Search results for: problems of care

Authors: Zhidong Zhang, Zhi-Chao Zhang

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This study focused on early adolescent rule-breaking behavioral problems using the instrument of Achenbach System of Empirically Based Assessment (ASEBA). The purpose was to analyze the relationships between the rule-breaking behavioral problems and relevant background variables such as sports activities, hobbies, chores and the number of close friends. The stratified sampling method was used to collect data from 2532 participants. The results indicated that several background variables as predictors could significantly predict rule breaking behavior and aggressive behavior. Further, a path analysis method was used to explore the correlational and causal relationships among background variables and breaking behavior variables.

Keywords: ASEBA, rule-breaking, path analysis, early adolescent

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Authors: M. Card

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Working with anorexia patients can be a challenging experience for mental and health care professionals. The reasons for not wanting to work with this patient population stems from the numerous concerns surrounding the patient’s health – physically and mentally. Many health care professionals reported having strong negative feelings, such as; anger, hopelessness and helplessness when working with anorexia patients. These feelings often impaired their judgement to treatment and affected how they related to the patient. This research focused on psychotherapists who preferred to work with anorexia patients; what countertransference feelings were evoked in them during sessions with patients and most importantly, how they managed the feelings. The research used interpretative phenomenological analysis (IPA) as the theoretical framework and data analysis method. Semi-structured interviews were used with ten experienced psychotherapists to obtain their countertransference experiences with anorexia patients and how they manage it. There were three main themes discovered; (1) the use of supervision, (2) their own personal therapy and finally (3) experience and evolution. The research unearthed that experienced psychotherapists also experienced strong countertransference feelings towards their patients; some positive and some negative. However, these feelings could actually be interpreted as co-transference with their anorexia patients. The psychotherapists were able to own their part in the evocative unconscious nature of a relational therapeutic space, where their personal issues may be entangled in their anorexia patient’s symptomatology.

Keywords: anorexia nervosa, countertransference, co-transference, psychotherapy, relational psychotherapy

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Authors: B. Sellami, M. Belloufi

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Conjugate gradient methods are an important class of methods for unconstrained optimization, especially for large-scale problems. Recently, they have been much studied. In this paper, we propose a new two-parameter family of conjugate gradient methods for unconstrained optimization. The two-parameter family of methods not only includes the already existing three practical nonlinear conjugate gradient methods, but also has other family of conjugate gradient methods as subfamily. The two-parameter family of methods with the Wolfe line search is shown to ensure the descent property of each search direction. Some general convergence results are also established for the two-parameter family of methods. The numerical results show that this method is efficient for the given test problems. In addition, the methods related to this family are uniformly discussed.

Keywords: unconstrained optimization, conjugate gradient method, line search, global convergence

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Authors: A. Das, L. Hitihamillage, S. Moridpour

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Natural disasters are inevitable to the biodiversity. Disasters such as flood, tsunami and tornadoes could be brutal, harsh and devastating. In Australia, flooding is a major issue experienced by different parts of the country. In such crisis, delays in evacuation could decide the life and death of the people living in those regions. Congestion management could become a mammoth task if there are no steps taken before such situations. In the past to manage congestion in such circumstances, many strategies were utilised such as converting the road shoulders to extra lanes or changing the road geometry by adding more lanes. However, expansion of road to resolving congestion problems is not considered a viable option nowadays. The authorities avoid this option due to many reasons, such as lack of financial support and land space. They tend to focus their attention on optimising the current resources they possess and use traffic signals to overcome congestion problems. Traffic Signal Management strategy was considered a viable option, to alleviate congestion problems in the City of Geelong, Victoria. Arterial road with signalised intersections considered in this paper and the traffic data required for modelling collected from VicRoads. Traffic signalling software SIDRA used to model the roads, and the information gathered from VicRoads. In this paper, various signal parameters utilised to assess and improve the corridor performance to achieve the best possible Level of Services (LOS) for the arterial road.

Keywords: congestion, constraints, management, LOS

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Authors: Shahid Iqbal

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It is observed that international migration is increased over a time period in all over the world counties and Pakistan is not escaped. It played a pivotal role in household economy and affecting the gender roles both positive and negative in the developing countries. A vast majority of males from Pakistan migrate to other countries in search of employment and income generating activities and their families left behind, particularly nuclear families are subjected to different social problems. In this scenario, most of the responsibilities lie on the female partners as they have to play the role of male as well as female for their children and household chores. Wives of some males feel loneliness, isolation and a sense of insecurity. Keeping in mind, these realities, this study aims to explore the social impact of husbands’ absentee ship on the lives of families left behind. Particularly, wives’ own experiences will be analyzed. This study will be carried out in the District Gujrat of Punjab Pakistan. Since this study will focus on observing the social impact of male’s migration on families, so, all the households that had at least one member abroad will be the potential respondents of the study. Purposes sampling technique will be used as method to locate the respondents. A focus group discussion will be conducted as a tool for the collection of data. Those women will be approached who are taking care of their families in the absence of their husbands for last three years. For the sake of analysis Interpretative Phenomenological Analysis (IPA) will be applied and researcher will explore how participants make sense of their personal experience and social world.

