Search results for: sleep disturbances
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 590

Search results for: sleep disturbances

200 Trauma Informed Healthy Lifestyle Program for Young Adults

Authors: Alicia Carranza, Hildemar Dos Santos, W. Lawrence Beeson, R. Patti Herring, Kimberly R. Freeman, Adam Arechiga

Abstract:

Early exposure to trauma can impact health-related behaviors later in life, which poses a considerable challenge for young adults transitioning into independence when they are lacking the necessary skills and support to live a healthy life. The study will be a non-experimental, mixed methods pre- and post-test (where subjects will serve as their own controls) to determine the impact of an eight-week trauma-informed healthy lifestyle program on self-efficacy for adopting health-promoting behaviors and health outcomes among young adults. Forty-two adults, ages 18-24 who are living in Orange County, CA will be recruited to participate in the eight-week trauma-informed healthy living program. Baseline and post-intervention assessments will be conducted to assess changes in self-efficacy for nutrition and physical exercise, sleep quality and quantity, body mass index (kg/m2), and coping skills used by comparing pre- to post-intervention. Some of the planned activities include cooking demonstrations, mindful eating activities and media literacy using Instagram. Frequencies analyses, paired t-test, and multiple regression will be used to determine if there was a change in coping skills. The results of this study can serve to assess the potential for mitigating the effects of Adverse Childhood Experiences (ACEs), or other toxic stress, experienced during adolescence across the lifespan. Young adults who learn how to cope with stress in a healthy way and engage in a healthy lifestyle can be better prepared to role model that behavior to their children.

Keywords: nutrition, healthy lifestyle, trauma-informed, stress management

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199 Dual Set Point Governor Control Structure with Common Optimum Temporary Droop Settings for both Islanded and Grid Connected Modes

Authors: Deepen Sharma, Eugene F. Hill

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For nearly 100 years, hydro-turbine governors have operated with only a frequency set point. This natural governor action means that the governor responds with changing megawatt output to disturbances in system frequency. More and more, power system managers are demanding that governors operate with constant megawatt output. One way of doing this is to introduce a second set point in the control structure called a power set point. The control structure investigated and analyzed in this paper is unique in the way that it utilizes a power reference set point in addition to the conventional frequency reference set point. An optimum set of temporary droop parameters derived based on the turbine-generator inertia constant and the penstock water start time for stable islanded operation are shown to be also equally applicable for a satisfactory rate of generator loading during its grid connected mode. A theoretical development shows why this is the case. The performance of the control structure has been investigated and established based on the simulation study made in MATLAB/Simulink as well as through testing the real time controller performance on a 15 MW Kaplan Turbine and generator. Recordings have been made using the labVIEW data acquisition platform. The hydro-turbine governor control structure and its performance investigated in this paper thus eliminates the need to have a separate set of temporary droop parameters, one valid for islanded mode and the other for interconnected operations mode.

Keywords: frequency set point, hydro governor, interconnected operation, isolated operation, power set point

Procedia PDF Downloads 350
198 Experimental Monitoring of the Parameters of the Ionosphere in the Local Area Using the Results of Multifrequency GNSS-Measurements

Authors: Andrey Kupriyanov

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In recent years, much attention has been paid to the problems of ionospheric disturbances and their influence on the signals of global navigation satellite systems (GNSS) around the world. This is due to the increase in solar activity, the expansion of the scope of GNSS, the emergence of new satellite systems, the introduction of new frequencies and many others. The influence of the Earth's ionosphere on the propagation of radio signals is an important factor in many applied fields of science and technology. The paper considers the application of the method of transionospheric sounding using measurements from signals from Global Navigation Satellite Systems to determine the TEC distribution and scintillations of the ionospheric layers. To calculate these parameters, the International Reference Ionosphere (IRI) model of the ionosphere, refined in the local area, is used. The organization of operational monitoring of ionospheric parameters is analyzed using several NovAtel GPStation6 base stations. It allows performing primary processing of GNSS measurement data, calculating TEC and fixing scintillation moments, modeling the ionosphere using the obtained data, storing data and performing ionospheric correction in measurements. As a result of the study, it was proved that the use of the transionospheric sounding method for reconstructing the altitude distribution of electron concentration in different altitude range and would provide operational information about the ionosphere, which is necessary for solving a number of practical problems in the field of many applications. Also, the use of multi-frequency multisystem GNSS equipment and special software will allow achieving the specified accuracy and volume of measurements.

Keywords: global navigation satellite systems (GNSS), GPstation6, international reference ionosphere (IRI), ionosphere, scintillations, total electron content (TEC)

Procedia PDF Downloads 160
197 The Effect of Shredded Polyurethane Foams on Shear Modulus and Damping Ratio of Sand

Authors: Javad Saeidaskari, Nader Khalafian

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The undesirable impact of vibrations induced by road and railway traffic is an important concern in modern world. These vibrations are transmitted through soil and cause disturbances to the residence area and high-tech production facilities alongside the train/traffic lines. In this paper for the first time a new method of soil improvement with vibration absorber material, is used to increase the damping factor, in other word, to reduce the ability of wave transitions in sand. In this study standard Firoozkooh No. 161 sand is used as the host sand. The semi rigid polyurethane (PU) foam which used in this research is one of the common materials for vibration absorbing purposes. Series of cyclic triaxial tests were conducted on remolded samples with identical relative density of 70% of maximum dry density for different volume percentage of shredded PU foam. The frequency of tests was 0.1 Htz with shear strain of 0.37% and 0.75% and also the effective confining pressures during the tests were 100 kPa and 350 kPa. In order to find out the best soil-PU foam mixture, different volume percent of PU foam varying from 10% to 30% were examined. The results show that adding PU foam up to 20%, as its optimum content, causes notable enhancement in damping ratio for both shear strains of 0.37% (52.19% and 69% increase for effective confining pressures of 100 kPa and 350 kPa, respectively) and 0.75% (59.56% and 59.11% increase for effective confining pressures of 100 kPa and 350 kPa, respectively). The results related to shear modulus present significant reduction for both shear strains of 0.37% (82.22% and 56.03% decrease for effective confining pressures of 100 kPa and 350 kPa, respectively) and 0.75% (89.32% and 39.9% decrease for effective confining pressures of 100 kPa and 350 kPa, respectively). In conclusion, shredded PU foams effectively affect the dynamic properties of sand and act as vibration absorber in soil.

