Search results for: group guidance
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8753

Search results for: group guidance

8453 Photoactivated Chromophore for Keratitis-Cross Linking Window Absorption Alone versus Combined Pack-CXL Window Absorption and Standard Anti-microbial Therapy for Treatment of Infectious Keratitis: A Prospective Study

Authors: Mohammed M. Mahdy Tawfeek

Abstract:

Objective: The aim of this work is to compare the outcome of photoactivated chromophore for keratitis-cross linking (PACK-CXL) window absorption (WA) alone with combined PACK-CXL WA and standard anti-microbial therapy (SAT) for the treatment of infectious keratitis. Patients and Methods: This is a randomized prospective comparative clinical trial. Thirty eyes with clinically suspected infectious keratitis were randomly assigned into two equal groups of 15 eyes each: Group (A) was treated by PACK-CXL WA alone and group (B) was treated by PACK-CXL WA combined with SAT. Identification of organisms was made by lab study before treatment. Corneal healing was evaluated by corneal examination and anterior segment OCT (AS-OCT). Written informed consent was obtained from all participants and the study was approved by the research ethics committee of the Faculty of Medicine, Zagazig University. The work has been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for studies involving humans. Results: Complete healing and resolution (Successful treatment) were observed in 10 eyes (66.7%) of a group (A) and 14 eyes (93.3%) of group (B) and failure was observed in 5 eyes (33.3%) of a group (A) and one eye (6.67%) of group (B). They were statistically significant (P =0.042 and 0.003) in a comparison between both groups regarding success and failure of treatment, respectively. Complete corneal healing was reported in the third month postoperatively in 10 eyes (66.7%) of group (A) and 14 eyes (93.3%) of group (B). Complications were absent in 12 patients (80%) in group (A) and 14 patients (93.3%) of group (B); however, perforation and impending perforation were found in 3 patients of group (A) and only one patient of group (B). Conclusion: PACK-CXL is a promising, non-invasive treatment option for infectious keratitis, especially when performed with the window absorption (WA) technique, either alone or combined with SAT. It has a synergistic effect with a standard antimicrobial treatment that gives good outcome results in the treatment of infectious keratitis. Also, it avoids the antibiotics resistance that has become rapidly spreading worldwide.

Keywords: corneal cross linking, infectious keratitis, PACK-CXL, window absorption

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8452 Effects of Exercise in the Cold on Glycolipid Metabolism and Insulin Sensitivity in Obese Rats

Authors: Chaoge Wang, Xiquan Weng, Yan Meng, Wentao Lin

Abstract:

Objective: Cold exposure and exercise serve as two physiological stimuli to glycolipid metabolism and insulin sensitivity. So far, it remains to be elucidated whether exercise plus cold exposure can produce an addictive effect on promoting glycolipid metabolism and insulin sensitivity. Methods: 64 SD rats were subjected to high-fat and high-sugar diets for 9-week and sucessfully to establish an obesity model. They were randomly divided into 8 groups: normal control group (NC), normal exercise group (NE), continuous cold control group (CC), continuous cold exercise group (CE), acute clod control group (AC), acute cold exercise group (AE), intermittent cold control group (IC) and intermittent cold exercise group (IE). For continuous cold exposure, the rats stayed in a cold environment all day; for acute cold exposure, the rats were exposed to cold for only 4h before the end of the experiment; for intermittent cold exposure, the rats were exposed to cold for 4h per day. The protocol for treadmill runnings were as follows: 25m/min (speed), 0°C (slope), 30 mins each time, an interval for 10 mins between two runnings, twice/two days, lasting for 5 weeks. Sampling were conducted on the 5th weekend. Blood lipids, free fatty acids, blood glucose (FBG), and serum insulin (FINS) were examined, and the insulin resistance index (HOMA-IR = FBG (mmol/L)×FINS(mIU/L)/22.5) was calculated. SPSS 22.0 was used for statistical analysis of the experimental results, and the ANOVA analysis was performed between groups (p < 0.05 was significant). Results: (1) Compared with the NC group, the FBG of the rats was significantly declined in the NE, CE, AC, AE, and IE groups (p < 0.05), the FINS of the rats was significantly declined in the AE group (p < 0.05), the HOMA-IR of the rats was significantly declined in the NE, CE, AC, AE and IE groups (p < 0.05). Compared with the NE group, the FBG of the rats was significantly declined in the CE, AE, and IE groups (p < 0.05), the FINS and HOMA-IR of the rats were significantly declined in the AE group (p < 0.05). (2) Compared with the NC group, the CHO, TG, LDL-C, and FFA of the rats were significantly declined in CE and IE groups (p < 0.05), the HDL-C of the rats was significantly higher in NE, CC, CE, AE, and IE groups (p < 0.05). Compared with the NE group, the HDL-C of the rats was significantly higher in the CE and IE groups (p < 0.05). Conclusions: Sedentariness or exercise in the acute cold doesn't make sense in the treatment of type 2 diabetes, which led to one-off increases of the body's insulin sensitivity. Exercise in the continuous and intermittent cold can effectively decline the FBG, TC, TG, LDL-C, and FFA levels and increase the HDL-C level and insulin sensitivity in obese rats. These results can impact the prevention and treatment of type 2 diabetes.

Keywords: cold, exercise, insulin sensitivity, obesity

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8451 The Effectiveness of Metaphor Therapy on Depression among Female Students

Authors: Marzieh Talebzadeh Shoushtari

Abstract:

The present study aimed to determine the effectiveness of Metaphor therapy on depression among female students. The sample included 60 female students with depression symptoms selected by simple sampling and randomly divided into two equal groups (experimental and control groups). Beck Depression Inventory was used to measure the variables. This was an experimental study with a pre-test/post-test design with control group. Eight metaphor therapy sessions were held for the experimental group. A post-test was administered to both groups. Data were analyzed using multivariate analysis of covariance (MANCOVA). Results showed that the Metaphor therapy decreased depression in the experimental group compared to the control group.

