Search results for: adult participants with intellectual disability

Authors: Mustafa M. Donma, Orkide Donma

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The examination of both serum lipid fractions and body’s lipid composition are quite informative during the evaluation of obesity stages. Within this context, alterations in lipid parameters are commonly observed. The variations in the fat distribution of the body are also noteworthy. Total cholesterol (TC), triglycerides (TRG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C) are considered as the basic lipid fractions. Fat deposited in trunk and extremities may give considerable amount of information and different messages during discrete health states. Ratios are also derived from distinct fat distribution in these areas. Trunk-to-leg fat ratio (TLFR) and trunk-to-appendicular fat ratio (TAFR) are the most recently introduced ratios. In this study, lipid fractions and TLFR, as well as TAFR, were evaluated, and the distinctions among healthy, obese (OB), and morbid obese (MO) groups were investigated. Three groups [normal body mass index (N-BMI), OB, MO] were constituted from a population aged 6 to 18 years. Ages and sexes of the groups were matched. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Written informed consent forms were obtained from the parents of the participants. Anthropometric measurements (height, weight, waist circumference, hip circumference, head circumference, neck circumference) were obtained and recorded during the physical examination. Body mass index values were calculated. Total, trunk, leg, and arm fat mass values were obtained by TANITA Bioelectrical Impedance Analysis. These values were used to calculate TLFR and TAFR. Systolic (SBP) and diastolic blood pressures (DBP) were measured. Routine biochemical tests including TC, TRG, LDL-C, HDL-C, and insulin were performed. Data were evaluated using SPSS software. p value smaller than 0.05 was accepted as statistically significant. There was no difference among the age values and gender ratios of the groups. Any statistically significant difference was not observed in terms of DBP, TLFR as well as serum lipid fractions. Higher SBP values were measured both in OB and MO children than those with N-BMI. TAFR showed a significant difference between N-BMI and OB groups. Statistically significant increases were detected between insulin values of N-BMI group and OB as well as MO groups. There were bivariate correlations between LDL and TLFR (r=0.396; p=0.037) as well as TAFR values (r=0.413; p=0.029) in MO group. When adjusted for SBP and DBP, partial correlations were calculated as (r=0.421; p=0.032) and (r=0.438; p=0.025) for LDL-TLFR as well as LDL-TAFR, respectively. Much stronger partial correlations were obtained for the same couples (r=0.475; p=0.019 and r=0.473; p=0.020, respectively) upon controlling for TRG and HDL-C. Much stronger partial correlations observed in MO children emphasize the potential transition from morbid obesity to metabolic syndrome. These findings have concluded that LDL-C may be suggested as a discriminating parameter between OB and MO children.

Keywords: children, lipid parameters, obesity, trunk-to-leg fat ratio, trunk-to-appendicular fat ratio

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Authors: Sima E. Rugarabamu, Mecky I. Matee, Elison N. M. Simon

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Background: In Tanzania bacteriological studies of etiological agents of oro-facial infections are very limited, and very few have investigated anaerobes. The aim of this study was to determine the spectrum of bacterial agents involved in oral and maxillofacial infections in patients attending Muhimbili National Hospital, Dar-es-salaam, Tanzania. Method: This was a hospital based descriptive cross-sectional study that was conducted in the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital in Dar es Salaam, Tanzania from 1st January 2014 to 31st August 2014. Seventy (70) patients with various forms of oral and maxillofacial infections who were recruited for the study. The study participants were interviewed using a prepared questionnaire after getting their consent. Pus aspirate was cultured on Blood agar, Chocolate Agar, MacConkey agar and incubated aerobically at 37°C. Imported blood agar was used for anaerobic culture whereby they were incubated at 37°Cin anaerobic jars in an atmosphere of generated using commercial gas-generating kits in accordance with manufacturer’s instructions. Plates were incubated at 37°C for 24 hours (For aerobic culture and 48 hours for anaerobic cultures). Gram negative rods were identified using API 20E while all other isolates were identified by conventional biochemical tests. Antibiotic sensitivity testing for isolated aerobic and anaerobic bacteria was detected by the disk diffusion, agar dilution and E-test using routine and commercially available antibiotics used to treat oral facial infections. Results: This study comprised of 41 (58.5%) males and 29 (41.5%) females with a mean age of 32 years SD +/-15.1 and a range of 19 to 70 years. A total of 161 bacteria strains were isolated from specimens obtained from 70 patients which were an average of 2.3 isolates per patient. Of these 103 were aerobic organism and 58 were strict anaerobes. A complex mix of strict anaerobes and facultative anaerobes accounted for 87% of all infections.The most frequent aerobes isolated was streptococcus spp 70 (70%) followed by Staphylococcus spp 18 (18%). Other organisms such as Klebsiella spp 4 (4%), Proteus spp 5 (5%) and Pseudomonas spp 2 (2%) were also seen. The anaerobic group was dominated by Prevotella spp 25 (43%) followed by Peptostreptococcus spp 18 (31%); other isolates were Pseudomonas spp 2 (1%), black pigmented Pophyromonas spp 4 (5%), Fusobacterium spp 3 (3%) and Bacteroides spp 5 (8%). Majority of these organisms were sensitive to Amoxicillin (98%), Gentamycin (89%), and Ciprofloxacin (100%). A 40% resistance to metronidazole was observed in Bacteroides spp otherwise this drug and others displayed good activity against anaerobes. Conclusions: Oral and maxillofacial facial infections at Muhimbili National Hospital are mostly caused by streptococcus spp and Prevotella spp. Strict anaerobes accounted for 36% of all isolates. The profile of isolates should assist in selecting empiric therapy for infections of the oral and maxillofacial region. Inclusion of antimicrobial agents against anaerobic bacteria is highly recommended.

Keywords: bacteria, oral and maxillofacial infections, antibiotic susceptibility, Tanzania

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Authors: Eva Degraeuwe, Margo Vandenheede, Nicholas Rennie, Jolien Braem, Miryam Serry, Frederik Berrevoet, Piet Pattyn, Wouter Willaert, InciSioN Belgium Consortium

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Background: Worldwide, five billion people lack access to safe and affordable surgical care. An added 1.27 million surgeons, anesthesiologists, and obstetricians (SAO) are needed by 2030 to meet the target of 20 per 100,000 population and to reach the goal of the Lancet Commission on Global Surgery. A well-informed future generation exposed early on to the current challenges in global surgery (GS) is necessary to ensure a sustainable future. Methods: InciSioN, the International Student Surgical Network, is a non-profit organization by and for students, residents, and fellows in over 80 countries. InciSioN Belgium, one of the prominent national working groups, has made a vast progression and collaborated with other networks to fill the educational gap, stimulate advocacy efforts and increase interactions with the international network. This report describes a roadmap to achieve sustainable development and education within GS, with the example of InciSioN Belgium. Results: Since the establishment of the organization’s branch in 2019, it has hosted an educational workshop for first-year residents in surgery, engaging over 2500 participants, and established a recurring directing board of 15 members. In the year 2020-2021, InciSioN Ghent has organized three workshops combining educational and interactive sessions for future prime advocates and surgical candidates. InciSioN Belgium has set up a strong formal coalition with the Belgian Medical Students’ Association (BeMSA), with its own standing committee, reaching over 3000+ medical students annually. In 2021-2022, InciSioN Belgium broadened to a multidisciplinary approach, including dentistry and nursing students and graduates within workshops and research projects, leading to a member and exposure increase of 450%. This roadmap sets strategic goals and mechanisms for the GS community to achieve nationwide sustained improvements in the research and education of GS focused on future SAOs, in order to achieve the GS sustainable development goals. In the coming year, expansion is directed to a formal integration of GS into the medical curriculum and increased international advocacy whilst inspiring SAOs to integrate into GS in Belgium. Conclusion: The development and implementation of durable change for GS are necessary. The student organization InciSioN Belgium is growing and hopes to close the colossal gap in GS and inspire the growth of other branches while sharing the know-how of a student organization.

