High Diploma Research Articles

Difficulties of Scientific research facing educational supervisors in Directorates of education of Irbid Governorate from their point of view

The study aimed to identify difficulties of scientific research facing educational supervisors in Directorates of education of Irbid Governorate from their point of view. The study sample consisted of (226) male and female supervisors. To achieve the objectives of the study, the inferential and descriptive analysis method was adopted. A questionnaire consisted of (27) items, where its validity and reliability were verified. To achieve the objectives of the study, the Statistical Package for the Social Sciences (SPPS) was used such as frequencies and percentages, arithmetic means, standard deviations, Cronbach’s Alpha, MANOVA and ANOVA tests. Through referring to the results, we find the arithmetic mean value of difficulties of scientific research facing educational supervisors in Directorates of education of Irbid Governorate was 4.49, which is considered a high value referring to the scale used in the study. The results also revealed statistical significance differences among means of the study population individuals about difficulties facing educational supervisors in Directorates of education of Irbid Governorate, and these differences are due to female supervisors where their mean was bigger than the males’ which reached 4.55. The results showed that were statistical significance differences among supervisors of high diploma. The results also showed that there were statistical significance differences among supervisors whose experience in supervision is less than 5 years.

High diploma students’ perceptions of justice and its correlation with organisational commitment

This study reveals the correlations between high diploma student’s perceptions of the level of organisational justice exhibited by Jordanian school principals and their own level of organisational commitment. To achieve these objectives, the researchers employed a descriptive correlation design. A 44-item questionnaire comprising four fields was administered to a sample of (354) high diploma students working as teachers in (15) public schools. The results show there is evidence of perceived justice and a high level of commitment among teachers; additionally, it identified a strong connection between teachers’ commitment and all aspects of organisational justice. These findings have implications for Jordanian school administration; accordingly, the researchers propose relevant recommendations for further investigation. Keywords: organisational justice (OJ); organisational commitment (OC); high diploma

10 minutes with Kelly Garside, Team Manager, Community Child and Adolescent Mental Health Service, Oxford Health Foundation Trust

![Graphic][1]</img> ### Biography Kelly Garside is a registered mental health nurse who graduated with Distinction in a Higher Diploma in Mental Health Nursing in 1997 and obtained her BSc (Hons)...

Agricultural Robots for Harvesting and Planting

The agricultural sector is at the forefront of technological innovation, seeking sustainable solutions to address the increasing demand for food production in the face of population growth and environmental challenges. Agricultural robots have emerged as a transformative force, revolutionizing traditional farming practices, with a particular focus on harvesting and planting operations. This paper provides a comprehensive review of the current landscape of agricultural robots, exploring their applications, technological advancements, benefits, challenges, and prospects. &#x0D; In recent years, the agricultural industry has witnessed a paradigm shift with the introduction of various types of robots designed to streamline and enhance harvesting and planting processes. These robots include drones equipped with advanced sensors, robotic arms for precise harvesting, and autonomous vehicles for efficient planting. The integration of these technologies aims to optimize resource utilization, reduce labour costs, and mitigate the environmental impact of farming practices.&#x0D; Harvesting robots play a pivotal role in precision agriculture, employing technologies such as computer vision and machine learning to identify ripe crops and execute precise harvesting manoeuvres. Case studies showcasing successful implementations of robotic fruit and vegetable harvesting underscore the potential for increased efficiency and reduced post-harvest losses. &#x0D; In the realm of planting, agricultural robots demonstrate their prowess through automated seeding and transplanting processes. These technologies contribute to precision planting, ensuring optimal spacing and depth for seeds, leading to improved crop yields. The paper delves into the specific applications and advancements in planting robots, losing light on their position in reshaping traditional planting methodologies. &#x0D; Technological improvements in sensing and imaging technologies, in addition to navigation and control structures, were pivotal within the evolution of agricultural robots. Real-time records analysis the usage of sensors and cameras, coupled with self-reliant navigation structures, allows these robots to perform with a high diploma of precision, contributing to the general achievement of automatic farming structures. &#x0D; While agricultural robots provide a myriad of benefits, consisting of extended productivity and reduced hard work costs, demanding situations persist. High preliminary expenses, ethical concerns, and the mixing with existing agricultural practices pose hurdles to large adoption. The paper severely examines these challenges, emphasizing the need for a holistic method to address financial, ethical, and social dimensions. &#x0D; Looking forward, the future of agricultural robots holds thrilling possibilities. Emerging technology, which include the mixing of robotics with the Internet of Things (IoT) and the capability of swarm robotics, promise similarly advancements. The sustainability and environmental effect of those technology also are explored, with a focus on minimizing ecological footprints and selling eco-friendly agricultural practices. &#x0D; In end, this studies paper affords a complete overview of the modern-day kingdom of agricultural robots in harvesting and planting operations. By inspecting the packages, blessings, challenges, and future possibilities, the paper contributes to the continued speak surrounding the integration of superior technology in agriculture, paving the manner for a extra sustainable and green destiny in meals production.

