Search results for: children with disability

Authors: Justin Ntokamunda Kadima, Christian Ahadi Irenge, Patient Birindwa Mulashe, Félicien Mushagalusa Kasali, Patient Wimba

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Background: Bacterial strains carrying multidrug resistance traits are gaining ground worldwide, especially in countries with limited resources. This study aimed to evaluate the spreading of multidrug-resistant bacteria strains in Bukavu city hospitals in the Democratic Republic of Congo. Methods: We analyzed 758 antibiogram data recorded in files of patients consulted between January 2016 and December 2017 at three reference hospitals selected as sentinel sites, namely the Panzi General Reference Hospital (HGP), BIO -PHARM hospital (HBP), and Saint Luc Clinic (CSL). Results: Of 758 isolates tested, the laboratories identified 12 bacterial strains in 712 isolates, of which 223 (29.42%) presented MDR profile, including Escherichia coli (11.48%), Klebsiella pneumonia (6.07%), Enterobacter (5.8%), Staphylococcus aureus and coagulase-negative Staphylococci (1.58%), Proteus mirabilis (1.85%), Salmonella enterica (1.19%), Pseudomonas aeruginosa (0.53%), Streptococcus pneumonia (0.4%)), Citrobacter (0.13%), Neisseria gonorrhea (0.13%), Enterococcus faecalis (0.13%), and Morganella morganii (0.13%). Infected patients were significantly more adults (73.1% vs. 21.5%) compared to children and mainly women (63.7% vs. 30.9%; p = 0.001). Conclusion: The observed expansion requires that hospital therapeutic committees set up an effective clinical management system and define the right combinations of antibiotics.

Keywords: multidrug resistance, bacteria, antibiogram, Bukavu

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Authors: F. A. Thomas, M. Schrafl-Altermatt, R. Treier, S. Kaufmann

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Stroke is the main cause of adult disability. Especially upper limb function is affected in most patients. Recently, cooperative hand movements have been shown to be a promising type of upper limb training in stroke rehabilitation. In these movements, which are frequently found in activities of daily living (e.g. opening a bottle, winding up a blind), the force of one upper limb has to be equally counteracted by the other limb to successfully accomplish a task. The use of standardized and reliable clinical assessments is essential to evaluate the efficacy of therapy and the functional outcome of a patient. Many assessments for upper limb function or impairment are available. However, the evaluation of cooperative hand movement tasks are rarely included in those. Thus, the aim of this study was (i) to develop a novel clinical assessment (CASA - Cooperative Activity Stroke Assessment) for the evaluation of patients’ capacity to perform cooperative hand movements and (ii) to test its inter- and interrater reliability. Furthermore, CASA scores were compared to current gold standard assessments for upper extremity in stroke patients (i.e. Fugl-Meyer Assessment, Box & Blocks Test). The CASA consists of five cooperative activities of daily living including (1) opening a jar, (2) opening a bottle, (3) open and closing of a zip, (4) unscrew a nut and (5) opening a clipbox. Here, the goal is to accomplish the tasks as fast as possible. In addition to the quantitative rating (i.e. time) which is converted to a 7-point scale, also the quality of the movement is rated in a 4-point scale. To test the reliability of CASA, fifteen stroke subjects were tested within a week twice by the same two raters. Intra-and interrater reliability was calculated using the intraclass correlation coefficient (ICC) for total CASA score and single items. Furthermore, Pearson-correlation was used to compare the CASA scores to the scores of Fugl-Meyer upper limb assessment and the box and blocks test, which were assessed in every patient additionally to the CASA. ICC scores of the total CASA score indicated an excellent- and single items established a good to excellent inter- and interrater reliability. Furthermore, the CASA score was significantly correlated to the Fugl-Meyer and Box & Blocks score. The CASA provides a reliable assessment for cooperative hand movements which are crucial for many activities of daily living. Due to its non-costly setup, easy and fast implementation, we suggest it to be well suitable for clinical application. In conclusion, the CASA is a useful tool in assessing the functional status and therapy related recovery in cooperative hand movement capacity in stroke patients.

Keywords: activitites of daily living, clinical assessment, cooperative hand movements, reliability, stroke

Procedia PDF Downloads 319

Authors: Sun-Ki Choi

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The U.S. student loan policy was initiated to improve the equality of educational opportunity and help low-income families to provide higher education opportunities for their children. However, with the increase in the average student loan amount, college graduates with student loans experience problems and restrictions in their early-career choices. This study examines the early career labor market choices of college graduates who obtained student loans to finance their higher education. In this study, National Survey of College Graduates (NSCG) data for 2017 and 2019 was used to estimate the effects of student loans on the employment status and current job wages of graduates with student loans. In the analysis, two groups of workers, those with student loans and those without loans, were compared. Using basic models and Mahalanobis distance matching, it was found that graduates who rely on student loans to finance their education are more likely to participate in the labor market than those who do not. Moreover, in entry-level jobs, graduates with student loans receive lower salaries than those without student loans. College graduates make job-related decisions based on their current and future wages and fringe benefits. Graduates with student loans tend to demonstrate risk-averse behaviors due to their financial restrictions. Thus, student loan debt creates inequity in the early-career labor market for college graduates. Furthermore, this study has implications for policymakers and researchers in terms of the student loan policy.

