Search results for: health care professional
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12126

Search results for: health care professional

10626 The Use of Cross-cultural Approaches (CCAs) in Psychotherapy in Addressing Mental Health Issues Amongst Women of Ethnic Minority

Authors: Adaku Thelma Olatise

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Mental health disparities among women from diverse ethnic, cultural, and religious backgrounds remain a pressing concern, particularly as current psychotherapeutic models often fail to address the unique challenges these groups face. This is of particular concern since epidemiological studies across various countries and cultures consistently demonstrate higher prevalence rates of common mental disorders amongst these groups of women because of a lack of access to culturally oriented psychotherapeutic services. This literature review aims to examine how CCAs in psychotherapy can address the specific ethnic, cultural, and religious challenges women encounter in accessing mental health care. A search of relevant articles was conducted through PsycARTICLES and PubMed databases, using terms such as ‘mental health’, ‘women’, ‘culture’, and ‘ethnic minorities’. Supplementary searches on Google Scholar were also performed to capture literature not covered by traditional databases. While the importance of cross-cultural approaches in psychotherapy has become more apparent because people from diverse ethnic backgrounds inevitably perceive the world through different lenses, influencing their interpretations of human behavior and norms, there is a notable gap in the literature in understanding the influences of using of CCAs in psychotherapy amongst women of an ethnic minority. This gap not only reflects a poor understanding of the complex stressors faced by these women—such as familial, communal, and societal expectations—but also highlights the lack of support and culturally adapted interventions available to them. Even though scholars have posited that aligning treatment approaches with patients' cultural backgrounds is important to enhance therapeutic effectiveness, and the acknowledgment of culture is crucial in psychotherapy theory and practice. As well as the increasing global focus on psychotherapy applications that integrate non-Western practices, such as spiritual healing and community-based interventions, the adaptation of these approaches in mainstream mental health care has remained limited. This review found that the expectations and experiences of ethnic minority women were heavily influenced by family and community pressures. However, there were limited evidence-based, culturally oriented psychotherapeutic interventions tailored to ethnic minority women. This gap extends to inadequate representation of minority groups in clinical research, as well as a lack of culturally validated mental health outcome measures. Furthermore, studies have shown that psychotherapeutic models have largely been Western-oriented and Euro-centric because of socially constructed hierarchies. The origin of psychology from the Western world has predominantly reflected Western cultural traditions, shaped by historical, linguistic, and sociopolitical influences. These factors have led to a lack of recognition of therapeutic approaches from minority ethnic groups and the biases that emanate from hegemonic cultural beliefs and power dynamics influence the decisions about which psychotherapeutic modalities to integrate and practice. Therefore, this plethora of factors adds to the challenges women from ethnically and culturally diverse backgrounds face in accessing mental health services at the individual, familial, community, and societal levels. In conclusion, a cross-cultural approach is urgently needed within psychotherapy to address these challenges, ensuring that treatment frameworks are both culturally sensitive and gender responsive. Only by considering the lived experiences of minority women, particularly in relation to their cultural and religious contexts, can mental health services provide the appropriate care necessary to support their well-being.

Keywords: mental health, women, culture, ethnicity

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10625 Palliation of Pain in Pyomyositis: A Case Series and Literature Review

Authors: Katie Jerram, Jacqui Nevols, Rebecca Howes, Hayley Richardson, Debbie Suso, Thomas Batten, Reny Mathai

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Pyomyositis is an uncommon acute purulent skeletal muscle infection, usually caused by Staphylococcus aureus, occurring either spontaneously or following local trauma. Immunocompromise is a risk factor. It presents with pyrexia, pain, and tenderness of the affected muscle, which may have a firm ‘woody’ feel. Management usually involves surgery and prolonged courses of antibiotics, but alongside these active treatments, palliation of symptoms such as pain is also a priority. A short case series of diabetic inpatients under the care of the Renal Medicine team with pyomyositis is presented, demonstrating that Hospital Palliative Care Teams may be well placed to provide symptom management advice by working jointly with the patient’s medical or surgical team. A review of the literature on the management of pain in pyomyositis is also presented, and there was no clear consensus on the best strategy. It may be that a combination of analgesics and adjuncts is the most effective strategy, perhaps combined with the holistic approach used within palliative care.

Keywords: pyomyositis, pain, palliation, analgesia

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10624 Unlocking Health Insights: Studying Data for Better Care

Authors: Valentina Marutyan

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Healthcare data mining is a rapidly developing field at the intersection of technology and medicine that has the potential to change our understanding and approach to providing healthcare. Healthcare and data mining is the process of examining huge amounts of data to extract useful information that can be applied in order to improve patient care, treatment effectiveness, and overall healthcare delivery. This field looks for patterns, trends, and correlations in a variety of healthcare datasets, such as electronic health records (EHRs), medical imaging, patient demographics, and treatment histories. To accomplish this, it uses advanced analytical approaches. Predictive analysis using historical patient data is a major area of interest in healthcare data mining. This enables doctors to get involved early to prevent problems or improve results for patients. It also assists in early disease detection and customized treatment planning for every person. Doctors can customize a patient's care by looking at their medical history, genetic profile, current and previous therapies. In this way, treatments can be more effective and have fewer negative consequences. Moreover, helping patients, it improves the efficiency of hospitals. It helps them determine the number of beds or doctors they require in regard to the number of patients they expect. In this project are used models like logistic regression, random forests, and neural networks for predicting diseases and analyzing medical images. Patients were helped by algorithms such as k-means, and connections between treatments and patient responses were identified by association rule mining. Time series techniques helped in resource management by predicting patient admissions. These methods improved healthcare decision-making and personalized treatment. Also, healthcare data mining must deal with difficulties such as bad data quality, privacy challenges, managing large and complicated datasets, ensuring the reliability of models, managing biases, limited data sharing, and regulatory compliance. Finally, secret code of data mining in healthcare helps medical professionals and hospitals make better decisions, treat patients more efficiently, and work more efficiently. It ultimately comes down to using data to improve treatment, make better choices, and simplify hospital operations for all patients.

