Search results for: adult with intellectual disability
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2460

Search results for: adult with intellectual disability

1920 The Effect of Normal Cervical Sagittal Configuration in the Management of Cervicogenic Dizziness: A 1-Year Randomized Controlled Study

Authors: Moustafa Ibrahim Moustafa

Abstract:

The purpose of this study was to determine the immediate and long term effects of a multimodal program, with the addition of cervical sagittal curve restoration and forward head correction, on severity of dizziness, disability, frequency of dizziness, and severity of cervical pain. 72 patients with cervicogenic dizziness, definite hypolordotic cervical spine, and forward head posture were randomized to experimental or a control group. Both groups received the multimodal program, additionally, the study group received the Denneroll cervical traction. All outcome measures were measured at three intervals. The general linear model indicated a significant group × time effects in favor of experimental group on measures of anterior head translation (F=329.4 P < .0005), cervical lordosis (F=293.7 P < .0005), severity of dizziness (F=262.1 P < .0005), disability (F=248.9 P < .0005), frequency of dizziness (F=53.9 P < .0005), and severity of cervical pain (F=350.1 P < .0005). The addition of Dennroll cervical traction to a multimodal program can positively affect dizziness management outcomes.

Keywords: randomized controlled trial, traction, dizziness, cervical

Procedia PDF Downloads 291
1919 Effect of Rehabilitative Nursing Program on Pain Intensity and Functional Status among Patients with Discectomy

Authors: Amal Shehata

Abstract:

Low back pain related to disc prolapse is localized in the lumbar area and it may be radiated to the lower extremities, starting from neurons near or around the spinal canal. Most of the population may be affected with disc prolapse within their lifetime and leads to lost productivity, disability and loss of function. The study purpose was to examine the effect of rehabilitative nursing program on pain intensity and functional status among patients with discectomy. Design: Aquasi experimental design was utilized. Setting: The study was carried out at neurosurgery department and out patient's clinic of Menoufia University and Teaching hospitals at Menoufia governorate, Egypt. Instrument of the study: Five Instruments were used for data collection: Structured interviewing questionnaire, Functional assessment instrument, Observational check list, Numeric rating Scale and Oswestry low back pain disability questionnaire. Results: There was an improvement in mean total knowledge score about disease process, discectomy and rehabilitation program in study group (25.32%) than control group (7.32%). There was highly statistically significant improvement in lumbar flexibility among study group (80%) than control group (30%) after rehabilitation program than before. Also there was a decrease in pain score in study group (58% no pain) than control group (28% no pain) after rehabilitation program. There was an improvement in total disability score of study group (zero %) regarding effect of pain on the activity of daily living after rehabilitation program than control group (16%). Conclusion: Application of rehabilitative nursing program for patient with discectomy had proven a positive effect in relation to knowledge score, pain reduction, activity of daily living and functional abilities. Recommendation: A continuous rehabilitative nursing program should be carried out for all patients immediately after discectomy surgery on regular basis. Also A colored illustrated booklet about rehabilitation program should be available and distributed for all patients before surgery.

Keywords: discectomy, rehabilitative nursing program, pain intensity, functional status

Procedia PDF Downloads 131
1918 Nonlinear Analysis of Postural Sway in Multiple Sclerosis

Authors: Hua Cao, Laurent Peyrodie, Olivier Agnani, Cecile Donze

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Multiple sclerosis (MS) is a disease, which affects the central nervous system, and causes balance problem. In clinical, this disorder is usually evaluated using static posturography. Some linear or nonlinear measures, extracted from the posturographic data (i.e. center of pressure, COP) recorded during a balance test, has been used to analyze postural control of MS patients. In this study, the trend (TREND) and the sample entropy (SampEn), two nonlinear parameters were chosen to investigate their relationships with the expanded disability status scale (EDSS) score. Forty volunteers with different EDSS scores participated in our experiments with eyes open (EO) and closed (EC). TREND and two types of SampEn (SampEn1 and SampEn2) were calculated for each combined COP’s position signal. The results have shown that TREND had a weak negative correlation to EDSS while SampEn2 had a strong positive correlation to EDSS. Compared to TREND and SampEn1, SampEn2 showed a better significant correlation to EDSS and an ability to discriminate the MS patients in the EC case. In addition, the outcome of the study suggests that the multi-dimensional nonlinear analysis could provide some information about the impact of disability progression in MS on dynamics of the COP data.

Keywords: balance, multiple sclerosis, nonlinear analysis, postural sway

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1917 Determinants of Happiness and Its Relation towards Life Satisfaction among Adult Community of Kampung Jaya Bakti

Authors: Khairul Abid Awang

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Happiness and life satisfaction are the vital components in assessing the well-being of the societies and their social progress. These components varies and changes within communities and across time. Thus, due to low level of happiness and life satisfaction, it might affect mental health status psychologically and generally disrupt the health pattern of the individual. Hence, this present study aims to identify the happiness determinants, assessing the happiness and life satisfaction level, as well as examine the relation between happiness among Kampung Jaya Bakti adult community. Quantitative and cross-sectional study with total of 100 observations of 18 years old and above was participated in this study. The study was done in a semi-rural village which is geocentric towards river that branched from South East Asia Sea. Several happiness and life satisfaction instruments was used, inclusive of Individual Determinants of Happiness Scale (IDoHS) that had been developed in this study, in order to identify the determinants of happiness in the area based on the listed determinants. The listed determinants in IDoHS are: i) Daily activities. ii) Adaptation. iii) Goals. iv) Life Events. v) Living condition. vi) Self-confidence. vii) Personality traits. viii) Religion. The results revealed that 98% of the respondents agreed that the listed determinants in IDoHS are statistically significant in determining the happiness. The happiness level revealed that 71 percent (%) of the respondents are ‘very happy’, followed by 26% (‘moderately happy’) and 3% (‘neutral’), while life satisfaction level revealed that 70% of the respondents are ‘very highly satisfied’, followed by 29% (‘highly satisfied’) and 1% (‘moderately satisfied’). Pearson Correlation (Pearson’s r) shows that; happiness determinants listed in IDoHS are affecting happiness level (Pearson’s r: .514, p < 0.01) and life satisfaction level (Pearson’s r: .504, p < 0.01) respectively, as well as happiness that are statistically significant in affecting life satisfaction (Pearson’s r: .653, p < 0.01; Pearson’s r; .546, p < 0.01). It is concluded that the listed determinants in IDoHS are the determinants that affecting happiness and it is also noted that happiness are affecting life satisfaction and vice versa.

