Search results for: health services

Authors: Ingrid van der Heijden, Kristen Dunkle, Rachel Jewkes

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Background: Emerging literature on prevalence shows that men with disabilities are four more times likely than men without disabilities to experience sexual violence during their lifetime. However, compared to women with disabilities, men with disabilities still have lesser experiences of violence. While empirical evidence on the prevalence of victimization of men with disabilities is emerging, there is scarcer evidence highlighting disabled men’s perpetration of different forms of violence, particularly intimate partner violence. We can assume that men are likely to be both perpetrators and victims of violence, making more complex the causes and risks of violence. Gender norms and disability stigma play important roles in men’s experiences of violence. Men may be stigmatized because of their inability to attain hegemonic masculine ideals of strength, control over women and sexual conquest, which makes them more susceptible to emotional, physical and sexual abuse. Little to no evidence exists of men with disabilities’ experiences of perpetration of intimate partner violence, family violence or community violence. So far studies on male victimization do not succeed to offer contextual evidence that would highlight why and how men with disabilities perpetrate and/or are victims of sexual or other forms of violence. Objective: The overall aim to highlight men with disabilities’ experiences of both victimization and perpetration, and how living up to normative and hegemonic ideals of masculinity and ‘ability’ shape their experiences. It will include: identifying how gender and impairments intersect and shape their experiences of violence; identifying the contexts of and risks for violence; identifying the impacts and consequences of violence on their lives (including mental health impacts), and identifying obstacles and enablers to support and interventions to prevent violence. Methodology: In-depth qualitative interviews with 20 men with disabilities participating in interventions conducted by the What Works Global Programme for violence prevention (DIFD) in Africa and Asia. Men with a range of disabilities will be invited to share their lifetime experiences of violence. Implications for Practice: The data from this study will be used to start thinking about strategies to include men with disabilities in violence prevention strategies for both men and women. Limitations: Because men will be participating in interventions, it is assumed that they will not have severe impairments that hamper their cognitive or physical ability to participate in the intervention activities - and therefore will be able to participate in the in-depth interviews. Of course, this is a limitation of the study as it does not include those men with severe disabilities – measured by the World Health Organization’s International Classification of Functioning - who may be more vulnerable and at higher risk of experiencing violence, and who are less likely to be able to access services and interventions.

Keywords: gender, men with disabilities, perpetration of violence, victimization

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Authors: Orathai Srithongtham, Ubonsri Thabuddha

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The youth with HIV positive is not difference from the general youth in term of sexual needs. Sexual health is crucial the most to support the youth with HIV positive to be sexual well-being. This study aims to elucidate the sexual health on protection from STDs (Sexual Transmitted Diseases) and HIV transmission and to explain sexual risk behavior of the youth with HIV positive. The target group was the youth with HIV positive about 23 cases from two provinces in northeastern part of Thailand. Qualitative method was applied for collecting data by in-depth interview. Content analysis was use for data analysis. The youth with HIV positive was protection from STDs and HIV transmission by using the condom during sexual activity. The reason to deny the condom use were ashamed, condom is not a part of life, no have fit size, and the youth fear to stigmatized as a mental disorder and fear to stigmatized as going to fuck someone. The youth who trust with nurse in clinic was dare to request the condom by face. Sexual activity without condom use is sexual risk behavior. The major causes were couple trust and the sexual enjoyment first and sexual active competition with friend without condom use. The concern on HIV was the boyfriend or girlfriend not accepts the HIV positive people, worry about the HIV transmutation, and finally not compliance to ARV drug. The youth with HIV positive was lacking of the knowledge on sexual health on the issues of access to condom and the concern to keep on relationship with the boyfriend or girlfriend. This concern issues was led to the non-adherence of ARV drug and HIV distribution. To provide the sexual health service is more essential to the youth with HIV positive.

Keywords: sexual health, sexual risk behavior, youth, HIV

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Authors: Xiaowen Zhang, Wanda Luen-Wun Siu

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The paper reviews the insights gained in combating COVID-19 in the US, Japan, and China. After evaluation and investigation, we found that China’s and Japan’s experience of fighting COVID-19 is commendable. The Chinese government and the Japanese administration have implemented highly effective governance and public health course of action to fight COVID-19. Government-led epidemic control with a staunch belief in science can roll out effective pandemic control strategies. In contrast, the US failed to react to COVID-19 effectively. The relaxed public health measures of ending shutdowns prematurely were not working. When the US keeps business open after the spring shutdown, COVID-19 cases are soaring. Such experiences inform us effective governance and a mandatory and stricter approach can better curb a pandemic than milder measures in handling a public health emergency. And China and Japan, where collectivistic culture reins, can better maneuver a public health crisis with collective efforts.

Keywords: US, China, Japan, COVID-19

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Authors: W. R. M. Shehani Shanika

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Selling goods and services using images, names and personalities of celebrities has become a common marketing strategy identified in modern physical and online markets. Two concepts called globalization and open economy have given numerous reasons to develop businesses to earn higher profits. Therefore, global market plus domestic markets in various countries have vigorously endorsing images of famous sport stars, film stars, singing stars and cartoon characters for the purpose of increasing demand for goods and services rendered by them. It has been evident that these trade strategies have become a threat to famous personalities in financially and personally. Right to the image is a basic human right which celebrities owned to avoid themselves from various commercial exploitations. In this respect, this paper aims to assess whether the law relating to character merchandising satisfactorily protects right to image of celebrities. However, celebrities can decide how much they receive for each representation to the general public. Simply they have exclusive right to decide monetary value for their image. But most commonly every country uses law relating to unfair competition to regulate matters arise thereof. Legal norms in unfair competition are not enough to protect image of celebrities. Therefore, celebrities must be able to avoid unauthorized use of their images for commercial purposes by fraudulent traders and getting unjustly enriched, as their images have economic value. They have the right for use their image for any commercial purpose and earn profits. Therefore it is high time to recognize right to image as a new dimension to be protected in the legal framework of character merchandising. Unfortunately, to the author’s best knowledge there are no any uniform, single international standard which recognizes right to the image of celebrities in the context of character merchandising. The paper identifies it as a controversial legal barrier faced by celebrities in the rapidly evolving marketplace. Finally, this library-based research concludes with proposals to ensure the right to image more broadly in the legal context of character merchandising.

