Search results for: health care workers' knowledge
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16838

Search results for: health care workers' knowledge

14258 Stakeholders Perspectives on the Social Determinants of Health and Quality of Life in Aseer Healthy Cities

Authors: Metrek Almetrek, Naser Alqahtani, Eisa Ghazwani, Mona Asiri, Mohammed Alqahtani, Magboolah Balobaid

Abstract:

Background: Advocacy of potential for community coalitions to positively address social determinants of health and quality of life, little is known about the views of stakeholders involved in such efforts. This study sought to assess the provinces leaders’ perspectives about social determinants related to the Health Neighborhood Initiative (HNI), a new county effort to support community coalitions. Method and Subjects: We used a descriptive, qualitative study using personal interviews in 2022. We conducted it in the community coalition's “main cities committees” set across service planning areas that serve vulnerable groups located in the seven registered healthy cities to WHO (Abha, Tareeb, Muhayel, Balqarn, Alharajah, Alamwah, and Bisha). We conducted key informant interviews with 76 governmental, profit, non-profit, and community leaders to understand their perspectives about the HNI. As part of a larger project, this study focused on leaders’ views about social determinants of health related to the HNI. All interviews were audio-recorded and transcribed. An inductive approach to coding was used, with text segments grouped by social determinant categories. Results: Provinces leaders described multiple social determinants of health and quality of life that were relevant to the HNI community coalitions: housing and safety, community violence, economic stability, city services coordination and employment and education. Leaders discussed how social determinants were interconnected with each other and the need for efforts to address multiple social determinants simultaneously to effectively improve health and quality of life. Conclusions: Community coalitions have an opportunity to address multiple social determinants of health and quality of life to meet the social needs of vulnerable groups. Future research should examine how community coalitions, like those in the HNI, can actively engage with community members to identify needs and then deliver evidence-based care.

Keywords: social determinants, health and quality of life, vulnerable groups, qualitative research

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14257 Capitalizing on Differential Network Ties: Unpacking Individual Creativity from Social Capital Perspective

Authors: Yuanyuan Wang, Chun Hui

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Drawing on social capital theory, this article discusses how individuals may utilize network ties to come up with creativity. Social capital theory elaborates how network ties enhances individual creativity from three dimensions: structural access, and relational and cognitive mechanisms. We categorize network ties into strong and weak in terms of tie strength. With less structural constraints, weak ties allow diverse and heterogeneous knowledge to prosper, further facilitating individuals to build up connections among diverse even distant ideas. On the other hand, strong ties with the relational mechanism of cooperation and trust may benefit the accumulation of psychological capital, ultimately to motivate and sustain creativity. We suggest that differential ties play different roles for individual creativity: Weak ties deliver informational benefit directly rifling individual creativity from informational resource aspect; strong ties offer solidarity benefits to reinforce psychological capital, which further inspires individual creativity engagement from a psychological viewpoint. Social capital embedded in network ties influence individuals’ informational acquisition, motivation, as well as cognitive ability to be creative. Besides, we also consider the moderating effects constraining the relatedness between network ties and creativity, such as knowledge articulability. We hypothesize that when the extent of knowledge articulability is low, that is, with low knowledge codifiability, and high dependency and ambiguity, weak ties previous serving as knowledge reservoir will not become ineffective on individual creativity. Two-wave survey will be employed in Mainland China to empirically test mentioned propositions.

Keywords: network ties, social capital, psychological capital, knowledge articulability, individual creativity

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14256 The Evaluation of Occupational Exposure of Chrome in Welders of Stainless Steels

Authors: L. Musak, J. Valachova, T. Vasicko, O. Osina

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Introduction: Stainless steel is resistant to electrochemical corrosion by passivation. Welders are greatly exposed to welding fumes of toxic metals, which added to this steel. The content of chromium (Cr) in steel was above 11.5%, Ni and Mo from 2 to 6.5%. The aim of the study was the evaluation of occupational exposure to Cr, chromosome analysis and valuation of individual susceptibility polymorphism of gene CCND1 c.870 G>A. Materials and Methods: The exposed group was consisted from 117 welders of stainless steels. The average age was 38.43 years and average exposure time 7.14 years. Smokers represented 40.17%. The control group consisted of 123 non-exposed workers with an average age of 39.74 years and time employment 16.67 years. Smokers accounted for 22.76%. Analysis of Cr in blood and urine was performed by atomic absorption spectrophotometry (AAS Varian SpectraAA 30P) with electrothermal decomposition of the sample in the graphite furnace. For the evaluation of chromosomal aberrations (CA) was used cytogenetic analysis of peripheral blood lymphocytes, gene polymorphism was determined by PCR-RFLP reaction using appropriate primers and restriction enzymes. For statistical analysis was used the Mann-Whitney U-test. Results: The mean Cr level in exposed group was 0.095 mmol/l (0.019 min-max 0.504). No value does exceed the average normal value. The average value Cr in urine was 7.9 mmol/mol creatinine (min 0.026 to max 19.26). The total number of CA was 1.86% in compared to 1.70% controls. (CTA-type 0.90% vs 0.80% and CSA-type 0.96% vs 0.90%). In the number of total CA was observed statistical difference between smokers and non-smokers of exposed group (S-1.57% vs. NS-2.04%, P<0.05). In CCND1 gene polymorphisms was observed the increasing of the total CA with wild-type allele (WT) via heterozygous to the VAR genotype (1.44%<1.82%<2.13%). There was observed a statistically higher incidence of CTA-type aberrations in variant genotypes between exposed and control groups (1.22% vs. 0.59%, P<0.05). Discussion and conclusions: The work place is usually higher source of exposure to harmful factors. Workers need consistently and checked frequently health control. In assessing the risk of adverse effects of metals is important to consider their persistence, behavior and bioavailability. Prolonged exposure to carcinogens may not manifest symptoms of poisoning, but delayed effects may occur, which resulted in a higher incidence of malignant tumors.

