Search results for: family and community support
Commenced in January 2007
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Edition: International
Paper Count: 12761

Search results for: family and community support

11141 Pilot Trial of Evidence-Based Integrative Group Therapy to Improve Executive Functioning among Adults: Implications for Community Mental Health and Training Clinics

Authors: B. Parchem, M. Watanabe, D. Modrakovic, L. Mathew, A. Franklin, M. Cao, R. E. Broudy

Abstract:

Objective: Executive functioning (EF) deficits underlie several mental health diagnoses including ADHD, anxiety, and depression. Community mental health clinics face extensive waitlists for services with many referrals involving EF deficits. A pilot trial of a four-week group therapy was developed using key components from Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness with an aim to improve EF skills and offer low-fee services. Method: Eight adults (M = 34.5) waiting for services at a community clinic were enrolled in a four-week group therapy at an in-house training clinic for doctoral trainees. Baseline EF, pre-/post-intervention ADHD and distress symptoms, group satisfaction, and curriculum helpfulness were assessed. Results: Downward trends in ADHD and distress symptoms pre/post-intervention were not significant. Favorable responses on group satisfaction and helpfulness suggest clinical utility. Conclusion: Preliminary pilot data from a brief group therapy to improve EF may be an efficacious, acceptable, and feasible intervention for adults waiting for services at community mental health and training clinics where there are high demands and limits to services and staffs.

Keywords: executive functioning, cognitive-behavioral therapy, dialectical behavior therapy, mindfulness, adult group therapy

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11140 Maori Primary Industries Responses to Climate Change and Freshwater Policy Reforms in Aotearoa New Zealand

Authors: Tanira Kingi, Oscar Montes Oca, Reina Tamepo

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The introduction of the Climate Change Response (Zero Carbon) Amendment Act (2019) and the National Policy Statement for Freshwater Management (2020) both contain underpinning statements that refer to the principles of the Treaty of Waitangi and cultural concepts of stewardship and environmental protection. Maori interests in New Zealand’s agricultural, forestry, fishing and horticultural sectors are significant. The organizations that manage these investments do so on behalf of extended family groups that hold inherited interests based on genealogical connections (whakapapa) to particular tribal units (iwi and hapu) and areas of land (whenua) and freshwater bodies (wai). This paper draws on the findings of current research programmes funded by the New Zealand Agricultural Greenhouse Gas Research Centre (NZAGRC) and the Our Land & Water National Science Challenge (OLW NSC) to understand the impact of cultural knowledge and imperatives on agricultural GHG and freshwater mitigation and land-use change decisions. In particular, the research outlines mitigation and land-use change scenario decision support frameworks that model changes in emissions profiles (reductions in biogenic methane, nitrous oxide and nutrient emissions to freshwater) of agricultural and forestry production systems along with impacts on key economic indicators and socio-cultural factors. The paper also assesses the effectiveness of newly introduced partnership arrangements between Maori groups/organizations and key government agencies on policy co-design and implementation, and in particular, decisions to adopt mitigation practices and to diversify land use.

Keywords: co-design and implementation of environmental policy, indigenous environmental knowledge, Māori land tenure and agribusiness, mitigation and land use change decision support frameworks

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11139 Direct and Moderating Effect of Religious Activities, Sustainability and Peer Support on Job Performance

Authors: Fahad Alam

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Work stress directly affects job performance, specifically in a worse environment. Consequently, a social provision plays a crucial part for enhancement. Therefore, the current research investigates the direct and moderating effect between religious activities, sustainability and peer support on job performance at hospitals in Khyber PakhtunKhwa (KPK), Pakistan. Both primary and secondary data are collected through 261 questionnaires of medical employees from four district hospitals in Khyber PakhtunKhwa, Pakistan, in 2018. The analysis was carried out by SPSS16 and SMART PLS3, to test the direct effect of religious activities, sustainability and social support on job performance and the effect of moderating variable 'work environment' on job performance. The finding confirmed that direct and moderating variables play a significant positive effect among religious activities, sustainability and peer support on job performance, the variables help to diminish the strain level or the stress level, consequently helps in the job completed. Affirmative social approaches produce desirable effects on job performance. The research revealed that social provisions are significant triggers for superior practices. Moreover, the results are stimulating because some of the past literature revealed an insignificant correlation between social provision and performance. This study found that there is a significant relationship which persuades health care organizations.

Keywords: job performance, peer’s support, religious activities, sustainability, work environment

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11138 Impact of Agroforestry Practices on Biodiversity Management and Livelihoods of Communities Adjacent Magamba Nature Reserve(MNR), Tanzania

Authors: P. J. Kagosi, M. Mndolwa, E. Japhate

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The study was conducted to communities adjacent MNR, Lushoto district, Tanzania. The MNR is one of the nine nature reserves in the Eastern Arc Mountains of Tanzania with an area of 8,700ha with high biological diversity. However, biodiversity in MNR have been threatened by increasing human activities for livelihood in 1970s. The AF systems in the study area was practised since 1980s however, no study was conducted on AF impacts. This paper presents the influence of AF on livelihood of communities adjacent MNR and biodiversity conservation. Qualitative and quantitative data were collected using socio-economic survey and botanical surveys. Data were analysed using Statistical Packages for Social Sciences and content analysis. The study found that in 1970s free livestock grazing caused considerable surface runoff, soil erosion and reduction of crop production. Since 1980s, the study area received various interventions based on the land conservations and improved livelihood through practising AF systems. It was further found that the AF farming improved crop productivity, reduced soil erosion, increased firewood (80.2%) and other forest products availability and AF encouraged community members practicing indoor livestock keeping.The dominant agroforestry tree found in the study area is grevillea reported by 74.1% of respondents planting an average of 40 trees. The study found that the AF reduced pressure to MNR as forest products and fodders were obtained from community's farms in turn, currently water flow from MNR has been increased. Thus AF products support livelihood needs and conserve biodiversity. The study recommends continuity education on new AF technology packages.

