Search results for: behavioral healthcare

Authors: Alireza Rahpeyma

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One of the most significant challenges faced by cities is inefficient and deteriorated urban fabric. Deteriorated areas bring about numerous issues, including economic, social, physical, and infrastructural problems, sewage management, environmental concerns, and security issues. One of the crucial necessities of modern urban life is the revitalization and renovation of these urban fabrics. Another important aspect is preserving a cohesive cultural and social identity during the urban renewal process. Urban renovation and upgrading are not a one-time occurrence but rather an ongoing process that ultimately needs to become ingrained in the system. This process is not swift; it involves sensitive and intricate stages that require well-designed plans within short, medium, and long-term timeframes. To revitalize dilapidated areas, a comprehensive understanding of the urban region's sustainability is essential. The goal of this study is to provide a suitable model for the upgrading and renewal of areas 2, 4, 5, 7, 8, and 10 in Tehran, preserving the heritage within these urban fabrics (urban assets), including the valuable morphologies of these areas, to prevent financial wastage. This study was conducted descriptively and analytically using the SWOT technique and GIS software. The research results regarding urban upgrading and renewal bring about the following points: 1) Urban upgrading and renewal ensure satisfactory efficiency, justice, environmental quality, safety and security, hygiene, sewage management, and the comfort and aesthetics of urban spaces. 2) Employing the above processes in old city centers re-establishes the historical and cultural connection between people and their past, a past that is evolving and improving and will not repeat itself. 3) Despite the expansion and growth of Iranian cities, cultural and national identity can be preserved by adhering to healthy urban revitalization principles. 4) Proper urban upgrading and renewal prevent social fragmentation, deviant behavioral patterns, psychological and occupational disorders, and financial losses. In general, preserving the identity and urban life in renovation and upgrading must be comprehensive, encompassing various dimensions, including physical, social, economic, political, and administrative aspects.

Keywords: dilapidated areas, renovation, sustainable reconstruction, Tehran-Iran

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Authors: Carolina Mayen Huerta, Clara Ivanescu, Paloma Marcos

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Due to their unique geographic challenges and the imperative to combat climate change, Small Island Developing States (SIDS) are experiencing rapid growth in the renewable energy (RE) sector. However, women's representation in formal employment within this burgeoning field remains significantly lower than their male counterparts. Conventional methodologies often overlook critical geographic data that influence women's job prospects. To address this gap, this paper introduces a Multicriteria Evaluation (MCE) framework designed to identify spatially enabling environments and restrictions affecting women's access to formal employment and business opportunities in the SIDS' RE sector. The proposed MCE framework comprises 24 key factors categorized into four dimensions: Individual, Contextual, Accessibility, and Place Characterization. "Individual factors" encompass personal attributes influencing women's career development, including caregiving responsibilities, exposure to domestic violence, and disparities in education. "Contextual factors" pertain to the legal and policy environment, influencing workplace gender discrimination, financial autonomy, and overall gender empowerment. "Accessibility factors" evaluate women's day-to-day mobility, considering travel patterns, access to public transport, educational facilities, RE job opportunities, healthcare facilities, and financial services. Finally, "Place Characterization factors" enclose attributes of geographical locations or environments. This dimension includes walkability, public transport availability, safety, electricity access, digital inclusion, fragility, conflict, violence, water and sanitation, and climatic factors in specific regions. The analytical framework proposed in this paper incorporates a spatial methodology to visualize regions within countries where conducive environments for women to access RE jobs exist. In areas where these environments are absent, the methodology serves as a decision-making tool to reinforce critical factors, such as transportation, education, and internet access, which currently hinder access to employment opportunities. This approach is designed to equip policymakers and institutions with data-driven insights, enabling them to make evidence-based decisions that consider the geographic dimensions of disparity. These insights, in turn, can help ensure the efficient allocation of resources to achieve gender equity objectives.

Keywords: gender, women, spatial analysis, renewable energy, access

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Authors: Carolina Mayen Huerta, Clara Ivanescu, Paloma Marcos

Abstract:

Due to their unique geographic challenges and the imperative to combat climate change, Small Island Developing States (SIDS) are experiencing rapid growth in the renewable energy (RE) sector. However, women's representation in formal employment within this burgeoning field remains significantly lower than their male counterparts. Conventional methodologies often overlook critical geographic data that influence women's job prospects. To address this gap, this paper introduces a Multicriteria Evaluation (MCE) framework designed to identify spatially enabling environments and restrictions affecting women's access to formal employment and business opportunities in the SIDS' RE sector. The proposed MCE framework comprises 24 key factors categorized into four dimensions: Individual, Contextual, Accessibility, and Place Characterization. "Individual factors" encompass personal attributes influencing women's career development, including caregiving responsibilities, exposure to domestic violence, and disparities in education. "Contextual factors" pertain to the legal and policy environment, influencing workplace gender discrimination, financial autonomy, and overall gender empowerment. "Accessibility factors" evaluate women's day-to-day mobility, considering travel patterns, access to public transport, educational facilities, RE job opportunities, healthcare facilities, and financial services. Finally, "Place Characterization factors" enclose attributes of geographical locations or environments. This dimension includes walkability, public transport availability, safety, electricity access, digital inclusion, fragility, conflict, violence, water and sanitation, and climatic factors in specific regions. The analytical framework proposed in this paper incorporates a spatial methodology to visualize regions within countries where conducive environments for women to access RE jobs exist. In areas where these environments are absent, the methodology serves as a decision-making tool to reinforce critical factors, such as transportation, education, and internet access, which currently hinder access to employment opportunities. This approach is designed to equip policymakers and institutions with data-driven insights, enabling them to make evidence-based decisions that consider the geographic dimensions of disparity. These insights, in turn, can help ensure the efficient allocation of resources to achieve gender equity objectives.

Keywords: gender, women, spatial analysis, renewable energy, access

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Authors: Noriyuki Suyama

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This paper looked into consumer behavioral changes by analyzing the data collected by ASMARKS Co., one of a research companies in Japan. The purpose of the paper is to understand the two differences of before vs. after COVID-19 pandemic and Japanese living in Japan. Subsequently, examining the analysis results helped obtain useful insights into new business models for business parties in Japan as a microlevel perspective. The paper also tried to explore future conditions of globalization by taking into consideration nation’s political and economic changes as a macro-level perspective. The COVID-19 has been continuing its spread across the world with more than 60 million confirmed cases in 190 countries. This pandemic with restricted scopes of behavior mandates have disrupted the consumer habits of their lifestyles. Consumers have tendency to learn new ways when they have trouble in taking routine action. For example, the government forces people to refrain from going out, they try to telecommute at home. If the situation come back to normal, people still change their lifestyles to fit in the best. Some of data show typical effects of COVID-19; forceful exposure to digitalized work-life styles; more flexible time at home; importance of trustful and useful information gathering between what's good and bad;etc. in comparison with before vs. after COVID-19 pandemic. In addition, Japanese have less changed their lifestyles than Expatriates living in Japan. For example, while 94% of the expatriates have decreased their outgo because of self-quarantine, only 55% of the Japanese have done. There are more differences in both comparisons in the analysis results. The economic downtrend resulting from COVID-19 is supposed to be at least as devastating if not more so than that of the financial crisis. With unemployment levels in the US taking two weeks to reach what took 6 months in the 2008 crisis, there is no doubt of a global recession some predict could reach 10% or above of GDP. As a result, globalization in the global supply chain of goods and services will end up with negative impact. A lot of governmental financial and economic policies are supposed to focus on their own profits and interests, exclusing other countries interests as is the case with the Recovery Act just after the global financial crisis from 2007 to 2008. Both micro- and macro-levels analysis successfully reveal important connotations and managerial implications of business in Japan for Japanese consumers as well as after COVID-19 global business.

