Search results for: community psychiatric mental health nursing

Authors: Ayşegül Bilge, Merve Uğuryol, Şeyda Dülgerler, Mustafa Yıldız

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The purpose of this research is to prove the Attitude towards Using Complementary Treatments Scale reliability and validity. The research is a methodological type of research that has been planned to determine the validity and reliability of the Attitude towards Using Complementary Treatments Scale. The scale has been developed by the researchers. In the scale, there are 23 questions including complementary and modern therapies individuals apply when they have health problems 4-item Likert-type evaluation has been carried out in preparing the questionnaire. High score obtained from the scale indicates a positive attitude towards complementary therapies. In the course of validity assessment of the scale, expert opinion has been received, and the content validity of the scale has been determined by using Kendall coefficient correlation test (Wa=0.200, p = 0.460). In the course of the reliability assessment of the scale, total score correlations of 23 materials have been examined, and those under 0.20 correlation limit has been removed from the scale correlation. As a result, the scale was left to be 13 items. In the internal consistency tests of the analyses, Cronbach's alpha value has been found to be 0.79. As a result, of the validity analyses of the Attitude towards Using Complementary Treatments Scale, the content and language validity analyses has been found to be at the expected level. It has been determined to be a highly reliable scale as the result of the reliability analyses. In conclusion, Attitude towards Using Complementary Treatments Scale is a valid and reliable scale.

Keywords: alternative health care, complementary treatment, instrument development, nursing practice

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Authors: Nur Inayah Ismaniar, Sukri Palutturi, Ansariadi, Atjo Wahyu

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Background: In various countries in the world, the problem of smoking is now considered something serious because of the effects of smoking which can not only lead to addiction but also have the potential to harm health. Public health authorities have concluded that one solution that can be done to protect the public from active smokers is to issue a policy that requires public facilities to be completely smoke-free. The hospital is one of the public facilities that has been designated as a smoke-free area. However, the implementation and maintenance of a successful program based on a smoke-free hospital are still considered an ongoing challenge worldwide due to the very low level of adherence. The low level of compliance with this smoke-free policy is also seen in other public facilities. The purpose of the literature review is to review the level of compliance with the application of the Non-Smoking Area policy, how this policy has succeeded in reducing smoking activity in hospitals, and what factors lead to such compliance in each country in the world. Methods: A literature review of articles was carried out on all types of research methods, both qualitative and quantitative. The sample is all subjects who are in the research location, which includes patients, staff and hospital visitors. Results: Various variations in the level of compliance were found in various kinds of literature. The literature with the highest level of compliance is 88.4%. Furthermore, several determinants that are known to affect the compliance of the Non-Smoking Area policies in hospitals include communication, information, knowledge, perceptions, interventions, attitudes and support. Obstacles to its enforcement are the absence of sanctions against violators of the Non-Smoking Area policy, the ineffectiveness of the function of policymakers in hospitals, and negative perceptions of smoking related to mental health. Conclusion: Violations of the Non-Smoking Area policy are often committed by the hospital staff themselves, which makes it difficult for this policy to be fully enforced at various points in the hospital.

Keywords: health policy, non-smoking area, hospital, implementation

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Authors: Robert D. Hanser, Gina M. Hanser

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This paper provides an overview of Coordinated Community Response Teams (CCRT) to Intimate Partner Violence (IPV). The CCRT, as a partnership and collaborative effort between multiple agencies is highlighted. This paper is a legal analysis that showcases new legislation and legal requirements in the United States for investigating, processing, and reporting to acts of victimization have transformed the role of the university’s CCRT on campus, making its mission all the more important, both internal and external to the campus. As a specific example, discussion of the CCRT in Northeast Louisiana at the University of Louisiana at Monroe is provided as an example of involvement in this initiative, where federal grant funding has allowed a micro version of the region’s CCRT to be implemented on that campus. Simultaneously, university personnel also work with external agencies throughout the community in intimate partner violence response. Amidst this, the result is a genuine partnership between practitioners and researchers who work together to provide public awareness, prevention, first-responder, and intervention services in a comprehensive manner throughout Northeast Louisiana.

Keywords: interperaonal violence, sexual assault, dating violence, campus violence

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Authors: Nabilah Haniph

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This paper tries to examine the social and economic conditions of women entrepreneurs from the Muslim community in Kerala. It also tries to explain the problems faced by these entrepreneurs in the light of socialist feminist approach for overcoming these hurdles. The results are presented from a qualitative perspective of research and there is an attempt to merge the results from the study on a critical angle of materialist feminism and thereby prove the superiority of socialist feminism over all other forms of feminism. The analysis of the study is based on data collected from women entrepreneurs from Muslim community in Kerala who run small scale and medium scale business as well as service oriented business all over Kerala. Most of the women entrepreneurs consider themselves to be conventional and God-fearing and domestic women from middle-income or upper-income family and think that they can balance their family and other functions on their own. Most of them understand the problems faced by women in the field of business and they believe that they can solve all these barriers from the socialist feminist perspective. Finally, the paper substantiates why other theories of feminism do not hold good from an Islamic perspective.

Keywords: feminism, Islamic perspective, Kerala Muslim community, women entrepreneurs

