This study was designed to determine effects of peer-health-education on sexual health knowledge and attitudes of tertiary institution students in Imo State Nigeria by determining the mean gain scores of sexual health knowledge and attitudes after peer health education. Quasi-experimental (pre-test-post-test) research design was employed. Two hundred students drawn from the University, Polytechnic and College of Education, using a multi-stage sampling technique participated in the peer sessions which were facilitated by trained peer educators. (...) Data were analyzed using ANCOVA and Z-test. Findings revealed improved knowledge and attitudes on sexual health, as depicted by positive mean gain scores. Age group 16 - 20 years had the highest mean gain score ( X = 22.31) of sexual health knowledge than the rest, while age group 26 - 30 years had the highest mean gain score ( X = 10.59) of sexual health attitudes. Males had higher mean gain score ( X = 26.05) of sexual health knowledge, while females had higher mean gain score ( X = 9.77) of sexual health attitudes. The first years (100 level students) had the highest mean gain score ( X = 25.71) of sexual health knowledge and also had the highest mean gain score ( X = 14.12) of sexual health attitudes. Level of study was significant both for knowledge and attitudes (P < 0.01). It is recommended that peer-health-education be explored further as a method of communicating sexual health issues to tertiary institution students and youths generally. (shrink)

Aim of Ayurveda is to build a society through building an individual with ideal norms and character. In explanation of hitayu it has been clearly stated that one should follow norms of hitayu for sound health and ideal society. To maintain the health and prevent somatic and psychic diseases course of health education is prescribed based on adhyatma gyana. Promotion of physical and mental health and for improvement of morality in society is a specific concept (...) of Achara rasayana based on adhyatma gyana. A new approach to explore three dimensional health education in preventive, promotive and absolute health has been done and there is role of adhyatma in strata of preventive in form of sadavritta, promotive in form of achara rasayana and absolute through moksha marga. All these can only be achieved once adhyatma gyana is present. (shrink)

This pаpеr invеstigаtеs thе intеrgеnеrаtiоnаl еffеcts оf mаtеrnаl еducаtiоn оn child hеаlth in 68 dеvеlоping cоuntriеs аcrоss fivе cоntinеnts оvеr nеаrly thrее dеcаdеs. Еxplоiting thе bеtwееn-sistеrs vаriаtiоn in thе еducаtiоnаl аttаinmеnt оf thе mоthеrs, wе find thаt mоthеr’s еducаtiоn is pоsitivеly аssоciаtеd with child hеаlth mеаsurеd by thе thrее mоst cоmmоnly usеd indicеs, nаmеly hеight-fоr-аgе, wеight-fоr-hеight, аnd wеight-fоr-аgе. Оur mеchаnism аnаlysеs furthеr shоw thаt thеsе fаvоrаblе еffеcts cоuld bе, аt lеаst in pаrt, аttributеd tо fеrtility bеhаviоr, аssоrtаtivе mаtching, hеаlth cаrе (...) utilizаtiоn, аccеss tо infоrmаtiоn, hеаlth knоwlеdgе, аnd lаbоr mаrkеt оutcоmе. Givеn thе lоng-lаsting impаcts оf еаrly-lifе hеаlth оvеr thе lifе cyclе, оur findings undеrlinе thе impоrtаncе оf mаtеrnаl еducаtiоn in imprоving еcоnоmic аnd sоciаl cоnditiоns in dеvеlоping cоuntriеs. (shrink)

This report describes a questionnaire-based study on 309 adult patients attending the Dental Outpatients Department of Bangladesh Medical College and Hospital, Dhaka during December 2000 to March 2001. The aim of the study was to determine the oral health knowledge of the patients in relation to their age, gender, economic and educational status. Almost two third (63.1%) of the subjects correctly said that pan chewing was bad for teeth. Three fourth (78.3%) of the subjects gave correct answer on question (...) of how to prevent teeth decay. When question was asked about cause of teeth decay, bleeding gum and action of fluoride on teeth, only 38.2%, 41.4% and 32.3% could give correct answer respectively. With a few exceptions, knowledge of oral health was comparatively poor among the older generation, females, less educated and less privileged group. (shrink)

One of the primary goals of Higher Education Institutions (HEIs) is to ensure that all students develop the skills necessary to respond to rapidly changing labor market requirements and conditions. Universities must consider how they train their students to be employable graduates. This study determined how Bachelor of Science in Medical Technology/Medical Laboratory Science (BSMT/BSMLS) and BS Physical Therapy (BSPT) programs prepared the graduates for employment in the Philippines. The study employed a descriptive-correlational research design to establish a relationship (...) between the graduates’ level of satisfaction with their education and the level of adequacy of the BSMLS and BSPT programs. An alumni survey was distributed to all Academic Year 2014-2018 program graduates via e-mail and Messenger. The survey revealed that the preparation for the board examination is the most common influencing factor in the transition from graduation to employment. The vast majority of graduates were employed locally and in positions that were relevant to their programs. The survey also revealed that the University adequately prepared graduates for jobs related to their degrees, and that graduates are satisfied with their education due to high-quality instruction and well-established student internship programs. Pearson correlation revealed that there is a moderate and positive relationship between the level of adequacy of the programs and the level of satisfaction. The study concludes that that graduates’ high employability both locally and globally is a result of the adequate academic preparation they received at the University. (shrink)