Keywords: brand endorsement, celebrity, character merchandising, intellectual property rights, right to image, unfair competition

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Authors: Fairuz Fadzilah Rahim

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Introduction: Indigenous adolescents are at higher risk of dog associated zoonotic infections (DAZI) as they live closely with free-roaming dogs and have limited access to veterinary care. This study aims to determine the effectiveness of health education interventions towards knowledge, attitudes, and preventive practices (KAP) of adolescents on DAZI. Methods: This one-group pre-and post-intervention study in 5 months period was conducted among Jahai adolescents aged 12 years and above. Jahai is one of the three major tribes of indigenous people in Peninsular Malaysia. Health education intervention programs using posters, slide presentations, comics, video clips, and discussion on DAZI were employed. Repeated measures of within-subjects analysis were used to identify the pre- and post- KAP of the adolescents. Results: There were 54 adolescents participated in this study with a mean age of 15.72 (SD: 2.49) and equal proportions of males (50%) and females (50%). Among the adolescents, 22.2% were married, 5.6% were illiterate, and 44.4% not continuing education at the time of data collection. The majority of them keep dogs as pets (64.8%), and few used dogs for hunting (11.1%). There was significant increase in mean scores of knowledge (F = 40.92, p < 0.001) and attitudes (F = 6.43, p = 0.014) of the adolescents. However, the preventive practices towards DAZI showed non-significant improvement on the intervention. Conclusions: The health education intervention programs showed to be effective in improving the attitudes and practices related to dog associated zoonotic infections. Emphasis on sustained health education programs is important to foster good health and wellbeing of the indigenous community.

Keywords: adolescent health, dog associated infection, zoonotic, KAP, indigenous

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Authors: E. M. Vieira, C. S. Vieira, L. P. Bonifácio, L. M. de Oliveira Ciabati, A. C. A. Franzon, F. S. Zaratini, J. A. C. Sanchez, M. S. Andrade, J. P. Dias de Souza

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The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20^th week of pregnancy up to 12^th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12^th and 24^th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.

Keywords: cellphone, health technology, prenatal care, prevention

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Authors: Chiung-Hui Chen

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Traditional service channel is losing its edge due to emerging service technology. To establish interaction with the clients, the service industry is using effective mechanism to give clients direct access to services with emerging technologies. Thus, as service science receives attention, special and unique consumption pattern evolves; henceforth, leading to new market mechanism and influencing attitudes toward life and consumption patterns. The market demand for customized services is thus valued due to the emphasis of personal value, and is gradually changing the demand and supply relationship in the traditional industry. In respect of interior design service, in the process of traditional interior design, a designer converts to a concrete form the concept generated from the ideas and needs dictated by a user (client), by using his/her professional knowledge and drawing tool. The final product is generated through iterations of communication and modification, which is a very time-consuming process. Although this process has been accelerated with the help of computer graphics software today, repeated discussions and confirmations with users are still required to complete the task. In consideration of what is addressed above a space user’s life model is analyzed with visualization technique to create an interaction system modeled after interior design knowledge. The space user document intuitively personal life experience in a model requirement chart, allowing a researcher to analyze interrelation between analysis documents, identify the logic and the substance of data conversion. The repeated data which is documented are then transformed into design information for reuse and sharing. A professional interior designer may sort out the correlation among user’s preference, life pattern and design specification, thus deciding the critical design elements in the process of service design.

Keywords: information design, life model-based, aesthetic computing, communication

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Authors: C. John Thomas, Sabitha Jannet

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The review concentrates on mental health wellbeing at workplace to create a safe work environment. The purpose of the study is to find the existing gaps in occupational health in the manufacturing sector. Mental wellbeing is important because it is an essential component of human life and influences our emotions, attitudes, and feelings. In the workplace, mental wellbeing can encourage a culture of safety and avoid accidents. An environment where individuals are comfortable voicing themselves and being themselves. More technically, when individuals have psychological protection at work, without regard for humiliation or punishment, they feel relaxed expressing complaints and errors. They are sure they are going to speak up and not humiliate, neglect, or accuse them. Once they are uncertain about something, they know they are going to ask questions. They are inclined to trust their colleagues and respect them. The reviews were considered through keywords and health-related topics. There are different characteristics of mental wellbeing in the literature and how it impacts the workplace. There is also a possibility that their personal lives will have an impact. In every occupation, however, there is widespread acknowledgment that psychosocial hazards are an important health risk for workers, yet in many workplaces, the focus remains on physical hazards. It is alleged that the understating of workplace psychosocial hazards is primarily due to the perception that they present a more difficult and complex challenge when compared to other health and safety issues. Others, however, allege it is the paucity of awareness about psychosocial hazards and their alleviation that explains their relative neglect. The other researchers focused that following global trends, it is believed that psychosocial hazards must be minimized within our workplaces and that there is a requirement for workplace interventions to reduce psychological harm and promote mental health for all the workman employees to achieve zero harm. In common, this literature review compares various results of the individual studies on their research methods and finding to fill gaps.

