Search results for: parents of children with disabilities
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3926

Search results for: parents of children with disabilities

2456 Combination of Work and Family Demands Correlated with the Severity of Wrist Musculoskeletal Disorders among Nurses

Authors: Hsien Hwa Kuo, Lin Wen Chun, Lin Wen Chun, Hsien Wen Kuo

Abstract:

Objective: Nurses represent an important occupational group frequently affected by wrist musculoskeletal disorders (WMSDs) due to a heavy workload, working shifts, poor posture, giving shots, making beds, lifting patients, bending their waist and insufficient rest time every day. However, lack of research reported nurses whether workload in household correlated with the severity of WMSDs. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire including the demographic information, workplace condition and nine body parts of musculoskeletal disorders. Results: 17.9% and 23.9% of severity and symptoms in WMSDs among nurses with children were significant higher than among nurses without children (1​2.4% and 15.9%). Based on multiple logistic regression models adjusted for age, work duration, job title and body mass index (BMI), we found that heavy workload in hospital had higher odds ratio (OR) of the severity and symptoms of WMSD among nurses with children (OR= 8.67 and OR= 4.30, p<0.05) compared to nurses without children (OR= 1.94 and OR= 1.70). Conclusion: The severity and symptoms of WMSDs among nurses significantly correlated with workload in hospital among nurses with children. If women are at greater risk because of the combination of their work and family demands, synergistic effect of WMSDs was found among nurses. Comment: Women's domestic work, especially once they become mothers, they invest more time and energy caring for children, helping others, and doing housework. Thus domestic work, per se, may be a risk factor for wrist musculoskeletal problems, and, more importantly, it may constrain women's ability to protect themselves from the effects of their paid work. If nurses with more domestic work periodically make efforts to physical activity or modify inappropriate posture, their WMSDs symptoms will be alleviated.

Keywords: musculoskeletal disorders, nurse, NMQ, WMSDs

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2455 The Application of Sensory Integration Techniques in Science Teaching Students with Autism

Authors: Joanna Estkowska

Abstract:

The Sensory Integration Method is aimed primarily at children with learning disabilities. It can also be used as a complementary method in treatment of children with cerebral palsy, autistic, mentally handicapped, blind and deaf. Autism is holistic development disorder that manifests itself in the specific functioning of a child. The most characteristic are: disorders in communication, difficulties in social relations, rigid patterns of behavior and impairment in sensory processing. In addition to these disorders may occur abnormal intellectual development, attention deficit disorders, perceptual disorders and others. This study was focused on the application sensory integration techniques in science education of autistic students. The lack of proper sensory integration causes problems with complicated processes such as motor coordination, movement planning, visual or auditory perception, speech, writing, reading or counting. Good functioning and cooperation of proprioceptive, tactile and vestibular sense affect the child’s mastery of skills that require coordination of both sides of the body and synchronization of the cerebral hemispheres. These include, for example, all sports activities, precise manual skills such writing, as well as, reading and counting skills. All this takes place in stages. Achieving skills from the first stage determines the development of fitness from the next level. Any deficit in the scope of the first three stages can affect the development of new skills. This ultimately reflects on the achievements at school and in further professional and personal life. After careful analysis symptoms from the emotional and social spheres appear to be secondary to deficits of sensory integration. During our research, the students gained knowledge and skills in the classroom of experience by learning biology, chemistry and physics with application sensory integration techniques. Sensory integration therapy aims to teach the child an adequate response to stimuli coming to him from both the outside world and the body. Thanks to properly selected exercises, a child can improve perception and interpretation skills, motor skills, coordination of movements, attention and concentration or self-awareness, as well as social and emotional functioning.

Keywords: autism spectrum disorder, science education, sensory integration, special educational needs

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2454 Children Overcome Learning Disadvantages through Mother-Tongue Based Multi-Lingual Education Programme

Authors: Binay Pattanayak

Abstract:

More than 9 out of every 10 children in Jharkhand struggle to understand the texts and teachers in public schools. The medium of learning in the schools is Hindi, which is very different in structure and vocabulary than those in children’s home languages. Hence around 3 out of 10 children enrolled in early grades drop out in these schools. The state realized the cause of children’s high dropout in 2013-14 when the M-TALL, the language research shared the findings of a state-wide socio-linguistic study. The study findings suggested that there was a great need for initiating a mother-tongue based multilingual education (MTB-MLE) programme for the state in early grades starting from pre-school level. Accordingly, M-TALL in partnership with department of education designed two learning packages: Bhasha Puliya pre-school education programme for 3-6-year-old children for their school readiness with bilingual picture dictionaries in 9 tribal and regional languages. This was followed by a plan for MTB-MLE programme for early primary grades. For this textbooks in five tribal and two regional languages were developed under the guidance of the author. These books were printed and circulated in the 1000 schools of the state for each child. Teachers and community members were trained for facilitating culturally sensitive mother-tongue based learning activities in and around the schools. The mother-tongue based approach of learning has worked very effectively in enabling them to acquire the basic literacy and numeracy skills in own mother-tongues. Using this basic early grade reading skills, these children are able to learn Hindi and English systematically. Community resource groups were constituted in each school for promoting storytelling, singing, painting, dancing, acting, riddles, humor, sanitation, health, nutrition, protection, etc. and were trained. School academic calendar was designed in each school to enable the community resource persons to visit the school as per the learning plan to assist children and teacher in facilitating rich cultural activities in mother-tongue. This enables children to take part in plethora of learning activities and acquire desired knowledge, skills and interest in mother-tongues. Also in this process, it is attempted to promote 21st Century learning skills by enabling children to apply their new knowledge and skills to look at their local issues and address those in a collective manner through team work, innovations and leadership.

