Experiences and Coping of Adults with Death of Siblings during Childhood in Chinese Context: Implications for Therapeutic Interventions

The death of a sibling in childhood leads to significant impacts on both personal and family development of the surviving siblings, however, both short-term and long-term effects of sibling loss in Chinese societies such as Hong Kong have been inadequately documented in the literature. This paper explores the experience of encountering siblings’ death during childhood with the use of semi-structured interviews. Through thematic analysis, the author explores the impacts on surviving siblings’ emotions, coping styles, struggles and challenges and personal development. Furthermore, the influences on family dynamics are explored thoroughly, including the changes in family atmosphere, family roles, family relationship, family communication and parenting styles. More importantly, the author identifies (i) existing continuing bonds; (ii) crying; (iii) adequate social support; (iv) hiding own emotions as a gesture of protecting parents as the crucial elements pertinent to surviving siblings’ successful adaptation in the face of sibling loss. In addition, “child-centered” and “family-centered” service implications of families with a sibling's death in a Chinese context are discussed.

Knowledge, Attitude and Practice of Pregnant Women toward Antenatal Care at Public Hospitals in Sana'a City-Yemen

Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of Antenatal Care (ANC) include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding ANC. Methodology: A descriptive knowledge, attitude, and practice (KAP) study was conducted in public hospitals in Sana'a City, Yemen. The study population included all pregnant women that intended to the prenatal department and clinical outpatient department; the final sample size was 371 pregnant women. A self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women had correct answers in total knowledge regarding ANC, and about two-thirds (67%) of pregnant women had performance practice regarding ANC and two-third (68%) of pregnant women had a positive attitude. Conclusions: More than three quarter of pregnant women had good knowledge level, most of pregnant women had moderate practice level, and more than two-thirds of pregnant women had a positive attitude regarding antenatal care. There was a statistically significant association between overall knowledge and practice level toward ANC and demographic characteristics of pregnant women, at P-value ≤ 0.05. Recommendations: we recommended more education and training courses, lecturers, and education sessions in clinical facilitators focused on ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

The Impact of COVID-19 Pandemic on Acute Urology Admissions in a Busy District General Hospital in the UK

Coronavirus disease 2019 (COVID-19) has had unprecedented effects on the healthcare system in the UK. The pandemic has impacted every service within secondary care, including urology. Our objective is to determine how COVID-19 has influenced acute urology admissions in a busy district general hospital in the UK. To conduct the study, retrospective data of patients presenting acutely to the urology department were collected between January 13 to March 22, 2020 (pre-lockdown period) and March 23 to May 31, 2020 (lockdown period). The nature of referrals, types of admission encountered, and management required in accordance with the new set of protocols established during the lockdown period were analysed and compared to the same data prior to UK lockdown. Included in the study were 1092 patients. The results show that an overall reduction of 32.5% was seen in the total number of admissions. A marked decrease was seen in non-urological pathology as compared to other categories. Urolithiasis showed the highest proportional increase. Treatment varied proportionately to the diagnosis, with conservative management accounting for the most likely treatment during lockdown. However, the proportion of patients requiring interventions during the lockdown period increased overall. No comparative differences were observed during the two periods in terms of source of referral, length of stay and patient age. The results of the study concluded that the admission rate showed a decrease, with no significant difference in the nature and timing of presentation. Our department was able to continue providing effective management to patients presenting acutely during the COVID-19 outbreak.

Capacities of Early Childhood Education Professionals for the Prevention of Social Exclusion of Children

Both policymakers and researchers recognize that participating in early childhood education and care (ECEC) is useful for all children, especially for those who are exposed to the high risk of social exclusion. Social exclusion of children is understood as a multidimensional construct including economic, social, cultural, health, and other aspects of disadvantage and deprivation, which individually or combined can have an unfavorable effect on the current life and development of a child, as well as on the child’s development and on disadvantaged life chances in adult life. ECEC institutions should be able to promote educational approaches that portray developmental, cultural, language, and other diversity amongst children. However, little is known about the ways in which Croatian ECEC institutions recognize and respect the diversity of children and their families and how they respond to their educational needs. That is why this paper is dedicated to the analysis of the capacities of ECEC professionals to respond to the demands of educational needs of this very diverse group of children and their families. The results obtained in the frame of the project “Models of response to educational needs of children at risk of social exclusion in ECEC institutions,” funded by the Croatian Science Foundation, will be presented. The research methodology arises from explanations of educational processes and risks of social exclusion as a complex and heterogeneous phenomenon. The preliminary results of the qualitative data analysis of educational practices regarding capacities to identify and appropriately respond to the requirements of children at risk of social exclusion will be presented. The data have been collected by interviewing educational staff in 10 Croatian ECEC institutions (n = 10). The questions in the interviews were related to various aspects of inclusive institutional policy, culture, and practices. According to the analysis, it is possible to conclude that Croatian ECEC professionals are still faced with great challenges in the process of implementation of inclusive policies, culture, and practices. There are several baselines of this conclusion. The interviewed educational professionals are not familiar enough with the whole complexity and diversity of needs of children at risk of social exclusion, and the ECEC institutions do not have enough resources to provide all interventions that these children and their families need.