Keywords: mental health wellbeing, occupational health, psychosocial hazards, safety culture, safety management systems, workman employee, workplace safety

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Authors: Flavia Oliveira de A. M. Cruz, Edison Tostes Faria, Paula Elaine D. Reis

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When the breast is submitted to radiation therapy (RT), the most common effects are pain, skin changes, mobility restrictions, local sensory alteration, and fatigue. These effects, if not managed properly, may reduce the quality of life of cancer patients and may lead to the treatment discontinuation. Therefore, promoting knowledge and guidelines for symptom management remain a high priority for patients and a challenge for health professionals, due to the need to handle side effects in a population with a life-threatening disease. Printed materials are important strategies for supporting educative activities since they help the individual to assimilate and understand the amount of information transmitted. Nurses' behavior can be systematized through the use of an educative manual, which may be effective in promoting information regarding the treatment, self-care and how to control the effects of RT at home. In view of the importance of guaranteeing the validity of the material before its use, the objective of this research was to validate the content and appearance of an educative manual for breast cancer patients undergoing RT. The Theory of Psychometrics was used for the validation process in this descriptive methodological research. A minimum agreement rate (AR) of 80% was considered to guarantee the validity of the material. The data were collected from October to December 2017, by means of two assessments tools, constructed in the form of a Likert scale, with five levels of understanding. These instruments addressed different aspects of the evaluation, in view of two different groups of participants; 17 experts in the theme area of the educative manual, and 12 women that received RT previously to treat breast cancer. The manual was titled 'Orientation Manual: radiation therapy in breast', and was focused on breast cancer patients attended at the Department of Oncology of the Brasília University Hospital (UNACON/HUB). The research project was submitted to the Research Ethics Committee at the School of Health Sciences of the University of Brasília (CAAE: 24592213.1.0000.0030). Only two items of the assessment tool for the experts, one related to the manual's ability to promote behavioral and attitude changes and the other related to the extent of its use for other health services, obtained AR < 80% and were reformulated based on the participants' suggestions and in the literature. All other items were considered appropriate and/or complete appropriate in the three blocks proposed for the experts: objectives - 89%, structure and form - 93%, and relevance - 93%; and good and/or very good in the five blocks of analysis proposed for patients: objectives - 100%, organization - 100%, writing style - 100%, appearance - 100%, and motivation. The appearance and content validation of the educative manual proposed were attended to. The educative manual was considered relevant and pertinent and may contribute to the understanding of the therapeutic process by breast cancer patients during RT, as well as support clinical practice through the nursing consultation.

Keywords: oncology nursing, nursing care, validation studies, educational technology

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Authors: Arnesh Vijay

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Ever since its early introduction in the late 1980s, the mobile industry has been rapidly evolving with each passing year. The development witnessed is not just in its ability to support diverse applications, but also its extension into diverse technological means to access and offer various services to users. Amongst the various technologies present, radio systems have clearly emerged as a strong contender, due to its fine attributes of accessibility, reachability, interactiveness, and cost efficiency. These advancements have no doubt guaranteed unprecedented ease, utility and sophistication to the cell phone users, but caused uncertainty due to the interdependence of various systems, making it extremely complicated to exactly map concepts on to 3GPP (3rd Generation Partnership Project) standards. Although the close interrelation and interdependence of intellectual property rights and mobile standard specifications have been widely acknowledged by the technical and legal community; there, however, is a requirement for clear distinction between the scope and future-proof of inventions to influence standards and its market place adoptability. For this, collaborative work is required between intellectual property professionals, researchers, standardization specialists and country specific legal experts. With the evolution into next generation mobile technology, i.e., to 5G systems, there is a need for further work to be done in this field, which has been felt now more than ever before. Based on these lines, this poster will briefly describe the importance of intellectual property rights in the European market. More specifically, will analyse the role played by intellectual property in various standardization institutes, such as 3GPP (3rd generation partnership project) and ITU (International Telecommunications Union). The main intention: to ensure the scope and purpose is well defined, and concerned parties on all four sides are well informed on the clear significance of good proposals which not only bring economic revenue to the company but those that are capable of improving the technology and offer better services to mankind. The poster will comprise different sections. The first segment begins with a background on the rapidly evolving mobile technology, with a brief insight on the industrial impact of standards and its relation to intellectual property rights. Next, section two will succinctly outline the interplay between patents and standards; explicitly discussing the ever changing and rapidly evolving relationship between the two sectors. Then the remaining sections will examine ITU and its role played in international standards development, touching upon the various standardization process and the common patent policies and related guidelines. Finally, it proposes ways to improve the collaboration amongst various sectors for a more evolved and sophisticated next generation mobile telecommunication system. The sole purpose here is to discuss methods to reduce the gap and enhance the exchange of information between the two sectors to offer advanced technologies and services to mankind.

Keywords: mobile technology, mobile standards, intellectual property rights, 3GPP

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Authors: Tara Hunter, Kristine Concepcion, Wendy Cheng, Brianna Pike, Jane Estoesta, Anne Stuart

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In 2015, Family Planning NSW was contracted by the NSW Ministry of Health to design and deliver Sexual Safety Policy training (SSPT) to mental health professionals across NSW. The training was based on their current guidelines and developed in consultation with an expert reference group. From October 2015 to April 2017 it was delivered to over 2,400 mental health professionals with a view to supporting implementation of consistent prevention and intervention related to sexual safety in the mental health setting. An evaluation was undertaken to determine the knowledge and confidence of participants related to sexual safety before and after the training, and whether any improvements were translated into changes in practice. Participants were invited to complete a survey prior to the training, upon completion and three to six months thereafter. Telephone interviews were conducted among service managers and mental health champions six months post-training. Prior to training, the majority of mental health professionals reported being slightly to moderately confident in identifying a sexual safety incident. When asked on their understanding of sexual safety, gender sensitive practice and trauma informed care, they reported no confidence, slight confidence and moderate confidence. Immediately after the training, 54.5% reported being very confident and 10.9% extremely confident in identifying a sexual safety incident. More than half felt very confident or extremely confident in their understanding of sexual safety principles. The impact survey (six months later) found that the majority of participants (91%) were highly confident in identifying a sexual safety incident. Telephone interviewees reported a change in workplace culture and increased awareness after the training. Mental health professionals experienced increased knowledge and confidence about sexual safety principles following the training and were able to implement positive changes and concrete actions to better address sexual safety issues in their workplace.

