Search results for: family medicine residents

Authors: Cecilia Fagerstrom, Solve Elmstahl, Lena S. Wranker

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The conditions of increased morbidity in an aging population cause the need for family care to become more common at an advanced age. The role of family caregivers may well last for a long time but may also change over time, from being caregivers to being non-caregivers or vice versa. Although demands associated with family caring change as individuals enter into, engage with, and exit from this role, the evidence regarding the impact of family caregiving transitions on the health of older carers is still limited. This study comprised individuals (n=2294, 60+years) from the southern part of Sweden included in the project Swedish National study of Aging and Care. Caregiving transitions are discussed in the categories: enter, exit, and continuing during a six-year period. Individuals who exited caregiving during the time were older than those who continued or entered into the role of caregiving. At the six-year follow-up, caregivers who were continuing or had exited caregiving were more often worried about their own health compared to baseline. Resembling findings were not found in those who entered caregiving. Family caregiving transitions of exiting, entering or continuing had no effect on the individuals’ functional, physical and mental health expect for participants who entered in caregiving. For them, entering the role of family caregiving was associated with an improvement in physical health during the six years follow up period. Conclusion: Although the health impact of different caregiving transitions in late life does not differ, individual conditions and health at baseline are important parameters to take into consideration to improve long-term health in family caregivers.

Keywords: family caregiving, health, old age, transition

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Authors: Ibrahim A. Alkali

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There is no reservation on the outstanding contribution of patient families in restoration of hospitalised patients, hence their consideration as essential component of hospital ward regimen. The psychological and emotional support a patient requires has been found to be solely provided by the patient’s family. However, consideration of their presence as one of the major functional requirements of an inpatient setting design have always been a source of disquiet, especially in developing countries where policies, norms and protocols of healthcare administration have no consideration for the patients’ family. This have been a major challenge to the hospital ward facilities, a concern for the hospital administration and patient management. The study therefore is aimed at obtaining a consensus opinion on the best approach for family integration in the design of an inpatient setting.  A one day visioning charrette involving Architects, Nurses, Medical Doctors, Healthcare assistants and representatives from the Patient families was conducted with the aim of arriving at a consensus opinion on practical design approach for sustainable family integration. Patient’s family are found to be decisive character of hospital ward regimen that cannot be undermined. However, several challenges that impede family integration were identified and subsequently a recommendation for an ideal approach. This will serve as a guide to both architects and hospital management in implementing much desired Patient and Family Centred Care.

Keywords: patient's family, inpatient setting, care giving, integration

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Authors: Arpan Upadhyaya, Sunaina Kuknor

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The paper examines the succession management strategies and the preparation level of heirs in the context of family-owned educational institutions in Nepal. Sixteen in-depth, semi-structured interviews with the institution's leader were conducted. The study's findings show the lack of awareness about the importance of succession planning among the institution owners due to the availability of limited resources. The paper also provides some insights into how family ownership and management are done and the lack of formal processes in succession management strategies. It will aid researchers in considering the societal perspective of the successor, which is also a significant worry.

Keywords: effective plans, family business, interest, leadership, successor

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Authors: Tripureshwari Paul

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We are born with nature molded by nurture. Studies have confirmed the productive role of genes and environment on an individual. This study examines the relationship of parental genotype values on the intellectual ability of their children. Keeping in mind that academic achievement-learning capacity of student through normative education, a function of exposure to family environment and pathology with intellectual quotient of the individual. Purposive sampling was used and children between ages 11 and 12 years and their respective parents were involved. Raven’s Standard Progressive Matrices (RSPM), Family Pathology Scale (FPS) and Family Environment Scale (FES) were administered. The results found significant relationship of Offspring IQ to Parental IQ, maternal IQ demonstrating higher values of correlation. Female IQ was significant to maternal IQ and male IQ was significant to paternal IQ. With Academic Achievement not significantly correlated to IQ, it was determined that Competitive framework, freedom to expression and Recreational Orientation in family affect a child’s intellectual performance.

Keywords: academic achievement, environment, family environment, family pathology, genotype, intelligence quotient, maternal IQ, paternal IQ

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Authors: Oluwayemisi O. Alaba, John O. Olaomi

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The 2013 Nigerian Demographic Health Survey (NDHS) data was used to investigate the determinants of family size in Nigeria using the geo-additive model. The fixed effect of categorical covariates were modelled using the diffuse prior, P-spline with second-order random walk for the nonlinear effect of continuous variable, spatial effects followed Markov random field priors while the exchangeable normal priors were used for the random effects of the community and household. The Negative Binomial distribution was used to handle overdispersion of the dependent variable. Inference was fully Bayesian approach. Results showed a declining effect of secondary and higher education of mother, Yoruba tribe, Christianity, family planning, mother giving birth by caesarean section and having a partner who has secondary education on family size. Big family size is positively associated with age at first birth, number of daughters in a household, being gainfully employed, married and living with partner, community and household effects.