The Role of the Public Policy Network in Making and Implementing Anti-Corruption Policies in Palestine

As a result for the official and unofficial interactions between many effective sides on both local and central levels, and as a result for the well of the policies network within its different parts such as the legislative council, civil society organizations, financial and administrative audit office, authors, parities and citizens as well as foreign parts such as the international bank and some donating countries, the polices networks started to develop itself and started to work in cooperation with other parties. The networks accomplished all stages in the absence of the legislative council from 2008 till 2019. However, the result of its accomplishments started with short term plans from 1998-2010, in the last year the corruption law as announced, the anti-corruption commission was established. Therefore, the three pillars of anti-corruption were completed including prosecution and anti - corruption court as a type of judicial independence. The Anti-Corruption Law and Strategy has become a systematic policy in all Palestinian public sector institutions. In mid-2019, the PAA obtained a license from the Palestinian Ministry of Higher Education to open the Anti-Corruption Academy for Higher Education, which follows the vision and objective of the Anti-Corruption Commission, which is administratively independent, which will grant a Master&amp;#39;s degree and a higher diploma to its members. Thus, we can note the integrated role of the Anti-Corruption Policy Network from implementation to evaluation.

The Drug Overdose Epidemic Seen through Different Lenses

Background: The age-adjusted death rate from drug overdoses in the United States per 100,000 individuals rose from 6.8 in 2010 to 17.1 in 2018. The most common explanation offered is the “deaths of despair†hypothesis. We identify additional factors that have contributed to the rise in drug overdose deaths in cities and counties. Methods: We utilize a period fixed effects model with a multi-variate panel data set for 94 independent cities and counties in Virginia for the period 2008 through 2017. Results: The drug overdose mortality rate is: (a) an increasing function (prob. <.05) of the percentages of the population that smoke, are obese, are White, are incarcerated, are receiving SNAP payments, have earned a high diploma, and are employed in mining, as well as the average minutes workers must travel to their jobs and the number of prescriptions written; and, (b) a decreasing function (prob. < .05) of median household income, population density, and the degree of market concentration of pharmacies filling drug prescriptions. We provide estimates of the percent change in the drug overdose death rate one can expect in response to changes in each of these factors - information highly useful to decision-makers. Conclusions: Although the “deaths of despair†hypothesis has a degree of empirical validity, multidisciplinary analysis reveals that oft-neglected factors, including commuting time, local pharmacy market structures, prescription practices, and prevalence of SNAP payments, also have a major impact on drug overdose death rates. The factors influencing drug overdose mortality are much more complex than the deaths of despair hypothesis suggests.

