Search results for: Kangaroo mother care
Commenced in January 2007
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Edition: International
Paper Count: 4231

Search results for: Kangaroo mother care

1891 Investigation of Preschool Children's Mathematics Concept Acquisition in Terms of Different Variables

Authors: Hilal Karakuş, Berrin Akman

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Preschool years are considered as critical years because of shaping the future lives of individuals. All of the knowledge, skills, and concepts are acquired during this period. Also, basis of academic skills is based on this period. As all of the developmental areas are the fastest in that period, the basis of mathematics education should be given in this period, too. Mathematics is seen as a difficult and abstract course by the most people. Therefore, the enjoyable side of mathematics should be presented in a concrete way in this period to avoid any bias of children for mathematics. This study is conducted to examine mathematics concept acquisition of children in terms of different variables. Screening model is used in this study which is carried out in a quantity way. The study group of this research consists of total 300 children, selected from each class randomly in groups of five, who are from public and private preschools in Çankaya, which is district of Ankara, in 2014-2015 academic year and attending children in the nursery classes and preschool institutions are connected to the Ministry of National Education. The study group of the research was determined by stage sampling method. The schools, which formed study group, are chosen by easy sampling method and the children are chosen by simple random method. Research data were collected with Bracken Basic Concept Scale–Revised Form and Child’s Personal Information Form generated by the researcher in order to get information about children and their families. Bracken Basic Concept Scale-Revised Form consists of 11 sub-dimensions (color, letter, number, size, shape, comparison, direction-location, and quantity, individual and social awareness, building- material) and 307 items. Subtests related to the mathematics were used in this research. In the “Child Individual Information Form” there are items containing demographic information as followings: age of children, gender of children, attending preschools educational intuitions for children, school attendance, mother’s and father’s education levels. At the result of the study, while it was found that children’s mathematics skills differ from age, state of attending any preschool educational intuitions , time of attending any preschool educational intuitions, level of education of their mothers and their fathers; it was found that it does not differ by the gender and type of school they attend.

Keywords: preschool education, preschool period children, mathematics education, mathematics concept acquisitions

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1890 Validation of an Educative Manual for Patients with Breast Cancer Submitted to Radiation Therapy

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

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

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

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1889 The Economic Impact of State Paid Family Leave and Medical Acts on Working Families with Old and Disabled Adults

Authors: Ngoc Dao

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State Paid Leave Programs (PFL) complement the Federal Family and Medical Leave Act (FMLA) by offering workers time off to take care of their newborns or sick family members with supplemental income, and further job protection. Up to date, four states (California, New Jersey, Rhode Island, and New York) implemented paid leave policies. This study adds further understanding of how state PFL policies help working families with elder parents improve their work balance by examining the paid leave policies on labor outcomes. Early findings suggest State Paid Leave Policies reduced the likelihood to exit the labor market by 1.6 percentage points, with larger effects among paid leave policies with job protection feature. In addition, the results imply job protection in paid leave policies matters in helping employed caregivers attach to the labor market.

Keywords: family paid leave, working caregivers, employment, social welfare

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1888 Unforeseen Inequity: Childhood Sexual Abuse in Aotearoa, New Zealand

Authors: Nicola Harrison

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Familial childhood sexual abuse (FCSA) prevalence rates in Aotearoa, New Zealand, are amongst the highest globally, particularly in indigenous communities. However, such statistics seem incongruent with indigenous paradigms of unity, care, and connection. The inability of policymakers and mainstream service providers to acknowledge the direct links between the social contexts created by colonisation for indigenous families in Aotearoa and intergenerational FCSA has meant there has been little meaningful success in combatting this significant social problem. This research traces the conditions of intergenerational FCSA to the systemic inequalities created by colonization. Kaupapa Māori methodologies were applied to this qualitative piece of empirical research wherein 17 indigenous contributors shared their stories of FCSA. From these stories and existing literature, we can identify how the machinations of colonisation are mirrored by techniques used to perpetrate abuse. Once identified, we are then able to recommend actions for halting FCSA for future generations.

Keywords: indigenity, family violence, childhood sexual abuse, colonization

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1887 A Comparative Study of the Evolution of Disparities in Salaries of Hospital Executives

Authors: Lesley Clack, Rachel Ellison, Elizabeth Chambers

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A belief exists that there are huge gender and racial disparities among hospital CEO’s in the United States, and historically, male, Caucasian healthcare executives have made significantly larger salaries than females and other races. With a recent focus on reducing barriers and disparities in healthcare, it remains to be seen whether there have been changes in these disparities over time. The purpose of this study was to explore disparities among salaries of hospital executives in the United States. Analysis of salary data was conducted utilizing online hospital salary databases. Statistical analysis was conducted to examine the significance of the differences. Results indicated that there had been improvements in disparities among some ethnicities. Gender disparities remain the largest gap. The implications of this study are significant for the field of healthcare management as disparities can affect both social dynamics and organizational culture. Understanding where disparities lie is the first step towards bridging the gap and reducing barriers for cultural diversity within healthcare management.

Keywords: health care, disparities, management, executives

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1886 Treatment Outcome Of Corneal Ulcers Using Levofloxacin Hydrate 1.5% Ophthalmic Solution And Adjuvant Oral Ciprofloxacin, A Treatment Strategy Applicable To Primary Healthcare

Authors: Celine Shi Ying Lee, Jong Jian Lee

Abstract:

