Social Support Systems Research Articles

REFRAMING AGING AND VISION LOSS AS A PUBLIC HEALTH IMPERATIVE

Abstract Severe vision impairment and blindness often have profound effects upon older people and those who care for and about them. Recent translational research reveals in the United States, 7.3% of older people report severe vision impairment or blindness. A recent study estimated that the population of people with vision impairment will increase by 118% by 2050. The greatest increases will be among the most senior, women, African Americans, and Hispanics. People with vision impairment report greater prevalence of chronic conditions, poorer health, and poorer quality of life than older people without vision impairment, and they are much more likely to experience multiple disabilities. These factors point to grave disparities in health equity. While the multiple studies have informed social, health, and economic disparities among older people with vision impairment at the national level, virtually nothing is known about the variability of the prevalence of vision impairment, chronic conditions, health-related quality of life, and disability at the state level. The geographic distribution of vision impairment varies among and within states. Often rural and poorer areas have a higher prevalence of vision impairment — areas that generally have a paucity of eye care providers, social support systems, and vision rehabilitation services. As aging issues are addressed at state and federal levels, vision loss and vision rehabilitation are frequently omitted from the conversations and plans (e.g., Master Plans on Aging and/or Age-Friendly Plans) and from policy instruments such as the Older Americans Act, which has no mention of vision or vision loss.

CAREGIVER CHALLENGES: SOCIAL SUPPORT FOR DEMENTIA CARE OF OLDER ADULTS DURING HOSPICE ENROLLMENT

Abstract Every year, many ADRD patients rely on informal caregivers for providing care during hospice enrollment. Driven by dedication, these caregivers play a vital role. However, their responsibilities intensify over time, leading to emotional strain. Inadequate support causes burnout and stress. Limited research targets the unique needs of caregivers of ADRD patients enrolled in hospice. The purpose of this study was to describe the caregivers’ experiences regarding social support while providing care for older adults with ADRD in hospice. A qualitative descriptive approach was taken with semi-structured interviews of 20 caregivers of ADRD hospice patients (85% female; mean age [SD]: 63.75 [12.1]), including both Caucasian (70%) and African American (30%) individuals. Through content analysis, we identified three themes that described caregivers’ experiences with social support: 1) Changes in social life (e.g., homebound, stress, and family conflicts), 2) Opportunities for social connection (e.g., social support systems with family, friends), 3) Communication Modalities. These findings offer crucial insights into the diverse range of experiences caregivers face regarding social support. Additionally, it highlights the significance of caregivers needing assistance to sustain connections, take essential breaks, and adapt to shifts in their social environments. The challenges they confront and the positive elements of the support they receive are brought to light through this study. Further research into effective communication modalities and respite services could significantly enhance caregivers’ support.

A RESEARCHER–PRACTITIONER COLLABORATION ON MEASURING SUCCESS IN ELDER MISTREATMENT INTERVENTION

Abstract One of the major barriers to conducting elder mistreatment intervention research is a lack of understanding on how to measure outcomes of success. Within the context of the RISE project, this presentation will describe a highly collaborative process between researchers and RISE practitioners (supervisor and advocates) to develop a measurement instrument that meets validated research standards as well as the needs of practitioners who work directly on elder mistreatment cases and are responsible for administering the tool. Informed by ecological-systems, relational, and client-centered perspectives, RISE is a conceptually driven, evidence-based, community-based elder mistreatment response program that works with older adults at risk of or experiencing EM, as well as their alleged harmers, their relationship, and their surrounding social support systems. This presentation will describe the process of developing an appropriate measurement tool through weekly meetings over a 6-month period, from a starting point characterized by widely discrepant instrument expectations across the researcher-practitioner dyad toward an ending that achieved mutual agreement. This process required high levels of honesty, openness, patience, and humor among members. The final version of the measurement tool will be presented, which measures intervention outcome constructs of older adult social support, self-efficacy, life satisfaction, and perceived stress, as well as practitioner-client working alliance.