The Effects of an Online Career Intervention on University Students’ Levels of Career Adaptability

People’s ability to adapt to a constantly changing environment is essential. Career adaptability is central to Career Construction Theory, where proper adaptation to new situations, changing environments, and jobs require adequate career development. Based on current career theories and the possibilities offered by digital technology, the primary goal of this study is to develop career adaptability through an online tool. Its secondary goal is to apply for an online career intervention program and explore its developmental possibilities. A total of 132 university students from the bachelor program took part in the study, from which 65 students received a four-week online career intervention, while 67 participants formed the control group. Based on the results, it can state that career adaptability can be developed, and there is a great demand and interest from university students to use career-related programs on online platforms. Career interventions should be performed online as well if there is suitable software and a well-constructed program. Limitations and further implications are discussed.

Robot-assisted Relaxation Training for Children with Autism Spectrum Disorders

Cognitive Behavioral Therapy (CBT) has been proven an effective tool to address anger and anxiety issues in children and adolescents with Autism Spectrum Disorders (ASD). Robot-enhanced therapy has been used in psychosocial and educational interventions for children with ASD with promising results. Whenever CBT-based techniques were incorporated in robot-based interventions, they were mainly performed in group sessions. Objectives: The study’s main objective was the implementation and evaluation of the effectiveness of a relaxation training intervention for children with ASD, delivered by the social robot NAO. Methods: 20 children (aged 7–12 years) were randomly assigned to 16 sessions of relaxation training implemented twice a week. Two groups were formed: the NAO group (children participated in individual sessions with the support of NAO) and the control group (children participated in individual sessions with the support of the therapist only). Participants received three different relaxation scenarios of increasing difficulty (a breathing scenario, a progressive muscle relaxation scenario and a body scan medication scenario), as well as related homework sheets for practicing. Pre- and post-intervention assessments were conducted using the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire for parents (SDQ-P). Participants were also asked to complete an open-ended questionnaire to evaluate the effectiveness of the training. Parents’ satisfaction was evaluated via a questionnaire and children satisfaction was assessed by a thermometer scale. Results: The study supports the use of relaxation training with the NAO robot as instructor for children with ASD. Parents of enrolled children reported high levels of satisfaction and provided positive ratings of the training acceptability. Children in the NAO group presented greater motivation to complete homework and adopt the learned techniques at home. Conclusions: Relaxation training could be effectively integrated in robot-assisted protocols to help children with ASD regulate emotions and develop self-control.

Manual Pit Emptiers and Their Heath: Profiles, Determinants and Interventions

The global sanitation workforce bridges the gap between sanitation infrastructure and the provision of sanitation services through essential public service work. Manual pit emptiers often perform the work at the cost of their dignity, safety, and health as their work requires repeated heavy physical activities such as lifting, carrying, pulling, and pushing. This exposes them to occupational and environmental health hazards and risking illness, injury, and death. The study will extend the studies by presenting occupational health risks and suggestions for improvement in informal settlements of Nairobi, Kenya. This is a qualitative study conducted among sanitation stakeholders in Korogocho, Mukuru and Kibera informal settlements in Nairobi. Data were captured using digital voice recorders, transcribed and thematically analysed. The discussion notes were further supported by observational notes made during the interviews. These formed the basis for a robust picture of occupational health of manual pit emptiers; a lack or inappropriate use of protective clothing, and prolonged duration of working hours were described to contribute to the occupational health hazard. To continue working, manual pit emptiers had devised coping strategies which include working in groups, improvised protective clothing, sharing the available protective clothing, working at night and consuming alcohol drinks while at work. Many of these strategies are detrimental to their health. Occupational health hazards among pit emptiers are key for effective working and is as a result of a lack of collaboration amongst stakeholders linked to health, safety and lack of PPE of pit emptiers. Collaborations amongst sanitation stakeholders is paramount for health, safety, and in ensuring the provision and use of personal protective devices.

