Search results for: older adult grandparents

Authors: M. K. Yusuf, W. O. Hamman, U. E. Umana, S. B. Oladele

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Background: Dilatation of the inferior vena cava (IVC) is used as the ultrasonic diagnostic feature in patients suspected of congestive heart failure. The IVC diameter has been reported to vary among the various body mass indexes (BMI) and body shape indexes (ABSI). Knowledge of these variations is useful in precision diagnoses of CHF by imaging scientists. Aim: The study aimed to establish an equation for predicting the ultrasonic mean diameter of the IVC among the various BMI/ABSI of inhabitants of Azare, Bauchi State-Nigeria. Methodology: Two hundred physically healthy adult subjects of both sexes were classified into under, normal, over, and obese weights using their BMIs after selection using a structured questionnaire following their informed consent for an abdominal ultrasound scan. The probe was placed on the midline of the body, halfway between the xiphoid process and the umbilicus, with the marker on the probe directed towards the patient's head to obtain a longitudinal view of the IVC. The maximum IVC diameter was measured from the subcostal view using the electronic caliper of the scan machine. The mean value of each group was obtained, and the results were analysed. Results: A novel equation {(IVC Diameter = 1.04 +0.01(X) where X= BMI} has been generated for determining the IVC diameter among the populace. Conclusion: An equation for predicting the IVC diameter from individual BMI values in apparently healthy subjects has been established.

Keywords: equation, ultrasonic, IVC diameter, body adiposities

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Authors: Fedor Semenov

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One of the most widespread facial bones’ malformations – the congenital palatoschisis – significant impact on drainage and ventilation of the middle ear through the incorrect work of soft palate muscles, which results in recurrent middle ear inflammation and subsequently leads to the hearing dysfunction. The purpose of this research is to evaluate the auditory tube function and hearing condition before the operative treatment (uranoplasty) and after 3 and 12 months. 42 patients aged from 6 months to 17 years who had soft and hard palate cleft and B and C type tympanogram were included in that study. The examination includes otoscopy, pure tone audiometry (for patients older than 8 years – 11 patients), tympanometry. According to the otoscopy results all the patients were divided into two groups: those who had a retracted eardrum and those who had a normal one. The results of pure tone audiometry showed that there were six patients with an air-bone gap of more than 10 dB and the five with normal audiograms. According to the results of this research, uranoplasty demonstrated strongly positive effects on the auditory tube function: normalization of eardrum view upon otoscopy was observed in 64% of children with a retracted eardrum three month after surgery and 85 % twelve months. The quantity of patients with A-type of tympanogram improved in 25 children out of 41 in 3 month and in 35 out of 41 in twelve months after operation. While before the operative treatment, six patients older than 8 years had had an air-bone gap of more than 10 dB; only two of them still had it in 12 months, and the others’ audiograms were normal. To sum it up, the uranoplasty showed a significant contribution in the restoration of auditory tube functioning. Some patients had signs of auditory dysfunction even after the operative treatment. That group of children needs further treatment by an otorhinolaryngologist.

Keywords: auditory tube dysfunction, palatoschisis, uranoplasy, otitis

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Authors: Davit Khachatryan, Shuo Xiang

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Numerous published studies on the use of prazosin in the treatment of PTSD-related sleep disturbances in adult population have resulted in updates to the recommendation for prazosin for nightmares that showed its strength of evidence elevated from C to B in the US Department of Veterans Affairs clinical practice guideline. In addition, the American Academy of Sleep Medicine clinical practice guideline gave prazosin a level-A recommendation for the treatment of PTSD-associated nightmares. The aim of this review is to summarize the available literature for prazosin use for nightmares and other sleep disturbances in children and adolescents with PTSD. Method: A comprehensive search for studies on prazosin use for sleep disturbances in child and adolescent population with PTSD has been performed. We looked at MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, Scopus, Web of Science, and Cochrane CENTRAL databases. Results: Compared to adult population with similar psychopathology, the available literature in child and adolescent population is scarce. Despite increased interest in prazosin in the management of PTSD, only six studies investigating this medication in children and adolescents have been published. Conclusion: A large randomized control trial on this topic is needed for more definite evidence on the efficacy and safety of prazosin in the treatment of nightmares in children and adolescents with PTSD.

Keywords: guidelines, prazosin, PTSD, sleep disturbance

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Authors: Nisa Mohan

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Adverse drug event (ADE) related hospital admissions are common among older people. The first step in prevention is accurately estimating the prevalence of ADE admissions. Clinical coding is an efficient method to estimate the prevalence of ADE admissions. The objective of the study is to estimate the rate of under-coding of ADE admissions in older people in New Zealand and to explore how clinical coders decide whether or not to code an admission as an ADE. There has not been any research in New Zealand to explore these areas. This study is done using a mixed-methods approach. Two common and serious ADEs in older people, namely bleeding and hypoglycaemia were selected for the study. In study 1, eight hundred medical records of people aged 65 years and above who are admitted to hospital due to bleeding and hypoglycemia during the years 2015 – 2016 were selected for quantitative retrospective medical records review. This selection was made to estimate the proportion of ADE-related bleeding and hypoglycemia admissions that are not coded as ADEs. These files were reviewed and recorded as to whether the admission was caused by an ADE. The hospital discharge data were reviewed to check whether all the ADE admissions identified in the records review were coded as ADEs, and the proportion of under-coding of ADE admissions was estimated. In study 2, thirteen clinical coders were selected to conduct qualitative semi-structured interviews using a general inductive approach. Participants were selected purposively based on their experience in clinical coding. Interview questions were designed in a way to investigate the reasons for the under-coding of ADE admissions. The records review study showed that 35% (Cl 28% - 44%) of the ADE-related bleeding admissions and 22% of the ADE-related hypoglycemia admissions were not coded as ADEs. Although the quality of clinical coding is high across New Zealand, a substantial proportion of ADE admissions were under-coded. This shows that clinical coding might under-estimate the actual prevalence of ADE related hospital admissions in New Zealand. The interviews with the clinical coders added that lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing might be the potential reasons for the under-coding of the ADE admissions. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. These results highlight that further work is needed on interventions to improve the clinical coding of ADE admissions, such as providing education to coders about the importance of ADEs, education to clinicians about the importance of clear and confirmed medical records entries, availing pharmacist service to improve the detection and clear documentation of ADE admissions and including a mandatory field in the discharge summary about external causes of diseases.