Keywords: genotoxicity, chromium, stainless steels, welders

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14255 A Study of the Resistance of Protective Glove Materials to Metalworking Fluids

Authors: Nguyen-Tri Phuong, Triki Ennouri, Gauvin Chantal, Tuduri Ludovic, Vu-Khanh Toan

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Hand injuries due to mechanical hazards such as cuts and punctures are major risks and concerns for several occupational groups, particularly for workers in the metal manufacturing sector and mechanical automotive services. Personal protective equipment such as gloves or clothing is necessary for many professionals to protect against a variety of occupational hazards, which arise daily in their work environments. In many working places such as metal manufacturing or automotive services, mechanical hazards often occur together with industrial contaminants, particularly metalworking fluids (MWFs). The presence of these contaminants could modify the properties of gloves made from polymeric materials and thus increase the risk of hand injuries for workers. The focus of this study is to determine the swelling characteristics and the resistance of six polymer membranes when they are contaminated with several industrial metalworking fluids. These polymer membranes, commonly used in protective gloves, are nitrile, neoprene, vinyl, butyl, polyurethane and latex rubbers. Changes swelling index were continuously followed during the contamination procedure to compare the performance of each polymer under different conditions. The modification of the samples surface, tensile properties during the contamination process was also investigated. The effect of temperature on mechanical properties and morphology of material was also examined.

Keywords: metalworking fluid, swelling behavior, protective glove materials, elastomers

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14254 Assessment of Knowledge, Awareness about Hemorrhoids Causes and Stages among the General Public of Saudi Arabia

Authors: Asaiel Mubark Al Hadi

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Background: A frequent anorectal condition known as hemorrhoids, sometimes known as piles, is characterized by a weakening of the anal cushion and the supporting tissue as well as spasms of the internal sphincter. Hemorrhoids are most frequently identified by painless bright red bleeding, prolapse, annoying grape-like tissue prolapse, itching, or a combination of symptoms. digital rectal examination (DRE) and anoscope are used to diagnose it. Constipation, a low-fiber diet, a high body- mass index (BMI), pregnancy, and a reduced physical activity are among the factors that are typically thought to increase the risk of hemorrhoids. Golighers is the most commonly used hemorrhoid classification scheme It is 4 degrees, which determines the degree of the event. The purpose of this study is to assess knowledge and awareness level of the causes and stages of Hemorrhoids in the public of Saudi Arabia. Method: This cross-sectional study was conducted in the Saudi Arabia between Oct 2022- Dec 2022. The study group included at least 384 aged above 18 years. The outcomes of this study were analyzed using the SPSS program using a pre-tested questionnaire. Results: The study included 1410 participants, 69.9% of them were females and 30.1% were males. 53.7% of participants aged 20- 30 years old. 17% of participants had hemorrhoids and 42% had a relative who had hemorrhoids. 42.8% of participants could identify stage 1 of hemorrhoids correctly, 44.7% identified stage 2 correctly, 46.7% identified stage 3 correctly and 58.1% identified stage 4 correctly. Only 28.9% of participants had high level of knowledge about hemorrhoids, 62.7% had moderate knowledge and 8.4% had low knowledge. Conclusion: In conclusion, Saudi general population has poor knowledge of hemorrhoids, their causes and their management approach. There was a significant association between knowledge scores of hemorrhoids with age, gender, residence area and employment.

Keywords: hemorrhoids, external hemorrhoid, internal hemorrhoid, anal fissure, hemorrhoid stages, prolapse, rectal bleeding

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14253 Factors Influencing Public Attitudes Towards Mental Illness in the Togolese Population

Authors: Myriam Roy

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The perspectives of the Togolese public towards mental illness were assessed, looking at religious affiliation, personal knowledge of someone with a mental illness, and education level as influencers. The goal was to observe which factors influenced most strongly the general public’s attitudes towards mental illness. The Togolese population was surveyed within the context of mental health awareness workshops and involved college and university students, rural community members, and company employees. Taylor and Dear’s Community Attitudes towards the Mentally Ill (CAMI) questionnaire was used to assess these influencers and includes four dimensions of community attitudes towards mental illness: authoritarianism, benevolence, social restrictiveness, and community mental health ideology (CMHI). Demographic questions were also included, tailored to the various realities of the Togolese population. These questions looked, among others, at religious, ethnical (region of origin within Togo), and educational background. It was found that religious affiliation and personal knowledge did not correlate significantly with changes in the four dimensions of the CAMI scale. It suggests that public perspectives towards mental illness might not be as associated with these variables as was previously thought. The dimensions, however, did correlate with themselves as was expected. Authoritarianism was associated positively with social restrictiveness, benevolence was associated negatively with social restrictiveness and positively with CMHI, and CMHI was associated negatively with social restrictiveness, indicating the CAMI did not suffer from reliability and validity issues when used with this population. Interestingly, level of education significantly impacted authoritarianism level, with higher education associated with a decrease in authoritarianism. This finding would support the notion that education is likely to provide access to a wide array of information as well as interaction with people from various backgrounds and situations. Providing increased awareness regarding mental health and illness in schools could be beneficial to favor the impact that education appears to have on public perspectives towards mental illness in Togo. Future studies could assess which mental health interventions in schools would be the most useful in Togo.

Keywords: CAMI questionnaire, cross-cultural psychology, stigma towards mental illness, West African psychology

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14252 The Impact of Resource-oriented Music Listening on Oversea Dispatch Employees Work Stress Relief

Authors: Wei Yaming

Abstract:

Objective: In order to compare the stress of employees sent overseas with (GRAS) before and after, we used the resource-oriented music listening intervention in this study. We also collected pertinent experimental data. Methods: The experiment involved 47 employees who were sent abroad by the Chinese side. They completed the stress scale test and documented it before the intervention. They tested for stress after five interventions and performed one-on-one interviews. Quantitative data and SPSS software were used to analyze relationships between stress reduction and resource-oriented music listening, as well as Pearson's correlation, multiple regression levels, and ANOVA. For the qualitative analysis, content analysis of one-on-one interviews was performed. Results: A comparison of data from before and after demonstrates how resource-focused music listening activities can lessen and relieve stress in remote workers. In the qualitative study, stress is broken down into six categories: relationship stress, health stress, emotional stress, and frustration stress. External pressures include work pressure and cultural stress. And it has been determined that listening to music that is resource-oriented can better ease internal stress (health, emotion, and dissatisfaction). Conclusion: The Guide Resource-oriented Music Listening (GROML) Program appears to have had some effect on the participants' stress levels. The resources that the participants encountered while listening to music are bravery, calm, letting go, and relaxing.

