Search results for: care skills

Authors: Hernán G. Cortés-Mora, José I. Péna-Reyes, Alfonso Herrera-Jiménez

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This article describes the implementation experience of Project-Based Learning (PBL) in an engineering course of the Universidad Nacional de Colombia, with the aim of strengthening student skills necessary for the exercise of their profession under a sustainability framework. Firstly, we present a literature review on the education for sustainability field, emphasizing the skills and knowledge areas required for its development, as well as the commitment of the Faculty of Engineering of the Universidad Nacional de Colombia, and other engineering faculties of the country, regarding education for sustainability. This article covers the general aspects of the course, describes how students team were formed, and how their experience was during the first semester of 2017. During this period two groups of students decided to develop their course project aiming to solve a problem regarding a Non-Governmental Organization (NGO) that works with head-of-household mothers in a low-income neighborhood in Bogota (Colombia). Subsequently, we show how sustainability is involved in the course, how tools are provided to students, and how activities are developed as to strengthen their abilities, which allows them to incorporate sustainability in their projects while also working on the methodology used to develop said projects. Finally, we introduce the results obtained by the students who sent the prototypes of their projects to the community they were working on and the conclusions reached by them regarding the course experience.

Keywords: sustainability, project-based learning, engineering education, higher education for sustainability

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Authors: K. V. N. K. C. Sharma

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Globalization, coupled with increase in competition is compelling organizations to adopt innovative strategies and identify core competencies in order to distinguish themselves from the competition. The capability of an organization is no longer determined by their products or services alone. The intellectual assets and quality of the human resource are fast emerging as key differentiators. Corporations are now positioning themselves as ‘brands’ not solely to market their products and services, but also to lure and to retain the best talent in the business. This paper identifies leadership as the ‘key element’ in developing an organization’s brand, which has a significant influence on the employee’s eventual perception of this external brand as portrayed by the organization. External branding incorporates innovation, consumer concern, trust, quality and sustainability. The paper contends that employees are indeed an organization’s ‘brand ambassadors. Internal branding involves taking care of these ambassadors of corporate brand i.e. human resource. If employees of an organization are not exposed to the organization’s branding (an ongoing process that functionally aligns, motivates and empower employees at all levels to consistently provide a satisfying customer experience), the external brand could be jeopardized. Internal branding, on the other hand, refers to employee’s perception of the organization’s brand. The current business environment can at best, be termed as volatile. Employees with the right technical and behavioral skills remain a scarce resource and the employers need to be ready to capture the attention, interest and commitment of the best and brightest candidates. This paper attempts to review and understand the relationship between employer branding and employee retention. The paper also seeks to identify potential impact of employer branding across all the factors affecting employees.

Keywords: external branding, organisation personnel, internal branding, leadership

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Authors: Kimberly Winnie Achieng Otieno

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The Nairobi Hospital plays a pivotal role in healthcare provision in East and Central Africa, yet it faces challenges in providing accessible dialysis care. This paper explores strategic interventions to enhance dialysis care, improve access and streamline health information management, with an aim of fostering an integrated and patient-centered healthcare system in our region. Challenges at The Nairobi Hospital The Nairobi Hospital currently grapples with insufficient dialysis machines which results in extended turn around times. This issue stems from both staffing bottle necks and infrastructural limitations given our growing demand for renal care services. Our Paper-based record keeping system and fragmented flow of information downstream hinders the hospital’s ability to manage health data effectively. There is also a need for investment in expanding The Nairobi Hospital dialysis facilities to far reaching communities. Setting up satellite clinics that are closer to people who live in areas far from the main hospital will ensure better access to underserved areas. Community Outreach and Education Implementing education programs on kidney health within local communities is vital for early detection and prevention. Collaborating with local leaders and organizations can establish a proactive approach to renal health hence reducing the demand for acute dialysis interventions. We can amplify this effort by expanding The Nairobi Hospital’s corporate social responsibility outreach program with weekend engagement activities such as walks, awareness classes and fund drives. Enhancing Efficiency in Dialysis Care Demand for dialysis services continues to rise due to an aging Kenyan population and the increasing prevalence of chronic kidney disease (CKD). Present at this years International Nursing Conference are a diverse group of caregivers from around the world who can share with us their process optimization strategies, patient engagement techniques and resource utilization efficiencies to catapult The Nairobi Hospital to the 21st century and beyond. Plans are underway to offer ongoing education opportunities to keep staff updated on best practices and emerging technologies in addition to utilizing a patient feedback mechanisms to identify areas for improvement and enhance satisfaction. Staff empowerment and suggestion boxes address The Nairobi Hospital’s organizational challenges. Current financial constraints may limit a leapfrog in technology integration such as the acquisition of new dialysis machines and an investment in predictive analytics to forecast patient needs and optimize resource allocation. Streamlining Health Information Management Fully embracing a shift to 100% Electronic Health Records (EHRs) is a transformative step toward efficient health information management. Shared information promotes a holistic understanding of patients’ medical history, minimizing redundancies and enhancing overall care quality. To manage the transition to community-based care and EHRs effectively, a phased implementation approach is recommended. Conclusion By strategically enhancing dialysis care access and streamlining health information management, The Nairobi Hospital can strengthen its position as a leading healthcare institution in both East and Central Africa. This comprehensive approach aligns with the hospital’s commitment to providing high-quality, accessible, and patient-centered care in an evolving landscape of healthcare delivery.