A Real-Time Bayesian Decision-Support System for Predicting Suspect Vehicle’s Intended Target Using a Sparse Camera Network

We present a decision-support tool to assist an operator in the detection and tracking of a suspect vehicle traveling to an unknown target destination. Multiple data sources, such as traffic cameras, traffic information, weather, etc., are integrated and processed in real-time to infer a suspect’s intended destination chosen from a list of pre-determined high-value targets. Previously, we presented our work in the detection and tracking of vehicles using traffic and airborne cameras. Here, we focus on the fusion and processing of that information to predict a suspect’s behavior. The network of cameras is represented by a directional graph, where the edges correspond to direct road connections between the nodes and the edge weights are proportional to the average time it takes to travel from one node to another. For our experiments, we construct our graph based on the greater Los Angeles subset of the Caltrans’s “Performance Measurement System” (PeMS) dataset. We propose a Bayesian approach where a posterior probability for each target is continuously updated based on detections of the suspect in the live video feeds. Additionally, we introduce the concept of ‘soft interventions’, inspired by the field of Causal Inference. Soft interventions are herein defined as interventions that do not immediately interfere with the suspect’s movements; rather, a soft intervention may induce the suspect into making a new decision, ultimately making their intent more transparent. For example, a soft intervention could be temporarily closing a road a few blocks from the suspect’s current location, which may require the suspect to change their current course. The objective of these interventions is to gain the maximum amount of information about the suspect’s intent in the shortest possible time. Our system currently operates in a human-on-the-loop mode where at each step, a set of recommendations are presented to the operator to aid in decision-making. In principle, the system could operate autonomously, only prompting the operator for critical decisions, allowing the system to significantly scale up to larger areas and multiple suspects. Once the intended target is identified with sufficient confidence, the vehicle is reported to the authorities to take further action. Other recommendations include a selection of road closures, i.e., soft interventions, or to continue monitoring. We evaluate the performance of the proposed system using simulated scenarios where the suspect, starting at random locations, takes a noisy shortest path to their intended target. In all scenarios, the suspect’s intended target is unknown to our system. The decision thresholds are selected to maximize the chances of determining the suspect’s intended target in the minimum amount of time and with the smallest number of interventions. We conclude by discussing the limitations of our current approach to motivate a machine learning approach, based on reinforcement learning in order to relax some of the current limiting assumptions.

Performance Prediction Methodology of Slow Aging Assets

Asset management of urban infrastructures faces a multitude of challenges that need to be overcome to obtain a reliable measurement of performances. Predicting the performance of slowly aging systems is one of those challenges, which helps the asset manager to investigate specific failure modes and to undertake the appropriate maintenance and rehabilitation interventions to avoid catastrophic failures as well as to optimize the maintenance costs. This article presents a methodology for modeling the deterioration of slowly degrading assets based on an operating history. It consists of extracting degradation profiles by grouping together assets that exhibit similar degradation sequences using an unsupervised classification technique derived from artificial intelligence. The obtained clusters are used to build the performance prediction models. This methodology is applied to a sample of a stormwater drainage culvert dataset.

Consequential Influences of Work-Induced Emotions on the Work-Induced Happiness of Frontline Workers in Finance-Oriented Firms

Frontline workers performing client service duties in finance-oriented firms in most sub-Saharan African countries, such as Ghana, are known to be challenged in the conduct of their activities. The challenge is attributed to clients’ continued demand for real-time services from such workers, despite the introduction of technological interventions to offset the situation. This has caused such frontline workers to experience increases in their work-induced emotions with consequential effects on their work-induced happiness. This study, therefore, explored the effect of frontline workers’ work-induced emotions on their worked-induced happiness when providing tellering services to clients. A cross-sectional design and quantitative technique were used. Data were collected from a sample of 280 frontline workers using questionnaire. Based on the analysis, it was found that an increase in the frontline workers’ work-induced emotions, caused by their feelings of strain, burnout, frustration, and hard work, had consequential effect on their work-induced happiness. This consequential effect was also found to be aggravated by the workers’ senses of being stretched beyond limit, being emotionally drained, and being used up by their work activities. It is concluded that frontline workers in finance-oriented firms can provide quality real-time services to clients without increases in their work-induced emotions, but with enhanced work-induced happiness, when the psychological and physiological emotional factors associated with the challenged work activities are understood and remedied. Management of the firms can use such understanding to redesign the activities of their frontline workers and improve the quality of their service delivery interactivity with clients.

