Search results for: trust experience

Authors: Zhilong Xie, Jinwen Huang, Guofang Zeng

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The existing body of research on bilingualism has consistently linked the use of multiple languages to enhanced cognitive control. Numerous studies have demonstrated that bilingual individuals exhibit advantages in non-linguistic tasks demanding cognitive control. However, recent investigations have challenged these findings, leading to a debate regarding the extent and nature of bilingual advantages. The adaptive control hypothesis posits that variations in bilingual experiences hold the key to resolving these controversies. This study aims to contribute to this discussion by exploring the impact of second language (L2) listening experience on cognitive control among young Chinese-English bilinguals. By examining this specific aspect of bilingualism, the study offers a perspective on the origins of bilingual advantages. This study employed a range of cognitive tasks, including the Flanker task, Wisconsin Card Sorting Test (WCST), Operation Span Task (OSPAN), and a second language listening comprehension test. After controlling for potential confounding variables such as intelligence, socioeconomic status, and overall language proficiency, independent sample t-test analysis revealed significant differences in performance between groups with high and low L2 listening proficiency in the Flanker task and OSPAN. However, no significant differences emerged between the two groups in the WCST. These findings suggest that L2 listening proficiency has a significant impact on inhibitory control and working memory but not on conflict monitoring or mental set shifting. These specific findings provide a more nuanced understanding of the origins of bilingual advantages within a specific bilingual context, highlighting the importance of considering the nature of bilingual experience when exploring cognitive benefits.

Keywords: bilingual advantage, inhibitory control, L2 listening, working memory

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Authors: Irena Balaban Cakirpaloglu, Karla Hrbackova

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This paper focuses on the issue of intercultural competencies of university students who are preparing to work in assisting professions. In recent years, the Czech Republic has become a major destination for many people from different cultural environments, and there is a growing need for workers in assisting professions to be able to respond flexibly and adequately to the changing living conditions of multicultural coexistence. The main objective of this study is to analyse the preparedness of students in assisting professions in relation to intercultural competencies. Intercultural competences include several essential skills for working successfully with diversity. Taking into account the main objective of this research, a pilot study was conducted among students of Social Pedagogy at the Faculty of Humanities at Tomas Bata University in Zlin in the academic year 2017/2018. The research sample consisted of 116 students. To obtain the data, we used the Cross-Cultural Adaptability Inventory (CCAI) by Kelley and Meyers. The inventory maps strengths and weaknesses in 4 skill areas: Emotional Resilience, Flexibility/Openness, Perceptual Acuity and Personal Autonomy. This inventory also examines individual ability to succeed in intercultural interaction and communication. The results obtained from the survey were statistically processed and analysed using the relevant statistical methods. The results of the survey point to the fact that students of social pedagogy achieve average to below average results in individual skill areas. At the same time, significant differences have been detected among the students with work experience in multicultural environment and those with no experience.

Keywords: cross–cultural adaptability inventory, diversity, intercultural competences, students of social pedagogy

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Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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

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

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Authors: Jibran Abbasy, Rizwan Sultan, Ammar Humayun, Tabish Chawla

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Background: Hydatid disease caused by Echinococcus Granulosus affects liver in 70-90% of cases. Dogs are the definitive host while humans are the accidental host. Modalities used for its treatment are especially important for our population as the disease is endemic in many Asian countries. The aim of the study was to perform an audit of the various modalities used for treatment of hydatid disease of liver and the response to each modality in tertiary care center of Pakistan. Materials and Methods: Retrospective audit of patients diagnosed and treated for Hydatid disease of the liver at Aga Khan University Hospital from 1st January 2007 to 31st December 2014 was completed. All patients aged 16 and above were included. Patients who had extra hepatic disease and missing records were excluded. Outcome measures were morbidity, mortality and recurrence of the disease. Results: During the study period 56 patients were treated for isolated hepatic hydatid disease and were included. Mean age was 39 years with 48% being females and 52% males. Most common presenting complaint was abdominal pain seen in 53% of patients(n=41). Duration of symptoms was less than 6 months in 74% (n=38). Mostly right lobe was involved in 69% (n=38).Most common treatment modality used was surgery in 34 patients followed by PAIR in 14 patients while 8 patients were treated medically. At a median follow up of 34 months recurrence was seen in 2 patients treated with PAIR while no patient treated with surgery had recurrence with the median follow up of 20 months. While no morbidity and mortality were observed in PAIR, but in surgery 5 patients had morbidity while 1 patient had mortality. Conclusion: Our data is comparative to other studies in terms of morbidity, mortality, and recurrence. We had adequate follow up. In our study PAIR and surgery both are effective and have less complications and recurrence rate. Surgery is still the gold standard in terms of recurrence.

