Search results for: intervention study
Commenced in January 2007
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Edition: International
Paper Count: 49967

Search results for: intervention study

49427 Research on the Path of Renewal and Activation of Public Space in Guangzhou Historical City under the Guidance of Public Art

Authors: Jingjing Li, Shifu Wang

Abstract:

After the irreversible consequences of the traditional renewal mode of ‘function first and then beautification’, such as the constructive destruction, social differentiation, and cultural, ecological imbalance, the renewal of the historical urban area began to pay attention to the excavation of cultural connotation, and entered a new stage from the pursuit of ‘quantity’ growth to the promotion of ‘quality’, expecting to rejuvenate the old city through the intervention of public art. This paper interprets the cases at home and abroad, summarizes the different forms of expression and application strategies of public art in the renewal of historical urban areas, and combs the limitations of the existing practice in Guangzhou through observation. Finally, it puts forward suggestions from three aspects of the system, implementation strategy, and implementation path, respectively, and explores the path of simultaneous rejuvenation of material space and cultural space in historical urban areas under the intervention of public art.

Keywords: public art, historic city, public space, renewal activation

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49426 Proposed Intervention to the Attention of Harassment at a Public University

Authors: R. Echeverría Echeverría, C. Carrillo Trujillo, N. Evia Alamilla

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Today, bullying is an expression of violence. It is a present problem in different contexts. Bullying and harassment have become subject matter of professional psychology , anthropology and other social sciences and related areas. However, most research on bullying have focused on peer violence and basic education. There is little attention to harassment in higher education. It also has little generation of research and interventions in universities, undergraduate and postgraduate level. The aim of this paper is to present a proposal for intervention to the attention of college students who have had an experience of harassment and / or bullying in a Public University of Merida, Yucatan, Mexico. The methodology was qualitative phenomenological. Semiestructura interview techniques and focus groups were used. 6 students participated who have lived harassment or bullying. Also they are participating teachers and university leaders who play an important role in the presence of such cases. The purpose is to analyze the presence of policies for the prevention, treatment and punishment of those problems. The qualitative data analysis will be based on the general proposal of Rodriguez Gomez Gil Flores and García Jiménez (1999). The results show the need to create a body entrusted to provide timely attention to cases of bullying or harassment that are reported. It is important to take legal and psychological support of the University authorities. It is proposed to create a mechanism to ensure timely care and not victimized who has had the experience; in addition to the punishment of those who exercised to ensure that violence. In discussing the successes and failures of the proposal are highlighted. And the processes that have been facilitated or hampered progress for the project.

Keywords: bullying, harassment, intervention, public university

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49425 Effects of Forest Therapy on Depression among Healthy Adults 

Authors: Insook Lee, Heeseung Choi, Kyung-Sook Bang, Sungjae Kim, Minkyung Song, Buhyun Lee

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Backgrounds: A clearer and comprehensive understanding of the effects of forest therapy on depression is needed for further refinements of forest therapy programs. The purpose of this study was to review the literature on forest therapy programs designed to decrease the level of depression among adults to evaluate current forest therapy programs. Methods: This literature review was conducted using various databases including PubMed, EMBASE, CINAHL, PsycArticle, KISS, RISS, and DBpia to identify relevant studies published up to January 2016. The two authors independently screened the full text articles using the following criteria: 1) intervention studies assessing the effects of forest therapy on depression among healthy adults ages 18 and over; 2) including at least one control group or condition; 3) being peer-reviewed; and 4) being published either in English. The Scottish Intercollegiate Guideline Network (SIGN) measurement tool was used to assess the risk of bias in each trial. Results: After screening current literature, a total of 14 articles (English: 6, Korean: 8) were included in the present review. None of the studies used randomized controlled (RCT) study design and the sample size ranged from 11 to 300. Walking in the forest and experiencing the forest using the five senses was the key component of the forest therapy that was included in all studies. The majority of studies used one-time intervention that usually lasted a few hours or half-day. The most widely used measure for depression was Profile of Mood States (POMS). Most studies used self-reported, paper-and-pencil tests, and only 5 studies used both paper-and-pencil tests and physiological measures. Regarding the quality assessment based on the SIGN criteria, only 3 articles were rated ‘acceptable’ and the rest of the 14 articles were rated ‘low quality.’ Regardless of the diversity in format and contents of forest therapies, most studies showed a significant effect of forest therapy in curing depression. Discussions: This systematic review showed that forest therapy is one of the emerging and effective intervention approaches for decreasing the level of depression among adults. Limitations of the current programs identified from the review were as follows; 1) small sample size; 2) a lack of objective and comprehensive measures for depression; and 3) inadequate information about research process. Futures studies assessing the long-term effect of forest therapy on depression using rigorous study designs are needed.

Keywords: forest therapy, systematic review, depression, adult

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49424 The Effectiveness of a School-Based Addiction Prevention Program: Pilot Evaluation of Rajasthan Addiction Prevention Project

Authors: Sadhana Sharma, Neha Sharma, Hardik Khandelwal, Arti Sharma

Abstract:

Background: It is widely acknowledged globally that parents must advocate for their children's drug and substance abuse prevention. However, many parents find it difficult to advocate due to systemic and logistical barriers. Alternatives to introducing advocacy, awareness, and support for the prevention of drug and substance abuse to children could occur in schools. However, little research has been conducted on the development of advocates for substance abuse in school settings. Objective: to evaluate the effectiveness of a school-based addiction prevention and control created as part of the Rajasthan Addiction Prevention Project (a partnership between state-community initiative). Methods: We conducted an evaluation in this study to determine the impact of a RAPP on a primary outcome (substance abuse knowledge) and other outcomes (family–school partnership, empowerment, and support). Specifically, between September-December 2022, two schools participated in the intervention group (advocacy training), and two schools participated in the control group (waiting list). The RAPP designed specialised 2-hrs training to equip teachers-parents with the knowledge and skills necessary to advocate for their own children and those of other families. All participants were required to complete a pre- and post-survey. Results: The intervention group established school advocates in schools where trained parents volunteered to lead support groups for high-risk children. Compared to the participants in the wait list control group, those in the intervention group demonstrated greater education knowledge, P = 0.002, and self-mastery, P = 0.04, and decreased family–school partnership quality, P = 0.002.Conclusions: The experimental evaluation of school-based advocacy programme revealed positive effects on substance abuse that persist over time. The approach wa s deemed feasible and acceptable by both parents and the school.

