Search results for: WASH interventions

Authors: Emmanouel Koumoulas, Aikaterini Rokkou, Marios Moschakis

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Theagenio" in Thessaloniki exists and works for three centuries now as a hospital. Since 1975, it has been operating as an Integrated Special Cancer Hospital and since 1985 it has been integrated into the National Health System. "Theagenio" Cancer Hospital is located at the central web of Thessaloniki residential complex and consists of two buildings, the "Symeonidio Research Center", which was completed in 1962 and the Nursing Ward, a project that was later completed in 1975. This paper examines the design of the Hospital Unit according to the requirements of the energy design of buildings. Initially, the energy characteristics of the Hospital are recorded, followed by a detailed presentation of the electromechanical installations. After the existing situation has been captured and with the help of the software TEE-KENAK, different scenarios for the energy upgrading of the buildings have been studied. Proposals for upgrading concern both the shell, e.g. installation of external thermal insulation, replacement of frames, addition of shading systems, etc. as well as electromechanical installations, e.g. use of ceiling fans, improvements in heating and cooling systems, interventions in lighting, etc. The simulation calculates the future energy status of the buildings and presents the economic benefits of the proposed interventions with reference to the environmental profits that arise.

Keywords: energy consumption in hospitals, energy saving interventions, energy upgrading, hospital facilities

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Authors: Vendula Safarova

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The author describes the architectural and social research through the project, Interventions Ostrava City 2013 (the idea came from Vallo + Sadovský architects), in which she participated as an organizer and as an architect. The project invited the public to actively participate, logging their "hits" or proposals (58), and resulted in three exhibitions in Ostrava, a catalog of the exhibition called Urban interventions Ostrava 2013 (published in 2014) and the implementation of two interventions (2014), with a third intervention still in preparation. The article dealt with the public's views and reactions of local authorities. The project also engaged Ostrava City council, who began to talk about the future of the city of Ostrava, taking part in public debates (organized by Fiducia), invited new associations, civil society - city for people (workers from Cooltour), as well as more established clubs such as the Beautification Committee for beautiful Ostrava (newsletter published since 2008). Currently, the City Interventions project has taken place in more than 10 cities, including Slovakia, where it originated, and in Bratislava in 2009. The aim of this article is to inform the public about the so-called Activism in architecture, which manifests itself in the form of community projects that are organized by volunteers (sometimes financially supported by local authorities). It is a unique way to survey public relations and representatives of state and local government for a public urban area.

Keywords: architecture, community project, public urban space, society and planning

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Authors: Mukondi Nethavhakone

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The high prevalence of violence against women is a global public health problem. Our societies have become dangerous places for women. Women during their child-bearing ages are at a higher risk of experiencing emotional, physical, and sexual violence. What makes it more concerning is that these violent acts are perpetrated by family members or partners, or ex-partners. Intimate Partner Violence (IPV) is associated with long-lasting physical, reproductive, sexual, mental, and maternal health implications. Expectedly women’s mental health would dimmish as a result of experiencing IPV. The burden of violence against women is seen to be heavier in low- and middle-income countries (LMICs) compared to the rest of the world. Countries have committed to eliminating all forms of violence against women through the sustainable development goal, aiming to see changes by the year 2030. As such, various countries have implemented psychosocial interventions of different levels of impact. However, little is known, especially in low- and middle-income countries, with regard to the potential of psychosocial interventions for IPV to improve the mental health outcomes for the survivors and/or victims of IPV. Analysing the risk for IPV through a social-ecological theoretical approach, low- and middle-income countries still readdressing gender inequality which is the cause of intimate partner violence. That is why it is taking time for these countries to shift psychosocial interventions to focus more on the improvement of the mental health of the survivors. It is, therefore, against this backdrop that the researcher intends to undertake a scoping review to understand the nature and characteristics of psychosocial interventions that have been implemented in low- and middle-income countries. With the findings from the scoping review, the researcher aims to develop a conceptual framework that may be a useful resource for healthcare practitioners and researchers in low- and middle-income countries. As this area of research has not been thoroughly reviewed, the results from this scoping will determine whether a systematic review will be justifiable. Additionally, the researcher will identify gaps and opportunities for future research in this area.

Keywords: mental health improvement, psychosocial interventions, intimate partner violence, LMICs

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Authors: Orestis Kasinopoulos, Maria Karekla, Vasilis Vasiliou, Evangelos Karademas

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Acceptance and Commitment Therapy (ACT) is an empirically supported intervention for treating Chronic Pain Patients, yet its effectiveness for some chronic conditions or when adapted to other languages, has not been explored. An ACT group intervention was designed to explore the effectiveness of treating a Greek speaking heterogeneous sample of Chronic Pain patients with the aim of increasing quality of life, acceptance of pain and functionality. Sixty-nine patients were assessed and randomly assigned to an ACT or control group (relaxation techniques) for eight, 90-minute, sessions. Results are currently being analysed and follow-ups (6 and 12 month) are being completed. Low adherence rates and high attrition rates observed in the study, however point to the direction of future modified interventions. Such modifications may include web-based and smartphone interventions and their benefits in being implemented in chronic pain patients.