Keywords: echinococcous granulosus, puncture aspiration irrigation reaspiration (PAIR), surgery, hydatid disease

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Authors: Marianne Paimre

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Estonia is heralded as the most successful digital country in the world with the highly acclaimed eHealth system. Yet 40% of the 65–74-year-olds do not use the Internet at all, and digital divide between young and elderly people's use of ICT is larger than in many advanced countries. Poor access to ICT resource and insufficient digital skills can lead to detachment from digital health resources, delayed diagnoses, and increased rates of hospitalization. To reveal digital divide within the elderly population itself, the presentation focuses on the health information behavior of Estonian seniors who either continue or have stopped working after retirement to use digital health applications. The author's main interest is on access, trust, and skills to use the Internet for medical purposes. Fifteen in-depth interviews with 65+ working persons, as well as 15 interviews with full-time retirees, were conducted. Also, six think-aloud protocols were conducted. The results indicate that older adults, who due to the nature of their work, have regular access to computers, often search for health-related information online. They exposed high source criticism and were successful in solving the given tasks. Conversely, most of the fully retired older adults claimed not using computers or other digital devices and cited lack of skills as the main reason for their inactivity. Thus, when developing health applications, it should be borne in mind that the ability and willingness of older adults to use e-solutions are very different.

Keywords: digital divide, digital healthcare, health information behavior, older adults

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Authors: Delband Yekta Moazami

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Background: For proper care and treatment of HIV patients and drug users, the medical staff and physicians must have a correct and positive attitude and knowledge towards such patients. We aimed to assess the attitudes in a sample of health care workers (HCW) working in different hospitals and clinics and medical students in Georgia towards HIV infected people and drug users in Tbilisi. Method: We conducted a cross-sectional study to assess attitudes of health care workers towards people living with HIV and drug users in hospitals and clinics in Tbilisi. The study was carried out from 1st of May 2020 till 30th of September 2020. Data were collected using a self-administered structured online questionnaire. With this tool we evaluated four facets of attitudes: Discrimination, Acceptance of HIV/AIDS patients, Acceptance of drug users and Fear. All data were imported and analyzed with the software SPSS 22 for windows. Results: In total data was collected from168 respondents, that among them 107 (65%) were women and majority of the participants were medical doctors. Women had more acceptance attitudes rather than men towards drug abusers. We found significant differences regarding expressing negative attitudes among HCW who were more than 50 years old comparing with other age groups in all four aspects. Medical doctors expressed more acceptances towards people with HIV and drug users comparing two other groups. Also our study revealed that the group with working experience 21 years and more, showed more discriminatory attitudes comparing other groups. Conclusion: Based on our study findings, there are significant differences regarding respondent’s attitudes based on gender, medical specialty and working experience in health care system. People struggling with HIV and drug use need nonjudgmental and positive behaviors from health care workers and physicians in order to help them for harm reduction and receiving appropriate treatment.

Keywords: hiv, addiction, attitudes, healthcare workers

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Authors: Daphne Fietz

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This paper builds on a reflection on an autobiographical experience of uncanniness during fieldwork in the white Afrikaner settlement Orania in South Africa. Drawing on Kristeva’s theory of abjection to establish a theory of Whiteness which is based on boundary threats, it is argued that the uncanny experience as the emergence of the abject points to a moment of crisis of the author’s Whiteness. The emanating abject directs the author to her closeness or convergence with Orania's inhabitants, that is a reciprocity based on mutual Whiteness. The experienced confluence appeals to the author’s White complicity to racism. With recourse to Butler’s theory of subjectivation, the abject, White complicity, inhabits both the outside of a discourse on racism, and of the 'self', as 'I' establish myself in relation to discourse. In this view, the qualities of the experienced abject are linked to the abject of discourse on racism, or, in other words, its frames of intelligibility. It then becomes clear, that discourse on (overt) racism functions as a necessary counter-image through which White morality is established instead of questioned, because here, by White reasoning, the abject of complicity to racism is successfully repressed, curbed, as completely impossible in the binary construction. Hence, such discourse endangers a preservation of racism in its pre-discursive and structural forms as long as its critique does not encompass its own location and performance in discourse. Discourse on overt racism is indispensable to White ignorance as it covers underlying racism and pre-empts further critique. This understanding directs us towards a form of critique which does necessitate self-reflection, uncertainty, and vigilance, which will be referred to as a discourse of relationality. Such a discourse diverges from the presumption of a detached author as a point of reference, and instead departs from attachment, dependence, mutuality and embraces the visceral as a resource of knowledge of relationality. A discourse of relationality points to another possibility of White engagement with Whiteness and racism and further promotes a conception of responsibility, which allows for and highlights dispossession and relationality in contrast to single agency and guilt.

Keywords: abjection, discourse, relationality, the visceral, whiteness

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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: E. Xavier, B. Nandita

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Rohingyas are an ethnic and religious minority that resides in the Rakhine State of Myanmar. Post the military coup in 1962, Rohingyas have not been recognized as one of the ethnic tribes of Burma under the legislation. They have lost citizenship, education, health care rights, and instantly became illegal immigrants. While the historicization of this conflict is crucial, this paper wants to humanize the Rohingya population’s embodiment of violence on three different levels – individual, social, and political. In addition, the study focuses on their liminal existence in refugee camps in Bangladesh and in other parts of the world, such as Malaysia and the United States of America. A multi-medium study, it includes first-hand interviews with the Rohingya community in Wisconsin and Chicago, second-hand interviews from documentaries and past ethnographies from scholars to draw meaningful conclusions about their experience as a community. In the end, it focuses on the group of Rohingyas who have managed to resettle in another country and their transitioning experience. Rohingyas embody violence on their individual, social, and political bodies in different ways. Along with rape, murder, and physical harm, the community also encounters sexually transmitted infections, post-traumatic stress disorder symptoms, and poor mental health. On a social level, they encounter heightened gender discrimination, work industry shifting, and immense, shared emotional pain. As for their political body, the news media and journalism industry uses their bodies for purposes that benefit both parties and flirts with a tone of sensationalism in their reporting. In addition, the Rohingya community fluctuates with the concept of nationality, patriotism, citizenship, and refugee when they think about the future. This study provides a framework that future aid or health programs can use to determine the type of community need and its significance in the Rohingya community.