Keywords: adverse drug events, bleeding, clinical coders, clinical coding, hypoglycemia

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Authors: Hawa Khan

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Autism is a complex disorder related to abnormalities in the development of brain structure and neurological function and a new phenomenon which is epidemically on the increase. The Muslim community, with its profound commitment to the all-encompassing Islamic precedence, views all phenomena in the light of religious imperatives. How autism is understood and treated in these communities is key to successful inclusive services. Moreover, parents mentioned their Islamic faith as a coping mechanism for the challenges they faced while caring for their child. This study utilises interpretative phenomenology analysis as a methodology that seeks to interpret the meaning the participants make of their experiences, which extends descriptive analysis. Semi-structured interviews were conducted with 5 family units that included fathers, mothers, grandparents, and siblings. In the preliminary stage, this study found families give high importance of accessible Islamic education for their child and questioning the accountability of the child who might not be able to follow the Islamic way of life entirely or understand the concept of Allah. Moreover, the families expressed their beliefs in traditional and religious treatment as an effective way to treat and cure autism. This poses a major barrier between families seeking support and professionals providing services. Consequentially, it can also result in a low uptake of mainstream services from the Muslim community. Exploring the lived experiences of parents from the Muslim community and how ASD is conceptualised in this community could have implications for improved and effective home, community, and service collaboration.

Keywords: autism spectrum disorder, Islamic education, religious beliefs, mainstream services

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Authors: Mathumalar Loganathan, Lina Syazana, Bryony Dean Franklin

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Background: The therapeutic benefit of self-administered medication for long-term use is limited by an average 50% non-adherence rate. Patient forgetfulness is a common factor in unintentional non-adherence. With a growing ageing population, strategies to improve self-administration of medication adherence are essential. Our aim was to review systematically the effects of interventions to optimise self-administration of medication. Method: Database searched were MEDLINE, EMBASE, PsynINFO, CINAHL from 1980 to 31 October 2013. Search terms included were ‘self-administration’, ‘self-care’, ‘medication adherence’, and ‘intervention’. Two independent reviewers undertook screening and methodological quality assessment, using the Downs and Black rating scale. Results: The search strategy retrieved 6 studies that met the inclusion and exclusion criteria. Three intervention strategies were identified: self-administration medication programme (SAMP), nursing education and medication packaging (pill calendar). A nursing education programme focused on improving patients’ behavioural self-management of drug prescribing. This was the most studied area and three studies highlighting an improvement in self-administration of medication. Conclusion: Results are mixed and there is no one interventional strategy that has proved to be effective. Nevertheless, self-administration of medication programme seems to show most promise. A multi-faceted approach and clearer policy guideline are likely to be required to improve prescribing for these vulnerable patients. Mixed results were found for SAMP. Medication packaging (pill calendar) was evaluated in one study showing a significant improvement in self-administration of medication. A meta-analysis could not be performed due to heterogeneity in the outcome measures.

Keywords: self-administered medication, intervention, prescribing, older patients

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Authors: Dalia Hanna, Alexander Ferworn

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This research provides detailed proposed training modules for the public safety teams and, specifically, SAR teams responsible for search and rescue operations related to finding lost persons with dementia. Finding a lost person alive is the goal of this training. Time matters if a lost person is to be found alive. Finding lost people living with dementia is quite challenging, as they are unaware they are lost and will not seek help. Even a small contribution to SAR operations could contribute to saving a life. SAR operations will always require expert professional and human volunteers. However, we can reduce their time, save lives, and reduce costs by providing practical training that is based on real-life scenarios. The content for the proposed training is based on the research work done by the researcher in this area. This research has demonstrated that, based on utilizing drones, the algorithmic approach could support a successful search outcome. Understanding the behavior of the lost person, learning where they may be found, predicting their survivability, and automating the search are all contributions of this work, founded in theory and demonstrated in practice. In crisis management, human behavior constitutes a vital aspect in responding to the crisis; the speed and efficiency of the response often get affected by the difficulty of the context of the operation. Therefore, training in this area plays a significant role in preparing the crisis manager to manage the emotional aspects that lead to decision-making in these critical situations. Since it is crucial to gain high-level strategic choices and the ability to apply crisis management procedures, simulation exercises become central in training crisis managers to gain the needed skills to respond critically to these events. The training will enhance the responders’ ability to make decisions and anticipate possible consequences of their actions through flexible and revolutionary reasoning in responding to the crisis efficiently and quickly. As adult learners, search and rescue teams will be approaching training and learning by taking responsibility of the learning process, appreciate flexible learning and as contributors to the teaching and learning happening during that training. These are all characteristics of adult learning theories. The learner self-reflects, gathers information, collaborates with others and is self-directed. One of the learning strategies associated with adult learning is effective elaboration. It helps learners to remember information in the long term and use it in situations where it might be appropriate. It is also a strategy that can be taught easily and used with learners of different ages. Designers must design reflective activities to improve the student’s intrapersonal awareness.