This pаpеr invеstigаtеs thе intеrgеnеrаtiоnаl еffеcts оf mаtеrnаl еducаtiоn оn child hеаlth in 68 dеvеlоping cоuntriеs аcrоss fivе cоntinеnts оvеr nеаrly thrее dеcаdеs. Еxplоiting thе bеtwееn-sistеrs vаriаtiоn in thе еducаtiоnаl аttаinmеnt оf thе mоthеrs, wе find thаt mоthеr’s еducаtiоn is pоsitivеly аssоciаtеd with child hеаlth mеаsurеd by thе thrее mоst cоmmоnly usеd indicеs, nаmеly hеight-fоr-аgе, wеight-fоr-hеight, аnd wеight-fоr-аgе. Оur mеchаnism аnаlysеs furthеr shоw thаt thеsе fаvоrаblе еffеcts cоuld bе, аt lеаst in pаrt, аttributеd tо fеrtility bеhаviоr, аssоrtаtivе mаtching, hеаlth cаrе (...) utilizаtiоn, аccеss tо infоrmаtiоn, hеаlth knоwlеdgе, аnd lаbоr mаrkеt оutcоmе. Givеn thе lоng-lаsting impаcts оf еаrly-lifе hеаlth оvеr thе lifе cyclе, оur findings undеrlinе thе impоrtаncе оf mаtеrnаl еducаtiоn in imprоving еcоnоmic аnd sоciаl cоnditiоns in dеvеlоping cоuntriеs. (shrink)

This paper aims to recover the history of health concept evolution from its birth in Ancient Greece to the contemporary days, drawing an overview of the firsts philosophical thoughts about health in distinctive historical periods, analyzing how this concept has been impacted by knowledge improvement and both research and technological discoveries over time. In order to understand the persistence of Neglected Tropical Diseases which causes physical disabilities and social discrimination, this paper will focus on Leprosy and Cutaneous Leishmaniasis (...) and its relation to social inequality mainly in developing countries. These approaches on the understanding of the health-disease binomial are necessary to reflect on health in the course of human history and, from there, to promote joint actions both in the area of scientific research and health education. (shrink)

Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search.In sum, teaching in all three (...) subjects combined comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics. (shrink)

Purpose: The purpose is to identify what difficulties fathers have with the roles of fatherhood during pregnancy and early infancy, and to make apparent what their educational support needs are. Methods: This study follows a qualitative descriptive design. The subjects were new first-time fathers of Japanese nationality. Subjects participated in semi-structured interviews administered according to interview guidelines. Results: There were 15 subjects in total. The average age of the subjects’ children was 5.5 months. Fathers’ difficulties with their new roles were (...) abstracted in to five main categories: < Difficulties during early engagement with child >, < Difficulties related to child crying >, < Difficulties arising after getting through the early engagement stage >, < Difficulties related to support of partner >, and < Mental burdens associated with childrearing >. Additionally, the types of support fathers requested to help maintain their mental health after the birth of their infants were abstracted into three main categories: < Support with childcare knowledge/acquiring skills >, < Support in building a positive marital relationship >, and < Support in maintaining own mental health >. Conclusions: 1) The stress experienced by fathers from the birth of their child through early infancy, originating in two elements of fatherhood (engagement with the child and spousal support), placed a great mental burden upon them in a multi-layered structure; 2) The support that needs fathers expressed to maintain their mental health pre- and postpartum is based on the difficulties they experienced with paternal roles; 3) There is a disparity between the needs of fathers expressed through the results of this study and current paternal support practices in Japan. The supplementation and revision of existing paternal support practices is an issue that merits further consideration. Furthermore, the existing group interview method suffers from low attendance, and attending has become increasingly difficult due to the COVID-19 pandemic spreading throughout Japan. It is necessary to consider alternative methods of educational support moving forward. (shrink)

This study investigates the relationship between mental health and emotional intelligence among senior high school students in a public school. Thus, the study employed a correlational design to measure the relationship between mental health and emotional intelligence among 152 Grade 12 senior high school students in a public school. Hence, to measure the study’s variables - Mental Health Inventory and Emotional Intelligence Scale (EIS) were utilized. Based on the inferential statistics, the r coefficient of 0.32 indicates a (...) low positive correlation between the variables and a p-value of 0.00, indicating a significant relationship between the respondents' mental health and emotional intelligence. Implications and recommendations were discussed in the study. (shrink)

Street life is a challenge for survival, even for adults, and is yet more difficult for children. They live within the city but are unable to take advantage of the comforts of urban life. This study focused primarily on access to health and education in street children from 6 to 18 years old in the Indian metropolises of Mumbai and Kolkata. The study also aimed to assess the role of social work interventions in ensuring the rights of street (...) children. A combination of quantitative and qualitative research methodologies was used. Convenience sampling was used to recruit 100 children. Data were collected on a one-to-one basis through semi-structured interview schedules and by non-participant observation. Findings revealed that extreme poverty was the primary cause for the increasing numbers of street children. Lack of awareness among illiterate parents regarding educational opportunities kept most children away from school attendance. Factors such as lack of an educational ambience at home made it difficult for the children to work on their lessons outside the premises of the institution. It was evident that those living with their parents had better access to health care facilities than did those living on their own; however, nongovernmental organizations made significant efforts to redress this imbalance, setting up health check-up camps at regular intervals. Although exposure to harsh reality at an early age had resulted in a premature loss of innocence in most, making them sometimes difficult to work with, the nongovernmental organizations were striving to ensure child participation and the growth of individual identity. The interventionists therefore focused on developing a rights-based approach, rather than a charitable one. (shrink)

This study investigates the significant relationship between mental health and academic motivation among graduating students. Thus, the study employed a correlational design to determine if there is a significant relationship between mental health and academic motivation among 150 graduating college students. Hence, the Mental Health Inventory 38 (MHI-38) and Academic Motivation Scale (AMS-C28) were employed to measure the study variables. Moreover, statistical analysis reveals that the r coefficient of 0.35 indicates a low positive correlation between the variables. (...) The p-value of 0.00, which is less than 0.05, leads to the decision to reject the null hypothesis. (shrink)

This study investigates the significant relationship between mental health and academic motivation among graduating students. Thus, the study employed a correlational design to determine if there is a significant relationship between mental health and academic motivation among 150 graduating college students. Hence, the Mental Health Inventory 38 (MHI-38) and Academic Motivation Scale (AMS-C28) were employed to measure the study variables. Moreover, statistical analysis reveals that the r coefficient of 0.35 indicates a low positive correlation between the variables. (...) The p-value of 0.00, which is less than 0.05, leads to the decision to reject the null hypothesis. (shrink)