Keywords: student loan, wage differential, unintended consequences, mahalanobis distance matching

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Authors: Aliyu Maje Bello, Yaowaluck Maprang Roshorm

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Hand, foot, and mouth disease (HFMD) is a highly contagious viral infection affecting mostly infants and children. Although the Enterovirus A71 (EV71) is usually the major causative agent of HFMD, other enteroviruses such as coxsackievirus A16, A10, and A6 are also found in some of the recent outbreaks. The commercially available vaccines have demonstrated their effectiveness against only EV71 infection but no protection against other enteroviruses. To address the limitation of the monovalent EV71 vaccine, the present study thus designed a tetravalent vaccine against the four major enteroviruses causing HFMD and primarily evaluated the designed vaccine using an immunoinformatics approach. The immunogen was designed to contain the EV71 VP1 protein and multiple reported epitopes from all four distinct enteroviruses and thus designated a tetravalent vaccine. The 3D structure of the designed tetravalent vaccine was modeled, refined, and validated. Epitope screening showed the presence of B-cell, CTL, CD4 T cell, and IFN epitopes with vast application among the Asian population. Docking analysis confirmed the stable and strong binding interactions between the immunogen and immune receptor B-cell receptor (BCR). In silico cloning and immune simulation analyses guaranteed high efficiency and sufficient expression of the vaccine candidate in humans. Overall, the promising results obtained from the in-silico studies of the proposed tetravalent vaccine make it a potential candidate worth further experimental validation.

Keywords: enteroviruses, coxsackieviruses, hand foot and mouth disease, immunoinformatics, tetravalent vaccine

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Authors: Anh T. P. Tran, Harald Von Korflesch

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Entrepreneurial intention play a major role in entrepreneurship academia and practice. The spectrum ranges from the first model of the so-called Entrepreneurial Event, then the Theory of Planned Behavior, the Theory of Planned Behavior Entrepreneurial Model, and the Social Cognitive Career Theory to some typical empirical studies with more or less diverse results. However, little is known so far about the intentions of entrepreneurs in the social areas of venture creation. It is surprising that, since social entrepreneurship is an emerging field with growing importance. Currently, all around the world, there is a big challenge with a lot of urgent soaring social and environmental problems such as poor households, people with disabilities, HIV/AIDS infected people, the lonely elderly, or neglected children, some of them even actual in the Western countries. In addition, the already existing literature on entrepreneurial intentions demonstrates a high level of theoretical diversity in general, especially the missing link to the social dimension of entrepreneurship. Seeking to fill the mentioned gaps in the social entrepreneurial intentions literature, this paper proposes a conceptual model of social entrepreneurial intentions based on the Social Cognitive Career Theory with two main factors influencing entrepreneurial intentions namely self-efficacy and outcome expectation. Moreover, motives, goals and plans do not arise from empty nothingness, but are shaped by interacting with the environment. Hence, personalities (i.e., agreeableness, conscientiousness, extraversion, neuroticism, openness) as well as contextual factors (e.g., role models, education, and perceived support) are also considered as the antecedents of social entrepreneurship intentions.

Keywords: entrepreneurial intention, social cognitive career theory, social entrepreneurial intention, social entrepreneurship

Procedia PDF Downloads 475

Authors: Soham Das

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Oedipus in Oedipus Rex is necessarily a victim of fate and his own psychology. His curiosity brings about his downfall. Ancient Greek plays weren't just portrayals of some obscure tale but were insights into human nature. Oedipus, although a victim of circumstances, digs his own grave by curiously unravelling his past. Jocasta foresees his doom and begs him to stop, but to no avail. The curiosity of Oedipus forces him, almost like a drug, to explore the mystery regarding his birth. This curiosity is not something extraordinary in Oedipus - it is an intrinsic attribute of human nature. Knowledge is not always desired - whether it is Adam or Oedipus, their curiosity caused their eventual downfall. Oedipus was ill-fated since birth. He did not know that Laius was his biological father and therefore killed him. He arrived at Thebes, solved the riddle of the Sphinx, and married Jocasta without knowing that she, in fact, was his biological mother. He begot children and was living happily with his family when a sudden calamity struck Thebes. The calamity, though at first seemed public in nature, but later proved to be very personal for Oedipus. It drives home the fundamental truth about uncertainty of human life. That Laius was slayed by his own son, even after many precautions, proves the helplessness of humans in front of the designs of fate. Oedipus's mutilation of his eyes is also fated. It was committed by him in the heat of the moment and was certainly not a rational decision. It is evident to any modern reader that Oedipus does not have justice. Destiny treats him unfairly. Oedipus, in fact, defends his actions in Oedipus Rex in its sequel Oedipus At Colonus. The research paper discusses the unhappy fate of Oedipus and the role of destiny and his own curiosity in achieving it.

Keywords: ancient Greek drama, Oedipus Rex, Sophocles, destiny

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Authors: Kerdsiri Hongthai, Darunee Jongudomkarn, Rutja Phuphaibul

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In Thailand, many adults in rural areas migrate to seek employ¬ment resulting in skipped-generation family where grandparents care for grandchildren with no other adults present. This is a preliminary study using qualitative case study methods, aimed to explore the situations of older adult grandparents' experiences in skipped-generation family in North-East of Thailand. Data were collected by in-depth inter¬views with 6 grandparents living in skipped-generation families; 5 females and 1 males grandparents, aged 62-75, some of them have diabetes mellitus, hypertension, during November to December, 2017. The finding themes are: ‘Caught up in the middle’: the older adults were pleased to have grandchildren but, at the same time, acknowledge the burden that this placed on them, especially when the migrant children failed to send enough money back to support the family. ‘Getting bad health’: they reported to be fatigued and stressed due to burden of caring for their grandchildren without support. This situation can aggravate problems of poor health status and be worsening economic status of the grandparents. In some cases of deprivation, the grandparents feel that having to be the sole care providers of their grandchildren can negative adversely affect their mental status. It is important to find out in other sectors similar to Thailand and lead to more in-depth research to answer the research questions about policy and social support in skipped-generation family in the future.

