclusion and Recommendations: Findings of the study showed that the level of knowledge and attitude of nurses on pain assessment and management is suboptimal; and no relationship between nurses’ knowledge and attitude and years of experience. It is recommended that further studies look into the nursing curriculum on pain education, culture-specific pain management protocols and evidence-based practices in the country.

Keywords: knowledge and attitude, nurses, pain management, practices on pain management

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Authors: Vimi Jham

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The banking sector has undergone tremendous change in all forms of service it provides to its customers. The efforts of the banks is to avoid customer defection and lead to customer satisfaction. The purpose of the study was to examine the linkages among the constructs such as customer perceived service quality, perceived service recovery quality and customer satisfaction in the banking industry. The moderating effect of negative brand perception due to service failure on recovery satisfaction were investigated. Random sampling methods are used to draw the sample from the population. Data was collected from 262 banking customers and were analyzed with the help of structural equation modelling approach using Smart PLS to understand the relationship among variables being studied. The results of the study contribute to the research by proving that customer service recovery satisfaction is dependent on customer perceived service quality and the moderating effect of negative brand perception due to service failure was insignificant.

Keywords: service recovery satisfaction, perceived service recovery quality, perceived service quality, structural equation modelling

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Authors: Lamia Bouzgarrou, Amira Omrane, Naima Bouatay, Chaima Harrathi, Samia Machroughl, Ahmed Mhalla

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Background and Aims: Professionals of health care sector are exposed to psychosocial constraints like stress, harassment, violence, which can lead to many mental health problems such as, depression, addictive behavior, and burn-out. Moreover, it’s well established that caregivers affected to intensive care units are more likely to experience such constraints and mental health problems. For these caregivers, the mental health state may affect care quality and patient’s safety. This study aims either to identify occupational psychosocial constraints and their mental health consequences among paramedical and medical caregivers affected to intensive units in Tunisian public hospital. Methods: An exhaustive three months cross-sectional study conducted among medical and paramedical staffs of intensive care units in three Tunisian university hospitals. After informed consent collection, we evaluated work-related stress, workplace harassment, depression, anxious troubles, addictive behavior, and self-esteems through an anonymous self-completed inquiry form. Five validated questionnaires and scales were included in this form: Karasek's Job Content Questionnaire, Negative Acts Questionnaire, Rosenberg, Beck depression inventory and Hamilton Anxiety scale. Results: We included 129 intensive unit caregivers; with a mean age of 36.1 ± 1.1 years and a sex ratio of 0.58. Among these caregivers, 30% were specialist or under-specialization doctors. The average seniority in the intensive care was 6.1 ± 1.2 (extremes=1 to 40 years). Atypical working schedules were noted among 36.7% of the subjects with an imposed choice in 52.4% of cases. During the last 12 months preceding the survey, 51.7% of care workers were absent from work because of a health problem with stops exceeding 15 days in 11.7%. Job strain was objective among 15% of caregivers and 38.33% of them were victims of moral harassment. A low or very low self-esteem was noted among 40% of respondents. Moreover, active smoking was reported by 20% subjects, alcohol consumption by 13.3% and psychotropic substance use by 1.7% of them. According to Beck inventory and Hamilton Anxiety scale, we concluded that 61.7% of intensive care providers were depressed, with 'severe' depression in 13.3% of cases and 49.9% of them present anxious disorders. Multivariate analysis objective that, job strain was correlated with young age (p=0.005) and shorter work seniority (p=0.001). Workplace and moral harassment was more prevalent among females (p=0.009), under-specialization doctor (p=0.021), those affected to atypical schedules (p=0.008). Concerning depression, it was more prevalent among staff in job strain situation (p = 0.004), among smokers caregivers (p = 0.048), and those with no leisure activity (p < 0.001). Anxious disorders were positively correlated to chronic diseases history (p = 0.001) and work-bullying exposure (p = 0.004). Conclusions: Our findings reflected a high frequency of caregivers who are under stress at work and those who are victims of moral harassment. These health professionals were at increased risk for developing psychiatric illness such depressive and anxious disorders and addictive behavior. Our results suggest the necessity of preventive strategies of occupational psychosocial constraints in order to preserve professional’s mental health and maximize patient safety and quality of care.

Keywords: health care sector, intensive care units, mental health, psychosocial constraints

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Authors: E. Kissi, V. K. Acheamfour, J. J. Gyimah, T. Adjei-Kumi

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Factoring accounts receivable is widely accepted as an alternative financing source and utilized in almost every industry that sells business-to-business or business-to-government. However, its patronage in the construction industry is very limited as some barriers hinder its application in the construction industry. This study aims at assessing the barriers to the use of factoring accounts receivables in the Ghanaian construction industry. The study adopted the sequential exploratory research method where structured and unstructured questionnaires were conveniently distributed to D1K1 and D2K2 construction firms in Ghana. Using the one-sample t-test and Kendall’s Coefficient of concordance data was analyzed. The most severe challenge concluded is the high cost of factoring patronage. Other critical challenges identified were low knowledge on factoring processes, inadequate access to information on factoring, and high risks involved in factoring. Hence, it is recommended that contractors should be made aware of the prospects of factoring of accounts receivables in the construction industry. This study serves as basis for further rigorous research into factoring of accounts receivables in the industry.

Keywords: barriers, contractors, factoring accounts receivables, Ghanaian, perception

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Authors: Dolapo Adeyemo

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Technology can be designed specifically for geriatrics and persons with disabilities or ICT accessibility solutions. Both solutions stand to benefit from advances in Artificial intelligence, which are computer systems that perform tasks that require human intelligence. Tasks such as decision making, visual perception, speech recognition, and even language translation are useful in both situation and will provide significant benefits to people with temporarily or permanent disabilities. This research’s goal is to review innovations focused on the use of artificial intelligence that bridges the accessibility gap in technology from a user-centered perspective. A mixed method approach that utilized a comprehensive review of academic literature on the subject combined with semi structure interviews of users, developers, and technology product owners. The internet of things and artificial intelligence technology is creating new opportunities in the assistive technology space and proving accessibility to existing technology. Device now more adaptable to the needs of the user by learning the behavior of users as they interact with the internet. Accessibility to devices have witnessed significant enhancements that continue to benefit people with disabilities. Examples of other advances identified are prosthetic limbs like robotic arms supported by artificial intelligence, route planning software for the visually impaired, and decision support tools for people with disabilities and even clinicians that provide care.