Background: Infectious keratitis is one of the leading causes of blindness worldwide. Prompt treatment with effective medication will control the infection early, preventing corneal scarring and visual loss. fluoroquinolones ophthalmic medication is used because of its broad-spectrum properties, potency, good intraocular penetration, and low toxicity. The study aims to evaluate the treatment outcome of corneal ulcers using Levofloxacin 1.5% ophthalmic solution (LVFX) with adjuvant oral ciprofloxacin when indicated and apply this treatment strategy in primary health care as first-line treatment. Methods: Patients with infective corneal ulcer treated in an eye center were recruited. Inclusion criteria includes Corneal infection consistent with bacterial keratitis, single or multiple small corneal ulcers. Treatment regime: LVFX hourly for the first 2 days, 2 hourly from the 3rd day, and 3 hourly on the 5th day of review. Adjuvant oral ciprofloxacin 500mg BD was administered for 5 days if there were multiple corneal ulcers or when the location of the cornea ulcer was central or paracentral. Results: 47 subjects were recruited. There were 16 (34%) males and 31 (66%) females. 40 subjects (85%) were contact lens (CL) related to corneal ulcer, and 7 subjects (15%) were non-contact lens related. 42 subjects (89%) presented with one ulcer, of which 20 of them (48%) needed adjuvant therapy. 5 subjects presented with 2 or 3 ulcers, of which 3 needed adjuvant therapy. A total of 23 subjects (49%) was given adjuvant therapy (oral ciprofloxacin 500mg BD for 5 days).21 of them (91%) were CL related. All subjects recovered fully, and the average duration of treatment was 3.7 days, with 49% of the subjects resolved on the 3rd day, 38% on the 5thday of and 13% on the 7thday. All subjects showed symptoms of relief of pain, light-sensitivity, and redness on the 3rd day with full visual recovery post-treatment. No adverse drug reactions were recorded. Conclusion: Our treatment regime demonstrated good clinical outcome as first-line treatment for corneal ulcers. A corneal ulcer is a common eye condition in Singapore, mainly due to CL wear. Pseudomonas aeruginosa is the most frequent and potentially sight-threatening pathogen involved in CL related corneal ulcer. Coagulase-negative Staphylococci, Staphylococcus aureus, and Streptococcus Pneumoniae were seen in non-CL users. All these bacteria exhibit good sensitivity rates to ciprofloxacin and levofloxacin. It is therefore logical in our study to use LVFX Eyedrops and adjuvant ciprofloxacin oral antibiotics when indicated as first line treatment for most corneal ulcers. Our study of patients, both CL related and non-CL related, have shown good clinical response and full recovery using the above treatment strategy. There was also a full restoration of visual acuity in all the patients. Eye-trained primary Healthcare practitioners can consider adopting this treatment strategy as first line treatment in patients with corneal ulcers. This is relevant during the COVID pandemic, where hospitals are overwhelmed with patients and in regions with limited access to specialist eye care. This strategy would enable early treatment with better clinical outcome.

Keywords: corneal ulcer, levofloxacin hydrate, treatment strategy, ciprofloxacin

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1885 Indoor Temperature, Relative Humidity and CO₂ Level Assessment in a Publically Managed Hospital Building

Authors: Ayesha Asif, Muhammad Zeeshan

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The sensitivity of hospital-microenvironments for all types of pollutants, due to the presence of patients with immune deficiencies, makes them complex indoor spaces. Keeping in view, this study investigated indoor air quality (IAQ) of two most sensitive places, i.e., operation theater (OT) and intensive care unit (ICU), of a publically managed hospital. Taking CO₂ concentration as air quality indicator and temperature (T) and relative humidity (RH) as thermal comfort parameters, continuous monitoring of the three variables was carried out. Measurements were recorded at an interval of 1 min for weekdays and weekends, including occupational and non-occupational hours. Outdoor T and RH measurements were also used in the analysis. Results show significant variation (p < 0.05) in CO₂, T and RH values over the day during weekdays while no significant variation (p > 0.05) have been observed during weekends of both the monitored sites. Maximum observed values of CO₂ in OT and ICU were found to be 2430 and 624 ppm, T as 24.7ºC and 28.9ºC and RH as 29.6% and 32.2% respectively.

Keywords: indoor air quality, CO₂ concentration, hospital building, comfort assessment

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1884 Effect of Preconception Picture-Based Nutrition Education on Knowledge and Adherence to Iron-Folic Acid Supplementation Among Women Planning to Be Pregnant in Ethiopia

Authors: Anteneh Berhane Yeyi, Tefera Belachew

Abstract:

Any woman who could become pregnant is at risk of having a baby with neural tube defects (NTDs). A spontaneous aborted women with immediately preceding pregnancy may have an increased risk of develop NTDs. Ethiopia has one of the highest rates of micronutrient deficiencies, including folate and iron deficiency. Currently, in Ethiopia, NTDs is emerged as a public health concern. Even if Ethiopia, has implement different strategies for reducing maternal and neonatal mortality and morbidity, there is no room in the health care system and lack of integration for preventing the risk of NTDs for those women who aborted spontaneously and women who discontinue long acting contraception to become pregnant. The purpose of this study was to evaluate the effect of preconception picture-based nutrition education on knowledge and adherence to iron-folic acid supplement (IFAS) intake to reduce the risk of developing neural tube defects (NTDs) and iron deficiency anemia (IDA) among women who had a planned to pregnancy in Ethiopia, a country with a high burden of NTDs. Methodology: This study was conducted in Eastern Ethiopia. A double blinded parallel randomized controlled trial design was employed among women in the age group of 18-45 years who requested to interrupt modern contraceptive who have an intention to be pregnant and women with spontaneous abortion who refused to take a contraceptive. The interventional arm (n=122) received a preconception picture-based nutrition education with iron-folic acid supplement, and the control arm (n=122) received only preconception IFAS. In this study male partners were participated. Result: After three months of intervention the proportion of adherence to IFAS was 23% (n=56). With regard to adherence within the groups, 42.6% (n=52) in the intervention group and 3.3% (n=4) in the control group and the intervention group were significantly higher than in control group. In the intervention group the proportion of adherence to IFAS intake among participants increased by 40.1% and there were statistically difference (P<0.0001). The difference in difference between the two groups of adherence to IFAS intake was 37.6% and there were a statistical significance (P<0.0001). Level of knowledge between the groups did differ before and after intervention (P= 0.87 Vs P<0.0001). The overall the mean change in knowledge Mean (+SE) between group was 0.9 (+3.04 SE) and there were significant differences between two groups (P<0.001). Conclusion: In general this intervention is effective toward adherence to IFAS and a critical milestone to improve maternal health and reduce the neonate mortality due to NTDs and other advert effect of pregnancy and birth outcomes. This intervention is very short, simple, and cost effective and has potential for adaptation, feasible development to large-scale implementation in the existing health care system. Furthermore, this type of interventional approach has the potential to reduce the country's ANC program dropout rates and increase male partner’s participation on reproductive health.