Keywords: Bayesian analysis, family size, geo-additive model, negative binomial

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Authors: Abdul Rahmat

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Community-based education in the economic empowerment of the family is an attempt to accelerate human development index (HDI) Dumbo Kingdom District of Gorontalo economics (purchasing power) program developed in this activity is the manufacture of functional skills shredded fish, fish balls, fish nuggets, chips anchovies, and corn sticks fish. The target audience of this activity is fishing se mothers subdistrict Dumbo Kingdom include Talumolo Village, Village Botu, Kampung Bugis Village, Village North and Sub Leato South Leato that each village is represented by 20 participants so totaling 100 participants. Time activities beginning in October s/d November 2014 held once a week on every Saturday at 9.00 s/d 13:00/14:00. From the results of the learning process of testing the skills of functional skills of making shredded fish, fish balls, fish nuggets, chips anchovies, fish and corn sticks residents have additional knowledge and experience are: 1) Order the concept include: nutrient content, processing food with fish raw materials , variations in taste, packaging, pricing and marketing sales. 2) Products made: in accordance with the wishes of the residents learned that estimated Eligible selling, product packaging logo creation, preparation and realization of the establishment of Business Study Group (KBU) and pioneered the marketing network with restaurant, store / shop staple food vendors that are around CLC.

Keywords: community development, functional skills, gender, HDI

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Authors: Busra Mutlu Ipek, Merve Mutlu, Ahmet Mutlu

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Novel coronavirus COVID-19, which has recently influenced the world, poses a great threat to humanity. In order to overcome this challenging situation, scientists are working on developing effective vaccine against coronavirus. Many experts and researchers have also produced articles and done studies on this highly important subject. In this direction, this special topic was chosen for article to make a contribution to this area. The purpose of this article is to perform RNA sequence analysis of selected virus forms in the Coronaviridae family and predict/classify SARS-CoV-2 (COVID-19) from other selected complete genomes in coronaviridae family using proposed Artificial Neural Network(ANN) algorithm.

Keywords: Coronaviridae family, COVID-19, RNA sequencing, ANN, neural network

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Authors: Anshita Sharma

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India is one of the countries to initiate family planning with intention to control the growing population by reducing fertility. In effort to this, India had introduced the National family planning programme in 1952. The level of unmet need in India shows a reducing trend with increasing effectiveness of family planning services as in NFHS-1 the unmet need for limiting, spacing and total was 46 percent, 14 percent & 9 percent, respectively. The demand for spacing has reduced to at 8 percent, 8 percent for limiting and total unmet need was 16 percent in NFHS-2. The total unmet need has reduced to 13 percent in NFHS-3 for all currently married women and the demand for limiting and spacing is 7 percent and 6 percent respectively. The level of unmet need in India shows a reducing trend with increasing effectiveness of family planning services. Despite the progress, there is chunk of women who are deprived of controlling unintended and unwanted pregnancies. The present paper examines the socio-cultural and economic and demographic correlates of unmet need for contraception in India. It also examines the effect of women’s autonomy and unmet need for contraception on family size among different socio-economic groups of population. It uses data from national family health survey-3 carried out in 2005-06 and employs bi-variate techniques and multivariate techniques for analysis. The multiple regression analysis has done to seek the level and direction of relationship among various socio-economic and demographic factors. The result reveals that women with higher level of education and economic status have low level of unmet need for family planning. Women living in non-nuclear family have high unmet need for spacing and women living in nuclear family have high unmet need for limiting and family size is slightly higher of women of nuclear family. In India, the level of autonomy varies at different life point; usually women with higher age enjoy higher autonomy than their junior female member in the family. The finding shows that women with higher autonomy have large family size counter to women with low autonomy have low family size. Unmet need for family planning decrease with women’s increasing exposure to mass- media. The demographic factors like experience of child loss are directly related to family size. Women who experience higher child loss have low unmet need for spacing and limiting. Thus, It is established with the help that women’s autonomy status play substantial role in fulfilling demand of contraception for limiting and spacing which affect the family size.

Keywords: family size, socio-economic correlates, unmet need for limiting, unmet need for spacing, women`s autonomy

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Authors: Yibeltal T. Bayou, Yohana S. Mashalla, Gloria Thupayagale-Tshweneagae