Keywords: data mining, healthcare, big data, large amounts of data

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10623 The Relation between Vitamin C and Oral Health

Authors: Mai Ashraf Talaat

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Background: Vitamin C (ascorbic acid) is an essential nutrient for the development and repair of all body tissues. It can be obtained from a healthy diet or through supplementation. Due to its importance, vitamin C has become a mainstay in the treatment and prevention of many diseases and in maintaining immune, skin, bone and overall health. This review article aims to discuss the studies and case reports conducted to evaluate the effect of Vitamin C on oral health and the recent advances in oral medicine that involve the use of vitamin C. Data/Sources: The review was conducted for clinical studies, case reports and published literature in the English language that addresses this topic. An extensive search in the electronic databases of PubMed, PubMed Central, Web of Science, National Library of Medicine and ResearchGate was performed. Conclusion: Vitamin C is thought to treat periodontal diseases and gingival enlargement. It also affects biofilm formation and therefore, it helps in reducing caries incidence. Recently, vitamin C mesotherapy has been used to treat inflamed gingiva, bleeding gums and gingival hyperpigmentation. More research and randomized controlled trials are needed on this specific topic for more accurate judgment. Clinical significance: A minimally invasive approach - the usage of vitamin C in dental care could drastically reduce the need for surgical intervention.

Keywords: oral health, periodontology, vitamin C, Gingivitis

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10622 Constructing Optimized Criteria of Objective Assessment Indicators among Elderly Frailty

Authors: Shu-Ching Chiu, Shu-Fang Chang

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The World Health Organization (WHO) has been actively developing intervention programs to deal with geriatric frailty. In its White Paper on Healthcare Policy 2020, the Department of Health, Bureau of Health Promotion proposed that active aging and the prevention of disability are essential for elderly people to maintain good health. The paper recommended five main policies relevant to this objective, one of which is the prevention of frailty and disability. Scholars have proposed a number of different criteria to diagnose and assess frailty; no consistent or normative standard of measurement is currently available. In addition, many methods of assessment are recursive, which can easily result in recall bias. Due to the relationship between frailty and physical fitness with regard to co-morbidity, it is important that academics optimize the criteria used to assess frailty by objectively evaluating the physical fitness of senior citizens. This study used a review of the literature to identify fitness indicators suitable for measuring frailty in the elderly. This study recommends that measurement criteria be integrated to produce an optimized predictive value for frailty score. Healthcare professionals could use this data to detect frailty at an early stage and provide appropriate care to prevent further debilitation and increase longevity.

Keywords: frailty, aging, physical fitness, optimized criteria, healthcare

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10621 Jail Reentry in Rural America: A Quasi-Experimental Examination of a Rural Behavioral Health Reentry Program

Authors: Debra L. Stanley, Gabriela Wasileski

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Offenders face many challenges as they transition from being incarcerated to the community, ranging from housing and employment needs to long standing problems with addictions and mental health issues. A lack of appropriate behavioral health services in the more remote parts of the United States has led to a significant illegal substance abuse problem, housing instability, and unaddressed mental health and trauma issues. High rates of poverty and unemployment exacerbate the growing behavioral health issues, drug overdoses, co-occurring disorders, and crime that are so prevalent across rural communities. This study examines the challenges of rural jail reentry faced by offenders in a treatment capacity. The client-centered evidence-based program is uniquely designed to provide continuity of care that focuses on issues which affect rural communities. Prior to release from jail, individuals go through comprehensive assessment screenings to measure mental health and substance use disorder as well as trauma and prior crime victimization histories; the assessments help to target client-specific services. The quasi-experimental research design tracks clients throughout their recovery and reintegration into the community. Individuals in a rural program often do not have the benefit of easy access or peer mentoring that is so often found in urban recovery programs. Therefore, much of the support is provided through telehealth and e-services. The goal of this study is to explore the nature of rural reentry programs and measures of recidivism, drug overdoses, and other behavioral health needs and successful reentry to include stable housing and employment.

Keywords: jail reentry, rehabilitation, behavioral health, drug abuse, recidivism

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10620 Retrospective Study of Bronchial Secretions Cultures Carried out in the Microbiology Department of General Hospital of Ioannina in 2017

Authors: S. Mantzoukis, M. Gerasimou, P. Christodoulou, N. Varsamis, G. Kolliopoulou, N. Zotos

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Purpose: Patients in Intensive Care Units (ICU) are exposed to a different spectrum of microorganisms relative to the hospital. Due to the fact that the majority of these patients are intubated, bronchial secretions should be examined. Material and Method: Bronchial secretions should be taken with care so as not to be mixed with sputum or saliva. The bronchial secretions are placed in a sterile container and then inoculated into blood, Mac Conkey No2, Chocolate, Mueller Hinton, Chapman and Saboureaud agar. After this period, if any number of microbial colonies are detected, gram staining is performed and then the isolated organisms are identified by biochemical techniques in the automated Microscan system (Siemens) followed by a sensitivity test in the same system using the minimum inhibitory concentration MIC technique. The sensitivity test is verified by a Kirby Bauer test. Results: In 2017 the Laboratory of Microbiology received 365 samples of bronchial secretions from the Intensive Care Unit. 237 were found positive. S. epidermidis was identified in 1 specimen, A. baumannii in 60, K. pneumoniae in 42, P. aeruginosa in 50, C. albicans in 40, P. mirabilis in 4, E. coli in 4, S. maltophilia in 6, S. marcescens in 6, S. aureus in 12, S. pneumoniae in 1, S. haemolyticus in 4, P. fluorescens in 1, E. aerogenes in 1, E. cloacae in 5. Conclusions: The majority of ICU patients appear to be a fertile ground for the development of infections. The nature of the findings suggests that a significant part of the bacteria found comes from the unit (nosocomial infection).