Keywords: NTDs, IFAS, WRA, Ethiopia

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1883 Bringing Ethics to a Violent System

Authors: Zeynep Selin Acar

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In international system, there has always been a cycle of violence, war and peace. As there travels the time, after Christianity and later Just War theorists, international relations theorists have been tried to limit violence and war. As pieces of international law, Peace of Augsburg, Kellog-Briand Pact, League of Nations Covenant and UN Charter were and are still not effective to prevent war. Moreover, in order to find a way around these rules, it is believed that a new excuse started to be used instead of violence or war, humanitarian intervention. However, it has neither a legal nor a universally accepted framework. As a result, it is open to be manipulated by states. In order to prevent this, Responsibility to Protect (RtoP) which gives a state the responsibility to protect its citizens against violence, is created. Additionally, RtoP transfers this responsibility to regional or international group of states at the time when a state is the origin of violence. In the lights of these, this paper analyzes RtoP as an ethical approach to war and peace studies because it provides other states as guardians and care-takers of people who do not belong to them or do not share any togetherness.

Keywords: ethics, humanitarian intervention, responsibility to protect, UN charter

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1882 Stigmatisation of People Living with HIV/AIDS as an Obstacle to Prevention of HIV

Authors: Vicent Lwanga

Abstract:

Background: Despite sensitization workshops that have been going on in rural areas in Kapchorwa District in Uganda to prevent stigmatization of People Living With HIV/AIDS (PLWHA), interview with PLWHA sows that they are still being stigmatized. This behavior of some people within the community possesses a serious danger to the successful prevention and control of HIV in our society. Evidence exists that some people still believe that eating, living together, and even discussing with PLWHA might make them infected, too, despite all persuasions against such attitude. Description: A face to face interview with some selected PLWHA in Kapchorwa, testified that stigmatization against those who have disclosed their status still lingers on. The interviews with the PLWHA reveals that people still believe that they are being bewitched and cursed by God for their sins, and as such, people keep away from them to avoid the wrath of God. Findings: The more the stigmatization against the PLWHA persists, the more difficult it will be to successfully prevent, control, and eradicate HIV in the society. This is because many PLWHA would prefer not to be identified if they are not shown love and care. Conclusion: A more continuous campaign to stop the stigmatization of PLWHA needs to be on-going. This could be done more effectively by Community-Based Organisations (CBOs) with workshops, print media, and seminars.

Keywords: aids, community, HIV, stigma

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1881 Investigation of Mangrove Area Effects on Hydrodynamic Conditions of a Tidal Dominant Strait Near the Strait of Hormuz

Authors: Maryam Hajibaba, Mohsen Soltanpour, Mehrnoosh Abbasian, S. Abbas Haghshenas

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This paper aims to evaluate the main role of mangroves forests on the unique hydrodynamic characteristics of the Khuran Strait (KS) in the Persian Gulf. Investigation of hydrodynamic conditions of KS is vital to predict and estimate sedimentation and erosion all over the protected areas north of Qeshm Island. KS (or Tang-e-Khuran) is located between Qeshm Island and the Iranian mother land and has a minimum width of approximately two kilometers. Hydrodynamics of the strait is dominated by strong tidal currents of up to 2 m/s. The bathymetry of the area is dynamic and complicated as 1) strong currents do exist in the area which lead to seemingly sand dune movements in the middle and southern parts of the strait, and 2) existence a vast area with mangrove coverage next to the narrowest part of the strait. This is why ordinary modeling schemes with normal mesh resolutions are not capable for high accuracy estimations of current fields in the KS. A comprehensive set of measurements were carried out with several components, to investigate the hydrodynamics and morpho-dynamics of the study area, including 1) vertical current profiling at six stations, 2) directional wave measurements at four stations, 3) water level measurements at six stations, 4) wind measurements at one station, and 5) sediment grab sampling at 100 locations. Additionally, a set of periodic hydrographic surveys was included in the program. The numerical simulation was carried out by using Delft3D – Flow Module. Model calibration was done by comparing water levels and depth averaged velocity of currents against available observational data. The results clearly indicate that observed data and simulations only fit together if a realistic perspective of the mangrove area is well captured by the model bathymetry data. Generating unstructured grid by using RGFGRID and QUICKIN, the flow model was driven with water level time-series at open boundaries. Adopting the available field data, the key role of mangrove area on the hydrodynamics of the study area can be studied. The results show that including the accurate geometry of the mangrove area and consideration of its sponge-like behavior are the key aspects through which a realistic current field can be simulated in the KS.

Keywords: Khuran Strait, Persian Gulf, tide, current, Delft3D

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1880 Progress of Research on Community Canteens and Reflections on Planning in China

Authors: Xi Zuo

Abstract:

Against the background of the aging population and changing family structure in China, community canteens have become an important vehicle for community-based home care services and a new space for social interaction. In this paper, we review past studies and the actual construction situation in China, firstly sort out the social interaction of the elderly and the types of places, and on this basis, we find that there is an obvious disconnection between the current construction and the academic research, and the contradiction between social benefit and cost-effectiveness, and therefore we put forward the relevant construction planning and thinking, in order to provide a disciplinary basis and academic support for the construction of community canteens and the construction of elderly-friendly cities. In order to provide disciplinary basis and academic support for the construction of community canteens and the construction of senior-friendly cities.