Keywords: social consequences, male migration, left behind, absentee ship, Pakistan

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Authors: Yogita M. Ahire, Nedal M. Mohammed, Ahmed A. Hamoud

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Scientific computation outsourcing is gaining popularity because it allows customers with limited computing resources and storage devices to outsource complex computation workloads to more powerful service providers. However, it raises some security and privacy concerns and challenges, such as customer input and output privacy, as well as cloud cheating behaviors. This study was motivated by these concerns and focused on privacy-preserving Two-Point Boundary Value Problems (BVP) as a common and realistic instance for verifiable safe multiparty computing. We'll look at the safe and verifiable schema with correctness guarantees by utilizing standard multiparty approaches to compute the result of a computation and then solely using verifiable ways to check that the result was right.

Keywords: verifiable computing, cloud computing, secure and privacy BVP, secure computation outsourcing

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Authors: S. Bagur, S. Verger, B. Mut

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Early childhood intervention (ECI) is understood as the set of interventions aimed at the child population with developmental disorders or disabilities from 0 to 6 years of age, the family, and the environment. Under the principles of family-centred practices, the members of the family nucleus are direct agents of intervention. Thus, the multidisciplinary team of professionals should work to improve family empowerment and the level of parenting skills. The aim of the present study is to analyse descriptively and differentially the level of parenting skills and family empowerment of parents using ECI services during the foster care phase. There were 135 families participating in the study. Three questionnaires were completed. The results show that the employment situation, the age of the child receiving an intervention, and the number of children in the family nucleus or the professional carrying out the intervention are variables that have a differential impact on different items of empowerment and parenting skills. The results are discussed and future lines of research are proposed, with the understanding that the initial analysis of the variables of empowerment and parenting skills may be predictors for the improvement of child development and family well-being. In addition, it is proposed to identify and analyse professional training in order to be able to adapt early care practices without depending on the discipline of the professional of reference.

Keywords: developmental disabilities, early childhood intervention, family empowerment, parenting skills

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Authors: Nahashon Mwirigi

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The management of HIV/AIDS is a global challenge, demanding precise tools to predict disease progression and guide tailored treatment. CD4 cell count dynamics, a crucial immune function indicator, play an essential role in understanding HIV/AIDS progression and enhancing patient care through effective modeling. While several models assess disease progression, existing methods often fall short in capturing the complex, non-linear nature of HIV/AIDS, especially across diverse demographics. A need exists for models that balance predictive accuracy with clinical applicability, enabling individualized care strategies based on patient-specific progression rates. This study utilizes patient data from Kenyatta National Hospital (2003–2014) to model HIV/AIDS progression across six CD4-defined states. The Exponential, 2-Parameter Weibull, and 3-Parameter Weibull models are employed to analyze failure rates and explore progression patterns by age and gender. Model selection is based on Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) to identify models best representing disease progression variability across demographic groups. The 3-Parameter Weibull model emerges as the most effective, accurately capturing HIV/AIDS progression dynamics, particularly by incorporating delayed progression effects. This model reflects age and gender-specific variations, offering refined insights into patient trajectories and facilitating targeted interventions. One key finding is that older patients progress more slowly through CD4-defined stages, with a delayed onset of advanced stages. This suggests that older patients may benefit from extended monitoring intervals, allowing providers to optimize resources while maintaining consistent care. Recognizing slower progression in this demographic helps clinicians reduce unnecessary interventions, prioritizing care for faster-progressing groups. Gender-based analysis reveals that female patients exhibit more consistent progression, while male patients show greater variability. This highlights the need for gender-specific treatment approaches, as men may require more frequent assessments and adaptive treatment plans to address their variable progression. Tailoring treatment by gender can improve outcomes by addressing distinct risk patterns in each group. The model’s ability to account for both accelerated and delayed progression equips clinicians with a robust tool for estimating the duration of each disease stage. This supports individualized treatment planning, allowing clinicians to optimize antiretroviral therapy (ART) regimens based on demographic factors and expected disease trajectories. Aligning ART timing with specific progression patterns can enhance treatment efficacy and adherence. The model also has significant implications for healthcare systems, as its predictive accuracy enables proactive patient management, reducing the frequency of advanced-stage complications. For resource limited providers, this capability facilitates strategic intervention timing, ensuring that high-risk patients receive timely care while resources are allocated efficiently. Anticipating progression stages enhances both patient care and resource management, reinforcing the model’s value in supporting sustainable HIV/AIDS healthcare strategies. This study underscores the importance of models that capture the complexities of HIV/AIDS progression, offering insights to guide personalized, data-informed care. The 3-Parameter Weibull model’s ability to accurately reflect delayed progression and demographic risk variations presents a valuable tool for clinicians, supporting the development of targeted interventions and resource optimization in HIV/AIDS management.