Keywords: training, OER, dementia, drones, search and rescue, adult learning, UDL, instructional design

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Authors: M. Manzoor, J. N. Ahmad, R. M. Giblin Davis, N. Javed, M. S. Haider

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The invasive Red Palm Weevil (RPW) (Rhynchophorus ferrugineus [Olivier] (Coleoptera: Curculionidae) is one of the most destructive palm pests in the world. Synthetic pesticides are environmentally hazardous pest control strategies being used in the past with emerging need of eco-friendly biological approaches including microbial entomopathogens for RPW management. The sublethal effects of a single entomopathogenic fungus (EPF) Beauveria bassiana (WG-11) (Ascomycota: Hypocreales) and two entomopathogenic nematode (EPN) species Heterorhabditis bacteriophora (Poinar) and Steinernema carpocapsae (Weiser) (Nematoda: Rhabditida) were evaluated in various combinations against laboratory-reared 3rd, 5th and 8th instar larvae of RPW in laboratory assays. Individual and combined effects of both entomopathogens (EP) were observed after the pre-application of B. bassiana fungus at 1-2-week intervals. A number of parameters were measured after the application of sub-lethal doses of EPF such as diet consumption, development, frass production, mortality, and weight gain. Combined treatments were tested for additive and synergistic effects. Synergism was more frequently observed in B. bassiana and S. carpocapsae combined treatments than in B. bassiana and H. bacteriophora combinations. Early instar larvae of RPW were more susceptible than older instars. Synergistic effects were observed in the 3rd and 5th instars exposed to B. bassiana and S. carpocapsae at 0, 7 and 14-day intervals. Whereas, in 8th instar larvae, the synergistic effect was observed only in B. bassiana and S. carpocapsae treatments after 0 and 7 days intervals. EPN treatments decreased pupation, egg hatching and emergence of adults. Lethal effects of nematodes were also observed in all growth stages of R. ferrugineus. Reduced larval weight, increased larval, pre-pupal and pupal duration, reduced adult weight and life span were observed. Sub-lethal concentrations of both entomopathogens induced variations in the different developmental stages and reduced food consumption, frass production, growth, and weight gain. So, on the basis of results, it is concluded that synthetic pesticides should be replaced with environmentally friendly sustainable biopesticides.

Keywords: H. bacteriophora, S. carpocapsae, B. bassiana, mortality

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Authors: Huimin Liu, Li Xiang, Yue Liu, Jing Wang

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Background: As one of typical case for the developing countries who are stepping into the aging times globally, more and more older people in China might face the problem of which they could not maintain normal life due to the functional disability. While the government take efforts to build long-term care system and further carry out related policies for the core concept, there is still lack of strong evidence to evaluating the profile of disability states in the elderly population and its transition rate. It has been proved that disability is a dynamic condition of the person rather than irreversible so it means possible to intervene timely on them who might be in a risk of severe disability. Objective: The aim of this study was to depict the picture of the disability transferring status of the older people in China, and then find out individual characteristics that change the state of disability to provide theory basis for disability prevention and early intervention among elderly people. Methods: Data for this study came from the 2011 baseline survey and the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). Normal ADL function, 1~2 ADLs disability,3 or above ADLs disability and death were defined from state 1 to state 4. Multi-state Markov model was applied and the four-state homogeneous model with discrete states and discrete times from two visits follow-up data was constructed to explore factors for various progressive stages. We modeled the effect of explanatory variables on the rates of transition by using a proportional intensities model with covariate, such as gender. Result: In the total sample, state 2 constituent ratio is nearly about 17.0%, while state 3 proportion is blow the former, accounting for 8.5%. Moreover, ADL disability statistics difference is not obvious between two years. About half of the state 2 in 2011 improved to become normal in 2013 even though they get elder. However, state 3 transferred into the proportion of death increased obviously, closed to the proportion back to state 2 or normal functions. From the estimated intensities, we see the older people are eleven times as likely to develop at 1~2 ADLs disability than dying. After disability onset (state 2), progression to state 3 is 30% more likely than recovery. Once in state 3, a mean of 0.76 years is spent before death or recovery. In this model, a typical person in state 2 has a probability of 0.5 of disability-free one year from now while the moderate disabled or above has a probability of 0.14 being dead. Conclusion: On the long-term care cost considerations, preventive programs for delay the disability progression of the elderly could be adopted based on the current disabled state and main factors of each stage. And in general terms, those focusing elderly individuals who are moderate or above disabled should go first.

Keywords: Markov model, elderly people, disability, transition intensity

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Authors: Lubabatu Sada Sodangi

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The rapid growth in exchange and accessibility of information via the internet makes many organisations acquire data on their own operation. The aim of data mining is to analyse the different behaviour of a dataset using observation. Although, the subset of the dataset being analysed may not display all the behaviours and relationships of the entire data and, therefore, may not represent other parts that exist in the dataset. There is a range of techniques used in data mining to determine the hidden or unknown information in datasets. In this paper, the performance of two algorithms Chi-Square Automatic Interaction Detection (CHAID) and multilayer perceptron (MLP) would be matched using an Adult dataset to find out the percentage of an/the adults that earn > 50k and those that earn <= 50k per year. The two algorithms were studied and compared using IBM SPSS statistics software. The result for CHAID shows that the most important predictors are relationship and education. The algorithm shows that those are married (husband) and have qualification: Bachelor, Masters, Doctorate or Prof-school whose their age is > 41<57 earn > 50k. Also, multilayer perceptron displays marital status and capital gain as the most important predictors of the income. It also shows that individuals that their capital gain is less than 6,849 and are single, separated or widow, earn <= 50K, whereas individuals with their capital gain is > 6,849, work > 35 hrs/wk, and > 27yrs their income will be > 50k. By comparing the two algorithms, it is observed that both algorithms are reliable but there is strong reliability in CHAID which clearly shows that relation and education contribute to the prediction as displayed in the data visualisation.

Keywords: data mining, CHAID, multi-layer perceptron, SPSS, Adult dataset

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Authors: Jeong-Moh John Yahng, Angelika Na

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Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

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Authors: Dmytro D. Buiadzhy

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The modern psychiatric discourse proves the existence of the direct ties between the children's mental health and their success in life as adults. The unresolved mental health problems in childhood are likely to lead individuals to poverty, isolation, and social exclusion as stated by Marcus Richards. Such an approach justifies the involvement of children in the view of supervision and control of power. The discourse, related to the mental health of children, provides a tight impact of family, educational institutions and medical authorities on the child through any manifestations of his psychic, having signs of "abnormality.” Throughout the adult life, the individual continues to feel the pressure of power through legal, political, and economic institutions that also appeal to the mental health regulation. The juvenile law declares the equality of a child and an adult, but in fact simply delegates the powers of parents to impersonal social institutions of the guardianship, education, and social protection. The psychiatric power in this study is considered in accordance with the Michel Foucault’s concept of power as a manifestation of "positive" technologies of power, which include various manifestations of subjectivity, in particular children’s one, in a view of supervision and control of the state power. The main issue disclosed in this paper is how weakening of the parental authority, in the context of legislative ratification of the child rights, strengthens the other forms of power over children, especially the psychiatric power, which justifies and affects the children mancipation.