Projections of human kinship for all countries

Demographers have long attempted to project future changes in the size and composition of populations, but have ignored what these processes will mean for the size, composition, and age distribution of family networks. Kinship structures matter because family solidarity-a crucial source of informal care for millions of people around the world-is conditional on kin being alive. Here, we present innovative projections of biological kin for the 1950 to 2100 period and discuss what they imply for the availability of informal care. Overall, we project that the number of living kin for individuals will decline dramatically worldwide. While a 65-yo woman in 1950 could expect to have 41 living kin, a 65-yo woman in 2095 is projected to have just 25 [18.8 to 34.7] relatives (lower and upper 80% projection intervals). This represents a 38% [15 to 54] global decline. The composition of family networks is also expected to change, with the numbers of living grandparents and great-grandparents markedly increasing, and the numbers of cousins, nieces and nephews, and grandchildren declining. Family networks will age considerably, as we project a widening age gap between individuals and their kin due to lower and later fertility and longer lifespans. In Italy, for example, the average age of a grandmother of a 35-yo woman is expected to increase from 77.9 y in 1950 to 87.7 y [87.1 to 88.5] in 2095. The projected changes in kin supply will put pressure on the already stretched institutional systems of social support, as more individuals age with smaller and older family networks.

Cross-Sectional Study of the Professional Quality of Life of Palliative Care Professionals during the COVID-19 Pandemic.

The display of compassionate care by palliative care professionals is of the utmost importance to the patients, their families, and even to their own professional well-being. Lately and, especially due to the emergence of the COVID-19 pandemic, palliative care professionals have been subjected to greater pressures stemming from their work environment, organizational standpoint, and emotional sense of view. Not only have these factors made it harder for professionals to deliver compassionate care to their patients, but they have also decreased their overall well-being. The aim is to study how sociodemographics, workplace characteristics, internal resources, and the COVID-19 pandemic-derived pressures have affected the professionals' capacity to perform compassionate care and their well-being while at the same time exploring the relationship between compassionate care and well-being. This study used a cross-sectional design with data gathered from Spanish palliative care professionals. The final sample was formed by 241 participants. They were surveyed about compassion, professional quality of life, well-being, sociodemographic data, working conditions, self-care, and coping with death competence, and the impact of the COVID-19 pandemic. The analyses used were descriptive statistics, bivariate tests, and the construction of a structural equation model. Compassion was predicted by the ability to control their workload and the ability to cope with death. Burnout was predicted by age, workload, workload control, self-care, material resources, and changes in teamwork. Moreover, compassion, age, workload control, and changes in teamwork and self-care were shown to significantly predict compassion satisfaction. When it comes to compassion fatigue, different variables were shown to predict it, those being compassion, control over the workload, social self-care, and the ability to cope with death. Having a healthy lifestyle and an adequate social support system is key to maintaining professional well-being in the case of palliative care professionals. Inner resources such as the ability to perform self-care and the capacity to cope with death are of vital importance to taking care of these professionals. Thus, it would be beneficial to establish training programs focused on these aspects in the myriad of sanitary centers that perform these tasks, as these abilities are necessary to withstand the work-related pressures and, at the same time, be able to provide compassionate care for patients.

Barriers and Facilitators to Breastfeeding Practices Among Immigrant Muslim Arab Women Living in a Metropolitan Area of the Southwestern United States

Objective:Immigrant Muslim Arab women are a fast-growing and underserved minority group in the United States. Immigrant Muslim Arab women face breastfeeding challenges in accessing and seeking healthcare. Little is known about breastfeeding challenges that immigrant Muslim Arab women face to establish successful breastfeeding. This study aimed to identify the barriers and facilitators to adequate breastfeeding among immigrant Muslim Arab women who reside in a metropolitan area of the Southwestern United States and inform recommendations for practice.Methods:A cross-sectional, descriptive study was used to identify facilitators and barriers to adequate breastfeeding using the social–ecological model of health promotion. A survey was carried out with a convenience sample of 116 immigrant Muslim Arab women with at least one child, 5 years or younger, from a large metropolitan area between September and November 2016.Results:Facilitators of breastfeeding within the sample were high intentions to breastfeed, positive breastfeeding attitudes related to the benefits of breastfeeding, religious teachings promoting breastfeeding, and encouragement to breastfeed from the mothers’ social support system. Several barriers to successful breastfeeding were related to lacking the specific knowledge of the benefits of breastfeeding and discomfort with breastfeeding in public and in front of strangers.Conclusions:Nurses and healthcare providers need to apply ecological breastfeeding interventions to promote optimal breastfeeding in this population.

