Search results for: combined intervention
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4869

Search results for: combined intervention

4389 Improving Depression, Anxiety and Distress Symptoms in Type 2 Diabetes Patients

Authors: Seyed Reza Alvani, Norzarina Mohd Zaharim

Abstract:

Diabetes mellitus is one of the chronic, progressive illnesses that has reached a widespread level all over the world and considered an extreme life-threatening condition in South East Asian countries region include Malaysia. Co-morbid psychological factors like diabetes-related distress and low level of psychological well-being are related to high levels of blood sugar and hypo/hyperglycemia complications. As a result, the implementation of any effective psychological interventions among diabetes patients is necessary. One such intervention is cognitive behavioural therapy (CBT) that is approved and suggested by many professionals as an empirically-supported technique of treatment for people how are suffering from diabetes around the world where there is no clear evidence of using this technique in Malaysia. The target of this study was to see whether or not participation in group CBT would end in an improvement of psychological well-being (by decreasing the levels of depression and anxiety) and diabetes-related distress followed by lower level of blood sugar level. The sample of the present study was 60 type 2 diabetes adults (ages 20-65) with HbA1c ≥ 7 from Universiti Sains Malaysia (USM) clinic. All participants were selected by the convenience sampling technique. Participants completed Well-Being Questionaire (W-BQ) and Distress Scale (DDS-17) after signing written consent form. Those participants who were interested to join CBT groups were placed to the experimental groups, and people who were not interested were assigned to the control group. The experimental groups (n = 30) received group CBT, whereas participants in the control group (n = 30) did not receive any kind of psychological intervention. For testing the effect of intervention, mixed between-within ANOVA used. The entire intervention program took three months, and a significant improvement in the level of psychological well-being and decline in the level of diabetes distress observed among participants from experimental group, but not for those in the control group. Additionally, the result of the study suggested that group CBT could help participants in experimental group achieve more acceptable HbA1c levels in comparison with those in the control group. Malaysian Ministry of Health, researcher and governors should give due interest and commitment to psychological care as a pathway to diabetes mitigation among Malaysian adults.

Keywords: cognitive behavioral therapy, diabetes related distress, diabetes type 2, Malaysia, well-being

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4388 Autonomy Supportive Coaching to Achieve Health Literacy

Authors: E. Knisel, H. Rupprich, A. Heissel

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Health Literacy is defined as the degree to which people have the capacity to obtain and understand information to make health decisions. Illustrated are three levels of health literacy: (1) Functional literacy refers to the transmission of information about e. g. physical activity and nutrition; (2) interactive literacy implies the development of personal and social skills to adopt health-related behaviour and (3) critical health literacy indicates advanced cognitive skills connected with personal empowerment to critically analyse health information, to define self-determined goals and taking action in various situations accordingly. The achievement of the third level refers to self-determination and autonomy which should be outcomes of exercise programs for overweight children as health-related behaviour change will occur and persist if it is autonomously motivated. Method: We adopted a quasi-experimental design with group (autonomy supportive coaching, control) and session (pre-test, intervention, post-test, and follow-up-test). Overweight and obese children and adolescents at the age of 8-14 years (N=40) received a 6-month (20 sessions) exercise program with autonomy supportive coaching implemented by the coaches and sandwiched between pre-test and post-test. All participants (N=92) completed the German version of the Basic Needs Satisfaction Scale Sport and Exercise. Additionally, we assessed the engagement in the exercise program by the MVPA (Moderate-to-Vigorous Physical Activity) and by the adherence and drop-out-rate. Results: Participants in the intervention group perceived their autonomy as moderate in the post-test and the follow-up-test. However, the psychological intervention failed to develop a high autonomy, as both groups show moderate perceived autonomy from the pre-test to the post-test. Participants in the intervention group were higher engaged in MVPA in the exercise program and they attend the program more regularly. Discussion: Young overweight and obese children and adolescents can acquire autonomy using autonomy supporting coaching. However, research identifying the extent they achieve critical health literacy is required to implement an autonomy-supportive coaching style into exercise programs for this target group.

Keywords: autonomy support, coaching, health literacy, health promotion

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4387 Managing Food Waste Behaviour in Saudi Arabia: Investigating the Role of Social Marketing

Authors: Suliman Al Balawi

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Food waste is a significant problem in the Kingdom of Saudi Arabia (KSA). About SR13 billion worth of food is wasted per year in the KSA. From moral, social, and economic perspectives, it is essential to reduce the wastage of food. Although studies have identified the amount of food waste in the KSA, there is a lack of research on why people in the KSA waste food; thus, it is difficult to design efficient intervention programs to reduce food waste. This research investigates the key factors that influence the food waste behavior of the people of the KSA. A food waste behavior model is proposed in this study that has moral disengagement at the center of the model. Following a literature survey, it is hypothesised that religiosity, hedonic value, frugality, and trait cynicism are the antecedents of moral disengagement that are likely to impact the food waste behavior of the people of the KSA. The study further posits that an intervention strategy in the form of a social marketing campaign that focuses on lowering the level of moral disengagement could reduce the food waste behavior of the people of the KSA. This study will apply a pre-test/post-test experimental design (control group). A random sampling method will be used to select participants from the (employees of a chosen firm) in the KSA. The social marketing campaign will be run for six months through the Corporate Social Responsibility Department of the Company, and to analyse the experimental data, structural equation modeling (SEM) will be used. The outcomes of the study will demonstrate the effectiveness of a social marketing campaign for improving the food waste behavior of the people of the KSA and will ultimately lay the foundation for designing efficient intervention programs in the future. This study will contribute to the knowledge on food waste behavior by testing a newly proposed food waste behavior model in the KSA.

Keywords: food waste, social marketing, Saudi Arabia, moral disengagement

Procedia PDF Downloads 159
4386 Evaluation of Two Earliness Cotton Genotypes in Three Ecological Regions

Authors: Gholamhossein Hosseini

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Two earliness cotton genotypes I and II, which had been developed by hybridization and backcross methods between sindise-80 as an early maturing gene parent and two other lines i.e. Red leaf and Bulgare-557 as a second parent, are subjected to different environmental conditions. The early maturing genotypes with coded names of I and II were compared with four native cotton cultivars in randomized complete block design (RCBD) with four replications in three ecological regions of Iran from 2016-2017. Two early maturing genotypes along with four native cultivars viz. Varamin, Oltan, Sahel and Arya were planted in Agricultural Research Station of Varamin, Moghan and Kashmar for evaluation. Earliness data were collected for six treatments during two years in the three regions except missing data for the second year of Kashmar. Therefore, missed data were estimated and imputed. For testing the homogeneity of error variances, each experiment at a given location or year is analyzed separately using Hartley and Bartlett’s Chi-square tests and both tests confirmed homogeneity of variance. Combined analysis of variance showed that genotypes I and II were superior in Varamin, Moghan and Kashmar regions. Earliness means and their interaction effects were compared with Duncan’s multiple range tests. Finally combined analysis of variance showed that genotypes I and II were superior in Varamin, Moghan and Kashmar regions. Earliness means and their interaction effects are compared with Duncan’s multiple range tests.

