Search results for: inclusive health care

Authors: Fardis Teifoori, Mehdi Dehghani, Idoia Postigo, Jorge Martinez

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Introduction: Many skin disorders, such as atopic dermatitis (AD), is characterized by inflammation, infection, and hyperplasia. In this work, keratinocytes from AD patients are used to study the pomegranate seed oil properties for skin care. Material and methods: Isolated keratinocytes from patients with AD were cultured and stimulated by IL-9 (20 ng/ml) and TNF-α (50ng/ml) for 48h to induce vascular endothelial growth factor (VEGF) and Regulated upon activation, normal T cell expressed and secreted (RANTES) production, respectively, in the presence of different concentrations of pomegranate seed oil (20, 50, 100, and 200 µM). Finally, the concentrations of RANTES and VEGF in the cell culture supernatant were quantified according to the standard protocol of commercial ELISA kits. Results: The results indicated that pomegranate seed oil concentrations of 50, 100, and 200 µM could significantly inhibit the production of VEGF and RANTES by stimulating keratinocytes with IL-9 (20 ng/ml) and TNF-α (50ng/ml), respectively. The decrease in VEGF and RANTES concentration in the presence of the pomegranate seed oil concentrations of 20 and 50 uM was not significant. Conclusion: It was concluded that pomegranate seed oil (PSO) counteracts atopic dermatitis conditions dose-dependently: with the highest effect at the concentration of 200 µM. We suggest that the inexpensive and easily available pomegranate seed oil is a good candidate for cosmetics and clinical utilization for skin care.

Keywords: atopic dermatitis, pomegranate, Punica granatum, RANTES, VEGF

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Authors: Zahra Salehi Shahrbabaki, Zahra Chavoshzadeh, Fahimeh Abdollahimajd, Samin Sharafian, Tolue Mahdavi, Mahnaz Jamee

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Background: Inborn errors of immunity (IEIs) are monogenic diseases of the immune the system with broad clinical manifestations. Despite the increasing genetic advancements, the diagnosis of IEIs still leans on clinical diagnosis. Dermatologic manifestations are observed in a large number of IEI patients and can lead to proper approach, prompt intervention and improved prognosis. Methods: This cross-sectional study was carried out between 2018 and 2020 on IEIs at a Children's tertiary care center in Tehran, Iran. Demographic details (including age, sex, and parental consanguinity), age at onset of symptoms and family history of IEI with were recorded. Results :212 patients were included. Cutaneous findings were reported in (95 ,44.8%) patients. and 61 of 95 (64.2%) reported skin lesions as the first clinical presentation. Skin infection (69, 72.6%) was the most frequent cutaneous manifestation, followed by an eczematous rash (24, 25 %). Conclusions: Skin manifestations are common feature in IEI patients and can be readily recognizable by healthcare providers. This study tried to provide information on prognostic consequences.

Keywords: primary immuno deficiency, inborn errror of metabolism, skin manifestation, skin infection

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Authors: Ezinne K. Okoro, Takahiko Katoh, Yoko Kawamura, Stanley C. Meribe

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HIV infection in children is largely as a result of vertical transmission (mother to child transmission [MTCT]). Thus, elimination of mother to child transmission of HIV/AIDS is critical in eliminating HIV infection in children. In Nigeria, drawbacks such as; limited pediatric screening, limited human capital, insufficient advocacy and poor understanding of ART guidelines, have impacted efforts at combating the disease, even as treatment services are free. Prevention of Mother to Child Transmission (PMTCT) program relies on health workers who not only counsel pregnant women on first contact but can competently provide HIV-positive pregnant women with accurate information about the PMTCT program such as feeding techniques and drug adherence. In developing regions like Nigeria where health care delivery faces a lot of drawbacks, it becomes paramount to address these issues of poor PMTCT coverage by conducting a baseline assessment of the knowledge, practices and perceptions related to HIV prevention amongst healthcare workers in Nigeria. A descriptive cross-sectional study was conducted amongst 250 health workers currently employed in health facilities in Abuja, Nigeria where PMTCT services were offered with the capacity to carry out early infant diagnosis testing (EID). Data was collected using a self-administered, pretested, structured questionnaire. This study showed that the knowledge of PMTCT of HIV was poor (30%) among healthcare workers who offer this service day-to-day to pregnant women. When PMTCT practices were analyzed in keeping with National PMTCT guidelines, over 61% of the respondents reported observing standard practices and the majority (58%) had good attitudes towards caring for patients with HIV/AIDS. Although 61% of the respondents reported being satisfied with the quality of service being rendered, 63% reported not being satisfied with their level of knowledge. Predictors of good knowledge were job designation and level of educational attainment. Health workers who were more satisfied with their working conditions and those who had worked for a longer time in the PMTCT service were more likely to observe standard PMTCT practices. With over 62% of the healthcare workers suggesting that more training would improve the quality of service being rendered, this is a strong pointer to stakeholders to consider a ‘healthcare worker-oriented approach’ when planning and conducting PMTCT training for healthcare workers. This in turn will increase pediatric ARV coverage, the knowledge and effectiveness of the healthcare workers in carrying out appropriate PMTCT interventions and culminating in the reduction/elimination of HIV transmission to newborns.