Keywords: COVID-19, lifestyle in Japan, expatriates, consumer behavior

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Authors: Abhijit Trailokya

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Background: Cardiovascular diseases (CVD’s) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy. In Indian patients, comprehensive data on dyslipidemia management and its treatment outcomes are inadequate. There is lack of information on existing treatment patterns, the patient’s profile being treated, and factors that determine treatment success or failure in achieving desired goals. Purpose: The present study was planned to determine the lipid control status in high-risk dyslipidemic patients treated with lipid-lowering therapy in India. Methods: This cross-sectional, non-interventional, single visit program was conducted across 483 sites in India where male and female patients with high-risk dyslipidemia aged 18 to 65 years who had visited for a routine health check-up to their respective physician at hospital or a healthcare center. Percentage of high-risk dyslipidemic patients achieving adequate LDL-C level (< 70 mg/dL) on lipid-lowering therapy and the association of lipid parameters with patient characteristics, comorbid conditions, and lipid lowering drugs were analysed. Results: 3089 patients were enrolled in the study; of which 64% were males. LDL-C data was available for 95.2% of the patients; only 7.7% of these patients achieved LDL-C levels < 70 mg/dL on lipid-lowering therapy, which may be due to inability to follow therapeutic plans, poor compliance, or inadequate counselling by physician. The physician’s lack of awareness about recent treatment guidelines also might contribute to patients’ poor adherence, not explaining adequately the benefit and risks of a medication, not giving consideration to the patient’s life style and the cost of medication. Statin was the most commonly used anti-dyslipidemic drug across population. The higher proportion of patients had the comorbid condition of CVD and diabetes mellitus across all dyslipidemic patients. Conclusion: As per the European Society of Cardiology guidelines the ideal LDL-C levels in high risk dyslipidemic patients should be less than 70%. In the present study, 7.7% of the patients achieved LDL-C levels < 70 mg/dL on lipid lowering therapy which is very less. Most of high risk dyslipidemic patients in India are on suboptimal dosage of statin. So more aggressive and high dosage statin therapy may be required to achieve target LDLC levels in high risk Indian dyslipidemic patients.

Keywords: cardiovascular disease, diabetes mellitus, dyslipidemia, LDL-C, lipid lowering drug, statins

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Authors: Melek Göregenli, Işık Gürşimşek

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There has been a great deal of research in the past few decades examining attitudes toward homosexuals.Theoretic research has demonstrated that antihomosexual attitudes are expressed in cognitive, affective, behavioral and cultural components. Homophobia is generally defined as hostility towards or fear of LGBTI people, but can also refer to social and cultural ideologies which stigmatize homosexuality. Negative feelings or attitudes towards non-heterosexual behavior, identity, relationships and community can lead to homophobic behavior and is the root of the discrimination experienced by many lesbian, gay, bisexual and transgender (LGBTI) people. Since the increase in number of hate crimes during the last decade, there has been a sense of urgency to respond to the problem of hate violence in Turkey. The LGBTI Rights Association KAOS-GL indicated that the most of lesbian, gay, bisexual, travesty and transsexuals reported some form of victimization in their lifetimes based on their sexual orientation in Turkey. This study explored the relations between homophobia, right-wing authoritarianism, social dominance orientation and just world belief attitudes towards LGBTI individuals in a sample of 393 Turkish college students from Ege University in Izmir, Turkey. Data were collected with a questionnaire including the Homosexism Scale, the Right-Wing Authoritarianism Scale, Social Dominance Orientation Scale and Just World Belief Scale. Participants completed a questionnaire containing the attitude measures and other several questions related with the socio-demographic variables. Consistent with the previous finding males were more homophobic than females. Contrary to this finding the main effects of other demographic variables (age, income, place of birth, class) were not statistically significant except the department of participants. These findings imply that efforts to garner wide-ranging support for policies designed to change negative attitudes to LGBT people and to enhance the given awareness on homophobia. The results of the study were discussed in cross-cultural and social psychological perspective considering cultural and social values of Turkey and current political circumstances of the country.

Keywords: homophobia, just world belief, right-wing authoritarianism, social dominance orientation, Turkey

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Authors: Fabiola Xavier Leal, Lara Campanharo, Sueli Aparecida Rodrigues Lucas

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The phenomenon of judicialization in health policy brings with it a great deal of problematization, but in general, it means that some issues that were previously solved by traditional political bodies are being decided by the Judiciary bodies. It is, therefore, a controversial topic that has generated many reflections both in the academic and political fields, considering that not only a dispute of public funds is at stake, but also the debate on access to social rights provided for in the Brazilian Federal Constitution of 1988 and in the various public policies, such as healthcare. With regard to the phenomenon in the Mental Health Policy focusing on people who use drugs, the disputes that permeate this scenario are evident: moral, cultural, sanitary, economic, psychological aspects. There are also the individual and collective dimensions of suffering. And in this process, we all question: What is the role of the Brazilian State in this matter? In this context, another question that needs to be answered is the amount spent on this procedure in the state of Espírito Santo (ES), Brazil (in the last 04 years, around R$121,978,591.44 were paid only for compulsory hospitalization of individuals) in the field in question, which is the financing of the services of the Psychosocial Care Network (RAPS). Therefore, this article aims to problematize the phenomenon of judicialization in Mental Health Policy through the compulsory hospitalization of people who use drugs in Espírito Santo (ES). We proposed a study that sought to understand how this has been occurring and making an impact on the provision of RAPS services in the Espírito Santo scenario. Therefore, the general objective of this study is to analyze the expenses with compulsory hospitalizations for drug use carried out by the State Health Department (SESA) between 2014 and 2019, in which we will seek to identify its destination and the impact of these actions on public health policy. For the purposes of this article, we will present the preliminary data of this study, such as the amount spent by the state and the receiving institutions. For data collection, the following data sources were used: documents available publicly on the Transparency Portal (payments made per year, institutions that received, subjects hospitalized, period and the amount of the daily rates paid); as well as the processes generated by SESA through its own system - ONBASE. For qualitative analysis, content analysis was used; and for quantitative analysis, descriptive statistics was used. Thus, we seek to problematize the issue of judicialization for compulsory hospitalizations, considering the current situation in which this resource has been widely requested to legitimize the war on drugs. This scenario highlights the moral-legal discourse, pointing out strategies through the control of bodies and through faith as an alternative.