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Background: Maternal mortality has been shown to be lower in urban areas than in rural areas. However, disparities for the fast-growing population of urban poor who struggle as much their rural counterparts to access quality healthcare are masked by the urban averages. The aim of this paper is to report on the findings of antenatal adequacy among slum residents in Addis Ababa, Ethiopia. Methods and Materials: A quantitative and cross-sectional community-based study design was employed. A stratified two-stage cluster sampling technique was used to determine the sample and data was collected using structured questionnaire administered to 837 women aged 15-49 years. Binary logistic regression models were employed to identify predictors of adequacy of antenatal care. Results: The majority of slum residents did not have adequate antenatal care services i.e., only 50.7%, 19.3% and 10.2% of the slum resident women initiated early antenatal care, received adequate antenatal care service contents and had overall adequate antenatal care services. Pregnancy intention, educational status and place of ANC visits were important determinant factors for adequacy of ANC in the study area. Women with secondary and above educational status were 2.9 times more likely to have overall adequate care compared to those with no formal education. Similarly, women whose last pregnancy was intended and clients of private healthcare facilities were 1.8 and 2.8 times more likely to have overall adequate antenatal care compared to those whose last pregnancy was unintended and clients of public healthcare facilities respectively. Conclusion: In order to improve ANC adequacy in the study area, the policymaking, planning, and implementation processes should focus on the poor adequacy of ANC among the disadvantaged groups in particular and the slum residents in general.

Keywords: Addis Ababa, adequacy of antenatal care, slum residents, maternal mortality

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Authors: Nien-Te Kuo, Yi-Sung Cheng, Kuo-Chien Chang

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Cultural festival tourism is now seen by many as an opportunity to facilitate community development because it has significant influences on the economic, social, cultural, and political aspects of local communities. The potential for tourist attraction has been recognized as a useful tool to strengthen local economies from governments. However, most community festivals in Taiwan are short-lived, often only lasting for a few years or occasionally not making it past a one-off event. Researchers suggested that most governments and other stakeholders do not recognize the importance of building a partnership with residents when developing community tourism. Thus, the sustainable community tourism development still remains a key issue in the existing literature. The success of community tourism is related to the attitudes and lifestyles of local residents. In order to maintain sustainable tourism, residents need to be seen as development partners. Residents’ support intention for tourism development not only helps to increase awareness of local culture, history, the natural environment, and infrastructure, but also improves the interactive relationship between the host community and tourists. Furthermore, researchers have identified the social capital theory as the core of sustainable community tourism development. The social capital of residents has been seen as a good way to solve issues of tourism governance, forecast the participation behavior and improve support intention of residents. In addition, previous studies have pointed out the role of community participation and place identity in increasing resident support intention for tourism development. A lack of place identity is one of the main reasons that community tourism has become a mere formality and is not sustainable. It refers to how much residents participate during tourism development and is mainly influenced by individual interest. Scholars believed that the place identity of residents is the soul of community festivals. It shows the community spirit to visitors and has significant impacts on tourism benefits and support intention of residents in community tourism development. Although the importance of community participation and place identity have been confirmed by both governmental and non-governmental organizations, real-life execution still needs to be improved. This study aimed to use social capital theory to investigate the social structure between community residents, participation levels in festival tourism, degrees of place identity, and resident support intention for future community tourism development, and the causal relationship that these factors have with cultural festival tourism. A quantitative research approach was employed to examine the proposed model. Structural equation model was used to test and verify the proposed hypotheses. This was a case study of the Kaohsiung Zuoying Wannian Folklore Festival. The festival was located in the Zuoying District of Kaohsiung City, Taiwan. The target population of this study was residents who attended the festival. The results reveal significant correlations among social capital, community participation, place identity and support intention. The results also confirm that impacts of social capital on support intention were significantly mediated by community participation and place identity. Practical suggestions were provided for tourism operators and policy makers. This work was supported by the Ministry of Science and Technology of Taiwan, Republic of China, under the grant MOST-105-2410-H-328-013.

Keywords: community participation, place identity, social capital, support intention

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Authors: A. Gagat-Matuła

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The aim of this article is to present a relation between family relationships and styles of approach to coping with stress among young people from migrant families with cerebral palsy. The study involved 70 persons (with cerebral palsy in the standard intellectual capacity) from families, in which at least one of parents is a migrant. To measure the level of communication in the family, the Family Relationships Questionnaire (FRQ) was employed, while the styles of coping with stress was investigated with the CISS Questionnaire. The relation between family relationships and styles of coping with stressful situations of the respondents was investigated. It was shown that there is an affiliation between the emotion-oriented style of coping with the stress and the variable of “communication in my family”. Moreover, it was demonstrated that there is a linkage between the task-oriented style of coping with the stress and the variable of “maternal control in mother-child relationship”. Young people with CP subjected to overprotection and control from their mothers in problem situations tend to focus on their own emotions instead of trying to undertake constructive actions. Excessive control in daily life by mothers results in passivity and a lack of motivation to cope with difficult situations.

