Search results for: community interventions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6091

Search results for: community interventions

4501 Towards an Understanding of Social Capital in an Online Community of Filipino Music Artists

Authors: Jerome V. Cleofas

Abstract:

Cyberspace has become a more viable arena for budding artists to share musical acts through digital forms. The increasing relevance of online communities has attracted scholars from various fields demonstrating its influence on social capital. This paper extends this understanding of social capital among Filipino music artists belonging to the SoundCloud Philippines Facebook Group. The study makes use of various qualitative data obtained from key-informant interviews and participant observation of online and physical encounters, analyzed using the case study approach. Soundcloud Philippines has over seven-hundred members and is composed of Filipino singers, instrumentalists, composers, arrangers, producers, multimedia artists, and event managers. Group interactions are a mix of online encounters based on Facebook and SoundCloud and physical encounters through meet-ups and events. Benefits reaped from the community are informational, technical, instrumental, promotional, motivational, and social support. Under the guidance of online group administrators, collaborative activities such as music productions, concerts and events transpire. Most conflicts and problems arising are resolved peacefully. Social capital in SoundCloud Philippines is mobilized through recognition, respect and reciprocity.

Keywords: Facebook, music artists, online communities, social capital

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4500 Telepsychiatry for Asian Americans

Authors: Jami Wang, Brian Kao, Davin Agustines

Abstract:

COVID-19 highlighted the active discrimination against the Asian American population easily seen through media, social tension, and increased crimes against the specific population. It is well known that long-term racism can also have a large impact on both emotional and psychological well-being. However, the healthcare disparity during this time also revealed how the Asian American community lacked the research data, political support, and medical infrastructure for this particular population. During a time when Asian American fear for safety with decreasing mental health, telepsychiatry is particularly promising. COVID-19 demonstrated how well psychiatry could integrate with telemedicine, with psychiatry being the second most utilized telemedicine visits. However, the Asian American community did not utilize the telepsychiatry resources as much as other groups. Because of this, we wanted to understand why the patient population who was affected the most by COVID-19 mentally did not seek out care. To do this, we decided to study the top top telepsychiatry platforms. The current top telepsychiatry companies in the United States include Teladoc and BetterHelp. In the Teladoc mental health sector, they only had 4 available languages (English, Spanish, French, and Danis,) with none of them being an Asian language. In a similar manner, Teladoc’s top competitor in the telepsychiatry space, BetterHelp, only listed a total of 3 Asian languages, including Mandarin, Japanese, and Malaysian. However, this is still a short list considering they have over 20 languages available. The shortage of available physicians that speak multiple languages is concerning, as it could be difficult for the Asian American community to relate with. There are limited mental health resources that cater to their likely cultural needs, further exacerbating the structural racism and institutional barriers to appropriate care. It is important to note that these companies do provide interpreters to comply with the nondiscrimination and language assistance federal law. However, interactions with an interpreter are not only more time-consuming but also less personal than talking directly with a physician. Psychiatry is the field that emphasizes interpersonal relationships. The trust between a physician and the patient is critical in developing patient rapport to guide in better understanding the clinical picture and treating the patient appropriately. The language barrier creates an additional barrier between the physician and patient. Because Asian Americans are one of the largest growing patient population bases, these telehealth companies have much to gain by catering to the Asian American market. Without providing adequate access to bilingual and bicultural physicians, the current system will only further exacerbate the growing disparity. The healthcare community and telehealth companies need to recognize that the Asian American population is a severely underserved population in mental health and has much to gain from telepsychiatry. The lack of language is one of many reasons why there is a disparity for Asian Americans in the mental health space.

Keywords: telemedicine, psychiatry, Asian American, disparity

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4499 Frequency of Problem Drinking and Depression in Males with a History of Alcohol Consumption Admitted to a Tertiary Care Setting in Southern Sri Lanka

Authors: N. H. D. P. Fonseka, I. H. Rajapakse, A. S. Dissanayake

Abstract:

Background: Problem drinking, namely alcohol dependence (AD) and alcohol abuse (AA) are associated with major medical, social and economic adverse consequences. Problem drinking behavior is noted among those admitted to hospitals due to alcohol-related medical/surgical complaints as well as those with unrelated complaints. Literature shows an association between alcohol consumption and depression. Aims of this study were to determine the frequency of problem drinking and depression among males with a history of alcohol consumption tertiary care setting in Southern Sri Lanka. Method: Two-hundred male patients who consumed alcohol, receiving care in medical and surgical wards in Teaching Hospital Galle, were assessed. A validated J12 questionnaire of the Mini International Neuropsychiatric Interview was administered to determine frequency AA and AD. A validated PHQ 9 questionnaire to determine the prevalence and severity of depression. Results: Sixty-three participants (31%) had problem drinking. Of them, 61% had AD, and 39% had AA. Depression was noted in 39 (19%) subjects. In those who reported alcohol consumption not amounting to problem drinking, depression was noted in 23 (16%) participants. Mild depression was seen in 17, moderate in five and moderately severe in one. Among those who had problem drinking, 16 (25%) had depression. Mild depression was seen in four, moderate in seven, moderately severe in three and severe in two. Conclusions: A high proportion alcohol users had problem drinking. Adverse consequences associated with problem drinking places a major strain on the health system especially in a low resource setting where healthcare spending is limited and alcohol cessation support services are not well organised. Thus alcohol consumption and problem drinking behaviour need to be inquired into all medical consultations. Community prevalence of depression in Sri Lanka is approximately 10%. Depression among those consuming alcohol was two times higher compared to the general population. The rates of depression among those with problem drinking were especially high being 2.5 times more common than in the general population. A substantial proportion of these patients with depression had moderately severe or severe depression. When depression coexists with problem drinking, it may increase the tendency to consume alcohol as well as act as a barrier to the success of alcohol cessation interventions. Thus screening all patients who consume alcohol for depression, especially those who are problem drinkers becomes an important step in their clinical evaluation. In addition, in view of the high prevalence of problem drinking and coexistent depression, the need to organize a structured alcohol cessation support service in Sri Lanka as well as the need for increasing access to psychological evaluation and treatment of those with problem drinking are highlighted.

