Search results for: consent and agency

Authors: F. Fabeil Noor, Roslinah Mahmud, Janice L. H. Nga, Rasid Mail

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In Malaysia, particularly in Sabah, the government has been promoting entrepreneurship among rural people to encourage them to earn their living by making good use of the diverse natural resources and local cultures of Sabah. Nevertheless, despite the government’s aim to encourage more local community in rural area to involve in entrepreneurship, the involvement of community in entrepreneurial activity is still low. It is crucial to identify the factors stimulate (or prevent) the involvement of rural community in Sabah in entrepreneurial activity. Therefore, this study tries to investigate the personal and contextual factors that may have impact on decision to start a business among the local community in Mantanani Island. In addition, this study also aims to identify the perceived benefits they receive from entrepreneurial activity. A structured face-to-face interview was conducted with 61 local communities in Mantanani Island. Data analysis revealed that passion, personal skills and self-confidence are the significant internal factors to entrepreneurial activity, whereas access to finance, labour and infrastructure are the significant external factors that are found to influence entrepreneurship. In terms of perceived rewards they received from taking up small business, it was found that respondents are predominantly agreed that entrepreneurship offers financial benefit than non-financial. In addition, this study also offers several suggestions for entrepreneurship development in Mantanani Island and it is hoped that this study may help the related agency to develop effective support policies in order to encourage more people in rural area to involve in entrepreneurship.

Keywords: entrepreneurship, motivation, perceived rewards, rural community

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Authors: Priyanka Sharma

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The women voter turnout in India is increasing. The rising female voter turnout is explained in part by men intimidating women in the household to vote. Women are more likely than men to be guided before voting. What is perhaps more significant is that the gender gap has shrunk significantly over the years. However, there are layers and categories of women voters in India. Some women are much more likely than the average woman to follow advice. Against this backdrop, this paper investigates the variation among women voters during the national elections of 2019 in India. The central question of this research paper is whether or not the development of greater political opinion among women would offset guided voting and allow them to emerge as more independent voters. So the independent variable of the study is Indian women’s opinion on politics, and the dependent variable is their voting behavior. The methodology used in this paper is both quantitative and qualitative. This study investigated and examined Lokniti’s election survey data. The sample size used in this survey is 11568. The analysis of this study has revealed that there is a considerable impact of women having a political opinion on their voting behavior. The Bivariate analysis of the variables states that 83% of Indian women who have opinions on political issues do not seek advice while going to vote. This proves the hypothesis of this paper that women with an opinion on politics are more likely to be independent voters. To check the statistical significance of the finding, a chi-square test was done and the p-value found is 0.009737, which shows it is statistically significant. Furthermore, a regression test has been done by controlling certain variables like age, educational qualification, caste, and financial position of the women to probe the influence on the dependent variable. The findings provide worthwhile insights into the relationship between these control variables and the women voting behavior in India.

Keywords: dependent voter, independent voter, political opinion, voting behavior, women voter

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Authors: Fatihin Khoirul, Muhammad Muqorrobin Ist

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Bojonegoro Regency is one of the districts that use the concept Agropolitan as the Territorial Development Policy. Three sub-district designated as Area Development District of Agropolitan are Kapas, Dander, and Kalitidu or commonly called KADEKA. Current policy has been shown results, but there was an inequality of results in some areas. One of them occurred in the Ngringinrejo village with the main commodities is Starfruit and Wedi village with the main commodities is Salak fruit. Therefore, a comparative study is used to search for causal factors of inequality result of the policy by using the 5 aspects compared, namely: (1) Management Development Agropolitan; (2) Physical Condition agropolitan Region; (3) Implementing Agency at the Village Level; (4) Village Government Support; and (5) Community support. Based on the discussion of qualitative analysis, it was found that five aspects have their respective roles in creating inequality of outcomes that occur in both villages. But beyond that, there are conditions where the two villages experienced the same condition that is when the initial implementation of the policy. The condition is referred to as 'the phenomenon of price trap.' The condition is caused by lower commodity prices, causing the village government's commitment in implementing policies too low, followed by public awareness in support of the policy is also low, so care for commodities is also low, and the quality is too low lead and eventually back causing low price. However, the difference is that the village Ngringinrejo able to get out of this condition with 'the new culture of administration' at the end of 2013. While the conditions in the village of Wedi compounded by not respected request assistance by the irrigation district.

Keywords: comparative policy analysis, qualitative comparative, inequallity, price trap, new culture of administration

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Authors: Emmanuel Iyamuremye, Edouard Singirankabo, Alexis Habineza, Yunvirusaba Nelson

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Temperature is one of the most important climatic factors for crop production. However, severe temperatures cause drought, feverish and cold spells that have various consequences for human life, agriculture, and the environment in general. It is necessary to provide reliable information related to the incidents and the probability of such extreme events occurring. In the 21st century, the world faces a huge number of threats, especially from climate change, due to global warming and environmental degradation. The rise in temperature has a direct effect on the decrease in rainfall. This has an impact on crop growth and development, which in turn decreases crop yield and quality. Countries that are heavily dependent on agriculture use to suffer a lot and need to take preventive steps to overcome these challenges. The main objective of this study is to model the statistical behaviour of extreme maximum temperature values in Rwanda. To achieve such an objective, the daily temperature data spanned the period from January 2000 to December 2017 recorded at nine weather stations collected from the Rwanda Meteorological Agency were used. The two methods, namely the block maxima (BM) method and the Peaks Over Threshold (POT), were applied to model and analyse extreme temperature. Model parameters were estimated, while the extreme temperature return periods and confidence intervals were predicted. The model fit suggests Gumbel and Beta distributions to be the most appropriate models for the annual maximum of daily temperature. The results show that the temperature will continue to increase, as shown by estimated return levels.