Keywords: older adult grandparents, experiences, principle care giver, skipped-generation family

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Authors: Sudheer Moorkoth, Leslie Edward Lewis, Pragna Rao

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Newborn screening (NBS) is a part of routine newborn care in many countries worldwide to detect early any rare treatable conditions and inborn errors of metabolism (IEM). India has not started this program yet. In an attempt to understand the challenges in implementing a national newborn screening program in India, we initiated a pilot newborn screening project funded by the Government of Canada. Along with initiating the newborn screening at Kasturba Hospital, Manipal in South India, for screening six disorders (Congenital Hypothyroidism(CH), Congenital Adrenal Hyperplasia (CAH), Galactosemia, Biotinidase deficiency, Glucose-6-Phosphate Dehydrogenase deficiency (G-6PD) and Phenylketonurea), we also studied the awareness of various stakeholders on the newborn screening. In a period of nine months from August 2017 to March 2018 we could screen 1915 newborns (999 male and 916 female). The result showed that there were seven babies screened positive. This interim result points to an incidence rate of 1 in 270 children for these rare disorders collectively. This includes three confirmed cases of CH, two cases of G-6PD deficiency, and one case each for Galctosemia and CAH. A questionnaire based study to understand the awareness among various stakeholders revealed that there is little awareness among parents, adolescents and anganwadi workers (public health worker). The interim data points to the need for a national newborn screening programme in India. There is also an immediate need to undertake large-scale awareness programme to create knowledge on NBS among the various stakeholders.

Keywords: awareness, inborn errors of metabolism (IEM), newborn screening, rare disease

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Authors: Guity Karim, Valiollah Ayareh

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Probiotic dairy products are those that contain biologically active components that may affect beneficially one or more target functions in the body, beyond their adequate nutritional effects. As far as chocolate milk is a popular dairy product in the country especially among children and youth, production of a symbiotic (probiotic + peribiotic) new product using chocolate milk, Bifidobacterium lactis (DSM, Netherland) and inulin (Bene, Belgium) would help to promote the nutritional and functional properties of this product. Bifidobacterium Lactis is used as a probiotic in a variety of foods, particularly dairy products like yogurt and as a probiotic bacterium has benefit effects on the human health. Inulin as a peribiotic agent is considered as functional food ingredient. Experimental studies have shown its use as bifidogenic agent. Chocolate milk with different percent of fat (1 and 2 percent), 6 % of sugar and 0.9 % cacao was made, sterilized (UHT) and supplemented with Bifidobacterium lactis and inulin (0.5 %) after cooling . A sample was made without inulin as a control. Bifidobacterium lactis population was enumerated at days 0, 4, 8 and 12 together with measurement of pH, acidity and viscosity of the samples. Also sensory property of the product was evaluated by a 15 panel testers. The number of live bacterial cells was maintained at the functional level of 106-108 cfu/ml after keeping for 12 days in refrigerated temperature (4°C). Coliforms were found to be absent in the products during the storage. Chocolate milk containing 1% fat and inulin has the best effect on the survival and number of B. lactis at day 8 and after that. Moreover, the addition of inulin did not affect the sensorial quality of the product. In this work, chocolate has been evaluated as a potential protective carrier for oral delivery of B. lactis and inulin.

Keywords: chocolate milk, synbiotic, bifidobacterium lactis, inulin

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Authors: Claudia Troccoli

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Childbearing constitutes one of the key factors affecting labour market differences between men and women, accounting for almost a quarter of the gender wage gap. Family leave policies, such as maternity, paternity, and parental leave, represent potential key policy tools to address these inequalities, as they can promote mothers' job continuity and career progression. This paper analyses four major reforms implemented in Finland between the 1960s and the early 1980s. It studies the effects of these maternity and parental leave extensions on mothers' short- and long-run labour market outcomes. Eligibility to longer leave was determined on the basis of the child's date of birth. Therefore, estimation of the causal effects of the reforms is possible by exploiting random variation in children's birthdates and comparing the outcomes of mothers giving birth just before and just after the reform cutoff date. Overall, the three maternity leave reforms did not significantly improve mothers' earnings or employment rates. On the contrary, the estimates, although imprecise, seem to indicate negative effects on women's labour market outcomes. The extension of parental leave is, on the other hand, the only reform that improved mothers' short- and long-term labour market outcomes, both in terms of earnings and employment rate. At the same time, fathers appeared to be negatively affected by the reform. These results provide suggestive evidence that shareable parental leave might have more beneficial effects on mothers' job continuity, as it weakens the connotation of childcare as a task reserved for mothers.

Keywords: family policies, Finland, maternal labour market outcomes, maternity leave

Procedia PDF Downloads 137

Authors: Fatima M. Jadu, Asmaa A. Alzahrani, Maha A. Almutairi, Salma O. Al-Amoudi, Mawya A. Khafaji

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Introduction: Estimating the potential radiation risk for a widely used imaging technique such as cone beam CT (CBCT) is crucial. The aim of this study was to examine the effect of varying two CBCT technical factors, the voxel size (VOX) and the Field-of-View (FOV) centralization, on the radiation dose. Methodology: The head and neck slices of a RANDO® man phantom (Alderson Research Laboratories) were used with nanoDot™ OSLD dosimeters to measure the absorbed radiation dose at 25 predetermined sites. Imaging was done using the i-CAT® (Imaging Science International, Hatfield, PA, USA) CBCT unit. The VOX was changed for every three cycles of exposures from 0.2mm to 0.3mm and then 0.4mm. Then the FOV was centered on the maxilla and mandible alternatively while holding all other factors constant. Finally, the effective radiation dose was calculated for each view and voxel setting. Results: The effective radiation dose was greatest when the smallest VOX was chosen. When the FOV was centered on the maxilla, the highest radiation doses were recorded in the eyes and parotid glands. While on the mandible, the highest radiation doses were recorded in the sublingual and submandibular glands. Conclusion: Minor variations in the CBCT exposure factors significantly affect the effective radiation dose and thus the radiation risk to the patient. Therefore, extreme care must be taken when choosing these parameters especially for vulnerable patients such as children.

