Mother's Anxiety Face Primigravidal Delivery Ages 20-35 Years at Mandiri Midwife Practices Cengkal Sewu Village, Kayen District, Pati Regency

Anxiety before labor in pregnant women is a physiological matter, but in facing labor process in which there are a series of physical and psychological changes that starting with uterine contractions, dilatation of the birth canal, and spending baby and placenta which ended with first punding between mother and baby. Anxiety and depression are two types of interference that related each other. The objectives of this study is to explore mother’s anxiety facing labor primigravid 20-35 years old in BPM Sulityowati Cengkalsewu Village Sub Kayen Pati Regency. This study used a qualitative method with phenomenological approach. Technique of data collection with in depth interview and purposive sampling. The results of in-depth interview in participant obtained information mother’s anxiety resolve labor primigravid 20-35 years old about definition, causes, family support, factors of anxiet. and how to prevent and resolve anxiety. All mothers who are facing labor already know about the content of the anxiety in the face of first child labor. As well as how to prevent and resolve that anxiety.Mother’s anxiety facing labor primigravid 20-35 years old is good.

Opportunities and Challenges of Nurses after Upgradation of Class 2 Status

Nurse’s job facilities and challenges have emerged as a burning issue in health care delivery system in Bangladesh. This descriptive cross sectional study with a mixed quantitative and qualitative design aimed to explore the opportunities and challenges of nurses after upgradation of class 2 status. The study was carried out in two specialized public hospitals for one year duration among purposively selected 144 nurses with a semi structured interview administered questionnaire In depth interview and focus group discussion (FGD) were conducted among selected personnel. The study revealed that the mean age of nurses was 42.3 (±6.3) years, majority (86.1%) were female, most of them (79.1%) were senior staff nurse with 16.8 years mean working experience. The study explored the opportunities of nurses after upgradation of class 2 status like increased responsibilities and honor in working place, promotional opportunities mentioned by majority of respondents. On the other hand, the challenges were noted as not changing the physicians attitude, not changing the working environment, limited scope for utilization of professional skill, not having job security mentioned by majority of respondents. The study also found that most of the nurses (90.3%) were satisfied after upgradation, but a large portion were not satisfied regarding fringe benefits and current salary structure. From FGD and in depth interview some suggestions come forward for nursing profession empowerment like good salary package, medical incentive, residence and training facilities etc. Few opportunities increased in upgradation of nurses in class 2 status, however nurses were depriving from many of their facilities, which indicated that 2nd class status was partially implemented in professionally, socially and culturally. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 20-26

Weil’s Disease Death Investigation and Outbreak Control Measures Instituted in the Field Area of a Family Health Center in Thiruvananthapuram, Kerala—A Case Report

Introduction: Weil syndrome, a rare infectious disorder, is a severe form of the bacterial infection caused by Leptospira bacteria known as leptospirosis. Weil syndrome is characterized by dysfunction of the kidneys and liver, abnormal enlargement of the liver (hepatomegaly), persistent yellowing of the skin, mucous membranes, whites of the eyes (jaundice), and/or alterations in consciousness. In most cases, Weil syndrome occurs among individuals who are exposed to affected animals. Case Presentation and Summary: The investigation of death was done by a team consisting of doctor, junior health inspector, and ASHA workers of the area. We did a qualitative approach of in-depth interview of the wife and daughter-in-law of the deceased for data collection. The patient’s name and other details are not revealed for anonymity. No particular statistical analyses are used for this case reporting. The CARE guidelines were followed for writing this report. Conclusion: Leptospirosis is a disease of outbreak potential and has high case fatality rate. Timely identification of cases and institution of preventive measures is very important in preventing outbreaks. The surveys conducted in the area did not reveal any signs of an imminent or ongoing outbreak of leptospirosis.

