Search results for: nutrition therapy guide
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3815

Search results for: nutrition therapy guide

3455 Structural Analysis of Hydro-Turbine Head Cover Using Ansys

Authors: Surjit Angra, Manisha Kumari, Vinod Kumar

Abstract:

The objective of the Hydro Turbine Head Cover is to support the guide bearing, guide vane regulating mechanism and even in some design for generator thrust bearing support. Mechanical design of head cover deals with high static as well as fluctuating load acting on the structure. In the present work structural analysis of hydro turbine Head-cover using ANSYS software is carried out. Finite element method is used to calculate stresses on head cover. These calculations were done for the maximum possible loading under operating condition “LCI Quick Shut Down”. The results for equivalent Von-Mises stress, total deformation and directional deformation have been plotted and compared with the existing results whether the design is safe or not.

Keywords: ANSYS, head cover, hydro-turbine, structural analysis, total deformation, Von-Mises stress

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3454 Symphony of Healing: Exploring Music and Art Therapy’s Impact on Chemotherapy Patients with Cancer

Authors: Sunidhi Sood, Drashti Narendrakumar Shah, Aakarsh Sharma, Nirali Harsh Panchal, Maria Karizhenskaia

Abstract:

Cancer is a global health concern, causing a significant number of deaths, with chemotherapy being a standard treatment method. However, chemotherapy often induces side effects that profoundly impact the physical and emotional well-being of patients, lowering their overall quality of life (QoL). This research aims to investigate the potential of music and art therapy as holistic adjunctive therapy for cancer patients undergoing chemotherapy, offering non-pharmacological support. This is achieved through a comprehensive review of existing literature with a focus on the following themes, including stress and anxiety alleviation, emotional expression and coping skill development, transformative changes, and pain management with mood upliftment. A systematic search was conducted using Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 2014 to 2023. The review solely incorporated studies focusing on the impact of music and art therapy on the health and overall well-being of cancer patients undergoing chemotherapy in North America. The findings from 16 studies involving pediatric oncology patients, females affected by breast cancer, and general oncology patients show that music and art therapies significantly reduce anxiety (standardized mean difference: -1.10) and improve perceived stress (median change: -4.0) and overall quality of life in cancer patients undergoing chemotherapy. Furthermore, music therapy has demonstrated the potential to decrease anxiety, depression, and pain during infusion treatments (average changes in resilience scale: 3.4 and 4.83 for instrumental and vocal music therapy, respectively). This data calls for consideration of the integration of music and art therapy into supportive care programs for cancer patients undergoing chemotherapy. Moreover, it provides guidance to healthcare professionals and policymakers, facilitating the development of patient-centered strategies for cancer care in Canada. Further research is needed in collaboration with qualified therapists to examine its applicability and explore and evaluate patients' perceptions and expectations in order to optimize the therapeutic benefits and overall patient experience. In conclusion, integrating music and art therapy in cancer care promises to substantially enhance the well-being and psychosocial state of patients undergoing chemotherapy. However, due to the small population size considered in existing studies, further research is needed to bridge the knowledge gap and ensure a comprehensive, patient-centered approach, ultimately enhancing the quality of life (QoL) for individuals facing the challenges of cancer treatment.

Keywords: anxiety, cancer, chemotherapy, depression, music and art therapy, pain management, quality of life

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3453 Effective Tandem Mesh Nebulisation of Pulmonary Vasodilator and Bronchodilators in Critical Respiratory Failure

Authors: Nathalie Bolding, Marta Montero, Joaquim Cevallos, Juan F. Martin-Lazaro

Abstract:

Background: Inhaled epoprostenol (iEPO) have been shown to improve PaO2:FiO2 (PF) in combination with bronchodilators (BD). However, there is not an available device to deliver these two therapies concomitantly. We describe a new method to provide this therapy successfully. Objective: To evaluate the response to continuous nebulization of iEPO and intermittent nebulization of Salbutamol/Ipratropium bromide in adults with severe respiratory failure through a double mesh nebulisation in tandem. Methods: This observational study included two mechanical ventilated adults under hourly ventilatory, gasometrical and clinical measurements during 48h. Both had severe respiratory failure treated with continuous iEPO (50 – 200 micrograms/h) and BD (Salbutamol 2.5 mg and Ipratropium bromide 500 mcg every 6 hours) through double mesh nebulisation (Aerogen solo®) placed in tandem in the dry side of the humidificator. The primary endpoints were the variables associated with a positive response to this tandem nebulised therapy (PaFiO2 index, ROX index). Secondary endpoints were laboratory (ABG) clinical and ventilatory variables. Statistical analysis (SPSS v29) included linear regression and ANOVA. Results: The patients included (n=2) survived, both extubated, one after ECMO therapy. Severe acute respiratory failure had a positive response rate to continuous iEPO and intermittent BD: PaFiO2 increased (7.40 to 30.91; P75: 27%) as well as ROX index (2.91 to 11.43; P75: 33%). There was a linear correlation of improvement between iEPO with PaFiO2 (ANOVA, r=0.393, p<0.002) and ROX (r=0.419, p<0.001). iEPO+BD therapy did not show any complications. Conclusion: Continuous and intermittent mesh tandem nebulisation can be effectively delivered with this method with a positive effect in ventilatory parameters without observed complications. Randomised studies will be able to provide reassurance in this new therapy.

Keywords: tandem, mesh, nebulisers, pulmonary, vasoldilators, bronchodilators, respiratory, failure

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3452 Synthesis of Size-Tunable and Stable Iron Nanoparticles for Cancer Treatment

Authors: Ambika Selvaraj

Abstract:

Magnetic iron oxide nanoparticles (IO) of < 20nm (superparamagnetic) become promising tool in cancer therapy, and integrated nanodevices for cancer detection and screening. The obstacles include particle heterogeneity and cost. It can be overcome by developing monodispersed nanoparticles in economical approach. We have successfully synthesized < 7 nm IO by low temperature controlled technique, in which Fe0 is sandwiched between stabilizer and Fe2+. Size analysis showed the excellent size control from 31 nm at 33°C to 6.8 nm at 10°C. Resultant monodispersed IO were found to be stable for > 50 reuses, proved its applicability in biomedical applications.

