Search results for: Older%20adults

Authors: Okafor UAC, Ibeabuchimn, Omidina JO, Igwesi-Chidobe CN, Akinbo SRA

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Purpose: The fear of falling is a major concern among the elderly. Sixty-five percent of individuals older than 60 years of age experience loss of balance often on a daily basis. Therefore, balance assessment in the elderly deserves special attention due to its importance in functional mobility and safety. This study aimed at assessing balance performance and comparing some anthropometric parameters among a Nigerian non-institutionalized elderly population.

Methods: Sixty one elderly subjects (31 males and 30 females) participated in this study. Their ages ranged between 62 and 84 years. Ability to maintain balance was assessed using Functional Reach Test (FRT) and Sharpened Romberg Test (SRT). Anthropometric data including age, weight, height, arm length, leg length, bi-acromial breadth, foot length and trunk length were also collected. Analysis was done using Pearson’s Product Moment Correlation Coefficient and Independent T-test, while level of significance was set as p<0.05.

Results: Age-related significant relationship was observed between balance performance and bi-acromial breadth among the elderly population. Gender and visual input also had a significant influence on balance performance. Other anthropometric variables (age, weight, height, arm length, leg length, foot length and trunk length) showed no significant relationship with balance performance among this elderly sample.

Conclusion: Only specific anthropometric variables may affect balance performances among the healthy elderly. The study further highlights the need for routine assessment of both static and dynamic balance to detect and appropriately manage aging-related diseases which could affect balance in the elderly.

Keywords: Balance Performance, Anthropometry, Non-institutionalized Elderly.

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Authors: Susana Oguntoye, Naana Otoo-Oyortey, Joanne Hemmings, Kate Norman, Eiman Hussein

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There is inadequate information on the practice of female genital mutilation (FGM) in the UK, and there are often myths and perceptions within communities that influence the effectiveness of prevention programmes. This means it is difficult to address the trends and changes in the practice in the UK. To this end, FORWARD undertook novel and innovative research using the Participatory Ethnographic and Evaluative Research (PEER) method to explore the views of women from Eritrea, Sudan, Somalia and Ethiopia that live in London and Bristol (two UK cities). Women-s views, taken from PEER interviews, reflected reasons for continued practice of FGM: marriageability, the harnessing and control of female sexuality, and upholding traditions from their countries of origin. It was also clear that the main supporters of the practice were believed to be older women within families and communities. Women described the impact FGM was having on their lives as isolating. And although it was clearly considered a private and personal matter, they developed a real sense of connection with their peers within the research process. The women were overwhelmingly positive about combating the practice, although they believed it would probably take a while before it ends completely. They also made concrete recommendations on how to improve support services for women affected by FGM: Training for professionals (particularly in healthcare), increased engagement with, and outreach to, communities, culturally appropriate materials and information made available and accessible to communities, and more consequent implementation of legislation. Finally, the women asked for more empathy and understanding, particularly from health professionals. Rather than presenting FGM as a completely alien and inconceivable practice, it may help for those looking into these women-s lives and working with them to understand the social and economic context in which the practice takes place.

Keywords: Female Genital Mutilation, FemaleCircumcision/Cutting, Participatory Research, PEER method.

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Authors: Omid F. Valilai, Mahmoud Houshmand

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Nowadays companies strive to survive in a competitive global environment. To speed up product development/modifications, it is suggested to adopt a collaborative product development approach. However, despite the advantages of new IT improvements still many CAx systems work separately and locally. Collaborative design and manufacture requires a product information model that supports related CAx product data models. To solve this problem many solutions are proposed, which the most successful one is adopting the STEP standard as a product data model to develop a collaborative CAx platform. However, the improvement of the STEP-s Application Protocols (APs) over the time, huge number of STEP AP-s and cc-s, the high costs of implementation, costly process for conversion of older CAx software files to the STEP neutral file format; and lack of STEP knowledge, that usually slows down the implementation of the STEP standard in collaborative data exchange, management and integration should be considered. In this paper the requirements for a successful collaborative CAx system is discussed. The STEP standard capability for product data integration and its shortcomings as well as the dominant platforms for supporting CAx collaboration management and product data integration are reviewed. Finally a platform named LAYMOD to fulfil the requirements of CAx collaborative environment and integrating the product data is proposed. The platform is a layered platform to enable global collaboration among different CAx software packages/developers. It also adopts the STEP modular architecture and the XML data structures to enable collaboration between CAx software packages as well as overcoming the STEP standard limitations. The architecture and procedures of LAYMOD platform to manage collaboration and avoid contradicts in product data integration are introduced.