The Political Impact of Chewing Khat (Chat) on Chewers: In the Case of Woldia City Administration of North Wollo, Amhara National Regional State

The main aim of this study was to investigate the political impact of chewing khat on the chewers in Woldia City Administration of North Wollo, Amhara National Regional State. As far as the researcher's reading, no research was conducted in Ethiopia dealing with the political impact of chewing khat on chewers. Accordingly, this study was conducted using qualitative methods of data collection. Semi-structured in-depth interview, focus group discussion (FGD), and complete observation were employed during data collection. The study used phenomenology design and the findings were analyzed thematically. The study found that khat chewers’ political unconsciousness, utopian involvement in politics, and fail in conspired politics were associated with khat chewing practices. Based on this findings, the researchers recommend that awarness creation about the anxiety of khat in political life is in need.

Upaya Perlindungan Pesisir dan Pulau-Pulau Kecil Pemerintah Provinsi Sumatera Barat dari Ancaman Abrasi dan Perubahan Iklim

Kerusakan pesisir dan pulau-pulau kecil akibat abrasi dan dampak perubahan iklim di Provinsi Sumatera Barat sudah di tingkat yang mengkhawatirkan. Kondisi geografis Sumatera Barat yang berhadapan langsung dengan Samudera Hindia membuat sifat tumbukan gelombang di pesisir relatif kuat sehingga abrasi berlangsung dengan cepat. Kerusakan ekosistem mangrove akibat penebangan, alih fungsi lahan, pencemaran muara, dan kerusakan terumbu karang akibat penggunaan bom, potas, dan pemutihan karang, turut mempercepat terjadinya abrasi. Kerusakan pesisir dan pulau-pulau kecil perlu dicegah karena dapat mengurangi keunggulan strategis pertahanan di wilayah terluar, mengganggu efektivitas fungsi infrastruktur sipil dan militer di pesisir, mengganggu stabilitas ekonomi dan mengurangi ruang hidup masyarakat, membahayakan navigasi, dan mengancam keanekaragaman hayati. Tujuan penelitian ini adalah untuk mengetahui sumberdaya dan upaya pemerintah daerah Provinsi Sumatera Barat dalam melindungi pesisir dan pulau-pulau kecil dari abrasi dan dampak perubahan iklim. Penelitian dilaksanakan pada 15-23 September 2019 di Kota Padang dan di Pulau Sipora. Pengumpulan data dilakukan dengan metode observasi, dan wawancara mendalam kepada pejabat instansi pemerintah daerah dan warga di sekitar pesisir. Data dianalisis menggunakan teknik data condensation, data display, dan conclusion drawing. Hasil penelitian menunjukkan instansi-instansi daerah memiliki keunggulan uniknya masing-masing dalam mendukung pencegahan abrasi dan adaptasi perubahan iklim, namun upaya-upaya yang dilaksanakan masih bersifat sporadis, reaktif, tidak terkoordinasi, dan tidak berkelanjutan. Sumber daya bahan baku untuk pencegahan abrasi dan adaptasi perubahan iklim tersedia melimpah di Sumatera Barat, namun sumber daya keorganisasian yang dimiliki instansi daerah relatif terbatas. Kondisi ini membuat abrasi dan dampak perubahan iklim tidak dapat dicegah secara efektif.ABSTRACTWest Sumatera Province has an alarming rate of coastal and small islands destruction caused by abrasion and the effect of climate change. Geographical characteristic of West Sumatera Province which directly face Hindia Ocean quickly have it’s coastal area eroded with abrasion caused by a strong wave. The destruction of mangrove forest and coral reefs further made the abrasion process worse. Coastal and small islands destruction need to be stopped because it could reduce military strategic advantage in national outer areas, reducing the effectiveness of military and civilian infrastructures, destabilizing economy and narrowing the living space of people, endangering the safety of ship navigation, and threatening nature’s biodiversity. The aim of this research is to understand the resources and actions of West Sumatera Province’s local government of how it protect the coastal area and small islands from abrasion and to adapt to the effects of climate change. The research was conducted in September 15 to 23 in 2019 at Padang City and Sipora Island of Kepulauan Mentawai Regency. Data collected by field observation and in-depth interview to officials from local government and the locals. Data analyzed by using data condensation, data display, and conclusion drawing analytical technique. The research shows that each provincional departments under West Sumatera Province local government have it’s own unique approach and technique to prevent abrasion and adapt to the effects of climate change, but the action taken usually implemented sporadically, reactive, uncoordinated, and not sustainable. Natural resources needed to prevent abrasion and to adapt to climate change are abundant, but the Province’s organisational resources is limited, causing the coastal area and small islands innefectively protected