Keywords: polyurethane foam, sand, damping ratio, shear modulus

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196 An Adaptive Controller Method Based on Full-State Linear Model of Variable Cycle Engine

Authors: Jia Li, Huacong Li, Xiaobao Han

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Due to the more variable geometry parameters of VCE (variable cycle aircraft engine), presents an adaptive controller method based on the full-state linear model of VCE and has simulated to solve the multivariate controller design problem of the whole flight envelops. First, analyzes the static and dynamic performances of bypass ratio and other state parameters caused by variable geometric components, and develops nonlinear component model of VCE. Then based on the component model, through small deviation linearization of main fuel (Wf), the area of tail nozzle throat (A8) and the angle of rear bypass ejector (A163), setting up multiple linear model which variable geometric parameters can be inputs. Second, designs the adaptive controllers for VCE linear models of different nominal points. Among them, considering of modeling uncertainties and external disturbances, derives the adaptive law by lyapunov function. The simulation results showed that, the adaptive controller method based on full-state linear model used the angle of rear bypass ejector as input and effectively solved the multivariate control problems of VCE. The performance of all nominal points could track the desired closed-loop reference instructions. The adjust time was less than 1.2s, and the system overshoot was less than 1%, at the same time, the errors of steady states were less than 0.5% and the dynamic tracking errors were less than 1%. In addition, the designed controller could effectively suppress interference and reached the desired commands with different external random noise signals.

Keywords: variable cycle engine (VCE), full-state linear model, adaptive control, by-pass ratio

Procedia PDF Downloads 294
195 Aggregation of Electric Vehicles for Emergency Frequency Regulation of Two-Area Interconnected Grid

Authors: S. Agheb, G. Ledwich, G.Walker, Z.Tong

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Frequency control has become more of concern for reliable operation of interconnected power systems due to the integration of low inertia renewable energy sources to the grid and their volatility. Also, in case of a sudden fault, the system has less time to recover before widespread blackouts. Electric Vehicles (EV)s have the potential to cooperate in the Emergency Frequency Regulation (EFR) by a nonlinear control of the power system in case of large disturbances. The time is not adequate to communicate with each individual EV on emergency cases, and thus, an aggregate model is necessary for a quick response to prevent from much frequency deviation and the occurrence of any blackout. In this work, an aggregate of EVs is modelled as a big virtual battery in each area considering various aspects of uncertainty such as the number of connected EVs and their initial State of Charge (SOC) as stochastic variables. A control law was proposed and applied to the aggregate model using Lyapunov energy function to maximize the rate of reduction of total kinetic energy in a two-area network after the occurrence of a fault. The control methods are primarily based on the charging/ discharging control of available EVs as shunt capacity in the distribution system. Three different cases were studied considering the locational aspect of the model with the virtual EV either in the center of the two areas or in the corners. The simulation results showed that EVs could help the generator lose its kinetic energy in a short time after a contingency. Earlier estimation of possible contributions of EVs can help the supervisory control level to transmit a prompt control signal to the subsystems such as the aggregator agents and the grid. Thus, the percentage of EVs contribution for EFR will be characterized in the future as the goal of this study.

Keywords: emergency frequency regulation, electric vehicle, EV, aggregation, Lyapunov energy function

Procedia PDF Downloads 76
194 Cerebral Venous Thrombosis at High Altitude: A Rare Presentation by Sub-Arachnoid Hemorrhage

Authors: Eman G. Alayad, Mazen G. Aleyad, Mohammed Alshahrani, Ibrahim Alnaami

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Introduction: Cerebral venous thrombosis (CVT) is a rare type of cerebrovascular disease that can occur at any age. Patients with CVT commonly present with headache, focal neurological deficit, decreased level of consciousness and seizures. Many etiologic risk factors have been reported for CVT, high altitude and oral contraceptive pill some of them. Case Presentation: A 37-year-old woman living in Abha city in the southeastern area of Saudi Arabia. (about 10,000 feet-3000 m) over the sea. complaining acute onset of severe diffuse headache and generalized tonic clonic convulsions. Followed by loss of consciousness. She was on contraceptive pills for the last 3 years. No significant Medical or surgical history. Brain CT revealed subarachnoid hemorrhage, with MRI findings showing thrombosis in transvers sinus. There was no vascular malformations such as aneurysm, arteriovenous malformation (AVM), or dural arteriovenous fistula. A CVT with subarachnoid hemorrhage was our final diagnosis based on clinical presentation and radiographic findings. Discussion: Patients with CVT had evidence of cortical SAH by 10 of 233, others found 3% of SAH was caused by CVT, indicating that the presence of cortical SAH without involvement of the basal cisterns may provide an early sign of underlying CVT. However, what is more interesting in this case, is the relationship of high altitude with CVT and SAH, which previously undescribed. Conclusion: High-altitude climbing per se was described as a risk factor for the development of CVT, though its occurrence was probably rare. Whether it is primary in etiology due to high altitude induced hypercoagulable state of unknown origin or due to cerebrovascular disturbances there is a need for further investigation especially at this unusual presentation of subarachnoid hemorrhage.

Keywords: cerebral venous thrombosis, high-altitude, subarachnoid hemorrhage, stroke

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193 Determining the Effect of Tdcs in Pain and Quality of Life in Patients with Fibromyalgia

Authors: Farid Rezaei, Zahra Reza Soltani, Behrouz Tavana, Afsaneh Dadarkhah, Masoume Bahrami Asl, S. Alireza Mirghasemi

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Introduction: Fibromyalgia is a syndrome comprised of a group of symptoms. The primary symptom of fibromyalgia is pain propagation is associated by Secondary symptoms include fatigue, cognitive disorders, sleep disorders and hypersensitivity to painful stimuli. Recent studies have shown that there is a direct relationship between fibromyalgia and certain changes in brain activity. Aim: The aim of this study is determining the effect of tDCS in pain and quality of life in patients with fibromyalgia. Method: 68 patients with fibromyalgia who had inclusion criterias were randomly divided into two groups of case and control. Groups were matched in terms of gender, age, education, duration of pain and PMS. Patient groups treated with tDCS device manufacture by Enraf company made in Netherlands (M1 anodal stimulation, 2 mA constant current, 20 minutes, for 10 sessions (3 days a week)). Also the protocol was done for control group, in sham mode of tDCS device that had no current, for 10 sessions of 20 minutes. Before treatment, immediately after the end of 10 sessions treatment (short-term) and 10 week later (long-term effect), pain intensity questionnaires (VAS) and quality of life in fibromyalgia patients questionnaire was completed by the patient. Results: Pain intensity were significantly lower in the treatment group than the sham group 2 weeks and 10 weeks after treatment than before treatment (P < 0.001). Although the quality of life of patients 2 weeks after treatment showed no significant change, but ten weeks after treatment were more than sham group (P < 0.0001). Conclusion: Our results suggest that tDCS is a safe and effective in treating fibromyalgia patients and an important effect in reducing pain and increasing quality of their life.