Keywords: compulsory hospitalization, drugs, judicialization, mental health

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Authors: M. Bassas, J. Grané-Morcillo, J. Segura, J.M. Soldevila

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Mental health prevention is key in a society where, according to the World Health Organization, the fourth leading cause of death worldwide is suicide. Compassion is closely linked to personal growth. It shows once again that therapies based on prevention remain an urgent and social need. In this sense, a growing body of research demonstrates how cultivating a compassionate mind can help alleviate and prevent a variety of psychological problems. In the early 21st century, there has been a boom in third-generation compassion-based therapies, although there is a lack of empirical evidence of their efficacy. This study proposes a psychotherapy method (‘Being Method’), whose central axis revolves around emotional management through the cultivation of compassion. Therefore, the objective of this research was to analyze the effectiveness of this method with regard to the emotional changes experienced when we focus on what we are concerned about through the filter of compassion. The Being Method was born from the influence of Buddhist philosophy and contemporary psychology based mainly on Western rationalist currents. A quantitative cross-sectional study has been carried out in a sample of women between 18 and 53 years old (n=47; Mage=36.02; SDage= 11.86) interested in personal growth in which the following 6 measuring instruments were administered: Peace of mind Scale (PoM), Rosenberg Self-Esteem Scale (RSES), Subjective Happiness Scale (SHS), 2 Sacles of the Compassionate Action and Engagement Scales (CAES), Coping Response Inventory for Adults (CRI-A) and Cognitive-Behavioral Strategies Evaluation Scale (MOLDES). Following an experimental method approach, participants were divided into an experimental and control group. Longitudinal analysis was also carried out through a pre-post program comparison. Pre-post comparison outcomes indicated significant differences (p<.05) between before and after the therapy in the variables Peace of Mind, Self-esteem, Happiness, Self-compassion (A-B), Compassion (A-B), in several mental molds, as well as in several coping strategies. Also, between-groups tests proved significantly higher means obtained in the experimental group. Thus, these outcomes highlighted the effectiveness of the therapy, improving all the analyzed dimensions. The social, clinical and research implications are discussed.

Keywords: being method, compassion, effectiveness, emotional management, intervention program, personal growth therapy

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Authors: Ponshano Kaselekela, Simooya O. Oscar, Lunshano Boyd

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The Copperbelt University Health Services (CBUHS) was designated by the Zambia Medicines Regulatory Authority (ZAMRA), formally the Pharmaceutical Regulatory Authority (PRA) as a regional pharmacovigilance centre to carryout activities of drug safety monitoring in four provinces in Zambia. CBUHS’s mandate included stimulating the reporting of adverse drug reactions (ADRs), as well as collecting and collating ADR reports from health institutions in the four provinces. This report covers the researchers’ experiences from May 2008 to September, 2016. The main objectives are 1) to monitor ADRs in the Zambian population, 2) to disseminate information to all health professionals in the region advising that the CBU health was a centre for reporting ADRs in the region, 3) to monitor polypharmacy as well as the benefit-risk profile of medicines, 4) to generate independent, evidence based recommendations on the safety of medicines, 5) to support ZAMRA in formulating safety related regulatory decisions for medicines, and 6) to communicate findings with all key stakeholders. The methodology involved monthly visits, beginning in early May 2008 to September, 2016, by the CBUHS to health institutions in the programme areas. Activities included holding discussions with health workers, distribution of ADR forms and collection of ADRs reports. These reports, once collected, were documented and assessed at the CBUHS. A report was then prepared for ZAMRA on quarterly basis. At ZAMRA, serious ADRs were noted and recommendations made to the Ministry of Health of the Republic of Zambia. The results show that 2,600 ADRs reports were received at the pharmacovigilance regional centre. Most of the ADRs reports that received were due to antiretroviral drugs, as well as a few from anti-malarial drugs like Artemether/Lumefantrine – Coartem®. Three hundred and twelve ADRs were entered in the Uppsala Monitoring Centre WHO Vigiflow for further analysis. It was concluded that in general, 2008-16 were exciting years for the pharmacovigilance group at CBUHS. From a very tentative beginning, a lot of strides were made and contacts established with healthcare facilities in the region. The researchers were encouraged by the support received from the Copperbelt University management, the motivation provided by ZAMRA and most importantly the enthusiasm of health workers in all the health care facilities visited. As a centre for drug safety in Zambia, the results show it achieves its objectives for monitoring ADRs, Pharmacovigilance (drug safety monitoring), and activities of monitoring ADRs as well as preventing them. However, the centre faces critical challenges caused by erratic funding that prevents the smooth running of the programme.

Keywords: adverse drug reactions, drug safety, monitoring, pharmacovigilance

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Authors: Malek Makki

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The main purpose of this research study is to assist non-profit organizations (NPOs) to better segment a group of least developing countries and to optimally target the most needier areas, so that the provided aids make positive and lasting differences. We applied international marketing and strategy approaches to segment a sub-group of candidates among a group of 151 countries identified by the UN-G77 list, and furthermore, we point out the areas of priorities. We use reliable and well known criteria on the basis of economics, geography, demography and behavioral. These criteria can be objectively estimated and updated so that a follow-up can be performed to measure the outcomes of any program. We selected 12 socio-economic criteria that complement each other: GDP per capita, GDP growth, industry value added, export per capita, fragile state index, corruption perceived index, environment protection index, ease of doing business index, global competitiveness index, Internet use, public spending on education, and employment rate. A weight was attributed to each variable to highlight the relative importance of each criterion within the country. Care was taken to collect the most recent available data from trusted well-known international organizations (IMF, WB, WEF, and WTO). Construct of equivalence was carried out to compare the same variables across countries. The combination of all these weighted estimated criteria provides us with a global index that represents the level of development per country. An absolute index that combines wars and risks was introduced to exclude or include a country on the basis of conflicts and a collapsing state. The final step applied to the included countries consists of a benchmarking method to select the segment of countries and the percentile of each criterion. The results of this study allowed us to exclude 16 countries for risks and security. We also excluded four countries because they lack reliable and complete data. The other countries were classified per percentile thru their global index, and we identified the needier and the areas where aids are highly required to help any NPO to prioritize the area of implementation. This new concept is based on defined, actionable, accessible and accurate variables by which NPO can implement their program and it can be extended to profit companies to perform their corporate social responsibility acts.