Keywords: bronchial secretions, cultures, infections, intensive care units

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10619 Telemedicine for Substance-Related Disorders: A Patient Satisfaction Survey among Individuals in Argentina

Authors: Badino Manuel, Farias Maria Alejandra

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Telemedicine (TM) has the potential to develop efficient and cost-effective means for delivering quality health care services and outcomes, showing equal or, in some cases, better results than in-person treatment. To analyze patient satisfaction with the use of TM becomes relevant because this can affect the results of treatment and the adherence to it. The aim is to assess patient satisfaction with telemedicine for treating substance-related disorders in a mental health service in Córdoba, Argentina. A descriptive cross-sectional study was conducted among patients with substance-related disorders (N=115). A patient satisfaction survey was conducted from December 2021 to March 2022. For a total of 115 participants, 59,1% were male, 38,3% were female and 2,6% non-binary. In relation to educational status, 40% finished university, 39,1% high school, and 20,9 % only primary school. Regarding age, 4,3 % were young, 92,2% were adults, and 3,5% were elderly. Regarding TM treatment, 95,7% reported being satisfied. Furthermore, 85,2% of users declared that they would continueTM treatment, and 14,8% said that they would not resume TM treatment. To conclude, high levels of patient satisfaction contributes to the continuity of TM modality.

Keywords: telemedicine, mental health, substance-related disorders, patient satisfaction

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10618 Factors Influencing Telehealth Services for Diabetes Care in Nepal: A Mixed Method Study

Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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10617 Online Teacher Professional Development: An Extension of the Unified Theory of Acceptance and Use of Technology Model

Authors: Lovemore Motsi

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The rapid pace of technological innovation, along with a global fascination with the internet, continues to result in a dominating call to integrate internet technologies in institutions of learning. However, the pressing question remains – how can online in-service training for teachers, support quality and success in professional development programmers. The aim of this study was to examine an integrated model that extended the Unified Theory of Acceptance and Use of Technology (UTAUT) with additional constructs – including attitude and behaviour intention – adopted from the Theory of Planned Behaviour (TPB) to answer the question. Data was collected from secondary school teachers at 10 selected schools in the Tshwane South district by means of the Statistical Package for Social Scientists (SPSS v 23.0), and the collected data was analysed quantitatively. The findings are congruent with model testing under conditions of volitional usage behaviour. In this regard, the role of facilitating condition variables is insignificant as a determinant of usage behaviour. Social norm variables also proved to be a weak determinant of behavioural intentions. Findings demonstrate that effort expectancy is the key determinant of online INSET usage. Based on these findings, the variable social influence and facilitating conditions are important factors in ensuring the acceptance of online INSET among teachers in selected secondary schools in the Tshwane South district.

Keywords: unified theory of acceptance and use of technology (UTAUT), teacher professional development, secondary schools, online INSET

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10616 Psychopathy Evaluation for People with Intellectual Disability Living in Institute Using Chinese Version of the Psychopathology Inventory

Authors: Lin Fu-Gong

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Background: As WHO announced, people with intellectual disability (ID) were vulnerable to mental health problems. And there were few custom-made mental health scales for those people to monitor their mental health. Those people with mental problems often accompanied worse prognosis and usually became to be a heavier burden on the caregivers. Purpose: In this study, we intend to develop a psychopathy scale as a practical tool for monitoring the mental health for people with ID living in institute. Methods: In this study, we adopt the Psychopathology Inventory for Mentally Retarded Adults developed by professor Matson with certified reliability and validity in Western countries with Dr. Matson’s agreement in advance. We first translated the inventory into Chinese validated version considering the domestic culture background in the past year. And the validity and reliability evaluation of mental health status using this inventory among the people with intellectual living in the institute were done. Results: The inventory includes eight psychiatric disorder scales as schizophrenic, affective, psychosexual, adjustment, anxiety, somatoform, personality disorders and inappropriate mental adjustment. Around 83% of 40 invested people, who randomly selected from the institute, were found to have at least one disorder who were recommended with medical help by two evaluators. Among the residents examined, somatoform disorder and inappropriate mental adjustment were most popular with 60% and 78% people respectively. Conclusion: The result showed the prevalence psychiatric disorders were relatively high among people with ID in institute and the mental problems need to be further cared and followed for their mental health. The results showed that the psychopathology inventory was a useful tool for institute caregiver, manager and for long-term care policy to the government. In the coming stage, we plan to extend the use of the valid Chinese version inventory among more different type institutes for people with ID to establish their dynamic mental health status including medical need, relapse and rehabilitation to promote their mental health.

Keywords: intellectual disability, psychiatric disorder, psychopathology inventory, mental health, the institute

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10615 Vocabulary Paradigm in Learning Romanian As a Foreign Language

Authors: Georgiana Ciobotaru

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The vocabulary that foreign students assimilate once they start studying the Romanian language must allow them to develop the linguistic competence of oral and written expression, but also the intercultural one, necessary for their integration into the new socio-cultural environment. Therefore, the familiarization courses with Romanian as a foreign language aim at fundamental language acquisitions in order to obtain the expected level of Romanian language. They also relate differently to the new culture and the new language they come in contact with, having a distinct way of expressing themselves. Foreign students want to continue their university and postgraduate studies at specialized faculties in the country; therefore, they need both a general language for their integration into society and for interaction with others, Romanians or students from countries other than their own, but also from a specialized language that facilitates didactic communication and professional development. The complexity of the vocabulary must thus cover the daily communication needs, but also the subsequent evolution of each one. This paper aims to illustrate the most important semantic fields that students must assimilate in order to crystallize a linguistic identity in the new context of their personal and professional development and to help them cope with the culture shock.

Keywords: integration, intercultural, language, linguistic, vocabulary

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10614 Schooling Culture in Egyptian Public Schools: Reform in Professional Development for Equity and hope in Education

Authors: Nora El-Bilawia

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This paper discovers the challenges and/or opportunities to implementing multiple intelligence (MI) practices in English as foreign language (EFL) classrooms at Egyptian public schools as part of the government’s educational reform plan. It is found that Egyptian EFL teachers value the use of MI’s ways of teaching as means for active and higher order thinking. However, teachers believed they were underprivileged, as the government did not provide appropriate trainings, tools, or means to integrate MI in their daily lessons. They also conferred challenges they face due to some Egyptian schooling cultural practices. At the end of this chapter, a proposed need for a paradigm shift in the schooling culture in Egypt to implement practical changes in schools to promote hope in education such as the use of MI teaching tools. This study promotes cross-cultural understanding of educational opportunities and efforts for equal learning outcomes around the globe.