Keywords: climate change, global warming, extreme value theory, rwanda, temperature, generalised extreme value distribution, generalised pareto distribution

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Authors: Tonya P. Bowers

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

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

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Authors: Chun-Yuan Chen, Ming-Chang Li, Xiu-Hui Wen, Yi-Ching Tu

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The objective of this study explores GPS (Global Positioning System) applied to trace construction vehicles such as trucks or cranes, help to pattern the earth-dumping stations of traffic construction in Taiwan. Traffic construction in this research is defined as the engineering of high-speed railways, expressways, and which that distance more than kilometers. Audit the location and check the compliance with regulations of earth-dumping stations is one of important tasks in Taiwan EPA. Basically, the earth-dumping station was known as one source of particulate matter from air pollution during construction process. Due to GPS data can be analyzed quickly and be used conveniently, this study tried to find out dumping stations by modeling vehicles tracks from GPS data during work cycle of construction. The GPS data updated from 13 vehicles related to an expressway construction in central Taiwan. The GPS footprints were retrieved to Keyhole Markup Language (KML) files so that can pattern the tracks of trucks by computer applications, the data was collected about eight months- from Feb. to Oct. in 2017. The results of GPS footprints identified dumping station and outlined the areas of earthwork had been passed to the Taiwan EPA for on-site inspection. Taiwan EPA had issued advice comments to the agency which was in charge of the construction to prevent the air pollution. According to the result of this study compared to the commonly methods in inspecting environment by manual collection, the GPS with KML patterning and modeling method can consumes less time. On the other hand, through monitoring the GPS data from construction vehicles could be useful for administration to development and implementation of strategies in environmental management.

Keywords: automatic management, earth-dumping station, environmental management, Global Positioning System (GPS), particulate matter, traffic construction

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Authors: Yu-Mei Hsueh, Cheng-Shiuan Tsai, Chao-Yuan Huang

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Prostate Cancer (PC) is a malignant tumor originated in prostate and is a second common male’s cancer in the world. Incidence of PC in Asia countries, have still been rising over the past few decades. As an antioxidant, selenium can slow down prostate cancer tumor progression, but the association between plasma selenium levels and risk of aggressive prostate cancer may be modified by different genotype of selenoprotein. The aim of this study is to determine the relationship between plasma selenium, polymorphism of selenoprotein, urinaty total arsenic, and prostate cancer. Two hundred ninety five pathologically-confirmed cases of PC and 295 cancer-free controls were individually matched to case subjects by age (± 5 years) were recruited from Department of Urology of National Taiwan University Hospital, Taipei Municipal Wan Fang Hospital and Taipei Medical University Hospital. Personal interview and biospeciment of urine and blood collection from participants were conducted by well-trained interviewers after participants’ informed consent was obtained. Plasma selenium was measured by an inductively coupled plasma mass. Urinary arsenic concentration was detected using high-performance liquid chromatography-linked hydride generator and atomic absorption spectrometry. The polymorphism of SEPP1rs3797310 and SEP15 rs5859 were determined using polymerase chain reaction-restriction fragment length polymorphism method. The higher plasma selenium was the lower OR of PC with a dose-response relationship. Prostate cancer patients with high plasma selenium had low tumor stage and grade. Participants carried SEPP1rs3797310 CT+TT genotype compared to those with CC genotype had a lower OR of PC in crude model; then this relationship was disappeared after confounder was adjusted. Prostate cancer patients with high urinary total arsenic concentration had high tumor stage and grade. Urinary total arsenic concentration was significantly positively related with plasma selenium and prostate specific antigen concentration. Participants with lower plasma selenium concentration and higher urinary total arsenic concentration compared to those with higher plasma selenium concentration and lower urinary total arsenic concentration had a higher OR of PC with a dose-response relationship.

Keywords: prostate cancer, plasma selenium concentration, urinary arsenic concentration, prostate specific antigen

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Authors: Chia-Feng Chen, Wan-Yi Lin, Chia-En Liu

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Background: There are approximately 600 newborns that stay four weeks in our postpartum agency every year. As we all know, newborn’s skin is 40-60% thinner than adult skin, newborn skin has a higher trans epidermal water loss, so many postpartum agencies use massage oil every day, no matter which seasons. In fact, neonatal miliaria or prickly heat is the most common condition from two to three -week- old newborns. According to research, about 80 percent of two to three -week- old baby are diagnosed with prickly heat because nurses apply massage oil to their faces every day. In China, we can use honeysuckle to wipe the newborn's face for treatment. Purpose: the purpose of the study is to discuss that using massage oil will be induced neonatal miliaria among two or three-week-old newborns and the aim of the study is to assess the protocol of miliaria condition with the face. Methods: a quasi-experimental design was used to evaluated the result between massage oil and non massage oil. A total of 22 participants were recruited randomly and analyzed from August to September in the south of China and collected for about 2 week long. The 22 participants were randomly selected and live in the stable air condition belong, 24 to 26℃. Results: the 64% of participants were diagnosed with miliaria using massage oil, the 2/8 of participants were diagnosed with miliaria no using massage oil. The pearson correction was0.67. The result of 22 participants, including massage oil, and diagnosed with miliaris. Besides, in our study, 9 of participants with miliaria for 3 to 6 days on the face, were treatment with honey-suckle wipe 3days through pediatric doctor suggestion. The effect of honey-suckle were useful in improving miliaria and decreasing the anxiety of parents. Conclusions: Miliaria is a common condition in newborns, especially in summer. The authors postulate that the massage oil did not find suitable for newborn in summer, and the study provides evidence that honey-suckle effectively control miliaria on using massage oil of participants.

Keywords: massage oil, miliaria, newborn, honey suckle

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Authors: Y. Mohammed, A. I. Kabuga

