Include Skills Training Research Articles

Promoting multidisciplinary pain management in low- and middle-income countries—challenges and achievements

Abstract The burden of pain in low- and middle income countries (LMICs) is high and expected to rise further with their ageing populations. Multidisciplinary pain management approaches based on the biopsychosocial model of pain have been shown to be effective in reducing pain-related distress and disability, but these approaches are still lacking in many LMICs due to various factors, including low levels of awareness about the role of multidisciplinary pain clinics, lack of prioritisation for pain services, and lack of healthcare professionals trained in pain management. The International Association for the Study of Pain (IASP) has several educational programs to promote multidisciplinary pain management in LMICs, in the form of education grants, pain fellowships, pain camps and, most recently, the development of a Multidisciplinary Pain Centre Toolkit. This article describes the various educational programs, focusing on Southeast Asia, that demonstrate how targeted educational programs which include skills training, follow-up and mentorship, can translate into the formation of new multidisciplinary pain management services in settings with limited resources.

Gereja Katolik dan Pengentasan Pengangguran Pemuda di Era Bonus Demografi

Youth unemployment in Indonesia remains notably high at 9.25%, posing a potential threat to the optimal utilization of the demographic dividend anticipated to peak by 2030. This research seeks to explore how the Catholic Church can contribute to addressing youth unemployment during this critical period. By employing the theoretical framework of Catholic social teaching—focusing on the principles of human dignity, solidarity, and integral justice—the study examines the Church's role, potential, and concrete opportunities in mitigating youth unemployment, and provides recommendations for key programs. A qualitative approach is used, involving a literature review of Catholic social teaching documents and analysis of secondary data. The study's findings suggest that the Catholic Church holds strategic potential through its extensive network of parishes and institutions to assist in resolving the youth unemployment issue. Suggested priority programs include skills training, educational scholarships, job fairs, the establishment of youth empowerment institutions, vocational schools, research centers, and business incubators. Effective cross-sector collaboration is crucial to ensuring that these Church-initiated programs function efficiently and offer long- term benefits to Indonesian youth, helping them seize the opportunities presented by the 2030 demographic bonus. This research adds to the understanding of the potential contributions of religious institutions in addressing contemporary socio-economic challenges and opens avenues for further study on the intersection of religion, public policy, and economic development within the framework of Indonesia‘s demographic dividend.

Influencing Factors and Countermeasures to Improve the Expressive Power of Guzheng Artistry

As one of the traditional Chinese musical instruments, guzheng has a deep cultural heritage and unique artistic charm. The improvement of guzheng's artistic expression is of great significance to the inheritance and development of guzheng culture. This paper analyses the factors affecting the guzheng's artistic expression from the aspects of players' skill level, emotional commitment, music selection and arrangement, as well as the playing environment, and puts forward corresponding countermeasures to improve the performance. Firstly, to improve the players' professionalism, including skills training and music theory learning. Secondly, to cultivate the players' musical emotion, so as to make the performance more infectious. Thirdly, innovate music arrangement and performance techniques to meet the needs of different audiences. Finally, improve the playing environment and equipment to provide good material conditions for playing. Through empirical analyses, this paper verifies the effectiveness of the proposed countermeasures and provides useful insights for the future enhancement of guzheng's expressive power.

Changes in Health Indicators Among Caregivers - United States, 2015-2016 to 2021-2022.

Caregivers provide support to persons who might otherwise require placement in long-term care facilities. Approximately one in five U.S. adults provides care to family members or friends who have a chronic health condition or disability. Promoting the well-being of this large segment of the population is a public health priority as recognized by the 2022 National Strategy to Support Family Caregivers. Although negative associations between caregiving and caregiver health are known, changes in the health status of caregivers over time are not. Data from the 2015-2016 and 2021-2022 Behavioral Risk Factor Surveillance System were analyzed to compare changes in the prevalence of 19 health indicators among cross-sectional samples of caregivers and noncaregivers at different time points. Caregivers experienced improvements in prevalence of four health indicators, whereas six worsened. Some health indicators, such as cigarette smoking, improved for both caregivers and noncaregivers, although smoking prevalence remained higher for caregivers (16.6% versus 11.7%). Prevalence of lifetime depression increased for both groups and remained higher among caregivers (25.6%) than among noncaregivers (18.6%). During 2021-2022, age-adjusted estimates for caregivers were unfavorable for 13 of the 19 health indicators when compared with noncaregivers. Strategies for supporting caregivers are available, and integrating these with existing programs to address mental health and chronic diseases among this population might improve caregiver well-being. For example, many community organizations support caregivers by offering interventions designed to relieve caregiver strain, including skills training, support groups, and care coordination.

