Provision Of Programs Research Articles

Abstract P3-17-01: Metastatic breast cancer caregiver participation in a psychoeducational cancer support program: Results from the frankly speaking about cancer: Metastatic breast cancer evidence-based educational workshops

Abstract Background: Education about metastatic breast cancer can help caregivers by providing tools to deal with the psychosocial effects of the disease. This analysis explores metastatic breast cancer caregivers’ experiences related to participation in Cancer Support Community’s national evidence-based educational program, Frankly Speaking About Cancer: Metastatic Breast Cancer. This comprehensive psychosocial education program, created for people diagnosed with metastatic breast cancer and their caregivers, provides information about current treatments, side-effect management, and social and emotional challenges of an advanced breast cancer diagnosis. Methods: Caregivers who attended 67 workshops across the country between 2014 and 2019 completed program evaluations and provided self-reported data on factors including pre- and post-workshop knowledge, workshop satisfaction, confidence levels, and intentions for patient-provider communication post-workshop. In total, 305 caregivers of patients with metastatic breast cancer attending in-person Frankly Speaking About Cancer: Metastatic Breast Cancer workshops nationwide completed a survey assessing their experiences and learnings as a result of the educational workshops. Descriptive analyses and pre-and post-workshop comparisons were conducted to assess workshop outcomes. Results: Caregivers were predominantly White (79%) and female (75%) and averaged 64.2 years old (s.d.=12.5). 75% strongly identified as caregivers and 69% were strongly involved in coordinating the patient’s care (rated a ‘4’ or ‘5’ on a 5-point scale for both). Most participants in the caregiving capacity (87%) reported experiencing emotional distress due to their loved one’s cancer. The workshop was well-received, with 92% recommending the workshop to others facing similar issues. Most caregivers (77%) reported gaining a “high or very high” level of knowledge about metastatic breast cancer, which was a significant increase compared with pre-workshop levels (42%; χ²= 13.4, p <.05). Caregivers were likely to report that they gained confidence to participate in treatment decision-making with their loved one’s health care team (79%) and to ask questions about side effects of metastatic breast cancer and its treatment (82%) as a result of participating in the workshop. Lastly, 92% of caregivers reported that because of the workshops, they felt better prepared to emotionally cope with their metastatic breast cancer caregiving experience. Discussion: Results suggest that comprehensive information and supportive services are highly relevant in meeting the psychosocial needs of cancer caregivers. Increased understanding of informational and emotional support service utilization can inform provision of services and programs addressing the emotional and informational needs of caregivers. Citation Format: Claire Saxton, Kirstin Fearnley, Maria B. Gonzalo, Cynthia Schwartz. Metastatic breast cancer caregiver participation in a psychoeducational cancer support program: Results from the frankly speaking about cancer: Metastatic breast cancer evidence-based educational workshops [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-17-01.

The Pendulum Has Swung: How Do We Ensure a Life Course Approach to Immunisation in Australia?

Rather than concentrating primarily on children and adolescents, there has been a shift in the discourse around immunisation to encompass a whole-of-life approach. Despite this acknowledgement and ongoing high burdens of vaccine preventable diseases in adults, coverage for some adult risk groups remains sub-optimal. This study aimed to explore key informant's and stakeholder's perceptions of factors impacting provision of immunisation programs for Australian adults and to identify strategies to promote acceptance and uptake. Semi-structured telephone interviews were undertaken with people involved in adult immunisation program delivery, advocacy, policy or research between September 2020 and June 2021. Transcripts were inductively analysed, with the resulting themes categorised into the five influences on vaccination gaps that have informed program planning in other countries: Access, Affordability, Awareness, Acceptance and Activation. Participants spoke of improvements in the provision of vaccines to adults, however, ongoing challenges persisted. Participants agreed that the focus or emphasis of policies and the promotion/communication strategies has been on childhood vaccination in Australia, however there is a sense that the “pendulum has swung.” These included understanding of eligibility amongst the Australian population and the reluctance of some health providers to dedicate time to exploring immunisation needs with adult patients. In comparison to the childhood vaccination program, there has been a lack of data available on coverage for adult vaccines on the national immunisation program. This has contributed to the ongoing challenges of identifying and promoting certain vaccines. At a government level, questions were raised about why the Australian government has never set an aspirational target for adult vaccination (i.e., influenza or pneumococcal) coverage. While significant improvements have been made in adult immunisation uptake, there are still gaps across the program. While the system remains under stress because of the COVID-19 pandemic, it is not appropriate to implement any additional programs. There needs to be strong commitment to establish the value of adult vaccination in the eyes of community members, policy makers and healthcare professionals. Having a national adult immunisation strategic plan would help advance action.

