Search results for: Kangaroo mother care

Authors: Suzanne L. Stewart, Sarah J. Ponton, Mikaela D. Gabriel, Roy Strebel, Xinyi Lu

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Indigenous Peoples have faced unique barriers to accessing and receiving culturally safe and appropriate mental health care while also facing daunting rates of mental health diagnoses and comorbidities. Indigenous researchers and clinicians have well established the connection of the current mental health issues in Indigenous communities as a direct result of colonization by way of intergenerational trauma throughout Canada’s colonial history. Such mental health barriers and challenges have become exacerbated during the COVID-19 pandemic. Throughout the pandemic, access to mental health, cultural, ceremonial, and community services were severely impacted and restricted; however, it is these same cultural activities and community resources that are key to supporting Indigenous mental health from a traditional and community-based perspective. This research employed a unique combination of a thorough, analytical scoping review of the existent mental health literature of Indigenous mental health in the COVID-19 pandemic, alongside narrative interviews employing an oral storytelling tradition methodology with key community informants that provide comprehensive cultural services to the Indigenous community of Toronto, as well as across Canada. These key informant interviews provided a wealth of insights into virtual transitions of Indigenous care and mental health support; intersections of historical underfunding and current financial navigation in technology infrastructure; accessibility and connection with Indigenous youth in remote locations; as well as maintaining community involvement and traditional practices in a current pandemic. Both the scoping review and narrative interviews were meticulously analyzed for overarching narrative themes to best explore the extent of the literature on Indigenous mental health and services during COVID-19; identify gaps in this literature; identify barriers and supports for the Indigenous community, and explore the intersection of community and cultural impacts to mental health. Themes of the scoping review included: Historical Context; Challenges in Culturally-Based Services; and Strengths in Culturally-Based Services. Meta themes across narrative interviews included: Virtual Transitions; Financial Support for Indigenous Services; Health Service Delivery & Wellbeing; and Culture & Community Connection. The results of this scoping review and narrative interviews provide wide application and contribution to the mental health literature, as well as recommendations for policy, service provision, autonomy in Indigenous health and wellbeing, and crucial insights into the present and enduring mental health needs of Indigenous Peoples throughout the COVID-19 pandemic.

Keywords: indigenous community services, indigenous mental health, indigenous scoping review, indigenous peoples and Covid-19

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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Authors: Shantol McIntosh

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Due to environmental and underlying health disparities, the COVID-19 pandemic has caused an added set of economic implications worldwide. Black and Hispanic individuals are more susceptible to contract COVID-19, and if they do, they are more likely to have a severe case that necessitates hospitalization or results in death (Altarum et al., 2020). The literature shows that disparities in health and health treatment are nothing new as they have been recorded for decades and indicate systemic and structural imbalances rooted in racism and discrimination. The purpose of this study is to determine the frequency with which these populations have access to healthcare and treatment. The study will also highlight the key drivers of health disparities. Findings and implications for research and policy will be discussed.

Keywords: COVID-19, racial and ethnic disparities, discrimination, policy

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Authors: Anne Hovgaard Jorgensen

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This study investigates how Muslim fathers in Denmark are struggling to overcome notions of mistrust from teachers and educators. Starting from school-home-cooperation (parent conferences, school-home communication, etc.), the study finds that many Muslim fathers do not feel acknowledged as a resource in the upbringing of their children. To explain these experiences further, the study suggest the notion of ‘mistrusted masculinity’ to grasp the controlling image these fathers meet in various schools and child-care-institutions in the Danish Welfare state. The paper is based on 9 months of fieldwork in a Danish school, a social housing area and in various ‘father groups’ in Denmark. Additional, 50 interviews were conducted with fathers, children, mothers, schoolteachers, and educators. By using Connell's concepts 'hegemonic' and 'marginalized' masculinity as steppingstones, the paper argues that these concepts might entail a too static and dualistic picture of gender. By applying the concepts of 'emergent masculinity' and 'emergent fatherhood' the paper brings along a long needed discussion of how Muslim men in Denmark are struggling to overcome and change the controlling images of them as patriarchal and/or ignorant fathers regarding the upbringing of their children. As such, the paper shows how Muslim fathers are taking action to change this controlling image, e.g. through various ‘father groups’. The paper is inspired by the phenomenological notions of ‘experience´ and in the light of this notion, the paper tells the fathers’ stories about their upbringing of their children and aspirations for fatherhood. These stories share light on how these fathers take care of their children in everyday life. The study also shows that the controlling image of these fathers have affected how some Muslim fathers are actually being fathers. The study shows that fear of family-interventions from teachers or social workers e.g. have left some Muslim fathers in a limbo, being afraid of scolding their children, and being confused of ‘what good parenting in Denmark is’. This seems to have led to a more lassie fair upbringing than these fathers actually wanted. This study is important since anthropologists generally have underexposed the notion of fatherhood, and how fathers engage in the upbringing of their children. Over more, the vast majority of qualitative studies of fatherhood have been on white middleclass fathers, living in nuclear families. In addition, this study is crucial at this very moment due to the major refugee crisis in Denmark and in the Western world in general. A crisis, which has resulted in a vast number of scare campaigns against Islam from different nationalistic political parties, which enforces the negative controlling image of Muslim fathers.