Keywords: embodiment, liminal, refugee, Rohingya

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Authors: Huang Wei-Yi

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

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

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Authors: K. S. Sivakumaran, T. Thanga, B. Halabieh

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The end panels of a large rectangular industrial duct, which experience significant internal pressures, also experience considerable transverse shear due to transfer of gravity loads to the supports. The current design practice of such thin plate panels for shear load is based on methods used for the design of plate girder webs. The structural arrangements, the loadings and the resulting behavior associated with the industrial duct end panels are, however, significantly different than those of the web of a plate girder. The large aspect ratio of the end panels gives rise to multiple bands of tension fields, whereas the plate girder web design is based on one tension field. In addition to shear, the industrial end panels are subjected to internal pressure which in turn produces significant membrane action. This paper reports a study which was undertaken to review the current industrial analysis and design methods and to propose a comprehensive method of designing industrial duct end panels for shear resistance. In this investigation, a nonlinear finite element model was developed to simulate the behavior of industrial duct end panel subjected to transverse shear and internal pressures. The model considered the geometric imperfections and constitutive relations for steels. Six scale independent dimensionless parameters that govern the behavior of such end panel were identified and were then used in an extensive parametric study. It was concluded that the plate slenderness dominates the shear strength of stockier end panels, and whereas, the aspect ratio and plate slenderness influence the shear strength of slender end panels. Based on these studies, this paper proposes design aids for estimating the shear strength of rectangular duct end panels.

Keywords: thin plate, transverse shear, tension field, finite element analysis, parametric study, design

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Authors: Majid Alizadeh, Sina Nematizadeh, Hassan Esmailpour

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The mutual effects of hospitality and the environment are undeniable, so that the tourism industry has major harmful effects on the environment. Hotels, as one of the most important pillars of the hospitality industry, have significant effects on the environment. Green marketing is a promising strategy in response to the growing concerns about the environment. A green hotel marketing model was proposed using a grounded theory approach in the hotel industry. The study was carried out as a mixed method study. Data gathering in the qualitative phase was done through literature review and In-depth, semi-structured interviews with 10 experts in green marketing using snowball technique. Following primary analysis, open, axial, and selective coding was done on the data, which yielded 69 concepts, 18 categories and six dimensions. Green hotel (green product) was adopted as the core phenomenon. In the quantitative phase, data were gleaned using 384 questionnaires filled-out by hotel guests and descriptive statistics and Structural equation modeling (SEM) were used for data analysis. The results indicated that the mediating role of behavioral response between the ecological literacy, trust, marketing mix and performance was significant. The green marketing mix, as a strategy, had a significant and positive effect on guests’ behavioral response, corporate green image, and financial and environmental performance of hotels.

Keywords: green marketing, sustainable development, hospitality, grounded theory, structural equations model

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Authors: Anupama A. P.

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The Malayalam film industry, known as Mollywood, has a rich tradition of storytelling and cultural significance within Indian cinema. Middlebrow films have emerged as a distinct influential category, particularly in the 1980s, with directors like K.G. George, who engaged with female subjectivity and drew inspiration from the ‘women’s cinema’ of the 1950s and 1960s. In recent decades, particularly post-2010, the industry has transformed significantly with a new generation of filmmakers diverging from melodrama and new wave of the past, incorporating advanced technology and modern content. This study examines the evolution and impact of Malayalam middlebrow cinema in the 21st century, focusing on post-2000 films and their influence on contemporary spectator experiences. These films appeal to a wide range of audiences without compromising on their artistic integrity, tackling social issues and personal dramas with thematic and narrative complexity. Historically, middlebrow films in Malayalam cinema have portrayed realism and addressed the socio-political climate of Kerala, blending realism with reflexivity and moving away from traditional sentimentality. This shift is evident in the new generation of Malayalam films, which present a global representation of characters and a modern treatment of individuals. To provide a comprehensive understanding of this evolution, the study analyzes a diverse selection of films such as Kerala Varma Pazhassi Raja (2009), Drishyam (2013), Maheshinte Prathikaaram (2016), Take Off (2017), and Thondimuthalum Driksakshiyum (2017) and Virus (2019) illustrating the broad thematic range and innovative narrative techniques characteristic of this genre. These films exemplify how middlebrow cinema continues to evolve, adapting to changing societal contexts and audience expectations. This research employs a theoretical methodology, drawing on cultural studies and audience reception theory, utilizing frameworks such as Bordwell’s narrative theory, Deleuze’s concept of deterritorialization, and Hall’s encoding/decoding model to analyze the changes in Malayalam middlebrow cinema and interpret the storytelling methods, spectator experience, and audience reception of these films. The findings indicate that Malayalam middlebrow cinema post-2010 offers a spectator experience that is both intellectually stimulating and broadly appealing. This study highlights the critical role of middlebrow cinema in reflecting and shaping societal values, making it a significant cultural artefact within the broader context of Indian and global cinema. By bridging entertainment with thought-provoking narratives, these films engage audiences and contribute to wider cultural discourse, making them pivotal in contemporary cinematic landscapes. To conclude, this study highlights the importance of Malayalam middle-brow cinema in influencing contemporary cinematic tastes. The nuanced and approachable narratives of post-2010 films are posited to assume an increasingly pivotal role in the future of Malayalam cinema. By providing a deeper understanding of Malayalam middlebrow cinema and its societal implications, this study enriches theoretical discourse, promotes regional cinema, and offers valuable insights into contemporary spectator experiences and the future trajectory of Malayalam cinema.

