Search results for: electronic health questionnaire

Authors: Oyuntsetseg Sandag, Lkhagvadorj Khosbayar, Naidansuren Tsendeekhuu, Densenbal Dansran, Bandi Solongo

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Introduction: Obstructive sleep apnea (OSA) is a common disorder affecting at least 2% to 4% of the adult population. It is estimated that nearly 80% of men and 93% of women with moderate to severe sleep apnea are undiagnosed. A number of screening questionnaires and clinical screening models have been developed to help identify patients with OSA, also it’s indeed to clinical practice. Purpose of study: Determine dependence of obstructive sleep apnea between for severe risk and risk factor. Material and Methods: A cross-sectional study included 114 patients presenting from theCentral state 3th hospital and Central state 1th hospital. Patients who had obstructive sleep apnea (OSA)selected in this study. Standard StopBang questionnaire was obtained from all patients.According to the patients’ response to the StopBang questionnaire was divided into low risk, intermediate risk, and high risk.Descriptive statistics were presented mean ± standard deviation (SD). Each questionnaire was compared on the likelihood ratio for a positive result, the likelihood ratio for a negative test result of regression. Statistical analyses were performed utilizing SPSS 16. Results: 114 patients were obtained (mean age 48 ± 16, male 57)that divided to low risk 54 (47.4%), intermediate risk 33 (28.9%), high risk 27 (23.7%). Result of risk factor showed significantly increasing that mean age (38 ± 13vs. 54 ± 14 vs. 59 ± 10, p<0.05), blood pressure (115 ± 18vs. 133 ± 19vs. 142 ± 21, p<0.05), BMI(24 IQR 22; 26 vs. 24 IQR 22; 29 vs. 28 IQR 25; 34, p<0.001), neck circumference (35 ± 3.4 vs. 38 ± 4.7 vs. 41 ± 4.4, p<0.05)were increased. Results from multiple logistic regressions showed that age is significantly independently factor for OSA (odds ratio 1.07, 95% CI 1.02-1.23, p<0.01). Predictive value of age was significantly higher factor for OSA (AUC=0.833, 95% CI 0.758-0.909, p<0.001). Our study showing that risk of OSA is beginning 47 years old (sensitivity 78.3%, specifity74.1%). Conclusions: According to most of all patients’ response had intermediate risk and high risk. Also, age, blood pressure, neck circumference and BMI were increased such as risk factor was increased for OSA. Especially age is independently factor and highest significance for OSA. Patients’ age one year is increased likelihood risk factor 1.1 times is increased.

Keywords: obstructive sleep apnea, Stop-Bang, BMI (Body Mass Index), blood pressure

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Authors: Mariana Sabino, Janes Cleiton de Oliveira, Carlos Luna de Melo

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This paper presents a discussion about the importance and influence of the environment in the patient’s recovery process. Some users (employees and patients) were submitted to a questionnaire that helps to diagnoses the major problems of the hospital, specially related to comfort (aesthetic, thermal, acoustic, light, ergonomic), well-being, how does the flow of patients and employees works in the hospital and wayfinding as well. After a short literature review presenting the topic, the hospital will be characterized, showing photos, the projects available and describing the hospital as well (how many rooms, functions of each one, receptions, waiting rooms, between other things.), than the questionnaire will be applied to patients and to the employees. Lastly the results of the answers given will be analyzed in graphics, and it will help to identify which are the major improvements needed immediately. This paper has the intention to propose a methodology to diagnose architecture problems in a cancer hospital in Brasilia, Brazil, besides to open a space to hear the people that use the building to tell about their discomforts and perceptions of the environment, it also will give an opportunity to apply the possible improvements. It is important to tell that it will be considered if the hospital has a healing environment, and it will also be considered the ergonomic issues about comfort and the way the system of this particular hospital works in general.

Keywords: cancer hospital, comfort, diagnose, healing environment

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Authors: Macdonald Kanyangale, Sandram Naluso

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Globally, researchers have struggled over time to adequately define the notion of health system to inform research. This study is significant because it proposes an integrative framework for a robust definition of the health system. The objective of this article is to examine major pitfalls in definitions of health system used in prior literature and implications of these for research and management. The study used methodological steps of a scoping review proposed by Arksey and O'Malley to identify and examine 24 definitions of a health system in articles selected from six databases and web search engines. Thematic analysis was used to delineate and categorise definitional pitfalls into broader themes. There are a plethora of five major pitfalls in the extant definitions of a health system which may easily scupper any unsuspecting researcher if not avoided or addressed in research. These definitional pitfalls are reductionist assumptions which ignore dynamic and complex connections, overly wide boundary and lack of specification of levels in a health system, and limited focus on process in a health system. In addition, there is the tendency of treating different components of the health system as equal and simplifying of the ontological complexity of the health system. Future scholars are advised to avoid or address the identified five major pitfalls if they are to develop robust definitions of an HS. The use of an integrative framework for a robust definition of a health system is recommended, while implications of the pitfalls are discussed as a basis and catalyst for complexity-informed research and managing interactively.

Keywords: complexity management, health system, pitfalls, reductionism, research

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Authors: Fredrick Forster, Gareth Ward, Matthew Tubby, Pamela Lithgow, Anne Nortcliffe