Keywords: metaphor therapy, depression, female, students

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8450 The Hypolipidemic and Anti-Nephrotoxic Potentials of Vernonia calvoana Extract in Acetaminophen-Treated Male Wistar Rats

Authors: Godwin E. Egbung, Item J. Atangwho, Diana O. Odey, Eyong U. Eyong

Abstract:

Background of the study: The frequent abuse of acetaminophen by field workers in Calabar metropolis necessitated the present study on the hypolipidemic and anti-nephrotoxic potentials of Vernonia calvoana (VC) extract in acetaminophen (paracetamol) treated male albino Wistar rats Methods:. Thirty-five (35) male albino Wistar rats weighing 100-150 g were divided into five (5) groups of seven rats each. Group 1 served as normal control, group 2 received normal saline after treatment with Acetaminophen (PCM), group 3 was treated with VC extracts (200 mg/kg body weight), group 4 received VC extracts ( 400 mg/kg body weight) and group 5 was administered 100 mg/kg body weight of Vitamin E. At the end of the 21 days treatment period, the animals were sacrificed using chloroform vapours, and blood was collected via cardiac puncture and used for analyses of haematological as well as biochemical indices. Results: Results indicated significant decreases (p < 0.001) in LDL-c, TC and TG levels in groups 3,4 and 5 relative to both the control as well as group 2, the atherogenic index showed a significant decrease at p < 0.001) in all treated groups compared with control and PCM- treated group. However, both extracts treated groups and vitamin E treated group showed significant (p < 0.001) increase in HDL-c relative to the control and PCM treated group. Serum potassium concentration was significantly (p < 0.05 and 0.001) reduced across all the treated groups compared with control and PCM- treated groups. Group 4 showed significant (p < 0.001) increase in RBC count, Hb, and PCV compared with PCM- treated group. Conclusions: We therefore conclude that ethanolic leaf extract of VC possesses probable anti-anemic, hypolipidemic potentials, and also ameliorates serum electrolyte imbalance in paracetamol- induced toxicity.

Keywords: acetaminophen, haematological indices, hypolipidemic potentials, serum lipid profile, vernonia calvoana, wistar rats

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8449 A Comparative Study of High Order Rotated Group Iterative Schemes on Helmholtz Equation

Authors: Norhashidah Hj. Mohd Ali, Teng Wai Ping

Abstract:

In this paper, we present a high order group explicit method in solving the two dimensional Helmholtz equation. The presented method is derived from a nine-point fourth order finite difference approximation formula obtained from a 45-degree rotation of the standard grid which makes it possible for the construction of iterative procedure with reduced complexity. The developed method will be compared with the existing group iterative schemes available in literature in terms of computational time, iteration counts, and computational complexity. The comparative performances of the methods will be discussed and reported.

Keywords: explicit group method, finite difference, helmholtz equation, rotated grid, standard grid

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8448 The Effect of 6 Weeks Endurance Swimming Training on Blood Glucose and Cardiac Tissue Antioxidants in Diabetic Rats

Authors: Kh. Dehkordi, R. Sharifi Gholam, S. Arshadi

Abstract:

Objective: Oxidative stress is produced under diabetic conditions and possibly causes various forms of tissue damage inpatients with diabetes. Antioxidants defend against the harmful effect of free radicals, which are associated with heart disease, cancer, arthritis, aging and many other diseases1). Antioxidants are very stable molecules capable of neutralizing free radicals by donating an electron to them.The aim of this study was to examine the effect of swimming training, fenugreek seed extract and glibenclamide on plasma glucose and cardiac antioxidants activity in diabetic rats. Design: For this purpose, fifty male wistar rats were divided into five groups, two groups of control rats (diabetic control [DC] and healthy control [HC]), one group of endurance swimming training (EST), one group of fenugreek seed extract highdose (F1, 1.74 g/kg b.w), one group of fenugreek seed extract middle dose (F2, 0.87 g/kg b.w), one group of glibenclamide (G, 0.5 mg/kg b.w). Materials and Methods: Diabetes induced by streptozotocine (STZ), data was analyzed using the one-way ANOVA followed by a Tukey test. Significance level was 0.05. Results: All of the groups' exception of HC showed significant decrease in body weight (P < 0.05), but the diabetic control and swimming training group exhibited a more decrease. All of the groups have shown a significant decrease in plasma glucose than DC group (P < 0.05) but this reduction was more in G group than DC no HC group. S, G and HC groups have shown significant increase in cardiac antioxidant than DC group (P < 0.05) but there wasn't significant difference in other groups (P > 0.05). Conclusion: The present results indicate that regular swimming training lead to decrease in plasma glucose and enhanced cardiac antioxidants in diabetic rats.

Keywords: swimming, glucose, cardiac, antioxidants

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8447 Chat-Based Online Counseling for Enhancing Wellness of Undergraduates with Emotional Crisis Tendency

Authors: Arunya Tuicomepee

Abstract:

During the past two decades, there have been the increasing numbers of studies on online counseling, especially among adolescents who are familiar with the online world. This can be explained by the fact that via this channel enables easier access to the young, who may not be ready for face-to-face service, possibly due to uneasiness to reveal their personal problems with a stranger, the feeling that their problems are to be shamed, or the need to protect their images. Especially, the group of teenagers prone to suicide or despair, who tend to keep things to or isolate from the society to themselves, usually prefer types of services that require no face-to-face encounter and allow their anonymity, such as online services. This study aimed to examine effectiveness of chat-based online counseling for enhancing wellness of undergraduates with emotional crisis tendency. Experimental with pretest-posttest control group design was employed. Participants were 47 undergraduates (10 males and 37 females) with high emotional crisis tendency. They were randomly assigned to experimental group (24 students) and control group (23 students). Participants in the experimental group received a 60-minute, 4-sessions of individual chat-based online counseling led by counselor. Those in control group received no counseling session. Instruments were the Emotional Crisis Scale and Wellness Scales. Two-way mixed-design multivariate analysis of variance was used for data analysis. Finding revealed that the posttest scores on wellness of those in the experimental group were higher than the scores of those in the control group. The posttest scores on emotional crisis tendency of those in the experimental group were lower than the scores of those in the control group. Hence, this study suggests chat-based online counseling services can become a helping source that increasing more adolescents would recognize and turn to in the future and that will receive more attention.

Keywords: chat-based online counseling, emotional crisis, undergraduate student, wellness

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8446 Group Decision Making through Interval-Valued Intuitionistic Fuzzy Soft Set TOPSIS Method Using New Hybrid Score Function

Authors: Syed Talib Abbas Raza, Tahseen Ahmed Jilani, Saleem Abdullah

Abstract:

This paper presents interval-valued intuitionistic fuzzy soft sets based TOPSIS method for group decision making. The interval-valued intuitionistic fuzzy soft set is a mutation of an interval-valued intuitionistic fuzzy set and soft set. In group decision making problems IVIFSS makes the process much more algebraically elegant. We have used weighted arithmetic averaging operator for aggregating the information and define a new Hybrid Score Function as metric tool for comparison between interval-valued intuitionistic fuzzy values. In an illustrative example we have applied the developed method to a criminological problem. We have developed a group decision making model for integrating the imprecise and hesitant evaluations of multiple law enforcement agencies working on target killing cases in the country.