Keywords: chronic pain, ACT, internet-delivered, digitalised intervention, adherence, attrition

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Authors: Simon Mwima, Kasule Solomon Kibirige, Evans Jennifer Mann, Bosco Mukuba, Edson Chipalo, Agnes Nzomene, Eusebius Small, Moses Okumu

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Introduction: Social workers must create, implement, and evaluate client-centered psychosocial interventions (CCPI) to reduce the impact of intersectional stigma on HIV service utilization among sexual minorities. We contribute to the scarcity of evidence about sexual minorities in Uganda by using social support theory to explore clients' perceptions that shape CCPI. Based on Focused Group Discussion (FGD) with 31 adolescents recruited from Kampala's HIV clinics in 2021, our findings reveal the positive influence of instrumental, informational, esteem, emotional, and social network support as intersectional stigma reduction interventions. Men who have sex with men, lesbians, and bisexual women used such strategies to navigate a heavily criminalized and stigmatizing setting during the COVID-19 pandemic in Uganda. Conclusion: This study provides evidence for the social work profession to develop and implement psychosocial interventions that reduce HIV stigma and discrimination among MSM, lesbians, and bisexual young people living with HIV in Uganda.

Keywords: pyschosocial interventions, social work, intersectional stigma, HIV/AIDS, adolescents, sexual minorities, Uganda

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Authors: H. Soltani, Kevin Laugero

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Obesity is becoming an increasingly critical issue in the United States due to the steady and substantial increase in prevalence over the last 30 years. Existing interventions have been able to help participants achieve short-term weight loss, but have failed to show long-term results. The complex nature of behavioral change remains one of the most difficult barriers in promoting sustainable weight-loss in overweight individuals. Research suggests that the 'intention-behavior gap' can be explained by a person’s ability to regulate higher-order thinking, or Executive Function (EF). A review of 63 research articles was completed in fall of 2017 to identify the role of EF in regulating eating behavior and to identify whether there is a potential for improving dietary quality by enhancing EF. Results showed that poor EF is positively associated with obesogenic behavior, namely increased consumption of highly palatable foods, eating in the absence of hunger, high saturated fat intake and low fruit and vegetable consumption. Recent research has indicated that interventions targeting an improvement in EF can be successful in helping promote healthy behaviors. Furthermore, interventions of longer duration have a more lasting and versatile effect on weight loss and maintenance. This may present an opportunity for the increasingly ubiquitous use of mobile application technology.

Keywords: eating behavior, executive function, nutrition, obesity, weight-loss

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Authors: Yvonne Howard

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This project currently under development is centered around current learning processes, including a thorough literature review and ongoing practical experiences gained as a deputy head in a school. These daily experiences with students engaging in animal-assisted interventions and the school therapy dog form a strong base for this research. The primary objective of this research is to comprehensively explore the impact of dog-assisted well-being interventions on student motivation and affective engagement within primary and secondary school settings. The educational domain currently encounters a significant challenge due to the lack of substantial research in this area. Despite the perceived positive outcomes of such interventions being acknowledged and shared in various settings, the evidence supporting their effectiveness in an educational context remains limited. This study aims to bridge the gap in the research and shed light on the potential benefits of dog-assisted well-being interventions in promoting student motivation and affective engagement. The significance of this topic recognizes that education is not solely confined to academic achievement but encompasses the overall well-being and emotional development of students. Over recent years, there has been a growing interest in animal-assisted interventions, particularly in healthcare settings. This interest has extended to the educational context. While the effectiveness of these interventions in these areas has been explored in other fields, the educational sector lacks comprehensive research in this regard. Through a systematic and thorough research methodology, this study seeks to contribute valuable empirical data to the field, providing evidence to support informed decision-making regarding the implementation of dog-assisted well-being interventions in schools. This research will utilize a mixed-methods design, combining qualitative and quantitative measures to assess the research objectives. The quantitative phase will include surveys and standardized scales to measure student motivation and affective engagement, while the qualitative phase will involve interviews and observations to gain in-depth insights from students, teachers, and other stakeholders. The findings will contribute evidence-based insights, best practices, and practical guidelines for schools seeking to incorporate dog-assisted interventions, ultimately enhancing student well-being and improving educational outcomes.

Keywords: therapy dog, wellbeing, engagement, motivation, AAI, intervention, school

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Authors: Santhani M. Selveindran

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Background: Natural disasters are traumatic global events that are becoming increasing more common, with significant psychosocial impact on survivors. This impact results not only in psychosocial distress but, for many, can lead to psychosocial disorders and chronic psychopathology. While there are currently available interventions that seek to prevent and treat these psychosocial sequelae, their effectiveness is uncertain. The evidence-base is emerging with more primary studies evaluating the effectiveness of various psychosocial interventions for survivors of natural disasters, which remains to be synthesized. Aim of Review: To identify, critically appraise and synthesize the current evidence-base on the effectiveness of psychosocial interventions in preventing or treating Post-Traumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD) and/or Generalized Anxiety Disorder (GAD) in adults and children who are survivors of natural disasters. Methods: A protocol was developed as a guide to carry out this review. A systematic search was conducted in eight international electronic databases, three grey literature databases, one dissertation and thesis repository, websites of six humanitarian and non-governmental organizations renowned for their work on natural disasters, as well as bibliographic and citation searching for eligible articles. Papers meeting the specific inclusion criteria underwent quality assessment using the Downs and Black checklist. Data were extracted from the included papers and analysed by way of narrative synthesis. Results: Database and website searching returned 3777 papers where 31 met the criteria for inclusion. Additional 2 papers were obtained through bibliographic and citation searching. Methodological quality of most papers was fair. Twenty-five studies evaluated psychological interventions, five, social interventions whereas three studies evaluated ‘mixed’ psychological and social interventions. All studies, irrespective of methodological quality, reported post-intervention reductions in symptom scores for PTSD, depression and/or anxiety and where assessed, reduced diagnosis of PTSD and MDD, and produced improvements in self-efficacy and quality of life. Statistically significant results were seen in 27 studies. However, three studies demonstrated that the evaluated interventions may not have been very beneficial. Conclusions: The overall positive results suggest that any psychosocial interventions are favourable and should be delivered to all natural disaster survivors, irrespective of age, country, and phase of disaster. Yet, heterogeneity and methodological shortcomings of the current evidence-base makes it difficult to draw definite conclusions needed to formulate categorical guidance or frameworks. Further, rigorously conducted research is needed in this area, although the feasibility of such, given the context and nature of the problem, is also recognized.