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This paper presents the results from a research study of random adult participants accessing one of four different commercially available Virtual Reality (VR) Head Mounted Displays (HMDs) and completing a post user experience reflection questionnaire. The research sort to understand how inclusive commercially available VR HMDs are and identify any associated barriers that could impact the widespread adoption of the devices, specifically in Higher Education (HE). In the UK, education providers are legally required under the Equality Act 2010 to ensure all education facilities are inclusive and reasonable adjustments can be applied appropriately. The research specifically aimed to identify the considerations that academics and learning technologists need to make when adopting the use of commercial VR HMDs in HE classrooms, namely cybersickness, user comfort, Interpupillary Distance, inclusiveness, and user perceptions of VR. The research approach was designed to build upon previously published research on user reflections on presence, usability, and overall HMD comfort, using quantitative and qualitative research methods by way of a questionnaire. The quantitative data included the recording of physical characteristics such as the distance between eye pupils, known as Interpupillary Distance (IPD). VR HMDs require each user’s IPD measurement to enable the focusing of the VR HMDs virtual camera output to the right position in front of the eyes of the user. In addition, the questionnaire captured users’ qualitative reflections and evaluations of the broader accessibility characteristics of the VR HMDs. The initial research activity was accomplished by enabling a random sample of visitors, staff, and students at Canterbury Christ Church University, Kent to use a VR HMD for a set period of time and asking them to complete the post user experience questionnaire. The study identified that there is little correlation between users who experience cyber sickness and car sickness. Also, users with a smaller IPD than average (typically associated with females) were able to use the VR HMDs successfully; however, users with a larger than average IPD reported an impeded experience. This indicates that there is reduced inclusiveness for the tested VR HMDs for users with a higher-than-average IPD which is typically associated with males of certain ethnicities. As action education research, these initial findings will be used to refine the research method and conduct further investigations with the aim to provide verification and validation of the accessibility of current commercial VR HMDs. The conference presentation will report on the research results of the initial study and subsequent follow up studies with a larger variety of adult volunteers.

Keywords: virtual reality, education technology, inclusive technology, higher education

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Authors: Nicole Marella G. Tan, Al Joseph R. Molina, Raisa Celine R. Rosete, Soraya Elisse E. Escandor, Blythe N. Ke, Veronica Marie E. Ramos, Apolinario Ericson B. Berberabe, Jose Jonas D. del Rosario, Regina Pascua-Berba, Eileen Liesl A. Cubillan, Winlove P. Mojica

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Emergency risk and health communications play a vital role in any pandemic response. However, the Philippine General Hospital (PGH) lacked a system of information delivery that could effectively fulfill the hospital’s communication needs as a COVID-19 referral hospital. This study aimed to describe the establishment of a communication framework for information dissemination within a tertiary government hospital during the COVID-19 pandemic and evaluated the perceived usefulness of its outputs. This is a mixed quantitative-qualitative study with two phases. Phase 1 documented the formation and responsibilities of the Information Education Communication (IEC) Committee. Phase 2 evaluated its output and outcomes through a hospital-wide survey of 528 healthcare workers (HCWs) using a pre-tested questionnaire. In-depth explanations were obtained from five focused group discussions (FGD) amongst various HCW subgroups. Descriptive analysis was done using STATA 16 while qualitative data were synthesized thematically. Communication practices in PGH were loosely structured at the beginning of the pandemic until the establishment of the IEC Committee. The IEC Committee was well-represented by concerned stakeholders. Nine types of infographics tackled different aspects of the hospital’s health operations after thorough inputs from concerned offices. Internal and external feedback mechanisms ensured accurate infographics. Majority of the survey respondents (98.67%) perceived these as useful in their work or daily lives. FGD participants cited the relevance of infographics to their occupations, suggested improvements, and hoped that these efforts would be continued in the future. Sustainability and comprehensive reach were the main concerns in this undertaking. The PGH COVID-19 IEC framework was developed through trial and testing as there were no existing formal structures to communicate health risks and to properly direct the HCWs in the chaotic time of a pandemic. It is a continuously evolving framework which is perceived as useful by HCWs and is hoped to be sustained in the future.

Keywords: COVID-19, pandemic, health communication, infographics, social media

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Authors: Priscilla Akua Agyapong

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Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

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Authors: Tamara Anderson, Neela Badrie

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Plant phenolics which are found in red grape wine, have received considerable attention due to their potential antioxidant activity. Grape by-products contain large amounts of phenolic compounds, mostly flavonoids at high concentrations of 1000-1800 mg/L. Plant phenolics contribute to the flavor, and nutritional value. Sorrel or roselle (Hibiscus sabdariffa L.) belongs to the family Malvaceae. The brilliant red pigments in sorrel calyces contain anthocyanins which are the major sources of antioxidant capacity. Consumers are demanding novel beverages that are healthier, convenient and have appealing consumer acceptance. The objectives of this study were to investigate the effects of adding grape polyphenols and the influence of presenting health claims on the sensory acceptability of the wines. Fresh red sorrel calyces were fermented into wines. The total soluble solids of the pectinase-treated sorrel puree were from 4°Brix to 23.8°Brix. Polyphenol in the form of grape pomace extract was added to sorrel wines (w/v) in specified levels to give 0. 25. 50 and 75 ppm. A focus group comprising of 12 panelists was use to select the level of polyphenol to be added to sorrel wines for sensory preference The sensory attributed of the wines which were evaluated were colour, clarity, aroma, flavor, mouth-feel, sweetness, astringency and overall preference. The sorrel wine which was most preferred from focus group evaluation was presented for hedonic rating. In the first stage of hedonic testing, the sorrel wine was served chilled at 7°C for 24 h prior to sensory evaluation. Each panelist was provided with a questionnaire and was asked to rate the wines on colour, aroma, flavor, mouth-feel, sweetness, astringency and overall acceptability using a 9-point hedonic scale. In the second stage of hedonic testing, the panelist were instructed to read a health abstract on the health benefits of polyphenolic compounds and again to rate sorrel wine with added 25 ppm polyphenol. Paired t-test was used for the analysis of the influence of presenting health information on polyphenols on hedonic scoring of sorrel wines. Focus groups found that the addition of polyphenol addition had no significant effect on sensory color and aroma but affected clarity and flavor. A 25 ppm wine was liked moderately in overall acceptability. The presentation of information on the health benefit of polyphenols in sorrel wines to panelists had no significant influence on the sensory acceptance of wine. More than half of panelists would drink this wine now and then. This wine had color L 19.86±0.68, chroma 2.10±0.12, hue° 16.90 ±3.10 and alcohol content of 13.0%. The sorrel wine was liked moderately in overall acceptability with the added polyphenols.