Keywords: community resource groups, learning, MTB-MLE, multilingual, socio-linguistic survey

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2453 Critiquing Israel as Child Abuse: How Colonial White Feminism Disrupts Critical Pedagogies of Culturally Responsive and Relevant Practices and Inclusion through Ongoing and Historical Maternalism and Neoliberal Settler Colonialism

Authors: Wafaa Hasan

Abstract:

In May of 2022, Palestinian parents in Toronto, Canada, became aware that educators and staff in the Toronto District School Board were attempting to include the International Holocaust and Remembrance Definition of Antisemitism (IHRA) in The Child Abuse and Neglect Policy of the largest school board in Canada, The Toronto District School Board (TDSB). The idea was that if students were to express any form of antisemitism, as defined by the IHRA, then an investigation could follow with Child Protective Services (CPS). That is, the student’s parents could be reported to the state and investigated for custodial rights to their children. The TDSB has set apparent goals for “Decolonizing Pedagogy” (“TDSB Equity Leadership Competencies”), Culturally Responsive and Relevant Practices (CRRP) and inclusive education. These goals promote the centering of colonized, racialized and marginalized voices. CRRP cannot be effective without the application of anti-racist and settler colonial analyses. In order for CRRP to be effective, school boards need a comprehensive understanding of the ways in which the vilification of Palestinians operates through anti-indigenous and white supremacist systems and logic. Otherwise, their inclusion will always be in tension with the inclusion of settler colonial agendas and worldviews. Feminist maternalism frames racial mothering as degenerate (viewing the contributions of racialized students and their parents as products of primitive and violent cultures) and also indirectly inhibits the actualization of the tenets of CRRP and inclusive education through its extensions into the welfare state and public education. The contradiction between the tenets of CRRP and settler colonial systems of erasure and repression is resolved by the continuation of tactics to 1) force assimilation, 2) punish those who push back on that assimilation and 3) literally fragment familial and community structures of racialized students, educators and parents. This paper draws on interdisciplinary (history, philosophy, anthropology) critiques of white feminist “maternalism” from the 19th century onwards in North America and Europe (Jacobs, Weber), as well as “anti-racist education” theory (Dei), and more specifically,” culturally responsive learning,” (Muhammad) and “bandwidth” pedagogy theory (Verschelden) to make its claims. This research contributes to vibrant debates about anti-racist and decolonial pedagogies in public education systems globally. This paper also documents first-hand interviews and experiences of diasporic Palestinian mothers and motherhoods and situates their experiences within longstanding histories of white feminist maternalist (and eugenicist) politics. This informal qualitative data from "participatory conversations" (Swain) is situated within a set of formal interview data collected with Palestinian women in the West Bank (approved by the McMaster University Humanities Research Ethics Board) relating to white feminist maternalism in the peace and dialogue industry.

Keywords: decolonial feminism, maternal feminism, anti-racist pedagogies, settler colonial studies, motherhood studies, pedagogy theory, cultural theory

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2452 Modelling and Maping Malnutrition Toddlers in Bojonegoro Regency with Mixed Geographically Weighted Regression Approach

Authors: Elvira Mustikawati P.H., Iis Dewi Ratih, Dita Amelia

Abstract:

Bojonegoro has proclaimed a policy of zero malnutrition. Therefore, as an effort to solve the cases of malnutrition children in Bojonegoro, this study used the approach geographically Mixed Weighted Regression (MGWR) to determine the factors that influence the percentage of malnourished children under five in which factors can be divided into locally influential factor in each district and global factors that influence throughout the district. Based on the test of goodness of fit models, R2 and AIC values in GWR models are better than MGWR models. R2 and AIC values in MGWR models are 84.37% and 14.28, while the GWR models respectively are 91.04% and -62.04. Based on the analysis with GWR models, District Sekar, Bubulan, Gondang, and Dander is a district with three predictor variables (percentage of vitamin A, the percentage of births assisted health personnel, and the percentage of clean water) that significantly influence the percentage of malnourished children under five.

Keywords: GWR, MGWR, R2, AIC

Procedia PDF Downloads 281
2451 Early Childhood Developmental Delay in 63 Low- and Middle-Income Countries: Prevalence and Inequalities Estimated from National Health Surveys

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

Abstract:

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

Keywords: child development, inequalities, global health, equity

Procedia PDF Downloads 104
2450 Android-Based Edugame Application for Earthquakes Disaster Mitigation Education

Authors: Endina P. Purwandari, Yolanda Hervianti, Feri Noperman, Endang W. Winarni

Abstract:

The earthquakes disaster is an event that can threaten at any moment and cause damage and loss of life. Game earthquake disaster mitigation is a useful educational game to enhance children insight, knowledge, and understanding in the response to the impact of the earthquake. This study aims to build an educational games application on the Android platform as a learning media for earthquake mitigation education and to determine the effect of the application toward children understanding of the earthquake disaster mitigation. The methods were research and development. The development was to develop edugame application for earthquakes mitigation education. The research involved elementary students as a research sample to test the developed application. The research results were valid android-based edugame application, and its the effect of application toward children understanding. The application contains an earthquake simulation video, an earthquake mitigation video, and a game consisting three stages, namely before the earthquake, when the earthquake occur, and after the earthquake. The results of the feasibility test application showed that this application was included in the category of 'Excellent' which the average percentage of the operation of applications by 76%, view application by 67% and contents of application by 74%. The test results of students' responses were 80% that showed that a positive their responses toward the application. The student understanding test results show that the average score of children understanding pretest was 71,33, and post-test was 97,00. T-test result showed that t value by 8,02 more than table t by 2,001. This indicated that the earthquakes disaster mitigation edugame application based on Android platform affects the children understanding about disaster earthquake mitigation.

Keywords: android, edugame, mitigation, earthquakes

Procedia PDF Downloads 337
2449 The Role of Authority's Testimony in Preschoolers' Ownership Judgment: A Study with Conflicting Cues Method

Authors: Zhanxing Li, Liqi Zhu

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Authorities often intervene in children’s property conflicts, which may affect young children’s ownership understanding. First possession is a typical rule of ownership judgment. We recruited Chinese preschoolers as subjects and investigated their ownership reasoning regarding first possession, by setting three conditions via a conflicting cues method, in which a third party (mother or peer friend)’s testimony was always opposite to the cue of first possession (authority/non-authority testimony condition), or only the cue of first possession was present (no testimony condition). In Study A, we examined forty-two 3- and 5-year olds’ attribution and justification of ownership. The results showed while 5-year olds gave more support for the first possessor as the owner across three conditions, 3-year olds’ choice for the first possessor had no difference from the non-first possessor in the authority testimony condition. Moreover, 3-year olds tended to justify by reference to what mother said in the authority testimony condition, 5-year olds consistently referred to the first possession in three conditions. In Study B, we added two ownership questions to quantify children’s ability of ownership reasoning with four age groups (n = 32 for the 3-year-olds, n = 33 for the 4-year-olds, n = 27 for the 5-year olds and n = 30 for the adults) to explore the developmental trajectory further. It revealed that while 5-year olds’ performances were similar to the adults’ and always judged the first possessor as owner in three conditions, 3- and 4-year olds’ performed at chance level in the authority testimony condition. The results imply that Chinese young preschooler’s ownership reasoning was susceptible to authority’s testimony. Family authority may play an important role in diluting children’s adherence to ownership principles, which will be helpful for children to learn to share with others.