Keywords: psychosocial interventions, natural disasters, survivors, effectiveness

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Authors: Kimberly Belfry, Shavon Stafford, Fariha Chowdhury, Jennifer Crawford, Soyeon Kim

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Intervention programs are mostly delivered online during the pandemic. Screen fatigue has become a significant deterrent for virtually-deliveredinterventions, and thus, we aimed to examine factors associated with recruitment and adherence toan online mindfulness program for youths. Our preliminary analysis indicated that 40% of interested youths enrolled in the program. No difference in gender and age was found for those enrolled in the program. Adherence rate was approximately 25%, which warrants further examination. Grounding on the preliminary findings, we will conduct a binary logistic regression analysis to identify elements associated with recruitment and adherence. The model will include predictors such as age, sex, recruiter, mental health status, time of the year. Odds ratios and 95% CI will be reported. Our preliminary analysis showed low recruitment and adherence rate. By identifying elements associated with recruitment and adherence, our study provides transferrable information that can improve recruitment and adherence of online-delivered interventions offered during the pandemic.

Keywords: virtual interventions, recruitment, youth, mindfulness

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Authors: Hui Fang Huang Su, Jia Borror

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This study compared two interventions for teaching math to preschool-aged students with autism spectrum disorder (ASD). The first is considered the business as usual (BAU) intervention, which uses the Strategies for Teaching Based on Autism Research (STAR) curriculum and discrete trial teaching as the instructional methodology. The second is the Math is Not Difficult (Project MIND) activity-embedded, naturalistic intervention. These interventions were randomly assigned to four preschool students with ASD classrooms and implemented over three months for Project Mind. We used measurement gained during the same three months for the STAR intervention. In addition, we used A quasi-experimental, pre-test/post-test design to compare the effectiveness of these two interventions in building mathematical knowledge and skills. The pre-post measures include three standardized instruments: the Test of Early Math Ability-3, the Problem Solving and Calculation subtests of the Woodcock-Johnson Test of Achievement IV, and the Bracken Test of Basic Concepts-3 Receptive. The STAR curriculum-based assessment is administered to all Baudhuin students three times per year, and we used the results in this study. We anticipated that implementing these two approaches would improve the mathematical knowledge and skills of children with ASD. Still, it is crucial to see whether a behavioral or naturalistic teaching approach leads to more significant results.

Keywords: early learning, autism, math for pre-schoolers, special education, teaching strategies

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Authors: Sarah Eldefrawi, Maike Didero

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In Egypt, residents’ urban interventions (colloquially named A’hali’s interventions) are always tackled by government, scholars, and media as an encroachment (taeadiyat), chaotic (a’shwa’i) or informal (gheir mokanan) practices. This paper argues that those interventions cannot be simply described as an encroachment on public space or chaotic behaviour. We claim here that they are relevant to traditional governing methods (‘Urf) that were governing Arab cities for many decades. Through an in-depth field study conducted in a real estate public housing project in the city of Giza called 'Masaken El-Barageel', we traced the urban transformations demonstrated in private and public spaces. To understand those transformations, we used wide-range of qualitative research methods such as semi-guided and informal interviews, observations and mapping of the built environment and the newly added interventions. This study was as well strengthened through the contributions of the author in studying nine sectors emerging by Ahali in six districts in Great Cairo. The results of this study indicate that a culturally and socially sensitive framework has to be related to the individual actions toward the spatial and social structures as well as to culturally transmitted views and meanings connected with 'Urf'. The study could trace three crucial principals in ‘urf that influenced these interventions; the eliminating of harm (Al-Marafiq wa Man’ al-Darar), the appropriation of space (Haqq el-Intefa’) and public interest (maslaha a’ma). Our findings open the discussion for the (il) legitimate of a’hali governing methods in contemporary cities.

Keywords: Urf, urban governance, public space, public housing, encroachments, chaotic, Egyptian cities

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Authors: Nahela Nowshin, Rafia Sultana, Farzana Misha, Sabina F. Rashid