Keywords: advocacy, education, global surgery, InciSioN, student network

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Authors: Tim J. Walsh, Lindsay E. Young, John A. Schneider

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Background: The disproportionate rate of HIV infection among Black men who have sex with men (BMSM) in the United States suggest the importance of Preexposure Prophylaxis (PrEP) interventions for this population. As such, there is an urgent need for innovative outreach strategies that extend beyond the traditional patient-provider relationship to reach at-risk populations. Training members of the BMSM community as peer change agents (PCAs) is one such strategy. An important piece of this training is goal-setting. Goal-setting not only encourages PCAs to define the parameters of the intervention according to their lived experience, it also helps them plan courses of action. Therefore, the aims of this mixed methods study are: (1) Characterize the goals that BMSM set at the end of their PrEP training and (2) Assess the relationship between goal types and PCA engagement. Methods: Between March 2016 and July 2016, preliminary data were collected from 68 BMSM, ages 18-33, in Chicago as part of an ongoing PrEP intervention. Once enrolled, PCAs participate in a half-day training in which they learn about PrEP, practice initiating conversations about PrEP, and identify strategies for supporting at-risk peers through the PrEP adoption process. Training culminates with a goal-setting exercise, whereby participants establish a goal related to their role as a PCA. Goals were coded for features that either emerged from the data itself or existed in extant goal-setting literature. The main outcomes were (1) number of PrEP conversations PCAs self-report during booster conversations two weeks following the intervention and (2) number of peers PCAs recruit into the study that completed the PrEP workshop. Results: PCA goals (N=68) were characterized in terms of four features: Specificity, target population, personalization, and purpose defined. To date, PCAs report a collective 52 PrEP conversations. 56, 25, and 6% of PrEP conversations occurred with friends, family, and sexual partners, respectively. PCAs with specific goals had more PrEP conversations with at-risk peers compared to those with vague goals (58% vs. 42%); PCAs with personalized goals had more PrEP conversations compared to those with de-personalized goals (60% vs. 53%); and PCAs with goals that defined a purpose had more PrEP conversations compared to those who did not define a purpose (75% vs. 52%). 100% of PCAs with goals that defined a purpose recruited peers into the study compared to 45 percent of PCAs with goals that did not define a purpose. Conclusion: Our preliminary analysis demonstrates that BMSM are motivated to set and work toward a diverse set of goals to support peers in PrEP adoption. PCAs with goals involving a clearly defined purpose had more PrEP conversations and greater peer recruitment than those with goals lacking a defined purpose. This may indicate that PCAs who define their purpose at the outset of their participation will be more engaged in the study than those who do not. Goal-setting may be considered as a component of future HIV prevention interventions to advance intervention goals and as an indicator of PCAs understanding of the intervention.

Keywords: HIV prevention, MSM, peer change agent, preexposure prophylaxis

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Authors: Vilma Zydziunaite, Monika Kelpsiene

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In early childhood and preschool education, play has an important role in learning and cognitive processes. In the context of a changing world, personal autonomy and the use of technology are becoming increasingly important for the development of a wide range of learner competencies. By integrating technology into learning environments, the educational reality is changed, promoting unusual learning experiences for children through play-based activities. Alongside this, teachers are challenged to develop encouragement and motivation strategies that empower children to act independently. The aim of the study was to reveal the changes in the roles and experiences of teachers in the application of AR technology for the enrichment of the learning process. A quantitative research approach was used to conduct the study. The data was collected through an electronic questionnaire. Participants: 319 teachers of 5-6-year-old children using AR technology tools in their educational process. Methods of data analysis: Cronbach alpha, descriptive statistical analysis, normal distribution analysis, correlation analysis, regression analysis (SPSS software). Results. The results of the study show a significant relationship between children's learning and the educational process modeled by the teacher. The strongest predictor of child learning was found to be related to the role of the educator. Other predictors, such as pedagogical strategies, the concept of AR technology, and areas of children's education, have no significant relationship with child learning. The role of the educator was found to be a strong determinant of the child's learning process. Conclusions. The greatest potential for integrating AR technology into the teaching-learning process is revealed in collaborative learning. Teachers identified that when integrating AR technology into the educational process, they encourage children to learn from each other, develop problem-solving skills, and create inclusive learning contexts. A significant relationship has emerged - how the changing role of the teacher relates to the child's learning style and the aspiration for personal leadership and responsibility for their learning. Teachers identified the following key roles: observer of the learning process, proactive moderator, and creator of the educational context. All these roles enable the learner to become an autonomous and active participant in the learning process. This provides a better understanding and explanation of why it becomes crucial to empower the learner to experiment, explore, discover, actively create, and foster collaborative learning in the design and implementation of the educational content, also for teachers to integrate AR technologies and the application of the principles of shared leadership. No statistically significant relationship was found between the understanding of the definition of AR technology and the teacher’s choice of role in the learning process. However, teachers reported that their understanding of the definition of AR technology influences their choice of role, which has an impact on children's learning.

Keywords: teacher, learner, augmented reality, collaboration, shared leadership, preschool education

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Authors: Chrysoula Mangafa

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Autism is a lifelong condition that affects how individuals interact with others and make sense of the world around them. The two core difficulties associated with autism are difficulties in social communication and interaction, and the manifestation of restricted, repetitive patterns of behaviour. However, children with autism may also have many talents and special interests among which is their affinity with digital technologies. Despite the increasing use of mobile tablets in schools and homes and the children’s motivation in using them, there is limited guidance on how to use the tablets to teach children with autism-specific skills. This study aims to fill this gap in knowledge by providing guidelines about the ways in which iPads and other tablets can be used by parents/carers and their child at home to support the development of social communication skills. Semi-structured interviews with 10 parents of primary school aged children with autism were conducted with the aim to explore their experiences in using mobile devices, such as iPads and Android tablets, and social activities with their children to create opportunities for social communication development. The interview involved questions about the parents’ knowledge and experience in autism, their understanding of social communication skills, the use of technology at home, and their links with the child’s school. Qualitative analysis of the interviews showed that parents used a variety of strategies to boost their child’s social communication skills. Among these strategies were a) the use of communication symbols, b) the use of the child’s special interest as motivator to gain their attention, and c) allowing time to their child to respond. It was also found that parents engaged their child in joint activities such as cooking, role play and creating social stories together on the device. Seven out of ten parents mentioned that the tablet is a motivating tool that can be used to teach social communication skills, nonetheless all parents raised concerns over screen time and their child’s sharing difficulties. The need for training and advice as well as building stronger links with their child’s school was highlighted. In particular, it was mentioned that recommendations would be welcomed about how parents can address their child’s difficulties in initiating or sustaining a conversation, taking turns and sharing, understanding other people’s feelings and facial expressions, and showing interest to other people. The findings of this study resulted in the development of a parents’ guide based on evidence-based practice and the participants’ experiences and concerns. The proposed guidelines aim to urge parents to feel more confident in using the tablet with their child in more collaborative ways. In particular, the guide offers recommendations about how to develop verbal and non-verbal communication, gives examples of tablet-based activities to interact and create things together, as well as it offers suggestions on how to provide a worry-free tablet experience and how to connect with the school.

Keywords: families, perception and cognition in early development, school-age intervention, social development

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Authors: William Kerua

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The PNG University of Technology (Unitech) has mandatory access to teaching, research and extension education. Given such function, the Agriculture Department has established the ‘South Pacific Institute of Sustainable Agriculture and Rural Development (SPISARD)’ in 2004. SPISARD is established as a vehicle to improve farming systems practiced in selected villages by undertaking pluralistic extension method through ‘Educational Institutional Approach’. Unlike other models, SPISARD’s educational institutional approach stresses on improving the whole farming systems practiced in a holistic manner and has a two-fold focus. The first is to understand the farming communities and improve the productivity of the farming systems in a sustainable way to increase income, improve nutrition and food security as well as livelihood enhancement trainings. The second is to enrich the Department’s curriculum through teaching, research, extension and getting inputs from farming community. SPISARD has established number of model villages in various provinces in Papua New Guinea (PNG) and with many positive outcome and success stories. Adaption of ‘educational institutional approach’ thus binds research, extension and training into one package with the use of students and academic staff through model village establishment in delivering development and extension to communities. This centre (SPISARD) coordinates the activities of the model village programs and linkages. The key to the development of the farming systems is establishing and coordinating linkages, collaboration, and developing partnerships both within and external institutions, organizations and agencies. SPISARD has a six-point step strategy for the development of sustainable agriculture and rural development. These steps are (i) establish contact and identify model villages, (ii) development of model village resource centres for research and trainings, (iii) conduct baseline surveys to identify problems/needs of model villages, (iv) development of solution strategies, (v) implementation and (vi) evaluation of impact of solution programs. SPISARD envisages that the farming systems practiced being improved if the villages can be made the centre of SPISARD activities. Therefore, SPISARD has developed a model village approach to channel rural development. The model village when established become the conduit points where teaching, training, research, and technology transfer takes place. This approach is again different and unique to the existing ones, in that, the development process take place in the farmers’ environment with immediate ‘real time’ feedback mechanisms based on the farmers’ perspective and satisfaction. So far, we have developed 14 model villages and have conducted 75 trainings in 21 different areas/topics in 8 provinces to a total of 2,832 participants of both sex. The aim of these trainings is to directly participate with farmers in the pursuit to improving their farming systems to increase productivity, income and to secure food security and nutrition, thus to improve their livelihood.