Keywords: prevention, school based, addiction, advocacy

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49423 An Extremely Rare Anatomical Vascular Variant of Lower Limb Arterial System - Duplication of Superficial Femoral Artery

Authors: Manik Sharma

Abstract:

Understanding the anatomy and normal anatomical variations of the lower limb arterial system is undeniably important not only to understand the pathology involving the vessels of the lower limb but also as a part of endovascular intervention and surgical planning in cases that demand them as a part of treatment. There have been very few cases of duplication of SFA cited in the literature, close to six worldwide and this being the seventh case in the world and first to be reported in the Indian population. We incidentally came across this normal variant during US lower limb (US-LL) duplex scan in a patient with claudicating pain in bilateral lower limbs hence suspected of having peripheral vascular disease. It was confirmed on CT-Peripheral Angiography (CT-PA), which was done successively.

Keywords: peripheral vascular disease, claudicating pain, normal anatomical variants, endovascular intervention, duplication, CT-peripheral angiography, duplex scan, Iohexol

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49422 Reducing Diagnostic Error in Australian Emergency Departments Using a Behavioural Approach

Authors: Breanna Wright, Peter Bragge

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Diagnostic error rates in healthcare are approximately 10% of cases. Diagnostic errors can cause patient harm due to inappropriate, inadequate or delayed treatment, and such errors contribute heavily to medical liability claims globally. Therefore, addressing diagnostic error is a high priority. In most cases, diagnostic errors are the result of faulty information synthesis rather than lack of knowledge. Specifically, the majority of diagnostic errors involve cognitive factors, and in particular, cognitive biases. Emergency Departments are an environment with heightened risk of diagnostic error due to time and resource pressures, a frequently chaotic environment, and patients arriving undifferentiated and with minimal context. This project aimed to develop a behavioural, evidence-informed intervention to reduce diagnostic error in Emergency Departments through co-design with emergency physicians, insurers, researchers, hospital managers, citizens and consumer representatives. The Forum Process was utilised to address this aim. This involves convening a small (4 – 6 member) expert panel to guide a focused literature and practice review; convening of a 10 – 12 person citizens panel to gather perspectives of laypeople, including those affected by misdiagnoses; and a 18 – 22 person structured stakeholder dialogue bringing together representatives of the aforementioned stakeholder groups. The process not only provides in-depth analysis of the problem and associated behaviours, but brings together expertise and insight to facilitate identification of a behaviour change intervention. Informed by the literature and practice review, the Citizens Panel focused on eliciting the values and concerns of those affected or potentially affected by diagnostic error. Citizens were comfortable with diagnostic uncertainty if doctors were honest with them. They also emphasised the importance of open communication between doctors and patients and their families. Citizens expect more consistent standards across the state and better access for both patients and their doctors to patient health information to avoid time-consuming re-taking of long patient histories and medication regimes when re-presenting at Emergency Departments and to reduce the risk of unintentional omissions. The structured Stakeholder Dialogue focused on identifying a feasible behavioural intervention to review diagnoses in Emergency Departments. This needed to consider the role of cognitive bias in medical decision-making; contextual factors (in Victoria, there is a legislated 4-hour maximum time between ED triage and discharge / hospital admission); resource availability; and the need to ensure the intervention could work in large metropolitan as well as small rural and regional ED settings across Victoria. The identified behavioural intervention will be piloted in approximately ten hospital EDs across Victoria, Australia. This presentation will detail the findings of all review and consultation activities, describe the behavioural intervention developed and present results of the pilot trial.

Keywords: behavioural intervention, cognitive bias, decision-making, diagnostic error

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49421 Effects of a School-Based Mindfulness Intervention on Stress and Emotions on Students Enrolled in an Independent School

Authors: Tracie Catlett

Abstract:

Students enrolled in high-achieving schools are under tremendous pressure to perform at high levels inside and outside the classroom. Achievement pressure is a prevalent source of stress for students enrolled in high-achieving schools, and female students in particular experience a higher frequency and higher levels of stress compared to their male peers. The practice of mindfulness in a school setting is one tool that has been linked to improved self-regulation of emotions, increased positive emotions, and stress reduction. A mixed methods randomized pretest-posttest no-treatment control trial, evaluated the effects of a six-session mindfulness intervention taught during a regularly scheduled life skills period in an independent day school, one type of high-achieving school. Twenty-nine students in Grades 10 and 11 were randomized by class where Grade 11 students were in the intervention group (n = 14) and Grade 10 students were in the control group (n = 15). Findings from the study produced mixed results. There was no evidence that the mindfulness program reduced participants’ stress levels and negative emotions. In fact, contrary to what was expected, students enrolled in the intervention group experienced higher levels of stress and increased negative emotions at posttreatment when compared to pretreatment. Neither the within-group nor the between-groups changes in stress level were statistically significant, p > .05, and the between-groups effect size was small, d = .2. The study found evidence that the mindfulness program may have had a positive impact on students’ ability to regulate their emotions. The within-group comparison and the between-groups comparison at posttreatment found that students in the mindfulness course experienced statistically significant improvement in the in their ability to regulate their emotions at posttreatment, p = .009 < .05 and p =. 034 < .05, respectively. The between-groups effect size was medium, d =.7, suggesting that the positive differences in emotion regulation difficulties were substantial and have practical implications. The analysis of gender differences as they relate to stress and emotions revealed that female students perceive higher levels of stress and report experiencing stress more often than males. There were no gender differences when analyzing sources of stress experienced by the student participants. Both females and males experience regular achievement pressures related to their school performance and worry about their future, college acceptance, grades, and parental expectations. Females reported an increased awareness of their stress and actively engaged in practicing mindfulness to manage their stress. Students in the treatment group expressed that the practice of mindfulness resulted in feelings of relaxation and calmness.