Keywords: Africa, urology, diaylsis, healthcare

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Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo N. Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: While delays to care exist in resource rich settings, greater delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of traumatic brain injury (TBI) in Sub Saharan Africa (SSA). While many LMICs have government subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold. First, due to a lack of a functional CT scanner at the tertiary hospital, patients need to arrange their own transportation to the nearby private facility for CT scans. Second, self-financing for the private CT scans ranges from $80 - $130, which is near the average monthly income in Kampala. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified ‘three delays’ framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: Lauren Dhugga, Meena Parameswaran, David Blundell, Abbas Khushnood

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Context: A multidisciplinary weekly safety briefing was implemented at the Paediatric Cardiothoracic Unit at the Freeman Hospital in Newcastle-upon-Tyne. It is a tertiary referral centre with a quarternary cardiac paediatric intensive care unit and provides complexed care including heart and lung transplants, mechanical support and advanced heart failure assessment. Aim: The aim of this briefing is to provide a structured platform of communication, in an effort to improve efficiency, safety, and patient care. Problem: The paediatric cardiothoracic unit is made up of a vast multidisciplinary team including doctors, intensivists, anaesthetists, surgeons, specialist nurses, echocardiogram technicians, physiotherapists, psychologists, dentists, and dietitians. It provides care for children with congenital and acquired cardiac disease and is one of only two units in the UK to offer paediatric heart transplant. The complexity of cases means that there can be many teams involved in providing care to each patient, and frequent movement of children between ward, high dependency, and intensive care areas. Currently, there is no structured forum for communicating important information across the department, for example, staffing shortages, prescribing errors and significant events. Strategy: An initial survey questioning the need for better communication found 90% of respondents agreed that they could think of an incident that had occurred due to ineffective communication, and 85% felt that incident could have been avoided had there been a better form of communication. Lastly, 80% of respondents felt that a weekly 60 second safety briefing would be beneficial to improve communication within our multidisciplinary team. Based on those promising results, a weekly 60 second safety briefing was implemented to be conducted on a Monday morning. The safety briefing covered four key areas (SAFE): staffing, awareness, fix and events. This was to highlight any staffing gaps, any incident reports to be learned from, any issues that required fixing and any events including teachings for the week ahead. The teams were encouraged to email suggestions or issues to be raised for the week or to approach in person with information to add. The safety briefing was implemented using change theory. Effect: The safety briefing has been trialled over 6 weeks and has received a good buy in from staff across specialties. The aim is to embed this safety briefing into a weekly meeting using the PDSA cycle. There will be a second survey in one month to assess the efficacy of the safety briefing and to continue to improve the delivery of information. The project will be presented at the next clinical governance briefing to attract wider feedback and input from across the trust. Lessons: The briefing displays promise as a tool to improve vigilance and communication in a busy multi-disciplinary unit. We have learned about how to implement quality improvement and about the culture of our hospital - how hierarchy influences change. We demonstrate how to implement change through a grassroots process, using a junior led briefing to improve the efficiency, safety, and communication in the workplace.

Keywords: briefing, communication, safety, team

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Authors: Ibrahim Aly, Waleed Elawamy, Hanan Taher, Amira Matar

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Schistosomiasis is infection with blood flukes of the genus Schistosoma, which are acquired trans-cutaneously by swimming or wading in contaminated freshwater. The present study was proposed to produce ultra-sensitive, field-friendly high-throughput rapid immunochromatography diagnostic device for accurate detection of asymptomatic parasite carriers in schistosomiasis pre-elimination settings.For assessing diagnostic potential of rapid device, 50 blood samples from patients with schistosomiasis mansoni, 29 other proven parasitic diseases and 25 blood samples as negative control were from healthy individuals were used. The sensitivity of Quantitative antigen-capture nano-ELISAwas 82 %, and specificity was 87.1 %, where the sensitivity of Nano Dot- ELISA was 86 % and specificity was 90.7 %. The sensitivity of diagnostic device was 78 % and specificity was 85.2 %, with PPV and NPV of 86.2 % and 83.1 %, respectively.The Point of care device resulted in a good performance for the diagnosis of low-intensity infections, it was able to identify 19 out of 25 (76 %) individuals with ⩽7 eggs, 10 out of 14 individuals (71.4 %) with 11–99 eggs and 100 % of individuals with 100–399 eggs.

Keywords: schistosomiasis, immunochromatography, naon-dot-ELISa, diagnostis device

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Authors: Amy Guidera, Steven Busby, Christian Williams, David Phillippi

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College students are a priority preventative healthcare population that can engage in high-risk behaviors which may concurrently increase the potential for unsafe sexual practices, including contracting sexually transmitted infections (STIs). Early education, screening, treatment, and partner notification are important interventions for breaking the chain of transmission and recurrence in relation to preventing poor health outcomes and mitigating college dropout rates. The aim of this quality improvement project was to determine if the reduction in STI screening costs for college students (aged 18-30 years old) would increase the amount of STI screenings conducted at a university health center over the course of an academic semester while evaluating our ability to achieve an improved quality of care at a reduced cost, along with improved STI reporting and documentation. This study was conducted through retrospective chart reviews of STI-related visits and utilized the RADAR matrix to provide a guiding, iterative mechanism to continuously reassess goals and outcomes defined in a memorandum of agreement (MOA) between a university health center and the state department of health (DOH) laboratory. The project failed to increase the amount of STI screenings, most likely due to the emergence of COVID-19, but resulted in improved quality of care for students, improved STI-related visit documentation and reporting, and significantly reduced costs for STI screening for collegiate students at a southeastern private university campus.

Keywords: college health, college students, preventive health, reproductive health, sexually transmitted infections, young adults

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Authors: Jeoffrey Oostrom, Robbert James Schlingmann, Hani Alers

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This document depicts the research into the indicators of dementia progression, the automation of quality of life assignments, and the visualization of it. To do this, the Smart Teddy project was initiated to make a smart companion that both monitors the senior citizen as well as processing the captured data into an insightful dashboard. With around 50 million diagnoses worldwide, dementia proves again and again to be a bothersome strain on the lives of many individuals, their relatives, and society as a whole. In 2015 it was estimated that dementia care cost 818 billion U.S Dollars globally. The Smart Teddy project aims to take away a portion of the burden from caregivers by automating the collection of certain data, like movement, geolocation, and sound-levels. This paper proves that the Smart Teddy has the potential to become a useful tool for caregivers but won’t pose as a solution. The Smart Teddy still faces some problems in terms of emotional privacy, but its non-intrusive nature, as well as diversity in usability, can make up for it.