Keywords: adult community, determinants, happiness, life satisfaction, subjective well-being

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1916 Resistance Evaluation of Common Wheat Varieties/Lines to Leaf Rust and Stripe Rust at Seedling and Adult-Plant Stage in China, Gansu Province

Authors: Shelin Jin, Jin Huang, Shiqin Cao, Qiuzhen Jia, Bo Zhang, Zhenyu Sun

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Stripe rust and leaf rust, caused by Puccinia striiformis f.sp. tritici and Puccinia recondita f.sp. tritici are two of the most damaging diseases of wheat in China. In recent years, leaf rust has migrated to some wheat growing areas previously suitable for stripe rust, resulting in a mixture of the two diseases occurring in the same area and at the same time, and seriously damage wheat production in China, Gansu Province. The most effective method of prevention those two diseases are through the use of resistant cultivars. However, many studies have only carried out of resistance of wheat varieties for a single disease; resistance to both diseases is unknown. In order to definite the resistance composition of wheat varieties to these two diseases, 715 wheat varieties/lines from 8 breeding units in Gansu province were collected to test for the resistance to stripe rust and leaf rust at seedling stage in greenhouse and at adult plant stage in field in 2016-2018, respectively. Spore suspensions with the fresh mixture races of CYR32, CYR33, and CYR34 of Puccinia striiformis f.sp. tritici and mixture races of THTP, THTT, TKTT, and THTS of Puccinia recondita f.sp. tritici were used for inoculation separately. The result shows that only 4.74% of the varieties/lines show comprehensive resistance to strip rust and leaf rust at all growth stages, and there are 34 wheat varieties/lines including Tianxuan 67, 2006-1-4-1-4-2-7-2-3-10, 03-139-1-2-2-1-2-1, Qingnong 21, Lenghan 5, 04-203-1-1-1 and so on. In seedling stage, the frequencies of resistant varieties/lines to wheat strip rust and leaf rust were 56.64% and 30.23%. While the materials were susceptible to these diseases were 43.36% and 69.77%. 71 varieties/lines were resistant to those two diseases, accounted for 9.93%. 10 varieties/lines, accounted for 1.4%, were highly resistant (including immune/near immune) to those two diseases. In adult-plant stage, the frequencies of resistant varieties/lines to wheat strip rust and leaf rust were 76.53% and 36.11%. While the materials were susceptible to these diseases were 23.47% and 63.89%. 137 varieties/lines were resistant to those two diseases, accounted for 19.16%. 59 varieties/lines, accounted for 8.25%, were highly resistant (including immune/near immune) to those two diseases. Overall, the 715 varieties /lines had high resistance to wheat strip rust, but poor resistance to leaf rust. This study found out some resistant materials which had better comprehensive resistance to leaf rust and strip rust, also pointed out the resistance characteristics of 715 varieties/lines to those two diseases at the seedling stage and adult-plant stage, which will be of great guiding significance in wheat resistance breeding and comprehensive control those two diseases in China, Gansu Province in the future.

Keywords: Puccinia striiformis f.sp. tritici, Puccinia recondita f.sp. tritici, resistance of variety, wheat

Procedia PDF Downloads 109
1915 Dietary Modification and Its Effects in Overweight or Obese Saudi Women with or without Type 2 Diabetes Mellitus

Authors: Nasiruddin Khan, Nasser M. Al-Daghri, Dara A. Al-Disi, Asim Al-Fadda, Mohamed Al-Seif, Gyanendra Tripathi, A. L. Harte, Philip G. Mcternan

Abstract:

For the last few decades, the prevalence of type 2 diabetes mellitus (T2DM) in the Kingdom of Saudi Arabia (KSA) is increasing alarmingly high and is unprecedented at 31.6 %. Preventive measures should be taken to curb down the increasing incidence. In this prospective, 3-month study, we aimed to determine whether dietary modification program would confer favorable affects among overweight and obese adult Saudi women with or without T2DM. A total of 92 Saudi women [18 healthy controls, 24 overweight subjects and 50 overweight or obese patients with early onset T2DM were included in this prospective study. Baseline anthropometrics and fasting blood samples were taken at baseline and after 3 months. Fasting blood sugar and lipid profile were measured routinely. A 500 Kcal deficit energy diet less than their daily recommended dietary allowances were prescribed to all participants. After 3 months of follow-up visit, significant improvements were observed in both the overweight and DMT2 group as compared to baseline with decreased mean BMI [Overweight Group 28.54±1.49 versus 27.95±2.25, p<0.05; DMT2 group 35.24±7.67 versus 35.04±8.07, p<0.05] and hip circumference [Overweight group 109.67±5.01 versus 108.07±4.07, p<0.05; DMT2 group 112.3±13.43 versus 109.21±12.71, p<0.01]. Moreover, in the overweight group, baseline HDL-cholesterol was significantly associated with protein intake and inversely associated with carbohydrate intake in controls. In the DMT2 group, carbohydrate intake at baseline was significantly associated with BMI. A 3-month 500kcal/day deficit dietary modification alone is probably effective among adult overweight or obese Saudi females without or with T2DM. Longer prospective studies are to determine whether the dietary intervention alone can reduce progression of T2DM among high-risk adult Arabs.

Keywords: diet, lipid, obesity, T2DM

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1914 Factors Impacting Training and Adult Education Providers’ Business Performance: The Singapore Context

Authors: Zan Chen, D. Kwok

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The SkillsFuture Singapore’s mission to develop a responsive and forward-looking Training and Adult Education (TAE) and workforce development system is undergirded by how successful TAE providers are in their business performance and strategies that strengthen their operational efficiency and processes. Therefore, understanding the factors that drive the business performance of TAE providers is critical to the success of SkillsFuture Singapore’s initiatives. This study aims to investigate how business strategy, work autonomy, work intensity and professional development support impact the business performance of private TAE providers. Specifically, the three research questions are: (1) Are there significant relationships between the above-mentioned four factors and TAE providers’ business performance?; (2) Are there significant differences on the four factors between low and high TAE providers’ business performance groups?; and (3) To what extent and in what manner do the four factors predict TAE providers’ business performance? This was part of the first national study on organizations and professionals working in the Training and Adult Education (TAE) sector. Data from 265 private TAE providers where respondents were Chief Executive Officers representatives from the Senior Management were analyzed. The results showed that business strategy (the extent that the organization leads the way in terms of developing new products and services; uses up-to-date learning technologies; customizes its products and services to the client’s needs), work autonomy (the extent that the staff personally have an influence on how hard they work; deciding what tasks they are to do; deciding how they are to do the tasks, and deciding the quality standards to which they work) and professional development support (both monetary and non-monetary support and incentives) had positive and significant relationships with business performance. However, no significant relationship is found between work intensity and business performance. A business strategy, work autonomy and professional development support were significantly higher in the high business performance group compared to the low-performance group among the TAE providers. Results of hierarchical regression analyses controlling for the size of the TAE providers showed significant impacts of business strategy, work autonomy and professional development support on TAE providers’ business performance. Overall, the model accounted for 27% of the variance in TAE providers’ business performance. This study provides policymakers with insights into improving existing policies, designing new initiatives and implementing targeting interventions to support TAE providers. The findings also have implications on how the TAE providers could better formulate their organizational strategies and business models. Finally, limitations of study, along with directions for future research will be discussed in the paper.