Keywords: fatherhood, Muslim fathers, mistrust, education

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Authors: Jessica Gladden

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This study explored the perceived benefits of trauma-sensitive yoga programs. Participants attended one of two six-week trauma-sensitive yoga programs utilizing the G.R.A.C.E model, a format developed based on Emerson’s trauma-sensitive yoga guidelines and modified by the instructors. Participants in this study completed surveys on their experiences. The results of the surveys indicated that participants perceived improvements in self-care, embodiment, and mood. These results show that trauma-sensitive yoga may have benefits beyond the treatment of specific diagnoses that could be applied to a variety of populations. Reflections from one of the researchers who teaches in this program, as well as qualitative statements from the participants, will be shared to support the continued use of this method.

Keywords: yoga, trauma-sensitive, yoga therapy, trauma

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Authors: Gabriela Smeckova

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The entire world is becoming more and more diverse. The reasons why people migrate are different and unique for each family /individual. Professionals delivering services (including speech-language pathologists) must be prepared to work with clients coming from different cultural and/or linguistic backgrounds. Well-educated speech-language pathologists will consider many factors when delivering services. Some of them will be discussed during the presentation (language spoken, beliefs about health care and disabilities, reasons for immigration, etc.). The communication styles of the client can be different than the styles of the speech-language pathologist. The goal is to become culturally responsive in service delivery.

Keywords: culture, cultural competence, culturallly responsive practices, speech-language pathologist, cultural and linguistical variables, communication styles

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Authors: Maria Ahmad, Michael Page, Danë Goodsman

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‘Educational’ debriefing – a construct distinct from clinical debriefing – is used following simulated scenarios and is central to learning and development in fields ranging from aviation to emergency medicine. However, little research into educational debriefing in prehospital medicine exists. This qualitative study explored the facilitation and effects of prehospital educational debriefing and identified obstacles to debriefing, using the London’s Air Ambulance Pre-Hospital Care Course (PHCC) as a model. Method: Ethnographic observations of moulages and debriefs were conducted over two consecutive days of the PHCC in October 2019. Detailed contemporaneous field notes were made and analysed thematically. Subsequently, seven one-to-one, semi-structured interviews were conducted with four PHCC debrief facilitators and three course participants to explore their experiences of prehospital educational debriefing. Interview data were manually transcribed and analysed thematically. Results: Four overarching themes were identified: the approach to the facilitation of debriefs, effects of debriefing, facilitator development, and obstacles to debriefing. The unpredictable debriefing environment was seen as both hindering and paradoxically benefitting educational debriefing. Despite using varied debriefing structures, facilitators emphasised similar key debriefing components, including exploring participants’ reasoning and sharing experiences to improve learning and prevent future errors. Debriefing was associated with three principal effects: releasing emotion; learning and improving, particularly participant compound learning as they progressed through scenarios; and the application of learning to clinical practice. Facilitator training and feedback were central to facilitator learning and development. Several obstacles to debriefing were identified, including mismatch of participant and facilitator agendas, performance pressure, and time. Interestingly, when used appropriately in the educational environment, these obstacles may paradoxically enhance learning. Conclusions: Educational debriefing in prehospital medicine is complex. It requires the establishment of a safe learning environment, an understanding of participant agendas, and facilitator experience to maximise participant learning. Aspects unique to prehospital educational debriefing were identified, notably the unpredictable debriefing environment, interdisciplinary working, and the paradoxical benefit of educational obstacles for learning. This research also highlights aspects of educational debriefing not extensively detailed in the literature, such as compound participant learning, display of ‘professional honesty’ by facilitators, and facilitator learning, which require further exploration. Future research should also explore educational debriefing in other prehospital services.

Keywords: debriefing, prehospital medicine, prehospital medical education, pre-hospital care course

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Authors: Legkikh Victoria

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The purpose of keeping bi/multilingualism is usually a way to let the child speak two/three languages at the same level. The main problem which normally appears is a mixed language or a domination of one language. The same level of two or more languages would be ideal but practically not easily reachable. So it was made an experiment with a girl with a natural multilingualism as an attempt to avoid a dominant language in the preschool age. The girl lives in Germany and the main languages for her are Italian, Russian and German but she also hears every day English. ‘One parent – one language’ strategy was used since the beginning so Italian and Russian were spoken to her since her birth, English was spoken between the parents and when she was 1,5 it was added German as a language of a nursery. In order to avoid a dominant language, she was always put in international groups with activity in different languages. Even if it was not possible to avoid an interference of languages in this case we can talk not only about natural multilingualism but also about balanced bilingualism in preschool time. The languages have been developing in parallel with different accents in a different period. Now at the age of 6 we can see natural horizontal multilingualism Russian/Italian/German/English. At the moment, her Russian/Italian bilingualism is balanced. German vocabulary is less but the language is active and English is receptive. We can also see a reciprocal interference of all the three languages (English is receptive so the simple phrases are normally said correctly but they are not enough to judge the level of language interference and it is not noticed any ‘English’ mistakes in other languages). After analysis of the state of every language, we can see as a positive and negative result of the experiment. As a positive result we can see that in the age of 6 the girl does not refuse any language, three languages are active, she differentiate languages and even if she says a word from another language she notifies that it is not a correct word, and the most important are the fact, that she does not have a preferred language. As a prove of the last statement it is to be noticed not only her self-identification as ‘half Russian and half Italian’ but also an answer to the question about her ‘mother tongue’: ‘I do not know, probably, when I have my own children I will speak one day Russian and one day Italian and sometimes German’. As a negative result, we can notice that not only a development of all the three languages are a little bit slower than it is supposed for her age but since she does not have a dominating language she also does not have a ‘perfect’ language and the interference is reciprocal. In any case, the experiment shows that it is possible to keep at least two languages without a preference in a pre-school multilingual space.