Keywords: ICT, IOT, accessibility solutions, universal design

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Authors: Zhuang Yiwen

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The paper examines the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. One of the major challenges identified is the lack of a standard coding system for medical devices, which makes it difficult to track them effectively. The paper suggests the use of the Unique Device Identifier (UDI) as a single standard for medical devices to improve tracking and reduce errors. The paper also explores the use of barcoding and image recognition to identify and document medical devices in nursing practices. In nursing practices, the use of barcodes for identifying medical devices is common. However, the information contained in these barcodes is often inconsistent, making it challenging to identify which segment contains the model identifier. Moreover, the use of barcodes may be improved with the use of UDI, but many subsidized accessories may still lack barcodes. The paper suggests that the readiness for UDI and barcode standardization requires standardized information, fields, and logic in electronic medical record (EMR), operating theatre (OT), and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. Nursing workflow and data flow also need to be taken into account. The paper also explores the use of image recognition, specifically the Tesseract OCR engine, to identify and document implants in public hospitals due to limitations in barcode scanning. The study found that the solution requires an implant information database and checking output against the database. The solution also requires customization of the algorithm, cropping out objects affecting text recognition, and applying adjustments. The solution requires additional resources and costs for a mobile/hardware device, which may pose space constraints and require maintenance of sterile criteria. The integration with EMR is also necessary, and the solution require changes in the user's workflow. The paper suggests that the long-term use of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) as a supporting terminology to improve clinical documentation and data exchange in healthcare. SNOMED CT provides a standardized way of documenting and sharing clinical information with respect to procedure, patient and device documentation, which can facilitate interoperability and data exchange. In conclusion, the paper highlights the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. The paper suggests the use of UDI and barcode standardization to improve tracking and reduce errors. It also explores the use of image recognition to identify and document medical devices in nursing practices. The paper emphasizes the importance of standardized information, fields, and logic in EMR, OT, and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. These recommendations could help the Singapore healthcare system to improve tracking and traceability of medical devices and ultimately enhance patient safety.

Keywords: medical device tracking, unique device identifier, barcoding and image recognition, systematized nomenclature of medicine clinical terms

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Authors: Clarence Dissanayake, Anishka A. Hettiarachchi

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Landscape architecture needs to encompass a placemaking process carefully composing and manipulating landscape elements to address perceptual needs of humans, especially aesthetic, psychological and spiritual. The objective of this qualitative investigation is to inquire the impact of elements of rock and water combination on landscape perception and related feelings, emotions, and behavior. The past empirical studies have assessed the impact of landscape elements in isolation on user preference, yet the combined effect of elements have been less considered. This research was conducted with reference to the verity of qualities of water and rock through a visual landscape quality assessment focusing on landscape qualities derived from five visual concepts (coherence, historicity imageability, naturalness, and ephemera). 'Kaludiya Pokuna' archeological site in Anuradhapura was investigated with a sample of University students (n=19, male 14, female 5, age 20-25) using a five-point Likert scale via a perception based questionnaire and a visitor employed photographic survey (VEP). Two hypothetical questions were taken into investigation concerning biophilic (naturalness) and topophilic (historicity) aspects of humans to prefer a landscape with rock and water. The findings revealed that this combination encourages both biophilic and topophilic aspects, but in varying degrees. The identified hierarchy of visual concepts based on visitor’s preference signify coherence (93%), historicity (89%), imageability (79%), naturalness (75%) and ephemera (70%) respectively. It was further revealed that this combination creates a scenery more coherent dominating information processing aspect of humans to perceive a landscape over the biophilic and topophilic aspects. Different characteristics and secondary landscape effects generated by rock and water combination were found to affect in transforming a space into a place, full filling the aesthetic and spiritual aspects of the visitors. These findings enhance a means of making places for people, resource management and historical landscape conservation. Equalization of gender based participation, taking diverse cases and increasing the sample size with more analytical photographic analysis are recommended to enhance the quality of further research.

Keywords: landscape perception, visitor’s preference, rock and water combination, visual concepts

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Authors: Kirsi Laurén, Tiina Seppä

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This study focuses on human-mire relations in the context of digital aestheticization and the long-standing tradition of folklore concerning mires. The study concentrates on the Patvinsuo mire in Eastern Finland and the Viiankiaapa mire in Finnish Lapland. Patvinsuo is a national park, and Viiankiaapa is a protected mire area with hiking trails and other recreational infrastructure. Perceiving the environment through digital technology can help to notice aesthetic details in nature. In addition, sharing images and texts digitally through social media adds a sense of community to the relationship with nature and, at the same time, creates a different kind of living heritage where old and new traditions meet and mingle. People visiting and camping in these areas 'self-care' themselves through recreation in nature. However, these practices and digital aestheticization can sometimes lead to the erosion of fragile mires. The research focuses on understanding the impact of digital aestheticization, such as taking digital photos, on the relationship with nature for individuals moving and working in mires. Additionally, the study aims to explore the contemporary perception of the water environment in mires and its cultural heritage, including mythical and folkloric elements. The research material consists of senso-digital walking interviews and digital recordings (audio recordings, photographs, videos) made during the mire walks, as well as archival material from the Finnish Literature Society’s Archives on mire folklore. The analysis of the material relies centrally on theories from sensory anthropology on the relationship between sensory perception and culture. The modern-day interviewees include outdoor enthusiasts spending their leisure time in mires, artists treating mires in their art, and nature experts (scientists, civil servants, and nature guides). The senso-digital walking interviews were conducted in Patvinsuo and Viiankiaapa mires on a trail chosen by the interviewees themselves. The material selected from the archive consists mainly of folk beliefs and folk poetry from the 19th and 20th centuries that express the relationship of the narrator to the mires. The interview and archival materials date from different periods and are different in character, which has to be taken into account in the analysis. However, in the analysis of both materials, particular attention is paid to the descriptions of sensations that appear in them. Analyzing the materials in parallel is limited by the fact that they date from different periods, but on the other hand, it is their different ages that make it possible to perceive the changes in the cultural heritage of mires.