Keywords: urban and rural planning, community canteens, elderly people, senior-friendly

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1879 Robots for the Elderly at Home: For Men Only

Authors: Christa Fricke, Sibylle Meyer, Gert G. Wagner

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Our research focuses on the question of whether assistive and social robotics could pose a promising strategy to support the independent living of elderly people and potentially relieve relatives of any anxieties. To answer the question of how elderly people perceive the potential of robotics, we analysed the data from the Berlin Aging Study BASE-II (https://www.base2.mpg.de/de) (N=1463) and data from the German SYMPARTNER study (http://www.sympartner.de) (N=120) and compared those to a control group made up of people younger than 30 years (BASE II: N=241; SYMPARTNER: N=30). BASE-II is a cohort study of people living in Berlin, Germany. The sample covers more than 2200 cases; a questionnaire on the use and acceptance of assistive and social robots was carried out with a sub-sample of 1463 respondents in 2015. The SYMPARTNER study was done by SIBIS institute of Social Research, Berlin and included a total of 120 persons between the ages of 60 and 87 in Berlin and the rural German federal state of Thuringia. Both studies included a control group of persons between the ages of 20 and 35 (BASE II: N=241; SYMPARTNER: N=30). Additional data, representative for the whole population in Germany, will be surveyed in fall 2017 (Survey “Technikradar” [technology radar] by the National Academy of Science and Engineering). Since this survey is including some identical questions as BASE-II/SYMPARTNER, comparative results can be presented at 20th International Conference on Social Robotics in New York 2018. The complexity of the data gathered in BASE-II and SYMPARTNER, encompassing detailed socio-economic background characteristics as well as personality traits such as the personal attitude to risk taking, locus of control and Big Five, proves highly valuable and beneficial. Results show that participants’ expressions of resentment against robots are comparatively low. Participants’ personality traits play a role, however the effect sizes are small. Only 15 percent of participants received domestic robots with great scepticism. Participants aged older than 70 years expressed greatest rejection of the robotic assistant. The effect sizes however account for only a few percentage points. Overall, participants were surprisingly open to the robot and its usefulness. The analysis also shows that men’s acceptance of the robot is generally greater than that of women (with odds ratios of about 0.6 to 0.7). This applies to both assistive robots in the private household and in care environments. Men expect greater benefits of the robot than women. Women tend to be more sceptical of their technical feasibility than men. Interview results prove our hypothesis that men, in particular of the age group 60+, are more accustomed to delegate household chores to women. A delegation to machines instead of humans, therefore, seems palpable. The answer to the title question of this planned presentation is: social and assistive robots at home robots are not only accepted by men – but by fewer women than men.

Keywords: acceptance, care, gender, household

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1878 Development and Evaluation of Antimicrobial Herbal Mouthwash Including Methanolic Extracts of Beautea monosperma and Cordia obliqua

Authors: Reenu Yadav, S. K. Yadav

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Herbal therapy has been used for daily oral health care to prevent, treat or cure oral conditions from halitosis to periodontal diseases. The importance of mouth and teeth cleanliness has been recognized from the earliest days of civilization to the 21st century. In the present study, leaves and seeds of Cordia obliqua and barks and twigs of Beautea monosperma, which is used traditionally for oral diseases was evaluated for its antimicrobial activity. The antimicrobial activity tests indicated that the methanolic extract exhibited stronger activities against the commonly encountered oral bacterial and fungal pathogens. The mouthwash formulation prepared and it is compared with marketed formulation HiOra. The results indicated that the herbal mouthwash could inhibit the growth of oral pathogens and may prevent plaque and other periodontal diseases caused by dental pathogens.

Keywords: herbal mouthwash, bio medicine, life sciences, herbal extracts

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1877 Restoration and Conservation of Historical Textiles Using Covalently Immobilized Enzymes on Nanoparticles

Authors: Mohamed Elbehery

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Historical textiles in the burial environment or in museums are exposed to many types of stains and dirt that are associated with historical textiles by multiple chemical bonds that cause damage to historical textiles. The cleaning process must be carried out with great care, with no irreversible damage, and sediments removed without affecting the original material of the surface being cleaned. Science and technology continue to provide innovative systems in the bio-cleaning process (using pure enzymes) of historical textiles and artistic surfaces. Lipase and α-amylase were immobilized on nanoparticles of alginate/κ-carrageenan nanoparticle complex and used in historical textiles cleaning. Preparation of nanoparticles, activation, and enzymes immobilization were characterized. Optimization of loading time and units of the two enzymes were done. It was found that, the optimum time and units of amylase were 4 hrs and 25U, respectively. While, the optimum time and units of lipase were 3 hrs and 15U, respectively. The methods used to examine the fibers using a scanning electron microscope equipped with an X-ray energy dispersal unit: SEM with EDX unit.

Keywords: nanoparticles, enzymes, immobilization, textiles

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1876 Influence of Strength Training on the Self-Efficacy of Sports Performance: National Collegiate Athletic Association Student-Athletes Experience of a Strength Training Program

Authors: Alfred M. Caronia

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The aim of this pilot study was to explore an NCAA Division 1 female volleyball players’ experience of a strength and conditioning program and the result this has on self-efficacy of sport skill performance. This phenomenological study comprised of 10 college aged participants that have strength training program experience. Data was collected using semi-structured interviews and a reflective journal; the transcribed interviews were analyzed using qualitative content analysis. From the analysis, four themes emerged: performance enhancement, injury prevention, motivational experience, and learning experience. From the players’ perspective, care needs to be taken to explain the purpose of an exercise and the benefit it will have for a play performance. Other factors that play an important role in a strength training program are team motivation, individual goal setting, bonding, and communication with the strength coach, as all these items appear to be fundamentals of coaching.

Keywords: self-efficacy, skill performance, sports performance, strength training

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1875 Postfeminism, Femvertising and Inclusion: An Analysis of Changing Women's Representation in Contemporary Media