Keywords: cotton, combined, analysis, earliness

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4385 Positive Effect of Manipulated Virtual Kinematic Intervention in Individuals with Traumatic Stiff Shoulder: Pilot Study

Authors: Isabella Schwartz, Ori Safran, Naama Karniel, Michal Abel, Adina Berko, Martin Seyres, Tamir Tsoar, Sigal Portnoy

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Virtual Reality allows to manipulate the patient’s perception, thereby providing a motivational addition to real-time biofeedback exercises. We aimed to test the effect of manipulated virtual kinematic intervention on measures of active and passive Range of Motion (ROM), pain, and disability level in individuals with traumatic stiff shoulder. In a double-blinded study, patients with stiff shoulder following proximal humerus fracture and non-operative treatment were randomly divided into a non-manipulated feedback group (NM-group; N=6) and a manipulated feedback group (M-group; N=7). The shoulder ROM, pain, and the Disabilities of the Arm, Shoulder and Hand (DASH) scores were tested at baseline and after the 6 sessions, during which the subjects performed shoulder flexion and abduction in front of a graphic visualization of the shoulder angle. The biofeedback provided to the NM-group was the actual shoulder angle and the feedback provided to the M-group was manipulated so that 10° were constantly subtracted from the actual angle detected by the motion capture system. The M-group showed greater improvement in the active flexion ROM, with median and interquartile range of 197.1 (140.5-425.0) compared to 142.5 (139.1-151.3) for the NM-group (p=.046). Also, the M-group showed greater improvement in the DASH scores, with median and interquartile range of 67.7 (52.8-86.2) compared to 89.7 (83.8-98.3) for the NM-group (p=.022). Manipulated intervention is beneficial in individuals with traumatic stiff shoulder and should be further tested for other populations with orthopedic injuries.

Keywords: virtual reality, biofeedback, shoulder pain, range of motion

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4384 Optimal Sizing and Placement of Distributed Generators for Profit Maximization Using Firefly Algorithm

Authors: Engy Adel Mohamed, Yasser Gamal-Eldin Hegazy

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This paper presents a firefly based algorithm for optimal sizing and allocation of distributed generators for profit maximization. Distributed generators in the proposed algorithm are of photovoltaic and combined heat and power technologies. Combined heat and power distributed generators are modeled as voltage controlled nodes while photovoltaic distributed generators are modeled as constant power nodes. The proposed algorithm is implemented in MATLAB environment and tested the unbalanced IEEE 37-node feeder. The results show the effectiveness of the proposed algorithm in optimal selection of distributed generators size and site in order to maximize the total system profit.

Keywords: distributed generators, firefly algorithm, IEEE 37-node feeder, profit maximization

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4383 Design of Evaluation for Ehealth Intervention: A Participatory Study in Italy, Israel, Spain and Sweden

Authors: Monika Jurkeviciute, Amia Enam, Johanna Torres Bonilla, Henrik Eriksson

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Introduction: Many evaluations of eHealth interventions conclude that the evidence for improved clinical outcomes is limited, especially when the intervention is short, such as one year. Often, evaluation design does not address the feasibility of achieving clinical outcomes. Evaluations are designed to reflect upon clinical goals of intervention without utilizing the opportunity to illuminate effects on organizations and cost. A comprehensive design of evaluation can better support decision-making regarding the effectiveness and potential transferability of eHealth. Hence, the purpose of this paper is to present a feasible and comprehensive design of evaluation for eHealth intervention, including the design process in different contexts. Methodology: The situation of limited feasibility of clinical outcomes was foreseen in the European Union funded project called “DECI” (“Digital Environment for Cognitive Inclusion”) that is run under the “Horizon 2020” program with an aim to define and test a digital environment platform within corresponding care models that help elderly people live independently. A complex intervention of eHealth implementation into elaborate care models in four different countries was planned for one year. To design the evaluation, a participative approach was undertaken using Pettigrew’s lens of change and transformations, including context, process, and content. Through a series of workshops, observations, interviews, and document analysis, as well as a review of scientific literature, a comprehensive design of evaluation was created. Findings: The findings indicate that in order to get evidence on clinical outcomes, eHealth interventions should last longer than one year. The content of the comprehensive evaluation design includes a collection of qualitative and quantitative methods for data gathering which illuminates non-medical aspects. Furthermore, it contains communication arrangements to discuss the results and continuously improve the evaluation design, as well as procedures for monitoring and improving the data collection during the intervention. The process of the comprehensive evaluation design consists of four stages: (1) analysis of a current state in different contexts, including measurement systems, expectations and profiles of stakeholders, organizational ambitions to change due to eHealth integration, and the organizational capacity to collect data for evaluation; (2) workshop with project partners to discuss the as-is situation in relation to the project goals; (3) development of general and customized sets of relevant performance measures, questionnaires and interview questions; (4) setting up procedures and monitoring systems for the interventions. Lastly, strategies are presented on how challenges can be handled during the design process of evaluation in four different countries. The evaluation design needs to consider contextual factors such as project limitations, and differences between pilot sites in terms of eHealth solutions, patient groups, care models, national and organizational cultures and settings. This implies a need for the flexible approach to evaluation design to enable judgment over the effectiveness and potential for adoption and transferability of eHealth. In summary, this paper provides learning opportunities for future evaluation designs of eHealth interventions in different national and organizational settings.

Keywords: ehealth, elderly, evaluation, intervention, multi-cultural

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4382 Improvement of Autism Diagnostic Observation Schedule Scores after Comprehensive Intensive Early Interventions in a Clinical Setting

Authors: Nils Haglund, Svenolof Dahlgren, Maria Rastam, Peik Gustafsson, Karin Kalien

