Search results for: immigrant families

Authors: Maffo Maffo Nicole Liliane, Mounmeni Kpoumie Hubert, Mbaire Matindje Karl Marx, Zapfack Louis

Abstract:

Sacred forests play a valuable role in conserving local biodiversity and provide numerous ecosystem services in Cameroon. The study was carried out in the sacred forests of Bandrefam and Batoufam (western Cameroon). The aim was to estimate the diversity of woody species, carbon stocks and degradation factors in these sacred forests. The floristic inventory was carried out in plots measuring 25m × 25m for trees with diameters greater than 10 cm and 5m × 5m for trees with diameters less than 10 cm. Carbon stocks were estimated using the non-destructive method and the allometric equations. Data on degradation factors were collected using semi-structured surveys in the Bandrefam and Batoufam neighborhoods. The floristic inventory identified 65 species divided into 57 genera and 30 families in the Bandrefam Sacred Forest and 45 species divided into 42 genera and 27 families in the Batoufam Sacres Forest. The families common to both sacred forests are as follows: Phyllanthaceae, Fabaceae, Moraceae, Lamiaceae, Malvaceae, Rubiaceae, Meliaceae, Anacardiaceae, and Sapindaceae. Three genera are present in both sites. These are: Albizia, Macaranga, Trichillia. In addition, there are 27 species in common between the two sites. The total carbon stock is 469.26 tC/ha at Batoufam and 291.41 tC/ha at Bandrefam. The economic value varies between 15 823 877.05 fcfa at Batoufam and 9 825 530.528 fcfa at Bandrefam. The study shows that despite the sacred nature of these forests, they are subject to degradation factors such as bushfires (35.42 %), the creation of plantations (23.96 %), illegal timber exploitation (21.88 %), young people's lack of interest in the notion of conservation (9.38 %), climate change (7.29 %) and growing urbanization (2.08 %). These factors threaten biodiversity and reduce carbon storage in these forests.

Keywords: sacred forests, degradation factors, carbon stocks, semi-structured surveys

Procedia PDF Downloads 19

Authors: Tejush Badal, Sanaa Alwidian

Abstract:

Class diagrams are useful tools within the Unified Modelling Language (UML) to model and visualize the relationships between, and properties of objects within a system. As a system evolves over time and space (e.g., products), a series of models with several commonalities and variabilities create what is known as a model family. In circumstances where there are several versions of a model, examining each model individually, becomes expensive in terms of computation resources. To avoid performing redundant operations, this paper proposes an approach for representing a family of class diagrams into Union Models to represent model families using a single generic model. The paper aims to analyze and reason about a family of class diagrams using union models as opposed to individual analysis of each member model in the family. The union algorithm provides a holistic view of the model family, where the latter cannot be otherwise obtained from an individual analysis approach, this in turn, enhances the analysis performed in terms of speeding up the time needed to analyze a family of models together as opposed to analyzing individual models, one model at a time.

Keywords: analysis, class diagram, model family, unified modeling language, union model

Procedia PDF Downloads 46

Authors: Anya Glikman, Anastasia Gorodzeisky

Abstract:

Since the late 1990th labor immigration and its consequences on the society have become one of the most frequently discussed and debated issues in Russia. Social scientists point that the negative attitudes towards immigrants among Russian majority population is widespread, and their level, at least, twice as high as their level in most other European countries. Moreover, recent study by Gorodzeisky, Glikman and Maskyleison (2014) demonstrates that the two sets of individual level predictors of anti-foreigner sentiment – socio-economic status and conservative views and ideologies – that have been repeatedly proved in research in Western countries are not effective in predicting of anti-foreigner sentiment in Post-Socialist Russia. Apparently, the social mechanisms underlying anti-foreigner sentiment in Western countries, which are characterized by stable regimes and relatively long immigration histories, do not play a significant role in the explanation of anti-foreigner sentiment in Post-Socialist Russia. The present study aims to examine alternative possible sources of anti-foreigner sentiment in Russia while controlling for socio-economic position of individuals and conservative views. More specifically, following the research literature on the topic worldwide, we aim to examine whether and to what extent human values (such as tradition, universalism, safety and power), ethnic residential segregation, fear of crime and exposure to mass media affect anti-foreigner sentiments in Russia. To do so, we estimate a series of multivariate regression equations using the data obtained from 2012 European Social Survey. The national representative sample consists of 2337 Russian born respondents. Descriptive results reveal that about 60% percent of Russians view the impact of immigrants on the country in negative terms. Further preliminary analysis show that anti-foreigner sentiments are associated with exposer to mass media as well as with fear of crime. Specifically, respondents who devoted more time watching news on TV channels and respondents who express higher levels of fear of crime tend to report higher levels of anti-immigrants sentiments. The findings would be discussed in light of sociological perspective and the context of Russian society.

Keywords: anti-immigrant sentiments, fear of crime, human values, mass media, Russia

Procedia PDF Downloads 425

Authors: Bernadette F. De La Cruz, Susan Marie R. Dela Cruz, Georgia D. Demavibas

Abstract:

The Expanded Student Grant-in-Aid Program for Poverty Alleviation (ESGP-PA) is a government program that aims to contribute to the National Government’s thrusts in effectively addressing poverty alleviation by increasing the number of graduates in higher education among indigent households and to get these graduates employed in in-demand occupations in order to lift their families out of poverty. Higher education continues to see an influx of these students from poor families that have never previously sent anyone to college. There are many challenges that face college students at all levels, but these are special challenges for first-generation students. Challenges that face these students can include lack of interest in attending school, low aptitude, being not single anymore, factors such as unfamiliarity with college expectations, lack of preparations while in secondary school, and limited support from family members. This research looks at some of the challenges first-generation college students face and examines the impact of these challenges on student’s aspirations for the attainment of a college degree and ultimately a high-paying career.