Keywords: developing countries, international marketing, non-profit organization, segmentation

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Authors: I. Stacher, B. Schrank, K. Stiehl, K. A. Woodcock

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Background: The need and desire for connectedness and belonging to a peer group is a major concern in middle childhood. This is particularly true for the period of school transition when making and maintaining friendships is put to the test. Social relations are important for enhancing self-esteem, confidence, and mental health. Conflicts with peers and victimization mark challenges in the complex social environment of early adolescents. Thus, the promotion of supportive peer relationships is an important social goal. The current literature lacks an in-depth analysis of young people’s experiences connected to making and maintaining friendships. Aim: This qualitative study aims to understand the factors that facilitate and hinder friendship and peer relations within the complex context of school transition. Methods: Youth engagement workshops at primary and secondary schools were conducted with 53 classes (N = 906 pupils; M age = 10.44; SD = .912) in 29 different schools across lower Austria. A big poster was created with the entire class, collecting early adolescents’ ideas on ways they can support each other in the school environment. Then, students were divided into smaller groups and encouraged to share their personal experiences of friendship. Verbatim quotes from students were collected on observation sheets and sticky notes during the activities. A thematic analysis was conducted. Results: Early adolescents describe facilitating factors that allow them to connect with peers. These descriptions are mainly on a behavioral level and are relevant for face-to-face and digital contact, e.g., practical and emotional support, spending time together, pleasure and fun. Specific challenges such as offensive actions, betrayal, and lack of emotion regulation exist and need to be addressed if aiming to reduce barriers between peers. Conclusion: Knowing first-hand experiences, desires, and barriers for making and maintaining friends at the time of school transition will help researchers to develop preventive health programs that adequately address the needs and preferences of today’s youth.

Keywords: youth voice, experts by experience, friendship, peer relations, primary-secondary school, transition

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Authors: Agnieszka Rolinska, Marta Makara-Studzinska

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Introduction: In recent years, there has been an intensive development of research into the physiological relationships between the experienced stress and obesity. Moreover, strong chronic stress leads to the disorganization of a person’s activeness on various levels of functioning, including the behavioral and cognitive sphere (also in one’s diet). Aim: The present work addresses the following research questions: Is there a relationship between an increase in stress related to the disease and the need for the cyclicality of diabetologic education in gestational diabetes? Are there any differences in terms of the experienced stress during the last three months of pregnancy in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Are there any differences in terms of stress coping styles in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Method: The study involved pregnant women with gestational diabetes (treated with diet, without insulin therapy) and in normal pregnancy – 206 women in total. The following psychometric tools were employed: Perceived Stress Scale (PSS; Cohen, Kamarck, Mermelstein), Coping Inventory for Stressful Situations (CISS; Endler, Parker) and authors’ own questionnaire. Gestational diabetes mellitus was diagnosed on the basis of the results of fasting oral glucose tolerance test (75 g OGTT). Body weight measurements were confirmed in a diagnostic interview, taking into account medical data. Regularities in weight gains in pregnancy were determined according to the recommendations of the Polish Gynecological Society and American norms determined by the Institute of Medicine (IOM). Conclusions: An increase in stress related to the disease varies in patients with differing requirements for the cyclical nature of diabetologic education (i.e. education which is systematically repeated). There are no differences in terms of recently experienced stress and stress coping styles between women with gestational diabetes and those in normal pregnancy. There is a relationship between weight gains in pregnancy and the stress experienced in life as well as stress coping styles – both in pregnancy complicated by diabetes and in physiological pregnancy. In the discussion of the obtained results, the authors refer to scientific reports from English-language magazines of international range.

Keywords: diabetologic education, gestational diabetes, stress, weight gain in pregnancy

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Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

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Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

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Authors: Merle Talvik, Taimi Tulva, Kristi Puusepp, Ülle Ernits

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Background data. This is a study in the field of health humanities. The 1930s were years of rapid cultural and economic development in Europe and in Estonia. The urban way of life the glamorous lifestyle gained popularity, although the society of Estonia in the 1930s had traditionally been agrarian. People's free time increased, which needed to be filled with activities either at home or outside the home. Therefore, the number of popular magazines aimed at housewives increased. More than 200 magazines and bulletins were published in the Republic of Estonia before the Second World War (in 1934, the population of Estonia was 1,126,000). In the 1930s, the Republic of Estonia faced several challenges in healthcare. Infectious diseases, alcoholism, prostitution and child mortality had to be dealt with. Healers without medical education operated in the villages. For the average person, medical care was quite expensive, and despite efforts, by 1940, only 20% of the population was covered by health insurance. Advice published in popular family magazines provided help in solving, understanding and preventing health problems. Aim. The aim of the study is to analyze the health counseling through magazines during the Republic of Estonia (1930-1940) in historical and cultural context. Method. In total, 420 magazine issues were processed. An extensive textual analysis, as well as an analysis of photographs and illustrations from the aspect of health advice was carried out to achieve the research objective. Results. Health counseling was written by well-known doctors of the time, leaders of the abstinence movement and others. There was advice in various areas: prevention of infectious and non-infectious diseases and their treatment with simple methods, first aid, combating sexually transmitted diseases, women's and children's health, mental health, folk medicine techniques, abstinence, healthy eating, skin care, hygiene, introducing pharmacy products. Advice was offered in both written and visual form. Photos and illustrations helped to empower the health advice. Folk heritage and health knowledge of the time were relied upon, and a scientific point of view was popularized. Aspirations towards a European lifestyle were reflected in articles and illustrations. Contribution. The article has an ethnological attitude, and its impact comes down to understanding the history of health care in its socio-cultural context. The health counseling topics of the 1930s are also applicable in today's health education and research. Health counseling builds on the legacy of the past, and it helps to understand that the past is in the future and the main principles of health counseling arise from our history and background.

Keywords: estonian republic, health counseling, lifestyle, magazines, media

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Authors: Anchal Rana

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Indian Himalayas with their diverse climatic conditions are home to many rare and endangered medicinal flora. One such species is Polygonatum verticillatum Linn., popularly known as King Solomon’s Seal or Solomon’s Seal. Its mention as an incredible medicinal herb comes from 5000 years ago in Indian Materia Medica as a component of Ashtavarga, a poly-herbal formulation comprising of eight herbs illustrated as world’s first ever revitalizing and rejuvenating nutraceutical food, which is now commercialised in the name ‘Chaywanprash’. It is an erect tall (60 to 120 cm) perennial herb with sessile, linear leaves and white pendulous flowers. The species grows well in an altitude range of 1600 to 3600 m amsl, and propagates mostly through rhizomes. The rhizomes are potential source for significant phytochemicals like flavonoids, phenolics, lectins, terpenoids, allantoin, diosgenin, β-Sitosterol and quinine. The presence of such phytochemicals makes the species an asset for antioxidant, cardiotonic, demulcent, diuretic, energizer, emollient, aphrodisiac, appetizer, glactagogue, etc. properties. Having profound concentrations of macro and micronutrients, species has fine prospects of being used as a diet supplement. However, due to unscientific and gregarious uprooting, it has been assigned a status of ‘vulnerable’ and ‘endangered’ in the Conservation Assessment and Management Plan (CAMP) process conducted by Foundation for Revitalisation of Local Health Traditions (FRLHT) during 2010, according to IUCN Red-List Criteria. Further, destructive harvesting, land use disturbances, heavy livestock grazing, climatic changes and habitat fragmentation have substantially contributed towards anomaly of the species. It, therefore, became imperative to conserve the diversity of the species and make judicious use in future research and commercial programme and schemes. A Gene Bank was therefore established at High Altitude Herbal Garden of the Forest Research Institute, Dehradun, India situated at Chakarata (30042’52.99’’N, 77051’36.77’’E, 2205 m amsl) consisting 149 accessions collected from thirty-one geographical locations spread over three Himalayan States of Jammu and Kashmir, Himachal Pradesh, and Uttarakhand. The present investigations purport towards sampling and collection of divergent germplasm followed by planting and cultivation techniques. The ultimate aim is thereby focussed on analysing genetic diversity of the species and capturing promising genotypes for carrying out further genetic improvement programme so to contribute towards sustainable development and healthcare.