Keywords: sorrel wines, Roselle Hibiscus sabdariffa L, novel wine, polyphenols, health benefits, physicochemical properties

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Authors: Jukka Torronen

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Introduction: Alcohol consumption and health are areas where gender binaries have persisted. By intoxication, men have displayed their masculinity as strong, while matters of health have formed a feminine undertaking. However, in recent years young people’s alcohol consumption has declined and been challenged by competing activities, including the rising health trend. This makes the comparison of young people’s masculinities and femininities in health and heavy drinking an important case to study. Methods: The data consists of semi-structured interviews about alcohol, health, and leisure activities among young people aged between 15 and 19 (N=56). By drawing on Butler’s work on “gender as performative” and Connell’s understanding of gendered identities as “configurations of practices,” the paper analyzes how the interviewees are doing masculinities and femininities in relation to health and heavy drinking, and how their gender performances are dichotomous, naturalized and contested. Results: The interviewees approach health from two perspectives, which are called “social health” and “physical health” approaches. They are both gendered. Especially in the “social health” approach, in which intoxication and risk-taking are used to increase well-being, the interviewees perform stereotypical gender binaries. The interviewees’ gendered performances in the “physical health” approach show more variability and are more reflective and critical. In contrast to intoxication, in relation to which the interviewees perform biologically driven gender binaries, they perform culturally driven genders in relation to health. Conclusions: Health seems to provide for the interviewees a field in which they feel more liberated to perform flexible and alternative genders.

Keywords: young people, decline in drinking, qualitative interviews, gender, health, risk-taking

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Authors: Tiffany Riggleman, Andrea Schultheis, Kalyn Jannace, Jerika Taylor, Michelle Nordstrom, Paul F. Pasquina

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Introduction: Posttraumatic Stress (PTS) and Posttraumatic Stress Disorder (PTSD) remain significant problems for military and veteran communities. Symptoms of PTSD often include poor sleep, intrusive thoughts, difficulty concentrating, and trouble with emotional regulation. Unfortunately, despite its high prevalence, service members diagnosed with PTSD often do not seek help, usually because of the perceived stigma surrounding behavioral health care. To help address these challenges, non-pharmacological, therapeutic approaches are being developed to help improve care and enhance compliance. The Service Dog Training Program (SDTP), which involves teaching patients how to train puppies to become mobility service dogs, has been successfully implemented into PTS/PTSD care programs with anecdotal reports of improved outcomes. This study was designed to assess the biopsychosocial effects of SDTP from military beneficiaries with PTS symptoms. Methods: Individuals between the ages of 18 and 65 with PTS symptom were recruited to participate in this prospective study. Each subject completes 4 weeks of baseline testing, followed by 6 weeks of active service dog training (twice per week for one hour sessions) with a professional service dog trainer. Outcome measures included the Posttraumatic Stress Checklist for the DSM-5 (PCL-5), Generalized Anxiety Disorder questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), social support/interaction, anthropometrics, blood/serum biomarkers, and qualitative interviews. Preliminary analysis of 17 participants examined mean scores on the GAD-7, PCL-5, and PHQ-9, pre- and post-SDTP, and changes were assessed using Wilcoxon Signed-Rank tests. Results: Post-SDTP, there was a statistically significant mean decrease in PCL-5 scores of 13.5 on an 80-point scale (p=0.03) and a significant mean decrease of 2.2 in PHQ-9 scores on a 27 point scale (p=0.04), suggestive of decreased PTSD and depression symptoms. While there was a decrease in mean GAD-7 scores post-SDTP, the difference was not significant (p=0.20). Recurring themes among results from the qualitative interviews include decreased pain, forgetting about stressors, improved sense of calm, increased confidence, improved communication, and establishing a connection with the service dog. Conclusion: Preliminary results of the first 17 participants in this study suggest that individuals who received SDTP had a statistically significant decrease in PTS symptom, as measured by the PCL-5 and PHQ-9. This ongoing study seeks to enroll a total of 156 military beneficiaries with PTS symptoms. Future analyses will include additional psychological outcomes, pain scores, blood/serum biomarkers, and other measures of the social aspects of PTSD, such as relationship satisfaction and sleep hygiene.

Keywords: post-concussive syndrome, posttraumatic stress, service dog, service dog training program, traumatic brain injury

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Authors: Ruttana Phetsitong, Patama Vapattanawong, Malee Sunpuwan, Marc Voelker

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The majority of care for older people at home in Thai society falls upon caregivers resulting in caregiver’s mental health problem. Beyond individual characteristics, household factors might have a profound effect on the caregiver’s mental health. But reliable data capturing this at the household level have been limited to date. The objectives of the present study were to explore the levels of Thai caregiver’s mental health and to investigate the factors affecting the mental health at household level. Data were obtained from the 2011 National Survey of Thai Older Persons conducted by the National Statistical Office of Thailand. Caregiver’s mental health was measured by using the 15- items-short version of the Thai Mental Health Indicator (TMHI-15) developed by the Department of Mental Health, the Ministry of Public Health. Multivariate logistic regression models were used to explore the impact of potential factors on caregiver’s mental health. The THMI-15 produced an overall average caregiver mental health score of 30.9 out of 45 (SD 5.3). The score can be categorized into good (34.02-45), fair (27.01-34), and poor (0-27). Duration of care for older people, household wealth, and functional dependency of the older people significantly predicted total caregiver’s mental health. Household economic factor was key in predicting better mental health. Compared to those poorest households, the adjusted effect of the fifth quintile household wealth was high (OR=2.34; 95%CI=1.47-3.73). The findings of this study provide a fuller picture to a better understanding of the level and factors that cause the mental health of Thai caregivers. Health care providers and policymakers should consider these factors when designing interventions aimed at alleviating caregiver’s psychological burden when provided care for older people at home.