Keywords: sexual safety, mental health professionals, trauma informed care, policy training

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Authors: Jiayue Guo, Lili You

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Background: Children and adolescent health are crucial for both personal well-being and the nation's future health landscape. Health Literacy (HL) is important in enabling adolescents to self-manage their health, a fundamental step towards health empowerment. However, there are limited tools for assessing HL among elementary and junior high school students. This study aims to construct and validate a test-based HL scale for Chinese students, offering a scientific reference for cross-cultural HL tool development. Methods: We conducted a cross-sectional online survey. Participants were recruited from a stratified cluster random sampling method, a total of 4189 Chinese in-school primary and secondary students. The development of the scale was completed by defining the concept of HL, establishing the item indicator system, screening items (7 health content dimensions), and evaluating reliability and validity. Delphi method expert consultation was used to screen items, the Rasch model was conducted for quality analysis, and Cronbach’s alpha coefficient was used to examine the internal consistency. Results: We developed four versions of the HL scale, each with a total score of 100, encompassing seven key health areas: hygiene, nutrition, physical activity, mental health, disease prevention, safety awareness, and digital health literacy. Each version measures four dimensions of health competencies: knowledge, skills, motivation, and behavior. After the second round of expert consultation, the average importance score of each item by experts is 4.5–5.0, and the coefficient of variation is 0.000–0.174. The knowledge and skills dimensions are judgment-based and multiple-choice questions, with the Rasch model confirming unidimensionality at a 5.7% residual variance. The behavioral and motivational dimensions, measured with scale-type items, demonstrated internal consistency via Cronbach's alpha and strong inter-item correlation with KMO values of 0.924 and 0.787, respectively. Bartlett's test of sphericity, with p-values <0.001, further substantiates the scale's reliability. Conclusions: The new test-based scale, designed to evaluate competencies within a multifaceted framework, aligns with current international adolescent literacy theories and China's health education policies, focusing not only on knowledge acquisition but also on the application of health-related thinking and behaviors. The scale can be used as a comprehensive tool for HL evaluation and a reference for other countries.

Keywords: adolescent health, Chinese, health literacy, rasch model, scale development

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Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

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Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

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Authors: S. Vadivukkarasi, K. Karthi, M. Karthick, C. Dinesh, S. Santhosh, A. Yogaraj

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The appointment system was designed to minimize patient’s idle time overlooking patients waiting time in hospitals. This is no longer valid in today’s consumer oriented society. Long waiting times for treatment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Queuing theory constitutes a very powerful tool because queuing models require relatively little data and are simple and fast to use. Because of this simplicity and speed, modelers can be used to quickly evaluate and compare various alternatives for providing service. The application of queuing models in the analysis of health care systems is increasingly accepted by health care decision makers. Timely access to care is a key component of high-quality health care. However, patient delays are prevalent throughout health care systems, resulting in dissatisfaction and adverse clinical consequences for patients as well as potentially higher costs and wasted capacity for providers. Arguably, the most critical delays for health care are the ones associated with health care emergencies. The allocation of resources can be divided into three general areas: bed management, staff management, and room facility management. Effective and efficient patient flow is indicated by high patient throughput, low patient waiting times, a short length of stay at the hospital and overtime, while simultaneously maintaining adequate staff utilization rates and low patient’s idle times.

Keywords: appointment system, patient scheduling, bed management, queueing calculation, system analysis

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Authors: Levent Dumenci, Laura A. Siminoff

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Health literacy has been shown to predict a variety of health outcomes. Reliable identification of persons with limited cancer health literacy (LCHL) has been proved questionable with existing instruments using an arbitrary cut point along a continuum. The CHLT-6, however, uses a latent mixture modeling approach to identify persons with LCHL. The purpose of this study was to estimate two-week and six-month stability of identifying persons with LCHL using the CHLT-6 with a discrete latent variable approach as the underlying measurement structure. Using a test-retest design, the CHLT-6 was administered to cancer patients with two-week (N=98) and six-month (N=51) intervals. The two-week and six-month latent test-retest agreements were 89% and 88%, respectively. The chance-corrected latent agreements estimated from Dumenci’s latent kappa were 0.62 (95% CI: 0.41 – 0.82) and .47 (95% CI: 0.14 – 0.80) for the two-week and six-month intervals, respectively. High levels of latent test-retest agreement between limited and adequate categories of cancer health literacy construct, coupled with moderate to good levels of change-corrected latent agreements indicated that the CHLT-6 classification of limited versus adequate cancer health literacy is relatively stable over time. In conclusion, the measurement structure underlying the instrument allows for estimating classification errors circumventing limitations due to arbitrary approaches adopted by all other instruments. The CHLT-6 can be used to identify persons with LCHL in oncology clinics and intervention studies to accurately estimate treatment effectiveness.

Keywords: limited cancer health literacy, the CHLT-6, discrete latent variable modeling, latent agreement

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Authors: Arif Tri Setyanto, Aditya Nanda Priyatama, Nugraha Arif Karyanta, Fadjri Kirana A., Afia Fitriani, Rini Setyowati, Moh.Abdul Hakim