The effect of blended learning on the achievement of HDE students in the methods of teaching Arabic language course and their attitudes towards its use at Ajman University: A case study

The UAE Ministry of Education strives to use modern technological and educational methods to teach students in higher education institutions and to assure high-quality education. This study aims to investigate the effects of the use of blended learning on the achievements of students in a higher diploma in education (HDE) course at Ajman University. It compares the results of different ways of teaching the ‘Methods of Teaching the Arabic Language course’, and students’ attitudes towards their use. The study was conducted using a quasi-experimental design case study. The participants of the study were 94 students, divided into two groups of equal sizes (n = 47): one an experimental group and the other a control group. An achievement test and questionnaire were designed to confirm the study’s validity and reliability. SPSS was used to analyze the data. The findings revealed that there were statistically significant differences between the experimental and the control groups, in favor of the experimental group teaching method and students of this experimental group have attitudes have positive towards the using of blended learning. Their attitudes were in favor of the students with academic evaluation (GPA 3.5–4), Computer skills (Students with excellent computer skills) and finally, there was no statistical significance according to teaching experience. The study recommends further research into using blended learning in higher education institutions.

Evaluation of Cardiopulmonary Resuscitation Knowledge and Its Impact on Practice Among Clinicians at a County Referral Hospital in Kenya

Background: Cardiopulmonary resuscitation (CPR) is a life-saving emergency procedure that ensures oxygen and blood supply in a victim who have had heart and/or breathing stoppage thereby maintaining the viability of vital organs until professional help arrives. All the health care workers should have adequate knowledge and skills to perform the procedure with ease in case of cardiac arrest. Sudden cardiac death in the western countries ranges from 300,000 to 400, 000 annually. This represents 0.36 to 1.28 per 1000 population in Europe and the United States. American Heart Association approximates that 100000 to 200000 adult lives could be saved annually if CPR is initiated early enough. The outcome of a patient with a cardiac event is determined by the knowledge and skills of the resuscitator and the promptness in which the procedure is instituted and the nature of the patient condition among others. Objective: To evaluate CPR knowledge and its impact on practice amongst clinicians working at Coast General Hospital, Mombasa Kenya. Methods: A descriptive cross sectional study was carried at the hospital in 2015 where a questionnaire was administered to 91 nurses, 27 clinical officers and 24 doctors. Results: The study comprised of 142 clinicians; 63.8% (n=90) nursing officers, 19.1% (n=27) clinical officers and 17.1% (n=24) medical officers. Their levels of training were; 57.4% (n=81) diploma, 25.5% (n=36) bachelors degree, 12.8% (n=18) higher diploma, 2.8% (n=4) certificate, and 1.4% (n=2) masters degree. The level of training was significant ( P =0.04) on the way they rated their CPR practices. It’s only a quarter of the clinicians who trained CPR at their respective colleges. A majority 68.8% (n=97) had trained on CPR and the training was significant ( P =0.000) on the way they rated their CPR practices. Three quarters 75.9% (n=104) were scored below average on specific aspects on CPR knowledge. This was significant ( P =0.001) on their rating of CPR practices. A third 33.3% (n= 47) of the clinicians had taken more than three years since their last training. This significantly ( P =0.000) affected the way they rated their CPR practices. Conclusion : The CPR practices at Coast General Hospital are significantly affected by the clinicians’ knowledge. The hospital administration needs to plan for frequent refresher trainings for all the staff. Professional bodies need to encompass CPR CPD points as a requirement to renewing practicing licences. Keywords : Cardiopulmonary Resuscitation (CPR), Cardiac arrest, Clinician, Coast General Hospital, CPD (continuing profession development) DOI : 10.7176/IKM/9-7-04 Publication date : August 31 st 2019

STUDENT AND TEACHER PERSPECTIVES ON FACTORS TO SUCCESS AND ATTRITION IN ENGINEERING MINI-MOOC USING TECHNOLOGY ACCEPTANCE MODEL (TAM)