Keywords: development, educational institutional approach, livelihood improvement, sustainable agriculture

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Authors: A. Noll, J. Roth, M. Scholz

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The importance of written language in a democratic society is non-controversial. Students with physical, learning, cognitive or developmental disabilities often have difficulties in understanding information which is presented in written language only. These students suffer from obstacles in diverse domains. In order to reduce such barriers in educational as well as in out-of-school areas, access to written information must be facilitated. Readability can be enhanced by linguistic simplifications like the application of easy-to-read language. Easy-to-read language shall help people with disabilities to participate socially and politically in society. The authors state, for example, that only short simple words should be used, whereas the occurrence of complex sentences should be avoided. So far, these guidelines were not empirically proved. Another way to reduce reading barriers is the use of visual support, for example, symbols. A symbol conveys, in contrast to a photo, a single idea or concept. Little empirical data about the use of symbols to foster the readability of texts exist. Nevertheless, a positive influence can be assumed, e.g., because of the multimedia principle. It indicates that people learn better from words and pictures than from words alone. A qualitative Interview and Eye-Tracking-Study, which was conducted by the authors, gives cause for the assumption that besides the illustration of single words, the visualization of complete sentences may be helpful. Thus, the effect of photos, which illustrate the content of complete sentences, is also investigated in this study. This leads us to the main research question which was focused on: Does the use of easy-to-read language and/or enriching text with symbols or photos facilitate pupils’ comprehension of learning tasks? The sample consisted of students with learning difficulties (N = 144) and students without SEN (N = 159). The students worked on the tasks, which dealt with introducing fractions, individually. While experimental group 1 received a linguistically simplified version of the tasks, experimental group 2 worked with a variation which was linguistically simplified and furthermore, the keywords of the tasks were visualized by symbols. Experimental group 3 worked on exercises which were simplified by easy-to-read-language and the content of the whole sentences was illustrated by photos. Experimental group 4 received a not simplified version. The participants’ reading ability and their IQ was elevated beforehand to build four comparable groups. There is a significant effect of the different setting on the students’ results F(3,140) = 2,932; p = 0,036*. A post-hoc-analyses with multiple comparisons shows that this significance results from the difference between experimental group 3 and 4. The students in the group easy-to-read language plus photos worked on the exercises significantly more successfully than the students who worked in the group with no simplifications. Further results which refer, among others, to the influence of the students reading ability will be presented at the ICERI 2018.

Keywords: inclusive education, mathematics education, easy-to-read language, photos, symbols, special educational needs

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Authors: Kiran Sharma, Viktor Kunder, Zerha Rizvi, Ricardo Soubelet

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Platelet rich plasma (PRP) has been recognized as a method of treatment in medicine since the 1980s. It primarily functions by releasing cytokines and growth factors that promote wound healing; these growth promoting factors released by PRP enact new processes such as angiogenesis, collagen deposition, and tissue formation that can change wound healing outcomes. Many studies recognize that PRP aids in chronic wound healing, which is advantageous for patients who suffer from chronic diabetic foot ulcers (DFUs). This scoping review aims to examine literature to identify the efficacy of PRP use in the healing of DFUs. Following PRISMA guidelines, we searched randomized-controlled trials involving PRP use in diabetic patients with foot ulcers using PubMed, Medline, CINAHL Complete, and Cochrane Database of Systematic Reviews. We restricted the search to articles published during 2005-2022, full texts in the English language, articles involving patients aged 19 years or older, articles that used PRP on specifically DFUs, articles that included a control group, articles on human subjects. The initial search yielded 119 articles after removing duplicates. Final analysis for relevance yielded 8 articles. In all cases except one, the PRP group showed either faster healing, more complete healing, or a larger percentage of healed participants. There were no situations in the included studies where the control group had a higher rate of healing or decreased wound size as compared to a group with isolated PRP-only use. Only one study did not show conclusive evidence that PRP caused accelerated healing in DFUs, and this study did not have an isolated PRP variable group. Application styles of PRP for treatment were shown to influence the level of healing in patients, with injected PRP appearing to achieve the best results as compared to topical PRP application. However, this was not conclusive due to the involvement of several other variables. Two studies additionally found PRP to be useful in healing refractory DFUs, and one study found that PRP use in patients with additional comorbidities was still more effective in healing DFUs than the standard control groups. The findings of this review suggest that PRP is a useful tool in reducing healing times and improving rates of complete wound healing in DFUs. There is room for further research in the application styles of PRP before conclusive statements can be made on the efficacy of injected versus topical PRP healing based on the findings in this study. The results of this review provide a baseline for further research in PRP use in diabetic patients and can be used by both physicians and public health experts to guide future treatment options for DFUs.

Keywords: diabetic foot ulcer, DFU, platelet rich plasma, PRP

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Authors: Natalie A. Sterk, Bernard van Vuuren, Petrie Marais, Bongani Mthombeni

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Injuries to the internal structures of the thorax and abdomen remain a leading cause of death among soldiers. Body armour is a standard issue piece of military equipment designed to protect the vital organs against ballistic and stab threats. When configured for maximum protection, the excessive weight and size of the armour may limit soldier mobility and increase physical fatigue and discomfort. Providing soldiers with more armour than necessary may, therefore, hinder their ability to react rapidly in life-threatening situations. The capability to determine the optimal trade-off between the amount of essential anatomical coverage and hindrance on soldier performance may significantly enhance the design of armour systems. The current study aimed to develop and pilot a methodology for relating internal anatomical structures with actual armour plate coverage in real-time using low-dose diagnostic X-ray scanning. Several pilot scanning sessions were held at Lodox Systems (Pty) Ltd head-office in South Africa. Testing involved using the Lodox eXero-dr to scan dummy trunk rigs at various degrees and heights of measurement; as well as human participants, wearing correctly fitted body armour while positioned in supine, prone shooting, seated and kneeling shooting postures. The verification of sizing and metrics obtained from the Lodox eXero-dr were then confirmed through a verification board with known dimensions. Results indicated that the low-dose diagnostic X-ray has the capability to clearly identify the vital internal structures of the aortic arch, heart, and lungs in relation to the position of the external armour plates. Further testing is still required in order to fully and accurately identify the inferior liver boundary, inferior vena cava, and spleen. The scans produced in the supine, prone, and seated postures provided superior image quality over the kneeling posture. The X-ray-source and-detector distance from the object must be standardised to control for possible magnification changes and for comparison purposes. To account for this, specific scanning heights and angles were identified to allow for parallel scanning of relevant areas. The low-dose diagnostic X-ray provides a non-invasive, safe, and rapid technique for relating vital internal structures with external structures. This capability can be used for the re-evaluation of anatomical coverage required for essential protection while optimising armour design and fit for soldier performance.

Keywords: body armour, low-dose diagnostic X-ray, scanning, vital organ coverage

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Authors: Judson P. LaGrone

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Simulation-based education in curricula was once a luxurious component of nursing programs but now serves as a vital element of an individual’s learning experience. A debriefing occurs after the simulation scenario or clinical experience is completed to allow the instructor(s) or trained professional(s) to act as a debriefer to guide a reflection with a purpose of acknowledging, assessing, and synthesizing the thought process, decision-making process, and actions/behaviors performed during the scenario or clinical experience. Debriefing is a vital component of the simulation process and educational experience to allow the learner(s) to progressively build upon past experiences and current scenarios within a safe and welcoming environment with a guided dialog to enhance future practice. The aim of this integrative review was to assess current practices of debriefing models in simulation-based education for health care professionals and students. The following databases were utilized for the search: CINAHL Plus, Cochrane Database of Systemic Reviews, EBSCO (ERIC), PsycINFO (Ovid), and Google Scholar. The advanced search option was useful to narrow down the search of articles (full text, Boolean operators, English language, peer-reviewed, published in the past five years). Key terms included debrief, debriefing, debriefing model, debriefing intervention, psychological debriefing, simulation, simulation-based education, simulation pedagogy, health care professional, nursing student, and learning process. Included studies focus on debriefing after clinical scenarios of nursing students, medical students, and interprofessional teams conducted between 2015 and 2020. Common themes were identified after the analysis of articles matching the search criteria. Several debriefing models are addressed in the literature with similarities of effectiveness for participants in clinical simulation-based pedagogy. Themes identified included (a) importance of debriefing in simulation-based pedagogy, (b) environment for which debriefing takes place is an important consideration, (c) individuals who should conduct the debrief, (d) length of debrief, and (e) methodology of the debrief. Debriefing models supported by theoretical frameworks and facilitated by trained staff are vital for a successful debriefing experience. Models differed from self-debriefing, facilitator-led debriefing, video-assisted debriefing, rapid cycle deliberate practice, and reflective debriefing. A reoccurring finding was centered around the emphasis of continued research for systematic tool development and analysis of the validity and effectiveness of current debriefing practices. There is a lack of consistency of debriefing models among nursing curriculum with an increasing rate of ill-prepared faculty to facilitate the debriefing phase of the simulation.

