Search results for: rural healthcare settings

Authors: Danielle Page

Abstract:

Foregoing studies, statistics, and medical evaluations have established a relationship between Posttraumatic stress disorder (PTSD) and criminal justice involvement in Vietnam veterans. War is highly trauma inducing and can leave combat veterans with mental disorders ranging from psychopathic thoughts to suicidal ideation. The majority of those suffering are unaware that they have PTSD, and as a coping mechanism, they often turn to self isolation. Beyond isolation, many veterans with symptomatic PTSD turn to aggression and substance abuse to cope with their internal agony. The most common crimes committed by veterans with PTSD fall into the assault and drug/alcohol abuse categories. Thus, a relationship is established between veteran populations and the criminal justice system. This dissertation aims to define the relationship between PTSD and criminal justice involvement in veterans, explore the mediating factors in this relationship, and analyze numerous court cases in this subject area. Further, it will examine the ways in which crime rates can be reduced for veterans with symptoms of PTSD. This ranges from the improvement of healthcare systems to the implementation of special courts to handle veteran cases.

Keywords: psychotraumatology, forensic psychology, PTSD, vietnam veterans

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Authors: Siriluk Ruangrungrote

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Analyses of available data from MFR-7 measurement were performed and discussed on the study of tropospheric aerosol and its consequence in Thailand. Since, ASSA (w) is one of the most important parameters for a determination of aerosol effect on radioactive forcing. Here the estimation of w was directly determined in terms of the ratio of aerosol scattering optical depth to aerosol extinction optical depth (ωscat/ωext) without any utilization of aerosol computer code models. This is of benefit for providing the elimination of uncertainty causing by the modeling assumptions and the estimation of actual aerosol input data. Diurnal w of 5 cloudless-days in winter and early summer at 5 distinct wavelengths of 415, 500, 615, 673 and 870 nm with the consideration of Rayleigh scattering and atmospheric column NO2 and Ozone contents were investigated, respectively. Besides, the tendency of spectral dependence of ω representing two seasons was observed. The characteristic of spectral results reveals that during wintertime the atmosphere of the inland rural vicinity for the period of measurement possibly dominated with a lesser amount of soil dust aerosols loading than one in early summer. Hence, the major aerosol loading particularly in summer was subject to a mixture of both soil dust and biomass burning aerosols.

Keywords: aerosol scattering optical depth, aerosol extinction optical depth, biomass burning aerosol, soil dust aerosol

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Authors: Vipul Shiralkar, Rohit Khadilkar, Shekhar Kulkarni, Ismail Mullani, Omkar Malvankar

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The use of water cooler has increased and become an important appliance in the world of global warming. Most of the coolers are electrically operated. In this study an experimental setup of evaporative water cooler using solar energy is designed and developed. It works on the principle of heat transfer using evaporation of water. Water is made to flow through copper tubes arranged in a specific array manner. Cotton plug is wrapped on copper tubes and rubber pipes are arranged in the same way as copper tubes above it. Water percolated from rubber pipes is absorbed by cotton plug. The setup has 40L water carrying capacity with forced cooling arrangement and variable speed fan which uses solar energy stored in 20Ah capacity battery. Fan speed greatly affects the temperature drop. Tests were performed at different fan speed. Maximum temperature drop achieved was 90C at 1440 rpm of fan speed. This temperature drop is very attractive. This water cooler uses solar energy hence it is cost efficient and it is affordable to rural community as well. The cooler is free from any harmful emissions like other refrigerants and hence environmental friendly. Very less maintenance is required as compared to the conventional electrical water cooler.

Keywords: evaporation, cooler, energy, copper, solar, cost

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Authors: M. Dahbi, M. Sellam, A. Benatiallah, A. Harrouz

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The wind energy is one of the most significant and rapidly developing renewable energy sources in the world and it provides a clean energy resource, which is a promising alternative in the short term in Algeria The main purpose of this paper is to compared and discuss the wind power potential in three sites located in sahara of Algeria (south west of Algeria) and to perform an investigation on the wind power potential of desert of Algeria. In this comparative, wind speed frequency distributions data obtained from the web site SODA.com are used to calculate the average wind speed and the available wind power. The Weibull density function has been used to estimate the monthly power wind density and to determine the characteristics of monthly parameters of Weibull for these three sites. The annual energy produced by the BWC XL.1 1KW wind machine is obtained and compared. The analysis shows that in the south west of Algeria, at 10 m height, the available wind power was found to vary between 136.59 W/m2 and 231.04 W/m2. The highest potential wind power was found at Adrar, with 21h per day and the mean wind speed is above 6 m/s. Besides, it is found that the annual wind energy generated by that machine lie between 512 KWh and 1643.2 kWh. However, the wind resource appears to be suitable for power production on the sahara and it could provide a viable substitute to diesel oil for irrigation pumps and rural electricity generation.