Menuju Inklusi Tenaga Kerja Penyandang Disabilitas: Implementasi Program Pengabdian di Yayasan Peduli Anak Cacat Malang

Yayasan Peduli Anak Cacat (YPAC) Malang is a non-profit organization that aims to provide services to children with disabilities. This community service program in partnership with YPAC Malang aims to improve the inclusion of the disabled workforce in the YPAC Malang environment through various efforts, including skills training, socialization, and the creation of a Special Employment Contract. The research method used in this service program uses a PAR (Participatory Action Research) based approach. Through the involvement of YPAC Malang partners, companies, academics, and government, this program aims to provide legal protection, equality, and employment opportunities for people with disabilities. Although faced with various challenges, such as limited company partners and labor classification mismatches, this program is expected to have a significant positive impact on people with disabilities and society as a whole.

Understanding Youth Vulnerability to HIV/AIDS in Uganda: Social, Economic, and Behavioural Dimensions

This review examines the multifaceted vulnerability of Ugandan youth to HIV/AIDS, emphasising the interplay of social, economic, and behavioural dimensions. Through a comprehensive analysis of HIV prevalence rates, trends, regional variations, and gender disparities, the review highlights key risk factors, including peer pressure, cultural norms, stigma, economic hardship, and substance use. It underscores the critical role of gender dynamics, with female youth facing unique challenges such as gender-based violence and economic dependence, while LGBTQ+ youth encounter compounded risks due to societal stigma and inadequate services. We also explore the disparities between rural and urban youth in access to information and services, uncovering significant barriers they face. Youth-led initiatives are critical in addressing these challenges, with peer education programs, youth-friendly services, and innovative digital campaigns all playing a crucial role in prevention efforts. We discuss barriers to youth participation, such as stigma, cultural norms, and educational gaps, and discuss strategies to overcome them, like culturally sensitive education and improved access to resources. We highlight the role of schools and educational institutions, emphasising the importance of integrating comprehensive sex education, school-based health services, and extracurricular activities to foster awareness and preventive behaviours. The review also highlights the importance of youth advocacy and leadership in shaping inclusive policies and driving effective interventions. We present economic empowerment strategies, including skills training andmicrofinance, as complementary to health-focused efforts by addressing socioeconomic vulnerabilities. The review concludes by advocating for a holistic approach that combines education, economic empowerment, gender-sensitive interventions, and collaborative partnerships among government, NGOs, civil society, and the private sector to effectively reduce HIV prevalence and improve the well-being of Ugandan youth. Keywords: Youth, HIV/AIDS, Uganda, social, economic, and behavioural dimensions

PERAN DISTRIBUSI ZAKAT PRODUKTIF TERHADAP PENINGKATAN KESEJAHTERAAN MUSTAHIK KAMPUNG ZAKAT TERPADU JEMBER

Productive zakat aims to support mustahik’s business so that they can fulfill their needs consistently and not spent on consumption, so that mustahik can change their status from mustahik to muzakki. This research was prepared to find out how the distribution of productive zakat in Kampung Zakat Terpadu Jember and its implication to the improvement of mustahik welfare of mustahik. The methodology used is descriptive qualitative field study and used the methods of interview, documentation, and observation to accumulate data. his research is different from previous research which shows that the distribution of productive zakat has a positive and significant relationship with the improvement of mustahik welfare which includesskills training, micro business funding, or capital assistance to start a business. As for yhis research, it shows that the distribution of productive zakat does not have a significant relationship with improving the welfare of mustahik’s welfare. Based on the research that has been conducted, researchers can conclude that distribution carried out by BAZNAS and zakat management institutions complies with the applicable procedures and the provisions pertaining to zakat administration found in Law Number 23 of 2011. In Kampung Zakat Terpadu Jember, productive zakat plays a crucial role in generating employment opportunities and enhancing the welfare and standard of living of the local community mustahik, thus creating new muzakki and transforming someone into a muktafi. The researcher categorizes the benefits received by the mustahik into three groups: (1) not feeling any significant benefits and not experiencing economic changes. (2) experiencing short-term benefits and not experiencing economic changes. (3) experiencing long-term benefits and experiencing economic improvement. Keywords: productive zakat, zakat village, welfare.