Keywords: professional development, schooling culture, acculturation, equitable education

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10613 Health Belief Model on Smoking Behaviors Causing Lung Cancer: A Cross-Sectional Study in Thailand

Authors: Dujrudee Chinwong, Chanida Prompantakorn, Ubonphan Chaichana, Surarong Chinwong

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Objective: Understanding the university students’ perceptions on smoking caused lung cancer based on the Health Belief Model should help health care providers in assisting them to quit smoking. Thus, this study aimed to investigate the University students’ health belief in smoking behaviors caused lung cancer, which based on the Health Belief Model. Methods: Data were collected from voluntary participants using a self-administered questionnaire. Participants were students studying at a University in northern Thailand who were current smokers; they were selected using snowball sampling. Results: Of 361 students, 84% were males; 78% smoked not more than 10 cigarettes a day; 68% intended to quit smoking. Our findings, based on the health belief model, showed that 1) perceived susceptibility: participants strongly believed that if they did not stop smoking, they were at high risk of lung cancer (88%); 2) perceived severity: they strongly believed that they had a high chance of death from lung cancer if they continued smoking (84%); 3) perceived benefits: they strongly believed that quitting smoking could reduce the chance of developing lung cancer; 4) perceived barriers of quitting smoking: they strongly believed in the difficulty of quitting smoking because it needed a high effort and strong intention (69%); 5) perceived self-efficacy: however, they strongly believed that they can quit smoking right away if they had a strong intention to quit smoking (70%); 6) cues to action: they strongly believed in the support of parents (85%) and lovers (78%) in helping them to quit smoking. Further, they believed that limitation on smoking area in the University and smoking cessation services provided by the University can assist them to quit smoking. Conclusion: The Health Belief Model helps us to understand students’ smoking behaviors caused lung cancer. This could lead to designing a smoking cessation program to assist students to quit smoking.

Keywords: health belief model, lung cancer, smoking, Thailand

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10612 Factors Determining Selection of Essential Nutrition Supplements

Authors: Daniel C. S. Lim

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There are numerous nutritional supplements, such as multivitamins and nutrition drinks, in the market today. Many of these supplements are expensive and tend to be driven commercially by business decisions and big marketing budgets. Many of the costs are ultimately borne by the end user in the quest for keeping to a healthy lifestyle. This paper proposes a system with a list of ten determinants to gauge how to decide the value of various supplements. It suggests variables such as composition, safety, efficacy and bioavailability, as well as several other considerations. These guidelines can help to tackle many of the issues that people of all ages face in the way that they receive essential nutrients. The system also aims to promote and improve the safety and choice of foods and supplements. In so doing, the system aims to promote the individual’s or population’s control over their own health and reduce the growing health care burden on the society.

Keywords: choice of foods and supplements, essential nutrients, nutritional supplements, system safety

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10611 Artificial Intelligence Based Online Monitoring System for Cardiac Patient

Authors: Syed Qasim Gilani, Muhammad Umair, Muhammad Noman, Syed Bilawal Shah, Aqib Abbasi, Muhammad Waheed

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Cardiovascular Diseases(CVD's) are the major cause of death in the world. The main reason for these deaths is the unavailability of first aid for heart failure. In many cases, patients die before reaching the hospital. We in this paper are presenting innovative online health service for Cardiac Patients. The proposed online health system has two ends. Users through device developed by us can communicate with their doctor through a mobile application. This interface provides them with first aid.Also by using this service, they have an easy interface with their doctors for attaining medical advice. According to the proposed system, we developed a device called Cardiac Care. Cardiac Care is a portable device which a patient can use at their home for monitoring heart condition. When a patient checks his/her heart condition, Electrocardiogram (ECG), Blood Pressure(BP), Temperature are sent to the central database. The severity of patients condition is checked using Artificial Intelligence Algorithm at the database. If the patient is suffering from the minor problem, our algorithm will suggest a prescription for patients. But if patient's condition is severe, patients record is sent to doctor through the mobile Android application. Doctor after reviewing patients condition suggests next step. If a doctor identifies the patient condition as critical, then the message is sent to the central database for sending an ambulance for the patient. Ambulance starts moving towards patient for bringing him/her to hospital. We have implemented this model at prototype level. This model will be life-saving for millions of people around the globe. According to this proposed model patients will be in contact with their doctors all the time.

Keywords: cardiovascular disease, classification, electrocardiogram, blood pressure

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10610 Reflective and Collaborative Professional Development Program in Secondary Education to Improve Student’s Oral Language

Authors: Marta Gràcia, Ana Luisa Adam-Alcocer, Jesús M. Alvarado, Verónica Quezada, Tere Zarza, Priscila Garza

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In secondary education, integrating linguistic content and reflection on it is a crucial challenge that should be included in course plans to enhance students' oral communication competence. In secondary education classrooms, a continuum can be identified in relation to teaching methodologies: 1) the traditional teacher-dominated transmission approach, which is described as that in which teachers transmit content to students unidirectionally; 2) dialogical, bidirectional teaching approach that encourages students to adopt a critical vision of the information provided by the teacher or that is generated through students’ discussion. In this context, the EVALOE-DSS (Assessment Scale of Oral Language Teaching in the School Context-Decision Support System) digital instrument has emerged to help teachers in transforming their classes into spaces for communication, dialogue, reflection, evaluation of the learning process, teaching linguistic contents, and to develop curricular competencies. The tool includes various resources, such as a tutorial with the objectives and an initial screen for teachers to describe the class to be evaluated. One of the main resources of the digital instrument consists of 30 items-actions with three qualitative response options (green, orange, and red face emoji) grouped in five dimensions. In the context of the participation of secondary education teachers in a professional development program using EVALOE-DSS, a digital tool resource aimed to generate more participatory, interactive, dialogic classes, the objectives of the study were: 1) understanding the changes in classrooms’ dynamics and in the teachers’ strategies during their participation in the professional developmental program; 2) analyzing the impact of these changes in students’ oral language development according to their teachers; 3) Deeping on the impact of these changes in the students’ assessment of the classes and the self-assessment of oral competence; 4) knowing teachers’ assessment and reflections about their participation in the professional developmental program. Participants were ten teachers of different subjects and 250 students of secondary education (16-18 years) schools in Spain. The principal instrument used was the digital tool EVALOE-DSS. For 6 months, teachers used the digital tool to reflect on their classes, assess them (their actions and their students’ actions), make decisions, and introduce changes in their classes to be more participatory, interactive, and reflective about linguistic contents. Other collecting data instruments and techniques used during the study were: 1) a questionnaire to assess students’ oral language competence before and at the end of the study, 2) a questionnaire for students’ assessment of the characteristics of classes, 3) teachers’ meetings during the professional developmental program to reflect collaboratively on their experience, 4) questionnaire to assess teacher’s experience during their participation in the professional developmental program, 5) focus group meetings between the teachers and two researchers at the end of the study. The results showed relevant changes in teaching strategies, in the dynamics of the classes, which were more interactive, participative, dialogic and self-managed by the students. Both teachers and students agree about the progressive classes’ transformation into spaces for communication, discussion, and reflection on the language, its development, and its use as an essential instrument to develop curricular competencies.