Comparison of Two Maintenance Policies for a Two-Unit Series System Considering General Repair

In recent years, maintenance optimization has attracted special attention due to the growth of industrial systems complexity. Maintenance costs are high for many systems, and preventive maintenance is effective when it increases operations' reliability and safety at a reduced cost. The novelty of this research is to consider general repair in the modeling of multi-unit series systems and solve the maintenance problem for such systems using the semi-Markov decision process (SMDP) framework. We propose an opportunistic maintenance policy for a series system composed of two main units. Unit 1, which is more expensive than unit 2, is subjected to condition monitoring, and its deterioration is modeled using a gamma process. Unit 1 hazard rate is estimated by the proportional hazards model (PHM), and two hazard rate control limits are considered as the thresholds of maintenance interventions for unit 1. Maintenance is performed on unit 2, considering an age control limit. The objective is to find the optimal control limits and minimize the long-run expected average cost per unit time. The proposed algorithm is applied to a numerical example to compare the effectiveness of the proposed policy (policy Ⅰ) with policy Ⅱ, which is similar to policy Ⅰ, but instead of general repair, replacement is performed. Results show that policy Ⅰ leads to lower average cost compared with policy Ⅱ. 

A Continuous Real-Time Analytic for Predicting Instability in Acute Care Rapid Response Team Activations

A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

A Deep-Learning Based Prediction of Pancreatic Adenocarcinoma with Electronic Health Records from the State of Maine

Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

An Analysis of the Strategies Employed to Curate, Conserve and Digitize the Timbuktu Manuscripts

This paper briefly reviews the range of curatorial interventions made to preserve and display the Timbuktu Manuscripts. The government of South Africa and Mali collaborated to preserve the manuscripts, and brief notes will be presented about the value of archives in those specific spaces. The research initiatives of the Tombouctou Manuscripts Project, based at the University of Cape Town, feature prominently in the text. A brief overview of the history of the archive will be presented and its preservation as a key turning point in curating the intellectual history of the continent. ­­­The strategies of preservation, curation, publication and digitization are presented as complimentary interventions. Each materialization of the manuscripts contributes something significant; the complexity of the contribution is dependent primarily on the format of presentation. This integrated reading of the manuscripts is presented as a means to gain a more nuanced understanding of the past, which greatly surpasses how much information would be gleaned from relying on a single media format.

A Quantitative Study Identifying the Prevalence of Anxiety in Dyslexic Students in Higher Education

Adult students with dyslexia in higher education can receive support for their cognitive needs but may also experience negative emotion such as anxiety due to their dyslexia in connection with their studies. This paper aims to test the hypothesis that adult dyslexic learners have a higher prevalence of academic and social anxiety than their non-dyslexic peers. A quantitative approach was used to measure differences in academic and social anxiety between 102 students with a formal diagnosis of dyslexia compared to 72 students with no history of learning difficulties. Academic and social anxiety was measured in a questionnaire based on the State-Trait Anxiety Inventory. Findings showed that dyslexic students showed statistically significant higher levels of academic, but not social anxiety in comparison to the non-dyslexic sample. Dyslexic students in higher education show academic anxiety levels that are well above what is shown by students without dyslexia. The implications of this for the dyslexia practitioner is that delivery of strategies to deal with anxiety should be seen equally as important, if not more so, than interventions to deal with cognitive difficulties.

Drawings as a Methodical Access to Reconstruct Children's Perspective on a Horse-Assisted Intervention

In this article, the collection and analysis of drawings are implemented and discussed as a methodological approach to reconstruct children's perspective on horse-assisted interventions. For this purpose, drawings of three children (8-10 years old) were included in the research process in order to clarify the question of what insights can be derived from the drawings about the child's perspective on the intervention. The children were asked to draw a picture of themselves at the horse stable. Practical implementation considerations are disclosed. The developed analysis steps consider the work of two art historians (Erwin Panofsky and Max Imdahl) to capture the visual sense and to interpret the children's drawings. Relevant topics about the children's perspective can be inferred from the drawings. In the drawings, the following topics are important for the children: Overcoming challenges and fears in handling the horse, support from an adult in handling the horse and feeling self-confident and competent to act after completing tasks with the horse. The drawings show the main topics which are relevant for the children and can be used as a basis for conversation. All in all, the child's drawing offers a useful addition to other survey methods in order to gain further insights into the experiences of children in a horse-assisted setting.