Keywords: fibromyalgia, tDCS, quality of life, VAS score

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192 Emotional, Behavioral and Social Problems in Children with Fecal Incontinence by Child Behavior Checklist (CBCL): A Cross-sectional Study

Authors: Roshanak Farjad, Amirhossein Hosseini

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Fecal incontinence (FI) is a stressful condition for children and their parents that may affect the patient’s psychological well-being. Evaluating the patients’ psychological status may help physicians manage the disease effectively. This study aimed to assess the emotional and behavioral disturbances in children with FI who were referred to the pediatric gastroenterology clinic in Mofid Children’s Hospital from April 2021 to 2022. This cross-sectional study included children (over four years old) with chronic constipation and fecal incontinence. The diagnosis of chronic constipation and FI were made according to Rome-IV criteria. The Child Behavior Checklist (CBCL) evaluated patients’ emotional, behavioral, and social problems. One hundred one patients with a mean age of 7.96 years were enrolled in the study; 67.32% were males. According to CBCL, 12% (12 patients) indicated emotional and behavioral problems, with CBCL scores in the clinical or at-risk range. We detected anxious/depressed problems in five (4.95%), withdrawn/depressed problems in eight (7.92%), somatic complaints in seven (6.93%), social problems in eight (7.92%), thought problems in nine (8.91%), attention problems in seven (6.93%), rule-breaking behavior in two (1.98%), and aggressive behavior in nine (8.91%) patients. The risk of internalizing and externalizing disorders was reported in four (3.96%) and five (4.95%) patients. Also, eight (7.92%) and seven (6.93%) patients had clinical symptoms of internalizing and externalizing disorders, respectively. There was no significant relationship between patients’ age and gender with the CBCL scores in any subscales. However, there was a significant difference in the total score among the age groups (P = 0.04). The relatively high prevalence of emotional, behavioral, and social problems in our study corroborates the importance of psychological screening of children with FI during the treatment process.

Keywords: chronic constipation, child behavior checklist (CBCL), fecal incontinence, rome-IV criteria

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191 Effect of Concurrent Training and Detraining on Insulin Resistance in Obese Children

Authors: Kaveh Azadeh, Saeid Fazelifar

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The main purpose of the present study was to examine the effect of 12 weeks (3 days/week) concurrent training followed by 4 weeks detraining on insulin resistance in obese boys without dietary intervention. Methods: 24 obese children boys (body mass index> 28, age= 11- 13year old) voluntarily participated in the study. Biochemical factors, body composition, and functional physical fitness were assessed in three stages [baseline, after 12 week’s combined endurance and resistance training and 4 week’s detraining in the experimental group (n=12); baseline and after 12 weeks in control group (n=12)]. Results: Indepented - Sample T test revealed that in experimental group after 12weeks trainings the insulin resistance, and body fat mass were significantly declined, whereas endurance and strength of abdominal muscles significantly increased compared to control group (p<0/05). One-way ANOVA for three different periods showed that insulin resistance, body fat mass, strength of abdominal muscles after 12week training was significantly improved in the experimental group compared with the baseline. Following 4weeks detraining insulin resistance again significantly increased (p<0/05). After detraining disturbances of physiological adaptation in obese children have more rapid course in comparison with those anthropological and functional indices. Conclusion: Results showed that participation in the regular concurrent trainings provides a decrease of insulin resistance in obese children. It may serve as a strategy in treatment of obesity and management on insulin resistance, as well as to increase endurance and strength muscles in obese children. Adaptations resulting from regular exercises following detraining are reversible.

Keywords: endurance and resistance trainings, detraining, insulin resistance, obese children

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190 Planning and Design Criteria to Make Urban Transport More Sustainable: The Case of Baku

Authors: Gülnar Bayramoğlu Barman

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Since the industrial revolution, technological developments and increased population have caused environmental damages. To protect the nature and architectural environment, firstly, green architecture, ecological architecture and then sustainability occurred. This term has been proposed not to be a new term but a response to environmental disturbances caused by human activities and it is re-conceptualization of architecture. Sustainable architecture or sustainability is lot more extensive than ecological and green architecture. It contains the imbalance between environmental problems that is natural environment and consumption that occurred all around the world. An important part of sustainability debate focused on urban planning and design for more sustainable forms and patterns. In particular, it is discussed that planning and design of urban areas have a major effect on transport and therefore can help reduce car usage, emissions, global warming and climate change. There are many planning and design approaches and movement that introduce certain criteria and strategies to prevent car dependency and encourage people to use public transportation and walking. However, when review the literature, it is seen that planning movements, such as New Urbanism and Transit Oriented Development originated and were implemented mostly in West European and North American Cities. The purpose of this study is to find out whether all those criteria, principles and strategies are also relevant planning approaches for more non-western cities like Baku, which has a very different planning background and therefore possibly different urban form and transport issues. In order to answer the above mentioned question, planning and design approaches in the literature and these recent planning movements were studied and a check list was formed which indicate planning and design approaches that can help attain a more sustainable transport outcome. The checklist was then applied to the case of Baku.

Keywords: sustainability, sustainable development, sustainable transportation, transport, urban design

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189 Percentage Contribution of Lower Limb Moments to Vertical Ground Reaction Force in Normal Walking

Authors: Salam M. Elhafez, Ahmed A. Ashour, Naglaa M. Elhafez, Ghada M. Elhafez, Azza M. Abdelmohsen

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Patients suffering from gait disturbances are referred by having muscle group dysfunctions. There is a need for more studies investigating the contribution of muscle moments of the lower limb to the vertical ground reaction force using 3D gait analysis system. The purpose of this study was to investigate how the hip, knee and ankle moments in the sagittal plane contribute to the vertical ground reaction force in healthy subjects during normal speed of walking. Forty healthy male individuals volunteered to participate in this study. They were filmed using six high speed (120 Hz) Pro-Reflex Infrared cameras (Qualisys) while walking on an AMTI force platform. The data collected were the percentage contribution of the moments of the hip, knee and ankle joints in the sagittal plane at the instant of occurrence of the first peak, second peak, and the trough of the vertical ground reaction force. The results revealed that at the first peak of the ground reaction force (loading response), the highest contribution was generated from the knee extension moment, followed by the hip extension moment. Knee flexion and ankle plantar flexion moments produced high contribution to the trough of the ground reaction force (midstance) with approximately equal values. The second peak of the ground reaction force was mainly produced by the ankle plantar flexion moment. Conclusion: Hip and knee flexion and extension moments and ankle plantar flexion moment play important roles in the supporting phase of normal walking.