Keywords: low temperature synthesis, hybrid iron nanoparticles, cancer therapy, biomedical applications

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3451 [Keynote Talk]: Green Supply Chain Management Concepts Applied on Brazilian Animal Nutrition Industries

Authors: Laura G. Caixeta, Maico R. Severino

Abstract:

One of the biggest challenges that the industries find nowadays is to incorporate sustainability practices into its operations. The Green Supply Chain Management (GSCM) concept assists industries in such incorporation. For the full application of this concept is important that enterprises of a same supply chain have the GSCM practices coordinated among themselves. Note that this type of analyses occurs on the context of developed countries and sectors considered big impactors (as automotive, mineral, among others). The propose of this paper is to analyze as the GSCM concepts are applied on the Brazilian animal nutrition industries. The method used was the Case Study. For this, it was selected a supply chain relationship composed by animal nutrition products manufacturer (Enterprise A) and its supplier of animal waste, such as blood, viscera, among others (Enterprise B). First, a literature review was carried out to identify the main GSCM practices. Second, it was done an individual analysis of each one selected enterprise of the application of GSCM concept. For the observed practices, the coordination of each practice in this supply chain was studied. And, it was developed propose of GSCM applications for the practices no observed. The findings of this research were: a) the systematization of main GSCM practices, as: Internal Environment Management, Green Consumption, Green Design, Green Manufacturing, Green Marketing, Green Packaging, Green Procurement, Green Recycling, Life Cycle Analysis, Consultation Selection Method, Environmental Risk Sharing, Investment Recovery, and Reduced Transportation Time; b) the identification of GSCM practices on Enterprise A (7 full application, 3 partial application and 3 no application); c) the identification of GSCM practices on Enterprise B (2 full application, 2 partial application and 9 no application); d) the identification of how is the incentive and the coordination of the GSCM practices on this relationship by Enterprise A; e) proposals of application and coordination of the others GSCM practices on this supply chain relationship. Based on the study, it can be concluded that its possible apply GSCM on animal nutrition industries, and when occurs the motivation on the application of GSCM concepts by a supply chain echelon, these concepts are deployed for the others supply chain echelons by the coordination (orchestration) of the first echelon.

Keywords: animal nutrition industries, coordination, green supply chain management, supply chain management, sustainability

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3450 Barriers to Yoga and Yoga-Based Therapy for Black and Brown Individuals in the United States: Implications for Social Work Practice

Authors: Jessica Gladden

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Yoga has been accepted in the majority of communities in the United States as a method of assisting individuals with improving their physical health. Both community yoga classes and yoga-based therapy have been shown to be highly useful for individual’s mental health. Yoga-based therapy has been supported by research to be an evidence-based practice for individuals experiencing anxiety, depression, and disordered eating and for those experiencing post traumatic stress disorder in the wake of trauma. Many individuals who have experienced trauma, as well as other mental health diagnoses, are either very disconnected from their physical bodies or feel unsafe in their bodies. Yoga can be a method of creating safety and control in the body. This is recommended by some of the leading researchers in trauma therapy as a beginning step towards finding safety in the body in order to begin to work on the additional mental health challenges before addressing other long-term challenges. Unfortunately, yoga for physical and mental health is underutilized in black and brown communities despite the research regarding the benefits. Very few studies have examined the barriers to access to yoga for black, brown, and indigenous individuals. This study interviewed 15 yoga practitioners who identified as black or brown and explored the barriers they see in their communities related to accessing yoga and yoga-based services. Several of the themes reported include not feeling welcome, cost of services, time, and cultural/ religious components. Methods for reducing barriers will also be discussed.

Keywords: yoga, sport, barrier, black

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3449 Conservative and Surgical Treatment of Antiresorptive Drug-Related Osteonecrosis of the Jaw with Ultrasonic Piezoelectric Bone Surgery under Polyvinylpyrrolidone Iodine Irrigation: A Case Series of 13 Treated Sites

Authors: Esra Yuce, Isil D. S. Yamaner, Murude Yazan

Abstract:

Aims and objective: Antiresorptive agents including bisphosphonates and denosumab as strong suppressors of osteoclasts are the most commonly used antiresorptive medications for the treatment of osteoporosis which counteract the negative quantitative alteration of trabecular and cortical bone by inhibition of bone turnover. Oral bisphosphonate therapy for the treatment of osteopenia, osteoporosis or Paget's disease is associated with the low-grade risk of osteonecrosis of the jaw, while higher-grade risk is associated with receiving intravenous bisphosphonates therapy in the treatment of multiple myeloma and bone metastases. On the other hand, there has been a remarkable increase in incidences of antiresorptive related osteonecrosis of the jaw (ARONJ) in oral bisphosphonate users. This clinical presentation will evaluate the healing outcomes via piezoelectric bone surgery under the irrigation of PVP-I solution irrigation in patients received bisphosphonate therapy. Material-Method: The study involved 8 female and 5 male patients that have been treated for ARONJ. Among 13 necrotic sites, 9 were in the mandible and 4 were in the maxilla. All of these 13 patients treated with surgical debridement via piezoelectric bone surgery under irrigation by solution with 3% PVP-I concentration in combination with long-term antibiotic therapy and 5 also underwent removal of mobile segments of bony sequestrum. All removable prosthesis in 8 patients were relined with soft liners during the healing periods in order to eliminate chronic minor traumas. Results: All patients were on oral bisphosphonate therapy for at least 2 years and 5 of which had received intravenous bisphosphonates up to 1 year before therapy with oral bisphosphonates was started. According to the AAOMS staging system, four cases were stage II, eight cases were stage I, and one case was stage III. The majority of lesions were identified at sites of dental prostheses (38%) and dental extractions (62%). All patients diagnosed with ARONJ stage I had used unadjusted removable prostheses. No recurrence of the symptoms was observed during the present follow-up (9–37 months). Conclusion: Despite their confirmed effectiveness, the prevention and treatment of osteonecrosis of the jaw secondary to oral bisphosphonate therapy remain major medical challenges. Treatment with piezoelectric bone surgery with irrigation of povidone-iodine solution was effective for management of bisphosphonate-related osteonecrosis of the jaw. Taking precautions for patients treated with oral bisphosphonates, especially also denture users, may allow for a reduction in the rate of developing osteonecrosis of the maxillofacial region.

Keywords: antiresorptive drug related osteonecrosis, bisphosphonate therapy, piezoelectric bone surgery, povidone iodine

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3448 The Connection between Body Composition and Blood Samples Results in Aesthetic Sports

Authors: Réka Kovács, György Téglásy, Szilvia Boros

Abstract:

Introduction: Aim of the Study: Low body fat percentage frequently occurs in aesthetic sports. Because of the unrealistic expectations, their quantity and quality of nutrition intake are inadequate. This can be linked to several health issues which appear in blood samples (iron, ferritin, creatine kinase, etc.). Our retrospective study aimed to investigate the connection between body composition (InBody 770 monitor) and blood samples test results among elite adolescent (14-18 years) and adult (19-28 years) aesthetic athletes. Methods: Data collection happened between 01.08.2022. and 15.08.2022 in National Institute for Sports Medicine, Budapest. The final group consisted of 111 athletes (n=111; adolescents: n=68, adults: n=43). We used descriptive statistics, a two-sample t-test, and correlation analysis with Microsoft Office Excel 2007 software. Our results were considered significant if p<0,05. Results: In 33,3% (37/111) we found low body fat percentage (girls and women: <12%, boys and men: <8%) and in 64% (71/111) high creatine kinase levels. Differences were found mainly in the adolescent group. We found a correlation between body weight and total cholesterol, visceral fat and triglyceride, hematocrit and iron-linking capacity, moreover body fat percentage and ferritin levels. Discussion: It is important to start education about sports nutrition at an early age. The connection between low body fat percentage, serum iron, triglyceride, and ferritin levels refers to the fact that the nutrition intake of the athletes is inadequate. High blood concentrations of creatine kinase may show a lack of proper recovery, which is essential to improve health and performance.