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Authors: Patrick Duffley

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Hanks (2021) identifies three Frege-inspired commitments concerning propositions that are widely shared across the philosophy of language: (1) propositions are the primary, inherent bearers of representational properties and truth-conditions; (2) propositions are neutral representations possessing a ‘content’ that is devoid of ‘force; (3) propositions can be entertained or expressed without being asserted. Hanks then argues that the postulate of neutral content must be abandoned, and the primary bearers of truth-evaluable representation must be identified as the token acts of assertoric predication that people perform when they are thinking or speaking about the world. Propositions are ‘types of acts of predication, which derive their representational features from their tokens.’ Their role is that of ‘classificatory devices that we use for the purposes of identifying and individuating mental states and speech acts,’ so that ‘to say that Russell believes that Mont Blanc is over 4000 meters high is to classify Russell’s mental state under a certain type, and thereby distinguish that mental state from others that Russell might possess.’ It is argued in this paper that there is no need to classify an utterance of 'Russell believes that Mont Blanc is over 4000 meters high' as a token of some higher-order utterance-type in order to identify what Russell believes; the meanings of the words themselves and the syntactico-semantic relations between them are sufficient. In our view what Hanks has accomplished in effect is to build a convincing argument for dispensing with propositions completely in the philosophy of language. By divesting propositions of the role of being the primary bearers of representational properties and truth-conditions and fittingly transferring this role to the token acts of predication that people perform when they are thinking or speaking about the world, he has situated truth in its proper place and obviated any need for abstractions like propositions to explain how language can express things that are true. This leaves propositions with the extremely modest role of classifying mental states and speech acts for the purposes of identifying and individuating them. It is demonstrated here however that there is no need whatsoever to posit such abstract entities to explain how people identify and individuate such states/acts. We therefore make the modest proposal that the term ‘proposition’ be stricken from the vocabulary of philosophers of language.

Keywords: propositions, truth-conditions, predication, Frege, truth-bearers

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Authors: Sisaye Tamrat Ayalew

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In Ethiopia, the relationships between different communities have been characterized by mistrust, prejudice, and conflict, resulting in mass killings, displacement, and human rights violations. These relationships are mainly based on ethnic, religious, and linguistic lines, leading to a polarized society. The aim of this study is to appraise the nature of two major community relationships, namely the I-Thou relationship, characterized by genuine dialogue and mutual understanding, and the I-It relationship, characterized by a monologue and mutual suspicion. The study also aims to analyze how these two types of relationships contribute to either resolving or aggravating conflicts and building or deteriorating peace in Ethiopia. The study adopts a qualitative approach, specifically hermeneutics, to explore the nature of the I-Thou and I-It relationships in the Ethiopian context. It also examines how political elites shape these relationships within the community. The study finds that the dominant relationship in Ethiopian society is the I-It relationship, which is manifested as "com-animation." This relationship is characterized by mutual mistrust, prejudice, hostility, and misunderstanding. As a result, conflicts have arisen, leading to violence, displacement, and human rights violations. The study concludes that there is a need to shift from the I-It (com-animation) relationship to the I-Thou (communication) relationship in Ethiopian society. This shift would involve rethinking and readjusting societal relationships, especially among political elites, to foster genuine dialogue, mutual understanding, and lasting peace. It is imperative to overcome mutual mistrust, prejudice, and misunderstanding in order to resolve conflicts and build a harmonious society in Ethiopia. The study's findings and recommendations contribute to raising awareness among both Ethiopians and the international community on the potential for conflict resolution and peacebuilding through a shift in community relationships.

Keywords: dialogue, I-Thou relationship, I-It relationship, conflict resolution, building peace

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Authors: Beverly Black

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Teen dating violence (TDV) is a significant public health problem with severe negative impact on youths’ mental and physical health and well-being. Exacerbating the negative impact of TDV victimization is the fact that teens rarely report the violence. They are fearful to tell friends or family, especially parents. The family context is the first place where children learn about interpersonal relationships, and therefore, parental response of teens’ life experiences influences teens’ actions and development. This study examined youths’ perspectives on parental responses to TDV. Effective parental responses to TDV may increase the likelihood that youth will leave abusive relationships. Method. Eleven gender-separate focus groups were conducted with 27 females and 28 males, ages 12 to 17, to discuss parental responses to teen dating violence. Youth were recruited from a metropolitan community in the southwestern part of the United States. Focus groups questions asked the middle and high school youth how they would want their parents to respond to them if they approached them about various incidents of dating violence. All focus groups were transcribed. Using QSR-N10, two researchers’ analyzed data first using open and axial coding techniques to find overarching themes. Researchers triangulated the coded data to ensure accurate interpretations of the participants’ messages and used the scenario questions to structure the coded results. Results. Most youths suggested that parents should simply talk with them; they recognized the importance of communication. Teens wanted parents to ask questions, educate them about healthy relationships, share their personal experiences, and give teens advice (tell them to break up, limit contact with perpetrator, go to police). Younger youth expressed more willingness to listen to parental advice. Older youth wanted their parents to give them the opportunity to make their decisions. Many of the teens’ comments focused on the importance of parents protecting the teen, providing support and empathy for the teen, and especially refraining from overreacting (not yelling, not getting angry and staying calm). Implications. Parents need to know how to effectively respond to youth needing to leave unhealthy relationships. Demanding that their children end a relationship may not be a realistic approach to TDV. A parent’s ineffective response, when approached by an adolescent for assistance in TDV, may influence a youth to dismiss parents and other adults as viable options for seeking assistance. Parents and prevention educators can learn from hearing youths’ voices about effective responses to TDV.

Keywords: adolescents dating abuse, adolescent and parent communication, parental responses to teen dating violence, teen dating violence

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Authors: Christine Hough, Eddie Abbott-Halpin, Tariq Mahmood, Jessica Giles