Keywords: attitudes, HIV/AIDS, healthcare workers, knowledge, mother to child transmission, Nigeria, perceptions

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Authors: García López

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The Government Departments of Health have the task of informing and educating citizens about public health issues. For this, they use channels like Twitter, key in the search for health information and the propagation of content. The tweets, important in the virality of the content, may contain emotions that influence the contagion and exchange of knowledge. The goal of this study is to perform an analysis of the emotional projection of health information shared on Twitter by official American accounts: the disease control account CDCgov, National Institutes of Health, NIH, the government agency HHSGov, and the professional organization PublicHealth. For this, we used Tone Analyzer, an International Business Machines Corporation (IBM) tool specialized in emotion detection in text, corresponding to the categorical model of emotion representation. For 15 days, all tweets from these accounts were analyzed with the emotional analysis tool in text. The results showed that their tweets contain an important emotional load, a determining factor in the success of their communications. This exposes that official accounts also use subjective language and contain emotions. The predominance of emotion joy over sadness and the strong presence of emotions in their tweets stimulate the virality of content, a key in the work of informing that government health departments have.

Keywords: emotions in tweets, emotion detection in the text, health information on Twitter, American health official accounts, emotions on Twitter, emotions and content

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Authors: Anan Jarab, Riham Almrayat, Salam Alqudah, Maher Khdour, Tareq Mukattash, Sharell Pinto

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Background: The prevalence of diabetes in Jordan is among the highest in the world, making it a particularly alarming health problem there. It has been indicated that poor adherence to the prescribed therapy lead to poor glycemic control and enhance the development of diabetes complications and unnecessary hospitalization. Purpose: To explore factors associated with medication non-adherence in patients with type 2 diabetes in Jordan. Materials and Methods: Variables including socio-demographics, disease and therapy factors, diabetes knowledge, and health-related quality of life in addition to adherence assessment were collected for 171 patients with type 2 diabetes using custom-designed and validated questionnaires. Logistic regression was performed to develop a model with variables that best predicted medication non-adherence in patients with type 2 diabetes in Jordan. Results: The majority of the patients (72.5%) were non-adherent. Patients were found four times less likely to adhere to their medications with each unit increase in the number of prescribed medications (OR = 0.244, CI = 0.08-0.63) and nine times less likely to adhere to their medications with each unit increase in the frequency of administration of diabetic medication (OR = 0.111, CI = 0.04-2.01). Patients in the present study were also approximately three times less likely (OR = 0.362, CI = 0.24-0.87) to adhere to their medications if they reported having concerns about side effects and twice more likely to adhere to medications (OR = 0.493, CI = 0.08-1.16) if they had one or more micro-vascular complication. Conclusion: The current study revealed low adherence rate to the prescribed therapy among Jordanians with type 2 diabetes. Simplifying dosage regimen, selecting treatments with lower side effects along with an emphasis on diabetes complications should be taken into account when developing care plans for patients with type 2 diabetes.

Keywords: type 2 diabetes, adherence, glycemic control, clinical pharmacist, Jordan

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Authors: D. Osborn, L. Easthope

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The increasing threat of ‘marauding terror,' utilising improvised explosive devices and firearms, has focused the attention of policy makers and emergency responders once again on the treatment of the critically injured patient in a highly volatile scenario. Whilst there have been significant improvements made in the response and lessons learned from recent disasters in the international disaster community there still remain areas of uncertainty and a lack of clarity in the care of the critically injured. This innovative, longitudinal study has at its heart the aim of using ethnographic methods to ‘slow down’ the journey such patients will take and make visible the ethical complexities that 2017 technologies, expectations and over a decade of improved combat medicine techniques have brought. The primary researcher, previously employed in the hospital emergency management environment, has closely followed responders as they managed casualties with life-threatening injuries. Ethnographic observation of Exercise Unified Response in March 2016, exposed the ethical and legal 'vacuums' within a mass casualty and fatality setting, specifically the extrication, treatment and care of critically injured patients from crushed and overturned train carriages. This article highlights a gap in the debate, evaluation, planning and response to an incident of this nature specifically the incapacitated, unidentified patients and the ethics of submitting them to the invasive ‘Disaster Victim Identification’ process. Using a qualitative ethnographic analysis, triangulating observation, interviews and documentation, this analysis explores the gaps and highlights the next stages in the researcher’s pathway as she continues to explore with emergency practitioners some of this century’s most difficult questions in relation to the medico-legal and ethical challenges faced by emergency services in the wake of new and emerging threats and medical treatment expectations.