Keywords: caregiver’s mental health, household, older people, Thailand

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Authors: Yuki Irie, Shota Ogawa, Hitomi Kosugi, Hiromitsu Shinozaki

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Background: Dropout from higher educational institutions is a major problem both for students and institutions, and poor mental health is one of the risk factors. Medical college students are at higher risk of poor mental health than general students because of their hard academic schedules. On the other hand, food insecurity has negative impacts on mental health. The healthcare college of the project site is located heavily snowy area. The students without own vehicles may be at higher risk of food insecurity, especially in the winter season. Therefore, they have many risks to mental health. The aim of the study is to clarify the relationship between mental health and its risk factors to promote students’ mental well-being. Method: A cross-sectional design was used to investigate the relationship between mental health status and lifestyle, including diet and food security among the students (n=421, 147 male, 274 females; 20.7 ± 2.8 years old). Participants were required to answer 3 questionnaires which consisted of diet, lifestyle, food security, and mental health. The survey was conducted during the snowy season from Dec. 2022 to Jan. 2023. Results: Mean mental score was 6.7±4.6 (max. score 27, a higher score means worse mental health). Significant risk factors in mental health were breakfast habit (p=0.02), subjective dietary habit (p=0.00), subjective health (p=0.00), exercise habit (p=0.02), food insecurity in the winter season (p=0.01), and vitamin A intakes (p=0.03). Conclusions: Nutrients intakes are not associated with mental health except vitamin A; however, some other lifestyle factors are significantly associated with mental health. Nutrition doesn’t lead to poor mental health directly; however, the promotion of a healthy lifestyle and improved food security in winter may be effective in better mental health.

Keywords: mental health, winter, lifestyle, students

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Authors: Ubonrattan Phophatanachai, Phensri Thongphet, Weerawan Kerdtong

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The purposes of this study were to compare the ethical behavior regarding responsibility and polite manners of nursing students of Boromarajonani College of Nursing, Suratthani, Thailand before and after providing the activity session of ethical behavior development. The samples consisted of 103 sophomores in the academic year 2006. The tools were tested for reliability and content validity. The reliability of the Ethical Behavior Questionnaire measured by Cronbach’s alpha coefficient was 0.94. Data were analyzed using means, standard deviations, and dependent t-test. The findings were as follows: a) after the activity session, the mean scores of ethical behavior regarding responsibility and polite manners of nursing students increased from middle level to high level; b) mean scores of responsibilities and polite manners after the activity session were significantly higher than those before the session (t =28.36, p < .001; t =23.9, p < .001, respectively).

Keywords: development of ethical behavior, nursing students, health, nursing informatics

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Authors: Emran M. Badghish

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Overweight and obesity have now become an epidemic around the globe, both in high-, as well as low-income regions. It is important to use preventive measures that are cost-effective. Schools are the essence of building societies and engaging them in healthy nutrition will offer a way to reach individuals at an early stage in life, with many positive and significant impacts. Aim: Provide healthy food in schools of children aged 5 to 18 years old. Methods: Distributing healthy food to a school and implementation of a star rating system for healthier foods, with five stars for the healthiest option to a half a star for the unhealthiest. The stars system was developed in Australia and should motivate children to consume the healthier nutritional options. Each canteen should be allowed a minimum of 3.5 stars rating for the food provided. Outcome Measurement: Body-mass-index as an indicator of overweight and obesity should be checked at the beginning of the study annually for five years for all children. Another side measurement is the performance by checking the grades and a questionnaire on eating habits at the start of the study and yearly. Expected Outcome: A lower health-risk behaviour and assistance to children in reaching their potentials as they will adapt to eating healthier. Nutrition during childhood has the potential to prevent obesity, type 2 diabetes, dental diseases, hypertension and, in later life, cardiovascular disease, osteoporosis and a variety of cancers. In Australia NSW starting from 2016 is expecting a 5% reduction of childhood overweight and obesity by 2025. As for Saudi-Arabia, it is expected to have an, even more, reduction by 2023 as a lot of our children are canteen-dependent. Conclusion: Introducing healthy food in schools is a preventative method that would have significant influence on the reduction of the prevalence of obesity in Saudi-Arabia and improves its general health.

Keywords: food, healthy, children, obesity, schools

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Authors: Jesus Carretero, Mario Vasile, Javier Garcia-Blas, Felix Garcia-Carballeira

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Supporting cross-border secure and reliable exchange of data and documents and to promote data interoperability is critical for Europe to enhance sector (like eFinance, eJustice and eHealth). This work presents the status and results of the European Project MADE, a Research Project funded by Connecting Europe facility Programme, to provide secure e-invoicing and e-document exchange systems among Europe countries in compliance with the eIDAS Regulation (Regulation EU 910/2014 on electronic identification and trust services). The main goal of MADE is to develop six new AS4 Access Points and SMP in Europe to provide secure document exchanges using the eDelivery DSI (Digital Service Infrastructure) amongst both private and public entities. Moreover, the project demonstrates the feasibility and interest of the solution provided by providing several months of interoperability among the providers of the six partners in different EU countries. To achieve those goals, we have followed a methodology setting first a common background for requirements in the partner countries and the European regulations. Then, the partners have implemented access points in each country, including their service metadata publisher (SMP), to allow the access to their clients to the pan-European network. Finally, we have setup interoperability tests with the other access points of the consortium. The tests will include the use of each entity production-ready Information Systems that process the data to confirm all steps of the data exchange. For the access points, we have chosen AS4 instead of other existing alternatives because it supports multiple payloads, native web services, pulling facilities, lightweight client implementations, modern crypto algorithms, and more authentication types, like username-password and X.509 authentication and SAML authentication. The main contribution of MADE project is to open the path for European companies to use eDelivery services with cross-border exchange of electronic documents following PEPPOL (Pan-European Public Procurement Online) based on the e-SENS AS4 Profile. It also includes the development/integration of new components, integration of new and existing logging and traceability solutions and maintenance tool support for PKI. Moreover, we have found that most companies are still not ready to support those profiles. Thus further efforts will be needed to promote this technology into the companies. The consortium includes the following 9 partners. From them, 2 are research institutions: University Carlos III of Madrid (Coordinator), and Universidad Politecnica de Valencia. The other 7 (EDICOM, BIZbrains, Officient, Aksesspunkt Norge, eConnect, LMT group, Unimaze) are private entities specialized in secure delivery of electronic documents and information integration brokerage in their respective countries. To achieve cross-border operativity, they will include AS4 and SMP services in their platforms according to the EU Core Service Platform. Made project is instrumental to test the feasibility of cross-border documents eDelivery in Europe. If successful, not only einvoices, but many other types of documents will be securely exchanged through Europe. It will be the base to extend the network to the whole Europe. This project has been funded under the Connecting Europe Facility Agreement number: INEA/CEF/ICT/A2016/1278042. Action No: 2016-EU-IA-0063.