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Sexual and reproductive health and rights (SRHR) are currently an area of neglect for males (aged 15-24 years) in Bangladesh. The lack of focus on the male youth population has consequences not only for their own health and wellbeing, but the patriarchal structure of Bangladeshi society and socio-cultural norms mean that the male population’s SRH behavior can severely impact the lives of their female counterparts. A majority of sexual and reproductive health and rights-related research and interventions in the country are female-centric. Although the Government of Bangladesh has taken many initiatives to improve the SRHR of the general population, the male youth segment has not been prioritized in most of these interventions. There is an urgent need for male-youth-focused SRHR interventions in Bangladesh, but due to a lack of evidence-based research on this issue, there exist data gaps on how such interventions could be better designed and implemented. Therefore, to ascertain strategies for better program design and smoother implementation of male-youth-focused sexual and reproductive health and rights interventions, we carried out 25 key informant interviews with experts as well as focal persons involved in more than 20 ongoing and recently-ended SRHR-related interventions of national and international non-government organizations in which male youth were targeted or engaged. The results show that program implementers face several challenges at the field, organizational and policy levels. Some of the most common field challenges include high sensitivity to SRHR topics due to cultural reasons, difficulties in acquiring access to boys and young men due to their high mobility and engagement in labor for commercial purposes, as well as accessing them in hard-to-reach areas due to transportation and communication issues. Common organizational-level challenges include a lack of skilled manpower. Policy-level challenges include the prohibition of SRH service provision to unmarried adolescents and youth and lack of readiness of local governments to implement existing action plans. Some ways in which male-youth-focused SRHR interventions can be made more effective are through sensitization of service providers, awareness-raising at the community level to engage parents, advocacy to increase donor interest, and generating data on SRHR of male youth.

Keywords: Bangladesh, intervention, male, SRHR

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Authors: Chia-Chen Hsieh, Fei-Hsiu Hsiao

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Objective: To examine the effects of supportive care interventions on depressive symptoms in patients with lung cancer. Methods: The databases of Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and Chinese Electronic Periodical Services (CEPS) were searched from their inception until September 2015. We included the studies with randomized controlled trial design that compared standard care with supportive care interventions using psychotherapeutic or exercises approach. The standardized mean differences (SMD) (Cohen’s d) were calculated to estimate the treatment effects. The Cochrane Risk of Bias Tool was used for quality assessment and subgroup analysis was conducted to identify possible sources of heterogeneity. Results: A total of 1472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74 with 95% CI = -1.07 to -0.41), and the effect was maintained at the 4th, 8th, and 12th weeks of follow-up. Either psychotherapy combined with psychoeducation or exercise alone produced significant improvements in depressive symptoms, while psychoeducation alone did not. The greater improvements in depressive symptoms occurred in lung cancer patients with severe depressive symptoms at baseline, total duration of interventions of less than ten weeks, and intervention provided through face-to-face delivery. Conclusions: Psychotherapy combined with psychoeducation can help patients manage the causes of depressive symptoms, including both symptom distress and psychological trauma due to lung cancer. Exercise can target the impaired respiratory function that is a cause of depressive symptoms in lung cancer patients.

Keywords: supportive care intervention, depressive symptoms, lung cancer, meta-analysis

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Authors: Crispin Rakibu Mbamba

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Twenty-two years after the adoption of the United Nation Trafficking Protocol, evidence suggest that child trafficking continues to rise. Community level factors, like poverty which creates the conditions for children’s vulnerability is key to the rise in trafficking cases in Ghana. Albeit, growing evidence suggestthat despite the vulnerabilities, communities have the capacity to prevent and address child trafficking issues. This study contributes to this positive agenda by exploring the ways in which communities (and the key actors) in Ghana contribute to child trafficking interventions.The study objective is explored through in-depth interviews with practitioners (including social workers) from an organization working in trafficking hotspots in Ghana. Interviews wereanalyzed thematically with the help of HyperRESEARCH software. From the in-depth interviews, three themes were identified as the ways in which communities are involved in child trafficking interventions: 1) engagement of community leaders, 2) community-led anti-trafficking committees and 3) knowledge about trafficking. Albeit the cultural differences, evidence on the instrumental role of community chiefs and leaders provide important learning on how to harness trafficking intervention measures and ensure better child protection practices. Based on the findings, we recommend the need to intensify trafficking awareness campaigns in rural communities where education is lacking to contribute to United Nations (UN) promoting Just, Peaceful and Inclusive societies’ mandate.

Keywords: child trafficking, community interventions, knowledge on trafficking, human trafficking intervention

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Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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Authors: R. Cooper, M. Kurien

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Background: Coeliac Disease affects around 1 in 100 people. Untreated, it can result in serious morbidity such as malabsorption and cancers. The only treatment is to adhere to a gluten free diet (GFD). International guidelines recommend that people with the coeliac disease receive follow-up healthcare annually to detect complications early and support their adherence to a GFD. However, there is a finite amount of healthcare in the UK, and as such, not all patients receive follow-up care as recommended by the guidelines. Furthermore, there is an increasing number of patients being diagnosed with coeliac disease. Given the potential severe morbidity that non-adherence to a GFD could result in, alongside reports that the rate of non- GFD adherence could be as high as 91%, it is imperative that action is taken. One potential solution to this would be to provide follow-up care digitally through utilising technology. This abstract reports on a rapid review undertaken to explore the existing evidence in this area. Methods: In June 2020, 11 bibliographic databases were searched to find any pertinent studies. The inclusion criteria required the study to be written in the English language and report on the use of digital healthcare interventions for people with Coeliac Disease. Results: A small amount of evidence (n=8) was found which met our inclusion criteria and pertained to the provision of CD follow-up digitally. These studies focussed either on educating and supporting patients to adhere to a GFD or providing consultation remotely with a focus on detecting complications early. These studies showed that there is potential for digital healthcare interventions to positively impact people with coeliac disease. However, it is suggested that the effectiveness of these interventions may depend on local circumstances, individual knowledge of CD and general attitudes. Conclusion: The above studies suggest that providing follow-up care digitally may offer a potential solution; however, the evidence about how this should be done and in what circumstances this will work for individuals is scarce. In the light of the COVID-19 pandemic, the introduction of digital healthcare interventions appears to be highly topical, and as such, this review may benefit from being refreshed in the future.