Contextual, structural, and mental health experiences of children of women engaged in high-risk sexual behaviour in Kampala: a mixed method study.

Children born to women who sell sex for money or commodities may face economic and social insecurity because of their mother's work, particularly in settings where sex work is illegal. From October 2020 to May 2021, we conducted a study with 60 children aged 12-24 years, born to sex workers in Kampala, Uganda. The children took part in 60 semi-structured interviews, 20 life history interviews, and 4 focus group discussions, which were used to explore their social, economic, and mental health experiences and investigate their vulnerabilities and resilience. Quantitative data were collected using REDcap, and descriptive analysis was done using Stata 14. Qualitative data were collected using semi-structured topic guides, and data analysed thematically. We explored findings in relation to a wellbeing framework. The findings showed that children experienced contextual and structural hardships, including incomplete and irregular schooling, a lack of privacy at home, food insecurity, and physical and psychological violence from relatives and sometimes from their mothers. Some children reported mental wellbeing struggles with hopelessness, nervousness, and sadness. Alcohol and drug use were common in most families. Community social network support systems, including neighbours and grandparents, were important; most children had absentee fathers. Some children suspected or knew how their mother earned her income. Resilience for most children was tagged to support from close networks and financial support from the government and civil society. Children of sex workers in Kampala experience structural, contextual, and mental health challenges but have a positive attitude towards the future. It is important to strengthen community support systems for these children and those living in similar circumstances in low- and middle-income countries.

“I can feel the money going out of the window”: How high energy prices evoke negative emotions in people with previous experience of homelessness

Current research on how energy vulnerability impacts the meaning of ‘home’, especially for those in marginalised groups, is limited. This research adds to the understanding of how high energy prices affect one of the most vulnerable sections of society: those at risk of or with experiences of homelessness. Through 15 in-person interviews with social housing tenants in Ireland who have recently exited homelessness, we find that high energy prices continue to affect the psychosocial benefits associated with ‘home’ in three different ways: 1) the constant pressure of monitoring energy expenses and lifestyle adjustments; 2) navigating the uncertainty of energy expenses and; 3) the impacts of negative emotions like stress and anxiety induced by high energy prices on tenants' fragile state of mental health and wellbeing. Based on the findings, we argue that living with high energy prices continues to interfere with the meaning of ‘home’ in an already vulnerable cohort, leading to deep senses of ontological insecurity. Therefore, specifically designed policy support is required to address energy vulnerability in people exiting homelessness, as ontological insecurity affects their mental and physical wellbeing, jeopardising their chances of a permanent transition from homelessness. Our findings indicate that perhaps a dual financial and social support system is needed to address the specific energy needs of vulnerable groups, that would provide intensive guidance for them as they settle into new routines and responsibilities. Policies to solve homelessness can be more impactful if they adequately address energy affordability-related challenges while a person transitions from homelessness.

Формирование и функционирование социального государства в Испании

The article presents the history of the Spanish social support system development from the Middle Ages to the beginning of the XXI century. The purpose of the article is to analyze the background and features of the Spanish social policy. To study the development of the Spanish welfare state, the article uses the comparative historical approach and the analysis of institutions, legal documents and statistical data. The experience of Spain and other countries is compared, approaches to the typology of social policy are considered, economic factors and transformations of support measures and principles of redistribution are analyzed. Despite the fact that some trends manifested in Spain earlier than in other countries, the Spanish welfare state formed relatively late. The country has developed a unique configuration of social support, combining the German logic of a corporatist approach with a British universalist one. The Spanish experience of organizational decisions in the field of social policy is of interest, since Spain is facing the problem of an aging population against a background of persistently high unemployment creating serious pressure on the social system, which retains its functionality due to a periodic revision of priorities.