Keywords: group decision making, interval-valued intuitionistic fuzzy soft set, TOPSIS, score function, criminology

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8445 The Effect of Online Self-Assessment Diaries on Academic Achievement

Authors: Zi Yan

Abstract:

The pedagogical value of self-assessment is widely recognized. However, identifying effective methods to help students develop productive SA practices poses a significant challenge. Since most students do not acquire self-assessment skills intuitively, they need instruction and guidance. This study is a randomized controlled trial aiming to test the effect of online self-assessment diaries on students’ achievement scores compared to a control group. Two groups of secondary school students (N=59), recruited through convenience sampling, participated in the study. The two groups were randomly designated to one of two conditions: control (n = 31) and online self-assessment diary (n = 28). The participants completed a curriculum-specific pre-test and a baseline survey on the first week of the 10-week study, as well as completed a post-test and survey by the tenth week. The results showed that the SA diary intervention had a significantly positive effect on post-intervention language learning scores after controlling for baseline scores. The findings highlight the potential of self-assessment to enhance educational outcomes, emphasizing its significant implications for educational policies that promote the integration of SA strategies into pedagogical practices.

Keywords: self-assessment, online diary, academic achievement, experimenal study

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8444 A Twelve-Week Intervention Programme to Improve the Gross Motor Skills of Selected Children Diagnosed with Autism Spectrum Disorder

Authors: Eileen K. Africa, Karel J. van Deventer

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Neuro-typical children develop the motor skills necessary to play, do schoolwork and interact with others. However, this is not observed in children who have learning or behavioural problems. Children with Autism Spectrum Disorder (ASD) are often referred to as clumsy because their body parts do not work well together in a sequence. Physical Activity (PA) has shown to be beneficial to the general population, therefore, providing children with ASD opportunities to take part in PA programmes, could prove to be beneficial in many ways and should be investigated. The purpose of this study was to design a specialised group intervention programme, to attempt to improve gross motor skills of selected children diagnosed with ASD between the ages of eight and 13 years. A government school for ASD learners was recruited to take part in this study, and a sample of convenience (N=7) was selected. Children in the experimental group (n=4) participated in a 12-week group intervention programme twice per week, while the control group continued with their normal daily routine. The Movement Assessment Battery for Children-Second Edition (MABC-2), was administered pre- and post-test to determine the children’s gross motor proficiency and to determine if the group intervention programme had an effect on the gross motor skills of the experimental group. Statistically significant improvements were observed in total motor skill proficiency (p < 0.05), of the experimental group. These results demonstrate the importance of gross motor skills interventions for children diagnosed with ASD. Future research should include more participants to ensure that the results can be generalised.

Keywords: autism spectrum disorder, children, gross motor skills, group intervention programme

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8443 Improving Flash Flood Forecasting with a Bayesian Probabilistic Approach: A Case Study on the Posina Basin in Italy

Authors: Zviad Ghadua, Biswa Bhattacharya

Abstract:

The Flash Flood Guidance (FFG) provides the rainfall amount of a given duration necessary to cause flooding. The approach is based on the development of rainfall-runoff curves, which helps us to find out the rainfall amount that would cause flooding. An alternative approach, mostly experimented with Italian Alpine catchments, is based on determining threshold discharges from past events and on finding whether or not an oncoming flood has its magnitude more than some critical discharge thresholds found beforehand. Both approaches suffer from large uncertainties in forecasting flash floods as, due to the simplistic approach followed, the same rainfall amount may or may not cause flooding. This uncertainty leads to the question whether a probabilistic model is preferable over a deterministic one in forecasting flash floods. We propose the use of a Bayesian probabilistic approach in flash flood forecasting. A prior probability of flooding is derived based on historical data. Additional information, such as antecedent moisture condition (AMC) and rainfall amount over any rainfall thresholds are used in computing the likelihood of observing these conditions given a flash flood has occurred. Finally, the posterior probability of flooding is computed using the prior probability and the likelihood. The variation of the computed posterior probability with rainfall amount and AMC presents the suitability of the approach in decision making in an uncertain environment. The methodology has been applied to the Posina basin in Italy. From the promising results obtained, we can conclude that the Bayesian approach in flash flood forecasting provides more realistic forecasting over the FFG.

Keywords: flash flood, Bayesian, flash flood guidance, FFG, forecasting, Posina

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8442 Changes in Serum Neopterin in Workers Exposed to Different Mineral Dust

Authors: Gospodinka Prakova, Pavlina Gidikova, Gergana Sandeva, Kamelia Haracherova, Emil Slavov

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Neopterin was demonstrated to be a sensitive marker of cell-mediated immune reactions which plays a key role in the interaction of monocyte / macrophage activation. The purpose of this work was to investigate changes in serum neopterin in workers exposed to different composition of mineral dust. Material and Methods: Serum neopterin was studied in 193 exposed workers, divided into three groups, depending on the mineral dust and content of the quartz in the respirable fraction. The I-st group-coal dust containing less than 2% free crystalline silica (n=44), II-nd group-coal dust containing over 2% free crystalline silica (n=94) and the III-rd group-mixed dust with corundum and carborundum (n=55). The control group was composed of 21 individuals without exposure to dust. Serum neopterin was investigated by Elisa method in ng/ml according to the instructions of the manufacturer. Results and Discussion: It was found significantly higher level of serum neopterin in exposed workers of mineral dust (2,10 ± 0,62 ng / ml), compared with that of the control group (1,10 ± 0,85 ng/ml; p < 0,05). Neopterin levels in workers exposed to coal dust (1,87 ± 0,42 ng / ml-I-st and 3,32 ± 0,77 ng / ml-II-nd group) were significantly higher compared with those exposed to a mixed dust (1,31±0,68 mg / ml-third) and control group (p < 0,05). No significant difference in serum neopterin when exposed to a mixed dust composed of corundum and carborundum (III-rd) and a control group. Conclusion: The results of this study indicate activates a cell-mediated immune response when exposed to a mineral dust. The level of that activation depends mainly on the composition of the dust and is significantly highest in workers exposed to coal dust.