Keywords: Malayalam cinema, middlebrow cinema, spectator experience, audience reception, deterritorialization

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Authors: Hande Burcu Deniz

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People in the U.S. spend a considerable portion of their time indoors. This makes it crucial to provide environments that support the well-being of people. Restorative environments aim to help people recover their cognitive resources that were spent due to intensive use of directed attention. Spending time in nature and taking a nap are two of the best ways to restore these resources. However, they are not possible to do most of the time. The problem is that many studies have revealed how nature and spending time in natural contexts can help boost restoration, but there are fewer studies conducted to understand how cognitive resources can be restored in interior settings. This study aims to explore the answer to this question: which qualities of interiors increase the restorativeness of an interior setting and how do they mediate restorativeness of an interior. To do this, a phenomenological qualitative study was conducted. The study was interested in the definition of attention restoration and the experiences of the phenomena. As the themes emerged, they were analyzed to match with Attention Restoration Theory components (being away, extent, fascination, compatibility) to examine how interior design elements mediate the restorativeness of an interior. The data was gathered from semi-structured interviews with international residents of Minnesota. The interviewees represent young professionals who work in Minnesota and often experience mental fatigue. Also, they have less emotional connections with places in Minnesota, which enabled data to be based on the physical qualities of a space rather than emotional connections. In the interviews, participants were asked about where they prefer to be when they experience mental fatigue. Next, they were asked to describe the physical qualities of the places they prefer to be with reasons. Four themes were derived from the analysis of interviews. The themes are in order according to their frequency. The first, and most common, the theme was “connection to outside”. The analysis showed that people need to be either physically or visually connected to recover from mental fatigue. Direct connection to nature was reported as preferable, whereas urban settings were the secondary preference along with interiors. The second theme emerged from the analysis was “the presence of the artwork,” which was experienced differently by the interviewees. The third theme was “amenities”. Interviews pointed out that people prefer to have the amenities that support desired activity during recovery from mental fatigue. The last theme was “aesthetics.” Interviewees stated that they prefer places that are pleasing to their eyes. Additionally, they could not get rid of the feeling of being worn out in places that are not well-designed. When we matched the themes with the four art components (being away, extent, fascination, compatibility), some of the interior qualities showed overlapping since they were experienced differently by the interviewees. In conclusion, this study showed that interior settings have restorative potential, and they are multidimensional in their experience.

Keywords: attention restoration, fatigue, interior design, qualitative study, restorative environments

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Authors: B. Self, V. Fleming, C. Maxwell

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The fourth clause of the UK 1967 Abortion Act allows individuals (including health care practitioners) to conscientiously object to participating in an abortion. Individuals are able to object if they consider that participating is incompatible with their religious, moral, philosophical, ethical, or personal beliefs. Currently, there is no research on service users’ opinions and understandings of conscientious objection or the impact of conscientious objection from the UK service users’ perspective. This perspective is imperative in understanding the real-world consequences and impact of conscientious objection and essential when creating policy and guidelines. This qualitative research took a liberal feminist approach. It provided a platform for service users to share their experiences of abortion and conscientious objection, as well as their opinions and understandings of conscientious objection. The method employed was semi-structured interviews. Findings indicated that conscientious objection could work in practice. However, it is currently failing some individuals, as health care practitioners are not always referring and informing service users. Participants didn’t experience burdens such as long waiting times and were still able to access legal abortion. However, participants did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred. Moreover, participants’ opinions on conscientious objection in the UK varied greatly. The majority supported the most common approach within the literature and in practice, whereby health care practitioners are able to object so long as they refer and inform the service user. However, the opinion that health care practitioners should not be allowed to object or should be able to object without referring and informing was also present. Without this research, the impact that conscientious objection is having on service users in the UK and service users’ opinions on conscientious objection wouldn’t be known. These findings will be used to inform national policy and guidelines, making access to abortion fairer and safer for all.