Keywords: young people with cerebral palsy, family relationships, styles of coping with stress, migration

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Authors: Abhinav Kumar Rajverma, Arun Kumar Misra, Abhijeet Chandra

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Family involvement in business is universal across countries, with varying characteristics. Firms of developed economies have diffused ownership structure; however, that of emerging markets have concentrated ownership structure, having resemblance with that of family firms. Optimization of dividend payout and leverage are very crucial for firm’s valuation. This paper studies dividend paying behavior of National Stock Exchange listed Indian firms from financial year 2007 to 2016. The final sample consists of 422 firms and of these more than 49% (207) are family firms. Results reveal that family firms pay lower dividend and are more leveraged compared to non-family firms. This unique data set helps to understand dividend behavior and capital structure of sample firms over a long-time period and across varying family ownership concentration. Using panel regression models, this paper examines factors affecting dividend payout and capital structure and establishes a link between the two using Two-stage Least Squares regression model. Profitability shows a positive impact on dividend and negative impact on leverage, confirming signaling and pecking order theory. Further, findings support bankruptcy theory as firm size has a positive relation with dividend and leverage and volatility shows a negative relation with both dividend and leverage. Findings are also consistent with agency theory, family ownership concentration has negative relation with both dividend payments and leverage. Further, the impact of family ownership control confirms the similar finding. The study further reveals that firms with high family ownership concentration (family control) do have an impact on determining the level of private benefits. Institutional ownership is not significant for dividend payments. However, it shows significant negative relation with leverage for both family and non-family firms. Dividend payout and leverage show mixed association with each other. This paper provides evidence of how varying level of family ownership concentration and ownership control influences the dividend policy and capital structure of firms in an emerging market like India and it can have significant contribution towards understanding and formulating corporate dividend policy decisions and capital structure for emerging economies, where majority of firms exhibit behavior of family firm.

Keywords: dividend, family firms, leverage, ownership structure

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Authors: Kelechi Emmanuel, Kyaw Thein Aung, William Burch

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Introduction: Although rewarding in more ways than one, rural medicine can be challenging. The factors that lead to the challenges experienced in rural medicine include but are not limited to scarcity of resources, poor patient education inadequately trained professionals. This is the first single center study done on the challenges of and ways to improve diagnosis in rural medicine. Materials and Methods: Questionnaires were given to providers in a single hospital in rural Tennessee USA. In which providers were asked the question ‘In the past six months, what measures have you taken to improve your diagnostic accuracy given limited resources. Results: The questionnaire was passed to ten physicians working in a two hundred and twentyfive hospital bed. Physicians who participated included physicians in hospital medicine, emergency medicine, surgery, cardiology and gastroenterology. The study found that improved physical examination skills, access to specialist especially via telemedicine and affiliation to centers with more experienced professionals improved diagnosis and overall patient outcome in rural medicine. Conclusion: From this single center study, there is evidence to show that in addition to honing physical examination skills and having access to immediate results of testing done; hospital collaborations and access to highly trained specialist via telemedicine does improve diagnosis in rural medicine.

Keywords: rural medicine, diagnostic accuracy, diagnosis, telemedicine

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Authors: K. M. Yuen

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This research examined the literature review of wedding preparation’s challenges and its developmental tasks of family transition under family life cycle. Five interviewees were invited to share their experiences on the differences with their parents in regard to wedding preparations and coping strategies. Some coping strategies and processes were highlighted for facilitating the family to achieve the developmental tasks during the wedding preparation. However, those coping strategies and processes may only act as the step and the behavior, while “concern towards parents” was found to be the essential element behind these behaviors. In addition to pre-marital counseling, a developmental group was suggested to develop under the framework of family life cycle and its related coping strategies on working with the newlyweds who encountered intergenerational differences in regard to their wedding preparations.

Keywords: wedding preparation, difference, parents, family life cycle, developmental tasks, coping strategies, process

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Authors: Farah Naja, Mohamad Alameddine

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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

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Authors: M. Moiz

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Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

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Authors: Bowen Li, Dan Shu, Shiguang Pang, Li Wang, Qian Liu

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Background: Every year, approximately 429,000 adolescents aged 0-19 are diagnosed with cancer worldwide. The diagnosis brings about substantial psychological pressure and caregiving responsibilities for family members and impacts the families significantly. Family resilience has been found to reduce caregiver distress and can also foster post-traumatic growth in cancer survivors. However, current research on family resilience in childhood cancer mainly focuses on individual caregiver resilience and child adaptation, with less attention given to categorizing family resilience among caregivers of children with cancer. Method: A total of 292 caregivers of children with cancer were recruited from four tertiary hospitals in central China from July 2022 to March 2024. This study was approved by the ethics committee, and participants provided informed consent, with the option to withdraw at any time. The Family Resilience Assessment Scale was used to measure family resilience among caregivers of children with cancer. The Quality of Life scale-family, The Perceived Social Support Scale, and The Connor-Davidson Resilience Scale were used to measure potential influencing factors. This study used latent profile analysis (LPA) to identify latent categories of family resilience among caregivers of children with cancer. Binary logistic regression was used to analyze the influencing factors of family resilience. Results: The results reveal two distinct categories: "high family resilience" and "low family resilience." "Low family resilience" group accounts for 85.96% of the total while "high family resilience" group is 14.04%. "High family resilience" scores higher across all dimensions compared to "low family resilience". Within-group comparisons reveals that "family communication and problem-solving" and "empowering the meaning of adversity" received the highest scores, while "utilizing social and economic resources" scores the lowest. "Maintaining a positive attitude" scores similarly high to "family communication and problem-solving" in the high family resilience group, whereas it scores similarly low to "utilizing social and economic resources" in the low family resilience group. In single-factor analysis, residence, number of siblings, caregiver's education level, resilience, social support, quality of life, physical well-being and psychological well-being showed significant difference between two categories. In binary logistic regression analysis, households with only one child are more likely to exhibit low family resilience, whereas high personal resilience is associated with a high level of family resilience. Conclusion: Most families with children suffering from cancer require strengthened family resilience. Support for utilizing socio-economic resources is important for both high and low family resilience families. Single-child families and caregivers with lower resilience require more attention. These findings imply the development of targeted interventions to enhance family resilience among families with children of cancer. Future studies could involve children and other family members for a comprehensive understanding of family resilience. Longitudinal studies are necessary to explore the dynamic changes in family resilience throughout the cancer journey.