Keywords: mineral dust, neopterin, occupational exposure, respirable crystalline silica

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8441 A Qualitative Study on Exploring How the Home Environment Influences Eating and Physical Activity Habits of Low-Income Latino Children of Predominantly Immigrant Families

Authors: Ana Cristina Lindsay, Sherrie Wallington, Faith Lees, Mary Greaney

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Purpose: Latino children in low-income families are at elevated risk of becoming overweight or obese. The purpose of this study was to examine low-income Latino parents’ beliefs, parenting styles and practices related to their children’s eating and physical activity behaviors while at home. Design and Methods: Qualitative study using focus group discussions with 33 low-income Latino parents of preschool children 2 to 5 years of age. Transcripts were analyzed using thematic analysis. Results: Data analyses revealed that most parents recognize the importance of healthy eating and physical activity for their children and themselves. However, daily life demands including conflicting schedules, long working hours, financial constraints, and neighborhood safety concerns, etc., impact parents’ ability to create a home environment supportive of these behaviors. Conclusions: This study provides information about how the home environment influences low-income Latino preschool children’s eating and physical activity habits. This information is useful for pediatric nurses in their health promotion and disease prevention efforts with low-income Latino families with young children, and for the development of home-based and parenting interventions to prevent and control childhood obesity among this population group. Practice Implications: Pediatric nurses can facilitate communication, provide education, and offer guidance to low-income Latino parents that support their children’s development of early healthy eating and physical activity habits, while taking into account daily life barriers faced by families. Moreover, nurses can play an important role in the integration and coordination of home-visitation to complement office-based visits and provide a continuum of care to low-income Latino families.

Keywords: home environment, Latino, obesity, parents, healthy eating, physical activity

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8440 Evaluating and Improving Healthcare Staff Knowledge of the [NG179] NICE Guidelines on Elective Surgical Care during the COVID-19 Pandemic: A Quality Improvement Project

Authors: Stavroula Stavropoulou-Tatla, Danyal Awal, Mohammad Ayaz Hossain

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The first wave of the COVID-19 pandemic saw several countries issue guidance postponing all non-urgent diagnostic evaluations and operations, leading to an estimated backlog of 28 million cases worldwide and over 4 million in the UK alone. In an attempt to regulate the resumption of elective surgical activity, the National Institute for Health and Care Excellence (NICE) introduced the ‘COVID-19 rapid guideline [NG179]’. This project aimed to increase healthcare staff knowledge of the aforementioned guideline to a targeted score of 100% in the disseminated questionnaire within 3 months at the Royal Free Hospital. A standardized online questionnaire was used to assess the knowledge of surgical and medical staff at baseline and following each 4-week-long Plan-Study-Do-Act (PDSA) cycle. During PDSA1, the A4 visual summary accompanying the guideline was visibly placed in all relevant clinical areas and the full guideline was distributed to the staff in charge together with a short briefing on the salient points. PDSA2 involved brief small-group teaching sessions. A total of 218 responses was collected. Mean percentage scores increased significantly from 51±19% at baseline to 81±16% after PDSA1 (t=10.32, p<0.0001) and further to 93±8% after PDSA2 (t=4.9, p<0.0001), with 54% of participants achieving a perfect score. In conclusion, the targeted distribution of guideline printouts and visual aids, combined with small-group teaching sessions, were simple and effective ways of educating healthcare staff about the new standards of elective surgical care at the time of COVID-19. This could facilitate the safe restoration of surgical activity, which is critical in order to mitigate the far-reaching consequences of surgical delays on an unprecedented scale during a time of great crisis and uncertainty.

Keywords: COVID-19, elective surgery, NICE guidelines, quality improvement

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8439 A Comparative Study of the Effectiveness of Narrative Therapy in Individual and Group Counseling on Promoting Hope in With Breast Cancer’s Women

Authors: Sajadian Akram, Tavasoli F.

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Breast cancer is the second most common cancer in the world and certainly the most frequent cancer mostly among women. This study was aimed to compare the effectiveness of individual counseling and group narrative therapy on female patients' life expectancy afflicted by breast cancer. The present study is a pre-test-post-test clinical trial. Fifty-five patients with breast cancer were randomly selected in the follow-up period and after their active medical treatment completion. Then, they were randomly divided into two groups: individual counseling and group counseling. Herth hope index (HHI) was used to measure the patients' hope level. Data were analyzed using t-test and SPSS software. hope rate was statistically significant in both groups receiving individual and group narrative therapy in the post-test compared to the pre-test (P <00000). Moreover, the comparative evaluation of hope in both groups (individual & group counseling) in the post-test showed that group narrative counseling is more effective than individual narrative counseling (P <00000). Conclusion: Narrative therapy promotes hope in breast cancer patients effectively. Due to the nature of breast cancer and its psychological effects in the post-treatment period, providing narrative group therapy can improve life quality. Patients' life quality changes in tandem with changes in hope.

Keywords: hope, narrative therapy, counseling, breast cancer

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8438 Effects of Waist-to-Hip Ratio and Visceral Fat Measurements Improvement on Offshore Petrochemical Company Shift Employees' Work Efficiency

Authors: Essam Amerian

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The aim of this study was to investigate the effects of improving waist-to-hip ratio (WHR) and visceral fat components on the health of shift workers in an offshore petrochemical company. A total of 100 male shift workers participated in the study, with an average age of 40.5 years and an average BMI of 28.2 kg/m². The study employed a randomized controlled trial design, with participants assigned to either an intervention group or a control group. The intervention group received a 12-week program that included dietary counseling, physical activity recommendations, and stress management techniques. The control group received no intervention. The outcomes measured were changes in WHR, visceral fat components, blood pressure, and lipid profile. The results showed that the intervention group had a statistically significant improvement in WHR (p<0.001) and visceral fat components (p<0.001) compared to the control group. Furthermore, there were statistically significant improvements in systolic blood pressure (p=0.015) and total cholesterol (p=0.034) in the intervention group compared to the control group. These findings suggest that implementing a 12-week program that includes dietary counseling, physical activity recommendations, and stress management techniques can effectively improve WHR, visceral fat components, and cardiovascular health among shift workers in an offshore petrochemical company.

