Search results for: family care team

Authors: Katja Wiedemann, Melinda Gainschnigg

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This paper deals with gender inequality in companies. In the context of this paper, it is analyzed how women are discriminated by means of Human Resources instruments. The existing gender inequality is made apparent by the ‘Equal Pay Day. Women in Austria work without payment from 20 October onwards, which represents inequality of 21.7 percent points. This gender pay gap is due to the unequal distribution of paid and unpaid work between men and women. Since the majority of activities related to the family and care are carried out by women, there are human capital deficits on women’s side. In addition to the discrimination of women in compensation, there are also discrimination cases caused by other Human Resources instruments. The aim of this paper is to analyze the use of Human Resources instruments with regard to the discrimination of women and to identify measures to counteract this discrimination. Within the scope of this paper, possible instructions for companies on how to design and implement Human Resources instruments will be elaborated. Therefore personnel planning, recruiting, workforce management, compensation, and leadership are used as the basis for that analysis. The data were collected by a literature review and evaluated by means of a summary content analysis. The literature analysis includes papers of scientific journals from various business fields. On the basis of the results of the literature review, it is clear that women are discriminated by all analyzed Human Resources instruments. As a result, existing potentials are not optimally used. In order to limit or even prevent this loss of potential, companies must take specific measures to counteract the discrimination of women.

Keywords: employment issues, gender inequality , women's studies, workplace

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Authors: Farnoush Haghanipour

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Recent research studies relation between coping strategies with stress and mental health situation in flying addicted family of self-introducer and private, Units of Guilan province. For this purpose 251 family (parent, spouse), that referred to private and self-introducer centers to break out of drug are selected in random sampling form. Research method was cross sectional-descriptive and purpose of research was fixing of between kinds of coping strategies with stress and mental health condition with attention to demographic variables. Therefore to collection of information, coping strategies questionnaire (CSQ) and mental health questionnaire (GHQ) was used and finally data analyzed by descriptive statistical methods (average, standard deviation) and inferential statistical correlation coefficient and regression. Study of correlation coefficient between mental healths with problem focused emotional focused and detachment strategies in level more than %99 is confirmed. Also mental health with avoidant focused hasn't correlation in other words relation is between mental health with problem focused strategies (r= 0/34) and emotional focused with mental health (r=0.52) and detachment with mental health (r= 0.18) in meaningful level 0.05. And also relation is between emotional focused strategies and mental health (r= 0.034) that is meaningless in Alpha 0.05. Also relation between problem processed coping strategies and mental health situation with attention to demographic variable is meaningful and relation level verified in confidence level more than 0.99. And result of anticipation equation regression statistical test has most a have in problem focused coping strategy, mental health, but relation of the avoidant emotional, detachment strategy with mental health was meaningless with attention to demographic variables.

Keywords: stress, coping strategy with stress, mental health, self introducer and private

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Authors: Martha Berg, Megan Ramaiya, Andi Schmidt, Susanna Sharma, Brandon Kohrt

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Nepali adolescents report tension and negative emotion due to perceived expectations of both academic and social achievement. These societal goals, which are internalized through early-life socialization, drive the development of self-regulatory processes such as emotion regulation. Emotion dysregulation is linked with adverse psychological outcomes such as depression, self-harm, and suicide, which are public health concerns for organizations working with Nepali adolescents. This study examined the relation among socialization, internalized cultural goals, and emotion regulation to inform interventions for reducing depression and suicide in this population. Participants included 102 students in grades 7 through 9 in a post-earthquake school setting in rural Kathmandu valley. All participants completed a tablet-based battery of quantitative measures, comprising transculturally adapted assessments of emotion regulation, depression, and self-harm/suicide ideation and behavior. Qualitative measures included two focus groups and semi-structured interviews with 22 students and 3 parents. A notable proportion of the sample reported depression symptoms in the past 2 weeks (68%), lifetime self-harm ideation (28%), and lifetime suicide attempts (13%). Students who lived with their nuclear family reported lower levels of difficulty than those who lived with more distant relatives (z=2.16, p=.03), which suggests a link between family environment and adolescent emotion regulation, potentially mediated by socialization and internalization of cultural goals. These findings call for further research into the aspects of nuclear versus extended family environments that shape the development of emotion regulation.

Keywords: adolescent mental health, emotion regulation, Nepal, socialization

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Authors: Maariyah Irfan

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Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

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Authors: Jamuna Rajeswaran

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In the past two decades, with a population of more than a billion. India is passing through a major socio-demographic and epidemiological transition with consequent changes in health scenario. TBI constitute significant burden on health care resources in India The impact on a person and family can be devastating. Patients with TBI experience persistent cognitive deficits, emotional changes, which contribute to the disruption of life activities. The recovery of TBI would be maximized by appropriate rehabilitation. Neurofeedback is an emerging neuroscience-based clinical application. Sixty patients were recruited for this study after obtaining informed consent. Rivermead Head Injury Follow-up Questionnaire, Rivermead Post Concussion Symptoms Questionnaire and Visual Analog Scale were used to assess the behavioral and symptomotolgy associated with post TBI. Neuropsychological assessment was carried out using NIMHANS neuropsychological battery 2004. The Intervention group received neurofeedback training and the waitlist group did not receive any treatment during this phase. Patients were allocated to intervention and waitlist group at random. There were 30 patients in each group. Patients were given 20 sessions of NFT Patients were trained on the O1 and O2 channels for alpha theta training. Each session was of 40 minutes duration with 5-6 sessions per week. The post-training assessment was carried out for the intervention group after 20 sessions of NFT. The waitlist group underwent assessment after one month. Results showed neurofeedback training is effective in ameliorating deficits in cognitive functions and quality of life in patients with TBI. Improvements were corroborated by the clinical interview with patients and significant others post NFT.