Keywords: gait analysis, ground reaction force, moment contribution, normal walking

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188 Application of the Best Technique for Estimating the Rest-Activity Rhythm Period in Shift Workers

Authors: Rakesh Kumar Soni

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Under free living conditions, human biological clocks show a periodicity of 24 hour for numerous physiological, behavioral and biochemical variables. However, this period is not the original period; rather it merely exhibits synchronization with the solar clock. It is, therefore, most important to investigate characteristics of human circadian clock, essentially in shift workers, who normally confront with contrasting social clocks. Aim of the present study was to investigate rest-activity rhythm and to vouch for the best technique for the computation of periods in this rhythm in subjects randomly selected from different groups of shift workers. The rest-activity rhythm was studied in forty-eight shift workers from three different organizations, namely Newspaper Printing Press (NPP), Chhattisgarh State Electricity Board (CSEB) and Raipur Alloys (RA). Shift workers of NPP (N = 20) were working on a permanent night shift schedule (NS; 20:00-04:00). However, in CSEB (N = 14) and RA (N = 14), shift workers were working in a 3-shift system comprising of rotations from night (NS; 22:00-06:00) to afternoon (AS; 14:00-22:00) and to morning shift (MS; 06:00-14:00). Each subject wore an Actiwatch (AW64, Mini Mitter Co. Inc., USA) for 7 and/or 21 consecutive days, only after furnishing a certificate of consent. One-minute epoch length was chosen for the collection of wrist activity data. Period was determined by using Actiware sleep software (Periodogram), Lomb-Scargle Periodogram (LSP) and Spectral analysis software (Spectre). Other statistical techniques, such as ANOVA and Duncan’s multiple-range test were also used whenever required. A statistically significant circadian rhythm in rest-activity, gauged by cosinor, was documented in all shift workers, irrespective of shift work. Results indicate that the efficiency of the technique to determine the period (τ) depended upon the clipping limits of the τs. It appears that the technique of spectre is more reliable.

Keywords: biological clock, rest activity rhythm, spectre, periodogram

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187 In Vitro Evaluation of the Antimitotic and Genotoxic Effect by the Allium cepa L. Test of the Aqueous Extract of Peganum harmala L. Leaves (Laghouat, Algeria)

Authors: Ouzid Yasmina, Aiche-Iratni Ghenima, Harchaoui Lina, Saadoun Noria, Houali Karim

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Medicinal plants are an important source of bioactive molecules with biological activities such as anticancer, antioxidant, anti-inflammatory, antibacterial, antimitotic.... These molecules include alkaloids, polyphenols and terpenes. The latter can be extracted by different solvents, namely: water, ethanol, methanol, butanol, acetone... This is why it seemed interesting to us to evaluate in vitro the antimitotic and genotoxic effect of these secondary metabolites contained in the aqueous extract of the leaves of Peganum harmala L. by the Allium cepa L. test on meristematic cells by calculating the mitotic parameters (The mitotic index, the aberration index and the limit value of cytotoxicity).A spectrophotometric determination of secondary metabolites, namely alkaloids and flavonoids in the aqueous extract of this essence, was performed. As a result, the alkaloid content is estimated to be 28.42 μg EC/mg extract, and the flavonoid content is 12.52 μg EQ/mg extract. The determination of the mitotic index revealed disturbances in cell division with a highly significant difference between the negative control (distilled water) and the different samples (aqueous extracts, colchicine and quecetin). The exposure of meristematic cells to our samples resulted in a large number of chromosomal, nuclear and cellular aberrations with an aberration index reaching 16.21±1.28% for the 4mg/ml aqueous extract and 11.71±3.32% for the 10mg/ml aqueous extract. The limit value of cytotoxicity revealed that our samples are sublethal on Allium cepa L. meristematic cells.

Keywords: allium cepa l., antimitotic and genotoxic effect, aqueous leaf extract, laghouat (algeria), peganum harmala l., secondary metabolites

Procedia PDF Downloads 63
186 Relationship between Pain, Social Support and Socio-Economic Indicators in Individuals with Spinal Cord Injury

Authors: Zahra Khazaeipour, Ehsan Ahmadipour, Vafa Rahimi-Movaghar, Fereshteh Ahmadipour

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Research Objectives: Chronic pain is one of the common problems associated with spinal cord injuries (SCI), which causes many complications. Therefore, this study intended to evaluate the relationship between pain and demographic, injury characteristics, socio-economic and social support in individuals with spinal cord Injury in Iran. Design: Descriptive cross-sectional study. Setting: Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran, between 2012 and 2013. Participants: The participants were 140 individuals with SCI, 101 (72%) men and 39 (28%) women, with mean age of 29.4 ±7.9 years. Main Outcome Measure: The Persian version of the Brief Pain Inventory (BPI) was used to measure the pain, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Results: About 50.7% complained about having pain, which 79.3% had bilateral pain. The most common locations of pain were lower limbs and back. The most quality of pain was described as aching (41.4%), and tingling (32.9%). Patients with a medium level of education had the least pain compared to high and low level of education. SCI individuals with good economic situation reported higher frequency of having pain. There was no significant relationship between pain and social support. There was positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P < 0.001). Conclusion: These findings revealed the importance of socioeconomic factors such as economic situation and educational level in understanding chronic pain in people with SCI and provide further support for the bio-psychosocial model. Hence, multidisciplinary evaluations and treatment strategies are advocated, including biomedical, psychological, and psycho-social interventions.