Keywords: debriefing model, debriefing intervention, health care professional, simulation-based education

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Authors: Rasha Waheeb, Bjorn Andersen, Rafa Shakir

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Purpose The purpose of this study is to avoid delays that occur in emergency reconstruction projects especially in post disaster circumstances whether if they were natural or manmade due to their particular national and humanitarian importance. We presented a theoretical and practical concepts for projects management in the field of construction industry that deal with a range of global and local trails. This study aimed to identify the factors of effective delay in construction projects in Iraq that affect the time and the specific quality cost, and find the best solutions to address delays and solve the problem by setting parameters to restore balance in this study. 30 projects were selected in different areas of construction were selected as a sample for this study. Design/methodology/approach This study discusses the reconstruction strategies and delay in time and cost caused by different delay factors in some selected projects in Iraq (Baghdad as a case study).A case study approach was adopted, with thirty construction projects selected from the Baghdad region, of different types and sizes. Project participants from the case projects provided data about the projects through a data collection instrument distributed through a survey. Mixed approach and methods were applied in this study. Mathematical data analysis was used to construct models to predict delay in time and cost of projects before they started. The artificial neural networks analysis was selected as a mathematical approach. These models were mainly to help decision makers in construction project to find solutions to these delays before they cause any inefficiency in the project being implemented and to strike the obstacles thoroughly to develop this industry in Iraq. This approach was practiced using the data collected through survey and questionnaire data collection as information form. Findings The most important delay factors identified leading to schedule overruns were contractor failure, redesigning of designs/plans and change orders, security issues, selection of low-price bids, weather factors, and owner failures. Some of these are quite in line with findings from similar studies in other countries/regions, but some are unique to the Iraqi project sample, such as security issues and low-price bid selection. Originality/value we selected ANN’s analysis first because ANN’s was rarely used in project management , and never been used in Iraq to finding solutions for problems in construction industry. Also, this methodology can be used in complicated problems when there is no interpretation or solution for a problem. In some cases statistical analysis was conducted and in some cases the problem is not following a linear equation or there was a weak correlation, thus we suggested using the ANN’s because it is used for nonlinear problems to find the relationship between input and output data and that was really supportive.

Keywords: construction projects, delay factors, emergency reconstruction, innovation ANN, post disasters, project management

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Authors: Dina C. Castro, Rossana Boyd, Eugenia Papadaki

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Immigration within and across continents is currently a global reality. The number of people leaving their communities in search for a better life for them and their families has increased dramatically during the last twenty years. Therefore, young children of the 21st century around the World are growing up in diverse communities, exposed to many languages and cultures. One consequence of these migration movements is the increased linguistic diversity in school settings. Depending on the linguistic history and the status of languages in the communities (i.e., minority-majority; majority-majority) the instructional approaches will differ. This session will discuss how bilingualism is addressed in early education programs in both minority-majority and majority-majority language communities, analyzing experiences in three countries with very distinct societal and demographic characteristics: Peru (South America), the United States (North America), and Italy (European Union). The ultimate goal is to identify commonalities and differences across the three experiences that could lead to a discussion of bilingualism in early education from a global perspective. From Peru, we will discuss current national language and educational policies that have lead to the design and implementation of bilingual and intercultural education for children in indigenous communities. We will also discuss how those practices are being implemented in preschool programs, the progress made and challenges encountered. From the United States, we will discuss the early education of Spanish-English bilingual preschoolers, including the national policy environment, as well as variations in language of instruction approaches currently being used with these children. From Italy, we will describe early education practices in the Bilingual School of Monza, in northern Italy, a school that has 20 years promoting bilingualism and multilingualism in education. While the presentations from Peru and the United States will discuss bilingualism in a majority-minority language environment, this presentation will lead to a discussion on the opportunities and challenges of promoting bilingualism in a majority-majority language environment. It is evident that innovative models and policies are necessary to prevent inequality of opportunities for bilingual children beginning in their earliest years. The cross-cultural examination of bilingual education experiences for young children in three part of the World will allow us to learn from our success and challenges. The session will end with a discussion of the following question: To what extent are early care and education programs being effective in promoting positive development and learning among all children, including those from diverse language, ethnic and cultural backgrounds? We expect to identify, with participants to our session, a set of recommendations for policy and program development that could ensure access to high quality early education for all bilingual children.

Keywords: early education for bilingual children, global perspectives in early education, cross-cultural, language policies

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Authors: Micael Sousa

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Board games (BGs) are thriving as new designs emerge from the hobby community to greater audiences all around the world. Although digital games are gathering most of the attention in game studies and serious games research fields, the post-digital movement helps to explain why in the world dominated by digital technologies, the analog experiences are still unique and irreplaceable to users, allowing innovation in new hybrid environments. The BG’s new designs are part of these post-digital and hybrid movements because they result from the use of powerful digital tools that enable the production and knowledge sharing about the BGs and their face-to-face unique social experiences. These new BGs, defined as modern by many authors, are providing innovative designs and unique game mechanics that are still not yet fully explored by the main serious games (SG) approaches. Even the most established frameworks settled to address SG, as fun games implemented to achieve predefined goals need more development, especially when considering modern BGs. Despite the many anecdotic perceptions, researchers are only now starting to rediscover BGs and demonstrating their potentials. They are proving that BGs are easy to adapt and to grasp by non-expert players in experimental approaches, with the possibility of easy-going adaptation to players’ profiles and serious objectives even during gameplay. Although there are many design thinking (DT) models and practices, their relations with SG frameworks are also underdeveloped, mostly because this is a new research field, lacking theoretical development and the systematization of the experimental practices. Using BG as case studies promise to help develop these frameworks. Departing from the Design, Experience, and Play (DPE) framework and considering the Common Design Think Tools (CDST), this paper proposes a new experimental framework for the adaptation and development of modern BG design for DT: the Design, Experience, and Play for Think (DPET) experimental framework. This is done through the systematization of the DPE and CDST approaches applied in two case studies, where two different sequences of adapted BG were employed to establish a DT collaborative process. These two sessions occurred with different participants and in different contexts, also using different sequences of games for the same DT approach. The first session took place at the Faculty of Economics at the University of Coimbra in a training session of serious games for project development. The second session took place in the Casa do Impacto through The Great Village Design Jam light. Both sessions had the same duration and were designed to progressively achieve DT goals, using BGs as SGs in a collaborative process. The results from the sessions show that a sequence of BGs, when properly adapted to address the DPET framework, can generate a viable and innovative process of collaborative DT that is productive, fun, and engaging. The DPET proposed framework intents to help establish how new SG solutions could be defined for new goals through flexible DT. Applications in other areas of research and development can also benefit from these findings.

Keywords: board games, design thinking, methodology, serious games

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Authors: Rahy Farooq, Maria Ahmad Khan, Ayesha Isani Majeed

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Objective: The main aim of this research is to assess the knowledge, attitude and practices of female nursing staff and nursing students regarding breast cancer, to provide a baseline for monitoring trends of breast cancer awareness in them. Background: Healthcare professionals are a direct source of information for the patients and the general public as a whole. It is, therefore, essential that the information they convey be accurate and helps in building additional awareness. However, clinical experience does not influence the knowledge, attitude and practices regarding breast cancer. Nurses, being the prime part of the healthcare professionals, play a significant role and hence, their awareness regarding this pressing issue is pertinent. Lack of awareness regarding common presenting symptoms or breast cancer risk factors translates to poor breast cancer screening practices and late diagnosis. Methodology: A cross-sectional study of 280 female nurses was conducted at a tertiary care hospital in Islamabad, Pakistan. A pre-tested structured questionnaire with additional variables like cultural barriers to seeking medical help was used. The scores for outcome variables including knowledge, attitude and practices were pre-defined. Data was analyzed using SPSSv23. Results: Of the 280 participants with a mean age of 28.99±9.98 years, 142 (50.7%) were married, and 138 (49.3%) were unmarried. Mean scores were computed to be 6.14±2.93 (out of 12), 0.30±0.7 (out of 3) and 9.53±1.92 (out of 16) for knowledge, attitude and practice respectively. Using independent sample T-test, a statistically significant correlation was found when means for the score of Attitude was compared with age. With a p-value of 0.018, 117 nurses of age more than 30 years, faced more practical, financial, emotional and service barriers as compared to 163 women younger than 30 years of age. Knowledge of age-related lifetime risks was also significantly poor more in single women; with a p-value of 0.006 for identification of correct age as a risk factor and a p-value of 0.005 for correct identification of risk for development of breast cancer in the lifetime of women. By application of Chi-square test, there was a significant correlation between marital status and cultural barriers to seeking medical help, showing that single women (58.7%) shy away from talking about breast cancer considering it a taboo (p-value 0.028) whereas, more married nurses (59.2%) were apprehensive that they might be considered at fault by the society, as compared to 40.8% of single nurses. (p-value 0.038). Conclusion: Owing to the scarcity of awareness among nurses, this study recognizes the need for delivering effective information to the female nurses regarding breast cancer. Educating patients is likely to be effective if the female nurses play their part and have correct attitudes towards breast cancer practices. A better understanding of the knowledge and practices regarding breast cancer among the nursing population will enable high-risk patients to be recognized early. Therefore, we recommend arrangement of special courses and seminars for all healthcare professionals including the nursing staff.