Keywords: ESGP-PA, first-generation college students, low aptitude, poverty alleviation

Procedia PDF Downloads 289

Authors: Christine Hough, Eddie Abbott-Halpin, Tariq Mahmood, Jessica Giles

Abstract:

This paper draws together the findings from two research studies, each undertaken with cohorts of South Asian Muslim respondents located in the North of England between 2017 and 2019. The first study, entitled Faith Family and Crime (FFC), investigated the extent to which a Muslim family’s social and health well-being is affected by a family member’s involvement in the Criminal Justice System (CJS). This study captured a range of data through a detailed questionnaire and structured interviews. The data from the interview transcripts were analysed using open coding and an application of aspects of the grounded theory approach. The findings provide clear evidence that the respondents were neither well-informed nor supported throughout the processes of the CJS, from arrest to post-sentencing. These experiences gave rise to mental and physical stress, potentially unfair sentencing, and a significant breakdown in communication within the respondents’ families. They serve to highlight a particular aspect of complexity in the current needs of those South Asian Muslim families who find themselves involved in the CJS and is closely connected to family structure, culture, and faith. The second study, referred to throughout this paper as #ImamsBritain (that provides the majority of content for this paper), explores how Imams, in their role as community faith leaders, can best address the complex – and changing - needs of South Asian Muslims families, such as those that emerged in the findings from FFC. The changing socio-economic and political climates of the last thirty or so years have brought about significant changes to the lives of Muslim families, and these have created more complex levels of social, cultural, and faith-based needs for families and individuals. As a consequence, Imams now have much greater demands made of them, and so their role has undergone far-reaching changes in response to this. The #ImamsBritain respondents identified a pressing need to develop a wider range of pastoral and counseling skills, which they saw as extending far beyond the traditional role of the Imam as a religious teacher and spiritual guide. The #ImamsBritain project was conducted with a cohort of British Imams in the North of England. Data was collected firstly through a questionnaire that related to the respondents’ training and development needs and then analysed in depth using the Delphi approach. Through Delphi, the data were scrutinized in depth using interpretative content analysis. The findings from this project reflect the respondents’ individual perceptions of the kind of training and development they need to fulfill their role in 21st Century Britain. They also provide a unique framework for constructing a professional guide for Imams in Great Britain. The discussions and critical analyses in this paper draw on the discourses of professionalization and pastoral care and relevant reports and reviews on Imam training in Europe and Canada.

Keywords: criminal justice system, faith and culture, Imams, Muslim community leadership, professionalization, South Asian family structure

Procedia PDF Downloads 93

Authors: Bharti Yadav

Abstract:

Global migration and the rise of far-right parties have expanded the significance of political discussions enclosing multiculturalism. This research paper will focus on the rise of far-right political parties in Europe over the last nearly two decades and how right-wing politics affect multiculturalism in a detrimental way; major European leaders have publicly stated that multiculturalism in their countries has failed. This paper also discusses the main reasons for right-wing politics is normalizing in Europe. Far-right political parties are the fastest-growing parties in Europe, and multiculturalism is an unescapable significant political issue. The rise of far-right anti-immigrant parties diminishes mainstream party support for multiculturalism. Mainstream parties are more receptive to both increasing in ethnic minorities’ electoral power and the rise of far-right parties.

Keywords: political parties, far-right, migration, multiculturalism

Procedia PDF Downloads 54

Authors: Edwina Owusu Panin, Kwame Baah Owusu Panin

Abstract:

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

Procedia PDF Downloads 43

Authors: Diobein Flores, Venus Buagas, Virgie Darunday

Abstract:

The study inventoried the species composition of terrestrial ferns and lycopods in Center for Ecological Development and Recreation (CEDAR) Impalutao, Impasug-ong, Bukidnon. Specifically, it aimed to determine and describe the species composition, and diagnostic characters of the ferns and lycopods in the study site. Transect walk method was employed in the inventory of the species. Each species were classified, identified and described according to its diagnostic characters. Results of the study revealed a total of 20 species of ferns and lycopods. Of these, 18 species were ferns and 2 species were lycopods. Eleven (11) families and fifteen (15) genera for ferns and one (1) family and one (1) genera for lycopods. Psomiocarpa apifolia is Philippine endemic and said to be vulnerable or threatened. Taxonomic characters based on habit, rhizome, leaf arrangement and orientation, stem structure and circinate vernation were used to identify the terrestrial pteridophtyes into families, genera and species. The species collected and assessment in CEDAR should be further investigated and monitor their conservation status.

Keywords: alpha taxonomy, conservation, habit, taxonomic characters

Procedia PDF Downloads 193

Authors: N. C. van der Merwe, J. Oosthuizen, M. F. Makhetha, J. Adams, B. K. Dajee, S-R. Schneider

Abstract:

Women representing high-risk breast cancer families, who tested negative for pathogenic mutations in BRCA1 and BRCA2, are four times more likely to develop breast cancer compared to women in the general population. Sequencing of genes involved in genomic stability and DNA repair led to the identification of novel contributors to familial breast cancer risk. These include BLM and PALB2. Bloom's syndrome is a rare homozygous autosomal recessive chromosomal instability disorder with a high incidence of various types of neoplasia and is associated with breast cancer when in a heterozygous state. PALB2, on the other hand, binds to BRCA2 and together, they partake actively in DNA damage repair. Archived DNA samples of 66 BRCA1/2 negative high-risk breast cancer patients were retrospectively selected based on the presence of an extensive family history of the disease ( > 3 affecteds per family). All coding regions and splice-site boundaries of both genes were screened using High-Resolution Melting Analysis. Samples exhibiting variation were bi-directionally automated Sanger sequenced. The clinical significance of each variant was assessed using various in silico and splice site prediction algorithms. Comprehensive screening identified a total of 11 BLM and 26 PALB2 variants. The variants detected ranged from global to rare and included three novel mutations. Three BLM and two PALB2 likely pathogenic mutations were identified that could account for the disease in these extensive breast cancer families in the absence of BRCA mutations (BLM c.11T > A, p.V4D; BLM c.2603C > T, p.P868L; BLM c.3961G > A, p.V1321I; PALB2 c.421C > T, p.Gln141Ter; PALB2 c.508A > T, p.Arg170Ter). Conclusion: The study confirmed the contribution of pathogenic mutations in BLM and PALB2 to the familial breast cancer burden in South Africa. It explained the presence of the disease in 7.5% of the BRCA1/2 negative families with an extensive family history of breast cancer. Segregation analysis will be performed to confirm the clinical impact of these mutations for each of these families. These results justify the inclusion of both these genes in a comprehensive breast and ovarian next generation sequencing cancer panel and should be screened simultaneously with BRCA1 and BRCA2 as it might explain a significant percentage of familial breast and ovarian cancer in South Africa.