Navigating the Australian child protection system: The importance of formal and informal support for carers to effectively provide care to children in out‐of‐home care

AbstractChildren in out‐of‐home care (OOHC) are a vulnerable group who often experience poorer outcomes than their peers who are not in OOHC. In 2020–2021, there were approximately 46 200 children in OOHC in Australia, with 91% in a family setting with foster or kinship carers. Data from other countries show similar patterns indicating that foster and kinship carers provide care for most children in OOHC. To effectively provide children in OOHC with the care they require, including safety, stability, and connection, the carers need a social support system that equips them to meet the needs of these vulnerable children and to prevent the breakdown of placements. The study presented in this paper draws on social constructivist and critical perspectives to examine the formal and informal social support available to carers using data from a qualitative study investigating OOHC in Queensland, Australia. Our sample is 113 carers, caring for 194 children aged 1–12 years old. We find lack of integration across formal support systems and failure to recognize the invisible workload undertaken by carers are two key challenges faced by carers. Upskilling and stabilizing the child protection work force, as well as better training for carers, is also required. Addressing these issues will enhance the social support systems of carers and improve the safety, stability, and connection of children in OOHC.

The Relationship Between Career Women and Its Effects on Achieving Family Harmony with Maqashid Shariah Framework

This research explores the involvement of career women and its effects on achieving family unity using the Maqashid Shariah framework. The research approach in this article is normative and is analyzed qualitatively. The data analysis technique employed is deductive, used to determine the rights and responsibilities of husbands and wives in the gender concept, which is then further examined, developed, and described in more detail using the study of Maqashid Shariah. The findings are women pursuing careers have both positive and negative impacts. The negative impact includes reduced interaction with family members and potentially less affection for their children. On the positive side, career-oriented women can self-actualize, contribute their knowledge to society, build extensive networks and experiences, and help meet their family’s financial needs. Career women who effectively integrate their professional and family responsibilities can establish a harmonious balance between individual needs and familial obligations. Within the Maqashid Shariah framework, this research highlights the importance of ensuring that the role of career women aligns with Islamic values and principles, strengthening family unity, and promoting gender equality. The implications of this research underscore the need for policies and programs that promote gender equity, social support systems, and an awareness of Islamic values among career women. The findings serve as a valuable reference for policymakers and practitioners, aiding in developing strategies that support career women in attaining family unity per Islamic values and principles.

Heart failure: a prevalence-based and model-based cost analysis.

Heart failure (HF) imposes a heavy economic burden on patients, their families, and society as a whole. Therefore, it is crucial to quantify the impact and dimensions of the disease in order to prioritize and allocate resources effectively. This study utilized a prevalence-based, bottom-up, and incidence-based Markov model to assess the cost of illness. A total of 502 HF patients (classes I-IV) were recruited from Madani Hospital in Tabriz between May and October 2022. Patients were followed up every two months for a minimum of two and a maximum of six months using a person-month measurement approach. The perspective of the study was societal, and both direct and indirect costs were estimated. Indirect costs were calculated using the Human Capital (HC) method. A two-part regression model, consisting of the Generalized Linear Model (GLM) and Probit model, was used to analyze the relationship between HF costs and clinical and demographic variables. The total cost per patient in one year was 261,409,854.9 Tomans (21,967.21 PPP). Of this amount, 207,147,805.8 Tomans (17,407.38 PPP) (79%) were indirect costs, while 54,262,049.09 Tomans (4,559.84 PPP) (21%) were direct costs. The mean lifetime cost was 2,173,961,178 Tomans. Premature death accounted for the highest share of lifetime costs (48%), while class III HF had the lowest share (2%). Gender, having basic insurance, and disease class significantly influenced the costs of HF, while comorbidity and age did not have a significant impact. The predicted amount closely matched the observed amount, indicating good predictive power. This study revealed that HF places a significant economic burden on patients in terms of both direct and indirect costs. The substantial contribution of indirect costs, which reflect the impact of the disease on other sectors of the economy, highlights the importance of unpaid work. Given the significant variation in HF costs among assessed variables, social and financial support systems should consider these variations to provide efficient and fair support to HF patients.