Keywords: ethics, disaster, Disaster Victim Identification (DVI), legality, unidentified

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Authors: Tang Jiacheng, Fang Tianyu, Liu Yicen, Xiang Xingzhou

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The proportion of healthcare services is increasing throughout the globe. The convergence of mobile technology is driving new business opportunities, innovations in healthcare service delivery and the promise of a better life tomorrow for different populations with various healthcare needs. One of the most important phases for the combination of health care and mobile applications is to elicit requirements correctly. In this paper, four articles from different research directions with four topics on healthcare were detailed analyzed and summarized. We identified the underlying problems in guidance to develop mobile applications to provide healthcare service for Older adults, Women in menopause, Patients undergoing covid. These case studies cover several elicitation methods: survey, prototyping, focus group interview and questionnaire. And the effectiveness of these methods was analyzed along with the advantages and limitations of these methods, which is beneficial to adapt the elicitation methods for future software development process.

Keywords: healthcare, software requirement elicitation, mobile applications, prototyping, focus group interview

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Authors: Anthony Vandarakis

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Today’s International Service Learning practices require an update: modern technologies, fresh educational frameworks, and a new operating system to accountably prosper. This paper describes a model of International Service Learning (ISL), which combines current technological hardware, electronic platforms, and asynchronous communications that are grounded in inclusive pedagogy. This model builds on the work around collaborative field trip learning, extending the reach to international partnerships across continents. Mobile technology, 21^st century skills and summit-basecamp modeling intersect to support novel forms of learning that tread lightly on fragile natural ecosystems, affirm local reciprocal partnership in projects, and protect traveling participants from common yet avoidable cultural pitfalls.

Keywords: International Service Learning, ISL, field experiences, mobile technology, out there in here, summit basecamp pedagogy

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Authors: Narges Hamidipour

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VOD, which stands for "video on demand", is one kind of watching movies and series on web platforms that, by using them, individuals can access lots of video content by paying abonnement. The first platform in Iran was funded in 2014, and in the last 10 years, it has become the main part of the movie and series industry. There are 374 VOD platforms in Iran, but just three of them are in the mainstream. However, in these years, they have been developed and famed in different ways. This article focuses on the reasons for this development in the past years. For the framework, "digital economy", "media industries," and "political economy" have been used with the interview method. In this research, some experts in SATRA (regulatory organization of inclusive audio and video media in Iran), owners or managers of VODs and some others who directly have been in the system conveyed their opinions. By the way, some documents and analysis statistics are invoked to reach complete results.

Keywords: digital economy, political economy, VOD, interview, iran

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Authors: Cheng-Yu Tsai, Chiung-En Huang, Ming-Tsang Wu

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The purpose of this study was to investigate the relationships among leisure motivation, leisure attitude, and health promotion lifestyle. The participants were recruited from a convenience sampling that subjects were at least 55 years of age in Tainan City, Taiwan. Three hundred survey instruments were distributed, and 227 effective instruments were returned, for an effective rate of 75.7%. The collected data were analyzed statistically. The findings of this research were as follows: 1.There is significantly correlated between leisure motivation and leisure attitude. 2. There is significantly correlated between leisure attitude and health promotion lifestyle. 3. There is significantly correlated between leisure motivation and health promotion lifestyle.

Keywords: leisure motivation, leisure attitude, health promotion lifestyle, tourism

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Authors: Abdulazeez Balogun Shittu

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This paper examines the relationship between parochial religiosity and peaceful coexistence in Nigeria. Parochial views, characterized by exclusive interpretations and dogmatic adherence to one's faith, are identified as a significant obstacle to interreligious harmony and social cohesion. Using a mixed-methods approach, the paper investigates how parochial religiosity fosters intergroup tensions, undermines inclusive governance, and hinders constructive dialogue. The parochial religiosity significantly hinders peaceful coexistence in Nigerian society. This research contributes to the ongoing discourse on religion, conflict, and peace building, emphasizing the urgency of addressing parochial religiosity as a major obstacle to harmonious coexistence in multi-religious states in general and Nigerian society in particular.