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This paper draws together the findings from two research studies, each undertaken with cohorts of South Asian Muslim respondents located in the North of England between 2017 and 2019. The first study, entitled Faith Family and Crime (FFC), investigated the extent to which a Muslim family’s social and health well-being is affected by a family member’s involvement in the Criminal Justice System (CJS). This study captured a range of data through a detailed questionnaire and structured interviews. The data from the interview transcripts were analysed using open coding and an application of aspects of the grounded theory approach. The findings provide clear evidence that the respondents were neither well-informed nor supported throughout the processes of the CJS, from arrest to post-sentencing. These experiences gave rise to mental and physical stress, potentially unfair sentencing, and a significant breakdown in communication within the respondents’ families. They serve to highlight a particular aspect of complexity in the current needs of those South Asian Muslim families who find themselves involved in the CJS and is closely connected to family structure, culture, and faith. The second study, referred to throughout this paper as #ImamsBritain (that provides the majority of content for this paper), explores how Imams, in their role as community faith leaders, can best address the complex – and changing - needs of South Asian Muslims families, such as those that emerged in the findings from FFC. The changing socio-economic and political climates of the last thirty or so years have brought about significant changes to the lives of Muslim families, and these have created more complex levels of social, cultural, and faith-based needs for families and individuals. As a consequence, Imams now have much greater demands made of them, and so their role has undergone far-reaching changes in response to this. The #ImamsBritain respondents identified a pressing need to develop a wider range of pastoral and counseling skills, which they saw as extending far beyond the traditional role of the Imam as a religious teacher and spiritual guide. The #ImamsBritain project was conducted with a cohort of British Imams in the North of England. Data was collected firstly through a questionnaire that related to the respondents’ training and development needs and then analysed in depth using the Delphi approach. Through Delphi, the data were scrutinized in depth using interpretative content analysis. The findings from this project reflect the respondents’ individual perceptions of the kind of training and development they need to fulfill their role in 21st Century Britain. They also provide a unique framework for constructing a professional guide for Imams in Great Britain. The discussions and critical analyses in this paper draw on the discourses of professionalization and pastoral care and relevant reports and reviews on Imam training in Europe and Canada.

Keywords: criminal justice system, faith and culture, Imams, Muslim community leadership, professionalization, South Asian family structure

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Authors: Thammarak Srimarut, Witthaya Mekhum

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This study analysed and developed a model for monk’s food bowl production on occupational health safety and environment at work for the encouragement of Rattanakosin local wisdom at Banbart Community. The process of blowpipe welding was necessary to produce the bowl which was very dangerous or 93.59% risk. After the employment of new sitting posture, the work risk was lower 48.41% or moderate risk. When considering in details, it was found that: 1) the traditional sitting posture could create work risk at 88.89% while the new sitting posture could create the work risk at 58.86%. 2) About the environmental pollution, with the traditional sitting posture, workers exposed to the polluted fume from welding at 61.11% while with the new sitting posture workers exposed to the polluted fume from welding at 40.47%. 3) On accidental risk, with the traditional sitting posture, workers exposed to the accident from welding at 94.44% while with the new sitting posture workers exposed to the accident from welding at 62.54%.

Keywords: occupational health safety, environment at work, Monk’s food bowl, machine intelligence

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Authors: Misagh Faezipour

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This paper explores the effects of screen time on children from a systems engineering perspective. We reviewed literature from several related works on the effects of screen time on children to explore all factors and interrelationships that would impact children that are subjected to using long screen times. Factors such as kids' age, parent attitudes, parent screen time influence, amount of time kids spend with technology, psychosocial and physical health outcomes, reduced mental imagery, problem-solving and adaptive thinking skills, obesity, unhealthy diet, depressive symptoms, health problems, disruption in sleep behavior, decrease in physical activities, problematic relationship with mothers, language, social, emotional delays, are examples of some factors that could be either a cause or effect of screen time. A systems engineering perspective is used to explore all the factors and factor relationships that were discovered through literature. A causal model is used to illustrate a graphical representation of these factors and their relationships. Through the causal model, the factors with the highest impacts can be realized. Future work would be to develop a system dynamics model to view the dynamic behavior of the relationships and observe the impact of changes in different factors in the model. The different changes on the input of the model, such as a healthier diet or obesity rate, would depict the effect of the screen time in the model and portray the effect on the children’s health and other factors that are important, which also works as a decision support tool.

Keywords: children, causal model, screen time, systems engineering, system dynamics

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Authors: E. Bennion, A. Acharya, S. Barnes, D. Ferrell, S. Luckett-Cole, G. Mower, J. Nelson, Y. Nguyen

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Objective: This study aimed to evaluate the validity of a firearm injury query in the Early Notification of Community-based Epidemics syndromic surveillance system. Syndromic surveillance data are used at the Utah Department of Health for early detection of and rapid response to unusually high rates of violence and injury, among other health outcomes. The query of interest was defined by the Centers for Disease Control and Prevention and used chief complaint and discharge diagnosis codes to capture initial emergency department encounters for firearm injury of all intents. Design: Two epidemiologists manually reviewed electronic health records of emergency department visits captured by the query from April-May 2020, compared results, and sent conflicting determinations to two arbiters. Results: Of the 85 unique records captured, 67 were deemed probable, 19 were ruled out, and two were undetermined, resulting in a positive predictive value of 75.3%. Common reasons for false positives included non-initial encounters and misleading keywords. Conclusion: Improving the validity of syndromic surveillance data would better inform outbreak response decisions made by state and local health departments. The firearm injury definition could be refined to exclude non-initial encounters by negating words such as “last month,” “last week,” and “aftercare”; and to exclude non-firearm injury by negating words such as “pellet gun,” “air gun,” “nail gun,” “bullet bike,” and “exit wound” when a firearm is not mentioned.

Keywords: evaluation, health information system, firearm injury, syndromic surveillance

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Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

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Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

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Authors: Yu Liang, Wei Wei

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Spatial representation of numbers and numerical magnitude are important for preschoolers’ mathematical ability. Mental number line, a typical index to measure numbers spatial representation, and numerical comparison are both related to arithmetic obviously. However, they seem to rely on different mechanisms and probably influence arithmetic through different mechanisms. In line with this idea, preschool children were trained with two tasks to investigate which one is more important for approximate arithmetic. The training of numerical processing and number line estimation were proved to be effective. They both improved the ability of approximate arithmetic. When the difficulty of approximate arithmetic was taken into account, the performance in number line training group was not significantly different among three levels. However, two harder levels achieved significance in numerical comparison training group. Thus, comparing spatial representation ability, symbolic approximation arithmetic relies more on numerical magnitude. Educational implications of the study were discussed.

Keywords: approximate arithmetic, mental number line, numerical magnitude, preschooler

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Authors: Ashwaq Alsulami, Jianhua Shao

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Various organisations often need to understand discussions on social media, such as what trending topics are and characteristics of the people engaged in the discussion. A number of approaches have been proposed to extract attributes that would characterise a discussion group. However, these approaches are largely based on supervised learning, and as such they require a large amount of labelled data. We propose an approach in this paper that does not require labelled data, but rely on lexical sources to detect meaningful attributes for online discussion groups. Our findings show an acceptable level of accuracy in detecting attributes for Twitter discussion groups.