Keywords: pain, social support, socio-economic indicators, spinal cord injury

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185 A Study on Soil Micro-Arthropods Assemblage in Selected Plantations in The Nilgiris, Tamilnadu

Authors: J. Dharmaraj, C. Gunasekaran

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Invertebrates are the reliable ecological indicators of disturbance of the forest ecosystems and they respond to environment changes more quickly than other fauna. Among these the terrestrial invertebrates are vital to functioning ecosystems, contributing to processes such as decomposition, nutrient cycling and soil fertility. The natural ecosystems of the forests have been subject to various types of disturbances, which lead to decline of flora and fauna. The comparative diversity of micro-arthropods in natural forest, wattle plantation and eucalyptus plantations were studied in Nilgiris. The study area was divided in to five major sites (Emerald (Site-I), Thalaikundha (Site-II), Kodapmund (Site-III), Aravankad (Site-IV), Kattabettu (Site-V). The research was conducted during period from March 2014 to August 2014. The leaf and soil samples were collected and isolated by using Berlese funnel extraction methods. Specimens were isolated and identified according to their morphology (Balogh 1972). In the present study results clearly showed the variation in soil pH, NPK (Major Nutrients) and organic carbon among the study sites. The chemical components of the leaf litters of the plantation decreased the diversity of micro-arthropods and decomposition rate leads to low amount of carbon and other nutrients present in the soil. Moreover eucalyptus and wattle plantations decreases the availability of the ground water source to other plantations and micro-arthropods and hences affects the soil fertility. Hence, the present study suggests to minimize the growth of wattle and eucalyptus tree plantations in the natural areas which may help to reduce the decline of forests.

Keywords: micro-arthropods, assemblage, berlese funnel, morphology, NPK, nilgiris

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184 The Effects of Functionality Level on Gait in Subjects with Low Back Pain

Authors: Vedat Kurt, Tansel Koyunoglu, Gamze Kurt, Ozgen Aras

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Low back pain is one of the most common health problem in public. Common symptoms that can be associated with low back pain include; pain, functional disability, gait disturbances. The aim of the study was to investigate the differences between disability scores and gait parameters in subjects with low back pain. Sixty participants are included in our study, (35 men, 25 women, mean age: 37.65±10.02 years). Demographic characteristics of participants were recorded. Pain (visual analog scale) and disability level (Oswestry Disability Index(ODI)) were evaluated. Gait parameters were measured with Zebris-FDM-2 platform. Independent samples t-test was used to analyse the differences between subjects with under 40 points (n=31, mean age:35.8±11.3) and above 40 points (n=29, mean age:39.6±8.1) of ODI scores. Significant level in statistical analysis was accepted as 0.05. There was no significant difference between the ODI scores and groups’ ages. Statistically significant differences were found in step width between subjects with under 40 points of ODI and above 40 points of ODI score(p < 0.05). But there were non-significant differences with other gait parameters (p > 0.05). The differences between gait parameters and pain scores were not statistically significant (p > 0.05). Researchers generally agree that individuals with LBP walk slower and take shorter steps and have asymmetric step lengths when compared with than their age-matched pain-free counterparts. Also perceived general disability may have moderate correlation with walking performance. In the current study, the patients classified as minimal/moderate and severe disability level by using ODI scores. As a result, a patient with LBP who have higher disability level tends to increase support surface. On the other hand, we did not find any relation between pain intensity and gait parameters. It may be caused by the classification system of pain scores. Additional research is needed to investigate the effects of functionality level and pain intensity on gait in subjects with low back pain under different classification types.

Keywords: functionality, low back pain, gait, pain

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183 Mental Health in Young People Living Poverty in Southeastern Mexico

Authors: Teresita Castillo, Concepción Campo, Carlos Carrillo

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Attention, comprehension and solution of poverty can be worked considering a socioeconomic approach; but it also can be attended from a multidimensional perspective that allows considering other dimensions including psychological variables manifested in behaviors, thoughts and feelings concerning this phenomenon. Considering the importance of research regarding psychology and poverty, this paper presents results about psychosocial impacts of poverty on young people related to mental health issues and its relation to fatalism. These results are part of a bigger transcultural study done in collaboration with the Federal University of Ceará, in Brazil. Participants were 101 young men and women, between 12 and 29 years old, living in two emarginated suburbs in Mérida, Mexico, located in the southeastern zone of the country. Participants responded the Self Report Questionnaire (SRQ- 20), with 20 items dichotomous presence/absence that assess anxious and depressive issues and the Fatalism Scale, with 30 items Likert five-point spread over five factors. Results show that one third of participants mentioned to get easily frightened, feeling nervous, tense or worried as well as unhappy, difficulty on making decisions, and troubles in thinking clearly. About 20% mentioned to have headaches, to sleep badly, to cry more than usual and to feel tired all the time. Regarding Fatalism, results show there is a greater internal allocation and lower external attribution in young participants, but they have some symptoms regarding poor mental health. Discussion is in terms of possible explanations about the results and emphasizes the importance of holistic approaches for a better understanding of the psychosocial impacts of poverty on young people and strengthening the resilience to increase positive mental health in emarginated contexts, where Community Psychology could have an important duty in community health promotion.

Keywords: fatalism, mental health, poverty, youth

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182 Review of Strategies for Hybrid Energy Storage Management System in Electric Vehicle Application

Authors: Kayode A. Olaniyi, Adeola A. Ogunleye, Tola M. Osifeko

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Electric Vehicles (EV) appear to be gaining increasing patronage as a feasible alternative to Internal Combustion Engine Vehicles (ICEVs) for having low emission and high operation efficiency. The EV energy storage systems are required to handle high energy and power density capacity constrained by limited space, operating temperature, weight and cost. The choice of strategies for energy storage evaluation, monitoring and control remains a challenging task. This paper presents review of various energy storage technologies and recent researches in battery evaluation techniques used in EV applications. It also underscores strategies for the hybrid energy storage management and control schemes for the improvement of EV stability and reliability. The study reveals that despite the advances recorded in battery technologies there is still no cell which possess both the optimum power and energy densities among other requirements, for EV application. However combination of two or more energy storages as hybrid and allowing the advantageous attributes from each device to be utilized is a promising solution. The review also reveals that State-of-Charge (SoC) is the most crucial method for battery estimation. The conventional method of SoC measurement is however questioned in the literature and adaptive algorithms that include all model of disturbances are being proposed. The review further suggests that heuristic-based approach is commonly adopted in the development of strategies for hybrid energy storage system management. The alternative approach which is optimization-based is found to be more accurate but is memory and computational intensive and as such not recommended in most real-time applications.