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In Sweden, like in most developed countries, there is a substantial increase of children diagnosed with autism and other conditions within the autism spectrum (ASD). The rapid increase of ASD rates stresses the importance of developing care programs to provide support and comprehensive interventions for affected families. The current observational study was conducted in order to evaluate an ongoing Comprehensive Intensive Early Intervention (CIEI) program for children with autism in southern Sweden. The change in autism symptoms among children participating in CIEI (intervention group, n=67) was compared with children who received traditional habilitation services only (comparison group, n=27). Children of parents who accepted the offered CIEI-program, constituted the intervention group, whereas children, whose parents (for some reason) were not interested in the offered CIEI-program, constituted the comparison group. The CIEI-program was individualized to each child by experienced applied behavior analysis (ABA) specialists with different backgrounds as psychologists, speech pathologists or special education teachers, in cooperation with parents and preschool staff. Due to the individualization, the intervention could vary in intensity and techniques. The intensity was calculated to 15-25 hours each week at home and the preschool altogether. Each child was assigned one 'trainer', who was often employed as a preschool teacher but could have another educational background. An agreement between supervisor- parents and preschool staff was reached to confirm the intensity and content of the CIEI- program over an approximately two-year intervention period. Symptom changes were measured as evaluation-ADOS-2-scores, total- and severity-scores, minus the corresponding baseline-scores, divided by the time between baseline and evaluation. The difference between the study-groups regarding change of ADOS-2-scores was estimated using ANCOVA. In the current study, children in the CIEI-group improved their ADOS-2-total scores between baseline and evaluation (-0.8 scores per year; 95%CI: -1.2 to -0.4), whereas no such improvement was detected in the comparison group (+0.1 scores per year; 95%CI: -0.7 to +0.9). The change difference (change in the CIEI-group vs. change in the comparison group) was statistically significant, both crude and after adjusting for possible confounders (-1.1; 95%CI -1.9 to -0.4). Children in the CIEI-group also significantly improved their ADOS-calibrated severity scores, but not significantly differently so from the comparison group. The results from the current study indicate that the CIEI program significantly improves social and communicative skills among children with autism and that children with developmental delay could benefit to a similar degree as other children. The results support earlier studies reporting on the improvement of autism symptoms after early intensive interventions. The results from observational studies are difficult to interpret, but it is nevertheless of uttermost importance to evaluate costly autism intervention programs. Such results may be of immediate importance to healthcare organizations when allocating the already strained resources to different patient groups. Albeit the obvious limitation of the current naturalistic study, the results support previous positive studies and indicate that children with autism benefit from participating in early comprehensive, intensive programs and that investments in these programs may be highly justifiable.

Keywords: autism symptoms, ADOS-scores, evaluation, intervention program

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4381 Growth and Yield Response of an Indian Wheat Cultivar (HD 2967) to Ozone and Water Stress in Open-Top Chambers with Emphasis on Its Antioxidant Status, Photosynthesis and Nutrient Allocation

Authors: Annesha Ghosh, S. B. Agrawal

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Agricultural sector is facing a serious threat due to climate change and exacerbation of different atmospheric pollutants. Tropospheric ozone (O₃) is considered as a dynamic air pollutant imposing substantial phytotoxicity to natural vegetations and agriculture worldwide. Naturally, plants are exposed to different environmental factors and their interactions. Amongst such interactions, studies related to O₃ and water stress are still rare. In the present experiment, wheat cultivar HD2967 were grown in open top chambers (OTC) under two O₃ concentration; ambient O₃ level (A) and elevated O₃ (E) (ambient + 20 ppb O₃) along with two different water supply; well-watered (W) and 50% water stress conditions (WS), with an aim to assess the individual and interactive effect of two most prevailing stress factors in Indo-Gangetic Plains of India. Exposure to elevated O₃ dose caused early senescence symptoms and reduction in growth and biomass of the test cultivar. The adversity was more pronounced under the combined effect of EWS. Significant reduction of stomatal conductance (gs) and assimilation rate were observed under combined stress condition compared to the control (AW). However, plants grown under individual stress conditions displayed higher gs, biomass, and antioxidant defense mechanism compared to the plants grown under the presence of combined stresses. Higher induction in most of the enzyme activities of catalase (CAT), ascorbate peroxidase (APX), glutathione reductase (GR), peroxidase (POD) and superoxide dismutase (SOD) was displayed by HD 2967 under EW while, under the presence of combined stresses (EWS), a moderate increment of APX and CAT activity was observed only at its vegetative phase. Furthermore, variations in nutrient uptake and redistribution to different plants parts were also observed in the present study. Reduction in water availability has checked nutrient uptake (N, K, P, Ca, Cu, Mg, Zn) in above-ground parts (leaf) and below-ground parts (root). On the other hand, carbon (C) accumulation with subsequent C-N ratio was observed to be higher in the leaves under EWS. Such major nutrient check and limitation in carbon fixation due to lower gs under combined stress conditions might have weakened the defense mechanisms of the test cultivar. Grain yield was significantly reduced under EWS followed by AWS and EW as compared to their control, exhibiting an additive effect on the grain yield.

Keywords: antioxidants, open-top chambers, ozone, water stress, wheat, yield

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4380 Diagnostic Evaluation of Urinary Angiogenin (ANG) and Clusterin (CLU) as Biomarker for Bladder Cancer

Authors: Marwa I. Shabayek, Ola A. Said, Hanan A. Attaia, Heba A. Awida

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Bladder carcinoma is an important worldwide health problem. Both cystoscopy and urine cytology used in detecting bladder cancer suffer from drawbacks where cystoscopy is an invasive method and urine cytology shows low sensitivity in low grade tumors. This study validates easier and less time-consuming techniques to evaluate the value of combined use of angiogenin and clusterin in comparison and combination with voided urine cytology in the detection of bladder cancer patients. This study includes malignant (bladder cancer patients, n= 50), benign (n=20), and healthy (n=20) groups. The studied groups were subjected to cystoscopic examination, detection of bilharzial antibodies, urine cytology, and estimation of urinary angiogenin and clusterin by ELISA. The overall sensitivity and specifcity were 66% and 75% for angiogenin, 70% and 82.5% for clusterin and 46% and 80% for voided urine cytology. Combined sensitivity of angiogenin and clusterin with urine cytology increased from 82 to 88%.

Keywords: angiogenin, bladder cancer, clusterin, cytology

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4379 Problem Solving Courts for Domestic Violence Offenders: Duluth Model Application in Spanish-Speaking Offenders

Authors: I. Salas-Menotti

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Problem-solving courts were created to assist offenders with specific needs that were not addressed properly in traditional courts. Problem-solving courts' main objective is to pursue solutions that will benefit the offender, the victim, and society as well. These courts were developed as an innovative response to deal with issues such as drug abuse, mental illness, and domestic violence. In Brooklyn, men who are charged with domestic violence related offenses for the first time are offered plea bargains that include the attendance to a domestic abuse intervention program as a condition to dismiss the most serious charges and avoid incarceration. The desired outcome is that the offender will engage in a program that will modify his behavior avoiding new incidents of domestic abuse, it requires accountability towards the victim and finally, it will hopefully bring down statistic related to domestic abuse incidents. This paper will discuss the effectiveness of the Duluth model as applied to Spanish-speaking men mandated to participate in the program by the specialized domestic violence courts in Brooklyn. A longitudinal study was conducted with 243 Spanish- speaking men who were mandated to participated in the men's program offered by EAC in Brooklyn in the years 2016 through 2018 to determine the recidivism rate of domestic violence crimes. Results show that the recidivism rate was less than 5% per year after completing the program which indicates that the intervention is effective in preventing new abuse allegations and subsequent arrests. It's recommended that comparative study with English-speaking participants is conducted to determine cultural and language variables affecting the program's efficacy.