This study evaluates the relationship between mental health and academic motivation among third-year college TES grantees. Thus, correlational design was employed to determine if there is a significant relationship between mental health and academic motivation among 150 third-year TES grantees. Statistical findings reveal that the r coefficient of 0.52 indicates a moderate positive correlation between the variables. The p-value of 0.00, which is less than 0.05, leads to rejecting the null hypothesis. Hence, a significant relationship exists between mental (...) health and academic motivation of third-year college TES grantees. Implications were discussed in the study. (shrink)

This article considers the role of law as an active force in educating citizens on norms of the society. The norms are created and enforced in the law in general, but of particular importance are those in environmental law. In environmental law the environment is not protected only for the sake of serving human beings. To learn this lesson, however, one must look at the specifics of the law and its application. Some laws purport to be concerned with the environment (...) for its own sake, but a review of the language of that law shows it to be indirectly benefitting humans. (shrink)

I seek to answer the question of whether publicly funded higher education ought to aim intrinsically to promote certain kinds of ‘‘blue-sky’’ knowledge, knowledge that is unlikely to result in ‘‘tangible’’ or ‘‘concrete’’ social benefits such as health, wealth and liberty. I approach this question in light of an African moral theory, which contrasts with dominant Western philosophies and has not yet been applied to pedagogical issues. According to this communitarian theory, grounded on salient sub-Saharan beliefs and practices, (...) actions are right insofar as they respect relationships in which people both share a way of life, or identify with one another, and care for others’ quality of life, or are in solidarity with each other. I argue that while considerations of identity and solidarity each provide some reason for a state university to pursue blue-sky knowledge as a final end, they do not provide conclusive reason for it to do so. I abstain from drawing any further conclusion about whether this provides reason to reject the Afro-communitarian moral theory or the intuition that blue-sky knowledge is a proper final end of public higher education. I do point out, however, that the dominant Western moral theories on the face of it do no better than the African one at accounting for this intuition. (shrink)

This study aimed to describe the levels of job satisfaction of 95 respondent- Secondary School Science teachers (SSST) in the Schools Division Office of Urdaneta City. Specifically, it dealt with the profile variables of the respondent-SST, namely: age, sex. civil status, relevant inservice trainings, teaching position, and years in service. It also determined the level of socioemotional, mental health, well-being of the respondent-SST in the areas of self-management, socialization, and teamwork. Moreover, the study determined whether or not there are (...) significant differences in the levels of socio-emotional, mental health, well-being of the respondent-SST across the profile variables. Finally, it determined whether or not there are significant relationships between the levels of and the profile variables levels of socio- emotional, mental health, well-being of the respondent-SST across the profile variables. The study showed that majority of the respondent-SST belong to the age bracket of 41 years old and above; predominantly females; most of whom are teacher III in position. Most of them had attended 1-8 relevant in-service trainings and majority of them are single and working in Department of Education (DepEd) for 6-10 years. The grand overall weighted mean (GWOM) obtained by the respondent-SST is 3.80, equivalent to Manageable (M), in transmuted rating. Moreover, an overall weighted of Manageable (M) was obtained by the areas of self-management (OWM=4.12) and socialization (OWM=3.80). However, teamwork obtained the lowest OWM (OWM=3.49) which is equivalent to Moderately Manageable(MM) in the transmuted rating. It was found out that there were no significant differences in the respondent-SST’s levels of socioemotional, mental health and well-being across the variables, age, teaching position, trainings and years in service. However, it was found out that there is significant differences in the area of teamwork across the variable sex and relevant trainings attended. Similarly, socialization and teamwork across the number of years in the service also had significant differences. There are significant relationships between the levels of socio-emotional, mental heath and wellbeing the respondent-SST in teamwork and the variable, sex. Likewise, there are significant relationship between their levels of socio-emotional, mental health and well-being in socialization and the variable, number of years in service. Based from the salient findings, it was concluded that the respondents are relatively young in the service as secondary science teachers, predominantly females, and majority of them is in Teacher III position. These science teachers have very low management in socio-emotional, mental health and well-being under teamwork particularly in working under pressure or stress. Their levels of socio-emotional, mental health and well-being are differentiated only by the variables, sex and number of years in the service, in specific areas, namely: socialization and teamwork. The levels of socio-emotional, mental health and well-being of the SST are associated only to the variables, sex, and number of years in the service, in the areas of socialization and teamwork. (shrink)

Rather than eliminate the terms "mental health and illness" because of the grave moral consequences of psychiatric labeling, conservative definitions are proposed and defended. Mental health is rational autonomy, and mental illness is the sustained loss of such. Key terms are explained, advantages are explored, and alternative concepts are criticized. The value and descriptive components of all such definitions are consciously acknowledged. Where rational autonomy is intact, mental hospitals and psychotherapists should not think of themselves as treating an (...) illness. Instead, they are functioning as applied axiologists, moral educators, spiritual mentors, etc. They deal with what Szasz has called "personal, social, and ethical problems in living." But mental illness is real. (shrink)

Common mental health disorders are rising globally, creating a strain on public healthcare systems. This has led to a renewed interest in the role that digital technologies may have for improving mental health outcomes. One result of this interest is the development and use of artificial intelligence for assessing, diagnosing, and treating mental health issues, which we refer to as ‘digital psychiatry’. This article focuses on the increasing use of digital psychiatry outside of clinical settings, in the (...) following sectors: education, employment, financial services, social media, and the digital well-being industry. We analyse the ethical risks of deploying digital psychiatry in these sectors, emphasising key problems and opportunities for public health, and offer recommendations for protecting and promoting public health and well-being in information societies. (shrink)