Keywords: alcohol abuse, alcohol, depression, problem drinking

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4498 From Arab Spring to Arabian Nightmare: State Failure and Identity in the Middle East

Authors: Kenneth Christie

Abstract:

Syria and Iraq are Arabian nightmares at the local, the regional and global levels in terms of human security and the protection of the vulnerable. Wracked by civil war, ethnic and political violence in the last 5 years in the case of Syria and 13 years in the case of Iraq, the body count now is staggering; the humanitarian crisis continues and there appears no end to this. A crisis that has claimed the lives of 200,000 people so far in Syria, sparked a humanitarian catastrophe fuelled violent Islamic extremism and exposed serious splits in the international community who appear to have no consensus. The international community’s failure to act is simply another sign of the desperate situation which has developed over conflicts that appears unsolvable in the immediate future and may be intractable in the long range. Three things are really at stake I’m going to argue in these continuing crises and how it will affect the human security dimensions of the conflict. Firstly, the protection of vulnerable individuals and civilians in the war, 2ndly, the dire consequences for regional instability as a result and thirdly the risks for minority and ethnic identities who are caught up in this, within and across these volatile borders. This paper will examine these elements and the consequences of the conflict in terms of human security, migration and development.

Keywords: human security, migration, Syria and Iraq, conflict and development

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4497 Tourism Development and Planning in Rwanda

Authors: Ntachobazi bosco

Abstract:

Tourism Development and Planning in Rwanda: Rwanda, a small landlocked country located in the heart of Africa, has experienced significant growth in its tourism industry in recent years. The country’s stunning natural beauty, rich cultural heritage, and warm hospitality have made it an attractive destination for travelers from around the world. However, to ensure sustainable tourism development and planning, the Rwandan government has implemented various strategies and policies to promote responsible tourism practices. Infrastructure Development: To support the growth of the tourism industry, the Rwandan government has invested heavily in infrastructure development. This includes the construction of new hotels, resorts, and lodges, as well as the upgrading of existing facilities. The government has also improved the country’s transportation network, including the construction of new airports and the upgrading of existing ones. Conservation Efforts: Rwanda is home to several national parks and reserves, including the famous Volcanoes National Park, which is known for its mountain gorilla populations. To protect these natural wonders, the Rwandan government has implemented conservation efforts, such as the establishment of protected areas and the development of sustainable tourism practices. Community-Based Tourism: Community-based tourism is a key component of Rwanda’s tourism development strategy. The government has established several community-based tourism programs, which aim to involve local communities in the tourism industry and provide them with economic benefits. These programs include homestays, village tours, and cultural performances. Sustainable Tourism Practices: To promote sustainable tourism practices, the Rwandan government has implemented several initiatives, such as the use of eco-friendly accommodations and the promotion of responsible wildlife viewing practices. The government has also established the Rwanda Tourism Board, which is responsible for promoting and regulating the tourism industry. Challenges and Opportunities: Despite the growth of the tourism industry in Rwanda, several challenges need to be addressed, such as the lack of skilled labor and the need for more infrastructure development. However, there are also several opportunities for the industry, such as the potential for ecotourism and the growth of the meetings, incentives, conventions, and exhibitions (MICE) market.

Keywords: tourism, in rwanda, developent, in africa

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4496 Relationships between Financial, Cultural, Emotional, and General Wellbeing: A Structural Equation Modeling Study

Authors: Michael Alsop, Hannah Heitz, Prathiba Natesan Batley, Marion Hambrick, Jason Immekus

Abstract:

The impacts of cultural engagement on individuals’ health and well-being have been well documented. The purposes of this study were to create an instrument to measure wellbeing constructs, including cultural wellbeing, and explore the relationships between cultural wellbeing and other wellbeing constructs (e.g., emotional, social, physical, spiritual). A sample of 358 participants attending concerts performed by a civic orchestra in the southeastern United States completed a questionnaire designed to measure eight wellbeing constructs. Split-half exploratory, confirmatory factor analyses resulted in the retention of four wellbeing constructs: general, emotional, financial, and cultural. Structural equation modeling showed statistically significant relationships between cultural wellbeing and other wellbeing constructs. In addition to the indirect effect of financial wellbeing on emotional and general wellbeing through cultural wellbeing, there were also direct statistically significant relationships (i.e., moderator). This highlights the importance of removing financial barriers to cultural engagement and the relationship between cultural wellbeing on emotional and general wellbeing. Additionally, the retained cultural wellbeing items focused primarily on community features, indicating the value of community-based cultural engagement opportunities.

Keywords: cultural wellbeing, cultural engagement, factor analysis, structural equation modeling

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4495 A Decrease in the Anxiety Levels of Participants with Autoimmune Disease: Efficacy of a Community-Based Educational Program

Authors: Jennifer Hunter, Francisco Ramirez, Neil A. Nedley, Thania Solorio, Christian Freed, Erica Kinjo

Abstract:

People who have autoimmune disease are often at an increased risk for psychological disorders such as anxiety. Untreated psychological conditions can affect the development of disease and can affect one’s general quality of life. In this study, it was hypothesized that an educational community-based intervention would be useful in decreasing the anxiety levels of participants with autoimmune disease. Programs, 2-hours long each, were held weekly over a period of eight weeks. During every meeting, a 45-minute DVD presentation by a skilled physician was shown, a small group discussion was guided by trained facilitators, and weekly practical assignments were given to each participant. The focus of the program was to educate participants about healthy lifestyle behaviors such as exercise, nutrition, sleep hygiene, helpful thought patterns etc., and to provide a group environment in which each participant was supported. Participants were assessed pre-post program for anxiety using the Depression and Anxiety Assessment Test (registration TX 7-398-022), a validated mental health test based on DSM-5 criteria and demographics. Anxiety scores were classified according to the DSM-5 criteria into 4 categories: none (0-6), mild (7-10), moderate (11-19) or severe (20 or more). Out of the participants who participated in programs conducted in the manner explained above (n=431), the average age was 54.9 (SD 16.6) and 81.9% were female. At baseline, the mean group anxiety level was 9.4 (SD 5.4). Within the baseline group, anxiety levels were as follows: none (21.1%), mild (22.0%), moderate (27.1%) and severe (29.7%). After the program, mean group anxiety decreased to 4.7 (SD 4.0). Post-program anxiety levels were as follows: none (54.8%), mild (27.1%), moderate (12.5%), severe (5.6%). The decrease in overall anxiety levels was significant t(431)=19.3 p<.001, 95% CI [0.815, 1.041]. It was concluded that the eight-week intensive was beneficial in decreasing the anxiety levels of participants. A long-term follow-up study would be beneficial in determining how lasting such improvements are especially since autoimmune diseases are often chronic. Additionally, future studies that utilize a control group would aid in establishing whether the improvements seen are due to the use of this specific lifestyle-educational program.