Keywords: breast cancer, cultural barriers, kap, nurses

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Authors: Raheel Shakoor Siddiqui, Shahbaz Malik, Manikandar Srinivas Cheruvu, Sanjay Narayana Murthy, Livio DiMascio

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Background: elderly traumatic hip fracture patients frequently present to trauma services globally. Rising low energy falls amongst an osteoporotic aging population is the commonest cause for injury. Hip fractures in this population are a major cause for severe pain, morbidity and mortality. The term hip fracture is interchangeable with neck of femur fracture, fractured neck of femur or proximal femur fracture. Hip fracture pain management protocols and guidelines suggest conventional analgesia, nerve block and opioid based treatment as rescue analgesia. There is a current global opioid crisis with overuse, abuse and dependence. Adverse opioid related complications in vulnerable elderly patients further adds to morbidity and mortality. Systematic reviews in literature have evidenced superiority of multimodal analgesia in osteoarthritic primary joint replacements compared to opioids however, this has not yet been conducted for elderly traumatic hip fracture patients. Aims: The primary aim of this systematic review is to provide standardised evidence following Cochrane and PRISMA guidance in determining advantages of perioperative multimodal analgesia over conventional opioid based treatments in elderly traumatic hip fractures. Methods: 5 databases were searched from January 2000-2023 which identified 8 randomised controlled trials and 446 total participants. These trials met defined PICOS eligibility criteria of patient mean age ≥ 65 years presenting with a unilateral traumatic fractured neck of femur for operative intervention. Analgesic intervention with perioperative multimodal analgesia has been compared to conventional opioid based analgesia. Outcomes of interest include, primarily, the change in postoperative opioid consumption within a 0-30 postoperative period and secondarily, the change in postoperative adverse events and complications. A qualitative synthesis has been performed due to clinical heterogenicity and variance amongst trials. Results: GRADE evidence of moderate quality supports perioperative multimodal analgesia leads to a reduction in postoperative opioid consumption however, low quality evidence supports a reduction of adverse effects and complications. Conclusion: Perioperative multimodal analgesia whether used preoperative, intraoperative and/or postoperative leads to a reduction in postoperative opioid consumption for elderly traumatic hip fracture patients. This review recommends the use of perioperative multimodal analgesia as part of hip fracture pain protocols however, caution and clinical judgement should be used as the risk of adverse effects may not be lower.

Keywords: trauma, orthopaedics, hip, fracture, neck of femur fracture, analgesia, multimodal analgesia, opioid

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Authors: A. Venkatakrishnan, M. Juneja, S. Kapoor

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Background: Gastrointestinal dysfunction is an emerging co morbidity seen in autism and may further strengthen the association between autism and celiac disease. This is supported by increased rates (22-70%) of gastrointestinal symptoms like diarrhea, constipation, abdominal discomfort/pain, and gastrointestinal inflammation in children with the etiology of autism is still elusive. In addition to genetic factors, environmental factors such as toxin exposure, intrauterine exposure to certain teratogenic drugs, are being proposed as possible contributing factors in the etiology of Autism Spectrum Disorders (ASD) in cognizance with reports of increased gut permeability and high rates of gastrointestinal symptoms noted in children with ASD, celiac disease has also been proposed as a possible etiological factor. Despite insufficient evidence regarding the benefit of restricted diets in Autism, GFD has been promoted as an alternative treatment for ASD. This study attempts to discern any correlation between ASD and celiac disease. Objective: This cross sectional study aims to determine the proportion of celiac disease in children with ASD. Methods: Study included 155 participants aged 2-12 yrs, diagnosed as ASD as per DSM-5 attending the child development center at a tertiary care hospital in Northern India. Those on gluten free diet or having other autoimmune conditions were excluded. A detailed Performa was filled which included sociodemographic details, history of gastrointestinal symptoms, anthropometry, systemic examination, and pertinent psychological testing was done using was assessed using Developmental Profile-3(DP-3) for Developmental Quotient, Childhood Autism Rating Scale-2 (CARS-2) for severity of ASD, Vineland Adaptive Behavior Scales (VABS) for adaptive behavior, Child Behavior Checklist (CBCL) for behavioral problems and BAMBI (Brief Autism Mealtime Behavior Scales) for feeding problems. Screening for celiac was done by TTG-IgA levels, and total serum IgA levels were measured to exclude IgA deficiency. Those with positive screen were further planned for HLA typing and endoscopic biopsy. Results: A total of 155 cases were included, out of which 5 had low IgA levels and were hence excluded from the study. The rest 150 children had TTG levels below the ULN and normal total serum IgA level. History of Gastrointestinal symptoms was present in 51 (34%) cases abdominal pain was the most frequent complaint (16.6%), followed by constipation (12.6%). Diarrhea was seen in 8 %. Gastrointestinal symptoms were significantly more common in children with ASD above 5 yrs (p-value 0.006) and those who were verbal (p = 0.000). There was no significant association between socio-demographic factors, anthropometric data, or severity of autism with gastrointestinal symptoms. Conclusion: None of the150 patients with ASD had raised TTG levels; hence no association was found between ASD and celiac disease. There is no justification for routine screening for celiac disease in children with ASD. Further studies are warranted to evaluate association of Non Celiac Gluten Sensitivity with ASD and any role of gluten-free diet in such patients.

Keywords: autism, celiac, gastrointestinal, gluten

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Authors: Farouq Sule Garo, Yahaya Yusuf

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The purpose of this study is to investigate why there is a general lack of successful adoption of sustainable energy in Nigeria. This is particularly important given the current global campaign for net-zero emissions. The 26th United Nations Conference of the Parties (COP26), held in 2021, was hosted by the UK, in Glasgow, where, amongst other things, countries including Nigeria agreed to a zero emissions pact. There is, therefore, an obligation on the part of Nigeria for transition from fossil fuel-based economy to a sustainable net-zero emissions economy. The adoption of renewable energy is fundamental to achieving this ambitious target if decarbonisation of economic activities were to become a reality. Nigeria has an abundance of sources of renewable energy and yet there has been poor uptake and where attempts have been made to develop and harness renewable energy resources, there has been limited success. It is not entirely clear why this is the case. When analysts allude to corruption as the reason for failure for successful adoption of renewable energy or project implementation, it is arguable that corruption alone cannot explain the situation. Therefore, there is the need for a thorough investigation into the underlying issues surrounding poor uptake of renewable energy in Nigeria. This pilot study, drawing upon stakeholders’ theory, adopts a multi-stakeholder’ perspectives to investigate the influence and impacts of economic, political, technological, social factors in adoption of renewable energy in Nigeria. The research will also investigate how these factors shape (or fail to shape) strategies for achieving successful adoption of renewable energy in the country. A qualitative research methodology has been adopted given the nature of the research requiring in-depth studies in specific settings rather than a general population survey. There will be a number of interviews and each interview will allow thorough probing of sources. This, in addition to the six interviews that have already been conducted, primarily focused on economic dimensions of the challenges in adoption of renewable energy. The six participants in these initial interviews were all connected to the Katsina Wind Farm Project that was conceived and built with the view to diversifying Nigeria's energy mix and capitalise on the vast wind energy resources in the northern region. The findings from the six interviews provide insights into how the economic factors impacts on the wind farm project. Some key drivers have been identified, including strong governmental support and the recognition of the need for energy diversification. These drivers have played crucial roles in initiating and advancing the Katsina Wind Farm Project. In addition, the initial analysis has highlighted various challenges encountered during the project's implementation, including financial, regulatory, and environmental aspects. These challenges provide valuable lessons that can inform strategies to mitigate risks and improve future wind energy projects.

Keywords: challenges in adoption of renewable energy, economic factors, net-zero emission, political factors

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Authors: E. Calil, L. A. Pereira

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The acquisition of orthography is a complex process, involving both lexical and grammatical questions. This learning occurs simultaneously with the domain of multiple textual aspects (e.g.: graphs, punctuation, etc.). However, most of the research on orthographic acquisition focus on this acquisition from an autonomous point of view, separated from the process of textual production. This means that their object of analysis is the production of words selected by the researcher or the requested sentences in an experimental and controlled setting. In addition, the analysis of the Spelling Problems (SP) are identified by the researcher on the sheet of paper. Considering the perspective of Textual Genetics, from an enunciative approach, this study will discuss the SPs recognized by dyads of newly literate students, while they are writing a text collaboratively. Six proposals of textual production were registered, requested by a 2nd year teacher of a Portuguese Primary School between January and March 2015. In our case study we discuss the SPs recognized by the dyad B and L (7 years old). We adopted as a methodological tool the Ramos System audiovisual record. This system allows real-time capture of the text in process and of the face-to-face dialogue between both students and their teacher, and also captures the body movements and facial expressions of the participants during textual production proposals in the classroom. In these ecological conditions of multimodal registration of collaborative writing, we could identify the emergence of SP in two dimensions: i. In the product (finished text): SP identification without recursive graphic marks (without erasures) and the identification of SPs with erasures, indicating the recognition of SP by the student; ii. In the process (text in progress): identification of comments made by students about recognized SPs. Given this, we’ve analyzed the comments on identified SPs during the text in progress. These comments characterize a type of reformulation referred to as Commented Oral Erasure (COE). The COE has two enunciative forms: Simple Comment (SC) such as ' 'X' is written with 'Y' '; or Unfolded Comment (UC), such as ' 'X' is written with 'Y' because...'. The spelling COE may also occur before or during the SP (Early Spelling Recognition - ESR) or after the SP has been entered (Later Spelling Recognition - LSR). There were 631 words entered in the 6 stories written by the B-L dyad, 145 of them containing some type of SP. During the text in progress, the students recognized orally 174 SP, 46 of which were identified in advance (ESRs) and 128 were identified later (LSPs). If we consider that the 88 erasure SPs in the product indicate some form of SP recognition, we can observe that there were twice as many SPs recognized orally. The ESR was characterized by SC when students asked their colleague or teacher how to spell a given word. The LSR presented predominantly UC, verbalizing meta-orthographic arguments, mostly made by L. These results indicate that writing in dyad is an important didactic strategy for the promotion of metalinguistic reflection, favoring the learning of spelling.