Keywords: cancer children, caregivers, family resilience, latent profile analysis

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Authors: Alexandra Telitsyna, Galina Semya, Elvira Garifulina

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Introduction: Starting from 2012 Russia conducts deinstitutionalization policy and now the main indicator of success is the number of children living in institutions. Active family placement process has resulted in residents of the institution now mainly consists of adolescents with behavioral and emotional problems, children with disabilities and groups of siblings. Purpose of science research: The purpose of science research is to identify factors for child’s wellbeing while temporary stay in an orphanage and the subjective assessment of children's level of well-being (psychological well-being). Methods: The data used for this project was collected by the questionnaire of 72 indicators, a tool for monitoring the behavior of children and caregivers, an additional questionnaire for children; well-being assessment questionnaire containing 10 scales for three age groups from preschool to older adolescents. In 2016-2018, the research was conducted in 1873 institution in 85 regions of Russia. In each region a team of academics, specialists from Non-profits, independent experts was created. Training was conducted for team members through a series of webinars prior to undertaking the assessment. The results: To ensure the well-being of the children, the following conditions are necessary: 1- Life of children in institution is organised according to the principles of family care (including the creation of conditions for attachment to be formed); 2- Contribution to find family-based placement for children (including reintegration into the primary family); 3- Work with parents of children, who are placed in an organization at the request of parents; 4- Children attend schools according to their needs; 5- Training of staff and volunteers; 6- Special environment and services for children with special needs and children with disabilities; 7- Cooperation with NGOs; 8 - Openness and accessibility of the organization. Conclusion: A study of the psychological well-being of children showed that the most emotionally stressful for children were questions about the presence and frequency of contact with relatives, and the level of well-being is higher in the presence of a trusted adult and respect for rights. The greatest contribution to the trouble is made by the time the child is in the orphanage, the lack of contact with parents and relatives, the uncertainty of the future.

Keywords: identifying factors, orphans, Russia, wellbeing

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Authors: Shih-Heng Sun, Hsiu-Yu Chang

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“Family centered service model” becomes mainstream in early intervention. Family outcome should be evaluated in addition child improvement in terms of outcome evaluation in early intervention. The purpose of this study is to develop a surveys to evaluate family outcomes in early intervention. Method: “Family Outcomes Survey- Revised Taiwan Version” (FOS-RT) was developed through translation, back-translation, and review by the original author. Expert meeting was held to determine the content validity. Two hundred and eighty six parent-child dyads recruited from 10 local Early Intervention Resource Centers (EIRC) participated in the study after they signed inform consent. The results showed both parts of FOS-RT exhibits good internal consistency and test-retest reliability. The result of confirmatory factor analysis indicated moderate fit of 5 factor structure of part A and 3 factor structure of part B of FOS-RT. The correlation between different sessions reached moderate to high level reveals some sessions measure similar latent trait of family outcomes. Correlation between FOS-RT and Parents‘ Perceived Parenting Skills Questionnaire was calculated to determine the convergence validity. The moderate correlation indicates the two assessments measure different parts of early intervention outcome although both assessments have similar sub-scales. The results of this study support FOS-RT is a valid and reliable tool to evaluate family outcome after the family and children with developmental disability receive early intervention services.

Keywords: early intervention, family service, outcome evaluation, parenting skills, family centered

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Authors: Nashalla Gwyn Nyinda

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The ancient system of Tibetan Medicine, known as Sowa Rigpa across the Himalayan regions, is a systematic system of healing encouraging balance primarily through diet and behavior modifications. With the rise of the popularity of Tibetan Medicine, compliance is critical to successful treatment outcomes. As patients learn more about who they are as individuals and how their elemental balances or imbalances affect disorders and mental-emotional balance, they develop faith and dedication to their healing process. Specifically, regarding diet and behavior and the basic principles of the medical system, patient compliance increases dramatically in all treatment areas when they understand why a treatment or dietary prescription guidance is effective. Successful responses to Tibetan treatment rely on a buy-in from the patient. Trust between the slower process of Traditional medicine treatments, the Tibetan physician and the patient is a cornerstone of treatment. The resulting decrease in the use of allopathic medicine and better health outcomes for acute and chronic disorders are well documented. This paper addresses essential points of the Tibetan Medicine system, dialogue between doctor and patient focused on appropriate and seasonal changing dietetics. Such fluctuating treatment approaches, based on external elemental factors, dramatically increase treatment outcomes. Specifically, this work addresses why allopathic medicine models may need more trust development between practitioner and patient.