Keywords: body fat percentage, creatine kinase, recovery, sports nutrition

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3447 Current and Future Global Distribution of Drosophila suzukii

Authors: Yousef Naserzadeh, Niloufar Mahmoudi

Abstract:

The spotted-wing drosophila, Drosophila suzukii (Matsumura) (Diptera: Drosophilidae), a vinegar fly native to South East Asia, has recently invaded Europe, North- and South America and is spreading rapidly. Species distribution modeling has been widely employed to indicate probable areas of invasion and to guide management strategies. Drosophila sp. is native to Asia, but since 2015, it has invaded almost every country in the world, including Africa, Australia, India, and most recently, the Americas. The growth of this species of Drosophila suzukii has been rapidly multiplying and spreading in the last decade. In fact, we examine and model the potential geographical distribution of D. suzukii for both present and future scenarios. Finally, we determine the environmental variables that affect its distribution, as well as assess the risk of encroachment on protected areas. D.suzukii has the potential to expand its occurrence, especially on continents that have already been invaded. The predictive models obtained in this study indicate potential regions that could be at risk of invasion by D. suzukii, including protected areas. These results are important and can assist in the establishment of management plans to avoid the possible harm caused by biological invasions.

Keywords: climate change, Drosophila suzukii, environmental variables, host preference, host plant, nutrition

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3446 A Retrospective Study of Vaginal Stenosis Following Treatment of Cervical Cancers and the Effectiveness of Rehabilitation Interventions

Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

Abstract:

Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: dilator, sexually active, vaginal dilation, vaginal stenosis

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3445 [Keynote Talk]: Treatment Satisfaction and Safety of Sitagliptin versus Pioglitazone in Patients with Type 2 Diabetes Mellitus Inadequately Controlled on Metformin Monotherapy

Authors: Shahnaz Haque, Anand Shukla, Sunita Singh, Anil Kem

Abstract:

Introduction: Diabetes Mellitus is a chronic metabolic disease affecting millions worldwide. Metformin is the most commonly prescribed first line oral hypoglycemic drug for type 2 diabetes mellitus, but due to progressive worsening of blood glucose control during the natural history of type 2 diabetes, combination therapy usually becomes necessary. Objective: This study was designed to assess the treatment satisfaction between Sitagliptin versus Pioglitazone added to Metformin in patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a prospective, open label, randomized, parallel group study in SIMS, Hapur, U.P. Eligible patients fulfilling inclusion criteria were randomized into two groups having 25 patients in each group using tab Sitagliptin 100mg, tab Pioglitazone 30mg added to ongoing tab Metformin (500mg) therapy for 16 weeks. The follow-up visits were on weeks 4,12 and 16. Result: 16 weeks later, addition of Sitagliptin 100mg compared to that of Pioglitazone 30 mg to ongoing Metformin therapy provided similar glycosylated hemoglobin (HbA1c) lowering efficacy in patients with T2DM with inadequate glycemic control on metformin monotherapy. Change in HbA1c in group1 was -0.656±0.21%(p<0.0001) whereas in group2 was -0.748±0.35%(p<0.0001). Hence decrease in HbA1c from baseline was more in group2. Both treatments were well tolerated with negligible risk of hypoglycaemia. Weight loss was observed with Sitagliptin in contrast to weight gain seen in Pioglitazone. Conclusion: In this study, Sitagliptin 100 mg along with metformin therapy in comparison to pioglitazone 30 mg plus metformin therapy was both effective, well-tolerated and improved glycemic control in both the groups. Addition of pioglitazone had cause oedema and weight gain to the patients whereas sitagliptin caused weight loss in its patients.

Keywords: sitagliptin, pioglitazone, metformin, type 2 diabetes mellitus

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3444 Evaluation of Immune Checkpoint Inhibitors in Cancer Therapy

Authors: Mir Mohammad Reza Hosseini

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In new years immune checkpoint inhibitors have gathered care as being one of the greatest talented kinds of immunotherapy on the prospect. There has been a specific emphasis on the immune checkpoint molecules, cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed cell death protein 1 (PD-1). In 2011, ipilimumab, the primary antibody obstructive an immune checkpoint (CTLA4) was authorized. It is now documented that recognized tumors have many devices of overpowering the antitumor immune response, counting manufacture of repressive cytokines, staffing of immunosuppressive immune cells, and upregulation of coinhibitory receptors recognized as immune checkpoints. This was fast followed by the growth of monoclonal antibodies directing PD1 (pembrolizumab and nivolumab) and PDL1 (atezolizumab and durvalumab). Anti-PD1/PDL1 antibodies have developed some of the greatest extensively set anticancer therapies. We also compare and difference their present place in cancer therapy and designs of immune-related toxicities and deliberate the role of dual immune checkpoint inhibition and plans for the organization of immune-related opposing proceedings. In this review, the employed code and present growth of numerous immune checkpoint inhibitors are abridged, while the communicating device and new development of Immune checkpoint inhibitors in cancer therapy-based synergistic therapies with additional immunotherapy, chemotherapy, phototherapy, and radiotherapy in important and clinical educations in the historical 5 years are portrayed and tinted. Lastly, we disapprovingly measure these methods and effort to find their fortes and faintness based on pre-clinical and clinical information.