Keywords: Bloom Syndrome, familial breast cancer, PALB2, South Africa

Procedia PDF Downloads 207

Authors: Alami Ilyass, Kharchoufa Loubna, Alachouri Mostafa

Abstract:

Cardiovascular disease (CDV) remains the major cause of morbidity; mortality and disability throughout the world. The ethnopharmcological and ethnobotanical studies are the paramount importance to set a high value on phytogenetic resources and to address health problems of some communities; especially poor peoples. Our work presents an analysis of published data from studies, that have been undertaken, in Morocco, by different seeker teams in separately areas during the last decades. Objectives: Evaluate and identify medicinal plants used for cardiovascular treatment by Moroccan people. Methodology: All these studies have the same approaches ; they were conducted by interviewing people suffering from diabetes. We use Factorial Analysis (FA) and principal Components analysis (PCA) to analyse the aggregated data from the different studies. Results: globally; 95 plants species were listed; all these plant were used empirically by Moroccan society for treating cardiovascular problems. These plants were divided in to 42 families and 87 genus. The lamiaceae; asteraceae; Apiaceae and poaceae are the botanical families with high number of plant species. Coclusion: Traditional medecine has been widely used for treatment of cardiovascular problems and it has been recognized as an interesting alternative to conventional medicine.

Keywords: cardiovascular, ethnobotanical, medicinal plants, Morocco

Procedia PDF Downloads 211

Authors: Md. Zahidul Islam

Abstract:

Illegal immigrants’ problem is a big problem all over the world including America. Malaysia is also facing this problem. Nowadays, it is turned into a major problem for Malaysia. Many illegal immigrants are staying in Malaysia from different countries such as Bangladesh, Myanmar, India, Pakistan, Indonesia, Vietnam, Thailand, Philippine, Nigeria. This article is only focusing on the present situation of illegal immigrants of Bangladesh. The aim of this article is to highlight how the Bangladeshi nationals are becoming an illegal immigrant in Malaysia. In the same time, this article also tries to identify the present situation of Bangladeshi illegal immigrants in Malaysia. The research will adopt qualitative methods of research. Both countries have to find a solution to solve this problem.

Keywords: illegal immigrants, present situation, Bangladesh, Malaysia

Procedia PDF Downloads 222

Authors: Bowen Li, Dan Shu, Shiguang Pang, Li Wang, Qian Liu

Abstract:

Background: Every year, approximately 429,000 adolescents aged 0-19 are diagnosed with cancer worldwide. The diagnosis brings about substantial psychological pressure and caregiving responsibilities for family members and impacts the families significantly. Family resilience has been found to reduce caregiver distress and can also foster post-traumatic growth in cancer survivors. However, current research on family resilience in childhood cancer mainly focuses on individual caregiver resilience and child adaptation, with less attention given to categorizing family resilience among caregivers of children with cancer. Method: A total of 292 caregivers of children with cancer were recruited from four tertiary hospitals in central China from July 2022 to March 2024. This study was approved by the ethics committee, and participants provided informed consent, with the option to withdraw at any time. The Family Resilience Assessment Scale was used to measure family resilience among caregivers of children with cancer. The Quality of Life scale-family, The Perceived Social Support Scale, and The Connor-Davidson Resilience Scale were used to measure potential influencing factors. This study used latent profile analysis (LPA) to identify latent categories of family resilience among caregivers of children with cancer. Binary logistic regression was used to analyze the influencing factors of family resilience. Results: The results reveal two distinct categories: "high family resilience" and "low family resilience." "Low family resilience" group accounts for 85.96% of the total while "high family resilience" group is 14.04%. "High family resilience" scores higher across all dimensions compared to "low family resilience". Within-group comparisons reveals that "family communication and problem-solving" and "empowering the meaning of adversity" received the highest scores, while "utilizing social and economic resources" scores the lowest. "Maintaining a positive attitude" scores similarly high to "family communication and problem-solving" in the high family resilience group, whereas it scores similarly low to "utilizing social and economic resources" in the low family resilience group. In single-factor analysis, residence, number of siblings, caregiver's education level, resilience, social support, quality of life, physical well-being and psychological well-being showed significant difference between two categories. In binary logistic regression analysis, households with only one child are more likely to exhibit low family resilience, whereas high personal resilience is associated with a high level of family resilience. Conclusion: Most families with children suffering from cancer require strengthened family resilience. Support for utilizing socio-economic resources is important for both high and low family resilience families. Single-child families and caregivers with lower resilience require more attention. These findings imply the development of targeted interventions to enhance family resilience among families with children of cancer. Future studies could involve children and other family members for a comprehensive understanding of family resilience. Longitudinal studies are necessary to explore the dynamic changes in family resilience throughout the cancer journey.