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Sexually transmitted infections (STIs) have continued to be a major public health problem in sub-Saharan Africa especially with the recent resurgence of syphilis. Syphilis is a systemic disease caused by the bacterium, spirochete Treponema pallidum and has been reported as one of the common sexually transmitted infections (STIs) in Nigeria. Presence of genital ulcer disease from syphilis facilitates human immunodeficiency virus (HIV) transmission and their ¬diagnosis is essential for the proper management. Venereal Disease Research Laboratory (VDRL) test is used as a screening test for the diagnosis of syphilis. However, unusual VDRL test results have been reported in HIV-infected persons with syphilis. There are reports showing higher than expected VDRL titers as well as biological false positive in most of the studies. A negative Rapid Plasma Reagin (RPR) test or VDRL test result may not rule out syphilis in patients with HIV infection. For laboratory confirmation of syphilis, one specific Treponemal test, namely, Fluroscent Treponemal Antibody Absorption (FTA-ABS) test or Treponema Pallidum Haemagglutination Assay (TPHA) should be done along with VDRL. A prospective cross sectional study was conducted for 2 years from Jun, 2012 to Jun 2014 to determine the prevalence of syphilis in HIV-seroreactive patients at 5 selected HIV/AIDS treatment and counseling centers in Kano State, North Western, Nigeria. New HIV-Seroreactive patients who gave informed consent to participate in the study were recruited. Venereal Diseases Research Laboratory (VDRL) test for Syphilis screening was performed on the same sera samples which were collected for HIV testing. A total of 238 patients, 113 (47%) males and 125 (53%) females, were enrolled. In the present study, 238 HIV-seropositive patients were screened for syphilis by VDRL test. Out of these 238 cases, 72 (32%) patients were positive for TPHA and 8 (3.4%) patients were reactive for VDRL in various titers with an overall prevalence of 3.4%. All the eight patients who were reactive for VDRL test were also positive for TPHA test. In Conclusions, with high prevalence of syphilis among HIV-infected people from this study, it is recommended that serological testing for syphilis should be carried out in all patients with newly diagnosed HIV infection. Detection and treatment of STI should have a central role in HIV prevention and control. This will help in proper management of patients having STIs and HIV co infection.

Keywords: HIV, infections, STIs, syphilis

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Authors: Sreelekha Prakash, Yulong Gu

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Background: About 61% of adults surveyed across 25 states reported they had experienced at least one type of Adverse Childhood Experience (ACE) before 18 years of age. Relationships between ACEs and a variety of substance-related behaviors and behavioral health have been reported in previous studies. ACEs can have lasting, negative effects on health, well-being, as well as life opportunities such as education and job potential. Objectives: For the current research, the aim was to assess the factors affecting substance use behavior in young adults. The further onset of drug use and its association was analyzed with ACEs and mental health. Method: The young adults from a county in the north-eastern United States were invited to participate in an online questionnaire survey with prior consent through an IRB approved study. The Survey included questions related to social determinants of health, 10 item ACE questionnaire, and substance use related to Alcohol, Marijuana, Opioids, Stimulants, and other drugs. PHQ-9 questionnaire was used to assess cognitive health. Results: Data was analyzed for the 244 completed surveys {68% (165) were females, and 78% (190) were Whites}. The average age of the participants was 26.7 years, and approximately 80% were lifelong residents of the county or year-round residents. Of the respondents, 50% (122) were high school graduates with some college education, and 56% (136) had a full-time jobs. Past 30-day usage for alcohol was 76% (72), and marijuana was 28.4% (27). The data showed that the higher the ACE scores, the younger they start using any substance (p < 0.0001). The data for PHQ-9 and ACE scores showed that the higher the ACE score, the higher the PHQ-9 score, with a significant p-value (p 0.0001). The current data also showed a significant association with other drugs; marijuana use showed significance for 30 days of use (p 0.0001), stimulant use (0.0008), prescription drug misuse (0.01), and opioids (0.01). Conclusion: These findings further support the association between ACEs and initiation of drug use and its correlation with mental health symptoms. Promoting a safe and supportive environment for children and youth in their earlier ages can prevent the youth and young adults from the effects of drug use and create healthy living habits for young adults.

Keywords: subtance use, young adults, adverse childhood experience, PHQ-9

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Authors: Miyako Oulevey, Kaori Tsutsui, David Lavallee, Naohiko Kohtake

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The Japan Sports Agency has made efforts to unify several career support programs for Olympic athletes prior to the 2020 Tokyo Olympics. One of the programs, the Japan Olympic Committee Career Academy (JCA) was established in 2008 for Olympic athletes at their retirement. Research focusing on the service content of sport career support programs can help athletes experience a more positive transition. This study was designed to investigate the service content of the JCA program in relation to athletes’ career transition needs, including any differences of the reasons for retirement between Summer/Winter and Male/Female Olympic athletes, and to suggest the directions of how to unify the career support programs in Japan after hosting the Olympic Games using sport career transition models. Semi-structured interviews were conducted and analyzed the JCA director who started and managed the program since its inception, and a total of 15 conceptual categories were generated by the analysis. Four conceptual categories were in the result of “JCA situation”, 4 conceptual categories were in the result of “Athletes using JCA”, and 7 conceptual categories were in the result of “JCA current difficulties”. Through the analysis it was revealed that: the JCA had occupational supports for both current and retired Olympic athletes; other supports such as psychological support were unclear due to the lack of psychological professionals in JCA and the difficulties collaborating with other sports organizations; and there are differences in tendencies of visiting JCA, financial situations, and career choices depending on Summer/Winter and Male/Female athletes.

Keywords: career support programs, causes of career termination, Olympic athlete, Olympic committee

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Authors: Marija Zulić, Vanda Hájková, Nina Brkić–Jovanović, Srećko Potić, Sanja Tomić

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The name cerebral palsy comes from the word cerebrum, which means the brain and the word palsy, which means seizure, and essentially refers to the movement disorder. In the clinical picture of cerebral palsy, basic neuromotor disorders are associated with other various disorders: behavioural, intellectual, speech, sensory, epileptic seizures, and bone and joint deformities. Motor speech disorders are among the most common difficulties present in people with cerebral palsy. Social participation represents an interaction between an individual and their social environment. Quality of social participation of the students with cerebral palsy at school is an important indicator of their successful participation in adulthood. One of the most important skills for the undisturbed social participation is ability of good communication. The aim of the study was to determine relation between social participation of students with cerebral palsy and presence of their speech impairment in primary schools in the Czech Republic. The study was performed in the Czech Republic in mainstream schools and schools established for the pupils with special education needs. We analysed 75 children with cerebral palsy aged between six and twelve years attending up to sixth grade by using the first and the third part of the school function assessment questionnaire as the main instrument. The other instrument we used in the research is the Gross motor function classification system–five–level classification system, which measures degree of motor functions of children and youth with cerebral palsy. Funding for this study was provided by the Grant Agency of Charles University in Prague.