Pengembangan Kewirausahaan Dan Bantuan Sosial Di Yayasan Almani Kota Batam

This study examines the efforts in entrepreneurship development and social assistance conducted by the Almani Foundation in Batam City. The foundation's entrepreneurship development program includes skill training, business mentoring, and access to capital for local communities, especially youth and housewives. Additionally, the Almani Foundation provides various forms of social assistance such as free healthcare services, educational scholarships, and distribution of food packages to underprivileged families. The aim of these initiatives is to improve economic welfare, reduce poverty rates, and enhance the quality of life of the local community. The results of these programs show an increase in entrepreneurial skills, economic independence, and better access to basic services for the beneficiaries. With a sustainable approach and comprehensive support, the Almani Foundation significantly contributes to creating positive change in Batam City.

Pemberdayaan Masyarakat melalui Keterampilan Lokal dalam Pengembangan Ekonomi Kreatif dan Pariwisata di Kampung Pelangi Semarang

This study aimed to explore the role of local skills in community empowerment in Kampung Pelangi Semarang, a tourist destination that has developed a community-based creative economy. The findings revealed that local skills such as handicrafts, painting, traditional performing arts, and culinary arts play a central role in economically empowering the community and promoting local cultural identity. Effective empowerment strategies included skills training, business assistance, and the formation of creative business groups that facilitated collaboration and product marketing. However, key challenges faced were limited access to capital, limited marketing reach, competition with mass products, and a lack of appreciation for the uniqueness of local skill products. To overcome these challenges, this study recommends strong synergy and collaboration among the community, government, academics, and the private sector. The government plays a role in providing access to capital, training, and business assistance. The private sector can be involved in expanding market opportunities. Academics can provide assistance and further studies. Additionally, local leadership and efforts to promote appreciation for local skills are crucial. To ensure sustainability, economic, social, and environmental aspects need to be considered in developing local skills. Product diversification, value addition, equal participation, and environmentally friendly production practices need to be adopted. The limitation of this study is its focus on a single case study in Kampung Pelangi Semarang, thus limiting the generalization of findings. Additionally, this study did not explore the environmental impact of creative economy and tourism activities in depth.

Integrating Rural Economic Development into the Adult Basic Education and Training (ABET) Curriculum as a Practice to Ensure Sustainable Livelihoods

Purpose: The purpose of this study is to explore the integration of rural economic development initiatives and practices into the Adult Basic Education and Training curriculum with a view to leverage the people in rural communities to boost their productivity towards sustainable livelihoods. Methodology: This study adopted a qualitative approach in which the data was collected through focus group interviews. The participants were sampled from former and current ABET learners and their principal. The interviews were intended to solicit information about their farming project; how they started the farming and whether they were able to feed their families from the sale of their produce. Findings: The findings from the focus group interviews are that though they had support from the Kruger National Park, they still felt that the Department of Higher Education and Training (DHET) needed to intervene and make ABET a means for sustainable livelihoods for the beneficiaries. Unique contribution to public, policy and practice: This study contributed uniquely in the area of policy. The students proposed that the ABET curriculum needed to be restructured to include skills training to enable them to make a living after the ABET encounter.

“Now there are fewer of me". A qualitative study of the impact of psychoeducative groups for complex dissociative disorder

ObjectiveThis study aimed to explore the experience and impact of participating in psychoeducative group therapy based on an explanatory model for dissociative symptoms. We further explored the potential significance this may have for the participants healing process. MethodsA total of 26 participants with Complex Dissociative Disorder (CDD) were interviewed 6 months after finishing a 20-week psychoeducative group therapy that included skills training. The research team analyzed the data with an interpretative interview-based qualitative research method. ResultsThe analysis resulted in two main categories with 12 subcategories. The first main category was “Developing a more coherent self”, describing an initial change in the participants' self-experience from confused and fragmented to increased coherency. The second main category “Increased sense of agency” represented a new way of relating to and helping oneself. The results are presented in a model which points towards some possible connections between the categories. ConclusionsOur results suggest that the psychoeducative group therapy contributed to a movement towards increased self-awareness which permits a sense of coherence among various parts of the self and an increased sense of agency. The model resulting from this work identifies crucial elements of change that can be applied to improving treatment.