Keywords: Polygonatum verticillatum Linn., phytochemicals, genetic diversity, conservation, gene bank

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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Authors: Masih Nikgou

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ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

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Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

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Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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Authors: Keenoo Bibi Sumera, Alsheikh Mona, Mubarak Jan Beebee Zeba Mahetaab

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Background: Due to the busy schedule of the practicing clinicians at the hospitals, students may not always be attended to, which is to their detriment. The clinicians at the hospitals are also not always acquainted with teaching and/or supervising students on their placements. Additionally, there is a high student-patient ratio. Since they are the prospective clinical doctors under training, they need to reach the competence levels in clinical decision-making skills to be able to serve the healthcare system of the country and to be safe doctors. Aims and Objectives: A reflective portfolio was used to provide a means for students to learn by reflecting on their experiences and obtaining continuous feedback. This practice is an attempt to compensate for the scarcity of lack of resources, that is, clinical placement supervisors and patients. It is also anticipated that it will provide learners with a continuous monitoring and learning gap analysis tool for their clinical skills. Methodology: A hardcopy reflective portfolio was designed and validated. The portfolio incorporated a mini clinical evaluation exercise (mini-CEX), direct observation of procedural skills and reflection sections. Workshops were organized for the stakeholders, that is the management, faculty and students, separately. The rationale of reflection was emphasized. Students were given samples of reflective writing. The portfolio was then implemented amongst the undergraduate medical students of years four, five and six during clinical clerkship. After 16 weeks of implementation of the portfolio, a survey questionnaire was introduced to explore how undergraduate students perceive the educational value of the reflective portfolio and its impact on their deep information processing. Results: The majority of the respondents are in MD Year 5. Out of 52 respondents, 57.7% were doing the internal medicine clinical placement rotation, and 42.3% were in Otorhinolaryngology clinical placement rotation. The respondents believe that the implementation of a reflective portfolio helped them identify their weaknesses, gain professional development in terms of helping them to identify areas where the knowledge is good, increase the learning value if it is used as a formative assessment, try to relate to different courses and in improving their professional skills. However, it is not necessary that the portfolio will improve the self-esteem of respondents or help in developing their critical thinking, The portfolio takes time to complete, and the supervisors are not useful. They had to chase supervisors for feedback. 53.8% of the respondents followed the Gibbs reflective model to write the reflection, whilst the others did not follow any guidelines to write the reflection 48.1% said that the feedback was helpful, 17.3% preferred the use of written feedback, whilst 11.5% preferred oral feedback. Most of them suggested more frequent feedback. 59.6% of respondents found the current portfolio user-friendly, and 28.8% thought it was too bulky. 27.5% have mentioned that for a mobile application. Conclusion: The reflective portfolio, through the reflection of their work and regular feedback from supervisors, has an overall positive impact on the learning process of undergraduate medical students during their clinical clerkship.

Keywords: Portfolio, Reflection, Feedback, Clinical Placement, Undergraduate Medical Education

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Authors: Sunidhi Sood, Drashti Narendrakumar Shah, Aakarsh Sharma, Nirali Harsh Panchal, Maria Karizhenskaia

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Cancer is a global health concern, causing a significant number of deaths, with chemotherapy being a standard treatment method. However, chemotherapy often induces side effects that profoundly impact the physical and emotional well-being of patients, lowering their overall quality of life (QoL). This research aims to investigate the potential of music and art therapy as holistic adjunctive therapy for cancer patients undergoing chemotherapy, offering non-pharmacological support. This is achieved through a comprehensive review of existing literature with a focus on the following themes, including stress and anxiety alleviation, emotional expression and coping skill development, transformative changes, and pain management with mood upliftment. A systematic search was conducted using Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 2014 to 2023. The review solely incorporated studies focusing on the impact of music and art therapy on the health and overall well-being of cancer patients undergoing chemotherapy in North America. The findings from 16 studies involving pediatric oncology patients, females affected by breast cancer, and general oncology patients show that music and art therapies significantly reduce anxiety (standardized mean difference: -1.10) and improve perceived stress (median change: -4.0) and overall quality of life in cancer patients undergoing chemotherapy. Furthermore, music therapy has demonstrated the potential to decrease anxiety, depression, and pain during infusion treatments (average changes in resilience scale: 3.4 and 4.83 for instrumental and vocal music therapy, respectively). This data calls for consideration of the integration of music and art therapy into supportive care programs for cancer patients undergoing chemotherapy. Moreover, it provides guidance to healthcare professionals and policymakers, facilitating the development of patient-centered strategies for cancer care in Canada. Further research is needed in collaboration with qualified therapists to examine its applicability and explore and evaluate patients' perceptions and expectations in order to optimize the therapeutic benefits and overall patient experience. In conclusion, integrating music and art therapy in cancer care promises to substantially enhance the well-being and psychosocial state of patients undergoing chemotherapy. However, due to the small population size considered in existing studies, further research is needed to bridge the knowledge gap and ensure a comprehensive, patient-centered approach, ultimately enhancing the quality of life (QoL) for individuals facing the challenges of cancer treatment.

Keywords: anxiety, cancer, chemotherapy, depression, music and art therapy, pain management, quality of life

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Authors: Jiyoung Lee, Andrew D. Gershoff, Jerry Jisang Han

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Most extant research on consumer privacy concerns and their willingness to share personal data has focused on contextual factors (e.g., types of information collected, type of compensation) that lead to consumers’ personal information disclosure. Unfortunately, the literature lacks a clear understanding of how consumers’ incidental psychological needs may influence consumers’ decisions to share their personal information with companies or brands. In this research, we investigate how social exclusion, which is an increasing societal problem, especially since the onset of the COVID-19 pandemic, leads to increased information disclosure intentions for consumers. Specifically, we propose and find that when consumers become socially excluded, their desire for social connection increases, and this desire leads to a greater willingness to disclose their personal information with firms. The motivation to form and maintain interpersonal relationships is one of the most fundamental human needs, and many researchers have found that deprivation of belongingness has negative consequences. Given the negative effects of social exclusion and the universal need to affiliate with others, people respond to exclusion with a motivation for social reconnection, resulting in various cognitive and behavioral consequences, such as paying greater attention to social cues and conforming to others. Here, we propose personal information disclosure as another form of behavior that can satisfy such social connection needs. As self-disclosure can serve as a strategic tool in creating and developing social relationships, those who have been socially excluded and thus have greater social connection desires may be more willing to engage in self-disclosure behavior to satisfy such needs. We conducted four experiments to test how feelings of social exclusion can influence the extent to which consumers share their personal information with brands. Various manipulations and measures were used to demonstrate the robustness of our effects. Through the four studies, we confirmed that (1) consumers who have been socially excluded show greater willingness to share their personal information with brands and that (2) such an effect is driven by the excluded individuals’ desire for social connection. Our findings shed light on how the desire for social connection arising from exclusion influences consumers’ decisions to disclose their personal information to brands. We contribute to the consumer disclosure literature by uncovering a psychological need that influences consumers’ disclosure behavior. We also extend the social exclusion literature by demonstrating that exclusion influences not only consumers’ choice of products but also their decision to disclose personal information to brands.