Keywords: authority, ownership judgment, preschoolers, testimony

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2448 Religious Cognition and Intergroup Bias in the Trolley Dilemma: Experimental Fieldwork in Fiji

Authors: Crystal Shackleford, Michael Pasek, Julia Smith, Jeremy Ginges

Abstract:

There is extensive debate about the causal role of religion in intergroup conflict. It is commonly accepted that religious beliefs promote in-group cohesion, but religion is often believed to exacerbate inter-group conflict. Fiji is religiously diverse and has a lengthy history of ethno-religious conflict. In a preregistered field experiment using a modified version of the trolley problem dilemma, Christian and Muslim Fijians were asked, first from their own perspective, and then from their God’s perspective, whether a religious ingroup member should sacrifice their life to save five children who were ingroup or outgroup members. Almost all Muslim participants believed that the person should always sacrifice themselves to save the children. Amongst Christian participants, thinking from God’s perspective increased their likelihood of saying the children should be saved by 35% and removed a 27% gap between responses to saving ingroup versus outgroup children. These results replicate previous findings from a Palestinian sample and demonstrate, in another cross-cultural context with a history of violent conflict, that religious cognition can decrease bias and promote the application of universal moral principles.

Keywords: conflict, moral dilemma, psychology, religion, thought experiments

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2447 An Inclusion Project for Deaf Children into a Northern Italy Contest

Authors: G. Tamanza, A. Bossoni

Abstract:

84 deaf students (from primary school to college) and their families participated in this inclusion project in cooperation with numerous institutions in northern Italy (Brescia-Lombardy). Participants were either congenitally deaf or their deafness was related to other pathologies. This research promoted the integration of deaf students as they pass from primary school to high school to college. Learning methods and processes were studied that focused on encour­aging individual autonomy and socialization. The research team and its collaborators included school teachers, speech ther­apists, psychologists and home tutors, as well as teaching assistants, child neuropsychiatrists and other external authorities involved with deaf persons social inclusion programs. Deaf children and their families were supported, in terms of inclusion, and were made aware of the research team that focused on the Bisogni Educativi Speciali (BES or Special Educational Needs) (L.170/2010 - DM 5669/2011). This project included a diagnostic and evaluative phase as well as an operational one. Results demonstrated that deaf children were highly satisfied and confident; academic performance improved and collaboration in school increased. Deaf children felt that they had access to high school and college. Empowerment for the families of deaf children in terms of networking among local services that deal with the deaf also improved while family satisfaction also improved. We found that teachers and those who gave support to deaf children increased their professional skills. Achieving autonomy, instrumental, communicative and relational abilities were also found to be crucial. Project success was determined by temporal continuity, clear theoretical methodology, strong alliance for the project direction and a resilient team response.

Keywords: autonomy, inclusion, skills, well-being

Procedia PDF Downloads 271
2446 Spatial Analysis of the Perception of Family Planning among Teenage Mothers in Nigeria

Authors: Mbuotidem Brendan, Nathanael Afolabi

Abstract:

Teenage pregnancy is a major health concern because of its association with high morbidity and mortality for both mother and child. In 2013, 23% of women in Nigeria, aged 15 - 19 yr have begun childbearing: 17% have had a child and 5% are pregnant with their first child. Reported differences across locations have been attributed to factors such as educational attainment and exposure to mass media. This study therefore seeks to determine the difference in the level of exposure among teenage mothers and older women of reproductive age in Nigeria. Over 12,000 women of reproductive age (18 – 49 yr) were interviewed across 8 states from the Northern and Southern region of Nigeria. The women were further segregated into two groups of 0 (women aged 18 – 20 yr who had children of their own) and 1 (women of reproductive age excluding teenage mothers). Data was collected via structured questionnaires on mobile devices using the open data kit platform. Initial data formatting and recoding was done using STATA 13 package. Initial analysis was also conducted using SPSS version 21 and the data points were mapped on QuantumGIS package. From the results of analyzed data obtained from the studied states, there were various mean ages of first births across the supported states. Though Akwa Ibom had one of the oldest mean ages (21.2 yr) at first birth and the lowest fertility rate of 3.9 births/woman according to the National Demographic Health Survey 2013, Akwa Ibom had the highest rate of teenage pregnancy (18.2%) across the respondents. Based on education, the respondents that had completed secondary school education (56.9%) made up the greatest cohorts of the teenage parents. This is counter indicative of the initial thinking that there is an inverse relationship between level of education and teenage pregnancy. Akwa Ibom, Bauchi and Delta states are states where respondents felt that contraceptive use is dangerous to health and they were the top 4 states that had a large proportion of teenage mothers. Similarly, across the states examined, all the women of reproductive age felt they could convince their spouses to use contraceptives, as using family planning does not cause women to be promiscuous. This study thus reveals that across the states studied, there was no marked variation in the perception of family planning between teenage parents and women of reproductive age. The study also highlights the need for future planning and exposure to family planning messages at secondary school level.

Keywords: adolescent, family planning, mass media, teenage mothers

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2445 Disability, Technology and Inclusion: Fostering and Inclusive Pedagogical Approach in an Interdisciplinary Project

Authors: M. Lopez-Pereyra, I. Cisneros Alvarado, M. Del Socorro Lobato Alba

Abstract:

This paper aims to discuss a conceptual, pedagogical approach that foster inclusive education and that create an awareness of the use of assistive technology in Mexico. Interdisciplinary understanding of disabilities and the use of assistive technology as a frame for an inclusive education have challenged the reality of the researchers’ participation in decision-making. Drawing upon a pedagogical inquiry process within an interdisciplinary academic project that involved the sciences, design, biotechnology, psychology and education fields, this paper provides a discussion on the challenges of assistive technology and inclusive education in interdisciplinary research on disabilities and technology project. This study is frame on an educational action research design where the team is interested in integrating, disability, technology, and inclusion, theory, and practice. Major findings include: (1) the concept of inclusive education as a strategy for interdisciplinary research; (2) inclusion as a pedagogical approach that challenges the creation of assistive technology from diverse academic fields; and, (3) inclusion as a frame, problem-focused, for decision-making. The findings suggest that inclusive pedagogical approaches provide a unique insight into interdisciplinary teams on disability and assistive technology in education.