Keywords: conscientious objection, abortion, medical ethics, reproductive justice

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Authors: Veepaul Kaur Mann Balwinder Singh

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The COVID-19 had an intense impact on several countries across the world. National governments have imposed widespread restrictions to prevent the growth of this pandemic. The new health competitive scenario induced by the COVID-19 crisis raised many issues on how business activities should be reorganized due to the difficulties of physical interactions with distributors, suppliers and customers. The pandemic has particularly affected the whole selling process because of the relevant issues that emerged in managing physical sale channels and interactions with one another, both in the Business-to-Consumer and in the Business-to-Business markets. Recent research about the appropriate actions and strategies that could help firms overcome the crisis has highlighted the key role of digital expertise that may ensure connections and, thus, help business activities run smoothly. This could be true, especially with the occurrence of strong limitations on physical interactions during the COVID-19 pandemic. The catastrophe changes life publically and economically. People are living alone for following the social distancing norms. In that set-up, Digital Marketing is playing an important role in civilization. Anyone can buy any item, pay bills, transfer money and compare items through Digital Marketing without physical interactions. After COVID-19, people will be more aware of health safety and trust. So, through Digital Marketing, organizations can approach customers and provide good service environments. In such a situation, the online network becomes the most important encouraging for online customers to get in contact with the firm and carry out online selling and purchasing activities around the world.

Keywords: COVID-19, business, digital marketing, online customer

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Authors: Elvira Loibl

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In Western countries, the demand for adoptable children, especially healthy babies, has been considerably high for several years. Rising infertility rates, liberal abortion politics, the widespread use of contraception, and the increasing acceptance of unmarried motherhood are factors that have decreased the number of infants available for domestic adoption in the U.S. and Europe. As a consequence, many involuntarily childless couples turn to intercountry adoption as a viable alternative to have a child of their own. However, the demand for children far outpaces the supply of orphans with the desired characteristics. The imbalance between the number of prospective adopters and the children available for intercountry adoption results in long waiting lists and high prices. The inordinate sums of money involved in the international adoption system have created a commercial ‘underbelly’ where unethical and illicit practices are employed to provide the adoption market with adoptable children. Children are being purchased or abducted from their families, hospitals or child care institutions and then trafficked to receiving countries as ‘orphans’. This paper aims to uncover and explain the factors of the German adoption system that are conducive to child trafficking for adoption purposes. It explains that the tension between money and integrity as experienced by German adoption agencies, blind trust in the authorities in the sending countries as well as a lenient control system encourage and facilitate the trafficking in children to Germany.

Keywords: child trafficking, intercountry adoption, market in adoptable babies, German adoption system

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Authors: Amin Banae Babazadeh

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In the contemporary world, NGOs are considered as important tool for motivating the community. So they committed their true mission and the promotion of civic participation and strengthen social identities. Functional characteristics of non-governmental organizations are the element to leverage the centers of political and social development of powerful governments since they are concrete and familiar with the problems of society and the operational strategies which would facilitate this process of mutual trust between the people and organizations. NGOs on the one hand offer reasonable solutions in line with approved organizations as agents to match between the facts and reality of society and on the other hand changes to a tool to have true political, social and economic behavior. However, the NGOs are active in the formulation of national relations and policy formulation in an organized and disciplined based on three main factors, i.e., resources, policies, and institutions. Organizations are not restricted to state administration in centralized system bodies and this process in the democratic system limits the accumulation of desires and expectations and at the end reaches to the desired place. Hence, this research will attempt to emphasis on field research (questionnaire) and according to the development evolution and role of NGOs analyze the effects of this center on youth. Therefore, the hypothesis is that there is a direct relationship between the Enlightenment and the effectiveness of policy towards NGOs and solving social damages.

Keywords: civic participation, community vulnerability, insightful, NGO, urmia

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Authors: Scholastic Nangila Adeli, Francisca Mbutitia Ngithi

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Stigma is commonly associated with mental health patients and may act as a barrier to individuals who may seek or engage in treatment services. Stigmatization among university students is common whether they know someone with a mental health problem, or have a good knowledge and experience of mental health issues. The objective of this study was to establish the various barriers that prevent university students who have mental health challenges from seeking treatment and care. The study was a descriptive in nature where 320 respondents helped to establish the barriers to treatment or participation in mental health care among university students. A questionnaire was used to help establish the barriers and attitude towards mental illness among the respondents. Results from this study revealed that mental illnesses are common among university students and they are manifested in different forms like; anxiety and panic attacks, mood and eating disorders, Impulse control leading to gambling, alcohol and drug addictions, anger and depression leading to loneliness. Mental stigma (both social and self) was the major barrier with 62% of the respondents stating that social stigma was worse than self-stigma. This is because of the social discrimination towards the victim of mental challenges. On issues of attitude, 71% of the respondents said that they can never admit that they have a mental issue and would rather secretly seek clinical or psychological help for fear of being discriminated or excluded by peers. This view is informed by the societal belief that people with mental health challenges were dangerous (associating them with criminal behavior) and hard to socialize with or help. From the findings of this study, it is concluded that mental health problems are real among university students in Kenya and it is important for the university environment to minimize or eradicate stigma within the social circles. Stigma can be minimized or eradicated by creating awareness among university students and fostering social inclusion so that the students who have mental health challenges can experience a sense of belonging and acceptance hence build their self-esteem.