Keywords: adult education, business performance, business strategy, training, work autonomy

Procedia PDF Downloads 192
1913 Ability of Gastric Enzyme Extract of Adult Camel to Clot Bovine Milk

Authors: Boudjenah-Haroun Saliha, Isselnane Souad, Nouani Abdelwahab, Baaissa Babelhadj, Mati Abderrahmane

Abstract:

Algeria is experiencing significant development of the dairy sector, where consumption of milk and milk products increased by 2.7 million tons in 2008 to 4,400,000 tons in 2013, and cheese production has reached 1640 tons in the year 2014 with average consumption of 0.7 kg/person/year. Although rennet is still the most used coagulating enzyme in cheese, its production has been growing worldwide shortage. This shortage is primarily due to a growing increase in the production and consumption of cheese, and the inability to increase in parallel the production of rennet. This shortage has caused very large fluctuations in its price). To overcome these obstacles, much research has been undertaken to find effective and competitive substitutes used industrially. For this, the selection of a local production of rennet substitute is desirable. It would allow a permanent supply with limited dependence on imports and price fluctuations. Investigations conducted by our research team showed that extracts coagulants from the stomachs of older camels are characterized by a coagulating power than those from younger camels. The objective of this work is to study the possibility of substituting commercial rennet coagulant by gastric enzymes from adult camels for coagulation bovine milk. Excerpts from the raw camel coagulants obtained are characterized through their teneures proteins and clotting and proteolytic activities. Milk clotting conditions by the action of these extracts were optimized. Milk clotting time all treated with enzyme preparations and under different conditions was calculated. Bovine rennet has been used for comparison. The results show that crude extracts from gastric adult camel can be good substituting bovine rennet.

Keywords: Algeria, camel, cheese, coagulation, gastric extracts, milk

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1912 Efficacy of Isometric Neck Exercises and Stretching with Ergonomics for Neck Pain in Computer Professionals

Authors: Esther Liyanage, Indrajith Liyanage, Masih Khan

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Neck pain has become a common epidemiological problem. One of the reasons for this is a sedentary way of life, connected with using a personal computer during all daily activities. Work place and work duration has not been properly adapted to the personal physical conditions of these employees. During 1990’s the importance of workstation design and work methods, or ergonomics on health was brought to the forefront of public attention. Ergonomics is the application of scientific information concerning humans to the design of objects. Ergonomic intervention results in improvement of working posture and a decrease in prevalence of musculoskeletal symptoms. Stretching and resistance exercises to the neck are easy to do, when performed 1-2 times daily reduce discomfort and ease neck stiffness. This study is aimed at finding if ergonomics with exercises to the neck prove beneficial to reduce neck pain in Computer Professionals. The outcomes measures used were: Oswestry neck disability index and VAS score for pain. 100 subjects satisfying the inclusion criteria were included in the study. Results: Ergonomic intervention along with isometric neck exercises and stretching proved to reduce neck pain and disability among computer professionals.

Keywords: ergonomics, neck pain, neck exercises, physiotherapy for neck pain

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1911 Disability Management and Occupational Health Enhancement Program in Hong Kong Hospital Settings

Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

Abstract:

Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

Procedia PDF Downloads 190
1910 The FINDRISC Score for Prediabetes and Diabetes Screening in Adult Libyan Males

Authors: Issam M Hajjaji, Adel Tajoury, Salah R Benhamid

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The MENA region has the highest prevalence of diabetes in the world. Various risk scores were developed, not all appropriate locally. The objective of this study is to apply the FINDRISC Score to adult Libyan males to determine its significance, sensitivity, specificity and Positive Predictive Values as an initial screening tool for type 2 diabetes, and suggest a cut-off point. Methods: 600 subjects answered the questionnaire at their place of work, and their waist, weight, height & BP were measured. Thereafter, after excluding those with known diabetes, an Oral Glucose Tolerance Test was done. Results: 414 subjects aged 19-78 completed the questionnaire and tests. 35 (8.4%) had impaired glucose tolerance (IGT) and 13 (3.1%) had diabetes (DM). The AUC-ROC for IGT was 0.614 (95% CI: 0.527-0.701), for DM 0.810 (95% CI: 0.709-0.911) and for both 0.689 (95% CI: 0.609-0.769). The Positive Predictive Value for a cut-off score of 5 were 15.5%, 11.7% & 5.7% for both conditions combined, prediabetes & diabetes respectively. The equivalent values for a cut-off score of 8 were 16.1%, 9.0% & 7.7%. The Negative Predictive Values were uniformly above 90%. Conclusions & Recommendations: The FINDRISC Score had a low predictive value for dysglycaemia in this sample and performed at a level of significance for IGT that is similar to other MENA countries, but did better for DM. A larger sample that included women is suggested, with a view of adjusting the Score to suit the local population.

Keywords: diabetes, FINDRISK, Libya, prediabetes

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1909 Acute Superior Mesenteric Artery Thrombosis Leading to Pneumatosis Intestinalis and Portal Venous Gas in a Young Adult after COVID-19 Vaccination

Authors: Prakash Dhakal

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Hepatic portal venous gas (HPVG) is diagnosed via computed tomography due to unusual imaging features. HPVG, when linked with pneumatosis intestinalis, has a high mortality rate and requires urgent intervention. We present a case of a 26-year-old young adult with superior mesenteric artery thrombosis who presented with severe abdominal pain. He had a history of COVID vaccination (First dose of COVISHILED) 15 days back. On imaging, HPVG and pneumatosis intestinalis were seen owing to the urgent intervention of the patient. The reliable interpretation of the imaging findings along with quick intervention led to a favorable outcome in our case. Herein we present a thorough review of the patient with a history of COVID-19 vaccination with superior mesenteric artery thrombosis leading to bowel ischemia and hepatic portal venous gas. The patient underwent subtotal small bowel resection.