Keywords: security, e-delivery, e-invoicing, e-delivery, e-document exchange, trust

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Authors: Ahmet Koyuncu, Abdullah Berkan Erdogmus, Orkun Dogu, Sinan Uygur

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Thermoelectric modules are integrated to electronic components to keep their temperature in specific values in electronic cooling applications. They can be used in different ambient temperatures. The cold side temperatures of thermoelectric modules depend on their hot side temperatures, operation currents, and heat loads. Performance curves of thermoelectric modules are given at most two different hot surface temperatures in product catalogs. Characteristic properties are required to select appropriate thermoelectric modules in thermal design phase of projects. Generally, manufacturers do not provide characteristic material property values of thermoelectric modules to customers for confidentiality. Common commercial software applied like ANSYS ICEPAK, FloEFD, etc., include thermoelectric modules in their libraries. Therefore, they can be easily used to predict the effect of thermoelectric usage in thermal design. Some software requires only the performance values in different temperatures. However, others like ICEPAK require three temperature-dependent equations for material properties (Seebeck coefficient (α), electrical resistivity (β), and thermal conductivity (γ)). Since the number and the variety of thermoelectric modules are limited in this software, definitions of characteristic material properties of thermoelectric modules could be required. In this manuscript, the method of derivation of characteristic material properties from the datasheet of thermoelectric modules is presented. Material characteristics were estimated from two different performance curves by experimentally and numerically in this study. Numerical calculations are accomplished in ICEPAK by using a thermoelectric module exists in the ICEPAK library. A new experimental setup was established to perform experimental study. Because of similar results of numerical and experimental studies, it can be said that proposed equations are approved. This approximation can be suggested for the analysis includes different type or brand of TEC modules.

Keywords: electrical resistivity, material characteristics, thermal conductivity, thermoelectric coolers, seebeck coefficient

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Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

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Contraceptives are an effective public health achievement, allowing for family planning and reducing the risk of sexually transmitted diseases (STDs). California’s rural Central Valley has high rates of teenage pregnancy and STDs. Factors affecting contraceptive usage here may include religious concerns, financial issues, and regional variations in the accessibility and availability of contraceptives. The increasing population and diversity of the Central Valley make the understanding of the determinants of unintended pregnancy and STDs increasingly nuanced. Patients in California’s Central Valley were surveyed at 6 surgical clinics to assess attitudes toward contraceptives. The questionnaire consisted of demographics and 14 Likert-scale statements investigating patients’ feelings regarding contraceptives. Parametric and non-parametric analysis was performed on the Likert statements. A correlation matrix for the Likert-scale statements was used to evaluate the strength of the relationship between each question. 76 patients aged 18-75 years completed the questionnaire. 90% of the participants were female, 76% Hispanic, 36% married, 44% with an income range between 30-60K, and 83% were between childbearing ages. 60% of participants stated they are currently using or had used some type of contraceptive. 25% of participants had at least one unplanned pregnancy. The most common type of contraceptives used were oral contraceptives(28%) and condoms(38%). The top reasons for patients’ contraceptive usage were: prevention of pregnancy (72%), safe sex/prevention of STDs (32%), and regulation of menstrual cycle (19%). Further analysis of Likert responses revealed that contraception usage increased due to approval of contraceptives (x̄=3.98, σ =1.02); partner approval of contraceptives (x̄=3.875, σ =1.16); and reduced anxiety about pregnancy (x̄=3.875, σ =1.23). Younger females (18-34 years old) agreed more with the statement that the cost of contraceptive supplies is too expensive than older females (35-75 years old), (x̄=3.2, σ = 1.4 vs x̄=2.8, σ =1.3, p<0.05). Younger females (44%) were also more likely to use short-acting contraceptive methods (oral and male condoms) compared to older females (64%) who use long-acting methods (implants/ intrauterine devices). 51% of Hispanic females were using some type of contraceptive. Of those Hispanic females who do not use contraceptives, 33% stated having no children, and all plan to have at least one child in the future. 35% of participants had a bachelor's degree. Those with bachelor’s degrees were more likely to use contraceptives, 58% vs 51%, p<0.05, and less likely to have unplanned pregnancy, 50% vs. 12%, p<0.01. There is increasing use and awareness among patients in rural settings concerning contraceptives. Our finding shows that younger women and women with higher educational attainment tend to have more positive attitudes towards the use of contraceptives. This work gives physicians an understanding of patients’ concerns about contraceptive methods and offers insight into culturally competent intervention programs that respect individual values.

Keywords: contraceptives, public health, rural california, women of child baring age

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Authors: Endalew Fufa Kufi

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Every married person aspires to be a parent regardless of the situation in which s/he lives. Such aspiration meets with reality when the destined parent is able to give adequate supports and services to his/her children, whether the latter are got by birth or through adoption. The adequacy of services parents provide their children is both enriched and tempted by the work on which they involve. On the one hand, parents need to work and earn a living in order to support their family. On the other hand, they must spend most of their time outside home to do the work, which shortens the time and might they spare to care for their children. Where the sufficiency of services parents owe their children could be ascertained by in terms of life skills, physical care and related provisions, the role of working fathers and mothers in providing such supports could be diverse across cultures and work traditions. Hence, this research deals with the investigation of working mothers’ parental practices, challenges they face in providing parental services and the implication for the future progress of the parents and their children. Target of the study will be Arsi University in Oromia Regional State of Ethiopia. Descriptive survey design in holding the research, and data for the research will be collected in the form of experiential self-report from 150 working mothers selected from the entire working women population of Colleges of Agriculture and Environmental Studies and College of Health Sciences through stratified random-sampling. Instruments of data collection will be closed and open-ended questionnaire. Complementary data will also be collected from purposively selected samples through semi-structured interview. Data for the research will be collected through questionnaire first and then through interview. Data analysis will also follow the same procedure. The collected data will systematically be organized and statistically and thematically analyzed in order to come up with indicative findings. The overarching thesis is that, working mothers in the study area bear a lot of responsibilities both at home and at work place which leave them very little time for parenting services. Unless due attention is given to the way they can spare time for their children, they are more likely to be tense between work-life and family care services, which tempt them in different directions.