Keywords: resource-oriented, music listening, oversea dispatch employees, work stress

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14251 Level of Knowledge, Attitude, Perceived Behavior Control, Subjective Norm and Behavior of Household Solid Waste towards Zero Waste Management among Malaysian Consumer

Authors: M. J. Zuroni, O. Syuhaily, M. A. Afida Mastura, M. S. Roslina, A. K. Nurul Aini

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The impact of country development has caused an increase of solid waste. The increase in population causes of excess usage thus effecting the sustainable environment. Zero waste management involves maximizing practices of recycling and minimizing residual waste. This paper seeks to analyze the relationship between knowledge, attitude, perceived behavior control, subjective norm and behavior of household solid waste towards household solid waste management among urban households in 8 states that have been implemented and enforced regulations under the Solid Waste Management and Public Cleansing Act 2007 (Act 672) in Malaysia. A total of respondents are 605 and we used a purposive sampling for location and simple sampling for sample size. Data collected by using self-administered questionnaire and were analyzed using SPSS software. The Pearson Correlation Test is to examine the relationship between four variables. Results show that knowledge scores are high because they have an awareness of the importance of managing solid waste. For attitude, perceived behavior control, subjective norm and behavioral scores at a moderate level in solid waste management activities. The findings show that there is a significant relationship between knowledge and behavior of household solid waste (r = 0.136 **, p = 0.001), there is a significant relationship between attitude and behavior (r = 0.238 **, p = 0.000), there is a significant relationship between perceived behavior control and behavior (r = 0.516 **, p = 0.000) and there is a significant relationship between subjective norm and behavior (r = 0.494 **, p = 0.000). The conclusion is that there is a relationship between knowledge, attitude, perceived behavior control and subjective norm toward the behavior of household solid waste management. Therefore, in the findings of the study, all parties including the government should work together to enhance the knowledge, attitude, perceived behavior control and behavior of household solid waste management in other states that have not implemented and enforced regulations under the Solid Waste and Public Cleansing Management Act 2007 (Act 672).

Keywords: solid waste management, knowledge, attitude, perceived behavior control, subjective norm, behavior

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14250 Assessing Musculoskeletal Disorder Prevalence and Heat-Related Symptoms: A Cross-sectional Comparison in Indian Farmers

Authors: Makkhan Lal Meena, R. C. Bairwa, G. S. Dangayach, Rahul Jain

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The current study looked at the frequency of chronic illness conditions, accidents, health complaints, and ergonomic issues among 100 conventional and 100 greenhouse farmers. Data related to the health symptoms and ergonomic problems were collected through questionnaires by conducting direct interviews of farmers. According to the findings, symptoms of heat exposure (skin rashes, headache, dizziness, and lack of appetite) were substantially higher among conventional farmers than greenhouse farmers. The greenhouse farmers reported much more pain, numbness, or weakness in wrists/hands, fingers, upper back, hips, and ankles/feet than conventional farmers. The findings of the study suggest that suitable ergonomic knowledge and awareness campaign programs concentrating on safety at work, particularly low back pain, should be implemented in workplaces to allow for earlier detection of symptoms among the greenhouse farmers.

Keywords: accident, conventional farmer, ergonomics, health symptoms, greenhouse farmers, pesticide

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14249 Jejunostomy and Protective Ileostomy in a Patient with Massive Necrotizing Enterocolitis: A Case Report

Authors: Rafael Ricieri, Rogerio Barros

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Objective: This study is to report a case of massive necrotizing enterocolitis in a six-month-old patient, requiring ileostomy and protective jejunostomy as a damage control measure in the first exploratory laparotomy surgery in massive enterocolitis without a previous diagnosis. Methods: This study is a case report of success in making and closing a protective jejunostomy. However, the low number of publications on this staged and risky measure of surgical resolution encouraged the team to study the indication and especially the correct time for closing the patient's protective jejunostomy. The main study instrument will be the six-month-old patient's medical record. Results: Based on the observation of the case described, it was observed that the time for the closure of the described procedure (protective jejunostomy) varies according to the level of compromise of the health status of your patient and of an individual of each person. Early closure, or failure to close, can lead to a favorable problem for the patient since several problems can result from this closure, such as new intestinal perforations, hydroelectrolyte disturbances. Despite the risk of new perforations, we suggest closing the protective jejunostomy around the 14th day of the procedure, thus keeping the patient on broad-spectrum antibiotic therapy and absolute fasting, thus reducing the chances of new intestinal perforations. Associated with the closure of the jejunostomy, a gastric tube for decompression is necessary, and care in an intensive care unit and electrolyte replacement is necessary to maintain the stability of the case.

Keywords: jejunostomy, ileostomy, enterocolitis, pediatric surgery, gastric surgery

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14248 The Impact of COVID-19 Measures on Children with Disabilities and Their Families in the Kingdom of Saudi Arabia

Authors: Faris Algahtani

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The COVID 19 pandemic and associated public health measures have disrupted the lives of peoplearound the world, including children. There is little knowledge about how pandemic measures have affected children in the Kingdom of Saudi Arabia (KSA). The aim and objectives of this qualitative study was to learn about the outcomes and impacts of the pandemic on children ages 0-8 in KSA. The study was based on 40 in-depth interviews that were conducted with experts in health, social protection, education, and early learning, children with special needs, and economics, including decision makers as well as specialists in service provision. The interviews were recorded and translated from Arabic to English into summary notes. The narrative was coded and analyzed following a thematic analysis.

Keywords: disabilities, COVID-19, families, children

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14247 A Description Logics Based Approach for Building Multi-Viewpoints Ontologies

Authors: M. Hemam, M. Djezzar, T. Djouad

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We are interested in the problem of building an ontology in a heterogeneous organization, by taking into account different viewpoints and different terminologies of communities in the organization. Such ontology, that we call multi-viewpoint ontology, confers to the same universe of discourse, several partial descriptions, where each one is relative to a particular viewpoint. In addition, these partial descriptions share at global level, ontological elements constituent a consensus between the various viewpoints. In order to provide response elements to this problem we define a multi-viewpoints knowledge model based on viewpoint and ontology notions. The multi-viewpoints knowledge model is used to formalize the multi-viewpoints ontology in description logics language.