Keywords: balanced bilingualism, language interference, natural multilingualism, preschool multilingual education

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Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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Authors: Abdulrahman Algaeed

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The Ophthalmic Ultrasound is the easiest method of early diagnosing Retinoblastoma after clinical examination. It can be done with ease without sedation. King Khaled Eye Specialist Hospital is a tertiary care center where Retinoblastoma patients are often seen and treated there. The first modality to rule out the disease is Ophthalmic Ultrasound. Classic Retinoblastoma is easily diagnosed by using the conventional 10MHz Ophthalmic Ultrasound probe in the regular clinic setup. Retinal lesion with multiple, very highly reflective surfaces within lesion typical of Calcium deposits. The use of Standardized A-scan is very useful where internal reflectivity is classified as very highly reflective. Color Doppler is extremely useful as well to show the blood flow within lesion/s. In conclusion: Ophthalmic Ultrasound should be the first tool to be used to diagnose Retinoblastoma after clinical examination. The accuracy of the Exam is very high.

Keywords: doppler, retinoblastoma, reflectivity, ultrasound

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Authors: Tiffany Wicks

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Queer patients can face issues with self-advocating due to the factors of implicit provider bias, lack of tools and resources to self-advocate, and lack of comfortability in self-advocating based on prior experiences. In this study, five participants who identify as queer discussed their interactions with their healthcare providers. This exploratory study revealed that there is a need for healthcare provider education to reduce implicit bias and judgments about queer patients. There is also an important need for peer advocates in order to further inform healthcare promotion and decision-making before and during provider visits in an effort for a better outcome. Through this exploration, queer patients voiced their experiences and concerns to inform a need for change in healthcare collaboration between providers and patients in the queer community.

Keywords: queer, LGBT, patient, self-advocacy, healthcare

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Authors: Sharon Ganzer

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Older adults want choices about where they ‘age-in-place’ and express the desire to remain in their home for as long as possible because it maintains feelings of independence and autonomy, perpetuates a sense of identity, enable people to have space for their belongings and supports connections and social engagement. When circumstances change, and alternative living arrangements are required, more and more older adults are considering a transition to a retirement village – the liminal space between home and residential care. This qualitative study explores the lived experience of older adults who relocate to a retirement village in Queensland, Australia, and the role that material culture plays in this process.

Keywords: material culture, social gerontology, concepts of home, retirement villages

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Authors: Gauranga Das

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People in cities have prosperity but there is immense pollution, chaos in the mind, anxiety and turbulence. People in the villages experience pristine pure environment but they also experience poverty. There is a need to find out ways by which the cities and the villages can complement each other through their strengths and take care of each other’s weaknesses. In order to do this, the case study of Govardhan Ecovillage has been explored in this paper. All its environment, social and economic initiatives along with eco-tourism and wellness features are being analyzed. The analysis shows that Govardhan Ecovillage is successfully able to harmonize its different initiatives and provide a package which has created a win-win solution for the city people and also the villagers. Such kind of Eco-tourism initiatives should be supported and replicated in other places in the world to benefit everyone.

Keywords: sustainability, ecotourism, ecology, rural development, wellness, biodiversity

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Authors: Ibrahim Darwish, Noora Abu Ain

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Referring to female relatives by male Jordanian speakers in public is governed by various linguistic and social constraints. Although Jordanian society is less conservative than it was a few decades ago, women are still considered the weaker link in society and men still believe that they need to protect them. Conservative Jordanians often avoid referring to their female relatives overtly, i.e., using their real names. Instead, they use covert names, such as pseudonyms, nicknames, pet names, etc. The reason behind such language use has to do with how Arab men, in general, see women as part of their honor. This study intends to investigate to what extent Jordanian males hide their female relatives’ names in public domains. The data was collected from spontaneous informal voice-recorded interviews carried out in the village of Saham in the far north of Jordan. Saham’s dialect is part of a larger Horani dialect used by speakers along a wide area that stretches from Salt in the south to the Syrian borders in the north of Jordan. The voice-recorded interviews were originally carried out as an audio record of some customs and traditions in the village of Saham in 2013. During most of these interviews, the researchers observed how the male participants indirectly referred to their female relatives. Instead of using real names, the male speakers used broad terms to refer to their female relatives, such al-Beit ‘the home,’ al-ciyaal ‘the kids’, um-x ‘the mother of x,’ etc. All tokens related to the issue in question were collected, analyzed and quantified about three age cohorts: young, middle-aged and old speakers. The results show that young speakers are more direct in referring to their female relatives than the other two age groups. This can point to a possible change in progress in the speech community of Saham. It is argued that due to contact with other urban speech communities, the young speakers in Saham do not feel the need to hide the real names of their female relatives as they consider them as equals. Indeed, the young generation is more open to the idea of women's rights and call for expanding Jordanian women’s roles in Jordanian society.