Keywords: achievement pressure, adolescents, emotion regulation, emotions, high-achieving schools, independent schools, mindfulness, negative affect, positive affect, stress

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49420 Effect of Satureja khuzestanica Jamzad Supplementation on Inflammatory and Antioxidant Indicators in Type 2 Diabetes Patients: A Randomized Controlled Clinical Trial Study

Authors: Maryam Bordbar, Yaser Mokhayeri, Sajjad Roosta, Fatemeh Ghasemi, Saeed Choobkar, Hamidreza Nikbakht, Ebrahim Falahi

Abstract:

Objective: Diabetes mellitus type 2 is the most common metabolic disorder that is growing exponentially worldwide. Satureja Khuzestanica Jamzad is a native plant of Iran that grows widely in the south of Iran. Its antimicrobial, antioxidant, anti-inflammatory and pain-relieving effects have been documented in animal studies. The purpose of this study is to investigate the effect of consumption daily S. khuzestanica on inflammatory and antioxidant indicators in type 2 diabetic patients. Methods and Materials: In a double-blind, placebo-controlled clinical trial, 67 patients with type 2 diabetes were included and divided into two groups. One group received S. khuzestanica (capsule containing 500 mg) and the other group received placebo (500 mg talcum powder) once a day for 12 weeks. After the intervention, the inflammatory and antioxidant indicators of the two groups were compared. Results: In comparison to placebo groups, there was a significant difference in levels of total antioxidant capacity, superoxide dismutase, catalase, glutathione reductase, and glutathione peroxidase; these antioxidant indicators were higher in the intervention group (P<0.05). Moreover, a considerable decrease in weight, CRP and IL-6 levels were observed in patients in the S.Khuzestanica group. Conclusion: Our findings may provide novel complementary treatments without adverse effects for diabetes complications.

Keywords: Satureja khuzestanica Jamzad, diabetes mellitus, antioxidant indicators, IL-6, C-reactive protein

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49419 Cultural Impact on Fairness Perception of Inequality: A Study on People With Chinese Roots Living in Germany

Authors: Yanping He-Ulbricht, Marc Oliver Rieger

Abstract:

Based on survey data collected from people with Chinese roots living in Germany, this paper examines the impact of assimilation degree and language priming (Chinese or German) on individuals’ perceived fairness of economic and social differences and their attitude towards these. The results show that both the language used and the length of time spent in a foreign culture have a significant impact. Subjects who had spent less than 10 years in Germany demonstrated a higher readiness to accept government intervention in markets with price limits than those who had lived there longer. Subjects who were asked and answered in German perceived the current economic situation as less fair and were also less inclined to accept inequality, even when it leads to a Pareto improvement. While the difference in fairness perception of inequality was a cultural effect, the difference in attitudes towards government intervention was rather a result of learning process. The findings imply that both learning processes of individuals and culture play an important role in perception and preferences regarding social and economic differences.

Keywords: assimilation, bilingualism, cross-cultural comparison, income inequality, language priming, price fairness

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49418 A Randomized Controlled Intervention Study of the Effect of Music Training on Mathematical and Working Memory Performances

Authors: Ingo Roden, Stefana Lupu, Mara Krone, Jasmin Chantah, Gunter Kreutz, Stephan Bongard, Dietmar Grube

Abstract:

The present experimental study examined the effects of music and math training on mathematical skills and visuospatial working memory capacity in kindergarten children. For this purpose, N = 54 children (mean age: 5.46 years; SD = .29) were randomly assigned to three groups. Children in the music group (n = 18) received weekly sessions of 60 min music training over a period of eight weeks, whereas children in the math group (n = 18) received the same amount of training focusing on mathematical basic skills, such as numeracy skills, quantity comparison, and counting objectives. The third group of children (n = 18) served as waiting controls. The groups were matched for sex, age, IQ and previous music experiences at baseline. Pre-Post intervention measurements revealed a significant interaction effect of group x time, showing that children in both music and math groups significantly improved their early numeracy skills, whereas children in the control group did not. No significant differences between groups were observed for the visuospatial working memory performances. These results confirm and extend previous findings on transfer effects of music training on mathematical abilities and visuospatial working memory capacity. They show that music and math interventions are similarly effective to enhance children’s mathematical skills. More research is necessary to establish, whether cognitive transfer effects arising from music interventions might facilitate children’s transition from kindergarten to first-grade.

Keywords: music training, mathematical skills, working memory, transfer

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49417 The Impact of Kids Science Labs Intervention Program on Independent Thinking and Academic Achievement in Young Children

Authors: Aliya Kamilyevna Salahova

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This study examines the effectiveness of the Kids Science Labs intervention program, based on STEM, in fostering independent thinking among preschool and elementary school children and its influence on their academic achievement. Through a comprehensive methodology involving interviews, surveys, observations, case studies, and statistical tests, data were collected from various sources to accurately analyze the program's effects. The findings indicate a significant positive impact on children's independent thinking abilities, leading to improved academic performance in mathematics and science, enhanced learning motivation, and a propensity to critically evaluate problem-solving approaches. This research contributes to the theoretical understanding of how STEM activities can foster independent thinking and academic success in young children, providing valuable insights for the development of educational programs. Introduction: The goal of this study is to investigate the influence of the Kids Science Labs intervention program, grounded in STEM, on the development of independent thinking skills among preschool and elementary school children. By addressing this objective, we aim to explore the program's potential to enhance academic performance in mathematics and science. The study's findings have theoretical significance as they shed light on the ways in which STEM activities can foster independent thinking in young children, thus enabling educators to design effective learning programs that promote academic success. Methodology: This study employs a robust methodology that includes interviews, surveys, observations, case studies, and statistical tests. These methods were carefully selected to collect comprehensive data from multiple sources, such as documents and records, ensuring a thorough analysis of the program's effects. The use of diverse data collection and analysis procedures facilitated an in-depth exploration of the research questions and yielded reliable results. Results: The results indicate that children participating in the Kids Science Labs program experienced a sustained positive impact on their independent thinking abilities. Moreover, these children demonstrated improved academic performance in mathematics and science, displaying higher learning motivation and the capacity to critically evaluate problem-solving methods and seek optimal solutions. Theoretical Importance: This study contributes significantly to the existing theoretical knowledge by elucidating how STEM activities can foster independent thinking and enhance academic success in preschool and elementary school children. The findings have practical implications for educators, empowering them to develop learning programs that stimulate independent thinking, leading to improved academic performance in young children. Discussion: The findings of this research affirm that the Kids Science Labs intervention program is highly effective in fostering independent thinking among preschool and elementary school children. The program's positive impact extends to improved academic performance in mathematics and science, highlighting its potential to enhance learning outcomes. Educators can leverage these findings to develop educational programs that promote independent thinking and elevate academic achievement in young children. Conclusion: In conclusion, the Kids Science Labs intervention program has been found to be highly effective in fostering independent thinking among preschool and elementary school children. Furthermore, participation in the program correlates with improved academic performance in mathematics and science. The study's outcomes underscore the importance of developing educational initiatives that stimulate independent thinking in young children, thereby enhancing their academic success.