Keywords: attributed community, attribute detection, community, social network

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Authors: Venkata Buddharaju, Irene Mccarron, Hazel Alba

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Introduction: Male external catheters (MECs) are commonly used to collect and drain urine. MECs are increasingly used in acute care, long-term acute care hospitals, and nursing facilities, and in other patients as an alternative to invasive urinary catheters to reduce catheter-associated urinary tract infections (CAUTI).MECs are also used to avoid the need for incontinence pads and diapers. Most of the Male External Catheters are held in place by skin adhesive, with the exception of a few, which uses a foam strap clamp around the penile shaft. The adhesive condom catheters typically stay for 24 hours or less. It is also a common practice that extra skin adhesive tape is wrapped around the condom catheter for additional security of the device. The fixed nature of the adhesive will not allow the normal skin expansion of penile size over time. The adhesive can cause skin irritation, redness, erosion, and skin damage. Acanthus condom catheter (ACC) is a patented, specially designed, stretchable silicone catheter without adhesive, adapts to the size and contour of the penis. It is held in place with a single elastic strap that wraps around the lower back and tied to the opposite catheter ring holescriss cross. It can be reused for up to 5 days on the same patient after daily cleaning and washingpotentially reducing cost. Methods: The study was conducted from September 17th to October 8th, 2020. The nursing staff was educated and trained on how to use and reuse the catheter. After identifying five (5) appropriate patients, the catheter was placed and maintained by nursing staff. The data on the ease of use, leak, and skin damage were collected and reported by nurses to the nursing education department of the hospital for analysis. Setting: RML Chicago, long-term acute care hospital, an affiliate of Loyola University Medical Center, Chicago, IL USA. Results: The data showed that the catheter was easy to apply, remove, wash and reuse, without skin problems or urine infections. One patient had used for 16 days after wash, reuse, and replacement without any urine leak or skin issues. A minimal leak was observed on two patients. Conclusion: Acanthus condom catheter was easy to use, functioned well with minimal or no leak during use and reuse. The skin was intact in all patients studied. There were no urinary tract infections in any of the studied patients.

Keywords: CAUTI, male external catheter, reusable, skin adhesive

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Authors: Thomas Kipkurgat, Silahs Chemwaina

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Communication and ICT is a crucial component in realization of vision 2030, radio has played a key role in dissemination of information to mass audience. Since time immemorial, mass media has played a vital role in passing information on agricultural development issues both locally and internationally. This paper aimed at assessing the role of community radio stations in enhancing agricultural development in Kenya. The paper sought to identify the main contributions of KASS FM radio in the agricultural development especially in rural areas, the study also aimed to establish the appropriate adjustments in editorial policies of KASS FM radio in helping to promote agricultural development related programmes in rural areas. Despite some weaknesses in radio programming and the mode of interaction with the rural people, the findings of this study showed that the rural communities are better off today than in the old days when FM radios were non-existent. KASS FM has come up with different developmental programmes that have positively contributed to changing the rural people’s ways of life. These programmes include farming, health, marital values, environment, cultural issues, human rights, democracy, religious teachings, peace and reconciliation. Such programmes feature experts, professionals and opinion leaders who address numerous topics of interest to the community. The local people participate in the production of these programmes through letters to the editor, and phone-ins, among others. Programmes such as political talk shows, which feature in KASS FM, has become one of the most important ways of community participation. The interpretation and conclusions are based on the empirical data analysis and the theories of development advanced by international development communication scholars, as presented in the paper. The study ends with some recommendations on how KASS FM can best serve the interests of the poor people in rural areas, and helps improve their lives.

Keywords: agriculture, development, communication, KASS FM, radio, rural areas, Kenya

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Authors: N. F. Mikhailova, M. E. Fattakhova, M. A. Mironova, E. V. Vyacheslavova

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For the mental and social adaptation of the deaf and hard-of-hearing people, cultural and social aspects - the formation of identity (acculturation) and educational conditions – are highly significant. We studied 137 deaf and hard-of-hearing students in different educational situations. We used these methods: Big Five (Costa & McCrae, 1997), TRF (Becker, 1989), WCQ (Lazarus & Folkman, 1988), self-esteem, and coping strategies (Jambor & Elliott, 2005), self-stigma scale (Mikhailov, 2008). Type of self-identification of students depended on the degree of deafness, type of education, method of communication in the family: large hearing loss, education in schools for deaf, and gesture communication increased the likelihood of a 'deaf' acculturation. Less hearing loss, inclusive education in public school or school for the hearing-impaired, mixed communication in the family contributed to the formation of 'hearing' acculturation. The choice of specific coping depended on the degree of deafness: a large hearing loss increased coping 'withdrawal into the deaf world' and decreased 'bicultural skills' coping. People with mild hearing loss tended to cover-up it. In the context of ongoing discussion, we researched personality characteristics in deaf and hard on-hearing students, coping and other deafness associated factors depending on their acculturation type. Students who identified themselves with the 'hearing world' had a high self-esteem, a higher level of extraversion, self-awareness, personal resources, willingness to cooperate, better psychological health, emotional stability, higher ability to empathy, a greater satiety of life with feelings and sense and high sense of self-worth. They also actively used strategies, problem-solving, acceptance of responsibility, positive revaluation. Student who limited themselves within the culture of deaf people had more severe hearing loss and accordingly had more communication barriers. Lack of use or seldom use of coping strategies by these students point at decreased level of stress in their life. Their self-esteem have not been challenged in the specific social environment of the students with the same severity of defect, and thus this environment provided sense of comfort (we can assume that from the high scores on psychological health, personality resources, and emotional stability). Students with bicultural acculturation had higher level of psychological resources - they used Positive Reappraisal coping more often and had a higher level of psychological health. Lack of belonging to certain culture (marginality) leads to personality disintegration, social and psychological disadaptation: deaf and hard-of-hearing students with marginal identification had a lower self-estimation level, worse psychological health and personal resources, lower level of extroversion, self-confidence and life satisfaction. They, in fact, become 'risk group' (many of them dropped out of universities, divorced, and one even ended up in the ranks of ISIS). All these data argue the importance of cultural 'anchor' for people with hearing deprivation. Supported by the RFBR No 19-013-00406.