Experience of living near a highway in Nepal: Community perceptions of road dangers in Makwanpur district

IntroductionRoad traffic injuries are a major but neglected global challenge. There are high and rising rates of road traffic injuries in Nepal. Most of the studies reporting these injuries in Nepal have used quantitative methods to describe the injury burden. Little qualitative research has been conducted to describe the contexts and social processes surrounding crashes, or public perceptions of risks and potential solutions. The aim of this study was to explore the perceptions of road dangers from communities living alongside a major highway in Nepal. MethodsIn this qualitative study we recruited members of neighbourhood development committees and a mother’s group to take part in focus groups exploring their views. Data were audio-recorded, transcribed, translated and analysed thematically. ResultsFour focus groups were conducted involving 34 participants aged 24-65. Our study findings highlight the challenges faced by people living near a major highway and their fear of getting injured on the road. Five themes that emerged were: risky behaviours of road users, infrastructure for safer behaviour, poor condition and maintenance of roads and vehicles, limited adherence and enforcement of traffic laws, and the need for road safety awareness programmes. ConclusionThe community groups expressed multiple concerns regarding the safety of members of their communities and lived-in fear of death and injury on the road where they lived. There is an urgent need for government agencies to understand these concerns and to take action in relating to infrastructure provision, regulation and behavioural change programmes.

Self-management support for older adults with chronic illness: implications for nursing practice.

Self-management is a key skill that older adults with multiple comorbidities require. Self-management interventions include medication management, self-monitoring and self-awareness and self-management often requires the older adult to manage the emotional consequences of having multiple comorbidities. The benefits of self-management for older adults include reduced reliance on the health system, enhanced quality of life, empowerment of the individual and reduction in the burden associated with chronic illness. Many factors can influence an older adult's ability to self-manage, including health literacy, mental health difficulties and socio-economic factors. Self-management support is the provision of structures, services and programmes to support and enhance the skills of older adults in managing their own conditions. Nurses are in a pivotal position across the continuum of care, using both person-centred care and the 'Making Every Contact Count' approach, to support older adults to self-manage their conditions.

Conservation and Sustainable Use Awareness among Visitors and Tour Operators of Marine Parks: Concise Review of the Benefits and Programs for Protecting Marine Biodiversity

This review paper highlights the level of awareness on the conservation and sustainable use of marine parks (MPs) among stakeholders in the marine tourism business. Authors present in detail the benefits, marine biodiversity (MB), and programs designed for the conservation and sustainable use of MPs. Numerous benefits of MPs range from the management of marine protected areas to the protection of natural resources, such as plants, animals, and the ecosystem. The primary role of MPs is to properly manage and conserve MB, which protects vulnerable or endangered species and habitats. Other benefits of MPs include protecting the long-term health of marine environment through the conservation of marine life. Hence, scientists are mandated by national governments to supervise and conduct research aimed at protecting and managing MPs. Likewise, numerous conservation programs have been proposed over the years to secure the conservation and sustainable use of MPs. MB conservation can be enhanced by objective zonation, promoting alternatives, and limiting visitor’s use of MPs and provision of on-site waste amenities. Overall, the review of the literature showed that the provision of education, awareness and outreach programs to local communities and visitors could ensure the successful conservation of MB in MPs.

Exploring layers of context-related work-from-home demands during COVID-19

PurposeThis article identifies the contextual demands impacting the work from home (WFH) experience during the COVID-19 pandemic and considers their respective impact on employees' personal and work-related outcomes.Design/methodology/approachDrawing on a qualitative methodology, the authors thematically analyzed written narratives from 41 employees who had been required to work from home during the COVID-19 pandemic.FindingsData analysis identified four layers of contextual demands (omnibus, task, social and personal) that had resulted in participants being required to work from home. Drawing on this finding, the authors develop a conceptual process model to extend current theory and explain how the respective demands impact individual affective reactions and work-related experiences, health and wellbeing. The authors’ findings offer new insights into contexts where WFH becomes mandatory, indicating that it is characterized by a range of challenges and opportunities.Practical implicationsThis paper signals the need to provide employees with a realistic preview of working from home demands, including interventions to better prepare them to navigate the daily stressors of working from home; and provision of virtual employee assistance programs in the form of online counseling.Originality/valueThis paper explores a unique phenomenon – the mandatory requirement to work from home during the COVID-19 pandemic and its impact on employees' personal and work-related experiences and outcomes.