Keywords: CBCT, cone beam CT, effective dose, field of view, mandible, maxilla, resolution, voxel

Procedia PDF Downloads 263

Authors: Sajed Yaghoubnezhad, Sedygheh Rezai

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Background and Aim: Since currently in Iran, students with learning disabilities are identified after entering school, and with the approach to the gap between IQ and academic achievement, the purpose of this study is to design and calculate the content validity of the pre-school screening checklist (5-7) exposed to learning difficulties. Methods: This research is a fundamental study, and in terms of data collection method, it is quantitative research with a descriptive approach. In order to design this checklist, after reviewing the research background and theoretical foundations, cognitive abilities (visual processing, auditory processing, phonological awareness, executive functions, spatial visual working memory and fine motor skills) are considered the basic variables of school learning. The basic items and worksheets of the screening checklist of pre-school students 5 to 7 years old with learning difficulties were compiled based on the mentioned abilities and were provided to the specialists in order to calculate the content validity ratio index. Results: Based on the results of the table, the validity of the CVR index of the background information checklist is equal to 0.9, and the CVR index of the performance checklist of preschool children (5 to7 years) is equal to 0.78. In general, the CVR index of this checklist is reported to be 0.84. The results of this study provide good evidence for the validity of the pre-school sieve screening checklist (5-7) exposed to learning difficulties.

Keywords: checklist, screening, preschoolers, learning difficulties

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Authors: Md. Rashed Aalm, Md. Nuruzzaman Khan, Yothin Sawangdee

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Background: Around 47% of the total pregnancies are unintended in Bangladesh, which lead to several adverse consequences, including maternal and child mortality. Use of menstrual regulation (MR) can help women to reduce unintended pregnancy related adverse consequences. We explored the prevalence and determinants of MR services among ever-married women in Bangladesh. Methods: Total of 14,346 ever-married women data were analysed from the 2017 Bangladesh Demographic and Health Survey. Our study variable was use or non-use of MR services. Individual, household, and community level factors were the explanatory factors. Multilevel mixed-effect Poisson regression model was used to determine the factors associated with MR services in Bangladesh. Results: Nearly 7% of the total women in Bangladesh use MR services. Use of MR services was found higher among women who were aged 20-30 ages (IRR 1.60, 95% CI: 1.17–2.17), who were overweight (IRR 1.43, 95% CI: 1.13–1.81), had at least 1 child (IRR 2.97, 95% CI: 2.34– 3.77) or > 2 children (IRR 3.22, 95% CI: 2.45–4.20), and the birth preceding birth interval was(2 – 4) years (IRR 1.56, 95% CI: 1.13–2.15). Around 1.39 times (95% CI: 1.11–1.73) higher likelihood of MR was found among women whose husbands were engage with business. At the community level, MR service was found lower among the women who resided in the community with higherilliteracy (IRR 0.67, 95% CI: 0.42–0.96) and the Mymensingh division (IRR 0.39, 95% CI: 0.31–0.91). Conclusion: Use of MR service is comparatively low, which indicate a significant proportion of unintended pregnancy continued toward life-birth. This could be responsible for higher adverse maternal and child health outcomes in Bangladesh. Initiatives should be taken to ensure MR services is available when women need this service.

Keywords: menstrual regulation, pattern, risk, maternal health, Bangladesh

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Authors: Jennifer Bradley

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With opportunities to live and work abroad on the rise, effective preparation and support for international employees needs to be addressed within the work-site. International employees must build new habits, routines and social networks in an unfamiliar culture. Culture shock typically occurs within the first year and can affect both physical and psychological health. Employers have the opportunity to support staff through the adaptation process and foster healthy habits and routines. Cross-cultural training that includes a combination of instructional teaching, cultural experiences, and practice, is shown to increase the international employee adaptation process. However, little evidence demonstrates that organizations provide all of these aspects for international employees. The occupational therapy practitioner (OTP) offers a unique perspective focusing on the employee transactional relationship and engagement of meaningful occupations to enhance and enable participation in roles, habits and routines within new cultural contexts. This paper examines one such program developed and implemented by an OTP at the New England Center for Children, in Abu Dhabi, United Arab Emirates. The effectiveness of the program was assessed via participant feedback and concluded that an international employee support program that focuses on a variety of meaningful experiences and knowledge can empower employees to navigate healthy practices, develop habits and routines, and foster positive inter-cultural relationships in the organization and community.

Keywords: occupational therapy practitioner, cross cultural training, international employee health, international employee support

Procedia PDF Downloads 159

Authors: Pooja Booluck

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A U-shaped learning curve entails a three-step process: a good performance followed by a bad performance followed by a good performance again. U-shaped curves have been observed not only in language acquisition but also in various fields such as temperature face recognition object permanence to name a few. Building on previous studies of the curve child language acquisition and Second Language Acquisition this empirical study seeks to investigate the relevance of the U-shaped learning model to the acquisition of the difference between cest and il est in the English Learners of French context. The present study was developed to assess whether older learners of French in the ELF context follow the same acquisition pattern. The empirical study was conducted on 15 English learners of French which lasted six weeks. Compositions and questionnaires were collected from each subject at three time intervals (after one week after three weeks after six weeks) after which students work were graded as being either correct or incorrect. The data indicates that there is evidence of a U-shaped learning curve in the acquisition of cest and il est and students did follow the same acquisition pattern as children in regards to rote-learned terms and subject clitics. This paper also discusses the need to introduce modules on U-shaped learning curve in teaching curriculum as many teachers are unaware of the trajectory learners undertake while acquiring core components in grammar. In addition this study also addresses the need to conduct more research on the acquisition of rote-learned terms and subject clitics in SLA.