Keywords: dementia care, medical data visualization, quality of life, smart companion

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Authors: Taik Kim

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Mathematics anxiety has an important consequence for teacher practices that influence students’ attitudes and achievement. Elementary prospective teachers have the highest levels of mathematics anxiety in comparison with other college majors. In his teaching practice, the researcher developed a highly successful teaching model to reduce pre-service teachers’ higher math anxiety and simultaneously to improve their pedagogical math content knowledge. There were eighty one participants from 2015 to 2018 who took the Mathematics for Elementary Teachers I and II. As the analysis data indicated, elementary prospective teachers’ math anxiety was greatly reduced with improving their math pedagogical knowledge. U.S encounters a critical shortage of well qualified educators. To solve the issue, it is essential to engage students in a long-term commitmentto shape better teachers, who will, in turn, produce k-12 school students that are better-prepared for college students. It is imperative that new instructional strategies are implemented to improve student learning and address declining interest, poor preparedness, a lack of diverse representation, and low persistence of students in mathematics. Many four year college students take math courses from the math department in the College of Arts& Science and then take methodology courses from the College of Education. Before taking pedagogy, many students struggle in learning mathematics and lose their confidence. Since the content course focus on college level math, instead of pre service teachers’ teaching area, per se elementary math, they do not have a chance to improve their teaching skills on topics which eventually they teach. The research, a joint appointment of math and math education, has been involved in teaching content and pedagogy. As the result indicated, participants were able to math content at the same time how to teach. In conclusion, the new initiative to use several teaching strategies was able not only to increase elementary prospective teachers’ mathematical skills and knowledge but also to improve their attitude toward mathematics. We need an innovative teaching strategy which implements evidence-based tactics in redesigning a education and math to improve pre service teachers’math skills and which can improve students’ attitude toward math and students’ logical and reasoning skills. Implementation of these best practices in the local school district is particularly important because K-8 teachers are not generally familiar with lab-based instruction. At the same time, local school teachers will learn a new way how to teach math. This study can be a vital teacher education model expanding throughout the State and nationwide. In summary, this study yields invaluable information how to improve teacher education in the elementary level and, eventually, how to enhance K-8 students’ math achievement.

Keywords: quality of education and improvement method, teacher education, innovative teaching and learning methodologies, math education

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Authors: Mary Katherine Hoth

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Despite racial and ethnic disparities in American psychiatry being well-documented, there remains an apathetic attitude among nurses and providers within the field to engage in active antiracism and provide equitable, recovery-oriented care. It is insufficient to be a “colorblind” nurse or provider and state that call care provided is identical for every patient. Maintaining an attitude of “colorblindness” perpetuates the racism prevalent throughout healthcare and leads to negative patient outcomes. The purpose of this literature review is to highlight the how the historical beginnings of psychiatry have evolved into the disparities seen in today’s practice, as well as to provide some insight on methods that providers and nurses can employ to actively participate in challenging these racial disparities. Background The application of psychiatric medicine to White people versus Black, Indigenous, and other People of Color has been distinctly different as a direct result of chattel slavery and the development of pseudoscience “diagnoses” in the 19th century. This weaponization of the mental health of Black people continues to this day. Population The populations discussed are Black, Indigenous, and other People of Color, with a primary focus on Black people’s experiences with their mental health and the field of psychiatry. Methods A literature review was conducted using CINAHL, EBSCO, MEDLINE, and PubMed databases with the following terms: psychiatry, mental health, racism, substance use, suicide, trauma-informed care, disparities and recovery-oriented care. Articles were further filtered based on meeting the criteria of peer-reviewed, full-text availability, written in English, and published between 2018 and 2023. Findings Black patients are more likely to be diagnosed with psychotic disorders and prescribed antipsychotic medications compared to White patients who were more often diagnosed with mood disorders and prescribed antidepressants. This same disparity is also seen in children and adolescents, where Black children are more likely to be diagnosed with behavior problems such as Oppositional Defiant Disorder (ODD) and White children with the same presentation are more likely to be diagnosed with Attention Hyperactivity Disorder. Medications advertisements for antipsychotics like Haldol as recent as 1974 portrayed a Black man, labeled as “agitated” and “aggressive”, a trope we still see today in police violence cases. The majority of nursing and medical school programs do not provide education on racism and how to actively combat it in practice, leaving many healthcare professionals acutely uneducated and unaware of their own biases and racism, as well as structural and institutional racism. Conclusions Racism will continue to grow wherever it is given time, space, and energy. Providers and nurses have an ethical obligation to educate themselves, actively deconstruct their personal racism and bias, and continuously engage in active antiracism by dismantling racism wherever it is encountered, be it structural, institutional, or scientific racism. Agents of change at the patient care level not only improve the outcomes of Black patients, but it will also lead the way in ensuring Black, Indigenous, and other People of Color are included in research of methods and medications in psychiatry in the future.

Keywords: disparities, psychiatry, racism, recovery-oriented care, trauma-informed care

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Authors: Adekunle Ayodeji Folorunso, Aisha S. Habeeb

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The purpose of this study was to determine the factors influencing the student’s choice of food intake, a case study of the Federal Polytechnic, Bida. A review of the past work was done, and many key points were noted. A sample population of 1000 students was selected randomly (i.e. 200 students from each school) who were in the 2011/2012 academic session. The factor influencing the students' foods intake ranges from economic factors (food cost, income, availability of food), physical factors (easy to cook, shortest time), social factors (cultural, family and meal pattern) attitudes, belief and knowledge about food were discovered. The data collected were tabulated in frequency and percentages. It was revealed that ‘easy method of cooking and preparation’ influenced students’ choice of food intake more (34%) and the food frequency questionnaire shows that the students eat more of carbohydrates foods compared to other classes of food. The cooking skills of students were low (1%) which may be responsible for the limitations in the food choices. It is, therefore, recommended that students should be equipped with sound cooking skills to increase their range of food intake. Variety is needed in diet/meal because the required nutrients are scattered among many different foods.