Keywords: disorders, impulse control, mental health problems, stigma

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Authors: Susan Evans, Janna Gordon-Elliott, Katarzyna Wyka, Virginia Mutch

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During the rise of the COVID-19 pandemic, healthcare workers needed an intervention that could address their profound acute stress. Mindfulness-based stress reduction (MBSR) is a program that has long established effectiveness for mental and physical health outcomes. In recent years, MBSR has been modified such that the duration of both class time and number of sessions has been abbreviated, and its delivery has been adapted for online dissemination, thus increasing the likelihood that individuals who could most benefit from the program would do so. We sought to investigate whether a brief, online version of MBSR could be feasible and acceptable for health care workers (HCW) in acute stress in response to the COVID-19 pandemic. Participants were recruited via an email sent to all hospital employees, which spans residents, physicians, nurses, housekeeping, lab technicians, administrators, and others. Participating HCW were asked about their previous experience with mindfulness and asked to commit to a minimum of 3 sessions. They were then provided with four weekly 1-hour sessions online that included the major mindfulness exercises taught during traditional MBSR programs (i.e., body scan, sitting meditation, mindful eating, and yoga). Participants were provided with supporting slides, videos, demonstrations and asked to track their practice. Hospital staff enrolled in the program; by the end of the first day of recruitment, 40 had applied; by the start date, about 100 were enrolled, and n attended a minimum of 3 sessions, supporting feasibility. Hospital staff also participated and practiced the mindfulness exercises (n=42), thus supporting acceptability. Participants reported that the program was logical, successful, and worth recommending both before starting the program and after completing it (M= 22.02 and M=21.76, respectively, possible range 0-27). There was a slight decline in the belief in improvement in health and well-being due to the program (ES=.37, p=.021). Secondary hypotheses regarding participants’ self-reported stress and levels of mindfulness were also supported, such that participants reported improvements in perceived stress (ES=.45, p=.006), compassion satisfaction, burnout, and secondary traumatic stress (ES=.41, ES=.31, ES=.35, respectively, p<.05). Participants reported significant improvements in the describing facet of mindfulness (ES=.49, p=.004), while all other facets (observing, acting with awareness, nonjudging of inner experience, nonreactivity to inner experience) remained unchanged pre- to post-program. Results from this study suggest that an abridged, online version of MBSR is feasible and accessible to health care workers in acute stress and provides benefits expected from traditional MBSR programs. The lack of a randomized control group limits generalizability. We intend to provide a structure, framework, and lessons learned to hospital administrators and clinical staff seeking to support their employees in acute stress.

Keywords: acute stress, health care workers, mindfulness, online interventions

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Authors: C. Peeper McDonald

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Despite the multiracial population growing exponentially in the world and especially in the U.S., there continues to be a lack of culturally responsive research addressing the unique experiences and needs of this population, especially within counseling and counselor education settings. It is evident that their unique racial microaggressive experiences need to be better understood within the field of professional counseling to not only underscore competent training and practice but also culturally responsive training and practice. The participants of this study were 13 (n=13) individuals from the United States who identified as multiracial and said they had a microaggressive experience with either their counselor or counseling professor. Data were gathered through one-on-one, semi-structured interviews. The analysis employed phenomenological methods based on the transcendental approach, resulting in themes that encapsulated the core of the participants' experiences, including multiracial microaggressions that are derogatory and perpetuate privilege/oppression; counselors and their training programs should embody safety, support, attentiveness, inter-personal sensitivity, and awareness of the impact on others; microaggressions negatively affect the counseling relationship and outcomes; awareness surrounding the emotional impact of microaggressions; strength-based responses and future responses to microaggressions; and advocacy and suggestions for counselors and counselor educators. These themes are discussed in detail, and recommendations for researchers, counselor educators, and professional counselors to improve training and practice are provided. This U.S. study's insights into the Multiracial experience of microaggressions within the mental health profession can inform global mental health practices by highlighting the need for culturally responsive counseling that recognizes and addresses racial nuances. Such knowledge is transferable to international settings where multiracial populations may also encounter similar challenges, aiding in the development of global standards for culturally competent counseling practices.

Keywords: culturally responsive training and practice, mental health, microaggressions, multiracial

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Authors: María-Dolores Olvera-Lobo, Bryan John Robinson, Juncal Gutierrez-Artacho

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Graduates are equipped with a wide range of generic competencies which complement solid curricular competencies and facilitate their access to the labour market in diverse fields and careers. However, some generic competencies such as instrumental, personal and systemic competencies related to teamwork and interpersonal communication skills, decision-making and organization skills are seldom taught explicitly and even less often assessed. In this context, translator training has embraced a broad range of competencies specified in the undergraduate program currently taught at universities and opens up the learning experience to cover areas often ignored due to the difficulties inherent in both teaching and assessment. In practice, translator training combines two well-established approaches to teaching/learning: project-based learning and genuinely cooperative – or merely collaborative – learning. Our professional approach to translator training is a model focused on and adapted to the teleworking context of professional translation and presented through the medium of blended e-learning. Teamwork-related competencies are extremely relevant, and they require explicit and implicit teaching so that graduates can be confident about their capacity to make their way in professional contexts. In order to highlight the importance of teamwork and intra-team relationships beyond the classroom, we aim to raise awareness of teamwork processes so as to empower translation students in managing their interaction and ensure that they gain valuable pre-professional experience. With these objectives, at the University of Granada (Spain) we have developed a range of classroom activities and assessment tools. The results of their application are summarized in this study.