Keywords: cancer children, caregivers, family resilience, latent profile analysis

Procedia PDF Downloads 9

Authors: Vinod Kumar Gupta, Narendrakumar M. Chaudhari, Suchismitha Iskepalli, Chitra Dutta

Abstract:

Background-The community composition of the human microbiome is known to vary at distinct anatomical niches. But little is known about the nature of variations if any, at the genome/sub-genome levels of a specific microbial community across different niches. The present report aims to explore, as a case study, the variations in gene repertoire of 28 Prevotella reference draft genomes derived from different body-sites of human, as reported earlier by the Human Microbiome Consortium. Results-The analysis reveals the exclusive presence of 11798, 3673, 3348 and 934 gene families and exclusive absence of 17, 221, 115 and 645 gene families in Prevotella genomes derived from the human oral cavity, gastro-intestinal tracts (GIT), urogenital tract (UGT) and skin, respectively. The pan-genome for Prevotella remains “open”. Distribution of various functional COG categories differs appreciably among the habitat-specific genes, within Prevotella pan-genome and between the GIT-derived Bacteroides and Prevotella. The skin and GIT isolates of Prevotella are enriched in singletons involved in Signal transduction mechanisms, while the UGT and oral isolates show higher representation of the Defense mechanisms category. No niche-specific variations could be observed in the distribution of KEGG pathways. Conclusion-Prevotella may have developed distinct genetic strategies for adaptation to different anatomical habitats through selective, niche-specific acquisition and elimination of suitable gene-families. In addition, individual microorganisms tend to develop their own distinctive adaptive stratagems through large repertoires of singletons. Such in situ, habitat-driven refurbishment of the genetic makeup can impart substantial intra-lineage genome diversity within the microbes without perturbing their general taxonomic heritage.

Keywords: body niche adaptation, human microbiome, pangenome, Prevotella

Procedia PDF Downloads 225

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

Abstract:

Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

Procedia PDF Downloads 48

Authors: Iori Hamada

Abstract:

Australia's skilled migrant selection system is constantly changing its target skills and criteria according to the labour market demands. The government's intention to employ this highly selective market-driven selection system is to better target the skills needed in the economy, enable skilled migrants to be employed in industries that have the highest need, and consequently boost the economy and population. However, migration scholars have called this intention into question, arguing that the system is not making the best use of skilled migrants. This paper investigates the impact of recent reforms in Australian skilled migration system on skilled migrants' employment and related life conditions. Drawing on semi-structured qualitative interviews with Japanese skilled migrants in Australia, it argues that Australia’s skilled migrant selection system guarantees neither skilled migrants' employment nor successful transfer of their skills to the labour market. The findings show that Japanese skilled migrants are often unemployed or under-employed, although they intend to achieve upward occupational mobility. The interview data also reveal that male unemployment or under-employment status prompts some Japanese men to leave Australia and find a job that better matches their skills and qualifications in a new destination. Further, it finds that Japanese male skilled migrants who experience downward occupational mobility tend to continue to take a primary breadwinner role, which affects the distribution of paid and unpaid work within their families. There is a growing body of research investigating skilled migrants’ downward career mobility. However, little has been written on skilled Japanese migrants. Further, the work-family intersection is a 'hot public policy topic' in Australia and elsewhere. Yet, the existing studies focus almost exclusively on non-migrant families. This calls attention to the urgency of assessing the work-family lives of skilled migrants. This study fills these gaps, presenting additional insight into Japanese skilled migrants’ work and family in and beyond Australia.

Keywords: Australia, employment, family, Japanese skilled migrants

Procedia PDF Downloads 88

Authors: Mariyan Tomov

Abstract:

Bulgarian working class immigrants are increasingly concerned with UK’s recent immigration policies in the context of Brexit. The new ID system would exclude many people currently working in Britain and would break the usual immigrant travel patterns. Post-Brexit Britain would aim to repeal seasonal immigrants. Measures for keeping long-term and life-long immigrants have been implemented and migrants that aim to remain in Britain and establish a household there would be more privileged than temporary or seasonal workers. The results of such regulating mechanisms come at the expense of migrants’ longings for a ‘normal’ existence, especially for those coming from Central and Eastern Europe. Based on in-depth interviews with Bulgarian working class immigrants, the study found out that their major concerns following the decision of the UK to leave the EU are related with the freedom to travel, reside and work in the UK. Furthermore, many of the interviewed women are concerned that they could lose some of the EU's fundamental rights, such as maternity and protection of pregnant women from unlawful dismissal. The soar of commodity prices and university fees and the limited access to public services, healthcare and social benefits in the UK, are also subject to discussion in the paper. The most serious problem, according to the interview, is that the attitude towards Bulgarians and other immigrants in the UK is deteriorating. Both traditional and social media in the UK often portray the migrants negatively by claiming that they take British job positions while simultaneously abuse the welfare system. As a result, the Bulgarian migrants often face social exclusion, which might have negative influence on their health and welfare. In this sense, some of the interviewed stress on the fact that the most important changes after Brexit must take place in British society itself. The aim of the proposed study is to provide a better understanding of the Bulgarian migrants’ economic, health and sociocultural experience in the context of Brexit. Methodologically, the proposed paper leans on: 1. Analysing ethnographic materials dedicated to the pre- and post-migratory experiences of Bulgarian working class migrants, using SPSS. 2. Semi-structured interviews are conducted with more than 50 Bulgarian working class migrants [N > 50] in the UK, between 18 and 65 years. The communication with the interviewees was possible via Viber/Skype or face-to-face interaction. 3. The analysis is guided by theoretical frameworks. The paper has been developed within the framework of the research projects of the National Scientific Fund of Bulgaria: DCOST 01/25-20.02.2017 supporting COST Action CA16111 ‘International Ethnic and Immigrant Minorities Survey Data Network’.