Keywords: domestic violence, domestic abuse intervention programs, Problem solving courts, Spanish-speaking offenders

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4378 Technical Evaluation of Upgrading a Simple Gas Turbine Fired by Diesel to a Combined Cycle Power Plant in Kingdom of Suadi Arabistan Using WinSim Design II Software

Authors: Salman Obaidoon, Mohamed Hassan, Omer Bakather

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As environmental regulations increase, the need for a clean and inexpensive energy is becoming necessary these days using an available raw material with high efficiency and low emissions of toxic gases. This paper presents a study on modifying a gas turbine power plant fired by diesel, which is located in Saudi Arabia in order to increase the efficiency and capacity of the station as well as decrease the rate of emissions. The studied power plant consists of 30 units with different capacities and total net power is 1470 MW. The study was conducted on unit number 25 (GT-25) which produces 72.3 MW with 29.5% efficiency. In the beginning, the unit was modeled and simulated by using WinSim Design II software. In this step, actual unit data were used in order to test the validity of the model. The net power and efficiency obtained from software were 76.4 MW and 32.2% respectively. A difference of about 6% was found in the simulated power plant compared to the actual station which means that the model is valid. After the validation of the model, the simple gas turbine power plant was converted to a combined cycle power plant (CCPP). In this case, the exhausted gas released from the gas turbine was introduced to a heat recovery steam generator (HRSG), which consists of three heat exchangers: an economizer, an evaporator and a superheater. In this proposed model, many scenarios were conducted in order to get the optimal operating conditions. The net power of CCPP was increased to 116.4 MW while the overall efficiency of the unit was reached to 49.02%, consuming the same amount of fuel for the gas turbine power plant. For the purpose of comparing the rate of emissions of carbon dioxide on each model. It was found that the rate of CO₂ emissions was decreased from 15.94 kg/s to 9.22 kg/s by using the combined cycle power model as a result of reducing of the amount of diesel from 5.08 kg/s to 2.94 kg/s needed to produce 76.5 MW. The results indicate that the rate of emissions of carbon dioxide was decreased by 42.133% in CCPP compared to the simple gas turbine power plant.

Keywords: combined cycle power plant, efficiency, heat recovery steam generator, simulation, validation, WinSim design II software

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4377 KUCERIA: A Media to Increase Students’ Reading Interest and Nutrition Knowledge

Authors: Luthfia A. Eka, Bertri M. Masita, G. Indah Lestari, Rizka. Ryanindya, Anindita D. Nur, Asih. Setiarini

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The preferred habit nowadays is to watch television or listen to the radio rather than reading a newspaper or magazine. The low interest in reading is the reason to the Indonesian government passed a regulation to foster interest in reading early in schoolchildren through literacy programs. Literacy programs are held for the first 10 - 15 minutes before classes begin and children are asked to read books other than textbooks such as storybooks or magazines. In addition, elementary school children have a tendency to buy less healthy snacks around the school and do not know the nutrition fact from the food purchased. Whereas snacks contribute greatly in the fulfillment of energy and nutrients of children every day. The purpose of this study was to increase reading interest as well as knowledge of nutrition and health for elementary school students. This study used quantitative method with experimental study design for four months with twice intervention per week and deepened by qualitative method in the form of interview. The participants were 130 students consisting of 3rd and 4th graders in selected elementary school in Depok City. The Interventions given using KUCERIA (Child Storybook) which were storybooks with pictures consisting of 12 series about nutrition and health given at school literacy hours. There were five questions given by using the crossword method to find out the students' understanding of the story content in each series. To maximize the understanding and absorption of information, two students were asked to retell the story in front of the class and one student to fill the crossword on the board for each series. In addition, interviews were conducted by asking questions about students' interest in reading books. Intervention involved not only students but also teachers and parents in order to optimize students' reading habits. Analysis showed > 80% of student could answer 3 of 5 questions correctly in each series, which showed they had an interest in what they read. Research data on nutrition and health knowledge were analyzed using Wilcoxon and Chi-Square Test to see the relationship. However, only 46% of students completed 12 series and the rest lost to follow up due to school schedule incompatibility with the program. The results showed that there was a significant increase of knowledge (p = 0.000) between before intervention with 66,53 score and after intervention with 81,47 score. Retention of knowledge was conducted one month after the last intervention was administered and the analysis result showed no significant decrease of knowledge (p = 0,000) from 79,17 score to 75,48 score. There is also no relationship between sex and class with knowledge. Hence, an increased interest in reading of elementary school students and nutritional knowledge interventions using KUCERIA was proved successful. These interventions may be replicated in other schools or learning communities.

Keywords: literation, reading interest, nutrition knowledge, school children

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4376 Let’s talk about it! Increasing Advance Directives and End-of-Life Planning Awareness & Acceptance in Multi-Cultural Population with Low Health Literacy in a Faith-Based Setting

Authors: Tonya P. Bowers

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Background: The community/patient-focused quality improvement (QI) project has resolved a clinical problem using a quantitative design evaluating behavior change practices in a convenience sample from a multi-cultural congregation in a faith-based setting. AD is a legal document that speaks for the patient when they are unable to speak for themselves. The AD provides detailed information regarding critical medical decisions on behalf of the patient if they’re unable to make decisions themselves. The goal of an AD is to improve EOL care renderings that align with the patient’s desires. The AD diminishes anxiety and stress associated with making difficult EOL care decisions for patients and their families. Method: The project has two intervention strategies: pre-intervention and post-intervention formative surveys and a final summative survey. Most of the data collection takes place during implementation. The Let’s Talk About It Program utilized an online meeting platform for presentation. Participants were asked to complete informed consent and surveys via an online portal. Education included slide presentation, Advance Directive demonstration, video clips, discussions and 1:1 assistance with AD completion with a project manager. Results: Considering the overwhelming likelihood responses where 87.5% identified they “definitely would” hold an End-Of-Life conversation with their healthcare provider or family, and 81.25% indicated their likelihood that they “definitely would” complete an advance directive. In addition, the final summative post-intervention survey (n-14) also demonstrated an overwhelming 93% positive response. Which undoubtedly demonstrates favorable outcomes for the project. Conclusion: the Let’s Talk About It Program demonstrated effectiveness in improving participants' attitudes and acceptance towards Advance Directives and expanding End-of-Life care discussions. Emphasis on program sustainment within the church is imperative in fostering continued awareness and improved health outcomes for the local community with low health literacy.