Keywords: compliancy in treatment, diet and lifestyle medicine, nature and elements as medicine, seasonal diets, Sowa Rigpa, traditional Tibetan medicine, treatment outcomes

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Authors: V. Moser-Siegmeth, M. C. Gambal, M. Jelovcak, B. Prytek, I. Swietalsky, D. Würzl, C. Fida, V. Mühlegger

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Adaptability is the capacity to adjust without great difficulty to changing circumstances. Within our project, we aimed to detect whether older people living within a long-term care hospital lose the ability to adapt. Theoretical concepts are contradictory in their statements. There is also lack of evidence in the literature how the adaptability of older people changes over the time. Following research questions were generated: Are older residents of a long-term care facility able to adapt to changes within their daily routine? How long does it take for older people to adapt? The study was designed as a convergent parallel mixed method intervention study, carried out within a four-month period and took place within seven wards of a long-term care hospital. As a planned intervention, a change of meal-times was established. The inhabitants were surveyed with qualitative interviews and quantitative questionnaires and diaries before, during and after the intervention. In addition, a survey of the nursing staff was carried out in order to detect changes of the people they care for and how long it took them to adapt. Quantitative data was analysed with SPSS, qualitative data with a summarizing content analysis. The average age of the involved residents was 82 years, the average length of stay 45 months. The adaptation to new situations does not cause problems for older residents. 47% of the residents state that their everyday life has not changed by changing the meal times. 24% indicate ‘neither nor’ and only 18% respond that their daily life has changed considerably due to the changeover. The diaries of the residents, which were conducted over the entire period of investigation showed no changes with regard to increased or reduced activity. With regard to sleep quality, assessed with the Pittsburgh sleep quality index, there is little change in sleep behaviour compared to the two survey periods (pre-phase to follow-up phase) in the cross-table. The subjective sleep quality of the residents is not affected. The nursing staff points out that, with good information in advance, changes are not a problem. The ability to adapt to changes does not deteriorate with age or by moving into a long-term care facility. It only takes a few days to get used to new situations. This can be confirmed by the nursing staff. Although there are different determinants like the health status that might make an adjustment to new situations more difficult. In connection with the limitations, the small sample size of the quantitative data collection must be emphasized. Furthermore, the extent to which the quantitative and qualitative sample represents the total population, since only residents without cognitive impairments of selected units participated. The majority of the residents has cognitive impairments. It is important to discuss whether and how well the diary method is suitable for older people to examine their daily structure.

Keywords: adaptability, intervention study, mixed methods, nursing home residents

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Authors: Padma Sree Potru

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Abstract: A co-relational descriptive study was conducted to assess the impact of cancer event on self, on family, coping strategies of cancer clients and quality of life among them in G.G.H., Guntur, Andhra Pradesh, India. Aim: The aim of the study was to investigate the impact of cancer events on self, on family, coping of clients and quality of life among cancer patients. Methods: 50 cancer patients were selected through random sampling technique. The data were obtained by using impact of events scale, impact on family scale, coping health inventory and WHOQOL-BREF scale. Results: The results revealed that majority (32%) of them were in the age group of 36-45 years, 72% were females, 44% were having the income of Rs. 5001-10000/- per month, 40% were working for daily wage, and 15% were newly diagnosed of cancer. Among 50 cancer patients, 65% had extreme impact of events, 61% shows extreme impact on family, 46% possess minimal coping strategies and 68% had poor quality of life. This study focuses on that there is a strong positive correlation between quality of life and coping behavior r=0.603 and also between impact of event and impact on family r=0.610, but a negative correlation existed between quality of life and impact of events r= -0.201. ANOVA test reveals that there is a significant difference between subscales of impact on family and coping behavior with f values = 3.893, 3.957 respectively. Chi-square highlights that there is a significant association between impact of events with age, occupation and impact on family with duration of illness. Conclusion: Even though cancer is a dreadful disease still there are many emerging treatment modalities and innovative procedures which are focusing on improving the standards of life among cancer clients. But all this can happen only when the clients accepts the reality, increase their willpower and confidence, desire to live, focusing on coping mechanisms and good ongoing support from the family members.