Keywords: STEM in preschool, STEM in elementary school, kids science labs, independent thinking, STEM activities in early childhood education

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49416 The Effect of Balance Training on Stable and Unstable Surfaces under Cognitive Dual-Task Condition on the Two Directions of Body Sway, Functional Balance and Fear of Fall in Non-Fallers Older Adults

Authors: Elham Azimzadeh, Fahimeh Khorshidi, Alireza Farsi

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Balance impairment and fear of falling in older adults may reduce their quality of life. Reactive balance training could improve rapid postural responses and fall prevention in the elderly during daily tasks. Performing postural training and simultaneously cognitive dual tasks could be similar to the daily circumstances. Purpose: This study aimed to determine the effect of balance training on stable and unstable surfaces under dual cognitive task conditions on postural control and fear of falling in the elderly. Methods: Thirty non-fallers of older adults (65-75 years) were randomly assigned to two training groups: stable-surface (n=10), unstable-surface (n=10), or a control group (n=10). The intervention groups underwent six weeks of balance training either on a stable (balance board) or an unstable (wobble board) surface while performing a cognitive dual task. The control group received no balance intervention. COP displacements in the anterioposterior (AP) and mediolateral (ML) directions using a computerized balance board, functional balance using TUG, and fear of falling using FES-I were measured in all participants before and after the interventions. Summary of Results: Mixed ANOVA (3 groups * 2 times) with repeated measures and post hoc test showed a significant improvement in both intervention groups in AP index (F= 11/652, P= 0/0002) and functional balance (F= 9/961, P= 0/0001). However, the unstable surface training group had more improvement. However, the fear of falling significantly improved after training on an unstable surface (p= 0/035). All groups had no significant improvement in the ML index (p= 0/817). In the present study, there was an improvement in the AP index after balance training. Conclusion: Unstable surface training may reduce reaction time in posterior ankle muscle activity. Furthermore, focusing attention on cognitive tasks can lead to maintaining balance unconsciously. Most of the daily activities need attention distribution among several activities. So, balance training concurrent to a dual cognitive task is challenging and more similar to the real world. According to the specificity of the training principle, it may improve functional independence and fall prevention in the elderly.

Keywords: cognitive dual task, elderly, fear of falling, postural control, unstable surface

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49415 Technology Enabled Bullying and Adolescent Reporting Response Behaviours

Authors: Regina Connolly, Justin Connolly

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Despite the benefits which they confer, Information & Communication Technologies (ICT) also have the potential to be used negatively. This paper focuses on one of those negative social effects - adolescent cyberbullying. Although early research in this field has pointed to the fact that the successful intervention and resolution of bullying incidents is to a large degree dependent on such incidents being reported to an adult caregiver, the literature consistently shows that adolescents who have been bullied tend not to inform others of their experiences. However, the reasons underlying such reluctance to seek adult intervention remain undetermined. Similarly, the degree to which gender, age or other variables apply in the case of adolescents’ resistance to report cyberbullying experiences has yet to be established. Understanding the factors that influence this resistance to communicate on the part of adolescents will assist caregivers, teachers and those involved in the formulation of school anti-bullying policies in their attempts to counter the cyberbullying phenomenon.

Keywords: information and Communication technologies, technology-enabled bullying, cyberbullying

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49414 Bringing Ethics to a Violent System

Authors: Zeynep Selin Acar

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In international system, there has always been a cycle of violence, war and peace. As there travels the time, after Christianity and later Just War theorists, international relations theorists have been tried to limit violence and war. As pieces of international law, Peace of Augsburg, Kellog-Briand Pact, League of Nations Covenant and UN Charter were and are still not effective to prevent war. Moreover, in order to find a way around these rules, it is believed that a new excuse started to be used instead of violence or war, humanitarian intervention. However, it has neither a legal nor a universally accepted framework. As a result, it is open to be manipulated by states. In order to prevent this, Responsibility to Protect (RtoP) which gives a state the responsibility to protect its citizens against violence, is created. Additionally, RtoP transfers this responsibility to regional or international group of states at the time when a state is the origin of violence. In the lights of these, this paper analyzes RtoP as an ethical approach to war and peace studies because it provides other states as guardians and care-takers of people who do not belong to them or do not share any togetherness.

Keywords: ethics, humanitarian intervention, responsibility to protect, UN charter

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49413 An Experimental Study on the Influence of Brain-Break in the Classroom on the Physical Health and Academic Performance of Fourth Grade Students

Authors: Qian Mao, Xiaozan Wang, Jiarong Zhong, Xiaolin Zou

Abstract:

Introduction: As a result of the decline of students' physical health level and the increase of study pressure, students’ academic performance is not so good. Objective: This study aims to verify whether the Brain-Break intervention in the fourth-grade classroom of primary school can improve students' physical health and academic performance. Methods: According to the principle of no difference in pre-test data, students from two classes of grade four in Fuhai Road Primary School, Fushan district, Yantai city, Shandong province, were selected as experimental subjects, including 50 students in the experimental class (25 males and 25 females) and 50 students in the control class (24 males and 26 females). The content of the experiment was that the students were asked to perform a 4-minute Brain-Berak program designed by the researcher in the second class in the morning and the afternoon, and the intervention lasted for 12 weeks. In addition, the lung capacity, 50-meter run, sitting body forward bend, one-minute jumping rope and one-minute sit-ups stipulated in the national standards for physical fitness of students (revised in 2014) were selected as the indicators of physical health. The scores of Chinese, Mathematics, and English in the unified academic test of the municipal education bureau were selected as the indicators of academic performance. The independent-sample t-test was used to compare and analyze the data of each index between the two classes. The paired-sample t-test was used to compare and analyze the data of each index in the two classes. This paper presents only results with significant differences. Results: in terms of physical health, lung capacity (P=0.002, T= -2.254), one-minute rope skipping (P=0.000, T=3.043), and one-minute sit-ups (P=0.045, T=6.153) were significantly different between the experimental class and the control class. In terms of academic performance, there is a significant difference between the Chinese performance of the experimental class and the control class (P=0.009, T=4.833). Conclusion: Adding Brain-Berak intervention in the classroom can effectively improve the cardiorespiratory endurance (lung capacity), coordination (jumping rope), and abdominal strength (sit-ups) of fourth-grade students. At the same time, it can also effectively improve their Chinese performance. Therefore, it is suggested to promote micro-sports in the classroom of primary schools throughout the country so as to help students improve their physical health and academic performance.