Keywords: collaborative writing, erasure, learning, metalinguistic awareness, spelling, text production

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Authors: Hamdan Hamood Aldumaini, Amjad Hussein Meqdam, Shamsaldeen kassim Ali, Hamed Mohammed Al-Yousefi, Haron Ahmed Al-Badawi

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Background: Autism Spectrum Disorder (ASD) is a complex developmental challenge characterized by significant impairments in social interaction, communication, and behavioral patterns. Diagnosing ASD is challenging due to the lack of definitive medical tests, making early identification crucial. Therefore, increasing people's awareness about autism leads to early diagnosis and better prognosis. Objective: Our study aims to identify the initial symptoms prompting families to seek medical advice, determine the timeline between symptom onset and formal diagnosis, and explore methods for assessing the severity of ASD. Subjects and Methods: The study design employed was a descriptive cross-sectional design, which was suitable for the nature of the research. The data collection took place from March 5, 2022, to April 5, 2022, in Autism Rehabilitation Centers in Sana'a, Yemen. The study population consisted of all children who were diagnosed with autism and visited Autism rehabilitation centers in Sana'a city. The sample size was determined using Epi info version 7, and a total population of 587 autistic children attending the treatment was calculated, but only 250 children were included in this study (176 were male vs. 74 female). Result: In terms of sociability problems, it was found that a significant proportion of Yemeni children with autism experienced difficulties in this area. Specifically, 39.6% were classified as having severe sociability problems, while 28.4% were classified as having moderate issues. Sensory-cognitive awareness problems were also prevalent among the respondents, with 29.6% exhibiting severe difficulties in this domain. Health and physical problems were identified as significant concerns for Yemeni children with autism. The results indicated that 38.4% of the participants experienced severe health and physical issues. Identifying the first symptoms of autism is crucial for early detection and intervention. According to the study, speech delay was the most commonly observed first abnormality, reported by 71.3% of parents. Communication difficulties with others were the second most noticed abnormality, reported by 54.9% of parents. Repetitive movements were the third most commonly observed abnormality, reported by 18% of parents. Regarding the awareness among parents of ASD, our study showed that a significant portion (62%) of parents lack awareness about Autism Spectrum Disorder (ASD) and its causes. Surprisingly, a majority of these parents (over 80%) believe that autism is a curable condition. Additionally, more than half (51.2%) of the parents surveyed reported insufficient knowledge about medication options available to support therapy and rehabilitation for their autistic children.

Keywords: autism characteristics, rehabilitation centres, yemen, children

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Authors: Justin Durham, Chanda Rooney, Robert Mather, Mickie Vanhoy

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The psychological construct of empathy is to understand a person’s cognitive perspective and experience the other person’s emotional state. Deciphering emotional states is conducive for interpreting vicarious pain. Observing others' physical pain activates neural networks related to the actual experience of pain itself. The study addresses empathy as a nonlinear dynamic process of simulation for individuals to understand the mental states of others and experience vicarious pain, exhibiting self-organized criticality. Such criticality follows from a combination of neural networks with an excitatory feedback loop generating bistability to resonate permutated empathy. Cortical networks exhibit diverse patterns of activity, including oscillations, synchrony and waves, however, the temporal dynamics of neurophysiological activities underlying empathic processes remain poorly understood. Mu rhythms are EEG oscillations with dominant frequencies of 8-13 Hz becoming synchronized when the body is relaxed with eyes open and when the sensorimotor system is in idle, thus, mu rhythm synchrony is expected to be highest in baseline conditions. When the sensorimotor system is activated either by performing or simulating action, mu rhythms become suppressed or desynchronize, thus, should be suppressed while observing video clips of painful injuries if previous research on mirror system activation holds. Twelve undergraduates contributed EEG data and survey responses to empathy and psychopathy scales in addition to watching consecutive video clips of sports injuries. Participants watched a blank, black image on a computer monitor before and after observing a video of consecutive sports injuries incidents. Each video condition lasted five-minutes long. A BIOPAC MP150 recorded EEG signals from sensorimotor and thalamocortical regions related to a complex neural network called the ‘pain matrix’. Physical and social pain are activated in this network to resonate vicarious pain responses to processing empathy. Five EEG single electrode locations were applied to regions measuring sensorimotor electrical activity in microvolts (μV) to monitor mu rhythms. EEG signals were sampled at a rate of 200 Hz. Mu rhythm desynchronization was measured via 8-13 Hz at electrode sites (F3 & F4). Data for each participant’s mu rhythms were analyzed via Fast Fourier Transformation (FFT) and multifractal time series analysis.

Keywords: desynchronization, dynamical systems theory, electroencephalography (EEG), empathy, multifractal time series analysis, mu waveform, neurophysiology, pain simulation, social cognition

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Authors: Sophie-Bo Heinkel, Andrea Rechenburg, Thomas Kistemann

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The current status of wellbeing and life satisfaction of subsistence farmers in a wetland in Uganda and the contributing role of place attachment has been assessed. The aim of this study is to shed light on environmental factors supporting wellbeing in a wetland setting. Furthermore, it has been assessed, how the emotional bonding to the wetland as ‘place’ influences the peoples’ wellbeing and life satisfaction. The results shed light on the human-environment-relationship. A survey was carried out in three communities in urban and rural areas in a wetland basin in Uganda. A sample (n=235) provided information about the attachment to the wetland, the participants’ relation to the place of their residence and their emotional wellbeing. The Wellbeing Index (WHO-5) was assessed as well as the Perceived Stress Scale (PSS-10) and Rosenberg’s Self-Esteem scale (RSE). Furthermore, the Satisfaction With Life Scale (SWLS) was applied as well as the Place Attachment Inventory (PAI), which consists of the two intertwined dimensions of place identity and place dependence. Beside this, binary indicators as ‘feeling save’ and ‘feeling comfortable’ and ‘enjoying to live at the place of residence’ have been assessed. A bivariate correlation analysis revealed a high interconnectivity between all metric scales. Especially, the subscale ‘place identity’ showed significances with all other scales. A cluster analysis revealed three groups, which differed in the perception of place-related indicators and their attachment to the wetland as well as the status of wellbeing. First, a cluster whose majority is dissatisfied with their lives, but mainly had a good status of emotional well-being. This group does not feel attached to the wetland and lives in a town. Comparably less persons of this group feel safe and comfortable at their place of residence. In the second cluster, persons feel highly attached to the wetland and identify with it. This group was characterized by the high number of persons preferring their current place of residence and do not consider moving. All persons feel well and satisfied with their lives. The third group of persons is mainly living in rural areas and feels highly attached to the wetland. They are satisfied with their lives, but only a small minority is in a good emotional state of wellbeing. The emotional attachment to a place influences life satisfaction and, indirectly, the emotional wellbeing. In the present study it could be shown that subsistence farmers are attached to the wetland, as it is the source of their livelihood. While those living in areas with a good infrastructure are less dependent on the wetland and, therefore, less attached to. This feeling also was mirrored in the perception of a place as being safe and comfortable. The identification with a place is crucial for the feeling of being at “home”. Subsistence farmers feel attached to the ecosystem, but they also might be exposed to environmental and social stressors influencing their short-term emotional wellbeing. The provision of place identity is an ecosystem service provided by wetlands, which supports the status of wellbeing in human beings.

Keywords: mental health, positive environments, quality of life, wellbeing

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Authors: Mokhlisur Rahman

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Consumers' understanding of the products depends on what levels of information the advertisement contains. Consumers' attitudes vary widely depending on factors such as their level of environmental awareness, their perception of the company's motives, and the perceived effectiveness of the advertising campaign. Considering the growing eco-consciousness among consumers and their concern for the environment, strategies for green advertising have become equally significant for companies to attract new consumers. It is important to understand consumers' habits of purchasing, knowledge, and attitudes regarding eco-friendly products depending on promotion because of the limitless options of the products in the market. Additionally, encouraging consumers to buy sustainable products requires a platform that can message the world that being a stakeholder in sustainability is possible if consumers show eco-friendly behavior on a larger scale. Social media platforms provide an excellent atmosphere to promote companies' sustainable efforts to be connected engagingly with their potential consumers. The unique strategies of green advertising use techniques to carry information and rewards for the consumers. This study aims to understand the consumer behavior and effectiveness of green advertising by experimenting in collaboration with three companies in promoting their eco-friendly products using green designs on the products. The experiment uses three sustainable personalized offerings, Nike shoes, H&M t-shirts, and Patagonia school bags. The experiment uses a pretest and posttest design. 300 randomly selected participants take part in this experiment and survey through Facebook, Twitter, and Instagram. Nike, H&M, and Patagonia share the post of the experiment on their social media homepages with a video advertisement for the three products. The consumers participate in a pre-experiment online survey before making a purchase decision to assess their attitudes and behavior toward eco-friendly products. The audio-only feature explains the product's information, like their use of recycled materials, their manufacturing methods, sustainable packaging, and their impact on the environment during the purchase while the consumer watches the product video. After making a purchase, consumers take a post-experiment survey to know their perception and behavior toward eco-friendly products. For the data analysis, descriptive statistical tools mean, standard deviation, and frequencies measure the pre- and post-experiment survey data. The inferential statistical tool paired sample t-test measures the difference in consumers' behavior and attitudes between pre-purchase and post-experiment survey results. This experiment provides consumers ample time to consider many aspects rather than impulses. This research provides valuable insights into how companies can adopt sustainable and eco-friendly products. The result set a target for the companies to achieve a sustainable production goal that ultimately supports companies' profit-making and promotes consumers' well-being. This empowers consumers to make informed choices about the products they purchase and support their companies of interest.