Keywords: digital tool, individual and collaborative reflection, oral language competence, professional development program, secondary education

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10609 Defining the Push and Pull Factors to Adopt Health Information Technologies by Health Entrepreneurs

Authors: Elaheh Ezami, Behzad Mohammadian, Elham Aznab

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Health service design will need to change due to bringing in new digital health tools. This highlights the importance of innovation in adopting Health Information Technology (HIT). It can be argued that innovation in the health sector correlates with entrepreneurship. Various reasons exist for health entrepreneurs to advocate increased investment in HIT to compensate for shortcomings in the health sector and improve the quality of healthcare. Furthermore, every innovative program presents challenges and motivations for entrepreneurs that may distract or encourage the adoption of technology. Our study used a systematic literature review to identify relevant articles that defined the frustrations and promotions of using health information technology in organizations or enterprises. A meta-analysis of the articles was conducted to identify the factors driving or pulling entrepreneurs to use HIT.

Keywords: health information technology, health entrepreneurship, health enterprise, health entrepreneurs' innovation

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10608 Improving the Uptake of Community-Based Multidrug-Resistant Tuberculosis Treatment Model in Nigeria

Authors: A. Abubakar, A. Parsa, S. Walker

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Despite advances made in the diagnosis and management of drug-sensitive tuberculosis (TB) over the past decades, treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging and complex particularly in high burden countries including Nigeria. Treatment of MDR-TB is cost-prohibitive with success rate generally lower compared to drug-sensitive TB and if care is not taken it may become the dominant form of TB in future with many treatment uncertainties and substantial morbidity and mortality. Addressing these challenges requires collaborative efforts thorough sustained researches to evaluate the current treatment guidelines, particularly in high burden countries and prevent progression of resistance. To our best knowledge, there has been no research exploring the acceptability, effectiveness, and cost-effectiveness of community-based-MDR-TB treatment model in Nigeria, which is among the high burden countries. The previous similar qualitative study looks at the home-based management of MDR-TB in rural Uganda. This research aimed to explore patient’s views and acceptability of community-based-MDR-TB treatment model and to evaluate and compare the effectiveness and cost-effectiveness of community-based versus hospital-based MDR-TB treatment model of care from the Nigerian perspective. Knowledge of patient’s views and acceptability of community-based-MDR-TB treatment approach would help in designing future treatment recommendations and in health policymaking. Accordingly, knowledge of effectiveness and cost-effectiveness are part of the evidence needed to inform a decision about whether and how to scale up MDR-TB treatment, particularly in a poor resource setting with limited knowledge of TB. Mixed methods using qualitative and quantitative approach were employed. Qualitative data were obtained using in-depth semi-structured interviews with 21 MDR-TB patients in Nigeria to explore their views and acceptability of community-based MDR-TB treatment model. Qualitative data collection followed an iterative process which allowed adaptation of topic guides until data saturation. In-depth interviews were analyzed using thematic analysis. Quantitative data on treatment outcomes were obtained from medical records of MDR-TB patients to determine the effectiveness and direct and indirect costs were obtained from the patients using validated questionnaire and health system costs from the donor agencies to determine the cost-effectiveness difference between community and hospital-based model from the Nigerian perspective. Findings: Some themes have emerged from the patient’s perspectives indicating preference and high acceptability of community-based-MDR-TB treatment model by the patients and mixed feelings about the risk of MDR-TB transmission within the community due to poor infection control. The result of the modeling from the quantitative data is still on course. Community-based MDR-TB care was seen as the acceptable and most preferred model of care by the majority of the participants because of its convenience which in turn enhanced recovery, enables social interaction and offer more psychosocial benefits as well as averted productivity loss. However, there is a need to strengthen this model of care thorough enhanced strategies that ensure guidelines compliance and infection control in order to prevent the progression of resistance and curtail community transmission.

Keywords: acceptability, cost-effectiveness, multidrug-resistant TB treatment, community and hospital approach

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10607 Health Advocacy in Medical School: An American Survey on Attitudes and Engagement in Clerkships