Keywords: impact of agroforestry, biodiversity management, communities’ livelihoods, Magamba nature reserve

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11137 A Case Study on the Seismic Performance Assessment of the High-Rise Setback Tower Under Multiple Support Excitations on the Basis of TBI Guidelines

Authors: Kamyar Kildashti, Rasoul Mirghaderi

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This paper describes the three-dimensional seismic performance assessment of a high-rise steel moment-frame setback tower, designed and detailed per the 2010 ASCE7, under multiple support excitations. The vulnerability analyses are conducted based on nonlinear history analyses under a set of multi-directional strong ground motion records which are scaled to design-based site-specific spectrum in accordance with ASCE41-13. Spatial variation of input motions between far distant supports of each part of the tower is considered by defining time lag. Plastic hinge monotonic and cyclic behavior for prequalified steel connections, panel zones, as well as steel columns is obtained from predefined values presented in TBI Guidelines, PEER/ATC72 and FEMA P440A to include stiffness and strength degradation. Inter-story drift ratios, residual drift ratios, as well as plastic hinge rotation demands under multiple support excitations, are compared to those obtained from uniform support excitations. Performance objectives based on acceptance criteria declared by TBI Guidelines are compared between uniform and multiple support excitations. The results demonstrate that input motion discrepancy results in detrimental effects on the local and global response of the tower.

Keywords: high-rise building, nonlinear time history analysis, multiple support excitation, performance-based design

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11136 The Diverse Experiences of Men Living with Disabilities Participating in Violence Prevention Interventions in Africa and Asia: Men as Victims; Men as Perpetrators

Authors: Ingrid van der Heijden, Kristen Dunkle, Rachel Jewkes

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Background: Emerging literature on prevalence shows that men with disabilities are four more times likely than men without disabilities to experience sexual violence during their lifetime. However, compared to women with disabilities, men with disabilities still have lesser experiences of violence. While empirical evidence on the prevalence of victimization of men with disabilities is emerging, there is scarcer evidence highlighting disabled men’s perpetration of different forms of violence, particularly intimate partner violence. We can assume that men are likely to be both perpetrators and victims of violence, making more complex the causes and risks of violence. Gender norms and disability stigma play important roles in men’s experiences of violence. Men may be stigmatized because of their inability to attain hegemonic masculine ideals of strength, control over women and sexual conquest, which makes them more susceptible to emotional, physical and sexual abuse. Little to no evidence exists of men with disabilities’ experiences of perpetration of intimate partner violence, family violence or community violence. So far studies on male victimization do not succeed to offer contextual evidence that would highlight why and how men with disabilities perpetrate and/or are victims of sexual or other forms of violence. Objective: The overall aim to highlight men with disabilities’ experiences of both victimization and perpetration, and how living up to normative and hegemonic ideals of masculinity and ‘ability’ shape their experiences. It will include: identifying how gender and impairments intersect and shape their experiences of violence; identifying the contexts of and risks for violence; identifying the impacts and consequences of violence on their lives (including mental health impacts), and identifying obstacles and enablers to support and interventions to prevent violence. Methodology: In-depth qualitative interviews with 20 men with disabilities participating in interventions conducted by the What Works Global Programme for violence prevention (DIFD) in Africa and Asia. Men with a range of disabilities will be invited to share their lifetime experiences of violence. Implications for Practice: The data from this study will be used to start thinking about strategies to include men with disabilities in violence prevention strategies for both men and women. Limitations: Because men will be participating in interventions, it is assumed that they will not have severe impairments that hamper their cognitive or physical ability to participate in the intervention activities - and therefore will be able to participate in the in-depth interviews. Of course, this is a limitation of the study as it does not include those men with severe disabilities – measured by the World Health Organization’s International Classification of Functioning - who may be more vulnerable and at higher risk of experiencing violence, and who are less likely to be able to access services and interventions.

Keywords: gender, men with disabilities, perpetration of violence, victimization

Procedia PDF Downloads 319
11135 Missing Narratives and Their Potential Impact on Resettlement Strategies

Authors: Natina Roberts, Hanhee Lee

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The existing and emerging refugee research reports unfavorable resettlement outcomes in multiple domains. The proposed paper highlights trends in refugee research in which empirical studies investigate resettlement of former refugees from individual and culturally homogeneous perspectives. The proposed paper then aims to examine the reality of the lived experience of resettlement from family and cross-cultural viewpoints. Proponents for this focus include the United Nations High Commissioner for Refugees (UNHCR). The UNHCR is responsible for leading resettlement efforts for refugees through the durable solutions of repatriation, local integration and resettlement. Life experiences with refugee families, and a report of literary findings on former refugee resettlement from various cultural backgrounds – that highlight similarities and differences among various ethnic groups, will be discussed. The proposed paper is expected to frame underrepresented refugee perspectives, and review policy implications in healthcare, education, and public support systems.

Keywords: refugee, cross-cultural, families, resettlement policy

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11134 Understanding Systemic Barriers (and Opportunities) to Increasing Uptake of Subcutaneous Medroxy Progesterone Acetate Self-Injection in Health Facilities in Nigeria

Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The DISC project collaborated with partners to implement demand creation and service delivery interventions, including the MoT (Moment of Truth) innovation, in over 500 health facilities across 15 states. This has increased the voluntary conversion rate to self-injection among women who opt for injectable contraception. While some facilities recorded an increasing trend in key performance indicators, few others persistently performed sub-optimally due to provider and system-related barriers. Methodology: Twenty-two facilities performing sub-optimally were selected purposively from three Nigerian states. Low productivity was appraised using low reporting rates and poor SI conversion rates as indicators. Interviews were conducted with health providers across these health facilities using a rapid diagnosis tool. The project also conducted a data quality assessment that evaluated the veracity of data elements reported across the three major sources of family planning data in the facility. Findings: The inability and sometimes refusal of providers to support clients to self-inject effectively was associated with the misunderstanding of its value to their work experience. It was also observed that providers still held a strong influence over clients’ method choices. Furthermore, providers held biases and misconceptions about DMPA-SC that restricted the access of obese clients and new acceptors to services – a clear departure from the recommendations of the national guidelines. Additionally, quality of care standards was compromised because job aids were not used to inform service delivery. Facilities performing sub-optimally often under-reported DMPA-SC utilization data, and there were multiple uncoordinated responsibilities for recording and reporting. Additionally, data validation meetings were not regularly convened, and these meetings were ineffective in authenticating data received from health facilities. Other reasons for sub-optimal performance included poor documentation and tracking of stock inventory resulting in commodity stockouts, low client flow because of poor positioning of health facilities, and ineffective messaging. Some facilities lacked adequate human and material resources to provide services effectively and received very few supportive supervision visits. Supportive supervision visits and Data Quality Audits have been useful to address the aforementioned performance barriers. The project has deployed digital DMPA-SC self-injection checklists that have been aligned with nationally approved templates. During visits, each provider and community mobilizer is accorded special attention by the supervisor until he/she can perform procedures in line with best practice (protocol). Conclusion: This narrative provides a summary of a range of factors that identify health facilities performing sub-optimally in their provision of DMPA-SC services. Findings from this assessment will be useful during project design to inform effective strategies. As the project enters its final stages of implementation, it is transitioning high-impact activities to state institutions in the quest to sustain the quality of service beyond the tenure of the project. The project has flagged activities, as well as created protocols and tools aimed at placing state-level stakeholders at the forefront of improving productivity in health facilities.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, barriers, opportunities, performance

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11133 Unsafe Abortions in India: Questioning the Propitiousness of MTP Act

Authors: Suresh Sharma, Neeti Goutam

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In India abortions are legal and with the exceedingly liberal and broadened law that was passed in 1971, “Medical Termination of Pregnancy Act” had opened a new window to Women’s’ freedom and choice over their fertility. This paper would like to focus on the factors responsible for or leading to unsafe abortion as well as such high incidence of abortion in India which can help in understanding the ways in which we can prevent this apathy. To study the intricacies involved in delivering safety to womanhood in terms of safe abortion practice which includes more trained personnel, detailed explanation and consequences of conducting an abortion, fine reporting, awareness regarding family planning measures and not only pressurizing them to sterilize immediately after an abortion but also prior to that informing them and lastly easy accessibility of Contraceptives with a educated and brief information on that. Data has been drawn from various sources such as National Family Household Survey (1, 2, 3), Health Management Information System and Annual Health Survey. To safeguard the interest of women when it comes to complications resulting from unsafe abortions, Reproductive Health laid its strict adherence to it in its guidelines. The Government could induce more measures in terms of family planning measures and increase in the number of skilled medical health force, chiefly in rural areas to prevent the illegality of abortions. But before that fine reporting on the number of abortions performed will give an insight to this very issue only then policies and programs will work much better in favor of women.

Keywords: abortion, MTP act, India, women

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11132 A Sustainable Training and Feedback Model for Developing the Teaching Capabilities of Sessional Academic Staff

Authors: Nirmani Wijenayake, Louise Lutze-Mann, Lucy Jo, John Wilson, Vivian Yeung, Dean Lovett, Kim Snepvangers

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Sessional academic staff at universities have the most influence and impact on student learning, engagement, and experience as they have the most direct contact with undergraduate students. A blended technology-enhanced program was created for the development and support of sessional staff to ensure adequate training is provided to deliver quality educational outcomes for the students. This program combines innovative mixed media educational modules, a peer-driven support forum, and face-to-face workshops to provide a comprehensive training and support package for staff. Additionally, the program encourages the development of learning communities and peer mentoring among the sessional staff to enhance their support system. In 2018, the program was piloted on 100 sessional staff in the School of Biotechnology and Biomolecular Sciences to evaluate the effectiveness of this model. As part of the program, rotoscope animations were developed to showcase ‘typical’ interactions between staff and students. These were designed around communication, confidence building, consistency in grading, feedback, diversity awareness, and mental health and wellbeing. When surveyed, 86% of sessional staff found these animations to be helpful in their teaching. An online platform (Moodle) was set up to disseminate educational resources and teaching tips, to host a discussion forum for peer-to-peer communication and to increase critical thinking and problem-solving skills through scenario-based lessons. The learning analytics from these lessons were essential in identifying difficulties faced by sessional staff to further develop supporting workshops to improve outcomes related to teaching. The face-to-face professional development workshops were run by expert guest speakers on topics such as cultural diversity, stress and anxiety, LGBTIQ and student engagement. All the attendees of the workshops found them to be useful and 88% said they felt these workshops increase interaction with their peers and built a sense of community. The final component of the program was to use an adaptive e-learning platform to gather feedback from the students on sessional staff teaching twice during the semester. The initial feedback provides sessional staff with enough time to reflect on their teaching and adjust their performance if necessary, to improve the student experience. The feedback from students and the sessional staff on this model has been extremely positive. The training equips the sessional staff with knowledge and insights which can provide students with an exceptional learning environment. This program is designed in a flexible and scalable manner so that other faculties or institutions could adapt components for their own training. It is anticipated that the training and support would help to build the next generation of educators who will directly impact the educational experience of students.

Keywords: designing effective instruction, enhancing student learning, implementing effective strategies, professional development

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11131 Building Knowledge Partnership for Collaborative Learning in Higher Education – An On-Line ‘Eplanete’ Knowledge Mediation Platform

Authors: S. K. Ashiquer Rahman

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This paper presents a knowledge mediation platform, “ePLANETe Blue” that addresses the challenge of building knowledge partnerships for higher education. The purpose is to present, as an institutional perception, the ‘ePLANETe' idea and functionalities as a practical and pedagogical innovation program contributing to the collaborative learning goals in higher education. In consequence, the set of functionalities now amalgamated in ‘ePLANETe’ can be seen as an investigation of the challenges of “Collaborative Learning Digital Process.” It can exploit the system to facilitate collaborative education, research and student learning in higher education. Moreover, the platform is projected to support the identification of best practices at explicit levels of action and to inspire knowledge interactions in a “virtual community” and thus to advance in deliberation and learning evaluation of higher education through the engagement of collaborative activities of different sorts.