Keywords: gender differences, Horan, proper names, social constraints

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Authors: Smriti Pahwa, Karishma Vats, Aditi Macwan, Jija Dutt, Sumukhi Vaid

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Age approporiate complementary feeding has been stressed upon for sound young child nutrition and appropriate growth. National Infant and Young Child Feeding guidelines, policies and programs indicate cognizance of the issue taken by the country’s government, policy makers and technical experts. However, it is important that ordinary people, the caregivers of young children too understand the importance of appropriate feeding. For this, an interface might be required where ordinary people could participate in assessing the gaps in IYCF as a first step to take subsequent action. In this context an attempt was made to extrapolate a citizen led learning level survey that has been involving around 25000 ordinary citizens to reach out to 600,000 children annually for over a decade in India. Based on this philosophy of involving ordinary people in simple assessments to produce understandable actionable evidence, a rapid diet assessment tool was developed and collected from caregivers of 90 < 3year children from two urban clusters in Ahmedabad and Baroda, Gujarat. Target sample for pilot was selected after cluster census. Around half the mothers reported that they had not yet introduced water or other fluids to their < 6 month babies. However, about a third were already feeding them food other than mother’s milk. Although complementary feeding was initiated in almost all (95%) children more than 6 months old, frequency was suboptimal in 60%; in 80% cases no measure was taken to either improve energy or nutrient density; only 33% were fed protective foods; Green Leafy Vegetables consumption was negligible (1.4%). Anganwadi food was not consumed. By engaging ordinary people to generate evidence and understand the gaps, such assessments have the potential to be used to generate useful evidence for action at scale as well as locally.

Keywords: citizen led, grass root engagement, IYCF (Infant and Young Child Feeding), rapid diet assessment, under nutrition

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Authors: Yi Huang

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Background: For the development of children, it is important for parents to encourage children not only on academic competence but also on children’s social competence. In the western cultural context, parents emphasize more heavily on female children’s social-behavioral development. However, whether the conclusion is correct in eastern culture and whether the parent’s gender affects such an emphasis remains unclear. And, more valuably, from the perspective of intervention, except for the nature factors - child’s gender and parent’s gender, it is also worth to probe whether the improvable factors, such as parent’s perspective taking, influence parent’s emphasis on child’s social competence. Aim: This study was aimed to investigate the impact of parent’s gender, child’s gender, and parent’s perspective-taking on parent’s attitudes of encouragement of the child’s social competence under the Chinese cultural context. Method: 461 Chinese parents whose children were in the first year of middle school during the research time participated in this study. Among all participants, there were 155 fathers and 306 mothers. The research adopted the self-report of perspective-taking, which is the sub-scale of the Interpersonal Reactivity Index and the self-report of the encouragement on a child’s social communication, which is the sub-scale of the Chinese version of The Children Rearing Practice Report. In this study, 291 parents reported regarding male children, and 170 parents reported regarding female children. Results: Contrary to the traditional western theory, which usually suggests parent puts more attention on social development and competence to girl the instead of the boy, in the Chinese context, parent emphasizes social competence more on the male child. Analogically, in China, compared to mother, father underscores the child’s social competence more heavily. By constructing the hierarchical regression model, the result indicated that after controlling the variables of the gender of child and the gender of parent, parent’s perspective-taking still explains for the variance of parent’s encouragement on child’s social competence, which means, parent’s perspective-taking predicts parent’s encouragement on child’s social competence after excluding the impact of the gender of parent and child. Conclusion: For Chinese parents, the ability of perspective-taking is beneficial to enhance their awareness of encouraging children’s social competence.

Keywords: parent; child, gender differences, perspective-taking, social development

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Authors: Mitiku Tefera

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Background: Meconium-stained amniotic fluid is one of the primary causes of birth asphyxia. Each year, over five million neonatal deaths occur worldwide due to meconium-stained amniotic fluid, with 90% of these deaths due to birth asphyxia. In Ethiopia meconium-stained amniotic fluid is under investigated, specifically in North Shoa Zone Amhara region Ethiopia. Objective: The aim of this study was to assess the magnitude of meconium-stained amniotic fluid and associated factors among women who gave birth in the North Shoa Zone Hospital’s Amhara Region, Ethiopia, in 2022. Methods: An institutional-based, cross-sectional study was conducted among 628 women who gave birth at North Shoa Zone Hospitals, Amhara, Ethiopia. The study was conducted from 08/June-08/August 2022. Two-stage cluster sampling was used to recruit study participants. The data was collected by using a structured interview-administered questionnaire and chart review. The collected data was entered into Epi-Data Version 4.6 and exported to SPSS Version 25. Logistics regression was employed, and a p-value <0.05 was considered significant. Result: The magnitude of meconium-stained amniotic fluid was 30.3%. Women presented with normal hematocrit level 83% less likely develop meconium-stained amniotic fluid. Women had mid-upper arm circumference value was less than 22.9cm(AOR=1.9; 95% CI;1.18-3.20), obstructed labor(AOR=3.6; 95% CI;1.48-8.83), prolonged labor ≥ 15hr (AOR=7.5; 95% CI ;7.68-13.3), the premature rapture of the membrane (AOR=1.7; 95% CI; 3.22-7.40), fetal tachycardia(AOR=6.2; 95% CI; 2.41-16.3) and Bradycardia (AOR=3.1; 95% CI;1.93-5.28) were significant association with meconium stained amniotic fluid. Conclusion: The magnitude of meconium-stained amniotic fluid, which was high. In this study, MUAC value <22.9 cm, obstructed and prolonged labor, PROM, bradycardia, and tachycardia were factors associated with meconium-stained amniotic fluid. A follow-up study and pooled similar articles will be mentioned for better evidence, enhancing intrapartum services and strengthening early detection of meconium-stained amniotic fluid for the health of the mother and baby.