Keywords: impact of event, impact on family, coping, quality of event

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Authors: Prakash Chandra Subedi

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Family farming is the family based farming activities, where the farmers cultivate their farm themselves and all the members of the family are engaged in farming as per their skill, age, and physical strength. This study was conducted to examine the food sufficiency level of family farmers and, was carried in the four VDCs of Kavrepalanchowk district -Jaisithok Mandan, Mahadevsthan Mandan and Gairi Bisouna Deupur. A total of 115 households determined as the sample size from each of the four VDCs were randomly visited for interview in the study. The size of land holding was found to be very small and fragmented. The quality of soil was fertile and could yield high production if irrigation existed. The labour used patterns were significant number of family labour but due to high youth migration there were labour shortage. The rate of adoption of agri-technology was low but the households adopting insectides/pesticides and chemical fertilizers were found to be high without any knowledge regarding its using techniques. In conclusion, the study highpoint that the crop production and food sufficiency level of the family farmers of the Kavrepalanchowk district is decreasing. Many farmers were leaving their farming and started seeking opportunity to go for foreign employment or engaged in non-agricultural activities in urban areas. If no action is taken timely, there may come situation that we will have to depend on imports for all the food requirements. Thus, the study reveals that the family farming could act as an agent for ensuring food sufficiency for all, if proper policies is promoted to family farmers with legal titles to their land or promoted with sustainable agriculture methods or provided with proper agri-technology or given their share of respect and responsibilities that farming as honorable profession.

Keywords: family farming, technology transfer, crop production, food sufficiency

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Authors: Vivek Nair

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The objective of this research is to find out happiness determinants in MBA student life. To figure out the factors influencing happiness in life is sorted by their personal profiles. This paper used survey method to collect data. The survey was mainly conducted among Management Students and is based on three hypothesis viz. Family relationship, Friendship and God as a source of happiness, and whether happiness is manageable and controllable. The statistics used for interpreting the results included the frequencies, percentages, and z test analysis. The findings revealed that family relationships and friendship have the same effect on individual happiness.

Keywords: happiness, family, MBA students, friends

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Authors: J. Banski

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Regardless of residence place, the type of business and the social system, an individual or groups of people use the accumulated knowledge and continuously deepen and expand its scope. Knowledge is needed by human beings to carry out certain tasks, achieve desired goals or make decisions. Knowledge is an attribute of the people of a region and is identified with the total experience and information that its residents and institutions possess, including the ability to use it. It is subject to constant development, which is the result of both the deepening and exchange of knowledge among the residents of a particular area, as well as the influx of knowledge with newly arriving residents. A good example of the aforementioned processes is in rural areas, where we are dealing with two basic groups of people between whom knowledge transfer takes place. The first group is made up of people who have lived in the village for a long time, while the second group is made up of people who migrate temporarily or permanently to the countryside. The English-language literature uses the terms oldtimers and newcomers for these groups, respectively. Newcomers, usually possessing different life experiences, cultural patterns and competencies, can be rich sources of knowledge for villagers. At the same time, the latter, with different knowledge and experience, along with knowledge of local conditions and customs, can also be an important source of knowledge for incomers to the countryside. The countryside is a particularly interesting environment for studying social interactions and the accompanying transfer of knowledge. This is because it is characterized by a high intensity of neighborly contact and a high level of trust in the private sphere. As a result of the migratory influx of new residents, the social and cultural image of the countryside is changing due to the interpenetration of urban and rural life patterns. Research on rural-urban knowledge transfer is both an opportunity to halt negative trends in the social and economic development of rural areas and support the establishment of a basis for rural renewal. This paper discusses the results of research on urban-rural knowledge transfer based on case studies carried out in a dozen villages from different regions of Poland. Their purpose was to answer three basic research questions: 1) what types of knowledge are transferred between urban and rural residents? 2) what are the main directions and intensity in knowledge transfer? And 3) what are the consequences of knowledge transfer between urban and rural residents?

Keywords: rural areas, villages, newcomers, knowledge transfer, Poland

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Authors: W. Promprom, W. Chatan

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Leguminosae is a large plant family and its members are important for local people utilization in the Northeast of Thailand. This research aimed to survey medicinal plants in this family in Kantharalak Community forest. The plant collection and exploration were made from October 2017 to September 2018. Folk medicinal uses were studied by interviewing villagers and folk medicine healers living around the community forest by asking about local names, using parts, preparation and properties. The results showed that 65 species belonging to 40 genera were found. Among these, 30 species were medicinal plant. The most used plant parts were leaf. Decoction and drinking were mostly preparation method and administration mode used. All medicinal plants could be categorized into 17 diseases/symptoms. Most plant (56.66%) were used for fever. The voucher specimens were deposited in Department of Biology, Faculty of Science, Mahasarakham University, Thailand. Therefore, the data from this study might be widely used by the local area and further scientific study.