"Blind men and an elephant": The need for animals in research, drug safety studies, and understanding civilizational diseases.

Animal-based research and drug safety studies are essential to understanding the mysteries of nature and the long-term survival of humans. Due to the rapid increase in the global human population, conflict- and economically driven human migration, tourism-related activities, densely populated metropolitan areas, and local policies, humans will be affected by a multitude of novel disease-causing microorganisms and civilizational diseases. Despite disparities among countries, recent and planned changes in regulations concerning animal research and drug safety studies could have detrimental effects on both the animal research community and nations lacking sufficient social support systems. Based on existing scientific literature, I argue that we need animal research encompassing aspects such as animal development, behavior, drug safety studies, and for the understanding of future civilizational diseases. Depending on the nature of the research questions and local challenges, a suitable animal model organism should be made mandatory.

중국 사범대학생의 대인관계능력과 자기효능감이 대학생활적응에 미치는 영향에서 사회적 지지의 매개효과

The purpose of this study is to analyze the mediating effect of social support in the effect of interpersonal relationship skills and self-efficacy of Chinese teachers' college students on college life adaptation. The research questions set up to achieve the purpose of this study are as follows First, what is the structural relationship between interpersonal skills, self-efficacy, social support, and college life adaptation of Chinese college students? Second, what is the mediating effect of social support in the effect of interpersonal relationship skills and self-efficacy of Chinese college of education students on college life adaptation? The subjects of this study were 560 first- to fourth-grade teachers' college students attending three universities in northwestern China, and 517 of them were used for the study. The conclusion of the study is as follows. First, in the structural relationship of measurement variables, Chinese teachers' college students' interpersonal skills and self-efficacy have a direct meaningful effect on social support, and social support has a significant effect on adapting to college life. In addition, interpersonal skills and self-efficacy have a direct meaningful effect on adapting to college life. Second, the mediating effect of social support was significant in the impact of interpersonal relationship skills and self-efficacy of Chinese teachers' college students on college life adaptation. Therefore, it is necessary to prepare a plan to establish various social support systems in adapting to college life at the university level and continue to operate them.

Anxiety in hospitalized patients with infectious diseases placed in isolation: a concept analysis

Purpose: This study conducted a concept analysis to clarify the meaning of anxiety in hospitalized patients with infectious diseases who have been placed in isolation. Methods: This study used Walker and Avant’s process of concept analysis. Results: Anxiety in hospitalized patients with infectious diseases who have been placed in isolation can be defined by the following attributes: 1) fear, 2) guilt, 3) isolation, 4) discrimination, 5) frustration, 6) shame, and 7) uncertainty. The antecedents of anxiety were as follows: 1) a lack of information about infectious diseases, 2) restrictions of movement, 3) blockage of the social support system, 4) helplessness, and 5) negative biases. The consequences of anxiety were 1) internalized stigma, 2) loss of confidence, 3) lack of social activities and avoidance, 4) insomnia, 5) poor quality of life. Conclusion: The definition and attributes of anxiety identified in this study can be applied to enhance the understanding of anxiety in hospitalized patients with infectious diseases who have been placed in isolation. Systematic suppose should also be provided to reduce anxiety in these patients.

Binary Gender Differences in Quality of Life and Social Supports Among Individuals with Immune Thrombocytopenia (ITP): Data from the ITP Natural History Study Registry