Keywords: HIV/AIDS progression, 3-parameter Weibull model, CD4 cell count stages, antiretroviral therapy, demographic-specific modeling

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Authors: Md, MCS, MPH Munyangi Wa Nkola Jerome

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The pandemic of COVID-19, a recently discovered contagious respiratory disease called SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2 Majority of people infected with SARS-CoV-2: Asymptomatic or mildly ill 14% of patients will develop severe illness requiring hospitalization and oxygen support, and 5% of these will be transferred to an intensive care unit, Urgent need for new treatments that can be used quickly to avoid transfer of patients to intensive care and death. Objective: To evaluate the clinical activity (efficacy) of ArtiCovid Hypothesis: Administration of 3 times a teaspoon per day by COVID patients (symptomatic, mild, or moderate forms) results in the disappearance of symptoms and improvement of biological parameters (including viral suppression). Clinical efficacy: the disappearance of clinical signs after seven days of treatment; reduction in the rate of patients transferred to intensive care units for mechanical ventilation and a decrease in mortality related to this infection Paraclinical efficacy: improvement of biological parameters (mainly d-dimer, CRP) Virological efficacy: suppression of the viral load after seven days of treatment (control test on the seventh day is negative) Pilot study using a standardized solution based on Artemisia annua (ARTICOVID) Obtaining authorization from the health authorities of the province of Central Kongo Recruitment of volunteer patients, mainly in the Kinkanda HospitalCarrying out tests before and after treatment as well as analyses before and after treatment. The protocol obtained the approval of the ethics committee 50 patients who completed the treatment were aged between 2 and 70 years, with an average age of 36 yearsMore half were male (56%). One in four patients was a health professional (25%) Of the 12 health professionals, 4 were physicians. For those who reported the date of onset of the disease, the average duration between the appearance of the first symptoms and the medical consultation was 5 days. The 50 patients put on ARTICOVID were discharged alive with CRP levels substantially normalizedAfter seven to eight days, the control test came back negative. This pilot study suggests that ARTICOVID may be effective against COVID-19 infection.

Keywords: artiCovid, DRC, Covid-19, SARS_COV_2

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Authors: Sun Ailu, Zhao Wanmin

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In the process of rapid urbanization, old urban renewal is an important task in China's urban construction. This study, using status survey and Analytic Hierarchy Process (AHP) method, taking Chongqing of China as an example, puts forward the problems faced by the old urban area from the aspects of function, facilities and environment. Further, this study summarizes the types of the old urban area and proposes space renewal strategies for three typical old urban areas, such as old residential area, old factory and old market. These old urban areas are confronted with the problems of functional layout confounding, lack of infrastructure and poor living environment. At last, this paper proposes spatial strategies for urban renewal, which are hoped to be useful for urban renewal management in China.

Keywords: old urban renewal, renewal mode, renewal strategy, Chongqing, China

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Authors: Samira Laidaoui, Mohammed Djermane, Nazihe Terfaya

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The fluid-structure coupling is a natural phenomenon which reflects the effects of two continuums: fluid and structure of different types in the reciprocal action on each other, involving knowledge of elasticity and fluid mechanics. The solution for such problems is based on the relations of continuum mechanics and is mostly solved with numerical methods. It is a computational challenge to solve such problems because of the complex geometries, intricate physics of fluids, and complicated fluid-structure interactions. The way in which the interaction between fluid and solid is described gives the largest opportunity for reducing the computational effort. In this paper, a problem of fluid structure interaction is investigated with two-way coupling method. The formulation Arbitrary Lagrangian-Eulerian (ALE) was used, by considering a dynamic grid, where the solid is described by a Lagrangian formulation and the fluid by a Eulerian formulation. The simulation was made on the ANSYS software.

Keywords: ALE, coupling, FEM, fluid-structure, interaction, one-way method, two-way method

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Authors: Cristina Maria Mendoza Sanchez, Maria Angeles Navarro Perán

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Introduction: Nursing as a profession, from its initial formation and after its development in practice, has been built and identified mainly from its technical competence and professionalization within the positivist approach of the XIX century that provides a conception of the disease built on the basis of to the biomedical paradigm, where the care provided is more focused on the physiological processes and the disease than on the suffering person understood as a whole. The main issue that is in need of study here is a review of the nursing profession's history to get to know how the nursing profession was before the XIX century. It is unclear if there were organizations or people with knowledge about looking after others or if many people survived by chance. The holistic care, in which the appearance of the disease directly affects all its dimensions: physical, emotional, cognitive, social and spiritual. It is not a concept from the 21st century. It is common practice, most probably since established life in this world, with the final purpose of covering all these perspectives through quality care. Objective: In this paper, we describe and analyze the history of education in nursing learning in terms of reviewing and analysing theoretical foundations of clinical teaching and learning in nursing, with the final purpose of determining and describing the development of the nursing profession along the history. Method: We have done a descriptive systematic review study, doing a systematically searched of manuscripts and articles in the following health science databases: Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL. The selection of articles has been made according to PRISMA criteria, doing a critical reading of the full text using the CASPe method. A compliment to this, we have read a range of historical and contemporary sources to support the review, such as manuals of Florence Nightingale and John of God as primary manuscripts to establish the origin of modern nursing and her professionalization. We have considered and applied ethical considerations of data processing. Results: After applying inclusion and exclusion criteria in our search, in Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL, we have obtained 51 research articles. We have analyzed them in such a way that we have distinguished them by year of publication and the type of study. With the articles obtained, we can see the importance of our background as a profession before modern times in public health and as a review of our past to face challenges in the near future. Discussion: The important influence of key figures other than Nightingale has been overlooked and it emerges that nursing management and development of the professional body has a longer and more complex history than is generally accepted. Conclusions: There is a paucity of studies on the subject of the review to be able to extract very precise evidence and recommendations about nursing before modern times. But even so, as more representative data, an increase in research about nursing history has been observed. In light of the aspects analyzed, the need for new research in the history of nursing emerges from this perspective; in order to germinate studies of the historical construction of care before the XIX century and theories created then. We can assure that pieces of knowledge and ways of care were taught before the XIX century, but they were not called theories, as these concepts were created in modern times.