Keywords: coeliac disease, follow-up, gluten free diet, digital healthcare interventions

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Authors: Despoina Andrioti Bygvraa, Ida-Maja Hassellöv, George Charalambous

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Exhaust gas cleaning systems, also known as scrubbers, are today widely used to allow for the use of High Sulphur Heavy Fuel Oil and still comply with the regulations limiting sulphur content in marine fuels. There are extensive concerns about environmental consequences, especially in the Baltic Sea, from the wide-scale use of scrubbers, as the wash water is acidic (ca pH 3) and contains high concentrations of toxic, carcinogenic, and mutagenic substances. The aim of this feasibility study is to investigate the potential adverse effects on seafarers’ health with the ultimate goal of raising awareness of chemical-related health and safety issues in the shipping environment. The project got funding from the Swedish Foundation. The team will extend previously compiled data on scrubber wash water concentrations of hazardous substances and pH to include the use of strong base in closed-loop scrubbers, and scoping assessment on handling and disposing practices. Based on the findings (a), a systematic review of risk assessment will follow to show the risk of exposures, the establishment of the hazardous levels for human health as well as the respective prevention practices. In addition, the researchers will perform (b) a systematic review to identify facilitators and barriers of the crew on compliance with the safe handling of chemicals. The study will run for 12 months, delivering (a) a risk assessment inventory with risk exposures and (b) a course description of safe handling practices. This feasibility study could provide valuable knowledge on how pollutants found in scrubbers should be considered from a human health perspective to facilitate evidence-based informed decisions in future technology- and policy development to make shipping a safer, healthier, and more attractive workplace.

Keywords: health and safety, seafarers, scrubbers, chemicals, risk exposures

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Authors: Yiyuan David Hu, Alex Lindqwister, Samuel B. Klein, Karen Moodie, Norman A. Paradis

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Introduction: Pseudo-Pulseless Electrical Activity (p-PEA) is a lifeless form of profound cardiac shock characterized by measurable cardiac mechanical activity without clinically detectable pulses. Patients in pseudo-PEA carry different prognoses than those in true PEA and may require different therapies. End-tidal carbon dioxide (ET-CO2) has been studied in ventricular fibrillation and true PEA but in p-PEA. We utilized an hypoxic porcine model to characterize the performance of ET-CO2 in resuscitation from p-PEA. Hypothesis: Capnography correlates to the number of required interventions for resuscitation from p-PEA. Methods: Female swine (N = 14) under intravenous anesthesia were instrumented with aortic and right atrial micromanometer pressure. ECG and ET-CO2 were measured continuously. p-PEA was induced by ventilation with 6% oxygen in 94% nitrogen and was defined as a systolic aortic (Ao) pressure less than 40 mmHg. Pigs were grouped based on the interventions required to achieve ROSC: 100%O2, 100%O2 + CPR, 100%O2 + CPR + epinephrine. Results: End tidal CO2 reliably predicted O2 therapy vs CPR-based interventions needed for resuscitation (Figure 1). Pigs who would recover with 100%O2 only had a mean ET-CO2 slope of 0.039 ± 0.013 [ R2 = 0.68], those requiring oxygen + CPR had a slope of -0.15 ± 0.016 [R2 = 0.95], and those requiring oxygen + CPR + epinephrine had a slope of -0.12 ± 0.031 [R2 = 0.79]. Conclusions: In a porcine model of hypoxic p-PEA, measured ET-CO2 appears to be strongly correlated with the required interventions needed for ROSC. If confirmed clinically, these results indicate that ET-CO2 may be useful in guiding therapy in patients suffering p-PEA cardiac arrest.

Keywords: pseudo-PEA, resuscitation, capnography, hypoxic pseudo-PEA

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Authors: Renee Fabian, Jordan Davidson

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Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.

Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions

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Authors: R. R. Billones, N. Lukkahatai, L. N. Saligan

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Mindfulness based interventions (MBIs) have been used in medically unexplained symptoms (MUS). This systematic review describes the literature investigating the general effect of MBIs on MUS and identifies the effects of specific MBIs on specific MUS conditions. The preferred reporting items for systematic reviews and meta-analysis guidelines (PRISMA) and the modified Oxford quality scoring system (JADAD) were applied to the review, yielding an initial 1,556 articles. The search engines included PubMed, ScienceDirect, Web of Science, Scopus, EMBASE, and PsychINFO using the search terms: mindfulness, or mediations, or mindful or MBCT or MBSR and medically unexplained symptoms or MUS or fibromyalgia or FMS. A total of 24 articles were included in the final systematic review. MBIs showed large effects on socialization skills for chronic fatigue syndrome (d=0.65), anger in fibromyalgia (d=0.61), improvement of somatic symptoms (d=1.6) and sleep (d=1.12) for painful conditions, physical health for chronic back pain (d=0.51), and disease intensity for irritable bowel disease/syndrome (d=1.13). A manualized MBI that applies the four fundamental elements present in all types of interventions were critical to efficacy. These elements were psycho-education sessions specific to better understand the medical symptoms, the practice of awareness, the non-judgmental observance of the experience at the moment, and the compassion to ones’ self. The effectiveness of different mindfulness interventions necessitates giving attention to improve the gaps that were identified related to home-based practice monitoring, competency training of mindfulness teachers, and sound psychometric properties to measure the mindfulness practice.