Keywords: parochial religiosity, peaceful coexistence, Nigerian society, interfaith relations, religious conflicts

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Authors: Sareh Rajabi, Taha Anjamrooz, Ahmed Hassan Almarzooqi

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Employee satisfaction, engagement, and performance are crucial for successful organizations. The performance of the employees now depends on their satisfaction level and whether they are satisfied with the management. Due to this fact, the organizations are now measuring the satisfaction level of their employees to increase profitability, productivity, and turnover. The aim of this research is to inspect the antecedents which direct in the direction of significant employee engagement and good job fit by finding the relationship between employee satisfaction and engagement. Based on an inclusive literature review on the employees’ satisfaction, engagement and performance, this research will conduct a study and survey in the UAE organizations in order to develop a framework for evaluating the impact of factors like employee satisfaction and engagement on the operation as an outcome by using statistical analysis. This study will allow in understanding the advantages of containing satisfied employees and how they perform in their peak motivation to make the company more profitable and competitive.

Keywords: employees’ satisfaction, employees’ engagement, antecedents, outcomes

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Authors: Amadou Darboe, Kuo Hsien-Wen

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Background/Objective: The Effort-Reward Imbalance (ERI) model by Siegrist et al (1986) have been widely used to examine the relationship between psychosocial factors at work and health. It claimed that failed reciprocity in terms of high efforts and low rewards elicits strong negative emotions in combination with sustained autonomic activation and is hazardous to health. The aim of this study is to identify the association between Self-rated Health and Effort-reward Imbalance (ERI) among Nurses and Environmental Health officers in the Gambia. Method: a cross-sectional study was conducted using a multi-stage random sampling of 296 healthcare professionals (206 nurses and 90 environmental health officers) working in public health facilities. The 22 items Effort-reward imbalance questionnaire (ERI-L version 22.11.2012) will be used to collect data on the psychosocial factors defined by the model. In addition, self-rated health will be assessed by using structured questionnaires containing Likert scale items. Results: We found that self-rated health among environmental health officers has a significant negative correlation with extrinsic effort and a positive significant correlations with occupational reward and job satisfaction. However, among the nurses only job satisfaction was significantly correlated with self-rated health and was positive. Overall, Extrinsic effort has a significant negative correlation with reward and job satisfaction but a positive correlation with over-commitment. Conclusion: Because low reward and high over-commitment among the nursing group, It is necessary to modify working conditions through improving psychosocial factors, such as reasonable allocation of resources to increase pay or rewards from government.

Keywords: effort-reward imbalance model, healthcare professionals, self-rated health

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Authors: Fiona Lord

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This paper presents research on strengthening urban governance and planning practices for sustainable and regenerative city transformations looking at urban governance in Cambodia as a case study. Transformations to urban sustainability and regeneration require systemic and long-term transformation processes, across multiple levels of society and inclusive of multiple urban actors. This paper presents the emerging findings of a qualitative case study comparing the urban governance and planning practices in two of Cambodia's secondary cities - Battambang and Sihanoukville. The lessons learned have broader implications for how governance and planning can be strengthened to initiate and sustain urban sustainability transformations in other developing country cities of Cambodia and the Southeast Asia region.

Keywords: Cambodia, planning practices, urban governance, urban sustainability transformations

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Authors: Anzal Abbas Jaffari, Wajiha Javed, Naseem Salahuddin

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Rationale: Rabies, a vaccine preventable disease, continues to be a critical public health issue as it kills around 2000-5000 people annually in Pakistan. Along with the disease spread among animals, the dog population remains a victim of brutal culling practices by the local authorities, which adversely affects ecosystem (sinking of poison in the soil – affecting vegetation & contaminating water) and the disease spread. The dog population has been exponentially rising primarily because a lack of a consolidated nationwide Animal Birth Control program and awareness among the local communities in general and children in particular. This is reflected in Pakistan’s low SARE score - 1.5, which makes the country trails behind other developing countries like Bangladesh (2.5) and Philippines (3.5).According to an estimate, the province of Sindh alone is home to almost 2.5 million dogs. The clustering of dogs in Peri-Urban areas and inner cities localities leads to an increase of reported dog bite cases in these areas specifically. Objective: Rabies Free Pakistan (RFP), which is a joint venture of Getz Pharma Private Limited and Indus Hospital & Health Network (IHHN); it was established in 2018 to eliminate Rabies from Pakistan by 2030 using the One Health Approach. Methodology: The RFP team is actively working on advocacy and policy front with both the Federal & Provincial government to ensure that all stakeholders currently involved in dog culling in Pakistan have a paradigm shift towards humane methods of vaccination and ABC. Along with the federal government, RFP aims to declare Rabies as a notifiable disease. Whereas RFP closely works with the provincial government of Sindh to initiate a province wide Rabies Control Program.RFP program follows international standards and WHO approved protocols for this program in Pakistan.RFP team has achieved various milestones in the fight against Rabies after successfully scaling up project operations and has vaccinated more than 30,000 dogs and neutered around 7,000 dogs since 2018. Recommendations: Effective implementation of Rabies program (MDV and ABC) requires a concentrated effort to address a variety of structural and policy challenges. This essentially demands a massive shift in the attitude of individuals towards rabies. The two most significant challenges in implementing a standard policy at the structural level are lack of institutional capacity, shortage of vaccine, and absence of inter-departmental coordination among major stakeholders: federal government, provincial ministry of health, livestock, and local bodies (including local councils). The lack of capacity in health care workers to treat dog bite cases emerges as a critical challenge at the clinical level. Conclusion: Pakistan can learn from the successful international models of Sri Lanka and Mexico as they adopted the One Health Approach to eliminate rabies like RFP. The WHO advised One Health approach provides the policymakers with an interactive and cross-sectoral guide, which involves all the essential elements of the eco system (including animals, humans, and other components).