Keywords: nursing history, nursing theory, Saint John of God, Florence Nightingale, learning, nursing education

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Authors: Salwa Hagag Abdelaziz, Dorria Salem, Hoda Zaki, Suzan Atteya

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Early detection of breast cancer saves many thousands of lives each year via application of mammography and genetic screening and many more lives could be saved if nurses are involved in breast care screening practices. So, the aim of the study was to identify nurse's role in early detection of breast cancer through mammography and genetic screening and its impact on patient's outcome. In order to achieve this aim, 400 women above 40 years, asymptomatic were recruited for mammography and genetic screening. In addition, 50 nurses and 6 technologists were involved in the study. A descriptive analytical design was used. Five tools were utilized: sociodemographic, mammographic examination and risk factors, women's before, during and after mammography, items relaying to technologists, and items related to nurses were also obtained. The study finding revealed that 3% of women detected for malignancy and 7.25% for fibroadenoma. Statistically, significant differences were found between mammography results and age, family history, genetic screening, exposure to smoke, and using contraceptive pills. Nurses have insufficient knowledge about screening tests. Based on these findings the present study recommended involvement of nurses in breast care which is very important to in force population about screening practices.

Keywords: mammography, early detection, genetic screening, breast cancer

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Authors: A. Venkatakrishnan, M. Juneja, S. Kapoor

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Background: Gastrointestinal dysfunction is an emerging co morbidity seen in autism and may further strengthen the association between autism and celiac disease. This is supported by increased rates (22-70%) of gastrointestinal symptoms like diarrhea, constipation, abdominal discomfort/pain, and gastrointestinal inflammation in children with the etiology of autism is still elusive. In addition to genetic factors, environmental factors such as toxin exposure, intrauterine exposure to certain teratogenic drugs, are being proposed as possible contributing factors in the etiology of Autism Spectrum Disorders (ASD) in cognizance with reports of increased gut permeability and high rates of gastrointestinal symptoms noted in children with ASD, celiac disease has also been proposed as a possible etiological factor. Despite insufficient evidence regarding the benefit of restricted diets in Autism, GFD has been promoted as an alternative treatment for ASD. This study attempts to discern any correlation between ASD and celiac disease. Objective: This cross sectional study aims to determine the proportion of celiac disease in children with ASD. Methods: Study included 155 participants aged 2-12 yrs, diagnosed as ASD as per DSM-5 attending the child development center at a tertiary care hospital in Northern India. Those on gluten free diet or having other autoimmune conditions were excluded. A detailed Performa was filled which included sociodemographic details, history of gastrointestinal symptoms, anthropometry, systemic examination, and pertinent psychological testing was done using was assessed using Developmental Profile-3(DP-3) for Developmental Quotient, Childhood Autism Rating Scale-2 (CARS-2) for severity of ASD, Vineland Adaptive Behavior Scales (VABS) for adaptive behavior, Child Behavior Checklist (CBCL) for behavioral problems and BAMBI (Brief Autism Mealtime Behavior Scales) for feeding problems. Screening for celiac was done by TTG-IgA levels, and total serum IgA levels were measured to exclude IgA deficiency. Those with positive screen were further planned for HLA typing and endoscopic biopsy. Results: A total of 155 cases were included, out of which 5 had low IgA levels and were hence excluded from the study. The rest 150 children had TTG levels below the ULN and normal total serum IgA level. History of Gastrointestinal symptoms was present in 51 (34%) cases abdominal pain was the most frequent complaint (16.6%), followed by constipation (12.6%). Diarrhea was seen in 8 %. Gastrointestinal symptoms were significantly more common in children with ASD above 5 yrs (p-value 0.006) and those who were verbal (p = 0.000). There was no significant association between socio-demographic factors, anthropometric data, or severity of autism with gastrointestinal symptoms. Conclusion: None of the150 patients with ASD had raised TTG levels; hence no association was found between ASD and celiac disease. There is no justification for routine screening for celiac disease in children with ASD. Further studies are warranted to evaluate association of Non Celiac Gluten Sensitivity with ASD and any role of gluten-free diet in such patients.

Keywords: autism, celiac, gastrointestinal, gluten

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Authors: Arif Tri Setyanto, Aditya Nanda Priyatama, Nugraha Arif Karyanta, Fadjri Kirana A., Afia Fitriani, Rini Setyowati, Moh.Abdul Hakim