Keywords: body composition, waist-hip-ratio, visceral fat, shift worker, work efficiency

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8437 The Effectiveness of Group Counseling of Mindfulness-Based Cognitive Therapy on Cognitive Emotion Regulation in High School Students

Authors: Hossein Ilanloo, Sedigheh Ahmadi, Kianoosh Zahrakar

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The present study aims at investigating the effectiveness of group counseling of mindfulness-based cognitive therapy on cognitive emotion regulation in high school students. The research design was quasi-experimental and pre-test-post-test type and a two-month follow-up with a control group. The statistical population of the study consisted of all-male high school students in Takestan city in the Academic Year 2020-2021. The sample comprised 30 high school male students selected through the convenience sampling method and randomly assigned to experimental (n=15) and control (n=15) groups. The experimental group then received ten sessions of 90-minute group counseling of mindfulness-based cognitive therapy, and the control group did not receive any intervention. In order to collect data, the author used the Cognitive Emotion Regulation Questionnaire (CERQ). The researcher also used multivariate analysis of covariance, repeated measures, LSD post hoc test, and SPSS-26 software for data analysis.

Keywords: mindfulness-based cognitive therapy, cognitive emotion regulation, students, high schools

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8436 Hierarchy and Weight of Influence Factors on Labor Productivity in the Construction Industry of the Nepal

Authors: Shraddha Palikhe, Sunkuk Kim

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The construction industry is the most labor intensive in Nepal. It is obvious that construction is a major sector and any productivity enhancement activity in this sector will have a positive impact in the overall improvement of the national economy. Previous studies have stated that Nepal has poor labor productivity among other south Asian countries. Though considerable research has been done on productivity factors in other countries, no study has addressed labor productivity issues in Nepal. Therefore, the main objective of this study is to identify and hierarchy the influence factors for poor labor productivity. In this study, a questionnaire approach is chosen as a method of the survey from thirty experts involved in the construction industry, such as Architects, Civil Engineers, Project Engineers and Site Engineers. A survey was conducted in Nepal, to identify the major factors impacting construction labor productivity. Analytic Hierarchy Process (AHP) analysis method was used to understand the underlying relationships among the factors, categorized into five groups, namely (1) Labor-management group; (2) Material management group; (3) Human labor group; (4) Technological group and (5) External group and was divided into 33 subfactors. AHP was used to establish the relative importance of the criteria. The AHP makes pairwise comparisons of relative importance between hierarchy elements grouped by labor productivity decision criteria. Respondents were asked to answer based on their experience of construction works. On the basis of the respondent’s response, weight of all the factors were calculated and ranked it. The AHP results were tabulated based on weight and ranking of influence factors. AHP model consists of five main criteria and 33 sub-criteria. Among five main criteria, the scenario assigns a weight of highest influential factor i.e. 26.15% to human labor group followed by 23.01% to technological group, 22.97% to labor management group, 17.61% material management group and 10.25% to external group. While in 33 sub-criteria, the most influential factor for poor productivity in Nepal are lack of monetary incentive (20.53%) for human labor group, unsafe working condition (17.55%) for technological group, lack of leadership (18.43%) for labor management group, unavailability of tools at site (25.03%) for material management group and strikes (35.01%) for external group. The results show that AHP model associated criteria are helpful to predict the current situation of labor productivity. It is essential to consider these influence factors to improve the labor productivity in the construction industry of Nepal.

Keywords: construction, hierarchical analysis, influence factors, labor productivity

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8435 Platelet Transfusion Thresholds for Pediatrics; A Retrospective Study

Authors: Hessah Alsulami, Majedah Aldosari

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Introduction: Platelet threshold of 10x109 /L is recommended for clinically stable thrombocytopenic pediatric patients. Transfusions at a higher level (given the absence of research evidence, as determined by clinical circumstances, generally at threshold of 40x109 /L) may be required for patients with signs of bleeding, high fever, hyper-leukocytosis, rapid fall in platelet count, concomitant coagulation abnormality, critically ill patients, and those with impaired platelet function (including drug induced). Transfusions at a higher level may be also required for patients undergoing invasive procedures. Method: This study is a retrospective observational analysis of platelet transfusion thresholds in a single secondary pediatric hospital in Riyadh. From the blood bank database, the list of the patients who received platelet transfusions in the second half of 2018 was retrieved. Patients were divided into two groups; group A, those belong to the category of high platelet level for transfusion (such as those with bleeding, high fever, rapid fall in platelet count, impaired platelet function or undergoing invasive procedures) and group B, those who were not. Then we looked at the pre and post transfusion platelet levels for each group. The data was analyzed using GraphPad software and the data expressed as Mean ± SD. Result: A total of 112 of transfusion episodes in 61 patients (38% female) were analyzed. The age ranged from 24 days to 8 years. The distribution of platelet transfusion episodes was 64% (n=72) for group A and 36% (n= 40) for group B. The mean pre-transfusion platelet count was 46x103 ± (11x 103) for group A and 28x103 ± (6x103) for group B. the post-transfusion mean platelet count was 61 x 103 ± (14 x 103) and 60 x103 ± (24 x 103) for group A and B respectively. Among the groups the rise in the mean platelet count after transfusion was significant among stable patients (group B) compared to unstable patients (group A) (P < 0.001). Conclusion: The platelet count threshold for transfusion varied with the clinical condition and is higher among unstable patients’ group which is expected. For stable patients the threshold was higher than what it should be which means that the clinicians don’t follow the guidelines in this regard. The rise of platelet count after transfusion was higher among stable patients.