Keywords: mires, living heritage, digital aestheticization, folklore, sensory anthropology

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Authors: Helen Coronel, Will Brewer, Peggy Bergeron, Clarissa Hall, Victoria Casson

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Simulation-based training provides the nurse practitioner (NP) student with a safe and controlled environment in which they can practice a real-life scenario. This type of learning fosters critical thinking skills essential to practice. The expectation of this study was that students would have an increase in their competency and confidence after performing the simulation. Approximately 8.4% of Americans suffer from depression. The state of Alabama is ranked 47th out of 50 for access to mental health care. As a result of this significant shortage of mental health providers, primary care providers are frequently put in the position of screening for and treating mental health conditions, such as depression. Family nurse practitioners are often utilized as primary care providers, making their ability to assess, diagnose and treat these disorders a necessary skill. The expected outcome of this simulation is an increase in confidence, competency and the empowerment of the nurse practitioner student’s ability to assess, diagnose and treat a common mood disorder they may encounter in practice. The Kirkpatrick Module was applied for this study. A non-experimental design using descriptive statistical analysis was utilized. The simulation was based on a common psychiatric mood disorder frequently observed in primary care and mental health clinics. Students were asked to watch a voiceover power point presentation prior to their on-campus simulation. The presentation included training on the assessment, diagnosis, and treatment of a patient with depression. Prior to the simulation, the students completed a pre-test, then participated in the simulation, and completed a post-test when done. Apple iPads were utilized to access a simulated health record. Major findings of the study support an increase in students’ competency and confidence when assessing, diagnosing, and treating an adult patient with depression.

Keywords: advanced practice, nurse practitioner, simulation, primary care, depression

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Authors: Valentine Seymour

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Environmental volunteering organisations use questionnaires to explore the relationship between environmental volunteers and their health. To the author’s best knowledge, no one has explored volunteers’ health perception, which could be considered when designing a health impact measurement tool used to increase effective communication. This paper examines environmental volunteers' perceptions of health, knowledge which can be used to design a health impact measurement tool. This study uses focus group interviews, content analysis, and a general inductive approach to explore the health perceptions of volunteers who engage in environmental volunteering activities from the perspective of UK charity The Conservation Volunteers. Findings showed that volunteer groups presented were relatively similar in how they defined the term health, with their overall conceptual model closely resembling that of the World Health Organization 1948 definition. This suggests that future health impact measurement tools in the environmental volunteering sector could base their design around the World Health Organization’s definition.

Keywords: health perception, impact measurement, mental models, tool development

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Authors: S. Zeynep Siretioglu Girgin, Gizem Turna Cebeci

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Turkey’s immigration policy is a controversial issue considering its legal, economic, social, and political and human rights dimensions. Formulation of an immigration policy goes hand in hand with political processes, where natives’ attitudes play a significant role. On the other hand, as was the case in Turkey, radical changes made in immigration policy or policies lacking transparency may cause severe reactions by the host society. The underlying discussion paper aims to analyze quantitatively the effects of the existing ‘open door’ immigration policy on the economic integration of Syrian refugees in Turkey, and on the perception of the native population of refugees. For the analysis, semi-structured in-depth interviews and focus group interviews have been conducted. After the introduction, a literature review is provided, followed by theoretical background on the explanation of natives’ attitudes towards immigrants. In the next section, a qualitative analysis of natives’ attitudes towards Syrian refugees is presented with the subtopics of (i) awareness, general opinions and expectations, (ii) open-door policy and management of the migration process, (iii) perception of positive and negative impacts of immigration, (iv) economic integration, and (v) cultural similarity. Results indicate that, natives concurrently have social, economic and security concerns regarding refugees, while difficulties regarding security and economic integration of refugees stand out. Socio-economic characteristics of the respondents, such as the educational level and employment status, are not sufficient to explain the overall attitudes towards refugees, while they can be used to explain the awareness of the respondents and the priority of the concerns felt.

Keywords: economic integration, immigration policy, integration policies, migrants, natives’ sentiments, perception, Syrian refugees, Turkey

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Authors: Patricia P. M. C. Lourenco, Javier Bringué Sala, Anaisa D. A. de Sena

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Almost everyone in Dramaland knows the names of big Korean stars that grace their computer screens on a roll through social media and video streaming platforms that enable awareness of Korean dramas and lifestyle at a click. A surface culture instilled with notions of belonging has redefined the meaning of friendship and challenged deep inner values. Not everyone, however, knows Chinese Dramas or their stars, which is a consequence of Dramaland's focus on Korean dramas and promoting the Korean experience. Despite a parity in terms of production quality, star power, scripts and compelling visual settings, Chinese Dramas have been playing catch up to their famous counterparts. While they might have a strong competitive soft power for international drama fans, the soft power of Korean dramas is imbued with substantial societal values that they want to share with others. Those values are portrayed in an artistic way that connects with audiences who experience loneliness in the non-virtual world contrary to the way Chinese Dramas are perceived.

Keywords: Chinese dramas, fandom, Korean dramas, participatory culture, value perception, soft power, surface culture

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Authors: R. W. C. Devindi, S. M. Buddika Harshanath

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E-learning is a widely used technology for learning in the modern world. With the pandemic situation the popularity of using e-learning has been increased in a larger capacity. The e-learning educational systems require software resources as well as hardware usually but it is hard for most of the education institutions to afford those resources. Also with the massive user load e-learning has to broaden the server side resources as well. Therefore, in the present cloud computing was implemented in order to make the e – learning systems more efficient. The researcher has analyzed the quality of the e-learning systems on the perception of the learners and the teachers with the aid of hypothesis and has given the analyzed results and the discussion in this report. Therefore, the future research will be able to get some steps to increase the quality of the online learning systems furthermore. In the case of e-learning, quality assurance and cost effectiveness are essential. A complex quality assurance system is used in the stated project. There are no well-defined standard evaluation measures in this field. As a result, accurately assessing the e-learning system's overall quality is challenging. The researcher has done the analysis with the aid of standard methods and software.