Keywords: challenges, mothers, practices, university, working

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Authors: Aikaterini Tsalampouni

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The European Union has long been the most developed model of economic and political integration that has brought a common market, a common currency and a standardization of national policies in certain areas in consistent with EU values and principles. To this direction, there is a parallel process of social integration that effect public policy decisions of member states. Even though social policy, i.e. social protection and moreover healthcare policy, still remains in state's responsibility to develop, EU applies different mechanisms in order to influence health policy systems, since from a more federalist point of view, EU ought to expand its regulatory and legislative roles in as many policy areas as possible. Recently, the pandemic has become a turning point for health care provision and at the same time has also highlighted the need to strengthen the EU’s role in coordinating health care. This paper analyses the EU health policy in general, as well as the response to COVID-19 pandemic with an attempt to identify indications of interaction between EU policies and the promotion of sustainable and resilient health systems. More analytically, the paper investigates the EU binding legal instruments, non-binding legal instruments, monitoring and assessment instruments and instruments for co-financing concerning health care provision in member states and records the evolution of health policies before and during the COVID-19 pandemic. The paper concludes by articulating some remarks regarding the improvement of health policy in EU. Since the ability to deal with a pandemic depends on continuous and increased investment in health systems, the involvement of the EU can lead to a policy convergence, necessary for the resilience of the systems, maintaining at the same time, a strong health policy framework in Europe.

Keywords: EU health policy, EU response to COVID-19, European Health Union, health systems in Europe

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Authors: Faranak Omidian

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The aim of this research was to examine the quality of education service at master's level in the Islamic Azad University of Dezful. In terms of objective, this is an applied research and in regard to methodology, it is a descriptive analytical research. The statistical population included all students of master's degree in the Islamic Azad University of Dezful. The sample size was determined using stratified random sampling method in different fields of study. The research questionnaire is the translated version of standardized Abdullah's HEdPERF 41-item scale which is based on a 5-point Likert scale. In order to determine the validity, the translated questionnaire was given to the professors of educational sciences. The correlation among all questions has been regarded at a value of 0.644. The results showed that the quality of educational service at master's level in this university, based on chi-square goodness of fit test, was equal to 73.36 and its degree of freedom was 2 at a significant level of 0.001, indicating the low desirability of the services. According to Friedman test, academic responsiveness has been reported to be in a higher status than other dimensions with an average rank of 3.94 while accessibility, with an average rank of 2.15, has been in the lowest status from master's students' viewpoint.

Keywords: educational service quality, master's level, Iranian university

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Authors: Paiboon Jeamponk, Tikamporn Thipsaeng

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This paper is aimed to investigate farmers’ level of awareness and behavior of chemical pesticide uses, by using a case study of Suan Luang Sub- District Municipality, Ampawa, Samut Songkram Province. Questionnaire was employed in this study with the farmers from 46 households to explore their level of awareness in chemical pesticide uses, while interview and observation were adopted in exploring their behavior of chemical pesticide uses. The findings reflected the farmers’ high level of awareness in chemical pesticide uses in the hazardous effects of the chemical to human and environmental health, while their behavior of chemical pesticide uses explained their awareness paid to the right way of using pesticides, for instance reading the direction on the label, keeping children and animals away from the area of pesticide mixing, covering body with clothes and wearing hat and mask, no smoking, eating or drinking during pesticide spray or standing in windward direction.

Keywords: awareness, behavior, pesticide, farmers

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Authors: Rania Kassir, Christophe Dos Santos, Halim Abboud, Olivier Godefroy

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The ability to communicate in at least two different languages is shared by a growing number of humans. Recently, many researchers have been studying the elderly bilingual population around the world in neuroscience, and yet, until today there’s no accurate nor universal measure or methodology used to examine bilingualism across these studies which constitute a real challenge for results generalization. This study contributes to the quest of a multidimensional bilingualism index and language proficiency literature by investigating a new bilingualism index from a reliable subjective questionnaire the Language Experience and Proficiency Questionnaire (LEAP-Q), multi-linguistic tests, and a diverse bilingual population all featured in one analysis and one index. One hundred Lebanese subjects aged between 55 and 92 years old divided into three different bilingualism subgroups (Arabic prominent, balanced, and French prominent) were recruited and underwent the LEAP-Q with a set of linguistic and cognitive tests. The analysis of the collected data led to the creation of a robust bilingualism index from speaking and oral understanding scores that underline specifically bilingualism subtype according to cutoffs scored. The practice implications of this index, particularly its use within bilingual populations, are addressed in the conclusion of this work.

Keywords: bilingualism, language dominance, bilingualism index, balanced bilingualism, Arabic first language, Lebanese, Arabic-French bilingualism

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Authors: Ahmeda Ali, Mary Codd, Susan Brundage