Keywords: consumer-brand relationship, consumer information disclosure, consumer privacy, social exclusion

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Authors: Sima Ajami, Batool Akbari

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Background: Radio frequency identification (RFID) system has been successfully applied to the areas of manufacturing, supply chain, agriculture, transportation, healthcare, and services. The RFID is already used to track and trace the victims in a disaster situation. Data can be collected in real time and be immediately available to emergency personnel and saves time by the RFID. Objectives: The aim of this study was, first, to identify stakeholders and customers for rescuing earthquake victims, second, to list key internal and external factors to use RFID to track earthquake victims, finally, to assess SWOT for rescuers' viewpoint. Materials and Methods: This study was an applied and analytical study. The study population included scholars, experts, planners, policy makers and rescuers in the "red crescent society of Isfahan province", "disaster management Isfahan province", "maintenance and operation department of Isfahan", "fire and safety services organization of Isfahan municipality", and "medical emergencies and disaster management center of Isfahan". After that, researchers held a workshop to teach participants about RFID and its usages in tracking earthquake victims. In the meanwhile of the workshop, participants identified, listed, and weighed key internal factors (strengths and weaknesses; SW) and external factors (opportunities and threats; OT) to use RFID in tracking earthquake victims. Therefore, participants put weigh strengths, weaknesses, opportunities, and threats (SWOT) and their weighted scales were calculated. Then, participants' opinions about this issue were assessed. Finally, according to the SWOT matrix, strategies to solve the weaknesses, problems, challenges, and threats through opportunities and strengths were proposed by participants. Results: The SWOT analysis showed that the total weighted score for internal and external factors were 3.91 (Internal Factor Evaluation) and 3.31 (External Factor Evaluation) respectively. Therefore, it was in a quadrant SO strategies cell in the SWOT analysis matrix and aggressive strategies were resulted. Organizations, scholars, experts, planners, policy makers and rescue workers should plan to use RFID technology in order to save more victims and manage their life. Conclusions: Researchers suppose to apply SO strategies and use a firm’s internal strength to take advantage of external opportunities. It is suggested, policy maker should plan to use the most developed technologies to save earthquake victims and deliver the easiest service to them. To do this, education, informing, and encouraging rescuers to use these technologies is essential. Originality/ Value: This study was a research paper that showed how RFID can be useful to track victims in earthquake.

Keywords: frequency identification system, strength, weakness, earthquake, victim

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Authors: Linghua Kong, Xinxia Chen, Mika Gissler, Catharina Lavebratt

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Background: Prenatal exposure to preeclampsia has been associated with an increased risk of offspring attention-deficit/hyperactivity disorders (ADHD), autism spectrum disorder (ASD), and intellectual disability. However, little is known about the association between prenatal exposure to severe preeclampsia and neurodevelopmental and psychiatric disorders in offspring. Objective: This study aimed to assess the risk of maternal preeclampsia combined with perinatal problems, specifically low birth weight and prematurity, on offspring neuropsychiatric disorders. Methods: All singleton live births in Finland between 1996 and 2014 (n=1 012 723) were followed up in nation-wide registries until 2018. Main exposures included pre-eclampsia, small for gestational age, and delivery before 34 gestational weeks. Offspring neurodevelopmental and psychiatric disorders (ICD-10 codes) were examined as outcomes variables. Offspring birth year, sex, maternal age at delivery, parity, marital status at birth, mother's country of birth, maternal smoking, maternal gestational diabetes, maternal use of psychotropic medication during pregnancy, and maternal systemic inflammatory diseases were used as covariates. Risks for neurodevelopmental and psychiatric disorders were estimated using Cox proportional hazards modeling. Results: Of the 1 012 723 offspring, 25 901 (2.6%) were exposed to preeclampsia, and 93 281 (9.2%) were diagnosed with a neuropsychiatric disorder. Compared to births unexposed to preeclampsia, small for gestational age or delivery before 34 gestational weeks, those exposed to preeclampsia only had a 21% increase in the likelihood of any neuropsychiatric disorders after adjusting for potential confounding (adjusted HR=1.21, 95% CI: 1.15-1.26), while exposure to preeclampsia combined with small for gestational age or delivery before 34 gestational weeks had a more than twofold increased risk of having a child with neuropsychiatric disorders (adjusted HR=2.16, 95% CI: 2.02-2.32). The adjusted HR for neuropsychiatric disorders in offspring with small for gestational age or delivery before 34 gestational weeks only was 1.79 (95% CI: 1.73-1.83). In addition, the risk estimate in offspring exposed to both preeclampsia and perinatal problems was greater than those only exposed to preeclampsia for having personality disorders (adjusted HR=1.66; 95% CI: 1.07-2.57), intellectual disabilities (adjusted HR=3.47; 95% CI: 2.86-4.22), specific developmental disorders (adjusted HR=2.91; 95% CI: 2.69-3.15), ASD (adjusted HR=1.75; 95% CI: 1.42-2.17), ADHD and conduct disorders (adjusted HR=2.00; 95%CI: 1.76-2.27), and other behavioral and emotional disorders (adjusted HR=2.09; 95% CI: 1.84-2.37). Conclusion: In utero exposure to severe preeclampsia increased the risk of several neurodevelopmental and psychiatric disorders in offspring. Our findings are relevant to women with hypertensive disorders with regard to pregnancy consultation and management and may yield effective clues for the prevention of neurodevelopmental and psychiatric disorders in childhood.

Keywords: low birth weight, neurodevelopmental disorders, preeclampsia, prematurity, psychiatric disorders

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Authors: Tracey Lion-Cachet

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Eating disorders typically manifest in adolescence and are notoriously difficult to treat. There are two notable reasons for this. Firstly, research consistently demonstrates that early intervention is a critical mediator of prognosis, with early intervention leading to a better prognosis. However, because eating disorders do not originate as full-syndrome diagnoses but rather as prodromal cases, they often go undetected; by the time symptoms meet diagnostic criteria, they have become recalcitrant. Another interrelated issue is motivation to change. Research demonstrates that in the early stages of an eating disorder, adolescents are highly resistant to change, and motivation increases only once symptoms have shifted from egosyntonic to egodystonic in nature. The purpose of this project was to design a prevention model based on the social psychology paradigm of Entertainment-Education, which embeds messages within the genre of film as a means of affecting change. The resulting project was a narrative screenplay targeting teenagers/young adults from diverse backgrounds. The goals of the project were to create a film script that, if ultimately made into a film, could serve to: 1) interrupt symptom progression and improve prognosis through early intervention; 2) incorporate techniques from third-wave cognitive behavioral treatment models, acceptance and commitment therapy (ACT) and rational recovery (RR), with a focus on the effects of mindfulness as a means of informing recovery; 3) target issues to do with motivation to change by shifting the perception of eating disorders from culturally specific psychiatric illnesses to habit-based brain wiring issues. Nine licensed clinicians were asked to evaluate two excerpts taken from the final script. They subsequently provided feedback on a Likert-scale, which assessed whether the script had achieved its goals. Overall, evaluators agreed that the project’s etiological and intervention models have the potential to inspire change and serve as an effective means of prevention and treatment of eating disorders. However, one-third of the evaluators did not find the content developmentally appropriate. This is a notable limitation to the study and will need to be addressed in the larger script before the final project can potentially be targeted to a teenage and young adult audience.