Keywords: green-advertising, sustainability, consumer-behavior, social media

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Authors: Kibret Berhanu Getinet

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Off-farm income diversification by farm rural households has gained the attention of researchers and policymakers due to the fact that agriculture failed to meet the needs of people in developing countries like Ethiopia. The objective of this study was to investigate income diversification strategies into off-farm activities among rural households in Hawassa Zuria Woreda, Sidama National Regional State, Ethiopia. The study used primary and secondary data sources for the primary data collection questionnaire employed as a data collection instrument. A multistage sampling technique was used to collect data from a total of 197 sample households from four kebeles of the study area. Descriptive statistics, as well as econometrics methods of data analysis, were employed. The descriptive statistics result indicates that the majority of sample rural households (68.53 %) have engaged in off-farm income diversification activities while the remaining 31.47% of households did not participate in the diversification in the study area. The choice of participants among the strategies indicates that 6.60% of respondents participated in off-farm wage employment, 30.46% participated in off-farm self-employment, and about 31.47% of them participated in both off-farm wage employment. The study revealed that the share of off-farm income in total annual earnings of households was about 48.457%, and thus, the off-farm diversification significantly contributes to the rural household income. Moreover, binary and multinomial logistic regression models were employed to identify factors that affect the participation and the choices of the off-farm income diversification strategies, respectively. The binary logit model result indicated that agro-ecological zone, education status of the households, available technical skills of the household, household saving, total livestock owned by the households, access to electricity, road access and being married of household head were significant and positively affected the chance of diversification in off-farm activities while the on-farm income of households is negatively affected the chance of diversification. Similarly, the multinomial logistic regression model estimate revealed that agroecological zone, on-farm income, available technical skills, household savings, and access to electricity are positively related and significantly influenced the household’s choice of employment into off-farm wage employment. The off-farm self-employment diversification choice is significantly influenced by on-farm income, available technical skills, household savings, total livestock owned, and access to electricity. Moreover, the result showed that the factors that affect the choice of farm households to engage in both off-farm wage and self-employment are ecological zone, education status, on-farm income, available technical skills, household own saving, market access, total livestock owned, access to electricity and road access. Thus, due attention should be given to addressing the demographic, socio-economic, and institutional constraints to strengthen off-farm income diversification strategies to improve the income of rural households.

Keywords: off-farm, incoem, diversification, logit model

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Authors: Mandayachepa C. Nyando, Lauren Suchman, Innocencia Mtalimanja, Address Malata, Tamanda Jumbe, Martha Kamanga, Peter Waiswa

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Background: Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is a new innovation in contraceptive methods that allow users to inject themselves with a hormonal contraceptive in their own homes. Self-injection (SI) of DMPA-SC has the potential to improve the accessibility of family planning to women who want it and who are capable of injecting themselves. Malawi started implementing this new innovation in 2018. SI was incorporated into the DMPA-SC delivery strategy from its outset. Methodology: This study involved two districts in Malawi where DMPA-SC SI was rolled out: Mulanje and Ntchisi. We used a qualitative cross-sectional study design where 60 in-depth interviews were conducted with women of reproductive age group stratified as 15-45 age band. These included women who were SI users, non-users, and any woman who was on any contraceptive methods. The women participants were tape-recorded, and data were transcribed and then analysed using Dedoose software, where themes were categorised into mother and child themes. Results: Women perceived DMPA SC SI as uniquely private, convenient, and less painful when self-injected. In terms of privacy, women in Mulanje and Ntchisi especially appreciated that self-injecting allowed them to use covertly from partners. Some men do not allow their spouses to use modern contraceptive methods; hence women prefer to use them covertly. “… but I first reach out to men because the strongest power is answered by men (MJ015).” In addition, women reported that SI offers privacy from family/community and less contact with healthcare providers. These aspects of privacy were especially valued in areas where there is a high degree of mistrust around family planning and among those who feel judged or antagonized purchasing contraception, such as young unmarried women. Women also valued the convenience SI provided in terms of their ability to save time by injecting themselves at home rather than visiting a healthcare provider and having more reliable access to contraception, particularly in the face of stockouts. SI allows for stocking up on doses to accommodate shifting work schedules in case of future stockouts or hard times, such as the period of COVID-19, where there was a limitation in the movement of the people. Conclusion: Our findings suggest that SI may meet the needs of many women in Malawi as long as the barriers are eliminated. The barriers women mentioned include fear of self-inject and proper storage of the DMPA SC SI, and these barriers can be eliminated by proper training. The findings also set the scene for policy revision and direction at a national level and integrate the approach with national family planning strategies in Malawi. Findings provide insights that may guide future implementation strategies, strengthen non-clinic family planning access programs and stimulate continued research.

Keywords: family planning, Malawi, Sayana press, self-injection

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Authors: Hande Burcu Deniz

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People in the U.S. spend a considerable portion of their time indoors. This makes it crucial to provide environments that support the well-being of people. Restorative environments aim to help people recover their cognitive resources that were spent due to intensive use of directed attention. Spending time in nature and taking a nap are two of the best ways to restore these resources. However, they are not possible to do most of the time. The problem is that many studies have revealed how nature and spending time in natural contexts can help boost restoration, but there are fewer studies conducted to understand how cognitive resources can be restored in interior settings. This study aims to explore the answer to this question: which qualities of interiors increase the restorativeness of an interior setting and how do they mediate restorativeness of an interior. To do this, a phenomenological qualitative study was conducted. The study was interested in the definition of attention restoration and the experiences of the phenomena. As the themes emerged, they were analyzed to match with Attention Restoration Theory components (being away, extent, fascination, compatibility) to examine how interior design elements mediate the restorativeness of an interior. The data was gathered from semi-structured interviews with international residents of Minnesota. The interviewees represent young professionals who work in Minnesota and often experience mental fatigue. Also, they have less emotional connections with places in Minnesota, which enabled data to be based on the physical qualities of a space rather than emotional connections. In the interviews, participants were asked about where they prefer to be when they experience mental fatigue. Next, they were asked to describe the physical qualities of the places they prefer to be with reasons. Four themes were derived from the analysis of interviews. The themes are in order according to their frequency. The first, and most common, the theme was “connection to outside”. The analysis showed that people need to be either physically or visually connected to recover from mental fatigue. Direct connection to nature was reported as preferable, whereas urban settings were the secondary preference along with interiors. The second theme emerged from the analysis was “the presence of the artwork,” which was experienced differently by the interviewees. The third theme was “amenities”. Interviews pointed out that people prefer to have the amenities that support desired activity during recovery from mental fatigue. The last theme was “aesthetics.” Interviewees stated that they prefer places that are pleasing to their eyes. Additionally, they could not get rid of the feeling of being worn out in places that are not well-designed. When we matched the themes with the four art components (being away, extent, fascination, compatibility), some of the interior qualities showed overlapping since they were experienced differently by the interviewees. In conclusion, this study showed that interior settings have restorative potential, and they are multidimensional in their experience.