Purpose: To keep abreast of the latest educational development and to enrich student learning. Vocational Training Council (VTC) is among the first vocational institutions in Hong Kong for piloting massive open online courses (MOOCs) (which are being referred as mini-MOOCs here) on various disciplines. This paper examines one of the mini-MOOCs we have developed for the Engineering discipline. The aim of this study is to gather information and investigate the influencing factors that contribute to the success and attrition in the Engineering mini-MOOC.&#x0D; Methodology: These insights come from the empirical study conducted in a mini-MOOC titled “Unauthorized Buildings Works” (UBWs), which was being implemented as a blended activity in the module. Two groups of second-year students from the higher diploma in construction were selected to participate in non-MOOC (i.e., the control group) and MOOC (i.e., the experimental group) classes over two years. The mini-MOOC subjects were invited to complete questionnaires and attend a focus group interview upon completion of the activity.&#x0D; Main Findings: The analysis yielded striking results, which led to a discussion on the contributing factors to success and attrition in the Engineering mini-MOOC using Technology Acceptance Model (TAM).&#x0D; Implications: Due to limited resources in the research, the methods of data collection were different over two years of study. An implication of this is that an enhanced methodology is needed to determine the academic effectiveness of the mini-MOOC and achieve the consistency of the findings.&#x0D; Novelty/Originality: The present study contributes to significant findings in how TAM factors and external variables influenced the usage of mini-MOOC from the perspectives of both learners and teachers.

Vocational Pedagogies for the Formation and Training of Early Childhood Educators: Perspectives of VET Lecturers and Level 5 Early Years Learners

This paper examines the kind of pedagogical approaches used in Higher Vocational Education, more specifically initial training programmes for early-years practitioners, from the perspectives of both VET lecturers and students currently involved or enrolled in these programmes. The focus is on understanding the ways in which the pedagogical models and tools adopted carefully match the requirements for the successful formation of early-years professionals. More specifically, this paper seeks to explore and understand the factors that influence the vocational pedagogical strategies used, the extent to which these pedagogies are learner-centred, the opportunities and challenges that Higher VET lecturers experience in their classrooms when embracing pedagogical innovation, the benefits for learners, as well as the impact on the quality of the training provided. Adopting a grounded theory methodology, with the aim of building theoretical ideas grounded in the data, two main data collection methods were used: one-to-one semi-structured interviews with a group of VET lecturers and a focus group with a group of Level 5 early-years learners who at the time of the study were in the process of completing the two-year higher diploma. Through a process involving inductive-abductive logic and the constant comparison, coding, and analysis of the data, a theoretical model of vocational pedagogies for the training and formation of early childhood educators emerged. The findings indicate the need for clear pedagogical direction and informed choices to be made individually and collectively by the team of lecturers teaching the programme; this requires the presence of an ethos and climate of critical reflective practice and life-long learning through the creation or seeking of opportunities for continuous professional development. Its relevance becomes more pronounced in the context of a training programme that prepares future educators as there is a greater application of the pedagogy used at higher vocational training level for its transfer to early-years classrooms and settings. The role of the VET lecturer as a role model is highlighted as being significant in the formation and training of early childhood educators by both sets of participants. The current pedagogical picture portrays a situation where different lecturers adopt different pedagogical approaches that range from the traditional, teacher-focused ones to more innovative, participatory, and practice-based strategies. There is a consensus about the validity of adopting more learner-centred, hands-on pedagogical approaches though this is usually influenced by contextual, cultural-historical, and philosophical factors. The topical debate on professionalizing the Early Years sector is also reflected in the data and seems to influence expectations that both lecturers and learners have on the quality of the programme and the need for more focused exploration of effective vocational pedagogies. The importance of a strategic plan on the relevance and advancement of the teaching and learning practices within the vocational training programmes is highlighted.

The role of the principal of the secondary school in activating extra-curricular activities in Sharorah province

The study aimed to identifying the role of the principal of the secondary schools in Sharorah province in activating the extra-curricular activities from the point of view of the teachers based on the variables (degree and practical experience). To achieve these goals, the researchers used the analytical descriptive method through a questionnaire including (22) items which was designed for this purpose and distributed to a study sample of (104) teachers, from the population of the study: (184).The results of the study showed that the degree of the Secondary Schools Principal's role was high, according to the level of the items, (13) items were very high, (2) were high, (3) items were intermediate level, and (1) item was low level, and (3) items were very low level. There was a statistically significant difference due to the variety of scientific qualification variable in favor of high diploma and there was a statistically significant difference due to the teaching experiences and for their experience from four years and more. With the Based of the results, a number of recommendations were presented to activate the role of the secondary schools principal's in Extra- curricular activities in Sharorah province and the Saudi as a whole.