Keywords: mediation, collaboration, deliberation, evaluation

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11130 Productive Engagements and Psychological Wellbeing of Older Adults; An Analysis of HRS Dataset

Authors: Mohammad Didar Hossain

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Background/Purpose: The purpose of this study was to examine the associations between productive engagements and the psychological well-being of older adults in the U.S by analyzing cross-sectional data from a secondary dataset. Specifically, this paper analyzed the associations of 4 different types of productive engagements, including current work status, caregiving to the family members, volunteering and religious strengths with the psychological well-being as an outcome variable. Methods: Data and sample: The study used the data from the Health and Retirement Study (HRS). The HRS is a nationally representative prospective longitudinal cohort study that has been conducting biennial surveys since 1992 to community-dwelling individuals 50 years of age or older on diverse issues. This analysis was based on the 2016 wave (cross-sectional) of the HRS dataset and the data collection period was April 2016 through August 2017. The samples were recruited from a multistage, national area-clustered probability sampling frame. Measures: Four different variables were considered as the predicting variables in this analysis. Firstly, current working status was a binary variable that measured by 0=Yes and 1= No. The second and third variables were respectively caregiving and volunteering, and both of them were measured by; 0=Regularly, 1= Irregularly. Finally, find in strength was measured by 0= Agree and 1= Disagree. Outcome (Wellbeing) variable was measured by 0= High level of well-being, 1= Low level of well-being. Control variables including age were measured in years, education in the categories of 0=Low level of education, 1= Higher level of education and sex r in the categories 0=male, 1= female. Analysis and Results: Besides the descriptive statistics, binary logistic regression analyses were applied to examine the association between independent and dependent variables. The results showed that among the four independent variables, three of them including working status (OR: .392, p<.001), volunteering (OR: .471, p<.003) and strengths in religion (OR .588, p<.003), were significantly associated with psychological well-being while controlling for age, gender and education factors. Also, no significant association was found between the caregiving engagement of older adults and their psychological well-being outcome. Conclusions and Implications: The findings of this study are mostly consistent with the previous studies except for the caregiving engagements and their impact on older adults’ well-being outcomes. Therefore, the findings support the proactive initiatives from different micro to macro levels to facilitate opportunities for productive engagements for the older adults, and all of these may ultimately benefit their psychological well-being and life satisfaction in later life.

Keywords: productive engagements, older adults, psychological wellbeing, productive aging

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11129 SARS-CoV-2 Transmission Risk Factors among Patients from a Metropolitan Community Health Center, Puerto Rico, July 2020 to March 2022

Authors: Juan C. Reyes, Linnette Rodríguez, Héctor Villanueva, Jorge Vázquez, Ivonne Rivera

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On July 2020, a private non-profit community health center (HealthProMed) that serves people without a medical insurance plan or with limited resources in one of the most populated areas in San Juan, Puerto Rico, implemented a COVID-19 case investigation and contact-tracing surveillance system. Nursing personnel at the health center completed a computerized case investigation form that was translated, adapted, and modified from CDC’s Patient Under Investigation (PUI) Form. Between July 13, 2020, and March 17, 2022, a total of 9,233 SARS-CoV-2 tests were conducted at the health center, 16.9% of which were classified as confirmed cases (positive molecular test) and 27.7% as probable cases (positive serologic test). Most of the confirmed cases were females (60.0%), under 20 years old (29.1%), and living in their homes (59.1%). In the 14 days before the onset of symptoms, 26.3% of confirmed cases reported going to the supermarket, 22.4% had contact with a known COVID-19 case, and 20.7% went to work. The symptoms most commonly reported were sore throat (33.4%), runny nose (33.3%), cough (24.9%), and headache (23.2%). The most common preexisting medical conditions among confirmed cases were hypertension (19.3%), chronic lung disease including asthma, emphysema, COPD (13.3%), and diabetes mellitus (12.8). Multiple logistic regression analysis revealed that patients who used alcohol frequently during the last two weeks (OR=1.43; 95%CI: 1.15-1.77), those who were in contact with a positive case (OR=1.58; 95%CI: 1.33-1.88) and those who were obese (OR=1.82; 95%CI: 1.24-2.69) were significantly more likely to be a confirmed case after controlling for sociodemographic variables. Implementing a case investigation and contact-tracing component at community health centers can be of great value in the prevention and control of COVID-19 at the community level and could be used in future outbreaks.

Keywords: community health center, Puerto Rico, risk factors, SARS-CoV-2

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11128 Spatial Analysis of the Perception of Family Planning among Teenage Mothers in Nigeria

Authors: Mbuotidem Brendan, Nathanael Afolabi

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

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

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11127 Intensive Care Unit Patient Self-Determination When Facing Cardiovascular Surgery for the First Time