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Importance: This research focuses on devising and improving Health Service Executive (HSE) policy and legislation and therefore improving patient trauma care and outcomes in Ireland. Objectives: The study measures components of the Trauma System in the district hospital setting of the Cavan/Monaghan Hospital Group (CMHG), HSE, Ireland, and uses the collected data to identify the strengths and weaknesses of the CMHG Trauma System organisation, to include governance, injury data, prevention and quality improvement, scene care and facility-based care, and rehabilitation. The information will be made available to local policy makers to provide objective situational analysis to assist in future trauma service planning and service provision. Design, setting and participants: From 28 April to May 28, 2016 a cross-sectional survey using World Health Organisation (WHO) Trauma System Assessment Tool (TSAT) was conducted among healthcare professionals directly involved in the level III trauma system of CMHG. Main outcomes: Identification of the strengths and weaknesses of the Trauma System of CMHG. Results: The participants who reported inadequate funding for pre hospital (62.3%) and facility based trauma care at CMHG (52.5%) were high. Thirty four (55.7%) respondents reported that a national trauma registry (TARN) exists but electronic health records are still not used in trauma care. Twenty one respondents (34.4%) reported that there are system wide protocols for determining patient destination and adequate, comprehensive legislation governing the use of ambulances was enforced, however, there is a lack of a reliable advisory service. Over 40% of the respondents reported uncertainty of the injury prevention programmes available in Ireland; as well as the allocated government funding for injury and violence prevention. Conclusions: The results of this study contributed to a comprehensive assessment of the trauma system organisation. The major findings of the study identified three fundamental areas: the inadequate funding at CMHG, the QI techniques and corrective strategies used, and the unfamiliarity of existing prevention strategies. The findings direct the need for further research to guide future development of the trauma system at CMHG (and in Ireland as a whole) in order to maximise best practice and to improve functional and life outcomes.

Keywords: trauma, education, management, system

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Authors: Wen-Chen Hwang, Yu-Hsi Yuan

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According to the estimation made by researchers of safety and hygiene, 80% to 90% of workplace accidents in enterprises could be attributed to human factors. Nevertheless, human factors are not the only cause for accidents; instead, happening of accidents is also closely associated with the safety culture of the organization. Therefore, the most effective way of reducing accident rate would be to improve the social and the organizational factors that influence organization’s safety performance. Overview the present study is to understand the current level of safety culture in manufacturing enterprises. A tool for evaluating safety culture matching the needs and characteristics of manufacturing enterprises was developed by reviewing literature of safety culture, and taking the special backgrounds of the case enterprises into consideration. Expert validity was also implied for developing the questionnaire. Moreover, safety culture assessment was conducted through the practical investigation of the case enterprises. Total 505 samples were involved, 53 were executives and 452 were operators. The result of this study in comparison of the safety culture level between the executives and the operators was reached the significant level in 8 dimensions: Safety Commitment, Safety System, Safety Training, Safety Involvement, Reward and Motivation, Communication and Reporting, Leadership and Supervision, Learning and Changing. In general, the overall safety culture were executive level higher than operators level (M: 74.98 > 69.08; t=2.87; p < 0.01).

Keywords: questionnaire survey, safety culture, t-test, media studies

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Authors: Habib Honari

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The purpose of this study is an investigation of the factors affecting entrepreneurship in sport from the point of view of experts in this field. This study is a descriptive analytic one and was conducted as a survey and statistical sample consisted of 64 subjects including top managers and sport management professors at physical education organization. Data is collected by research designed questionnaire. Its reliability (α=.95) is obtained after its validity confirmation (by professors). In this article the most important factors affecting sport entrepreneurship, both as an interdisciplinary field in the world, are studied. Initially, infrastructures are identified for entrepreneurial opportunities in sports and related problems become known so that identifying factors for social, cultural, and economical development to entrepreneurs will be a smooth path, because sport entrepreneurship, given its effective roles in business development, welfare, health development, and participation in various aspects of society, can also play a crucial role in the development of the country. Finally, some solutions for developing entrepreneurial sport are introduced.

Keywords: sport entrepreneurship, entrepreneurial opportunities, entrepreneurial barriers, interdisciplinary

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Authors: Benet Reid, Nina Laurie, Matt Baillie-Smith

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Trans-national and tropical medicine, historically associated with colonial power and missionary activity, is now central to discourses of global health and development, thrust into mainstream media by events like the 2014 Ebola crisis and enshrined in the Sustainable Development Goals. Research in this area remains primarily the province of health professional disciplines, and tends to be framed within a simple North-to-South model of development. The continued role of voluntary work in this field is bound up with a rhetoric of partnering and partnership. We propose, instead, the idea of International Voluntary Health Networks (IVHNs) as a means to de-centre global-North institutions in these debates. Drawing on our empirical work with IVHNs in countries both North and South, we explore geographical and sociological theories for mapping the multiple spatial and conceptual dynamics of power manifested in these phenomena. We make a radical break from conventional views of health as a de-politicised symptom or corollary of social development. In studying health work as it crosses between cultures and contexts, we demonstrate the inextricably political nature of health and health work everywhere.

Keywords: development, global health, power, volunteering

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Authors: Vidula Shevade, B. J. Nagare, Sajeev Chacko

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First principles simulation, meaning density functional theory (DFT) calculations with plane waves and pseudopotential, has become a prized technique in condensed matter theory. Nanoparticles (NP) have been known to possess good catalytic activities, especially for molecules such as CO, O₂, etc. Among the metal NPs, Aluminium based NPs are also widely known for their catalytic properties. Aluminium metal is a lightweight, excellent electrical, and thermal abundant chemical element in the earth’s crust. Aluminium NPs, when added to solid rocket fuel, help improve the combustion speed and considerably increase combustion heat and combustion stability. Adding aluminium NPs into normal Al/Al₂O₃ powder improves the sintering processes of the ceramics, with high heat transfer performance, increased density, and enhanced thermal conductivity of the sinter. We used VASP and Gaussian 0₃ package to compute the geometries, electronic structure, and bonding properties of Al₁₂Ni as well as its interaction with O₂ and CO molecules. Several MD simulations were carried out using VASP at various temperatures from which hundreds of structures were optimized, leading to 24 unique structures. These structures were then further optimized through a Gaussian package. The lowest energy structure of Al₁₂Ni has been reported to be a singlet. However, through our extensive search, we found a triplet state to be lower in energy. In our structure, the Ni atom is found to be on the surface, which gives the non-zero magnetic moment. Incidentally, O2 and CO molecules are also triplet in nature, due to which the Al₁₂-Ni cluster is likely to facilitate the oxidation process of the CO molecule. Our results show that the most favourable site for the CO molecule is the Ni atom and that for the O₂ molecule is the Al atom that is nearest to the Ni atom. Al₁₂Ni-O₂ and Al₁₂-Ni-CO structures we extracted using VMD. Al₁₂Ni nanocluster, due to in triplet electronic structure configuration, indicates it to be a potential candidate as a catalyst for oxidation of CO molecules.