Keywords: checkpoint, cancer therapy, PD-1, PDL-1, CTLA4, immunosuppressive

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3443 Developing an Intervention Program to Promote Healthy Eating in a Catering System Based on Qualitative Research Results

Authors: O. Katz-Shufan, T. Simon-Tuval, L. Sabag, L. Granek, D. R. Shahar

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Meals provided at catering systems are a common source of workers' nutrition and were found as contributing high amounts calories and fat. Thus, eating daily catering food can lead to overweight and chronic diseases. On the other hand, the institutional dining room may be an ideal environment for implementation of intervention programs that promote healthy eating. This may improve diners' lifestyle and reduce their prevalence of overweight, obesity and chronic diseases. The significance of this study is in developing an intervention program based on the diners’ dietary habits, preferences and their attitudes towards various intervention programs. In addition, a successful catering-based intervention program may have a significant effect simultaneously on a large group of diners, leading to improved nutrition, healthier lifestyle, and disease-prevention on a large scale. In order to develop the intervention program, we conducted a qualitative study. We interviewed 13 diners who eat regularly at catering systems, using a semi-structured interview. The interviews were recorded, transcribed and then analyzed by the thematic method, which identifies, analyzes and reports themes within the data. The interviews revealed several major themes, including expectation of diners to be provided with healthy food choices; their request for nutrition-expert involvement in planning the meals; the diners' feel that there is a conflict between sensory attractiveness of the food and its' nutritional quality. In the context of the catering-based intervention programs, the diners prefer scientific and clear messages focusing on labeling healthy dishes only, as opposed to the labeling of unhealthy dishes; they were interested in a nutritional education program to accompany the intervention program. Based on these findings, we have developed an intervention program that includes: changes in food served such as replacing several menu items and nutritional improvement of some of the recipes; as well as, environmental changes such as changing the location of some food items presented on the buffet, placing positive nutritional labels on healthy dishes and an ongoing healthy nutrition campaign, all accompanied by a nutrition education program. The intervention program is currently being tested for its impact on health outcomes and its cost-effectiveness.

Keywords: catering system, food services, intervention, nutrition policy, public health, qualitative research

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3442 The Effects of a Hippotherapy Simulator in Children with Cerebral Palsy: A Pilot Study

Authors: Canan Gunay Yazici, Zubeyir Sarı, Devrim Tarakci

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Background: Hippotherapy considered as global techniques used in rehabilitation of children with cerebral palsy as it improved gait pattern, balance, postural control, balance and gross motor skills development but it encounters some problems (such as the excess of the cost of horses' care, nutrition, housing). Hippotherapy simulator is being developed in recent years to overcome these problems. These devices aim to create the effects of hippotherapy made with a real horse on patients by simulating the movements of a real horse. Objectives: To evaluate the efficacy of hippotherapy simulator on gross motor functions, sitting postural control and dynamic balance of children with cerebral palsy (CP). Methods: Fourteen children with CP, aged 6–15 years, seven with a diagnosis of spastic hemiplegia, five of diplegia, two of triplegia, Gross Motor Function Classification System level I-III. The Horse Riding Simulator (HRS), including four-speed program (warm-up, level 1-2-3), was used for hippotherapy simulator. Firstly, each child received Neurodevelopmental Therapy (NDT; 45min twice weekly eight weeks). Subsequently, the same children completed HRS+NDT (30min and 15min respectively, twice weekly eight weeks). Children were assessed pre-treatment, at the end of 8th and 16th week. Gross motor function, sitting postural control, dynamic sitting and standing balance were evaluated by Gross Motor Function Measure-88 (GMFM-88, Dimension B, D, E and Total Score), Trunk Impairment Scale (TIS), Pedalo® Sensamove Balance Test and Pediatric Balance Scale (PBS) respectively. Unit of Scientific Research Project of Marmara University supported our study. Results: All measured variables were a significant increase compared to baseline values after both intervention (NDT and HRS+NDT), except for dynamic sitting balance evaluated by Pedalo®. Especially HRS+NDT, increase in the measured variables was considerably higher than NDT. After NDT, the Total scores of GMFM-88 (mean baseline 62,2 ± 23,5; mean NDT: 66,6 ± 22,2; p < 0,05), TIS (10,4 ± 3,4; 12,1 ± 3; p < 0,05), PBS (37,4 ± 14,6; 39,6 ± 12,9; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 92,3 ± 5,2; p > 0,05) and Pedalo® standing balance points (80,2 ± 10,8; 82,5 ± 11,5; p < 0,05) increased by 7,1%, 2%, 3,9%, 5,2% and 6 % respectively. After HRS+NDT treatment, the total scores of GMFM-88 (mean baseline: 62,2 ± 23,5; mean HRS+NDT: 71,6 ± 21,4; p < 0,05), TIS (10,4 ± 3,4; 15,6 ± 2,9; p < 0,05), PBS (37,4 ± 14,6; 42,5 ± 12; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 93,8 ± 3,7; p > 0,05) and standing balance points (80,2 ± 10,8; 86,2 ± 5,6; p < 0,05) increased by 15,2%, 6%, 7,3%, 6,4%, and 11,9%, respectively, compared to the initial values. Conclusion: Neurodevelopmental therapy provided significant improvements in gross motor functions, sitting postural control, sitting and standing balance of children with CP. When the hippotherapy simulator added to the treatment program, it was observed that these functions were further developed (especially with gross motor functions and dynamic balance). As a result, this pilot study showed that the hippotherapy simulator could be a useful alternative to neurodevelopmental therapy for the improvement of gross motor function, sitting postural control and dynamic balance of children with CP.

Keywords: balance, cerebral palsy, hippotherapy, rehabilitation

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3441 Study of Pre-Handwriting Factors Necessary for Successful Handwriting in Children

Authors: Lalitchandra J. Shah, Katarzyna Bialek, Melinda L. Clarke, Jessica L. Jansson

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Handwriting is essential to academic success; however, the current literature is limited in the identification of pre-handwriting skills. The purpose of this study was to identify the pre-handwriting skills, which occupational therapy practitioners deem important to handwriting success, as well as those which aid in intervention planning. The online survey instrument consisted of 33 questions that assessed various skills related to the development of handwriting, as well as captured demographic information. Both occupational therapists and occupational therapy assistants were included in the survey study. The survey found that the respondents were in agreement that purposeful scribbling, the ability of a child to copy (vertical/horizontal lines, circle, squares, and triangles), imitating an oblique cross, cognitive skills (attention, praxis, self-regulation, sequencing), grasp patterns, hand dominance, in hand manipulation skills (shift, translation, rotation), bilateral integration, stabilization of paper, crossing midline, and visual perception were important indicators of handwriting readiness. The results of the survey support existing research regarding the skills necessary for the successful development of handwriting in children.