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The Basic Health Research Report by the Ministry of Health (2018) shows an increase in the prevalence of mental health disorders in the adolescent and early adult age ranges. Supporting this finding, data on the psychological examination of the student health service unit at one State University recorded 115 cases of moderate and severe health problems in the period 2016 - 2019. More specifically, the highest number of cases was experienced by clients in the age range of 21-23 years or equivalent, with the mid-semester stage towards the end. Based on the distribution of cases experienced and the disorder becomes a psychological problem experienced by students. A total of 29% or the equivalent of 33 students experienced anxiety disorders, 25% or 29 students experienced problems ranging from mild to severe, as well as other classifications of disorders experienced, including adjustment disorders, family problems, academics, mood disorders, self-concept disorders, personality disorders, cognitive disorders, and others such as trauma and sexual disorders. Various mental health disorders have a significant impact on the academic life of students, such as low GPA, exceeding the limit in college, dropping out, disruption of social life on campus, to suicide. Based on literature reviews and best practices from universities in various countries, one of the effective ways to prevent and treat student mental health disorders is to implement a mental health monitoring system in universities. This study uses a participatory action research approach, with a sample of 423 from a total population of 32,112 students. The scale used in this study is the Beck Depression Inventory (BDI) to measure depression and the Taylor Minnesota Anxiety Scale (TMAS) to measure anxiety levels. This study aims to (1) develop a digital-based health monitoring system for students' mental health situations in the mental health category. , dangers, or those who have mental disorders, especially indications of symptoms of depression and anxiety disorders, and (2) implementing a mental health monitoring system in universities at the beginning and end of each semester. The results of the analysis show that from 423 respondents, the main problems faced by all coursework, such as thesis and academic assignments. Based on the scoring and categorization of the Beck Depression Inventory (BDI), 191 students experienced symptoms of depression. A total of 24.35%, or 103 students experienced mild depression, 14.42% (61 students) had moderate depression, and 6.38% (27 students) experienced severe or extreme depression. Furthermore, as many as 80.38% (340 students) experienced anxiety in the high category. This article will review this review of the student mental health service system on campus.

Keywords: monitoring system, mental health, psychological problems, students

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Authors: Sobia Rana

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The study intends to explain the problems of English collocational use faced by college students in Rawalpindi, Pakistan and recommends some authentic ways that will help in removing the learning barriers in light of the concerning methodological issues. It will not only help the students to improve their knowledge of the phenomena but will also enlighten the target teachers about the significance of authentic collocational use and how it naturalizes both written and spoken expressions. Data from both the students and teachers have been collected with the help of open/close-ended questionnaires to unearth the genuine cause/s and supplement them with the required solutions rooted in the actual problems. The students fail to use authentic collocations owing to multiple reasons: lack of awareness about English collocational use, improper teaching methodologies, and inexpert teachers.

Keywords: English collocational use, teaching methodologies, English learning barriers, vocabulary acquisition, college students of Rawalpindi

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Authors: Hiromi Takafuji

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It is a well-known fact that health care and welfare are the foundation of human activities, and human service professionals such as nurses and child care workers support these activities. COVID-19 pandemic has made the severity of the working environment in these fields even more known. It is high time to discuss the work of human service workers for the sustainable development of the human environment. Early turnover has been recognized as a long-standing issue in these fields. In Japan, the attrition rate within three years of graduation for these occupations has remained high at about 40% for more than 20 years. One of the reasons for this is Reality Shock: RS, which refers to the stress caused by the gap between pre-employment expectations and the post-employment reality experienced by new workers. The purpose of this study was to academically elucidate the mechanism of RS among human service professionals and to contribute to countermeasures against it. Firstly, to explore the structure of the relationship between professionalism and workers' RS, an exploratory interview survey was conducted and analyzed by text mining and content analysis. The results showed that the expectation of professionalism influences RS as a pre-employment job expectation. Next, the expectations of professionalism were quantified and categorized, and the responses of a total of 282 human service work professionals, nurses, child care workers, and caregivers; were finalized for data analysis. The data were analyzed using exploratory factor analysis, confirmatory factor analysis, multiple regression analysis, and structural equation modeling techniques. The results revealed that self-control orientation and authority orientation by qualification had a direct positive significant impact on RS. On the other hand, interpersonal helping orientation and altruistic orientation were found to have a direct negative significant impact and an indirect positive significant impact on RS.; we were able to clarify the structure of work expectations that affect the RS of welfare professionals, which had not been clarified in previous studies. We also explained the limitations, practical implications, and directions for future research.

Keywords: human service professional, new hire turnover, SEM, reality shock

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Authors: Michael Safwat Kotit Istemalek

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In this study, a project on a small project called Zeytinseli, which plays an important role from the beginning to the end of olive oil and olive oil production, is presented with the help of tourism companies that play an important role in the tourism sector. In the study, first of all, a framework of ideas about travel agency, tourism, specific tourism agency and rural tourism was created and tourism knowledge in the modern world was emphasized. After this, the "olive", which had an important place in both mythology and the religion of God, disappeared in the field of rural tourism. Since Didim Zeytinseli is the Aydın district, accommodation prices were calculated within the scope of the project and a 15-day factory tour was given at the end of the project. It can be said that the study is an original study as it covers not only environmental and agricultural tourism but also cultural tourism and non-traditional tourism98.