Keywords: catalyst, gaussian, nanoparticles, oxidation

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Authors: Constantinos S. Mammas, Andreas Lazaris, Adamantia S. Mamma-Graham, Georgia Kostopanagiotou, Chryssa Lemonidou, John Mantas, Eustratios Patsouris

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The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the evaluation of the grafts. Α high percentage of solid organs arrive at the recipient hospitals and are considered as injured or improper for transplantation in the UK. Digital microscopy adds information on a microscopic level about the grafts (G) in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G will arrive at the recipient hospital for implantation. Aim: The aim of this study is to analyze the ergonomics of digital microscopy (DM) based on virtual slides, on telemedicine systems (TS) for tele-pathological evaluation (TPE) of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of renal graft (RG), liver graft (LG) and pancreatic graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying virtual slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included the development of an OTE-TS similar experimental telemedicine system (Exp.-TS) for simulating the integrated VS based microscopic TPE of RG, LG and PG Simulation of DM on TS based TPE performed by 2 specialists on a total of 238 human renal graft (RG), 172 liver graft (LG) and 108 pancreatic graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to accurately diagnose the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a desktop, followed by the ES of the applied Exp.-TS. Tablet and mobile-phone ES seem significantly risky for the application of DM in OT (p<.001). Conclusion: To make the largest reduction in errors and adverse events referring to the quality of the grafts, it will take application of human factors engineering to procurement, design, audit, and awareness-raising activities. Consequently, it will take an investment in new training, people, and other changes to management activities for DM in OT. The simulating VS based TPE with DM of RG, LG and PG tissues after retrieval, seem feasible and reliable and dependable on the size of the electronic space of the applied TS, for remote prevention of diseased grafts from being retrieved and/or sent to the recipient hospital and for post-grafting and pre-transplant planning.

Keywords: digital microscopy, organ transplantation, tele-pathology, virtual slides

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Authors: Maryam Bakhtyar-Pegah Akrami

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The relationship between spiritual health and spirituality is one of the important is that in recent years, the research about it is expanding and due to the rich heritage of the in this field of study and research in this important field more than before and we will come to spiritual life and healthier than before. In this research, we provide the following and the basics of Islamic Mysticism in the realm of spiritual health thoughts. This research is based on a descriptive method and comparison with analytical-method to data collected. The findings show that human beings due to this pivotal topic of full Islamic slab, and mental and physical education with the sought to reach the human place are complete, we can provide the basics along with new discussions of spiritual health help human beings to spiritual education along with our faiths in the reconstruction of the spiritual foundations of spiritual health are extremely helpful

Keywords: spirituality, health, Islam, mysticism, perfect human

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Authors: Lucie Côté, Martin Lauzier, Guy Beauchamp, France Guertin

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Stress causes deleterious effects to the physical, psychological and organizational levels, which highlight the need to use effective coping strategies to deal with it. Several coping models exist, but they don’t integrate the different strategies in a coherent way nor do they take into account the new research on the emotional coping and acceptance of the stressful situation. To fill these gaps, an integrative model incorporating the main coping strategies was developed. This model arises from the review of the scientific literature on coping and from a qualitative study carried out among workers with low or high levels of stress, as well as from an analysis of clinical cases. The model allows one to understand under what circumstances the strategies are effective or ineffective and to learn how one might use them more wisely. It includes Specific Strategies in controllable situations (the Modification of the Situation and the Resignation-Disempowerment), Specific Strategies in non-controllable situations (Acceptance and Stubborn Relentlessness) as well as so-called General Strategies (Wellbeing and Avoidance). This study is intended to undertake and present the process of development and validation of an instrument to measure coping strategies based on this model. An initial pool of items has been generated from the conceptual definitions and three expert judges have validated the content. Of these, 18 items have been selected for a short form questionnaire. A sample of 300 students and employees from a Quebec university was used for the validation of the questionnaire. Concerning the reliability of the instrument, the indices observed following the inter-rater agreement (Krippendorff’s alpha) and the calculation of the coefficients for internal consistency (Cronbach's alpha) are satisfactory. To evaluate the construct validity, a confirmatory factor analysis using MPlus supports the existence of a model with six factors. The results of this analysis suggest also that this configuration is superior to other alternative models. The correlations show that the factors are only loosely related to each other. Overall, the analyses carried out suggest that the instrument has good psychometric qualities and demonstrates the relevance of further work to establish predictive validity and reconfirm its structure. This instrument will help researchers and clinicians better understand and assess coping strategies to cope with stress and thus prevent mental health issues.

Keywords: acceptance, coping strategies, stress, validation process

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Authors: Peter R. Reuter

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Health professionals play important roles in helping patients use Complementary and Alternative Medicine (CAM) practices safely and accurately. Consequently, it is important for future health professionals to learn about CAM practices during their time in undergraduate and graduate programs. To satisfy this need for education, teaching CAM in nursing and medical schools and other health professions programs is becoming more prevalent. Our study was the first to look specifically at the knowledge of, and attitude toward CAM of undergraduate health professions students at a university in the U.S. Students were invited to participate in one of two anonymous online surveys depending on whether they were pre-health professions students or graduating health professions seniors. Of the 763 responses analyzed, 71.7% were from pre-health professions students, and 28.3% came from graduating seniors. The overall attitude of participants toward and interest in learning about CAM practices was generally fairly positive with graduating seniors being more positive than pre-health professions students. Yoga, meditation, massage therapy, aromatherapy, and chiropractic care were the practices most respondents had personal experience with. Massage therapy, yoga, chiropractic care, meditation, music therapy, and diet-based therapy received the highest ratings from respondents. Three-quarters of respondents planned on including aspects of holistic medicine in their future career as a health professional. The top five practices named were yoga, meditation, massage therapy, diet-based therapy, and music therapy. The study confirms the need to educate health professions students about CAM practices to give them the background information they need to select or recommend the best practices for their patients' needs.

Keywords: CAM education, health professions, health professions students, pre-health professions students

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