Keywords: anxiety, auto-immune disease, community-based educational program, lifestyle

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4494 District 10 in Tehran: Urban Transformation and the Survey Evidence of Loss in Place Attachment in High Rises

Authors: Roya Morad, W. Eirik Heintz

Abstract:

The identity of a neighborhood is inevitably shaped by the architecture and the people of that place. Conventionally the streets within each neighborhood served as a semi-public-private extension of the private living spaces. The street as a design element formed a hybrid condition that was neither totally public nor private, and it encouraged social interactions. Thus through creating a sense of community, one of the most basic human needs of belonging was achieved. Similar to major global cities, Tehran has undergone serious urbanization. Developing into a capital city of high rises has resulted in an increase in urban density. Although allocating more residential units in each neighborhood was a critical response to the population boom and the limited land area of the city, it also created a crisis in terms of social communication and place attachment. District 10 in Tehran is a neighborhood that has undergone the most urban transformation among the other 22 districts in the capital and currently has the highest population density. This paper will explore how the active streets in district 10 have changed into their current condition of high rises with a lack of meaningful social interactions amongst its inhabitants. A residential building can be thought of as a large group of people. One would think that as the number of people increases, the opportunities for social communications would increase as well. However, according to the survey, there is an indirect relationship between the two. As the number of people of a residential building increases, the quality of each acquaintance reduces, and the depth of relationships between people tends to decrease. This comes from the anonymity of being part of a crowd and the lack of social spaces characterized by most high-rise apartment buildings. Without a sense of community, the attachment to a neighborhood is decreased. This paper further explores how the neighborhood participates to fulfill ones need for social interaction and focuses on the qualitative aspects of alternative spaces that can redevelop the sense of place attachment within the community.

Keywords: high density, place attachment, social communication, street life, urban transformation

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4493 An Integral Sustainable Design Evaluation of the 15-Minute City and the Processes of Transferability to Cities of the Global South

Authors: Chitsanzo Isaac

Abstract:

Across the world, the ongoing Covid-19 pandemic has challenged urban systems and policy frameworks, highlighting societal vulnerabilities and systemic inequities among many communities. Measures of confinement and social distancing to contain the Covid-19 virus have fragmented the physical and social fabric of cities. This has caused urban dwellers to reassess how they engage with their urban surroundings and maintain social ties. Urbanists have presented strategies that would allow communities to survive and even thrive, in extraordinary times of crisis like the pandemic. Tactical Urbanism, particularly the 15-Minute City, has gained popularity. It is considered a resilient approach in the global north, however, it’s transferability to the global south has been called into question. To this end, this paper poses the question: to what extent is the 15-Minute City framework integral sustainable design, and are there processes that make it adoptable by cities in the global south? This paper explores four issues using secondary quantitative data analysis and convergence analysis in the Paris and Blantyre urban regions. First, it questions how the 15-Minute City has been defined and measured, and how it impacts urban dwellers. Second, it examines the extent to which the 15-minute city performs under the lens of frameworks such as Wilber’s integral theory and Fleming’s integral sustainable design theory. Thirdly this work examines the processes that can be transferred to developing cities which foster community resilience through the perspectives of experience, behaviors, cultures, and systems. Finally, it reviews the principal ways in which a multi-perspective reality can be the basis for resilient community design and sustainable urban development. This work will shed a light on the importance of a multi-perspective reality as a means of achieving sustainable urban design goals in developing urban areas.

Keywords: 15-minute city, developing cities, global south, community resilience, integral sustainable design, systems thinking, complexity, tactical urbanism

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4492 Coping with Climate Change in Agriculture: Perception of Farmers in Oman

Authors: B. S. Choudri

Abstract:

Introduction: Climate change is a major threat to rural livelihoods and to food security in the developing world, including Oman. The aim of this study is to provide a basis for policymakers and researchers in order to understand the impacts of climate change on agriculture and developing adaptation strategies in Oman. Methodology: The data was collected from different agricultural areas across the country with the help of a questionnaire survey among farmers, discussion with community, and observations at the field level. Results: The analysis of data collected from different areas within the country shows a shift in the sowing period of major crops and increased temperatures over recent years. Farmer community is adopting through diversification of crops, use of heat-tolerant species, and improved measures of soil and water conservation. Agriculture has been the main livelihood for most of the farmer communities in rural areas in the country. Conclusions: In order to reduce the effects of climate change at the local and farmer communities, risk reduction would be important along with an in-depth analysis of the vulnerability. Therefore, capacity building of local farmers and providing them with scientific knowledge, mainstreaming adaptation into development activities would be essential with additional funding and subsidies.

Keywords: agriculture, climate change, vulnerability, adaptation

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4491 Risk Reduction of Household Refuse, a Case Study of Shagari Low-Cost, Mubi North (LGA) Adamawa State, Nigeria

Authors: Maryam Tijjani Kolo

Abstract:

Lack of refuse dumping points has made the residents of Shagari low-cost well armed with some health and environmental related hazards. These studies investigate the effect of household refuse on the resident of Shagari low-cost. A well structured questionnaire was administered to elicit views of the respondent in the study area through adopting cluster sampling method. A total of 100 questionnaires were selected and divided into 50, each to both sections of the study area. Interview was conducted to each household head. Data obtained were analyzed using simple parentages to determine the major hazard in the area. Result showed that majority of the household are civil servant and traders, earning reasonable monthly income. 68% of the respondent has experienced the effect of living close to waste dumping areas, which include unpleasant smell and polluted smoke when refuse is burnt, which causes eye and respiratory induction, human injury from broken bottles or sharp objects as well as water, insect and air borne diseases. Hence, the need to urgently address these menace before it overwhelms the capacities of the community becomes paramount. Thus, the community should be given more enlightenment and refuse dumping sites should be created by the local government area.

Keywords: household, refuse, refuse dumping points, Shagari low-cost

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4490 Genesis and Achievements of Madhesh Movement in Nepal

Authors: Deepak Chaudhary

Abstract:

The main objective of the study is to explore the genesis and achievements of the Madhesh movement. Madhesh Movement is a social movement that brought massive political changes and contributed a lot to the nation-building process in the modern history of Nepal. This movement erupted in January 2007 in the Tarai/Madhesh region following the promulgation of the Interim Constitution that left the incorporation of federalism and proportional representation in the Constitution. The most excluded community in Nepal- Madheshi community, seemed to have angered against state-sponsored discrimination and exclusion that have been occurred for centuries. Since Madheshis were treated as non-Nepali, though the history of Nepal’s Tarai/Madhesh has been ancient. In the beginning, this movement was against Maoist, but later, it went against the state's prejudices and discriminations. It extended across the Tarai/Madhesh region of Nepal for a month. The movement was spontaneous to a large extent. A researcher himself is a witness to the movement. Key Informant Interviews with participants, including politicians, journalists, and activists, have mainly carried out for the study. This movement ensured Madheshi identity first. Secondly, the number of electoral constituencies was increased as it reached 120 in Tarai/Madhesh while it was 80 only. As a result, Madheshi representation in the Constitution Assembly reached 35 %, while it was 20% only. The main thing that this movement played a major role in ensuring the federalism as a political system in Nepal.