Keywords: women, meconium-staned amniotic fluid, magnitude, Ethiopia

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Authors: Ganeshkumar, Ashika, Valavan, Ramesh, Thangam, Chirayu

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MSCs are found in much higher concentration in the Wharton’s jelly compared to the umbilical cord blood, which is a rich source of hematopoietic stem cells. Umbilical cord tissue is collected at the time of birth; it is processed and stored in liquid nitrogen for future therapeutical purpose. The source of contamination might be either from vaginal tract of mother or from hospital environment or from personal handling during cord tissue sample collection. If the sample were contaminated, decontamination procedure will be done with 70% ethanol (1 minute) in order to avoid sample rejection. Ethanol is effective against a wide range of bacteria, protozoa and fungi and has low toxicity to humans. Among the 1954 samples taken for the study, 24 samples were found to be contaminated with microorganism. The organisms isolated from the positive samples were found to be E. coli, Stenotrophomonas maltophilia, Pseudomonas aueroginosa, Enterococcus fecalis, Acinetobacter bowmani, Staphylococcus epidermidis, Enterobacter cloacae, and Proteus mirabilis. Among these organisms 70% ethanol successfully eliminated E. coli, Enterococcus fecalis, Acinetobacter bowmani, Staphylococcus epidermidis, and Proteus mirabilis. 70% ethanol was unsuccessful in eliminating Stenotrophomonas maltophilia, Pseudomonas aueroginosa, and Enterobacter cloacae. Stenotrophomonas maltophilia and Pseudomonas aueroginosa have the ability to form biofilm that make them resistant to alcohol. Biofilm act as protective layer for bacteria and which protects them from host defense and antibiotic wash. Finally it was found 70% ethanol wash saved 58.3% cord tissue samples from rejection and it is ineffective against 41% of the samples. The contamination rate can be reduced by maintaining proper aseptic techniques during sample collection and processing.

Keywords: umblical cord tissue, decontamination, 70% ethanol effectiveness, contamination

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Authors: M. Vassou, A. Karasimos

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A primary concern in the field of Second Language Acquisition (SLA) research is to determine the innate mechanisms of second language learning and acquisition through the systematic study of a learner's interlanguage. Errors emerge while a learner attempts to communicate using the target-language and can be seen either as the observable linguistic product of the latent cognitive and language process of mental representations or as an indispensable learning mechanism. Therefore, the study of the learner’s erroneous forms may depict the various strategies and mechanisms that take place during the language acquisition process resulting in deviations from the target-language norms and difficulties in communication. Mapping the erroneous utterances of a late adult learner in the process of acquiring Greek as a second language constitutes one of the main aims of this study. For our research purposes, we created an error-tagged learner corpus composed of the participant’s written texts produced throughout a period of a 4- year instructed language acquisition. Error analysis and interlanguage theory constitute the methodological and theoretical framework, respectively. The research questions pertain to the learner's most frequent errors per linguistic category and per year as well as his choices concerning the Greek Article System. According to the quantitative analysis of the data, the most frequent errors are observed in the categories of the stress system and syntax, whereas a significant fluctuation and/or gradual reduction throughout the 4 years of instructed acquisition indicate the emergence of developmental stages. The findings with regard to the article usage bespeak fossilization of erroneous structures in certain contexts. In general, our results point towards the existence and further development of an established learner’s (inter-) language system governed not only by mother- tongue and target-language influences but also by the learner’s assumptions and set of rules as the result of a complex cognitive process. It is expected that this study will contribute not only to the knowledge in the field of Greek as a second language and SLA generally, but it will also provide an insight into the cognitive mechanisms and strategies developed by multilingual learners of late adulthood.

Keywords: Greek as a second language, error analysis, interlanguage, late adult learner

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Authors: Gargi Prasad, Ashiho A. Mao, Deepu Vijayan, S. Mandal

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The main objective of the present study was to optimize and develop an efficient protocol for in vitro propagation of a medicinally important orchid Cephalantheropsis obcordata (Lindl.) Ormerod along with genetic stability analysis of regenerated plants. This plant has been traditionally used in Chinese folk medicine and the decoction of whole plant is known to possess anticancer activity. Nodal segments used as explants were inoculated on Murashige and Skoog (MS) medium supplemented with various concentrations of isopentenyl adenine (2iP). The rooted plants were successfully acclimatized in the greenhouse with 100% survival rate. Inter-simple sequence repeats (ISSR) markers were used to assess the genetic fidelity of in vitro raised plants and the mother plant. It was revealed that monomorphic bands showing the absence of polymorphism in all in vitro raised plantlets analyzed, confirming the genetic uniformity among the regenerants. Phytochemical analysis was done to compare the antioxidant activities and HPLC fingerprinting assay of 80% aqueous ethanol extract of the leaves and stem of in vitro and in vivo grown C. obcordata. The extracts of the plants were examined for their antioxidant activities by using free radical 1, 1-diphenyl-2-picryl hydrazyl (DPPH) scavenging method, 2,2’-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical scavenging ability, reducing power capacity, estimation of total phenolic content, flavonoid content and flavonol content. A simplified method for the detection of ascorbic acid, phenolic acids and flavonoids content was also developed by using reversed phase high-performance liquid chromatography (HPLC). This is the first report on the micropropagation, genetic integrity study and quantitative phytochemical analysis of in vitro regenerated plants of C. obcordata.