Keywords: factors, food intake, influencing, choice, students

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Authors: Ted Silva

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Dietrich de Velsa's Équation à un inconnu / Equation to an Unknown hybridizes art cinema style with the sexually explicit aesthetics of pornography to envision a uniquely queer world unmoored by heteronormative influence. This stylization evokes the memory of a queer history that once approximated such a prospect. With this historical and political context in mind, this paper utilizes formal analysis to assess how the film frames queer sexual encounters as tender acts of care, sometimes literally mending physical wounds. However, Equation to Unknown also highlights the transience of these sexual exchanges. By emphasizing the homogeneity of the protagonist’s sexual conquests, the film reveals that these practices have a darker meaning when the men reject the individualized connection to pursue purely visceral gratification. Given the lack of diversity or even recognizable identifying factors, the men become more anonymous to each other the more they pair up. Ultimately, Equation to an Unknown both celebrates and problematizes its vision of a queer utopia, highlighting areas in the community wherein intimacy and care flourish and locating those spots in which they are neglected.

Keywords: pornography studies, queer cinema, French cinema, history

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Authors: Saira Maqbool, Qaisara Parveen, Muhammad Arshad Dahar

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Improving females' involvement in management and enterprises in Pakistan requires the development of female entrepreneurs as leaders. Entrepreneurial education aims for providing students the knowledge, aptitudes and motivation to energize innovative accomplishment in various settings. Assortments of venture instruction are advertised at all stages of mentoring, from fundamental or discretionary institutes through graduate institutional platforms. The business enterprise will be considered the procedure by which a looming business visionary or business person pursues after openings without respect to the resources they directly regulate. This entails the ability of the business visionary to join every single other generation. This study explores the relationship between developing Women's Leadership skills and Entrepreneurship Education The essential reason for this consider was to analyze the role of Entrepreneurship Edification (EE) towards women's Leadership and develop entrepreneurial intentions among students. The major goal of this study was to foster entrepreneurial attitudes among PMAS Arid Agriculture University undergraduate students concerning their choice to work for themselves. This study focuses on the motivation and interest of female students in the social sciences to build entrepreneurial leadership skills. The quantitative analysis used a true-experimental, pretest-posttest control group research design. Female undergraduate students from PMAS Arid Agriculture University made up the study population. For entrepreneurial activity, a training module has been created. The students underwent a three-week training program at PMAS Arid Agriculture University, where they learned about entrepreneurial leadership abilities. The quantitative data were analyzed using descriptive statistics and T-tests. The findings indicated that students acquired entrepreneurial leadership skills and intentions after training. They have decided to launch their businesses as leaders. It is advised that other PMAS Arid Agriculture University departments use the training module and course outline because the research's usage of them has important results.

Keywords: business, entrepreneurial, intentions, leadership, women

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Authors: Jessica Raven Gates, Gemma Wilson-Menzfeld, Professor Alison Steven

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In 2019, the Primary Care system in the UK National Health Service (NHS) was subject to reform and restructuring. Primary Care Networks (PCNs) were established, which aligned with a trend towards integrated care both within the NHS and internationally. The introduction of PCNs brought groups of GP practices in a locality together, to operate as a network, build on existing services and collaborate at a larger scale. PCNs were expected to bring a range of benefits to patients and address some of the workforce pressures in the NHS, through an expanded and collaborative workforce. The early establishment of PCNs was disrupted by the emerging COVID-19 pandemic. This study, set in the context of the pandemic, aimed to explore experiences of the PCN workforce, and their perceptions of the establishment of PCNs. Specific objectives focussed on examining factors perceived as enabling or hindering the success of a PCN, the impact on day-to-day work, the approach to implementing change, and the influence of the COVID-19 pandemic upon PCN development. This study is part of a three-phase PhD project that utilized qualitative approaches and was underpinned by social constructionist philosophy. Phase 1: a systematic narrative review explored the provision of preventative healthcare services in UK primary settings and examined facilitators and barriers to delivery as experienced by the workforce. Phase 2: informed by the findings of phase 1, semi-structured interviews were conducted with fifteen participants (PCN workforce). Phase 3: follow-up interviews were conducted with original participants to examine any changes to their experiences and perceptions of PCNs. Three main themes span across phases 2 and 3 and were generated through a Framework Analysis approach: 1) working together at scale, 2) network infrastructure, and 3) PCN leadership. Findings suggest that through efforts to work together at scale and collaborate as a network, participants have broadly accepted the concept of PCNs. However, the workforce has been hampered by system design and system complexity. Operating against such barriers has led to a negative psychological impact on some PCN leaders and others in the PCN workforce. While the pandemic undeniably increased pressure on healthcare systems around the world, it also acted as a disruptor, offering a glimpse into how collaboration in primary care can work well. Through the integration of findings from all phases, a new theoretical model has been developed, which conceptualises the findings from this Ph.D. study and demonstrates how the workforce has experienced change associated with the establishment of PCNs. The model includes a contextual component of the COVID-19 pandemic and has been informed by concepts from Complex Adaptive Systems theory. This model is the original contribution to knowledge of the PhD project, alongside recommendations for practice, policy and future research. This study is significant in the realm of health services research, and while the setting for this study is the UK NHS, the findings will be of interest to an international audience as the research provides insight into how the healthcare workforce may experience imposed policy and service changes.