Keywords: acculturation, coping, deafness, marginality

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Authors: Mbuso Siwela

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Background: The Sub-Saharan Africa region has the greatest number of people eligible to receive antiretroviral treatment (ART). Multi-month Drug dispensing (MMD) of antiretroviral treatment (ART) aims to reduce patient-related barriers to access long-term treatment and improve health system efficiency. In Eswatini, however, few children and adolescents are on MMD. Young Heroes is implementing an HIV program that aims to avert new HIV infections in children and youth and improve treatment outcomes for children and adolescents living with HIV (C/ALHIV: 0-19 Years) and OVC caregivers with HIV prevention and impact mitigation interventions that prevent new HIV infections and reduce vulnerability. Aim of the study: The study aimed to ascertain factors that are associated with the assignment of the MMD model on C/ALHIVs. Methodology: The project provides treatment adherence support through well-trained community cadres (Home Visitors - HVs) at both community and health facility levels. During door-to-door visits, HVs track all C/ALHIV enrolled in the project monthly and refer any who might have stopped or interrupted treatment. C/ALHIV with unsuppressed viral load is supported through case conferencing and teen clubs. A quantitative cross-sectional analysis was conducted using STATA for children and adolescents living with HIV enrolled in the project. Bivariate analysis was conducted, and the Logistic Regression model was used to ascertain the effects of duration on ART on the choice of MMD model. Results: Data for 544 C/ALHIV (0-19 Years) was analyzed in STATA. Results show a strong association between (duration on ART, Age, being in teen club) and enrolment in an MMD model. Duration on ART is a major predictor for the choice of MMD model at (95% CI: 0.0012905 – 0.0039812; P = <0.0001). C/ALHIV who have been on ART for less than a year are less likely to be on MMD. C/ALHIVs who are 1 or more years on ART are more likely to be in 3 months dispensing, while those who are 5 years or more are most likely to be in 6 months model.

Keywords: C/ALHIV, OVC, HIV, treatment

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Authors: Gabriel I. Oke, Faremi O. Ayodeji

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Background: Access to youth Friendly Health Corners is vital for ensuring sexual reproductive health and total well being of young Adults since human sexuality has been widely misunderstood. Meanwhile, behavior of young people towards it remains at variance with the alarm. This study attempt to access the impact of youth corners also called Adolescent Friendly Health Corners on manifestation of human sexual behavior among Nigerian adolescent and young adults. Description: Hundred young adults and adolescents of both sex between the Age range of 12-25years were randomly selected from 5 secondary schools and 3 prominent universities in Southwestern Nigeria and focal group discussions (FGD) were conducted among them. Fifty secondary and primary health facilities were visited between February and June 2017 to conduct interviews for health workers and to ascertain the presence or absence of youth corners. Results: 95% of the health facilities visited lack Youth Corners section neither are they willing to make provision for it due to lack of workmanship and sponsorship. However, 5% with Youth corners does not have well-trained Counselors or a Health Educator but health professionals from nursing profession. 90% of the respondents of which 16-17 years of Age is the mean age had their first sexual exposure with no use of protection even before been introduced to what Sexuality is all about. Virtually, none of the respondents had ever visited a Youth Corner before or heard the term before. 86% have heard about the term STI before of which 60% are using protection, 10% care less about any information attached to the term STI, 4% have not heard of the term STI before even when translated to their local dialect. 20% are abstaining as at the time the study was conducted and they attribute their sexual decision to religion and parental influence. Of the age group 20-25, 45% claimed they have had symptoms of one STI or the other and 40% claimed they have been tested positive for an STI before of which 12% have positive HIV status. Promiscuous behaviors were found among them before they reach the age 16years with pornography ranking the highest, followed by masturbation. Respondents blame this on peer pressure, the lack of Youth Friendly Centers in their locality and lack of proper Sexual Orientation on time. About half of the respondents make use of contraceptives while others have varying views. We found out that inability to access Youth Friendly Centers amongst the respondents might be one of the singular reasons of their early experimentation of their sex life and lack of healthy sexual lifestyle. (95% CI, P=0.922) Conclusion: The study reveals that a connection between youth Friendly Centers and Prevention of Sexually Transmitted Diseases, therefore more sustainable Friendly Youth Corners with well-trained educators are needed in various Health facilities to checkmate the numerous risks of Young People along the path of adulthood.

Keywords: adolescents, sexually transmitted infections, reproductive health, youth corners

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Authors: Louiza C. Duncker, Duarte Gonçalves

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Wildlife crime is a complex problem with many interconnected facets, which are generally responded to in parts or fragments in efforts to “break down” the complexity into manageable components. However, fragmentation increases complexity as coherence and cooperation become diluted. A whole-of-society approach has been developed towards finding a common goal and integrated approach to preventing wildlife crime. As part of this development, research was conducted in rural communities adjacent to conservation areas in South Africa to define and comprehend the challenges faced by them, and to understand their perceptions of wildlife crime. The results of the research showed that the perceptions of community members varied - most were in favor of conservation and of protecting rhinos, only if they derive adequate benefit from it. Regardless of gender, income level, education level, or access to services, conservation was perceived to be good and bad by the same people. Even though people in the communities are poor, a willingness to stop rhino poaching does exist amongst them, but their perception of parks not caring about people triggered an attitude of not being willing to stop, prevent or report poaching. Understanding the nuances, the history, the interests and values of community members, and the drivers behind poaching mind-sets (intrinsic or driven by transnational organized crime) is imperative to create sustainable and resilient communities on multiple levels that make a substantial positive impact on people’s lives, but also conserve wildlife for posterity.