Keywords: assessment, rehabilitation, cognition, EEG neurofeedback

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Authors: Sabrina Neururer, Marco Schweitzer, Werner Hackl, Bernhard Tilg, Patrick Raudaschl, Andreas Huber, Bernhard Pfeifer

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History and the current outbreak of Covid-19 have shown the deadly potential of infectious diseases. However, infectious diseases also have a serious impact on areas other than health and healthcare, such as the economy or social life. These areas are strongly codependent. Therefore, disease control measures, such as social distancing, quarantines, curfews, or lockdowns, have to be adopted in a very considerate manner. Infectious disease modeling can support policy and decision-makers with adequate information regarding the dynamics of the pandemic and therefore assist in planning and enforcing appropriate measures that will prevent the healthcare system from collapsing. In this work, an agent-based simulation package named “survival” for simulating infectious diseases is presented. A special focus is put on SARS-Cov-2. The presented simulation package was used in Austria to model the SARS-Cov-2 outbreak from the beginning of 2020. Agent-based modeling is a relatively recent modeling approach. Since our world is getting more and more complex, the complexity of the underlying systems is also increasing. The development of tools and frameworks and increasing computational power advance the application of agent-based models. For parametrizing the presented model, different data sources, such as known infections, wastewater virus load, blood donor antibodies, circulating virus variants and the used capacity for hospitalization, as well as the availability of medical materials like ventilators, were integrated with a database system and used. The simulation result of the model was used for predicting the dynamics and the possible outcomes and was used by the health authorities to decide on the measures to be taken in order to control the pandemic situation. The survival package was implemented in the programming language Java and the analytics were performed with R Studio. During the first run in March 2020, the simulation showed that without measures other than individual personal behavior and appropriate medication, the death toll would have been about 27 million people worldwide within the first year. The model predicted the hospitalization rates (standard and intensive care) for Tyrol and South Tyrol with an accuracy of about 1.5% average error. They were calculated to provide 10-days forecasts. The state government and the hospitals were provided with the 10-days models to support their decision-making. This ensured that standard care was maintained for as long as possible without restrictions. Furthermore, various measures were estimated and thereafter enforced. Among other things, communities were quarantined based on the calculations while, in accordance with the calculations, the curfews for the entire population were reduced. With this framework, which is used in the national crisis team of the Austrian province of Tyrol, a very accurate model could be created on the federal state level as well as on the district and municipal level, which was able to provide decision-makers with a solid information basis. This framework can be transferred to various infectious diseases and thus can be used as a basis for future monitoring.

Keywords: modelling, simulation, agent-based, SARS-Cov-2, COVID-19

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Authors: A. Aldawsari

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The complex issue of women working in a mixed-gender work environment has its roots in social and cultural factors. This research was done to identify and explore the social and cultural challenges Saudi women face in a mixed-gender work environment in Saudi Arabia. Over the years, Saudi women in mixed-gender work environments in Saudi Arabia have been of interest in various research areas, especially within the context of a hospital work environment. This research, which involves a female researcher interacting one-on-one with Saudi women, will address this issue as well as the effect of the 2030 Vision in Saudi Arabia, and it will aim to include several new fields of work environments for women in Saudi Arabia. The aim of this research is to examine the perceptions of Saudi women who work in a mixed gender environment regarding the general empowerment of women in these settings. The objective of this research is to explore the cultural and social challenges that influence Saudi women's rights to work in a mixed-gender environment in Saudi Arabia. The significance of this research lies in the fact that there is an urgency to resolve issue of female employment in Saudi Arabia, where Saudi women still suffer from inequality in employment opportunity. Although the Saudi government is seeking to empower women by integrating them into a mixed-gender work environment, which is a key goal and prominent social change advocated for in the 2030 Vision, this same goal is one of the main challenges in the face of achieving female empowerment. The methodology section focuses on appropriate methods that can be used to study the effect of social and cultural challenges on the employment of women. It then determines the conditions and limitations of the research by applying a qualitative research approach to the investigation and analysing the data collected from the interviews. A statistical analysis tool, such as NVivo, will be used for the qualitative analysis of the interviews. The study found that the factor most responsible for creating social and cultural challenges is family—whether close family or distant family—more so than tribe or community.

Keywords: women, work, mixed-gender, environment

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Authors: R. Nayak, T. Panwar, R. Padhye

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Protective textiles get soiled, stained and even worn during their use, which may not be usable after a certain period due to the loss of protective performance. They need regular cleaning and maintenance, which helps to extend the durability of the clothing, retains their useful properties and ensures that fresh clothing is ready to wear when needed. Generally, the cleaning processes used for various protective clothing include dry-cleaning (using solvents) or wet cleaning (using water). These cleaning processes can alter the fabric surface properties, dimensions, and physical, mechanical and performance properties. The technology of laundering and dry-cleaning has undergone several changes. Sustainable methods and products are available for faster, safer and improved cleaning of protective textiles. We performed a comprehensive and systematic review of green technologies and eco-friendly products for sustainable cleaning of protective textiles. Special emphasis is given on the care and maintenance procedures of protective textiles for protection from fire, bullets, chemical and other types of protective clothing.