Keywords: platelet, transfusion, threshold, pediatric

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8434 Comparison of Depth of Cure and Degree of Conversion between Opus Bulk Fill and X-Tra Fill Bulk Fill Composites

Authors: Yasaman Samani, Ali Golmohammadi

Abstract:

Introduction: The degree of conversion and depth of cure affects the clinical success of resin composite restorations directly. One of the main challenges in achieving a successful composite restoration is the achievement of sufficient depth of cure. The insufficient polymerization may lead to a decrease in the physical/mechanical and biological properties of resin composites and, as a result of that, unsuccessful composite restoration. Thus, because of the importance of studying and evaluating the depth of cure and degree of conversion in bulk-fill composites, we decided to evaluate and compare the degree of conversion and depth of cure in two bulk-fill composites; x-tra fill (Voco, Germany) and Opus Bulk fill APS (FGM, Brazil). Materials and Methods: Composite resin specimens (n=10) per group were prepared as cylinder blocks (4×8 mm) with bulk-fill composites, x-tra fil (Voco, Germany) designated as Group A, and Opus Bulk fill APS (FGM, Brazil) designated as Group B. Depth of cure was determined according to “ISO 4049; Depth of Cure” method, In which each specimen were cured (iLED, Woodpecker, China) 40 seconds and FTIR spectroscopy method was used to estimate the degree of conversion of both the bulk-fill composites. The degree of conversion of monomer to polymer was estimated individually in the coronal half (Group A1 and B1) and pulpal half (Group A2 and Group B2) by dividing each specimen into two halves. The data were analyzed using a Student’s t-test and one-way ANOVA at a 5% level of significance. Results: The mean depth of cure in x-tra fil (Voco, Germany) was 3.99 (±0.16), and for Opus Bulk fill, APS (FGM, Brazil) was 2.14 (±0.3). The degree of conversion percentage in Group A1 was 82.7 (±6.1), in group A2 was 73.4 (±5.2), in group B1 was 63.3 (±4.7) and in Group B2 was 56.5 (±7.7). Statistical analysis revealed a significant difference in the depth of cure between the two bulk-fill composites with x-tra fil (Voco, Germany) higher than Opus Bulk fill APS (FGM, Brazil) (P<0.001). The degree of conversion percentage also showed a significant difference, Group A1 being higher than A2 (P=0.0085), B1, and B2 (P<0.001). Group A2 was also higher than B1 (P=0.003) and B2 (P<0.001). There was no significant difference between B1 and B2 (P=0.072). Conclusion: The results indicate that x-tra fill has more depth of cure and a higher percentage of the degree of conversion than Opus Bulk fill APS. The coronal half of x-tra fil had the highest depth of cure percentage (82.66%), and the pulpal half of Opus Bulk fill APS had the lowest percentage (56.45%). Even though both bulk-fill composite materials had an acceptable degree of conversion (55% and higher), x-tra fill has shown better results.

Keywords: depth of cure, degree of conversion, bulk-fill composite, FTIR

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8433 Analysis of Brownfield Soil Contamination Using Local Government Planning Data

Authors: Emma E. Hellawell, Susan J. Hughes

Abstract:

BBrownfield sites are currently being redeveloped for residential use. Information on soil contamination on these former industrial sites is collected as part of the planning process by the local government. This research project analyses this untapped resource of environmental data, using site investigation data submitted to a local Borough Council, in Surrey, UK. Over 150 site investigation reports were collected and interrogated to extract relevant information. This study involved three phases. Phase 1 was the development of a database for soil contamination information from local government reports. This database contained information on the source, history, and quality of the data together with the chemical information on the soil that was sampled. Phase 2 involved obtaining site investigation reports for development within the study area and extracting the required information for the database. Phase 3 was the data analysis and interpretation of key contaminants to evaluate typical levels of contaminants, their distribution within the study area, and relating these results to current guideline levels of risk for future site users. Preliminary results for a pilot study using a sample of the dataset have been obtained. This pilot study showed there is some inconsistency in the quality of the reports and measured data, and careful interpretation of the data is required. Analysis of the information has found high levels of lead in shallow soil samples, with mean and median levels exceeding the current guidance for residential use. The data also showed elevated (but below guidance) levels of potentially carcinogenic polyaromatic hydrocarbons. Of particular concern from the data was the high detection rate for asbestos fibers. These were found at low concentrations in 25% of the soil samples tested (however, the sample set was small). Contamination levels of the remaining chemicals tested were all below the guidance level for residential site use. These preliminary pilot study results will be expanded, and results for the whole local government area will be presented at the conference. The pilot study has demonstrated the potential for this extensive dataset to provide greater information on local contamination levels. This can help inform regulators and developers and lead to more targeted site investigations, improving risk assessments, and brownfield development.

Keywords: Brownfield development, contaminated land, local government planning data, site investigation

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8432 Efficacy Of Tranexamic Acid On Blood Loss After Primary Total Hip Replacement : A Case-control Study In 154 Patients

Authors: Fedili Benamar, Belloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

Abstract:

Introduction: Perioperative blood loss is a frequent cause of complications in total hip replacement (THR). The present prospective study assessed the efficacy of tranexamic acid (Exacyl(®)) in reducing blood loss in primary THR. Hypothesis: Tranexamic acid reduces blood loss in THR. Material and method: -This is a prospective randomized study on the effectiveness of Exacyl (tranexamic acid) in total hip replacement surgery performed on a standardized technique between 2019 and September 2022. -It involved 154 patients, of which 84 received a single injection of Exacyl (group 1) at a dosage of 10 mg/kg over 20 minutes during the perioperative period. -All patients received postoperative thromboprophylaxis with enoxaparin 0.4 ml subcutaneously. -All patients were admitted to the post-interventional intensive care unit for a duration of 24 hours for monitoring and pain management as per the service protocol. Results: 154 patients, of which 84 received a single injection of Exacyl (group 1) and 70 patients patients who did not receive Exacyl perioperatively : (Group 2 ) The average age is 57 +/- 15 years The distribution by gender was nearly equal with 56% male and 44% female; "The distribution according to the ASA score was as follows: 20.2% ASA1, 82.3% ASA2, and 17.5% ASA3. "There was a significant difference in the average volume of intraoperative and postoperative bleeding during the 48 hours." The average bleeding volume for group 1 (received Exacyl) was 614 ml +/- 228, while the average bleeding volume for group 2 was 729 +/- 300, with a chi-square test of 6.35 and a p-value < 0.01, which is highly significant. The ANOVA test showed an F-statistic of 7.11 and a p-value of 0.008. A Bartlett test revealed a chi-square of 6.35 and a p-value < 0.01." "In Group 1 (patients who received Exacyl), 73% had bleeding less than 750 ml (Group A), and 26% had bleeding exceeding 750 ml (Group B). In Group 2 (patients who did not receive Exacyl perioperatively), 52% had bleeding less than 750 ml (Group A), and 47% had bleeding exceeding 750 ml (Group B). "Thus, the use of Exacyl reduced perioperative bleeding and specifically decreased the risk of severe bleeding exceeding 750 ml by 43% with a relative risk (RR) of 1.37 and a p-value < 0.01. The transfusion rate was 1.19% in the population of Group 1 (Exacyl), whereas it was 10% in the population of Group 2 (no Exacyl). It can be stated that the use of Exacyl resulted in a reduction in perioperative blood transfusion with an RR of 0.1 and a p-value of 0.02. Conclusions: The use of Exacyl significantly reduced perioperative bleeding in this type of surgery.