Keywords: Cephalantheropsis obcordata, genetic fidelity, ISSR markers, HPLC

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Authors: K. Prasanth, S. Hafeezullah Khan, B. Haribalakrishnan, D. Arun, S. Jayapriya, S. Dhivya, N. Vijayarangan

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The main goal of our approach is to find the optimum positions for the sensor nodes, reinforcing the communications in points where certain lack of connectivity is found. Routing is the major problem in sensor network’s data transfer between nodes. We are going to provide an efficient routing technique to make data signal transfer to reach the base station soon without any interruption. Clustering and routing are the two important key factors to be considered in case of WSN. To carry out the communication from the nodes to their cluster head, we propose a parameterizable protocol so that the developer can indicate if the routing has to be sensitive to either the link quality of the nodes or the their battery levels.

Keywords: clusters, routing, wireless sensor networks, three phases, sensor networks

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Authors: Ekaterina Sánchez Romero, Emily Gabriela Aguirre Herrera, Sandra Luz Espinoza Esquerra, Jorge García Campos

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Female, 7 months old, daughter of a mother with anemia during pregnancy, with no history of atopy in the family, since birth she presents with recurrent dermatological and gastrointestinal infections, chronically treated for recurrent diaper dermatitis. At 6 months of age, she begins with generalized pallor, hyperpigmentation in hands and feet, smooth tongue, psychomotor retardation with lack of head support, sedation, and hypoactivity. She was referred to our hospital for a fever of 38°C, severe diaper rash, and pancytopenia with HB 9.3, platelets 38000, neutrophils 0.39 MCV: 86.80 high for her age. The approach was initiated to rule out myeloproliferative syndrome, with negative immunohistochemical results of bone marrow aspirate; during her stay, she presented neurological regression, lack of sucking, and focal seizures. CT scan showed cortical atrophy. The patient was diagnosed with primary immunodeficiency due to history; gamma globulin was administered without improvement with normal results of immunoglobulins and metabolic screening. When dermatological and neurological diagnoses were ruled out as the primary cause, a nutritional factor was evaluated, and a therapeutic trial was started with the administration of vitamin B12 and zinc, presenting clinical neurological improvement and resolution of pancytopenia in 2 months. It was decided to continue outpatient management. Discussion: We present a patient with neurological, dermatological involvement, and pancytopenia, so the most common differential diagnoses in this population were ruled out. Vitamin B12 deficiency is an uncommon entity. Due to maternal and clinical history, a therapeutic trial was started resulting in an improvement. Conclusion: VitaminB12 deficiency should be considered one of the differential diagnoses in the approach to pancytopenia with megaloblastic anemia associated with dermatologic and neurologic manifestations. Early treatment can reduce irreversible damage in these patients.

Keywords: vitamin B12 deficiency, pediatrics, pancytopenia, diaper dermatitis

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Authors: Mirjana Dokmanovic

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In recent years, the disadvantaged and marginalised position of rural women in the Republic of Serbia has been recognised in a number of national strategies and policy papers. A number of measures have been adopted by the government aimed at economic empowerment of rural women and eliminating barriers to accessing decision making and economic and social opportunities. However, their implementation pace is still slow. The aim of the paper is to indicate the necessity of a comprehensive policy approach to eliminating discrimination against rural women that would include policy and financial commitments for enhancing agricultural and rural development as a whole, instead of taking fragmented measures targeting consequences instead of causes. The paper introduces main findings of the study of challenges, constraints, and opportunities of rural women in Serbia to enjoy their economic and social rights. The research methodology included the desk research and the qualitative analysis of the available data, statistics, policy papers, studies, and reports produced by the government, ministries and other governmental bodies, independent human rights bodies, and civil society organizations (CSOs). The findings of the study reveal that rural women are at great risk of poverty, particularly in remote areas, and when getting old or widowed. Young rural women working in agriculture are also in unfavorable position, as they do not have opportunities to enjoy their rights during pregnancy and maternity leave, childcare leave and leave due to the special care of a child. The study indicates that the main causes of their unfavorable position are related to the prevalent patriarchal surrounding and economic and social underdevelopment of rural areas in Serbia. Gender inequalities have been particularly present in accessing land and property rights, inheritance, education, social protection, healthcare, and decision making. Women living in the rural areas are exposed at high risk of discrimination in all spheres of public and private life that undermine their enjoyment of basic economic, social and cultural rights. The vulnerability of rural women to discrimination increases in cases of the intersectionality of other grounds of discrimination, such as disability, ethnicity, age, health condition and sexual discrimination. If they are victims of domestic violence, their experience lack of access to shelters and protection services. Despite the State’s recognition of the marginalized position of rural women, there is still a lack of a comprehensive policy approach to improving the economic and social position of rural women.