Keywords: financial problems, the problems of tourism businesses, tourism businesses, internet, marketing, tourism, tourism management economic competitiveness, enhancing competitiveness

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Authors: Emily Jin, Harry Sharples, Anne Weist

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Introduction: NICE Evidence Search Student Champion Scheme is a peer-assisted learning scheme that aims to improve the routine use of evidence-based information by future health and social care staff. The focus is on the NICE evidence search portal that provides selected information from more than 800 reliable health, social care, and medicines sources, including up-to-date guidelines and information for the public. This paper aims to evaluate the effectiveness of the scheme when implemented in Liverpool School of Medicine and to understand the experiences of those attending. Methods: Twelve student champions were recruited and trained in February 2020 as peer tutors during a workshop facilitated by NICE. Cascade sessions were then organised and delivered on an optional basis for students, in small groups of < 10 to approximately 70 attendees. Surveys were acquired immediately before and 8-12 weeks after cascade sessions (n=47 and 45 respectively). Data from these surveys facilitated the analysis of the scheme. Results: Surveys demonstrated 74% of all attendees frequently searched for health and social care information online as a part of their studies. However, only 15% of attendees reported having prior formal training on searching for health information, despite receiving such training earlier on in the curriculum. After attending cascade sessions, students reported a 58% increase in confidence when searching for information using evidence search, from a pre-session a baseline of 36%. Conclusion: NICE Evidence Search Student Champion Scheme provided clear benefits for attending students, increasing confidence in searching for peer-reviewed, mainly secondary sources of health information. The lack of reported training represents the unmet need that the champion scheme satisfies, and this likely benefits student champions as well as attendees. Increasing confidence in searching for healthcare information online may support future evidence-based decision-making.

Keywords: evidence-based medicine, NICE, medical education, medical school, peer-assisted learning

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Authors: Pugazhenthan Thangaraju

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Background: Since the pandemic began, more than millions of people have become infected with COVID-19. Globally, researchers are working for safe and effective treatments for this disease. Remdesivir is a drug that has been approved for the treatment of COVID-19. Many aspects are still being considered that may influence the future use of remdesivir. Aim: To assess the safety and efficacy of Remdesivir in hospitalized adult patients diagnosed with moderate and severe COVID-19. Methods: It was a record-based retrospective cohort study conducted between April 1st, 2020 and June 30th, 2021 at the tertiary care teaching hospital All India Institutes of Medical Sciences (AIIMS), Raipur Results: There were a total of 10,559 medical records of COVID-19 patients of which 1034 records were included in this study. Overall, irrespective of the survival status, there was statistical significant difference observed between the WHO score at the time of admission and discharge. Clinical improvement among the survivors was found to be statistically significant. Conclusion: Remdesivir's potential efficacy against coronaviruses has so far been limited to in vitro studies and animal models. However, information about COVID-19 is rapidly expanding. Several clinical trials for the treatment of COVID-19 with remdesivir are now underway. However, the findings of this study support remdesivir as a promising agent in the fight against SARS-CoV-2.

Keywords: Remdesivir, COVID-19, SARS-CoV-2, antiviral, RNA-dependent RNA polymerase, viral pneumonia

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Authors: Surendra Kumar Patel

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Disability is not just a health problem; it is a complex phenomenon, reflecting the interaction between features of a person’s age and physiology. Population ageing is a major demographic issue for India in the 21st century. Older population of India constituted 8% of total population, while 5.19% has affected by disability of older age group. Objective of the present research paper is to examine the state wise differential in disability among 60+ population and to access the health care of disabled population especially the 60+ disabled persons. The data sources of the present paper are census 2001 and 2011. For analyzing the state wise differentials by disability types and comparative advantage of data, rate, ratio, and percentage have been used. The Standardized Index of Diversity of Disability (SIDD) studies differential and diversity in disability. The results show that there are 5.19% persons have disability among 60+ population and sex differential not very significant, as it is 5.3 % of male and 5.05% in female in India but place of residence shows significant variation from 2001 to 2011 census. There is huge diversity in disability prevalence among 60+ in India, highest in Sikkim followed by Rajasthan, approximately, they comprise 11%, and the lowest found in Tamil Nadu as 2.53%. This huge gap in prevalence percentage shows the health care needs of highly prevailing states.

Keywords: disability, Standardized Index of Diversity of Disability (SIDD), differential and diversity in disability, 60+ population

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Authors: Florian Tille, Heide Weishaar, Bernhard Gibis, Susanne Schnitzer

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Introduction: The quality of patient-doctor communication and of written health information is central to organizational health literacy (HL). Whether patients understand their doctors’ explanations and textual material on health, however, is understudied. This study identifies the overall levels of patient understanding of health information and its associations with patients’ social characteristics in outpatient health care in Germany. Materials & Methods: This analysis draws on data collected via a 2017 national health survey with a sample of 6,105 adults. Quality of communication was measured for consultations with general practitioners (GPs) and specialists (SPs) via the Ask Me 3 program questions, and through a question on written health material. Correlations with social characteristics were explored employing bivariate and multivariate logistic regression analyses. Results: Over 90% of all respondents reported that they had understood their doctors’ explanations during the last consultation. Failed understanding was strongly correlated with patients’ very poor health (Odds Ratio [OR]: 5.19; 95% confidence interval [CI]: 2.23–12.10; ref. excellent/very good health), current health problem (OR: 6.54, CI: 1.70–25.12; ref. preventive examination) and age 65 years and above (OR: 2.97, CI: 1.10–8.00; ref. 18 to 34 years). Fewer patients answered they understood written material well (86.7% for las visit at GP, 89.7% at SP). Understanding written material poorly was highly associated with basic education (OR: 4.20, CI: 2.76–6.39; ref. higher education) and 65 years old and above (OR: 2.66, CI: 1.43–4.96). Discussion: Overall ratings of oral patient-doctor communication and written communication of health information are high. Yet, a considerable share of patients reports not-understanding their doctors and poor understanding of the written health-related material. Interventions that can contribute to improving organizational HL in outpatient care in Germany include HL training for doctors, reducing system barriers to easily-accessible health information for patients and combining oral and written health communication means. Conclusion: This work adds to the study of organizational HL in Germany. To increase patient understanding of health-relevant information and thereby possibly reduce health disparities, meeting the communication needs especially of persons in different age groups, with basic education and in very poor health is suggested.