An Analysis of Household Perceptions of Water Costs across the United States: A Survey Based Approach

Research analyzing perceptions of water services has focused on water quality, water safety, and the propensity to consume water from different sources. It has not assessed perceptions of water costs. To address this knowledge gap, this study collected nationally representative survey data from households in the United States about water issues and incorporated these data into logistic regression models. In doing so, our study advances the water and public policy literature in three ways. One, it addresses the need for household resolution information about water issues given the absence of data at this scale in the United States. Two, it creates and utilizes one-of-a-kind survey data to understand the perceptions of household water bills and the drivers of these perceptions. Three, we assess the impact of proposed solutions to improve water affordability on household perceptions of water costs. Model results indicate low-income and households in underrepresented groups were more likely to perceive their water bills to be too high. The perception of water costs also varied geographically. From a policy perspective, model results indicate utilities can positively affect perceptions of water bills via the frequency of water billing and provision of payment assistance programs.

Study protocol for the investigation of the clinical effectiveness of a physical activity behaviour change intervention for individuals living with and beyond cancer

Most individuals living with and beyond cancer are not sufficiently active to achieve the health benefits associated with regular physical activity (PA). The purpose of this study was to describe the study protocol for a two-arm non-randomised comparison trial conducted within a community-based setting, which aimed to investigate the clinical effectiveness of a cancer-specific PA behaviour change (BC) intervention, namely MedEx IMPACT (IMprove Physical Activity after Cancer Treatment), compared to a general exercise rehabilitation programme, among survivors of cancer. Individuals who had completed active-cancer treatment who were referred to a community-based exercise rehabilitation programme were invited to participate in the trial. Participants in the control group (CG) attended twice-weekly supervised exercise classes for 12 weeks. Classes were delivered as part of a chronic illness exercise rehabilitation programme. Participants in the MedEx IMPACT intervention group (IG) also attended the twice-weekly supervised exercise classes for 12 weeks and received cancer-specific materials, namely an independent PA programme, 4 PA information sessions and a 1:1 exercise consultation. The primary outcome was PA levels measured by 6-day accelerometry and self-report PA. Secondary outcomes included cardiorespiratory fitness (CRF), quality of life (QoL) and sedentary behaviour. Outcomes were measured at baseline and months 3, 6 and 12. Few effective PA BC interventions for individuals living with and beyond cancer have been identified. The results of this study will have implications for the planning and provision of community-based exercise oncology rehabilitation programmes for individuals living with and beyond cancer.

The development of a decision matrix to guide and support the provision of effective arts programs in schools

In the current education climate, Australian schools are encouraged to provide arts programs, yet there is little dedicated funding for provision and leadership must balance resource allocation with other curriculum and policy priorities. To determine how best to support school leaders in this area, we undertook a three-year project with local industry partners to investigate relationships between different provision approaches, benefits and conditions necessary to realize them, using an emergent, three-stage design. Stage 1 explored current arts provision approaches in 19 Catholic primary schools in Melbourne, along with notions of sustainability. Stages 2 and 3 used ethnographic methods to develop and trial a decision-making matrix to facilitate discussion with school leaders about arts provision goals and provision feasibility. Leaders identified several distinct goals for engaging the arts, and a range of outcomes were anticipated that would require certain conditions and inputs for different program models to be successful. These goals, models, conditions and inputs were organized into a logic model that became the refined Arts Engagement Matrix. Trials showed that the matrix was considered accessible, and capable of assisting leadership navigate arts provision. While not prescriptive, we argue this matrix offers a uniquely comprehensive tool to help school leaders make realistic decisions about how the arts could enrich their school community.