Keywords: COVID-19 vaccination, SMA thrombosis, portal venoius gas, pneumatosis intestinalis

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1908 Engaging Mature Learners through Video Case Studies

Authors: Jacqueline Mary Jepson

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This article provides a case study centred on the development of 13 video episodes which have been created to enhance student engagement with a post graduate online course in Project Management. The student group was unique as their online course needed to provide for asynchronistic learning and an adult learning pedagogy. In addition, students had come from a wide range professional backgrounds, with some having no Project Management experience, while others had 20 years or more. Students had to gain an understanding of an advanced body of knowledge and the course needed to achieve the academic requirements to qualify individuals to apply their learning in a range of contexts for professional practice and scholarship. To achieve this, a 13 episode case study was developed along with supportive learning materials based on the relocation of a zoo. This unique project provided a learning environment where the project could evolve over each video episode demonstrating the application of Project Management methodology which was then tied into the learning outcomes for the course and the assessment tasks. Discussion forums provided a way for students to converse and demonstrate their own understanding of content and how Project Management methodology can be applied.

Keywords: project management, adult learning, video case study, asynchronistic education

Procedia PDF Downloads 326
1907 The Lasting Impact of Parental Conflict on Self-Differentiation of Young Adult OffspringThe Lasting Impact of Parental Conflict on Self-Differentiation of Young Adult Offspring

Authors: A. Benedetto, P. Wong, N. Papouchis, L. W. Samstag

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Bowen’s concept of self-differentiation describes a healthy balance of autonomy and intimacy in close relationships, and it has been widely researched in the context of family dynamics. The current study aimed to clarify the impact of family dysfunction on self-differentiation by specifically examining conflict between parents, and by including young adults, an underexamined age group in this domain (N = 300; ages 18 to 30). It also identified a protective factor for offspring from conflictual homes. The 300 young adults (recruited online through Mechanical Turk) completed the Differentiation of Self Inventory (DSI), the Children’s Perception of Interparental Conflict Scale (CPIC), the Parental Bonding Instrument (PBI), and the Symptom Checklist-90-Revised (SCL-90-R). Analyses revealed that interparental conflict significantly impairs self-differentiation among young adult offspring. Specifically, exposure to parental conflict showed a negative impact on young adults’ sense of self, emotional reactivity, and interpersonal cutoff in the context of close relationships. Parental conflict was also related to increased psychological distress among offspring. Surprisingly, the study found that parental divorce does not impair self-differentiation in offspring, demonstrating the distinctly harmful impact of conflict. These results clarify a unique type of family dysfunction that impairs self-differentiation, specifically in distinguishing it from parental divorce; it examines young adults, a critical age group not previously examined in this domain; and it identifies a moderating protective factor (a strong parent-child bond) for offspring exposed to conflict. Overall, results suggest the need for modifications in parental behavior in order to protect offspring at risk of lasting emotional and interpersonal damage.

Keywords: divorce, family dysfunction, parental conflict, parent-child bond, relationships, self-differentiation, young adults

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1906 A Critical Review of the Success Model of Indian Pharmaceutical Industry

Authors: Ekta Pandey

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The Indian Pharmaceutical Industry is ranked third largest by volume and fourteenth by value. It thus accounts for 10% of world’s production by volume and 1.5% by value according to Department of Pharmaceuticals, Government of India. The industry has shown phenomenal growth over past few years, moving from US $ 1 billion turnover in 1990 to a turnover of around US $30 billion in 2015. The Indian pharmaceutical sector is ranked seventeenth in terms of export value of active pharmaceutical ingredients and dosage forms to more than 200 countries around the globe. It has shown tremendous changes especially after Trade Related Aspects of Intellectual Property Rights (TRIPS) agreement. Recognizing the immense potential for growth and its direct impact on Indian economy, it is important to look up the industrial policies adopted since Indian independence which turnaround the Indian pharmaceutical industry. A systematic review of changes in market structure of Indian pharmaceutical industry due to shift in policy regimes is done from 1850 to 2015 using secondary peer reviewed published research work. The aim is to understand the impact of anti-trust laws, intellectual property rights, industry competition acts and regulations are quite crucial in determining effective economic policy and have overall lasting effects on international trade and ties. The proposed paper examines the position of Indian domestic firms relative to multinational pharmaceutical firms tries to throw some light on the growth curve of Indian pharmaceutical sector.

Keywords: active pharmaceutical ingredients, competition act, pharmaceutical industry, TRIPS

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1905 Short Term Effects of Mobilization with Movement in a Patient with Fibromyalgia: A Case Report

Authors: S. F. Kanaan, Fatima Al-Kadi, H. Khrais

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Background: Fibromyalgia is a chronic condition that is characterized by chronic pain that limits physical and functional activities. To our best knowledge, there is currently no key physiotherapy approach recommended to reduce pain and improve function. In addition, there are scarce studies that investigated the effect of manual therapy in the management of Fibromyalgia, and no study investigated the efficacy of Mulligan´s mobilization with movement (MWM) in particular. Methods: A 51-year-old female diagnosed with Fibromyalgia for more than a year. The patient was complaining of generalized pain including neck, lower back, shoulders, elbows, hips, and knees. In addition, the patient reported severe limitation in activities and inability to complete her work as a lawyer. The Intervention provided for the patient consisted of 4 sessions (in two weeks) of MWM for neck, lower back, shoulders, elbows, sacroiliac joint, hips, and knees. The Visual Analogue Scale of pain (VAS), Range of Motion (ROM), 10-minute walk test, Roland Morris Low Back Pain and Disability Questionnaire (RMQ), Disability of the Arm, Shoulder and Hand Score (DASH) were collected at the baseline and at the end of treatment. Results: Average improvement of ROM in the neck, lower back, shoulder, elbows, hips, and knees was 45%. VAS scale changed from pre-treatment to post-treatment as the following: neck pain (9 to 0), lower back pain (8 to 1), shoulders pain (8 to 2), elbows pain (7 to 1), and knees pain (9 to 0). The patient demonstrated improvement in all functional scale from pre-intervention to post-intervention: 10-meter walk test (9.8 to 4.5 seconds), RMQ (21 to 11/24), and DASH (88.7% to 40.5%). The patient did not report any side effect of using this approach. Conclusion: Fibromyalgia can cause joint 'faulty position' leading to pain and dysfunction, which can be reversed by using MWM. MWM showed to have clinically significant improvement in ROM, pain, and ability to walk and a clinically significant reduction in disability in only 4 sessions. This work can be expanded in a larger sample.