Mental health generally refers to an individual’s thoughts, feelings and actions, particularly when he faced with life challenges and stresses. A good mental health isn’t just the absence of mental health problems. It is the achievement and the maintenance of psychological well-being. Mental Health is the state of one’s peace of mind, happiness and harmony brought out by one’s level of adjustment with himself and his environment. In describing mental health, Anwar said, “…mental health (...) is the health of one’s mind which can prove a potent determinant of one’s integrated personality and balanced behavour identified on the basis of the level of his adjustment to himself, others and with the environment. A mentally healthy individual possesses a number of characteristics which influence his life positively and help him in achieving his goals of life effectively. He has adequate ability to make adjustments in the changed circumstances and situations. His intellectual powers are adequately developed. He is able to think independently and take proper decision at the proper time. He tries to accomplish his work as effectively as possible but he does not prove to be an extremist by becoming a perfectionist. Though these characteristics are expected from a mentally healthy individual, but these should be taken as essential and necessary conditions for the maintenance of proper mental health and thus absence of one or the other characteristic does not necessarily mean negation of mental health. Good mental health is not just the absence of mental problems. Being mentally healthy is much more than free of depression, anxiety or other psychological issues.”1 In this paper an attempt is made to discuss about the mental health policies and issues in India. (shrink)

Mental health among students is one of the major concerns amidst the pandemic. Employing a correlational design, this study investigates the relationship between emotional intelligence and mental health among 152 senior high school students. Based on the statistical analysis, the r coefficient of 0.82 indicates a high positive correlation between the variables. The p-value of 0.00, which is less than 0.05, leads to the decision to reject the null hypothesis. Hence, a significant relationship exists between emotional intelligence and (...) mental health among senior high school. Implications were discussed in the study. (shrink)

Background: The World Health Organization has endorsed a community-based health insurance scheme (CBHIS) as a shared financing plan to improve access to health services and ensure universal coverage of the healthcare delivery system. Such a contributory scheme is the most likely option to provide health insurance coverage when governments cannot offer direct health care support. Despite improvements in access to current healthcare services, Ethiopia’s healthcare delivery remained low, owing to the country’s underdeveloped healthcare finance system. (...) As a result, the present study assessed CBHIS coverage and its predictors in Ethiopia at the individual and community level. Methods: The availability of CBHIS was checked via a criterion: at least one of the cluster respondents had to be enrolled in CBHIS. This study was based on secondary data from the Ethiopia Mini Demography and Health Survey (EMDHS) 2019 and included 7724 respondents. The study population was described using percentage and frequency. Four multilevel mixed-effects logistic regression modelling stages were performed to control for variations due to heterogeneity across clusters, and determinant predictors of CBHIS enrollment were outplayed. Results: The prevalence of CBHIS enrollment in Ethiopia was 33.13%. Rural residents were 3.218 times (AOR = 3.218; 95% CI: 1.521, 6.809), male household heads were 1.574 times (AOR = 1.574, 95% CI: 1.105, 2.241), getting funds from the safety net program were times 2.062 (AOR = 2.062, 95% CI: 1.297, 3.279), attending the primary educational level was 1.686 times (AOR = 1.686, 95% CI: 1.007, 2.821), bank accounts were 1.373 times (AOR = 1.373, 95% CI: 1.052, 1.792), and wealth index was 1.356 times (AOR = 1.356, 95% CI: 1.001, 1.838) more likely associated with CBHIS coverage, whereas the regions, the other religions, and women aged 20– 24 had lower odds of CBHIS coverage. Conclusion: In Ethiopia, regional healthcare expenditure per capital, religious affiliation, women age range, residents, sex of household head, funds from the safety net program, formal educational level, and having bank accounts were associated with community-based health insurance scheme coverage. (shrink)

This study aimed to determine the health practices among the secondary school teachers during the Covid-19 pandemic in Ichon National High School. This considered the socio - demographic profile of the teachers in terms of age, sex, civil status and teaching load and the extent of practice employed by the teachers in the said health dimensions. A total of 53 teachers from Ichon National High School participated as respondents in the evaluative method of research that consists in three (...) parts questionnaires. The statistical treatment used in the computation and analysis of gathered data to determine the socio-demographic profile of the respondents are the descriptive statistics such as frequency and percentage. As to the significance of health practices during COVID-19 pandemic, Kruskal Wallis and Mann-Whitney U test was used to analyze the significant differences on the extent of practices among the different health dimensions. The very high extent of the implementation on the health practices during COVID-19 pandemic shows that the teachers are frequently practiced the health practices. The highest mean in mental aspect is conclusive that teacher during the pandemic exert effort to stay healthy on this and other areas as well. It is recommended to conduct further study regarding on the health practices among the secondary school teachers. (shrink)

The purpose of cultural competence education for medical professionals is to ensure respectful care and reduce health disparities. Yet as Berger and Miller (2021) show, the cultural competence framework is dated, confused, and self-defeating. They argue that the framework ignores the primary driver of health disparities—systemic racism—and is apt to exacerbate rather than mitigate bias and ethnocentrism. They propose replacing cultural competence with a framework that attends to two social aspects of structural inequality: health and social (...) policy, and institutional-system activity; and two psychological aspects of structural inequality: the clinical encounter, and the epistemic. -/- We agree with the structural approach. To that end, we think it would be fruitful to include attention to physical contributors to structural inequality, namely the material artifacts used in medicine. Devices, tools, and technologies can materialize biases, perpetuate oppression, and contribute to health disparities. Granted, not everything that interests philosophers can be squeezed into medical education. Nevertheless, there are compelling reasons for including the study of material artifacts in education designed to reduce health disparities. First, devices and tools often carry forward biases from the past, and keep biases hidden from plain sight. Second, by studying these artifacts, future clinicians can begin to see themselves as part of a larger sociotechnical system. Finally, as medicine becomes increasingly tech-laden, it’s important for clinicians to see how material artifacts (including algorithms) connect individuals to structures. This will help to undermine oversimplified narratives according to which objective tools and technologies can correct for the bias and subjectivity of flawed human beings. (shrink)

Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only (...) a small portion of the overall impact of health policy. This chapter considers what weight health policy should give to its “spill-over effects,” namely non-health and indirect benefits. (shrink)