Authors: Hsiao-Lin Fang

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The Patient Self-Determination Act is based on the belief that each life is unique. The act regards each patient as an autonomous entity and explicitly protects the patient’s rights to know and make decisions and choices while ensuring that the patient’s wish for a peaceful end is granted. Even when the patient is unconscious and unable to express himself/herself, the patient’s self-determination and its exercise are still protected under the law. The act also ensures that healthcare professionals (HCPs) have a specific set of rules to follow and complete legal protection when their patients are unable to express themselves clearly. This report is about a 55-year-old female patient who weighed 110 kg and was diagnosed with acute type A aortic dissection. The case was that the patient suddenly felt backache and nausea during sleep before daybreak and was therefore transferred to this hospital from the original one. After the doctor explained the patient’s conditions, it was concluded that surgery was necessary. However, the patient’s family was immediately against the surgery after having heard its possible complications. Nevertheless, the patient was still willing to receive the surgery. Being at odds with her family, the patient decided to sign the surgery agreement herself and agreed to receive the two surgical procedures: (1) ascending aorta replacement and (2) innominate artery debranching. After the surgery, the patient did not regain consciousness and therefore received computed tomography scanning of the brain, which revealed false lumen involving proximal left common carotid artery, left subclavian artery and innominate artery, and severe compression of the true lumen with total/subtotal occlusion in the left common carotid artery. On the following day, the doctor discussed two further surgical procedures: (1) endografting for descending aorta and (2) endografting for left common carotid artery and subclavian artery with the family. However, as the patient’s postoperative recovery of consciousness only reached the level of stupor and her family had no intention of subsequent healthcare for the patient, the family made the joint decision three days later to have the endotracheal tube removed from the patient and let her die a natural death. Suggestion: An advance directive (AD) can be created beforehand. Once the patient is in a special clinical state (e.g., terminal illness, permanent vegetative state, etc.), the AD can determine whether to sustain the patient’s life through ‘medical intervention’ or to respect the patient’s rights to choose a peaceful end and receive palliative care. Through the expression of self-determination, it is possible to respect the patient’s medical practice autonomy and protect the patient’s dignity and right to a peaceful end, thereby respecting and supporting the patient’s decision. This also allows the three sides: the patient, the family and the medical team to understand the patient’s true wish in the process of advance care planning (ACP) and thereby promote harmony in the HCP-patient relationship.

Keywords: intensive care unit patient, cardiovascular surgery, self-determination, advance directive

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11126 Exploring the Barriers Regarding Safe Discussions about Menopausal Symptom Management, As Perceived or Experienced by Pre-menopausal and Menopausal Women

Authors: Karish Thavabalan, Aman Sutaria, Alistair Ovenell, Annabelle Parkhouse, Numan Baydemir, Theodore Lally

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Background: Open discussions surrounding menopause are often associated with stigma, with many women feeling uncomfortable engaging in them with friends, colleagues, and healthcare professionals. Though the barriers regarding safe discussions of symptom management experienced by menopausal women are well documented, existing research offers little insight into whether these were shared by pre-menopausal women. This study aimed to explore the barriers regarding safe discussions about menopausal symptom management as perceived or experienced by pre-menopausal and menopausal women. Methods: This qualitative study was conducted over a 2-month period (March 2022 - April 2022) under the auspices of Imperial College Business School, London, UK. Snowball sampling was used to recruit both menopausal (age 45-70) and pre-menopausal participants (age <45) and sampling continued until data saturation was achieved. Sixteen semi-structured online interviews were conducted, and transcripts were thematically analyzed following Braun and Clarke’s six-step methodology. Results: A total of 7 higher themes regarding safe discussion of menopausal symptom management were identified by both pre-menopausal and menopausal women, including: “ineffective coping mechanisms,” “perceived onus to self-endure,” “lack of workplace support,” “poor knowledge of management approaches,” “poor healthcare infrastructure,” “poor support from friends and family,” “lack of knowledge and interest from a young age.” Conclusion: Identifying the barriers regarding safe discussion helped to highlight which areas require the most significant intervention. Alongside tackling the barriers, menopausal women face, ultimately, there is a pertinent need to address the lack of insight into menopause from a younger age and to encourage earlier discussions so as to not propagate the cycle of stigma.

Keywords: menopause, safe discussion, symptom management, stigma

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11125 Exploring Family and Preschool Early Interactive Literacy Practices in Jordan

Authors: Rana Alkhamra

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Background: Child's earliest experiences with books and stories during the first years of his life are strongly linked with the development of his early language and literacy skills. Interacting in routine learning activities, such as shared book reading, storytelling, and teaching about the letters of the alphabet make a critical foundation for early learning, language growth and emergent literacy. Aim: The current study explores family and preschool early interactive literacy practices in families and preschools (nursery and kindergarten) in Jordan. It highlights the importance of early interactive literacy activities on child language and literacy growth and development. Methods: This is a cross sectional study that surveyed 243 Jordanian families. The survey investigated literacy routine practices, largely shared books reading, at home and at preschool; child speech and language development; and family demographics. Results: Around 92.5% of the families read books and stories to their children, as frequently as 1-2 times weekly or monthly (75%). Only 19.6% read books on daily basis. Many families reported preferring story-telling (97%). Despite that families acknowledged the importance of early literacy activities, on language, reading and writing, cognitive, and academic development, 45% asked for education and training pertaining to specific ways and ideas to help their young children develop language and literacy skills. About 69% of the families reported reading books and stories to their children for 15 minutes a day, while 71.2% indicated having their children watch television for 3 to > 6 hours a day. At preschool, only 52.8% of the teachers were reported to read books and stories. Factors like parent education, monthly income, living inside (33.6%) or outside (66.4%) the capital city of Amman significantly (p < 0.05) affected child early literacy interactive activities whether at home or at preschool. Conclusion: Early language and literacy skills depend largely on the opportunities and experiences provided to children in the home and in preschool environment. Family literacy programs can play an important role in bridging the gap in early literacy experiences for families that need help. Also, speech therapists can work in collaboration with families and educators to ensure that young children have high quality and sufficient opportunities to participate in early literacy activities both at home and in preschool environments.

Keywords: literacy, interactive activities, language, practices, family, preschool, Jordan

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11124 A Self-Study of the Facilitation of Science Teachers’ Action Research

Authors: Jawaher A. Alsultan, Allen Feldman

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With the rapid switch to remote learning due to the COVID-19 pandemic, science teachers were suddenly required to teach their classes online. This breakneck shift to eLearning raised the question of how teacher educators could support science teachers who wanted to use reform-based methods of instruction while using virtual technologies. In this retrospective self-study, we, two science teacher educators, examined our practice as we worked with science teachers to implement inquiry, discussion, and argumentation [IDA] through eLearning. Ten high school science teachers from a large school district in the southeastern US participated virtually in the COVID-19 Community of Practice [COVID-19 CoP]. The CoP met six times from the end of April through May 2020 via Zoom. Its structure was based on a model of action research called enhanced normal practice [ENP], which includes exchanging stories, trying out ideas, and systematic inquiry. Data sources included teacher educators' meeting notes and reflective conversations, audio recordings of the CoP meetings, teachers' products, and post-interviews of the teachers. Findings included a new understanding of the role of existing relationships, shared goals, and similarities in the participants' situations, which helped build trust in the CoP, and the effects of our paying attention to the science teachers’ needs led to a well-functioning CoP. In addition, we became aware of the gaps in our knowledge of how the teachers already used apps in their practice, which they then shared with all of us about how they could be used for online teaching using IDA. We also identified the need to pay attention to feelings about tensions between the teachers and us around the expectations for final products and the project's primary goals. We found that if we are to establish relationships between us as facilitators and teachers that are honest, fair, and kind, we must express those feelings within the collective, dialogical processes that can lead to learning by all members of the CoP, whether virtual or face-to-face.