Keywords: Sustainable cleaning, protective textiles, ecofriendly cleaning, ozone laundering, ultrasonic cleaning

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Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

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Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

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Authors: Mudafara Bengleil

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Estimation of the magnitude and causes of poisoning was the objective of the current study. A retrospective study of medical records of all poisoning children admitted to Benghazi Children Hospital in Libya from January 2008 up to December 2010. Number of children admitted was 244; the age ranged from less than one to 13 years old. Most of cases were admitted with mild symptom and the majority of them were boys. Only few cases admitted to intensive care unit and there was no mortality recorded through the period of study. Age group 1 to 3 years (50.8%) had the highest frequency of admission and the peak of admission was during summer. The most common cause of admission was due to ingestion of medication (53.69%), House hold product exposure (26.64%) was the second causes of admission while, 19.67% of admissions were due to Food poisoning. Almost all admitted cases were accidental and medicines were the most consumed substances in addition, improper storage of toxic agents were the first risk factor of poisoning. Present results indicated that, children poisoning seems to be a common pediatric care problem which need to control and prevent.

Keywords: poisoning, children, hospital, medical

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Authors: Isomar Lima da Silva, Aristeu Jonatas Leite de Oliveira, Roberto Maia Augusto

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Biological isolation capsules are equipment commonly used in the control and prevention of infectious diseases in the hospital environment. This type of equipment, combined with pre-established medical protocols, contributes significantly to the containment of highly transmissible pathogens such as COVID-19. Due to its hermetic isolation, it allows more excellent patient safety, protecting companions and the health team. In this context, this work presents the development, testing, and validation of a medical capsule to treat patients affected by COVID-19. To this end, requirements such as low cost and easy handling were considered to meet the demand of people infected with the virus in remote locations in the Amazon region and/or where there are no ICU beds and mechanical ventilators for orotracheal intubation. Conceived and developed in a partnership between SAMEL Planos de Saúde and Instituto Conecthus, the device entitled "Vanessa Capsule" was designed to be used together with the NIV protocol (non-invasive ventilation), has an automatic exhaust system and filters performing the CO2 exchange, in addition to having BiPaps ventilatory support equipment (mechanical fans) in the Cabin Kit. The results show that the degree of effectiveness in protecting against infection by aerosols, with the protection cabin, is satisfactory, implying the consideration of the Vanessa capsule as an auxiliary method to be evaluated by the health team. It should also be noted that the medical observation of the evaluated patients found that the treatment against the COVID-19 virus started earlier with non-invasive mechanical ventilation reduces the patient's suffering and contributes positively to their recovery, in association with isolation through the Vanessa capsule.

Keywords: COVID-19, mechanical ventilators, medical capsule, non-invasive ventilation

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Authors: Maren J. Coffman, Victoria C. Scott, J. Claire Schuch, Ashley N. Kelley, Jeri L. Ryan

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Postpartum Depression (PPD) is a leading cause of postpartum morbidity. PPD affects 7.1% of postpartum women and 19.2% of postpartum women when including minor depression. Lower-income women and ethnic minorities are more at risk for developing PPD and face multiple attitudinal and institutional barriers to receiving care. This study aims to identify PPD among low-income women and connect them to appropriate services in order to reduce the illness burden and enhance access to care. Screenings were conducted in two Women, Infants, and Children (WIC) clinics in the city of Charlotte, North Carolina, USA, from April 2017 to April 2018. WIC is a supplemental nutrition program that provides healthcare and nutrition to low-income pregnant women, breastfeeding women, and children under the age of 5. Additionally, a qualitative study was conducted to better understand the PPD continuum of care in order to identify opportunities for improvement. Mothers with infants were screened for depression risk using the PHQ-2. Mothers who scored ≥ 2 completed two additional standardized screening tools (PHQ-7, to complete the PHQ-9, and the Edinburgh) to assess depressive symptomatology. If indicated they may be suffering from depression, women were referred for case management services. Open-ended questions were used to understand treatment barriers. Four weeks after the initial survey, a follow-up telephone call was made to see if women had received care. Seven focus groups with WIC staff and managers, referral agency staff, local behavioral health professionals, and students examining the screenings, are being conducted March - April, 2018 to gather information related to current screening practices, referrals, follow up and treatment. Mothers (n = 231 as of February, 2018) were screened in English (65%) or Spanish (35%). According to preliminary results, 29% of mothers screened were at risk for postpartum depression (PHQ-2 ≥ 2). There were significant differences in preliminary screening results based on survey language (

Keywords: health disparities, maternal health, mental health, postpartum depression

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Authors: Rohit Sane, Pravin Ghadigaonkar, Purvi Ahuja, Suvarna Tirmare, Archana Kelhe, Kranti Shinde, Rahul Mandole