Keywords: LMS–learning management system, SPSS–statistical package for social sciences (software), eigen value, hypothesis

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Authors: Raniya Alsharif

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The color theory of good and evil is the association of colors to the omnipresent concept of good and evil, where human behavior and perception can be highly influenced by seeing black and white, making these connotations almost dangerously distinctive where they can be very hard to distinguish. This theory is a human construct that dates back to ancient Egypt and has been used since then in almost all forms of communication and expression, such as art, fashion, literature, and religious manuscripts, helping the implantation of preconceived ideas that influence behavior and society. This is a mixed-methods research that uses both surveys to collect quantitative data related to the theory and a vignette to collect qualitative data by using a scenario where participants aged between 18-25 will style two characters of good and bad characteristics with color contrasting clothes, both yielding results about the nature of the preconceived perceptions associated with ‘black and white’ and ‘good and evil’, illustrating the important role of media and communications in human behavior and subconscious, and also uncover how far this theory goes in the age of social media enlightenment.

Keywords: color perception, interpretivism, thematic analysis, vignettes

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Authors: Babak Mirbaha, Mahmoud Saffarzadeh, Atieh Asgari Toorzani

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Pedestrians are the most vulnerable road users since they do not have a protective shell. One of the most common collisions for them is pedestrian-vehicle at intersections. In order to develop appropriate countermeasures to improve safety for them, researches have to be conducted to identify the factors that affect the risk of getting involved in such collisions. More specifically, this study investigates factors such as the influence of walking alone or having a baby while crossing the street, the observable age of pedestrian, the speed of pedestrians and the speed of approaching vehicles on risk perception of pedestrians. A nested logit model was used for modeling the behavioral structure of pedestrians. The results show that the presence of more lanes at intersections and not being alone especially having a baby while crossing, decrease the probability of taking a risk among pedestrians. Also, it seems that teenagers show more risky behaviors in crossing the street in comparison to other age groups. Also, the speed of approaching vehicles was considered significant. The probability of risk taking among pedestrians decreases by increasing the speed of approaching vehicle in both the first and the second lanes of crossings.

Keywords: pedestrians, intersection, nested logit, risk

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Authors: Prama Mukhopadhyay, Rishika Mukhopadhyay

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The twentieth century has seen the world getting divided into three distinct blocks, created by the proponents of the mainstream developmental discourse. India, which has now gained the label of being a ‘developing nation’, stands in between these three groups, as it constantly tries to ‘catch up’ and emulate the developmental standards of the ‘west’. In this endeavour, we find our country trying really hard to blindly replicate the health care infrastructures of the ‘first worlds’, without realizing the needs of evaluating the ground reality. In such a situation, the sudden outbreak of child death in the district of Malda, WB, poses an obvious questions towards the kind of development that our country has been engaging in, ever since its Post Colonial inception. Through this paper we thus try to understand the harsh veracity of the health care facility that exists in rural Bengal, and thereby challenge the conventional notion of ‘health-care’ as is normally discussed in the mainstream developmental discourse. Grounding our research work on detailed ethnography and through the help of questionnaire, interviews and focus group discussions with the local government officials(BDOs), health workers (ICDS, ASHA workers, ANHM and BMOHs) and members of families with experiences of child deaths, we have tried to find out the real and humane factors behind the sudden rise of reported infant deaths in the district, issues which are normally neglected and left out while discussing and evaluating IMR in the mainstream studies on health care and planning in our nation. Therefore the main aim of this paper is to try and look at child death from a ‘wider perspective’, where it is seen from an eye not bounded by the common registers of caste, class and religion. This paper, would thus be an eye opener in some sense, bringing in stories from the rural belt of the country; where the people are regularly torn between the binaries of the developing and shining modernity of ‘India’ which now gets ready to run the last lap and gain the status of becoming a ‘developed nation’ by 2020, and the staggering, dark traditional ‘ Bharat, which lags behind.

Keywords: child mortality, development discourse, health care, tradition and modernity

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Authors: Sunghyun Cho, Seung-Ah Lee

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Parental overprotection is known to have negative effects such as low independence, immature emotion regulation, and immoral behaviors on children’s development. This study investigated the effects of parental overprotection on Korean college students’ moral behaviors. In order to test the hypothesis that overprotected participants are more likely to show immoral behaviors in moral dilemma situations, we measured perceived parental overprotection using Korean-Parental Overprotection Scale (K-POS), Helicopter Parenting Behaviors, and Helicopter Parenting Instrument (HPI) for 200 college students. Participants’ level of morality was assessed using two types of online experimental tasks consisting of a word-searching puzzle and a visual perception task. Based on the level of perceived parental overprotection, 14 participants with high total scores in overparenting scales and 14 participants with average total scores in the scales were assigned to a high perceived overparenting student group, and control group, respectively. Results revealed that the high perceived overparenting group submitted significantly more untruthful answers compared to the control group in the visual perception task (t = 2.72, p < .05). However, there was no significant difference in immorality in the word-searching puzzle(t = 1.30, p > .05), yielding inconsistent results for the relationship between. These inconsistent results of two tasks assessing morality may be because submitting untruthful answers in the word-searching puzzle initiated a larger sense of immorality compared to the visual perception task. Thus, even the perceived overparenting participants seemingly tended not to submit immoral answers. Further implications and limitations of the study are discussed.