Prospects for Sustainable Chemistry in South Africa: A Plural Healthcare System

The notion of sustainable chemistry has become significant in the discourse for a global post-colonial era, including South Africa, especially when it comes to access to the general health system and related policies in relation to disease or ease of human life. In view of the stubborn vestiges of coloniality in the daily lives of indigenous African people in general, the fundamentals of present Western medical and traditional medicine systems and related policies in the democratic era were examined in this study. The situation of traditional healers in relation to current policy was also reviewed. The advent of democracy in South Africa brought about a variety of development opportunities and limitations, particularly with respect to indigenous African knowledge systems such as traditional medicine. There were high hopes that the limitations of previous narrow cultural perspectives would be rectified in the democratic era through development interventions, but some sections of society, such as traditional healers, remain marginalised. The Afrocentric perspective was explored in dissecting government interventions related to traditional medicine. This article highlights that multiple medical systems should be adopted and that health policies should be aligned in order to guarantee mutual respect and to address the remnants of colonialism in South Africa, Africa and the broader global community.

Etiquette Learning and Public Speaking: Early Etiquette Learning and Its Impact on Higher Education and Working Professionals

The purpose of this paper is to call education professionals to implement etiquette and public speaking skills for preschoolers, primary, middle and higher school students. In this paper the author aims to present importance of etiquette learning and public speaking curriculum for preschoolers, reflect on experiences from implementation of the curriculum and discuss the effect of the said implementation on higher education/global job market. Author’s aim to introduce this curriculum was to provide children with innovative learning and all around development. This training of soft skills at kindergarten level can have a long term effect on their social behaviors which in turn can contribute to professional success once they are ready for campus recruitment/global job markets. Additionally, if preschoolers learn polite, appropriate behavior at early age, it will enable them to become more socially attentive and display good manners as an adult. It is easier to nurture these skills in a child rather than changing bad manners at adulthood. Preschool/Kindergarten education can provide the platform for children to learn these crucial soft skills irrespective of the ethnicity, economic or social background they come from. These skills developed at such early years can go a long way to shape them into better and confident individuals. Unfortunately, accessibility of the etiquette learning and public speaking skill education is not standardized in pre-primary or primary level and most of the time embedding into the kindergarten curriculum is next to nil. All young children should be provided with equal opportunity to learn these soft skills which are essential for finding their place in job market.

Using Project MIND - Math Is Not Difficult Strategies to Help Children with Autism Improve Mathematics Skills

This study aimed to provide a practical, systematic, and comprehensive intervention for children with Autism Spectrum Disorder (ASD). A pilot study of quasi-experimental pre-post intervention with control group design was conducted to evaluate if the mathematical intervention (Project MIND - Math Is Not Difficult) increases the math comprehension of children with ASD Children with ASD in the primary grades (K-1, 2) participated in math interventions to enhance their math comprehension and cognitive ability. The Bracken basic concept scale was used to evaluate subjects’ language skills, cognitive development, and school readiness. The study found that our systemic interventions of Project MIND significantly improved the mathematical and cognitive abilities in children with autism. The results of this study may lead to a major change in effective and adequate health care services for children with ASD and their families. All statistical analyses were performed with the IBM SPSS Statistics Version 25 for Windows. The significant level was set at 0.05 P-value.

State of Emergency in Turkey (July 2016 – July 2018): A Case of Utilization of Law as a Political Instrument

In this study, we will aim to analyze how the period of the state of emergency in Turkey lead to gaps in law and the formation of areas in which there was a complete lack of supervision. The state of emergency that was proclaimed following the coup attempt of July 15, 2016, continued until July 18, 2018, that is to say, 2 years, without taking into account whether the initial circumstances persisted. As part of this work, we claim that the state of emergency provided the executive power with important tools for governing, which it took constant use. We can highlight how the concern for security at the center of the basic considerations of the people in a city was exploited as a foundation by the military power in Turkey to interfere in the political, legal and social spheres. The constitutions of 1924, 1961 and 1982 entrusted the army with the role of protector of the integrity of the state. This became an instrument at the hands of the military to legitimize their interventions in the name of public security. Its interventions in the political field are indeed politically motivated. The constitution, the legislative and regulatory systems are modified and monopolized by the military power that dominates the legislative, regulatory and judicial power, leading to a state of exception. With the political convulsions over a decade, the government was able to usurp the instrument called the state of exception. In particular, the decree-laws of the state of emergency, which the executive makes frequent and generally abusive use, became instruments in the hands of the government to take measures that it wishes to escape from the rules and the pre-established control mechanisms. Thus the struggle against the political opposition becomes more unbalanced and destructive. To this must also be added the ineffectiveness of ex-post controls and domestic remedies. This research allows us to stress how a legal concept such as "the state of emergency" can be politically exploited to make it a legal weapon that continues to produce victims.