Keywords: animal birth control, dog population, mass dog vaccination, one health, rabies elimination

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Authors: Maatouk Mohamed, Nouira Mariem

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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Authors: Zakaria Mowafy Emam Mowafy, Hamed Abd Allah Hamed, Marwa Mahmoud Abd-Elmotalb, Andrew Anis Fakhray Mosaad

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The purpose of this paper is to determine the efficacy of polarized light therapy for chemotherapy-treated cancer patients who have oral mucositis. Methods of evaluation are the measurement of the WHO oral mucositis scale and the common toxicity criteria scale. Methods: Thirty cancer patients receiving chemotherapy (males and females) who had oral mucositis and ulceration pain, and their ages ranged from 30 to 55 years, were divided into two groups. Group (A), composed of 15 patients, received the Bioptron light therapy (BLT) in addition to the routine medical care of oral mucositis. Group (B) received only the routine medical care of oral mucositis; the duration of the BLT application was 10 minutes applied daily for 30 days. Results and conclusion: Results showed that the application of the BLT had valuable healing effects on oral mucositis in cancer patients receiving chemotherapy, as evidenced by the high decreases of the WHO oral mucositis scale and the common toxicity criteria scale.

Keywords: Bioptron light therapy, oral mucositis, WHO oral mucositis scale, common toxicity criteria scale

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Authors: Ricky Leung

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Artificial intelligence (AI) and machine learning (ML) have revolutionized the way health organizations approach social media. The sheer volume of data generated through social media can be overwhelming, but AI and ML can help organizations effectively manage this information to improve the health and well-being of individuals and communities. One way AI can be used to enhance social media in health organizations is through sentiment analysis. This involves analyzing the emotions expressed in social media posts to better understand public opinion and respond accordingly. This can help organizations gauge the impact of their campaigns, track the spread of misinformation, and improve communication with the public. While social media is a useful tool, researchers and practitioners have expressed fear that it will be used for the spread of misinformation, which can have serious consequences for public health. Health organizations must work to ensure that AI systems are transparent, trustworthy, and unbiased so they can help minimize the spread of misinformation. In conclusion, AI and ML have the potential to greatly enhance the use of social media in health organizations. These technologies can help organizations effectively manage large amounts of data and understand stakeholders' sentiments. However, it is important to carefully consider the potential consequences and ensure that these systems are carefully designed to minimize the spread of misinformation.

Keywords: AI, ML, social media, health organizations

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Authors: G. Fouché, J. N. Eloff, K. Wellington

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Acaricides are commonly used to control ticks but are toxic, harmful to the environment and too expensive to resource-limited farmers. Traditionally, many communities in South Africa rely on a wide range of indigenous practices to keep their livestock healthy. One of these health care practices includes the use of medicinal plants and this offers an alternative to conventional medicine. An investigation was conducted at the CSIR in South Africa, and selected indigenous plants used in communities were scientifically evaluated for the management of ticks in animals. 17 plants were selected from 239 plants used traditionally in South Africa. Two different organic extracts were prepared from the 17 samples, resulting in 34 plant samples. These were tested for efficacy against two tick species, namely Rhipicephalus microplus and Rhipicephalus turanicus. The plant extracts were also screened against Vero cells and most were found to have low cytotoxicity. This study has shown that there is potential for the development of botanicals as natural acaricides against ticks that are non-toxic and environmentally benign.