BACKGROUND AND AIMS Immune thrombocytopenia (ITP) is an autoimmune bleeding condition characterized by low platelet count and a range of bleeding risks. Patients with ITP often report their quality-of-life (QoL) is negatively impacted by fatigue, mental health, and changes in their physical appearance. Research on impact of sex differences on QoL for ITP patients is limited. Studies show the importance of social support systems for patients with rare disease, but variation in social support between male and female ITP patients have not been reported. Using patient inputted registry data, we highlight binary gender differences in social support and ITP disease impact on survey participants overall health related QoL. METHODS This is a prospective cohort study of self-reporting adults with ITP registered in the ITP Natural History Study Registry. Data were collected using responses from three surveys within the Registry up to July 3, 2023. Participants were included in the study if they completed all three surveys. Data was analyzed with descriptive statistics and chi-squared tests. Majority of questions asked were based on a Likert scale. Responses were divided into the following categories: ‘Social Supports’, ‘Physical health’, ‘Emotional health’, and overall health related QoL (HRQoL). RESULTS Four hundred and sixty participants were included in the study; 358 (78%) were females over 18 years of age and 102 (22%) were males over 18 years of age. Most participants were from the US (382; 83%) and between ages 18-100 years (mean age 47 years). Social Supports: Women and men reported similar levels of social support.Within the prior seven days, 280 (90%) females and 80 (79%) males reported they had someone to listen to them ‘often’ or ‘always’ (n = 354 (females), 102 males). Two hundred and seventy-nine (78%) females and 77 (72%) males reported they had someone to confide in ‘often’ or ‘always’ (n = 354 (females), 102 males), and 233 (63%) females and 71 (71%) males reported they had someone in their life who understands them ‘often’ or ‘always’ (n = 355 (females), 102 males). Physical health: Women reported significantly more limitations in activities due to physical health compared to men (85; 23% vs 8; 8%; p = .0004) (n = 358 (females); 102 (males). Women reported higher average fatigue levels (109; 19% vs 15; 14%; p = .0015), and greater frequency of feeling tired compared to men (207; 58% vs 27; 27%; p = .00001). Emotional health: Women reported significantly higher levels of negative mental health ‘often’ or ‘always’ impacting mood and ability to think compared to men (201; 57% vs 38; 38%; p = .000618) (n = 356 (females); 102 (males), and reported being bothered ‘often’ or ‘always’ by emotional problems such as feeling anxious, depressed, or irritable, more than men (76; 21% vs 12; 12%; p = .032). Overall HRQoL: Men reported overall HRQoL as either ‘very good’ or ‘excellent’ more than women (179; 50% vs 59; 59%). The difference was not statistically significant. CONCLUSION Our study demonstrates adult females and males with ITP have differences in reported HRQoL. Both reported similar levels of social support, such as having someone who understands their problems and can listen. Despite this, females reported higher frequencies of being limited in doing various activities, feeling tired, mental health struggles, and emotional problems. This study offers novel insight into experiences between adult women and men with ITP. Comparisons with non-ITP participants would be helpful to include in future studies to investigate whether sex differences in HRQoL are in fact due to the ITP itself. Future treatment plans may consider which HRQoL factors are impacted most by ITP and could tailor management approaches accordingly.

Defeminization of practicing dentists: A national perspective

Madam, The dental profession has witnessed a progressive shift where female dentists are becoming more prevalent in many countries, including Pakistan. This trend, known as the feminization of dentistry1, can be attributed to changing societal and economic perceptions, increased acceptance of diverse gender roles, and the recognition of the benefits of adopting feminine traits in the dental profession.2 In Pakistan, the transition began in the early 1990s when the quota system limiting seats for women in medical and dental schools was abolished. Currently, around 70% of undergraduate dental students in Pakistan are female.2 However, despite the promising number of female dental students, there is a significant drop in postgraduate training and professional practice. Only 5% of graduating female dentists pursue postgraduate training, and only half of the registered female dentists work.3 The reasons for this decline include a glass ceiling effect, which hinders women's advancement in their careers, the lack of female representation in leadership roles, the absence of female mentorship at the postgraduate level, and dual family and domestic responsibilities. Additionally, female dentists may face bias and preference towards their male counterparts in high-status specialities, impacting their promotional opportunities and patient preferences.4,5 Persistence of societal pressure and traditional gender roles also contribute to the dropout rate of female dentists in Pakistan. Many young women are often pressured to prioritize family obligations over professional commitments, leading them to leave the dental profession early. Moreover, the absence of part-time options further limits their ability to balance family responsibilities with dental practice. To address these challenges and enable the sustained involvement of female dentists, several measures are necessary. Increasing female representation in leadership roles, make leadership part of the educational curriculum, providing mentorship opportunities, and establishing strong social support systems for women are crucial. Reforms should also focus on improving ergonomics in dental practice, highlighting cultural loopholes for gender biases, equity issues and implementing policies that support working mothers, such as flexible working hours, adequate maternity leave and family care facilities. While efforts have been made to increase the number of female dental students, there is still a long way to go in creating an inclusive and supportive environment for practicing female dentists in Pakistan. By addressing the root causes of the gender disparity and implementing necessary reforms, Pakistani society can break the glass ceiling and allow future generations of women to contribute fully to the field of dental healthcare.