Authors: Rachel S. Chang, Samuel P. Massion, Alan Z. Grusky, Heather A. Ridinger

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Introduction Health advocacy is defined as activities that improve access to care, utilize resources, address health disparities, and influence health policy. Advocacy is increasingly being recognized as a critical component of a physician’s role, as understanding social determinants of health and improving patient care are important aspects within the American Medical Association’s Health Systems Science framework. However, despite this growing prominence, educational interventions that address advocacy topics are limited and variable across medical school curricula. Furthermore, few recent studies have evaluated attitudes toward health advocacy among physicians-in-training in the United States. This study examines medical student attitudes towards health advocacy, along with perceived knowledge, ability, and current level of engagement with health advocacy during their clerkships. Methods This study employed a cross-sectional survey design using a single anonymous, self-report questionnaire to all second-year medical students at Vanderbilt University School of Medicine (n=96) in December 2020 during clerkship rotations. The survey had 27 items with 5-point Likert scale (15), multiple choice (11), and free response questions (1). Descriptive statistics and thematic analysis were utilized to analyze responses. The study was approved by the Vanderbilt University Institutional Review Board. Results There was an 88% response rate among second-year clerkship medical students. A majority (83%) agreed that formal training in health advocacy should be a mandatory part of the medical student curriculum Likewise, 83% of respondents felt that acting as a health advocate or patients should be part of their role as a clerkship student. However, a minority (25%) felt adequately prepared. While 72% of respondents felt able to identify a psychosocial need, 18% felt confident navigating the healthcare system and only 9% felt able to connect a patient to a psychosocial resource to fill that gap. 44% of respondents regularly contributed to conversations with their medical teams when discussing patients’ social needs, such as housing insecurity, financial insecurity, or legal needs. On average, respondents reported successfully connecting patients to psychosocial resources 1-2 times per 8-week clerkship block. Barriers to participating in health advocacy included perceived time constraints, lack of awareness of resources, lower emphasis among medical teams, and scarce involvement with social work teams. Conclusions In this single-institutional study, second-year medical students on clerkships recognize the importance of advocating for patients and support advocacy training within their medical school curriculum. However, their perceived lack of ability to navigate the healthcare system and connect patients to psychosocial resources, result in students feeling unprepared to advocate as effectively as they hoped during their clerkship rotations. Our results support the ongoing need to equip medical students with training and resources necessary for them to effectively act as advocates for patients.

Keywords: clerkships, medical students, patient advocacy, social medicine

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10606 The Kindergarten as a Multicultural Workplace

Authors: Monika Haanpää

Abstract:

Well-functioning workplaces are often characterized by good co-operation, adequate flow of information, open interaction between workers and a supportive work environment. The workplace is a mosaic of human personalities and the influx of people, who speak different languages and who are from different cultural backgrounds, may bring about new challenges and enrich this environment. However, this influx of people could also pose a problem as the adaptation of immigrant people to new terms of work may depend heavily on the level of language skills, the stage of culture shock, professional identity, and personality. Migration is not a rare phenomenon in Finland anymore; nobody is surprised to see people from different countries and different backgrounds in the schools, on the streets or in shops. However, this does not mean that immigration is an easy process for people coming from other countries. The experience of workers, with diverse language and backgrounds, has rarely been researched, particularly from the superior's point of view. In addition, the vast majority of researchers have paid more attention to multicultural kindergartens in terms of immigrant children and their families. Hence, there is a need to show the problem which exists in the recruitment of the increasing number of workers who come from different countries. Opinions about kindergartens, as multicultural workplaces, have been gathered through interviews with immigrant workers responsible for education. In addition, a questionnaire for native Finnish workers and superiors in kindergartens was carried out. The collected material has been analyzed qualitatively, focusing on topics such as: the kindergarten as a multicultural workplace, factors influencing career success of workers with diverse language and cultural backgrounds, the social relations in the multicultural workplaces and teachers’ changing professional identity. The results of the research provided a novel aspect of the multicultural workplace and emphasized a dependency of immigrant workers’ on language skills in Finnish; affecting professional success. In addition, they showed the good relations between other native Finnish co-workers and superiors. The results also illustrate why writing skills in Finnish are so important in kindergartens. Part of the investigation also questions some results of the research i.e. which is more important in the kindergarten as a multicultural workplace: personality, good professional skills or good language skills.

Keywords: kindergarten, multicultural workplace, social relations at work, work satisfaction

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10605 Personalized Intervention through Causal Inference in mHealth

Authors: Anna Guitart Atienza, Ana Fernández del Río, Madhav Nekkar, Jelena Ljubicic, África Periáñez, Eura Shin, Lauren Bellhouse

Abstract:

The use of digital devices in healthcare or mobile health (mHealth) has increased in recent years due to the advances in digital technology, making it possible to nudge healthy behaviors through individual interventions. In addition, mHealth is becoming essential in poor-resource settings due to the widespread use of smartphones in areas where access to professional healthcare is limited. In this work, we evaluate mHealth interventions in low-income countries with a focus on causal inference. Counterfactuals estimation and other causal computations are key to determining intervention success and assisting in empirical decision-making. Our main purpose is to personalize treatment recommendations and triage patients at the individual level in order to maximize the entire intervention's impact on the desired outcome. For this study, collected data includes mHealth individual logs from front-line healthcare workers, electronic health records (EHR), and external variables data such as environmental, demographic, and geolocation information.

Keywords: causal inference, mHealth, intervention, personalization

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10604 The Effect of 'Teachers Teaching Teachers' Professional Development Course on Teachers’ Achievement and Classroom Practices

Authors: Nuri Balta, Ali Eryilmaz

Abstract:

High-quality teachers are the key to improve student learning. Without a professional development of the teachers, the improvement of student success is difficult and incomplete. This study offers an in-service training course model for professional development of teachers (PD) entitled "teachers teaching teachers" (TTT). The basic premise of the PD program, designed for this study, was primarily aimed to increase the subject matter knowledge of high school physics teachers. The TTT course (the three hour long workshops), organized for this study, lasted for seven weeks with seventeen teachers took part in the TTT program at different amounts. In this study, the effect of the TTT program on teachers’ knowledge improvement was searched through the modern physics unit (MPU). The participating teachers taught the unit to one of their grade ten classes earlier, and they taught another equivalent class two months later. They were observed in their classes both before and after TTT program. The teachers were divided into placebo and the treatment groups. The aim of Solomon four-group design is an attempt to eliminate the possible effect of pre-test. However, in this study the similar design was used to eliminate the effect of pre teaching. The placebo group teachers taught their both classes as regular and the treatment group teachers had TTT program between the two teachings. The class observation results showed that the TTT program increased teachers’ knowledge and skills in teaching MPU. Further, participating in the TTT program caused teachers to teach the MPU in accordance with the requirements of the curriculum. In order to see any change in participating teachers’ success, an achievement test was applied to them. A large effect size (dCohen=.93) was calculated for the effect of TTT program on treatment group teachers’ achievement. The results suggest that staff developers should consider including topics, attractive to teachers, in-service training programs (a) to help teachers’ practice teaching the new topics (b) to increase the participation rate. During the conduction of the TTT courses, it was observed that teachers could not end some discussions and explain some concepts. It is now clear that teachers need support, especially when discussing counterintuitive concepts such as modern physics concepts. For this reason it is recommended that content focused PD programs be conducted at the helm of a scholarly coach.