Keywords: dignity, exclusion, federalism, inclusion, Madhesh movement, nation-building

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4489 Barriers to Health Promotion Advice Delivered by Paramedics and Emergency Department Nurses – Promoted Study

Authors: B. Schofield, F. Gul, S. McClean, R. Hoskins, R. Terry, U. Rolfe, A. Gibson, S. Voss, J. Benger

Abstract:

Aim: The aim of this study is to determine whether and how health promotion activities are undertaken by paramedics and emergency department nurses and investigate ways of overcoming potential barriers. Background: Paramedics and emergency department nurses are uniquely placed to reach millions of people and could use these contacts as positive opportunities to help people improve their health by identifying people with risk factors and provide information, brief interventions, and signposting to locally provided services. These interventions can be carried out when the opportunity arises, typically take no more than a few minutes, have a low financial cost and can be a highly efficient method of health promotion. Methodology: Three NHS Emergency Departments and four Ambulance Trusts in England were recruited to the study. A link to an online survey was distributed to paramedics and emergency department nurses at participating sites. Staff were invited to participate in virtual semi-structured interviews. Patients seen, treated, and discharged at the participating sites were invited to virtual semistructured interviews. Findings: A total of 331 survey responses were received, 21 virtual semi-structured staff interviews and 11 patient interviews were completed. Staff reported lack of time to prioritise, lack of knowledge, resources, and confidence as barriers. Receptiveness of patients guided their decision to undertake health promotion activities. They reported a desire to learn how to undertake health promotion conversations. Emergency department nurses felt more supported than paramedics by their organisations to undertake health promotion activities. Patients were not aware of health promotion activities and reported fear and lack of privacy as barriers. Conclusions: These results will guide the development of an intervention to support the provision of health promotion by staff in urgent and emergency care settings. The components of the intervention will be mapped to a framework which will consider the needs of staff working within these settings, patients they treat, and organisational issues and practices related to the implementation of such an intervention.

Keywords: emergency service, hospital, nursing, allied health personnel, emergency medical services, health promotion

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4488 Biodiversity Indices for Macrobenthic Community structures of Mangrove Forests, Khamir Port, Iran

Authors: Mousa Keshavarz, Abdul-Reza Dabbagh, Maryam Soyuf Jahromi

Abstract:

The diversity of mangrove macrobenthos assemblages at mudflat and mangrove ecosystems of Port Khamir, Iran were investigated for one year. During this period, we measured physicochemical properties of water temperature, salinity, pH, DO and the density and distribution of the macrobenthos. We sampled a total of 9 transects, at three different topographic levels along the intertidal zone at three stations. Assemblages at class level were compared. The five most diverse and abundant classes were Foraminifers (54%), Gastropods (23%), Polychaetes (10%), Bivalves (8%) & Crustaceans (5%), respectively. Overall densities were 1869 ± 424 ind/m2 (26%) in spring, 2544 ± 383 ind/m2(36%) in summer, 1482 ± 323 ind/m2 (21%) in autumn and 1207 ± 80 ind/m2 (17%) in winter. Along the intertidal zone, the overall relative density of individuals at high, intermediate, and low topographic levels was 40, 30, and 30% respectively. Biodiversity indices were used to compare different classes: Gastropoda (Shannon index: 0.33) and Foraminifera (Simpson index: 0.28) calculated the highest scores. It was also calculated other bio-indices. With the exception of bivalves, filter feeders were associated with coarser sediments at higher intertidal levels, while deposit feeders were associated with finer sediments at lower levels. Salinity was the most important factor acting on community structure, while DO and pH had little influence.

Keywords: macrobenthos, biodiversity, mangrove forest, Khamir Port

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4487 Organising Field Practicum for International Social Work Students through Creative Projects in the Community Sector in Elderly Care: An Evaluation of the Placement Experiences

Authors: Kalpana Goel

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Australian social work schools are finding it difficult to find appropriate placements for the increasing number of international students enrolled in their Master of Social Work qualifying (MSWQ) programs. Anecdotally, it has been noticed that fewer social work students are ready to work with older people whose numbers are rising globally. An innovative and unique placement for international students enrolled in the MSWQ at one Australian university was organised in partnership with a community-based service working with older clients to meet two objectives: increasing the number of suitable placements for international students and preparing social work students to work with older people. Creative activities and projects were designed to provide meaningful engagement and experience in working with older people in the community. Students participated in a number of projects that were matched with their interest and capability in a 500-hour placement. The students were asked to complete an online survey after all work for the placement had been completed. The areas of assessment were: self-perceived change in perception towards age and older people, valued field placement experiences including reflective practice, knowledge and skill development, and constraints and challenges experienced in the placement. Findings revealed students’ increased level of confidence in applying social work theory to practice, developing effective communication and interpersonal skills, and use of innovation and creativity in preparing well-being plans with older adults. Challenges and constraints related to their limited English language ability and lack of cultural knowledge of the host society. It was recognised that extra support for these students and more planning in the beginning phase of placement are vital to placement success. Caution in matching students with clients of similar cultural background must be exercised to ensure that there is equity in task allocation and opportunities for wider experiences.

Keywords: field placement, international students, older people, social work

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4486 Bacterial Community Diversity in Soil under Two Tillage Systems

Authors: Dalia Ambrazaitienė, Monika Vilkienė, Danute Karcauskienė, Gintaras Siaudinis