Keywords: college students, morality, overparenting, parental overprotection

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Authors: Gianluca Castelnuovo, Giada Pietrabissa, Gian Mauro Manzoni, Margherita Novelli, Emanuele Maria Giusti, Roberto Cattivelli, Enrico Molinari

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Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. Such conditions include not only type 2 diabetes, but also cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. The financial direct and indirect burden (considering also the clinical resources involved and the loss of productivity) is a real challenge in many Western health-care systems. Recently the Lancet journal defined diabetes as a 21st-century challenge. In order to promote patient compliance in diabesity treatment reducing costs, evidence-based interventions to improve weight-loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. Moreover, new technologies can provide useful solutions in this multidisciplinary approach, above all in maintaining long-term compliance and adherence in order to ensure clinical efficacy. Psychological therapies with diet and exercise plans could better help patients in achieving weight loss outcomes, both inside hospitals and clinical centers and during out-patient follow-up sessions. In the management of chronic diseases clinical psychology play a key role due to the need of working on psychological conditions of patients, their families and their caregivers. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies: one of the best up-to-date application is the management of obesity with type 2 diabetes, where mHealth solutions can provide remote opportunities for enhancing weight reduction and reducing complications from clinical, organizational and economic perspectives. A stepped care mHealth-based approach is an interesting perspective in chronic care management of obesity with type 2 diabetes. One promising future direction could be treating obesity, considered as a chronic multifactorial disease, using a stepped-care approach: -mhealth or traditional based lifestyle psychoeducational and nutritional approach. -health professionals-driven multidisciplinary protocols tailored for each patient. -inpatient approach with the inclusion of drug therapies and other multidisciplinary treatments. -bariatric surgery with psychological and medical follow-up In the chronic care management of globesity mhealth solutions cannot substitute traditional approaches, but they can supplement some steps in clinical psychology and medicine both for obesity prevention and for weight loss management.

Keywords: clinical health psychology, mhealth, obesity, type 2 diabetes, stepped care, chronic care management

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Authors: Amira Yousef Mahrous Yousef

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This paper includes fast fashion verses sustainable fashion or slow fashion Indian based consumers. The expression ‘Fast fashion’ is generally referred to low-cost clothing collections that considered first hand copy of luxury brands, sometime interchangeably used with ‘mass fashion’. Whereas slow fashion or limited fashion which are consider to be more organic or eco-friendly. "Sustainable fashion is ethical fashion and here the consumer is just not design conscious but also social-environment conscious". Paper will deal with desire of young Indian consumer towards such luxury brands present in India, and their understanding of sustainable fashion, how to maintain the equilibrium between never newer fashion, style, and fashion sustainability. The green fashion market is growing rapidly as eco-friendly consumers are willing to expand their organic lifestyle to include clothing. With an increasing share of fashion consumers globally, Indian consumers are observed to consider the social and environmental ethics while making purchasing decisions. While some research clearly identifies the efforts of responsible consumers towards green fashion, some argue that fashion-orientated consumers who are sensitive towards environment do not actively participate towards supporting green fashion. This study aims to analyze the current perception of green fashion among Indian consumers. A small-scale exploratory study is conducted where consumers’ perception of green fashion is examined followed by an analysis of translation of this perception into purchase decision making. This research paper gives insight into consumer awareness on green fashion and provides scope towards the expansion of ethical fashion consumption .

Keywords: inclusions, temperature gradient, HPHT synthetic fibers, polyamide fibers, fiber volume, compressive strength. gold nano clusters, copper ions, wool keratin, fluorescence

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Authors: Kadhim Alabady

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Purpose: Mental health problems affect women and men equally, but some are more common among women. To Provide a baseline of the current picture of major mental health challenges among women in Dubai. which can then be used to measure the impact of interventions or service development. Method: We have used mixed methods evaluation approaches. This was used to increase the validity of findings by using a variety of data collection techniques. We have integrated qualitative and quantitative methods in this piece of work. Conducting the two approaches is to explore issues that might not be highlighted enough through one method. Results: The key findings are: The prevalence of people who suffer from different types of mental disorders remains largely unknown, many women are unwilling to seek professional help because of lack of awareness or the stigma attached to it. -It is estimated there were around 2,928–4,392 mothers in Dubai (2014) suffering from postnatal depression of which 858–1,287, early intervention can be effective. -The system for managing health care for women with mental illness is fragmented and contains gaps and duplications. -It is estimated 1,029 girl aged 13–19 years affected with anorexia nervosa and there would be an estimated 1,029 girl aged 13–19 years affected with anorexia nervosa. Recommendations: -Work is required with primary health care in order to identify women with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. -It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions that are not routinely collected to get a clear sense of what is needed and to assist decision and policy making in getting a complete picture on what services are required. -Emergency Mental Health Care – there is a need for a crisis response team to respond to emergencies in the community. -Continuum of care – a significant gap in the services for women once they diagnosed with mental disorder.

Keywords: mental health, depression, schizophrenia, women

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Authors: Fay A. Al-Khalifa, Fariel Khan, Anamika Jiwane

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Responding to some governmentally enforced building sustainability criteria is today becoming an unavoidable challenge to the real estate development industry and is no longer an extra that allows developers to gain competitive advantages. Previous studies suggested that using green technologies, if done under the right circumstances, could lead to positive incentives, tax breaks, higher rents, cost savings and higher property values in the long run. This is all in addition to the marketing benefits of the green label. There are, however, still countries, mostly in the developing world, that lack the implementation of such sustainability guidelines and assessment tools. This research aspires to investigate the market’s readiness to implement such criteria, its perception of sustainable architecture and building users motivation to use and/or invest in sustainable buildings. The study showed via a survey administered to 385 inhabitants and investors in commercial real estate in Bahrain that the respondents have a limited understanding of the benefits of green buildings and are unlikely to want to occupy or invest in a green building under the current social, economic and industrial conditions. Reliability of green technology, effectiveness, price and the questionable long-term financial benefits were among the major concerns. The study suggests that the promotion of sustainable architecture should respond to the current market concerns in a more direct way to trigger an interest in investors and users of commercial real estate project. This stimulated attention should consequently encourage developers to consider incorporating sustainability measures, apply for green building assessment programs and invest in green technologies, all of which need higher capitals that are nonetheless financially justifiable on the long run.