Keywords: description logic, knowledge engineering, ontology, viewpoint

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14246 The Relationship among Exercise Participation, Job Stress and Job Satisfaction: A Study on Food Service Employees in Taiwan

Authors: Jui-Hsiu Chang

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As an increasing number of restaurants are growing, the demand for man force in the food service industry is dramatically increasing as well. However, food service workers often complete the heavy workload, infrequent breaks, long hours and shifts. With the overwhelming workload, many workers have experienced high injury rates. As a result, the restaurant industry reports a higher employee turnover rate compare to other service industries in Taiwan. Restaurant managers are seeing ways to retain good employees in order to provide good quality service for daily operation. The purpose of this study was to explore the relationship among exercise participation, job stress and job satisfaction on the food service employees. In addition, to examine how the job stress affected their job satisfaction. A survey using a self-reported questionnaire was conducted to collect data, and 269 questionnaires were collected for data analysis. The obtained materials were analyzed using descriptive statistic, independent t-test, one-way ANOVA, linear regression analysis. The results show that 1. Job stress had a significantly negative influence on employees’ job satisfaction. 2. Exercise participation had significantly positive influence on employees’ job satisfaction. 3. Job stress and job satisfaction varied among the groups of respondent with different level of exercise involvement. Furthermore, the practical implications were proposed for the food service company management when developing daily operational strategies.

Keywords: exercise participation, food service employees, job satisfaction, job stress

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14245 Sexuality and Quality of Life Among Older Adults

Authors: Ahuva Even-Zohar, Shoshi Werner

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Context: Sexuality is an important aspect of overall quality of life for individuals across different age groups and health conditions. Sexual interest and activity continue to be important and play a role in people's life as they age. Despite this, there is limited research on the sexual health of older adults. Research Aim: The study aims to examine the knowledge, attitudes, and sexual activity of older adults and to explore the relationship between sexual activity and quality of life among this population. Methodology: The study involved 203 Jewish participants from Israel, with an average age of 69.59. The participants completed questionnaires administered through an Internet panel. The questionnaires measured variables such as knowledge about and attitudes towards sexuality, sexual activity, quality of life, and socio-demographic information. Findings: The study found that a majority of the participants reported engaging in sexual activity, with most of them experiencing full sexual intercourse. Approximately half of the participants expressed high levels of satisfaction with their sexual activity. The results indicated that older adults demonstrated a moderate level of knowledge and permissive attitudes towards sexuality in later life. Moreover, higher levels of knowledge and permissive attitudes were associated with increased sexual activity. The frequency of sexual activity was identified as a predictor of quality of life, with a mediating effect on the relationship between attitudes towards older adults' sexuality and quality of life. Notably, men and older adults who were married or in a relationship reported higher frequencies of sexual activity compared to women and older adults without a partner. Furthermore, a majority of participants did not seek professional help or discuss their sexual concerns with a therapist. Theoretical Importance: This research contributes to our understanding of a topic that is often considered taboo - sexuality among older adults. It highlights that older adults maintain an interest in sexual activity, and that engaging in such activity contributes to their overall quality of life. Data Collection and Analysis Procedures: The data for this study were collected using structured questionnaires administered through an Internet panel. The questionnaires included closed-ended questions, allowing for quantitative data analysis. Descriptive statistics and regression analysis were performed to examine the relationships between the variables. Questions Addressed: This study aimed to address the following questions: What is the level of knowledge and attitudes towards sexuality among older adults? How prevalent is sexual activity among older adults and what factors are associated with it? How does sexual activity impact the quality of life of older adults? Do older adults seek professional help for their sexual concerns? Conclusion: The main conclusion drawn from this research is that sexuality is a crucial aspect of older adults' lives and significantly contributes to their quality of life. The study emphasizes the need for educational programs aimed at older adults and professionals, which promote the understanding and benefits of sexuality in later life. It also suggests that professionals should actively encourage older individuals to seek help and support when experiencing difficulties related to sexuality.

Keywords: men, older adults, quality of life, sexuality, women

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14244 A Bayesian Approach for Health Workforce Planning in Portugal

Authors: Diana F. Lopes, Jorge Simoes, José Martins, Eduardo Castro

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Health professionals are the keystone of any health system, by delivering health services to the population. Given the time and cost involved in training new health professionals, the planning process of the health workforce is particularly important as it ensures a proper balance between the supply and demand of these professionals and it plays a central role on the Health 2020 policy. In the past 40 years, the planning of the health workforce in Portugal has been conducted in a reactive way lacking a prospective vision based on an integrated, comprehensive and valid analysis. This situation may compromise not only the productivity and the overall socio-economic development but the quality of the healthcare services delivered to patients. This is even more critical given the expected shortage of the health workforce in the future. Furthermore, Portugal is facing an aging context of some professional classes (physicians and nurses). In 2015, 54% of physicians in Portugal were over 50 years old, and 30% of all members were over 60 years old. This phenomenon associated to an increasing emigration of young health professionals and a change in the citizens’ illness profiles and expectations must be considered when planning resources in healthcare. The perspective of sudden retirement of large groups of professionals in a short time is also a major problem to address. Another challenge to embrace is the health workforce imbalances, in which Portugal has one of the lowest nurse to physician ratio, 1.5, below the European Region and the OECD averages (2.2 and 2.8, respectively). Within the scope of the HEALTH 2040 project – which aims to estimate the ‘Future needs of human health resources in Portugal till 2040’ – the present study intends to get a comprehensive dynamic approach of the problem, by (i) estimating the needs of physicians and nurses in Portugal, by specialties and by quinquenium till 2040; (ii) identifying the training needs of physicians and nurses, in medium and long term, till 2040, and (iii) estimating the number of students that must be admitted into medicine and nursing training systems, each year, considering the different categories of specialties. The development of such approach is significantly more critical in the context of limited budget resources and changing health care needs. In this context, this study presents the drivers of the healthcare needs’ evolution (such as the demographic and technological evolution, the future expectations of the users of the health systems) and it proposes a Bayesian methodology, combining the best available data with experts opinion, to model such evolution. Preliminary results considering different plausible scenarios are presented. The proposed methodology will be integrated in a user-friendly decision support system so it can be used by politicians, with the potential to measure the impact of health policies, both at the regional and the national level.