Keywords: academic performance, brain break, fourth grade, physical health

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49412 Intervention Programs for Children of Divorced Parents: Presentation of the Children’s Support Group Developed in Belgium

Authors: Therese Scali

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Couple separations and divorces seem to be commonplace events. However, their frequency does not reduce their impact. Indeed, the adverse effects of parental divorce on children have been well documented. Thus, supporting the children from divorced families is a key concern. Several preventive interventions have been developed for children of divorced parents, such as Children’s Support Group. The present paper aims at presenting the program that has been created in Liege (Belgium). The setting and the tools will be presented. This Children’s Support Group is based on psychoeducational and systemic principles, art-therapy, and aims at acquiring coping skills and seeking social support. Also, the effectiveness of the program will be discussed. Results show that after parental divorce, a group intervention for children can be efficacious in promoting children’s well-being and parent-child communication. This paper contributes to enrich the understanding of children’s needs and to highlight the existence and efficacy of a program that helps them overcome the difficulties of divorce.

Keywords: art-therapy, children’s support group, divorce, efficacy, separation

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49411 Chinese Students’ Use of Corpus Tools in an English for Academic Purposes Writing Course: Influence on Learning Behaviour, Performance Outcomes and Perceptions

Authors: Jingwen Ou

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Writing for academic purposes in a second or foreign language poses a significant challenge for non-native speakers, particularly at the tertiary level, where English academic writing for L2 students is often hindered by difficulties in academic discourse, including vocabulary, academic register, and organization. The past two decades have witnessed a rising popularity in the application of the data-driven learning (DDL) approach in EAP writing instruction. In light of such a trend, this study aims to enhance the integration of DDL into English for academic purposes (EAP) writing classrooms by investigating the perception of Chinese college students regarding the use of corpus tools for improving EAP writing. Additionally, the research explores their corpus consultation behaviors during training to provide insights into corpus-assisted EAP instruction for DDL practitioners. Given the uprising popularity of DDL, this research aims to investigate Chinese university students’ use of corpus tools with three main foci: 1) the influence of corpus tools on learning behaviours, 2) the influence of corpus tools on students’ academic writing performance outcomes, and 3) students’ perceptions and potential perceptional changes towards the use of such tools. Three corpus tools, CQPWeb, Sketch Engine, and LancsBox X, are selected for investigation due to the scarcity of empirical research on patterns of learners’ engagement with a combination of multiple corpora. The research adopts a pre-test / post-test design for the evaluation of students’ academic writing performance before and after the intervention. Twenty participants will be divided into two groups: an intervention and a non-intervention group. Three corpus training workshops will be delivered at the beginning, middle, and end of a semester. An online survey and three separate focus group interviews are designed to investigate students’ perceptions of the use of corpus tools for improving academic writing skills, particularly the rhetorical functions in different essay sections. Insights from students’ consultation sessions indicated difficulties with DDL practice, including insufficiency of time to complete all tasks, struggle with technical set-up, unfamiliarity with the DDL approach and difficulty with some advanced corpus functions. Findings from the main study aim to provide pedagogical insights and training resources for EAP practitioners and learners.

Keywords: corpus linguistics, data-driven learning, English for academic purposes, tertiary education in China

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49410 Human Security Providers in Fragile State under Asymmetric War Conditions

Authors: Luna Shamieh

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Various players are part of the game in an asymmetric war, all making efforts to provide human security to their own adherents. Although a fragile state is not able to provide sufficient and comprehensive services, it still provides special services and security to the elite; the insurgents as well provide services and security to their associates. The humanitarian organisations, on the other hand, provide some fundamental elements of human security, but only in the regions, they are able to access when possible (if possible). The counterinsurgents (security forces of the state and intervention forces) operate within a narrow band defined by the vision of the responsibility to protect and the perspective of the resolution of the conflict through combat; hence, the possibility to provide human security is shaken at this end. This article examines how each player provides human security from the perspective of freedom from want in order to secure basic and strategic needs, freedom from fear through providing protection against all kinds of violence, and the freedom to live in dignity. It identifies a vicious cycle caused by the intervention of the different players causing a centrifugal force that may lead to disintegration of the nation under war.

Keywords: asymmetric war, counterinsurgency, fragile state, human security, insurgency

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49409 Iodine Nutritional Knowledge of Food Handlers: A Capricorn and Waterberg District Study, Limpopo Province, South Africa

Authors: Solomon Ngoako Mabapa, Selekane Ananias Motadi, Nteseng Mailula, Hlekani Vanessa Mbhatsani, Lindelani Fhumudzani Mushaphi

Abstract:

Background: South Africa has indeed made good progress towards IDD elimination, as far as implementation of salt iodization and coverage of iodized salt are concerned, the education and promotion aspects of the iodized salt intervention are seriously lacking. Objective: To determine the iodine nutritional knowledge of food handlers at primary schools under the National School Nutrition Programme in Capricorn and Waterberg district. Design: This study included 300 food handlers recruited from 95 primary schools in Capricorn district and 105 primary schools in Waterberg district, Limpopo Province, South Africa. Primary schools and study participants where conveniently selected. The data was collected by means of a structured questionnaire. Information obtained was on the socio-demographic characteristics of the participants, general knowledge on salt fortification and knowledge test. Results: The iodine knowledge for the food handlers in two districts was poor with the entire population’s iodine nutritional knowledge of 12% on the Lickert scale. The mean score on the Lickert scale for Capricorn and Waterberg districts was 17% and 8.6% respectively indicated poor iodine nutritional knowledge. Conclusion: The two districts had poor iodine nutritional knowledge. Giving nutrition education to the public on the importance of iodine and the consequences of iodine deficiency disorder (IDD) and continue advocacy on mass media on the iodine fortification as an intervention strategy to combat the escalating problem of micronutrient malnutrition control.