Keywords: community perceptions, conservation, rhino poaching, whole-of-society approach, wildlife crime

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Authors: Kunthida Kulprateepunya, Napat Boontiam, Bunthita Phuasa, Chatsuda Kankayant, Bantoeng Polsawat, Sumran Poontong

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Frailty is the thin line between good health and illness. The syndrome is more common in the elderly who transition from strong to weak. (Vulnerability). Fragility can prevent and promote healthy recovery before it goes into disability. This research and development aim to analyze the situation analysis of frailty of the elderly, develop a program, and evaluate the effect of a health promotion program to prevent and solve the problem of frailty among the elderly. The research consisted of 3 phases: 1) analysis of the frailty situation, 2) development of a model, 3) evaluation of the effectiveness of the model. Samples were 328, 122 elderlies using the multi-stage random sampling method. The research instrument was a frailty questionnaire use of the five symptoms, the main characteristics were muscle weakness, slow walking, low physical activity. Fatigue and unintentional weight loss, criteria frailty use more than or equal to three or more symptoms are frailty. Data were analyzed by descriptive and t-test dependent test statistics. The findings showed three parts. First, frailty in the elderly was 23.05 percentage and 56.70% pre-frailty. Second, it was development of a health promotion program to prevent and solve the problem of frailty the elderly with a combination of Nine-Square Exercise, Elastic Band Exercise, Elastic Coconut Shell. Third, evaluation of the effectiveness of the model by comparison of the elderly's get up and go test, the average time before using the program was 14.42 and after using the program was 8.57. It was statistically significant at the .05 level. In conclusion, the findings can used to develop guidelines to promote the health of the frailty elderly.

Keywords: elderly, fragile, nine-square exercise, elastic coconut shell

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Authors: F. Argurio, F. G. Vaccaro

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In a global environment defined by ever-increasing health issues, in spite of the progress made by modern medicine, this paper seeks to readdress the question of global health in an international relations perspective. The research hypothesis is: the lower the security environment, the higher the spread of communicable diseases. This question will be channeled by re-scaling the connotation of 'global' and 'international' dimension through the theoretical lens of glocalization, a theory by Bauman that starts its analysis from simple systems to get to the most complex ones. Glocalization theory will be operationalized by analyzing health in an armed-conflict context. In this respect, the independent variable 'low security environment' translates into the cases of Syria and Yemen, which provide a clear example of the all-encompassing nature of conflict on national health and the effects on regional development. In fact, Syria and Yemen have been affected by poliomyelitis and cholera outbreaks respectively. The dependent variable will be constructed on said communicable diseases which belong to the families of sanitation-related and vaccine-preventable diseases. The research will be both qualitative and quantitative, based on primary (interviews) and secondary (WHO and other NGO’s reports) sources. The methodology is based on the assessment of the vaccine coverage and case-analysis in time and space using epidemiological data. Moreover, local health facilities’ functioning and efficiency will be studied. The article posits that the intervention and cooperation of international organizations with the local authorities becomes crucial to provide the local populations with their primary health needs. In Yemen, the majority of fatal cholera cases were in the regions controlled by the Houthi rebels, not officially accredited by the International Community. Similarly, the polio outbreak in Syria primarily affected the areas not controlled by the Syrian Arab Republic forces, recognized as the leading interlocutor by the WHO. The jeopardized possibilities to access these countries have been pivotal to the determining the problem in controlling sanitation-related and vaccine preventable diseases. This represents a potential threat to global health.

Keywords: health in conflict-affected areas, cholera, polio, Yemen, Syria, glocalization

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Authors: Ann Dashwood

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Using standard Australian English with confidence is a cultural expectation of parents of primary school aged children who want to engage effectively with their children’s teachers and school administration. That confidence in support of their children’s learning at school is seldom experienced by parents whose first language is not English. Sharing language with competence in an intercultural environment is the common denominator for meaningful communication and engagement to occur in a school community. Experience in relevant interactive sessions is known to enhance engagement and participation. The purpose of this paper is to identify interactional settings for which parents who are isolated from the daily use of functional Australian cultural language learned to engage more effectively in their children’s learning at school. The outcomes measured parents’ intercultural engagement with classroom teachers and attention to the school’s administrative procedures. The study used quantitative and qualitative methods. The principles of communicative task-based language learning combined with intercultural communication principles provided the theoretical base for intensive English task-based learning and engagement. The quantitative analysis examined data samples collected by classroom teachers and administrators and parents’ writing samples. Interviews and observations qualitatively informed the study. Currently significant numbers of projects are active in community centres and schools to enhance English language knowledge of parents from Language Backgrounds Other Than English (LBOTE). The study was significant to explore the effects of conducting intensive English with parents of varied English language backgrounds by targeting language use for social interactions in the community, specific engagement in school activities, cultural interaction with teachers and responsiveness to complying with school procedures.

Keywords: engagement, intercultural communication, LBOTE, school community

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Authors: Save Kumwenda, Khumbo Kalulu, Kondwani Chidziwisano, Limbani Kalumbi, Vincent Doyle, Bagrey Ngwira

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Introduction: The Malawi Government in partnership with Non-Governmental Organizations adopted Community Led Total Sanitation (CLTS) in 2008 as an approach in sanitation and hygiene promotion with an aim of declaring Malawi Open Defeacation Free (ODF) by 2015. While there is a significant body of research into CLTS available in public domain, there is little research done on challenges faced in implementing CLTS in Malawi. Methods: A cross-sectional qualitative study was carried out in three districts of Ntcheu, Balaka, and Phalombe. Data was collected using Focus Group Discussions (FGDs) and Key informant interviews (KII) and analysed manually. Results: In total, 96 people took part in FGDs and 9 people in KII. It was shown that choice of leaders after triggering was commonly done by chiefs, facilitators, and VHC without following CLTS principles as opposed to identifying individuals who showed leadership skills. Despite capacity building initiatives involving District Coordinating Teams, lack of resources to undertake follow-ups contributed to failure to sustain ODF in the community. It was also found that while most respondents appreciating the need for no subsidies, the elderly and those with disabilities felt the need for external support because do not have money for buying strong logs, slabs for durable toilet floor and also to hire people to build latrines for them. Conclusion: Effective implementation of CLTS requires comprehensive consideration of various issues that may affect its success.