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The soil is a complex ecosystem that is part of our biosphere. The ability of soil to provide ecosystem services is dependent on microbial diversity. T Tillage is one of the major factors that affect soil properties. The no-till systems or shallow ploughless tillage are opposite of traditional deep ploughing, no-tillage systems, for instance, increase soil organic matter by reducing mineralization rates and stimulating litter concentrations of the top soil layer, whereas deep ploughing increases the biological activity of arable soil layer and reduces the incidence of weeds. The role of soil organisms is central to soil processes. Although the number of microbial species in soil is still being debated, the metagenomic approach to estimate microbial diversity predicted about 2000 – 18 000 bacterial genomes in 1 g of soil. Despite the key role of bacteria in soil processes, there is still lack of information about the bacterial diversity of soils as affected by tillage practices. This study focused on metagenomic analysis of bacterial diversity in long-term experimental plots of Dystric Epihypogleyic Albeluvisols in western part of Lithuania. The experiment was set up in 2013 and had a split-plot design where the whole-plot treatments were laid out in a randomized design with three replicates. The whole-plot treatments consisted of two tillage methods - deep ploughing (22-25 cm) (DP), ploughless tillage (7-10 cm) (PT). Three subsamples (0-20 cm) were collected on October 22, 2015 for each of the three replicates. Subsamples from the DP and PT systems were pooled together wise to make two composition samples, one representing deep ploughing (DP) and the other ploughless tillage (PT). Genomic DNA from soil sample was extracted from approximately 200 mg field-moist soil by using the D6005 Fungal/Bacterial Miniprep set (Zymo Research®) following the manufacturer’s instructions. To determine bacterial diversity and community composition, we employed a culture – independent approach of high-throughput pyrosequencing of the 16S rRNA gene. Metagenomic sequencing was made with Illumina MiSeq platform in Base Clear Company. The microbial component of soil plays a crucial role in cycling of nutrients in biosphere. Our study was a preliminary attempt at observing bacterial diversity in soil under two common but contrasting tillage practices. The number of sequenced reads obtained for PT (161 917) was higher than DP (131 194). The 10 most abundant genus in soil sample were the same (Arthrobacter, Candidatus Saccharibacteria, Actinobacteria, Acidobacterium, Mycobacterium, Bacillus, Alphaproteobacteria, Longilinea, Gemmatimonas, Solirubrobacter), just the percent of community part was different. In DP the Arthrobacter and Acidobacterium consist respectively 8.4 % and 2.5%, meanwhile in PT just 5.8% and 2.1% of all community. The Nocardioides and Terrabacter were observed just in PT. This work was supported by the project VP1-3.1-ŠMM-01-V-03-001 NKPDOKT and National Science Program: The effect of long-term, different-intensity management of resources on the soils of different genesis and on other components of the agro-ecosystems [grant number SIT-9/2015] funded by the Research Council of Lithuania.

Keywords: deep ploughing, metagenomics, ploughless tillage, soil community analysis

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4485 Eclectic Therapy in Approach to Clients’ Problems and Application of Multiple Intelligence Theory

Authors: Mohamed Sharof Mostafa, Atefeh Ahmadi

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Most of traditional single modality psychotherapy and counselling approaches to clients’ problems are based on the application of one therapy in all sessions. Modern developments in these sciences focus on eclectic and integrative interventions to consider all dimensions of an issue and all characteristics of the clients. This paper presents and overview eclectic therapy and its pros and cons. In addition, multiple intelligence theory and its application in eclectic therapy approaches are mentioned.

Keywords: eclectic therapy, client, multiple intelligence theory, dimensions

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4484 Community Participation of the Villagers: Corporate Social Responsibility Programme in Pantai Harapan Jaya Village, Bekasi Regency, West Java

Authors: Auliya Adzillatin Uzhma, Ismu Rini Dwi Ari, I. Nyoman Suluh Wijaya

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Corporate Social Responsibility (CSR) programme in Pantai Harapan Jaya village is cultivation of mangrove and fishery capital distribution, to achieve the goal the CSR programme needed participation from the society in it. Moeliono in Fahrudin (2011) mentioned that participation from society is based by intrinsic reason from inside people it self and extrinsic reason from the other who related to him or from connection with other people. The fundamental connection who caused more boundaries from action which the organization can do called the social structure. The purpose of this research is to know the form of public participation and the density of the villager and people who is participated in CSR programme. This research use Social Network Analysis method by knew the Rate of Participation and Density. The result of the research is people who is involved in the programme is lived in Dusun Pondok Dua and they work in fisheries field. Rate of Participation is 11,61 and that means people involved in 11 or 12 activites of CSR Programme. The rate of participation of CSR Programme is categorized as high rate participation. The density value from the participant is 0.516 it’s mean that 51.6% of the people that participated is involved in the same step of CSR programme.

Keywords: community participation, social network analysis, corporate social responsibility, urban and regional studies

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4483 Improvement of Autism Diagnostic Observation Schedule Scores after Comprehensive Intensive Early Interventions in a Clinical Setting

Authors: Nils Haglund, Svenolof Dahlgren, Maria Rastam, Peik Gustafsson, Karin Kalien

Abstract:

In Sweden, like in most developed countries, there is a substantial increase of children diagnosed with autism and other conditions within the autism spectrum (ASD). The rapid increase of ASD rates stresses the importance of developing care programs to provide support and comprehensive interventions for affected families. The current observational study was conducted in order to evaluate an ongoing Comprehensive Intensive Early Intervention (CIEI) program for children with autism in southern Sweden. The change in autism symptoms among children participating in CIEI (intervention group, n=67) was compared with children who received traditional habilitation services only (comparison group, n=27). Children of parents who accepted the offered CIEI-program, constituted the intervention group, whereas children, whose parents (for some reason) were not interested in the offered CIEI-program, constituted the comparison group. The CIEI-program was individualized to each child by experienced applied behavior analysis (ABA) specialists with different backgrounds as psychologists, speech pathologists or special education teachers, in cooperation with parents and preschool staff. Due to the individualization, the intervention could vary in intensity and techniques. The intensity was calculated to 15-25 hours each week at home and the preschool altogether. Each child was assigned one 'trainer', who was often employed as a preschool teacher but could have another educational background. An agreement between supervisor- parents and preschool staff was reached to confirm the intensity and content of the CIEI- program over an approximately two-year intervention period. Symptom changes were measured as evaluation-ADOS-2-scores, total- and severity-scores, minus the corresponding baseline-scores, divided by the time between baseline and evaluation. The difference between the study-groups regarding change of ADOS-2-scores was estimated using ANCOVA. In the current study, children in the CIEI-group improved their ADOS-2-total scores between baseline and evaluation (-0.8 scores per year; 95%CI: -1.2 to -0.4), whereas no such improvement was detected in the comparison group (+0.1 scores per year; 95%CI: -0.7 to +0.9). The change difference (change in the CIEI-group vs. change in the comparison group) was statistically significant, both crude and after adjusting for possible confounders (-1.1; 95%CI -1.9 to -0.4). Children in the CIEI-group also significantly improved their ADOS-calibrated severity scores, but not significantly differently so from the comparison group. The results from the current study indicate that the CIEI program significantly improves social and communicative skills among children with autism and that children with developmental delay could benefit to a similar degree as other children. The results support earlier studies reporting on the improvement of autism symptoms after early intensive interventions. The results from observational studies are difficult to interpret, but it is nevertheless of uttermost importance to evaluate costly autism intervention programs. Such results may be of immediate importance to healthcare organizations when allocating the already strained resources to different patient groups. Albeit the obvious limitation of the current naturalistic study, the results support previous positive studies and indicate that children with autism benefit from participating in early comprehensive, intensive programs and that investments in these programs may be highly justifiable.