Keywords: food handlers, nutritional knowledge, iodine, National School Nutrition Programme

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49408 Effects of a School-based Mindfulness Intervention on Stress Levels and Emotion Regulation of Adolescent Students Enrolled in an Independent School

Authors: Tracie Catlett

Abstract:

Students enrolled in high-achieving schools are under tremendous pressure to perform at high levels inside and outside the classroom. Achievement pressure is a prevalent source of stress for students enrolled in high-achieving schools, and female students, in particular, experience a higher frequency and higher levels of stress compared to their male peers. The practice of mindfulness in a school setting is one tool that has been linked to improved self-regulation of emotions, increased positive emotions, and stress reduction. A mixed methods randomized pretest-posttest no-treatment control trial evaluated the effects of a six-session mindfulness intervention taught during a regularly scheduled life skills period in an independent day school, one type of high-achieving school. Twenty-nine students in Grades 10 and 11 were randomized by class, where Grade 11 students were in the intervention group (n = 14) and Grade 10 students were in the control group (n = 15). Findings from the study produced mixed results. There was no evidence that the mindfulness program reduced participants’ stress levels and negative emotions. In fact, contrary to what was expected, students enrolled in the intervention group experienced higher levels of stress and increased negative emotions at posttreatment when compared to pretreatment. Neither the within-group nor the between-groups changes in stress level were statistically significant, p > .05, and the between-groups effect size was small, d = .2. The study found evidence that the mindfulness program may have had a positive impact on students’ ability to regulate their emotions. The within-group comparison and the between-groups comparison at posttreatment found that students in the mindfulness course experienced statistically significant improvement in the in their ability to regulate their emotions at posttreatment, p = .009 < .05 and p =. 034 < .05, respectively. The between-groups effect size was medium, d =.7, suggesting that the positive differences in emotion regulation difficulties were substantial and have practical implications. The analysis of gender differences, as they relate to stress and emotions, revealed that female students perceive higher levels of stress and report experiencing stress more often than males. There were no gender differences when analyzing sources of stress experienced by the student participants. Both females and males experience regular achievement pressures related to their school performance and worry about their future, college acceptance, grades, and parental expectations. Females reported an increased awareness of their stress and actively engaged in practicing mindfulness to manage their stress. Students in the treatment group expressed that the practice of mindfulness resulted in feelings of relaxation and calmness.

Keywords: achievement pressure, adolescents, emotion regulation, emotions, high-achieving schools, independent schools, mindfulness, negative affect, positive affect, stress

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49407 Application of Bundle Care to Reduce Invasive Catheter-Associated Infection in High Risk Units at a Medical Center

Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng

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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.

Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work

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49406 mHealth-based Diabetes Prevention Program among Mothers with Abdominal Obesity: A Randomized Controlled Trial

Authors: Jia Guo, Qinyuan Huang, Qinyi Zhong, Yanjing Zeng, Yimeng Li, James Wiley, Kin Cheung, Jyu-Lin Chen

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Context: Mothers with abdominal obesity, particularly in China, face challenges in managing their health due to family responsibilities. Existing diabetes prevention programs do not cater specifically to this demographic. Research Aim: To assess the feasibility, acceptability, and efficacy of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in reducing weight-related variables and diabetes risk. Methodology: A randomized controlled trial was conducted in Changsha, China, where the mHealth group received personalized modules and health messages, while the control group received general health education. Data were collected at baseline, 3 months, and 6 months. Findings: The mHealth intervention significantly improved waist circumference, modifiable diabetes risk scores, daily steps, self-efficacy for physical activity, social support for physical activity, and physical health satisfaction compared to the control group. However, no differences were found in BMI and certain other variables. Theoretical Importance: The study demonstrates the feasibility and efficacy of a tailored mHealth intervention for Chinese mothers with abdominal obesity, emphasizing the potential for such programs to improve health outcomes in this population. Data Collection: Data on various variables including weight-related measures, diabetes risk scores, behavioral and psychological factors were collected at baseline, 3 months, and 6 months from participants in the mHealth and control groups. Analysis Procedures: Generalized estimating equations were used to analyze the data collected from the mHealth and control groups at different time points during the study period. Question Addressed: The study addressed the effectiveness of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in improving various health outcomes compared to traditional general health education approaches. Conclusion: The tailored mHealth intervention proved to be feasible and effective in improving weight-related variables, physical activity, and physical health satisfaction among Chinese mothers with abdominal obesity, highlighting its potential for delivering diabetes prevention programs to this population.

Keywords: type 2 diabetes, mHealth, obesity, prevention, mothers

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49405 Reducing Later Life Loneliness: A Systematic Literature Review of Loneliness Interventions

Authors: Dhruv Sharma, Lynne Blair, Stephen Clune

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Later life loneliness is a social issue that is increasing alongside an upward global population trend. As a society, one way that we have responded to this social challenge is through developing non-pharmacological interventions such as befriending services, activity clubs, meet-ups, etc. Through a systematic literature review, this paper suggests that currently there is an underrepresentation of radical innovation, and underutilization of digital technologies in developing loneliness interventions for older adults. This paper examines intervention studies that were published in English language, within peer reviewed journals between January 2005 and December 2014 across 4 electronic databases. In addition to academic databases, interventions found in grey literature in the form of websites, blogs, and Twitter were also included in the overall review. This approach yielded 129 interventions that were included in the study. A systematic approach allowed the minimization of any bias dictating the selection of interventions to study. A coding strategy based on a pattern analysis approach was devised to be able to compare and contrast the loneliness interventions. Firstly, interventions were categorized on the basis of their objective to identify whether they were preventative, supportive, or remedial in nature. Secondly, depending on their scope, they were categorized as one-to-one, community-based, or group based. It was also ascertained whether interventions represented an improvement, an incremental innovation, a major advance or a radical departure, in comparison to the most basic form of a loneliness intervention. Finally, interventions were also assessed on the basis of the extent to which they utilized digital technologies. Individual visualizations representing the four levels of coding were created for each intervention, followed by an aggregated visual to facilitate analysis. To keep the inquiry within scope and to present a coherent view of the findings, the analysis was primarily concerned the level of innovation, and the use of digital technologies. This analysis highlights a weak but positive correlation between the level of innovation and the use of digital technologies in designing and deploying loneliness interventions, and also emphasizes how certain existing interventions could be tweaked to enable their migration from representing incremental innovation to radical innovation for example. This analysis also points out the value of including grey literature, especially from Twitter, in systematic literature reviews to get a contemporary view of latest work in the area under investigation.