Keywords: Weibull distribution, parameters of Wiebull, wind energy, wind turbine, operating hours

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Authors: Rafat Alwazna

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Translation teaching is a particular activity that includes translators and interpreters training either inside or outside institutionalised settings, such as universities. It can also serve as a means of teaching other fields, such as foreign languages. Translation teaching began in the twentieth century. Teachers of translation hold the responsibilities of educating students, developing their translation competence and training them to be professional translators. The activity of translation teaching involves various tasks, including curriculum design, course delivery, material writing as well as application and implementation. The present paper addresses translation teaching during COVID-19 outbreak, seeking to find out the challenges encountered by translation teachers in online translation teaching and the discoveries/solutions arrived at to resolve them. The paper makes use of a comprehensive questionnaire, containing closed-ended and open-ended questions to elicit both quantitative as well as qualitative data from about sixty translation teachers who have been teaching translation at BA and MA levels during COVID-19 outbreak. The data shows that about 40% of the participants evaluate their online translation teaching experience during COVID-19 outbreak as enjoyable and exhilarating. On the contrary, no participant has evaluated his/her online translation teaching experience as being not good, nor has any participant evaluated his/her online translation teaching experience as being terrible. The data also presents that about 23.33% of the participants evaluate their online translation teaching experience as very good, and the same percentage applies to those who evaluate their online translation teaching experience as good to some extent. Moreover, the data indicates that around 13.33% of the participants evaluate their online translation teaching experience as good. The data also demonstrates that the majority of the participants have encountered obstacles in online translation teaching and have concurrently proposed solutions to resolve them.

Keywords: online translation teaching, electronic learning platform, COVID-19 outbreak, challenges, solutions

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Authors: Ian Walmsley

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The aim of this paper is to explore the influence of time and temporality on the experience of coming off heroin in prison. The presentation draws on qualitative data collected during a small-scale pilot study of the role of self-care in the process of coming off drugs in prison. Time and temporality emerged as a key theme in the interview transcripts. Drug dependent prisoners experience of time in prison has not been recognized in the research literature. Instead, the literature on prison time typically views prisoners as a homogenous group or tends to focus on the influence of aging and gender on prison time. Furthermore, there is a tendency in the literature on prison drug treatment and recovery to conceptualize drug dependent prisoners as passive recipients of prison healthcare, rather than active agents. In building on these gaps, this paper argues that drug dependent prisoners experience multiple temporalities which involve an interaction between the body-times of the drug dependent prisoner and the economy of time in prison. One consequence of this interaction is the feeling that they are doing, at this point in their prison sentence, double prison time. The second part of the argument is that time and temporality were a means through which they governed their withdrawing bodies. In addition, this paper will comment on the challenges of prison research in England.

Keywords: heroin withdrawal, time and temporality, prison, body

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Authors: Arundhati Devi Maibam, K. Ingocha Singh

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Cervical cancer is preventable if detected early. Determination of risk factors is essential to plan screening programmes to prevent the disease. To study the demographic risk factors of cervical cancer among Manipuri women, information on age, marital status, educational level, monthly family income and socioeconomic status were collected through a pre-tested interview schedule. In this study, 64 incident cases registered at the RT Dept, RIMS (Regional Institute of Medical Sciences), Imphal, Manipur, India during 2008-09 participated. Data were entered in Microsoft Excel and the results were expressed in percentages. Among the 64 patients with cervical cancer, 56 (88.9%) were in the age group of 40+ years. The majority of the patients were from rural areas (68.75%) and 31.25% were from urban areas. The majority of the patients were Hindus (73%), 55(85.9%) were of low educational level, 43(67.2%) were married, and 36 (56.25%) belonged to Class IV socioeconomic status. In conclusion, if detected early, cervical cancer is preventable and curable. The potential risk factors need to be identified and women in the risk group need to be motivated for screening. Affordable screening programmes and health care resources will help in lessening the burden of the disease.

Keywords: cervical cancer, Manipuri women, RIIMS, socio-demographic risk factors

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Authors: Farhana Alam Bhuiyan, Saad Khan, Tanveer Hassan, Jhalok Ranjon Talukder, Syeda Farjana Ahmed, Rahil Roodsaz, Els Rommes, Sabina Faiz Rashid