Keywords: advance directive, end of life, advance care planning, palliative care, low health literacy, faith-based

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4375 A Single Stage Rocket Using Solid Fuels in Conventional Propulsion Systems

Authors: John R Evans, Sook-Ying Ho, Rey Chin

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This paper describes the research investigations orientated to the starting and propelling of a solid fuel rocket engine which operates as combined cycle propulsion system using three thrust pulses. The vehicle has been designed to minimise the cost of launching small number of Nano/Cube satellites into low earth orbits (LEO). A technology described in this paper is a ground-based launch propulsion system which starts the rocket vertical motion immediately causing air flow to enter the ramjet’s intake. Current technology has a ramjet operation predicted to be able to start high subsonic speed of 280 m/s using a liquid fuel ramjet (LFRJ). The combined cycle engine configuration is in many ways fundamentally different from the LFRJ. A much lower subsonic start speed is highly desirable since the use of a mortar to obtain the latter speed for rocket means a shorter launcher length can be utilized. This paper examines the means and has some performance calculations, including Computational Fluid Dynamics analysis of air-intake at suitable operational conditions, 3-DOF point mass trajectory analysis of multi-pulse propulsion system (where pulse ignition time and thrust magnitude can be controlled), etc. of getting a combined cycle rocket engine use in a single stage vehicle.

Keywords: combine cycle propulsion system, low earth orbit launch vehicle, computational fluid dynamics analysis, 3dof trajectory analysis

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4374 Effectiveness of a Peer-Mediated Intervention on Writing Skills in Students with Autism Spectrum Disorder in the Inclusive Classroom

Authors: Siddiq Ahmed

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The current study aimed to investigate the effectiveness of a Peer-Mediated Intervention (PMI) on writing skills for a student with autism spectrum disorders in inclusive classrooms. The participants in this study were two students, one as a tutor and another as a tutee who was diagnosed with autism spectrum disorder (ASD). The target participant struggled with writing skills and was paired with a student with high academic outcomes. The Tutor had a readiness to act as a tutor for his peer and was trained on how to assist his peer and how to identify and guide his peer’s writing mistakes. Multiple baseline design across behaviors was implemented to monitor the student’s progress in writing skills. The results of the present study showed that PMI yielded significant improvements in academic achievements for the target student. This study suggests that further studies should replicate the current study with an intensive focus on other academic skills such as reading comprehension, writing social stories, and math.

Keywords: peer tutoring, writing skills, autism, inclusion

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4373 Feasibility and Acceptability of Mindfulness-Based Cognitive Therapy in People with Depression and Cardiovascular Disorders: A Feasibility Randomised Controlled Trial

Authors: Modi Alsubaie, Chris Dickens, Barnaby Dunn, Andy Gibson, Obioha Ukoumunned, Alison Evans, Rachael Vicary, Manish Gandhi, Willem Kuyken

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Background: Depression co-occurs in 20% of people with cardiovascular disorders, can persist for years and predicts worse physical health outcomes. While psychosocial treatments have been shown to effectively treat acute depression in those with comorbid cardiovascular disorders, to date there has been no evaluation of approaches aiming to prevent relapse and treat residual depression symptoms in this group. Therefore, the current study aimed to examine the feasibility and acceptability of a randomised controlled trial design evaluating an adapted version of mindfulness-based cognitive therapy (MBCT) designed specifically for people with co-morbid depression and cardiovascular disorders. Methods: A 3-arm feasibility randomised controlled trial was conducted, comparing MBCT adapted for people with cardiovascular disorders plus treatment as usual (TAU), mindfulness-based stress reduction (MBSR) plus TAU, and TAU alone. Participants completed a set of self-report measures of depression severity, anxiety, quality of life, illness perceptions, mindfulness, self-compassion and affect and had their blood pressure taken immediately before, immediately after, and three months following the intervention. Those in the adapted-MBCT arm additionally underwent a qualitative interview to gather their views about the adapted intervention. Results: 3400 potentially eligible participants were approached when attending an outpatient appointment at a cardiology clinic or via a GP letter following a case note search. 242 (7.1%) were interested in taking part, 59 (1.7%) were screened as being suitable, and 33 (<1%) were eventually randomised to the three groups. The sample was heterogeneous in terms of whether they reported current depression or had a history of depression and the time since the onset of cardiovascular disease (one to 25 years). Of 11 participants randomised to adapted MBCT seven completed the full course, levels of home mindfulness practice were high, and positive qualitative feedback about the intervention was given. Twenty-nine out of 33 participants randomised completed all the assessment measures at all three-time points. With regards to the primary outcome (depression), five out of the seven people who completed the adapted MBCT and three out of five under MBSR showed significant clinical change, while in TAU no one showed any clinical change at the three-month follow-up. Conclusions: The adapted MBCT intervention was feasible and acceptable to participants. However, aspects of the trial design were not feasible. In particular, low recruitment rates were achieved, and there was a high withdrawal rate between screening and randomisation. Moreover, the heterogeneity in the sample was high meaning the adapted intervention was unlikely to be well tailored to all participants needs. This suggests that if the decision is made to move to a definitive trial, study recruitment procedures will need to be revised to more successfully recruit a target sample that optimally matches the adapted intervention.

Keywords: mindfulness-based cognitive therapy (MBCT), depression, cardiovascular disorders, feasibility, acceptability

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4372 Effect of Reminiscence Therapy on the Sleep Quality of the Elderly Living in Nursing Homes

Authors: Güler Duru Aşiret

Abstract:

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

Keywords: nursing, older people, reminiscence therapy, sleep

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4371 Predictors and 3-Year Outcomes of Compromised Left Circumflex Coronary Artery After Left Main Crossover Stenting

Authors: Hameed Ullah, Karim Elakabawi, Han KE, Najeeb Ullah, Habib Ullah, Sardar Ali Shah, Hamad Haider Khan, Muhammad Asad Khan, Ning Guo, Zuyi Yuan

Abstract:

Background: Predictors of decreased fractional flow reserve at left circumflex coronary artery after left main (LM) crossover stenting are still lacking. The objectives of the present study were to provide the predictors for low Fractional flow reserve (FFR) at coronary artery (LCx) and the possible treatment strategies for the compromised LCx-together with their long term outcomes. Methods: A total of 563 included patients out of 1974 patients admitted to our hospital from February 2015 to November 2020 with significant distal LM-bifurcation lesions. The enrolled patients underwent single-stent cross-over PCI under IVUS guidance with further LCx intervention as indicated by measured FFR. Results: The included patients showed angiographic significant LCx ostial affection after LM-stenting, but only 116 (20.6%) patients had FFR <0.8. The 3-year composite MACE rates were comparable between the high and low FFR groups (16.8% vs. 15.5%, respectively; P=0.744). In a multivariable analysis, a low FFR in the LCx was associated with post-stenting MLA of the LCx (OR: 0.032, P <0.001), post-stenting LCx-plaque burden (OR: 1.166, P <0.001), post-stenting LM-MLA (OR: 0.821, P =0.038) and pre-stenting LCx-MLA (OR: 0.371, P =0.044). In patients with low FFR, management of compromised LCx with DEB had the lowest 3-year MACE rate (8.1%) as compared to either KBI (17.5%) or stenting group (20.5%), P =0.299. Conclusion: FFR-guided LCx intervention can avoid unnecessary LCx intervention. The post-stenting predictors of low FFR include post-stenting MLA and plaque burden of the LCx and MV stent length. The 3-year MACE rates were comparable between high FFR patients and patients who had low FFR and were adequately managed.