Keywords: health survey, organizational health literacy, patient-doctor communication, social characteristics, outpatient care, Ask Me 3

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Authors: Tessa Verhallen, Mama Africa

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By co-constructing personal narratives of sex workers in Namibia this paper represents how sex workers experience their violation of rights in Namibia. It is written from an emic (as an advisor for a sex worker-led organization named Rights not Rescue Trust) and an etic (as an ethnographer) point of view, in collaboration with the staff of the organization Rights not Rescue Trust. This organization represents circa 3000 members. The paper describes the current deplorable situation of sex workers in Namibia, encompassing the stigma and discrimination they face, their struggle to have their work decriminalized and their urge to advocate for human rights and the end of violations. Based on a triangular research design (ethnography, narratives, literature study, human rights’ training and counseling sessions) the authors show that sex workers, particularly LGBTI sex workers, are extremely vulnerable to emotional, physical, and sexual violence in Namibia. The main perpetrators of violence turn out to be not only clients and intimate partners but also law enforcement officers and health care workers who are supposed to protect and support sex workers. The sex workers’ narratives voice their disgraceful circumstances regarding how their rights are violated. It also highlights their importance to fight for their rights and access to health care, legal services and education in order to improve the sexual reproductive health of sex workers.

Keywords: HIV/aids, LGBTI, methodological innovative, sex work

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Authors: Juliana da Silva Cardoso, Cláudia Correia, Rita Gomes, Carolina Fraga, Inês Cascais, Sara Monteiro, Beatriz Teixeira, Sandra Ribeiro, Carolina Andrade, Cláudia Oliveira, Diana Gonzaga, Catarina Prior, Inês Vaz Matos

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The average daily screen time (ST) has been increasing in children, even at young ages. This seems to be associated with a higher incidence of neurodevelopmental disorders, and as the time of exposure increases, the greater is the functional impact. This study aims to compare the daily ST of toddlers and preschoolers previously and during the COVID-19 pandemic. A questionnaire was applied by telephone to parents/caregivers of children between 1 and 5 years old, followed up at 4 primary care units belonging to the Group of Primary Health Care Centers of Western Porto, Portugal. 520 children were included: 52.9% male, mean age 39.4 ± 13.9 months. The mean age of first exposure to screens was 13.9 ± 8.0 months, and most of the children were exposed to more than one screen daily. Considering the WHO recommendations, before the COVID-19 pandemic, 385 (74.0%) and 408 (78.5%) children had excessive ST during the week and the weekend, respectively; during the lockdown, these values increased to 495 (95.2%) and 482 (92.7%). Maternal education and both the child's median age and the median age of first exposure to screens had a statistically significant association with excessive ST, with OR 0.2 (p = 0.03, CI 95% 0.07-0.86), OR 1.1 (p = 0.01, 95% CI 1.05-1.14) and OR 0.9 (p = 0.05, 95% CI 0. 87-0.98), respectively. Most children in this sample had a higher than recommended ST, which increased with the onset of the COVID-19 pandemic. These results are worrisome and point to the need for urgent intervention.

Keywords: COVID-19 pandemic, preschoolers, screen time, toddlers

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Authors: Richa Grover, Rahul Grover, V. Balaji Rao, Kavish Kejriwal

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Selection of suppliers is a crucial problem in the supply chain management. On top of that, sustainable supplier selection is the biggest challenge for the organizations. Environment protection and social problems have been of concern to society in recent years, and the traditional supplier selection does not consider about this factor; therefore, this research work focuses on introducing sustainable criteria into the structure of supplier selection criteria. Sustainable Supply Chain Management (SSCM) is the management and administration of material, information, and money flows, as well as coordination among business along the supply chain. All three dimensions - economic, environmental, and social - of sustainable development needs to be taken care of. Purpose of this research is to maximize supply chain profitability, maximize social wellbeing of supply chain and minimize environmental impacts. Problem statement is selection of suppliers in a sustainable supply chain network by ranking the suppliers against sustainable criteria identified. The aim of this research is twofold: To find out what are the sustainable parameters that can be applied to the supply chain, and to determine how these parameters can effectively be used in supplier selection. Multicriteria decision making tools will be used to rank both criteria and suppliers. AHP Analysis will be used to find out ratings for the criteria identified. It is a technique used for efficient decision making. TOPSIS will be used to find out rating for suppliers and then ranking them. TOPSIS is a MCDM problem solving method which is based on the principle that the chosen option should have the maximum distance from the negative ideal solution (NIS) and the minimum distance from the ideal solution.