Keywords: health services research, qualitative research, NHS workforce, primary care

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Authors: Vakhtang Charaia, Mariam Lashkhi

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Foreign direct investment (FDI) plays a vital role in global business. It provides firms with new markets and advertising channels, cheaper production facilities, admission to new technology, products, skills and financing. FDI can provide a recipient country/company with a source of new technologies, capital, practice, products, management skills, and as such can be a powerful drive for economic development. It is one of the key elements of stable economic development in many countries, especially in developing ones. Therefore the size of FDI inflow is one of the most crustal factors for economic perfection in small economy countries (like, Georgia), while most of developed ones are net exporters of FDI. Since, FDI provides firms with new markets; admission to new technologies, products and management skills; marketing channels; cheaper production facilities, and financing opportunities. It plays a significant role in Georgian economic development. Increasing FDI inflows from all over the world to Georgia in last decade was achieved with the outstanding reforms managed by the Georgian government. However, such important phenomenon as world financial crisis and Georgian-Russian war put its consequence on the over amount of FDI inflow in Georgia in the last years. It is important to mention that the biggest investor region for Georgia is EU, which is interested in Georgia not only from the economic points of view but from political. The case studies from main EU investor countries show that Georgia has a big potential of investment in different areas, such as; financial sector, energy, construction, tourism industry, transport and communications. Moreover, signing of Association Agreement between Georgia and EU will further boost all the fields of economy in Georgia in both short and long terms. It will attract more investments from different countries and especially from EU. The last, but not least important issue is the calculation of annual FDI inflow to Georgia, which it is calculated differently by different organizations, based on different methodologies, but what is more important is that all of them show significant increase of FDI in last decade, which gives a positive signal to investors and underlines necessity of further improvement of investment climate in the same direction.

Keywords: foreign direct investment (FDI), Georgia, investment development path, investment climate

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Authors: Hami-Ziniman Revital, Ashwall Rachelly

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The conflict resolution realm has developed tremendously during the last half-decade. Three main approaches should be mentioned: an Alternative Dispute Resolution (ADR) suggesting processes such as Arbitration or Interests-based Negotiation was developed as an answer to obligations and rights-based conflicts. The Pragmatic mediation approach focuses on the gap between interests and needs of disputants. The Transformative mediation approach focusses on relations and suits identity-based conflicts. In the current study, we examine the conflictual relations between religious and non-religious Jews in Israel and the impact of three transformative mechanisms: Inter-group recognition, In-group empowerment and Value-based reframing on the relations between the participants. The research was conducted during four facilitated joint mediation classes. A unique finding was found. Using both transformative mechanisms and the Contact Hypothesis criteria, we identify transformation in participants’ relations and a considerable change from anger, alienation, and suspiciousness to an increased understanding, affection and interpersonal concern towards the out-group members. Intergroup Recognition, In-group empowerment, and Values-based reframing were the skills discovered as the main enablers of the change in the relations and the research participants’ fostered mutual recognition of the out-group values and identity-based issues. We conclude this transformation was possible due to a constant intergroup contact, based on the Contact Hypothesis criteria. In addition, as Interests-based mediation uses “Reframing” as a skill to acknowledge both mutual and opposite needs of the disputants, we suggest the use of “Value-based Reframing” in intergroup identity-based conflicts, as a skill contributes to the empowerment and the recognition of both mutual and different out-group values. We offer to implement those insights and skills to assist conflict resolution facilitators in various intergroup identity-based conflicts resolution efforts and to establish further research and knowledge.

Keywords: empowerment, identity-based conflict, intergroup recognition, intergroup relations, mediation skills, multi-cultural society, reframing, value-based recognition

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Authors: Alexander Dolin

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In the practice of Faith-based counseling, the clinician frequently faces multifaceted issues that come together when theological directives meet professional ethics to create a special set of dilemmas. The study narrates one working through the professional dilemmas of these Faith-based counselors, thereby looking into the tensions between the necessity of fidelity to faith and the requirements to follow the American Counseling Association Code of Ethics. Through a qualitative analysis of interviews with practitioners from various denominational backgrounds, the study has identified common ethical challenges and best practices that enable the integration of faith and ethics in practice. The findings provide insight into how faith-based counselors would reconcile a situation of conflict between religious belief and professional obligations but are striving to provide care that honors both their spiritual convictions and ethical responsibilities. This will add to existing discussions related to ethical decision-making in faith-based counseling by providing practical ways of dealing with these dilemmas in support of the counselor's professional integrity and spiritual mission.

Keywords: ethics, faith, common challenges, practical tools, counseling

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Authors: F. Nasser-Abu Alhija

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In many countries, much efforts and resources are devoted to empowering and integrating minorities within the mainstream population. Major ventures in this route are crafted in higher education institutions where different outreach programs and methods such as lenient entry requirements, monitory incentives, learning skills workshops, tutoring and mentoring, are utilized. Although there is some information regarding these programs, their effectiveness still needs to be thoroughly examined. The Ethiopian community In Israel is one of the minority groups that has been targeted by sponsoring foundations and higher education institutions with the aim to ease the access, persistence and success of its young people in higher education and later in the job market. The evaluation study we propose to present focuses on the implementation of a program designed for this purpose. This program offers relevant candidates for study at a prestigious university a variety of generous incentives that include tuitions, livening allowance, tutoring, mentoring, skills and empowerment workshops and cultural meetings. Ten students were selected for the program and they started their studies in different subject areas before three and half years. A longitudinal evaluation has been conducted since the implementation of the program. Data were collected from different sources: participating students, program coordinator, mentors, tutors, program documents and university records. Questionnaires and interviews were used for collecting data on the different components of the program and on participants' perception of their effectiveness. Participants indicate that the lenient entry requirements and the monitory incentives are critical for starting their studies. During the first year, skills and empowering workshops, torturing and mentoring were evaluated as very important for persistence and success in studies. Tutoring was perceived as very important also at the second year but less importance is attributed to mentoring. Mixed results regarding integration in the Israeli culture emerged. The results are discussed with reference to findings from different settings around the world.