Keywords: community of practice, facilitators, self-study, action research

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11123 Linking Museum Education with School Curriculum: Primary Education Case Study Grade 4

Authors: Marwa Hanafy

Abstract:

The objective of linking the museum with school curriculum is to focus on the values and principles of the educational standards of the fourth grade as "equality, cooperation, allegiance, belonging, participation, peace, tolerance, pride and patriotism, etc." through activities, discussion, exhibits, etc., which can help the students to develop their characters and be useful for their society. For example, there is a lesson in Module 3 assess the role of women as mothers and queens, here this research will focus on the value of women and respect them through statues or images of women which support and affect positively on the students who will apply these Morals to themselves and to the community by dependency. It cannot be denied that the students have to be a part of the museum educational programs which have designed for them, by giving them the opportunity to participate, talk, discuss and express their opinions and hear them in the museums, this may be an effective way to confirm that the interests of children are taken into account.

Keywords: museum education, primary school education, school curriculum, informal learning

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11122 Lived Experience of Breast Cancer for Arab Muslim Women

Authors: Nesreen M. Alqaissi

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Little is known about the lived experiences of breast cancer among Arab Muslim women. The researcher used a qualitative interpretive phenomenological research design to explore the lived experiences of breast cancer as described by Jordanian Muslim women. A purposive sample of 20 women with breast cancer was recruited. Data were collected utilizing individual semi-structured interviews, and analyzed using Heideggerian Hermeneutical methodology. Results: Five related themes and one constitutive pattern: (a) breast cancer means death; (b) matriarchal family members as important source of support; (c) spirituality as a way to live and survive breast cancer; (d) concealing cancer experiences to protect self and families; (e) physicians as protectors and treatment decision makers; (f) the constitutive pattern: culture influencing Jordanian women experiences with breast cancer. In conclusion, researchers and healthcare providers should consider the influence of culture, spirituality, and families, when caring for women with breast cancer from Jordan.

Keywords: breast cancer, Arab Muslim, Jordan, lived experiences, spirituality, culture

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11121 Democracy in Gaming: An Artificial Neural Network Based Approach towards Rule Evolution

Authors: Nelvin Joseph, K. Krishna Milan Rao, Praveen Dwarakanath

Abstract:

The explosive growth of Smart phones around the world has led to the shift of the primary engagement tool for entertainment from traditional consoles and music players to an all integrated device. Augmented Reality is the next big shift in bringing in a new dimension to the play. The paper explores the construct and working of the community engine in Delta T – an Augmented Reality game that allows users to evolve rules in the game basis collective bargaining mirroring democracy even in a gaming world.

Keywords: augmented reality, artificial neural networks, mobile application, human computer interaction, community engine

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11120 Predicting Acceptance and Adoption of Renewable Energy Community solutions: The Prosumer Psychology

Authors: Francois Brambati, Daniele Ruscio, Federica Biassoni, Rebecca Hueting, Alessandra Tedeschi

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This research, in the frame of social acceptance of renewable energies and community-based production and consumption models, aims at (1) supporting a data-driven approachable to dealing with climate change and (2) identifying & quantifying the psycho-sociological dimensions and factors that could support the transition from a technology-driven approach to a consumer-driven approach throughout the emerging “prosumer business models.” In addition to the existing Social Acceptance dimensions, this research tries to identify a purely individual psychological fourth dimension to understand processes and factors underling individual acceptance and adoption of renewable energy business models, realizing a Prosumer Acceptance Index. Questionnaire data collection has been performed throughout an online survey platform, combining standardized and ad-hoc questions adapted for the research purposes. To identify the main factors (individual/social) influencing the relation with renewable energy technology (RET) adoption, a Factorial Analysis has been conducted to identify the latent variables that are related to each other, revealing 5 latent psychological factors: Factor 1. Concern about environmental issues: global environmental issues awareness, strong beliefs and pro-environmental attitudes rising concern on environmental issues. Factor 2. Interest in energy sharing: attentiveness to solutions for local community’s collective consumption, to reduce individual environmental impact, sustainably improve the local community, and sell extra energy to the general electricity grid. Factor 3. Concern on climate change: environmental issues consequences on climate change awareness, especially on a global scale level, developing pro-environmental attitudes on global climate change course and sensitivity about behaviours aimed at mitigating such human impact. Factor 4. Social influence: social support seeking from peers. With RET, advice from significant others is looked for internalizing common perceived social norms of the national/geographical region. Factor 5. Impact on bill cost: inclination to adopt a RET when economic incentives from the behaviour perception affect the decision-making process could result in less expensive or unvaried bills. Linear regression has been conducted to identify and quantify the factors that could better predict behavioural intention to become a prosumer. An overall scale measuring “acceptance of a renewable energy solution” was used as the dependent variable, allowing us to quantify the five factors that contribute to measuring: awareness of environmental issues and climate change; environmental attitudes; social influence; and environmental risk perception. Three variables can significantly measure and predict the scores of the “Acceptance in becoming a prosumer” ad hoc scale. Variable 1. Attitude: the agreement to specific environmental issues and global climate change issues of concerns and evaluations towards a behavioural intention. Variable 2. Economic incentive: the perceived behavioural control and its related environmental risk perception, in terms of perceived short-term benefits and long-term costs, both part of the decision-making process as expected outcomes of the behaviour itself. Variable 3. Age: despite fewer economic possibilities, younger adults seem to be more sensitive to environmental dimensions and issues as opposed to older adults. This research can facilitate policymakers and relevant stakeholders to better understand which relevant psycho-sociological factors are intervening in these processes and what and how specifically target when proposing change towards sustainable energy production and consumption.