Keywords: assistive technology, inclusive education, inclusive pedagogy, interdisciplinary research

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2444 Play-Based Early Education and Teachers’ Professional Development: Impact on Vulnerable Children

Authors: Chirine Dannaoui, Maya Antoun

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This paper explores the intricate dynamics of play-based early childhood education (ECE) and the impact of professional development on teachers implementing play-based pedagogy, particularly in the context of vulnerable Syrian refugee children in Lebanon. By utilizing qualitative methodologies, including classroom observations and in-depth interviews with five early childhood educators and a field manager, this study delves into the challenges and transformations experienced by teachers in adopting play-based learning strategies. The research unveils the critical role of continuous and context-specific professional development in empowering teachers to implement play-based pedagogies effectively. When appropriately supported, it emphasizes how such educational approaches significantly enhance children's cognitive, social, and emotional development in crisis-affected environments. Key findings indicate that despite diverse educational backgrounds, teachers show considerable growth in their pedagogical skills through targeted professional development. This growth is vital for fostering a learning environment where vulnerable children can thrive, particularly in humanitarian settings. The paper also addresses educators' challenges, including adapting to play-based methodologies, resource limitations, and balancing curricular requirements with the need for holistic child development. This study contributes to the discourse on early childhood education in crisis contexts, emphasizing the need for sustainable, well-structured professional development programs. It underscores the potential of play-based learning to bridge educational gaps and contribute to the healing process of children facing calamity. The study highlights significant implications for policymakers, educators, schools, and not-for-profit organizations engaged in early childhood education in humanitarian contexts, stressing the importance of investing in teacher capacity and curriculum reform to enhance the quality of education for children in general and vulnerable ones in particular.

Keywords: play-based learning, professional development, vulnerable children, early childhood education

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2443 A Literature Review on Sexual Abuse Prevention for People with Intellectual Disability

Authors: Hanh Thi My Nguyen, Phuong Thu Dinh

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People with intellectual disability are at high risk for sexual abuse. The reasons may originate from their communication skills deficits, lack of skills and knowledge to protect themselves from sexual abuse, or limited access to sexual abuse prevention programs. This article aims to present a systematic review about strategies for preventing sexual abuse for young people with intellectual disability. A range of articles in 10 years from 2009 to 2018 are searched by using online database. 5 papers are included for the final review. The results of this comprehensive literature review showed that there are two main strategies used: programs designed for people with intellectual, including evaluation on sex education programs; and sexual education program for parents of children with intellectual disability. However, none of the papers were conducted in low-and middle-income countries. Therefore, cautions should be taken when it comes to interpret these findings. The findings of studies showed that participants increased their awareness and skills for protecting themselves from sexual abuse after participating in the programs. It is also recommended that more effective evidence-based programs should be developed.

Keywords: intellectual disability, prevention, sexual abuse, sexual education program

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2442 Empowering Persons with Disabilities in Indonesia: Translating the Disability Law into Practice

Authors: Marthella Rivera Roidatua

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Since the release of Convention on the Rights of Persons with Disabilities in 2006, disability became a mainstreamed global issue. Many developed countries have shown the continuous effort to improve their disability employment policy, for example, the US and the UK with their integrated support system through disability benefits. Relative little recent research on developing country is available. Surprisingly, Indonesia, just enacted the Law No.8/2016 on Disability that bravely highlighted on integrating disabled people into the workforce. It shows a positive progress shifting traditional perspective to what Tom Shakespeare’s concept of a social model of disability. But, the main question is how can this law support the disabled people to access and maintain paid work. Thus, besides the earlier literature reviews, interviews with leading sectors, Ministry of Social Affairs and Ministry of Manpower, was conducted to examine government’s attitude towards the disabled worker. Insights from two local social enterprises on disability were also engaged in building better perspective. The various source of data was triangulated then analysed with a thematic approach. Results were encouraging the Indonesian government to have a better collaboration with other impactful local organisations in promoting the disability employment. In the end, this paper also recommends the government to make a reasonable adjustment and practical guideline for companies in hiring disabled.

Keywords: disability, employment, policy, Indonesia, collaboration, guidelines

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2441 The Prevalence of Obesity among a Huge Sample of 5-20 Years Old Jordanian Children and Adolescents Based on CDC Criteria

Authors: Walid Al-Qerem, Ruba Zumot

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Background: The rise of obesity among children and adolescents remains a primary challenge for healthcare providers globally and in the Middle East. The aim of the present study is to determine the prevalence of obesity among 5-20 years old Jordanians based on CDC criteria. Method: A total of 5722 Jordanians (37% males; 63% females) aged 5-20 years data were retrieved from the Jordanian Ministry of Health electronic database (Hakeem). As per the CDC selection criteria, the chosen data pertains exclusively to healthy Jordanian children and adolescents who are medically sound, not suffering from health conditions, and not undergoing any treatments that could hinder normal growth patterns, such as severe infection, chronic kidney disease (CKD), Down’s syndrome, attention deficit hyperactivity disorder, cancer, heart disease, lung disease, cystic fibrosis, Crohn’s disease, type 1 diabetes, hormonal disturbances, any stress-related conditions, hormonal therapy such as corticosteroids, Growth hormones (GHS) or gonadotropin-releasing hormone agonists, insulin, and amphetamines or any other stimulants. In addition, participants with missing or invalid data values for anthropometric measurements were excluded from the study. Weight for age and body mass index for age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The Z-score for each record was computed based on CDC equations. As per CDC classifications, BMI for age percentiles, values ≥85th and < 95th are classified as overweight, and value at ≥ 95th is classified as obesity. Results: The average age of the evaluated sample was 12.33 ±4.39 years (10.79 ±3.39 for males and 13.23 ± 4.66 for females). The mean weight for males and females were 33.16±14.17 Kg and 133.54±17.17 cm for males, 43.86 ±18.82 Kg, and 142.19±18.35 for females, while for BMI the mean was for boys and girls 17.81±3.88 and 20.52±5.03 respectively. The results indicated that based on CDC criteria, 8.9% of males were classified as children/adolescents with overweight, and 9.7% were classified as children/adolescents with obesity, while in females, 17.8% were classified as children/adolescents with overweight and 10.2% were classified as children/adolescents with obesity. Discussion: The high prevalence of obesity reported in the present study emphasizes the importance of applying different strategies to prevent childhood obesity, including encouraging physical activity, promoting healthier food options, and behavioral changes. Conclusion: The results presented in this study indicated the high prevalence of overweight/obesity among Jordanian adolescents and children, which must be tagged by healthcare planners and providers.