Keywords: attention restoration, fatigue, interior design, qualitative study, restorative environments

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Authors: Barbara Behre, Verolien Cauberghe, Dieneke Van de Sompel

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Sustainable consumption is on the rise, yet it has still not entered the mainstream in several industries, such as the fashion industry. In online fashion contexts, sustainability cues have been used to signal the sustainable benefits of certain garments to promote sustainable consumption. These sustainable cues may focus on the ecological or social dimension of sustainability. Since sustainability, in general, relates to distant, abstract benefits, the current study aims to examine if and how psychological distance may mediate the effects of exposure to different sustainability cues on consumption outcomes. Following the framework of Construal Level Theory of Psychological Distance, reduced psychological distance renders the construal level more concrete, which may influence attitudes and subsequent behavior in situations like fashion shopping. Most studies investigated sustainability as a composite, failing to differentiate between ecological and societal aspects of sustainability. The few studies examining sustainability more in detail uncovered that environmental sustainability is rather perceived in abstract cognitive construal, whereas social sustainability is linked to concrete construal. However, the construal level affiliation of the sustainability dimensions likely is not universally applicable to different domains and stages of consumption, which further suggest a need to clarify the relationships between environmental and social sustainability dimensions and the construal level of psychological distance within fashion brand consumption. While psychological distance and construal level have been examined in the context of sustainability, these studies yielded mixed results. The inconsistent findings of past studies might be due to the context-dependence of psychological distance as inducing construal differently in diverse situations. Especially in a hedonic consumption context like online fashion shopping, the role of visual processing of information could determine behavioural outcomes as linked to situational construal. Given the influence of the mode of processing on psychological distance and construal level, the current study examines the moderating role of verbal versus non-verbal presentation of the sustainability cues. In a 3 (environmental sustainability vs. social sustainability vs. control) x 2 (non-verbal message vs. verbal message) between subjects experiment, the present study thus examines how consumers evaluate sustainable brands in online shopping contexts in terms of psychological distance and construal level, as well as the impact on brand attitudes and buying intentions. The results among 246 participants verify the differential impact of the sustainability dimensions on fashion brand purchase intent as mediated by construal level and perceived psychological distance. The ecological sustainability cue is perceived as more concrete, which might be explained by consumer bias induced by the predominance of pro-environmental sustainability messages. The verbal versus non-verbal presentation of the sustainability cue neither had a significant influence on distance perceptions and construal level nor on buying intentions. This study offers valuable contributions to the sustainable consumption literature, as well as a theoretical basis for construal-level framing as applied in sustainable fashion branding.

Keywords: construal level theory, environmental vs social sustainability, online fashion shopping, sustainable fashion

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Authors: Claudia Rodriguez-Espinosa, Erika Elizabeth Pérez Múzquiz

Abstract:

Since the creation of the “Pueblos Mágicos” program in 2001, a series of social and cultural events had directly affected the heritage conservation of the 121 registered localities until 2018, when the federal government terminated the program. Many studies have been carried out that seek to analyze from different perspectives and disciplines the consequences that these appointments have generated in the “Pueblos Mágicos.” Multidisciplinary groups such as the one headed by Carmen Valverde and Liliana López Levi, have brought together specialists from all over the Mexican Republic to create a set of diagnoses of most of these settlements, and although each one has unique specificities, there is a constant in most of them that has to do with the loss of cultural heritage and that is related to transculturality. There are several factors identified that have fostered a cultural loss, as a direct reflection of the economic crisis that prevails in Mexico. It is important to remember that the origin of this program had as its main objective to promote the growth and development of local economies since one of the conditions for entering the program is that they have less than 20,000 inhabitants. With this goal in mind, one of the first actions that many “Pueblos Mágicos” carried out was to improve or create an infrastructure to receive both national and foreign tourists since this was practically non-existent. Creating hotels, restaurants, cafes, training certified tour guides, among other actions, have led to one of the great problems they face: globalization. Although by itself it is not bad, its impact in many cases has been negative for heritage conservation. The entry into and contact with new cultures has led to the undervaluation of cultural traditions, their transformation and even their total loss. This work seeks to present specific cases of transformation and loss of cultural heritage, as well as to reflect on the problem and propose scenarios in which the negative effects can be reversed. For this text, 36 “Pueblos Mágicos” have been selected for study, based on those settlements that are cited in volumes I and IV (the first and last of the collection) of the series produced by the multidisciplinary group led by Carmen Valverde and Liliana López Levi (researchers from UNAM and UAM Xochimilco respectively) in the project supported by CONACyT entitled “Pueblos Mágicos. An interdisciplinary vision”, of which we are part. This sample is considered representative since it forms 30% of the total of 121 “Pueblos Mágicos” existing at that moment. With this information, the elements of its intangible heritage loss or transformation have been identified in every chapter based on the texts written by the participants of that project. Finally, this text shows an analysis of the effects that this federal program, as a public policy applied to 132 populations, has had on the conservation or transformation of the intangible cultural heritage of the “Pueblos Mágicos.” Transculturality, globalization, the creation of identities and the desire to increase the flow of tourists have impacted the changes that traditions (main intangible cultural heritage) have had in the 18 years that the federal program lasted.

Keywords: public policies, cultural tourism, heritage preservation, pueblos mágicos program

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Authors: Rene Hellmuth

Abstract:

The requirements for the factory planning and the building concerned have changed in the last years. Factory planning has the task of designing products, plants, processes, organization, areas, and the building of a factory. Regular restructuring gains more importance in order to maintain the competitiveness of a factory. Restrictions regarding new areas, shorter life cycles of product and production technology as well as a VUCA (volatility, uncertainty, complexity and ambiguity) world cause more frequently occurring rebuilding measures within a factory. Restructuring of factories is the most common planning case today. Restructuring is more common than new construction, revitalization and dismantling of factories. The increasing importance of restructuring processes shows that the ability to change was and is a promising concept for the reaction of companies to permanently changing conditions. The factory building is the basis for most changes within a factory. If an adaptation of a construction project (factory) is necessary, the inventory documents must be checked and often time-consuming planning of the adaptation must take place to define the relevant components to be adapted, in order to be able to finally evaluate them. The different requirements of the planning participants from the disciplines of factory planning (production planner, logistics planner, automation planner) and industrial construction planning (architect, civil engineer) come together during reconstruction and must be structured. This raises the research question: Which requirements do the disciplines involved in the reconstruction planning place on a digital factory model? A subordinate research question is: How can model-based decision support be provided for a more efficient design of the conversion within a factory? Because of the high adaptation rate of factories and its building described above, a methodology for rescheduling factories based on the requirements engineering method from software development is conceived and designed for practical application in factory restructuring projects. The explorative research procedure according to Kubicek is applied. Explorative research is suitable if the practical usability of the research results has priority. Furthermore, it will be shown how to best use a digital factory model in practice. The focus will be on mobile applications to meet the needs of factory planners on site. An augmented reality (AR) application will be designed and created to provide decision support for planning variants. The aim is to contribute to a shortening of the planning process and model-based decision support for more efficient change management. This requires the application of a methodology that reduces the deficits of the existing approaches. The time and cost expenditure are represented in the AR tablet solution based on a building information model (BIM). Overall, the requirements of those involved in the planning process for a digital factory model in the case of restructuring within a factory are thus first determined in a structured manner. The results are then applied and transferred to a construction site solution based on augmented reality.

Keywords: augmented reality, digital factory model, factory planning, restructuring

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Authors: Anna Slupik, Anna Mosiolek, Sebastian Wojtowicz, Dariusz Bialoszewski

Abstract:

Introduction: Whole-body vibration (WBV) uses high frequency mechanical stimuli generated by a vibration plate and transmitted through bone, muscle and connective tissues to the whole body. Research has shown that long-term vibration-plate training improves neuromuscular facilitation, especially in afferent neural pathways, responsible for the conduction of vibration and proprioceptive stimuli, muscle function, balance and proprioception. Some researchers suggest that the vibration stimulus briefly inhibits the conduction of afferent signals from proprioceptors and can interfere with the maintenance of body balance. The aim of this study was to evaluate the influence of a single set of exercises associated with whole-body vibration on the joint position sense and body balance. Material and methods: The study enrolled 55 people aged 19-24 years. These individuals were randomly divided into a test group (30 persons) and a control group (25 persons). Both groups performed the same set of exercises on a vibration plate. The following vibration parameters: frequency of 20Hz and amplitude of 3mm, were used in the test group. The control group performed exercises on the vibration plate while it was off. All participants were instructed to perform six dynamic exercises lasting 30 seconds each with a 60-second period of rest between them. The exercises involved large muscle groups of the trunk, pelvis and lower limbs. Measurements were carried out before and immediately after exercise. Joint position sense (JPS) was measured in the knee joint for the starting position at 45° in an open kinematic chain. JPS error was measured using a digital inclinometer. Balance was assessed in a standing position with both feet on the ground with the eyes open and closed (each test lasting 30 sec). Balance was assessed using Matscan with FootMat 7.0 SAM software. The surface of the ellipse of confidence and front-back as well as right-left swing were measured to assess balance. Statistical analysis was performed using Statistica 10.0 PL software. Results: There were no significant differences between the groups, both before and after the exercise (p> 0.05). JPS did not change in both the test (10.7° vs. 8.4°) and control groups (9.0° vs. 8.4°). No significant differences were shown in any of the test parameters during balance tests with the eyes open or closed in both the test and control groups (p> 0.05). Conclusions. 1. Deterioration in proprioception or balance was not observed immediately after the vibration stimulus. This suggests that vibration-induced blockage of proprioceptive stimuli conduction can have only a short-lasting effect that occurs only as long as a vibration stimulus is present. 2. Short-term use of vibration in treatment does not impair proprioception and seems to be safe for patients with proprioceptive impairment. 3. These results need to be supplemented with an assessment of proprioception during the application of vibration stimuli. Additionally, the impact of vibration parameters used in the exercises should be evaluated.

Keywords: balance, joint position sense, proprioception, whole body vibration

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