Keywords: fractional flow reserve, left main stem, percutaneous coronary interventions, intravascular ultrasound

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4370 Reduction in Hospital Acquire Infections after Intervention of Hand Hygiene and Personal Protective Equipment at COVID Unit Indus Hospital Karachi

Authors: Aisha Maroof

Abstract:

Introduction: Coronavirus Disease 2019 (COVID-19) is spreading rapidly around the world with devastating consequences on patients, health care workers and health systems. Severe 2019 novel coronavirus infectious disease (COVID-19) with pneumonia is associated with high rates of admission to the intensive care unit (ICU) and they are at high risk to obtain the hospital acquire bloodstream infection (HAIs) such as central line associated bloodstream infection (CLABSI), catheter associated urinary tract infections (CAUTI) and laboratory confirm bloodstream infection (LCBSI). The chances of infection transmission increase when healthcare worker’s (HCWs) practice is inappropriate. Risk related to hand hygiene (HH) and personal protective equipment (PPE) as regards multidrug-resistant organism transmission: use of multiple gloving instead of HH and incorrect use of PPE can lead to a significant increase of device-related infections. As it reaches low- and middle-income countries, its effects could be even more, because it will be difficult for them to react aggressively to the pandemic. HAIs are one of the biggest medical concerns, resulting in increased mortality rates. Objective: To assess the effect of intervention on compliance of hand hygiene and PPE among HCWs reduce the rate of HAI in COVID-19 patients. Method: An interventional study was done between July to December, 2020. CLABSI, CAUTI and LCBSI data were collected from the medical record and direct observation. There were total of 50 Nurses, 18 doctors and all patients with laboratory-confirmed severe COVID-19 admitted to the hospital were included in this research study. Respiratory tract specimens were obtained after the first 48 h of ICU admission. Practices were observed after and before intervention. Education was provided based on WHO guidelines. Results: During the six months of study July to December, the rate of CLABSI, CAUTI and LCBSI pre and post intervention was reported. CLABSI rate decreasedd from 22.7 to 0, CAUTI rate was decreased from 1.6 to 0, LCBSI declined from 3.3 to 0 after implementation of intervention. Conclusion: HAIs are an important cause of morbidity and mortality. Most of the device related infections occurs due to lack of correct use of PPE and hand hygiene compliance. Hand hygiene and PPE is the most important measure to protect patients, through education it can be improved the correct use of PPE and hand hygiene compliance and can reduce the bacterial infection in COVID-19 patients.

Keywords: hospital acquire infection, healthcare workers, hand hygiene, personal protective equipment

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4369 Development and Effects of Transtheoretical Model Exercise Program for Elderly Women with Chronic Back Pain

Authors: Hyun-Ju Oh, Soon-Rim Suh, Mihan Kim

Abstract:

The steady and rapid increase of the older population is a global phenomenon. Chronic diseases and disabilities are increased due to aging. In general, exercise has been known to be most effective in preventing and managing chronic back pain. However, it is hard for the older women to initiate and maintain the exercise. Transtheoretical model (TTM) is one of the theories explain behavioral changes such as exercise. The application of the program considering the stage of behavior change is effective for the elderly woman to start and maintain the exercise. The purpose of this study was to develop TTM based exercise program and to examine its effect for elderly women with chronic back-pain. For the program evaluation, the non-equivalent control pre-posttest design was applied. The independent variable of this study is exercise intervention program. The contents of the program were constructed considering the characteristics of the elderly women with chronic low back pain, focusing on the process of change, the stage of change by the previous studies. The developed exercise program was applied to the elderly women with chronic low back pain in the planning stage and the preparation stage. The subjects were 50 older women over 65 years of age with chronic back-pain who did not practice regular exercise. The experimental group (n=25) received the 8weeks TTM based exercise program. The control group received the book which named low back pain management. Data were collected at three times: before the exercise intervention, right after the intervention, and 4weeks after the intervention. The dependent variables were the processes of change, decisional balance, exercise self-efficacy, back-pain, depression and muscle strength. The results of this study were as follows. Processes of change (<.001), pros of decisional balance (<.001), exercise self-efficacy (<.001), back pain (<.001), depression (<.001), muscle strength (<.001) were higher in the experimental group than in the control group right after the program and 4weeks after the programs. The results of this study show that applying the TTM based exercise program increases the use of the change process, increases the exercise self-efficacy, increases the stage of changing the exercise behavior and strengthens the muscular strength by lowering the degree of pain and depression Respectively. The significance of the study was to confirm the effect of continuous exercise by maintaining regular exercise habits by applying exercise program of the transtheoretical model to the chronic low back pain elderly with exercise intention.

Keywords: chronic back pain, elderly, exercise, women

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4368 Promotion of Healthy Food Choices in School Children through Nutrition Education

Authors: Vinti Davar

Abstract:

Introduction: Childhood overweight increases the risk for certain medical and psychological conditions. Millions of school-age children worldwide are affected by serious yet easily treatable and preventable illnesses that inhibit their ability to learn. Healthier children stay in school longer, attend more regularly, learn more and become healthier and more productive adults. Schools are an important setting for nutrition education because one can reach most children, teachers and parents. These years offer a key window for shaping their lifetime habits, which have an impact on their health throughout life. Against this background, an attempt was made to impart nutrition education to school children in Haryana state of India to promote healthy food choices and assess the effectiveness of this program. Methodology: This study was completed in two phases. During the first phase, pre-intervention anthropometric and dietary survey was conducted; the teaching materials for nutrition intervention program were developed and tested; and the questionnaire was validated. In the second phase, an intervention was implemented in two schools of Kurukshetra, Haryana for six months by personal visits once a week. A total of 350 children in the age group of 6-12 years were selected. Out of these, 279 children, 153 boys and 126 girls completed the study. The subjects were divided into four groups namely: underweight, normal, overweight and obese based on body mass index-for-age categories. A power point colorful presentation to improve the quality of tiffin, snacks and meals emphasizing inclusion of all food groups especially vegetables every day and fruits at least 3-4 days per week was used. An extra 20 minutes of aerobic exercise daily was likewise organized and a healthy school environment created. Provision of clean drinking water by school authorities was ensured. Selling of soft drinks and energy-dense snacks in the school canteen as well as advertisements about soft drink and snacks on the school walls were banned. Post intervention, anthropometric indices and food selections were reassessed. Results: The results of this study reiterate the critical role of nutrition education and promotion in improving the healthier food choices by school children. It was observed that normal, overweight and obese children participating in nutrition education intervention program significantly (p≤0.05) increased their daily seasonal fruit and vegetable consumption. Fat and oil consumption was significantly reduced by overweight and obese subjects. Fast food intake was controlled by obese children. The nutrition knowledge of school children significantly improved (p≤0.05) from pre to post intervention. A highly significant increase (p≤0.00) was noted in the nutrition attitude score after intervention in all four groups. Conclusion: This study has shown that a well-planned nutrition education program could improve nutrition knowledge and promote positive changes in healthy food choices. A nutrition program inculcates wholesome eating and active life style habits in children and adolescents that could not only prevent them from chronic diseases and early death but also reduce healthcare cost and enhance the quality of life of citizens and thereby nations.