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Breaking the shame’ is a 3 year (2015-2018) qualitative implementation research project which investigates several aspects of sexual and reproductive health and rights (SRHR) issues for adolescents living in Bangladesh. Scope of learning SRHR issues for adolescents is limited here due to cultural and religious taboos. This study adds to the ongoing discussions around adolescent’s SRHR needs and aims to, 1) understand the overall SRHR needs of urban and rural unmarried female and male adolescents and the challenges they face, 2) explore existing gaps in the content of SRHR curriculum and 3) finally, addresses some critical knowledge gaps by developing and implementing innovative SRHR educational materials. 18 in-depth interviews (IDIs) and 10 focus-group discussions (FGDs) with boys and 21 IDIs and 14 FGDs with girls of ages 13-19, from both urban and rural setting took place. Curriculum materials from two leading organizations, Unite for Body Rights (UBR) Alliance Bangladesh and BRAC Adolescent Development Program (ADP) were also reviewed, with discussions with 12 key program staff. This paper critically analyses the relevance of some of the SRHR topics that are covered, the challenges with existing pedagogic approaches and key sexuality issues that are not covered in the content, but are important for adolescents. Adolescents asked for content and guidance on a number of topics which remain missing from the core curriculum, such as emotional coping mechanisms particularly in relationships, bullying, impact of exposure to porn, and sexual performance anxiety. Other core areas of concern were effects of masturbation, condom use, sexual desire and orientation, which are mentioned in the content, but never discussed properly, resulting in confusion. Due to lack of open discussion around sexuality, porn becomes a source of information for the adolescents. For these reasons, several myths and misconceptions regarding SRHR issues like body, sexuality, agency, and gender roles still persist. The pedagogical approach is very didactic, and teachers felt uncomfortable to have discussions on certain SRHR topics due to cultural taboos or shame and stigma. Certain topics are favored- such as family planning, menstruation- and presented with an emphasis on biology and risk. Rigid formal teaching style, hierarchical power relations between students and most teachers discourage questions and frank conversations. Pedagogy approaches within classrooms play a critical role in the sharing of knowledge. The paper also describes the pilot approaches to implementing new content in SRHR curriculum. After a review of findings, three areas were selected as critically important, 1) myths and misconceptions 2) emotional management challenges, and 3) how to use condom, that have come up from adolescents. Technology centric educational materials such as web page based information platform and you tube videos are opted for which allow adolescents to bypass gatekeepers and learn facts and information from a legitimate educational site. In the era of social media, when information is always a click away, adolescents need sources that are reliable and not overwhelming. The research aims to ensure that adolescents learn and apply knowledge effectively, through creating the new materials and making it accessible to adolescents.

Keywords: adolescents, Bangladesh, media, sexuality education, unmet needs

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Authors: Shaoyi Lu

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Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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Authors: Elnaz Alimi, Keriakoula Andriopoulos, Sam Boyer, Weronika Zuczek

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Occupational therapists can use coaching strategies to guide parents in providing therapy for their children with developmental disabilities. Evidence from various fields has shown increased parental self-efficacy and positive child outcomes as benefits of home and community-based parent coaching models. A literature review was conducted to investigate the effectiveness of parent coaching interventions delivered in home and community settings for children with developmental disabilities ages 0-12, on a variety of parent and child outcomes. CINAHL Plus, PsycINFO, PubMed, OTseeker were used as databases. The inclusion criteria consisted of: children with developmental disabilities ages 0-12 and their parents, parent coaching models conducted in the home and community, and parent and child outcomes. Studies were excluded if they were in a language other than English and published before 2000. Results showed that parent coaching interventions led to more positive therapy outcomes in child behaviors and symptoms related to their diagnosis or disorder. Additionally, coaching strategies had positive effects on parental satisfaction with therapy, parental self-efficacy, and family dynamics. Findings revealed decreased parental stress and improved parent-child relationships. Further research on parent coaching could involve studying the feasibility of coaching within occupational therapy specifically, incorporating cultural elements into coaching, qualitative studies on parental satisfaction with coaching, and measuring the quality of life outcomes for the whole family.

Keywords: coaching model, developmental disabilities, occupational therapy, pediatrics

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Authors: James Pietris

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Glaucoma is a collection of irreversible optic neuropathies which, if left untreated, lead to severe visual field loss. These diseases are a leading cause of blindness across the globe and are estimated to affect approximately 80 million people, particularly women and people of Asian descent.1This represents a major burden on healthcare systems worldwide. Recently, there has been increasing interest in the potential of nicotinamide (vitamin B3) as a novel option in the management of glaucoma. This review aims to analyse the currently available literature to determine whether there is evidence of an association between nicotinamide adenine dinucleotide (NAD+) and glaucomatous optic neuropathy and whether nicotinamide has the potential to prevent or reverse these effects. The literature showed a strong connection between reduced NAD+ levels and retinal ganglion cell dysfunction through multiple different studies. There is also evidence of the positive effect of nicotinamide supplementation on retinal ganglion cell function in models of mouse glaucoma and in a study involving humans. Based on the literature findings, a recommendation has been made that more research into the efficacy, appropriate dosing, and potential side effects of nicotinamide supplementation is needed before it can be definitively determined whether it is appropriate for widespread prophylactic and therapeutic use against glaucoma in humans.