Keywords: child language acquisition, rote-learning, subject clitics, u-shaped learning model

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Authors: Claire Baudry, Jessica Pearson, Laura-Emilie Savage, George Tarbulsy

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Over the last fifty years, maternal sensitivity and child development among vulnerable families have been a priority for researchers. For this reason, attachment-based interventions have been implemented and been shown to be effective in enhancing child development. Most of the time, child outcomes are measured shortly after the intervention. Objectives: The goal of the study was to investigate the effects of an attachment-based intervention on child development shortly after the intervention ended and one-year post-intervention. Methods: Over the seventy-two mother-child dyads referred by Child Protective Services in the province of Québec, Canada, forty-two were included in this study: 24 dyads who received 6 to 8 intervention sessions and 18 dyads who did not. Intervention and none intervention dyads were matched for the following variables: duration of child protective services, the reason for involvement with child protection, age, sex, and family status. Internalizing and externalizing behaviors were measured 3 and 12 months after the end of the intervention when the average age of children were respectively 45 and 54 months old. Findings: Independent-sample t-tests were conducted to compare scores between the two groups and the two data collection times. In general, on differences observed between the two groups three months after the intervention ended, just a few of them were still present nine months later. Conclusions: This first set of analyses suggests that the effects of attachment-based intervention observed three months following the intervention are not lasting for most of them. Those results inform us of the importance of considering the possibility to offer more attachment-based intervention sessions for those highly vulnerable families.

Keywords: attachment-based intervention, child behaviors, child protective services, highly vulnerable families

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Authors: Honey Bryant, Elvina Chu

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Stroke is the leading cause of disability in adults in Canada and directly related to depression, anxiety, and sleep disorders; with an estimated annual cost of $50 billion in health care. Strokes not only impact the individual but society as a whole. Current stroke rehabilitation does not include Music Therapy, although it has success in clinical research in the use of stroke rehabilitation. This study examines the use of neurologic music therapy (NMT) in conjunction with stroke rehabilitation to improve sleep quality, reduce stress levels, and promote neurogenesis. Existing research on NMT in stroke is limited, which means any conclusive information gathered during this study will be significant. My novel hypotheses are a.) stroke patients will become less depressed and less anxious with improved sleep following NMT. b.) NMT will reduce stress levels and promote neurogenesis in stroke patients admitted for rehabilitation. c.) Beneficial effects of NMT will be sustained at least short-term following treatment. Participants were recruited from the in-patient stroke rehabilitation program at Providence Care Hospital in Kingston, Ontario, Canada. All participants-maintained stroke rehabilitation treatment as normal. The study was spilt into two groups, the first being Passive Music Listening (PML) and the second Neurologic Music Therapy (NMT). Each group underwent 10 sessions of intensive music therapy lasting 45 minutes for 10 consecutive days, excluding weekends. Psychiatric Assessments, Epworth Sleepiness Scale (ESS), Hospital Anxiety & Depression Rating Scale (HADS), and Music Engagement Questionnaire (MusEQ), were completed, followed by a general feedback interview. Physiological markers of stress were measured through blood pressure measurements and heart rate variability. Serum collections reviewed neurogenesis via Brain-derived neurotrophic factor (BDNF) and stress markers of cortisol levels. As this study is still on-going, a formal analysis of data has not been fully completed, although trends are following our hypotheses. A decrease in sleepiness and anxiety is seen upon the first cohort of PML. Feedback interviews have indicated most participants subjectively felt more relaxed and thought PML was useful in their recovery. If the hypothesis is supported, larger external funding which will allow for greater investigation of the use of NMT in stroke rehabilitation. As we know, NMT is not covered under Ontario Health Insurance Plan (OHIP), so there is limited scientific data surrounding its uses as a clinical tool. This research will provide detailed findings of the treatment of neuropsychiatric aspects of stroke. Concurrently, a passive music listening study is being designed to further review the use of PML in rehabilitation as well.

Keywords: music therapy, psychotherapy, neurologic music therapy, passive music listening, neuropsychiatry, counselling, behavioural, stroke, stroke rehabilitation, rehabilitation, neuroscience

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Authors: Mohammad H. Taheri, David J. Brown, Nasser Sherkat

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Engagement is one of the most important factors in determining successful outcomes and deep learning in students. Existing approaches to detect student engagement involve periodic human observations that are subject to inter-rater reliability. Our solution uses real-time multimodal multisensor data labeled by objective performance outcomes to infer the engagement of students. The study involves four students with a combined diagnosis of cerebral palsy and a learning disability who took part in a 3-month trial over 59 sessions. Multimodal multisensor data were collected while they participated in a continuous performance test. Eye gaze, electroencephalogram, body pose, and interaction data were used to create a model of student engagement through objective labeling from the continuous performance test outcomes. In order to achieve this, a type of continuous performance test is introduced, the Seek-X type. Nine features were extracted including high-level handpicked compound features. Using leave-one-out cross-validation, a series of different machine learning approaches were evaluated. Overall, the random forest classification approach achieved the best classification results. Using random forest, 93.3% classification for engagement and 42.9% accuracy for disengagement were achieved. We compared these results to outcomes from different models: AdaBoost, decision tree, k-Nearest Neighbor, naïve Bayes, neural network, and support vector machine. We showed that using a multisensor approach achieved higher accuracy than using features from any reduced set of sensors. We found that using high-level handpicked features can improve the classification accuracy in every sensor mode. Our approach is robust to both sensor fallout and occlusions. The single most important sensor feature to the classification of engagement and distraction was shown to be eye gaze. It has been shown that we can accurately predict the level of engagement of students with learning disabilities in a real-time approach that is not subject to inter-rater reliability, human observation or reliant on a single mode of sensor input. This will help teachers design interventions for a heterogeneous group of students, where teachers cannot possibly attend to each of their individual needs. Our approach can be used to identify those with the greatest learning challenges so that all students are supported to reach their full potential.