Authors: Saveria Capecchi

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In this paper, the results of qualitative content research on postfeminist female representation in contemporary Western media (advertising, television series, films, social media) are presented. Female role models spectacularized in media culture are an important part of the development of social identities and could inspire new generations. Postfeminist cultural texts have given rise to heated debate between gender and media studies scholars. There are those who claim they are commercial products seeking to sell feminism to women, a feminism whose political and subversive role is completely distorted and linked to the commercial interests of the cosmetics, fashion, fitness and cosmetic surgery industries, in which women’s ‘power’ lies mainly in their power to seduce. There are those who consider them feminist manifestos because they represent independent ‘modern women’ free from male control who aspire to achieve professionally and overcome gender stereotypes like that of the ‘housewife-mother’. Major findings of the research show that feminist principles have been gradually absorbed by the cultural industry and adapted to its commercial needs, resulting in the dissemination of contradictory values. On the one hand, in line with feminist arguments, patriarchal ideology is condemned and the concepts of equality and equal opportunity between men and women are promoted. On the other hand, feminist principles and demands are ascribed to individualism, which translates into the slogan: women are free to decide for themselves, even to objectify their own bodies. In particular, it is observed that femvertising trend in media industry is changing female representation moving away from classic stereotypes: the feminine beauty ideal of slenderness, emphasized in the media since the seventies, is ultimately challenged by the ‘curvy’ body model, which is considered to be more inclusive and based on the concept of ‘natural beauty’. Another aspect of change is the ‘anti-romantic’ revolution performed by some heroines, who are not in search of Prince Charming, in television drama and in the film industry. In conclusion, although femvertising tends to simplify and trivialize the concepts characterizing fourth-wave feminism (‘intersectionality’ and ‘inclusion’), it is also a tendency that enables the challenging of media imagery largely based on male viewpoints, interests and desires.

Keywords: feminine beauty ideal, femvertising, gender and media, postfeminism

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1874 Determine the Optimal Path of Content Adaptation Services with Max Heap Tree

Authors: Shilan Rahmani Azr, Siavash Emtiyaz

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Recent development in computing and communicative technologies leads to much easier mobile accessibility to the information. Users can access to the information in different places using various deceives in which the care variety of abilities. Meanwhile, the format and details of electronic documents are changing each day. In these cases, a mismatch is created between content and client’s abilities. Recently the service-oriented content adaption has been developed which the adapting tasks are dedicated to some extended services. In this method, the main problem is to choose the best appropriate service among accessible and distributed services. In this paper, a method for determining the optimal path to the best services, based on the quality control parameters and user preferences, is proposed using max heap tree. The efficiency of this method in contrast to the other previous methods of the content adaptation is related to the determining the optimal path of the best services which are measured. The results show the advantages and progresses of this method in compare of the others.

Keywords: service-oriented content adaption, QoS, max heap tree, web services

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1873 Disparities in Language Competence and Conflict: The Moderating Role of Cultural Intelligence in Intercultural Interactions

Authors: Catherine Peyrols Wu

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Intercultural interactions are becoming increasingly common in organizations and life. These interactions are often the stage of miscommunication and conflict. In management research, these problems are commonly attributed to cultural differences in values and interactional norms. As a result, the notion that intercultural competence can minimize these challenges is widely accepted. Cultural differences, however, are not the only source of a challenge during intercultural interactions. The need to rely on a lingua franca – or common language between people who have different mother tongues – is another important one. In theory, a lingua franca can improve communication and ease coordination. In practice however, disparities in people’s ability and confidence to communicate in the language can exacerbate tensions and generate inefficiencies. In this study, we draw on power theory to develop a model of disparities in language competence and conflict in a multicultural work context. Specifically, we hypothesized that differences in language competence between interaction partners would be positively related to conflict such that people would report greater conflict with partners who have more dissimilar levels of language competence and lesser conflict with partners with more similar levels of language competence. Furthermore, we proposed that cultural intelligence (CQ) an intercultural competence that denotes an individual’s capability to be effective in intercultural situations, would weaken the relationship between disparities in language competence and conflict such that people would report less conflict with partners who have more dissimilar levels of language competence when the interaction partner has high CQ and more conflict when the partner has low CQ. We tested this model with a sample of 135 undergraduate students working in multicultural teams for 13 weeks. We used a round-robin design to examine conflict in 646 dyads nested within 21 teams. Results of analyses using social relations modeling provided support for our hypotheses. Specifically, we found that in intercultural dyads with large disparities in language competence, partners with the lowest level of language competence would report higher levels of interpersonal conflict. However, this relationship disappeared when the partner with higher language competence was also high in CQ. These findings suggest that communication in a lingua franca can be a source of conflict in intercultural collaboration when partners differ in their level of language competence and that CQ can alleviate these effects during collaboration with partners who have relatively lower levels of language competence. Theoretically, this study underscores the benefits of CQ as a complement to language competence for intercultural effectiveness. Practically, these results further attest to the benefits of investing resources to develop language competence and CQ in employees engaged in multicultural work.

Keywords: cultural intelligence, intercultural interactions, language competence, multicultural teamwork

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1872 A Sociolinguistic Study of the Outcomes of Arabic-French Contact in the Algerian Dialect Tlemcen Speech Community as a Case Study

Authors: R. Rahmoun-Mrabet

Abstract:

It is acknowledged that our style of speaking changes according to a wide range of variables such as gender, setting, the age of both the addresser and the addressee, the conversation topic, and the aim of the interaction. These differences in style are noticeable in monolingual and multilingual speech communities. Yet, they are more observable in speech communities where two or more codes coexist. The linguistic situation in Algeria reflects a state of bilingualism because of the coexistence of Arabic and French. Nevertheless, like all Arab countries, it is characterized by diglossia i.e. the concomitance of Modern Standard Arabic (MSA) and Algerian Arabic (AA), the former standing for the ‘high variety’ and the latter for the ‘low variety’. The two varieties are derived from the same source but are used to fulfil distinct functions that is, MSA is used in the domains of religion, literature, education and formal settings. AA, on the other hand, is used in informal settings, in everyday speech. French has strongly affected the Algerian language and culture because of the historical background of Algeria, thus, what can easily be noticed in Algeria is that everyday speech is characterized by code-switching from dialectal Arabic and French or by the use of borrowings. Tamazight is also very present in many regions of Algeria and is the mother tongue of many Algerians. Yet, it is not used in the west of Algeria, where the study has been conducted. The present work, which was directed in the speech community of Tlemcen-Algeria, aims at depicting some of the outcomes of the contact of Arabic with French such as code-switching, borrowing and interference. The question that has been asked is whether Algerians are aware of their use of borrowings or not. Three steps are followed in this research; the first one is to depict the sociolinguistic situation in Algeria and to describe the linguistic characteristics of the dialect of Tlemcen, which are specific to this city. The second one is concerned with data collection. Data have been collected from 57 informants who were given questionnaires and who have then been classified according to their age, gender and level of education. Information has also been collected through observation, and note taking. The third step is devoted to analysis. The results obtained reveal that most Algerians are aware of their use of borrowings. The present work clarifies how words are borrowed from French, and then adapted to Arabic. It also illustrates the way in which singular words inflect into plural. The results expose the main characteristics of borrowing as opposed to code-switching. The study also clarifies how interference occurs at the level of nouns, verbs and adjectives.