Assessment and predictors of HIV knowledge among vocational school adolescents in Thailand

Background: Despite substantial progress in the fight against human immunodeficiency virus and acquired immunodeficiency syndrome globally, it remains a threat to global adolescent health. This study assessed the level of HIV knowledge among vocational school students and identified the relevant factors. Methods: This was an analytical cross-sectional study conducted from August to September 2019. A total of 345 students aged 15 to 19 years were selected from three vocational schools in Phitsanulok Province, Thailand, using a multistage random sampling technique. The HIV Knowledge Questionnaire (18 item version) was used to collect the data, which were analysed by mean, frequency, Chi- square and binary logistic regression. Results: Only 38.8% of participants were fully aware of HIV knowledge; five individual items showed a significant difference in knowledge of HIV between males and females; two items relating to HIV prevention knowledge (P=0.021, 0.009); two items relating HIV transmission (P=0.028, 0.035); one item relating to HIV diagnosis (P=0.008). Factors that were significantly associated with HIV knowledge included gender (male vs. female, OR 1.83, 95% CI 1.01-3.34), residence (sub-district municipality area vs. sub-district of administrative organization area, OR 0.44, 95% CI 0.23-0.84), education (2nd and 3rd academic year vs. 1st, OR 7.00, 95% CI 2.40-20.41; OR 6.40, 95% CI 2.05-20.01) and source of income (from both parents vs. self, OR 0.07, 95% CI 0.04-0.64). Conclusions: There are serious deficits and disparities in the knowledge of male and female adolescents on HIV transmission, prevention and diagnosis, and there is a need to expand the provision of gender-focused sexual health education programs.

An Exploratory Investigation of Difficulties in Applying Functional Behavior Assessment and Implementing Behavioral Intervention Plans in ADHD Programs in Saudi Arabia

Functional behavior assessment (FBA) and behavioral intervention plans (BIPs) can be effective for students with attention deficit hyperactivity disorder (ADHD); however, teachers may face difficulties when implementing FBA procedures and, in turn, BIPs because of lack of time, insufficient training, and multiplicity of beliefs. Thus, it is important to identify the difficulties teachers may face and the obstacles that can deter them from implementing intervention plans. This is a worthwhile endeavor because nearly all classrooms will have students with behavioral problems who will benefit from specifically designed educational interventions. This study aimed to identify the difficulties in applying FBA and the barriers in implementing BIPs among Saudi teachers in specialized ADHD programs. Using the descriptive-analytical approach, a questionnaire targeting difficulties and barriers was administered to 209 public school teachers from specialized ADHD programs in Saudi Arabia. The results revealed that the difficulty level of applying FBA in ADHD programs was high. The level of barriers in implementing BIPs was moderate. Finally, the study indicated that barriers in implementing BIPs could be predicted by the difficulties of applying FBA. The results suggest the importance of finding better practices, restructuring the provision of ADHD programs, training teachers, improving assessment tool availability, and ensuring cooperation between school administrators and teachers.

Change in attitude and help-seeking pattern of caregivers and patients with mental disorders in the community - Recent findings from India.

The researchers utilised a cross-sectional study design. A face-to-face interview was used to collect data using the WHO Encounter Form. Using a successive sample technique, patients with various diagnoses of mental illness undergoing Psychiatry outpatient therapy at a tertiary care medical college were included in the study. In terms of gender, ladies (53.3%) were seen to use psychiatric services more than males (46.7%) from an urban or semi-urban background. For dissociative disorders, the median time from onset to first contact with a care provider was 0.1 years; 0.3 years for mood episodes; 0.6 years for anxiety disorders; one year for psychotic disorders; and seven years for Substance Use Disorders (SUD). However, interaction with current psychiatric services took an average of six months for dissociation; 3.5 years for mood disorders; three years for anxiety disorders; six years for psychotic disorders; and a maximum of seventeen years for SUD. Participants in the study who had a family history of mental illness sought care more quickly (OR = 4.3, 95 percent CI 1.19 to 7.11, P = 0.03). The fact that 73 percent of patients have a GP or mental health professional as their first point of contact for various mental diseases is good. Higher education status, urban background, dwelling closer to the mental health centre, and having a biological attribution model for psychological illness were the other clinical and demographic characteristics important for quicker paths to mental health treatment. In most cases of psychosis and SUD (substance use disorders), there is still a significant delay in receiving modern psychiatric therapy. The number of initial contacts with Native Healers ha s decreased. The majority of people said mental illness was caused by environmental or biological factors. Education and scientific information regarding mental health have aided the process of seeking treatment, and there should be a provision of training programmes for family physicians and community health professionals to facilitate the process of help-seeking behavior of psychiatric patients in the Indian subcontinent.