Keywords: glaucoma, nicotinamide, vitamin B3, optic neuropathy

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Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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Authors: G.S. Patel

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In this research paper the discussion have been made on teachers work mental stress and coping strategies. Stress Measurement scale was developed for school teachers. All the scientific steps of test construction was followed. For this test construction, different factors like teachers workplace, teachers' residential area, teachers' family life, teachers' ability and skills, economic factors and other factors to construct teachers stress measurement scale. In this research tool, situational statements have been made and teachers have to give a response in each statement on five-point rating scale what they experienced in their daily life. Special features of the test also established like validity and reliability of this test and also computed norms for its interpretation. A sample of 320 teachers of school teachers of Gujarat state was selected by Cluster sampling technique. t-test was computed for testing null hypothesis. The main findings of the present study are Urban area teachers feel more stressful situation compare to rural area teachers. Those teachers who live in the joint family feel less stress compare to teachers who live in a nuclear family. This research work is very useful to prepare list of activities to reduce teachers mental stress.

Keywords: stress measurement scale, level of stress, validity, reliability, norms

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Authors: Jessie Fazel, Kristen Smith

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Human trafficking is a multi-billion-dollar criminal industry that affects 24.9 million people around the world. There are several different types of trafficking, the most common being sex trafficking, labor trafficking, and domestic servitude. Survival sex is common in the pediatric population, as they engage in sex for food, a place to sleep, or other basic needs. Statistics show that health care workers are at a unique advantage to help identify victims and get them the help they need, as 88% of trafficked victims encounter a health care worker while being trafficked. Unfortunately, victims don’t usually self-identify that they are being trafficked and the situations they face can vary dramatically. It is imperative to remember that traditional red flags are not always present in the pediatric population. Risk factors and red flags with their history and physical exam are one of the best indicators that health care providers need to be vigilant in looking at. There are numerous barriers for disclosure in the healthcare setting. Periods of time before and after disclosure are often emotionally difficult and could be dangerous for the victim. It is extremely important to have a plan in place for intervention if the victim does disclose trafficking. A trauma informed approach to medical and mental health interventions, that focus on safety, are vital in this population. This is happening where you live and you can make a difference in their lives.

Keywords: human trafficking, public health, emergency medicine, sexual health

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Authors: Mehrnaz Mostafavi, Mahtab Shabani, Alireza Azani, Fatemeh Ghafari

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Artificial intelligence (AI) can transform breast cancer diagnosis and therapy by providing sophisticated solutions for screening, imaging interpretation, histopathological analysis, and treatment planning. This literature review digs into the many uses of AI in breast cancer treatment, highlighting the need for collaboration between AI scientists and healthcare practitioners. It emphasizes advances in AI-driven breast imaging interpretation, such as computer-aided detection and diagnosis (CADe/CADx) systems and deep learning algorithms. These have shown significant potential for improving diagnostic accuracy and lowering radiologists' workloads. Furthermore, AI approaches such as deep learning have been used in histopathological research to accurately predict hormone receptor status and categorize tumor-associated stroma from regular H&E stains. These AI-powered approaches simplify diagnostic procedures while providing insights into tumor biology and prognosis. As AI becomes more embedded in breast cancer care, it is crucial to ensure its ethical, efficient, and patient-focused implementation to improve outcomes for breast cancer patients ultimately.

Keywords: breast cancer, artificial intelligence, cancer diagnosis, clinical practice

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Authors: Danika Tynes

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Innovations in technology have implications for sustainable development in health and wellness. Remote monitoring is one innovation for which the evidence-base has grown to support its viability as a quality healthcare delivery adjunct. This research reviews global data on telehealth adoption, in particular, remote monitoring, and the conditions under which its success becomes more likely. System-level indicators were selected to represent four constructs of DoI theory (relative advantage, compatibility, complexity, and observability) and assessed against 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using ordinal logistic regression. Analyses include data from 84 countries, as extracted from the World Health Organization, World Bank, ICT (Information Communications Technology) Index, and HDI (Human Development Index) datasets. Analyses supported relative advantage and compatibility as the strongest influencers of remote monitoring adoption. Findings from this research may help focus on the allocation of resources, as a sustainability concern, through consideration of systems-level factors that may influence the success of remote monitoring adoption.

Keywords: remote monitoring, diffusion of innovation, telehealth, digital health

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Authors: Oxana Vasilyeva

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This paper draws on research in progress focusing on independent art in the Russian Federation. I am using the concept of independent art to mean art free from state control and established restrictive narratives. The Russian state pursues its interests by supporting or forbidding certain forms of art, and art that promotes values in opposition to the official political course is often forbidden. Arguments presented below draw from fieldwork carried out in Russian cities of Moscow and Saint Petersburg in June – August 2019, which included in-depth interviews with artists. This research explores socially engaged artistic works and their effect on socio-political state of affairs. It argues that artistic works entering public places have a potential to challenge autocratic system and inspire civil society to be critically engaged and to be capable to resist state propaganda. I am focusing on those artists who have a critical stance towards the current Russian political regime and analyzing their works in terms of transgression. By using the framework of transgression I aim to demonstrate how artists step across existing norms with their art influencing political and social order. To show the connection between the factors mentioned above, I will turn to two examples of transgressive aesthetics; one is individual and another is collective. The first example is Konstantin Benkovich, an artist who makes his works out of steel rebar, which is considered to be a symbol of the lack of freedom, as it is usually encountered in prison settings. The second example is a collective art practice called Monstration. It combines techniques of a demonstration and a carnival atmosphere. In 2019 Monstration was held in 30 Russian cities, despite the dissatisfaction of the authorities.