Keywords: mindfulness-based interventions, medically unexplained symptoms, mindfulness-based cognitive therapy, mindfulness-based stress reduction, fibromyalgia, irritable bowel syndrome

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Authors: Ghazal Zahed, Leila Tabatabaee, Amirhossein Hosseini, Somaye Fatahi

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Functional retentive overflow incontinence (Retentive FI) is the most common cause of fecal soiling in children. Affected patients may have more problems with their parents and peer group, self-esteem issues, and more psychiatric comorbidities than the general population. Therapeutic interventions for Retentive FI and related problems and comorbid conditions are needed at the same time. Based on the clinical experiences, patients with retentive FI and comorbid psychiatric disorders, were accelerated in their treatment of fecal incontinence when they were being treated with Risperidone for their psychiatric comorbidities, therefore this study was conducted to evaluate the effect of Risperidone in the treatment of Retentive FI in children and adolescents. In this double-blind randomized clinical trial, 136 patients aged 4-18 years eligible for the study were randomly divided into two groups receiving Risperidone and placebo. About half of these patients had newly diagnosed psychiatric disorders and were drug naïve, this was considered in their division. In addition to polyethylene glycol, all the participants received family counseling and education for withholding behaviors and related behavioral interventions, and nonpharmacological interventions for psychiatric comorbidities. A significant correlation was observed between the duration of treatment with risperidone and the presence of psychiatric comorbidities (P <0.001) for diurnal fecal incontinence. Based on our findings in this study, Risperidone, used commonly for psychiatric disorders in children and adolescents, may be useful in the treatment of retentive fecal incontinence in the presence of psychiatric comorbidities, and along with other interventions.

Keywords: Retentive Fecal Incontinence, Risperidone, Treatment, Pediatric, Encopresis, Atypical Antipsychotics, Fecal Soiling

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Authors: Ankita Sharma, Reenu Singh

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In order to conserve the ecology and the environment, there is a need to focus on sustainable lighting solutions such as LED bulbs instead of incandescent bulbs, candle-powered lamps, self-cooling smart bulbs, and many more, that are both eco-friendly and practical. This paper focuses on such sustainable solutions to lighting, which will have a major positive impact on the environment in the coming future. A questionnaire survey was conducted to note the responses of people living in high-rise buildings in metropolitan cities with regards to such sustainable lighting choices in their homes. The result of such questionnaire survey has helped to design parameters which are used to ideate design interventions in this field of sustainable lighting choices. This paper includes proposals to facilitate the reduction of electric power in interior lighting through various lighting accessory design interventions. Thus, such design interventions will allow us to design more sustainable interior spaces, and renewable energy strategies can be developed in the field of lighting, which will not only help to save energy but also positively affect other aspects of human well-being such as productivity, heritage conservation and economic well-being too!

Keywords: sustainable, interior lighting, lighting design, environmental impact, metropolitan cities

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Authors: Ganeshkumar, Ashika, Valavan, Ramesh, Thangam, Chirayu

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MSCs are found in much higher concentration in the Wharton’s jelly compared to the umbilical cord blood, which is a rich source of hematopoietic stem cells. Umbilical cord tissue is collected at the time of birth; it is processed and stored in liquid nitrogen for future therapeutical purpose. The source of contamination might be either from vaginal tract of mother or from hospital environment or from personal handling during cord tissue sample collection. If the sample were contaminated, decontamination procedure will be done with 70% ethanol (1 minute) in order to avoid sample rejection. Ethanol is effective against a wide range of bacteria, protozoa and fungi and has low toxicity to humans. Among the 1954 samples taken for the study, 24 samples were found to be contaminated with microorganism. The organisms isolated from the positive samples were found to be E. coli, Stenotrophomonas maltophilia, Pseudomonas aueroginosa, Enterococcus fecalis, Acinetobacter bowmani, Staphylococcus epidermidis, Enterobacter cloacae, and Proteus mirabilis. Among these organisms 70% ethanol successfully eliminated E. coli, Enterococcus fecalis, Acinetobacter bowmani, Staphylococcus epidermidis, and Proteus mirabilis. 70% ethanol was unsuccessful in eliminating Stenotrophomonas maltophilia, Pseudomonas aueroginosa, and Enterobacter cloacae. Stenotrophomonas maltophilia and Pseudomonas aueroginosa have the ability to form biofilm that make them resistant to alcohol. Biofilm act as protective layer for bacteria and which protects them from host defense and antibiotic wash. Finally it was found 70% ethanol wash saved 58.3% cord tissue samples from rejection and it is ineffective against 41% of the samples. The contamination rate can be reduced by maintaining proper aseptic techniques during sample collection and processing.