Keywords: mobilization, fibromyalgia, dysfunction, manual therapy

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1904 Constructing Optimized Criteria of Objective Assessment Indicators among Elderly Frailty

Authors: Shu-Ching Chiu, Shu-Fang Chang

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The World Health Organization (WHO) has been actively developing intervention programs to deal with geriatric frailty. In its White Paper on Healthcare Policy 2020, the Department of Health, Bureau of Health Promotion proposed that active aging and the prevention of disability are essential for elderly people to maintain good health. The paper recommended five main policies relevant to this objective, one of which is the prevention of frailty and disability. Scholars have proposed a number of different criteria to diagnose and assess frailty; no consistent or normative standard of measurement is currently available. In addition, many methods of assessment are recursive, which can easily result in recall bias. Due to the relationship between frailty and physical fitness with regard to co-morbidity, it is important that academics optimize the criteria used to assess frailty by objectively evaluating the physical fitness of senior citizens. This study used a review of the literature to identify fitness indicators suitable for measuring frailty in the elderly. This study recommends that measurement criteria be integrated to produce an optimized predictive value for frailty score. Healthcare professionals could use this data to detect frailty at an early stage and provide appropriate care to prevent further debilitation and increase longevity.

Keywords: frailty, aging, physical fitness, optimized criteria, healthcare

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1903 Intellectual Property Rights Reforms and the Quality of Exported Goods

Authors: Gideon Ndubuisi

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It is widely acknowledged that the quality of a country’s export matters more decisively than the quantity it exports. Hence, understanding the drivers of exported goods’ quality is a relevant policy question. Among other things, product quality upgrading is a considerable cost uncertainty venture that can be undertaken by an entrepreneur. Once a product is successfully upgraded, however, others can imitate the product, and hence, the returns to the pioneer entrepreneur are socialized. Along with this line, a government policy such as intellectual property rights (IPRs) protection which lessens the non-appropriability problem and incentivizes cost discovery investments becomes both a panacea in addressing the market failure and a sine qua non for an entrepreneur to engage in product quality upgrading. In addendum, product quality upgrading involves complex tasks which often require a lot of knowledge and technology sharing beyond the bounds of the firm thereby creating rooms for knowledge spillovers and imitations. Without an institution that protects upstream suppliers of knowledge and technology, technology masking occurs which bids up marginal production cost and product quality fall. Despite these clear associations between IPRs and product quality upgrading, the surging literature on the drivers of the quality of exported goods has proceeded almost in isolation of IPRs protection as a determinant. Consequently, the current study uses a difference-in-difference method to evaluate the effects of IPRs reforms on the quality of exported goods in 16 developing countries over the sample periods of 1984-2000. The study finds weak evidence that IPRs reforms increase the quality of all exported goods. When the industries are sorted into high and low-patent sensitive industries, however, we find strong indicative evidence that IPRs reform increases the quality of exported goods in high-patent sensitive sectors both in absolute terms and relative to the low-patent sensitive sectors in the post-reform period. We also obtain strong indicative evidence that it brought the quality of exported goods in the high-patent sensitive sectors closer to the quality frontier. Accounting for time-duration effects, these observed effects grow over time. The results are also largely consistent when we consider the sophistication and complexity of exported goods rather than just quality upgrades.

Keywords: exports, export quality, export sophistication, intellectual property rights

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1902 Importance of Detecting Malingering Patients in Clinical Setting

Authors: Sakshi Chopra, Harsimarpreet Kaur, Ashima Nehra

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Objectives: Malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of secondary gains or motives, which may include financial compensation; avoiding work; getting lighter criminal sentences; or simply to attract attention or sympathy. Malingering is different from somatization disorder and factitious disorder. The prevalence of malingering is unknown and difficult to determine. In an estimated study in forensic population, it can reach up to 17% cases. But the accuracy of such estimates is questionable as successful malingerers are not detected and thus, not included. Methods: The case study of a 58 years old, right handed, graduate, pre-morbidly working in a national company with reported history of stroke leading to head injury; cerebral infarction/facial palsy and dementia. He was referred for disability certification so that his job position can be transferred to his son as he could not work anymore. A series of Neuropsychological tests were administered. Results: With a mental age of < 2.5 years; social adaptive functioning was overall < 20 showing profound Mental Retardation, less than 1 year social age in abilities of self-help, eating, dressing, locomotion, occupation, communication, self-direction, and socialization; severely impaired verbal and performance ability, 96% impairment in Activities of Daily Living, with an indication of very severe depression. With inconsistent and fluctuating medical findings and problem descriptions to different health professionals forming the board for his disability, it was concluded that this patient was malingering. Conclusions: Even though it can be easily defined, malingering can be very challenging to diagnosis. Cases of malingering impose a substantial economic burden on the health care system and false attribution of malingering imposes a substantial burden of suffering on a significant proportion of the patient population. Timely, tactful diagnosis and management can help ease this patient burden on the healthcare system. Malingering can be detected by only trained mental health professionals in the clinical setting.

Keywords: disability, India, malingering, neuropsychological assessment

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1901 Higher Education Leadership and Creating Sites of Institutional Belonging: A Global Case Study

Authors: Lisa M. Coleman

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The focus on disability, LGBTQ+, and internationalization has certainly been the subject of much research and programmatic across higher education. Many universities have entered into global partnerships with varying success and challenges across the various areas, including laws and policies. Attentiveness to the specific nuances of global inclusion, diversity, equity, belonging, and access (GIDBEA) and the leadership to support these efforts is crucial to the development of longstanding success across the programs. There have been a number of shifts related to diversification across student and alumni bodies. These shifts include but are not limited to how people identify gender, race, and sexuality (and the intersections across such identities), as well as trends across emerging and diverse disability communities. NYU is the most international campus in the United States, with the most campuses and sites outside of its county of origin and the most international students and exchange programs than any other university. As a result, the ongoing work related to GIDEBA is at the center of much of the leadership, administrative, and research efforts. Climate assessment work across NYU’s diverse global campus landscape will serve as the foundation to exemplify best practices related to data collection and dissemination, community and stakeholder engagement, and effective implementation of innovative strategies to close gap areas as identified. The data (quantitative and qualitative) and related research findings represent data collected from close to 22,000 stakeholders across the NYU campuses. The case study centers on specific methodological considerations, data integrity, stakeholder engagement from across student-faculty, staff, and alumni constituencies, and tactics to advance specific GIDBEA initiatives related to navigating shifting landscapes. Design thinking, incubation, and co-creation strategies have been employed to expand, leverage, actualize, and implement GIDBEA strategies that are – concrete, measurable, differentiated, and specific to global sites and regions and emerging trends.