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The Basic Health Research Report by the Ministry of Health (2018) shows an increase in the prevalence of mental health disorders in the adolescent and early adult age ranges. Supporting this finding, data on the psychological examination of the student health service unit at one State University recorded 115 cases of moderate and severe health problems in the period 2016 - 2019. More specifically, the highest number of cases was experienced by clients in the age range of 21-23 years or equivalent, with the mid-semester stage towards the end. Based on the distribution of cases experienced and the disorder becomes a psychological problem experienced by students. A total of 29% or the equivalent of 33 students experienced anxiety disorders, 25% or 29 students experienced problems ranging from mild to severe, as well as other classifications of disorders experienced, including adjustment disorders, family problems, academics, mood disorders, self-concept disorders, personality disorders, cognitive disorders, and others such as trauma and sexual disorders. Various mental health disorders have a significant impact on the academic life of students, such as low GPA, exceeding the limit in college, dropping out, disruption of social life on campus, to suicide. Based on literature reviews and best practices from universities in various countries, one of the effective ways to prevent and treat student mental health disorders is to implement a mental health monitoring system in universities. This study uses a participatory action research approach, with a sample of 423 from a total population of 32,112 students. The scale used in this study is the Beck Depression Inventory (BDI) to measure depression and the Taylor Minnesota Anxiety Scale (TMAS) to measure anxiety levels. This study aims to (1) develop a digital-based health monitoring system for students' mental health situations in the mental health category. , dangers, or those who have mental disorders, especially indications of symptoms of depression and anxiety disorders, and (2) implementing a mental health monitoring system in universities at the beginning and end of each semester. The results of the analysis show that from 423 respondents, the main problems faced by all coursework, such as thesis and academic assignments. Based on the scoring and categorization of the Beck Depression Inventory (BDI), 191 students experienced symptoms of depression. A total of 24.35%, or 103 students experienced mild depression, 14.42% (61 students) had moderate depression, and 6.38% (27 students) experienced severe or extreme depression. Furthermore, as many as 80.38% (340 students) experienced anxiety in the high category. This article will review this review of the student mental health service system on campus.

Keywords: monitoring system, mental health, psychological problems, students

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Authors: Soundarya Lahari Vedula

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Dalit women make up a significant portion of the Indian population. However, they are victims of age old discrimination. This paper presents a brief background of the Indian caste system which is a hierarchical division placing Dalits at the lowest rank. Dalits are forced to perform menial and harsh tasks. They often face social ostracism. The situation of Dalit women is of unique significance as they face triple discrimination due to their caste, gender, and class. Dalit women are strictly withheld by the rigid boundaries of the caste system. They are discriminated at every stage of their life and are denied access to public places, education and healthcare facilities among others. They face the worst forms of sexual violence. In spite of legislations and international conventions in place, their plight is not adequately addressed. This paper discusses, in brief, the legal mechanism in place to prohibit untouchability. Furthermore, this paper details on the specific human rights violations faced by Dalit women in the social, economic and political spheres. The violations range from discrimination in public places, denial of education and health services, sexual exploitation and barriers to political representation. Finally, this paper identifies certain lacunae in the existing Indian statutes and broadens on the measures to be taken to improve the situation of Dalit women. This paper offers some recommendations to address the plight of Dalit women such as amendments to the existing statutes, effective implementation of legal mechanisms and a more meaningful interpretation of the international conventions.

Keywords: Dalit, caste, class, discrimination, equality

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Authors: Abrar Almutairi, Alyaa Farouk, Amal Gouda

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Background: Social capital is a factor that helps in bonding in a social network. The individual and the neighborhood social capital affect the health status of members of a particular society. In addition, to the influence of social health on the health of the population, social health has a significant effect on women, especially those with pregnancy. Study objective was to assess the impact of the social capital on the health status of pregnant women Design: A descriptive crosssectional correlational design was utilized in this study. Methods: A convenient sample of 210 pregnant women who attended the outpatient antenatal clinicsfor follow-up in King Fahad hospital (Ministry of National Guard Health Affairs/Riyadh) and King Abdullah bin Abdelaziz University Hospital (KAAUH, Ministry of Education /Riyadh) were included in the study. Data was collected using a self-administered questionnaire that was developed by the researchers based on the “World Bank Social Capital Assessment Tool” and SF-36 questionnaire (Short Form Health Survey). The questionnaire consists of 4 parts to collect information regarding socio-demographic data, obstetric and gynecological history, general scale of health status and social activity during pregnancy and the social capital of the study participants, with different types of questions such as multiple-choice questions, polar questions, and Likert scales. Data analysis was carried out by using Statistical Package for the Social Sciences version 23. Descriptive statistic as frequency, percentage, mean, and standard deviation was used to describe the sample characteristics, and the simple linear regression test was used to assess the relationship between the different variables, with level of significance P≤0.005. Result: This study revealed that only 31.1% of the study participants perceived that they have good general health status. About two thirds (62.8%) of the participants have moderate social capital, more than one ten (11.2٪) have high social capital and more than a quarter (26%) of them have low social capital. All dimensions of social capital except for empowerment and political action had positive significant correlations with the health status of pregnant women with P value ranging from 0.001 to 0.010in all dimensions. In general, the social capital showed high statistically significant association with the health status of the pregnant (P=0.002). Conclusion: Less than one third of the study participants had good perceived health status, and the majority of the study participants have moderate social capital, with only about one ten of them perceived that they have high social capital. Finally, neighborhood residency area, family size, sufficiency of income, past medical and surgical history and parity of the study participants were all significantly impacting the assessed health domains of the pregnant women.

Keywords: impact, social capital, health status, pregnant women

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Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee

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Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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Authors: S. N. Susenburger, D. Boecker