Keywords: child rights, psychiatric power, discourse, parental authority

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Authors: Katherine Maurer

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Background and purpose: Violence that occurs within families is a global social problem. Children who are victims or witness to family violence are at risk for many negative effects both proximally and distally. One of the most disconcerting long-term effects occurs when child victims become adult perpetrators: the intergenerational transmission of family violence (ITFV). Early identification of those children most at risk for ITFV is needed to inform interventions to prevent future family violence perpetration and victimization. Only about 25-30% of child family violence victims become perpetrators of adult family violence (either child abuse, partner abuse, or both). Prior research has primarily been conducted using dichotomous measures of exposure (yes; no) to predict ITFV, given the low incidence rate in community samples. It is often assumed that exposure to greater amounts of violence predicts greater risk of ITFV. However, no previous longitudinal study with a community sample has tested a dose-response model of exposure to physical child abuse and parental physical intimate partner violence (IPV) using count data of frequency and severity of violence to predict adult ITFV. The current study used advanced statistical methods to test if increased childhood exposure would predict greater risk of ITFV. Methods: The study utilized 3 panels of prospective data from a cohort of 15 year olds (N=338) from the Project on Human Development in Chicago Neighborhoods longitudinal study. The data were comprised of a stratified probability sample of seven ethnic/racial categories and three socio-economic status levels. Structural equation modeling was employed to test a hurdle regression model of dose-response to predict ITFV. A version of the Conflict Tactics Scale was used to measure physical violence victimization, witnessing parental IPV and young adult IPV perpetration and victimization. Results: Consistent with previous findings, past 12 months incidence rates severity and frequency of interpersonal violence were highly skewed. While rates of parental and young adult IPV were about 40%, an unusually high rate of physical child abuse (57%) was reported. The vast majority of a number of acts of violence, whether minor or severe, were in the 1-3 range in the past 12 months. Reported frequencies of more than 5 times in the past year were rare, with less than 10% of those reporting more than six acts of minor or severe physical violence. As expected, minor acts of violence were much more common than acts of severe violence. Overall, regression analyses were not significant for the dose-response model of ITFV. Conclusions and implications: The results of the dose-response model were not significant due to a lack of power in the final sample (N=338). Nonetheless, the value of the approach was confirmed for the future research given the bi-modal nature of the distributions which suggest that in the context of both child physical abuse and physical IPV, there are at least two classes when frequency of acts is considered. Taking frequency into account in predictive models may help to better understand the relationship of exposure to ITFV outcomes. Further testing using hurdle regression models is suggested.

Keywords: intergenerational transmission of family violence, physical child abuse, intimate partner violence, structural equation modeling

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Authors: Suzan Sayegh, Izzeldin Ibrahim, Mercia Van Der Walt, Mohamed Al-Kuwari

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Background: Walking is the most common form of physical activity which can promote a healthy well-being among people of different age groups. In this regard, pedometers are becoming more popular within research and are considered useful tools in monitoring physical activity levels based on individuals’ daily steps. A value of ˂5,000 steps/day is identified as a sedentary lifestyle index where individuals are physically inactive. Those achieving 5,000-7,499 steps/day have a low active lifestyle as they do not meet the moderate-to-vigorous physical activity (MVPA) recommendations. Moreover, individuals achieving ≥7,500 steps/day are classified as physically active. The objective of this study is to assess the physical activity levels of adult population in Qatar through a pedometer-based program over a one-year period. Methods: A cross-sectional analysis, as part of a longitudinal study, was carried out over one year to assess the daily step count. “Step into Health” is a community-based program launched by Aspire as an approach for the purpose of improving physical activity across the population of Qatar. The program involves distribution of pedometers to registered members which is supported by a self-monitoring online account and linked to a web database. Daily habitual physical activity (daily total step count) was assessed through Omron HJ-324U pedometer. Analyses were done on data extracted from the web database. Results: A total of 1,988 members were included in this study (males: n=1,143, 57%; females: n=845, 43%). Average age was 37.8±10.9 years distributed as 60% of age between age 25-54 (n=1,186), 27% of age 45-64 (n=546), and 13% of age 18-24 years (n=256). Majority were non-Qataris, 81% (n=1,609) compared with 19% of the Qatari nationality (n=379). Average body mass index (BMI) was 27.8±6.1 (kg/m2) where most of them (41%, n=809) were found to be overweight, between 25-30 kg/m2. Total average step count was 5,469±3,884. Majority were found to be sedentary (n=1110, 55.8%). Middle aged individuals were more active than the other two age groups. Males were seen as more active than females. Those who were less active had a higher BMI. Older individuals were more active. There was a variation in the physical activity level throughout the year period. Conclusion: It is essential to further develop the available intervention programs and increase their physical activity behavior. Planning such physical activity interventions for female population should involve aspects such as time, environmental variables and aerobic steps.