Cervical Cancer Awareness and Screening Practises Amongst Migrant Women Living in Sydney

Cervical cancer is the 4^th most prevalent cancer among women worldwide. The incidence rate of cervical cancer is low in Australia. Despite the use of vaccinations and cervical screening programs in Australia, migrant women living in Sydney still face significant health disparities when accessing cervical cancer screening services. Overall, there are limited studies that explore the barriers and facilitators that migrant women are exposed to when accessing cervical screening tests. The aim of this study is to describe the attitudes, beliefs, knowledge and awareness of cervical cancer screening and screening practices amongst migrant women aged 25 and above living in Sydney, Australia for more than one year with no history of cervical cancer. Fifty-two women (30 South-East Asian, 12 Middle Eastern & 10 African) were recruited using two non-probabilistic sampling methods, convenience and snowball sampling. Data was collected through Focus Group Discussions (FGDs). In total, 5 FGDs were conducted in homogenous groups of 8-12 participants. Each FGD was audio-recorded and verbatim transcribed. The data were analysed using thematic analysis. Results show that average age of the participants were 38 years, majority were from South East Asia (58%), married (87%), unemployed (65%), had tertiary education (67%), were in low income categories (84%), and a third (35%) living in Australia for < 5 years. Results further show that migrant women living in Sydney displayed a lack of awareness and knowledge about cervical cancer and screening practices. Individual and system-level barriers and facilitators that influenced screening attendance were identified. Factors such as lack of knowledge, emotional barriers, cultural and religious barriers, psychological barriers, and organisational factors influence screening practices. Furthermore, results also revealed that African migrants were less likely to be aware of cervical cancer and screening compared to South-East Asian and Middle Eastern women. Our study also reported that short-term migrants had an overall lack of awareness about cervical screening and therefore, differences in migration status must be considered when administering health education programs. Understanding migrant women’s experiences, facilitators, and barriers to accessing cervical screening is essential in assisting health care professionals and policy makers to provide culturally appropriate services. Provision of training or programs to increase culturally appropriate health services amongst health care providers is also recommended. To increase cervical cancer screening uptake of migrant women living in Sydney, culturally appropriate education programs and health promotion strategies targeted towards different ethnic groups need to be administered.

Unveiling how Clinical Nursing Education can be Improved in Northern Ghana: The Perspectives of Key Informants.

IntroductionClinical nursing education is an important component of the professional development of nursing students. Key informants such as nursing lecturers, nurse managers and clinical placement coordinators play an essential role in clinical education.PurposeThe purpose of the study was to explore the perspectives of key informants on how the current state of clinical nursing education in Northern Ghana can be improved.MethodsThe study used an exploratory qualitative design. Sixteen participants were purposively selected and data were collected through face-to-face individual interviews. Data were analysed using framework analysis.FindingsThe study findings indicate that clinical nursing education can be improved by decreasing the overcrowding of students in the clinical setting, decreasing the theory-practice gap and providing relevant material resources in the clinical facilities. Also, nursing education institutions can improve clinical nursing education by equipping the skills laboratories, engaging an adequate number of lecturers, and carrying out clinical accompaniment.ConclusionThere is a need to improve clinical education through collaboration between nursing education institutions and clinical facilities. Effective collaboration will ensure the planning of clinical placement to avoid overcrowding, provision of continuous professional development programmes for preceptors and improvement in clinical supervision. Also, the provision of material resources in skills laboratories and clinical facilities to enhance clinical teaching should be given priority.