Keywords: South Africa, ticks, plant extracts, Rhipicephalus (Boophilus) microplus

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Authors: Sylvia Acquah

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The assumption that social enterprises are empowering has strong theoretical support, but empirical verification is anecdotal at best. Social enterprises blend social goal with an enterprising idea and therefore in theory these enterprises should provide meaningful jobs that are empowering. Whether jobs created are meaningful, or whether these organizations are practicing social entrepreneurship remains unexplored key questions. This paper addresses these key questions through a comprehensive literature review and an ethnographical study of a Domiciliary Home Care Social Enterprise in the UK. The social entrepreneurs, management and 9 staff members were observed, interviewed and achieves were reviewed and analyzed. In this study, the social entrepreneur’s vision was lost in transition during management change and the organization was only identified as a social enterprise by name. The organization that was set up to tackle lack of continuity in care and create a family of independent carers, was eventually closed down overnight and subjected to investigation by social services and the local council. Also, the ineffectiveness of the organization led to staff being stressed and without the support of the management to help rectify the issues; staff started displaying symptoms of burnout. Social enterprise managers should not only focus on profit maximization or generation, but should equally live up to the core tenets of the enterprise and effectively communicate and gain buy-in of all employees for any changes. Further, there ought to be an independent organization that regulates social enterprises to ensure that they are adhering to their social goals.

Keywords: ethnography, carer, social, enterprise

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Authors: Jonathan D. Recchi

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Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.

Keywords: de-escalation, nursing, emergency department, workplace violence

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Authors: Manar Ahmed Elbadawy

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Background: Empirical evidence suggested that improving nursing teamwork (NTW) may be the key to reducing medical error. The functioning nursing teams require open communication, mutual respect, and shared mental models to activate quality patient care. The complexity and the high demands for specialized nursing knowledge and skill also require nursing staff to consult with one another and work in teams regularly. The current study aimed to evaluate the effect of the nursing teamwork training program on nursing teamwork effectiveness. Design: A quasi-experimental (one group pretest-posttest) design was utilized. Three medical intensive care units at a teaching hospital affiliated to Cairo University Hospital, Egypt. Subjects: A convenient sample of 48 nursing staff worked at the selected units. The Nursing Teamwork Observational Checklist was used. Results: Total (NTW) mean scores exhibited quite elevation post-program implementation compared to preprogram and showed little decrease 3 months later ( = 2.52, SD = ± 0.27, mean % =51.98, = 2.72, SD = ± 0.20, mean %=72.45, = 2.67, SD = ± 0.11, mean %= 67.48 respectively). Conclusion: Implementation of (NTW) training program had a positive effect on increasing (NTW) effectiveness. Regular and frequent short-term teamwork training is important to be introduced as well as sustainable monitoring is required to ensure nursing attitudes, knowledge and skills’ change about teamwork effectiveness.

Keywords: effectiveness, nursing, teamwork, training

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Authors: Rosabelle Boswell

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South Africa, a country with experience of both colonial rule and apartheid is now more than 25 years past its first democratic elections. However, and as noted in this article, South Africa is still experiencing the legacies of racial segregation and is concerned to address inequality by attracting investment for socioeconomic development. The paper offered considers five cultural heritage impact assessments conducted in South Africa for offshore oil and gas exploration and development. The results of the research, from more than 20 towns and cities in southern Africa, indicate a rich intangible cultural heritage in South Africa and Namibia, and the potential impacts on investor engagements for more inclusive and sustainable coastal development practices. The discussion advances critical heritage studies, taking into account socioeconomic realities and aboriginal concepts of nature and nature management.

Keywords: cultural heritage impact assessments, intangible cultural heritage, South Africa, ocean philosophies

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Authors: F. Marchini, A. Caputo, J. Balonan, F. Fedele, A. Napoli, V. Langher

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Aim: The present study aims to explore the specific role of defense mechanisms in persons with type 2 diabetes mellitus in treatment adherence. Materials and methods: A correlational study design was employed. Thirty-two persons with type 2 diabetes mellitus were enrolled and assessed with Defense Mechanism Inventory, Beck Depression Inventory-II, Toronto Alexithymia Scale and Self-Care Inventory-Revised. Bivariate correlation and two-step regression analyses were performed. Results: Treatment adherence negatively correlates with hetero-directed hostility (r= -.537; p < .01), whereas it is positively associated with principalization (r= .407; p < .05). These two defense mechanisms overall explain an incremental variance of 26.9% in treatment adherence (ΔF=4.189, df1=2, df2 =21, p < .05), over and above the control variables for depression and alexithymia. However, only higher hetero-directed hostility is found to be a solid predictor of a decreased treatment adherence (β=-.497, p < .05). Conclusions: Despite providing preliminary results, this pilot study highlights the original contribution of defense mechanisms in adherence to type 2 diabetes regimens. Specifically, hetero-directed hostility may relate to an unconscious process, according to which disease-related painful feelings are displaced onto care relationships with negative impacts on adherence.