Keywords: affective computing in education, affect detection, continuous performance test, engagement, flow, HCI, interaction, learning disabilities, machine learning, multimodal, multisensor, physiological sensors, student engagement

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Authors: Tatjana Stefanovic Stanojevic, Milica Tosic Radev, Aleksandra Bogdanovic

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Depression is considered to be a leading cause of death and disability in the female population, and that is the reason why understanding the dynamics of the onset of depressive symptomatology is important. A review of the literature indicates the relationship between depressive symptoms and insecure attachment patterns, but very few studies have examined the mechanism underlying this relation. The aim of the study was to examine the pathway from the preoccupied attachment pattern to depressive symptomatology, as well as to test the mediation effect of mentalization, social anxiety and rumination in this relationship using a serial mediation model. The research was carried out on a geographical cluster sample from the general population of Serbia included within the project ‘Indicators and models of family and work roles harmonization’ funded by the Ministry of Education, Science and Technological Development of the Republic of Serbia. This research was carried out on a subsample of 791 working-age female adults from 37 urban and rural locations distributed through 20 administrative districts of Serbia. The respondents filled in a battery of instruments, including Relationship Questionnaire - Clinical Version (RQ - CV), The Mentalization Scale (MentS), Scale of Social Anxiety (SA), Patient Ruminative Thought Style Questionnaire (RTSQ), Health Questionnaire (PHQ-9). The results confirm our assumption that the total indirect effect of the preoccupied attachment pattern to depressive symptoms is significant across all mediators separately. More importantly, this effect is still present in a model with a sequential mediator relationship, where social anxiety, rumination, and mentalization were perceived as serial mediators of a relationship between preoccupied attachment and depressive symptoms (estimated indirect effect=0.004, boot-strapped 95% CI=0.002 to 0.007). Our findings suggest that there is a significant specific indirect effect of the preoccupied attachment pattern to depressive symptoms, occurring through mentalization, social anxiety and rumination, indicating that preoccupied attachment cause decrease of a self related mentalization, which in turn causes increasing of social anxiety and rumination, concluding in depressive symptoms as a final consequence. The finding that the path from the preoccupied attachment pattern to depressive symptoms is typical in women is understandable from the perspective of both evolutionary and culturally conditioned gender differences. The practical implications of the study are reflected in the recommendations for the prevention and forehand psychotherapy response among preoccupied women with depressive symptomatology. Treatment of this specific group of depressed patients should be focused on strengthening mentalization, learning to accept and to understand herself better, reducing anxiety in situations where mistakes are visible to others, and replacing the rumination strategy with more constructive coping strategies.

Keywords: preoccupied attachment, depression, serial mediation model, mentalization, rumination

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Authors: Onyeke Paul Chuks

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Nigeria is ranked among the developing nations and a country with a low income per capita. The consequences of this economic situation have led to the low achievement records below UN benchmark especially in the area of basic education for her citizens. The country is, however, making relentless efforts at arresting the situation by making budgetary allocations to ensure the realization of Millennium Development Goal No. 2 which is achieving universal basic education, her distressed economy notwithstanding. Basic education which comprises primary and lower secondary education as well as pre-primary and/or adult literacy programs have suffered serious setbacks orchestrated by the dwindling of the nation’s economy. This category of education being the bedrock of all other levels of education is regarded as a priority by developing countries and also the focus of the Education for All Movement led by UNESCO. The introduction of child-friendly school model is one of the strategies designed by UNESCO to achieving this all important MDGs goal No. 2. Child-friendly education model is aimed at replacing the out-dated, mundane, regimented and officious school administrative model where the basic rights of school children are trampled upon with impunity and community participation in school activities is viewed as unnecessary interference by school managers. This paper ex-rayed the potential obstacles likely to impinge on the implementation of child-friendly school model in Nigeria especially from the angle of her distressed economy and the colossal effects of the corrupt practices bedeviling the nation. The paper as well outlines prospects for the successful implementation of the child-friendly school model in Nigeria.

Keywords: child-friendly school, distressed economy, model, Nigeria

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Authors: Ofelia A. Damag

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The study was focused on the development and assessment of the illustrated language activities of the 1996 Edition of the Portage Guide to Early Education. It determined the extent of appropriateness, applicability, time efficiency and aesthetics of the illustrated language activities to be used as instructional material not only by teachers, but parents and caregivers as well. The eclectic research design was applied in this study using qualitative and quantitative methods. To determine the applicability and time efficiency of the study, a try out was done. Since the eclectic research design was used, it made use of a researcher-made survey questionnaire and focus group discussion. Analysis of the data was done through weighted mean and ANOVA. The respondents of the study were representatives of Special Education (SPED) teachers, caregivers and parents of a special-needs child, particularly with difficulties in learning basic language skills. The results of the study show that a large number of respondents are SPED teachers and caregivers and are mostly college graduates. Many of them have earned units towards Master’s studies. Moreover, a majority of the respondents have not attended seminars or in-service training in early intervention for them to be more competent in the area of specialization. It is concluded that the illustrated language activities under review in this study are appropriate, applicable, time efficient and aesthetic for use as a tool in teaching. The recommendations are focused on the advocacy for SPED teachers, caregivers and parents of special-needs children to be more consistent in the implementation of the new instructional materials as an aid in an intervention program.

Keywords: illustrated language activities, inclusion, portage guide to early education, special educational needs

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Authors: Muhammad Abubakar Alhassan, Diane Pennington

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Social networking sites have become a space for people to discuss public health issues such as non-suicidal self-injury (NSSI). There are thousands of tweets containing self-harm and self-injury hashtags on Twitter. It is difficult to distinguish between different users who participate in self-injury discussions on Twitter and how their opinions change over time. Also, it is challenging to understand the topics surrounding NSSI discussions on Twitter. We retrieved tweets using #selfham and #selfinjury hashtags and investigated those from the United kingdom. We applied inductive coding and grouped tweeters into different categories. This study used the Latent Dirichlet Allocation (LDA) algorithm to infer the optimum number of topics that describes our corpus. Our findings revealed that many of those participating in NSSI discussions are non-professional users as opposed to medical experts and academics. Support organisations, medical teams, and academics were campaigning positively on rais-ing self-injury awareness and recovery. Using LDAvis visualisation technique, we selected the top 20 most relevant terms from each topic and interpreted the topics as; children and youth well-being, self-harm misjudgement, mental health awareness, school and mental health support and, suicide and mental-health issues. More than 50% of these topics were discussed in England compared to Scotland, Wales, Ireland and Northern Ireland. Our findings highlight the advantages of using the Twitter social network in tackling the problem of self-injury through awareness. There is a need to study the potential risks associated with the use of social networks among self-injurers.