Keywords: battery state estimation, hybrid electric vehicle, hybrid energy storage, state of charge, state of health

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181 Allied Health Students Health-Related Quality of Life and Its Musculoskeletal and Mental Stress Predictors

Authors: Khader A. Almhdawi, Saddam F. Kanaan

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Background: Allied health (AH) students, including rehabilitation sciences students, are subjected to significant levels of physical and mental stressors, which could affect their education. This study aimed to study physical and mental of Health-related Quality of Life (HR-QoL) levels along with their predictors among students of nine AH majors. Methods: Students filled validated anonymous surveys covering demographics and life style, Nordic Musculoskeletal Questionnaire, 12-item Short-Form Health Survey (SF-12), and Depression Anxiety Stress Scale (DASS- 42). SF-12 Mental (MCS) and Physical (PCS) summary scores were compared between academic majors and gender. Multiple linear regression models were conducted to examine potential predictors of PCS and MCS scores. Results: 838 students (77.4% females) participated in this study. Participants’ PCS mean score was 45.64±7.93 and found statistically different between the nine academic majors (P < 0.001). Additionally, participants’’ MCS mean score was 39.45±10.86 and significantly greater in males (P < 0.001). Significant PCS scores predictors included hip and upper back musculoskeletal pain, anxiety score, diet self-evaluation, and GPA. Finally, MCS scores were statistically associated with neck musculoskeletal pain, stress score, depression score, number of weekly clinical training hours, gender, university year, GPA, sleep quality self-evaluation, and diet self-evaluation. Conclusion: Clinical educators of AH need to account for students’ low levels of HR-QoL and their academic-related, health-related, and lifestyle-related associated factors. More studies are recommended to investigate the progression of HR-QoL throughout university years and to create effective interventions to improve HR-QoL among healthcare students.

Keywords: medical education, quality of life, stress, anxiety, depression

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180 Cognitive Dysfunctioning and the Fronto-Limbic Network in Bipolar Disorder Patients: A Fmri Meta-Analysis

Authors: Rahele Mesbah, Nic Van Der Wee, Manja Koenders, Erik Giltay, Albert Van Hemert, Max De Leeuw

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Introduction: Patients with bipolar disorder (BD), characterized by depressive and manic episodes, often suffer from cognitive dysfunction. An up-to-date meta-analysis of functional Magnetic Resonance Imaging (fMRI) studies examining cognitive function in BD is lacking. Objective: The aim of the current fMRI meta-analysis is to investigate brain functioning of bipolar patients compared with healthy subjects within three domains of emotion processing, reward processing, and working memory. Method: Differences in brain regions activation were tested within whole-brain analysis using the activation likelihood estimation (ALE) method. Separate analyses were performed for each cognitive domain. Results: A total of 50 fMRI studies were included: 20 studies used an emotion processing (316 BD and 369 HC) task, 9 studies a reward processing task (215 BD and 213 HC), and 21 studies used a working memory task (503 BD and 445 HC). During emotion processing, BD patients hyperactivated parts of the left amygdala and hippocampus as compared to HC’s, but showed hypoactivation in the inferior frontal gyrus (IFG). Regarding reward processing, BD patients showed hyperactivation in part of the orbitofrontal cortex (OFC). During working memory, BD patients showed increased activity in the prefrontal cortex (PFC) and anterior cingulate cortex (ACC). Conclusions: This meta-analysis revealed evidence for activity disturbances in several brain areas involved in the cognitive functioning of BD patients. Furthermore, most of the found regions are part of the so-called fronto-limbic network which is hypothesized to be affected as a result of BD candidate genes' expression.

Keywords: cognitive functioning, fMRI analysis, bipolar disorder, fronto-limbic network

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179 Place of Radiotherapy in the Treatment of Intracranial Meningiomas: Experience of the Cancer Center Emir Abdelkader of Oran Algeria

Authors: Taleb L., Benarbia M., Boutira F. M., Allam H., Boukerche A.

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Introduction and purpose of the study: Meningiomas are the most common non-glial intracranial tumors in adults, accounting for approximately 30% of all central nervous system tumors. The aim of our study is to determine the epidemiological, clinical, therapeutic, and evolutionary characteristics of a cohort of patients with intracranial meningioma treated with radiotherapy at the Emir Abdelkader Cancer Center in Oran. Material and methods: This is a retrospective study of 44 patients during the period from 2014 to 2020. The overall survival and relapse-free survival curves were calculated using the Kaplan-Meier method. Results and statistical analysis: The median age of the patients was 49 years [21-76 years] with a clear female predominance (sex ratio=2.4). The average diagnostic delay was seven months [2 to 24 months], the circumstances of the discovery of which were dominated by headaches in 54.5% of cases (n=24), visual disturbances in 40.9% (n=18), and motor disorders in 15.9% (n=7). The seat of the tumor was essentially at the level of the base of the skull in 52.3% of patients (n=23), including 29.5% (n=13) at the level of the cavernous sinus, 27.3% (n=12) at the parasagittal level and 20.5% (n=9) at the convexity. The diagnosis was confirmed surgically in 36 patients (81.8%) whose anatomopathological study returned in favor of grades I, II, and III in respectively 40.9%, 29.5%, and 11.4% of the cases. Radiotherapy was indicated postoperatively in 45.5% of patients (n=20), exclusive in 27.3% (n=12) and after tumor recurrence in 27.3% of cases (n=18). The irradiation doses delivered were as follows: 50 Gy (20.5%), 54 Gy (65.9%), and 60 Gy (13.6%). With a median follow-up of 69 months, the probabilities of relapse-free survival and overall survival at three years are 93.2% and 95.4%, respectively, whereas they are 71.2% and 80.7% at five years. Conclusion: Meningiomas are common primary brain tumors. Most often benign but can also progress aggressively. Their treatment is essentially surgical, but radiotherapy retains its place in specific situations, allowing good tumor control and overall survival.

Keywords: diagnosis, meningioma, surgery, radiotherapy, survival

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178 An Exploration of the Association Between the Physical Activity and Academic Performance in Internship Medical Students

Authors: Ali Ashraf, Ghazaleh Aghaee, Sedigheh Samimian, Mohaya Farzin

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Objectives: Previous studies have indicated the positive effect of physical activity and sports on different aspects of health, such as muscle endurance and sleep cycle. However, in university students, particularly medical students, who have limited time and a stressful lifestyle, there have been limited studies exploring this matter with proven statistical results. In this regard, this study aims to find out how regular physical activity can influence the academic performance of medical students during their internship period. Methods: This was a descriptive-analytical study. Overall, 160 medical students (including 80 women and 88 men) voluntarily participated in the study. The Baecke Physical Activity Questionnaire was applied to determine the student’s physical activity levels. The student's academic performance was determined based on their total average academic scores. The data were analyzed in SPSS version 16 software using the independent t-test, Pearson correlation, and linear regression. Results: The average age of the students was 26.0±1.5 years. Eighty-eight students (52.4%) were male, and 142 (84.5%) were single. The student's mean total average academic score was 16.2±1.2, and their average physical activity score was 8.3±1.1. The student's average academic score was not associated with their gender (P=0.427), marital status (P=0.645), and age (P=0.320). However, married students had a significantly lower physical activity level compared to single students (P=0.020). The results indicated a significant positive correlation between student's physical activity levels and average academic scores (r=+0.410 and P<0.001). This correlation was independent of the student’s age, gender, and marital status based on the regression analysis. Conclusion: The results of the current study suggested that the physical activity level in medical students was low to moderate in most cases, and there was a significant direct relationship between student’s physical activity level and academic performance, independent of age, gender, and marital status.