Keywords: CDC, obesity, childhood, Jordan

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2440 Activities for Increasing Childhood Vaccination Coverage of the Refugee and Migrant Population, Greece, European Program PHILOS, 2017

Authors: C. Silvestros, K. Mellou, T. Georgakopoulou, A. Koustenis, E. Kokkinou, C. Botsi, A. Terzidis

Abstract:

'PHILOS – Emergency health response to refugee crisis' is a programme of the Greek Ministry of Health, implemented by the Hellenic Center for Disease Control and Prevention (HCDCP) funded by the Asylum, Migration and Integration Fund (AMIF) of EU’s DG Migration and Home Affairs. One of the main objectives of the program is the immunization coverage of the target – population to assure the prevention of vaccine-preventable diseases. The program foresees vaccination needs assessment of children hosted at camps at the mainland and implementation of interventions to cover the vaccination gaps in co-operation with the Ministry of Health. The National Immunization Advisory Committee in Greece recommended that MMR (Measles, Mumps, and Rubella), PCV (Pneumococcal conjugate vaccine) and HEXA (diphtheria, tetanus, pertussis, polio, hepatitis B and Haemophilus influenzae type b) vaccines should be performed in priority. Recording was completed at 24 camps (May - June 2017); 3381 children (0-18 years) were recorded. The median number of children hosted at each camp was 95 (range: 5-553). For 68% of the children, the WHO vaccination booklet was available. 44%, 48.5% and 61% of the children were vaccinated with at least one dose of PCV, HEXA, and MMR, respectively. The proportion of vaccinated children for the three vaccines mentioned above is significantly lower for the remaining doses; PCV (second dose 8%, third dose 1.3%), HEXA (second dose 13%, third dose 2.7%, forth dose 0.1%) and MMR (second dose 23%). None of the 37 (10 from Afghanistan, 3 from Bangladesh, 23 from Pakistan, 1 from Syria) recorded unaccompanied children did not have a WHO vaccination booklet and were considered unvaccinated. There is no differentiation in vaccination coverage among different ethnicities. Massive catch up vaccination was performed at 4 camps, and 671 vaccinations were performed (245 PCV, 307 HEXA, and 119 MMR). Similar interventions are planned for all camps of the country. Recording reveled gaps in vaccination coverage of the population, mainly because of the mobility of the population, the influx of refugees- which is still ongoing- and new births. Mass vaccination campaigns are considered vital in order to increase vaccination coverage, and continuous efforts are needed in order all children living at the camps to have full access to the National Childhood Immunization Program.

Keywords: vaccine preventable, refugee–migrants camps, vaccination coverage, PCV, MMR, HEXA

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2439 Behavioral and EEG Reactions in Children during Recognition of Emotionally Colored Sentences That Describe the Choice Situation

Authors: Tuiana A. Aiusheeva, Sergey S. Tamozhnikov, Alexander E. Saprygin, Arina A. Antonenko, Valentina V. Stepanova, Natalia N. Tolstykh, Alexander N. Savostyanov

Abstract:

Situation of choice is an important condition for the formation of essential character qualities of a child, such as being initiative, responsible, hard-working. We have studied the behavioral and EEG reactions in Russian schoolchildren during recognition of syntactic errors in emotionally colored sentences that describe the choice situation. Twenty healthy children (mean age 9,0±0,3 years, 12 boys, 8 girls) were examined. Forty sentences were selected for the experiment; the half of them contained a syntactic error. The experiment additionally had the hidden condition: 50% of the sentences described the children's own choice and were emotionally colored (positive or negative). The other 50% of the sentences described the forced-choice situation, also with positive or negative coloring. EEG were recorded during execution of error-recognition task. Reaction time and quality of syntactic error detection were chosen as behavioral measures. Event-related spectral perturbation (ERSP) was applied to characterize the oscillatory brain activity of children. There were two time-frequency intervals in EEG reactions: (1) 500-800 ms in the 3-7 Hz frequency range (theta synchronization) and (2) 500-1000 ms in the 8-12 Hz range (alpha desynchronization). We found out that behavioral and brain reactions in child brain during recognition of positive and negative sentences describing forced-choice situation did not have significant differences. Theta synchronization and alpha desynchronization were stronger during recognition of sentences with children's own choice, especially with negative coloring. Also, the quality and execution time of the task were higher for this types of sentences. The results of our study will be useful for improvement of teaching methods and diagnostics of children affective disorders.

Keywords: choice situation, electroencephalogram (EEG), emotionally colored sentences, schoolchildren

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2438 The Effectiveness of Social Story with the Help Smart Board use to Teach Social Skills for Preschool Children with ASD

Authors: Dilay Akgun Giray

Abstract:

Basic insuffiency spaces of ASD diagnosed individuals can be grouped as cognitive and academic characteristics, communicational characteristics, social characteristics and emotional characteristics. Referring to the features that children with ASD exhibit on social events, it is clear they have limitations for several social skills. One of the evidence based practices which has been developed and used for the limitations of definite social skills for individuals with autism is “Social Story Method”. Social stories was designed and applied for the first time in 1991, a special education teacher, in order to acquire social skills and improve the existing social skills for children with ASD. Many studies have revealed the effectiveness of social stories for teaching the social skills to individuals with ASD. In this study, three social skills that the child ,who was diagnosed ASD, is going to need primarily will be studied with smart board. This study is multiple probe across-behavior design which is one of the single subject research models.