Keywords: Bulgarian migrants in UK, economic experiences, sociocultural experiences, Brexit

Procedia PDF Downloads 93

Authors: Mingaile Jurkute, Vilnius University

Abstract:

The memory of the Lithuanian partisan war (1944-1953) underwent extremely dramatic transformations. During this war, the image of the resistance and a partisan was one of the key elements of Lithuanian identity. Its importance is evidenced by the extremely large legacy of songs about partisans, no other topic has collected so much folklore in Lithuania. In the Soviet years, this resistance was practically forced to be forgotten. Terror and Soviet laws have forced people to stop talking about the events, even in the family circle. In addition, the Soviets created their own propaganda story, reinterpreting the Lithuanian partisan war, presenting partisans as bandits who brutally tortured and murdered locals. But even in the Soviet years, the memory could neither be completely suppressed, nor completely transformed into wishful shape. The analysis of fiction and cinema shows that the traumatic memory of real events rushed to the surface, thus transforming the very propagandistic narrative. After the restoration of the Republic of Lithuania in 1990, the Lithuanian partisan war was gradually returned to the central place of Lithuanian history. After 2014 the nationalist heroic narrative about Lithuanian partisans became the central narrative of modern Lithuanian history. Nevertheless, interviews I conducted in Lithuanian villages reveal that the memory of local communities and families preserves quite different experiences that do not fit into neither the Soviet narrative nor the heroic one. Such experiences include, for example, partisan violence against local families. This paper is about the efforts of two political ideologies (the Soviet and the Lithuanian patriotic) to use the history of the Lithuanian partisans for their own needs, and the attempts of small communities (mostly families) to resist these efforts. The research reveals that family memory, even when opposed to aggressive state memory policies, can preserve counter-narratives by exploiting unexpected objects beyond the control of the state, such as nature and wildlife. Basically, the paper analyses the limits of the instrumentalization of memory, even by extremely aggressive political regimes.

Keywords: collective memory, post-memory, violence, military conflict, family memory

Procedia PDF Downloads 69

Authors: Zina Nasr, Faiek Errouissi

Abstract:

Forest ecosystems are known for its ability to contain a large diversity of fauna especially insects that represent a huge taxonomic group. A portion of forest insects are recognized as saproxylic including the group of organisms that ‘depend on dead or dying wood’ about them, 20% are beetles. We focused our study on saproxylic beetles in an old urban park ‘the park of Belvedere’, located in the north west of Tunis (36° 49'21’ N 10°10'24’ W). The vegetation is dominated by old trees (Eucalyptus, Olea, Aberia, Pinus) and many fallen wood exist. Saproxylic beetles were collected using three interception traps set in the park over one year (from June 2014 to May 2015) and recovered monthly. In total, we collected 189 beetles belonging to 20 families and 57 species. Several saproxylic families (Bostrichidae, Cerambycidae, Curculionidae, Melyridae, Nitidulidae, Staphylinidae), and well known genus (Rhizopertha, Thrychoplerus, Otiorhychus, Dolichosoma, Epuraea, Anotylus) are recorded. We have retained the largest activity of beetles in spring and a very low richness in winter with zero insect per traps. This result was certainly caused by the variation of meteorological factors that mainly influenced the activity of these organisms. Therefore, we were interested on the saproxylic diversity in an urban ‘forest’, and these results will be more interesting when they are compared in the future with other works from natural forest.

Keywords: saproxylic beetles, seasons, urban park, wood

Procedia PDF Downloads 314

Authors: Eli Buchbinder

Abstract:

Introduction. Language is the basis to our experience as human being. We use language in describing our experiences and construct meaning and narratives from experiences. Metaphors are a valuable linguistic tool commonly use. Metaphors link two domains that are ordinarily not related. Metaphors achieve simultaneously multi-level integration: abstract and concrete, rational and imaginative, familiar and the unfamiliar, conscious and preconscious/unconscious. As such, metaphors epistemological and ontological tool that are important in social work in every field and domain. Goals and Methods The presentation’s aim is to validate the value of metaphors through the first psychiatric breakdown is a traumatic for families. The presentation is based on two pooled qualitative studies. The first study focused on 12 spouses: 7 women and 5 men, between the ages of 22 and 57, regarding their experiences and meanings of the first psychiatric hospitalization of their partners diagnosed with affective disorders. The second study focused on 10 parents, between the ages of 47 and 62, regarding their experiences and meanings following their child's first psychotic breakdown during young adulthood. Results Two types of major metaphors evolved from the interviews in farming the trauma of the first mental breakdown. The first mode - orientation (spatial) metaphors, reflect symbolic expression of the loss of a secure base, represented in the physical environment, e.g., describing hospitalization as "falling into an abyss." The second mode- ontological metaphors, reflect how parents and spouses present their traumatic experiences of hospitalization in terms of discrete, powerful and coherent entities, e.g., describing the first hospitalization as "swimming against the tide." The two metaphors modes reflect the embodiment of the unpredictability, being mired in distress, shock, intense pain and the experience the collapse of continuity on the life course and cuts off the experience of control. Conclusions Metaphors are important and powerful guide in assessing individuals and families’ phenomenological reality. As such, metaphors are useful for understanding and orientated therapeutic intervening, in the studies above, with the first psychiatric hospitalization experienced, as well as in others social workers’ interventions.

Keywords: first mental breakdown, metaphors, family perspective, qualitative research

Procedia PDF Downloads 42

Authors: Lorand Bodo

Abstract:

There are many stories of young British citizens who have left their country and families to join Islamist militant groups. So, what drives these young people to abandon their families and countries to join terrorist groups such as the so-called Islamic State? Much has been written to explain the phenomenon of violent radicalisation, whereby the concepts of identity and belonging are identified as one of the most significant drivers for violent radicalisation. In this respect, this paper explores the connection between the sense of belonging and violent radicalisation. That is necessary to gain a more nuanced understanding of the process of violent radicalisation in order to create and implement more effective counter-measures for tackling violent radicalisation. By using an inductive approach, this dissertation attempts to answer the question to what extent does the sense of non-belonging lead to the violent radicalisation of a few individuals. Therefore, alongside an expert interview, a survey, and qualitative content analysis of secondary sources, an exclusive semi-structured interview was conducted with a former violently radicalised Jihadi and recruiter. Overall, the sense of non-belonging significantly affects the process of violent radicalisation of a few individuals. Nevertheless, being religiously fundamental is not the problem of becoming violently radicalised in the first place, but belonging to the wrong group that is strongly determined by ideology, constitutes the main problem.