Keywords: development, handwriting, occupational therapy, visual perceptual skills

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3440 Breaking Barriers: Utilizing Innovation to Improve Educational Outcomes for Students with Disabilities

Authors: Emily Purdom, Rachel Robinson

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As the number of students worldwide requiring speech-language therapy, occupational therapy and mental health services during their school day increases, innovation is becoming progressively more important to meet the demand. Telepractice can be used to reach a greater number of students requiring specialized therapy while maintaining the highest quality of care. It can be provided in a way that is not only effective but ultimately more convenient for student, teacher and therapist without the added burden of travel. Teletherapy eradicates many hurdles to traditional on-site service delivery and helps to solve the pervasive shortage of certified professionals. Because location is no longer a barrier to specialized education plans for students with disabilities when teletherapy is conducted, there are many advantages that can be deployed. Increased frequency of engagement is possible along with students receiving specialized care from a clinician that may not be in their direct area. Educational teams, including parents, can work together more easily and engage in face-to-face, student-centered collaboration through videoconference. Practical strategies will be provided for connecting students with qualified therapists without the typical in-person dynamic. In most cases, better therapy outcomes are going to be achieved when treatment is most convenient for the student and educator. This workshop will promote discussion in the field of education to increase advocacy for remote service delivery. It will serve as a resource for those wanting to expand their knowledge of options for students with special needs afforded through innovation.

Keywords: education technology, innovation, student support services, telepractice

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3439 Latest Advances in the Management of Liver Diseases

Authors: Rabab Makki, Deputy Chief Dietitian

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Malnutrition is commonly seen in Liver Disease patients. Prevalence of malnutrition in cirrhosis, is as high as 65-90%. Protein depletion and reduced muscle function are common. There are many mechanisms of malnutrition in liver cirrhosis e.g. insulin resistance, low respiratory quotient, increased glucogenesis etc. Nutrition support improves outcome in patients unable to maintain an intake of 35-40 Kcal/kg and 1.2-1.5 gm/kg/day. Simple methods of assessment such as subjective global assessment, calorie counting, MMC are useful. The value of BCAAs remains uncertain despite a considerable number of studies. Normal protein diets have been given safely to patients with hepatic encephalopathy. Restriction of protein not more than 48 hours pre- and pro-biotic, glutamine, fish oil etc are all part of the latest advanced techniques used.

Keywords: liver cirrhosis, omega 3 for liver disease, nutrition management, malnutrition

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3438 The Design of Smart Tactile Textiles for Therapeutic Applications

Authors: Karen Hong

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Smart tactile textiles are a series of textile-based products that incorporates smart embedded technology to be utilized as tactile therapeutic applications for 2 main groups of target users. The first group of users will be children with sensory processing disorder who are suffering from tactile sensory dysfunction. Children with tactile sensory issues may have difficulty tolerating the sensations generated from the touch of certain textures on the fabrics. A series of smart tactile textiles, collectively known as ‘Tactile Toys’ are developed as tactile therapy play objects, exposing children to different types of touch sensations within textiles, enabling them to enjoy tactile experiences together with interactive play which will help them to overcome fear of certain touch sensations. The second group of users will be the elderly or geriatric patients who are suffering from deteriorating sense of touch. One of the common consequences of aging is suffering from deteriorating sense of touch and a decline in motoric function. With the focus in stimulating the sense of touch for this particular group of end users, another series of smart tactile textiles, collectively known as ‘Tactile Aids’ are developed also as tactile therapy. This range of products can help to maintain touch sensitivity and at the same time allowing the elderly to enjoy interactive play to practice their hand-eye coordination and enhancing their motor skills. These smart tactile textile products are being designed and tested out by the end users and have proofed their efficacy as tactile therapy enabling the users to lead a better quality of life.

Keywords: smart textiles, embedded technology, tactile therapy, tactile aids, tactile toys

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3437 Predictors of Response to Interferone Therapy in Chronic Hepatitis C Virus Infection

Authors: Ali Kassem, Ehab Fawzy, Mahmoud Sef el-eslam, Fatma Salah- Eldeen, El zahraa Mohamed

Abstract:

Introduction: The combination of interferon (INF) and ribavirin is the preferred treatment for chronic hepatitis C viral (HCV) infection. However, nonresponse to this therapy remains common and is associated with several factors such as HCV genotype and HCV viral load in addition to host factors such as sex, HLA type and cytokine polymorphisms. Aim of the work: The aim of this study was to determine predictors of response to (INF) therapy in chronic HCV infected patients treated with INF alpha and ribavirin combination therapy. Patients and Methods: The present study included 110 patients (62 males, 48 females) with chronic HCV infection. Their ages ranged from 20-59 years. Inclusion criteria were organized according to the protocol of the Egyptian National Committee for control of viral hepatitis. Patients included in this study were recruited to receive INF ribavirin combination therapy; 54 patients received pegylated NF α-2a (180 μg) and weight based ribavirin therapy (1000 mg if < 75 kg, 1200 mg if > 75 kg) for 48 weeks and 53 patients received pegylated INF α-2b (1.5 ug/kg/week) and weight based ribavirin therapy (800 mg if < 65 kg, 1000 mg if 65-75 kg and 1200 mg if > 75kg). One hundred and seven liver biopsies were included in the study and submitted to histopathological examination. Hematoxylin and eosin (H&E) stained sections were done to assess both the grade and the stage of chronic viral hepatitis, in addition to the degree of steatosis. Modified hepatic activity index (HAI) grading, modified Ishak staging and Metavir grading and staging systems were used. Laboratory follow up including: HCV PCR at the 12th week to assess the early virologic response (EVR) and at the 24th week were done. At the end of the course: HCV PCR was done at the end of the course and tested 6 months later to document end virologic response (ETR) and sustained virologic response (SVR) respectively. Results One hundred seven patients; 62 males (57.9 %) and 45 females (42.1%) completed the course and included in this study. The age of patients ranged from 20-59 years with a mean of 40.39±10.03 years. Six months after the end of treatment patients were categorized into two groups: Group (1): patients who achieved sustained virological response (SVR). Group (2): patients who didn't achieve sustained virological response (non SVR) including non-responders, breakthrough and relapsers. In our study, 58 (54.2%) patients showed SVR, 18 (16.8%) patients were non-responders, 15 (14%) patients showed break-through and 16 (15 %) patients were relapsers. Univariate binary regression analysis of the possible risk factors of non SVR showed that the significant factors were higher age, higher fasting insulin level, higher Metavir stage and higher grade of hepatic steatosis. Multivariate binary regression analysis showed that the only independent risk factor for non SVR was high fasting insulin level. Conclusion: Younger age, lower Metavir stage, lower steatosis grade and lower fasting insulin level are good predictors of SVR and could be used in predicting the treatment response of pegylated interferon/ribavirin therapy.