Keywords: self-harm, non-suicidal self-injury, Twitter, social networks

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Authors: My Ha, Suwei Lin, Huiying Zou

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This study aimed at investigating the association between teacher support and academic resilience in a developing country. Using the data from PISA 2018 Student Questionnaire and Cognitive Tests, the study provided evidence of the significant impact teacher support had on reading literacy among 15-year-old students from low socio-economic status (SES) homes in Vietnam. From a total of 5773 Vietnamese participants from all backgrounds, a sample of 1765 disadvantaged students was drawn for analysis. As a result, 32 percent of the low SES sample was identified as resilient. Through their response to the PISA items regarding the frequency of support they received from teachers, the result of Latent Class Analysis (LCA) divides children into three subgroups: High Support (74.6%), Fair Support (21.6%), and Low Support (3.8%). The high support group reported the highest proportion of resilient students. Meanwhile, the low support group scored the lowest mean on reading test and had the lowest rate of resilience. Also, as the level of support increases, reading achievement becomes less dependent on socioeconomic status, reflected by the decrease in both the slope and magnitude of their correlation. Logistic regression revealed that 1 unit increase in standardized teacher support would lead to an increase of 29.1 percent in the odds of a student becoming resilient. The study emphasizes the role of supportive teachers in promoting resilience, as well as lowering educational inequity in general.

Keywords: academic resilience, disadvantaged students, teacher support, inequity, PISA

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Authors: Malab Sana Balouch, Meenakshi Nayar

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Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.

Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist

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Authors: Chao Fang

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Due to the Confucian emphasis on filial piety and an undeveloped social welfare system in mainland China, adult children are both socially and legally obliged to care for their parents, including financial assistance and physical care as well as emotional and social support. Thus a family-centred care pattern for elderly people has been firmly established in China. However, because of the nationwide ‘One Child Policy’, over one million parents are excluded from such care because of the death of their only child and, therefore, their primary caregiver. Without their child’s support, these parents must manage the day to day challenges of growing old alone, with little support from society. By overturning established expectations of a ‘good’ elderly life, the loss of an only child may be accompanied by social and self-stigmatization, pushing these bereaved parents to the margin of society and threatening their economic, physical, emotional and social well-being. More importantly, since the One Child Policy was implemented from the late 1970s and early 1980s, the first generation of bereaved or ‘Shidu’ parents has reached an age at which those parents need elderly care. However, their predicament has been largely ignored. This paper reports on a qualitative interview study that found elderly care to be the main concern for Shidu parents’ everyday life. The paper identifies and discusses the concerns these bereaved parents raised about the prospect of having nowhere to turn at a time of increased need for financial, physical, social and emotional support in old age. The paper also identifies how Shidu parents have been coming together in grief and negotiate to make their predicament known to the government and wider society and to re-define their elderly life by rebuilding a sense of ‘family’.

Keywords: culture, bereavement, China, elderly care

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Authors: Bavneet Kaur Sidhu, Manoj Tiwari

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Global Developmental Delay (GDD) is a common pediatric condition. Etiologies of GDD might, however, differ in developing countries. In the last decade, sporadic families are being reported in various countries. As to the author’s best knowledge, many risk factors and their correlation with the prevalence of GDD have been studied but its statistical correlation has not been done. Thus we propose the present study by targeting the risk factor, prevalence and their statistical correlation with GDD. FMR1 gene was studied to confirm the disease and its penetrance. A complete questionnaire-based performance was designed for the statistical studies having a personal, past and present medical history along with their socio-economic status as well. Methods: We distributed the children’s age in 4 different age groups having 5-year intervals and applied structural equation modeling (SEM) techniques, Spearman’s rank correlation coefficient, Karl Pearson correlation coefficient, and chi-square test.Result: A total of 1100 families were enrolled for this study; among them, 330 were clinically and biologically confirmed (radiological studies) for the disease, 204 were males (61.8%), 126 were females (38.18%). We found that 27.87% were genetic and 72.12 were sporadic, out of 72.12 %, 43.277% cases from urban and 56.72% from the rural locality, the mothers' literacy rate was 32.12% and working women numbers were 41.21%. Conclusions: There is a significant association between mothers' age and GDD prevalence, which is also followed by mothers' literacy rate and mothers' occupation, whereas there was no association between fathers' age and GDD.

Keywords: global developmental delay, FMR1 gene, spearman’ rank correlation coefficient, structural equation modeling

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Authors: Hyang Lim, Sungwon Choi

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Many previous studies in area of adolescents' depression have used a longitudinal design. The previous studies have found that the developmental trajectory of them is only one. But it needs to be examined whether the trajectory is applied to all adolescents. Some factors in their home and/or school have an effect on adolescents' depression and more likely to be specific groups. The present study was a longitudinal study aimed to identify the trajectories and to explore the predictors of adolescents' depression. The study used Korean Children and Youth Panel Survey (KCYPS) data. In this study, 2,351 second and third-year of middle school and first of high school students' data was analyzed by using semi-parametric group modeling (SGM). There were 5 trajectory groups for adolescents; low depressed stables, low depressed risers, moderately depressed decreases, moderately depressed stables, severe depressed decreases. The predictors of adolescents' depression were parental abuse, parental neglect, annual family income, parental academic background, friendship at school, and teacher-student relationship at school. All predictors had the significant difference across trajectory group profile for adolescents. The findings of the present study recommend to promote the socioeconomic status and to train social skill for the interpersonal relationship at the home and school. And the results suggest that the proper prevention programs for each group in the middle adolescents that target selected factors may be helpful in reducing the level of depression.