Keywords: umblical cord tissue, decontamination, 70% ethanol effectiveness, contamination

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Authors: Anastasia Constantinou, Panayiotis Laouris, Stephen Morris

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Background: Climate change has been reported as one of the worst threats to healthcare. The healthcare sector is a significant contributor to greenhouse gas emissions with primary care being responsible for 23% of the NHS’ total carbon footprint. Digital interventions, primarily focusing on telemedicine, offer a route to change. This systematic review aims to quantify and characterize the carbon footprint savings associated with the implementation of digital interventions in the setting of primary care. Methods: A systematic review of published literature was conducted according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, PubMed, and Scopus databases as well as Google scholar were searched using key terms relating to “carbon footprint,” “environmental impact,” “sustainability”, “green care”, “primary care,”, and “general practice,” using citation tracking to identify additional articles. Data was extracted and analyzed in Microsoft Excel. Results: Eight studies were identified conducted in four different countries between 2010 and 2023. Four studies used interventions to address primary care services, three studies focused on the interface between primary and specialist care, and one study addressed both. Digital interventions included the use of mobile applications, online portals, access to electronic medical records, electronic referrals, electronic prescribing, video-consultations and use of autonomous artificial intelligence. Only one study carried out a complete life cycle assessment to determine the carbon footprint of the intervention. It estimate that digital interventions reduced the carbon footprint at primary care level by 5.1 kgCO2/visit, and at the interface with specialist care by 13.4 kg CO₂/visit. When assessing the relationship between travel-distance saved and savings in emissions, we identified a strong correlation, suggesting that most of the carbon footprint reduction is attributed to reduced travel. However, two studies also commented on environmental savings associated with reduced use of paper. Patient savings in the form of reduced fuel cost and reduced travel time were also identified. Conclusion: All studies identified significant reductions in carbon footprint following implementation of digital interventions. In the future, controlled, prospective studies incorporating complete life cycle assessments and accounting for double-consulting effects, use of additional resources, technical failures, quality of care and cost-effectiveness are needed to fully appreciate the sustainable benefit of these interventions

Keywords: carbon footprint, environmental impact, primary care, sustainable healthcare

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Authors: Edwina Owusu Panin, Kwame Baah Owusu Panin

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This abstract intends to demonstrate multiple strategies of autism management in Ghana by exploring the possibilities. The advantages of adopting creative art forms as a therapeutic method. Autism is a developmental disorder that includes social interaction, communication, and repetitive behaviours. In Ghana, as in many other countries, there is a rising demand for effective intervention and support for people with autism and their families. Creative arts such as music, dance, drama and visual arts have shown promise in promoting communication, social interaction and inclusion of people with autism. These art forms provide alternative channels for self-expression and can be powerful tools for autistic people to interact with the world, their friends and families around them. Creative art forms interventions have been found to improve social skills, improve emotion regulation, promote creativity and increase self-confidence in people with autism. This study examines existing programs and interventions in Ghana involving creative art forms for people with autism through a comparative analysis. It explores the different approaches, methods and results of these interventions. By comparing and evaluating these programs, the study aims to identify best practices, challenges and areas for development in managing autism through the creative arts in Ghana. Although many schools and rehabilitation centres employ various forms in therapeutic approaches for autism. There is no comparative analysis of which type of autism and which creative art forms is suitable. The results of this study will contribute to the development of evidence-based practices for the management of autism in Ghana. It provides valuable information about the effectiveness of creative arts interventions and helps inform policy makers, educators, therapists and other stakeholders involved in autism support. Ultimately, the goal is to improve the well-being and quality of life of people with autism in Ghana and their families by promoting inclusive and accessible interventions that harness the power of creative art forms.

Keywords: autism, therapeutic, creative art, art form

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Authors: Modi Alsubaie, Willem Kuyken, Rebecca Abbott, Barnaby Dunn, Chris Dickens, Tina Keil, William Henley

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Background: Recently, there has been an increased interest in studying the effects of mindfulness-based interventions for people with psychological and physical problems. However, the mechanisms of action in these interventions that lead to beneficial physical and psychological outcomes have yet to be clearly identified. Purpose: The aim of this paper is to review, systematically, the evidence to date on the mechanisms of action in mindfulness interventions in populations with physical and/or psychological conditions. Method: Searches of seven databases (PsycINFO, Medline (Ovid), Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, AMED, ClinicalTrials.gov) were undertaken in June 2014 and July 2015. We evaluated to what extent the studies we identified met the criteria suggested by Kazdin for establishing mechanisms of action within a psychological treatment (2007, 2009). Results: We identified four trials examining mechanisms of mindfulness interventions in those with comorbid psychological and physical health problems and 14 in those with psychological conditions. These studies examined a diverse range of potential mechanisms, including mindfulness and rumination. Of these candidate mechanisms, the most consistent finding was that greater self-reported change in mindfulness mediated superior clinical outcomes. However, very few studies fully met the Kazdin criteria for examining treatment mechanisms. Conclusion: There was evidence that global changes in mindfulness are linked to better outcomes. This evidence pertained more to interventions targeting psychological rather than physical health conditions. While there is promising evidence that MBCT/MBSR intervention effects are mediated by hypothesised mechanisms, there is a lack of methodological rigour in the field of testing mechanisms of action for both MBCT and MBSR, which precludes definitive conclusions.