Keywords: art, culture, resistance, Russia

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Authors: Caroline Smith, Professor Debi Bhattacharya, Sion Scott

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Introduction: Oropharyngeal Dysphagia (OD) effects around 15% of older people, however it is often unrecognised and under diagnosed until they are hospitalised. There is a need for primary care healthcare practitioners (HCPs) to assume a proactive role in identifying and managing OD to prevent adverse outcomes such as aspiration pneumonia. Understanding the determinants of primary care HCPs undertaking this new behaviour provides the intervention targets for addressing. This realist review, underpinned by the Theoretical Domains Framework (TDF), aims to synthesise relevant literature and develop programme theories to understand what interventions work, how they work and under what circumstances to facilitate HCPs to prevent harm from OD. Combining realist methodology with behavioural science will permit conceptualisation of intervention components as theoretical behavioural constructs, thus informing the design of a future behaviour change intervention. Furthermore, through the TDF’s linkage to a taxonomy of behaviour change techniques, we will identify corresponding behaviour change techniques to include in this intervention. Methods & analysis: We are following the five steps for undertaking a realist review: 1) clarify the scope 2) Literature search 3) appraise and extract data 4) evidence synthesis 5) evaluation. We have searched Medline, Google scholar, PubMed, EMBASE, CINAHL, AMED, Scopus and PsycINFO databases. We are obtaining additional evidence through grey literature, snowball sampling, lateral searching and consulting the stakeholder group. Literature is being screened, evaluated and synthesised in Excel and Nvivo. We will appraise evidence in relation to its relevance and rigour. Data will be extracted and synthesised according to its relation to Initial programme theories (IPTs). IPTs were constructed after the preliminary literature search, informed by the TDF and with input from a stakeholder group of patient and public involvement advisors, general practitioners, speech and language therapists, geriatricians and pharmacists. We will follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and publication standards to report study results. Results: In this ongoing review our search has identified 1417 manuscripts with approximately 20% progressing to full text screening. We inductively generated 10 IPTs that hypothesise practitioners require: the knowledge to spot the signs and symptoms of OD; the skills to provide initial advice and support; and access to resources in their working environment to support them conducting these new behaviours. We mapped the 10 IPTs to 8 TDF domains and then generated a further 12 IPTs deductively using domain definitions to fulfil the remaining 6 TDF domains. Deductively generated IPTs broadened our thinking to consider domains such as ‘Emotion,’ ‘Optimism’ and ‘Social Influence’, e.g. If practitioners perceive that patients, carers and relatives expect initial advice and support, then they will be more likely to provide this, because they will feel obligated to do so. After prioritisation with stakeholders using a modified nominal group technique approach, a maximum of 10 IPTs will progress to test against the literature.

Keywords: behaviour change, deglutition disorders, primary healthcare, realist review

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Authors: Soma Gholamveisy, Vahid Mirghavameddin

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Aquaculture activities face wide environmental, social, and economic problems today. To deal with these problems, the aquaculture business, which is already a highly significant agricultural activity, is influenced by sustainability, which can assure the rural community's safety and food health with minimal environmental damage. The objective of this study's systematic review of the literature (SLR) is to look into the use of global perspective Promotion of Sustainable Fisheries and Aquaculture. SLR aims to identify the goals of a promotional system, also one of its main components. This research seeks to empower, increase economic productivity, facilitate, pay more attention to the sustainability of the environment and inform the audience in this regard. A method used to assess hypotheses, condense the results of past studies or verify the consistency of studies. It presents a succinct analysis of original research using an unambiguous and verifiable approach. A thorough repository with a vast array of papers and effective exploration methods are frequently utilized in a systematic literature review, enabling the application of advanced logical statements. A comprehensive literature review was carried out to ensure that the most relevant studies were included. This type of review clarifies publication selection criteria and allows evaluation of the studies conducted and their repetition or extension.