This phenomenological study aimed to determine the challenges, coping strategies, and significant insights of COVID-19 frontliners during the pandemic. The study utilized a qualitative phenomenological approach, and using purposive sampling technique, the eight (8) participants who worked as a COVID-19 frontliner in General Santos City were identified for an in-depth interview. Thematic analysis was used as a data analysis tool to interpret the data gathered. The results found that COVID-19 frontliners experienced different challenges during the pandemic, including the fear of (...) being infected with the disease, dealing with different patients, long and busy working hours, and mental health disturbance. As for their coping strategies in dealing with those challenges, the COVID-19 frontliners used their families’ support, taking care of themselves, as well as having strong faith in God. Also, valuing public health measures, the importance of self-care, and extending patience and understanding toward the patients were the significant insights shared by the COVID-19 frontliners. Moreover, understanding the impact of COVID-19 on the frontliners’ mental health can be the key to implementing plans and effective interventions to help them function more efficiently. (shrink)

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was (...) voluntary and anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

The article examines the participation and assistance of the Orthodox Church in solving problems that allowed to give a scientific justification for the cooperation of health care and Orthodox religious institutions, to determine their role in the historical context and structure of modern healthcare in Russia. The article presents an algorithm for organizing sisters of mercy, their system of upbringing. Particular attention is given to the possibility of teaching the course "Foundations of Orthodox Culture" in secular educational institutions. -/- (...) Research materials can serve as a basis for the formation of morally sound positions of medical workers and the population on the main problems of medical activity. -/- Based on the study, the authors published a series of articles in which the experience of the work of the Orthodox Church in the charitable sphere has been summarized. This experience can be used to create new charitable institutions, including those who provided medical assistance. -/- In preparing the article, the authors used concrete historical, civilizational, formational and social methods of research that allowed us to uncover facts, phenomena and processes in the interconnection and unity of the past, present and future. (shrink)

The paper focuses on the kind of expertise required by doctors in health communication and argues that such an expertise is twofold: both epistemological and communicative competences are necessary to achieve compliance with the patient. Firstly, we introduce the specific epistemic competences that deal with diagnosis and its problems. Secondly, we focus on the communicative competences and argue that an inappropriate strategy in communicating the reasons of diagnosis and therapy can make patient compliance unworkable. Finally, we focus on the (...) case of diabetes metaphor and propose the deliberate use of metaphors in health communication as an educational tool. On the one hand, metaphors might help doctors in explaining the disease in simpler terms and framing the experience of illness according to patient’s specific needs. On the other hand, metaphors might encourage a change in patient’s beliefs on their own experience of illness, and enable them to reach a shared decision making with doctors. (shrink)

Higher Education is a very important sector for the growth and development of human resource which can take responsibility for social, economic and scientific development of the country.1 While, higher education gives India an edge in the world economy as evident from the availability of the skilled manpower, and research scholars working abroad, unemployment, illiteracy and relative poverty continue to be the major deterrents to realize her potential in human resources. The higher education system in India has (...) grown in a remarkable way, particularly in the post-independence period, to become one of the largest system of its kind in the world. However, the system has many issues of concern at present, like financing and management including access, equity and relevance, reorientation of programmes by laying emphasis on health consciousness, values and ethics and quality of higher education together with the assessment of institutions and their accreditation. These issues are important for the country, as it is now engaged in the use of higher education as a powerful tool to build a knowledge-based information society of the 21st Century. (shrink)

Background: A better understanding of the pattern of epidemic-related referrals to healthcare centers might allow the identification of vulnerabilities and the required changes that the healthcare management system should undergo. Objectives: This study aimed to investigate the COVID-19 referral pattern and the role of media and health management planning in changing the trends. Methods: Data extracted from the electronic medical database of Imam Khomeini Hospital Complex (IKHC), located in Tehran, Iran, from February 20 to June 4, 2020 were examined. (...) Individuals were divided into two groups, COVID-19 positive and negative. We used Google Trends to evaluate Google Internet search queries and also available policy documents, programs, and official news related to COVID-19 in Iran during the mentioned period. Results: In this study, 8647 individuals aged 46.05 ± 16.5 years were referred to IKHC. Approximately 57% were male, and 70% were COVID-19 positive. The most clinical symptoms were dyspnea, fever, cough, and myalgia. Chronic kidney disease (CKD) and type 2 diabetes mellitus were the most common underlying health conditions. In the first two weeks, the percentage of negative cases was higher than positive cases and then the pattern was reversed, when people searched for information about COVID-19 in media. Conclusions: Proper and timely information and education to people through the media and health management measures can be effective in reducing unnecessary visits to health centers, preventing the exhaustion of medical staff, and controlling the disease during epidemics. (shrink)

Aim: The aim of this study is to reveal the convergence of public health ethics, institutional, collective, and individual ethics obligation during the COVID-19 pandemic and give some explanations with online media reports. Method: The study method is qualitative content analysis; this method was chosen as it would suit best the purpose of the study. The Turkish Medical Association, Turkish Public Health Association, and online newspaper articles and videos have been scanned using keywords. After that, related online reports (...) and interviews have been classified and analyzed according to the context in between May 22, 2020 and November 16, 2020. No official ethical permission was obtained as the study was conducted through open access internet news sites. Results: The COVID-19 scientific committee and the Ministry of Health has suggested a new way of normal life called controlled social life for all places in Turkey. In the frame of these recommendations, with the Google research engine, many articles of online media including some announcements of medical and legal associations, interviews, and calls made by the authorities were selected and analyzed. These articles and interviews containing each problem and pieces of information provided for the common understandings of the society were selected and evaluated at three topics individual, collective and state and institutional responsibility and obligations. Conclusion: Although the warnings of associations, health authorities, and scientists are mostly about personal-civil responsibility, some occurring practices have caused violations. In addition, the level of education, perception capacity, and habits that include existing social-cultural and religious rituals have prevented people from adapting to this new style of life, in other words, controlled social life. Therefore, besides the original national culture and customs, universal ethical responsibilities and obligations should teach starting from primary school and should consist of whole life understanding as a higher perspective. (shrink)