Keywords: blended learning, collaborative teamwork, cross-curricular competencies, higher education, intra-team relationships, students’ perceptions, translator training

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Authors: Ekta Pandey

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The Indian Pharmaceutical Industry is ranked third largest by volume and fourteenth by value. It thus accounts for 10% of world’s production by volume and 1.5% by value according to Department of Pharmaceuticals, Government of India. The industry has shown phenomenal growth over past few years, moving from US $ 1 billion turnover in 1990 to a turnover of around US $30 billion in 2015. The Indian pharmaceutical sector is ranked seventeenth in terms of export value of active pharmaceutical ingredients and dosage forms to more than 200 countries around the globe. It has shown tremendous changes especially after Trade Related Aspects of Intellectual Property Rights (TRIPS) agreement. Recognizing the immense potential for growth and its direct impact on Indian economy, it is important to look up the industrial policies adopted since Indian independence which turnaround the Indian pharmaceutical industry. A systematic review of changes in market structure of Indian pharmaceutical industry due to shift in policy regimes is done from 1850 to 2015 using secondary peer reviewed published research work. The aim is to understand the impact of anti-trust laws, intellectual property rights, industry competition acts and regulations are quite crucial in determining effective economic policy and have overall lasting effects on international trade and ties. The proposed paper examines the position of Indian domestic firms relative to multinational pharmaceutical firms tries to throw some light on the growth curve of Indian pharmaceutical sector.

Keywords: active pharmaceutical ingredients, competition act, pharmaceutical industry, TRIPS

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Authors: Catherine Mangan, Beth Anderson

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There has been a significant drive to use online or hybrid learning in Higher Education (HE) over recent years. HEs with a virtual presence offer their communities a range of benefits, including the potential for greater inclusivity, diversity, and collaboration; more flexible learning packages; and more engaging, dynamic content. Institutions can also experience significant challenges when seeking to extend learning spaces in this way, as can learners themselves. For example, staff members’ and learners’ digital literacy varies (as do their perceptions of technologies in use), and there can be confusion about optimal approaches to implementation. Furthermore, the speed with which HE institutions have needed to shift to fully online or hybrid models, owing to the COVID19 pandemic, has highlighted the significant barriers to successful implementation. HE environments have been shown to predict a range of organisational, academic, and experiential outcomes, both positive and negative. Much research has focused on the social aspect of virtual platforms, as well as the nature and effectiveness of the technologies themselves. There remains, however, a relative paucity of synthesised knowledge on the psychology of learners’ relationships with their institutions; specifically, how individual difference and interpersonal factors predict students’ ability and willingness to engage with novel virtual learning spaces. Accordingly, extending learning spaces remains challenging for institutions, and wholly remote courses, in particular, can experience high attrition rates. Focusing on the last five years, this pragmatic review summarises evidence from the psychological and pedagogical literature. In particular, the review highlights the importance of addressing the psychological and relational complexities of students’ shift from offline to online engagement. In doing so, it identifies considerations for HE institutions looking to deliver in this way.

Keywords: higher education, individual differences, interpersonal relationships, online learning, virtual environment

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Authors: A. Fordham, A. Hudson

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Background: Studies have suggested 16-25% of normotensive trauma patients with no clinical signs of shock have abnormal lactate and BD readings evidencing shock; a phenomenon known as occult hypoperfusion (OH). In light of the scarce quantity of evidence currently documenting OH, this study aimed to identify the prevalence of OH in the pre-hospital setting and explore ways to improve its identification and management. Methods: A quantitative retrospective data analysis was carried out on 75 sets of patient records for trauma patients treated by Kent Surrey Sussex Air Ambulance Trust between November 2013 and October 2014. The KSS HEMS notes and subsequent ED notes were collected. Trends between patients’ SBP on the scene, whether or not they received PRBCs on the scene as well as lactate and BD readings in the ED were assessed. Patients’ KSS HEMS notes written by the HEMS crew were also reviewed and recorded. Results: -Suspected OH was identified in 7% of the patients who did not receive PRBCs in the pre-hospital phase. -SBP heavily influences the physicians’ decision of whether or not to transfuse PRBCs in the pre-hospital phase. Preliminary conclusions: OH is an under-studied and underestimated phenomenon. We suggest a prospective trial is carried out to evaluate whether detecting trauma patients’ tissue perfusion status in the pre-hospital phase using portable devices capable of measuring serum BD and/or lactate could aid more accurate detection and management of all haemorrhaging trauma patients, including patients with OH.

Keywords: occult hypoperfusion, PRBC transfusion, point of care testing, pre-hospital emergency medicine, trauma

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Authors: Hiromi Takafuji

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Flight attendant:FA is one of popular occupation, especially in Asian countries, and the decision to be hired is made after clearing a high multiplier. On the other hand, immediately after joining the company, they experience unique stress due to the fact that the organization requires them to perform security and customer service duties in a highly specialized and limited space and time. As a result, despite the high level of difficulty in joining the company, many new recruits retire early at a high rate. It is commonly said that 30% of new graduates leave the company within three years in Japan and speculated that Reality Shock:RS is one of the causes of this. RS is that newcomers experience refers to the stress caused by the difference between pre-employment expectations and post-employment reality. The purpose of this study was to elucidate the mechanism by which the expertise required of new FA and the expectation of expertise held by each of them cause reality shock, which affects motivation and the decision to leave. This study identified the professionalism required of new FA and the impact of that expectation for professionalism on RS through an exploratory study of the experiences and psychological processes of FA who left within three years. Semi-structured in-depth interviews were conducted with five FA who left a major Japanese airline at an early stage, and their experiences were categorized, integrated, and classified by qualitative content analysis. They were chosen under a number of controlled conditions. Then two major findings emerged: first, that pre-employment expectations defining RS were hierarchical, and second, that training amplified expectations of professionalism, which strongly influenced early turnover. From these, this study generated a model of RS generative process model of FA that expectations are hierarchical and influential. This could contribute to the prevention of mental health deterioration by reality shock among new FA.