Keywords: systematic review, sustainable, fisheries, aquaculture

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Authors: Fariba Ebrahimi, Mehdi Ghorbani

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Comprehensive water management considers economic, environmental, technical and social sustainability of water resources for future generations. Integrated water management implies cooperative approach and involves all stakeholders and also introduces issues to managers and decision makers. Solving these issues needs integrated and system approach according to the recognition of actors or key persons in necessary to apply cooperative management of water resources. Therefore, social network analysis can be used to demonstrate the most effective actors for environmental base decisions. The linkage of diverse sets of actors and knowledge systems across management levels and institutional boundaries often poses one of the greatest challenges in adaptive water management. Bridging stakeholder can facilitate interactions among actors in management settings by lowering the transaction costs of collaboration. This research examines how network connections between group members affect in co- management. Cohesive network structures allow groups to more effectively achieve their goals and objectives Strong; centralized leadership is a better predictor of working group success in achieving goals and objectives. Finally, geometric position of each actor was illustrated in the network. The results of the research based on between centrality index have a key and bridging actor in recognition of cooperative management of water resources in Darbandsar village and also will help managers and planners of water in the case of recognition to organization and implementation of sustainable management of water resources and water security.

Keywords: co-management, water management, social network, bridging stakeholder, darbandsar village

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Authors: S. S. Amoor

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Insecurity is becoming a major tool in the hand of Nigeria’s enemies to increase poverty and hatred among the citizens and split the county into several political segments. It is based on this background that this paper critically examines Vocational and Technical Education as a practical and realistic approach to reducing insecurity in Nigeria so as to save the country from total disintegration. The paper discusses the concept of insecurity, types, causes and effects of insecurity, and how vocational and technical education and its variables are fundamental and practical measures to reducing insecurity in Nigeria. The paper concludes that the large army of unemployed and unskilled youths in Nigeria requires immediate attention in the area of provision of marketable vocational and technical skills, creativity and competences that will prepare them for employment or self-reliance. It is hoped that government jobs or self-employment will keep the teeming youths busy and therefore take their minds away from odd jobs that threaten the security of the country. In line with these, the paper recommends, among others, that since the teeming unemployed and unskilled youths are mostly from the rural areas, the state governments in collaboration with the local governments should take appropriate steps to provide the youths with vocational skills in carpentry, fashion designing, hair-dressing, driving, welding, mechanical works, among others. Once the youths are involved in one skilled trade or the other, insecurity would be reduced.

Keywords: vocational and technical education, insecurity, practical approach to reducing insecurity, unemployment

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Authors: Subramaniam Chandran, A. Geetha

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This paper addresses three issues: how to prepare instructional design for imparting English language skill from inter-disciplinary self-learning material; how the disadvantaged students are benefited from such kind of language skill imparted through m-learning; and how do the m-learners perform better than the other learners. This paper examines these issues through an experimental study conducted among the distance learners enrolled in preparatory program for bachelor’s degree. This program is designed for the disadvantage learners especially for the school drop-outs to qualify to pursue graduate program through distant education. It also explains how mobile learning helps them to enhance their capacity in learning despite their rural background and other disadvantages. In India nearly half of the students enrolled in schools do not complete their study. The pursuance of higher education is very low when compared with developed countries. This study finds a significant increase in their learning capacity and mobile learning seems to be a viable alternative where conventional system could not reach the disadvantaged learners. Improving the English language skill is one of the reasons for such kind of performance. Exercises framed from the relevant self-learning material for enhancing English language skill not only improves language skill but also widens the subject-knowledge. This paper explains these issues out of the study conducted among the disadvantaged learners.

Keywords: English language skill, disadvantaged learners, distance education, m-learning

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Authors: M. Lizzy Madiwani, Ignatious Ncube, Evelyn Madoroba

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This study was designed to determine the distribution of pathogenic bacteria in household raised chickens and study their virulence and antibiotic profiles. For this purpose, 40 chickens were purchased from families in the Capricorn district and sacrificed for sampling. Tissues were cultured on different bacteriological media followed by biotyping using Matrix-assisted Laser Desorption Ionization-time of Flight (MALDI-TOF). Disk diffusion test was performed to determine the antibiotic susceptibility profiles of these bacteria. Out of a total of 160 tissue samples evaluated, E. coli and Salmonella were detected in these tissues. Furthermore, determination of the pathogenic E. coli and Salmonella strains at species level using primer sets that target selected genes of interest in the polymerase chain reaction (PCR) assay was employed. The invA gene, a confirmatory gene of Salmonella was detected in all the Salmonella isolates. The study revealed that there is a high distribution of Salmonella and pathogenic E. coli in these chickens. Therefore, further studies on identification at the species level are highly recommended to provide management and sanitation practices to lower this prevalence. The antimicrobial susceptibly data generated from this study can be a valuable reference to veterinarians for treating bacterial diseases in poultry.

