Solitude, Religious and Cultural Uniqueness in a Foreign Environment: Adjustments as an Arab Student.

Arab-Muslims have extremely religious-centered and restrictive cultural practices. Living in a foreign country where Islam is a minority religion and culture is categorically different entails a great deal of adjustment. This study explored how Arab-Muslim International Students live and cope in a non-Arab, non-Muslim country. The authors used phenomenological approach with Colaizzi's method of analysis to (1) explore the lived experience of the Arab students' academic and social life and (2) come up with recommendations that can be supported by universities in Philippines and other countries with Arab students. Emergent themes include Hybrid vision and empowerment from education beyond borders "Tatallo at wa kudurat," Stigma in the Arab world "Hallah," Islam as way of life "Al Islam: Manhaj Hayyat," and Future of the Arab-Muslim students "Wahaa." The major concepts that emerged from the lived experience of these students focused on the practical reasons for quality education, challenges along the way, culture shock, the stigma, and misconceptions about Arabs and Muslims. They experienced discrimination, the impact of stereotyping and misconceptions about the Arab-Muslims. Their tenacity of the Islam faith has become a coping mechanism and kept them enormously strong. They also strived to show the real meaning of being Muslim, and finally, looking forward to how they can become the oasis in the desert. The Arab-Muslim International Students experience difficult adjustments in a foreign country to acquire high quality education, while holding on to their Islam faith and keeping their culture intact.

Effects of Cognitively Stimulating Activities on the Cognitive Functioning of Older People with Mild Cognitive Impairment: A Meta-analysis.

Background: The number of individuals with mild cognitive impairment (MCI), or those people without dementia who are experiencing age-related cognitive decline, has increased in recent years. Conveniently, several interventions to delay cognitive decline exist, where cognitively stimulating activities (CSA) have been receiving too much attention. However, its beneficial effects have not been well established among older people with MCI due to conflicting findings. Objectives: This study aimed to assess and summarize the available evidence on the effects of CSA on the overall cognitive functioning of older people with MCI. Specifically, it sought to answer the PICO question, "In older people with MCI, does engagement in cognitively stimulating activities improve cognitive function?" Methods: A systematic review and meta-analysis of randomized controlled trials examining the effects of CSA on older people with MCI were conducted. Three studies met the inclusion criteria from the 1,328 records from BioMed Central, CINAHL, Cochrane Library, Health Source: Nursing/Academic Edition, MEDLINE, and PubMed databases and 156 articles from WorldCat, DSpace Saint Louis University, and Google Scholar databases and catalogs. Effect size values were inspected using the random-effects model. Data were summarized as standardized mean difference (SMD) with corresponding 95% confidence intervals in the forest plot. Results: This meta-analysis which compared studies that employed similar methodologies, found that CSA has a significant, large effect in improving cognitive functioning among older people with MCI, evidenced by an SMD of 0.798 (95% CI = 0.510-1.085, p = 0.001). While its superiority over other interventions that improve cognitive function was not observed in this study, it was still found that using CSA was helpful in terms of its cost-effectiveness. Also, heterogeneity across studies was non-significant (Cochran's Q = 0.151, df = 2, p = 0.927, I2 = 0.00%). These results mean that clinical heterogeneity was absent even though a diverse range of CSA was employed. Additionally, methodological diversity was not present since there were no variations in the study design and minimal variability in the risk of bias assessment. Conclusion: Overall, it is acknowledged that CSA are effective and practical, inexpensive, non-pharmacologic cognitive training approaches to delay cognitive decline among older people with MCI. However, interpreting this study's significant, large effect, and non-significant heterogeneity warrants caution.

Beliefs and Practices on Depression Among Selected Filipino Indigenous Peoples: A Focused Ethnography.

INTRODUCTION: Depression beliefs and practices among indigenous peoples are essential to creating responsive mental health services. The purpose of the study is to explore the cultural beliefs and practices on depression among the Ilocanos, Kankana-eys, and Maranaos indigenous peoples in the Philippines. METHOD: The study employed a focused ethnography research design. The study involved 41 (N = 41) traditional healers and tribal leaders across Ilocano, Kankana-ey, and Maranao ethnic groups in the Philippine Islands. Interviews, reviews of records, and participant observation were used as data gathering tools. RESULTS: Beliefs about depression include magico-spiritual influence, relational problems, economic pressure, and emotional domains. Practices were divided into three domains: preventive, curative, and rehabilitative interventions. DISCUSSION: The depression beliefs and practices of Ilocano, Kankana-ey, and Maranao indigenous peoples are rooted in their tradition, culture, religion, and medical influences largely rooted in magico-spiritual approaches. These findings suggest the inclusion of culturally-based care to address depression.

Clinical epidemiology and outcomes of ventilator-associated pneumonia in critically ill adult patients: protocol for a large-scale systematic review and planned meta-analysis.

BACKGROUND: An increasing number of studies have investigated the clinical epidemiology and outcomes of ventilator-associated pneumonia (VAP) in intensive care units. However, these findings have not been clearly defined in broad subgroups of mechanically ventilated adults. Hence, this protocol for a systematic review and meta-analysis is designed to better understand the clinical and epidemiological features of VAP in these patient populations by establishing its overall prognosis of and risk factors for morbidity and mortality and to determine the differences in clinical and economic outcomes between VAP and non-VAP patients. METHODS: This present review will systematically search available full-text articles without date and language restrictions and indexed in PubMed, CENTRAL, CINAHL, Web of Science, and EMBASE databases. In addition, reference lists and citations of retrieved articles and relevant medical and nursing journals will be manually reviewed. Supplementary search in other databases involving trials, reviews, and grey literatures, including conference proceedings, theses, and dissertations, will be performed. Study investigators will be contacted to clarify missing or unpublished data. All prognostic studies meeting the pre-defined eligibility criteria will be included. The study selection, risk of bias assessment, data extraction, and grading of the quality of evidence will be carried out in duplicate, involving independent evaluation by two investigators with consensus or a third-party adjudication. The degree of inter-rater agreement will be calculated using the kappa statistic. For meta-analysis, dichotomous and continuous outcome measures will be pooled using odds ratios and standardized mean differences with 95% confidence intervals, respectively. The Mantel-Haenszel or inverse variance methods with random effects model will be used as a guide for analysis. The heterogeneity of each outcome measure will be assessed using both X2 and I2 statistics. In addition, sensitivity and subgroup analyses will be performed to ensure consistency of pooled results. The review protocol described herein is in accordance with the PRISMA-P standards. DISCUSSION: The investigation of the epidemiological profiles, prognostic factors, and outcomes associated with VAP is critical for the identification of high-risk groups of mechanically ventilated patients and evaluation of possible clinical endpoints. This may provide substantial links for improved VAP prevention practices targeting modifiable risk factors. Implications for future research directions are discussed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017048158.