Keywords: agricultural and rural development, care economy, discrimination against women, economic and social rights, feminization of poverty, Republic of Serbia, rural women

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Authors: Akbar Khodavirdizadeh, Ali Nemati Babaylou, Hassan Moomivand

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The history of human access to water technique has been one of the factors in the formation of human civilizations in the ancient world. The technique that makes surface water and groundwater accessible to humans on the ground has been a clever technique in human life to reach the water. In this study, while examining the water technique of ancient Iran using the Qanats technique, the water supply system of different regions of the ancient world were also studied and compared. Six groups of the ancient region of ancient Greece (Archaic 480-750 BC and Classical 223-480 BC), Urartu in Tuspa (600-850 BC), Petra (106-168 BC), Ancient Rome (265 BC), and the ancient United States (1450 BC) and ancient Iranian water technologies were studied under water supply systems. Past water technologies in these areas: water transmission systems in primary urban centers, use of water structures in water control, use of bridges in water transfer, construction of waterways for water transfer, storage of rainfall, construction of various types of pottery- ceramic, lead, wood and stone pipes have been used in water transfer, flood control, water reservoirs, dams, channel, wells, and Qanat. The central plateau of Iran is one of the arid and desert regions. Archaeological, geomorphological, and paleontological studies of the central region of the Iranian plateau showed that without the use of Qanats, the possibility of urban civilization in this region was difficult and even impossible. Zarch aqueduct is the most important aqueduct in Yazd region. Qanat of Zarch is a plain Qanat with a gallery length of 80 km; its mother well is 85 m deep and has 2115 well shafts. The main purpose of building the Qanat of Zārch was to access the groundwater source and transfer it to the surface of the ground. Regarding the structure of the aqueduct and the technique of transferring water from the groundwater source to the surface, it has a great impact on being different from other water techniques in the ancient world. The results show that the use of water technologies in ancient is very important to understand the history of humanity in the use of hydraulic techniques.

Keywords: ancient water technologies, groundwaters, qanat, human history, Ancient Iran

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Authors: A. Raceviciute-Stupeliene, V. Sasyte, V. Viliene, V. Slausgalvis, J. Al-Saifi, R. Gruzauskas

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The objective of this study was to investigate the influence of special additives such as chelators, zinc sulphate and silicic acid on productivity parameters, carcass characteristics and meat quality of fattening pigs. The test started with 40 days old fattening pigs (mongrel (mother) and Yorkshire (father)) and lasted up to 156 days of age. During the fattening period, 32 pigs were divided into 2 groups (control and experimental) with 4 replicates (total of 8 pens).  The pigs were fed for 16 weeks’ ad libitum with a standard wheat-barley-soybean meal compound (Control group) supplemented with chelators, zinc sulphate and silicic acid (dosage 2 kg/t of feed, Experimental group). Meat traits in live pigs were measured by ultrasonic equipment Piglog 105. The results obtained throughout the experimental period suggest that supplementation of chelators, zinc sulphate and silicic acid tend to positively affect average daily gain and feed conversion ratio of pigs for fattening (p < 0.05). Pigs’ evaluation with Piglog 105 showed that thickness of fat in the first and second point was by 4% and 3% respectively higher in comparison to the control group (p < 0.05). Carcass weight, yield, and length, also thickness of fat showed no significant difference among the groups. The water holding capacity of meat in Experimental group was lower by 5.28%, and tenderness – lower by 12% compared with that of the pigs in the Control group (p < 0.05). Regarding pigs’ meat chemical composition of the experimental group, a statistically significant difference comparing with the data of the control group was not determined. Cholesterol concentration in muscles of pigs fed diets supplemented with chelators, zinc sulphate and silicic acid was lower by 7.93 mg/100 g of muscle in comparison to that of the control group. These results suggest that supplementation of chelators, zinc sulphate and silicic acid in the feed for fattening pigs had significant effect on pigs growing performance and meat quality.

Keywords: silicic acid, chelators, meat quality, pigs, zinc sulphate

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Authors: R. Bhagwan, M. Subbhan

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Nursing is a very challenging field in South Africa and due to the burden of disease it is critical that nursing students are prepared with the adequate knowledge and skills to deliver effective patient care. Despite this very little research has been done on the teaching strategies used by nurse educators to teach nursing students. It is in this context that a survey of all nurse educators at Nursing Colleges and Universities in Kwa-Zulu Natal was undertaken (n=300) to explore what current pedagogical strategies were being used and which more creative methodologies should be implemented in relation to specific nursing content. Findings revealed that most nurse educators still utlize the lecture approach, but although believe other methodologies such as e-learning are important have not done so because of inadequate training. The recommendations made are that more creative pedagogical strategies such as simultation, portfoloios and case studies be adopted.