Keywords: MBCT, MBSR, mechanisms, physical conditions, psychological conditions, systematic review

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Authors: Ahmed Kadry, Gwyn Dodd

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There has been a growing call globally for police forces to embed evidence-based policing research methods into police interventions in order to better understand and evaluate their impact. This research study highlights the success and challenges that police forces may encounter when trying to embed evidence-based research methods within their organisation. 10 in-depth qualitative interviews were conducted with police officers and staff at Greater Manchester Police (GMP) who were tasked with integrating evidence-based research methods into their operational interventions. The findings of the study indicate that with adequate resources and individual expertise, evidence-based research methods can be applied to operational work, including the testing of initiatives with strict controls in order to fully evaluate the impact of an intervention. However, the findings also indicate that this may only be possible where an operational intervention is heavily resourced with police officers and staff who have a strong understanding of evidence-based policing research methods, attained for example through their own graduate studies. In addition, the findings reveal that ample planning time was needed to trial operational interventions that would require strict parameters for what would be tested and how it would be evaluated. In contrast, interviewees underscored that operational interventions with the need for a speedy implementation were less likely to have evidence-based research methods applied. The study contributes to the wider literature on evidence-based policing by providing considerations for police forces globally wishing to apply evidence-based research methods to more of their operational work in order to understand their impact. The study also provides considerations for academics who work closely with police forces in assisting them to embed evidence-based policing. This includes how academics can provide their expertise to police decision makers wanting to underpin their work through evidence-based research methods, such as providing guidance on how to evaluate the impact of their work with varying research methods that they may otherwise be unaware of.  

Keywords: evidence based policing, evidence-based practice, operational policing, organisational change

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Authors: Anubha Kaushik, Raman Preet

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Distillery wastewater in the form of spent wash is a complex and strong industrial effluent, with high load of organic pollutants that may deplete dissolved oxygen on being discharged into aquatic systems and contaminate groundwater by leaching of pollutants, while untreated spent wash disposed on land acidifies the soil. Stringent legislative measures have therefore been framed in different countries for discharge standards of distillery effluent. Utilising the organic pollutants present in various types of wastes as food by mixed microbial populations is emerging as an eco-friendly approach in the recent years, in which complex organic matter is converted into simpler forms, and simultaneously useful gases are produced as renewable and clean energy sources. In the present study, wastewater from a rice bran based distillery has been used as the substrate in a dark fermenter, and native microbial consortium from the digester sludge has been used as the inoculum to treat the wastewater and produce hydrogen. After optimising the operational conditions in batch reactors, sequential batch mode and continuous flow stirred tank reactors were used to study the best operational conditions for enhanced and sustained hydrogen production and removal of pollutants. Since the rate of hydrogen production by the microbial consortium during dark fermentation is influenced by concentration of organic matter, pH and temperature, these operational conditions were optimised in batch mode studies. Maximum hydrogen production rate (347.87ml/L/d) was attained in 32h dark fermentation while a good proportion of COD also got removed from the wastewater. Slightly acidic initial pH seemed to favor biohydrogen production. In continuous stirred tank reactor, high H₂ production from distillery wastewater was obtained from a relatively shorter substrate retention time (SRT) of 48h and a moderate organic loading rate (OLR) of 172 g/l/d COD.

Keywords: distillery wastewater, hydrogen, microbial consortium, organic pollution, sludge

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Authors: Joshua Midha

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The basis for information campaigns and behavioral interventions has long reigned as a tactic. From the Soviet-era propaganda machines to the opinion hijacks in Iran, these measures are now commonplace and are used for dissemination and disassembly. However, the use of these tools for strategic diffusion, specifically in a counter-terrorism setting, has only been explored on the surface. This paper aims to introduce a larger conceptual portion of guided information campaigns into preexisting terror cells and situations. It provides an alternative, low-risk intervention platform for future military strategy. This paper highlights a theoretical framework to lay out the foundationary details and explanations for behavioral interventions and moves into using a case study to highlight the possibility of implementation. It details strategies, resources, circumstances, and risk factors for intervention. It also sets an expanding foundation for offensive PsyOps and argues for tactical diffusion of information to battle extremist sentiment. The two larger frameworks touch on the internal spread of information within terror cells and external political sway, thus charting a larger holistic purpose of strategic operations.

Keywords: terrorism, behavioral intervention, propaganda, SNA, extremism

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Authors: Jeremy Bekker, Guy Salazar

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Introduction: Nature-exposure interventions on university campuses may serve as an effective addition to overburdened counseling and student support centers. Nature-exposure interventions can work as a preventative well-being enhancement measure on campuses, which can be used adjacently with existing health resources. Specifically, this paper analyzes how spending time in nature impacts psychological well-being, cognitive functioning, and physical health. The poster covers the core findings and recommendations of this paper, which has been previously published in the BYU undergraduate psychology journal Intuition. Research Goals and Method: The goal of this paper was to outline the potential benefits of nature exposure for students’ physical health, mental well-being, and academic success. Another objective of this paper was to outline potential research-based interventions that use campus green spaces to improve student outcomes. Given that the core objective of this paper was to identify and establish research-based nature exposure interventions that could be used on college campuses, a broad literature review focused on these areas. Specifically, the databases Scopus and PsycINFO were used to screen for research focused on psychological well-being, physical health, cognitive functioning, and nature exposure interventions. Outcomes: Nature exposure has been shown to help increase positive affect, life satisfaction, happiness, coping ability and subjective well-being. Further, nature exposure has been shown to decrease negative affect, lower mental distress, reduce cognitive load, and decrease negative psychological symptoms. Finally, nature exposure has been shown to lead to better physical health. Findings and Recommendations: Potential interventions include adding green space to university buildings and grounds, dedicating already natural environments as nature restoration areas, and providing means for outdoor excursions. Potential limitations and suggested areas for future research are also addressed. Many campuses already contain green spaces, defined as any part of an environment that is predominately made of natural elements, and these green spaces comprise an untapped resource that is relatively cheap and simple.

Keywords: nature exposure, preventative care, undergraduate mental health, well-being intervention

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