Keywords: investment, real estate, sustainability, clients perception, Bahrain

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Authors: Felib Ayman Shawky Salem

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This paper includes fast fashion verses sustainable fashion or slow fashion Indian based consumers. The expression ‘Fast fashion’ is generally referred to low-cost clothing collections that considered first hand copy of luxury brands, sometime interchangeably used with ‘mass fashion’. Whereas slow fashion or limited fashion which are consider to be more organic or eco-friendly. "Sustainable fashion is ethical fashion and here the consumer is just not design conscious but also social-environment conscious". Paper will deal with desire of young Indian consumer towards such luxury brands present in India, and their understanding of sustainable fashion, how to maintain the equilibrium between never newer fashion, style, and fashion sustainability. The green fashion market is growing rapidly as eco-friendly consumers are willing to expand their organic lifestyle to include clothing. With an increasing share of fashion consumers globally, Indian consumers are observed to consider the social and environmental ethics while making purchasing decisions. While some research clearly identifies the efforts of responsible consumers towards green fashion, some argue that fashion-orientated consumers who are sensitive towards environment do not actively participate towards supporting green fashion. This study aims to analyze the current perception of green fashion among Indian consumers. A small-scale exploratory study is conducted where consumers’ perception of green fashion is examined followed by an analysis of translation of this perception into purchase decision making. This research paper gives insight into consumer awareness on green fashion and provides scope towards the expansion of ethical fashion consumption

Keywords: diamond, inclusions, temperature gradient, HPHT synthetic fibers, polyamide fibers, fiber volume, compressive strength. gold nano clusters, copper ions, wool keratin, fluorescence

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Authors: Areej Al-Hamad, Cheryl Forchuk, Abe Oudshoorn, Gerald Patrick Mckinley

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Syrian refugee women face many obstacles when accessing health services in host countries that are influenced by various cultural, structural, and practical factors. This paper is based on critical ethnographic research undertaken in Canada to explore Syrian refugee women's migration experiences. Also, we aim to critically examine how the intersection of gender, trauma, violence and the political and economic conditions of Syrian refugee women shapes their everyday lives and health. The study also investigates the strategies and practices by which Syrian refugee women are currently addressing their healthcare needs and the models of care that are suggested for meeting their physical and mental health needs. Findings show that these women experienced constant worries, hardship, vulnerability, and intrusion of dignity. These experiences and challenges were aggravated by the structure of the Canadian social and health care system. This study offers a better understanding of the impact of migration and trauma on Syrian refugee women's roles, responsibilities, gender dynamics, and interaction with Ontario's healthcare system to improve interaction and outcomes. Health care models should address these challenges among Syrian refugee families in Canada.

Keywords: Syrian refugee women, intersectionality, critical ethnography, migration

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Authors: Roseanne Sharon Borromeo, Mariana Carvalho, Mariia Karizhenskaia

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Healthcare providers need to comprehend cultural diversity for optimal patient-centered care, especially near the end of life. Although a universal method for navigating cultural differences would be ideal, culture’s high complexity makes this strategy impossible. Adding cultural humility, a process of self-reflection to understand personal and systemic biases and humbly acknowledging oneself as a learner when it comes to understanding another's experience leads to a meaningful process in palliative care generating respectful, honest, and trustworthy relationships. This study is a systematic review of the literature on cultural humility in palliative care research and best practices. Race, religion, language, values, and beliefs can affect an individual’s access to palliative care, underscoring the importance of culture in palliative care. Cultural influences affect end-of-life care perceptions, impacting bereavement rituals, decision-making, and attitudes toward death. Cultural factors affecting the delivery of care identified in a scoping review of Canadian literature include cultural competency, cultural sensitivity, and cultural accessibility. As the different parts of the world become exponentially diverse and multicultural, healthcare providers have been encouraged to give culturally competent care at the bedside. Therefore, many organizations have made cultural competence training required to expose professionals to the special needs and vulnerability of diverse populations. Cultural competence is easily standardized, taught, and implemented; however, this theoretically finite form of knowledge can dangerously lead to false assumptions or stereotyping, generating poor communication, loss of bonds and trust, and poor healthcare provider-patient relationship. In contrast, Cultural humility is a dynamic process that includes self-reflection, personal critique, and growth, allowing healthcare providers to respond to these differences with an open mind, curiosity, and awareness that one is never truly a “cultural” expert and requires life-long learning to overcome common biases and ingrained societal influences. Cultural humility concepts include self-awareness and power imbalances. While being culturally competent requires being skilled and knowledgeable in one’s culture, being culturally humble involves the sometimes-uncomfortable position of healthcare providers as students of the patient. Incorporating cultural humility emphasizes the need to approach end-of-life care with openness and responsiveness to various cultural perspectives. Thus, healthcare workers need to embrace lifelong learning in individual beliefs and values on suffering, death, and dying. There have been different approaches to this as well. Some adopt strategies for cultural humility, addressing conflicts and challenges through relational and health system approaches. In practice and research, clinicians and researchers must embrace cultural humility to advance palliative care practices, using qualitative methods to capture culturally nuanced experiences. Cultural diversity significantly impacts patient-centered care, particularly in end-of-life contexts. Cultural factors also shape end-of-life perceptions, impacting rituals, decision-making, and attitudes toward death. Cultural humility encourages openness and acknowledges the limitations of expertise in one’s culture. A consistent self-awareness and a desire to understand patients’ beliefs drive the practice of cultural humility. This dynamic process requires practitioners to learn continuously, fostering empathy and understanding. Cultural humility enhances palliative care, ensuring it resonates genuinely across cultural backgrounds and enriches patient-provider interactions.