Keywords: open defecation, community-led, sanitation, faecal matter, hygiene, Malawi

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Authors: Karimeh Alnuaimi, Manal Kassab, Reem Ali, Khitam Mohammad, Kholoud Shattnawi

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Aim: To compare pregnancy outcomes of Syrian refugee women and Jordanian women. Background and introduction: The current conflict in Syria continues to displace thousands to neighboring countries, including Jordan. Pregnant refugee women are therefore facing many difficulties are known to increase the prevalence of poor reproductive health outcomes and antenatal complications. However, there is very little awareness of whether Syrian refugee women have different risks of pregnancy outcomes than Jordanian women. Methods: Using a retrospective cohort design, we examined pregnancy outcomes for Syrian refugee (N = 616) and Jordanian women (N = 644) giving birth at two governmental Hospitals in the north of Jordan, between January 1, 2014, and December 31, 2014. A checklist of 13 variables was utilized. The primary outcome measures were delivery by Caesarean section, maternal complications, low birth weight (< 2500 g), Apgar score and preterm delivery (< 37 weeks' gestational age). Results: Statistical analysis revealed that refugee mothers had a significant increase in the rate of cesarean section and the higher rate of anemia, a lower neonates’ weight, and Apgar scores when compared to their Jordanian counterparts. Discussion and Conclusion: Results were congruent with findings from other studies in the region and worldwide. Minimizing inequalities in pregnancy outcomes between Syrian refugees and Jordan women is a healthcare priority. Implications for nursing and health policy: The findings could guide the planning and development of health policies in Jordan that would help to alleviate the situation regarding refugee populations. The action is required by the policy makers, specifically targeting public and primary health care services, to address the problem of adequately meeting the need for antenatal care of this vulnerable population.

Keywords: pregnancy, Syrian refugee, Jordanian women, comparative study

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Authors: Pauline Calleja, Brooke Alexander

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In 2010 the College of Emergency Nursing Australasia (CENA) undertook sole administration of the Trauma Nursing Program (TNP) across Australia. The original TNP was developed from recommendations by the Review of Trauma and Emergency Services-Victoria. While participant and faculty feedback about the program was positive, issues were identified that were common for industry training programs in Australia. These issues included didactic approaches, with many lectures and little interaction/activity for participants. Participants were not necessarily encouraged to undertake deep learning due to the teaching and learning principles underpinning the course, and thus participants described having to learn by rote, and only gain a surface understanding of principles that were not always applied to their working context. In Australia, a trauma or emergency nurse may work in variable contexts that impact on practice, especially where resources influence scope and capacity of hospitals to provide trauma care. In 2011, a program review was undertaken resulting in major changes to the curriculum, teaching, learning and assessment approaches. The aim was to improve learning including a greater emphasis on pre-program preparation for participants, the learning environment and clinically applicable contextualized outcomes participants experienced. Previously if participants wished to undertake assessment, they were given a take home examination. The assessment had poor uptake and return, and provided no rigor since assessment was not invigilated. A new assessment structure was enacted with an invigilated examination during course hours. These changes were implemented in early 2012 with great improvement in both faculty and participant satisfaction. This presentation reports on a comparison of participant evaluations collected from courses post implementation in 2012 and in 2015 to evaluate if positive changes were sustained. Methods: Descriptive statistics were applied in analyzing evaluations. Since all questions had more than 20% of cells with a count of <5, Fisher’s Exact Test was used to identify significance (p = <0.05) between groups. Results: A total of fourteen group evaluations were included in this analysis, seven CENA TNP groups from 2012 and seven from 2015 (randomly chosen). A total of 173 participant evaluations were collated (n = 81 from 2012 and 92 from 2015). All course evaluations were anonymous, and nine of the original 14 questions were applicable for this evaluation. All questions were rated by participants on a five-point Likert scale. While all items showed improvement from 2012 to 2015, significant improvement was noted in two items. These were in regard to the content being delivered in a way that met participant learning needs and satisfaction with the length and pace of the program. Evaluation of written comments supports these results. Discussion: The aim of redeveloping the CENA TNP was to improve learning and satisfaction for participants. These results demonstrate that initial improvements in 2012 were able to be maintained and in two essential areas significantly improved. Changes that increased participant engagement, support and contextualization of course materials were essential for CENA TNP evolution.

Keywords: emergency nursing education, industry training programs, teaching and learning, trauma education

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Authors: Nopparet Thammasaranyakun

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This research objects are: 1: To study the biodiversity of medicinal plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province. 2: To study the use of medicinal plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province. 3: To provide a database of information on biodiversity for food and medicinal plants and medicinal tourism economies along the Phu Sing district Sisaket province. 4: Learn to create a biodiversity of medicinal plants used as food and treatment by Journeys economic Phu Sing district Sisaket province Boundaries used in this study was the Phu Sing district. Population and Agricultural Development Center, rayong Mun due to the initiative for youth Local, Government Health officials, community leaders, teachers, students, schools, the local people and tourists. Sage wisdom to know the herbs and women's groups, OTOP Phu Sing district in SiisaKet province. By selecting the specific data that way. The process of participatory action research (PAR) is a community-based research. The method of collecting qualitative data. (Qualitative) tool is used from context, Community areas, interview and Taped recordings. Observation and focus group data was statistically analyzed using descriptive statistics (Descriptive Statistics). The results findings: 1- A study of the biodiversity of plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province. Were used in the dry season and the rainy season find the medicinal plants of 251 species 41 types of drugs. 2- The study utilized medicinal plants used as food and the treatment of indigenous Phu Sing Sisaket province. Found 251 species have medicinal properties that are used for food and medicinal purposes 41 types of drugs. 3- Of the database technology of biodiversity for food and medicinal plants used by local treatment Phu Sing district Sisaket province. A data base of 251 medicinal species 41 types of drugs is used for food and medicinal properties Sisaket province. 4- learning the biodiversity of medicinal plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province.