Keywords: alexithymia, defense mechanisms, treatment adherence, type 2 diabetes mellitus

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Authors: B. O. Adegoke, B. O. Ola, D. T. Ademiluyi

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This paper examines the use of computer and its related health hazard among computer users in South-Western zone of Nigeria. Two hundred and eighteen (218) computer users constituted the population used to evaluate association between posture, extensive computer use and related health hazard. The instruments for the study are a questionnaire on demographics, lifestyle, body features and work ability index while mean rating, standard deviation and t test were used for data analysis. Identified health related hazard include damages to the eyesight, bad posture, arthritis, musculoskeletal disorders, headache, stress and so on. The results showed that factors such as work demand, posture, closeness to computer screen and excessive working hours on computers constitute health hazards in both old and young computer users of various gender. It is therefore recommended that total number of hours spent with computer should be monitored and controlled.

Keywords: computer-related health hazard, musculoskeletal disorders, computer usage, work ability index

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Authors: A. Noll, J. Roth, M. Scholz

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The importance of written language in a democratic society is non-controversial. Students with physical, learning, cognitive or developmental disabilities often have difficulties in understanding information which is presented in written language only. These students suffer from obstacles in diverse domains. In order to reduce such barriers in educational as well as in out-of-school areas, access to written information must be facilitated. Readability can be enhanced by linguistic simplifications like the application of easy-to-read language. Easy-to-read language shall help people with disabilities to participate socially and politically in society. The authors state, for example, that only short simple words should be used, whereas the occurrence of complex sentences should be avoided. So far, these guidelines were not empirically proved. Another way to reduce reading barriers is the use of visual support, for example, symbols. A symbol conveys, in contrast to a photo, a single idea or concept. Little empirical data about the use of symbols to foster the readability of texts exist. Nevertheless, a positive influence can be assumed, e.g., because of the multimedia principle. It indicates that people learn better from words and pictures than from words alone. A qualitative Interview and Eye-Tracking-Study, which was conducted by the authors, gives cause for the assumption that besides the illustration of single words, the visualization of complete sentences may be helpful. Thus, the effect of photos, which illustrate the content of complete sentences, is also investigated in this study. This leads us to the main research question which was focused on: Does the use of easy-to-read language and/or enriching text with symbols or photos facilitate pupils’ comprehension of learning tasks? The sample consisted of students with learning difficulties (N = 144) and students without SEN (N = 159). The students worked on the tasks, which dealt with introducing fractions, individually. While experimental group 1 received a linguistically simplified version of the tasks, experimental group 2 worked with a variation which was linguistically simplified and furthermore, the keywords of the tasks were visualized by symbols. Experimental group 3 worked on exercises which were simplified by easy-to-read-language and the content of the whole sentences was illustrated by photos. Experimental group 4 received a not simplified version. The participants’ reading ability and their IQ was elevated beforehand to build four comparable groups. There is a significant effect of the different setting on the students’ results F(3,140) = 2,932; p = 0,036*. A post-hoc-analyses with multiple comparisons shows that this significance results from the difference between experimental group 3 and 4. The students in the group easy-to-read language plus photos worked on the exercises significantly more successfully than the students who worked in the group with no simplifications. Further results which refer, among others, to the influence of the students reading ability will be presented at the ICERI 2018.

Keywords: inclusive education, mathematics education, easy-to-read language, photos, symbols, special educational needs

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Authors: Pierre Angelo Alino, Rafael Alejandro Ang, Maria Carmela Espanol, Dominic Gerard Ferreol, Jendrietch Adrian Lopez

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This study aims to explore the differences in perception between Generation X and Generation Z towards mental health and mental health illnesses. Through this study, the researchers seek to identify and explore the differences that exist in the generational perception and determine the possible factors that influence the difference in perception. In order to achieve this, we conducted two focus group discussions (FGD), one composed of Generation X and the other composed of Generation Z. Participants for both focus group discussions were recruited through purposive sampling and online recruitment methods. In these discussions, they were asked questions relating to their personal history, experiences with mental health, and related illnesses, as well as their opinions regarding the subject matter. Afterwhich, we analyzed our data through a thematic analysis. Our study’s findings indicate notable differences in the perception of mental health as well as mental illness between the members of Generations X and Z. Additionally, factors such as culture, personal history, and intimate relationships influence the perceptions of mental health between generation groups.