Integrar e acolher: o acesso de refugiados e imigrantes haitianos nas universidades

Abstract Considering the growth of migrations and characteristics that involve the insertion of these people into the new country, especially in the labor market, this paper analyzes how this population gets welcomed and integrated into the educational context of Brazil. This study aimed to verify the process of accepting and integrating Haitian refugee and immigrant students into undergraduate courses of the Brazilian Federal Universities. The research focuses on the country’s southern region, universities that have an agreement with the Sérgio Vieira de Mello Chair (CSVM), and specific selection processes for immigrants and refugees. It questions whether the notices published by universities instituting a unique selection process for refugees and immigrants are sufficient to integrate these students into the educational context. Therefore, through multiple case studies, this qualitative research verified that universities have isolated actions of reception and integration, demonstrating that, however much these students gain access to educational environments, there is still a lack of policies that integrate them. Thus, some actions proposed may become unified among universities. If applied jointly, it will have more strength and guide new efforts, such as the provision of language accessibility programs before the beginning of the school year, activities aimed against xenophobic and discriminatory behaviors, and training on human rights and migrations for university employees. Finally, it presents a research agenda that suggests some points to explore in future studies.

Effectiveness of Care for Child Development Program on the Sensitivity and Responsiveness Skills of Mothers.

ObjectivesThe present study was done to analyze the impact of the "care for child development" program on the sensitivity and responsiveness skills among mothers of children at risk of developmental delay.Materials & Methods This study was a quasi-experimental research with a pretest-posttest design and experimental and control groups. The statistical population included all mothers with children at risk of developmental delay in Tabriz. Fifty mothers were selected through purposive sampling. Then, they were divided into two groups of 25 cases (one experimental group and one control group) using simple random sampling. The experimental group received training about the “care for child development“ program, while the control group received no training. The Social-Emotional Assessment/Evaluation Measure Family Profile (SEAM TM family profile) and Maternal Caregiving Quality Scale were the research measurement tools. The obtained data were evaluated by analysis of covariance (ANCOVA) and independent t-test using SPSS software version 20.Results There was a significant difference between the experimental and control groups in maternal caregiving quality and responsiveness, provision of appropriate activities, predictable programs, and provision of play environment and safe home (P <0.05).Conclusion: The results showed that the care for child development program has positive effects on sensitivity and responsiveness skills of mothers of children at risk of developmental delays and can be considered and applied as a practical plan in national health policies.

Level of Technology Adoption in Groundnut (&lt;em&gt;Arachis hypogeae&lt;/em&gt; L.) Production: A Case Study in Batticaloa District

Groundnut is a major commercial crop cultivated in Sri Lanka, especially in the dry zone depending on the monsoon seasons. However, groundnut cultivation has been significantly affected by contemporary challenges, such as irrigation, climate change, methods of land preparation and selection of good seeds, which require adoption of new technologies. Especially, seed production aspects for groundnut cultivation requires a higher attention to maintain the sustainability and cost-efficiency of the process. Nevertheless, farmers are reluctant in utilizing new technology, considering their dependency on traditional methods passed through previous generations. Therefore, the current study was conducted to determine the knowledge level of farmers on technology adoption in groundnut production. A total of one hundred farmers from Eravur Pattu DS division in Batticaloa district were recruited for the current study, based on the stratified random sampling technique. An interviewer administrated pre-tested structured questionnaire was used for data collection. Descriptive analysis techniques were used to summarize the socio-demographic data and the cultivation practices among the farmers. The Chi-square test of association was used identify the significant driving factors on the level of technology adoption by farmers for groundnut seed production. It was noted that around 52% of the farmers were characterized with a moderate level of technology adoption, followed by 37% of farmers denoting a higher technology adoption level in groundnut production. According to the Chi-square statistics, the technology adoption level in groundnut seed production among the studied farmers denoted significant associations with age (p=0.049), education level (p=0.015), monthly income (p=0.047), farming experience (p=0.005), and farming extent (p=0.006). Provision of more training programmes on technology adoption for groundnut farming, extension services and insurance schemes are important to promote the technology adoption among farmers for groundnut seed production.

Knowledge regarding learning disabilities in children among primary school teachers

Background: Children are precious resources of a nation and if they are physically and psychologically healthy, then they can excel in all domains of life. Learning disabilities mainly affects the psychological domain of child as it interferes with basic skills such as organization, time planning, abstract reasoning, memory and attention. This disorder is unable to cure at primary stages as it is mostly neglected due to lack of knowledge regarding learning disabilities.Methods: A descriptive cross sectional study was used to assess the knowledge regarding learning disabilities in children among primary school teachers in selected schools of Jodhpur, Rajasthan, India in April 2017. A total sample size of 70 primary school teachers from Class 1st to 5th of four selected schools of Jodhpur, Rajasthan, India were taken using total enumeration sampling technique. The tool for data collection was self structured questionnaire.Results: The results of the study showed that the majority of primary school teachers (70% had average knowledge regarding learning disabilities, 27.14% had poor knowledge whereas only 2.86% had good knowledge and there is no significant association between the knowledge of primary school teachers and their socio-demographic variables like age, gender, marital status, religion, educational qualification, type of school, teaching experience, in-service education on learning disabilities, any family member/friend suffering with learning disabilities.Conclusions: The study concluded that primary school teachers had limited knowledge regarding learning disabilities in children. Therefore, there should be provision of awareness programmes among them along with parents of children.