Comparison of Conventional Small Group Teaching with Skill-based Teaching in the Proper Use of Drug Delivery Systems in Phase II MBBS Students of a Medical College in New Delhi, India: A Randomised, Crossover Experimental Study

Introduction: The conventional small group teaching method primarily focuses on the knowledge aspect of Bachelor of Medicine and Bachelor of Surgery (MBBS) students. However, under the Curriculum Based Medical Education (CBME) framework, the National Medical Council (NMC) has introduced a new method of small group teaching called skill-based teaching for Phase II MBBS students. This method includes skill training and communication training in the proper use of Drug Delivery Systems (DDS), in addition to the knowledge aspect. Aim: To compare the conventional method of small group teaching with skill-based teaching in terms of learning the proper use of DDS in Phase II MBBS students. Materials and Methods: The present randomised, crossover experimental study was conducted in the Department of Pharmacology at North Delhi Muncipal Corporation Medical college, Hindu Roa Hospital, New Delhi, India, over a period of six months July 2022 to December 2022 to assess knowledge (cognitive domain), skill (psychomotor domain), and communication (affective domain). The students were initially given a questionnaire (pretest) followed by a didactic lecture on DDS. They were then randomly divided into two groups. Group A received skill-based teaching for insulin pen, while Group B received conventional teaching. The groups were then crossed over for Metered Dose Inhaler (MDI) training. After the teaching sessions, the students were given the same questionnaire (post-test). All students were assessed for their skill in using the device and their communication skills. The scores of the two groups were compared using an unpaired t-test. Results: A total of 51 students (31 males and 20 females; age range 18-20 years) participated in the study. There was a significant improvement in the questionnaire scores between the pretest and post-test (p<0.0001). In the skill-based teaching group, there was a significant improvement in the students’ performance in using MDI (p<0.05) and in communication of insulin pen (p=0.0001). Similar results were observed in the skill of using insulin pen and the communication aspect of MDI in both groups. Conclusion: Skill-based teaching resulted in similar or better performance in terms of skill and communication in the use of DDS compared to conventional teaching methods.

KEBIJAKAN PEMBERDAYAAN PEREMPUAN DI NEGERI SULI: TINJAUAN TERHADAP PERAN PEREMPUAN DALAM PEMBANGUNAN LOKAL

Empowerment of women has become a significant topic on both the global and national development agendas, acknowledging the crucial contributions women can make to the development process. This article aims to examine and evaluate the women's empowerment policies implemented in Negeri Suli, a region in Central Maluku, Indonesia. This study employs a qualitative approach involving interviews with policy stakeholders, community leaders, and women participating in empowerment programs. We also analyze policy documents and relevant data to comprehend the policy's implementation and impact. The research findings reveal that Negeri Suli has adopted several women's empowerment policies, including skills training programs, education initiatives, and improved access to economic resources for women. The study highlights that women's empowerment has yielded positive outcomes for local economic development and an enhancement of women's social status in the region. Women in Negeri Suli are increasingly active in social, economic, and political spheres. Nevertheless, challenges remain, including gender disparities in resource access and opportunities. Furthermore, the sustainability of women's empowerment programs needs to be ensured through long-term commitment from both the government and the local community. This study contributes to understanding the implementation of women's empowerment policies in a local context, with the hope that its findings can serve as valuable considerations for policy improvements in Negeri Suli and similar regions in Indonesia. The conclusions drawn from this research underscore the importance of continually advocating for women as agents of change in the local development process, providing a foundation for further policy discussions on women's empowerment in this area.

Community Empowerment in Drainage Management to Overcome Floods

Flooding is a serious problem that often disrupts the lives of urban communities. Increased rainfall intensity, climate change, and rapid urban development have made existing drainage systems less effective at coping with flooding. To face this challenge, this study aims to examine community empowerment efforts in drainage management as a flood mitigation strategy. This research was conducted by combining participatory approaches and field research methods. Local communities, local governments, and stakeholders are involved in planning, implementing, and evaluating empowerment programs. This program includes skills training, education on the importance of drainage maintenance, as well as the formation of community groups active in drainage maintenance. The results showed that community empowerment in drainage management has had a positive impact in reducing flood risk. Community groups involved in this program actively maintain the cleanliness and drainage function in their neighborhoods. In addition, education about climate change and rain patterns also helps people to be better prepared for extreme conditions.