Keywords: CAx, Collaboration management, STEP applicationmodules, STEP standard, XML data structures

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Authors: Md. Emaj Uddin

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Age and sex are biological terms that are socioculturally constructed for marriage and marital sexual behavior in every society. Marriage is a universal norm that makes legitimate sexual behavior between a man and a woman in marital life cycle to gain bio-social purposes. Cross-cultural studies reveal that marital sexual frequency as a part of marital sexual behavior not only varies within the couple-s life cycle, but also varies between and among couples in diverse cultures. The purpose of the study was to compare marital sexual frequency in association with age status and length of marital relationship between Muslim and Santal couples in rural Bangladesh. For this we assumed that (1) Santal culture compared to Muslim culture preferred earlier age at marriage for meeting marital sexual purposes in rural Bangladesh; (2) Marital duration among the Muslim couples was higher than that among the Santal couples; (3) Sexual frequency among the younger couples in both the ethnic communities was higher than the older couples; (4) Sexual frequency across the Muslim couples- marital life cycle was higher than that the Santal couples- marital life cycle. In so doing, 288 active couples (145 for Muslim and 143 for Santal) selected by cluster random sampling were interviewed with questionnaire method. The findings of Independent Samples T Test on age at marriage, current age, marital duration and sexual frequency independently reveal that there were significant differences in sexual frequency not only across the couples- life cycle but also vary between the Muslim and Santal couples in relation to marital duration. The results of Pearson-s Inter- Correlation Coefficients reveal that although age at marriage, current age and marital duration for husband and wife were significantly positive correlated with each other between the communities, there were significantly negative correlation between the age at marriage, current age, marital duration and sexual frequency among the selected couples between the communities.

Keywords: Bangladesh, Cross-Cultural Perspective, MaritalDuration, Muslim, Santal, Marital Sexual Frequency.

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Authors: Amirali Shirazibeheshti, Tarik Radwan, Alireza Ettefaghian, Farbod Khanizadeh, George Wilson, Cristina Luca

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Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. This work evaluates the association between the average risk score and measures of socioeconomic status (index of multiple deprivation) and health (index of health and disability). The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, suggesting that females are more at risk from this kind of multiple medication. The risk may be monitored and controlled in a healthcare management system that is well-equipped with tools implementing appropriate techniques of artificial intelligence.

Keywords: Anticholinergic medication, socioeconomic status, deprivation, clustering, risk analysis.

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Authors: Bujar Ismaili, Bahti Ismajli, Venhar Ismaili, Skender Ramadani

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In Kosovo, the problem with the electricity supply is huge and it does not meet the demands of consumers. Older thermal power plants, which are regarded as big environmental polluters, produce most of the energy. Our experiment is based on the production of electricity using the closed method that does not affect environmental pollution by using waste as fuel that is considered to pollute the environment. The experiment was carried out in the village of Godanc, municipality of Shtime, Kosovo. In the experiment, a production line based on the production of electricity and central heating was designed at the same time. The results are the benefits of electricity as well as the release of temperature for heating with minimal expenses and with the release of 0% gases into the atmosphere. During this experiment, coal, plastic, waste from wood processing, and agricultural wastes were used as raw materials. The method utilized in the experiment allows for the release of gas through pipes and filters during the top-to-bottom combustion of the raw material in the boiler, followed by the method of gas filtration from waste wood processing (sawdust). During this process, the final product, gas, is obtained. This gas passes through the carburetor, enabling the combustion process to put the internal combustion machine and the generator into operation and produce electricity that does not release gases into the atmosphere. The results show that the system provides energy stability without environmental pollution from toxic substances and waste, as well as with low production costs. From the final results, it follows that, in the case of using coal fuel, we have benefited from more electricity and higher temperature release, followed by plastic waste, which also gave good results. The results obtained during these experiments prove that the current problems of lack of electricity and heating can be met at a lower cost and have a clean environment and waste management.