Evaluation the Role of Nutrition Support Team for Monitoring the Types, Complication, Nutrients and Drugs Provision in the Parenteral Nutrition

Parenteral nutrition (PN) is a form of administering nutrients, include water, macro and micronutrients and is one of widely used mode of therapy used in patients who are unable to tolerate oral or enteral feeding. Therefore, the success of nutritional therapy depends chiefly on nutrition support teams. The aim of the present work to evaluation the provision of parenteral nutrition in the Benghazi medical center. A total of 86 patients were involved in the study and numbers of questions were answered from nutrition support team at the hospital. The result revealed that PPN (IV drip) most common used and mixture of dextrose and sodium chloride were highly provision in the hospital. Furthermore the Doctors at the ward were shown have fully responsibility for provided PN but there were neglected role of dietitian and pharmacist. Patients monitoring were not carried out routinely. Most drug delivered by PN found NSAIDs and insulin. Dextrose and sodium chlorides commonly used in the hospital for delivery medication. The present study also demonstrated that, PN did not fulfill the patients requirement and there were no patients monitoring. PN found to be used most frequently in some condition were where in real need such as pulmonary disease, GIT disorder and renal disease. Furthermore, TPN provided for the admitted patients include in emergencies, therapeutic and for unconscious patients. There were reported a number of complication in patient received PN due to lack of monitoring and prolong replacements of PN drainage. PPN (Iv drips) were the most common uses at the hospital and longer duration was proved which might led to patients burden in the hospital. Furthermore, due to the uses of PPN for longer times this could contribute for patients malnutrition. Our data suggested that, comprehensive nutrition support team and provision of intervention programs in order to increased quality and reduced patients burden and also the result of our study needed to be validated in large sample to know the real role of dietitian and pharmacist for ordered of drugs and nutrients and nutrients drug interactions. Keywords: Nutrients, Provision, TPN, PN, complication, medications.

Evaluating the effectiveness of problem-solving courts at preventing fatal and non-fatal opioid events: preliminary findings from Indiana

BackgroundFatal and non-fatal events associated with drug misuse are skyrocketing in most United States jurisdictions, including Indiana. Historically, the role of the judiciary is to arrest, impose sanctions and protect society from harm. Adults arrested for drug abuse in Indiana can be sentenced to 1 of 17 correctional facilities. As an alternative, they may be eligible to participate in a problem-solving court (PSC) programme that refers individuals to treatment as a pretrial diversionary strategy. The aim of the study is to determine which interventions offered by PSCs and correctional facilities impact morbidity and mortality. The study began in 2019 and will end in 2023; therefore, the results in this manuscript are preliminary.MethodsThe study cohort included two populations arrested for drug misuse: (1) adults sentenced to Indianan correctional facilities (1 January 2018 to 30 June 2021) and (2) adults participating in an Indiana PSC programme (1 January 2018 to 30 June 2021). The study used a mixed-methods design that integrated qualitative interviews of deputy wardens, PSC team members and service providers with the following quantitative datasets: sentencing information, emergency department visits, inpatient hospitalization admissions, prescription drug monitoring programme data and death records. The individuals will be followed at 2-week, 4-week, 6-month and 1-year intervals post-release. Difference-in-difference and time-to-event analyses will identify impactful interventions. A model will be created to show the effect of impactful interventions in Indiana counties that do not have PSCs.ResultsFindings are preliminary. There is variability amongst correctional facilities regarding programme eligibility, provided services and provision of medication-assisted treatment. All correctional facilities were severely impacted by the COVID-19 pandemic.ConclusionIt is anticipated that the adoption of impactful interventions will lower opioid-related morbidity and mortality rates.