Keywords: cerebral palsy, social participation, speech disorders, The Czech Republic, the school function assessment

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Authors: Agoun-bahar Salima

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The environmental variations to which plants are subjected require them to have a strong capacity for adaptation. Some plants are affected by pollutants and are used as pollution indicators; others have the capacity to block, extract, accumulate, transform or degrade the xenobiotic. The diversity of the legume family includes around 20 000 species and offers opportunities for exploitation through their agronomic, dietary and ecological interests. The lack of data on the bioavailability of the Aromatic Polycyclic Hydrocarbon (PAH) in polluted environments, as their passage in the food chains and on the effects of interaction with other pollutants, justifies priority research on this vast family of hydrocarbons. Naphthalene is a PAH formed from two aromatic rings, it is listed and classified as priority pollutant in the list of 16 PAH by the United States Environmental Protection Agency. The aim of this work was to determinate effect of naphthalene at different concentrations on morphological and physiological responses of pea seedlings. At the same time, the behavior of the pollutant in the soil and its fate at the different parts of plant (roots, stems, leaves and fruits) were also recorded by Gas Chromatography/ Mass Spectrometry (GC / MS). In it controlled laboratory studies, plants exposed to naphthalene were able to grow efficiently. From a quantitative analysis, 67% of the naphthalene was removed from the soil and then found on the leaves of the seedlings in just three weeks of cultivation. Interestingly, no trace of naphthalene or its derivatives were detected on the chromatograms corresponding to the dosage of the pollutant at the fruit level after ten weeks of cultivating the seedlings and this for all the pollutant concentrations used. The pea seedlings seem to tolerate the pollutant when it is applied to the soil. In conclusion, the pea represents an interesting biological model in the study of phytoremediation mechanisms.

Keywords: naphtalene, PAH, Pea, phytoremediation, pollution

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Authors: Nicole Banton

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The maternal and infant mortality rate of Blacks is three times that of Whites in the US. Research indicates that breastfeeding lowers both. In this paper, the researcher examines how the ideas that Black/African American mothers had about breastfeeding before, during, and after pregnancy (postpartum) affected whether or not they initiated breastfeeding. The researcher used snowball sampling to recruit thirty African-American mothers from the Orlando area. At the time of her interview, each mother had at least one child who was at least three years old. Through in-depth face-to-face interviews, the researcher investigated how mothers’ healthcare providers affected their decision-making about infant feeding, as well as how the type of birth that she had (e.g., preterm, vaginal, c-section, full term) affected her actual versus idealized infant feeding practice. Through our discussions, we explored how pre-pregnancy perceptions, birth and postpartum experiences, social support, and the discourses surrounding motherhood within an African-American context affected the perceptions and experiences that the mothers in the study had with their infant feeding practice(s). Findings suggest that the pregnancy and birth experiences of the mothers in the study influenced whether or not they breastfed exclusively, combined breastfeeding and infant formula use, or used infant formula exclusively. Specifically, the interplay of invocation of agency (the ability to control their bodies before, during, and after birth), birth outcomes, and the interaction that the mothers in this study had with resources, human and material, had the highest impact on the initiation, duration, and attitude toward breastfeeding.

Keywords: African American mothers, maternal health, breastfeeding, birth, midwives, obstetricians, hospital birth, breast pumps, formula use, infant feeding, lactation consultant, postpartum, vaginal birth, c-section, familial support, social support, work, pregnancy

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Authors: Muhammad Naziru Yahaya, Mustapha Bashir Ayinde

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Noise has been recognized as a major source of pollution in many urban and semi-urban settlements. Noise pollution causes by vehicular movement in urban cities has reaches an alarming proportion due to continuous increases in vehicles and industrialization. This research aim to determine the geo-physical characteristics of the study area and to determine the level of noise generation and volume intensity in areas where noise levels are high within the metropolis and compare with NESREA and WHO standards. This study identified the various sources of noise, compared noise levels in various parts of the study area with recommended standards and determined the geo-physical characteristic of noise generated. A sound level meter Gm 1352, was used for the noise measurements. The study showed that the noise pollution levels measured in minimum noise level of 63.75 dBA and average maximum of 95.175 dBA, at some locations in Birnin Kebbi metropolis the noise level have exceeded the standard limits set by the World Health Organization (WHO), Federal Environment Protection Agency (FEPA). Results revealed that there was a considerable increase in noise pollution in First Bank roundabout and Haliru Abdu roundabout, attribute to high numbers of vehicular movement and road congestion within Birnin Kebbi. The study therefore concluded that there should be an enforcement and adherence to the regulation regarding noise pollution limit. The minimum average day noise level recorded was 67.225 dBA, and average maximum of 96.6 dBA is an indication that the noise level of Birnin Kebbi metropolis was highly unsatisfactory. Based on this, it is suggested that taking adequate measures and following the laid-down recommendations will reduce traffic noise to the barest minimum.

Keywords: decibel, noise level, pollution, sound level, traffic, highway

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Authors: John Hardy

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The early twenty-first century national security environment has been characterized by political coercion. Despite an abundance of political commentary on the various forms of non-state coercion leveraged against the state, there is a lack of literature which distinguishes between the mechanisms and the mediums of coercion. Frequently non-state movements seeking to coerce the state are labelled by their tactics, not their strategies. Terrorists, insurgencies and social movements are largely defined by the ways in which they seek to influence the state, rather than by their political aims. This study examines the strategies of coercion used by non-state actors against states. This approach includes terrorist groups, insurgencies, and social movements who seek to coerce state politics. Not all non-state actors seek political coercion, so not all examples of different group types are considered. This approach also excludes political coercion by states, focusing on the non-state actor as the primary unit of analysis. The study applies a general theory of political coercion, which is defined as attempts to change the policies or action of a polity against its will, to the strategies employed by terrorist groups, insurgencies, and social movements. This distinguishes non-state actors’ strategic objectives from their actions and motives, which are variables that are often used to differentiate between types of non-state actors and the labels commonly used to describe them. It also allows for a comparative analysis of theoretical perspectives from the disciplines of terrorism, insurgency and counterinsurgency, and social movements. The study finds that there is a significant degree of overlap in the way that different disciplines conceptualize the mechanism of political coercion by non-state actors. Studies of terrorism and counterterrorism focus more on the notions of cost tolerance and collective punishment, while studies of insurgency focus on a contest of legitimacy between actors, and social movement theory tend to link political objectives, social capital, and a mechanism of influence to leverage against the state. Each discipline has a particular vernacular for the mechanism of coercion, which is often linked to the means of coercion, but they converge on three core theoretical components of compelling a polity to change its policies or actions: exceeding resistance to change, using political or violent punishments, and withholding legitimacy or consent from a government.