Keywords: utilization of biodiversity, peaces herbals, used as Food, Sing district, sisaket

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Authors: Abdulsallam A. Bakdash, Aiyshah M. Alshehri, Hind M. Alenzi

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Benzatropine (benztropine) is used to treat symptoms of Parkinson's disease or involuntary movements due to the side effects of certain psychiatric drugs. We report in this study, results of a procedure for the determination of benzatropine in hair using LLE, once with methanol and second with phosphate buffer (pH 6.0), followed by filtration and then re-extraction with dichloromethane. A GC/MS method was developed and validated for this determination using selected ion monitoring (SIM) detection without derivatization. Linearity established over the concentration range 0.1-20.0 ng/mg hair, and the correlation coefficients were greater than 0.99. Recoveries were 52.2% and 21.1% using methanol and phosphate buffer extraction, respectively. Detection limits of benzatropine in hair were between 0.65 and 3.0 ng/mg hair, while the accuracy were 10.4% and 18.5% (RSD), respectively. We also applied this method to the analysis of soaked hair samples and demonstrated that the LLE using methanol meets the requirement for the analysis of benzatropine in hair.

Keywords: hair analysis, benzatropine, liquid-liquid extraction, GC/MS

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Authors: Glenda Wrenn, Juliet Muzere, Meldra Hall, Allyson Belton, Kisha Holden, Chanita Hughes-Halbert, Martha Kent, Bekh Bradley

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Understanding the help seeking decision making process and experiences of health disparity populations with posttraumatic stress disorder (PTSD) is central to development of trauma-informed, culturally centered, and patient focused services. Yet, little is known about the decision making process among adult Black women who are non-treatment seekers as they are, by definition, not engaged in services. Methods: Audiotaped interviews were conducted with 30 African American adult women with clinically significant PTSD symptoms who were engaged in primary care, but not in treatment for PTSD despite symptom burden. A qualitative interview guide was used to elucidate key themes. Independent coding of themes mapped to theory and identification of emergent themes were conducted using qualitative methods. An existing quantitative dataset was analyzed to contextualize responses and provide a descriptive summary of the sample. Results: Emergent themes revealed that active mental avoidance, the intermittent nature of distress, ambivalence, and self-identified resilience as undermining to help seeking decisions. Participants were stuck within the help-seeking phase of ‘recognition’ of illness and retained a sense of “it is my decision” despite endorsing significant social and environmental negative influencers. Participants distinguished ‘help acceptance’ from ‘help seeking’ with greater willingness to accept help and importance placed on being of help to others. Conclusions: Elucidation of the decision-making process from the perspective of non-treatment seekers has implications for outreach and treatment within models of integrated and specialty systems care. The salience of responses to trauma symptoms and stagnation in the help seeking recognition phase are findings relevant to integrated care service design and community engagement.

Keywords: culture, help-seeking, integrated care, PTSD

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Authors: Waqas Abrar

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Background: Pakistan is confronted with a formidable challenge to increase uptake of modern contraceptive methods. USAID, through its flagship Maternal and Child Survival Program (MCSP), in Pakistan is determined to support provincial Departments of Health and Population Welfare to increase the country's contraceptive prevalence rates (CPR) in Sindh, Punjab and Balochistan to achieve FP2020 goals. To inform program design and planning, a Rapid Situation Assessment (RSA) of family planning was carried out in Rawalpindi and Lahore districts in Punjab and Karachi district in Sindh. Methodology: The methodology consisted of comprehensive desk review of available literature and used a qualitative approach comprising of in-depth interviews (IDIs) and focus group discussions (FGDs). FGDs were conducted with community women, men, and mothers-in-law whereas IDIs were conducted with health facility in-charges/chiefs, healthcare providers, and community health workers. Results: Some of the oft-quoted reasons captured during desk review included poor quality of care at public sector facilities, affordability and accessibility in rural communities and providers' technical incompetence. Moreover, providers had inadequate knowledge of contraceptive methods and lacked counseling techniques; thereby, leading to dissatisfied clients and hence, discontinuation of contraceptive methods. These dissatisfied clients spread the myths and misconceptions about contraceptives in their respective communities which seriously damages community-level family planning efforts. Private providers were found reluctant to insert Intrauterine Contraceptive Devices (IUCDs) due to inadequate knowledge vis-à-vis post insertion issues/side effects. FGDs and IDIs unveiled multi-faceted reasons for poor contraceptives uptake. It was found that low education and socio-economic levels lead to low contraceptives uptake and mostly uneducated women rely on condoms provided by Lady Health Workers (LHWs). Providers had little or no knowledge about postpartum family planning or lactational amenorrhea. At community level family planning counseling sessions organized by LHWs and Male Mobilizers do not sensitize community men on permissibility of contraception in Islam. Many women attributed their physical ailments to the use of contraceptives. Lack of in-service training, job-aids and Information, Education and Communications (IEC) materials at facilities seriously comprise the quality of care in effective family planning service delivery. This is further compounded by frequent stock-outs of contraceptives at public healthcare facilities, poor data quality, false reporting, lack of data verification systems and follow-up. Conclusions: Some key conclusions from this assessment included capacity building of healthcare providers on long acting reversible contraceptives (LARCs) which give women contraception for a longer period. Secondly, capacity building of healthcare providers on postpartum family planning is an enormous challenge that can be best addressed through institutionalization. Thirdly, Providers should be equipped with counseling skills and techniques including inculcation of pros and cons of all contraceptive methods. Fourthly, printed materials such as job-aids and Information, Education and Communications (IEC) materials should be disseminated among healthcare providers and clients. These concluding statements helped MCSP to make informed decisions with regard to setting broad objectives of project and were duly approved by USAID.

Keywords: capacity building, contraceptive prevalence rate, family planning, Institutionalization, Pakistan, postpartum care, postpartum family planning services

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