Keywords: Energy, heating, atmosphere, waste management, gasification.

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Authors: Ian Heazlewood, Joe Walsh, Mike Climstein, Stephen Burke, Kent Adams, Mark DeBeliso

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Whilst there is growing evidence that activity across the lifespan is beneficial for improved health, there are also many changes involved with the aging process and subsequently the potential for reduced indices of health. The nexus between all forms of health, physical activity and aging is complex and has raised much interest in recent times due to the realization that a multifaceted approached is necessary in order to counteract a growing obesity epidemic. By investigating age based trends within a population adherring to competitive sport at older ages, further insight might be gleaned to assist in understanding one of many factors influencing this relationship. This study evaluated those sport psychological constructs of health, physical fitness, mental health states, and social dimension factors in sport that were associated with factors to participate in sport and physical activity based on responses from the 2009 World Masters Games in Sydney. The sample consisted of 7846 athletes who competed at the games and who completed a 56 item sports participation survey using a 7-point Likert response (1 - not important to 7 - very important). Questions focuses on factors thought to promote participation, such as weight control, living longer, improving mental health (self-esteem, mood states), improving physical health and factors related to the athlete-s competitive perspective. The most significant factors related to participation with this cohort of masters athletes were the socializing environment of sport, getting physically fit and improving competitive personal best performances. Strategies to increase participation in masters sport should focus on these factors as other factors such as weight loss, improving mental health and living longer were not identified as important determinates of sports participation at the World Masters level.

Keywords: masters sport, promoting participation, sport psychology.

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Authors: Sheel Chakraborty

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Modern society in developed countries has distanced itself from the earlier norm of joint family living, and with the increase of economic pressure, parents' availability for their children during their infant years has been consistently decreasing over the past three decades. This has been promoted in the US through the legislature and funding. Early care and education may have a positive impact on young minds, but a growing number of kids facing social challenges in making friendships in their teenage years raises serious concerns about its effectiveness. The survey-based primary research presented here shows that a statistically significant number of millennials between the ages of 10 and 25 years prefer to build friendships virtually than face-to-face interactions. Moreover, many teenagers depend more on their virtual friends whom they never met. Contrary to the belief that early social interactions in a non-home setup make the kids confident and more prepared for the real world, many shy-natured kids seem to develop a sense of shakiness in forming social relationships, resulting in loneliness by the time they are young adults. Reflecting on George Mead’s theory of self that is made up of “I” and “Me”, most functioning homes provide the required freedom and forgivable, congenial environment for building the "I" of a toddler; however, daycare or preschools can barely match that. It seems social images created from the “Me” perspective in preschoolers in a daycare environment has interfered and greatly overpowered the formation of a confident "I" thus created a crisis around the inability to form friendships face to face when they grow older. Though the pervasive nature of social media cannot be ignored, the non-parental early care and education practices adopted largely by the urban population have created a favorable platform of teen psychology on which social media popularity thrived, especially providing refuge to shy Gen-Z teenagers. This can explain why young adults today perceive social media as their preferred outlet of expression and a place to form dependable friendships, despite the risk of being cyberbullied.

Keywords: Digital socialization, shyness, developmental psychology, friendship, early education.

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Authors: Kaniknun Photchong, Phusit Phukamchanoad

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The objective of this research is to study the people’s level of participation in activities of the community, their satisfaction towards the community, the attachment they have to the community, factors that influence the attachment, as well as the characteristics of the relationships of military families’ of the Royal Guards community of Dusit District. The method used was non-probability sampling by quota sampling according to people’s age. The determined age group was 18 years or older.