Keywords: authism spectrum disorders, social skills, social story, smart board

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2437 Differentials of Motor Fitness Components among the School Children of Rural and Urban Areas of the Jammu Region

Authors: Sukhdev Singh, Baljinder Singh Bal, Amandeep Singh, Kanchan Thappa

Abstract:

A nation's future almost certainly rests on the future of its children, and a nation's wellbeing can be greatly improved by providing for the right upbringing of its children. Participating in physical education and sports programmes is crucial for reaching one's full potential. As we are all aware, sports have recently become incredibly popular on a global scale. Sports are continually becoming more and more popular, and this positive trend is probably going to last for some time to come. Motor abilities will provide more accurate information on the developmental process of children. Motor fitness is a component of physical fitness that includes strength, speed, flexibility, and agility, and is related to enhanced performance and the development of motor skills. In recent years, there has been increased interest in the differences in child growth between urban and rural environments. Differences in student growth, body dimensions, body composition, and fitness levels due to urban and rural environmental disparities have come into focus in recent years. The main aim of this study is to know the differentials of motor fitness components among the school children of rural and urban areas of the Jammu region. Material and Methods: In total, sixty male subjects (mean ± SD; age, 16.475 ± 1.0124 yrs.; height, 172.8 ± 2.0153 cm; Weight, 59.75 ± 3.628 kg) from the Jammu region took part in the study. A minimum sample size of 40 subjects was obtained and was derived from Rural (N1=20) and Urban (N2=20) school-going children. Statistical Applications: The Statistical Package for the Social Sciences (SPSS) version 14.0 was used for all analyses. The differences in the mean of each group for the selected variable were tested for the significance of difference by an independent samples t-test. For testing the hypotheses, the level of significance was set at 0.05. Results: Results revealed that there were significant differences of leg explosive strength (p=0.0040*), dynamic balance (p=0.0056*), and Agility (p=0.0176*) among the School Children of the rural and urban areas of the Jammu region. However, Results further revealed that there were not significant differences of cardio respiratory endurance (p=0.8612), speed (p=0.2231), Low Back/Hamstring Flexibility (p=0.6478), and Two Hand Coordination. (p= 0.0953) among the School Children of the rural and urban areas of the Jammu region. Conclusion: The results of study showed that there is significance difference between Rural and Urban School children of the Jammu region with regards to a variable," leg explosive strength, dynamic balance, Agility” and the there is no significance difference between Rural and Urban School children of the Jammu region with regards variable “cardio-respiratory endurance, speed, Low Back/Hamstring Flexibility, Two Hand Coordination”.

Keywords: motor fitness, rural areas, school children, urban areas

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2436 An Action Toolkit for Health Care Services Driving Disability Inclusion in Universal Health Coverage

Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

Abstract:

Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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2435 Development of Family Quality of Life Scale for a Family Which Has a Person with Disability: Results of a Delphi Study

Authors: Thirakorn Maneerat, Darunee Jongudomkarn, Jiraporn Khiewyoo

Abstract:

Family quality of life of families who have persons with disabilities is a core concern in government services and community health promotion to deal with the multidimensionality of today’s health and societal issues. The number of families who have persons with disabilities in Thailand is gradually increasing. However, facilitation and evaluation of such family quality of life are limited by the lack of feasible tools. As a consequence, service provided for the families is not optimally facilitated and evaluated. This paper is part of a larger project which is aimed to develop a scale for measuring of family quality of life of families who have persons with developmental disabilities in Thailand, presenting the results of a three-round Delphi method involving 11 experts. The study was obtained during December 2013 to May 2014. The first round consisted of open-ended questionnaire and content analysis of the answers. The second round comprised a 5-point Likert scale structured questionnaire based on the first round analysis, with required the experts to identify the most relevant studied tool aspects. Their feedbacks levels of agreements were statistic analysis using the median, interquartile range and quartile deviation. The included criteria for items acceptance were greater than 3.50 of the median, lesser than 1.50 of interquartile range, and 0.65 or less of a quartile deviation. Finally, the proposed questionnaire was structured and validated by the experts in the third round. The results found that across all three rounds, the experts achieved 100% agreement on the five factors regarding to quality of life of a family who have person with disability were considered. These five factors with 38 items were included: 1) 10 items of family interactions; 2) 9 items of child rearing; 3) 7 items of physical and material resources; 4) 5 items of social-emotional status; and 7 items of disability-related services and welfare. Next step of the study was examined the construct validity by using factor analysis methods.

Keywords: tool development, family quality of life scale, person with disability, Delphi study

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2434 The Differential Impacts of Shame and Guilt on Father Involvement in Families with Special Needs Children

Authors: Lo Kai Chung

Abstract:

Fathers in the family of disabled children play a crucial role in fostering child development. Previous studies addressing emotions of father involvement in rearing children with special needs have been rare. With reference to the cultural orientation and masculine idea of Chinese fathers, shame and guilt are probable causal emotions that affect fathers’ psycho-behavioral reactions and, thus, father involvement. Based on the findings of our earlier qualitative studies, the current study aims to develop and validate a multi-item scale of guilt or shame and explore their relations with and fatherhood in families with children with special needs. A model is proposed to understand the roles that shame and guilt play in affecting fathers’ involvement in their family system. The severity and type of the child’s special needs are regarded as independent variables affecting the father’s emotional responses – shame and guilt. It is hypothesized that shame and guilt, under the influence of masculinity, lead to avoidance and compensation, respectively, which subsequently decrease and increase father involvement with children with special needs. A cross-sectional online questionnaire survey of fathers with children with special needs recruited by convenience sampling was conducted. Potential participants were reached by bulk emails, related groups on the Internet and education/social services providers. Totally 537 valid sets of online questionnaires were collected from fathers of children with special needs. EFA on the items pool of shame and guilt was performed, resulting in an x-item single-factor solution and y-item single-factor solution, respectively. Further path model analysis revealed that shame and guilt, under the influence of masculinity, showed differential avoidance and compensation responses and resulted in a decrease and increase in father involvement with special needs children. Demographic and key confounding variables were controlled in the analysis. The shame and guilt scales developed show good psychometric properties. Furthermore, they showed significant differential impacts, under the influence of masculinity, on avoidance and compensation behaviours, consequently resulting in a decrease/increase in father involvement in the expected directions. The findings have important theoretical and practical implications. At the community and policy level, the findings inform the design of strategies for strengthening the role of men in families with special needs children.