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To evaluate the efficacy of Comprehensive Diabetic Care Program with the reduction of HbA1c in overweight Diabetes Mellitus Type II patients retrospectively. Methods: Retrospective study was carried out on 34 overweight type II diabetic patients (Mean Age = 54.58 ±11.38 yrs). A total of 34 patients were enrolled after screening of 68 patients (HbA1c 7-10%). The patients were on concomitant drugs namely insulin (11.76%), DPP-4 inhibitor (17.64%), Biguanide (55.88%), Sulfonylurea (52.94%), thiazolidinedione (11.76%), other medications (20.58%) and no allopathic medications (14.70%). The patients were given Comprehensive Diabetic Care Program consisting of panchkarma procedures namely snehana (external oleation), swedana (passive heat therapy) and basti (enema), which was completed in 15 sittings. During the therapy and next 90 days, the patients followed low carbohydrate and moderate protein & fat diet. The primary endpoint of this study was the evaluation of reduction in HbA1c at the end of the follow-up after 90 days. Results: Thirty-four overweight type II diabetic patients (mean age: 54.58[±11.38], HbA1c[7-10%], 67.64% male and 32.35% female) were enrolled in the study. A significant reduction was observed in HbA1c levels (14.30%, p<0.05) at the end of the 90 days follow-up as compared to baseline. Also, BMI was reduced by 5.87%. There was reduction in the usage of the concomitant drugs namely insulin (2.94%), DPP-4 inhibitor (2.94%), Biguanide (32.35%), Sulfonylurea (35.29%), thiazolidinedione (5.88%), other medications(17.64%) and no allopathic medications (32.35%). Conclusion: The results of the study highlight not only in the reduction of HbA1c, but also in BMI and drug tapering of the CDC program in the overweight type II diabetic patients with HbA1c (7-10%).

Keywords: HbA1c, low carb diet, Panchakarma therapy, Type II Diabetes

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Authors: Waqas Shafqat Chattha, Muhammad Iqbal, Amir Shakeel

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Transcriptional factors are proteins that play a vital role in regulating the transcription of target genes in different biological processes and are being widely studied in different plant species. In the current era of genomics, plant genomes sequencing has directed to the genome-wide identification, analyses and categorization of diverse transcription factor families and hence provide key insights into their structural as well as functional diversity. The DNA-binding with One Finger (DOF) proteins belongs to C2-C2-type zinc finger protein family. DOF proteins are plant-specific transcription factors implicated in diverse functions including seed maturation and germination, phytohormone signalling, light-mediated gene regulation, cotton-fiber elongation and responses of the plant to biotic as well as abiotic stresses. In this context, a genome-wide in-silico analysis of DOF TF family in diploid cotton species i.e. Gossypium raimondii has enabled us to identify 55 non-redundant genes encoding DOF proteins renamed as GrDofs (Gossypium raimondii Dof). Gene distribution studies have shown that all of the GrDof genes are unevenly distributed across 12 out of 13 G. raimondii chromosomes. The gene structure analysis illustrated that 34 out of 55 GrDof genes are intron-less while remaining 21 genes have a single intron. Protein sequence-based phylogenetic analysis of putative 55 GrDOFs has divided these proteins into 5 major groups with various paralogous gene pairs. Molecular evolutionary studies aided with the conserved domain as well as gene structure analysis suggested that segmental duplications were the principal contributors for the expansion of Dof genes in G. raimondii.

Keywords: diploid cotton , G. raimondii, phylogenetic analysis, transcription factor

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Authors: Jane E. Souyave, Judith Bower

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This study is an ongoing collaborative project between the University of Central Lancashire and the Alzheimer’s Society to design and test the idea of using interactive tools for a person living with dementia and their carers. It is hoped that the tools will fulfill the possible needs of engagement and interaction as dementia progresses, therefore enhancing wellbeing and improving quality of life for the person with dementia and their carers. The project was informed by Kitwood’s five psychological needs for producing wellbeing and explored evidence that fidgeting is often seen as a form of agitation and a negative symptom of dementia. Although therapy for agitation may be well established, there is a lack of appropriate items aimed at people in the later stage of dementia, that are not childlike or medical in their aesthetic. Individuals may fidget in a particular way and the tools in the Fidget Widget Toolkit have been designed to encourage repetitive movements of the hand, specifically to address the abilities of people with relatively advanced dementia. As an intervention, these tools provided a new approach that had not been tested in dementia care. Prototypes were created through an iterative design process and tested with a number of people with dementia and their carers, using quantitative and qualitative methods. Dementia Care Mapping was used to evaluate the impact of the intervention in group settings. Cohen Mansfield’s Agitation Inventory was used to record the daily use and interest of the intervention for people in their usual place of residence. The results informed the design of a new set of devices to promote safe, stigma free fidgeting as a positive experience, meaningful activity and enhance wellbeing for people in the later stage of dementia. The outcomes addressed the needs of individuals by reducing agitation and restlessness through helping them to connect, engage and act independently, providing the means of doing something for themselves that they were able to do. The next stage will be to explore the commercial feasibility of the Fidget Widget Toolkit so that it can be introduced as good practice and innovation in dementia care. It could be used by care homes, with carers and their families to support wellbeing and lead the way in providing some positive experiences and person-centred approaches that are lacking in the later stage of dementia.

Keywords: dementia, design, fidgeting, healthcare, positive moments, quality of life, wellbeing

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Authors: Mohamad Reza Khodabakhsh

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Violence against women is a historical phenomenon; although its form and type are common in various societies and cultures, this type of violence occurs in terms of physical, psychological, financial, and sexual dimensions. This is the cause of many social deviations and endangers the center of the family as the most important institution. This research seeks to investigate the relationship between personality characteristics and the tendency to addiction to domestic violence. One hundred fifty women and one hundred fifty men were selected by the available sampling method. One hundred fifty men were admitted to drug addiction camps, and women included domestic violence cases. A questionnaire on addiction tendency, Five Personality Traits (NEO), and attitudes toward violence against women was used. Data were analyzed in descriptive and inferential statistics. The data were analyzed at the level of descriptive mean, mean, and standard deviation and analyzed using SPSS 20 software using correlation and analysis of variance at the level of inferential level. And the data were analyzed at the p≤0.05 significance level. The results showed that there is a significant relationship between personality traits and a tendency to addiction and domestic violence.