Keywords: bayesian estimation, health economics, health workforce planning, human health resources planning

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14243 Indigenous Knowledge and Nature of Science Interface: Content Considerations for Science, Technology, Engineering, and Mathematics Education

Authors: Mpofu Vongai, Vhurumuku Elaosi

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Many African countries, such as Zimbabwe and South Africa, have curricula reform agendas that include incorporation of Indigenous Knowledge and Nature of Science (NOS) into school Science, Technology, Engineering and Mathematics (STEM) education. It is argued that at high school level, STEM learning, which incorporates understandings of indigenization science and NOS, has the potential to provide a strong foundation for a culturally embedded scientific knowledge essential for their advancement in Science and Technology. Globally, investment in STEM education is recognized as essential for economic development. For this reason, developing countries such as Zimbabwe and South Africa have been investing into training specialized teachers in natural sciences and technology. However, in many cases this training has been detached from the cultural realities and contexts of indigenous learners. For this reason, the STEM curricula reform has provided implementation challenges to teachers. An issue of major concern is the teachers’ pedagogical content knowledge (PCK), which is essential for effective implementation of these STEM curricula. Well-developed Teacher PCK include an understanding of both the nature of indigenous knowledge (NOIK) and of NOS. This paper reports the results of a study that investigated the development of 3 South African and 3 Zimbabwean in-service teachers’ abilities to integrate NOS and NOIK as part of their PCK. A participatory action research design was utilized. The main focus was on capturing, determining and developing teachers STEM knowledge for integrating NOIK and NOS in science classrooms. Their use of indigenous games was used to determine how their subject knowledge for STEM and pedagogical abilities could be developed. Qualitative data were gathered through the use dialogues between the researchers and the in-service teachers, as well as interviewing the participating teachers. Analysis of the data provides a methodological window through which in-service teachers’ PCK can be STEMITIZED and their abilities to integrate NOS and NOIK developed. Implications are raised for developing teachers’ STEM education in universities and teacher training colleges.

Keywords: indigenous knowledge, nature of science, pedagogical content knowledge, STEM education

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14242 Policy for Implementing Decolonial Practices, Equity, Inclusivity, and Diversity into Radical Democratic Informal Art Gallery Education

Authors: Kaida Kobylka

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Museum education policy can be developed through the lens of radical democracy and radically democratic relational aesthetics to provoke a more wholistic, agonistic, and utopian educational experiences that expand a viewer’s experiences and knowledge of artwork in a museum’s permanent collection to encourage a deeper understanding of art and the community of a museum’s connections to equity, diversity, inclusion, and decolonization. Practices used by the museum will create cohesive and engaging informal education that utilizes community-based, alternative knowledge and create dignity-safe spaces for viewers to engage critically with the visual objects.

Keywords: museum education, radical democracy, Canadian policy, community-based knowledge

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14241 Video-Based Psychoeducation for Caregivers of Persons with Schizophrenia

Authors: Jilu David

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Background: Schizophrenia is one of the most misunderstood mental illnesses across the globe. Lack of understanding about mental illnesses often delay treatment, severely affects the functionality of the person, and causes distress to the family. The study, Video-based Psychoeducation for Caregivers of Persons with Schizophrenia, consisted of developing a psychoeducational video about Schizophrenia, its symptoms, causes, treatment, and the importance of family support. Methodology: A quasi-experimental pre-post design was used to understand the feasibility of the study. Qualitative analysis strengthened the feasibility outcomes. Knowledge About Schizophrenia Interview was used to assess the level of knowledge of 10 participants, before and after the screening of the video. Results: Themes of usefulness, length, content, educational component, format of the intervention, and language emerged in the qualitative analysis. There was a statistically significant difference in the knowledge level of participants before and after the video screening. Conclusion: The statistical and qualitative analysis revealed that the video-based psychoeducation program was feasible and that it facilitated a general improvement in knowledge of the participants.

Keywords: Schizophrenia, mental illness, psychoeducation, video-based psychoeducation, family support

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14240 Need for Eye Care Services, Clinical Characteristics, Surgical Outcome and Prognostic Predictors of Cataract in Adult Participants with Intellectual Disability

Authors: Yun-Shan Tsai, Si-Ping Lin, En-Chieh Lin, Xin-Hong Chen, Shin-Yun Ho, Shin-Hong Huang, Ching-ju Hsieh

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Background and significance: Uncorrected refractive errors and cataracts are the main visually debilitating ophthalmological abnormalities in adult participants with intellectual disability (ID). However, not all adult participants with ID may receive a regular and timely ophthalmological assessment. Consequently, some of the ocular diseases may not be diagnosed until late, thereby causing unnecessary ocular morbidity. In addition, recent clinical practice and researches have also suggested that eye-care services for this group are neglected. Purpose: To investigate the unmet need for eye care services, clinical characteristics of cataract, visual function, surgical outcome and prognostic predictors in adult participants with ID at Taipei City Hospital in Taiwan. Methods: This is a one-year prospective clinical study. We recruited about 120 eyes of 60 adult participants with ID who were received cataract surgery. Caregivers of all participants received a questionnaire on current eye care services. Clinical demographic data, such as age, gender, and associated systemic diseases or syndromes, were collected. All complete ophthalmologic examinations were performed 1 month preoperatively and 3 months postoperatively, including ocular biometry, visual function, refractive status, morphology of cataract, associated ocular features, anesthesia methods, surgical types, and complications. Morphology of cataract, visual and surgical outcome was analyzed. Results: A total of 60 participants with mean age 43.66 ± 13.94 years, including 59.02% male and 40.98% female, took part in comprehensive eye-care services. The prevalence of unmet need for eye care services was high (about 70%). About 50% of adult participants with ID have bilateral cataracts at the time of diagnosis. White cataracts were noted in about 30% of all adult participants with ID at the time of presentation. Associated ocular disorders were included myopic maculopathy (4.54%), corneal disorders (11.36%), nystagmus (20.45%), strabismus (38.64%) and glaucoma (2.27%). About 26.7% of adult participants with ID underwent extracapsular cataract extraction whereas a phacoemulsification was performed in 100% of eyes. Intraocular lens implantation was performed in all eyes. The most common postoperative complication was posterior capsular opacification (30%). The mean best-corrected visual acuity was significantly improved from preoperatively (mean log MAR 0.48 ± 0.22) to at 3 months postoperatively (mean log MAR 0.045 ± 0.22) (p < .05). Conclusions: Regular follow up will help address the need for eye-care services in participants with ID. A high incidence of bilateral cataracts, as well as white cataracts, was observed in adult participants with ID. Because of early diagnosis and early intervention of cataract, the visual and surgical outcomes of cataract are good, but the visual outcomes are suboptimal due to associated ocular comorbidities.