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In the age of Volatility, Uncertainty, Complexity, and Ambiguity (VUCA), where digital transformation is challenging long standing traditional hardware and manufacturing companies, innovation needs a different methodology, strategy, mindset, and culture. What used to be a mindset of scaling per quantity is now shifting to orchestrating ecosystems, platform business models and service bundles. While large corporations are trying to mimic the nimbleness and versatile mindset of startups in the core of their digital strategies, they’re at the frontier of facing one of the largest organizational and cultural changes in history. This paper elaborates on how a manufacturing giant transformed its Corporate Information Technology (IT) to enable digital and Internet of Things (IoT) business while establishing the mindset and the approaches of the Innovation Inside-Out/Outside-In Strategy. It gives insights into the core elements of an innovation culture and the tactics and methodologies leveraged to support the cultural shift and transformation into an IoT company. This paper also outlines the core elements for an innovation culture and how the persona 'Connected Engineer' thrives in the digital innovation environment. Further, it explores how tapping domain-focused ecosystems in vibrant innovative cities can be used as a part of the strategy to facilitate partner co-innovation. Therefore, findings from several use cases, observations and surveys led to conclusion for the strategy tandem of Innovation Inside-Out/Outside-In. The findings indicate that it's crucial in which phases and maturity level the Innovation Inside-Out/Outside-In Strategy is activated: cultural aspects of the business and the regional ecosystem need to be considered, as well as cultural readiness from management and active contributors. The 'not invented here syndrome' is a barrier of large corporations that need to be addressed and managed to successfully drive partnerships, as well as embracing co-innovation and a mindset shifting away from physical products toward new business models, services, and IoT platforms. This paper elaborates on various methodologies and approaches tested in different countries and cultures, including the U.S., Brazil, Mexico, and Germany.

Keywords: innovation management, innovation culture, innovation methodologies, digital transformation

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Authors: Teresa Isabel Lozano Pérez, Sandra Soca Lozano

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In Cuba, the childcare is one of the programs prioritized by the Ministry of Public Health and the birth of a child becomes a desired and rewarding event for the family, which is prepared for the reception of a healthy child. When this does not happen and after the first months of the child's birth begin to appear developmental deviations that indicate the presence of a disorder, the event becomes a live event potentially negative and generates disruptions in the family health. A quantitative, descriptive, and cross-sectional research methodology was conducted to describe the impact on family health of diagnosis of autism in a sample of 25 families of children diagnosed with infantile autism at the University Pediatric Hospital Juan Manuel Marquez Havana, Cuba; in the period between January 2014 and May 2015. The sample was non probabilistic and intentional from the inclusion criteria selected. As instruments, we used a survey to identify the structure of the family, life events inventory and an instrument to assess the relative impact, adaptive resources of family and social support perceived (IRFA) to identify the diagnosis of autism as life event. The main results indicated that the majority of families studied were nuclear, small and medium and in the formation stage. All households surveyed identified the diagnosis of autism in a child as an event of great importance and negative significance for the family, taking in most of the families studied a high impact on the four areas of family health and impact enhancer of involvement in family health. All the studied families do not have sufficient adaptive resources to face this situation, sensing that they received social support frequently, mainly in information and emotional areas. We conclude that the diagnosis of autism one of the members of the families studied is valued as a life event highly significant with unfavorably way causing an enhancer impact of involvement in family health especially in the areas ‘health’ and ‘socio-psychological’. Among the social support networks health institutions, partners and friends are highlighted. We recommend developing intervention strategies in families of these children to support them in the process of adapting the diagnosis.

Keywords: family, family health, infantile autism, life event

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Authors: Terry Gomez

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This interpretive phenomenological qualitative study explored potential risks related to infant mental health with parental smartphone use while caring for infants. Data were collected through nine online interviews of first-time parents with infants under one-year-old. All parents reported using their smartphone during child-bonding activities such as playtime, feeding, and sleep-time. Results indicated that smartphone distractions appear to influence the synchrony of parent-child interactions. Infants displayed physical, verbal, or emotional reactions to parents’ smartphone distractions, indicating that smartphone use influences infants’ behaviors. Parents shared information on how smartphones helped them with their transition into parenthood. The findings of this study provide insights helpful to inform infant mental health professionals and parents about potential developmental consequences associated with parental technoference and absent presence.

Keywords: absent presence, infant mental health, parental distractions, smartphones, technoference

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Authors: Tabussam Tufail

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Purpose: The core purpose of the current review article is to elaborate the phytochemicals present in turnip (brassica rapus l.) and also allied health claims. Plant-based foods contain a significant amount of bioactive compounds which provide desirable health benefits beyond the basic nutrition. Epidemiological evidence suggests that consumption of a diet rich in vegetables and fruits has positive implications for human health. Design: Potential of turnip peroxidase (TP) for the treatment of phenolic-contaminated solutions has been reviewed. However, issues of taste along with behavioral nutrition ought to be considered. So in the last decades, special attention has been paid towards edible plants, especially those that are rich in secondary metabolites (frequently called phytochemicals) and nowadays, there is an increasing interest in the antioxidant activity of such phytochemicals present in the diet. These chemicals favor nutritional and phytotherapy that is emerging as new concepts of health aid in recent years. Turnip is rich in these valuable ingredients though it can be employed as having health promoting and healing properties. Findings: Numerous bioactive components i.e. organic acids, phenolic compounds, turnip peroxidase, kaempeferol, vitamin-K, etc. are present in turnip. The review focused on the significance of plant derived (especially turnip) phenolic compounds as a source of certain beneficial compounds for human health. Owing to the presence of bioactive moieties, the turnip has high antioxidant activity, positive role in blood clotting, effectual in phenobarbital-induced sleeping time, effective against hepatic injury in diabetics and also have a good hepatoprotective role. Strong recommendations for consumption of nutraceuticals from turnip have become progressively popular to improve health, and to prevent from diseases.

Keywords: phytochemicals, turnip, antioxidants, health benefits

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Authors: Supranee Sittikan, Darunee Jongudomkarn, Rutja Phuphaibul

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Thai’s families with disabilities are diverse, poor economy, low education disproportionately characterized their living that includes stress and suffering. This article reports a preliminary study using a qualitative case study with six disabilities (five physical and one mental problem) Their six family caregivers who perceived they were managing well with their conditions as well. Data were collected by in-depth interviews during November-December 2017 in North-East of Thailand. Preliminary results were found factors of moving in comprised of three themes as followings Karma: the families believe that the disability happened because of bad-karma which attached to them. From the reason, the members of families have to deserve and accept it. Family attachment: the families believe in the importance of being the family so they have to take good care in one another whether happy or suffering Community support: the families can get more to received helping hands from local health care providers and community health volunteers. These activities are very important to be representative in taking the families through health accessibility, which help them face with disabling problems. Nevertheless, the study needs further exploring on other families’ and health care team's perspective in larger scales leading to develop an appropriate health care service system which can support and promote the well-being of the families living with disabilities in the future.