One set of a sample group was done per family. The questionnaires were conducted by 287 people. Snowball sampling was also used by interviewing people of the community, starting from the Royal Guards Community’s leader, then by 20 of the community’s well-respected persons. The data was analyzed by using descriptive statistics, such as arithmetic mean and standard deviation, as well as by inferential statistics, such as Independent - Samples T test (T-test), One-Way ANOVA (F-test), Chi-Square. Descriptive analysis according to the structure of the interview content was also used. The results of the research is that the participation of the population in the Royal Guards Community in various activities is at a medium level, with the average participation level during Mother’s and Father’s Days. The people’s general level of satisfaction towards the premises of the Royal Guards Community is at the highest level.

The people were most satisfied with the transportation within the community and in contacting with people from outside the premises. The access to the community is convenient and there are various entrances. The attachment of the people to the Royal Guards Community in general and by each category is at a high level. The feeling that the community is their home rated the highest average. Factors that influence the attachment of the people of the Royal Guards Community are age, status, profession, income, length of stay in the community, membership of social groups, having neighbors they feel close and familiar with, and as well as the benefits they receive from the community. In addition, it was found that people that participate in activities have a high level of positive relationship towards the attachment of the people to the Royal Guards Community. The satisfaction of the community has a very high level of positive relationship with the attachment of the people to the Royal Guards Community.

The characteristics of the attachment of military families’ is that they live in big houses that everyone has to protect and care for, starting from the leader of the family as well as all members. Therefore, they all love the community they live in. The characteristics that show the participation of activities within the community and the high level of satisfaction towards the premises of the community will enable the people to be more attached to the community. The people feel that everyone is close neighbors within the community, as if they are one big family.

Keywords: Activities, Attachment, Community, Royal Guards, Satisfaction.

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Authors: Daniele Traversaro

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Problem: Senior citizens have been facing a challenging reality as a result of strict public health measures designed to protect people from the COVID-19 outbreak. These include the risk of social isolation due to the inability of the elderly to integrate with technology. Never before have Information and Communication Technology (ICT) skills become essential for their everyday life. Although third-age ICT education and lifelong learning are widely supported by universities and governments, there is a lack of literature on which teaching strategy/methodology to adopt in an entirely online ICT course aimed at third-age learners. This contribution aims to present an application of the Think-Pair-Share (TPS) learning method in an ICT third-age virtual classroom with an intergenerational approach to conducting online group labs and review activities. Research Question: Is collaborative learning suitable and effective, in terms of student engagement and learning outcomes, in an online ICT course for the elderly? Methods: In the TPS strategy a problem is posed by the teacher, students have time to think about it individually, and then they work in pairs (or small groups) to solve the problem and share their ideas with the entire class. We performed four experiments in the ICT course of the University of the Third Age of Genova (University of Genova, Italy) on the Microsoft Teams platform. The study cohort consisted of 26 students over the age of 45. Data were collected through online questionnaires. Two have been proposed, one at the end of the first activity and another at the end of the course. They consisted of five and three close-ended questions, respectively. The answers were on a Likert scale (from 1 to 4) except two questions (which asked the number of correct answers given individually and in groups) and the field for free comments/suggestions. Results: Groups achieve better results than individual students (with scores greater than one order of magnitude) and most students found TPS helpful to work in groups and interact with their peers. Insights: From these early results, it appears that TPS is suitable for an online third-age ICT classroom and useful for promoting discussion and active learning. Despite this, our work has several limitations. First of all, the results highlight the need for more data to be able to perform a statistical analysis in order to determine the effectiveness of this methodology in terms of student engagement and learning outcomes as future direction.

Keywords: Collaborative learning, information technology education, lifelong learning, older adult education, think-pair-share.