The Incidence of Suicide in Pakistan Day by Day, Especially the Educated Youth Trying to Commit Suicide in 2022 2023

The focus of this study the Incidence of Suicide in Pakistan Day by Day, Especially the Educated Youth Trying to Commit Suicide in 2022 2023 is to provide understanding for human nature, the societal impact of suicides, to explore the trend and causes of suicide, and to create awareness about this sensitive and unlawful act. The main theme is a try to stop this inhuman act by helping the needed people by approaching the related authorities. This report is an effort to stop this sinful act by explaining the bad effects because this act can never eliminate the problems but on the other hand give rise to them. This whole effort can only bring about change, if everyone really wants to help others and contribute to get rid of this evil and unlawful act. This study discovers that suicide is an indication of the problems in the lives of many people such as financial, social or medical. The most common underlying disorder is depression, 30% to 70% of suicide victims suffer from major depression, no matter which strata of society they belong to. A suicide attempt is often a cry for help that ends in tragedy. The research paper is an analytical study of adverse effect of criminalization of Attempt to Suicide in Pakistan in Section 325 of PPC 1860. Criminalization of attempted suicide is one of the major reasons that have made people reluctant to get help for the psychological problem that causes such act. This study aims to provide significant reasons for decriminalizing attempted suicide in Pakistan. Quantitative and Qualitative research method was used to gather, analyse and abridge the data. This paper focuses on the problem of criminalization of attempted suicide and tends to provide a new framework in the replacement of existing one. It is pertinent to mention that committing suicide is an illness not a crime, so the one who attempts to commit suicide must be treated as a „patient‟ not as a „culprit‟. The existing law provides punishment for the person who attempted suicide but failed, this represents the harshness of the state as it prescribes „punishment‟ for the person suffering from mental disorder, instead of „treatment‟. The analysis includes problems of criminalizing attempted suicide and challenges of the applicability of relevant law as well as negative impacts of it. Moreover, this paper deliberates upon the introduction of new practice in law. According to this practice, state institutions will provide rehabilitation/treatment to those persons who attempted suicide but failed under the law. Suicidal behavior is one of the serious consequences of depression. Depression disrupts the daily life functioning including ability to think properly, planning, problem solving and decision- making. This happens because of excessively experiencing the negative emotions. Dialectical behavior therapy sessions were planned including skills training for emotional stability, obsessions and impulse control. Evaluation of the behavior at the end of this intervention had fruitful outcomes and better change in the patient’s condition. Columbia Suicide Severity Rating Scale was used to measure the change after ten sessions, once a week of one hour each.

A randomized controlled trial to assess the efficacy of Parenting-STAIR in treating maternal PTSD to reduce maltreatment recidivism: protocol for the Safe Mothers, Safe Children study

BackgroundChild maltreatment recidivism substantially increases the likelihood of adverse life outcomes, but there is little evidence that family preservation services are effective at reducing recidivism. Mothers in child welfare have very high rates of trauma exposure; maternal post-traumatic stress disorder (PTSD) is an intervention target that has the potential to reduce abuse and neglect. The Safe Mothers, Safe Children (SMSC) intervention program involves the delivery of an innovative combination of interventions, including Skills Training in Affective and Interpersonal Regulation (STAIR) and Parent-Child Interaction Therapy (PCIT). The combined intervention, Parenting-STAIR (P-STAIR), targets maternal PTSD and comorbid depression symptoms to reduce the adverse effects of PTSD on parenting, improve positive parenting skills, and prevent maltreatment recidivism.MethodsThis study is a two-arm randomized controlled trial: P-STAIR (23 sessions) versus supportive counseling (23 sessions). Participants are mothers receiving child welfare family preservation services (FPS), with a child in the age range of 1–8 years old and meeting diagnostic criteria for PTSD (with/without depression). Clinical assessment occurs at pre-treatment (baseline), two in-treatment assessments (mid-assessment #1 after module 9 and mid-assessment #2 after module 15), post-treatment, and at a 6-month follow-up. Recidivism will be measured using the New York State Child Welfare Registry (NYSCWR). We will enroll a total of 220 participants over 4 years: half (N = 110) randomly assigned to the P-STAIR condition and half (N = 110) to the supportive counseling condition.DiscussionThis is the first RCT to investigate the efficacy of P-STAIR. The findings for the trial have the potential to contribute to the expansion of evidence-based practices for maternal PTSD, maltreatment, and child welfare.

Investigating a Participatory Intervention in Multidisciplinary Cancer Care Teams Using an Integrative Organizational Model: A Study Protocol.