Keywords: reality shock, flight attendant, early turnover, qualitative study

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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: Mahmoud Abdel Hameed Shahin

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Job demands that are incompatible with an employee's skills, resources, or needs cause unpleasant emotional and physical reactions known as job stress. Nurses offer care in hospital emergency rooms all around the world, and since they operate in such a dynamic and unpredictable setting, they are constantly under pressure. It has been discovered that job stress has harmful impacts on nurses' health as well as their capacity to handle the demands of their jobs. The purpose of this study was to evaluate the level of job stress experienced by the emergency department nurses at King Fahad Specialist Hospital in Buraidah City, Saudi Arabia. In October 2021, a cross-sectional descriptive study was conducted. 80 nurses were conveniently selected for the study, the bulk of them worked at King Fahad Specialist Hospital's emergency department. An electronic questionnaire with a sociodemographic data sheet and a job stress scale was given to the participating nurses after ethical approval was received from the Ministry of Health's representative bodies. Using SPSS Version 26, both descriptive and inferential statistics were employed to analyze and tabulate the acquired data. According to the findings, the factors that contributed to the most job stress in the clinical setting were having an excessive amount of work to do and working under arbitrary deadlines, whereas the factors that contributed to the least stress were receiving the proper recognition or rewards for good work. In the emergency room of King Fahad Specialist Hospital, nurses had a moderate level of stress (M=3.32 ± 0.567/5). Based on their experience, emergency nurses' levels of job stress varied greatly, with nurses with less than a year of experience notably experiencing the lowest levels of job stress. The amount of job stress did not differ significantly based on the emergency nurses' age, nationality, gender, marital status, position, or level of education. The causes and impact of stress on emergency nurses should be identified and alleviated by hospitals through the implementation of interventional programs.

Keywords: emergency nurses, job pressure, Qassim, Saudi Arabia, job stress

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Authors: A. Mukrimah, M. Mohd Parid, H. F. Lim

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Wetland ecosystem has valuable resources that contribute to national income generation and public well-being, either directly by resources that have a market value or indirectly by resources that have no market value. Economic approach is used to evaluate the resources to determine the best use of wetland resources and should be emphasized in policy development planning. This approach is to prevent imbalance in the allocation of resources and welfare benefits. A case study was conducted in 2016 to assess the economic value of wetland ecosystem services at Pulau Kukup National Parks (PKNP). This study has applied dichotomous choice survey design Contingent Valuation Method (CVM) to investigate empirically the willingness-to-pay (WTP) by the public. The study interviewed 400 household respondents at Pontian, Johor. Analysis showed 81% of household interviewed were willing to contribute to the Wetland Conservation Trust Fund. The results also indicated that on average a household was willing to pay RM87 annually. By taking into account 21,664 households in Pontian district in 2016, public’s contribution to conserves wetland ecosystem at PKNP was calculated to be RM1, 884,334. From the public’s interest to contribute to the conservation of wetland ecosystem services at PKNP, it indicates that more concerted effort is needed by both the federal and state governments to conserve and rehabilitate the mangrove ecosystem in Malaysia.

Keywords: environmental economy, economic valuation, choice experiment, Pulau Kukup national parks

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Authors: Bihan Qaimari

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In many areas of the world there are political conflicts the consequences of which have an inevitable impact on the educational system. Palestine is one such country where the experience of political conflict, going back over many years, has had a devastating effect on the development and maintenance of a stable educational environment for children and their teachers. Up to now there have been few studies that have focussed on the effects of living and working in a war zone on the professional identity of teachers. The aim of this study is to explore how the formation of Palestinian teachers’ professional identity is affected by their experience of the current political conflict its impact on the school social culture. In order to gain an in-depth understanding of the impact of political violence on the formation of the professional identity of Palestinian teachers, a qualitative multiple case-study approach was adopted which draws on sociocultural theories of identity formation. An initial study was first conducted in six schools and this was followed by an in-depth study of teachers working in three further primary schools. Data sources included participant observation, a research diary, semi-structured group and individual interviews. Grounded theory, constant-comparative methods, and discourse analysis procedures were used to interpret the data. The findings suggest that the Palestinian primary school teachers negotiate multiple conflicting identities through their every day experiences of political conflict and the schools’ social culture. This tension is formed as a result of the historical cultural meaning that teachers construct about themselves and within the current unstable and unsettling conditions that exist in their country. In addition, the data indicate that the geographical location of the schools in relation of their proximity to the events of the political conflict also had an influence on the degree of tension inherent in teachers’ professional identity. The study makes significant theoretical, practical, and methodical contributions to the study of the formation of teachers’ professional identity in countries affected by political conflict.

Keywords: identity, political conflict, Palestine, teacher's professional identity

Procedia PDF Downloads 412