Keywords: antimicrobial, Escherichia coli, pathogens, Salmonella

Procedia PDF Downloads 132

Authors: Fares Almomani, Majeda Khraisheh, Rahul Bhosale, Anand Kumar, Ujjal Gosh

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Septic tanks (STs) are very commonly used wastewater collection systems in the world especially in rural areas. In this study, the use of moving bed biological reactors (MBBR) for the treatment of septic tanks effluents (STE) was studied. The study was included treating septic tank effluent from one house hold using MBBRs. Significant ammonia removal rate was observed in all the reactors throughout the 180 days of operation suggesting that the MBBRs were successful in reducing the concentration of ammonia from septic tank effluent. The average ammonia removal rate at 25◦C for the reactor operated at hydraulic retention time of 5.7 hr (R1) was 0.540 kg-N/m3and for the reactor operated at hydraulic retention time of 13.3hr (R2) was 0.279 kg-N/m3. Ammonia removal rates were decreased to 0.3208 kg-N/m3 for R1 and 0.212 kg-N/m3 for R3 as the temperature of reactor was decreased to 8 ◦C. A strong correlation exists between theta model and the rates of ammonia removal for the reactors operated in continuous flow. The average ϴ values for the continuous flow reactors during the temperature change from 8°C to 20 °C were found to be 1.053±0.051. MBBR technology can be successfully used as a polishing treatment for septic tank effluent.

Keywords: septic tanks, wastewater treatment, morphology, moving biological reactors, nitrification

Procedia PDF Downloads 344

Authors: Omar Mayyas

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Clinical decision-making (CDM) is essential to community health nursing (CHN) education. For this reason, nursing educators are responsible for developing these skills among nursing students because nursing students are exposed to highly critical conditions after graduation. However, due to limited exposure to real-world situations, many nursing students need help developing clinical decision-making skills in this area. Therefore, the impact of Virtual Simulation (VS) on community health nursing students' clinical decision-making in nursing education has to be investigated. This study aims to examine the difference in CDM ability among CHN students who received traditional education compared to those who received VS classes, to identify the factors that may influence CDM ability differences between CHN students who received a traditional education and VS classes, and to provide recommendations for educational programs that can enhance the CDM ability of CHN students and improve the quality of care provided in community settings. A mixed-method study will conduct. A randomized controlled trial will compare the CDM ability of CHN students who received 1hr traditional class with another group who received 1hr VS scenario about diabetic patient nursing care. Sixty-four students in each group will randomly select to be exposed to the intervention from undergraduate nursing students who completed the CHN course at York University. The participants will receive the same Clinical Decision Making in Nursing Scale (CDMNS) questionnaire. The study intervention will follow the Medical Research Council (MRC) approach. SPSS and content analysis will use for data analysis.

Keywords: clinical decision-making, virtual simulation, community health nursing students, community health nursing education

Procedia PDF Downloads 70

Authors: Erin Curtis, Avraham Schwiger

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Neuropsychological testing and evaluation is a crucial step in providing patients with effective diagnoses and treatment while in clinical care. The variety of batteries used in these evaluations can help clinicians better understand the nuanced declivities in a patient’s cognitive, behavioral, or emotional functioning, consequently equipping clinicians with the insights to make intentional choices about a patient’s care. Despite the knowledge these batteries can yield, some aspects of neuropsychological testing remain largely inaccessible to certain patient groups as a result of fundamental cultural, educational, or social differences. One such battery includes the Dot Counting Test (DCT), during which patients are required to count a series of dots on a page as rapidly and accurately as possible. As the battery progresses, the dots appear in clusters that are designed to be easily multiplied. This task evaluates a patient’s cognitive functioning, attention, and level of effort exerted on the evaluation as a whole. However, there is evidence to suggest that certain social groups, particularly Latinx groups, may perform worse on this task as a result of cultural or educational differences, not reduced cognitive functioning or effort. As such, this battery fails to account for baseline differences among patient groups, thus creating questions surrounding the accuracy, generalizability, and value of its results. Accessibility and cultural sensitivity are critical considerations in the testing and treatment of marginalized groups, yet have been largely ignored in the literature and in clinical settings to date. Implications and improvements to applications are discussed.

Keywords: culture, latino, neuropsychological assessment, neuropsychology, accessibility

Procedia PDF Downloads 115

Authors: Davaanyam Surenjav, Chinzolboo Dandarbaatar, Ganbold Batkhuyag

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Primate city induced rapid urbanization has been become one of the main challenges in sustainable development in Mongolia like other developing countries since transition to market economy in 1990. According due to statistical yearbook, population number of Ulaanbaatar city has increased from 0.5 million to 1.5 million for last 30 years and contains now almost half (47%) of total Mongolian population. Rural-Ulaanbaatar and local Cities-Ulaanbaatar city migration leads to social issues like uncontrolled urbanization, income inequality, poverty, overwork of public service, economic over cost for redevelopment and limitation of transport and environmental degradation including air, noise, water and soil pollution. Most thresholds of all of the sustainable urban development main and sub-indicators over exceeded from safety level to unsafety level in Ulaanbaatar. So, there is an urgent need to remove migration pull factors including some administrative and high education functions from Ulaanbaatar city to its satellite cities or secondary cities. Moreover, urban smart transport system and green and renewable energy technologies should be introduced to urban development master plan of Ulaanbaatar city.