Keywords: adults, pedometer, physical activity, step-count

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Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher

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Bionaut Labs, LLC is developing a minimally invasive robotic microdevice designed to treat non-communicating hydrocephalus in both adult and pediatric patients. The device utilizes biocompatible microsurgical particles (Bionaut™) that are specifically designed to safely and reliably perform accurate fenestration(s) in the 3rd ventricle, aqueduct of Sylvius, and/or trapped intraventricular cysts of the brain in order to re-establish normal cerebrospinal fluid flow dynamics and thereby balance and/or normalize intra/intercompartmental pressure. The Bionaut™ is navigated to the target via CSF or brain tissue in a minimally invasive fashion with precise control using real-time imaging. Upon reaching the pre-defined anatomical target, the external driver allows for directing the specific microsurgical action defined to achieve the surgical goal. Notable features of the proposed protocol are i) Bionaut™ access to the intraventricular target follows a clinically validated endoscopy trajectory which may not be feasible via ‘traditional’ rigid endoscopy: ii) the treatment is microsurgical, there are no foreign materials left behind post-procedure; iii) Bionaut™ is an untethered device that is navigated through the subarachnoid and intraventricular compartments of the brain, following pre-designated non-linear trajectories as determined by the safest anatomical and physiological path; iv) Overall protocol involves minimally invasive delivery and post-operational retrieval of the surgical Bionaut™. The approach is expected to be suitable to treat pediatric patients 0-12 months old as well as adult patients with obstructive hydrocephalus who fail traditional shunts or are eligible for endoscopy. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebrospinal fluid, CSF, fenestration, hydrocephalus, micro-robot, microsurgery

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Authors: Pradeep M. C. Chand

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Virtual infrastructure initiatives often spring from data center server consolidation projects, which focus on reducing existing infrastructure “box count”, retiring older hardware or life-extending legacy applications. Server consolidation benefits result from a reduction in the overall number of systems and related recurring costs (power, cooling, rack space, etc.) and also helps in the reduction of heat to the environment.

Keywords: server virtualization, data center, consolidation, project

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Authors: Arunas Emeljanovas, Brigita Mieziene, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen

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Background: Gender differences in physical fitness were tracked in many studies with lower effect in preschool children and increasing difference among genders across age. In Lithuania, on a population level, secular trends in physical fitness were regularly observed each ten years for the last two decades for 11-18 years old students. However, there is apparently a lack of such epidemiological studies among primary school students. Assessing and monitoring physical fitness from an early age is of particular importance seeking to develop and strengthen physical abilities of youths for future health benefits. The goal of the current study was to indicate age and gender differences in anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children. Methods: The study included 3456 1-4th grade students from 6 to 10 years. The data reliably represents the population of primary school children in Lithuania. Among them, 1721 (49.8 percent) were boys. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues (2011). Height and weight were measured and body mass index was calculated. Student t test evaluated differences in physical fitness between boys and girls, ANOVA was performed to indicate differences across age. Results: All anthropometric and fitness means that were identified as significantly different were better in boys than in girls and in older than younger students (p < .05). Among anthropometric measures, height was higher in boys aged 7 through 9 years. Weight and BMI differed among boys and girls only at 8 years old. Means of height and weight increased significantly across all ages. Among musculoskeletal fitness tests, means of standing broad jump, throwing a tennis ball and pushing a medicine ball were different between genders within each age group and across all ages. Differences between genders were less likely in motor fitness than in musculoskeletal or cardiorespiratory fitness. Differences in means of shuttle run 10 x 5 test between genders occurred at age 6, 9 and 10 years; running 20 m at age 6 and 9 years, and climbing wall bars at age 9 and 10. Means of Reduced Cooper test representing cardiorespiratory fitness were different between genders within each age group but did not differ among age 6 and 8 as well as 7 and 8 years in boys, and among age 7 and 8 years in girls. Conclusion: In general, the current study confirms gender differences in musculoskeletal, motor and cardiorespiratory fitness found in other studies across the world in primary school and older children. Observed gender differences might be explained by higher physical activity in boys rather than girls. As it is explained by previous literature, older boys and girls had better performances than younger ones, because of the components of fitness change as a function of growth, maturation, development, and interactions among the three processes.

Keywords: primary school children, motor fitness, musculoskeletal fitness, cardiovascular fitness

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Authors: Umair Riaz, Mudassar Iqbal, Umer Farooq, Farah Ali, Musadiq Idris

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The present work was designed to establish biometrical norms for ovaries, oviducts and crevices of one humped camels (Camelus dromedarius) and the diseases associated thereof in various age groups viz. calves (< 2 years, n=15), heifers (2-4 years, n=34) and adults (> 4 years, n=81). The genitalia were attained from Lahore Abbatoir, Punjab, Pakistan. Ovaries, oviducts and cervices of experimental genitalia were assessed for their length, width, thickness and weight. Statistically, there was no difference in the length and width of both left and right ovaries which however, increased with the advancement of age of camel. Similar results were noticed regarding the width of oviducts. The mean length of cervices of female camels correlated well with the number of cervical annular rings amongst the age groups. Regarding the abnormalities of ovaries and cervices in the 3 age groups, camel calves did not have any of the abnormalities. However, ovarian hypoplasia in heifers (2.94%) and follicular cyst in adult female camels (1.23%) were revealed in the present study. Mucocervix in heifers (2.96%) and cervicitis 1.23% in adult camels was also noticed. The present work presents a preliminary data on biometrical analysis for one humped camels and envisages a broader study with increased population and sample size.

Keywords: camelus dromedarius, pathology, biometry, female genital tract

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Authors: Souzan Al Sayegh, Izzeldin Ibrahim, Mercia Van Der Walt, Mohamed Al-Kuwari