Keywords: personality, addiction, domestic violence, family

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Authors: Joshua W. Edefo, Shafiul Azam, Murray D. Smith

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Introduction: In April 2022, the Welsh Government introduced the six goals for urgent and emergency care programs. One of these goals was to provide access to clinically safe alternatives, leading to the establishment of the Same Day Emergency Care (SDEC) program. The SDEC initiative aims to offer viable options that maintain patient safety while avoiding unnecessary hospital stays. The aim of the study is to determine the duration of patient stay in SDEC and compare it with that of Emergency department (ED) stay to ascertain if one of the objectives of SDEC is achieved. Methods: Patient stays and attendance datasets were constructed from Withybush SDEC and ED patient records. These records were provided by Hywel Dda University Health Board Informatics. Some hypothetical pathways were identified, notably SDEC visits involving a single attendance and ED visits then immediately transferred to SDEC. Descriptive statistics were used to summarise the data, and hypothesis tests for mean differences used the student t-test. Propensity scoring was employed to match a set of ED patient stays to SDEC patient stays which were then used to determine the average treatment effect (ATE) to compare durations of stay in SDEC with ED. Regression methods were used to model the natural logarithm of the duration of SDEC attendance, and the level of statistical significance was set to 0.05. Results: SDEC visits involving a single attendance (170 of 384; 44.3%) is the most frequently observed pathway with patient length of stay at 256 minutes (95%CI 237.4 - 275.1). The next most frequently observed pathway of patient stay was SDEC attendance after presenting to ED (80 of 384; 20.8%) and gave the length of stay of 440 minutes (95%CI 351.6 - 529.2). Time spent in this pathway significantly increased by 184 minutes (95%CI 118.0 - 250.2, support for no difference p<0.001) compared to the most seen pathway. When SDEC data were compared with ED, the estimate for the ATE from SDEC single attendance was -272 minutes (95%CI -334.1 - -210.5; p<0.001), while that of ED then SDEC pathway was -50.6 min (95%CI -182.7-81.5; p=0.453). Conclusion: When patients are admitted to SDEC and successfully discharged, their stays are significantly shorter, approximately 4.5 hours, compared to patients who spend their entire stay in the Emergency Department. That difference vanishes when the patient stay includes a period spent previously in ED before transfer to SDEC.

Keywords: attendance, emergency-department, patient-stay, same-day-emergency-care

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Authors: Kate Catherine D. Belotindos, Micah Marie F. Indab, Angelia B. Lacuna, Dafnie S. Solo, Kreshianne T. Rosales

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Disney, a Western global media giant, has long been celebrated for its enchanting storytelling and iconic characters. Its advertisements, often infused with a touch of magic and nostalgia, create a significant influence in shaping one’s perspective of a culture. This research delved into the semiotic landscape of Disney’s advertisement in 2020 entitled ‘From Our Family To Yours’. The frameworks of this study - Enriquez’s cultural theory on the Psychology of the Filipino and the Bakhtinian approach to semiotics- provided foundations in the exploration of the interplay of meaning that emerged within the semiotic resources that shaped Disney’s portrayal of the Filipino Christmas. Through these frameworks, this descriptive qualitative research sheds light on the nuanced ways in which Disney reflects Filipino Christmas and culture, further looking at how the cultural integration of Filipino traditions, norms, and values within the advertisement positions Disney as a brand. The analyses reveal Filipino norms, values, and historical references that emerged within the media text. Disney highlights the Kapampangan parol-making tradition and the importance of the parol in the Philippines: a symbol of hope, comfort, and nostalgia to the Filipinos. Furthermore, socio-economic realities are also reflected within the advertisement as semiotic resources highlight the Filipino diaspora in shaping the advertisement’s narrative, reflecting on the contemporary Filipino identity. Finally, the timelessness of Mickey Mouse, a classic symbol of Disney, is integrated throughout each symbolism that reflects on the Filipino culture, correlating the Filipino familial value to that of Disney’s family. It is then drawn from the study that Disney further elevates its reach to the Philippines and maybe embraced as a company that highlights the Filipino identity.

Keywords: Disney, Filipino Christmas, semiotics, culture, media studies

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Authors: Jitendra Gouda, Chander Shekhar

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With the addition of 27 million elderly in India in past census decade from 2001 to 2011, it is imperative to work towards exploring the issues and concerns of this increasingly aged population. In Indian society, the elderly person is assumed to be looked after by the family members, especially by children but with changing economy, society, and lifestyle, this assumption demands examining. This paper is an attempt to explore the living arrangement of the elderly and their perceptions about this in India. The findings are based on the BKPAI dataset of 2011, which was conducted in seven states – Himachal Pradesh, Kerala, Maharashtra, Odisha, Punjab, Tamil Nadu, and West Bengal. The result shows that three fourth of elderly lives with their children. Having son and staying with children is positively associated among elderly. More than 40 percent as compared to 37 percent of elderly feels comfortable living with sons and daughters respectively. Half of elderly across sexes viewed that sons are the best person to live with. The result of discriminant analysis suggest that health status and living arrangement of elderly are the good discriminators to ensure their importance in the family.