Multidisciplinary teams encounter many challenges that can lead to higher levels of distress and burnout. This trend is acutely prevalent among multidisciplinary cancer care teams who frequently contend with increased task complexity and numbers of patients. Resilience is emerging as a critical resource that may optimize team members’ psychological health and wellbeing, work efficiency, and organizational agility, while reducing burnout. Accordingly, the proposed study aims to implement and evaluate a promising participatory interventional approach that fosters team resilience. Specifically, the effects of the intervention on participating team members will be compared to a control group of non-participating team members. This intervention’s core components include skills training, patient-centered meetings, talking spaces, and an agile problem-solving approach. The proposed study also seeks to determine whether enhanced resilience improves team mental health status and organizational outcomes. A participatory interventional approach will be implemented and assessed at three-time intervals [i.e., pre-intervention deployment (N = 375), 12 months post-deployment (N = 236), and 24 months post-deployment (N = 146)] across five cancer care teams in three Quebec healthcare institutions. A mixed methods design will be used that includes observations, semi-structured interviews, focus groups, and self-report questionnaires. Direct observation will document team functioning and structural resources (e.g., meetings, conflict management, and leadership). Semi-structured interviews will explore participants’ experience with activities related to the participatory interventional approach, its perceived benefits and potential challenges. Focus groups will explore participants’ perceptions of their team’s resilience and the effectiveness of the intervention. Questionnaires will assess support, recognition, empowerment, organizational justice, individual resilience, psychological safety, work climate, team resilience, workplace burnout, engagement, quality of work life, wellbeing, and organizational citizenship behaviors, and sociodemographic variables. Moreover, objective measures including absenteeism and staff turnover will be obtained via human resource records. Structural equation modeling will be used to test the study’s hypotheses. The proposed protocol and related findings will provide stakeholders with quantitative and qualitative data concerning a participatory interventional approach to optimize team effectiveness. It will also identify critical factors implicated in favorable organizational outcomes in connection with multidisciplinary cancer care teams. Expected results and future directions are also presented herein.

Why do medical residents prefer paternalistic decision making? An interview study

BackgroundAlthough shared decision making is championed as the preferred model for patient care by patient organizations, researchers and medical professionals, its application in daily practice remains limited. We previously showed that residents more often prefer paternalistic decision making than their supervisors. Because both the views of residents on the decision-making process in medical consultations and the reasons for their ‘paternalism preference’ are unknown, this study explored residents’ views on the decision-making process in medical encounters and the factors affecting it.MethodsWe interviewed 12 residents from various specialties at a large Dutch teaching hospital in 2019–2020, exploring how they involved patients in decisions. All participating residents provided written informed consent. Data analysis occurred concurrently with data collection in an iterative process informing adaptations to the interview topic guide when deemed necessary. Constant comparative analysis was used to develop themes. We ceased data collection when information sufficiency was achieved.ResultsParticipants described how active engagement of patients in discussing options and decision making was influenced by contextual factors (patient characteristics, logistical factors such as available time, and supervisors’ recommendations) and by limitations in their medical and shared decision-making knowledge. The residents’ decision-making behavior appeared strongly affected by their conviction that they are responsible for arriving at the correct diagnosis and providing the best evidence-based treatment. They described shared decision making as the process of patients consenting with physician-recommended treatment or patients choosing their preferred option when no best evidence-based option was available.ConclusionsResidents’ decision making appears to be affected by contextual factors, their medical knowledge, their knowledge about SDM, and by their beliefs and convictions about their professional responsibilities as a doctor, ensuring that patients receive the best possible evidence-based treatment. They confuse SDM with acquiring informed consent with the physician’s treatment recommendations and with letting patients decide which treatment they prefer in case no evidence based guideline recommendation is available. Teaching SDM to residents should not only include skills training, but also target residents’ perceptions and convictions regarding their role in the decision-making process in consultations.