Keywords: counter terrorism, homeland security, insurgency, political coercion, social movement theory, terrorism

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Authors: Piotr Tylec, Julia Wierzbicka, Natalia Gajewska, Krzysztof Przeczek, Grzegorz Torbicz, Alicja Dudek, Magdalena Pisarska-Adamczyk, Mateusz Wierdak, Michal Pedziwiatr

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Introduction: Many patients have described changes in taste perception after weight loss surgery. However, little data is available about short term changes in taste after surgery. Aim: We aimed to evaluate short-term changes in taste preference after bariatric surgeries in comparison to colorectal surgeries. Material and Methods: Between April 2018 and April 2019, a total of 121 bariatric patients and 63 controls participated. Bariatric patients underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric by-pass. Controls underwent oncological colorectal surgeries. Patients who developed clinical complications requiring restriction of oral intake after surgery or withdraw their consent were excluded from the study. In the end, 85 bariatric patients and 44 controls were included. In all of them, the 16-item ERAS Protocol was applied. Using 10-points Numeric Rating Scale (1-10) patients completed questionnaire and rated their appetite and thirst (1 - no appetite/not thirsty, 10 – normal appetite/very thirsty) and flavoured standardized liquids' taste (1- horrible, 10-very tasty) and food images for the 6 group of taste (sweet, umami, sour, spicy, bitter and salty) (1 - not appetizing, 10 - very appetizing) preoperatively and on the first postoperative day. Data were analysed with Statistica 13.0 PL. Results: Analysed group consist of 129 patients (85 bariatric, 44 controls). Mean age and BMI in a research group was 44.91 years old, 46.22 kg/m² and in control group 62.09 years old, 25.87 kg/m², respectively. Our analysis revealed significant differences in changes of appetite between both groups (research: -4.55 ± 3.76 vs. control: -0.85 ± 4.37; p < 0.05), ratings bitter (research: 0.60 ± 2.98 vs. control: -0.88 ± 2.58; p < 0.05) and salty (research: 1.20 ± 3.50 vs. control: -0.52 ± 2.90; p < 0.05) flavoured liquids and ratings for sweet (research: 1.62 ± 3.31 vs. control: 0.01 ± 2.63; p < 0.05) and bitter (research: 1.21 ± 3.15 vs. control: -0.09 ± 2.25; p < 0.05) food images. There were statistically significant results in the ratings of other images, but in comparison to the control group, they were not statistically significant. Conclusion: The study showed that bariatric surgeries quickly decreases appetite and desire to eat certain types of food, such as salty. Moreover, the bitter taste was more desirable in the research group in comparison to control group. Nevertheless, the sweet taste was more appetible in the bariatric group than in control.

Keywords: bariatric surgery, general surgery, obesity, taste preference

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Authors: Rhaetian Bern D. Azaula

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The Philippines' indigenous population, estimated to be 10%-20%, is protected by the Indigenous Peoples Rights Act (IPRA), passed in 1997. However, due to their isolation and limited access to basic services such as health education or needs for health assistance, the law's implementation remains a challenge. As traditional medicine continues to play a significant role in society as the prevention and treatment of some illnesses, it is still customary and widely used to use plants in both traditional and modern ways; however, commercially prepared drugs are progressively advanced as time goes by. Therefore, the purpose of this quantitative study is to investigate the indigenous community at Barangay Magsikap General Nakar, Quezon, and analyze the factors that affect the respondent’s preferences in an indigenous community and reasons for patronizing traditional and commercially prepared medicines and proposes updated health education strategies and instructional materials. Slovin's formula was utilized to reduce the total population representation, followed by stratified sampling for proportional allocation of respondents. The study selects respondents (1) from an Indigenous Community in Barangay Magsikap, General Nakar, Quezon, (2) aged 60 and above, and (3) who are willing to participate. The researcher utilized a checklist-based questionnaire with a Tagalog version, and a Likert Scale was utilized to assess the respondent's choices on selected items. The researcher obtained informed consent from the indigenous community's regional and local office, the chieftain of the tribe, and the respondents, ensuring confidentiality in the collection and retrieval of data. The study revealed that respondents aged 60-69, males with no formal education, are unemployed and have no income source. They prefer traditional medicines due to their affordability, availability, and cultural practices but lack safe preparation, dosages, and contraindications of used medicines. Commercially prepared medications are acknowledged, but respondents are not fully aware of proper administration instructions and dosage labels. Recommendations include disseminating approved herbal medicines and ensuring proper preparation, indications, and contraindications.

Keywords: traditional medicine, commercially prepared medicine, indigenous community, elderly adult

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Authors: Jana Stepanovska, Roman Matejka, Jozef Rosina, Marta Vandrovcova, Lucie Bacakova

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The aim of this study was to develop a system for mechanical and also electrical stimulation controlling in vitro osteogenesis under conditions more similar to the in vivo bone microenvironment than traditional static cultivation, which would achieve good adhesion, growth and other specific behaviors of osteogenic cells in cultures. An engineered culture system for mechanical stimulation of the mesenchymal stem cells on the charged surface was designed. The bioreactor allows efficient mechanical loading inducing an electrical response and perfusion of the culture chamber with seeded cells. The mesenchymal stem cells were seeded to specific charged materials, like polarized hydroxyapatite (Hap) or other materials with piezoelectric and ferroelectric features, to create electrical potentials for stimulating of the cells. The material of the matrix was TiNb alloy designed for these purposes, and it was covered by BaTiO3 film, like a kind of piezoelectric material. The process of mechanical stimulation inducing electrical response is controlled by measuring electrical potential in the chamber. It was performed a series of experiments, where the cells were seeded, perfused and stimulated up to 48 hours under different conditions, especially pressure and perfusion. The analysis of the proteins expression was done, which demonstrated the effective mechanical and electrical stimulation. The experiments demonstrated effective stimulation of the cells in comparison with the static culture. This work was supported by the Ministry of Health, grant No. 15-29153A and the Grant Agency of the Czech Republic grant No. GA15-01558S.