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Background: Walking is the most common form of physical activity which can promote a healthy well-being among people of different age groups. In this regard, pedometers are becoming more popular within research and are considered useful tools in monitoring physical activity levels based on individuals’ daily steps. A value of ˂5,000 steps/day is identified as a sedentary lifestyle index where individuals are physically inactive. Those achieving 5,000-7,499 steps/day have a low active lifestyle as they do not meet the moderate-to-vigorous physical activity (MVPA) recommendations. Moreover, individuals achieving ≥7,500 steps/day are classified as physically active. The objective of this study is to assess the physical activity levels of adult population in Qatar through a pedometer-based program over a one-year period. Methods: A cross-sectional analysis, as part of a longitudinal study, was carried out over one year to assess the daily step count. 'Step into Health' is a community-based program launched by Aspire as an approach for the purpose of improving physical activity across the population of Qatar. The program involves the distribution of pedometers to registered members which is supported by a self-monitoring online account and linked to a web database. Daily habitual physical activity (daily total step count) was assessed through Omron HJ-324U pedometer. Analyses were done on data extracted from the web database. Results: A total of 1,988 members were included in this study (males: n=1,143, 57%; females: n=845, 43%). Average age was 37.8±10.9 years distributed as 60% of age between age 25-54 (n=1,186), 27% of age 45-64 (n=546), and 13% of age 18-24 years (n=256). Majority were non-Qataris, 81% (n=1,609) compared with 19% of the Qatari nationality (n=379). Average body mass index (BMI) was 27.8±6.1 (kg/m2) where most of them (41%, n=809) were found to be overweight, between 25-30 kg/m2. Total average step count was 5,469±3,884. Majority were found to be sedentary (n=1110, 55.8%). Middle aged individuals were more active than the other two age groups. Males were seen as more active than females. Those who were less active had a higher BMI. Older individuals were more active. There was a variation in the physical activity level throughout the year period. Conclusion: It is essential to further develop the available intervention programs and increase their physical activity behavior. Planning such physical activity interventions for female population should involve aspects such as time, environmental variables and aerobic steps.

Keywords: adults, pedometer, physical activity, step-count

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Authors: Stefan Kurbatfinski, Aliyah Dosani, Andrew F. Hayes, Deborah Dewey, Nicole Letourneau

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Background: Maternal adverse childhood experiences (ACEs) have been associated with internalizing and externalizing behavioral problems in preschool children. However, little is known about the influence of maternal adult attachment patterns on this association. Further, potential moderation by maternal mental health, maternal social support, or child sex is poorly understood. Therefore, this study examined associations between 1) maternal ACEs and preschool children’s behavioural problems, with mediation through maternal attachment patterns and moderation by maternal mental health, maternal social support, and child sex; and 2) maternal attachment patterns and children’s behavioural problems, with mediation through maternal mental health and social support and moderation by child sex. Methods: This secondary analysis used data (n=625) from a high socioeconomic, longitudinally prospective cohort (Alberta Pregnancy Outcomes and Nutrition). Child behaviour (BASC-2) and maternal adult attachment (ECR-Q) were measured at five years of child age, maternal ACEs (ACEs Questionnaire) at around 12 months, and maternal mental health (CESD and SCL-90-R) and social support (SSQ) across various prenatal and postnatal time points. All moderation and mediation analyses occurred through RStudio using PROCESS, interpreting significant interactions through Johnson-Neyman plots. Findings: Maternal ACEs interacted with maternal anxiety symptoms to predict both behavioural problems (pexternalizing=0.007; pinternalizing=0.0159). An indirect pathway via dismissive attachment was moderated by maternal social support ([0.0058, 0.0596]). Attachment patterns predicted all behavioural problems (p<0.05) and interacted with maternal anxiety symptoms to predict internalizing behaviours among male children ([0.0321, 0.1307]; [0.0321, 0.1291]). Interpretation: Maternal attachment patterns may predict children’s behavioural problems more than ACEs. Social support interventions may not always be beneficial for highly dismissively attached mothers. Implications for policy and child health include mandatory sex and gender education for teachers; assessing attachment patterns prior to recommending social support as an intervention; and anxiety-focused interventions for mothers in higher socioeconomic populations.

Keywords: maternal adverse childhood experiences, internalizing behaviours, externalizing behaviours, mediators and moderators, attachment patterns, child health

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Authors: Ismail Bayram, Aamir Iqbal, E. Eren Gultepe, Cangir Uyarlar, Umit Ozcınar, I. Sadi Cetingul

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The current study was planned with the objective to explore the potential of pomegranate molasses (PM) on performance, egg quality and blood parameters in older laying hens. A total of 240 Babcock white laying hens (52 weeks old) were divided into 5 groups (n=48) with 8 subgroups having 6 hens in each. Pomegranate molasses was added in the drinking water to experimental groups with 0 %, 0.1%, 0.25 %, 0.5%, and 1%, respectively during one month. In our results, egg weight values were remained the same in all pomegranate molasses supplemented groups except 1% group over control. However, feed consumption, egg production, feed conversion ratio (FCR), egg mass, egg yolk cholesterol, body weights, and water consumption remained unaffected (P > 0.05). During mid-study (15 Days) analyses, egg quality parameters such as Haugh unit, eggshell thickness, albumin index, yolk index, and egg yolk color were remained non-significant (P > 0.05) while after final (30 Days) egg analyses, only egg yolk color had positively (P < 0.05) increased in 0.5% group. Moreover, Haugh unit, eggshell thickness, and albumin index were not significantly (P > 0.05) affected by the supplementation of pomegranate molasses. Regarding serological parameters, pomegranate molasses did not show any positive effect on cholesterol, total protein, LDL, HDL, GGT, AST, ALT, and glucose level. Similarly, pomegranate molasses also showed non-significant (P > 0.05) results on different blood parameters such as HCT, RBC, MCV, MCH, MCHC, PLT, RDWC, MPV except hemoglobin level. Only hemoglobin level was increased in all experimental groups over control showing that pomegranate molasses can be used as an enhancer in animals with low hemoglobin level.

Keywords: pomegranate molasses, laying hen, egg yield, blood parameters

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Authors: Chethan Purushothama

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Coronary artery disease is one of the major causes of death in developing countries. The coronary arteries show wide range of variations and these variations have not been dealt with different population groups. The present study aims to focus on the pattern and variations of coronary artery in south Indian population. The study was performed to analyze the coronary artery dominance and divisions of main trunk of left coronary artery in 81 isolated adult human cadaveric hearts of South Indian population. The specimens were fixed in 10% formalin and were dissected manually. In our specimens, 74.1% of the hearts were right dominant, 11.1% were left dominant, and 14.8% were co-dominant. Bifurcation, trifurcation, and quadrifurcation of main trunk of left coronary artery were seen in 49.4%, 48.1%, and 2.5% cases respectively. The right dominant hearts had bifurcation, trifurcation and quadrifurcation of main trunk of left coronary artery in 46.7%, 50% and 3.3% hearts respectively. The left dominant hearts had bifurcation and trifurcation of main trunk of left coronary artery in 55.6% and 44.4% cases respectively. The co-dominant hearts had bifurcation and trifurcation of main trunk of left coronary artery in 58.3% and 41.7% respectively. Quadrifurcation of main trunk of left coronary artery were seen only in right dominant hearts. We believe that the data obtained from the present study are important to the interventional cardiologists and radiologists. The details obtained will also be helpful for the clinical anatomists.