Keywords: high school physics, in-service training course, modern physics unit, teacher professional development

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10603 Family Treatment Drug Court Cost Analysis: An In-depth Look At The Cost And Savings Of A Southeastern Family Treatment Drug Court

Authors: Ashley R. Logsdon, Becky F. Antle, Cynthia M. Kamer

Abstract:

This study examines the cost and benefits of a family treatment drug court in an urban county in a southeastern state. Additionally, this cost analysis will provide a detailed description of the type and cost of activities to produce the services provided to child welfare families. This study utilized return-on-investment analysis, which uses child welfare practices, disaggregates them into separate activities and estimates costs for these activities including child-level placement data for total cost of care for the child. Direct and indirect costs were considered as well as saving calculations what costs would be associated with child welfare outcomes both short and long term. The costs included were general program costs (salaries, drug screens, transportation, childcare, parent education, program evaluation, visitation, incentives) or personnel costs for other team members (judges, court administrators, child welfare workers, child welfare supervisors, and community mental health provider). The savings that were used in the study were length of time in out of home care, Medicaid costs, substance exposed births, emergency room utilization and jail/probation costs. This study documents an overall savings of between $168,993.30 and $837,993.30. The total savings per family divided by the 40 families who have participated in the program was between $4,224.83 to $20,949.83 per family. The results of this cost benefit analysis are consistent with prior research documenting savings associated with out of home care and jail/probation; however, there are also unique contributions of this study to the literature on cost effectiveness of family treatment drug courts. We will present recommendations for further utilization of family treatment drug courts and how to expand the current model.

Keywords: child welfare, cost analysis, family drug court, family treatment drug court

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10602 The Accuracy of Measures for Screening Adults for Spiritual Suffering in Health Care Settings: A Systematic Review

Authors: Sayna Bahraini, Wendy Gifford, Ian Graham, Liquaa Wazni, Suzettee Bremault-Phillips, Rebekah Hackbusch, Catrine Demers, Mary Egan

Abstract:

Objective: Guidelines for palliative and spiritual care emphasize the importance of screening patients for spiritual suffering. The aim of this review was to synthesize the research evidence on the accuracy of measures used to screen adults for spiritual suffering. Methods: A systematic review has been conducted. We searched five scientific databases to identify relevant articles. Two independent reviewers screened extracted data and assessed study methodological quality. Results: We identified five articles that yielded information on 24 spiritual screening measures. Among all identified measures, the 2-item Meaning/Joy & Self-Described Struggle has the highest sensitivity (82-87%), and the revised Rush protocol has the highest specificity (81-90%). The methodological quality of all included studies was low. Significance of Results: While most of the identified spiritual screening measures are brief (comprise 1 to 12 number of items), few have sufficient accuracy to effectively screen patients for spiritual suffering. We advise clinicians to use their critical appraisal skills and clinical judgment when selecting and using any of the identified measures to screen for spiritual suffering.

Keywords: screening, suffering, spirituality, diagnostic test accuracy, systematic review

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10601 'The Network' - Cradle to Cradle Engagement Framework for Women in STEM

Authors: Jessica Liqin Kong

Abstract:

Female engineers and scientists face unique challenges in their careers that make the development of professional networks crucial, but also more difficult. Working to overcome these challenges, ‘The Network’ was established in 2013 at the Queensland University of Technology (QUT) in Australia as an alumni chapter with the purpose of evoking continuous positive change for female participation and retention in science, technology, engineering and mathematics (STEM). ‘The Network’ adopts an innovative model for a Women in STEM alumni chapter which was inspired by the cradle to cradle approach to engagement, and the concept of growing and harvesting individual and collective social capital through a variety of initiatives. ‘The Network’ fosters an environment where the values exchanged in social and professional relationships can be capitalized for both current and future women in STEM. The model of ‘The Network’ acts as a simulation and opportunity for participants to further develop their leadership and other soft skills through learning, building and experimenting with ‘The Network’.

Keywords: women in STEM, engagement, Cradle-to-Cradle, social capital

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10600 Northern Nigeria Vaccine Direct Delivery System

Authors: Evelyn Castle, Adam Thompson

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Background: In 2013, the Kano State Primary Health Care Management Board redesigned its Routine immunization supply chain from diffused pull to direct delivery push. It addressed issues around stockouts and reduced time spent by health facility staff collecting, and reporting on vaccine usage. The health care board sought the help of a 3PL for twice-monthly deliveries from its cold store to 484 facilities across 44 local governments. eHA’s Health Delivery Systems group formed a 3PL to serve 326 of these new facilities in partnership with the State. We focused on designing and implementing a technology system throughout. Basic methodologies: GIS Mapping: - Planning the delivery of vaccines to hundreds of health facilities requires detailed route planning for delivery vehicles. Mapping the road networks across Kano and Bauchi with a custom routing tool provided information for the optimization of deliveries. Reducing the number of kilometers driven each round by 20%, - reducing cost and delivery time. Direct Delivery Information System: - Vaccine Direct Deliveries are facilitated through pre-round planning (driven by health facility database, extensive GIS, and inventory workflow rules), manager and driver control panel customizing delivery routines and reporting, progress dashboard, schedules/routes, packing lists, delivery reports, and driver data collection applications. Move: Last Mile Logistics Management System: - MOVE has improved vaccine supply information management to be timely, accurate and actionable. Provides stock management workflow support, alerts management for cold chain exceptions/stock outs, and on-device analytics for health and supply chain staff. Software was built to be offline-first with user-validated interface and experience. Deployed to hundreds of vaccine storage site the improved information tools helps facilitate the process of system redesign and change management. Findings: - Stock-outs reduced from 90% to 33% - Redesigned current health systems and managing vaccine supply for 68% of Kano’s wards. - Near real time reporting and data availability to track stock. - Paperwork burdens of health staff have been dramatically reduced. - Medicine available when the community needs it. - Consistent vaccination dates for children under one to prevent polio, yellow fever, tetanus. - Higher immunization rates = Lower infection rates. - Hundreds of millions of Naira worth of vaccines successfully transported. - Fortnightly service to 326 facilities in 326 wards across 30 Local Government areas. - 6,031 cumulative deliveries. - Over 3.44 million doses transported. - Minimum travel distance covered in a round of delivery is 2000 kms & maximum of 6297 kms. - 153,409 kms travelled by 6 drivers. - 500 facilities in 326 wards. - Data captured and synchronized for the first time. - Data driven decision making now possible. Conclusion: eHA’s Vaccine Direct delivery has met challenges in Kano and Bauchi State and provided a reliable delivery service of vaccinations that ensure t health facilities can run vaccination clinics for children under one. eHA uses innovative technology that delivers vaccines from Northern Nigerian zonal stores straight to healthcare facilities. Helped healthcare workers spend less time managing supplies and more time delivering care, and will be rolled out nationally across Nigeria.