Keywords: chronic HCV infection, interferon ribavirin combination therapy, predictors to antiviral therapy, treatment response

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3436 The Effect of Exercise Therapy and Electroacupuncture on Some Clinical Outcomes in People with Post Total Hip Arthroplasty

Authors: Marzieh Yassin, Masoud Rashed, Soheil Mansour Sohani, Reza Salehi

Abstract:

Background: Hip arthroplasty is one of the surgical methods to improve symptoms in patients with hip osteoarthritis. The use of electroacupuncture and TENS reduces pain, increases range of motion and improves performance. Methods: In this clinical trial study, 30 patients after hip arthroplasty were randomly divided into two groups: electroacupuncture (n=16) with exercise therapy and TENS with exercise therapy (n=14). Severity of pain, quality of life, range of motion, edema and function were evaluated in two groups before and after the interventions. Interventions of 10 sessions (three sessions per week) were conducted for two groups. The significance level in all tests was below 0.05. Results: The results showed that both groups improved all of the symptoms after the intervention (p≤0.05), although there was no statistically significant difference between the two groups in terms of effectiveness (p≥0.05). Conclusion: The results showed that both methods improve symptoms in patients after surgery. According to this study, electroacupuncture is suggested as a new method effective for the treatment of people with post-Total Hip Arthroplasty.

Keywords: electroacupuncture, physical performance, total hip arthroplasty, TENS

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3435 Predictor Factors for Treatment Failure among Patients on Second Line Antiretroviral Therapy

Authors: Mohd. A. M. Rahim, Yahaya Hassan, Mathumalar L. Fahrni

Abstract:

Second line antiretroviral therapy (ART) regimen is used when patients fail their first line regimen. There are many factors such as non-adherence, drug resistance as well as virological and immunological failure that lead to second line highly active antiretroviral therapy (HAART) regimen treatment failure. This study was aimed at determining predictor factors to treatment failure with second line HAART and analyzing median survival time. An observational, retrospective study was conducted in Sungai Buloh Hospital (HSB) to assess current status of HIV patients treated with second line HAART regimen. Convenience sampling was used and 104 patients were included based on the study’s inclusion and exclusion criteria. Data was collected for six months i.e. from July until December 2013. Data was then analysed using SPSS version 18. Kaplan-Meier and Cox regression analyses were used to measure median survival times and predictor factors for treatment failure. The study population consisted mainly of male subjects, aged 30-45 years, who were heterosexual, and had HIV infection for less than 6 years. The most common second line HAART regimen given was lopinavir/ritonavir (LPV/r)-based combination. Kaplan-Meier analysis showed that patients on LPV/r demonstrated longer median survival times than patients on indinavir/ritonavir (IDV/r) based combination (p<0.001). The commonest reason for a treatment to fail with second line HAART was non-adherence. Based on Cox regression analysis, other predictor factors for treatment failure with second line HAART regimen were age and mode of HIV transmission.

Keywords: adherence, antiretroviral therapy, second line, treatment failure

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3434 Effect of Reminiscence Therapy on the Sleep Quality of the Elderly Living in Nursing Homes

Authors: Güler Duru Aşiret

Abstract:

Introduction: Poor sleep quality is a common problem among the older people living in nursing homes. Our study aimed at assessing the effect of individual reminiscence therapy on the sleep quality of the elderly living in nursing homes. Methods: The study had 22 people in the intervention group and 24 people in the control group. The intervention group had reminiscence therapy once a week for 12 weeks in the form of individual sessions of 25-30 minutes. In our study, we first determined the dates suitable for the intervention group and researcher and planned the date and time of individual reminiscence therapies, which would take 12 weeks. While preparing this schedule, we considered subjects’ time schedules for their regular visits to health facilities and the arrival of their visitors. At this stage, the researcher informed the participants that their regular attendance in sessions would affect the intervention outcome. One topic was discussed every week. Weekly topics included: introduction in the first week; childhood and family life, school days, starting work and work life (a day at home for housewives), a fun day out of home, marriage (friendship for the singles), plants and animals they loved, babies and children, food and cooking, holidays and travelling, special days and celebrations, assessment and closure, in the following weeks respectively. The control group had no intervention. Study data was collected by using an introductory information form and the Pittsburgh Sleep Quality Index (PSQI). Results: In our study, participants’ average age was 76.02 ± 7.31. 58.7% of them were male and 84.8% were single. All of them had at least one chronic disease. 76.1% did not need help for performing their daily life activities. The length of stay in the institution was 6.32 ± 3.85 years. According to the participants’ descriptive characteristics, there was no difference between groups. While there was no statistically significant difference between the pretest PSQI median scores (p > 0.05) of both groups, PSQI median score had a statistically significant decrease after 12 weeks of reminiscence therapy (p < 0.05). There was no statistically significant change in the median scores of the subcomponents of sleep latency, sleep duration, sleep efficiency, sleep disturbance and use of sleep medication before and after reminiscence therapy. After the 12-weeks reminiscence therapy, there was a statistically significant change in the median scores for the PSQI subcomponents of subjective sleep quality (p<0.05). Conclusion: Our study found that reminiscence therapy increased the sleep quality of the elderly living in nursing homes. Acknowledgment: This study (project no 2017-037) was supported by the Scientific Research Projects Coordination Unit of Aksaray University. We thank the elderly subjects for their kind participation.

Keywords: nursing, older people, reminiscence therapy, sleep

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3433 Augmentation of Conventional Medicine for Post-concussion Syndrome with Cognitive Behavioral Therapy Accelerates Symptomatic Relief in Affected Individuals

Authors: Waqas Mehdi, Muhammad Umar Hassan, Khadeeja Mustafa

Abstract:

Objective: Post-concussion syndrome (PCS) is a medical term used to point out the complicated combination of physical, emotional, cognitive and behavioral signs and symptoms associated with Mild Traumatic Brain Injury(mTBI). This study was conducted to assess the improvement or debilitating effect of behavioral therapy in addition to the conventional treatment and to document these results for increasing the efficiency of treatment provided to such cases. Method: This was primarily an interventional prospective cohort study which was conducted in the Department of Neurosurgery, Mayo Hospital Lahore. The sample size was 200 patients who were randomly distributed into two groups. The interventional group with Cognitive behavioral therapy was added in addition to the conventional treatment regimen and the Control group receiving only conventional treatment. Results were noted initially as well as after two weeks of the follow-up period. Data were subsequently analyzed by Statistical Package for Social Sciences (SPSS) software and associations worked out. Result and conclusion: Among the patients that were given therapy sessions along with conventional medicine, there was a significant improvement in the symptoms and their overall quality of life. It is also important to notice that the time period taken for these effects to wane is cut down by psychiatric solutions too. So we can conclude that CBT sessions not only speed up recovery in patients with post-concussion syndrome they also aid in the efficiency improvement in functional capability and quality of life.