Keywords: ethnobotany, ethnophamacology, medicinal plant, taxonomy, utilization

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Authors: Rajani Bogati, Gopini Pathak

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Women living in husband’s home (second home) after getting married is a common culture in Nepalese society. Most of the marriages are arranged between the mutual understandings of their parents as per their cultural practice. Culturally, arranged marriage system protects women in the society. Even though, women domestic violence is also still alive in the society. It depends upon the family class, ethnicity, caste, religion etc. Lower class (poor) family always try to get marriage from the higher class (rich) family of girl and also try to send their girl in higher class family. This study analysis the freedom of women of Armala Village Development Committee, Kaski district on the base of the family class of girl where she born (First home). 88% women are getting more respect in their second home if their family class of first home and second homes are same. They feel more comfortable and freedom in their second home. 79% of Women are suffering from domestic violence while the marriage between the boys from higher class and the girls from lower class. But less than 10% women are getting distress from violence if the marriage is accompanied between the girls from higher class and the boys from lower class. Less domestic violence is seem where the both families are educated, even though they are from different class. This study recommends that the society should be educated first to reduce women domestic violence.

Keywords: arranged marriage, women, family class, domestic violence

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Authors: Joanna Bielecka-Prus

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In the view of increasing number of labour migrations associated with broadly understood economic crisis, many families experience migration separation. Currently, in the era of globalization, migration movements include an increasing number of families, more and more frequently a new type of family, a transnational family. Accordingly, the functions of the family, family practice of care, and the relationships between members of the group change especially in the case of female migration. Sociologists highlight the emotional aspects of migrants’ family lives: managing emotions, coping with guilt, loneliness and rejection. Not without significance is the fact that today's public discourse often represents migrant women in a negative light. On the one hand, consumption and expanding material resources are assessed positively, on the other hand, deficits emotional and devastation of family life in the transnational families appear. Opinions expressed by different environments: the media, the political environment, etc. do not always take into account the context of mobility and their different effects on family life. The paper will present the analysis of qualitative studies of Polish female migrants’ families left-behind (children, parents, caregivers N = 100) and their coping strategies in different situations in the event of migration separation. The main area of care deficit will be defined and it will be showed who and how help to solve the problems.

Keywords: care, children left behind, female migration, parents left behind

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Authors: Chimey Lhamo, Ngawang Tsering

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Traditional Tibetan medicine, known as Sowa Rigpa (Science of healing), originated more than 2500 years ago with an insightful background, and it has been growing significant attention in many Asian countries like China, India, Bhutan, and Nepal. Particularly, the Indian government has targeted Traditional Tibetan medicine as its major Indian medical system, including Ayurveda. Although Traditional Tibetan medicine has been growing interest and has a long history, it is not easily recognized worldwide because it exists only in the Tibetan language and it is neither accessible nor understood by patent examiners at the international patent office, data about Traditional Tibetan medicine is not yet broadly exist in the Internet. There has also been the exploitation of traditional Tibetan medicine increasing. The Traditional Knowledge Digital Library is a database aiming to prevent the patenting and misappropriation of India’s traditional medicine knowledge by using India’s Traditional knowledge Digital Library on Sowa Rigpa in order to prevent its exploitation at international patent with the help of information technology tools and an innovative classification systems-traditional knowledge resource classification (TKRC). As of date, more than 3000 Sowa Rigpa formulations have been transcribed into a Traditional Knowledge Digital Library database. In this paper, we are presenting India's Traditional Knowledge Digital Library for Traditional Tibetan medicine, and this database system helps to preserve and prevent the exploitation of Sowa Rigpa. Gradually it will be approved and accepted globally.

Keywords: traditional Tibetan medicine, India's traditional knowledge digital library, traditional knowledge resources classification, international patent classification

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Authors: Myriam Castonguay, Florence Vinit

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This study aims to gain a better understanding of the lived experience of seven children growing up in a family where another child is severely disabled, informed by family systems theory and the socio-ecological model of development. In depth semi-structured interviews were conducted with seven children who described they everyday life since their brother’s or sister’s diagnosis. Thematic analysis revealed four themes : struggling with loneliness inside the family, supporting the disabled child through its journey, accommodating to a changing routine and keeping a “bubble” for oneself. Brothers and sisters depict a family life characterized by much loneliness, with severe disabilities requiring ongoing care and prolonged hospitalizations. In the midst of adversity, siblings describe themselves as highly committed to supporting the disabled child and to preserve family cohesion, even if that means getting exposed to emotionally challenging situations and adjusting their daily routine frequently. Children recount that keeping up with schoolwork and leisure activities of their own is central to their well-being. Having a space where one can reconnect with his ordinary life as a kid is also deemed very important. This study reminds us that more needs to be done to counteract the loneliness experienced by siblings through the family experience of disability. Family members and clinicians need to be extra vigilant to ensure siblings’ needs don’t go unnoticed or dismissed, as it may be difficult for this population of children to voice their own experience and needs. Family, school and other actors in the community may help brothers and sisters pursue their personal dreams, goals and projects, to continue experiencing well-being despite adverse life circumstances.

Keywords: sibling’s lived experience of disability, sibling’s needs at various levels of the ecosystem, family adjustment to the disability experience, supporting family wellness through the disability experience

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