Keywords: access to higher education, minority groups, monitory incentives, torturing, mentoring

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Authors: Narges Nemati, Mohammadreza Fallahpour, Hossein Bozorgian

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Reading is one of the receptive skills which has an important role in improving other skills like writing and speaking. Furthermore, language learners can acquire plenty of vocabularies and become more acquainted with written expression through reading. Also, negative attitudes toward reading can cause negligible reading comprehension, which could prompt poor performance in the English language. Considering the fact that reading instruction was discussed as a low priority skill in the field of EFL teacher education, this study attempted to investigate EFL teachers’ attitudes toward reading instruction. Therefore, to serve the purpose of this study, a mixed-method approach was utilized by inviting 100 Iranian EFL teachers who taught at English language institutes of Iran to fill out a validated questionnaire on teachers’ attitude toward reading. Subsequently, 10 participants were randomly selected for further observations and interview sessions to evaluate the differences between their stated attitude and their actual practices. The findings from analyzing questionnaires, observations, and interviews revealed that EFL teachers’ stated attitude toward reading instruction was positive; whereas, due to some reasons like lack of time, scarcity of interesting passages, and lack of interest in reading long passages, teachers did not show positive actual attitude toward teaching reading skill.

Keywords: English as foreign language classroom, English language, reading skill, teachers' attitude

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Authors: Yunfan Jiang

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In response to an identified gap in available treatment programmes for high-risk offenders with multiple criminogenic needs and guided by emerging literature in the field of correctional rehabilitation, Singapore Prison Service (SPS) developed the Integrated Criminogenic Programme (ICP) in 2012. This evidence-informed psychological programme was designed to address all seven dynamic criminogenic needs (from the Central 8) of high-risk offenders by applying concepts from rehabilitation and psychological theories such as Risk-Need-Responsivity, Good Lives Model, narrative identity, and motivational interviewing. This programme also encompasses a 6-month community maintenance component for the purpose of providing structured step-down support in the aftercare setting. These sessions provide participants the opportunity for knowledge reinforcement and application of skills attained in-care. A quantitative evaluation of the ICP showed that the intervention group had statistically significant improvements across time in most self-report measures of criminal attitudes, substance use attitudes, and psychosocial functioning. This was congruent with qualitative data from participants saying that the ICP had the most impact on their criminal thinking patterns and management of behaviours in high-risk situations. Results from the comparison group showed no difference in their criminal attitudes, even though they reported statistically significant improvements across time in their substance use attitudes and some self-report measures of psychosocial functioning. The programme’s efficacy was also apparent in the lower rates of recidivism and relapse within 12 months for the intervention group. The management of staff issues arising from the development and implementation of an innovative high-intensity psychological programme such as the ICP will also be discussed.

Keywords: evaluation, forensic psychology, intervention programme, offender rehabilitation

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Authors: Jean Ware, Susan W. Jones

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Background: The benefits of grammar instruction in the teaching of writing is contested in most English speaking countries. A majority of Anglophone countries abandoned the teaching of grammar in the 1950s based on the conclusions that it had no positive impact on learners’ development of reading, writing, and language. Although the decontextualised teaching of grammar is not helpful in improving writing, a curriculum with a focus on grammar in an embedded and meaningful way can help learners develop their understanding of the mechanisms of language. Although British learners are generally not taught grammar rules explicitly, learners in schools in France, the Netherlands, and Germany are taught explicitly about the structure of their own language. Exposing learners to grammatical analysis can help them develop their understanding of language. Indeed, if learners are taught that each part of speech has an identified role in the sentence. This means that rather than have to memorise lists of words or spelling patterns, they can focus on determining each word or phrase’s task in the sentence. These processes of categorisation and deduction are higher order thinking skills. When considering definitions of dyslexia available in Great Britain, the explicit teaching of grammar in context could help learners with persistent literacy difficulties. Indeed, learners with dyslexia often develop strengths in problem solving; the teaching of grammar could, therefore, help them develop their understanding of language by using analytical and logical thinking. Aims: This study aims at gaining a further understanding of how the explicit teaching of grammar in context can benefit learners with persistent literacy difficulties. The project is designed to identify ways of adapting existing grammar focussed teaching materials so that learners with specific learning difficulties such as dyslexia can use them to further develop their writing skills. It intends to improve educational practice through action, analysis and reflection. Research Design/Methods: The project, therefore, uses an action research design and multiple sources of evidence. The data collection tools used were standardised test data, teacher assessment data, semi-structured interviews, learners’ before and after attempts at a writing task at the beginning and end of the cycle, documentary data and lesson observation carried out by a specialist teacher. Existing teaching materials were adapted for use with five Year 9 learners who had experienced persistent literacy difficulties from primary school onwards. The initial adaptations included reducing the amount of content to be taught in each lesson, and pre teaching some of the metalanguage needed. Findings: Learners’ before and after attempts at the writing task were scored by a colleague who did not know the order of the attempts. All five learners’ scores were higher on the second writing task. Learners reported that they had enjoyed the teaching approach. They also made suggestions to be included in the second cycle, as did the colleague who carried out observations. Conclusions: Although this is a very small exploratory study, these results suggest that adapting grammar focused teaching materials shows promise for helping learners with persistent literacy difficulties develop their writing skills.

Keywords: explicit teaching of grammar in context, literacy acquisition, persistent literacy difficulties, writing skills

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Authors: Sinan Serkan Çağlı

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This study explores the effectiveness of incorporating storytelling tasks into language acquisition programs for young learners. The research investigates how storytelling, as a pedagogical tool, can contribute to the enhancement of language acquisition skills in children. Drawing upon relevant literature and empirical data, this article examines the impact of storytelling on vocabulary development, comprehension, and overall language proficiency in early childhood education in Turkey. The study adopts a qualitative approach, including classroom observations and interviews with teachers and students. Findings suggest that storytelling tasks not only foster linguistic competence but also stimulate cognitive and socio-emotional development in young learners. Additionally, the article explores various storytelling techniques and strategies suitable for different age groups. It is evident that integrating storytelling tasks into language learning environments can create engaging and effective opportunities for young learners to acquire language skills in a natural and enjoyable way. This research contributes valuable insights into the pedagogical practices that promote language acquisition in early childhood, emphasizing the significance of storytelling as a powerful educational tool, especially in Turkey for EFL students.