Keywords: neurosurgery, CBT, PCS, mTBI

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3432 Collaboration between Dietician and Occupational Therapist, Promotes Independent Functional Eating in Tube Weaning Process of Mechanical Ventilated Patients

Authors: Inbal Zuriely, Yonit Weiss, Hilla Zaharoni, Hadas Lewkowicz, Tatiana Vander, Tarif Bader

Abstract:

early active movement, along with adjusting optimal nutrition, prevents aggravation of muscle degeneracy and functional decline. Eating is a basic activity of daily life, which reflects the patient's independence. When eating and feeding are experienced successfully, they lead to a sense of pleasure and satisfaction. However, when they are experienced as a difficulty, they might evoke feelings of helplessness and frustration. This stresses the essential process of gradual weaning off the enteral feeding tube. the work describes the collaboration of a dietitian, determining the nutritional needs of patients undergoing enteral tube weaning as part of the rehabilitation process, with the suited treatment of an occupational therapist. Occupational therapy intervention regarding eating capabilities focuses on improving the required motor and cognitive components, along with environmental adjustments and aids, imparting eating strategies and training to patients and their families. The project was conducted in the long-term, ventilated patients’ department at the Herzfeld Rehabilitation Geriatric Medical Center on patients undergoing enteral tube weaning with the staff’s assistance. Establishing continuous collaboration between the dietician and the occupational therapist, starting from the beginning of the feeding-tube weaning process: 1.The dietician updates the occupational therapist about the start of the process and the approved diet. 2.The occupational therapist performs cognitive, motor, and functional assessments and treatments regarding the patient’s eating capabilities and recommends the required adjustments for independent eating according to the FIM (Functional Independence Measure) scale. 3.The occupational therapist closely follows up on the patient’s degree of independence in eating and provides a repeated update to the dietician. 4.The dietician accordingly guides the ward staff on whether and how to feed the patient or allow independent eating. The project aimed to promote patients toward independent feeding, which leads to a sense of empowerment, enjoyment of the eating experience, and progress of functional ability, along with performing active movements that will motivate mobilization. From the beginning of 2022, 26 patients participated in the project. 79% of all patients who started the weaning process from tube feeding achieved different levels of independence in feeding (independence levels ranged from supervision (FIM-5) to complete independence (FIM-7). The integration of occupational therapy and dietary treatment is based on a patient-centered approach while considering the patient’s personal needs, preferences, and goals. This interdisciplinary partnership is essential for meeting the complex needs of prolonged mechanically ventilated patients and promotes independent functioning and quality of life.

Keywords: dietary, mechanical ventilation, occupational therapy, tube feeding weaning

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3431 Buddhist Cognitive Behavioral Therapy to Address Depression Among Elderly Population: Multi-cultural Model of Buddhist Based Cognitive Behavioral Therapy to Address Depression Among Elderly Population

Authors: Ashoke Priyadarshana Premananda

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As per the suggestions of previously conducted research in Counseling Psychology, the necessity of forming culture- friendly approaches has been strongly emphasized by a number of scholars in the field. In response to that, Multicultural-model of Buddhist Based Cognitive Behavioral Therapy (MMBCBT) has been formed as a culture-friendly therapeutic approach to address psychological disturbances (depression) in late adulthood. Elderly population in the world is on the rise by leaps and bounds, and forming a culture-based therapeutic model which is blended with Buddhist teachings has been the major objective of the study. Buddhist teachings and cultural applications, which were mapped onto Cognitive Behavioral Therapy (CBT) in the West, ultimately resulted in MMBCBT. Therefore, MMBCBT is a blend of cultural therapeutic techniques and the essence of certain Buddhist teachings extracted from five crucial suttas, which include CBT principles. In the process of mapping, MeghiyaSutta, GirimānandaSutta, SallekhaSutta, DvedhāvitakkaSutta, and Vitakka- SaṇṭhānaSutta have been taken into consideration mainly because of their cognitive behavioral content. The practical components of Vitakka- Saṇṭhānasutta (Aññanimittapabbaṃ) and Sallekhasutta (SallekhaPariyāya and CittuppādaPariyāya) have been used in the model while mindfulness of breathing was also carried out with the participants. Basically, multi-cultural therapeutic approaches of MMBCBT aim at modifying behavior (behavioral modification), whereas the rest is centered to the cognitive restructuring process. Therefore, MMBCBT is endowed with Behavioral Therapy (BT) and Cognitive Therapy(CT). In order to find out the validation of MMBCBT as a newly formed approach, it was then followed by mixed research (quantitative and qualitative research) with a sample selected from the elderly population following the purposive sampling technique. 40 individuals were selected from three elderly homes as per the purposive sampling technique. Elderly people identified to be depressed via Geriatric Depression Scale underwent MMBCBT for two weeks continuously while action research was being conducted simultaneously. Additionally, a Focus Group interview was carried out to support the action research. As per the research findings, people who identified depressed prior to the exposure to MMBCBT were found to be showing positive changes after they were exposed to the model. “Paired Sample t test” showed that the Multicultural Model of Buddhist based Cognitive Behavioral Therapy reduced depression of elderly people (The mean value (x̄) of the sample (level of depression) before the model was 10.7 whereas the mean value after the model was 7.5.). Most importantly, MMBCBT has been found to be effectively used with people from all walks of life despite religious diversities.

Keywords: buddhist psychotherapy, cognitive behavioral therapy in buddhism, counseling in cultural context, gerontology, and buddhism

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3430 A Model Approach of Good Practice Based on the Project Management Body of Knowledge® Guide in the Project Owner

Authors: Claudia Marcela Munoz Gonzalez, Diego Fernando Hernandez Losada, Hugo Alberto Herrera Fonseca

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The project owner's role in the public-private investment consists of controlling and verifying the correct execution of the project's objectives and resources. Likewise, it is a discipline little explored in the academic field, whereby this work wishes to contribute with a model of good practices based on the project management methodology proposed by the Project Management Body of Knowledge® Guide. In the same way, highlight what are the controls that an integral project owner should take into account in its exercise and application, through the stages in which its contract runs. This proposal aims to structure its practice and integrate its functions according to a project management methodology. In addition, these practices will be applied in a case study of projects in the agricultural sector, particularly in the construction of irrigation district in Cundinamarca, Colombia.

Keywords: controls, construction of irrigation district, PMBOK®, project owner

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3429 Use of Nutritional Screening Tools in Cancer-Associated Malnutrition

Authors: Meryem Saban Guler, Saniye Bilici

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Malnutrition is a problem that significantly affects patients with cancer throughout the course of their illness, and it may be present from the moment of diagnosis until the end of treatment. We searched electronic databases using key terms such as ‘malnutrition in cancer patients’ or ‘nutritional status in cancer’ or ‘nutritional screening tools’ etc. Decline in nutritional status and continuing weight loss are associated with an increase in number and severity of complications, impaired quality of life and decreased survival rate. Nutrition is an important factor in the treatment and progression of cancer. Cancer patients are particularly susceptible to nutritional depletion due to the combined effects of the malignant disease and its treatment. With increasing incidence of cancer, identification and management of nutritional deficiencies are needed. Early identification of malnutrition, is substantial to minimize or prevent undesirable outcomes throughout clinical course. In determining the nutritional status; food consumption status, anthropometric methods, laboratory tests, clinical symptoms, psychosocial data are used. First-line strategies must include routine screening and identification of inpatients or outpatients at nutritional risk with the use of a simple and standardized screening tool. There is agreement among international nutrition organizations and accredited health care organizations that routine nutritional screening should be a standard procedure for every patient admitted to a hospital. There are f management of all cancer patients therefore routine nutritional screening with validated tools can identify cancer patients at risk.