Keywords: charged surface, dynamic cultivation, electrical stimulation, ferroelectric layers, mechanical stimulation, piezoelectric layers

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Authors: Susan K. Steele-Moses, Aimee Badeaux

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Introduction: Nurse anesthesia education places high demands on students, creating stress and anxiety that can impact their success. Framed in Watson’s caring theory, the research question posed for this study was: What is the effect of a mindfulness application on the perceived stress and anxiety of nurse anesthesia students. Methods: A quantitative comparative research design was used to determine the effect of a mindfulness meditation application, Mindshift, on SRNA’s perceived stress and anxiety over time. The stress and anxiety subscales of the Depression Anxiety Stress Scale 21 (DASS-21) were used to measure the effectiveness of the intervention. After the IRB approval was obtained the 2024, 2025, and 2026 SRNA cohorts were invited to participate in the study (N = 56). Thirty-six students agreed to participate, completed the electronic informed consent, and the electronic DASS-21 baseline measure (64.3%). The Mindshift app was downloaded from the app store onto their personal device and the mindfulness meditation exercises were integrated into their daily routine. The stress and anxiety subscale of the DASS-21 was repeated at 1-month, 3-months, and 6-months, with 31 students completing all measures (86.1%). The difference over time was computed using a repeated measures ANCOVA. Results: Instrument reliability and validity was reconfirmed (Stress: α = .890; Anxiety: α = .788; χ2 = 232.898, p < .001). There was no difference in the student’s stress over time (F = 2.62, p = .079, η2 = .086). When the intervention was considered stress decreased at the 3- month (F = 4.497, p = .014, η2 .138) and 6-month (F = 7.998, p < .001, η2 = .222) intervals. Post-hoc analysis revealed no change between baseline and 1-month (p = .245) but improved from 1-month to 3-months (p = .014), 1-month to 6-months (p < .001), and 3-months to 6- months (p = .007). There was no difference in the student’s anxiety over time (F = .326, p = .683, η2 = .011) or at the three-month interval (F = .647 , p = .488, η2 .024), but anxiety decreased at the six-month interval (F = 4.686, p = .004, η2 = .143). Post-hoc analysis revealed no change between baseline and 1-month (p = .261) or 1-month to 3-months (p = .132). However the student’s anxiety significantly improved from 1-month to 6-months ( p < .001), and 3-months to 6-month (p = .014). Discussion: The mindfulness intervention reduced perceived stress and anxiety levels over time. The gradual decline in stress and the delayed improvement in anxiety suggest that continuous interventions are needed to achieve positive results. It is recommended that mindfulness meditation techniques are integrated into the curriculum highlighting the importance of longitudinal interventions.

Keywords: nurse anesthesia, nursing education, innovation in education, stress, anxiety

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Authors: Sanjay Sinha, Mohd Umair Khan

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The level of income inequality in India has been worrisome as the World Inequality Report termed it as a “poor and unequal country, with an affluent elite”. As important as income is to understand inequality and deprivation, it is just one dimension. But the historical roots and current realities of inequality and deprivation in India lies in many of the non-income dimensions such as housing, nutrition, education, agency, sense of inclusion etc. which are often ignored, especially in solution-oriented research. The level of inequality and deprivation among the tribal is one such case. There is a corpus of literature establishing that the tribal communities in India are disadvantageous on various grounds. Given their rural geography, issues of access and quality of basic facilities such as education and healthcare are often unaddressed. COVID-19 has further exacerbated this challenge and climate change will make it even more worrying. With this background, a succinct measurement tool at the village level is necessary to design short to medium-term actions with reference to risk mitigation for tribal communities. This research paper examines the level of inequality and deprivation among the tribal communities in the rural areas of Andhra Pradesh state of India using a Multidimensional Inequality and Deprivation Index based on the Alkire-Foster methodology. The methodology is theoretically grounded in the capability approach propounded by Amartya Sen, emphasizing on achieving the “beings and doings” (functionings) an individual reason to value. In the index, the authors have five domains, including Livelihood, Food Security, Education, Health and Housing and these domains are divided into sixteen indicators. This assessment is followed by domain-wise short-term and long-term solutions.

Keywords: Andhra Pradesh, Alkire-Foster methodology, deprivation, inequality, multidimensionality, poverty, tribal

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Authors: Lakmali Anthony, Madeline Gillies

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Background Breast cancer (BC) is usually managed with surgical resection. Many outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO) such as Health-Related Quality of life (HRQoL) provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods Patients who had resection of BC in a regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Results Forty-six patients completed the survey. Clinically significant levels of FCR and emotional distress were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for BC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL for breast cancer. All psychosocial factors measured were associated with HRQoL. Conclusion HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative breast cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: breast cancer, surgery, quality of life, regional population

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Authors: N. Y. H. Konagano

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Riverside population of Brazilian amazon suffers drinking water scarcity, seeking alternative water resources such as well and rivers, ordinary polluted. Although Amazon Region holds high annual river inflow and enough available of underground water, human activities have compromised the conservation of water resources. In addition, decentralized rural households make difficult to access of potable water. Main objective is to analyze quantitatively the potential of rainwater harvesting to human consumption at Marupaúba community, located in northeast of Amazon region, Brazil. Methods such as historical rainfall data series of municipality of Tomé-Açu at Pará state were obtained from Hydrological Information System of National Water Agency (ANA). Besides, Rippl method was used to calculate, mainly, volume of the reservoir based on difference of water demand and volume available through rainwater using as references two houses (CA I and CA II) as model of rainwater catchment and supply. Results presented that, from years 1984 to 2017, average annual precipitation was 2.607 mm, average maximum precipitation peak was 474 mm on March and average minimum peak on September was 44 mm. All months, of a year, surplus volume of water have presented in relation to demand, considering catchment area (CA) I = 134.4m² and demand volume =0.72 m³/month; and, CA II = 81.84 m² and demand volume = 0.48 m³/month. Based on results, it is concluded that it is feasible to use rainwater for the supply of the rural community Marupaúba, since the access of drinking water is a human right and the lack of this resource compromises health and daily life of human beings.