Keywords: sustainable supply chain management, sustainable criteria, MCDM tools, AHP analysis, TOPSIS method

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Authors: Ayse Ozturk

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The study extends the prior research on modeling competencies by positioning students’ cognitive and language resources as the fundamentals for pursuing their own inquiry and expression lines through mathematical modeling. This strategy aims to answer the question that guides this study, “How do students’ group approaches to modeling tasks affect their modeling competencies over a unit of instruction?” Six bilingual tenth-grade students worked on open-ended modeling problems along with the content focused on quantities over six weeks. Each group was found to have a unique cognitive approach for solving these problems. Three different problem-solving strategies affected how the groups’ modeling competencies changed. The results provide evidence that the discussion around groups’ solutions, coupled with their reflections, advances group interpreting and validating competencies in the mathematical modeling process

Keywords: cognition, collective learning, mathematical modeling competencies, problem-solving

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Authors: Carla Caiazza, Valentina Preziosi, Giovanna Tomaiuolo, Denis O'Sullivan, Vincenzo Guida, Stefano Guido

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In the last decades, wormlike micellar solutions have been extensively used to tune the rheological behavior of home care and personal care products. This and other successful applications underlie the growing attention that both basic and applied research are devoting to these systems, and to their unique rheological and flow properties. One of the key research topics is the occurrence of flow instabilities at high shear rates (such as shear banding), with the possibility of appearance of flow induced structures. In this scenario, microfluidics is a powerful tool to get a deeper insight into the flow behavior of a wormlike micellar solution, as the high confinement of a microfluidic device facilitates the onset of the flow instabilities; furthermore, thanks to its small dimensions, it can be coupled with optical microscopy, allowing a direct visualization of flow structuring phenomena. Here, the flow of a widely used wormlike micellar solution through a glass capillary has been studied, by coupling the microfluidic device with μPIV techniques. The direct visualization of flow-induced structures and the flow visualization analysis highlight a relationship between solution structuring and the onset of discontinuities in the velocity profile.

Keywords: flow instabilities, flow-induced structures, μPIV, wormlike micelles

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Authors: Wanlapa Kunsongkeit

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When a person gets sick, he or she goes to hospital for the treatment. In the case of severe illness, there might be no hope for some patients to recover. In this state, the patients will face anxiety and fear. These feelings make the patients suffer in mind until the time of death or called bad death. These feeling also directly effect to family members who are loved ones and significant persons of the patients. They can help the dying patients to have good death. From literature reviews, many studies focused on good death in patients and nurses. Little is known about good death in family member. Therefore, the qualitative research based on Heideggerian phenomenology aimed to describe good death as perceived by the critically ill patients’ family members. Five informants who were the critically ill patients’ family members at hospital in Chonburi were purposively selected. Data were collected by in-depth interview, observation and critical reflection during January, 2014 to March, 2014 . Cohen, Kahn and Steeves’s (2000) steps guided data analysis. Trustworthiness was maintained throughout the study following Lincoln and Guba’s guidelines. Four themes were emerged, which were no suffering, acceptance of imminent death, preparing for death, and being with the family. This findings provide deep understanding of good death as perceived by the critically ill patients’ family members. It can be basic information for nurses to provide good death nursing care and further explore for development of knowledge regarding good death nursing care.

Keywords: good death, family member, critically ill patient, phenomenology

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Authors: Attila Vámosi, Tamás Mankovits, Dávid Huri, Imre Kocsis, Tamás Szabó

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Non-linear FEM calculations are indispensable when important technical information like operating performance of a rubber component is desired. Rubber bumpers built into air-spring structures may undergo large deformations under load, which in itself shows non-linear behavior. The changing contact range between the parts and the incompressibility of the rubber increases this non-linear behavior further. The material characterization of an elastomeric component is also a demanding engineering task. The shape optimization problem of rubber parts led to the study of FEM based calculation processes. This type of problems was posed and investigated by several authors. In this paper the time demand of certain calculation methods are studied and the possibilities of time reduction is presented.

Keywords: rubber bumper, data acquisition, finite element analysis, support vector regression

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Authors: Ekroop Singh Sethi, Arshnoor Kaur, M. H. Bharath

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India is the fastest growing economy and a land of tradition, culture and realm of 19 % of the world’s children. Children are an essential part of any economy as its future GDP contributors and, therefore, it is the duty of a country to take care of its future wealth providers. Each country has its own way of child welfare. India is a developing country, has its own child welfare schemes in place, but the question is, are they really as effective as they seem? Are the schemes sufficient? And what about implementation? With 41% of the population below the age of 18, questions relating to child education and welfare require focus. Right to education is a significant act of the government of India that explains the roadmap of free and compulsory elementary education for children in India, making the India 135th country to bring education as right, involving proper support from the government to overcome the shadow of economic conditions and status which prevents children to learn and grow. But is right to education a children-centric movement? As faces the major problem of well-planned, practical curriculum and facilitators, as only 40% of grade 5 students could barely read the textbook of grade 2. Is the policy worthy of settling the child or still trapped in negative realities of the competitive environment of private VS government schools. From the steps to encouragement from the pupil's home to enlightening centers, the article focuses on level of execution, impact and difference in terms to contributing and enabling the children of India for a better tomorrow and a solution to multilayered problems of elementary education in India.

Keywords: growing economy, child welfare, right to education, elementary education, private vs government schools, pupil's home, enlightening centers, execution, impact

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