Keywords: bilingualism, borrowing, code-switching, interference, language contact

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1871 Superparamagnetic Sensor with Lateral Flow Immunoassays as Platforms for Biomarker Quantification

Authors: M. Salvador, J. C. Martinez-Garcia, A. Moyano, M. C. Blanco-Lopez, M. Rivas

Abstract:

Biosensors play a crucial role in the detection of molecules nowadays due to their advantages of user-friendliness, high selectivity, the analysis in real time and in-situ applications. Among them, Lateral Flow Immunoassays (LFIAs) are presented among technologies for point-of-care bioassays with outstanding characteristics such as affordability, portability and low-cost. They have been widely used for the detection of a vast range of biomarkers, which do not only include proteins but also nucleic acids and even whole cells. Although the LFIA has traditionally been a positive/negative test, tremendous efforts are being done to add to the method the quantifying capability based on the combination of suitable labels and a proper sensor. One of the most successful approaches involves the use of magnetic sensors for detection of magnetic labels. Bringing together the required characteristics mentioned before, our research group has developed a biosensor to detect biomolecules. Superparamagnetic nanoparticles (SPNPs) together with LFIAs play the fundamental roles. SPMNPs are detected by their interaction with a high-frequency current flowing on a printed micro track. By means of the instant and proportional variation of the impedance of this track provoked by the presence of the SPNPs, quantitative and rapid measurement of the number of particles can be obtained. This way of detection requires no external magnetic field application, which reduces the device complexity. On the other hand, the major limitations of LFIAs are that they are only qualitative or semiquantitative when traditional gold or latex nanoparticles are used as color labels. Moreover, the necessity of always-constant ambient conditions to get reproducible results, the exclusive detection of the nanoparticles on the surface of the membrane, and the short durability of the signal are drawbacks that can be advantageously overcome with the design of magnetically labeled LFIAs. The approach followed was to coat the SPIONs with a specific monoclonal antibody which targets the protein under consideration by chemical bonds. Then, a sandwich-type immunoassay was prepared by printing onto the nitrocellulose membrane strip a second antibody against a different epitope of the protein (test line) and an IgG antibody (control line). When the sample flows along the strip, the SPION-labeled proteins are immobilized at the test line, which provides magnetic signal as described before. Preliminary results using this practical combination for the detection and quantification of the Prostatic-Specific Antigen (PSA) shows the validity and consistency of the technique in the clinical range, where a PSA level of 4.0 ng/mL is the established upper normal limit. Moreover, a LOD of 0.25 ng/mL was calculated with a confident level of 3 according to the IUPAC Gold Book definition. Its versatility has also been proved with the detection of other biomolecules such as troponin I (cardiac injury biomarker) or histamine.

Keywords: biosensor, lateral flow immunoassays, point-of-care devices, superparamagnetic nanoparticles

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1870 Healthcare Utilization and Costs of Specific Obesity Related Health Conditions in Alberta, Canada

Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

Abstract:

Obesity-related health conditions impose a substantial economic burden on payers due to increased healthcare use. Estimates of healthcare resource use and costs associated with obesity-related comorbidities are needed to inform policies and interventions targeting these conditions. Methods: Adults living with obesity were identified (a procedure-related body mass index code for class 2/3 obesity between 2012 and 2019 in Alberta, Canada; excluding those with bariatric surgery), and outcomes were compared over 1-year (2019/2020) between those who had and did not have specific obesity-related comorbidities. The probability of using a healthcare service (based on the odds ratio of a zero [OR-zero] cost) was compared; 95% confidence intervals (CI) were reported. Logistic regression and a generalized linear model with log link and gamma distribution were used for total healthcare cost comparisons ($CDN); cost ratios and estimated cost differences (95% CI) were reported. Potential socio-demographic and clinical confounders were adjusted for, and incremental cost differences were representative of a referent case. Results: A total of 220,190 adults living with obesity were included; 44% had hypertension, 25% had osteoarthritis, 24% had type-2 diabetes, 17% had cardiovascular disease, 12% had insulin resistance, 9% had chronic back pain, and 4% of females had polycystic ovarian syndrome (PCOS). The probability of hospitalization, ED visit, and ambulatory care was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (hospitalization: 1.8-times [OR-zero: 0.57 [0.55/0.59]] / ED visit: 1.9-times [OR-zero: 0.54 [0.53/0.56]] / ambulatory care visit: 2.4-times [OR-zero: 0.41 [0.40/0.43]]), cardiovascular disease (2.7-times [OR-zero: 0.37 [0.36/0.38]] / 1.9-times [OR-zero: 0.52 [0.51/0.53]] / 2.8-times [OR-zero: 0.36 [0.35/0.36]]), osteoarthritis (2.0-times [OR-zero: 0.51 [0.50/0.53]] / 1.4-times [OR-zero: 0.74 [0.73/0.76]] / 2.5-times [OR-zero: 0.40 [0.40/0.41]]), type-2 diabetes (1.9-times [OR-zero: 0.54 [0.52/0.55]] / 1.4-times [OR-zero: 0.72 [0.70/0.73]] / 2.1-times [OR-zero: 0.47 [0.46/0.47]]), hypertension (1.8-times [OR-zero: 0.56 [0.54/0.57]] / 1.3-times [OR-zero: 0.79 [0.77/0.80]] / 2.2-times [OR-zero: 0.46 [0.45/0.47]]), PCOS (not significant / 1.2-times [OR-zero: 0.83 [0.79/0.88]] / not significant), and insulin resistance (1.1-times [OR-zero: 0.88 [0.84/0.91]] / 1.1-times [OR-zero: 0.92 [0.89/0.94]] / 1.8-times [OR-zero: 0.56 [0.54/0.57]]). After fully adjusting for potential confounders, the total healthcare cost ratio was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (1.54-times [1.51/1.56]), cardiovascular disease (1.45-times [1.43/1.47]), osteoarthritis (1.36-times [1.35/1.38]), type-2 diabetes (1.30-times [1.28/1.31]), hypertension (1.27-times [1.26/1.28]), PCOS (1.08-times [1.05/1.11]), and insulin resistance (1.03-times [1.01/1.04]). Conclusions: Adults with obesity who have specific disease-related health conditions have a higher probability of healthcare use and incur greater costs than those without specific comorbidities; incremental costs are larger when other obesity-related health conditions are not adjusted for. In a specific referent case, hypertension was costliest (44% had this condition with an additional annual cost of $715 [$678/$753]). If these findings hold for the Canadian population, hypertension in persons with obesity represents an estimated additional annual healthcare cost of $2.5 billion among adults living with obesity (based on an adult obesity rate of 26%). Results of this study can inform decision making on investment in interventions that are effective in treating obesity and its complications.