Keywords: adolescents, eating disorders, pediatrics, entertainment-education, mindfulness-based intervention, prevention

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Authors: Angelika Dierolf, K. Rischer, A. Gonzalez-Roldan, P. Montoya, F. Anton, M. Van der Meulen

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Placebo analgesia is a powerful cognitive endogenous pain modulation mechanism with high relevance in pain treatment. Older people would benefit, especially from non-pharmacologic pain interventions, since this age group is disproportionately affected by acute and chronic pain, while pharmacological treatments are less suitable due to polypharmacy and age-related changes in drug metabolism. Although aging is known to affect neurobiological and physiological aspects of pain perception, as for example, changes in pain threshold and pain tolerance, its effects on cognitive pain modulation strategies, including placebo analgesia, have hardly been investigated so far. In the present study, we are assessing placebo analgesia in 35 older adults (60 years and older) and 35 younger adults (between 18 and 35 years). Acute pain was induced with short transdermal electrical pulses to the inner forearm, using a concentric stimulating electrode. Stimulation intensities were individually adjusted to the participant’s threshold. Next to the stimulation site, we applied sham transcutaneous electrical nerve stimulation (TENS). Participants were informed that sometimes the TENS device would be switched on (placebo condition), and sometimes it would be switched off (control condition). In reality, it was always switched off. Participants received alternating blocks of painful stimuli in the placebo and control condition and were asked to rate the intensity and unpleasantness of each stimulus on a visual analog scale (VAS). Pain-related evoked potentials were recorded with a 64-channel EEG. Preliminary results show a reduced placebo effect in older compared to younger adults in both behavioral and neurophysiological data. Older people experienced less subjective pain reduction under sham TENS treatment compared to younger adults, as evidenced by the VAS ratings. The N1 and P2 event-related potential components were generally reduced in the older group. While younger adults showed a reduced N1 and P2 under sham TENS treatment, this reduction was considerably smaller in older people. This reduced placebo effect in the older group suggests that cognitive pain modulation is altered in aging and may at least partly explain why older adults experience more pain. Our results highlight the need for a better understanding of the efficacy of non-pharmacological pain treatments in older adults and how these can be optimized to meet the specific requirements of this population.

Keywords: placebo analgesia, aging, acute pain, TENS, EEG

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Authors: Mercedes Sepulveda, Saras Henderson, Dana Farrell, Gaby Heuft

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In Australia, there is a significant number of Culturally and Linguistically Diverse (CALD) Grandparent Carers who are sole carers for their grandchildren. Services in the community such as accessible healthcare, financial support, legal aid, and transport to services can assist Grandparent Carers to continue to live in their own home whilst caring for their grandchildren. Community nurses can play a major role by being aware of the needs of these grandparents and link them to services via information and referrals. The CALD Grandparent Carer experiences have only been explored marginally and may be similar to the general Grandparent Carer population, although cultural aspects may add to their difficulties. This Needs-Gap Analysis aimed to uncover ‘hidden issues’ for CALD Grandparent Carers such as service gaps and actions needed to address these issues. The stakeholders selected for this Needs-Gap Analysis were drawn from relevant service providers such as community and aged care services, child and/or grandparents support services and CALD specific services. One hundred relevant service providers were surveyed using six structured questions via face to face, phone interviews, or email correspondence. CALD Grandparents who had a significant or sole role of being a carer for grandchildren were invited to participate through their CALD community leaders. Consultative Forums asking five questions that focused on the caring role, issues encountered, and what needed to be done, were conducted with the African, Asian, Spanish-Speaking, Middle Eastern, European, Pacific Islander and Maori Grandparent Carers living in South-east Queensland, Australia. Data from the service provider survey and the CALD Grandparent Carer forums were content analysed using thematic principles. Our findings highlighted social determinants of health grouped into six themes. These were; 1) service providers and Grandparent Carer perception that there was limited research data on CALD grandparents as carers; 2) inadequate legal and financial support; 3) barriers to accessing information and advice; 4) lack of childcare options in the light of aging and health issues; 5) difficulties around transport; and 6) inadequate technological skills often leading to social isolation for both carer and grandchildren. Our Needs-Gap Analysis provides insight to service providers especially health practitioners such as doctors and community nurses, particularly on the impact of caring for grandchildren on CALD Grandparent Carers. Furthermore, factors such as cultural differences, English language difficulties, and migration experiences also impacted on the way CALD Grandparent Carers are able to cope. The findings of this Need-Gap Analysis signposts some of the ‘ hidden issues’ that CALD Grandparents Carers face and draws together recommendations for the future as put forward by the stakeholders themselves.

Keywords: CALD grandparents, carer needs, community nurses, grandparent carers

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Authors: Jung Lee

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This study identifies how the cultivation capabilities of social capital influence the overall attitudes of social media users and how these influences differ across user groups. First, the cultivation capabilities of social capital are identified from three aspects, namely, social capital accessibility, potentiality and sensitivity. These three types of social capital acquisition capabilities collectively represent how the social media users perceive the social media environment in terms of possibilities for social capital creation. These three capabilities are hypothesized to influence social media satisfaction and continuing use intention. Next, two essential activities in social media are identified, namely, posting and replying, to categorise social media users based on behavioral patterns. Various social media activities consist of the combinations of these two basic activities. Posting represents the broadcasting aspect of social media, whereas replying represents the communicative aspect of social media. We categorize users into four from communicators to observers by using these two behaviors to develop usage pattern matrix. By applying the usage pattern matrix to the capability model, we argue that posting behavior generally has a positive moderating effect on the attitudes of social media users, whereas replying behavior occasionally exhibits the negative moderating effect. These different moderating effects of posting and replying behavior are explained based on the different levels of social capital sensitivity and expectation of individuals. When a person is highly expecting social capital from social media, he or she would post actively. However, when one is highly sensitive to social capital, he or she would actively respond and reply to postings of other people because such an act would create a longer and more interactive relationship. A total of 512 social media users are invited to answer the survey. They were asked about their attitudes toward the social media and how they expect social capital through this practice. They were asked to check their general social media usage pattern for user categorization. Result confirmed that most of the hypotheses were supported. Three types of social capital cultivation capabilities are significant determinants of social media attitudes, and two social media activities (i.e., posting and replying) exhibited different moderating effects on attitudes. This study provides following discussions. First, three types of social capital cultivation capabilities were identified. Despite the numerous concerns about social media, such as whether it is a decent and real environment that produces social capital, this study confirms that people explicitly expect and experience social capital values from social media. Second, posting and replying activities are two building blocks of social media activities. These two activities are useful in explaining different the attitudes of social media users and predict future usage.