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Authors: N. Mirzaei Varzeghani, M. Saffarzadeh, A. Naderan, A. Taheri

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Countries are progressing, and the world's busiest airports see year-on-year increases in travel demand. Passenger acceptability of an airport depends on the airport's appeals, which may include one of these routes between the city and the airport, as well as the facilities to reach them. One of the critical roles of transportation planners is to predict future transportation demand so that an integrated, multi-purpose system can be provided and diverse modes of transportation (rail, air, and land) can be delivered to a destination like an airport. In this study, 356 questionnaires were filled out in person over six days. First, the attraction of business and non-business trips was studied using data and a linear regression model. Lower travel costs, more passengers aged 55 and older using this airport, and other factors are essential for business trips. Non-business travelers, on the other hand, have prioritized using personal vehicles to get to the airport and ensuring convenient access to the airport. Business travelers are also less price-sensitive than non-business travelers regarding airport travel. Furthermore, carrying additional luggage (for example, more than one suitcase per person) undoubtedly decreases the attractiveness of public transit. Afterward, based on the manner and purpose of the trip, the locations with the highest trip generation to the airport were identified. The most famous district in Tehran was District 2, with 23 visits, while the most popular mode of transportation was an online taxi, with 12 trips from that location. Then, significant variables in separation and behavior of travel methods to access the airport were investigated for all systems. In this scenario, the most crucial factor is the time it takes to get to the airport, followed by the method's user-friendliness as a component of passenger preference. It has also been demonstrated that enhancing public transportation trip times reduces private transportation's market share, including taxicabs. Based on the responses of personal and semi-public vehicles, the desire of passengers to approach the airport via public transportation systems was explored to enhance present techniques and develop new strategies for providing the most efficient modes of transportation. Using the binary model, it was clear that business travelers and people who had already driven to the airport were the least likely to change.

Keywords: Multimodal transportation, travel behavior, demand modeling, statistical models.

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Authors: Dhruv Sharma, Lynne Blair, Stephen Clune

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Later life loneliness is a social issue that is increasing alongside an upward global population trend. As a society, one way that we have responded to this social challenge is through developing non-pharmacological interventions such as befriending services, activity clubs, meet-ups, etc. Through a systematic literature review, this paper suggests that currently there is an underrepresentation of radical innovation, and underutilization of digital technologies in developing loneliness interventions for older adults. This paper examines intervention studies that were published in English language, within peer reviewed journals between January 2005 and December 2014 across 4 electronic databases. In addition to academic databases, interventions found in grey literature in the form of websites, blogs, and Twitter were also included in the overall review. This approach yielded 129 interventions that were included in the study. A systematic approach allowed the minimization of any bias dictating the selection of interventions to study. A coding strategy based on a pattern analysis approach was devised to be able to compare and contrast the loneliness interventions. Firstly, interventions were categorized on the basis of their objective to identify whether they were preventative, supportive, or remedial in nature. Secondly, depending on their scope, they were categorized as one-to-one, community-based, or group based. It was also ascertained whether interventions represented an improvement, an incremental innovation, a major advance or a radical departure, in comparison to the most basic form of a loneliness intervention. Finally, interventions were also assessed on the basis of the extent to which they utilized digital technologies. Individual visualizations representing the four levels of coding were created for each intervention, followed by an aggregated visual to facilitate analysis. To keep the inquiry within scope and to present a coherent view of the findings, the analysis was primarily concerned the level of innovation, and the use of digital technologies. This analysis highlights a weak but positive correlation between the level of innovation and the use of digital technologies in designing and deploying loneliness interventions, and also emphasizes how certain existing interventions could be tweaked to enable their migration from representing incremental innovation to radical innovation for example. This analysis also points out the value of including grey literature, especially from Twitter, in systematic literature reviews to get a contemporary view of latest work in the area under investigation.

Keywords: Loneliness, ageing, innovation, digital.

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Authors: Mustafa M. Donma, Orkide Donma

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Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.

Keywords: Blood pressure, children, index, metabolic syndrome, obesity.