Keywords: bifurcation, coronary artery, trifurcation, quadrifurcation

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Authors: Mahnaz Khalafehnilsaz, Rozina Rahnama

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Introduction: The elderly population is growing rapidly, and with this growth comes an increased demand for healthcare services. Artificial intelligence (AI) has the potential to revolutionize the delivery of healthcare services to the elderly population. In this study, the various ways in which AI is used to create health content for elderly people and its transformative impact on the healthcare industry will be explored. Method: A systematic review of the literature was conducted to identify studies that have investigated the role of AI in creating health content specifically for elderly people. Several databases, including PubMed, Scopus, and Web of Science, were searched for relevant articles published between 2000 and 2022. The search strategy employed a combination of keywords related to AI, personalized health content, and the elderly. Studies that utilized AI to create health content for elderly individuals were included, while those that did not meet the inclusion criteria were excluded. A total of 20 articles that met the inclusion criteria were identified. Finding: The findings of this review highlight the diverse applications of AI in creating health content for elderly people. One significant application is the use of natural language processing (NLP), which involves the creation of chatbots and virtual assistants capable of providing personalized health information and advice to elderly patients. AI is also utilized in the field of medical imaging, where algorithms analyze medical images such as X-rays, CT scans, and MRIs to detect diseases and abnormalities. Additionally, AI enables the development of personalized health content for elderly patients by analyzing large amounts of patient data to identify patterns and trends that can inform healthcare providers in developing tailored treatment plans. Conclusion: AI is transforming the healthcare industry by providing a wide range of applications that can improve patient outcomes and reduce healthcare costs. From creating chatbots and virtual assistants to analyzing medical images and developing personalized treatment plans, AI is revolutionizing the way healthcare is delivered to elderly patients. Continued investment in this field is essential to ensure that elderly patients receive the best possible care.

Keywords: artificial intelligence, health content, older adult, healthcare

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Authors: Tomohiko Utsuki, Kyoka Sato

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In emergency medicine, it is recognized that brain resuscitation is very important for the reduction of mortality rate and neurological sequelae. Especially, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) are most required for stabilizing brain’s physiological state in the treatment for such as brain injury, stroke, and encephalopathy. However, the manual control of BT, ICP, and CBF frequently requires the decision and operation of medical staff, relevant to medication and the setting of therapeutic apparatus. Thus, the integration and the automation of the control of those is very effective for not only improving therapeutic effect but also reducing staff burden and medical cost. For realizing such integration and automation, a mathematical model of brain physiological state is necessary as the controlled object in simulations, because the performance test of a prototype of the control system using patients is not ethically allowed. A model of cerebral blood circulation has already been constructed, which is the most basic part of brain physiological state. Also, a migration model of extracellular fluid in brain has been constructed, however the condition that the total volume of intracranial cavity is almost changeless due to the hardness of cranial bone has not been considered in that model. Therefore, in this research, the dynamic migration model of extracellular fluid in brain was constructed on the consideration of the changelessness of intracranial cavity’s total volume. This model is connectable to the cerebral blood circulation model. The constructed model consists of fourteen compartments, twelve of which corresponds to perfused area of bilateral anterior, middle and posterior cerebral arteries, the others corresponds to cerebral ventricles and subarachnoid space. This model enable to calculate the migration of tissue fluid from capillaries to gray matter and white matter, the flow of tissue fluid between compartments, the production and absorption of cerebrospinal fluid at choroid plexus and arachnoid granulation, and the production of metabolic water. Further, the volume, the colloid concentration, and the tissue pressure of/in each compartment are also calculable by solving 40-dimensional non-linear simultaneous differential equations. In this research, the obtained model was analyzed for its validation under the four condition of a normal adult, an adult with higher cerebral capillary pressure, an adult with lower cerebral capillary pressure, and an adult with lower colloid concentration in cerebral capillary. In the result, calculated fluid flow, tissue volume, colloid concentration, and tissue pressure were all converged to suitable value for the set condition within 60 minutes at a maximum. Also, because these results were not conflict with prior knowledge, it is certain that the model can enough represent physiological state of brain under such limited conditions at least. One of next challenges is to integrate this model and the already constructed cerebral blood circulation model. This modification enable to simulate CBF and ICP more precisely due to calculating the effect of blood pressure change to extracellular fluid migration and that of ICP change to CBF.

Keywords: dynamic model, cerebral extracellular migration, brain resuscitation, automatic control

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Authors: Adam Musa Adam Eissa

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Environmental and weather changes especially rainfall affects the distribution and densities of mosquitoes. This work was carried out to study the distribution and densities of mosquitoes adults and larvae in a total of five selected stations in El Obied Town. A cross-sectional survey of Anopheline mosquito larval habitats was conducted. The survey was conducted during the dry season (January 2013). Larvae were collected by using the standard dipping technique, while adult stages were collected by rearing larvae in cage, because the density of adults Anopheles mosquito per room was zero by using spray sheet method by using Permethrin pesticide 25%E.C, during the study period. The results revealed that (2347) Anopheline mosquito larvae were found and collected from only one station. All of which (2347) larvae (100%) were classified as probably Anopheles Squamosus. The study also showed that, a number of 81 adults (100%) Anopheline mosquito were classified as probably Anopheles Squamosus. Anopheles Squamosus were found only in the shallow pond water habitat in Alrahma west area of El Obied, the mean Anopheline density in the study area for larvae was 0.313 per dip while the mean density of adult was 0 per room. The high mosquito larval density in Alrahma west area indicated that, this part of El Obied Town is at risk of mosquito-borne diseases including malaria. This study recommended to apply the control program against mosquito at this part of the Town.