Keywords: adolescent, depression, KCYPS, school life, semi-parametric group-based modeling

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Authors: C. S. Chen, F. Y. Hui, B. S. Farhana, J. De Leon

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Introduction: Stroke can lead to long-term disability, affecting one’s quality of life. Providing stroke education to patient and family members is essential to optimize stroke recovery and prevent recurrent stroke. Currently, nurses conduct stroke education by handing out pamphlets and explaining their contents to patients. However, this is not always effective as nurses have varying levels of knowledge and depth of content discussed with the patient may not be consistent. With the advancement of information technology, health education is increasingly being disseminated via electronic software and studies have shown this to have benefitted patients. Hence, a multi-disciplinary team consisting of doctors, nurses and allied health professionals was formed to create the stroke journey map software to deliver consistent and concise stroke education. Research Objectives: To evaluate the effectiveness of using a stroke journey map software in improving patients’ perceived knowledge in the acute stroke unit during hospitalization. Methods: Patients admitted to the acute stroke unit were given stroke journey map software during patient education. The software consists of 31 interactive slides that are brightly coloured and 4 videos, based on input provided by the multi-disciplinary team. Participants were then assessed with pre-and-post survey questionnaires before and after viewing the software. The questionnaire consists of 10 questions with a 5-point Likert scale which sums up to a total score of 50. The inclusion criteria are patients diagnosed with ischemic stroke and are cognitively alert and oriented. This study was conducted between May 2017 to October 2017. Participation was voluntary. Results: A total of 33 participants participated in the study. The results demonstrated that the use of a stroke journey map as a stroke education medium was effective in improving patients’ perceived knowledge. A comparison of pre- and post-implementation data of stroke journey map revealed an overall mean increase in patients’ perceived knowledge from 24.06 to 40.06. The data is further broken down to evaluate patients’ perceived knowledge in 3 domains: (1) Understanding of disease process; (2) Management and treatment plans; (3) Post-discharge care. Each domain saw an increase in mean score from 10.7 to 16.2, 6.9 to 11.9 and 6.6 to 11.7 respectively. Project Impact: The implementation of stroke journey map has a positive impact in terms of (1) Increasing patient’s perceived knowledge which could contribute to greater empowerment of health; (2) Reducing need for stroke education material printouts making it environmentally friendly; (3) Decreasing time nurses spent on giving education resulting in more time to attend to patients’ needs. Conclusion: This study has demonstrated the benefit of using stroke journey map as a platform for stroke education. Overall, it has increased patients’ perceived knowledge in understanding their disease process, the management and treatment plans as well as the discharge process.

Keywords: acute stroke, education, ischemic stroke, knowledge, stroke

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Authors: Maha M.Saber, Eitedal Daoud, Moetazza M. Alshafei, Lobna M. Abd El-Latif

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Children in the third world consumes many food products colored red like sweets and soft drink without knowing its effect on health or the type of color used in these products Erythrosine (ER,FD & C Red No.3) is one of the most common coloring agent used in these products and in coloring cherry in compotes. The possible adverse effect of erythrosine ER on the thyroid gland function is investigated in albino rats. Forty-five adult male albino rats were divided to three groups two groups will receive ER orally in doses 68 and I36mg/kg respectively. Third group will receive distilled water for three months Sections of thyroid glands were examined for histopathological, morphometric analysis and MIB-I Ki67 (proliferative marker). Serum concentration of triiodothyronine (T3), Thyroxin (T4) and thyrotrophin (TSH) were determined, results showed histological changes in the two treatment groups versus control group in the group with 68mg/kg dose show vaculation of the cytoplasm of follicular cells and pleomorphism of their nuclei. While the other treated group {136mg /kg} showed congestion of blood vessels, hyperplasia of the interstitial cells and increased multilayer of the follicular cells. Highly significant increase in the mean area of the thyroid follicles in both treated groups compared to control group.Erythrosine treated groups showed a very highly significant decrease (P < 0.001) in serum concentration of T3 and T 4 while TSH showed a very highly significant increase versus control.

Keywords: erythrosine, thyroid, morphometrics, proliferative marker

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Authors: Constance Kirker

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This paper examines examples of the shared use of mango references as a culinary metaphor powerful in maintaining immigrant identity in the works of diaspora authors from a variety of regions of the world, including South Asia, the Caribbean, and Africa, and across a variety of genres, including novels, culinary memoirs, and children’s books. There has been past criticism of so-called sari-mango literature, suggesting that use of the image of mango is a cliché, even “lazy,” attempt to “exoticize” and sentimentalize South Asia in particular. A broader review across national boundaries reveals that diaspora authors, including those beyond South Asia, write nostalgically about mango as much about the messy “full body” tactile experience of eating a mango as about the “exotic” quality of mango representing the “otherness” of their home country. Many of the narratives detail universal childhood food experiences that are more shared than exotic, such as a desire to subvert the adult societal rules of neatness and get very messy, or memories of small but memorable childhood transgressions such as stealing mangoes from a neighbor’s tree. In recent years, food technology has evolved, and mangoes have become more familiar and readily available in Europe and America, from smoothies and baby food to dried fruit snacks. The meaning associated with the imagery of mangoes for both writers and readers in diaspora literature evolves as well, and authors do not have to heed Salman Rushdie’s command, “There must be no tropical fruits in the title. No mangoes.”

Keywords: identity, immigrant diaspora, culinary metaphor, food studies

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