Keywords: discriminant analysis, elderly, India, living arrangment

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Authors: Satu Lautamäki

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This paper presents findings from a multidisciplinary course (bachelor level) implemented at Seinäjoki University of Applied Sciences, Finland. The course aims to develop innovative thinking of students, by having projects given by companies, using design thinking methods as a tool for creativity and by integrating students into multidisciplinary teams working on the given projects. The course is obligatory for all first year bachelor students across four faculties (business and culture, food and agriculture, health care and social work, and technology). The course involves around 800 students and 30 pedagogical coaches, and it is implemented as an intensive one-week course each year. The paper discusses the pedagogy, structure and coordination of the course. Also, reflections on methods for the development of creative skills are given. Experts in contemporary, global context often work in teams, which consist of people who have different areas of expertise and represent various professional backgrounds. That is why there is a strong need for new training methods where multidisciplinary approach is at the heart of learning. Creative learning takes place when different parties bring information to the discussion and learn from each other. When students in different fields are looking for professional growth for themselves and take responsibility for the professional growth of other learners, they form a mutual learning relationship with each other. Multidisciplinary team members make decisions both individually and collectively, which helps them to understand and appreciate other disciplines. Our results show that creative and multidisciplinary project learning can develop diversity of knowledge and competences, for instance, students’ cultural knowledge, teamwork and innovation competences, time management and presentation skills as well as support a student’s personal development as an expert. It is highly recommended that higher education curricula should include various studies for students from different study fields to work in multidisciplinary teams.

Keywords: multidisciplinary learning, creative skills, innovative thinking, project-based learning

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Authors: Fatima U. Maigari, Musa Halilu, M. Maryam Umar, Rabiu Zainab

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Plants as therapeutic agents are used as drug in many parts of the world. Medicinal plants are mostly used in developing countries due to culture acceptability, belief or due to lack of easy access to primary health care services. Jatropha curcas is a plant from the Euphorbiaceae family which is widely used in Northern Nigeria as an anti-diarrheal agent. This study was conducted to determine the anti-diarrheal effect of the leaf extract on castor oil induced diarrhea in albino rats. The leaves of J. curcas were collected from Balanga Local government in Gombe State, north-eastern Nigeria; due to its bioavailability. The leaves were air-dried at room temperature and ground to powder. Phytochemical screening was done and different concentrations of the extract was prepared and administered to the different categories of experimental animals. From the results, aqueous leaf extract of Jatropha curcas at doses of 200mg/Kg and 400mg/Kg was found to reduce the mean stool score as compared to control rats, however, maximum reduction was achieved with the standard drug of Loperamide (5mg/Kg). Treatment of diarrhea with 200mg/Kg of the extract did not produce any significant decrease in stool fluid content but was found to be significant in those rats that were treated with 400mg/Kg of the extract at 2hours (0.05±0.02) and 4hours (0.01±0.01). A significant reduction of diarrhea in the experimental animals signifies it to possess some anti-diarrheal activity.

Keywords: anti-diarrhea, diarrhea, Jatropha curcas, loperamide

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Authors: Keyvan Molanorouzi, Selina Khoo, Tony Morris

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In recent years, there has been a decline in physical activity among adults. Motivation has been shown to be a crucial factor in maintaining physical activity. The purpose of this study was to whether PA motives measured by the Physical Activity and Leisure Motivation Scale PALMS predicted actual amount of PA at a later time to provide evidence for the construct validity of the PALMS. A quantitative, cross-sectional descriptive research design was employed. The Demographic Form, PALMS, and International Physical Activity Questionnaire Short form (IPAQ-S) questionnaires were used to assess motives and amount for physical activity in adults on two occasions. A sample of 640 (489 male, 151 female) undergraduate students aged 18 to 25 years (mean ±SD; 22.30±8.13 years) took part in the study. Male participants were divided into three types of activities, namely exercise, racquet sport, and team sports and female participants only took part in one type of activity, namely team sports. After 14 weeks, all 640 undergraduate students who had filled in the initial questionnaire (Occasion 1) received the questionnaire via email (Occasion 2). Of the 640 students, 493 (77%; 378 males, 115 females) emailed back the completed questionnaire. The results showed that not only were pertinent sub-scales of PALMS positively related to amount of physical activity, but separate regression analyses showed the positive predictive effect of PALMS motives for amount of physical activity for each type of physical activity among participants. This study supported the construct validity of the PALMS by showing that the motives measured by PALMS did predict amount of PA. This information can be obtained to match people with specific sport or activity which in turn could potentially promote longer adherence to the specific activity.Methods: A quantitative, cross-sectional descriptive research design was employed. The Demographic Form, PALMS, and International Physical Activity Questionnaire Short form (IPAQ-S) questionnaires were used to assess motives and amount for physical activity in adults on two occasions. A sample of 640 (489 male, 151 female) undergraduate students aged 18 to 25 years (mean ±SD; 22.30±8.13 years) took part in the study. Male participants were divided into three types of activities, namely exercise, racquet sport, and team sports and female participants only took part in one type of activity, namely team sports. After 14 weeks, all 640 undergraduate students who had filled in the initial questionnaire (Occasion 1) received the questionnaire via email (Occasion 2). Of the 640 students, 493 (77%; 378 males, 115 females) emailed back the completed questionnaire. Results: The results showed that not only were pertinent sub-scales of PALMS positively related to amount of physical activity, but separate regression analyses showed the positive predictive effect of PALMS motives for amount of physical activity for each type of physical activity among participants. This study supported the construct validity of the PALMS by showing that the motives measured by PALMS did predict amount of PA. Conclusion: This information can be obtained to match people with specific sport or activity which in turn could potentially promote longer adherence to the specific activity.

