Bangsa yang maju adalah bangsa yang celik sejarah

Telah menjadi kebiasaan bagi rakyat Malaysia setiap 31 Ogos kita akan merayakan sambutan kemerdekaan. Bangga sungguh kita menjadi rakyat Malaysia yang mana negaranya aman, makmur dan sejahtera. Orang luar pun suka datang dan tinggal di sini dan mereka juga mengiyakan bahawa Malaysia sungguh aman dan sejahtera. Apa yang penting, di sini tidak ada bom yang jatuh di sana dan jatuh di sini. Sebab itulah hari kemerdekaan dapat disambut dengan penuh meriah. Harus diingat sambutan kemerdekaan bukan sahaja cukup dengan meraikannya, memperingati perjuangan orang-orang terdahulu, pengisian ceramah, pertandingan esei sempena kemerdekaan, dan mengibarkan bendera. Asas untuk seseorang itu menghargai kemerdekaan dan keamanan yang dikecapi selama ini adalah dengan mempelajari dan menghayati perjalanan sejarah negara

Transforming Their Journey by Listening to Their Voices: A Photovoice Study of Barriers and Facilitators to Physical Activity Among Rural Youth with Cerebral Palsy

Background and Objective(s): Young people with cerebral palsy (CP) face unique barriers to initiating and sustaining physical activity. The International Classification of Functioning, Disability and Health (ICF) indicates that environmental barriers can play a significant role mediating activities. In rural areas, youth with CP and their families face barriers that are unique. The purpose of this study was to explore barriers and facilitators to physical activity among youth with CP and their families. Study Design: Participatory Action Research using Photovoice. Study Participants & Setting: A total of 15 participants were purposefully sampled including youth with CP (age range 14y 10M–21y 0 m; 3 females, 4 males) and caregivers (n=8) in rural, southeast Georgia participated in this study. Youth participants included a variety of functional levels (GMFCS I‐IV). Materials/Methods: Participants used photography to capture barriers and facilitators to participating in physical activity in their local community. Participants were given a minimum of 14 days to take pictures. After 14 days, the researchers reconvened the youth and parent participants, and used in‐depth interviews structured by Photovoice\u27s SHOWeD method to review and contextualize the photographs. Furthermore, a set of interview techniques were customized to facilitate youth interviews and to mediate the child‐researcher power differential. After all in‐depth interviews were complete, the participating parents reconvened to review all contextualized photographs to identify an action plan to present to local community stakeholders. Transcriptions from all interviews and focus group were transcribed verbatim. Content analysis of interview and focus group transcripts was used to identify the themes that emerged. Photographs and accompanying text were presented to local stakeholders and an action plan to increase physical activity for young people with CP was created. Results: Results provided insight into the day‐to‐day factors that made it easier or more difficult for children with CP to participate in physical activity. Factors were identified at multiple ecological levels and provided new insight into the CP experience. Common barriers to physical activity included a) inaccessible facilities and equipment; b) social isolation from a lack of inclusiveness; and c) the emotional stress experienced by caregivers as a result of reduced supports for their child. Facilitators included a) community‐based support for families and b) adaptive sports leagues. Conclusions/Significance: Photovoice was a powerful technique for elucidating challenges faced by youth diagnosed with CP. The process provided children and their families a mechanism to illustrate the everyday realities of living with CP and provided the opportunity to reach community stakeholders to develop actions centered around the multifaceted levels of impacting a child\u27s and their family\u27s ability to participate in daily physical activity

Using Participatory Action Research to Examine Barriers and Facilitators to Physical Activity Among Rural Adolescents with Cerebral Palsy

Purpose: The purpose of this study was to use a qualitative, community-based participatory action research method – Photovoice – to identify perceived facilitators and barriers to physical activity among adolescents with cerebral palsy (CP) in a rural community. Materials and methods: Fifteen participants including adolescents with CP (n = 7) and parents (n = 8) were included in this study. The researchers followed the nine-step methodology recommended for Photovoice. During the training session, participants completed versions of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments. This questionnaire was used to generate descriptive information about participant barriers and facilitators. Participants were given 14 days to take photographs after which researchers used in-depth and focus group interviews structured by the SHOWeD method. Content analysis of transcripts was used to identify common themes. Results and conclusions: Photographs and accompanying text were presented to local stakeholders and an action plan to increase physical activity for adolescents with CP was created. Perceived barriers included lack of inclusiveness, family isolation, and limited accessibility of equipment and resources. Facilitators included support services for families and adaptive sport leagues. Photovoice serves as a powerful tool to initiate change to promote physical activity among rural adolescents with CP. Implications for rehabilitation Adolescents with cerebral palsy living in rural areas face unique barriers to physical activity. Accessibility of equipment and the structural environment can serve as barriers to participation. Lack of accessibility can lead to feelings of isolation. Families need support services outside of rehabilitation settings to support physical activity for their children and overcome potential barriers

Community-Based Services: The Gateway to Coordinated Care for Children with Special Healthcare Needs (CHSCN)

Background: Care coordination (CC) is important because Children with Special Healthcare Needs (CSHCN) often have complex needs that require services from a variety providers. Access to these services within the community may be a major factor in CC for CSHCN. Therefore, we examined the relationship between access to community-based services and CC while accounting for potential covariates. Method: The latest version of the NS-CSHCN included questions that addressed insurance coverage, access to services, and CC. Maternal Child Health Bureau (MCHB) Core Outcomes, National Chartbook Indicators, and Stratifiers were used to model the likelihood of CSHCN receiving CC (N=29,845). Results: Odds ratios indicated that access to community-based service systems had the greatest influence on the receiving CC (Exp(B) = 2.92). Those who had adequate insurance (Exp(B) = 1.45) and who were white (as opposed to Hispanic) were also more likely to receive CC(Exp(B) = 1.18). Those who participated in shared decision-making were slightly less likely to receive CC (Exp(B) = .338). Higher out-of-pocket expenses, family financial burden, more hours per week providing care, and greater impact on family work life further decreased the likelihood of CC. Increasing age, nontraditional family structures, public insurance, higher education levels, and residences within metropolitan statistical areas also had negative influences on CC. Conclusion: The results support the need for accessible community-based services for CHSCN in order for care to be coordinated. All stakeholders must address issues related to eligibility, availability, cost, and lack of information which can all limit access to community-based services. This presentation was given at the American Public Health Association

Using Community-Based Participatory Action Research to Examine Barriers and Facilitators to Physical Activity Among Rural Adolescents with Cerebral Palsy

This presentation was given at the American Public Health Association