Keywords: anopheles, squamosus, Alrahma, distribution

Procedia PDF Downloads 285

Authors: E. Von Cheong, Carol Sinnott, Darren Dahly, Patricia M. Kearney

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Introduction and Aim: Adverse childhood experiences (ACEs) are all too common and have been linked to poorer health and wellbeing across the life course. While the prevention of ACEs is a worthy goal, it is important that we also try to lessen the impact of ACEs for those who do experience them. This study aims to investigate associations between adverse childhood experiences (ACEs) and later-life depressive symptoms; and to explore whether perceived social support (PSS) moderates these. Method: We analysed baseline data from the Mitchelstown (Ireland) 2010-11 cohort involving 2047 men and women aged 50–69 years. Self-reported assessments included ACEs (Centre for Disease Control ACE questionnaire), PSS (Oslo Social Support Scale), and depressive symptoms (CES-D). The primary exposure was self-report of at least one ACE. We also investigated the effects of ACE exposure by the subtypes abuse, neglect, and household dysfunction. Associations between each of these exposures and depressive symptoms were estimated using logistic regression, adjusted for socio-demographic factors that were selected using the Directed Acyclic Graph (DAG) approach. We also tested whether the estimated associations varied across levels of PSS (poor, moderate, and good). Results: 23.7% of participants reported at least one ACE (95% CI: 21.9% to 25.6%). ACE exposures (overall or subtype) were associated with a higher odds of depressive symptoms, but only among individuals with poor PSS. For example, exposure to any ACE (vs. none) was associated with 3 times the odds of depressive symptoms (Adjusted OR 2.97; 95% CI 1.63 to 5.40) among individuals reporting poor PSS, while among those reporting moderate PSS, the adjusted OR was 1.18 (95% CI 0.72 to 1.94). Discussion: ACEs are common among older adults in Ireland and are associated with higher odds of later-life depressive symptoms among those also reporting poor PSS. Interventions that enhance perception of social support following ACE exposure may help reduce the burden of depression in older populations.

Keywords: adverse childhood experiences, depression, later-life, perceived social support

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Authors: Tiyisani L. Chavalala, Nicole B. Richoux, Martin H. Villet

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Rivers and their adjacent ecosystems are linked by reciprocal ecological subsidies. Rivers receive nutrients and energy from land, and these transfers can represent important food subsidies, a phenomenon known as allochthony. Emergence of adult aquatic invertebrates can also provide important food sources to terrestrial consumers. Reciprocal subsidies are influenced by factors such as canopy cover, river flow rate and channel width, which can be highly variable through space and time. The aim of this study is to identify and quantify the main trophic links between adjacent ecosystems (terrestrial and freshwater systems) in several Eastern Cape Rivers with different catchment sizes and flow rates and to develop an understanding of the factors that affect the strength of these links and their spatial dynamics. Food sources and consumers were sampled during four seasons (August 2016, November 2016, February 2017 and May 2017), and stable isotope ratios will serve as tracers to estimate the food web structures. Emergence traps are being used to quantify the rates of emergence of adult aquatic insects, and infall-pan traps are being used to quantify the terrestrial insects falling into rivers as potential food subsidies.

Keywords: emerging aquatic insects, in-falling terrestrial insects, reciprocal resource subsidies, stable isotopes

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Authors: Zoltan Abram

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Background: In the last time it was hardly increased the prevalence of psychical diseases and disorders which reduce work capacity, life quality and life expectancy. Objectives: The aim of our research is to study the psychical health state of the Romanian adults living in the middle part of the country and the role of some economical, psychological and social factors, especially in relationship with depression. Methods: The study is based on a complex anonymous questionnaire, including Beck depressive scale, which was completed by a representative sample among adult population. The applied method was a combination between stratification and more-steps sampling. Results: After our results depression is the most common psychical illness with 9,1% diagnosis, but the tendency to depression, the existence of depressive symptoms is much higher than the treated illness. The percentage of suicide attempt among the studied population was 2,9%. It is analysed how gender, age, professional and social status, living and working conditions and different social factors are influencing the health state. According to Beck score, it was established a significant difference in the favour of female, elderly people, lower educational level, urban population. Conclusions: In our study it is underlined the importance of health promotion and education. It is concluded that improving living standards, modifying in a proper way the lifestyle of the population, we can positively influence the physical and mental health state of the Romanian adult population.

Keywords: Beck scale, depression, psychological aspects, suicide attempt

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Authors: Mustafa M. Donma, Orkide Donma

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Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.

Keywords: blood pressure, children, index, metabolic syndrome, obesity

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Authors: Mai Kaneda, Sarah Feeney

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This study examined the association between adult attachment security and career decision-making self-efficacy (CDMSE) among college students in the United States. Previous studies show that attachment security is associated with levels of CDMSE among college students. Given that a majority of studies examining career development variables have used parental attachment measures, this study adds to understanding of this phenomenon by utilizing a broader measure of attachment. The participants included 269 college students (76% female) between the ages of 19-29. An anonymous survey was distributed online via social media as well as in hard copy format in classrooms. Multiple regression analyses were conducted to determine the relationship between anxious and avoidant attachment and CDMSE. Results revealed anxious attachment was a significant predictor of CDMSE (B = -.13, p = .01), such that greater anxiety in attachment was associated with lower levels of CDMSE. When accounting for anxious attachment, avoidant attachment was no longer significant as a predictor of CDMSE (B = -.12, p = .10). The variance in college CDMSE explained by the model was 7%, F(2,267) = 9.51, p < .001. Results for anxious attachment are consistent with existing literature that finds insecure attachment to be related to lower levels of CDMSE, however the non-significant results for avoidant attachment as a predictor of CDMSE suggest not all types of attachment insecurity are equally related to CDMSE. Future research is needed to explore the nature of the relationship between different dimensions of attachment insecurity and CDMSE.

Keywords: attachment, career decision-making, college students, self-efficacy

Procedia PDF Downloads 221