The Incidence of Suicide in Pakistan Day by Day, Especially the Educated Youth Trying to Commit Suicide in 2022 - 2023

The focus of this study the Incidence of Suicide in Pakistan Day by Day, Especially the Educated Youth Trying to Commit Suicide in 2022 2023 is to provide understanding for human nature, the societal impact of suicides, to explore the trend and causes of suicide, and to create awareness about this sensitive and unlawful act. The main theme is a try to stop this inhuman act by helping the needed people by approaching the related authorities. This report is an effort to stop this sinful act by explaining the bad effects because this act can never eliminate the problems but on the other hand give rise to them. This whole effort can only bring about change, if everyone really wants to help others and contribute to get rid of this evil and unlawful act. This study discovers that suicide is an indication of the problems in the lives of many people such as financial, social or medical. The most common underlying disorder is depression, 30% to 70% of suicide victims suffer from major depression, no matter which strata of society they belong to. A suicide attempt is often a cry for help that ends in tragedy. The research paper is an analytical study of adverse effect of criminalization of Attempt to Suicide in Pakistan in Section 325 of PPC 1860. Criminalization of attempted suicide is one of the major reasons that have made people reluctant to get help for the psychological problem that causes such act. This study aims to provide significant reasons for decriminalizing attempted suicide in Pakistan. Quantitative and Qualitative research method was used to gather, analyse and abridge the data. This paper focuses on the problem of criminalization of attempted suicide and tends to provide a new framework in the replacement of existing one. It is pertinent to mention that committing suicide is an illness not a crime, so the one who attempts to commit suicide must be treated as a „patient‟ not as a „culprit‟. The existing law provides punishment for the person who attempted suicide but failed, this represents the harshness of the state as it prescribes „punishment‟ for the person suffering from mental disorder, instead of „treatment‟. The analysis includes problems of criminalizing attempted suicide and challenges of the applicability of relevant law as well as negative impacts of it. Moreover, this paper deliberates upon the introduction of new practice in law. According to this practice, state institutions will provide rehabilitation/treatment to those persons who attempted suicide but failed under the law. Suicidal behavior is one of the serious consequences of depression. Depression disrupts the daily life functioning including ability to think properly, planning, problem solving and decision-making. This happens because of excessively experiencing the negative emotions. Dialectical behavior therapy sessions were planned including skills training for emotional stability, obsessions and impulse control. Evaluation of the behavior at the end of this intervention had fruitful outcomes and better change in the patient’s condition. Columbia Suicide Severity Rating Scale was used to measure the change after ten sessions, once a week of one hour each.

OUT-OF-POCKET HEALTHCARE PAYMENTS AND IMPOVERISHMENT AMONG MIGRANT ADOLESCENT FEMALE HEAD PORTERS IN GHANA: A CROSS SECTIONAL STUDY

Direct out-of-pocket (OOP) payments for healthcare can have devastating effects on vulnerable populations leading to impoverishments. Ghana’s National Health Insurance Scheme (NHIS) aims to remove financial hardships associated with seeking healthcare. However, there are concerns that vulnerable sections of the population still face healthcare-related financial hardships. This paper examines the impoverishing effects of OOP healthcare payments and the determinants of impoverishment due to OOP healthcare payments among migrant adolescent female head porters aged 10-19 years in Ghana. A quantitative cross-sectional survey was administered to a sample of 336 respondents who reported ill and sought healthcare within the last 12 months, January-December 2015, prior to the survey in 2016. Impoverishment due to OOP payment was assessed by computing the net income after payment for health care using the World Bank’s poverty line of income of $1.90 a day converted to 2015 purchasing power parity (PPP) equivalence for Ghana. The results illustrate that poverty incidence increased from 23 percent before OOP payment to 76 percent post OOP payment for healthcare. In a multivariate analysis, primary education [AOR=0.32, 95%CI=0.15-0.68]; Mamprusi (AOR=0.41, 95%CI=0.19-0.87) and other ethnic groups [AOR=0.33, 95%CI=0.14-0.75] compared to Dagomba; >1year in head portage (AOR=0.46; 0.23 - 0.95); drug store (AOR=0.43, 95%CI=0.19 - 0.96) and home treatment [AOR=0.20, 95%CI=0.05-0.85] were significantly associated with lower odds, whilst never registering for (AOR=4.05; 95%=1.82 - 9.03) or no valid NHIS card (2.29; 95%CI=1.08 - 4.83), Kumasi city [AOR=5.14; 95% CI:2.45-10.77] and severity of illness[AOR=2.86, CI 1.49-5.45] were associated with higher odds, of impoverishment due to OOP payment.. We recommend that the Ministries of Gender, Children and Social Protection and Health should collaborate to enrol adolescent female head porters onto the NHIS in order to increase their financial risk protection. Government should also put in place policy interventions including skills training and livelihood programmes to increase income levels, and improve the poverty situation of adolescent girl head porters. 
 
 Key Words: Impoverishment, out-of-pocket healthcare payments, adolescent girls, migrants, Ghana