Keywords: storytelling, language acquisition, young learners, early childhood education, pedagogy, language proficiency

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Authors: Samaneh Sadat Fattahi Massoom, Hossein Salimi Bajestani

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The study examines loneliness and depression in students who regularly care for themselves after school (latchkey students) in Mashhad and compares them with parent supervised students using a causal-comparative research method. The 270 participants, aged 7 -13, were selected using convenience and cluster random-assignment sampling. Independent t-test results showed significant differences between loneliness (-4.32, p ≤ 0.05) and depression (-3.02, p ≤0.05) among latchkey and non-latchkey students. Using the Pearson correlation test, significant correlation between depression and loneliness among latchkey students was also discovered (r=0.59, p ≤ 0.05). However, regarding non latchkey students, no significant difference between loneliness and depression was observed (r= 0.02. p ≥ 0.05). Multiple regression results also showed that depression variance can be determined by gender (22%) and loneliness (34%). The findings of this study, specifically the significant difference between latchkey and non-latchkey children regarding feelings of loneliness and depression, carries clear implications for parents. It can be concluded that mothers who spend most of their time working out of the house and devoid their children of their presence in the home may cause some form of mental distress like loneliness and depression. Moreover, gender differences affect the degree of these psychological disorders.

Keywords: loneliness, depression, self-care students, latchkey and non-latchkey students, gender

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Authors: Liane J. Ioannou, Jonathan Serpell, Cino Bendinelli, David Walters, Jenny Gough, Dean Lisewski, Win Meyer-Rochow, Julie Miller, Duncan Topliss, Bill Fleming, Stephen Farrell, Andrew Kiu, James Kollias, Mark Sywak, Adam Aniss, Linda Fenton, Danielle Ghusn, Simon Harper, Aleksandra Popadich, Kate Stringer, David Watters, Susannah Ahern

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BACKGROUND: There are significant variations in the management, treatment and outcomes of thyroid cancer, particularly in the role of: diagnostic investigation and pre-treatment scanning; optimal extent of surgery (total or hemi-thyroidectomy); use of active surveillance for small low-risk cancers; central lymph node dissections (therapeutic or prophylactic); outcomes following surgery (e.g. recurrent laryngeal nerve palsy, hypocalcaemia, hypoparathyroidism); post-surgical hormone, calcium and vitamin D therapy; and provision and dosage of radioactive iodine treatment. A proven strategy to reduce variations in the outcome and to improve survival is to measure and compare it using high-quality clinical registry data. Clinical registries provide the most effective means of collecting high-quality data and are a tool for quality improvement. Where they have been introduced at a state or national level, registries have become one of the most clinically valued tools for quality improvement. To benchmark clinical care, clinical quality registries require systematic measurement at predefined intervals and the capacity to report back information to participating clinical units. OBJECTIVE: The aim of this study was to develop a core set clinical indicators that enable measurement and reporting of quality of care for patients with thyroid cancer. We hypothesise that measuring clinical quality indicators, developed to identify differences in quality of care across sites, will reduce variation and improve patient outcomes and survival, thereby lessening costs and healthcare burden to the Australian community. METHOD: Preparatory work and scoping was conducted to identify existing high quality, clinical guidelines and best practice for thyroid cancer both nationally and internationally, as well as relevant literature. A bi-national panel was invited to participate in a modified Delphi process. Panelists were asked to rate each proposed indicator on a Likert scale of 1–9 in a three-round iterative process. RESULTS: A total of 236 potential quality indicators were identified. One hundred and ninety-two indicators were removed to reflect the data capture by the Australian and New Zealand Thyroid Cancer Registry (ANZTCR) (from diagnosis to 90-days post-surgery). The remaining 44 indicators were presented to the panelists for voting. A further 21 indicators were later added by the panelists bringing the total potential quality indicators to 65. Of these, 21 were considered the most important and feasible indicators to measure quality of care in thyroid cancer, of which 12 were recommended for inclusion in the final set. The consensus indicator set spans the spectrum of care, including: preoperative; surgery; surgical complications; staging and post-surgical treatment planning; and post-surgical treatment. CONCLUSIONS: This study provides a core set of quality indicators to measure quality of care in thyroid cancer. This indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research. Inclusion of these quality indicators into monitoring databases such as clinical quality registries will enable opportunities for benchmarking and feedback on best practice care to clinicians involved in the management of thyroid cancer.

Keywords: clinical registry, Delphi survey, quality indicators, quality of care

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Authors: Mahathir Sarjan, Ramos Radzly, Noor Baiti Jamaluddin, Mohd Hafiz Zakaria, Hisham Suhadi

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Creativity is marked by the ability or power, to produce through imaginative skill and create something anew. The University is one of the great places to improve the talent in imaginative skill. Thus, it is important that for the student have a creativity to adapt the multimedia element in the development of presentation products for learning and teaching the process. The purpose of this study was to identify a creativity of the student in presentation product development. Two hundred seventeen Technical and Vocational Education (TVE) students in Universiti Tun Hussein Onn had chosen as a respondent. This study is to survey the level of creativity which is focused on knowledge, skills, presentation style and character of creative personnel. The level of creativity was measured based on the scale at low, medium and high followed by mean score level. The data collected by questionnaire then analyzed using SPSS version 20.0. The result of the study indicated that the students showed a higher of creativity (mean score in Knowledge = 4.12 and Skills= 4.02). In conjunction with the findings s implications and recommendations were suggested forward like to ensconce the research and improve with a more creativity concept in presentation product of development for learning and teaching the process.