Keywords: families with disabilities, Karma, family attachment, community support

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Authors: Naiara Ozamiz Etcebarria, Sonia Ruiz De Azua Garcia, Agurtzane Ortiz Jauregi, Virginia Guillen Cañas

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Introduction: The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes´ improvement and efficiency of health services. The ability of Active listening , empathy, assertiveness and social skills, are important abilities to develop in all professions in which there is a relationship with other people. In the field of health, it is even more important to have adequate qualities so that the treatment with the patient will be adequate and satisfactory. We conducted a research with students of third year in the Degree of Medicine with the objectives: - to know how the active listening, empathy, assertiveness and social skills of students are. - to know if there are differences according to different demographic variables, such as sex, language, age, number of siblings and interest in the subject. Material and Methods: The students of the Third year in the Degree of Medicine (N = 212) participated voluntarily. Sociodemographic data were collected. Descriptive and comparative analysis of the averages of the students with respect to active listening, empathy, assertiveness and social skills were performed. Once the questionnaires were collected, they were entered into the SPSS 21 database. Four communicational aspects were evaluated: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. The active listening questionnaire assesses these factors: Listening without interruption and less contradiction, Listening with 100% attention, Listening beyond words, Listening encouraging the other to go deeper. The TECA questionnaire of cognitive and affective empathy evaluates: Adoption of perspectives, Emotional Comprehension, Emphasizing stress, Empathic joy. The EHS questionnaire Social Skills Scale: Self-expression in social situations, Defending one's own rights as a consumer, Expressing anger or dissatisfaction, Refusing to do and cutting interactions off, Making requests, Initiating positive interactions with the other sex. The ACDA questionnaire Assertiveness Assessment Scale evaluates self-assertiveness and heteroaservitivity. Applicability: To train these skills is so important for clinical practice of medical students and these capabilities that can be measured in a longitudinal way time. Ethical-legal aspects: The data were anonymous. The study was approved by the Ethics Committee. Results: The students of the Third year in the Degree of Medicine (34.4% Basque speakers and 65.6% Spanish speakers) with average age 20.93, (27.8% men and 72.2% women). There are no differences in social skills between men and women. The Basque speaker students of are more heteroactive (ACDA) than Spanish students. Active listening has a high correlation with social skills, especially with self-expression in social situations. Listening without interruption has a high correlation with self-expression in social situations and initiating positive interactions with the opposite sex. Adoption of perspectives presents a high correlation with auto- assertiveness. Emotional understanding presents a high correlation with positive interactions with the opposite sex. Empathic joy correlates with self-assertiveness, self-expression in social situations, and initiating positive interactions with the opposite sex.

Keywords: active listening, assertiveness, communicational skills, empathy, students of medicine

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Authors: M. S. Aparna, Pushparaj Shetty D.

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Nowadays social networking sites have become so popular that the producers or the sellers look for these sites as one of the best options to target the right audience to market their products. There are several tools available to monitor or analyze the social networks. Our task is to identify the right community web pages and find out the behavior analysis of the members by using these tools and formulate an appropriate strategy to market the products or services to achieve the set goals. The advertising becomes more effective when the information of the product/ services come from a known source. The strategy explores great buying influence in the audience on referral marketing. Our methodology proceeds with critical budget analysis and promotes viral influence propagation. In this context, we encompass the vital bits of budget evaluation such as the number of optimal seed nodes or primary influential users activated onset, an estimate coverage spread of nodes and maximum influence propagating distance from an initial seed to an end node. Our proposal for Buyer Prediction mathematical model arises from the urge to perform complex analysis when the probability density estimates of reliable factors are not known or difficult to calculate. Order Statistics and Buyer Prediction mapping function guarantee the selection of optimal influential users at each level. We exercise an efficient tactics of practicing community pages and user behavior to determine the product enthusiasts on social networks. Our approach is promising and should be an elementary choice when there is little or no prior knowledge on the distribution of potential buyers on social networks. In this strategy, product news propagates to influential users on or surrounding networks. By applying the same technique, a user can search friends who are capable to advise better or give referrals, if a product interests him.

Keywords: viral marketing, social network analysis, community web pages, buyer prediction, influence propagation, budget constraints

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Authors: Siti Napsiyah, Ismet Firdaus, Lisma Dyawati Fuaida, Ellies Sukmawati

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This paper examines the existence, role, and challenge of Family Service Agency, in Bahasa Indonesia known as Lembaga Konsultasi Kesejahteraan Keluarga (LK3) of Syarif Hidayatullah State Islamic University (UIN) Jakarta. It has been established since 2012. It is an official agency under the Ministry of Social Affairs of Indonesia. The establishment of LK3 aims to provide psychosocial services for families of students who has psychosocial problem in their life. The study also aims to explore the trend of psychosocial problems of its client (student) for the past three years (2014-2016). The research method of the study is using a qualitative social work research method. A review of selected data of the client of LK3 UIN Syarif Hidayatullah Jakarta around five main issues: Family background, psychosocial mapping, potential resources, student coping mechanism strategy, client strength and network. The study also uses a review of academic performance report as well as an interview and observation. The findings show that the trend of psychosocial problems of the client of LK3 UIN Syarif Hidayatullah Jakarta vary as follow: bad academic performance, low income family, broken home, domestic violence, disability, mental disorder, sexual abuse, and the like. LK3 UIN Syarif Hidayatullah Jakarta has significant roles to provide psychosocial support and services for the survival of the students to deal with their psychosocial problems. Social worker of LK3 performs indigenous social work practice: individual counseling, family counseling, group therapy, home visit, case conference, Islamic Spiritual Approach, and Spiritual Emotional Freedom Technique (SEPT).