Keywords: disability, LGBTQ+, DEI, research, case studies

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1900 Functioning of a Temporarily Single Parent Family System Due to Migration from the Perspective of Adolescents with Cerebral Palsy

Authors: A. Gagat-Matuła

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There is a definite lack – in Poland, as well as around the world – of empirical studies of families raising handicapped child, in which one parent migrates. In diagnostics of the functioning of such families emphasis should be placed not only on the difficulties, but most of all it should be indicated what possibilities are there for the family and how it overcomes the difficulties. Migration of a parent on the one hand is a chance to improve the family’s material situation. In certain circumstances this may only be an “escape” into work from the issues associated with the upbringing and rehabilitation of a handicapped child. The aim of the study was to learn the functioning of a temporarily single parent family system as a result of migration of a parent from the perspective of adolescents with cerebral palsy. The study was conducted in the year 2013 in the area of Eastern Poland. It involved an analysis of 70 persons (with cerebral palsy in an intellectual capacity) from families in which at least one of the parents migrates. The study incorporated the diagnostic survey method. These tools were used: Family Evaluation Scales (SOR) adapted for Poland by Andrzej Margasiński. The explorations in this study indicate, that 47% of studied temporarily single parent families are balanced models. This is evidence of the resources at the disposal of the family which, despite the disability of the child and temporary separation, is able to function properly. The conducted studies show, that 37% of temporarily single parent families are imbalanced models in the perception of adolescents with cerebral palsy. These families experience functional difficulties and require psychological and pedagogical support. There is a need for building skills related to effective coping with family stress. Especially considering, that families of an imbalanced type do not use the internal and external resources of the family system. Such a situation may deepen the disarrangement of family life. In intermediate families (16%) there are also temporary difficulties in functioning. Separation anxiety experienced by mothers may disrupt relations and introduce additional stress factors. For that reason it is important to provide support for women with difficulties coping with the emotions associated with raising handicapped adolescents and migratory separation.

Keywords: child with cerebral palsy, family, migration, parents

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1899 Adult Language Learning in the Institute of Technology Sector in the Republic of Ireland

Authors: Una Carthy

Abstract:

A recent study of third level institutions in Ireland reveals that both age and aptitude can be overcome by teaching methodologies to motivate second language learners. This PhD investigation gathered quantitative and qualitative data from 14 Institutes of Technology over a three years period from 2011 to 2014. The fundamental research question was to establish the impact of institutional language policy on attitudes towards language learning. However, other related issues around second language acquisition arose in the course of the investigation. Data were collected from both lectures and students, allowing interesting points of comparison to emerge from both datasets. Negative perceptions among lecturers regarding language provision were often associated with the view that language learning belongs to primary and secondary level and has no place in third level education. This perception was offset by substantial data showing positive attitudes towards adult language learning. Lenneberg’s Critical Age Theory postulated that the optimum age for learning a second language is before puberty. More recently, scholars have challenged this theory in their studies, revealing that mature learners can and do succeed at learning languages. With regard to aptitude, a preoccupation among lecturers regarding poor literacy skills among students emerged and was often associated with resistance to second language acquisition. This was offset by a preponderance of qualitative data from students highlighting the crucial role which teaching approaches play in the learning process. Interestingly, the data collected regarding learning disabilities reveals that, given the appropriate learning environments, individuals can be motivated to acquire second languages, and indeed succeed at learning them. These findings are in keeping with other recent studies regarding attitudes towards second language learning among students with learning disabilities. Both sets of findings reinforce the case for language policies in the Institute of Technology (IoTs). Supportive and positive learning environments can be created in third level institutions to motivate adult learners, thereby overcoming perceived obstacles relating to age and aptitude.

Keywords: age, aptitude, second language acquisition, teaching methodologies

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1898 The Strategic Importance of Technology in the International Production: Beyond the Global Value Chains Approach

Authors: Marcelo Pereira Introini

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The global value chains (GVC) approach contributes to a better understanding of the international production organization amid globalization’s second unbundling from the 1970s on. Mainly due to the tools that help to understand the importance of critical competences, technological capabilities, and functions performed by each player, GVC research flourished in recent years, rooted in discussing the possibilities of integration and repositioning along regional and global value chains. Regarding this context, part of the literature endorsed a more optimistic view that engaging in fragmented production networks could represent learning opportunities for developing countries’ firms, since the relationship with transnational corporations could allow them build skills and competences. Increasing recognition that GVCs are based on asymmetric power relations provided another sight about benefits, costs, and development possibilities though. Once leading companies tend to restrict the replication of their technologies and capabilities by their suppliers, alternative strategies beyond the functional specialization, seen as a way to integrate value chains, began to be broadly highlighted. This paper organizes a coherent narrative about the shortcomings of the GVC analytical framework, while recognizing its multidimensional contributions and recent developments. We adopt two different and complementary perspectives to explore the idea of integration in the international production. On one hand, we emphasize obstacles beyond production components, analyzing the role played by intangible assets and intellectual property regimes. On the other hand, we consider the importance of domestic production and innovation systems for technological development. In order to provide a deeper understanding of the restrictions on technological learning of developing countries’ firms, we firstly build from the notion of intellectual monopoly to analyze how flagship companies can prevent subordinated firms from improving their positions in fragmented production networks. Based on intellectual property protection regimes we discuss the increasing asymmetries between these players and the decreasing access of part of them to strategic intangible assets. Second, we debate the role of productive-technological ecosystems and of interactive and systemic technological development processes, as concepts of the Innovation Systems approach. Supporting the idea that not only endogenous advantages are important for international competition of developing countries’ firms, but also that the building of these advantages itself can be a source of technological learning, we focus on local efforts as a crucial element, which is not replaceable for technology imported from abroad. Finally, the paper contributes to the discussion about technological development as a two-dimensional dynamic. If GVC analysis tends to underline a company-based perspective, stressing the learning opportunities associated to GVC integration, historical involvement of national States brings up the debate about technology as a central aspect of interstate disputes. In this sense, technology is seen as part of military modernization before being also used in civil contexts, what presupposes its role for national security and productive autonomy strategies. From this outlook, it is important to consider it as an asset that, incorporated in sophisticated machinery, can be the target of state policies besides the protection provided by intellectual property regimes, such as in export controls and inward-investment restrictions.