Keywords: generational difference, mental health, mental health illness, perception

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Authors: Adistya Maulidya, Mujuna Abbas, Nur Assyifa, Putri Dewi Gutiyani

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Countries are moving forward to develop databases from electronic health records for monitoring and research. Since the issuance of Information and Electonic Transaction Constitution No. 11 of 2008 as well as Minister Regulation No. 269 of 2008, there has been a gradual progress of Indonesian hospitals adopting Electonic Health Record (EHR) in its systems. This paper is the result of a literature study about the progress that has been made in Indonesia to develop national health information infrastructure through EHR within the hospitals. The purpose of this study was to describe trends in adoption of EHR systems among hospitals in Indonesia from 2008 to 2015 as well as to assess the preparedness of Indonesian national health information infrastructure facing ASEAN Economic Community.

Keywords: adoption, Indonesian hospitals, electronic health record, ASEAN economic community

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Authors: Cherng-Jye Jeng, Ming-Feng Hou, Hsing-Yuan Liu, Chuan-Feng Chang, Lih-Rong Wang, Yen-Chin Lin

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Introduction: The incidence of breast cancer has gradually increased in Taiwan, and the characteristic of younger ages impact these women in their middle age, and may also cause challenges in terms of family, work, and illness. Breasts are symbols of femininity, as well as of sex. For women, breasts are important organs for the female identity and sexual expression. Losing breasts not only affects the female role, but would also affect sexual attraction and sexual desire. Thus, women with breast cancer who have need for mastectomies experience physical incompletion, which affects women’s self-confidence, physical image, and self-orientation. Purposes: 1. To understand the physical experience of women with breast cancer. 2. To explore the issue of sexual issues on the health effects of women with breast cancer. 3. To construct a domestic sex life issue group model for domestic women with breast cancer. 4. To explore the accompaniment experiences and sexual relationship adjustments of spouses when women have breast cancer. Method: After the research plan passes IRB review, participants will be recruited at breast surgery clinic in the affiliated hospital, to screen suitable subjects for entry into the group. Between March and May 2015, two sexual health and sex life consultation groups were conducted, which were (1) 10 in postoperative groups for women with cancer; (2) 4 married couples group for postoperative women with cancer. After sharing experiences and dialogue, women can achieve mutual support and growth. Data organization and analysis underwent descriptive analysis in qualitative research, and the group process was transcribed into transcripts for overall-content and category-content analysis. Results: Ten women with breast cancer believed that participating in group can help them exchange experiences, and elevate sexual health. The main issues include: (1) after breast cancer surgery, patients generally received chemotherapy or estrogen suppressants, causing early menopause; in particular, vaginal dryness can cause pain or bleeding in intercourse, reducing their desire for sexual activity; (2) breast cancer accentuates original spousal or family and friend relationships; some people have support and care from their family, and spouses emphasize health over the appearance of breasts; however, some people do not have acceptance and support from their family, and some even hear spousal sarcasm about loss of breasts; (3) women with breast cancer have polarized expressions of optimism and pessimism in regards to their emotions, beliefs, and body image regarding cancer; this is related to the women’s original personalities, attribution of causes of cancer, and extent of worry about relapse. Conclusion: The research results can be provided as a reference to medical institutions or breast cancer volunteer teams, to pay attention to maintaining the health of women with breast cancer.

Keywords: women with breast cancer, experiences of objectifying the body, quality of sex life, sexual health

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Authors: Abdela Zeinu Yasin

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The current research aimed to assess the status of IMC in providing treatment for malnourished children and programs in water, sanitation, and hygiene (WASH), food and livelihood security, and comprehensive healthcare through Mobile health and nutrition programs during the last 5 years period. We have conducted 60 in-depth interviews with women during the period from conception to a child’s birthday, health facility staff, and female community health volunteers (FCHVs), as well as 12 focus group discussions with health facility staff and other household decision-makers. We employed thematic analysis using framework matrices and analytical memorandums. The study revealed that 78% of the respondents, of whom 97% were women, have benefited from the selected vulnerable areas. The use of the clear water and sanitization program has reached the 81% of selected households. The use of a modern baby delivery system among the respondent has been 68% of the women and health facilities among the decision-makers/focal person. More than 8 in 10 participants (84%) could read and understand the health facility instructions, and the majority (82%) of women, health facility staff, and male decision-makers can also read and write bulletins and instructions. We found that decision-maker women preferred participative education, whereas health facilities and the IMC desired educational and motivational bulletins. A Mobile Health and Nutrition program intervention by the IMC is acceptable in the conditions of the Ethiopian community and has the potential to improve community health and nutrition service utilization, particularly by providing clean water and sanitization; women’s birth control, and health improvement in the vulnerable regions of the country. The current research findings shall contribute to text IMC Mobile Health and Nutritional intervention design in under-resourced settings.

Keywords: clean water, health and nutrition services, hygiene, IMC, mobile health, sanitation

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