An exploration of Higher Diploma Program (HDP) Trained Instructors Implementation Competencies in their Classroom Instruction

An exploration of Higher Diploma Program (HDP) Trained Instructors Implementation Competencies in their Classroom Instruction

درجة تطبیق إدارة المخاطر لدى قادة المدارس الحکومیة فی منطقة القصیم

Degree of the risk management application from the publicschools leaders in Qassim This study aimed to determine the degree of the risk management applicationfrom the public schools leaders in Qassim. The sample consists of (456) schoolleaders. To achieve the objectives of the study, a questionnaire was prepared, itsvalidity and reliability were confirmed. It contains (33) items divide into threedomains: the planning of the risk management, the risk managementimplementation and the risk management evaluation. The results of the studyshow that the degree of the risk management application from the public schoolsleaders is medium in the following order: the risk management implementation,the planning of the risk management and finally the risk managementevaluation. The study reveals statistically significant differences between themeans of the sample responses at the risk management application according tothe experience variable for the school leaders (from 5 to less than 10 years)experience, according to the academic qualification variable for the schoolleaders with (high diploma), and according to the school stage variable for theleaders of (primary schools). The study recommends organizing trainingprograms for middle and high school leaders in Qassim to raise their awarenessof planning, implementation and evaluation the risk management.

Evaluating role of individuals’ subjective career success in organization

This study examines the factors affecting individuals’ subjective career success based on the sponsor and contest mobility of career success (Turner, 1960; Rosenbaum, 1984). Authors this study tests hypotheses about the relations between organizational sponsorship, external marketability, person-organization fit, subjective career success, and life satisfaction. Therefore, managers and leaders know how to motivate their employees toward career achievement. To achieve this goal, authors use confirmatory factor analysis (CFA) and structural equation model (SEM) to examine all of the three perspectives individual structural, and behavioral-in which the individual and behavioral approaches belong to the contest-mobility model of career success while the structural one belongs to the sponsored-mobility model. Research findings indicate that organizational sponsorship and external marketability make significant impacts on subjective career success and these relationships are positive. This study also examines a number of personal information like gender, marital status, age, highest diploma, and occupation, number of working years, and monthly salary when it comes to perceived career success. In addition, subjective career success also positively affects life satisfaction. The findings have important practical implications for managers and leaders who generally seek to motivate their employees toward career achievement.

The Extent to Which Resource Room Teachers Making Use of Visual Organizations to Teach Students with Learning Disabilities

This study aimed at revealing the reality of teacher&amp;rsquo;s use of learning resources rooms of graphic organizers in teaching students with learning disabilities, and the difficulties the teachers face while teaching these students. The study sample consisted of 83 of resource room teachers in Irbid Directorates of Education schools, to achieve the goals of the study, a questionnaire of 28 items was developed; 16 were used to reveal the reality of teachers&amp;rsquo; use of learning resources, 12 items were used to reveal the difficulties that limit the teachers&amp;rsquo; use of learning resource rooms of graphic organizers. The study also attempted to find the effect of certain variables such as gender, scientific qualifications and years of experiences on the teachers&amp;rsquo; use of learning resource rooms of graphic organizers in teaching students with learning disabilities. The results of the study revealed the following: 1) In terms of the use of graphic organizers, the average of the means was 2.13 with a low level, and in the terms of difficulties, the average of the means was 2.77 with a high level. 2) There were significant differences among the means due to gender and in favor of males; due to level of qualifications and in favor of high diploma and, master degree; and due to years of teaching experiences and in favor of those who taught more than 10 years. The study reported certain recommendations for professionals and researchers.