Keywords: psychosocial, indigenizing social work, resiliency, coping mechanism

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Authors: Zenawi Tadesse, Jonathan Fireman, Roza Belayneh, Oren Shelef

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Healthy soils are crucial for sustainable agriculture, supporting plant productivity, air and water quality, and overall - public health. Soils are dynamic ecosystems that host diverse organisms that facilitate key processes such as nutrient cycling and soil formation. Soil biodiversity, especially microarthropods, plays a vital role in these functions. Despite their importance, the link between soil biodiversity and agricultural practices is not fully understood. Soil management practices such as cover cropping can enhance soil biodiversity and quality. However, specific impacts on microarthropod diversity and function require further investigation. This study aims to evaluate how vegetation cover in agriculture modifies soil microarthropod assemblage in three Mediterranean agroecosystems. The practices included mixed cover crops in almonds, single crop intercropped in olives, and local vegetation retention in vineyards. Samples were taken from soils with vegetation and from bare soil within the same system and analyzed for microarthropod adaptation, diversity, and differences in community composition using the Soil Biological Quality index for arthropods (QBS-ar), Shannon diversity index, and non-metric multidimensional scaling (NMDS). Our result suggested that areas with vegetation cover had higher QBS-ar values and differed in community composition compared to no-vegetative-covered areas. An Indicator Species Analysis (ISA) identified Acari, Coleoptera, and Diplura as indicators of cover crop habitat in an almond orchard, while Collembola was prominent in plots with vegetation in olive groves and vineyards. Chilopoda and Symphyla were also indicators of vegetation cover in the vineyard. On the contrary, no indicator groups were found in non-covered areas in all agroecosystems. These findings suggest that soil microarthropod diversity and community structure are positively linked to vegetation cover, highlighting its potential benefits for soil health and sustainability as agricultural practices. However, since the experimental design of this study was limited to specific sites, more research with replicated independent sites would be necessary to extend these findings and to generalize the effect of vegetation cover on soil fauna in agroecosystems. Furthermore, studying the long-term impacts of cover cropping practices on soil biodiversity and ecosystem services is suggested for future research.

Keywords: agriculture, biological index, cover crop, microarthropods, soil functioning

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Authors: Lisa Robins, Jill Newby, Kay Wilhelm, Therese Fletcher, Jessica Smith, Trevor Ma, Adam Finch, Lesley Campbell, Jerry Greenfield, Gavin Andrews

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Background:Depression treatment for people living with depression comorbid with diabetes is of critical importance for improving quality of life and diabetes self-management, however depression remains under-recognised and under-treated in this population. Cost—effective and accessible forms of depression treatment that can enhance the delivery of mental health services in routine diabetes care are needed. Provision of internet-delivered Cognitive Behaviour Therapy (iCBT) provides a promising way to deliver effective depression treatment to people with diabetes. Aims:To explore the outcomes of the clinician assisted iCBT program for people with comorbid Major Depressive Disorder (MDD) and diabetes compared to those who remain under usual care. The main hypotheses are that: (1) Participants in the treatment group would show a significant improvement on disorder specific measures (Patient Health Questionnaire; PHQ-9) relative to those in the control group; (2) Participants in the treatment group will show a decrease in diabetes-related distress relative to those in the control group. This study will also examine: (1) the effect of iCBT for MDD on disability (as measured by the SF-12 and SDS), general distress (as measured by the K10), (2) the feasibility of these treatments in terms of acceptability to diabetes patients and practicality for clinicians (as measured by the Credibility/Expectancy Questionnaire; CEQ). We hypothesise that associated disability, and general distress will reduce, and that patients with comorbid MDD and diabetes will rate the program as acceptable. Method:Recruit 100 people with MDD comorbid with diabetes (either Type 1 or Type 2), and randomly allocate to: iCBT (over 10 weeks) or treatment as usual (TAU) for 10 weeks, then iCBT. Measure pre- and post-intervention MDD severity, anxiety, diabetes-related distress, distress, disability, HbA1c, lifestyle, adherence, satisfaction with clinicians input and the treatment. Results:Preliminary results comparing MDD symptom levels, anxiety, diabetes-specific distress, distress, disability, HbA1c levels, and lifestyle factors from baseline to conclusion of treatment will be presented, as well as data on adherence to the lessons, homework downloads, satisfaction with the clinician's input and satisfaction with the mode of treatment generally.

Keywords: cognitive behaviour therapy, depression, diabetes, internet

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Authors: Do Thi Ha, Khanitta Nuntaboot

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Background: Competency of nurses is vital to safe nursing practice as well as essential component to drive quality of nursing services. There exists little up to date information concerning actual competency among Vietnamese nurses. Purposes: The purpose of this study is to identify the actual nursing competency among nurses in clinical settings in Vietnam. Methods: A qualitative study, ethnographic method, comprised of the participant-observation, in-depth interview, and focus group discussion with multidisciplinary groups of nurses employing in Cho Ray hospital, Vietnam, managers/administrators, nurse teachers, medical doctors, other health care providers, patients and family members which derived from purposeful sampling technique. Content analysis was used for data analysis. Results: Five essential themes of nursing competencies among nurses were identified include (1) knowledge, (2) skills, (3) attitude and value-based nursing practice, (4) legal and ethical competencies, and (5) transcultural competencies. Basic and advanced knowledge were identified as further two dimensions of knowledge. There were five sub themes identified as further dimensions of skills include technical skills, communication skills, organizing and management skills, teamwork and interrelationship, and critical thinking skills. Conclusions: The findings from this study provide valuable information and understanding of the actual competency among nurses in clinical settings in Vietnam. It is expected that this understanding would assist in developing a guide to nursing education and training, nursing practice and relevant policy regulation used for promoting nursing competency among nurses.

Keywords: ethnographic method, nursing competency, qualitative design, Vietnam

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