Keywords: Amazon Region, rainwater harvesting, rainwater resource, rural community

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Authors: Manee Hasap, Mongkolchai Hasap, Tasanee Nasae

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The purpose of this study was to evaluate the primary caregivers’ knowledge and capabilities for providing quality care to be hospitalized post-hip fracture surgery elderly patients. The theoretical framework of the study was derived from the concepts of dependent care agency in Orem’s Self-Care theory, and family care provision for the elderly and chronically ill patients. 59 subjects were purposively selected. The subjects were primary caregivers of post-operated hip fracture elderly patients who had been admitted to the Orthopaedic Ward of Songklanagarind Hospital. Demographic data of the caregivers and patients were collected by non-participant observation using the evaluation and recording forms. The reliability of caregivers’ knowledge measurement (0.86) was obtained by KR-20 and that of caregivers’ capabilities for post-operative care evaluation form (0.97) obtained from 2 observers by interrater reliability. The data were analyzed using descriptive statistic, which were frequency, percentage, mean, and standard deviation. The result of this study indicated that elderly patients with post-hip fracture surgery had many pre-discharge self care limitations. Approximately, 75% of the caregivers had knowledge to respond to patient’s essential needs at a high level, while the rest (25%) had this knowledge a moderate level. For observation, 57.63% of the subjects had capabilities in care practice at a moderate level; 28.81% had capabilities in care practice at a high level, while 13.56% had at a low level. The result of this study can be used as basic information for patients and caregivers capabilities developing plan especially, providing patients’ activities, accident surveillance and complications prevention for a good life quality of elderly patients after hip surgery both hospitalization and rehabilitation at home.

Keywords: care givers’ knowledge, care givers’ capabilities, elderly hip fracture patients, patients

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Authors: Jonghoon Chun, Insung Kim, Jonghyun Lim, Gun Ro

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We believe that it is possible to provide a solution to reduce patient safety accidents by displaying correct medical records and prescription information through interactive patient identification. Our system is based on the use of smart bands worn by patients and these bands communicate with the hybrid gateways which understand both BLE and Wifi communication protocols. Through the convergence of low-power Bluetooth (BLE) and hybrid gateway technology, which is one of short-range wireless communication technologies, we implement ‘Intelligent Patient Identification and Location Tracking System’ to prevent medical malfunction frequently occurring in medical institutions. Based on big data and IOT technology using MongoDB, smart band (BLE, NFC function) and hybrid gateway, we develop a system to enable two-way communication between medical staff and hospitalized patients as well as to store locational information of the patients in minutes. Based on the precise information provided using big data systems, such as location tracking and movement of in-hospital patients wearing smart bands, our findings include the fact that a patient-specific location tracking algorithm can more efficiently operate HIS (Hospital Information System) and other related systems. Through the system, we can always correctly identify patients using identification tags. In addition, the system automatically determines whether the patient is a scheduled for medical service by the system in use at the medical institution, and displays the appropriateness of the medical treatment and the medical information (medical record and prescription information) on the screen and voice. This work was supported in part by the Korea Technology and Information Promotion Agency for SMEs (TIPA) grant funded by the Korean Small and Medium Business Administration (No. S2410390).

Keywords: BLE, hybrid gateway, patient identification, IoT, safety management, smart band

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Authors: Ayanda Magida, Brian Armstrong

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The study aimed to assess the third level of the digital divide among the millennials and post-millennials in South Africa. The millennials are people born from 1981-to 1996, that is, people between the ages of 25-40 years old and post-millennials are people born from 1997 to date. For the study, only post-millennials born between 1997-2003 were included as they were old enough to consent to participation in the study. Data was collected as part of the Ph.D. project that focuses on the relationship between income inequality, the digital divide, and social cohesion in South Africa. The digital divide has three main levels, namely the first, second and third. The first and second focus on access and usage, respectively. The third-level digital divide can be defined as the differences in the benefits associated with being online. The current paper focuses on the third level: the benefits derived by being online using four domains: economic, educational, social, and personal benefits. The economic benefits include income, employment and finance-related activities; the social benefits include socializing belonging, identity, and informal networks. The personal benefits include personal wellbeing and self-actualization. A total of 763 participants completed the survey, and 61.3% were post-millennials between the ages of 18-24 and s 38.6 % were millennials between 25 and 40. The majority of the respondents were female (62%), male (34%) and nonbinary (1%), respectively. Most of the respondents were black, followed by whites, Indians and colored, respectively. Thus, they represented the status of the demographics of the country. Most of the respondents had access to the internet and smartphone. Most expressed that they use laptops (68%) or mobile (71%) to access the internet and 54 % access the internet using wireless/Wi-Fi. There were no differences between the millennial and post-millennial economic and educational benefits of being online. However, the post-millennials were more inclined to use the internet for social and personal benefits than the millennials. This could be attributed to many factors, such as age. The post-millennials are still discovering themselves and therefore would derive social and personal benefits associated with being online. The findings confirm studies that argue that younger generations derive more benefits from being online than the older generation. Based on the findings, it is evident that the post-millennials are not using the internet or online activities for social networks and socializing but can derive economic benefits such as job looking and education benefits from being online. It can be inferred that there are no significant differences between the two groups, and it seems like the third-level digital divide is not evident among the two groups as they both have been able to derive meaningful benefits from being online. Further studies should focus on the third-level divide between the baby boomers and Generation X.

Keywords: third-level digital divide, millennials, post-millennials, online activities

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Authors: Jansen Ang, Andrew Neo, Dawn Chia

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Border Security is unlike mainstream policing in that officers are essentially in static deployment, working round the clock every day and every hour of the year looking for illegitimate entry of persons and goods. In Singapore, Border Security officers perform multiple functions to ensure the nation’s safety and security. They are responsible for safeguarding the borders of Singapore to prevent threats from entering the country. Being the first line of defence in ensuring the nation’s border security officers are entrusted with the responsibility of screening travellers inbound and outbound of Singapore daily. They examined 99 million arrivals and departures at the various checkpoints in 2014, which is a considerable volume compared to most immigration agencies. The officers’ work scopes also include cargo clearance, protective and security functions of checkpoints. The officers work in very demanding environment which can range from the smog at the land checkpoints to the harshness of the ports at the sea checkpoints. In addition, all immigration checkpoints are located at the boundaries, posing commuting challenges for officers. At the land checkpoints, festive seasons and school breaks are peak periods as given the surge of inbound and outbound travellers at the various checkpoints. Such work provides unique challenges in comparison to other law enforcement duties. This paper assesses the current stressors faced by officers of a border security agency through the conduct of ground observations as well as a perceived stress survey as well as recommendations in combating stressors faced by border security officers. The findings from the field observations and surveys indicate organisational and operational stressors that are unique to border security and recommends interventions in managing these stressors. Understanding these stressors would better inform border security agencies on the interventions needed to enhance the resilience of border security officers.