Keywords: autism symptoms, ADOS-scores, evaluation, intervention program

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4482 Rehabilitation of Dilapidated Buildings in Morocco: Turning Urban Challenges into Opportunities

Authors: Derradji A., Ben El Mamoun M., Zakaria E., Charadi I. Anrur

Abstract:

The issue of dilapidated buildings represents a significant opportunity for constructive and beneficial interventions in Morocco. Faced with challenges associated with aging constructions and rapid urbanization, the country is committed to developing innovative strategies aimed at revitalizing urban areas and enhancing the sustainability of infrastructure, thereby ensuring citizens' safety. Through targeted investments in the renovation and modernization of existing buildings, Morocco aims to stimulate job creation, boost the local economy, and improve the quality of life for residents. Additionally, the integration of sustainable construction standards and the strengthening of regulations will promote resilient and environmentally friendly urban development. In this proactive perspective, LABOTEST has been commissioned by the National Agency for Urban Renewal (ANRUR) to conduct an in-depth study. This study focuses on the technical expertise of 1800 buildings identified as dilapidated in the prefectures of Rabat and Skhirat-Témara following an initial clearance operation. The primary objective of this initiative is to conduct a comprehensive diagnosis of these buildings and define the necessary interventions to eliminate potential risks while ensuring appropriate treatment. The article presents the adopted intervention methodology, taking into account the social dimensions involved, as well as the results of the technical expertise. These results include the classification of buildings according to their degree of urgency and recommendations for appropriate conservatory measures. Additionally, different pathologies are identified and accompanied by specific treatment proposals for each type of building. Since this study, the adopted approach has been generalized to the entire territory of Morocco. LABOTEST has been solicited by other cities such as Casablanca, Chefchaouen, Ouazzane, Azilal, Bejaad, and Demnate. This extension of the initiative demonstrates Morocco's commitment to addressing urban challenges in a proactive and inclusive manner. These efforts also illustrate the endeavors undertaken to transform urban challenges into opportunities for sustainable development and socio-economic progress for the entire population.

Keywords: building, dilapidated, rehabilitation, Morocco

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4481 Competitiveness and Value Creation of Tourism Sector: In the Case of 10 ASEAN Economies

Authors: Apirada Chinprateep

Abstract:

The ASEAN Economic Community (AEC) shall be the goal of regional economic integration by 2015. Tourism is an activity that is growing important, especially as a source of foreign currency, employment creation and distribution of income bringing to the region. The preparation of members of the countries group, given the complexity of the issues entail to the concept of sustainable tourism, this paper tries to assess tourism sustainability, based on a number of quantitative indicators for all the ten economies, first, Thailand, compared with other nine countries, Myanmar, Laos, Vietnam, Malaysia, Singapore, Indonesia, Philippines, Cambodia, and Brunei. The proposed methodological framework will provide a number of benchmarks of tourism activities in these countries assessed. They include identification of the dimensions, for example, economic, socio-ecologic, infrastructure and indicators, method of scaling, chart representation and evaluation on Asian countries. This specification shows us that a similar level of tourism activity might introduce different sort of implementation in the tourism activity and might have different consequences for the socio-ecological environment and sustainability. The heterogeneity of developing countries exposed briefly here would be useful to detect and prepare for coping with the main problem of each country in their tourism activities, as well as competitiveness and value creation of tourism for ASEAN economic community, and will compare with other parts of the world and the world benchmark.

Keywords: AEC, ASEAN, sustainable, tourism, competitiveness

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4480 The Territorial Expression of Religious Identity: A Case Study of Catholic Communities

Authors: Margarida Franca

Abstract:

The influence of the ‘cultural turn’ movement and the consequent deconstruction of scientific thought allowed geography and other social sciences to open or deepen their studies based on the analysis of multiple identities, on singularities, on what is particular or what marks the difference between individuals. In the context of postmodernity, the geography of religion has gained a favorable scientific, thematic and methodological focus for the qualitative and subjective interpretation of various religious identities, sacred places, territories of belonging, religious communities, among others. In the context of ‘late modernity’ or ‘net modernity’, sacred places and the definition of a network of sacred territories allow believers to attain the ‘ontological security’. The integration on a religious group or a local community, particularly a religious community, allows human beings to achieve a sense of belonging, familiarity or solidarity and to overcome, in part, some of the risks or fears that society has discovered. The importance of sacred places comes not only from their inherent characteristics (eg transcendent, mystical and mythical, respect, intimacy and abnegation), but also from the possibility of adding and integrating members of the same community, creating bonds of belonging, reference and individual and collective memory. In addition, the formation of different networks of sacred places, with multiple scales and dimensions, allows the human being to identify and structure his times and spaces of daily life. Thus, each individual, due to his unique identity and life and religious paths, creates his own network of sacred places. The territorial expression of religious identity allows to draw a variable and unique geography of sacred places. Through the case study of the practicing Catholic population in the diocese of Coimbra (Portugal), the aim is to study the territorial expression of the religious identity of the different local communities of this city. Through a survey of six parishes in the city, we sought to identify which factors, qualitative or not, define the different territorial expressions on a local, national and international scale, with emphasis on the socioeconomic profile of the population, the religious path of the believers, the religious group they belong to and the external interferences, religious or not. The analysis of these factors allows us to categorize the communities of the city of Coimbra and, for each typology or category, to identify the specific elements that unite the believers to the sacred places, the networks and religious territories that structure the religious practice and experience and also the non-representational landscape that unifies and creates memory. We conclude that an apparently homogeneous group, the Catholic community, incorporates multitemporalities and multiterritorialities that are necessary to understand the history and geography of a whole country and of the Catholic communities in particular.

Keywords: geography of religion, sacred places, territoriality, Catholic Church

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4479 Classroom Curriculum That Includes Wisdom Skills

Authors: Brian Fleischli, Shani Robins

Abstract:

In recent years, the implementation of wisdom skills, including emotional intelligence, mindfulness, empathy, compassion, gratitude, realism (Cognitive-Behavioral Therapy), and humility, within K-12 educational settings has demonstrated significant benefits in reducing stress, anxiety, anger, and conflict among students. This study summarizes the findings of research conducted over several years, showcasing the positive outcomes associated with teaching these skills to elementary and high school students. Additionally, this overview includes an updated synthesis of current literature concerning the application and effectiveness of training these skill sets in K-12 schools. The research outcomes highlight substantial improvements in student well-being and behavior. Demonstrated with treatment group students exhibiting notable reductions in anger, anxiety, depression, and disruptive behaviors compared to control groups. For instance, fourth-grade students showed enhanced empathy, responsibility, and attention, particularly benefiting those with lower initial scores on these measures. Specific interaction effects suggest that older students and males particularly benefit from these interventions, showcasing the nuanced impact of wisdom skill training across different demographics. Furthermore, this presentation emphasizes the critical role of Social and Emotional Learning (SEL) programs in addressing the multifaceted challenges faced by children and adolescents, including mental health issues, academic performance, and social behaviors. The integration of wisdom skills into school curricula not only fosters individual growth and emotional regulation but also enhances overall school climate and academic achievement. In conclusion, the findings contribute to the growing body of empirical evidence supporting the efficacy of teaching wisdom skills in educational settings. The success of these interventions underscores the potential for widespread implementation of evidence-based programs to promote emotional well-being and academic success among students nationwide.