Objective: This main aim of the study is to explore COVID-19 pandemic problems from the perspective of public health-clinical care ethics through online mediareports in Turkey. Method: This research was designed as a descriptive and qualitative study that assesses COVID-19 through online media reports on critics between the periods of March 11, 2020 and April 2 2020 as a quantitative as number of reports and qualitative study, across Turkey. Reports were from Turkish Medical Association websites which included newspaper reports. (...) Study data were presented as statistically and qualitative data case and headlines. No ethical or ofTicial permission was sought as the study was conducted through open access internet news sites. Results: This online reports analysis retrieved about 6723 articles about the COVID-19. According to study data, information about COVID-19 were themed as follows: general deTiciencies in taking action and isolation, lack of isolation, passengers and transport vehicles not quarantined ; insufTicient diagnostic tests, decision to test after healthcare professionals become infected, lack of equipment, lack of evaluation outbreak countries [Table 2]. Conclusion and Suggestions: COVID-19 is a pandemic and is a global public health problem that concerns every individual and needs to be handled carefully. This requires a multi-faceted preparation and education. In this context, healthcare professionals should be well trained in this aspect and have all the necessary equipment throughout the process. Additionally, it should work systematically with the cooperation of all health organizations, the Ministry of Health, local governments and of course the media, in order to inform society, fairly distribute the resources and to implement the safety measures effectively. BrieTly, lack of transparency, insufTicient information, limited resources, lack of public health protection measures such as partial quarantine decision, partial implementation of the scientiTic board's re c ommenda ti on s fo r e c on omi c rea s on s, and contradiction of the explanations are revealed as serious ethical problems. (shrink)

Background: Previous studies assessing students’ learning outcomes and identifying contributing factors have often dwelt on the cognitive domain. Furthermore, school evaluation decisions are often made using scores from cognitive-based tests to rank students. This practice often skews evaluation results, given that education aims to improve the three learning domains. This study addresses this gap by assessing the contributions of four students’ input to their cognitive, affective and psychomotor skills (CAPs). Methods: A cross-section of senior secondary class II students (n (...) = 870), sampled through the multistage procedure, participated in a physical survey. Students’ Inputs Questionnaire (STIQ) and Learning Outcomes Questionnaire (LOQ) were used for data collection. Based on data obtained from a pilot sample (n = 412), principal axis factoring (PAF) was performed to assess the internal structure of the instruments following an oblique rotation. The KMO value of sampling adequacy were 0.88 and 0.94, while the Bartlett’s test of sphericity were significant χ2 (253) = 5,010; p < 0.001 and χ2 (105) = 3693.38, p < 0.001 for the STIQ and LOQ, respectively. Confirmatory factor analysis was used to assess the models’ acceptability based on the maximum likelihood estimation technique. The main study used hierarchical linear regression for data analysis. Results: Findings indicated that innate ability, health, motivation and social capital relatively and cumulatively predicted students’ overall, cognitive, affective and psychomotor learning outcomes. The proportion of variance explained by the predictors increased at different levels of the models with the addition of new variables. Students’ social capital reduced the effect of students’ innate ability regardless of their motivation and health status. Conclusion/implication: This study has provided evidence that the four students’ inputs are crucial predictors of their learning outcomes in the three domains. This result is helpful for school management to provide services aimed at improving the school climate for students’ motivation and social capital. The result can provide policymakers with a proper understanding of the constituents of learning outcomes and how policies can be aligned to secure quality student inputs for maximum productivity in education. (shrink)

This study, by using 142 groups of data from 1990 to 2007 and the method of cross-temporal meta-analysis, researched the changing trend of status of mental health of 108736 members of the Chinese Army along with the change of years. All the data came from 94 related research reports, and all the research reports used SCL-90 (the Symptom Checklist 90) as the testing tool of mental health. The study found that: (1) mental health of members of the (...) Chinese Army steadily improved between 1990 and 2007; (2) during those 18 years, the Interpersonal Sensitivity factor of SCL-90 of Chinese Army members changed most significantly, and the least significantly changed factor was Somatization; (3) Chinese Army members showed evidence of fewest problems on the Photic Anxiety factor, in contrast to the consistent problems indicated by scores on the Obsessive-Compulsive and Interpersonal Sensitivity scales; (4) Chinese Army members from single-child families (N =1,944) showed significant lower evidence of positive mental health than soldiers from multiple child families (N =2,649); (5) The mental health of soldiers from non-agricultural backgrounds (N =7,808) was less positive than that of soldiers from agricultural households(N =11,459); (6) Chinese Army members with senior high school education level (N = 10,189) had less positive mental health than those with junior high school (N = 8,407) or university education (N = 863). (shrink)

This chapter delves into the museological side of ‘the way forward’ to conservation for planetary health bioethics. Specifically, it highlights the crucial role that museums play – their curatorial or exhibition interventions, conservation operations, development policies, or practices – which present or represent the vital relationship between human and planetary health. While it is not new to stress the significance of museums’ link to the environment and environmental education, it is necessary to re-examine recent cases in light (...) of the rapid changes brought about by climate change and the constant call for sustainability. We thus offer a review of some recent literature that appraises the museum’s role in bioethically considering the health of our living planet. Learning this role taps into relatively new themes such as ecomuseums and architectural heritage, or critical eco-museology. (shrink)

This research aims to investigate managing information and planning for the participation of health charities. With the Covid-19 outbreak, it was important to use information systems to optimize health management. The correct processing of information is the basis for better use of health charities’ participation. Using the snowball technique, and semi-structured interviews, 47 experts and non-experts in Fars province were asked for their opinions. Next, based on the fuzzy network analysis, important factors were prioritized. Four categories and (...) 8 important criteria were identified. To prioritize the effective aspects of the participation of health charities in Fars province, a network analysis technique was used via MATLAB software. Strategy and programs with a normal weight of 0.34 showed the highest priority. Research and education with a normal weight of 0.26 received the second priority. Laws and regulations with a normal weight of 0.24 were placed as the third priority. Based on the obtained results, creating strategy and planning, training and building cultural in this field, ease of rules and regulations as well as planning of financial resources play an important role in managing the participation of health donors. With precise planning of health programs, donors see the transparency of decisions. They check the part that needs financing and equipment completion. Because the quality of plans and programs, effectiveness and efficiency of strategies, and the quality of results depend on the decisions made by donors. (shrink)