Keywords: cancer, malnutrition, nutrition, nutritional screening

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3428 Comparison the Effectiveness of Pain Cognitive- Behavioral Therapy and Its Computerized Version on Reduction of Pain Intensity, Depression, Anger and Anxiety in Children with Cancer: A Randomized Controlled Trial

Authors: Najmeh Hamid, Vajiheh Hamedy , Zahra Rostamianasl

Abstract:

Background: Cancer is one of the medical problems that have been associated with pain. Moreover, the pain is combined with negative emotions such as anxiety, depression and anger. Poor pain management causes negative effects on the quality of life, which results in negative effects that continue a long time after the painful experiences. Objectives: The aim of this research was to compare the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, depression, anger and anxiety in children with cancer. Methods: The research method of this “Randomized Controlled Clinical Trial” was a pre, post-test and follow-up with a control group. In this research, we have examined the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, anxiety, depression and anger in children with cancer in Ahvaz. Two psychological interventions (cognitive behavioral therapy for pain and the computerized version) were compared with the control group. The sample consisted of 60 children aged 8 to 12 years old with different types of cancer at Shafa hospital in Ahwaz. According to the including and excluding criteria such as age, socioeconomic status, clinical diagnostic interview and other criteria, 60 subjects were selected. Then, randomly, 45 subjects were selected. The subjects were randomly divided into three groups of 15 (two experimental and one control group). The research instruments included Spielberger Anxiety Inventory (STAY-2) and International Pain Measurement Scale. The first experimental group received 6 sessions of cognitive-behavioral therapy for 6 weeks, and the second group was subjected to a computerized version of cognitive-behavioral therapy for 6 weeks, but the control group did not receive any interventions. For ethical considerations, a version of computerized cognitive-behavioral therapy was provided to them. After 6 weeks, all three groups were evaluated as post-test and eventually after a one-month follow-up. Results: The findings of this study indicated that both interventions could reduce the negative emotions (pain, anger, anxiety, depression) associated with cancer in children in comparison with a control group (p<0.0001). In addition, there were no significant differences between the two interventions (p<0.01). It means both interventions are useful for reducing the negative effects of pain and enhancing adjustment. Conclusion: we can use CBT in situations in which there is no access to psychologists and psychological services. In addition, it can be a useful alternative to conventional psychological interventions.

Keywords: pain, children, psychological intervention, cancer, anger, anxiety, depression

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3427 Finite Element Analysis of High Performance Synchronous Reluctance Machines

Authors: T. Mohanarajah, J. Rizk, M. Nagrial, A. Hellany

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This paper analyses numerous features of the synchronous Reluctance Motor (Syn-RM) and propose a rotor for high electrical torque, power factor & efficiency using Finite Element Method (FEM). A comprehensive analysis completed on solid rotor structure while the total thickness of the flux guide kept constant. A number of tests carried out for nine different studies to find out optimum location of the flux guide, the optimum location of multiple flux guides & optimum wall thickness between flux guides for high-performance reluctance machines. The results are concluded with the aid of FEM simulation results, the saliency ratio and machine characteristics (location, a number of barriers & wall width) analysed.

Keywords: electrical machines, finite element method, synchronous reluctance machines, variable reluctance machines

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3426 Training Hearing Parents in SmiLE Therapy Supports the Maintenance and Generalisation of Deaf Children's Social Communication Skills

Authors: Martina Curtin, Rosalind Herman

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Background: Deaf children can experience difficulties with understanding how social interaction works, particularly when communicating with unfamiliar hearing people. Deaf children often struggle with integrating into a mainstream, hearing environments. These negative experiences can lead to social isolation, depression and other mental health difficulties later in life. smiLE Therapy (Schamroth, 2015) is a video-based social communication intervention that aims to teach deaf children skills to confidently communicate with unfamiliar hearing people. Although two previous studies have reported improvements in communication skills immediately post intervention, evidence for maintenance of gains or generalisation of skills (i.e., the transfer of newly learnt skills to untrained situations) has not to date been demonstrated. Parental involvement has been shown to support deaf children’s therapy outcomes. Therefore, this study added parent training to the therapy children received to investigate the benefits to generalisation of children’s skills. Parents were also invited to present their perspective on the training they received. Aims: (1) To assess pupils’ progress from pre- to post-intervention in trained and untrained tasks, (2) to investigate if training parents improved their (a) understanding of their child’s needs and (b) their skills in supporting their child appropriately in smiLE Therapy tasks, (3) to assess if parent training had an impact on the pupil’s ability to (a) maintain their skills in trained tasks post-therapy, and (b) generalise their skills in untrained, community tasks. Methods: This was a mixed-methods, repeated measures study. 31 deaf pupils (aged between 7 and 14) received an hour of smiLE Therapy per week, for 6 weeks. Communication skills were assessed pre-, post- and 3-months post-intervention using the Communication Skills Checklist. Parents were then invited to attend two training sessions and asked to bring a video of their child communicating in a shop or café. These videos were used to assess whether, after parent training, the child was able to generalise their skills to a new situation. Finally, parents attended a focus group to discuss the effectiveness of the therapy, particularly the wider impact, i.e., more child participation within the hearing community. Results: All children significantly improved their scores following smiLE therapy and maintained these skills to high level. Children generalised a high percentage of their newly learnt skills to an untrained situation. Parents reported improved understanding of their child’s needs, their child’s potential and in how to support them in real-life situations. Parents observed that their children were more confident and independent when carrying out communication tasks with unfamiliar hearing people. Parents realised they needed to ‘let go’ and embrace their child’s independence and provide more opportunities for them to participate in their community. Conclusions: This study adds to the evidence base on smiLE Therapy; it is an effective intervention that develops deaf children’s ability to interact competently with unfamiliar, hearing, communication partners. It also provides preliminary evidence of the benefits of parent training in helping children to generalise their skills to other situations. These findings will be of value to therapists wishing to develop deaf children’s communication skills beyond the therapy setting.

Keywords: deaf children, generalisation, parent involvement, social communication

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