An investigation on the professionalization of education in Maritime logistics and supply chains

PurposeThis paper aims to investigate the development of logistics and supply chain education through conducting comparative study between high diploma and associate degree. This study will critically review the added value of sub-degree courses of professional education. What exactly drives sub-degree students to enroll for a high diploma and associate degree program in maritime logistics and supply chain studies? How do they select to enroll such programs? Do such programs foster the students to equip in the professions? What do they look for obtaining professional status afterwards?Design/methodology/approachTo address the stated queries, this study will analyze students’ evaluation of the effectiveness of sub-degree education and their motivation on enrolling these courses through a questionnaire survey.FindingsIn the context of higher education, sub-degrees of professional studies experienced tremendous growth in recent decades. Many academic institutions have recorded an upward trend in providing professional education on subjects that traditionally focused on apprentice-style, non-academic learning approach. However, the reasons behind the steady growth of the demand of sub-degree level of professional education have been under-researched.Research limitations/implicationsThis research is based on Hong Kong data only.Originality/valueThe paper not only increases the scope and depth of research area in logistics and supply chain education but also contributes theoretically to the understanding on the curriculum of sub-degree logistics and supply chain programs.

ANALISIS MODEL NAIVE BAYES UNTUK IDENTIFIKASI PENGGOLONGAN DAYA LISTRIK DI KOTA LHOKSUMAWE

Electricity subsidy is provided for all 450 VA power household customers and 900 VA power household customers who are poor and disadvantaged. However, there are many facts that household customers with 450 VA power are capable and 900 VA power household customers consist of capable households, boarding houses or luxury rented. Households are able to use more electricity than poor households. This paper describe to the identification of household customers' electrical power in the Lhokseumawe city to facilitate PLN in classifying customer power by using the Naive Bayes method. Naive bayes value variables used in this study are: monthly income, highest diploma, last job, house area, subscription fee and government registered household. The classification of household customer power is grouped into three categories, namely low (450 VA down), medium (900 VA) and high (above 1300 VA).. Based on household customer data that is used as training data, the Naive Bayes method is able to classify the customer data tested. So the Naive Bayes method successfully predicts the magnitude of the probability of household electrical power with an accuracy percentage of 80%.Keywords: Electricity, Naive Bayes, CBS, low birth weight, subsidy

Impact of the foundation program and high school grade in predicting the cumulative grade point average (CGPA) among the graduates of the nursing program at the Ministry of Health Educational Institutes in Oman

Background and objective: Higher education has witnessed significant changes in order to provide quality education that meets the needs of the 21st century. To be in par with international best practices, the foundation program was established to prepare the high school leavers for higher education in Oman, a middle-eastern country. The aims of this study were to (1) assess the relationship between students’ high school scores and their cumulative grade point average (CGPA) among the graduates of the nursing program in Oman, and (2) compare the CGPA of the student who attended the general foundation program (GFP) compared to the ones who did not attend the GFP. Methods: Secondary data analysis approach was used to access the alumni files one year before and one year after the implementation of the GFP. A retrospective approach was used to gather data from the alumni files, which included high school grade, whether the graduates have attended the foundation program or not, their first year Grade point average (GPA), and their CGPA.Results: Six hundred twenty-seven (n = 627) graduates were recruited from two cohorts, one attended the GFP (n = 287; 45.8%) and the others did not attend the GFP (n = 340; 54.2%). Majority of the participants who were included in this study were female graduate (n = 535; 85.3%). The students who attended the GFP were found to have higher first year GPA and higher CGPA compared to those who did not attend the GFP. High Diploma Scores and First Year GPA were significant predictors of the graduation CGPA of the graduates who did not enroll in the GFP whereas First Year GPA was the main predictors of the CGPA of the graduates who attended the GFP. It was also obvious that the first year GPA showed a higher significant correlation with CGPA among GFP attenders (r = 0.912, p &lt; .01) in comparison to non GFP attenders (r = 0.775, p &lt; .01).Conclusions: This study sheds light into the impact of foundation program on the overall students’ performance in the nursing program. It significantly reveals that GFP, has a positive impact on the overall CGPA, as it equipped the students with the necessary study skills and increased their English proficiency levels.