Keywords: global value chains, innovation systems, intellectual monopoly, technological development

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1897 COVID-19 and Heart Failure Outcomes: Readmission Insights from the 2020 United States National Readmission Database

Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

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Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

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1896 Design Criteria Recommendation to Achieve Accessibility In-House to Different Users

Authors: Claudia Valderrama-Ulloa, Cristian Schmitt, Juan Pablo Marchetti, Viviana Bucarey

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Access to adequate housing is a fundamental human right and a crucial factor for health. Housing should be inclusive, accessible, and able to meet the needs of all its inhabitants at every stage of their lives without hindering their health, autonomy, or independence. This article addresses the importance of designing housing for people with disabilities, which varies depending on individual abilities, preferences, and cultural considerations. Based on the components of the International Classification of Functioning, Disability and Health, wheelchair users, little people (achondroplasia), children with autism spectrum disorder and Down syndrome were characterized, and six domains of activities related to daily life inside homes were defined. The article describes the main barriers homes present for this group of people. It proposes a list of architectural and design aspects to reduce barriers to housing use. The aspects are divided into three main groups: space management, building services, and supporting facilities. The article emphasizes the importance of consulting professionals and users with experience designing for diverse needs to create inclusive, safe, and supportive housing for people with disabilities.

Keywords: achondroplasia, autism spectrum disorder, disability, down syndrome, wheelchair user

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1895 Copyright Infringement for Academic Authorship in Uganda: Implications on Exemptions of Fair Use for Educational Purposes in Universities

Authors: Elisam Magara

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Like any other property, Intellectual Property (IP) must be regarded, respected, and remunerated to address the historical, ethical, economical and informational needs of society. Article 26 of the Constitution of the Republic of Uganda 1995, the Copyright and Neighbouring Rights (CNR) Act 2006 and CNR Regulations 2010 guide copyright protection in Uganda. However, an unpredictable environment has negatively impact on certain author/intellectual freedoms; and the infringements on academic works that affect the economic rights of authors that limit authors from fully enjoying the benefits of authorship. Notwithstanding the different licensing systems and copyright protection avenues, educational institutions and custodians of copyright works (libraries, archives) have continued to advocate for open access to information resources, under the legal exceptions of fair use for educational purposes. Thus, a study was conducted in educational institutions, libraries and archives in Uganda to assess the state of copyright infringement in Uganda in an increased use of academic authored works. The study attempted to establish the nature and forms of Copyright Infringement, the circumstances for copyright infringement, assessed the opinions from the custodians on strategies for balancing copyright protection for economic and moral gains by authors and increased access to information for educational purposes and fair-use. Through a survey, using a self-administered questionnaire, interviews and physical visits, the study was conducted in higher education institutions, libraries and archives among the officers that manage and keep copyright works. It established that the uncontrolled reproduction of copyright works in educational institutions and information institutions, have contributed copyright infringement robbing authors of their potential economic earnings and limiting their academic innovativeness and creativity. The study also established that lack of consciousness and awareness on copyright issues by lecturers, universities and libraries has made copyright works in Universities highly susceptible to copyright infringement. Thus the increased access to materials without restrictions has resulted in copyright infringement among the educational institutions, libraries and archives. A strategic alliance by the collecting Society (Uganda Reproduction Rights Organisation (URRO), government, Universities and right holders organisations (UTANA) to work together and institute a programme to address copyright protection and access to information is pertinently required.

Keywords: access to information, academic Writing, copyright, copyright infringement, copyright protection, exemptions of fair use, intellectual property rights

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1894 Role of Speech Language Pathologists in Vocational Rehabilitation

Authors: Marlyn Mathew

Abstract:

Communication is the key factor in any vocational /job set-up. However many persons with disabilities suffer a deficit in this very area in terms of comprehension, expression and cognitive skills making it difficult for them to get employed appropriately or stay employed. Vocational Rehabilitation is a continuous and coordinated process which involves the provision of vocational related services designed to enable a person with disability to obtain and maintain employment. Therefore the role of the speech language pathologist is crucial in assessing the communication deficits and needs of the individual at the various phases of employment- right from the time of seeking a job and attending interview with suitable employers and also at regular intervals of the employment. This article discusses the various communication deficits and the obstacles faced by individuals with special needs including but not limited to cognitive- linguistic deficits, execution function deficits, speech and language processing difficulties and strategies that can be introduced in the workplace to overcome these obstacles including use of visual cues, checklists, flow charts. The paper also throws light on the importance of educating colleagues and work partners about the communication difficulties faced by the individual. This would help to reduce the communication barriers in the workplace, help colleagues develop an empathetic approach and also reduce misunderstandings that can arise as a result of the communication impairment.

Keywords: vocational rehabilitation, disability, speech language pathologist, cognitive, linguistics

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1893 Dual Carriage of Hepatitis B Surface and Envelope Antigen in Adults in the Poorest Region of Nigeria: 2000-2015

Authors: E. Isaac, I. Jalo, Y. Alkali, A. Ajani, A. Rasaki, Y. Jibrin, K. Mustapha, A. Ayuba, S. Charanchi, H. Danlami

Abstract:

Introduction: Hepatitis B infection continues to be a serious global health problem with about 2 billion people infected worldwide, many of these in sub-Saharan Africa. Nigeria is one of the countries with the highest incidence, with a prevalence of 10-15%. Methods: Records of Hepatitis B surface and envelope antigen test results in adults in Federal Teaching Hospital, Gombe between May 2000 and May 2015 were retrieved and analyzed. Findings: Adult out-patient consultations and in-patient admissions were 343,083 and 67,761 respectively, accounting for 87% of total. Hepatitis B surface antigenaemia was tested for in 23,888 adults and children. 88.9% (21240) were adults. Males constituted 56% (11902/21240) and females 44% (9211/21240). 5104 (24.0%) of tested individuals were 19-25years; 12,039 (56.7%) 26-45years; 21119 (9.0%) 46-55years; 2.8% (590/21240) and 766 (3.6%) >65years. Among adult males, 17% (2133/11902) was contributed by ages 19-25. 58% (7017/11902), 11.9% (1421/11902), 6.4% (765/11902) and 4.7% (563/11902) of males were 26-45 years old, 46-55 years old and 56-65 years and >65year old respectively. Adults aged 19-25years, 26-45 years, 46-55years, 56-65 and > 65years each constituted 32% (2966/9211); 54.4% (5009/9211); 7.4% (684/9211), 3.8% (350/9211) and 2.2% (201/9211) of females respectively. 16.2% (3431/21,240) demonstrated Hepatitis B surface antigenaemia. The sero-positivity rate was 16.9% (865//5104) between 19-25years, 21.2% (2559/12,039) among 26-45year old individuals. 17.9% (377/2111); 14.1% (83/590) and 7.3% (56/766) of 46-55year old, 56-65year old and >65year old individuals screened were seropositive. The highest sero-positivity rate was found in male young adults aged 19-25years 27.9% (398/1426) and lowest in elderly males 7.4% (28/377). HBe antigen testing rate among HbSAg seropositive individuals was 97.3% (3338/3431). Males constituted 59.7% (1992/3338) and females 40.3% (1345/3338). 25.3% (844/3338) were aged 19-25years; 61.1% (2039/3338) 26-45years; 10.2% (340/3338) 46-55years; 2.7% (90/3338) 56-65years and 0.7% >65years old. HB e antigenaemia was positive in 8.2% (275/3338) of those tested. 41% (113/275); 50.2% (138/275); 5.4% (15/275); 1.8% (5/275) and 1.1 (3/275) of HB e sero-positivity was among age groups 19-25, 26-45, 46-55, 56-65 and > 65year old individuals. Dual sero-positivity rate was highest 13% (113/844) in young adults 19-25years and lowest between 46-55years; 15/340 (4.4%). 4.2% (15/360); 13.5% (69/512); 6.7% (90/1348); 4.6% (10/214); 5% (2/40) and 6.7% (1/15) of males aged 19-25; 26-45; 46-55; 56-65; and >65years had HB e antigenaemia respectively. Among females - 27/293 (9.2%) aged 19-25; 26/500 (5.2%) 26-45; 2/84 (2.4%) 46-55; 1/12 (8.3%) 56-65 and 1/9(11.1%) >65years had dual antigenaemia. In women of childbearing age, 6.9% (53/793) had a dual carriage. Conclusion: Dual hepatitis B surface and envelope antigenaemia are highest in young adult males. This will have significant implications for the development of chronic liver disease and hepatocellular carcinoma.

Keywords: adult, Hepatitis B, Nigeria, dual carriage

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1892 The Effect of Positional Release Technique versus Kinesio Tape on Iliocostalis lumborum in Back Myofascial Pain Syndrome

Authors: Shams Khaled Abdelrahman Abdallah Elbaz, Alaa Aldeen Abd Al Hakeem Balbaa

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Purpose: The purpose of this study was to compare the effects of Positional Release Technique versus Kinesio Tape on pain level, pressure pain threshold level and functional disability in patients with back myofascial pain syndrome at iliocostalis lumborum. Backgrounds/significance: Myofascial Pain Syndrome is a common muscular pain syndrome that arises from trigger points which are hyperirritable, painful and tender points within a taut band of skeletal muscle. In more recent literature, about 75% of patients with musculoskeletal pain presenting to a community medical centres suffer from myofascial pain syndrome.Iliocostalis lumborum are most likely to develop active trigger points. Subjects: Thirty patients diagnosed as back myofascial pain syndrome with active trigger points in iliocostalis lumborum muscle bilaterally had participated in this study. Methods and materials: Patients were randomly distributed into two groups. The first group consisted of 15 patients (8 males and 7 females) with mean age 30.6 (±3.08) years, they received positional release technique which was applied 3 times per session, 3/week every other day for 2 weeks. The second group consisted of 15 patients(5 males, 10 females) with a mean age 30.4 (±3.35) years, they received kinesio tape which was applied and changed every 3 days with one day off for a total 3 times in 2 weeks. Both techniques were applied over trigger points of the iliocostalis lumborum bilaterally. Patients were evaluated pretreatment and posttreatment program for Pain intensity (Visual analogue scale), pressure pain threshold (digital pressure algometry), and functional disability (The Oswestry Disability Index). Analyses: Repeated measures MANOVA was used to detect differences within and between groups pre and post treatment. Then the univariate ANOVA test was conducted for the analysis of each dependant variable within and between groups. All statistical analyses were done using SPSS. with significance level set at p<0.05 throughout all analyses. Results: The results revealed that there was no significant difference between positional release technique and kinesio tape technique on pain level, pressure pain threshold and functional activities (p > 0.05). Both groups of patients showed significant improvement in all the measured variables (p < 0.05) evident by significant reduction of both pain intensity and functional disability as well as significant increase of pressure pain threshold Conclusions : Both positional release technique and kinesio taping technique are effective in reducing pain level, improving pressure pain threshold and improving function in treating patients who suffering from back myofascial pain syndrome at iliocostalis lumborum. As there was no statistically significant difference was proven between both of them.

Keywords: positional release technique, kinesio tape, myofascial pain syndrome, Iliocostalis lumborum

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1891 An Analysis of Miguel Syjuco’s Ilustrado: The Reconstructed Oriental Image

Authors: Christine Ivy A. Nogot

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Under the colony of Spain for more than three centuries, the Philippines has a deep-rooted structure of Western ideologies and colonialism. The late 19th century, the period of Enlightenment, created a significant impact on our history when a group of middle-class Filipino men were sent to Europe to study. They were called Ilustrados, a Spanish word for erudite. They were the enlightened; the well-educated, intellectual scholars. Their writings provide intellectual grounds for the awakening of national consciousness that eventually prompted national movements and revolutions. They helped to establish a postcolonial society. In the modern era, Miguel Syjuco, a Filipino expatriate, wrote a novel and titled it Ilustrado. It is a representation of the liberal mind of the diasporic author in contemporary discourse. It provides a critical examination of the ilustrado in transition through the character of Miguel, who is also an expatriate writer. Using Syjuco’s award-winning novel as the primary text and anchored on Said’s concept of Orientalism, this paper examines how the depiction of features of the Eastern world is presented in the literary discourse. This paper looks into Said’s concept of orientalism as a hegemonic discursive structure and shows how Western superiority influences the Eastern culture in literary discourse. It explores Gramsci’s theory of cultural hegemony to explore Said’s argument that Western powers conquer the orient through culture and ideology. This paper presents how dominant ideologies and the social context redefine the ilustrado in the contemporary era.

Keywords: cultural hegemony, ilustrado, orientalism, postcolonial

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