Keywords: ageing, loneliness, innovation, digital

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49404 Implementing Teacher Students’ Coaching in Practical Periods of University Teacher Education: The Significance of Training Cultures

Authors: Rahm Sibylle

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The core element in most European teacher training concepts consists in practical periods where teacher students may review the chosen profession before going on to their theoretical studies. In Germany, teacher students learn in practical studies about everyday teaching and learning in schools. Teacher students appreciate opportunities to explore school practice and to feel responsible for students’ learning. In practical studies, teacher students often idealize their teacher mentors (and consequently tend to imitate their teaching style) or contrarily feel disappointed about school practice. Concepts of empowerment through practical experience in school-based academic teacher training have to be developed. Our Swiss-German research project COPRA (Coaching in practical periods; funded by the Swiss National Science Foundation (SNF) and the German Research Foundation (DFG), aims at gaining resilient results about the effectiveness of (peer) coaching in practical school periods. To explore innovative ways of accompanying novice teachers in practical periods we consider different cultures of teacher training institutions. School cultures, including teachers’ beliefs and teaching traditions involve different training cultures as starting positions for our intervention study. In our qualitative study, we describe typologies of teacher training institutions by analyzing group discussions with teacher students, mentor teachers and university lecturers concerning participation, cooperation, and relationships. In our paper, we present the design of our intervention study, our coaching concept as well as typologies of teacher training cultures. We discuss opportunities for teacher students to learn through domain-specific (peer) coaching on the background of these typologies.

Keywords: teacher training (practical periods), teacher students' coaching, training cultures (typologies), COPRA (coaching in practical periods)

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49403 Reliability-Based Maintenance Management Methodology to Minimise Life Cycle Cost of Water Supply Networks

Authors: Mojtaba Mahmoodian, Joshua Phelan, Mehdi Shahparvari

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With a large percentage of countries’ total infrastructure expenditure attributed to water network maintenance, it is essential to optimise maintenance strategies to rehabilitate or replace underground pipes before failure occurs. The aim of this paper is to provide water utility managers with a maintenance management approach for underground water pipes, subject to external loading and material corrosion, to give the lowest life cycle cost over a predetermined time period. This reliability-based maintenance management methodology details the optimal years for intervention, the ideal number of maintenance activities to perform before replacement and specifies feasible renewal options and intervention prioritisation to minimise the life cycle cost. The study was then extended to include feasible renewal methods by determining the structural condition index and potential for soil loss, then obtaining the failure impact rating to assist in prioritising pipe replacement. A case study on optimisation of maintenance plans for the Melbourne water pipe network is considered in this paper to evaluate the practicality of the proposed methodology. The results confirm that the suggested methodology can provide water utility managers with a reliable systematic approach to determining optimum maintenance plans for pipe networks.

Keywords: water pipe networks, maintenance management, reliability analysis, optimum maintenance plan

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49402 Effectiveness of Project Grit in Building Resilience among At-Risk Adolescents: A Case Study

Authors: Narash Narasimman, Calvin Leong Jia Jun, Raksha Karthik, Paul Englert

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Background: Project Grit, a 12-week youth resilience program implemented by Impart and Spartans Boxing Club, aimed to help at-risk adolescents develop resilience through psychoeducation and mental health techniques for dealing with everyday stressors and adversity. The programme consists of two parts-1.5 hours of group therapy followed by 1 hour of boxing. Due to the novelty of the study, 6 male participants, aged 13 to 18, were recruited to participate in the study. Aim: This case study aims to examine the effectiveness of Project Grit in building resilience among at-risk adolescents. Methods: A case study design was employed to capture the complexity and uniqueness of the intervention, without oversimplifying or generalizing it. A 15-year-old male participant with a history of behavioural challenges, delinquency and gang involvement was selected for the study. Teacher, parent and child versions of the Strengths and Difficulties Questionnaire (SDQ) were administered to the facilitators, parents and participants respectively before and after the programme. Relevant themes from the qualitative interviews will be discussed. Results: Scores from all raters revealed improvements in most domains of the SDQ. Total difficulties scores across all raters improved from “very high” to “close to average”. High interrater reliability was observed (κ= .81). The participant reported learning methods to effectively deal with his everyday concerns using healthy coping strategies, developing a supportive social network, and building on his self efficacy. Themes from the subject’s report concurred with the improvement in SDQ scores. Conclusions: The findings suggest that Project Grit is a promising intervention for promoting resilience among at-risk adolescents. The teleological behaviourism framework and the combination of sports engagement and future orientation may be particularly effective in fostering resilience among this population. Further studies need to be conducted with a larger sample size to further validate the effectiveness of Project Grit.