Keywords: identity, sense of non-belonging, social identity theory, violent radicalisation

Procedia PDF Downloads 170

Authors: Ozge Karayalçin

Abstract:

This study tries to find out the reasons for the integration problems of third generation Dutch-Turkish youngsters by particularly focusing on the socio-cultural and socio-economic situations of these people in the Netherlands. The results obtained from the field research are summed up under four sections. These four sections are education and language, labour market, cultural factors, religion, and nationality. The underlying reasons of the integration problems are reflected from two different perspectives. The first one is the effects of social and economic enforcements implemented on the Turkish immigrant society. The second one is the traditional Turkish values that are quite different from Dutch values. The problems experienced by third generation Turkish origin Dutch youngsters are not one-sided. To conclude, solution-oriented advisements are asserted.

Keywords: acculturation levels, Dutch-Turkish youngsters, integration, transnational migrants, identity conflicts

Procedia PDF Downloads 390

Authors: McKenna Halverson, Allison Karpyn

Abstract:

Introduction: The COVID-19 pandemic posed unprecedented challenges for families with young children in the United States. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutrition assistance program that provides low-income mothers and young children with access to healthy foods (e.g., infant formula, milk, and peanut butter), mitigated some financial challenges for families. However, the U.S. experienced a national infant formula shortage and rising inflation rates during the pandemic, which likely impacted WIC participants’ shopping experiences and well-being. As such, this study aimed to characterize how the COVID-19 pandemic and related events impacted Delaware WIC participants’ in-store benefit redemption experiences and overall well-being. Method: The authors conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions and open-ended questions regarding participants’ experiences with WIC benefit redemption during the COVID-19 pandemic. Data were analyzed using a hybrid inductive and deductive coding approach. Findings: The COVID-19 pandemic significantly impacted WIC participants’ shopping experiences and well-being. Specifically, participants were forced to alter their shopping behaviors to account for rising food prices (e.g., used coupons, bought less food, used food banks). Additionally, WIC participants experienced significant distress during the national infant formula shortage resulting from difficulty finding formula to feed their children. Participants also struggled with in-store benefit redemption due to inconsistencies in shelf labelling, the WIC app, and low stock of WIC foods. These findings highlight the need to reexamine WIC operations and emergency food response policy in the United States during times of crisis to optimize public health and ensure federal nutrition assistance programs meeting the needs of low-income families with young children.

Keywords: benefit redemption, COVID-19 pandemic, infant formula shortage, inflation, shopping, WIC

Procedia PDF Downloads 46

Authors: An-Yi Wang, Wei-Fong Kao, Shin-Han Tsai

Abstract:

Introduction: Information as patient characteristics, resuscitation scene, resuscitation provider perspectives and families wish affects on resuscitation decision-making for out-of-hospital cardiac arrest (OHCA). There is no consistency consensus on how families and emergency physicians approach this decision. The main purpose of our study is to evaluate the characteristics of withholding resuscitation efforts arrival at the hospital. Methods: We retrospectively analyzed patients with OHCA without pre-hospital return-of-spontaneous circulation (ROSC) who was sent to our emergency department (ED) between January 2014 and December 2015. Baseline characteristics, pre-hospital course, and causes of the cardiopulmonary arrest among patients were compared. Results: In 2 years, total 155 arrest patients without pre-hospital ROSC was included. 33(21.3%) patients withhold the resuscitation efforts in ED with mean resuscitation duration 4.45 ± 7.04 minutes after ED arrival. In withholding group, the initial rhythm of arrests was all non-shockable. 9 of them received endotracheal intubation before decision-making. None of the patients in withhold resuscitation group survived to discharge. There was no significant difference among gender, underlying cardiovascular disease, malignancy, chronic renal disease, nor witness collapse between withhold and continue resuscitation groups. Univariate analysis showed there was lower percentage of bystander resuscitation (32.3% vs. 50.4%, p=0.071), and the lower percentage of transport via emergency medical service (EMS) (78.8% vs. 91.8%, p=0.054) in withholding group. Multivariate analysis showed old age (adjusted odds ratio=1.06, 95% C.I.=[1.02-1.11], p<0.05), with underlying respiratory insufficiency (adjusted odds ratio=12.16, 95% C.I.=[3.34-44.29], p<0.05), living at home compared with nursing home (adjusted odds ratio=37.75, 95% C.I.=[1.09-1110.70], p<0.05) were more likely to withhold resuscitation. Transport via EMS was more likely to continue resuscitation (adjusted odds ratio=0.11, 95% C.I.=[0.02-0.71], p<0.05). Conclusion: The decision-making for families and emergency physicians to withhold or continue resuscitation for out-of-hospital cardiac arrest is complex and multi-factorial. Continue resuscitation efforts in nursing home residents is high, and further study among this population is warranted.