Keywords: physical activity, motivation, level of physical activity, type of physical activity

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Authors: Carmen W. H. Chan, Helen Y. L. Chan, Kai Chow Choi, Ka Ming Chow, Cecilia W. M. Kwan, Nancy H. Y. Ng, Jackie Robinson

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Introduction: In Hong Kong, a significant number of deaths occur in acute care wards, which requires nurses in these settings to provide end-of-life care and lead ACP implementation. However, nurses in these settings, in fact, have very low-level involvement in ACP discussions because of limited training in ACP conversations. Objective: This study aims to assess the impact of a multi-media experiential ACP (MEACP) training program, which is guided by the experiential learning model and theory of planned behaviour, on nurses' knowledge and confidence in assisting patients with ACP. Methodology: The study utilizes a cluster randomized controlled trial with a 12-week follow-up. Eligible nurses working in acute care hospital wards are randomly assigned at the ward level, in a 1:1 ratio, to either the control group (no ACP education) or the intervention group (4-week MEACP training program). The training programme includes training through a webpage and mobile application, as well as a face-to-face training workshop with enhanced lectures and role play, which is based on the Theory of Planned Behavior and Kolb's Experiential Learning Model. Questionnaires were distributed to assess nurses' knowledge (a 10-item true/false questionnaire) and level of confidence (five-point Likert scale) in ACP at baseline (T0), four weeks after the baseline assessment (T1), and 12 weeks after T1 (T2). In this interim report, data analysis was mainly descriptive in nature. Result: The interim report focuses on the preliminary results of 165 nurses at T0 (Control: 74, Intervention: 91) over a 5-month period, 69 nurses from the control group who completed the 4-week follow-up and 65 nurses from the intervention group who completed the 4-week MEACP training program at T1. The preliminary attrition rate is 6.8% and 28.6% for the control and intervention groups, respectively, as some nurses did not complete the whole set of online modules. At baseline, the two groups were generally homogeneous in terms of their years of nursing practice, weekly working hours, working title, and level of education, as well as ACP knowledge and confidence levels. The proportion of nurses who answered all ten knowledge questions correctly increased from 13.8% (T0) to 66.2% (T1) for the intervention group and from 13% (T0) to 20.3% (T1) for the control group. The nurses in the intervention group answered an average of 7.57 and 9.43 questions correctly at T0 and T1, respectively. They showed a greater improvement in the knowledge assessment at T1 with respect to T0 when compared with their counterparts in the control group (mean difference of change score, Δ=1.22). They also exhibited a greater gain in level of confidence at T1 compared to their colleagues in the control group (Δ=0.91). T2 data is yet available. Conclusion: The prevalence of nurses engaging in ACP and their level of knowledge about ACP in Hong Kong is low. The MEACP training program can enrich nurses by providing them with more knowledge about ACP and increasing their confidence in conducting ACP.

Keywords: advance directive, advance care planning, confidence, knowledge, multi-media experiential, randomised control trial

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Authors: Naima Nur, Safa Islam, Saeema Islam, Md. Faridul Alam

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Background: The worldwide increase in pediatric presumptive tuberculosis (TB) is the most life-threatening challenge in effectively controlling TB. The objective of this study was to determine the proportion of presumptive TB and the factors associated with it. Methods: A cross-sectional study was conducted between March and November 2013 at ICDDR-Bangladesh. Two hundred twelve pulmonary and extra-pulmonary specimens were collected from 84 suspected pediatric patients diagnosed with TB based on their clinical symptoms/radiological findings. Presumptive TB and confirmed TB were considered presumptive TB and non-presumptive TB and were isolated by smear-microscopy, culture, and GeneXpert. Logistic regression was used to analyze associations between outcome and predictor variables. Results: The proportion of presumptive TB was 85.7%, and 14.3% of non-presumptive TB. In presumptive TB, vaccine scars, family TB history, and school-going children were 16.6%, 33.3%, and 56.9%, respectively. In contrast, vaccine scars and family TB history were 8.3%, and school-going children were 58.3% in non-presumptive TB. Significant factors did not appear in the logistic regression analysis. Conclusion: Despite the high proportion of presumptive TB, there was no statistically significant between presumptive TB and non-presumptive TB.

Keywords: presumptive tuberculosis, confirmed tuberculosis, patient's characteristics, diagnosis

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Authors: Abeer M. Orabi

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Midwives are being seen as a key factor in returning birth care to a normal physiologic process that is woman-centered. On the other hand, more needs to be done to increase access for every woman to professional midwifery care. Because of the nature of the midwifery specialty, the magnitude of the effect that can result from a lack of knowledge if midwives make a mistake in their care has the potential to affect a large number of the birthing population. So, the development, running, and management of midwifery educational programs should follow international standards and come after a thorough community needs assessment. At the same time, the number of accredited midwifery educational programs needs to be increased so that larger numbers of midwives will be educated and qualified, as well as access to skilled midwifery care will be increased. Indeed, the selection of promising midwives is important for the successful completion of an educational program, achievement of the program goals, and retention of graduates in the field. Further, the number of schooled midwives in midwifery education programs, their background, and their experience constitute some concerns in the higher education industry. Basically, preceptors and clinical sites are major contributors to the midwifery education process, as educational programs rely on them to provide clinical practice opportunities. In this regard, the selection of clinical training sites should be based on certain criteria to ensure their readiness for the intended training experiences. After that, communication, collaboration, and liaison between teaching faculty and field staff should be maintained. However, the shortage of clinical preceptors and the massive reduction in the number of practicing midwives, in addition to unmanageable workloads, act as significant barriers to midwifery education. Moreover, the medicalized approach inherent in the hospital setting makes it difficult to practice the midwifery model of care, such as watchful waiting, non-interference in normal processes, and judicious use of interventions. Furthermore, creating a motivating study environment is crucial for avoiding unnecessary withdrawal and retention in any educational program. It is well understood that research is an essential component of any profession for achieving its optimal goal and providing a foundation and evidence for its practices, and midwifery is no exception. Midwives have been playing an important role in generating their own research. However, the selection of novel, researchable, and sustainable topics considering community health needs is also a challenge. In conclusion, ongoing education and research are the lifeblood of the midwifery profession to offer a highly competent and qualified workforce. However, many challenges are being faced, and barriers are hindering their improvement.