Keywords: adult participants with intellectual disability, cataract, cataract surgery

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14239 Financial Benefits after the Implementation of Antimicrobial Copper in Intensive Care Units (ICUs)

Authors: P. Efstathiou, E. Kouskouni, S. Papanikolaou, K. Karageorgou, Z. Manolidou, Tseroni Maria, A. Efstathiou, V. Karyoti, I. Agrafa

Abstract:

Aim: Aim of this study was to evaluate the reduction on Intensive Care Unit (ICU) microbial flora after the antimicrobial copper alloy (Cu+) implementation as well as the effect on financial-epidemiological operation parameters. Methods: Medical, epidemiological and financial data in two time periods, before and after the implementation of copper (Cu 63% - Zn 37%, low lead) were recorded and analyzed in a general ICU. The evaluated parameters were: the importance of patients' admission (Acute Physiology and Chronic Health Evaluation - APACHE II and Simplified Acute Physiology Score - SAPS), microbial flora's record in the ICU before and after the implementation of Cu+ as well as the impact on epidemiological and ICU's operation financial parameters. Results: During December 2010 and March 2011 and respectively during December 2011 and March 2012 comparative results showed statistically significant reduction on the microbial flora (CFU/ml) by 95% and the use of antimicrobial medicine (per day per patient) by 30% (p = 0,014) as well as patients hospitalization time and cost. Conclusions: The innovative implementation of antimicrobial copper in ICUs contributed to their microbial flora significant reduction and antimicrobial drugs use reduction with the apparent positive effect (decrease) in both patient’s hospitalization time and cost. Under the present circumstances of economic crisis, survey results are of highest importance and value.

Keywords: antimicrobial copper, financial benefits, ICU, cost reduction

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14238 Economic Cost of Malaria: A Threat to Household Income in Nigeria

Authors: Nsikan Affiah, Kayode Osungbade, Williams Uzoma

Abstract:

Malaria remains one of the major killers of humans worldwide, threatening the lives of more than one-third of the world’s population. Some people refers it to; a disease of poverty because it contributes towards national poverty through its impact on foreign direct investment, tourism, labour productivity, and trade. At the micro level, it may cause poverty through spending on health care, income losses, and premature deaths. Unfortunately, malaria is a disease that affects both low-income household and its high-income counterpart, but low-income households are still at greater risk because significant part of the available monthly income is dedicated to various preventive and treatment measures. The objective of this study is to estimate direct and indirect cost of malaria treatment in households in a section of South-South Region (Akwa Ibom State) of Nigeria. A cross-sectional study of Six Hundred and Forty (640) heads of households or any adult representative of households in three local government areas of Akwa Ibom State, Nigeria from May 1-31, 2015 were ascertained through interviewer-administered questionnaire adapted from Nigerian Malaria Indicator Survey Report. The clustering technique was used to select 640 households with the help of Primary Health Care (PHC) house numbering system. Using exchange rate of 197 Naira/USD, result shows that direct cost of malaria treatment was 8,894.44 USD while the indirect cost of malaria treatment was 11,012.81 USD. Total cost of treatment made up of 44.7% direct cost and 55.3% indirect cost, with average direct cost of malaria treatment per household estimated at 20.6 USD and the average indirect cost of treatment per household estimated at 25.1 USD. Average total cost for each episode (888) of malaria was estimated at 22.4 USD. While at household level, the average total cost was estimated at 45.5 USD. From the average total cost, low-income households would spend 36% of monthly household income on treating malaria and the impact could be said to be catastrophic, compared to high-income households where only 1.2% of monthly household income is spent on malaria treatment. It could be concluded that the cost of malaria treatment is well beyond the means of households and given the reality of repeated bouts of malaria and its contribution to the impoverishment of households, there is a need for urgent action.

Keywords: direct cost, indirect cost, low income households, malaria

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14237 Innovative Power Engineering in a Selected Rural Commune

Authors: Pawel Sowa, Joachim Bargiel

Abstract:

This paper presents modern solutions of distributed generation in rural communities aiming at the improvement of energy and environmental security, as well as power supply reliability to important customers (e.g. health care, sensitive consumer required continuity). Distributed sources are mainly gas and biogas cogeneration units, as well as wind and photovoltaic sources. Some examples of their applications in a selected Silesian community are given.

Keywords: energy security, mini energy centres , power engineering, power supply reliability

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14236 Accuracy of Trauma on Scene Triage Screen Tool (Shock Index, Reverse Shock Index Glasgow Coma Scale, and National Early Warning Score) to Predict the Severity of Emergency Department Triage

Authors: Chaiyaporn Yuksen, Tapanawat Chaiwan

Abstract:

Introduction: Emergency medical service (EMS) care for trauma patients must be provided on-scene assessment and essential treatment and have appropriate transporting to the trauma center. The shock index (SI), reverse shock index Glasgow Coma Scale (rSIG), and National Early Warning Score (NEWS) triage tools are easy to use in a prehospital setting. There is no standardized on-scene triage protocol in prehospital care. The primary objective was to determine the accuracy of SI, rSIG, and NEWS to predict the severity of trauma patients in the emergency department (ED). Methods: This was a retrospective cross-sectional and diagnostic research conducted on trauma patients transported by EMS to the ED of Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand, from January 2015 to September 2022. We included the injured patients receiving prehospital care and transport to the ED of Ramathibodi Hospital by the EMS team from January 2015 to September 2022. We compared the on-scene parameter (SI, rSIG, and NEWS) and ED (Emergency Severity Index) with the area under ROC. Results: 218 patients were traumatic patients transported by EMS to the ED. 161 was ESI level 1-2, and 57 was level 3-5. NEWS was a more accurate triage tool to discriminate the severity of trauma patients than rSIG and SI. The area under the ROC was 0.743 (95%CI 0.70-0.79), 0.649 (95%CI 0.59-0.70), and 0.582 (95%CI 0.52-0.65), respectively (P-value <0.001). The cut point of NEWS to discriminate was 6 points. Conclusions: The NEWs was the most accurate triage tool in prehospital seeing in trauma patients.