Keywords: creative, teaching methodologies, dydactic, nursing

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Authors: Tetyana Kendzerska, David T. Zhu, Michael Pugliese, Douglas Manuel, Mohsen Sadatsafavi, Marcus Povitz, Therese A. Stukel, Teresa To, Shawn D. Aaron, Sunita Mulpuru, Melanie Chin, Claire E. Kendall, Kednapa Thavorn, Rebecca Robillard, Andrea S. Gershon

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The impact of the COVID-19 pandemic on the management of ambulatory care sensitive conditions (ACSCs) remains unknown. To compare observed and expected (projected based on previous years) trends in all-cause mortality and healthcare use for ACSCs in the first year of the pandemic (March 2020 - March 2021). A population-based study using provincial health administrative data.General adult population (Ontario, Canada). Monthly all-cause mortality, and hospitalizations, emergency department (ED) and outpatient visit rates (per 100,000 people at-risk) for seven combined ACSCs (asthma, COPD, angina, congestive heart failure, hypertension, diabetes, and epilepsy) during the first year were compared with similar periods in previous years (2016-2019) by fitting monthly time series auto-regressive integrated moving-average models. Compared to previous years, all-cause mortality rates increased at the beginning of the pandemic (observed rate in March-May 2020 of 79.98 vs. projected of 71.24 [66.35-76.50]) and then returned to expected in June 2020—except among immigrants and people with mental health conditions where they remained elevated. Hospitalization and ED visit rates for ACSCs remained lower than projected throughout the first year: observed hospitalization rate of 37.29 vs. projected of 52.07 (47.84-56.68); observed ED visit rate of 92.55 vs. projected of 134.72 (124.89-145.33). ACSC outpatient visit rates decreased initially (observed rate of 4,299.57 vs. projected of 5,060.23 [4,712.64-5,433.46]) and then returned to expected in June 2020. Reductions in outpatient visits for ACSCs at the beginning of the pandemic combined with reduced hospital admissions may have been associated with temporally increased mortality—disproportionately experienced by immigrants and those with mental health conditions. The Ottawa Hospital Academic Medical Organization

Keywords: COVID-19, chronic disease, all-cause mortality, hospitalizations, emergency department visits, outpatient visits, modelling, population-based study, asthma, COPD, angina, heart failure, hypertension, diabetes, epilepsy

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Authors: Mai Ali

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The abstract underscores the critical importance of junior paediatricians acquiring expertise in handling paediatric emergencies, with a particular focus on Diabetic Ketoacidosis (DKA). Existing literature reveals a wealth of research on healthcare professionals' knowledge regarding DKA, encompassing diverse cultural backgrounds and medical specialties. Consistently, challenges such as the absence of standardized protocols and inadequacies in training emerge as common issues across healthcare centres. This research proposal seeks to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom in managing DKA within various clinical contexts. The primary objective is to assess their level of competence and propose effective strategies to enhance DKA training comprehensively.

Keywords: DKA, knowledge, Junior paediatricians, local protocols

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Authors: Ismail Bamidele Afolabi, Abdulmujeeb Babatunde Aremu, Lawal Abdurraheem Maidoki, Nnodimele Onuigbo Atulomah

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Background: Hepatitis B virus infection remains a significant global public health challenge with infectivity as well as the potential for transmission more than 50 to 100 times that of HIV. Annually, global HBV-related mortality is linked primarily to cirrhosis and liver carcinoma. The ever-increasing endemicity of HBV among children under-5-years, owing to vertical transmission and its lingering chronicity in developing countries, will hamper the global efforts concertedly endorsed towards eliminating viral hepatitis as a global public health threat by 2030. Objective: This study assessed information motivation behavioral skills model constructs as predictors of HBV infection prevention practices among consenting expectant mothers attending antenatal care in Central Uganda as a focal point of intervention towards breaking materno-foetal transmission of HBV. Methods: A cross-sectional study with a quantitative data collection approach based on the constructs of the IMB model was used to capture data on the study variables among 385 randomly selected pregnant women between September and October 2020. Data derived from the quantitative instrument were transformed into weighted aggregate scores using SPSS version 26. ANOVA and regression analysis were done to ascertain the study hypotheses with a significance level set as (p ≤ 0.05). Results: Relatively 60% of the respondents were aged between 18 and 28. Expectant mothers with secondary education (42.3%) were predominant. Furthermore, an average but inadequate knowledge (X ̅=5.97±6.61; B=0.57; p<.001), incorrect perception (X ̅=17.10±18.31; B=0.97; p=.014), and good behavioral skills (X ̅=12.39±13.37; B=0.56; p<.001) for adopting prevention practices all statistically predicted the unsatisfactory level of prevention practices (X ̅=15.03±16.20) among the study respondents as measured on rating scales of 12, 33, 21 and 30 respectively. Conclusion: Evidence from this study corroborates the imperativeness of IMB constructs in reducing the burden of HBV infection in developing countries. Therefore, the inadequate HBV knowledge and misperception among obstetric populations necessitate personalized health education during antenatal visits and subsequent health campaigns in order to inform better prevention practices and, in turn, reduce the lingering chronicity of HBV infection in developing countries.

Keywords: behavioral skills, HBV infection, knowledge, perception, pregnant women, prevention practices

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Authors: Narges Solaymani

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medical training of patients. Nursing is a very important profession in the societies of the world. Although in the past, all caregivers of the sick and disabled were called nurses, nowadays, a nurse is a person who has a university education in this field. There are nurses in bachelor's, master's, and doctoral degrees in nursing. New courses have been launched in the master's degree based on duty-oriented nurses. A nurse cannot have an independent treatment center but is a member of the treatment team in established treatment centers such as hospitals, clinics, or offices. Nurses can establish counseling centers and provide nursing services at home. According to the standards, the number of nurses should be three times the number of doctors or twice the number of hospital beds, or there should be three nurses for every thousand people. Also, international standards show that in the internal and surgical department, every 4 to 6 patients should have a nurse.

Keywords: Nurse, Intensive Care, CPR, Bandage

Procedia PDF Downloads 47