Keywords: cardiopulmonary resuscitation, out-of-hospital cardiac arrest, termination resuscitation, withhold resuscitation

Procedia PDF Downloads 229

Authors: Sofiya An, Akbota Kanderzhanova, Assel Akhmetova, Faye Foster, Chee K. Chan

Abstract:

Healthcare, education and social support for children with autism in Kazakhstan has been evolving and transforming over the last three decades. There is still limited knowledge of the use of complementary and alternative medicine by families caring for autistic children in this post-Soviet region. An exploratory qualitative focus group study of Kazakhstani families was carried out to capture and understand their experiences of using complementary and alternative (CAM) medicine. A total of six focus groups were conducted in five cities across the country including Nur-Sultan, Almaty, Kyzylorda, Karaganda and Taraz. The perceived factors driving the availability, choice, and use of complementary and alternative medicine by families of autistic children in the country were distilled and evaluated. The data collected was analyzed using a framework analysis and themes and subthemes were developed. Two major themes stood out. The first was the “unmet needs”, which relates to the predisposing factors that motivate parents to CAM uptake, and the second was the “chasing hope”, which relates to the enabling factors that facilitate parents’ uptake of CAM. Fear of missing out (FOMO) is a latent underlying motivation underscoring these two themes as well. Parents of autism spectrum disorder (ASD) children in Kazakhstan have to deal with many challenges when seeking treatment for their children with ASD. They are prepared and resort to try out whatever CAM interventions available. The motivation and rationale of choice of use is driven by the lack of options and the hope of any potential positive outcome rather than from rational decisions based on efficacy or the evidence-based data of CAM. Parents get desperate and are willing to try CAM regardless of and independent of their cultural and belief systems and they do not want to miss out just in case it might work. This study also gives an international and cross-cultural perspective on the motives, choice and practice of parents with ASD children using CAM in Kazakhstan, a Central Asian country.

Keywords: autism spectrum disorder, Central Asia, complementary and alternative medicine, cross-cultural perspective, qualitative research

Procedia PDF Downloads 117

Authors: Damla Tas, Robert Rudolf

Abstract:

Fast economic development and women empowerment in Korea have contributed to an unprecedented family and gender crisis, with Korean fertility rates at a global record low. This study explores the predictors and time trends of Korean women’s attitudes toward family formation and the household division of labor by using the Korean Longitudinal Survey of Women and Families from 2007 to 2018. Results indicate that education, age, marital status, and motherhood are significantly associated with women’s attitudes toward family formation and gender attitudes toward the intrahousehold division of labor. In addition, more educated women and those aged 26 to 45 are less likely to support traditional marriage and traditional household division of labor statements. Unmarried and divorced women are more likely to support progressive values and roles. Also, retrospective factors such as mothers’ schooling and parents’ relationship are significantly associated with gender role ideology. Our findings also indicate a downward trend in the number of Korean women stating one must have children. The study suggests that Korean families and society need to adjust to women’s changing preferences concerning their societal roles toward less traditional. Hence, a new agreement between men and women is needed on how work can be divided more equally.

Keywords: marriage, family formation, intrahousehold division of labor, gender role attitudes, Korea

Procedia PDF Downloads 44

Authors: Nadia Arikat, Katharine Blain

Abstract:

During the worst of the COVID pandemic, only essential treatment was provided for patients needing urgent care. With the prolonged extent of the pandemic, there has been a return to more routine referrals for paediatric dentistry advice and treatment for specialist conditions. However, some of these patients and/or their carers may have significant medical issues meaning that attending in-person appointments carries additional risks. This poses an ethical dilemma for clinicians. This project looks at how a secure video conferencing platform (“Near Me”) has been used to assess the need and urgency for in-person new patient visits, particularly for patients and families with additional risks. “Near Me” is a secure online video consulting service used by NHS Scotland. In deciding whether to bring a new patient to the hospital for an appointment, the clinical condition of the teeth together with the urgency for treatment need to be assessed. This is not always apparent from the referral letter. In addition, it is important to judge the risks to the patients and carers of such visits, particularly if they have medical issues. The use and effectiveness of “Near Me” consultations to help decide whether vulnerable paediatric patients should have in-person appointments will be illustrated and discussed using two families: one where the child is medically compromised (Alagille syndrome with previous liver transplant), and the other where there is a medically compromised parent (undergoing chemotherapy and a bone marrow transplant). In both cases, it was necessary to take into consideration the risks and moral implications of requesting that they attend the dental hospital during a pandemic. The option of remote consultation allowed further clinical information to be evaluated and the families take part in the decision-making process about whether and when such visits should be scheduled. These cases will demonstrate how medically compromised patients (or patients with vulnerable carers), could have their dental needs assessed in a socially distanced manner by video consultation. Together, the clinician and the patient’s family can weigh up the risks, with regards to COVID-19, of attending for in-person appointments against the benefit of having treatment. This is particularly important for new paediatric patients who have not yet had a formal assessment. The limitations of this technology will also be discussed. It is limited by internet availability, the strength of the connection, the video quality and families owning a device which allows video calls. For those from a lower socio-economic background or living in some rural areas, this may not be possible or limit its usefulness. For the two patients discussed in this project, where the urgency of their dental condition was unclear, video consultation proved beneficial in deciding an appropriate outcome and preventing unnecessary exposure of vulnerable people to a hospital environment during a pandemic, demonstrating the usefulness of such technology when it is used appropriately.

Keywords: COVID-19, paediatrics, triage, video consultations

Procedia PDF Downloads 62

Authors: Arul Aram, Vishnu Priya, Monicka Karunanithi

Abstract:

In India, in particular, festivals are the occasions of celebrations. They create beautiful moments to cherish. Mostly, people pay a visit to their native places to celebrate with their loved ones. So are wedding celebrations. The Covid-19 pandemic came upon us unexpectedly, and to fight it, the festivals and weddings are celebrated unusually. Crowded places are deserted. Mass gatherings are avoided, changes and alterations are made in our rituals and celebrations. The warmth usually people have at their heart during any festival and wedding has disappeared. Some aspects of the celebrations become virtual/digital rather than real -- for instance, digital greetings/invitations, digital conduct of ceremonies by priests, YouTube worship, online/digital cash gifts, and digital audience for weddings. Each festival has different rituals which are followed with the divine nature in every family, but the pandemic warranted some compromises on the traditions. Likewise, a marriage is a beautiful bond between two families where a lot of traditional customs are followed. The wedding ceremonies are colorful and celebrations may extend for several days. People in India spend financial resources to prepare and celebrate weddings. The bride's and the groom's homes are fully decorated with colors, balloons and other decorations. The wedding rituals and celebrations vary by religion, region, preference and the resources of the groom, bride and their families. They can range from one day to multiple-days events. But the Covid-19 pandemic situation changes the mindset of people over ceremonies. This lockdown has affected those weddings and industries that support them and make the people postpone or at times advance without fanfare their 'big day.' People now adopt the protocols, guidelines and safety measures to reduce the risk and minimize the fear during celebrations. The study shall look into: how the pandemic shattered the expectations of people celebrating; problems faced economically by people/service providers who are benefited by the celebrations; and identify the alterations made in the rituals or the practices of our culture for the safety of families. The study shall employ questionnaires, interviews and visual ethnography to collect data. The study found that during a complete lockdown, people have not bought new clothes, sweets, or snacks, as they generally do before a pandemic. Almost all of them kept their celebrations low-key, and some did not celebrate at all. Digital media played a role in keeping the celebration alive, as people used it to wish their friends and families virtually. During partial unlock, the situation was under control, and people began to go out and see a few family and friends. They went shopping and bought new clothes and needs, but they did it while following safety precautions. There is also an equal percentage of people who shopped online. Although people continue to remain disappointed, they were less stressed up as life was returning to normal.

Keywords: covid-19, digital, festivals, India, wedding

Procedia PDF Downloads 156

Authors: Dejana Bouillet, Vlatka Domović

Abstract:

Both policymakers and researchers recognize that participating in early childhood education and care (ECEC) is useful for all children, especially for those who are exposed to the high risk of social exclusion. Social exclusion of children is understood as a multidimensional construct including economic, social, cultural, health, and other aspects of disadvantage and deprivation, which individually or combined can have an unfavorable effect on the current life and development of a child, as well as on the child’s development and on disadvantaged life chances in adult life. ECEC institutions should be able to promote educational approaches that portray developmental, cultural, language, and other diversity amongst children. However, little is known about the ways in which Croatian ECEC institutions recognize and respect the diversity of children and their families and how they respond to their educational needs. That is why this paper is dedicated to the analysis of the capacities of ECEC professionals to respond to the demands of educational needs of this very diverse group of children and their families. The results obtained in the frame of the project “Models of response to educational needs of children at risk of social exclusion in ECEC institutions,” funded by the Croatian Science Foundation, will be presented. The research methodology arises from explanations of educational processes and risks of social exclusion as a complex and heterogeneous phenomenon. The preliminary results of the qualitative data analysis of educational practices regarding capacities to identify and appropriately respond to the requirements of children at risk of social exclusion will be presented. The data have been collected by interviewing educational staff in 10 Croatian ECEC institutions (n = 10). The questions in the interviews were related to various aspects of inclusive institutional policy, culture, and practices. According to the analysis, it is possible to conclude that Croatian ECEC professionals are still faced with great challenges in the process of implementation of inclusive policies, culture, and practices. There are several baselines of this conclusion. The interviewed educational professionals are not familiar enough with the whole complexity and diversity of needs of children at risk of social exclusion, and the ECEC institutions do not have enough resources to provide all interventions that these children and their families need.

Keywords: children at risk of social exclusion, ECEC professionals, inclusive policies, culture and practices, quallitative analysis

Procedia PDF Downloads 84

Authors: Tanya Anand, Arun Kandasamy, L. N. Suman

Abstract:

Family based therapy for adolescent substance abuse has been studied to be effective in the West. Whereas, based on literature review, family therapy and interventions for adolescent substance abuse is still in its nascent stages in India. A multidimensional perspective to treatment has been indicated consistently in the Indian literature, but standardized therapy which addresses early substance abuse, from a social-ecological perspective has not been developed and studied for Indian population. While numerous researches have been conducted in India on the need of engaging the family in therapy for the purpose of symptom reduction, long-term maintenance of gains, and reducing family burnout, distress and dysfunction; a family based model in the Indian context has not been developed and tried, to the best of our knowledge. Hence, from the aim of building a model to treat adolescent substance abuse within the family context, experts in the area of mental health and deaddiction were interviewed to inform upon the clinical difficulties, challenges, uniqueness that Indian families present with. The integration of indigenous techniques that would be helpful in engaging families of young individuals with difficulties were also explored. Eight experts' who were interviewed, have 10-30 years of experience in working with families and substance users. An open-ended interview was conducted with the experts individually and audio-recorded. The interviews were then transcribed and subjected to qualitative analysis for building a framework and treatment guideline. Additionally, interviews with patients and their parents were conducted to elicit ‘felt needs’. The results of the analysis revealed culture-specific issues widely experienced within Indian families by adolescents and young adults, centering around the theme of Individuation versus collective identity and living. Substance abuse, in this framework, was found to be perceived as one of the maladaptive ways of the youth to disengage from the family and attempt at individuation and the responsibilities that are considered entitlements in the culture. On the other hand, interviews with family members revealed them to be engaging in inconsistent patterns of care and parenting. This was experienced and observed in terms of fostering interdependence within the family, sometimes within adverse socio-economic and societal conditions, where enacted and perceived stigma kept the individual and family members in a vicious loop of maladaptive coping patterns, dysfunctional family arrangements, and often leading to burnout with poor help seeking. The paper inform upon a framework that lays down the foundation for assessments, planning, case management and therapist competencies, required to address alcohol and drug issues in an Indian family context with such etiological factors at its heart. This paper will cover qualitative results of the interviews and present a model that may guide mental health professionals for treatment of adolescent substance use and family therapy.

Keywords: Indian families, family therapy, de-addiction, adolescent, youth, substance abuse, behavioral issues, felt needs, culture, etiology, model building, framework development, interviews

Procedia PDF Downloads 104

Authors: D. M. Lewis, L. Frisby, U. Stead

Abstract:

Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

Procedia PDF Downloads 81