Keywords: administrative data, healthcare cost, obesity-related comorbidities, real world evidence

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1869 Raising Awareness among Residents about the Exact Fate of Dirt in the Neighborhood of Porto Belo

Authors: Marie Oslène Honorat

Abstract:

Porto Belo is a neighborhood in the city of Foz do Iguaçu / PR, located in the Vila C region of Brazil. It is a project that addresses the question of the dirt generated by the neighborhood community about how they dispose and recycle domestic waste. This project aimed at raising awareness among residents, on how important it is to preserve the environment and take care, especially of the space in which we are located. Living this way manages to minimize the exploitation of natural resources, soil and water pollution. After collecting information about what one saw, we questioned some people in the neighborhood to find out about selective collection, recycling, and the separation and final destination of garbage. From the study, it was possible to verify the importance of placing more trash cans on neighborhood streets, where garbage is discarded, and the importance of promoting environmental education to improve the environment and quality of life. The methodology used in this research was a qualitative methodology that seeks the principle of transforming reality through investigation.

Keywords: awareness, recycling, selective collection, waste disposal

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1868 (Re)Assessing Clinical Spaces: How Do We Critically Provide Mental Health and Disability Support and Effective Care for Young People Who Are Impacted by Structural Violence and Structural Racism?

Authors: Sireen Irsheid, Stephanie Keeney Parks, Michael A. Lindsey

Abstract:

The medical and mental health field have been organized as reactive systems to respond to symptoms of mental health problems and disability. This becomes problematic particularly for those harmed by structural violence and racism, typically pushing us in the direction of alleviating symptoms and personalizing structural problems. The current paper examines how we assess, diagnose, and treat mental health and disability challenges in clinical spaces. We provide the readers with some context to think about the problem of racism and mental health/disability, ways to deconstruct the problem through the lens of structural violence, and recommendations to critically engage in clinical assessments, diagnosis, and treatment for young people impacted by structural violence and racism.

Keywords: mental health, disability, race and ethnicity, structural violence, structural racism, young people

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1867 The Grand Egyptian Museum as a Cultural Interface

Authors: Mahmoud Moawad Mohamed Osman

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The Egyptian civilization was and still is an inspiration for many human civilizations and modern sciences. For this reason, there is still a passion for the ancient Egyptian civilization. Due to the breadth and abundance of the outputs of the ancient Egyptian civilization, many museums have been established that contribute to displaying and demonstrating the splendor of the ancient Egyptian civilization, and among those museums is the Grand Egyptian Museum (Egypt's gift to the whole world). The idea of establishing the Grand Egyptian Museum began in the nineties of the last century, and in 2002 the foundation stone was laid for the museum project to be built in a privileged location overlooking the eternal pyramids of Giza, where the Egyptian state was declared, and under the auspices of the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the International Union of Architects. , for an international architectural competition for the best design for the museum. The current design submitted by Heneghan Peng Architects in Ireland won, and its design was based on the rays of the sun extending from the tops of the three pyramids when they meet to represent a conical mass, which is the Grand Egyptian Museum. The construction of the museum project began in May 2005, when the site was paved and prepared, and in 2006, the largest antiquities restoration center in the Middle East was established, dedicated to the restoration, preservation, maintenance and rehabilitation of the antiquities scheduled to be displayed in the museum halls, which was opened in 2010. The construction of the museum building, which has an area of more than 300,000 square meters, was completed during the year 2021, and includes a number of exhibition halls, each of which is considered larger than many current museums in Egypt and the world. The museum is considered one of the most important and greatest achievements of modern Egypt. It was created to be an integrated global civilizational, cultural and entertainment edifice, and to be the first destination for everyone interested in ancient Egyptian heritage, as the largest museum in the world that tells the story of the history of ancient Egyptian civilization, as it contains a large number of distinctive and unique artifacts, including the treasures of the golden king Tutankhamun, which... It is displayed for the first time in its entirety since the discovery of his tomb in November 1922, in addition to the collection of Queen Hetepheres, the guard of the mother of King Khufu, the builder of the Great Pyramid in Giza, as well as the Museum of King Khufu’s Boats, as well as various archaeological collectibles from the pre-dynastic era until the Greek and Roman eras.