Keywords: social media, social capital, social media satisfaction, social media use intention

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Authors: Muhammad Shafi'u Adamu

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This study examined the effects of two Group Cognitive Behavioural Therapies (Cognitive Restructuring and Rational Emotive Behavioural Therapy) on Psychological Distress of awaiting-trial Inmates in Correctional Centres in North-West, Nigeria. The study had four specific objectives, four research questions, and four null hypotheses. The study used a quasi-experimental design that involved pre-test and post-test. The population comprised of all 7,962 awaiting-trial inmates in correctional centres in North-west, Nigeria. 131 awaiting trial inmates from three intact Correctional Centres were randomly selected using the census technique. The respondents were sampled and randomly put into 3 groups (CR, REBT and Control). Kessler Psychological Distress Scale (K10) was adapted for data collection in the study. The instrument was validated by experts and subjected to pilot study using Cronbach's Alpha with reliability co-efficient of 0.772. Each group received treatment for 8 consecutive weeks (60 minutes/week). Data collected from the field were subjected to descriptive statistics of mean, standard deviation and mean difference to answer the research questions. Inferential statistics of ANOVA and independent sample t-test were used to test the null hypotheses at P≤ 0.05 level of significance. Results in the study revealed that there was no significant difference among the pre-treatment mean scores of experimental and control groups. Statistical evidence also showed a significant difference among the mean sores of the three groups, and thus, results of the Post Hoc multiple-comparison test indicating the posttreatment reduction of psychological distress on the awaiting-trial inmates. Documented output also showed a significant difference between the post-treatment psychologically distressed mean scores of male and female awaiting-trial inmates, but there was no difference on those exposed to REBT. The research recommends that a standardized structured CBT counselling technique treatment should be designed for correctional centres across Nigeria, and CBT counselling techniques could be used in the treatment of PD in both correctional and clinical settings.

Keywords: awaiting-trial inmates, cognitive restructuring, correctional centres, group cognitive behavioural therapies, rational emotive behavioural therapy

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Authors: Ziv Kassner, Gal Ribak

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Members of the Odonata order (dragonflies and damselflies) stand out for their maneuverability and superb flight control, which allow them to catch flying prey in the air. These outstanding aerial abilities were fine-tuned during millions of years of an evolutionary arms race between Odonata and their prey, providing an attractive research model for studying the relationship between sensory input – and aerodynamic output in a flying insect. The ability to catch a maneuvering target in air is interesting not just for insect behavioral ecology and neuroethology but also for designing small and efficient robotic air vehicles. While the aerial prey interception of dragonflies (suborder: Anisoptera) have been studied before, little is known about how damselflies (suborder: Zygoptera) intercept prey. Here, high-speed cameras (filming at 1000 frames per second) were used to explore how damselflies catch unpredictable targets that move through air. Blue-tailed damselflies - Ischnura elegans (family: Coenagrionidae) were introduced to a flight arena and filmed while landing on moving targets that were oscillated harmonically. The insects succeeded in capturing targets that were moved with an amplitude of 6 cm and frequencies of 0-2.5 Hz (fastest mean target speed of 0.3 m s⁻¹) and targets that were moved in 1 Hz (an average speed of 0.3 m s⁻¹) but with an amplitude of 15 cm. To land on stationary or slow targets, damselflies either flew directly to the target, or flew sideways, up to a point in which the target was fixed in the center of the field of view, followed by direct flight path towards the target. As the target moved in increased frequency, damselflies demonstrated an ability to track the targets while flying sideways and minimizing the changes of their body direction on the yaw axis. This was likely an attempt to keep the targets at the center of the visual field while minimizing rotational optic flow of the surrounding visual panorama. Stabilizing rotational optic flow helps in estimation of the velocity and distance of the target. These results illustrate how dynamic visual information is used by damselflies to guide them towards a maneuvering target, enabling the superb aerial hunting abilities of these insects. They also exemplifies the plasticity of the damselfly flight apparatus which enables flight in any direction, irrespective of the direction of the body.

Keywords: bio-mechanics, insect flight, target fixation, tracking and interception

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Authors: Aakriti Chetan Shah, Elle Sein

Abstract:

Background/purpose: Group B Streptococcus(GBS) is the leading cause of severe early onset infection in newborns, with the incidence of Early Onset Group B Streptococcus (EOGBS) in the UK and Ireland rising from 0.48 to 0.57 per 1000 births from 2000 to 2015. A WHO study conducted in 2017, has shown that 38.5% of cases can result in stillbirth and infant deaths. This is an important problem to consider as 20% of women worldwide have GBS colonisation and can suffer from these detrimental effects. Current Royal College of Obstetricians and Midwives (RCOG) guidelines do not recommend bacteriological screening for pregnant women due to its low sensitivity in antenatal screening correlating with the neonate having GBS but advise a patient information leaflet be given to pregnant women. However, a Healthcare Safety Investigation Branch (HSIB) 2019 learning report found that only 50% of trusts and health boards reported giving GBS information leaflets to all pregnant mothers. Therefore, this audit aimed to assess current practices of information dissemination about GBS at Chelsea & Westminster (C&W) Hospital. Methodology: A quantitative cross-sectional study was carried out using a questionnaire based on the RCOG GBS guidelines and the HSIB Learning report. The study was conducted in antenatal clinics at Chelsea & Westminster Hospital, from 29th January 2021 to 14th February 2021, with twenty-two practicing obstetricians and midwives participating in the survey. The main outcome measure was the proportion of obstetricians and midwives who disseminate information about GBS to pregnant women, and the reasons behind why they do or do not. Results: 22 obstetricians and midwives responded with 18 complete responses. Of which 12 were obstetricians and 6 were midwives. Only 17% of clinical staff routinely inform all pregnant women about GBS, and do so at varying timeframes of the pregnancy, with an equal split in the first, second and third trimester. The primary reason for not informing women about GBS was influenced by three key factors: Deemed relevant only for patients at high risk of GBS, lack of time in clinic appointments and no routine NHS screening available. Interestingly 58% of staff in the antenatal clinic believe it is necessary to inform all women about GBS and its importance. Conclusion: It is vital for obstetricians and midwives to inform all pregnant women about GBS due to the high prevalence of incidental carriers in the population, and the harmful effects it can cause for neonates. Even though most clinicians believe it is important to inform all pregnant women about GBS, most do not. To ensure that RCOG and HSIB recommendations are followed, we recommend that women should be given this information at 28 weeks gestation in the antenatal clinic. Proposed implementations include an information leaflet to be incorporated into the Mum and Baby app, an informative video and end-to-end digital clinic documentation to include this information sharing prompt.

Keywords: group B Streptococcus, early onset sepsis, Antenatal care, Neonatal morbidity, GBS

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