Keywords: creativity, technical, vocational education, presentation products and development for learning and teaching process

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Authors: Angela Obose Oriazowanlan

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Despite the introduction of Entrepreneurship education into the Nigerian University curriculum to prepare graduates for self-employment roles in order to abate employment challenges, their unemployment rate still soars high. The study, therefore, examined the relevance of the curriculum contents and its delivery mechanism to equip graduates with appropriate entrepreneurial skills prior to graduation. Four research questions and two hypotheses guided the study. The survey research design was adopted for the study. An infinite population of graduates of a period of five years with 200 sample representatives using the simple random sampling technique was adopted. A 45-item structured questionnaire was used for data gathering. The gathered data thereof was anlysed using the descriptive statistics of mean and standard deviation, while the formulated hypotheses were tested with Z-score at 0.5 level of significance. The findings revealed, among others, that graduates acquisition of appropriate entrepreneurial skills for self-employment generation is low due to curriculum deficiencies, insufficient time allotment, and the delivery mechanism. It was recommended, among others, that the curriculum should be reviewed to improve its relevancy and that sufficient time should be allotted to enable adequate teaching and learning process.

Keywords: evaluation of entrepreneurship education (EE) curriculum, self-employment generation, graduates of tertiary institutions, Edo state, Nigeria

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Authors: Fariea Bakul, Chhanda Karmaker

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The present study was designed to investigate the effects of parental bonding on adult’s cognitive emotion regulation and also to investigate gender differences in parental bonding and cognitive emotion regulation. Data were collected by using convenience sampling technique from 100 adult students (50 males and 50 females) of different universities of Dhaka city, ages between 20 to 25 years, using Bengali version of Parental Bonding Inventory and Bengali version of Cognitive Emotion Regulation Questionnaire. The obtained data were analyzed by using multiple regression analysis and independent samples t-test. The results revealed that fathers care (β =0.317, p < 0.05) was only significantly positively associated with adult’s cognitive emotion regulation. Adjusted R² indicated that the model explained 30% of the variance in adult’s adaptive cognitive emotion regulation. No significant association was found between parental bonding and less adaptive cognitive emotion regulations. Results from independent samples t-test also revealed that there was no significant gender difference in both parental bonding and cognitive emotion regulations.

Keywords: cognitive emotion regulation, parental bonding, parental care, parental over-protection

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Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor

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Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.

Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan

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Authors: Rana Parween, Rob Marchant

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With the continued loss of global biodiversity despite the application of modern conservation techniques, it has become crucial to investigate non-conventional methods. Accelerated destruction of ecosystems due to altered land use, climate change, cultural and social change, necessitates the exploration of society-biodiversity attitudes and links. While the loss of species and their extinction is a well-known and well-documented process that attracts much-needed attention from researchers, academics, government and non-governmental organizations, the loss of traditional ecological knowledge and practices is more insidious and goes unnoticed. The growing availability of 'indirect experiences' such as the internet and media are leading to a disaffection towards nature and the 'Extinction of Experience'. Exacerbated by the lack of documentation of traditional practices and skills, there is the possibility for the 'extinction' of traditional practices and skills before they are fully recognized and captured. India, as a mega-biodiverse country, is also known for its historical conservation strategies entwined in traditional beliefs. Indigenous communities hold skillsets, knowledge, and traditions that have accumulated over multiple generations and may play an important role in conserving biodiversity today. This study explores the differences in knowledge and attitudes towards conserving biodiversity, of three different stakeholder groups living around Jim Corbett National Park, based on their age, traditions, and association with the protected area. A triangulation designed multi-strategy investigation collected qualitative and quantitative data through a questionnaire survey of village elders, the general public, and forest officers. Following an inductive approach to analyzing qualitative data, the thematic content analysis was followed. All coding and analysis were completed using NVivo 11. Although the village elders and some general public had vast amounts of traditional knowledge, most of it was related to animal husbandry and the medicinal value of plants. Village elders were unfamiliar with the concept of the term ‘biodiversity’ albeit their way of life and attitudes ensured that they care for the ecosystem without having the scientific basis underpinning biodiversity conservation. Inherently, village elders were keen to conserve nature; the superimposition of governmental policies without any tangible benefit or consultation was seen as detrimental. Alienating villagers and consequently the village elders who are the reservoirs of traditional knowledge would not only be damaging to the social network of the area but would also disdain years of tried and tested techniques held by the elders. Forest officers advocated for biodiversity and conservation education for women and children. Women, across all groups, when questioned about nature conservation, showed more interest in learning and participation. Biodiversity not only has an ethical and cultural value, but also plays a role in ecosystem function and, thus, provides ecosystem services and supports livelihoods. Therefore, underpinning and using traditional knowledge and incorporating them into programs of biodiversity conservation should be explored with a sense of urgency.

Keywords: biological diversity, mega-biodiverse countries, traditional ecological knowledge, society-biodiversity links

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Authors: Maria Vinca Novenia

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The number of school-aged children with autism in Indonesia has been increasing each year. Autism is a developmental disorder which can be diagnosed in childhood. One of the symptoms is the lack of communication skills. Music therapy is known as an effective treatment for children with autism. Music elements and structures create a good space for children with autism to express their feelings and communicate their thoughts. School-aged children are expected to be able to communicate non-verbally very well, but children with autism experience the difficulties of communicating non-verbally. The aim of this research is to analyze the significance of music therapy treatment to improve non-verbal communication tools for children with autism. This research informs teachers and parents on how music can be used as a media to communicate with children with autism. The qualitative method is used to analyze this research, while the result is described with the microanalysis technique. The result is measured specifically from the whole experiment, hours of every week, minutes of every session, and second of every moment. The samples taken are four school-aged children with autism in the age range of six to 11 years old. This research is conducted within four months started with observation, interview, literature research, and direct experiment. The result demonstrates that music therapy could be effectively used as a non-verbal communication tool for children with autism, such as changes of body gesture, eye contact, and facial expression.

Keywords: autism, improvisation, microanalysis, music therapy, nonverbal communication, school-aged

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