Keywords: cultural competency, cultural diversity, cultural humility, palliative care, self-awareness

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Authors: Yun-Shan Tsai, Si-Ping Lin, En-Chieh Lin, Xin-Hong Chen, Shin-Yun Ho, Shin-Hong Huang, Ching-ju Hsieh

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Background and significance: Uncorrected refractive errors and cataracts are the main visually debilitating ophthalmological abnormalities in adult participants with intellectual disability (ID). However, not all adult participants with ID may receive a regular and timely ophthalmological assessment. Consequently, some of the ocular diseases may not be diagnosed until late, thereby causing unnecessary ocular morbidity. In addition, recent clinical practice and researches have also suggested that eye-care services for this group are neglected. Purpose: To investigate the unmet need for eye care services, clinical characteristics of cataract, visual function, surgical outcome and prognostic predictors in adult participants with ID at Taipei City Hospital in Taiwan. Methods: This is a one-year prospective clinical study. We recruited about 120 eyes of 60 adult participants with ID who were received cataract surgery. Caregivers of all participants received a questionnaire on current eye care services. Clinical demographic data, such as age, gender, and associated systemic diseases or syndromes, were collected. All complete ophthalmologic examinations were performed 1 month preoperatively and 3 months postoperatively, including ocular biometry, visual function, refractive status, morphology of cataract, associated ocular features, anesthesia methods, surgical types, and complications. Morphology of cataract, visual and surgical outcome was analyzed. Results: A total of 60 participants with mean age 43.66 ± 13.94 years, including 59.02% male and 40.98% female, took part in comprehensive eye-care services. The prevalence of unmet need for eye care services was high (about 70%). About 50% of adult participants with ID have bilateral cataracts at the time of diagnosis. White cataracts were noted in about 30% of all adult participants with ID at the time of presentation. Associated ocular disorders were included myopic maculopathy (4.54%), corneal disorders (11.36%), nystagmus (20.45%), strabismus (38.64%) and glaucoma (2.27%). About 26.7% of adult participants with ID underwent extracapsular cataract extraction whereas a phacoemulsification was performed in 100% of eyes. Intraocular lens implantation was performed in all eyes. The most common postoperative complication was posterior capsular opacification (30%). The mean best-corrected visual acuity was significantly improved from preoperatively (mean log MAR 0.48 ± 0.22) to at 3 months postoperatively (mean log MAR 0.045 ± 0.22) (p < .05). Conclusions: Regular follow up will help address the need for eye-care services in participants with ID. A high incidence of bilateral cataracts, as well as white cataracts, was observed in adult participants with ID. Because of early diagnosis and early intervention of cataract, the visual and surgical outcomes of cataract are good, but the visual outcomes are suboptimal due to associated ocular comorbidities.

Keywords: adult participants with intellectual disability, cataract, cataract surgery

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Authors: Asif Khaliq, Sayeeda A. Sayed

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The drug information centers provide drug related information to the requesters that include physicians, pharmacist, nurses and other allied health care professionals. The International Pharmacist Federation (FIP) describes basic functions of a drug and poison information centers as drug evaluation, therapeutic counseling, pharmaceutical advice, research, pharmaco-vigilence and toxicology. Continuous advancement in the field of medicine has expanded the medical literature, which has increased demand of a drug and poison information center for the guidance, support and facilitation of physicians. The objective of the study is to determine the need of drug and poison information centers in public and private hospitals of Karachi, Pakistan. A cross sectional study was conducted during July 2013 to April 2014 using a self-administered, multi-itemed questionnaire. Non Probability Convenient sampling was used to select the study participants. A total of 307 physicians from public and private hospitals of Karachi participated in the study. The need for 24/7 Drug and poison information center was highlighted by 92 % of physicians and 67% physicians suggested opening a drug information center at the hospital. It was reported that 70% physicians take at least 15 minutes for searching the information about the drug while managing a case. Regarding the poisoning case management, 52% physicians complaint about the unavailability of medicines in hospitals; and mentioned the importance of medicines for safe and timely management of patients. Although 73% physicians attended continued medical education (CME) sessions, 92 % physicians insisted on the need of 24/7 Drug and poison information center. The scarcity of organized channel for obtaining the information about drug and poisons is one of the most crucial problems for healthcare workers in Pakistan. The drug and poison information center is an advisory body that assists health care professional and patients in provision of appropriate drug and hazardous substance information. Drug and poison information center is one of the integral needs for running an effective health care system. Provision of a 24 /7 drug information centers with specialized staff offer multiple benefits to the hospitals while reducing treatment delays, addressing awareness gaps of all stakeholders and ensuring provision of quality health care.

Keywords: drug and poison information centers, Pakistan, physicians, public and private hospitals

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Authors: Saad Bin Nasir

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This study imperially evaluated of five human resource (HR) practices (Wellness program extents are Employee’s assistance program, Health care screenings, and Recreation trips, Seminars for life style, Indoor and Outdoor activities) and there likely impact on the organization productivity in Pakistani organizations. The data were gathering by administrating questionnaires. The result indicated that all five variables are positively and significantly correlated with organization productivity. Results of regressing the all variables on organization productivity show that seminars for life style and employee’s assistance program strong predictors of organization productivity.

Keywords: wellness program, organization’s productivity, employee’s assistance program, health care screening

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Authors: Diego S. Caetano, Doreen E. Kalz, Louise L. B. Lomardo, Luiz P. Rosa

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The energy consumption in non-residential buildings in Brazil has a great impact on the national infrastructure. The growth of the energy consumption has a special role over the building cooling systems, supported by the increased people's requirements on hygrothermal comfort. This paper presents how the occupants of office buildings notice and evaluate the hygrothermic comfort regarding temperature, humidity, and air movement, considering the cooling systems presented at the buildings studied, analyzed by real occupants in areas of hot and humid climate. The paper presents results collected over a long time from 3 office buildings in the cities of Rio de Janeiro and Niteroi (Brazil) in 2015 and 2016, from daily questionnaires with eight questions answered by 114 people between 3 to 5 weeks per building, twice a day (10 a.m. and 3 p.m.). The paper analyses 6 out of 8 questions, emphasizing on the perception of temperature, humidity, and air movement. Statistics analyses were made crossing participant answers and humidity and temperature data related to time high time resolution time. Analyses were made from regressions comparing: internal and external temperature, and then compared with the answers of the participants. The results were put in graphics combining statistic graphics related to temperature and air humidity with the answers of the real occupants. Analysis related to the perception of the participants to humidity and air movements were also analyzed. The hygrothermal comfort statistic model of the European standard DIN EN 15251 and that from the Brazilian standard NBR 16401 were compared taking into account the perceptions of the hygrothermal comfort of the participants, with emphasis on air humidity, taking basis on prior studies published on this same research. The studies point out a relative tolerance for higher temperatures than the ones determined by the standards, besides a variation on the participants' perception concerning air humidity. The paper presents a group of detailed information that permits to improve the quality of the buildings based on the perception of occupants of the office buildings, contributing to the energy reduction without health damages and demands of necessary hygrothermal comfort, reducing the consumption of electricity on cooling.