Individual and neighbourhood socioeconomic disparities and high blood pressure in France: Results from a cross-sectional analysis of the CONSTANCES cohort

Introduction The influence of socioeconomic status (SES) on cardiovascular outcomes has already been well-established. Lower income, lower education or manual occupation are associated with a higher prevalence of cardiovascular risk factors such as high blood pressure (HBP) as well as with cardiovascular mortality. Neighborhood factors, such as the affluence of the area of residence have also been associated with cardiovascular diseases. However, few studies have been able to analyze jointly the influence of individual and neighborhood SES on the prevalence of HBP. We aimed to do so using a large sample of French adults. Methods Participants are randomly selected adults aged 18 to 69 recruited to the CONSTANCES cohort between 2012 and 2015. Information on lifestyle was collected by a self-administered questionnaire. Blood pressure (BP) was measured in 16 recruitment centers using a standardized protocol. HBP has been defined as BP over 140/90 mmHg and/or taking antihypertensive medication as indicated by matched records from the national database or reimbursements from the French health insurance. SES has been defined at an individual-level using education and at a neighborhood-level through an indicator of socioeconomic deprivation of the area of residence (FDep), divided in quintiles in this study. Analyses were stratified by gender. We first calculated prevalence of HBP according to individual and neighborhood variables separately. We then performed three-level logistic regressions (recruitment center, neighborhood, individual) to analyze jointly the influence of individual and neighborhood SES on the prevalence of HBP, taking into account the specific structure of the data. Results A total of 63,627 individuals (53% women) recruited between 2012 and 2015 were included in the analyses. Mean age in men and women was 48.8 ± 13.3 years and 47.2 ± 13.5 years, respectively. In this sample, 19,383 individuals were classified hypertensive, so the crude prevalence of HBP was 30.5%. Using 2016 French population as reference, standardized prevalence of HBP was 27.5% [95% CI: 27.1–27.8], higher among men (33.8% [95% CI: 33.2–34.5%]) than women (21.3% [95% CI: 20.8–21.8%]). Prevalence increased with age, from 9.5% in 18–34 years to 63.5% in people aged 65 years and more. Prevalence of HBP strongly differed according to the education level in all age groups in both gender. For instance in women with no diploma, prevalence of HBP increased from 10% among 18–34 years to 65% among 65–70 years compared with 4% to 46% in women with highest diploma. The corresponding age-adjusted odds ratios (OR) for prevalence of HBP comparing the lowest versus highest level of education were 2.22 [95% CI: 2.00–2.50] in women and 1.82 [95% CI: 1.67–2.00] in men. Regarding neighborhood, living in more deprived areas was associated with a higher prevalence of HBP in women and men. Age-adjusted ORs for prevalence of HBP comparing the most versus least deprived quintile of areas of residence were 1.61 [95% CI: 1.47–1.75] in women and 1.69 [95% CI: 1.56–1.85] in men. In models including both individual and neighborhood indicators, OR comparing the lowest versus highest level of education were 2.09 [95% CI: 1.87–2.34] in women and 1.70 [95% CI: 1.53–1.88] in men. OR for prevalence of HBP comparing the most versus least deprived quintile of areas of residence were 1.25 [95% CI: 1.11–1.41] in women and 1.15 [95% CI: 1.03–1.30] in men. Conclusions In this cross-sectional analysis of a large sample of adults, we found marked socioeconomic gradients of HBP in all age groups and among both men and women. Individual and contextual indicators of SES were independently associated with the prevalence of HBP.