Keywords: behavioural intention, environmental risk perception, prosumer, renewable energy technology, social acceptance

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11119 Enhancing a Competitive Advantage for Thailand’s IT Entrepreneurs

Authors: T. Niracharapa, W. Angkana

Abstract:

Since information and communication technology (ICT) plays a critical role in enhancing national competitiveness, it is a driving force for social and economic growth and prosperity. The ASEAN Economic Community (AEC) will integrate this into ASEAN countries as a new mechanism and a measure that will improve economic performance as a global economy. Government policies may support or impede such harmonization. This study was to investigate, analyze the status of Thai IT entrepreneurs and define key strategies to enhance their competitive advantage. Data were collected based on in-depth interviews, questionnaires, focus groups, seminars and fieldwork on information technology excluding communication. SWOT was used as a tool to analyze the study. The results of this study can be used to enable the government to guide policy, measures and strategies for creating a competitive advantage for Thailand’s IT entrepreneurs in the global market.

Keywords: AEC, ASEAN, competitive advantage, IT entrepreneurs

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11118 Elder Abuse Interventions: What We Know and What We Need to Know

Authors: Sepali Guruge

Abstract:

Background: There is an increase in interest among health care professionals and social workers in understanding how best to identify, mitigate, and prevent elder abuse. Purpose & method: Based on a recently completed scoping review of related literature, this paper will focus on the current state of knowledge on elder abuse interventions. Results: The results will be presented in light of the fact that limited literature exists on primary prevention of elder abuse. The existing literature on interventions to reduce or stop abuse will be critically examined in terms of their effectiveness. Particular attention will be paid to interventions such as relocation of older adults experiencing abuse, in-home assessments, empowerment and psycho-educational support for older adults. Conclusions: Overall, multi-stakeholder collaborative, community-based interventions should be designed to identify, mitigate, and prevent elder abuse.

Keywords: elder abuse, interventions, scoping review, prevention

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11117 Proximal Method of Solving Split System of Minimization Problem

Authors: Anteneh Getachew Gebrie, Rabian Wangkeeree

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The purpose of this paper is to introduce iterative algorithm solving split system of minimization problem given as a task of finding a common minimizer point of finite family of proper, lower semicontinuous convex functions and whose image under a bounded linear operator is also common minimizer point of another finite family of proper, lower semicontinuous convex functions. We obtain strong convergence of the sequence generated by our algorithm under some suitable conditions on the parameters. The iterative schemes are developed with a way of selecting the step sizes such that the information of operator norm is not necessary. Some applications and numerical experiment is given to analyse the efficiency of our algorithm.

Keywords: Hilbert Space, minimization problems, Moreau-Yosida approximate, split feasibility problem

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11116 Exploring Coping Strategies among Caregivers of Children Who Have Survived Cancer

Authors: Noor Ismael, Somaya Malkawi, Sherin Al Awady, Taleb Ismael

Abstract:

Background/Significance: Cancer is a serious health condition that affects individuals’ quality of life during and after the course of this condition. Children who have survived cancer and their caregivers may deal with residual physical, cognitive or social disabilities. There is little research on caregivers’ health and wellbeing after cancer. To the authors’ best knowledge; there is no specific research about how caregivers cope with everyday stressors after cancer. Therefore, this study aimed to explore the coping strategies that caregivers of children who have survived cancer utilize to overcome everyday stressors. Methods: This study utilized a descriptive survey design. The sample consisted of 103 caregivers, who visited the health and wellness clinic at a national cancer center (additional demographics are presented in the results). The sample included caregivers of children who were off cancer treatments for at least two years from the beginning of data collection. The institution’s internal review board approved this study. Caregivers who agreed to participate completed the survey. The survey collected caregiver reported demographic information and the Brief COPE which measures caregivers' frequency of engaging in certain coping strategies. The Brief COPE consisted of 14 coping sub-scales, which are self-distraction, active coping, denial, substance use, use of emotional support, use of instrumental support, behavioral disengagement, venting, positive reframing, planning, humor, acceptance, religion, and self-blame. Data analyses included calculating sub-scales’ scores for the fourteen coping strategies and analysis of frequencies of demographics and coping strategies. Results: The 103 caregivers who participated in this study were 62% mothers, 80% married, 45% finished high school, 50% do not work outside the house, and 60% have low family income. Result showed that religious coping (66%) and acceptance (60%) were the most utilized coping strategies, followed by positive reframing (45%), active coping (44%) and planning (43%). The least utilized coping strategies in our sample were humor (5%), behavioral disengagement (8%), and substance-use (10%). Conclusions: Caregivers of children who have survived cancer mostly utilize religious coping and acceptance in dealing with everyday stressors. Because these coping strategies do not directly solve stressors like active coping and planning coping strategies, it is important to support caregivers in choosing and implementing effective coping strategies. Knowing from our results that some caregivers may utilize substance use as a coping strategy, which has negative health effects on caregivers and their children, there must be direct interventions that target these caregivers and their families.