Keywords: thermal comfort, energy consumption, energy standards, comfort models

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Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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The neonatal care of cats and dogs represents a challenge to veterinarians due to the small size of the newborns and their physiological particularities. In addition, many Veterinary Medicine colleges around the world do not include neonatology in the curriculum, which makes it less likely for the veterinarian to have basic knowledge regarding neonatal care and worsens the clinical care these patients receive. Therefore, lack of assistance and negligence have become frequent in the field, which contributes towards the high mortality rates. This study aims at describing cases and the main conditions pertaining to the neonatology clinical routine in cats and dogs, highlighting the importance of specialized care in this field of Veterinary Medicine. The study included 808 neonates admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil, between January 2018 and November 2019. Of these, 87.3% (705/808) were dogs and 12.7% (103/808) were cats. Among the neonates admitted, 57.3% (463/808) came from emergency c-sections due to dystocia, 8.7% (71/808) cane from vaginal deliveries with obstetric maneuvers due to dystocia, and 34% (274/808) were admitted for clinical care due to neonatal conditions. Among the neonates that came from emergency c-sections and vaginal deliveries, 47.3% (253/534) was born in respiratory distress due to severe hypoxia or persistent apnea and required resuscitation procedure, such as the Jen Chung acupuncture point (VG26), oxygen therapy with mask, pulmonary expansion with resuscitator, heart massages and administration of emergency medication, such as epinephrine. On the other hand, in the neonatal clinical care, the main conditions and alterations observed in the newborns were omphalophlebitis, toxic milk syndrome, neonatal conjunctivitis, swimmer puppy syndrome, neonatal hemorrhagic syndrome, pneumonia, trauma, low weight at birth, prematurity, congenital malformations (cleft palate, cleft lip, hydrocephaly, anasarca, vascular anomalies in the heart, anal atresia, gastroschisis, omphalocele, among others), neonatal sepsis and other local and systemic bacterial infections, viral infections (feline respiratory complex, parvovirus, canine distemper, canine infectious traqueobronchitis), parasitical infections (Toxocara spp., Ancylostoma spp., Strongyloides spp., Cystoisospora spp., Babesia spp. and Giardia spp.) and fungal infections (dermatophytosis by Microsporum canis). The most common clinical presentation observed was the neonatal triad (hypothermia, hypoglycemia and dehydration), affecting 74.6% (603/808) of the patients. The mortality rate among the neonates was 10.5% (85/808). Being knowledgeable about neonatology is essential for veterinarians to provide adequate care for these patients in the clinical routine. Adding neonatology to college curriculums, improving the dissemination of information on the subject, and providing annual training in neonatology for veterinarians and employees are important to improve immediate care and reduce the mortality rates.

Keywords: neonatal care, puppies, neonatal, conditions

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Authors: Sue S. Feldman

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As clinical and nursing informatics mature, an area that has gotten a lot of attention is the value capstone projects. Capstones are meant to address authentic and complex domain-specific problems. While capstone projects have not always been essential in graduate clinical and nursing informatics education, employers are wanting to see evidence of the prospective employee's knowledge and skills as an indication of employability. Capstones can be organized in many ways: a single course over a single semester, multiple courses over multiple semesters, as a targeted demonstration of skills, as a synthesis of prior knowledge and skills, mentored by one single person or mentored by various people, submitted as an assignment or presented in front of a panel. Because of the potential for capstones to enhance the educational experience, and as a mechanism for application of knowledge and demonstration of skills, a rigorous capstone can accelerate a graduate's potential in the workforce. In 2016, the capstone at the University of Alabama at Birmingham (UAB) could feel the external forces of a maturing Clinical and Nursing Informatics discipline. While the program had a capstone course for many years, it was lacking the depth of knowledge and demonstration of skills being asked for by those hiring in a maturing Informatics field. Since the program is online, all capstones were always in the online environment. While this modality did not change, other contributors to instruction modality changed. Pre-2016, the instruction modality was self-guided. Students checked in with a single instructor, and that instructor monitored progress across all capstones toward a PowerPoint and written paper deliverable. At the time, the enrollment was few, and the maturity had not yet pushed hard enough. By 2017, doubling enrollment and the increased demand of a more rigorously trained workforce led to restructuring the capstone so that graduates would have and retain the skills learned in the capstone process. There were three major changes: the capstone was broken up into a 3-course sequence (meaning it lasted about 10 months instead of 14 weeks), there were many chunks of deliverables, and each faculty had a cadre of about 5 students to advise through the capstone process. Literature suggests that the chunking, breaking up complex projects (i.e., the capstone in one summer) into smaller, more manageable chunks (i.e., chunks of the capstone across 3 semesters), can increase and sustain learning while allowing for increased rigor. By doing this, the teaching responsibility was shared across faculty with each semester course being taught by a different faculty member. This change facilitated delving much deeper in instruction and produced a significantly more rigorous final deliverable. Having students advised across the faculty seemed like the right thing to do. It not only shared the load, but also shared the success of students. Furthermore, it meant that students could be placed with an academic advisor who had expertise in their capstone area, further increasing the rigor of the entire capstone process and project and increasing student knowledge and skills.

Keywords: capstones, clinical informatics, health informatics, informatics

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