Pushing the Boundaries: The Impact of the Role of the Clinical Nurse /Midwife Specialist (CN/MS) Sexual Assault Forensic Examination (SAFE) in Ireland

Introduction: Landmark research of Magee et al. (2002) (n=3,120) found that in Ireland , 4 in 10 women (42%) and almost 3 in 10 men (28%) experienced sexual assault or abuse in their lifetime. Subsequently, a National Review of Sexual Assault Treatment Services found sexual assault remains one of the most underreported and under recorded violent crimes in Ireland (O’Shea 2006). Key recommendations included expansion of existing services and introduction of a pilot programme in forensic nursing in Ireland, where nurses would undergo a higher diploma and apply for accreditation as CN/MS (SAFE). Short description of practice change implemented: Expansion of Sexual Assault Treatment Units (SATU) from four to six units in Cork, Dublin, Letterkenny, Waterford, adding Galway, Mullingar (2009). Successful implementation of nurse training following pilot programme CN/MS (SAFE). Aim and theory of change: Patients attending SATU may be physically and /or psychologically traumatised making difficult, life changing decisions. SATUs need to be appropriately staffed and available around the clock to provide prompt medical /supportive care and collect forensic evidence. As a nationally agreed service with defined multiagency guidelines (National SATU Guidelines 2014) and choice of care pathways, the CN/MS (SAFE) can consolidate the initial healthcare response to the under-reported crime of rape/sexual assault by utilising specialistic clinical nursing/midwifery knowledge and critical thinking skills to provide optimum patient care. This change also addresses the issue of recruitment/retention of doctors to carry out forensic examinations (O’Shea 2006). Targeted population and stakeholders: All male /female patients age 14 or older who present to SATU following recent rape/sexual assault. The optimisation of the role of nurses /midwives as Forensic Clinical Examiners realises advantages to Patients, SATU services, Nursing/Midwifery, the wider Inter-disciplinary Team, Inter-disciplinary working ,Criminal Justice System. Timeline: 3 groups of CN/CM (SAFE) graduated 2010-16 developing, assimilating, integrating a broad in-depth knowledge base in this speciality through a structured academic and clinical framework. Highlights: Innovations, Impact, Outcomes CN/MS (SAFE) has transformed the care/services for patients significantly advancing and extending the breadth /depth of SATU services namely: availability of trained staff on a 24 hr basis streamlined response times, accessibility, efficiency of healthcare/forensic service delivery (see Table 1) implementation of patient focused care initiatives including increased patient care pathways influential in driving quality improvement in SATUs nationally participation in patient, staff, community education / risk reduction programmes contribute to development, evaluation and implementation of national strategies Table 1 table of case numbers from 2009 to present day will not load! Sustainability: Some CN/MS (SAFE) have advanced skills in both the academic and practice arena and the enhancement and expansion of this nursing/midwifery role to Registered Advance Nurse Practitioner (RANP (SAFE) would support national policy direction promoting quality patient care. Realisation of the RANP (SAFE) would also ‘assist sustainability, the long range thinking’ (Markowitz 2009) for this unique and extremely challenging area of healthcare practice. Transferability: Transferable skills to other health related services e.g. sexual health, paediatric sexual assault forensic examination etc. Scope for other jurisdictions internationally to adopt and develop the Irish model of CN/MS (SAFE) training and role into their own programmes of care. Discussions & Key findings: CN/CM (SAFE) are attached to a SATU strategically located nationally so that the patient has no more than a three hour drive to the nearest SATU. SATU availability helps to minimise patient distress and ensures timely collection of forensic evidence (O’Shea 2006). The CN/CM (SAFE) initiative is unique to Ireland. It demonstrates international leadership, supported at Government level and by the many different disciplines /agencies involved including An Garda Siochana, the Rape Crisis Centres. Since 2009, Forensic Clinical Examiners in Ireland are either Medical Doctors or CN/MSs (SAFE). Conclusions: To date, CN/MS (SAFE) in the realms of rape / sexual assault in Ireland have forged a path through a previously unknown clinical area. Working as Forensic Clinical Examiners, the CN/MS (SAFE) use a consistent, standardised, patient focused approach with the interdisciplinary team to improve outcomes and reduce the long term sequelae for each patient regardless of the circumstances of the incident or a person’s engagement, or not with the criminal justice system. Expansion of SATU services in Ireland and availability of CN/MS (SAFE) has greatly improved accessibility for patients following rape /sexual assault.