Keywords: children, eating habits healthy food, obesity, school going, fast foods

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4367 The Effectiveness of the Sensory-Motor and Spatial Perception Rehabilitation Program Based on Parent-Child Interaction and Its Effectiveness on Kinesio phobia in Children with Visually Impairment

Authors: Saheb Yousefi, Kim T. Zebehazy, Parviz Sharifi Daramadi, Tahereh Najafi Fard, Kevin Murfitt

Abstract:

Context: Children with visual impairments often face challenges in their cognitive, motor, and social development. Sensory-motor and spatial perception therapies can be beneficial for these children, but many existing programs only focus on a limited set of therapies. This study aims to investigate the effectiveness of a rehabilitation program for sensory- motor and spatial perception in reducing the fear of mobility in visually impaired children. Research Aim: The aim of this study is to determine if a rehabilitation program based on parent-child interaction can reduce the fear of mobility in visually impaired children. Methodology: This study uses a semi-experimental approach with an uneven control group design. Visually impaired children aged 10 to 14 and their parents from the Board of the Blind and Visually Impaired in Tehran Province were included in the study. The sample was divided into experimental and control groups, with a total of 30 participants. The experimental group participated in a rehabilitation program for sensory-motor and spatial perception based on parent-child interaction, while the control group did not receive this intervention. Data was collected using questionnaires on transportation issues and analyzed using multivariate and univariate mixed analysis of variance tests. Findings: The analysis of the data showed that the fear of movement was significantly improved in the experimental group compared to the control group after the intervention. Theoretical Importance: This study highlights the effectiveness of a rehabilitation program for sensory- motor and spatial perception based on parent-child interaction in reducing the fear of mobility in visually impaired children. It contributes to the existing knowledge by demonstrating the positive impact of this type of intervention on the cognitive, motor, and social development of these children. Data Collection and Analysis Procedures: Data was collected through the use of questionnaires administered to the children before and after the intervention. The data was analyzed using multivariate and univariate mixed analysis of variance tests to examine the effects of the rehabilitation program. Questions Addressed: This study addresses the question of whether a rehabilitation program based on parent-child interaction can reduce the fear of mobility in visually impaired children. Conclusion: The findings of this study support the effectiveness of the sensory-motor and spatial perception rehabilitation program based on parent-child interaction in reducing the fear of movement in visually impaired children. This intervention can be considered as a suitable method to enhance the fear of mobility in these children.

Keywords: vision impairment, sensory-motor rehabilitation, space perception, parent-child interaction, fear of movement.

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4366 Effect of Educational Information with Video Compact Disc on Anxiety Level in Patients Undergoing Bronchoscopy in Ramathibodi Hospital

Authors: Chariya Laohavich, Viboon Bunsrangsuk

Abstract:

Objective: Bronchoscopy is a common outpatient procedure. The authors compared the patient anxiety level before and after received video-assisted procedural information. Method: One hundred and twenty patients who never received bronchoscopy and scheduled for elective bronchoscopy at outpatient Bronchosope unit at Ramathibodi Hospital, Mahidol University were randomized into control and intervention group. Video-assisted procedural information was given in intervention group. Pre and post procedural anxiety score were recorded and compared between two groups. Paired T-test was used for statistical analysis. Result: There was statistically significant decrease (p < 0.001) for anxiety score in patients who received video assisted procedural information compare with control group. Conclusion: Video-assisted procedural information should be given to patient who will have bronchoscopy to reduce anxiety.

Keywords: anxiety, bronchoscopy, video compact disc (VCD)

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4365 Priority Analysis for Korean Disaster Mental Health Service Model Using Analytic Hierarchy Process

Authors: Myung-Soo Lee, Sun-Jin Jo, Kyoung-Sae Na, Joo-Eon Park

Abstract:

Early intervention after a disaster is important for recovery of disaster victims and each country has its own professional mental health service system such as Disaster Psychiatric Assistant Team in Japan and Crisis Counseling Program in the USA. The purpose of this study was to determine key prior components of the Korean Disaster Psychiatric Assistant Team (K-DPAT) for building up Korean disaster mental health service system. We conducted an Analytic Hierarchy Process(AHP) with disaster mental health experts using pairwise comparison questionnaire which compares the relative importance of the key components of Korean disaster mental health service system. Forty-one experts answered the first online survey, and among them, 36 responded to the second. Ten experts were participated in panel meeting and discussed the results of the survey and AHP process. Participants decided the relative importance of the Korean disaster mental health service system regarding initial professional intervention as follows. K-DPAT could be organized at a national level (43.0%) or regional level (40.0%). K-DPAT members should be managed (59.0%) and educated (52.1%) by national level than regional or local level. K-DPAT should be organized independent of the preexisting mental health system (70.1%). Funding for K-DPAT should be from the Ministry of Public Safety and the system could be managed by Ministry of Health (65.8%). Experts agreed K-DPAT leader is suitable for key decision maker for most types of disaster except infectious disease. We expect new model for disaster mental health services can improve insufficiency of the system such as fragmentation and decrease the unmet needs of early professional intervention for the disaster victims.

Keywords: analytic hierarchy process, decision making, disaster, DPAT, mental health services

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4364 Effects of G-jitter Combined with Heat and Mass Transfer by Mixed Convection MHD Flow of Maxwell Fluid in a Porous Space

Authors: Faisal Salah, Z. A. Aziz, K. K. Viswanathan

Abstract:

In this article, the effects of g-jitter induced and combined with heat and mass transfer by mixed convection of MHD Maxwell fluid in microgravity situation is investigated for a simple system. This system consists of two heated vertical parallel infinite flat plates held at constant but different temperatures and concentrations. By using modified Darcy’s law, the equations governing the flow are modelled. These equations are solved analytically for the induced velocity, temperature and concentration distributions. Many interesting available results in the relevant literature (i.e. Newtonian fluid) is obtained as the special case of the present general analysis. Finally, the graphical results for the velocity profile of the oscillating flow in the channel are presented and discussed for different values of the material constants.