Keywords: on-scene triage, trauma patient, ED triage, accuracy, NEWS

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14235 Early Initiation of Breastfeeding and Its Determinants among Non-Caesarean Deliveries at Primary and Secondary Health Facilities: A Case Observational Study

Authors: Farhana Karim, Abdullah N. S. Khan, Mohiuddin A. K. Chowdhury, Nabila Zaka, Alexander Manu, Shams El Arifeen, Sk Masum Billah

Abstract:

Breastfeeding, an integral part of newborn care, can reduce 55-87% of all-cause neonatal mortality and morbidity. Early initiation of breastfeeding within 1 hour of birth can avert 22% of newborn mortality. Only 45% of world’s newborns and 42% of newborns in South-Asia are put to the breast within one hour of birth. In Bangladesh, only a half of the mothers practice early initiation of breastfeeding which is less likely to be practiced if the baby is born in a health facility. This study aims to generate strong evidence for early initiation of breastfeeding practices in the government health facilities and to explore the associated factors influencing the practice. The study was conducted in selected health facilities in three neighbouring districts of Northern Bangladesh. Total 249 normal vaginal delivery cases were observed for 24 hours since the time of birth. The outcome variable was initiation of breastfeeding within 1 hour while the explanatory variables included type of health facility, privacy, presence of support person, stage of labour at admission, need for augmentation of labour, complications during delivery, need for episiotomy, spontaneous cry of the newborn, skin-to-skin contact with mother, post-natal contact with the service provider, receiving a post-natal examination and counselling on breastfeeding during postnatal contact. The simple descriptive statistics were employed to see the distribution of samples according to socio-demographic characteristics. Kruskal-Wallis test was carried out for testing the equality of medians among two or more categories of each variable and P-value is reported. A series of simple logistic regressions were conducted with all the potential explanatory variables to identify the determining factors for breastfeeding within 1 hour in a health facility. Finally, multiple logistic regression was conducted including the variables found significant at bi-variate analyses. Almost 90% participants initiated breastfeeding at the health facility and median time to initiate breastfeeding was 38 minutes. However, delivering in a sub-district hospital significantly delayed the breastfeeding initiation in comparison to delivering in a district hospital. Maintenance of adequate privacy and presence of separate staff for taking care of newborn significantly reduced the time in early breastfeeding initiation. Initiation time was found longer if the mother had an augmented labour, obstetric complications, and the newborn needed resuscitation. However, the initiation time was significantly early if the baby was put skin-to-skin on mother’s abdomen and received a postnatal examination by a provider. After controlling for the potential confounders, the odds of initiating breastfeeding within one hour of birth is higher if mother gives birth in a district hospital (AOR 3.0: 95% CI 1.5, 6.2), privacy is well-maintained (AOR 2.3: 95% CI 1.1, 4.5), babies cry spontaneously (AOR 7.7: 95% CI 3.3, 17.8), babies are put to skin-to-skin contact with mother (AOR 4.6: 95% CI 1.9, 11.2) and if the baby is examined by a provider in the facility (AOR 4.4: 95% CI 1.4, 14.2). The evidence generated by this study will hopefully direct the policymakers to identify and prioritize the scopes for creating and supporting early initiation of breastfeeding in the health facilities.

Keywords: Bangladesh, early initiation of breastfeeding, health facility, normal vaginal delivery, skin to skin contact

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14234 The Effect of Reverse Trendelenburg Position on the Back Pain after Cardiovascular Angiography and Interventions

Authors: Pramote Thangkratok

Abstract:

The aims of this experimental study were to investigate the effect of Reverse Trendelenburg Position on the Back Pain after Cardiovascular Angiography and Interventions. In addition, to compare bleeding and hematoma occurrences at the Access site between experimental and control groups. The randomized controlled trial (RCT) was conducted in 70 patients who underwent Cardiovascular Angiography and Interventions via the femoral artery and received post procedural care at the intermediate cardiac care unit, Bangkok Heart Hospital. From December 2015 to February 2016. The control group (35 patients) was to get standard care after the intervention, whereas the experimental group (35 patients) was Reverse Trendelenburg Position 30-45 degrees. The groups were not significantly different in terms of demographic characteristics, Age, Gender, BMI, blood pressure, heart rate. While not significantly different from each other, the intensity of back pain control group had a significantly higher pain score than experimental group. Vascular complications in terms of bleeding and hematoma were not significantly different between the control and experimental groups. The findings show that Reverse Trendelenburg Position after Cardiovascular Angiography and Interventions would reduce or prevent the back pain without increasing the chance of bleeding and hematoma.

Keywords: reverse trendelenburg position, back pain, cardiovascular angiography, cardiovascular interventions

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14233 A Comparative Analysis of Social Stratification in the Participation of Women in Agricultural Activity: A Case Study of District Khushab (Punjab) and D. I. Khan (KPK), Pakistan

Authors: Sohail Ahmad Umer

Abstract:

Since last few decades a question is raising on the subject of the importance of women in different societies of the world particularly in the developing societies of Asia and Africa. Female population constitutes almost 50% of the total population of the world and is playing a significant role in the economy with male population. In Pakistan, a developing country of Asia with majority of Muslim population, working women role is more focused. Women of rural background who are working as voluntary workers and their working hours are neither recorded nor recognized. Agricultural statistics shows that the female participation rate is below 40% while other sources claim them below 20%. Here in present study, another effort has been made to compare the women role in two different provinces of Pakistan to analyze the participation of women in agricultural activities like sowing, picking, irrigating the fields, harvesting and threshing of crops, caring and feeding of the animals, collecting the firewood and etc,as without these activities the farming would be incomplete. One hundred villages in the district Khushab (Punjab) and one hundred villages in district D.I.Khan (KPK) were selected and 33% of the families of each village have been interviewed to study their input in agriculture work. Another important feature is the social stratification therefore the contribution by different variables like the ownership, tenancy, education and caste has also been studied.