Keywords: grand egyptian museum, egyptian civilization, education, museology

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1866 The Effect of Non-Surgical Periodontal Therapy on Metabolic Control in Children

Authors: Areej Al-Khabbaz, Swapna Goerge, Majedah Abdul-Rasoul

Abstract:

Introduction: The most prevalent periodontal disease among children is gingivitis, and it usually becomes more severe in adolescence. A number of intervention studies suggested that resolution of periodontal inflammation can improve metabolic control in patients diagnosed with diabetes mellitus. Aim: to assess the effect of non-surgical periodontal therapy on glycemic control of children diagnosed with diabetes mellitus. Method: Twenty-eight children diagnosed with diabetes mellitus were recruited with established diagnosis diabetes for at least 1 year. Informed consent and child assent form were obtained from children and parents prior to enrolment. The dental examination for the participants was performed on the same week directly following their annual medical assessment. All patients had their glycosylated hemoglobin (HbA1c%) test one week prior to their annual medical and dental visit and 3 months following non-surgical periodontal therapy. All patients received a comprehensive periodontal examination The periodontal assessment included clinical attachment loss, bleeding on probing, plaque score, plaque index and gingival index. All patients were referred for non-surgical periodontal therapy, which included oral hygiene instruction and motivation followed by supra-gingival and subg-ingival scaling using ultrasonic and hand instruments. Statistical Analysis: Data were entered and analyzed using the Statistical Package for Social Science software (SPSS, Chicago, USA), version 18. Statistical analysis of clinical findings was performed to detect differences between the two groups in term of periodontal findings and HbA1c%. Binary logistic regression analysis was performed in order to examine which factors were significant in multivariate analysis after adjusting for confounding between effects. The regression model used the dependent variable ‘Improved glycemic control’, and the independent variables entered in the model were plaque index, gingival index, bleeding %, plaque Statistical significance was set at p < 0.05. Result: A total of 28 children. The mean age of the participants was 13.3±1.92 years. The study participants were divided into two groups; Compliant group (received dental scaling) and non-complaints group (received oral hygiene instructions only). No statistical difference was found between compliant and non-compliant group in age, gender distribution, oral hygiene practice and the level of diabetes control. There was a significant difference between compliant and non-compliant group in term of improvement of HBa1c before and after periodontal therapy. Mean gingival index was the only significant variable associated with improved glycemic control level. In conclusion, this study has demonstrated that non-surgical mechanical periodontal therapy can improve HbA1c% control. The result of this study confirmed that children with diabetes mellitus who are compliant to dental care and have routine professional scaling may have better metabolic control compared to diabetic children who are erratic with dental care.

Keywords: children, diabetes, metabolic control, periodontal therapy

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1865 The Quantum Theory of Music and Human Languages

Authors: Mballa Abanda Luc Aurelien Serge, Henda Gnakate Biba, Kuate Guemo Romaric, Akono Rufine Nicole, Zabotom Yaya Fadel Biba, Petfiang Sidonie, Bella Suzane Jenifer

Abstract:

The main hypotheses proposed around the definition of the syllable and of music, of the common origin of music and language, should lead the reader to reflect on the cross-cutting questions raised by the debate on the notion of universals in linguistics and musicology. These are objects of controversy, and there lies its interest: the debate raises questions that are at the heart of theories on language. It is an inventive, original, and innovative research thesis. A contribution to the theoretical, musicological, ethno musicological, and linguistic conceptualization of languages, giving rise to the practice of interlocution between the social and cognitive sciences, the activities of artistic creation, and the question of modeling in the human sciences: mathematics, computer science, translation automation, and artificial intelligence. When you apply this theory to any text of a folksong of a world-tone language, you do not only piece together the exact melody, rhythm, and harmonies of that song as if you knew it in advance but also the exact speaking of this language. The author believes that the issue of the disappearance of tonal languages and their preservation has been structurally resolved, as well as one of the greatest cultural equations related to the composition and creation of tonal, polytonal, and random music. The experimentation confirming the theorization, I designed a semi-digital, semi-analog application that translates the tonal languages of Africa (about 2,100 languages) into blues, jazz, world music, polyphonic music, tonal and anatonal music, and deterministic and random music). To test this application, I use music reading and writing software that allows me to collect the data extracted from my mother tongue, which is already modeled in the musical staves saved in the ethnographic (semiotic) dictionary for automatic translation ( volume 2 of the book). The translation is done (from writing to writing, from writing to speech, and from writing to music). Mode of operation: you type a text on your computer, a structured song (chorus-verse), and you command the machine a melody of blues, jazz, and world music or variety, etc. The software runs, giving you the option to choose harmonies, and then you select your melody.

Keywords: language, music, sciences, quantum entenglement

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1864 Examining the Level of Compliance of Patients’ Rights in Physiotherapy Clinic

Authors: Hokuma Isgandarova, Khalil Aryanfar

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The patient's rights include all care items that the patient has the right to receive. Considering the growing importance of this important issue and its effect on improving treatment results and customer satisfaction, the present study was conducted with the aim of investigating the level of respect for patient rights in the physiotherapy clinic of the Faculty of Medicine University of Medical Sciences in 2023. In this study, the patients or companions who were referred to the clinic answered questions about the performance status of the clinic with respect to various aspects of the patient's rights. The aspects that were studied: choosing the service provider, having authority, respect, safety, prevention and access were found to have inappropriate performance scores. However, communication and interaction, continuity of service, quality of basic facilities and facilities, timely and immediate attention and trust had appropriate performance. Also, the results of the data analysis showed that there is no significant relationship between the total performance score and any of the demographic variables.

Keywords: compliance, patients' rights, physiotherapy clinic, performance level

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1863 Knowledge, Attitude and Beliefs Towards Polypharmacy Amongst Older People Attending Family Medicine Clinic at the Aga Khan University Hospital, Nairobi, Kenya (AKUHN) Sub-Saharan Africa-Qualitative Study

Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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1862 Prioritizing The Evaluation factors of Hospital Information System with The Analytical Hierarchy Process

Authors: F.Sadoughi, A. Sarsarshahi, L, Eerfannia, S.M.A. Khatami

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Hospital information systems with lots of ability would lead to health care quality improvement. Evaluation of this system has done according different method and criteria. The main goal of present study is to prioritize the most important factors which are influence these systems evaluation. At the first step, according relevant literature, three main factor and 29 subfactors extracted. Then, study framework was designed. Based on analytical hierarchical process (AHP), 28 paired comparisons with Saaty range, in a questionnaire format obtained. Questionnaires were filled by 10 experts in health information management and medical informatics field. Human factors with weight of 0.55 were ranked as the most important. Organization (0.25) and technology (0.14) were in next place. It seems MADM methods such as AHP have enough potential to use in health research and provide positive opportunities for health domain decision makers.

Keywords: Analytical hierarchy process, Multiple criteria decision-making (MCDM), Hospital information system, Evaluation factors

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