Keywords: challenge for sustainable urban development, migration factors, primate city , urban safety thresholds

Procedia PDF Downloads 134

Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the country. The elevated death and disease among ex-slaves were attributable to the unavailability of healthcare. To address the paucity of healthcare services, the College, an institution with the mission of educating minority professionals and serving the under served population, was established in 1876. This study was designed to assess if the College has accomplished its mission of serving under served communities and contributed to the elimination of health disparities in the United States. The study objective was to quantify the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities, which, in turn, was significantly associated with a health professional shortage score partly designated by the U.S. Department of Health and Human Services. Various statistical methods were used to analyze the alumni data in years 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates into the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t test was performed to detect the significant mean differences for clustering and criterion variables between Disadvantaged and Non-disadvantaged Communities, which confirms the “content” validity of cluster analysis model. Chi-square test was used to assess if the proportion of cluster groups (Disadvantaged vs Non-disadvantaged Communities) were consistent with that of practicing specialties (primary care vs. non-primary care). Finally, the partial least squares (PLS) path model was constructed to explore the “construct” validity of analytics model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving disadvantaged community. The social ecological theory along with statistical models mentioned was used to establish the relationship between medical and dental graduates (primary care professionals serving disadvantaged communities) and their social environments (socioeconomic status, adverse health outcome, health professional shortage score). Based on social ecological framework, it was hypothesized that the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities could be quantified. Also, primary care professionals serving disadvantaged communities related to a health professional shortage score can be measured. Adverse health outcome (adult obesity rate, age-adjusted premature mortality rate, and percent of people diagnosed with diabetes) could be affected by the latent variable, namely socioeconomic status (unemployment rate, poverty rate, percent of children who were in free lunch programs, and percent of uninsured adults). The study results indicated that approximately 83% (3,192/3,864) of the College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. In addition, the PLS path modeling demonstrated that primary care professionals serving disadvantaged community was significantly associated with socioeconomic status and adverse health outcome (p < .001). In summary, the majority of medical and dental graduates from the College provide primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcomes, which demonstrate that the College has fulfilled its mission.

Keywords: disadvantaged community, K-means cluster analysis, PLS path modeling, primary care

Procedia PDF Downloads 553

Authors: Nahid Ehsani, Amir Hossein Rezvanfar

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The main objective of this study is to investigate psychological and socio-cultural factors effective on the tendency of the villagers to use e-banking services. The current paper is an applied study considering its objectives. The main data gathering tool in the current study is a made questionnaire which is designed and executed based on the conceptual background of the subject matter and the objectives and hypotheses of the study. The statistical population of this study includes all the customers of rural branches of Agricultural Bank in Ilam Province (N=82885). Among these 120 participants were chosen through sample size determination formula and they were studied using stratified random sampling method. In the analytical statistics level the results obtained from calculating Spearman’s Correlative Coefficient showed that socio-cultural and psychological factors had a significant impact of the extent of the tendency of the villagers to use e-banking services of the Agricultural Bank at the 99% level. Furthermore, stepwise multiple regression analysis showed that both sets of psychological factors as well as socio-economic factors were able to explain 50 percent of the variance of the independent variable; namely the tendency of villagers to use e-banking services.

Keywords: e-banking, agricultural bank, tendency, socio-economic factors, psychological factors

Procedia PDF Downloads 533

Authors: Natalia Naoumova

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Facing changes and continuous growth of the contemporary cities, along with the globalization effects that accelerate cultural dissolution, the maintenance of cultural authenticity, which is implicit in historical areas as a part of cultural diversity, can be considered one of the key elements of a sustainable society. This article focuses on the polychromy of buildings in a historical context as an important feature of urban settings. It analyses the coloring of Brazilian urban heritage, characterized by the study of historical districts in Pelotas and Piratini, located in the State of Rio Grande do Sul, Brazil. The objective is to reveal the coloring characteristics of different historical periods, determine the chromatic typologies of the corresponding building styles, and clarify the connection between the historical chromatic aspects and their relationship with the contemporary urban identity. Architectural style data were collected by different techniques such as stratigraphic prospects of buildings, survey of historical records and descriptions, analysis of images and study of projects with colored facades kept in historical archives. Three groups of characteristics were considered in searching for working criteria in the formation of chromatic model typologies: 1) coloring palette; 2) morphology of the facade, and 3) their relationship. The performed analysis shows the formation of the urban chromatic image of the historical center as a continuous and dynamic process with the development of constant chromatic resources. It establishes that the changes in the formal language of subsequent historical periods lead to the changes in the chromatic schemes, providing a different reading of the facades both in terms of formal interpretation and symbolic meaning.

Keywords: building style, historic colors, urban heritage, urban polychromy

Procedia PDF Downloads 145