Keywords: exercise, education, physical activity, academic performance

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177 Macrocephaly-Cutis Marmorata Telangiectatica Congenita Associated with Epilepsy: Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Krifi Farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Cutis marmorata telangiectatica congenita (CMTC) is a rare cutaneous vascular malformation. It most often appears at birth or during the first days of life. Its origin is still unknown. It associates a livedo with telangiectasias of diffuse or segmental topography. In rare cases, it can be associated with neurological disorders such as macrocephaly and, less frequently, with epilepsy. Methodology: We report a case of an infant with Macrocephaly- Cutis marmorata telangiectatica congenita syndrome associated with epilepsy. Results: This is the case of a one month and 15 days old female infant from a non-consanguineous marriage, admitted for a status epilepticus in the context of apyrexia. Infectious and metabolic causes had been eliminated. Physical examination had shown non-infiltrated and reticular livedoid erythematous patches affecting the left upper limb and atrophic on the back of the left hand. Cerebral magnetic resonance imaging (MRI) showed thin layers of bifrontal, temporal, and left parietal hygromas associated with the widening of the bifrontal subarachnoid spaces. The electroencephalogram showed a well-organized sleep tracing with a single right occipital paroxysmal abnormality. Antiepileptic treatment has been administered with good clinical evolution and regression of the skin lesion and a control electroencephalogram without abnormality. Conclusion: This observation illustrates an association of CMTC with both macrocephaly and epilepsy. This pathology, which is relatively benign and has a good prognosis, generally does not require treatment. However, a detailed examination must be carried out, and a follow-up plan must be put in place for each patient presenting with CMTC, given the risk of association with other abnormalities, which can be potentially serious.

Keywords: cutis marmorata telangiectatica congenita, macrocephaly, epilepsy, children

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176 Application of the Critical Decision Method for Monitoring and Improving Safety in the Construction Industry

Authors: Juan Carlos Rubio Romero, Francico Salguero Caparros, Virginia Herrera-Pérez

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No one is in the slightest doubt about the high levels of risk involved in work in the construction industry. They are even higher in structural construction work. The Critical Decision Method (CDM) is a semi-structured interview technique that uses cognitive tests to identify the different disturbances that workers have to deal with in their work activity. At present, the vision of safety focused on daily performance and things that go well for safety and health management is facing the new paradigm known as Resilience Engineering. The aim of this study has been to describe the variability in formwork labour on concrete structures in the construction industry and, from there, to find out the resilient attitude of workers to unexpected events that they have experienced during their working lives. For this purpose, a series of semi-structured interviews were carried out with construction employees with extensive experience in formwork labour in Spain by applying the Critical Decision Method. This work has been the first application of the Critical Decision Method in the field of construction and, more specifically, in the execution of structures. The results obtained show that situations categorised as unthought-of are identified to a greater extent than potentially unexpected situations. The identification during these interviews of both expected and unexpected events provides insight into the critical decisions made and actions taken to improve resilience in daily practice in this construction work. From this study, it is clear that it is essential to gain more knowledge about the nature of the human cognitive process in work situations within complex socio-technical systems such as construction sites. This could lead to a more effective design of workplaces in the search for improved human performance.

Keywords: resilience engineering, construction industry, unthought-of situations, critical decision method

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175 Exploring Dimensions of Consciousness: Insights from Dreams, Sleep, and Spiritual Perspectives

Authors: Deniz Erten

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This paper delves into the multifaceted nature of human consciousness, examining its structure through the lens of three distinct selves. These selves represent varying thresholds of consciousness, characterized by seven soul levels and seven nafs levels. The attainment of gamma brain wave states signifies the emergence of the Perfect Human Being, whose consciousness transcends the boundaries of individuality to encompass the entirety of existence. Central to this exploration is the notion that consciousness pervades all aspects of reality, underscoring the significance of a comprehensive understanding of the concept of God. Contrary to conventional beliefs, God is not to be construed as a person but rather as an all-encompassing consciousness that manifests within every sentient being. The post-mortem journey through black holes and wormholes, culminating in an encounter with one's creations in the quantum field, provides compelling evidence for the mental nature of the universe. Drawing distinctions between mind and consciousness, as well as self and spirit, elucidates the intricate dynamics underlying human existence. The fusion of body and spirit gives rise to the self, or avatar, which undergoes trials to ascend towards divine consciousness within the Creator's simulated reality. The concept of observation, rooted in the Arabic term "Shahada," underscores the importance of introspection in the quest for enlightenment. The convergence of disciplines such as quantum physics, neuroscience, and religious scriptures like the Quran highlights humanity's collective state of unawareness, with dreams serving as windows into different levels of consciousness. This study further explores the nuanced relationship between consciousness and self, examining the hierarchical progression of the avatar's journey towards spiritual realization.