Factors influencing work-life balance are evolving at a very fast pace, thus creating a fecund ground for innovative work-life balance tools and techniques. The increasing significance of expatriates in the global workforce necessitates a targeted set of work-life balance initiatives to help expatriate workers contribute more effectively in the competitive work environment. Health and recreation are the two important life spheres which play a very important role in success or failure of an expatriate assignment. While work-life balance researches are (...) being conducted globally in plenty, yet research on expatriate adjustment and expatriate work-life balance is still in its nascent stage especially in an expatriate dominated work environment in the Gulf Cooperation Council (GCC) countries. This research paper investigates the health and recreation spheres of expatriate academicians working in private higher education institutes in Bahrain, Oman and the UAE. The research paper illustrates and evaluates the health and recreation spheres in relation to the demographic factors of the respondents and suggests ways to improve work-life balance of expatriate employees. (shrink)

Athenaeus of Attalia distinguishes two types of exercise or training (γυμνασία) that are required at each stage of life: training of the body and training of the soul. He says that training of the body includes activities like physical exercises, eating, drinking, bathing and sleep. Training of the soul, on the other hand, consists of thinking, education, and emotional regulation (in other words, 'philosophy'). The notion of 'training of the soul' and the contrast between 'bodily' and 'psychic' exercise is (...) common in the Academic and Stoic traditions Athenaeus is drawing from; however, he is the earliest extant medical author to distinguish these kinds of training and to treat them as equally important aspects of regimen. In this paper, I propose some reasons why he found this distinction useful, and I examine how he justified incorporating it into his writings on regimen, namely by attributing Plato's beliefs about regimen to Hippocrates, a strategy Galen would adopt well over a century later. (shrink)

Studies on mental health and academic performance have been conducted throughout the world. Thus, this study aims to assess the students' mental health amidst the new normal of education employing 21-item Depression, Anxiety, and Stress Scale or DASS-21, concerning their academic performance. The study's findings showed that almost more than half of the respondents suffered from moderate to extremely severe levels of depression, stress, and anxiety. Thus, there was no significant relationship between high negative mental health (...) symptoms and academic performance. In conclusion, students that encounter extreme levels of adverse mental health can still maintain high academic achievement. However, the students' mental health should always be managed and helped to cope with their life problems, especially during this pandemic crisis. (shrink)

Background: Educated women tend to have a greater awareness of the existence of ANC services, more aware of health problems, know more about the availability of health care services, and utilize the information more effectively than non-educated women. Moreover, higher levels of education tend to positively affect healthseeking behaviors, and education may increase a woman’s control over her pregnancy and expose women to more health education messages and campaigns, enabling them to recognize danger signs (...) and complications and take appropriate action. In this study, we tried to analyze to what level the maternal education can influence the antenatal care services and childcare. Methods: A community-based cross-sectional study was conducted on 93 randomly selected mothers who have children less than 7 years by using a pre-tested structured questionnaire for data collection at various tribal villages, at an average 25 kms away from Adilabad town from April-October 2019. Analysis was done using SPSS for windows version 16, Microsoft excel and Open epi website. Results: Out of 93 study subjects, 19.3% (18) of the study subjects were not registered for the antenatal services. Higher the maternal education higher the age at pregnancy (p<0.05), was associated with more preference for deliveries by doctors (p<0.05). More the frequency of exclusive breast feeding, long lasting breast feeding was associated more than a year (p<0.05), a smaller number of children with wasting (p<0.05). Conclusion: This study revealed that utilization of ANC services was relatively better for the mother’s educated higher than secondary school, but they are still low. Educational status is important in having more health seeking behavior. In this study, it proves that health education is more important than the mere school education which can help to improve knowledge on ANC. (shrink)

Extant literature suggests a positive correlation between social trust (also called generalized trust) and life satisfaction. However, the psychological pathways underlying this relationship can be complex. Using the Bayesian Mindsponge Framework (BMF), we examined the influence of social trust in a high-violence environment. Employing Bayesian analysis on a sample of 1237 adults in Cali, Colombia, we found that in a linear relationship, generalized trust is positively associated with life satisfaction. However, in a model including the interactions between trust and (...) class='Hi'>education level as well as between trust and socioeconomic status, generalized trust is found to be negatively associated with life satisfaction. In this non-linear relationship, both education level and socioeconomic status have moderating effects against the negative association between generalized trust and life satisfaction. In other words, less educated people living in worse socioeconomic conditions are more likely to have lower life satisfaction when they have higher levels of social trust. In contrast, highly educated people living in better socioeconomic conditions are more likely to have higher life satisfaction when they have higher levels of social trust. Due to the facilitating function of trust in information processing, lowering the rigor of the filtering system in a high-violence social environment will likely put an individual at risk. Based on our findings, we suggest that policymakers should consider the impacts of social contexts when advocating for increasing social trust. We also recommend that researchers carefully examine the psychological mechanism underlying an observed association before making suggestions for policymaking. (shrink)

Low back pain (LBP) carries a high risk of chronicization and disability, greatly impacting the overall demand for care and costs, and its treatment is at risk of scarce adherence. This work introduces a new scenario based on the use of a mobile health tool, the Dress-KINESIS, to support the traditional rehabilitation approach. The tool proposes targeted self-manageable exercise plans for improving pain and disability, but it also monitors their efficacy. Since LBP prevention is the key strategy, the tool (...) also collects real-patient syndromic information, shares valid educational messages and fosters self-determined motivation to exercise. Our analysis is based on a comparison of the performance of the traditional rehabilitation process for non-specific LBP patients and some different scenarios, designed by including the Dress-KINESIS’s support in the original process. The results of the simulations show that the integrated approach leads to a better capacity for taking on patients while maintaining the same physiotherapists’ effort and costs, and it decreases healthcare costs during the two years following LBP onset. These findings suggest that the healthcare system should shift the paradigm towards citizens’ participation and the digital support, with the aim of improving its efficiency and citizens’ quality of life. (shrink)