Keywords: g-jitter, heat and mass transfer, mixed convection, Maxwell fluid, porous medium

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4363 Development and Psychometric Properties of the Dutch Contextual Assessment of Social Skills: A Blinded Observational Outcome Measure of Social Skills for Adolescents with Autism Spectrum Disorder

Authors: Sakinah Idris, Femke Ten Hoeve, Kirstin Greaves-Lord

Abstract:

Background: Social skills interventions are considered to be efficacious if social skills are improved as a result of an intervention. Nevertheless, the objective assessment of social skills is hindered by a lack of sensitive and validated measures. To measure the change in social skills after an intervention, questionnaires reported by parents, clinicians and/or teachers are commonly used. Observations are the most ecologically valid method of assessing improvements in social skills after an intervention. For this purpose, The Program for the Educational and Enrichment of Relational Skills (PEERS) was developed for adolescents, in order to teach them the age-appropriate skills needed to participate in society. It is an evidence-based intervention for adolescents with ASD that taught ecologically valid social skills techniques. Objectives: The current study aims to describe the development and psychometric evaluation of the Dutch Contextual Assessment of Social Skills (CASS), an observational outcome measure of social skills for adolescents with Autism Spectrum Disorder (ASD). Methods: 64 adolescents (M = 14.68, SD = 1.41, 71% boys) with ASD performed the CASS before and after a social skills intervention (i.e. PEERS or the active control condition). Each adolescent completed a 3-minute conversation with a confederate. The conversation was prompt as a natural introduction between two-unfamiliar, similar ages, opposite-sex peers who meet for the first time. The adolescent and the confederate completed a brief questionnaire about the conversation (Conversation Rating Scale). Results: Results indicated sufficient psychometric properties. The Dutch CASS has a high level of internal consistency (Cronbach's α coefficients = 0.84). Data supported the convergent validity (i.e., significant correlated with the Social Skills Improvement System (SSiS). The Dutch CASS did not significantly correlate with the autistic mannerism subscale from Social Responsiveness Scale (SRS), thus proved the divergent validity. Based on scorings made by raters who were kept blind to the time points, reliable change index was computed to assess the change in social skills. With regard to the content validity, only the learning objectives of the first two meetings of PEERS about conversational skills relatively matched with rating domains of the CASS. Due to this underrepresentation, we found an existing observational measure (TOPICC) that covers some of the other learning objectives of PEERS. TOPICC covers 22% of the learning objectives of PEERS about conversational skills, meanwhile, CASS is 45%. Unfortunately, 33% of the learning objectives of PEERS was not covered by CASS or TOPICC. Conclusion: Recommendations are made to improve the psychometric properties and content validity of the Dutch CASS.

Keywords: autism spectrum disorder, observational, PEERS, social skills

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4362 The Impact of Group Hope Therapy on the Life Satisfaction, Happiness, and Hopefulness of Older Adults

Authors: Gholamzadeh Sakineh, Jedi Maryam, Fereshteh Dehghanrad

Abstract:

Background: Mental and psychological issues are common among older adults. Positive psychology theorists and researchers recommend focusing on constructs such as happiness, life satisfaction and hope rather than dwelling on negative experiences and perceptions. Objective: The research aim was to evaluate the impact of hope therapy interventions on the life satisfaction, happiness, and hopefulness of older adults in Iran. Methodology: This study used a quasi-experimental design. A convenience sample of 32 older adults was recruited from a retirement center in Shiraz, Iran. Participants were randomly assigned to either a control group (n = 16) or an experimental group (n = 16). The experimental group received eight sessions of hope therapy, each lasting 1.5 hours. The data for this study were collected using Snyder's Adult Hope Scale (AHS), Oxford Happiness Questionnaire, and Life Satisfaction Index-Z. The questionnaires were administered before, immediately after the intervention, and two months later. Descriptive and analytical statistical tests were used to analyze the data using SPSS version 19. Descriptive statistics were used to describe the sample characteristics and the distribution of the data. Analytical statistics were used to test the research hypotheses. Findings: The results showed that the hope therapy intervention significantly increased the life satisfaction and hopefulness of older adults (p < 0.05). In addition, the influence of time was also significant (p < 0.05). However, the intervention did not affect happiness in statistically significant ways. Conclusions: The findings of this study support the theoretical importance of hope therapy in improving the life satisfaction and hopefulness of older adults. Hope therapy interventions can be considered as an effective way to improve the emotional well-being and quality of life of older adults.

Keywords: older adults, life satisfaction, happiness, hopefulness, hope therapy

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4361 ICanny: CNN Modulation Recognition Algorithm

Authors: Jingpeng Gao, Xinrui Mao, Zhibin Deng

Abstract:

Aiming at the low recognition rate on the composite signal modulation in low signal to noise ratio (SNR), this paper proposes a modulation recognition algorithm based on ICanny-CNN. Firstly, the radar signal is transformed into the time-frequency image by Choi-Williams Distribution (CWD). Secondly, we propose an image processing algorithm using the Guided Filter and the threshold selection method, which is combined with the hole filling and the mask operation. Finally, the shallow convolutional neural network (CNN) is combined with the idea of the depth-wise convolution (Dw Conv) and the point-wise convolution (Pw Conv). The proposed CNN is designed to complete image classification and realize modulation recognition of radar signal. The simulation results show that the proposed algorithm can reach 90.83% at 0dB and 71.52% at -8dB. Therefore, the proposed algorithm has a good classification and anti-noise performance in radar signal modulation recognition and other fields.

Keywords: modulation recognition, image processing, composite signal, improved Canny algorithm

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4360 An Approach to Electricity Production Utilizing Waste Heat of a Triple-Pressure Cogeneration Combined Cycle Power Plant

Authors: Soheil Mohtaram, Wu Weidong, Yashar Aryanfar

Abstract:

This research investigates the points with heat recovery potential in a triple-pressure cogeneration combined cycle power plant and determines the amount of waste heat that can be recovered. A modified cycle arrangement is then adopted for accessing thermal potentials. Modeling the energy system is followed by thermodynamic and energetic evaluation, and then the price of the manufactured products is also determined using the Total Revenue Requirement (TRR) method and term economic analysis. The results of optimization are then presented in a Pareto chart diagram by implementing a new model with dual objective functions, which include power cost and produce heat. This model can be utilized to identify the optimal operating point for such power plants based on electricity and heat prices in different regions.

Keywords: heat loss, recycling, unused energy, efficient production, optimization, triple-pressure cogeneration

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