Keywords: caregivers, cancer, stress, coping

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11115 Global Learning Supports Global Readiness with Projects with Purpose

Authors: Brian Bilich

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A typical global learning program is a two-week project based, culturally immersive and academically relevant experience built around a project with purpose and catered to student and business groups. Global Learning in Continuing Education at Austin Community College promotes global readiness through projects with purpose with special attention given to balancing learning, hospitality and travel. A recent project involved CommunityFirst! Village; a 51-acre planned community which provides affordable, permanent housing for men and women coming out of chronic homelessness. Global Learning students collaborated with residents and staff at the Community First! Village on a project to produce two-dimensional remodeling plans of residents’ tiny homes with a focus on but not limited to design improvements on elements related to accessibility, increased usability of living and storage space and esthetic upgrades to boost psychological and emotional appeal. The goal of project-based learning in the context of global learning in Continuing Educaiton at Austin Community Collegen general is two fold. One, in rapid fashion we develop a project which gives the learner a hands-on opportunity to exercise soft and technical skills, like creativity and communication and analytical thinking. Two, by basing projects on global social conflict issues, the project of purpose promotes the development of empathy for other people and fosters a sense of corporate social responsibility in future generations of business leadership. In the example provide above the project informed the student group on the topic of chronic homelessness and promoted awareness and empathy for this underserved segment of the community. Project-based global learning based on projects with purpose has the potential to cultivate global readiness by developing empathy and strengthening emotional intelligence for future generations.

Keywords: project-based learning, global learning, global readiness, globalization, international exchange, collaboration

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11114 Trajectories of Conduct Problems and Cumulative Risk from Early Childhood to Adolescence

Authors: Leslie M. Gutman

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Conduct problems (CP) represent a major dilemma, with wide-ranging and long-lasting individual and societal impacts. Children experience heterogeneous patterns of conduct problems; based on the age of onset, developmental course and related risk factors from around age 3. Early childhood represents a potential window for intervention efforts aimed at changing the trajectory of early starting conduct problems. Using the UK Millennium Cohort Study (n = 17,206 children), this study (a) identifies trajectories of conduct problems from ages 3 to 14 years and (b) assesses the cumulative and interactive effects of individual, family and socioeconomic risk factors from ages 9 months to 14 years. The same factors according to three domains were assessed, including child (i.e., low verbal ability, hyperactivity/inattention, peer problems, emotional problems), family (i.e., single families, parental poor physical and mental health, large family size) and socioeconomic (i.e., low family income, low parental education, unemployment, social housing). A cumulative risk score for the child, family, and socioeconomic domains at each age was calculated. It was then examined how the cumulative risk scores explain variation in the trajectories of conduct problems. Lastly, interactive effects among the different domains of cumulative risk were tested. Using group-based trajectory modeling, four distinct trajectories were found including a ‘low’ problem group and three groups showing childhood-onset conduct problems: ‘school-age onset’; ‘early-onset, desisting’; and ‘early-onset, persisting’. The ‘low’ group (57% of the sample) showed a low probability of conducts problems, close to zero, from 3 to 14 years. The ‘early-onset, desisting’ group (23% of the sample) demonstrated a moderate probability of CP in early childhood, with a decline from 3 to 5 years and a low probability thereafter. The ‘early-onset, persistent’ group (8%) followed a high probability of conduct problems, which declined from 11 years but was close to 70% at 14 years. In the ‘school-age onset’ group, 12% of the sample showed a moderate probability of conduct problems from 3 and 5 years, with a sharp increase by 7 years, increasing to 50% at 14 years. In terms of individual risk, all factors increased the likelihood of being in the childhood-onset groups compared to the ‘low’ group. For cumulative risk, the socioeconomic domain at 9 months and 3 years, the family domain at all ages except 14 years and child domain at all ages were found to differentiate childhood-onset groups from the ‘low’ group. Cumulative risk at 9 months and 3 years did not differentiate between the ‘school-onset’ group and ‘low’ group. Significant interactions were found between the domains for the ‘early-onset, desisting group’ suggesting that low levels of risk in one domain may buffer the effects of high risk in another domain. The implications of these findings for preventive interventions will be highlighted.

Keywords: conduct problems, cumulative risk, developmental trajectories, early childhood, adolescence

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11113 “Ethiopian Approach” to Combating Desertification: The Case of Semi-Arid Savanna Grasslands in Southern Ethiopia

Authors: Wang Yongdong, Yeneayehu Fenetahun, You Yuan, Ogbue Chukwuka, Yahaya Ibrahim, Xu Xinwen

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This paper explores an innovative Ethiopian approach to combatting desertification, focusing on the semi-arid savanna grasslands in Southern Ethiopia. The study investigates the multifaceted strategies employed by Ethiopian communities, governmental bodies, and non-governmental organizations to address desertification challenges in the region. Through an analysis of legislative frameworks, community engagement, afforestation programs, and sustainable land management techniques, this research highlights the efficacy of Ethiopia's strategy in reducing the effects of desertification. The results emphasize how crucial it is to build effective measures for halting desertification in fragile ecosystems by utilizing local knowledge, community involvement, and adaptive governance. In addition, this study also addresses how the Ethiopian approach may be applied to other areas with comparable environmental problems. In summary, this research adds significant perspectives to the worldwide conversation about desertification and provides useful guidance for sustainable land use.

Keywords: adaptive governance, community engagement, desertification, policy frameworks

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11112 Buckling of Plates on Foundation with Different Types of Sides Support

Authors: Ali N. Suri, Ahmad A. Al-Makhlufi

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In this paper the problem of buckling of plates on foundation of finite length and with different side support is studied. The Finite Strip Method is used as tool for the analysis. This method uses finite strip elastic, foundation, and geometric matrices to build the assembly matrices for the whole structure, then after introducing boundary conditions at supports, the resulting reduced matrices is transformed into a standard Eigenvalue-Eigenvector problem. The solution of this problem will enable the determination of the buckling load, the associated buckling modes and the buckling wave length. To carry out the buckling analysis starting from the elastic, foundation, and geometric stiffness matrices for each strip a computer program FORTRAN list is developed. Since stiffness matrices are function of wave length of buckling, the computer program used an iteration procedure to find the critical buckling stress for each value of foundation modulus and for each boundary condition. The results showed the use of elastic medium to support plates subject to axial load increase a great deal the buckling load, the results found are very close with those obtained by other analytical methods and experimental work. The results also showed that foundation compensates the effect of the weakness of some types of constraint of side support and maximum benefit found for plate with one side simply supported the other free.

Keywords: buckling, finite strip, different sides support, plates on foundation

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