Keywords: emotions, father involvement, guilt, shame, special needs

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2433 Intervention of Threat and Surveillance on the Obedience of Preschool Children

Authors: Sarah Mhae Diaz, Erika Anna De Leon, Jacklin Alwil Cartagena, Geordan Caruncong, Micah Riezl Gonzales

Abstract:

This study examined the intervention of threat and surveillance on the obedience of 100 preschool children through a task variable experiment replicated from the previous studies of Higbee (1979), and Chua, J., Chua, M., & Pico (1983). Nowadays, obedience among Filipino children to authority is disregarded since they are more outspoken and rebel due to social influences. With this, aside from corporal punishment, threat and surveillance became a mean of inducing obedience. Threat, according to the Dissonance Theory, can give attitudinal change. On the other hand, surveillance, according to the Theory of Social Facilitation, can either contribute to the completion or failure to do a task. Through a 2x2 factorial design, results show; (1) threat (F(1,96) = 12.487, p < 0.05) and (2) surveillance (F(1,96)=9.942, p<.05) had a significant main effect on obedience, suggesting that the Dissonance Theory and Theory of Social Facilitation is respectively true in the study. On the other hand, (3) no interaction (F(1,96)=1.303, p > .05) was seen since threat and surveillance both have a main effect that could be positive or negative, or could be because of their complementary property as supported by the post-hoc results. Also, (4) most effective commanding style is threat and surveillance setting (M = 30.04, SD = 7.971) due to the significant main effect of the two variables. With this, in the Filipino Setting, threat and surveillance has proven to be a very effective strategy to discipline and induce obedience from a child.

Keywords: experimental study, obedience, preschool children, surveillance, threat

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2432 Students Awareness on Reproductive Health Education in Sri Lanka

Authors: Ayomi Indika Irugalbandara

Abstract:

Reproductive Health (RE) education among Sri Lankan Adolescents (comprising one fifth inner population) remains unsatisfactory despite 91.8% of them completing primary education & 56.2 % receiving post secondary level education. The main reason for this large population not receiving satisfactory RH education is traditional values and longstanding taboos surrounding sexuality. The current study was undertaken with there objectives. The relevance of achieving them being to formulate RH educational policies and programs that address a sizable and sensitive chunk of the population thereby achieving the goal of mental and social well being and not merely the absence of reproductive disease or infirmity. This research was a descriptive study, using random sampling technique, sample of the study consisting of 160 adolescent in the age group of 16-19, studying in government schools in Sri Lanka. Questionnaire was the main instrument of data collection, qualitative and quantitative techniques were used in data analysis. According to the data it was revealed that a majority has some idea about RH education. While this awareness had been provided by the school, the source of information had been Health and Physical Education. The entire sample mentioned that more RH information, than was provided, should be given and everybody wanted further knowledge regarding sexuality, and in depth information on it was essential. About 96 adolescents were of the opinion that their behavior was respectful to elders and 64 felt embarrassed while communicating with elders regarding RH issues. About their preferred sources of information, both genders named health providers as their first choice, followed by family members and friends. The internet was cited by a few boys; less than 5 percent cited religious figures. More than 50% of respondents had no knowledge about abortion and they were unaware of dangerous abortion. The practice of abortion was reported among zero percent. Although every member of the sample did not possess knowledge of the scientific process involved in abortion, all of them totally rejected the idea of destroying a foetus. Adolescence is a critical period in the life of girls and boys and sexuality education empowers young people to protect their health and well-being. Schools have the proper staff, and environment for learning. It might be stated that the greater segment of individuals entering adolescents and going through their adolescence are still in the school. This becomes the reason why it is mandatory that the school should be geared to handle this critical stage of the students. Adolescents or those approaching adolescence are best educated by the relevant parents, but this being quite a sensitive issue in the socio cultural context, it is somewhat doubtful whether all parents are prepared to handle this candidly, due either to lack of knowledge or absence of the appropriate state of mind. As such it is best that seminars/workshops be conducted to enlighten parents on handling HR issues related to their adolescent children. Apart from the awareness on HR provided through the school curriculum a greater impact can be brought about through street dramas, exhibitions etc. specific to HR. Finally the researcher would like to suggest that Sunday schools be harnessed for the provision of HR education linked with cultural values, ethics, and social well-being.

Keywords: reproductive health, awareness, perception, school curriculum

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2431 Influence of Gender Inequality on Pre – Primary School Children’s Literacy Skills Development in Ojo Local Government Area, Lagos State

Authors: Morenikeji Aliu Balaji

Abstract:

Gender inequality is seen as persistent discrimination of one group of people based gender, and it manifests itself differently according to race, culture, politics, country and economic situation. Multiple explanations have been offered for gender differences in literacy skill development. Three prominent explanations that precipitated the gender differences are; biological, where the assumption is that differential brain structures and hemispheric activation patterns cause the sexes to be hardwired differently for reading, with girls developing the cognitive skills associated with reading before boys. Secondly, schooling favour girls and ‘girly’ behaviour, and that boys are, as a result, lagging behind on several behavioural, social and academic measures and thirdly, cultural influences, where literacy is defined as a feminine characteristic – propagated by an overrepresentation of female teachers – and that modern culture steers boys towards activities such as sport and computers. Therefore the study investigated the influence of gender inequality on pre – primary school children literacy skills development in Ojo Local Government Area, Lagos State. Descriptive survey research design was adopted for the study. 100 pre-primary school teachers were involved in the study. A self-designed instrument was used for data collection titled ‘Influence of Gender Inequality on Literacy Skill Development in Children Questionnaire (IGILSDCQ)’. The instrument was validated and tested for reliability. The reliability index for IGILSDCQ (α = 0.79). Five research questions were answered using descriptive (frequency count, simple percentage, mean and standard deviation). The findings showed that that gender inequality to some extent influence children phonemic awareness (WA=1.76), the extent to which gender inequality influence children awareness of print is high (WA=2.8), gender inequality to some extent influence children vocabulary development (WA = 2.4), the extent to which gender inequality influence children speaking skill development is high (WA = 2.5) and lastly, the extent to which gender inequality influence children comprehension ability is high (WA = 2.5). It was recommended among others that effort by the school administrators is necessary in the provision of reading materials and literacy skill development packages that are both male-oriented and female-oriented.