Keywords: direct delivery information system, health delivery system, GIS mapping, Northern Nigeria, vaccines

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10599 Teaching Neuroscience from Neuroscience: an Approach Based on the Allosteric Learning Model, Pathfinder Associative Networks and Teacher Professional Knowledge

Authors: Freddy Rodriguez Saza, Erika Sanabria, Jair Tibana

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Currently, the important role of neurosciences in the professional training of the physical educator is known, highlighting in the teaching-learning process aspects such as the nervous structures involved in the adjustment of posture and movement, the neurophysiology of locomotion, the process of nerve impulse transmission, and the relationship between physical activity, learning, and cognition. The teaching-learning process of neurosciences is complex, due to the breadth of the contents, the diversity of teaching contexts required, and the demanding ability to relate concepts from different disciplines, necessary for the correct understanding of the function of the nervous system. This text presents the results of the application of a didactic environment based on the Allosteric Learning Model in morphophysiology students of the Faculty of Military Physical Education, Military School of Cadets of the Colombian Army (Bogotá, Colombia). The research focused then, on analyzing the change in the cognitive structure of the students on neurosciences. Methodology. [1] The predominant learning styles were identified. [2] Students' cognitive structure, core concepts, and threshold concepts were analyzed through the construction of Pathfinder Associative Networks. [3] Didactic Units in Neuroscience were designed to favor metacognition, the development of Executive Functions (working memory, cognitive flexibility, and inhibitory control) that led students to recognize their errors and conceptual distortions and to overcome them. [4] The Teacher's Professional Knowledge and the role of the assessment strategies applied were taken into account, taking into account the perspective of the Dynamizer, Obstacle, and Questioning axes. In conclusion, the study found that physical education students achieved significant learning in neuroscience, favored by the development of executive functions and by didactic environments oriented with the predominant learning styles and focused on increasing cognitive networks and overcoming difficulties, neuromyths and neurophobia.

Keywords: allosteric learning model, military physical education, neurosciences, pathfinder associative networks, teacher professional knowledge

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10598 The Impact of an Educational Program on Knowledge, Attitude and Practices of Healthcare Professionals towards Family Presence during Resuscitation in an Emergency Department at a Tertiary Care Setting, in Karachi, Pakistan

Authors: Shaista Meghani, Rozina Karmaliani, Khairulnissa Ajani, Shireen Shahzad, Nadeem Ullah Khan

Abstract:

Background: The concept of Family Presence During Resuscitation (FPDR) is gradually gaining recognition in western countries, however, it is rarely considered in South Asian countries including Pakistan. Over time, patients’ and families’ rights have gained recognition and healthcare has progressed to become more patient-family centered. Objectives: The objective of this study was to evaluate the impact of an educational program on the Knowledge, Attitude, and Practices (KAP) of healthcare professionals (HCPs) towards FPDR in Emergency Department (ED), at a tertiary care setting, in Karachi, Pakistan. Methods: This was a Pre-test and Post-test study design. A convenient universal sampling was done, and all ED nurses and physicians with more than one year of experience were eligible. The intervention included one-hour training sessions for physicians (three sessions) and nurses (eight sessions), The KAP of nurses and physicians were assessed immediately after (post-test I), and two weeks(post-test II) after the intervention using a pretested questionnaire. Results: The findings of the study revealed that the mean scores of knowledge and attitude of HCPs at both time points were statistically significant (p-value=<0.001), however, an insignificant difference was found on practice of FPDR (p-value=>0.05). Conclusion: The study findings recommend that the educational program on FPDR for HCPs needs to be offered on an ongoing basis. Moreover, training modules need to be developed for the staff, and formal guidelines need to be proposed for FPDR, through a multidisciplinary team approach.

Keywords: family presence, cardiopulmonary resuscitation, attitude, education, practices, health care professionals

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10597 Regulation on the Protection of Personal Data Versus Quality Data Assurance in the Healthcare System Case Report

Authors: Elizabeta Krstić Vukelja

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Digitization of personal data is a consequence of the development of information and communication technologies that create a new work environment with many advantages and challenges, but also potential threats to privacy and personal data protection. Regulation (EU) 2016/679 of the European Parliament and of the Council is becoming a law and obligation that should address the issues of personal data protection and information security. The existence of the Regulation leads to the conclusion that national legislation in the field of virtual environment, protection of the rights of EU citizens and processing of their personal data is insufficiently effective. In the health system, special emphasis is placed on the processing of special categories of personal data, such as health data. The healthcare industry is recognized as a particularly sensitive area in which a large amount of medical data is processed, the digitization of which enables quick access and quick identification of the health insured. The protection of the individual requires quality IT solutions that guarantee the technical protection of personal categories. However, the real problems are the technical and human nature and the spatial limitations of the application of the Regulation. Some conclusions will be drawn by analyzing the implementation of the basic principles of the Regulation on the example of the Croatian health care system and comparing it with similar activities in other EU member states.

Keywords: regulation, healthcare system, personal dana protection, quality data assurance

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