Keywords: acid tranexamic, blood loss, anesthesia, total hip replacement, surgery

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8431 Characterization of Number of Subgroups of Finite Groups

Authors: Khyati Sharma, A. Satyanarayana Reddy

Abstract:

The topic of how many subgroups exist within a certain finite group naturally arises in the study of finite groups. Over the years, different researchers have investigated this issue from a variety of angles. The significant contributions of the key mathematicians over the time have been summarized in this article. To this end, we classify finite groups into three categories viz. (a) Groups for which the number of subgroups is less than |G|, (b) equals to |G|, and finally, (c) greater than |G|. Because every element of a finite group generates a cyclic subgroup, counting cyclic subgroups is the most important task in this endeavor. A brief survey on the number of cyclic subgroups of finite groups is also conducted by us. Furthermore, we also covered certain arithmetic relations between the order of a finite group |G| and the number of its distinct cyclic subgroups |C(G)|. In order to provide pertinent context and possibly reveal new novel areas of potential research within the field of research on finite groups, we finally pose and solicit a few open questions.

Keywords: abstract algebra, cyclic subgroup, finite group, subgroup

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8430 Carotid Intima-Media Thickness and Ankle-Brachial Index as Predictors of the Severity of Coronary Artery Disease

Authors: Ali Kassem, Yaser Kamal, Mohamed Abdel Wahab, Mohamed Hussen

Abstract:

Introduction: Atherosclerosis is one of the leading causes of death all over the world. Recently, there is an increasing interest in Carotid Intima-Medial Thickness (CIMT) and Ankle Brachial Index (ABI) as non-invasive tools for identifying subclinical atherosclerosis. We aim to examine the role of CIMT and ABI as predictors of the severity of angiographically documented coronary artery disease (CAD). Methods: A cross-sectional study conducted on 60 patients who were investigated by coronary angiography at Sohag University Hospital, Egypt. CIMT: After the carotid arteries were located by transverse scans, the probe was rotated 90 ° to obtain and record longitudinal images of bilateral carotid arteries ABI: Each patient was evaluated in the supine position after resting for 5 min. ABI was measured in each leg using a Doppler Ultrasound while the patient remained in the same position. The lowest ABI obtained for either leg was taken as the ABI measurement for the patient. Results: Patients with carotid mean IMT ≥ 0.9 mm had significantly more severe coronary artery disease than patients without thickening (mean IMT > 0.9 mm). Similarly, patients with low ABI (< 0.9) had significantly more severe coronary artery disease than patients with ABI ≥ 0.9. When the patients were divided into 4 groups (group A, n = 15, mean IMT < 0.9 mm, ABI ≥ 0.9; group B, n = 25, mean IMT < 0.9 mm, low ABI; group C, n = 5, mean IMT ≥ 0.9 mm, ABI ≥ 0.9; group D, n = 19, mean IMT ≤ 0.9 mm, low ABI), the presence of significant coronary stenosis (> 50%) of the groups were significantly different (group A, n = 5: (33.3%); group B, n = 11: (52.4%); group C, n = 4: (60%); group D, n=15, (78.9%), P = 0.001). Conclusion: CIMT and ABI provide useful information on the severity of CAD. Early and aggressive intervention should be considered in patients with CAD and abnormalities in one or both of these non-invasive modalities.

Keywords: ankle brachial index, carotid intima media thickness, coronary artery disease, predictors of severity

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8429 Improving Access to Palliative Care for Heart Failure Patients in England Using a Health Systems Approach

Authors: Alex Hughes

Abstract:

Patients with advanced heart failure develop specific palliative care needs due to the progressive symptom burden and unpredictable disease trajectory. NICE guidance advises that palliative care should be provided to patients with both cancer and non-cancer conditions as and when required. However, there is some way to go before this guidance is consistently and effectively implemented nationwide in conditions such as heart failure. The Ambitions for Palliative and End of Life Care: A national framework for local action in England provides a set of foundations and ambitions which outline a vision for what high-quality palliative and end-of-life care look like in England. This poster aims to critically consider how to improve access to palliative care for heart failure patients in England by analysing the foundations taken from this framework to generate specific recommendations using Soft Systems Methodology (SSM). The eight foundations analysed are: ‘Personalised care planning’, ‘Shared records’, ‘Evidence and information’, ‘Involving, supporting and caring for those important to the dying Person’, ‘Education and training’, ‘24/7 access’, ‘Co-design’ and ‘Leadership.’ A number of specific recommendations have been generated which highlight a need to close the evidence-policy gap and implement policy with sufficient evidence. These recommendations, alongside the creation of an evidence-based national strategy for palliative care and heart failure, should improve access to palliative care for heart failure patients in England. Once implemented, it will be necessary to evaluate the effect of these proposals to understand if access to palliative care for heart failure patients actually improves.

Keywords: access, health systems, heart failure, palliative care

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8428 The Effect of Computer-Based Formative Assessment on Learning Outcome

Authors: Van Thien NGO

Abstract:

The purpose of the study is to examine the effect of student response systems in computer-based formative assessment on learning outcomes. The backward design course is a tool to be applied for collecting necessary assessment evidence. The quasi-experimental research design involves collecting pre and posttest data on students assigned to the control group and the experimental group. The sample group consists of 150 college students randomly selected from two of the eight classes of electrical and electronics students at Cao Thang Technical College in Ho Chi Minh City, Vietnam. Findings from this research revealed that the experimental group, in which student response systems were applied, got better results than the controlled group, who did not apply them. Results show that using student response systems for technology-based formative assessment is vital and meaningful not only for teachers but also for students in the teaching and learning process.