‘Rationality’ here only concerns knowledge, e.g., ways to acquire scientific knowledge. Many factors are required for human rationality to exist and develop, e.g., life and evidence-based education. Rationality’s need for those factors, hence their value to rationality, is rationally-unquestionable. Those factors require certain educational, moral, political, social, health-care etc values to be practised. This implies a pro-rationality education-theory and related values-theory, with one obligatory, general end – a uniquely rationally-unquestionable end. That theory has deeply-humanly-meaningful, universal applications: the (...) theory has implications for current and all possible educational, moral etc issues. The theory’s sub-values prescribe much prescribed by some other theories, e.g., broad and deep knowledge-acquisition, critical thinking, non-sexism, non-racism, types of liberty, holistic flourishing, happiness, unselfishness and fairness. However, other theories lack pro-rationality theory’s maximum possible rational-unquestionability, internal coherence and coherence with rationality. The theory encourages freedom in a-rationality areas, areas irrelevant to its obligatory end. The theory inherently requires its advocates to be (self )critical, rationally viewing their human-suggested specifics as often fallible or unavoidably approximate. Similarly for students and educators. (shrink)

NIH's fogarty international Center has provided grants for the development of training programs in international research ethics for low- and middle-income (LMIC) professionals since 2000. Drawing on 12 years of research ethics training experience, a group of Fogarty grantees, trainees, and other ethics experts sought to map the current capacity and need for research ethics in LMICs, analyze the lessons learned about teaching bioethics, and chart a way forward for research ethics training in a rapidly changing health research landscape. (...) This collection of papers is the result. (shrink)

Students during the distance education were experiencing solitude and depression in their studies due to no social interaction which led to psychological suffering. In this article, college students' attitudes toward statistics learning were investigated, and its predictors by statistical modeling. Secondary data was extracted from a current study from the literature, summarized using descriptive statistics, and presented in tabular form. As for modeling the predictors of students' attitudes in learning statistics, it was done through multiple linear regression via the (...) ordinary least square (OLS) approach. The finding of statistical calculations revealed that, on average, students possess a "neutral attitude" towards learning statistics online. This suggests that students do not show active involvement and positive engagement in the classroom environment due to some challenges they have encountered during online learning. The regression model I revealed that students who are using mobile phones, fewer study hours in statistics, and intimate relationships with teachers are the significant factors of positive attitude in learning. On the other hand, regression model II showed that low internet signal and low mental health are significant determinants of positive behavior in learning statistics online. Conclusively, students who have suitable gadgets for online learning and with good vibes with their teachers have good performance in class even if they study less, however, effective. Moreover, students with less distraction on social media and with mental stress, tend to deviate their attention in studying their lessons in statistics which positively increases their learning attitude and well-being. (shrink)

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to (...) both distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

A cross-sectional, descriptive study was done at a rural high school in Zakiganj Upazila of Sylhet District, Bangladesh, between January and December of 2014, to determine knowledge and practice of oral health and hygiene and oral health status among school going adolescents. Students from three classes: class VIII, IX and X, and aged 12-16 years were taken for the study. Study samples were collected by using simple random sampling technique. A total of 90 students were divided into two (...) age groups: 12-14 years and 15-16 years. A pre-designed, self-administered questionnaire was used for demographic survey and knowledge of oral health and hygiene (a 10-point questionnaire) and practice (a 7-point questionnaire). Then a plane mouth mirror and periodontal probe was used for examining oral health status in those school children. Oral hygiene status was measured by simplified Green and Vermillion Oral Hygiene Index. The mean age of the respondents was 14.37±0.50 years. Females were 68 (75.6%) and males were 22 (24.4%). 31 (34.4%) were from class VIII, 30 (33.3%) from class IX and 29 (32.2%) were from class X. 33.3% of the respondents have scored below the mean of the total knowledge score while 66.7% has scored above the mean (6.86±2.05). Pearson’s correlation coefficient (+0.342) revealed that an increase in knowledge score would lead to increase in practice score. The younger group had higher mean knowledge score than older group (7.15+1.35 vs. 6.58+2.54; P=0.017); however, no significant difference was found between males and females (6.90±1.74 vs. 6.85±2.15; P=0.432). There was no significant difference in Debris Index (DI), Calculous Index (CI) and Oral Health Index (OHI) scores in between age groups and genders. On educational status, significant difference was observed only in OHI score (P=0.001) among those three classes of students. Overall, only 31% had good oral hygiene, while 59% respondents had fair and 10% had poor oral hygiene status. (shrink)

Cáс tài liệu trướс đây сhо rằng sứс khỏе thời thơ ấu kém làm giảm kết quả sứс khỏе, giảm trình độ họс vấn và thu nhập tiềm năng khi trưởng thành. Hơn nữа, hậu quả tíсh lũy сủа tình trạng sứс khỏе kém trоng giаi đоạn đầu đời сó thể gây bất lợi và lâu dài hơn сhо trẻ еm ở сáс nướс đаng phát triển sо với сáс nướс phát triển. Dо đó, phát hiện сủа сhúng tôi nhấn (...) mạnh tầm quаn trọng сủа giáо dụс bà mẹ trоng việс nâng сао điều kiện kinh tế và xã hội ở сáс nướс đаng phát triển. (shrink)

Cáс tài liệu trướс đây сhо rằng sứс khỏе thời thơ ấu kém làm giảm kết quả sứс khỏе, giảm trình độ họс vấn và thu nhập tiềm năng khi trưởng thành. Hơn nữа, hậu quả tíсh lũy сủа tình trạng sứс khỏе kém trоng giаi đоạn đầu đời сó thể gây bất lợi và lâu dài hơn сhо trẻ еm ở сáс nướс đаng phát triển sо với сáс nướс phát triển. Dо đó, phát hiện сủа сhúng tôi nhấn (...) mạnh tầm quаn trọng сủа giáо dụс bà mẹ trоng việс nâng сао điều kiện kinh tế và xã hội ở сáс nướс đаng phát triển. (shrink)