Acceptability of Plant-Based Diets for People with Chronic Kidney Disease: Perspectives of Renal Dietitians

The purpose of this study was to explore the perspective of renal dietitians regarding plant-based diets for chronic kidney disease (CKD) management and evaluate the acceptability of a hypothetical plant-based dietary prescription aiming for the consumption of 30 unique plant foods per week. This study used an exploratory mixed methods design. Forty-six renal dietitians participated in either an online survey (n = 35) or an in-depth interview (n = 11). Dietitians perceived that plant-based diets could address multiple clinical concerns relevant to CKD. Forty percent of survey respondents reported the hypothetical dietary prescription was realistic for people with CKD, 34.3% were unsure, and 25.7% perceived it as unrealistic. Strengths of the hypothetical prescription included shifting the focus to whole foods and using practical resources like recipes. Limited staffing, time, and follow-up opportunities with patients, as well as differing nutrition philosophies were the most commonly reported challenges to implementation; while a supportive multidisciplinary team was identified as an important enabler. To increase patient acceptance of plant-based dietary approaches, education about plant food benefits was recommended, as was implementing small, incremental dietary changes. Successful implementation of plant-based diets is perceived to require frequent patient contact and ongoing education and support by a dietitian. Buy-in from the multidisciplinary team was also considered imperative.

The Economic Burden and Determinant Factors of Parents/Caregivers of Children with Cerebral Palsy in Malaysia: A Mixed Methods Study

The economic burden is a major concern for parents/caregivers of children with cerebral palsy (CP). This study used the sequential explanatory mixed-method approach to explorethe economic burden on parents/caregivers with a CP child in Malaysia and the factors associated with the economic burden. The study period spanned April 2020 and December 2020. A total of 106 questionnaire respondents were selected for the quantitative part, and 15 were interviewed to obtain qualitative input. A retrospective costing analysis was conducted based on the cost data obtained from the questionnaire. The majority of the children were GrossMotor Function Classification System (GMFCS) Level 5 (71%), quadriplegic (63%), and aged >4 years (90%). The estimated annual median total economic burden on the parents/caregivers per child in 2020 was RM52,540.00 (~USD12,515.03), with indirect cost being the greatest cost (RM28,800.00, ~USD6860.16), followed by developmental cost (RM16,200.00, ~USD3858.84), direct healthcare cost (RM4540.00, ~USD1081.43) and direct non-healthcare cost (RM3000.00, ~USD714.60). The annual household income was identified as a significant determinant factor (p=0.019, 95% CI: 0.04, 0.40) of the economic burden. The participants’ responses during the in-depth interview in the qualitative part of the study supported the premise that socioeconomic factors play a substantial role in determining the total economic burden. Our findings may aid local policymakers when planning the greater provision of support to the affected families in the future, especially for the parents/caregivers of children with CP, who are facing socioeconomic challenges.

Interpreting Solidarity

In metro Charlotte, North Carolina, dynamic newcomer Latinx communities have changed the demographics of K-8 education as the region has emerged as a new gateway for an influx of immigrants and migrants. Today, in what has come to be known as “the New Latino South,” K-12 teachers are eager to expand their knowledge base for working with this relatively new population. To that end, bilingual (Spanish/English) educators are increasingly tapped to serve as impromptu interpreters as monolingual administrators and teachers interact more frequently with Spanish dominant communities. Drawing from an in-depth interview sequence, the chapter narrates a Dominican-American's lived experience with simultaneous K-12-based interpreting as a K-12 student teacher, and a licensed early-grades educator. This chapter theorizes the layered emotional and professional advocacy of heritage-language bilingual school-based professionals and their agency in advancing access and equity to public resources with recommendations for policy and practice.