Keywords: pre-primart, literacy, awareness, phonemic, gender

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2430 The Synchronous Online Environment: Impact on Instructor’s Empathy

Authors: Lystra Huggins

Abstract:

The COVID-19 pandemic affected all facets of life, including pedagogical strategies and perceptual experiences for both instructors and students. While there have also been many challenges and advantages to the online teaching and learning environment, when students’ cameras are on, the daily experiences of students’ lives have been magnified during synchronous online instruction and have served to humanize them in the classroom. This means that students’ everyday experiences, now often on display on ZOOM, allow instructors to see the realities of students. They include children running, spouses walking by parents cooking or sitting on the sofa following the lecture, students at their place of employment or driving from work, or having their classroom engagement interrupted by a delivery. Students’ backgrounds and spaces create unique dynamics during synchronous instruction, which offers a holistic view of them outside academia. This research explores whether witnessing students’ daily experiences leads to empathy from their instructors and whether it results in a greater understanding of students’ challenges and circumstances. Ultimately, it will amplify instructors’ stance on the advantages of students having their cameras on during synchronous online classes to develop a connection with the instructor and a more cohesive classroom environment.

Keywords: instructor’s empathy, synchronous class, asynchronous class, online environment

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2429 A Collaborative Action Research by Using the Children’s School Success Plus Curriculum Framework to Support Early Childhood Education/Early Childhood Special Education Teachers to Build a Professional Learning Community

Authors: Chiou-Shiue Ko, Pei-Fang Wu, Shu-hsien Tseng

Abstract:

The researchers adopted two-year action research to investigate the professional collaborative process and development in learning communities for both early childhood and early childhood special education teachers on implementing the children’s school success curriculum framework. The participating teachers were recruited from three preschool sites for this current study. Research data were collected from multiple methods in order to ensure the data quality and validity. The results showed that participating educators had achieved professional growth, and they became more aware of teaching intentions and the preparation for the curriculum. Teachers in this research become more child-focused in teaching and create opportunities for children to participate in classroom activities and routines. The researcher also finds teachers’ participation levels were driven by each individual personality; during professional growth, some teachers are more proactive and reflective, and some are not. According to the research findings, suggestions for future studies and practices are provided.

Keywords: children’s school success curriculum framework, early childhood special education, preschool education, professional learning community

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2428 ‘Doctor Knows Best’: Reconsidering Paternalism in the NICU

Authors: Rebecca Greenberg, Nipa Chauhan, Rashad Rehman

Abstract:

Paternalism, in its traditional form, seems largely incompatible with Western medicine. In contrast, Family-Centred Care, a partial response to historically authoritative paternalism, carries its own challenges, particularly when operationalized as family-directed care. Specifically, in neonatology, decision-making is left entirely to Substitute Decision Makers (most commonly parents). Most models of shared decision-making employ both the parents’ and medical team’s perspectives but do not recognize the inherent asymmetry of information and experience – asking parents to act like physicians to evaluate technical data and encourage physicians to refrain from strong medical opinions and proposals. They also do not fully appreciate the difficulties in adjudicating which perspective to prioritize and, moreover, how to mitigate disagreement. Introducing a mild form of paternalism can harness the unique skillset both parents and clinicians bring to shared decision-making and ultimately work towards decision-making in the best interest of the child. The notion expressed here is that within the model of shared decision-making, mild paternalism is prioritized inasmuch as optimal care is prioritized. This mild form of paternalism is known as Beneficent Paternalism and justifies our encouragement for physicians to root down in their own medical expertise to propose treatment plans informed by medical expertise, standards of care, and the parents’ values. This does not mean that we forget that paternalism was historically justified on ‘beneficent’ grounds; however, our recommendation is that a re-integration of mild paternalism is appropriate within our current Western healthcare climate. Through illustrative examples from the NICU, this paper explores the appropriateness and merits of Beneficent Paternalism and ultimately its use in promoting family-centered care, patient’s best interests and reducing moral distress. A distinctive feature of the NICU is the fact that communication regarding a patient’s treatment is exclusively done with substitute decision-makers and not the patient, i.e., the neonate themselves. This leaves the burden of responsibility entirely on substitute decision-makers and the clinical team; the patient in the NICU does not have any prior wishes, values, or beliefs that can guide decision-making on their behalf. Therefore, the wishes, values, and beliefs of the parent become the map upon which clinical proposals are made, giving extra weight to the family’s decision-making responsibility. This leads to why Family Directed Care is common in the NICU, where shared decision-making is mandatory. However, the zone of parental discretion is not as all-encompassing as it is currently considered; there are appropriate times when the clinical team should strongly root down in medical expertise and perhaps take the lead in guiding family decision-making: this is just what it means to adopt Beneficent Paternalism.

Keywords: care, ethics, expertise, NICU, paternalism

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2427 A Comparison Study of Different Methods Used in the Detection of Giardia lamblia on Fecal Specimen of Children

Authors: Muhammad Farooq Baig

Abstract:

Objective: The purpose of this study was to compare results obtained using a single fecal specimen for O&P examination, direct immunofluorescence assay (DFA), and two conventional staining methods. Design: Hundred and fifty children fecal specimens were collected and examined by each method. The O&P and the DFA were used as the reference method. Setting: The study was performed at the laboratory in the Basic Medical Science Institute JPMC Karachi. Patients or Other Participants: The fecal specimens were collected from children with a suspected Giardia lamblia infection. Main Outcome Measures: The amount of agreement and disagreement between methods.1) Presence of giardiasis in our population. 2) The sensitivity and specificity of each method. Results: There was 45(30%) positive 105 (70%) negative on DFA, 41 (27.4%) positive 109 (72.6%) negative on iodine and 34 (22.6%) positive 116(77.4%) on saline method. The sensitivity and specificity of DFA in comparision to iodine were 92.2%, 92.7% respectively. The sensitivity and specificity of DFA in comparisoin to saline method were 91.2%, 87.9% respectively. The sensitivity of iodine method and saline method in compariosn to DFA were 82.2%, 68.8% respectively. There is mark diffrence in sensitivity of DFA to conventional method. Conclusion: The study supported findings of other investigators who concluded that DFA method have the greater sensitivity. The immunologic methods were more efficient and quicker than the conventional O&P method.

Keywords: direct immunofluorescence assay (DFA), ova and parasite (O&P), Giardia lamblia, children, medical science

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