Keywords: avatar, black holes, cosmic interconnectedness, consciousness, divine matrix, divine simulation, existential exploration, God consciousness, interdisciplinary perspective, levels of consciousness, quantum field, Quran, spiritual realization, Sufism, universal consciousness

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174 Comparative Evaluation of the Effectiveness of Different Mindfulness-Based Interventions on Medically Unexplained Symptoms: A Systematic Review

Authors: R. R. Billones, N. Lukkahatai, L. N. Saligan

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Mindfulness based interventions (MBIs) have been used in medically unexplained symptoms (MUS). This systematic review describes the literature investigating the general effect of MBIs on MUS and identifies the effects of specific MBIs on specific MUS conditions. The preferred reporting items for systematic reviews and meta-analysis guidelines (PRISMA) and the modified Oxford quality scoring system (JADAD) were applied to the review, yielding an initial 1,556 articles. The search engines included PubMed, ScienceDirect, Web of Science, Scopus, EMBASE, and PsychINFO using the search terms: mindfulness, or mediations, or mindful or MBCT or MBSR and medically unexplained symptoms or MUS or fibromyalgia or FMS. A total of 24 articles were included in the final systematic review. MBIs showed large effects on socialization skills for chronic fatigue syndrome (d=0.65), anger in fibromyalgia (d=0.61), improvement of somatic symptoms (d=1.6) and sleep (d=1.12) for painful conditions, physical health for chronic back pain (d=0.51), and disease intensity for irritable bowel disease/syndrome (d=1.13). A manualized MBI that applies the four fundamental elements present in all types of interventions were critical to efficacy. These elements were psycho-education sessions specific to better understand the medical symptoms, the practice of awareness, the non-judgmental observance of the experience at the moment, and the compassion to ones’ self. The effectiveness of different mindfulness interventions necessitates giving attention to improve the gaps that were identified related to home-based practice monitoring, competency training of mindfulness teachers, and sound psychometric properties to measure the mindfulness practice.

Keywords: mindfulness-based interventions, medically unexplained symptoms, mindfulness-based cognitive therapy, mindfulness-based stress reduction, fibromyalgia, irritable bowel syndrome

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173 Computational Fluid Dynamics Model of Various Types of Rocket Engine Nozzles

Authors: Konrad Pietrykowski, Michal Bialy, Pawel Karpinski, Radoslaw Maczka

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The nozzle is an element of the rocket engine in which the conversion of the potential energy of gases generated during combustion into the kinetic energy of the gas stream takes place. The design parameters of the nozzle have a decisive influence on the ballistic characteristics of the engine. Designing a nozzle assembly is, therefore, one of the most responsible stages in developing a rocket engine design. The paper presents the results of the simulation of three types of rocket propulsion nozzles. Calculations were made using CFD (Computational Fluid Dynamics) in ANSYS Fluent software. The next types of nozzles differ in shape. The analysis was made of a conical nozzle, a bell type nozzle with a conical supersonic part and a bell type nozzle. Calculation results are presented in the form of pressure, velocity and kinetic energy distributions of turbulence in the longitudinal section. The courses of these values along the nozzles are also presented. The results show that the cone nozzle generates strong turbulence in the critical section. Which negatively affect the flow of the working medium. In the case of a bell nozzle, the transformation of the wall caused the elimination of flow disturbances in the critical section. This reduces the probability of waves forming before or after the trailing edge. The most sophisticated construction is the bell type nozzle. It allows you to maximize performance without adding extra weight. The bell type nozzle can be used as a starter and auxiliary engine nozzle due to its advantages. The project/research was financed in the framework of the project Lublin University of Technology-Regional Excellence Initiative, funded by the Polish Ministry of Science and Higher Education (contract no. 030/RID/2018/19).

Keywords: computational fluid dynamics, nozzle, rocket engine, supersonic flow

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172 Possible Modulation of FAS and PTP-1B Signaling in Ameliorative Potential of Bombax ceiba against High Fat Diet Induced Obesity

Authors: Paras Gupta, Rohit Goyal, Yamini Chauhan, Pyare Lal Sharma

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Background: Bombax ceiba Linn., commonly called as Semal, is used in various gastro-intestinal disturbances. It contains lupeol which inhibits PTP-1B, adipogenesis, TG synthesis and accumulation of lipids in adipocytes and adipokines whereas the flavonoids isolated from B. ceiba has FAS inhibitory activity. The present study was aimed to investigate ameliorative potential of Bombax ceiba to experimental obesity in Wistar rats, and its possible mechanism of action. Methods: Male Wistar albino rats weighing 180–220 g were employed in present study. Experimental obesity was induced by feeding high fat diet for 10 weeks. Methanolic extract of B. ceiba extract 100, 200 and 400 mg/kg and Gemfibrozil 50 mg/kg as standard drug were given orally from 7th to 10th week. Results: Induction with HFD for 10 weeks caused significant (p < 0.05) increase in % body wt, BMI, LEE indices; serum glucose, triglyceride, LDL, VLDL, cholesterol, free fatty acid, ALT, AST; tissue TBARS, nitrate/nitrite levels; different fat pads and relative liver weight; and significant decrease in food intake (g and kcal), serum HDL and tissue glutathione levels in HFD control rats. Treatment with B. ceiba extract and Gemfibrozil significantly attenuated these HFD induced changes, as compared to HFD control. The effect of B. ceiba 200 and 400 mg/kg was more pronounced in comparison to Gemfibrozil. Conclusion: On the basis of results obtained, it may be concluded that the methanolic extract of stem bark of Bombax ceiba has significant ameliorative potential against HFD induced obesity in rats, possibly through modulation of FAS and PTP-1B signaling due to the presence of flavonoids and lupeol.

Keywords: obesity, Bombax ceiba, free fatty acid, protein tyrosine phosphatase-1B, fatty acid synthase

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171 The Biopsychosocial Effects of Amputation on Transtibial Amputees in Kwazulu-Natal

Authors: Riyona Chetty, Raisuyah Bhagwan, Nalini Govender

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Background: A myriad of physical, psychosocial, and environmental sequelae are associated with limb loss. However, there is a paucity of empirical South African data, which focuses on these sequelae, how they interface with the amputee’s quality of life as well as the challenges they experience following amputation. Objective: This study sought to explore the biopsychosocial effects of amputation and how amputation affected the quality of life of transtibial amputees. Setting: Participants were recruited from a medical facility, under the KwaZulu-Natal Department of Health in South Africa. Methods: A qualitative approach guided this study. Data was collected using one-on-one interviews with 14 unilateral transtibial amputees. Data was analysed thematically. Results: Five broad themes emerged from the inquiry, which captured amputees’ experiences of phantom limb pain, body image disturbances, and their challenges related to adapting to daily activities. Participants also expressed the salience of familial support as well as the importance of psychological interventions to cope. Conclusion: The findings suggested that support networks and professional psychological intervention are imperative in facilitating successful adjustment to the amputation experience. Raising awareness of limb loss in both, rural and urban settings may help reduce the stigma attached to it. Contribution: Quality of life comprises several domains, namely physical, psychological, environmental, and social albeit limited local and international data exists regarding the environmental and social effects. This study brought to the fore the positive and negative effects of amputation in each domain, as well as various strategies that facilitate successful adjustment to amputation.

Keywords: amputation, quality of life, biopsychosocial, phantom limb pain, body image, support

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