Keywords: student response system, computer-based formative assessment, learning outcome, backward design course

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8427 A Comparison of Implant Stability between Implant Placed without Bone Graft versus with Bone Graft Using Guided Bone Regeneration (GBR) Technique: A Resonance Frequency Analysis

Authors: R. Janyaphadungpong, A. Pimkhaokham

Abstract:

This prospective clinical study determined the insertion torque (IT) value and monitored the changes in implant stability quotient (ISQ) values during the 12 weeks healing period from implant placement without bone graft (control group) and with bone graft using the guided bone regeneration (GBR) technique (study group). The relationship between the IT and ISQ values of the implants was also assessed. The control and study groups each consisted of 6 patients with 8 implants per group. The ASTRA TECH Implant System™ EV 4.2 mm in diameter was placed in the posterior mandibular region. In the control group, implants were placed in bone without bone graft, whereas in the study group implants were placed simultaneously with the GBR technique at favorable bone defect. IT (Ncm) of each implant was recorded when fully inserted. ISQ values were obtained from the Osstell® ISQ at the time of implant placement, and at 2, 4, 8, and 12 weeks. No difference in IT was found between groups (P = 0.320). The ISQ values in the control group were significantly higher than in the study group at the time of implant placement and at 4 weeks. There was no significant association between IT and ISQ values either at baseline or after the 12 weeks. At 12 weeks of healing, the control and study groups displayed different trends. Mean ISQ values for the control group decreased over the first 2 weeks and then started to increase. ISQ value increases were statistically significant at 8 weeks and later, whereas mean ISQ values in the study group decreased over the first 4 weeks and then started to increase, with statistical significance after 12 weeks. At 12 weeks, all implants achieved osseointegration with mean ISQ values over the threshold value (ISQ>70). These results indicated that implants, in which guided bone regeneration technique was performed during implant placement for treating favorable bone defects, were as predictable as implants placed without bone graft. However, loading in implants placed with the GBR technique for correcting favorable bone defects should be performed after 12 weeks of healing to ensure implant stability and osseointegration.

Keywords: dental implant, favorable bone defect, guided bone regeneration technique, implant stability

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8426 Central Line Stock and Use Audit in Adult Patients: A Quality Improvement Project on Central Venous Catheter Standardisation Across Hospital Departments

Authors: Gregor Moncrieff, Ursula Bahlmann

Abstract:

A number of incident reports were filed from the intensive care unit with regards to adult patients admitted following operations who had a central venous catheter inserted of the incorrect length for the relevant anatomical site and catheters not compatible with pressurised injection inserted whilst in theatre. Incorrect catheter length can lead to a variety of complications and pressurised injection is a requirement for contrast enhanced computerised tomography scans. This led to several patients having a repeat procedure to insert a catheter of the correct length and also compatible with pressurised injection. This project aimed to identify the types of central venous catheters used in theatres and ensure the correct equipment would be stocked and used in future cases in accordance the existing Association of Anaesthetics of Great Britain and Northern Ireland guidelines. A questionnaire was sent out to all of the anaesthetic department in our hospital aiming to determine what types of central venous catheters were preferably used by anaesthetists and why these had been chosen. We also explored any concerns regarding introduction of standardised, pressure injectable central venous catheters to the theatre department which were already in use in other parts of the hospital and in keeping with national guidance. A total of 56 responses were collected. 64% of respondents routinely used a central venous catheter which was significantly shorter than the national recommended guidance with a further 4 different types of central venous catheters used which were different to other areas of the hospital and not pressure injectable. 75% of respondents were in agreement to standardised introduction of the pressure injectable catheters of the recommended length in accordance with national guidance. Reasons why 25% respondents were opposed to introduction of these catheters were explored and discussed. We were successfully able to introduce the standardised central catheters to the theatre department following presentation at the local anaesthetic quality and safety meeting. Reasons against introduction of the catheters were discussed and a compromise was reached that the existing catheters would continue to be stocked but would only be available on request, with a focus on encouraging use of the standardised catheters. Additional changes achieved included removing redundant catheters from the theatre stock. Ongoing data is being collected to analyse positive and negative feedback from use of the introduced catheters.

Keywords: central venous catheter, medical equipment, medical safety, quality improvement

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8425 Compared Psychophysiological Responses under Stress in Patients of Chronic Fatigue Syndrome and Depressive Disorder

Authors: Fu-Chien Hung, Chi‐Wen Liang

Abstract:

Background: People who suffer from chronic fatigue syndrome (CFS) frequently complain about continuous tiredness, weakness or lack of strength, but without apparent organic etiology. The prevalence rate of the CFS is nearly from 3% to 20%, yet more than 80% go undiagnosed or misdiagnosed as depression. The biopsychosocial model has suggested the associations among the CFS, depressive syndrome, and stress. This study aimed to investigate the difference between individuals with the CFS and with the depressive syndrome on psychophysiological responses under stress. Method: There were 23 participants in the CFS group, 14 participants in the depression group, and 23 participants in the healthy control group. All of the participants first completed the measures of demographic data, CFS-related symptoms, daily life functioning, and depressive symptoms. The participants were then asked to perform a stressful cognitive task. The participants’ psychophysiological responses including the HR, BVP and SC were measured during the task. These indexes were used to assess the reactivity and recovery rates of the automatic nervous system. Results: The stress reactivity of the CFS and depression groups was not different from that of the healthy control group. However, the stress recovery rate of the CFS group was worse than that of the healthy control group. Conclusion: The results from this study suggest that the CFS is a syndrome which can be independent from the depressive syndrome, although the depressive syndrome may include fatigue syndrome.

Keywords: chronic fatigue syndrome, depression, stress response, misdiagnosis

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8424 Self-Reliance Support and Environment Interaction in Long-Term Care

Authors: Chen-Yuan Hsu

Abstract:

Introduction Elderly is growing and results to live in the long-term care (LTC) and then due to the routine of the facilities in Taiwan, also resulted to losing of those people with environment interaction, so, the self-reliance support (SRS) for those people to experience environment interaction is an essential. Methods This study was recruited samples of a LTC in the central of Taiwan. There was a following research on the SRS group with 20 samples collected and routine care group with 20 samples. A structured questionnaire as the Environment Interaction Dimension, as data collection included demographic information and the dimensions of environment interaction. Data analysis used SPSS 22.0 for Window 2000 to report the finding. Results The Environment Interaction Dimension for Taiwanese is a Chinese version of the containing 8 items. The result of t-test analysis found that environment interaction showed a significant difference between groups (p<.05), the result recommended that there was a higher score of environment interaction dimension on the SRS group (29.90±5.56) comparing with the routine care group (22.1±5.53). Conclusion This study showed that the SRS group was higher than the routine care group on the environment interaction dimension for Taiwanese elderly living in the LTC. The results can also provide the reference for LTC, to encourage those people to participate in SRS in LTC, and therefore also improving their environment interaction.

Keywords: self-reliance support, environment interaction, long-term care, elderly

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