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Authors: Chrysoula Karathanasi, Senad Karavdic, Angela Odero, Michèle Baumann

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It is not only the economic determinants that impact on life conditions, but maintaining a good level of life satisfaction (LS) may also be an important challenge currently. In Luxembourg, university students receive financial aid from the government. They are then registered at the Centre for Documentation and Information on Higher Education (CEDIES). Luxembourg is built on migration with almost half its population consisting of foreigners. It is upon this basis that our research aims to analyze the associations with mental health factors (health satisfaction, psychological quality of life, worry), perceived financial situation, career attitudes (adaptability, optimism, knowledge, planning) and LS, for non-Luxembourgish and native postgraduate students. Between 2012 and 2013, postgraduates registered at CEDIES were contacted by post and asked to participate in an online survey with either the option of English or French. The study population comprised of 644 respondents. Our statistical analysis excluded: those born abroad who had Luxembourgish citizenship, or those born in Luxembourg who did not have citizenship. Two groups were formed one consisting 147 non-Luxembourgish and the other 284 natives. A single item measured LS (1=not at all satisfied to 10=very satisfied). Bivariate tests, correlations and multiple linear regression models were used in which only significant relationships (p<0.05) were integrated. Among the two groups no differences were found between LS indicators (7.8/10 non-Luxembourgish; 8.0/10 natives) as both were higher than the European indicator of 7.2/10 (for 25-34 years). In the case of non-Luxembourgish students, they were older than natives (29.3 years vs. 26.3 years) perceived their financial situation as more difficult, and a higher percentage of their parents had an education level higher than a Bachelor's degree (father 59.2% vs 44.6% for natives; mother 51.4% vs 33.7% for natives). In addition, the father’s education was related to the LS of postgraduates and the higher was the score, the greater was the contribution to LS. Whereas for native students, when their scores of health satisfaction and career optimism were higher, their LS’ score was higher. For both groups their LS was linked to mental health-related factors, perception of their financial situation, career optimism, adaptability and planning. The higher the psychological quality of life score was, the greater the LS of postgraduates’ was. Good health and positive attitudes related to the job market enhanced their LS indicator.

Keywords: Career attitudes, fathers’ education level, life satisfaction, mental health.

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Authors: Nomataru P. Gontse, Lavanithum Joseph

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Deafness coupled with a lack of support and resources in developing countries poses a serious threat to the well- being of children. The mismatch between the needs of persons with disabilities and the resources available to them is a key factor in service provision in resource constrained contexts. Furthermore, deafness in children is the most common childhood sensory disorder in developing countries, and as such seriously affected with regard to resource constraints. This paper discusses the issues and research protocol for a Ph.D. study that aims to develop a practice guideline that is contextually sensitive and includes an interdisciplinary approach that will improve the outcomes of learners and the relationships in hearing households with deaf learners in rural areas of the Eastern Cape, one of the poorest provinces in South Africa. The guideline developed will consider the lived experiences of deaf children and their hearing families on the impact deafness has on their relationships and communication at home. Ethical clearance for the study has been obtained. The methodology is a mixed-methods approach in the form of a survey using questionnaires and semi-structured interviews with deaf learners in primary and high school and their hearing parents to get their perspective on the impact deafness has on their relationships and communication at home. The study is conducted using adolescent learners from Grades 7 to 12 (excluding learners younger than 12 years and older than 21 years). An audiologist, teachers, and support staff will also give their views on how the intervention is currently done and possible suggestions on how management can be done differently. Data collection will be conducted in isiXhosa by the researcher, as isiXhosa is dominant in this region. The interviews will be conducted in South African Sign Language by the sign language interpreter for deaf learners and educational professionals. An expected outcome for this study is the development of recommendations and a practice guideline for deaf children diagnosed late from rural or under-resourced environments. To ensure the implementation of the findings, in the end, professionals will be given feedback on the outcomes of the study so that they can identify areas within their practices that require updated knowledge. The developed guideline is expected to have an impact on the Department of Education policies both regionally and nationally, providing recommendations for a strategic management plan and practice guidelines for this vulnerable and marginalized population. The IsiXhosa specific context could be generalized to other similar contexts.

Keywords: Deafness, family-centred approach, early identification, rural communities.

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