Keywords: caste, social stratification, tenancy, voluntary workers

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14232 Exploring the Perspective of Service Quality in mHealth Services during the COVID-19 Pandemic

Authors: Wan-I Lee, Nelio Mendoza Figueredo

Abstract:

The impact of COVID-19 has a significant effect on all sectors of society globally. Health information technology (HIT) has become an effective health strategy in this age of distancing. In this regard, Mobile Health (mHealth) plays a critical role in managing patient and provider workflows during the COVID-19 pandemic. Therefore, the users' perception of service quality about mHealth services plays a significant role in shaping confidence and subsequent behaviors regarding the mHealth users' intention of use. This study's objective was to explore levels of user attributes analyzed by a qualitative method of how health practitioners and patients are satisfied or dissatisfied with using mHealth services; and analyzed the users' intention in the context of Taiwan during the COVID-19 pandemic. This research explores the experienced usability of a mHealth services during the Covid-19 pandemic. This study uses qualitative methods that include in-depth and semi-structured interviews that investigate participants' perceptions and experiences and the meanings they attribute to them. The five cases consisted of health practitioners, clinic staff, and patients' experiences using mHealth services. This study encourages participants to discuss issues related to the research question by asking open-ended questions, usually in one-to-one interviews. The findings show the positive and negative attributes of mHealth service quality. Hence, the significant importance of patients' and health practitioners' issues on several dimensions of perceived service quality is system quality, information quality, and interaction quality. A concept map for perceptions regards to emergency uses' intention of mHealth services process is depicted. The findings revealed that users pay more attention to "Medical care", "ease of use" and "utilitarian benefits" and have less importance for "Admissions and Convenience" and "Social influence". To improve mHealth services, the mHealth providers and health practitioners should better manage users' experiences to enhance mHealth services. This research contributes to the understanding of service quality issues in mHealth services during the COVID-19 pandemic.

Keywords: COVID-19, mobile health, service quality, use intention

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14231 Problem Gambling in the Conceptualization of Health Professionals: A Qualitative Analysis of the Discourses Produced by Psychologists, Psychiatrists and General Practitioners

Authors: T. Marinaci, C. Venuleo

Abstract:

Different conceptualizations of disease affect patient care. This study aims to address this gap. It explores how health professionals conceptualize gambling problem, addiction and the goals of recovery process. In-depth, semi-structured, open-ended interviews were conducted with Italian psychologists, psychiatrists, general practitioners, and support staff (N= 114), working within health centres for the treatment of addiction (public health services or therapeutic communities) or medical offices. A Lexical Correspondence Analysis (LCA) was applied to the verbatim transcripts. LCA allowed to identify two main factorial dimensions, which organize similarity and dissimilarity in the discourses of the interviewed. The first dimension labelled 'Models of relationship with the problem', concerns two different models of relationship with the health problem: one related to the request for help and the process of taking charge and the other related to the identification of the psychopathology underlying the disorder. The second dimension, labelled 'Organisers of the intervention' reflects the dialectic between two ways to address the problem. On the one hand, they are the gambling dynamics and its immediate life-consequences to organize the intervention (whatever the request of the user is); on the other hand, they are the procedures and the tools which characterize the health service to organize the way the professionals deal with the user’ s problem (whatever it is and despite the specify of the user’s request). The results highlight how, despite the differences, the respondents share a central assumption: understanding gambling problem implies the reference to the gambler’s identity, more than, for instance, to the relational, social, cultural or political context where the gambler lives. A passive stance is attributed to the user, who does not play any role in the definition of the goal of the intervention. The results will be discussed to highlight the relationship between professional models and users’ ways to understand and deal with the problems related to gambling.

Keywords: cultural models, health professionals, intervention models, problem gambling

Procedia PDF Downloads 139
14230 The Journey from Lean Manufacturing to Industry 4.0: The Rail Manufacturing Process in Mexico

Authors: Diana Flores Galindo, Richard Gil Herrera

Abstract:

Nowadays, Lean Manufacturing and Industry 4.0 are very important in every country. One of the main benefits is continued market presence. It has been identified that there is a need to change existing educational programs, as well as update the knowledge and skills of existing employees. It should be borne in mind that behind each technological improvement, there is a human being. Human talent cannot be neglected. The main objectives of this article are to review the link between Lean Manufacturing, the incorporation of Industry 4.0 and the steps to follow to implement it; analyze the current situation and study the implications and benefits of this new trend, with a particular focus on Mexico. Lean Manufacturing and Industry 4.0 implementation waves must always take care of the most important capital – intellectual capital. The methodology used in this article comprised the following steps: reviewing the reality of the fourth industrial revolution, reviewing employees’ skills on the journey to become world-class, and analyzing the situation in Mexico. Lean Manufacturing and Industry 4.0 were studied not as exclusive concepts, but as complementary ones. The methodological framework used is focused on motivating companies’ collaborators to guarantee common results, innovate, and remain in the market in the face of new requirements from company stakeholders. The key findings were that both trends emphasize the need to improve communication across the entire company and incorporate new technologies into everyday work, from the shop floor to administrative staff, to help improve processes. Taking care of people, activities and processes will bring a company success. In the specific case of Mexico, companies in all sectors need to be aware of and implement technological improvements according to their specific needs. Low-cost labor represents one of the most typical barriers. In conclusion, companies must build a roadmap according to their strategy and needs to achieve their short, medium- and long-term goals.

Keywords: lean management, lean manufacturing, industry 4.0, motivation, SWOT analysis, Hoshin Kanri

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14229 Being Reticent for Healing – Singularity and Non-Verbalization in Indigenous Medical Practices in Sri Lanka

Authors: Ayami Umemura

Abstract:

The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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