Keywords: wisdom skills, CBT, cognitive behavioral training, mindfulness, empathy, anxiety

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4478 Development of Technologies for the Treatment of Nutritional Problems in Primary Care

Authors: Marta Fernández Batalla, José María Santamaría García, Maria Lourdes Jiménez Rodríguez, Roberto Barchino Plata, Adriana Cercas Duque, Enrique Monsalvo San Macario

Abstract:

Background: Primary Care Nursing is taking more autonomy in clinical decisions. One of the most frequent therapies to solve is related to the problems of maintaining a sufficient supply of food. Nursing diagnoses related to food are addressed by the nurse-family and community as the first responsible. Objectives and interventions are set according to each patient. To improve the goal setting and the treatment of these care problems, a technological tool is developed to help nurses. Objective: To evaluate the computational tool developed to support the clinical decision in feeding problems. Material and methods: A cross-sectional descriptive study was carried out at the Meco Health Center, Madrid, Spain. The study population consisted of four specialist nurses in primary care. These nurses tested the tool on 30 people with ‘need for nutritional therapy’. Subsequently, the usability of the tool and the satisfaction of the professional were sought. Results: A simple and convenient computational tool is designed for use. It has 3 main entrance fields: age, size, sex. The tool returns the following information: BMI (Body Mass Index) and caloric consumed by the person. The next step is the caloric calculation depending on the activity. It is possible to propose a goal of BMI or weight to achieve. With this, the amount of calories to be consumed is proposed. After using the tool, it was determined that the tool calculated the BMI and calories correctly (in 100% of clinical cases). satisfaction on nutritional assessment was ‘satisfactory’ or ‘very satisfactory’, linked to the speed of operations. As a point of improvement, the options of ‘stress factor’ linked to weekly physical activity. Conclusion: Based on the results, it is clear that the computational tools of decision support are useful in the clinic. Nurses are not only consumers of computational tools, but can develop their own tools. These technological solutions improve the effectiveness of nutrition assessment and intervention. We are currently working on improvements such as the calculation of protein percentages as a function of protein percentages as a function of stress parameters.

Keywords: feeding behavior health, nutrition therapy, primary care nursing, technology assessment

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4477 Effects of Soil Erosion on Vegetation Development

Authors: Josephine Wanja Nyatia

Abstract:

The relationship between vegetation and soil erosion deserves attention due to its scientific importance and practical applications. A great deal of information is available about the mechanisms and benefits of vegetation in the control of soil erosion, but the effects of soil erosion on vegetation development and succession is poorly documented. Research shows that soil erosion is the most important driving force for the degradation of upland and mountain ecosystems. Soil erosion interferes with the process of plant community development and vegetation succession, commencing with seed formation and impacting throughout the whole growth phase and affecting seed availability, dispersal, germination and establishment, plant community structure and spatial distribution. There have been almost no studies on the effects of soil erosion on seed development and availability, of surface flows on seed movement and redistribution, and their influences on soil seed bank and on vegetation establishment and distribution. However, these effects may be the main cause of low vegetation cover in regions of high soil erosion activity, and these issues need to be investigated. Moreover, soil erosion is not only a negative influence on vegetation succession and restoration but also a driving force of plant adaptation and evolution. Consequently, we need to study the effects of soil erosion on ecological processes and on development and regulation of vegetation succession from the points of view of pedology and vegetation, plant and seed ecology, and to establish an integrated theory and technology for deriving practical solutions to soil erosion problems

Keywords: soil erosion, vegetation, development, seed availability

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4476 Determination of Community Based Reference Interval of Aspartate Aminotransferase to Platelet Ratio Index (APRI) among Healthy Populations in Mekelle City Tigray, Northern Ethiopia

Authors: Getachew Belay Kassahun

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Background: Aspartate aminotransferase to Platelet Ratio Index (APRI) currently becomes a biomarker for screening liver fibrosis since liver biopsy procedure is invasive and variation in pathological interpretation. Clinical Laboratory Standard Institute recommends establishing age, sex and environment specific reference interval for biomarkers in a homogenous population. The current study was aimed to derive community based reference interval of APRI aged between 12 and 60 years old in Mekelle city Tigrai, Northern Ethiopia. Method: Six hundred eighty eight study participants were collected from three districts in Mekelle city. The 3 districts were selected through random sampling technique and sample size to kebelles (small administration) were distributed proportional to household number in each district. Lottery method was used at household level if more than 2 study participants to each age partition were found. A community based cross sectional in a total of 534 study participants, 264 male and 270 females, were included in the final laboratory and data analysis but around 154 study participants were excluded through exclusion criteria. Aspartate aminotransferase was analyzed through Biosystem chemistry analyzer and Sysmix machine was used to analyze platelet. Man Whitney U test non parametric stastical tool was used to appreciate stastical difference among gender after excluding the outliers through Box and Whisker. Result: The study appreciated stastical difference among gender for APRI reference interval. The combined, male and female reference interval in the current study was 0.098-0.390, 0.133-0.428 and 0.090-0.319 respectively. The upper and lower reference interval of males was higher than females in all age partition and there was no stastical difference (p-value (<0.05)) between age partition. Conclusion: The current study showed using sex specific reference interval is significant to APRI biomarker in clinical practice for result interpretation.

Keywords: reference interval, aspartate aminotransferase to platelet ratio Index, Ethiopia, tigray

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4475 A Collaborative Action Research by Using the Children’s School Success Plus Curriculum Framework to Support Early Childhood Education/Early Childhood Special Education Teachers to Build a Professional Learning Community

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

Abstract:

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

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

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4474 Long-Term Health and Quality of Life Outcomes Following War-Related Traumatic Lower-Limb Amputation; A Study on Community Re-Integrated Army Veterans in Sri Lanka

Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Civil war in Sri Lanka ended a decade ago, leaving thousands of army veterans permanently disabled following lower-limb amputations. Quantifying long-term functional health and psychological wellbeing will inform the development of tailored home-based rehabilitation intervention. Objectives: To assess the long-term health and quality of life of Sri Lankan soldiers with traumatic lower-limb amputation.Methods and Materials: A comparative cross-sectional study was conducted in five districts of Sri Lanka. Using stratified random sample technique, two groups of 85 participants were selected; group 1, community re-integrated male army veterans with unilateral lower-limb amputation, and group 2, age and sex matched normal healthy individuals. Long-term health and quality of life (QoL) outcomes were assessed and compared between the two groups using self-administered Short-Form Health Survey-36 questionnaire (SF-36) previously validated for use in Sri Lanka. Results: Group 1 were active prosthetic users who had undergone amputation > ten years ago (Mean±SD: 21.7±5.9). The most prevalent comorbidities for group 1 and 2 were hypertension and diabetes (22.4% and 30.6% and 9.4% and 9.8%, respectively). In group 1, injury-associated long-term health outcomes included knee osteoarthritis (18.8%), knee pain (20.0%), and back pain (69.4%). Scores of physical health and psychological wellbeing were 53.1 (IQR 64.4- 43.8) and 63.5 (IQR 73.3- 51.4) for each group, respectively. Scores revealed the highest QoL related to social functioning (75 (IQR 87.5- 62.5)) and the poorest aspects of QoL related to general health (40 (IQR 50- 35)). Prevalence of comorbidities was significantly higher, and QoL outcomes were significantly lower among soldiers compared to normal healthy individuals (p<0.05).Conclusion: Higher prevalence of comorbidities, poor physical health, and lower QoL outcomes were more prevalent in soldiers with lower-limb amputation when compared to healthy counterparts.

Keywords: community-based, disability, health outcomes, quality of life, soldiers

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4473 Development of an Omaha System-Based Remote Intervention Program for Work-Related Musculoskeletal Disorders (WMSDs) Among Front-Line Nurses

Authors: Tianqiao Zhang, Ye Tian, Yanliang Yin, Yichao Tian, Suzhai Tian, Weige Sun, Shuhui Gong, Limei Tang, Ruoliang Tang

Abstract:

Introduction: Healthcare workers, especially the nurses all over the world, are highly vulnerable to work-related musculoskeletal disorders (WMSDs), experiencing high rates of neck, shoulder, and low back injuries, due to the unfavorable working conditions. To reduce WMSDs among nursing personnel, many workplace interventions have been developed and implemented. Unfortunately, the ongoing Covid-19 (SARS-CoV-2) pandemic has posed great challenges to the ergonomic practices and interventions in healthcare facilities, particularly the hospitals, since current Covid-19 mitigation measures, such as social distancing and working remotely, has substantially minimized in-person gatherings and trainings. On the other hand, hospitals throughout the world have been short-staffed, resulting in disturbance of shift scheduling and more importantly, the increased job demand among the available caregivers, particularly the doctors and nurses. With the latest development in communication technology, remote intervention measures have been developed as an alternative, without the necessity of in-person meetings. The Omaha System (OS) is a standardized classification system for nursing practices, including a problem classification system, an intervention system, and an outcome evaluation system. This paper describes the development of an OS-based ergonomic intervention program. Methods: First, a comprehensive literature search was performed among worldwide electronic databases, including PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), between journal inception to May 2020, resulting in a total of 1,418 scientific articles. After two independent screening processes, the final knowledge pool included eleven randomized controlled trial studies to develop the draft of the intervention program with Omaha intervention subsystem as the framework. After the determination of sample size needed for statistical power and the potential loss to follow-up, a total of 94 nurses from eight clinical departments agreed to provide written, informed consent to participate in the study, which were subsequently assigned into two random groups (i.e., intervention vs. control). A subgroup of twelve nurses were randomly selected to participate in a semi-structured interview, during which their general understanding and awareness of musculoskeletal disorders and potential interventions was assessed. Then, the first draft was modified to reflect the findings from these interviews. Meanwhile, the tentative program schedule was also assessed. Next, two rounds of consultation were conducted among experts in nursing management, occupational health, psychology, and rehabilitation, to further adjust and finalize the intervention program. The control group had access to all the information and exercise modules at baseline, while an interdisciplinary research team was formed and supervised the implementation of the on-line intervention program through multiple social media groups. Outcome measures of this comparative study included biomechanical load assessed by the Quick Exposure Check and stresses due to awkward body postures. Results and Discussion: Modification to the draft included (1) supplementing traditional Chinese medicine practices, (2) adding the use of assistive patient handling equipment, and (3) revising the on-line training method. Information module should be once a week, lasting about 20 to 30 minutes, for a total of 6 weeks, while the exercise module should be 5 times a week, each lasting about 15 to 20 minutes, for a total of 6 weeks.

Keywords: ergonomic interventions, musculoskeletal disorders (MSDs), omaha system, nurses, Covid-19

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4472 Perception of Health Care Providers: A Need to Introduce Screening of Maternal Mental Health at Primary Health Care in Nepal

Authors: Manisha Singh, Padam Simkhada

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Background: Although mental health policy has been adapted in Nepal since 1997, the implementation of the policy framework is yet to happen. The fact that mental health services are largely concentrated in urban areas more specific to treatment only provides a clear picture of the scarcity of mental health services in the country. The shreds of evidence from around the world, along with WHO’s (World Health Organization) Mental Health Gap Action Program (mhGAP) suggest that effective mental health services can be provided from Primary Health Care (PHC) centers through community-based programs without having to place a specialized health worker. However, the country is still facing the same challenges to date with very few psychiatrists and psychologists, but they are largely based in cities. Objectives: The main objectives of this study are; (a) to understand the perception of health workers at PHC on maternal mental health, and (b) to assess the availability of the mental health services at PHC to address maternal mental health. Methods: This study used a qualitative approach where an in-depth interview was conducted with the health workers at the primary level. “Mayadevi” rural municipality in Rupendehi District that comprised of 13 small villages, was chosen as the study site. A total 8 health institutions which covered all 13 sites were included where either the health post in- charge or health worker working in maternal and child health care was interviewed for the study. All the health posts in the study area were included in the study. The interviews were conducted in Nepali; later, they were translated in English, transcribed, and triangulated. NViVO was used for the analysis. Results: The findings show that most of the health workers understood what maternal mental health was and deemed it as a public health issue. They could explain the symptoms and knew what medication to prescribe if need be. However, the majority of them failed to name the screening tools in place for maternal mental health. Moreover, they hadn’t even seen one. None of the health care centers had any provision for screening mental health status. However, one of the centers prescribed medication when the patients displayed symptoms of depression. But they believed there were a significant number of hidden cases in the community due to the stigma around mental health and being a woman with mental health problem makes the situation even difficult. Nonetheless, the health workers understood the importance of having screening tools and acknowledged the need of training and support in order to provide the services from PHC. Conclusion: Community health workers can identify cases with mental health problems and prevent them from deteriorating further. But there is a need for robust training and support to build the capacity of the health workers. The screening tools on mental health needs to be encouraged to be used in the PHC levels. Furthermore, community-based culture-sensitive programs need to be initiated and implemented to mitigate the stigma related issues around mental health.

Keywords: maternal mental health, health care providers, screening, Nepal

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