Keywords: barriers, challenges, midwifery education, educational programs

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Authors: Agnes Crisostomo, Alvin Joseph Mapoy

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This is a qualitative study which focuses on ten (10) children, with a mean age of 13.6, working in fireworks factories in Bocaue, Bulacan. The municipality of Bocaue was chosen since it is the center of trade for fireworks, and child laborers can easily penetrate in factories here. The researcher wanted to know what the possible negative effects are caused by working at an early age of a child in the physical, psychosocial, intellectual and emotional aspects of life. Results showed that social status of their parents and their lack of income forced the children to work for their family. Second, the child laborers still allot time for studying. They still do not give up in pursuing education even if they experience fatigue and illness which affect their physical development. Third, working has a great influence to the child’s life. Fourth, through socializing with others, they become more aware of life’s hardships. Usually, their co-workers are also their family members and friends; this is how they know the social status is their place, that due to poverty even the children should work for a living. Fifth, these child laborers are still hoping for a better future. Despite of their poor situation, they are still hoping that they can turn it upside down through education, perseverance and determination.

Keywords: child labor, emotional, intellectual, psychosocial

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Authors: Weihsuan Lin

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The Swiss Bethlehem Mission Society (BMS) in Taiwan has influenced and made an important contribution to religion and social work in Taidong. This German-speaking Catholic missionary society is located in Taidong, which is the political and economic periphery of Taiwan but is the cultural center of the Chinese and many different Austronesian ethnic groups, including Amis, Paiwan, Puyuma, Yami, Bunun, and Rukai. Through document analysis and fieldwork, this research aims to explore the result of the confrontation, exchange, and innovation between the BMS and other ethnic groups. Further, based upon Michael Foucault’s discussion of two modalities of constructing individuals, namely ‘discipline’ and ‘care of the self,’ this research will analyze the ‘discipline’ and ‘care of the self’ mechanisms of and between BMS Fathers, Brothers, and Church followers at the scale of individuals. At the scale of groups, the ‘autonomy’ and ‘been governed’ of the BMS in relationship to the Catholic Church in Taiwan and the world will also be examined.

Keywords: Bethlehem Mission Society, Religion and Geography, Spirituality, Foucault

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Authors: Ahmed Sami Hammami, Mohamed Jellazi

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Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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Authors: B. O. Diyaolu

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The web created by sport in academics has made it difficult for it to be separated from adolescent educational development. The enthusiasm expressed towards sport by students in higher institutions is quite enormous. Primarily, academic performance should be the pride of all students but whether sports affect the academic performance of student-athletes remain an unknown fact. This study investigated the influence of sports participation on academic performance among Afe Babalola University student-athletes. Ex post facto research design was used. Two groups of students were used for the study; Student-athlete (SA) and Regular Students (RS). Purposive sampling technique was used to select 224 student-athletes, only those that are regular in the university sports team training were considered and their records (i.e. name, department, level, matriculation number, and phone number) were collected through the assistance of their coaches. For the regular students, purposive sampling technique was used to select 224 participants, only those that have no interest in sports were considered and their records were retrieved from the college registration officer. The first and second semester examination results of the two groups were compared in 10 general study courses without their knowledge, using descriptive statistics of frequency counts, mean, and standard deviation. Out of the 10 compared courses, 7 courses result showed no significant difference between students-athlete and regular students while student-athletes perform better in 3 practically oriented courses. Sports role in academics is quite significant. Exposure to sports can help build the confidence that athletes need especially when it comes to practical courses. Student-athletes can perform better in academics if the environment is friendly and not intimidating. Lecturers and coaches need to work together in order to build a well cultured and intelligent graduate.

Keywords: academic performance, regular students, sports participation, student-athlete, university sports team

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Authors: Oznur Ispir, S. Duygulu

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Health institutions are the places where fast and efficient decisions are required and mistakes and uncertainties are not tolerated due to the urgency of the services provided within the body of these institutions. Thus, in those institutions where patient care services are targeted to be provided quality and safety, the nurses attending the decisions, creating the solutions for problems, taking initiative and bearing the responsibility of results in brief having the control over practices are needed. Control over nursing practices is defined as affecting the employment and work environment at the unit level of the institution, perceived freedom for organizing and evaluating nursing practices, the ability to make independent decisions about patient care and accountability for the results of such decisions. This study scrutinizes the concept of control over nursing practices (organizational autonomy), which is frequently confused with other concepts (autonomy) in the literature, by reviewing the literature and making suggestions to improve nurses’ control over nursing practices.

Keywords: control over nursing practice, nurse, nursing, organizational autonomy

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