Keywords: border security, Singapore, stress, operations

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Authors: Demelash Kassaye Debalkie

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The primary objective of this study is to report the tributes that are significantly impeding the Ethiopian police's ability to provide quality services to the people. Policing in Ethiopia started in the medieval period. However, modern policing was introduced instead of vigilantism in the early 1940s. The progress counted since the date police became modernized is, however, under contention when viewed from the standpoint of officers’ development and technologies in the 21st century. The police in Ethiopia are suffering a lot to be set free from any form of political interference by the government and to be loyal to impartiality, equity, and justice in enforcing the law. Moreover, the institutional competence of the police in Ethiopia is currently losing its power derived from the constitution as a legitimate enforcement agency due to the country’s political landscape encouraging ethnic-based politics. According to studies, the impact of ethnic politics has been a significant challenge for police in controlling conflicts between two ethnic groups. The study used qualitative techniques and data was gathered from key informants selected purposely. The findings indicate that governments in the past decades were skeptical about establishing a constitutional police force in the country. This has certainly been one of the challenges of pluralizing the police: building police-community relations based on trust. The study conducted to uncover the obstructions has finally reported that the government’s commitment to form a non-partisan, functionally decentralized, and operationally demilitarized police force is too minimal and appalling. They mainly intend to formulate the missions of the police in accordance with their interests and political will to remain in power. It, therefore, reminds the policymakers, law enforcement officials, and the government in power to revise its policies and working procedures already operational to strengthen the police in Ethiopia based on public participation and engagement.

Keywords: community, constitution, Ethiopia, law enforcement

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Authors: Nika GorgoShadze, Anri Shainidze, Bachuki Katamadze

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In parallel to the development of the digital economy in the world, electronic commerce is also widely developing. Internet and ICT (information and communication technology) have created new business models as well as promoted to market consolidation, sustainability of the business environment, creation of digital economy, facilitation of business and trade, business dynamism, higher competitiveness, etc. Electronic commerce involves internet technology which is sold via the internet. Nowadays electronic commerce is a field of business which is used by leading world brands very effectively. After the research of internet market in Georgia, it was found out that quality of internet is high in Tbilisi and is low in the regions. The internet market of Tbilisi can be evaluated as high-speed internet service, competitive and cost effective internet market. Development of electronic commerce in Georgia is connected with organizational and methodological as well as legal problems. First of all, a legal framework should be developed which will regulate responsibilities of organizations. The Ministry of Economy and Sustainable Development will play a crucial role in creating legal framework. Ministry of Justice will also be involved in this process as well as agency for data exchange. Measures should be taken in order to make electronic commerce in Georgia easier. Business companies may be offered some model to get low-cost and complex service. A service centre should be created which will provide all kinds of online-shopping. This will be a rather interesting innovation which will facilitate online-shopping in Georgia. Development of electronic business in Georgia requires modernized infrastructure of telecommunications (especially in the regions) as well as solution of institutional and socio-economic problems. Issues concerning internet availability and computer skills are also important.

Keywords: electronic commerce, internet market, electronic business, information technology, information society, electronic systems

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Authors: Sung Hyun Kim

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Introduction: Sleep disturbance is common in children with developmental disorders (D.D.). Sleep disturbance has a variety of negative effects, such as behavior problems, medical problems, and even developmental problems in children with D.D. However, to our best knowledge, there has been no proper treatment for sleep disorders in children with D.D. Therefore, we conduct this study to know the positive effects of intensive rehabilitation therapy in children with D.D. on the degree of sleep disturbance. Method: We prospectively recruited 22 patients with a diagnosis of D.D. during the period of January 2022 through May 2022. The inclusion criteria were as follows: 1) a patient who would participate in the intensive rehabilitation therapy of our institution; 2) the age participant under 18 years at the time of assessment; 3) a child who has consented to participate in the study by signing the consent form by the legal guardian. We investigated the clinical characteristics of participants by the medical record, including sex, age, underlying diagnosis of D.D., and Gross Motor Function Measures (GMFM). Before starting the intensive rehabilitation therapy, we conducted a Sleep disturbance scale for children (SDSC). It contains 26 questions about children’s sleep, and those questions are grouped into six subscales, such as Disorders of initiating and maintaining sleep (DIMS), Sleep Breathing Disorders(SBD), Disorders of arousal(DOA), Sleep-Wake Transition Disorders(SWTD), Disorders of excessive somnolence(DOES) and Sleep Hyperhydrosis(SHY). We used the t-score, which was calculated by comparing the scores of normal children. Twenty two patients received 8 weeks of intensive rehabilitation, including daily physical and occupational therapy. After that, we did follow up with SDSC. The comparison between SDSC before and after intensive rehabilitation was calculated using the paired t-test, and P< 0.05 was considered statistically significant. Results: Demographic data and clinical characteristics of 22 patients are enrolled. Patients were 4.03 ± 2.91 years old, and of the total 22 patients, 14 (64%) were male, and 8 (36%) were female. Twelve patients(45%) were diagnosed with Cerebral palsy(C.P.), and the mean value of participants’ GMFM was 47.82 ± 20.60. Each mean value of SDSC’s subscales was also calculated. DIMS was 62.36 ± 13.72, SBD was 54.18 ± 8.39, DOA was 49.59 ± 7.01, SWTD was 58.95 ± 9.20, DOES was 53.09 ± 15.15, SHY was 52.14 ± 8.82, and the total was 59.86 ± 13.18. These values suggest that children with D.D. have sleep disorders. After 8 weeks of intensive rehabilitation treatment, the score of DIMS showed improvement(p=0.016), but not the other subscale and total score of SDSC. Conclusion: This result showed that intensive rehabilitation could be helpful to patients of D.D. with sleep disorders. Especially intensive rehabilitation therapy itself can be a meaningful treatment in inducing and maintaining sleep.

Keywords: sleep disorder, developmental delay, intensive rehabilitation therapy, cerebral palsy

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