Keywords: resilience, project grit, adolescents, at-risk, boxing, future orientation

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49401 Stress and Distress among Physician Trainees: A Wellbeing Workshop

Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

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Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

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49400 Facets of an Upcoming Urban Industrial Hub: A Case Study of Gurgaon-Manesar

Authors: Raman Kumar Singh

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Urbanization and economic growth are considered to be the most striking features of the past century. There is currently a radical demographic shift in progress worldwide, wherein people are moving from rural to urban areas at an increasing rate. The UN-Habitat report 2005 indicates that in 2025, 61 per cent of the 5 billion world population will reside in the urban areas with about 85 per cent of the development process taking place in the urban hinterlands widely referred to as ‘peri-urban’, ‘suburbs’, ‘urban fringe’, ‘city edge’, ‘metropolitan shadow’, or ‘urban sprawl’. In this context the study is broadly concerned with understanding the development of the industrial hub in the Gurgaon and its impact on the immediate neighbourhood. However studies have revealed that with the increase of industrial development the growth pattern changes rapidly, not only the growth of the urban area but the overall economy shifts from more agrarian to non-agrarian, with the change in the occupational pattern of the people. The process is mainly known as tertiarization, where a number of tertiary activities increase in comparison to primary or secondary. The change in the occupational pattern creates a pull factor on its immediate neighbourhood, which triggers the in- migrations from the rural areas as people come in the core urban area in search of the better job opportunities and increased standards of living. But this gives way to the unplanned growth of the urban fringe and the villages which tend to accommodate the migrants and in turn the pressure on the socio-economic infrastructure increases. Therefore, it becomes increasing necessary for the government institution and policy level intervention to provide an overall socio-economic growth along with rapid industrial growth.

Keywords: policy intervention, urban morphology, urban industrial hub, livelihood transformation

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49399 Efficacy of Yoga and Meditation Based Lifestyle Intervention on Inflammatory Markers in Patients with Rheumatoid Arthritis

Authors: Surabhi Gautam, Uma Kumar, Rima Dada

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A sustained acute-phase response in Rheumatoid Arthritis (RA) is associated with increased joint damage and inflammation leading to progressive disability. It is induced continuously by consecutive stimuli of proinflammatory cytokines, following a wide range of pathophysiological reactions, leading to increased synthesis of acute phase proteins like C - reactive protein (CRP) and dysregulation in levels of immunomodulatory soluble Human Leukocyte Antigen-G (HLA-G) molecule. This study was designed to explore the effect of yoga and meditation based lifestyle intervention (YMLI) on inflammatory markers in RA patients. Blood samples of 50 patients were collected at baseline (day 0) and after 30 days of YMLI. Patients underwent a pretested YMLI under the supervision of a certified yoga instructor for 30 days including different Asanas (physical postures), Pranayama (breathing exercises), and Dhayna (meditation). Levels of CRP, IL-6, IL-17A, soluble HLA-G and erythrocyte sedimentation rate (ESR) were measured at day 0 and 30 interval. Parameters of disease activity, disability quotient, pain acuity and quality of life were also assessed by disease activity score (DAS28), health assessment questionnaire (HAQ), visual analogue scale (VAS), and World Health Organization Quality of Life (WHOQOL-BREF) respectively. There was reduction in mean levels of CRP (p < 0.05), IL-6 (interleukin-6) (p < 0.05), IL-17A (interleukin-17A) (p < 0.05) and ESR (p < 0.05) and elevation in soluble HLA-G (p < 0.05) at 30 days compared to baseline level (day 0). There was reduction seen in DAS28-ESR (p < 0.05), VAS (p < 0.05) and HAQ (p < 0.05) after 30 days with respect to the base line levels (day 0) and significant increase in WHOQOL-BREF scale (p < 0.05) in all 4 domains of physical health, psychological health, social relationships, and environmental health. The present study has demonstrated that yoga practices are associated with regression of inflammatory processes by reducing inflammatory parameters and regulating the levels of soluble HLA-G significantly in active RA patients. Short term YMLI has significantly improved pain perception, disability quotient, disease activity and quality of life. Thus this simple life style intervention can reduce disease severity and dose of drugs used in the treatment of RA.

Keywords: inflammation, quality of life, rheumatoid arthritis, yoga and meditation

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49398 The Importance of Development Evaluation to Preterm Children in Remote Area

Authors: Chung-Yuan Wang, Min Hsu, Bo-Ya Juan, Hsiv Ching Lin, Hsveh Min Lin, Hsiu-Fang Yeh

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The success of Taiwan's National Health Insurance (NHI) system attracts widespread praise from the international society. However, the availability of medical care in a emote area is limited. Without the convenient public transportation system and mature social welfare policy, these people are difficult to regain their health and prevent disability. Preterm children have more risk to get development delay. Preterm children in a remote area have the human right to get rehabilitation resources as those in the city area. Therefore, the aim of this study was to show the importance of development screening to preterm children in a remote area and a tract the government to notice the issue. In Pingtung, children who are suspected development delay would be suggested to take a skillful screening evaluation in our hospital. Those preterm children (within 1-year-old) visited our pediatric clinic would also be referred to take the development evaluation. After the physiatrist’s systemic evaluation, the subjects would be scheduled to take the development evaluation. Gross motor, fine motor, speech comprehension/expression and mental study were included. The evaluation was in-charged by a physical therapist, occupational therapy, speech therapist and pediatric psychologist. The tools were Peabody developmental scale, Bayley Scales of Infant and Toddler Development (Bayley-III) and Wechsler Preschool & Primary Scale of Intelligence-Revised (WPPSI-R). In 2013, 459 children received the service in our hospital. Among these children, fifty-seven were noted with preterm baby history (gestation within 37 weeks). Thirty-six of these preterm children, who had never receive development evaluation, were included in this study. Thirty-six subjects (twenty-six male and ten female) were included. Nineteen subjects were found development delay. Six subjects were found suspected development delay. In gross motor, six subjects were development delay and eight were suspected development delay. In fine motor, five subjects were development delay and three were suspected development delay. In speech, sixteen subjects were development delay and six were suspected development delay. In our study, through the provision of development evaluation service, 72.2% preterm baby were found their development delay or suspected delay. They need further early intervention rehabilitation service. We made their parents realize that when development delay was recognized at the early stage, they are often reversible. No only the patients but also their families were improved their health status. The number of the subjects was limited in our study. Further study might be needed. Compared with 770 physical therapist (PT) and 370 occupational therapy (OT) in Taipei, there are only 108 PT and 54 OT in Pingtung. Further, there are much fewer therapists working on the field of pediatric rehabilitation. Living healthy is a human's right, no matter where does he live. For those development delay children in remote area, particularly preterm children, early detection, and early intervention rehabilitation service could play an important role in decreasing their disability and improving their quality of life. Through this study, we suggest the government to add more national resources on the development evaluation to preterm children in a remote area.

Keywords: development, early intervention, preterm children, rehabilitation

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