Self – Advocacy Significance in Work Placement Adjustment of PwID

Self – Advocacy of differently abled adults living in Urban cities, Suburban and Rural areas were examined with respect to self - advocacy of their technical training, life skill development programs and social support systems. In the present situation based on applicability of scientific knowledge helping the Intellectual disabled adult children from positive psychology frameworks and from the strengths-based approach through which they can learn natural language and understanding language is currently focused by special education and vocational training centres for differently abled adult students. Under this framework, Self-determined, Self – advocacy action is including and able to implement practically by two following essential criteria’s: 1. Vocational training action, 2. Self - governing action. Vocational action refers to the extent to which a person makes intentional, conscious choices based on differently abled adult choice and interests. Self - governing action involves self-directing and managing actions in service of a chosen work area and implies identifying different ways and methods to solve their disable problem. This study paper focusing on the dedicated services of Vocational training centres rendering multiple roles in promoting technical skills and life skills based on identifying different abilities and preparing the differently abled adults to enter into suitable work places for self-earning with intellectual disabilities. The study was conducted with the purpose to identifying the role of Vocational instructors in development of assessment tool, need assessment of functional skills, programming, implementation, and evaluation of training program by involving even parents in all stages. Differently abled adults in DAIL section identified male and female students and their parents who showed their commitment to participate in the program were involved in the Work Placement Adjustment of PwID program. Need assessment of functional skills of each adult was done through technical and functional skills training programs were developed by implementing and evaluated with the support of parents. Data showed that Instructors played multiple roles were observed in the whole study; their teaching style, use of different behaviour modification technique and other were come forth and performance of differently abled adults was increased.

Multimodal therapies and strategies for the treatment of interstitial cystitis/bladder pain syndrome in Taiwan.

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic disease characterized by bladder pain, frequency, and nocturia. The most common pathologies include chronic inflammation and bladder urothelium dysfunction. According to the bladder condition with or without Hunner's lesions, IC/BPS can be divided into "IC" in patients with Hunner's lesion (HIC) and "BPS" in those without Hunner's lesion (NHIC). Previous studies have reported greater central sensitization and interorgan cross-talk in patients with NHIC. Multimodal treatments have been recommended in clinical guidelines under the biopsychosocial model. The bladder-gut-brain axis has also been speculated, and multimodal therapies are necessary. Unfortunately, currently, no treatment has been reported durable for IC/BPS. Patients with IC/BPS usually experience anxiety, depression, holistic physical responses, and even threats to social support systems. The lack of durable treatment outcomes might result from inadequate diagnostic accuracy and differentiation of clinical phenotypes based on the underlying pathophysiology. Precision assessment and treatment are essential for optimal therapy under definite IC/BPS phenotype. This article reviewed currently available literature and proposed a diagnosis and treatment algorithm. Based on bladder therapy combined with suitable physical and psychological therapies, a well-grounded multimodal therapy and treatment algorithm for IC/BPS following a diagnostic protocol are indispensable.

Exploring infant and young child-feeding practices among mothers of well-nourished children in northern Ghana: An INPreP substudy.

This study investigated infant and young child-feeding (IYCF) practices among mothers of well-nourished children in northern Ghana. This was a qualitative study where in-depth individual interviews were conducted with participants. The interviews were audio recorded, transcribed, and QSR Nvivo software version 11 was used to organize the data before thematic analysis. It was observed that mothers of well-nourished children were likely to adhere to breastfeeding guidelines and also practice appropriate complementary feeding. Furthermore, these mothers mostly had some form of support from their husbands and mother-in-laws in feeding their infants. While adoption and adherence to appropriate IYCF practices contribute to improved nutrition outcomes in children, social support systems are needed to sustain the practice.