Search results for: family therapy

Authors: B. J. Mahen, N. E. Lloyd-Gale, S. Johnson, W. P. Rakowicz, M. J. Harris, A. D. Miller

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Background: Migraine is a leading cause of disability in the world. Calcitonin gene-related peptide (CGRP) receptor antagonists offer an approach to migraine prophylaxis by inhibiting the inflammatory and vasodilatory effects of CGRP. In recent years, NICE licensed the use of three CGRP-receptor antagonists: Fremanezumab, Galcanezumab, and Erenumab. Here, we present the outcomes of CGRP-antagonist treatment in a cohort of patients who suffer from episodic or chronic migraine and have failed at least three oral prophylactic therapies. Methods: We offered CGRP antagonists to 86 patients who met the NICE criteria to start therapy. We recorded the number of headache days per month (HDPM) at 0 weeks, 3 months, and 12 months. Of those, 26 patients were switched to an alternative treatment due to poor response or side effects. Of the 112 total cases, 9 cases did not sufficiently maintain their headache diary, and 5 cases were not followed up at 3 months. We have therefore included 98 sets of data in our analysis. Results: Fremanezumab achieved a reduction in HDPM by 51.7% at 3 months (p<0.0001), with 63.7% of patients meeting NICE criteria to continue therapy. Patients trialed on Galcanezumab attained a reduction in HDPM by 47.0% (p=0.0019), with 51.6% of patients meeting NICE criteria to continue therapy. Erenumab, however, only achieved a reduction in HDPM by 17.0% (p=0.29), and this was not statistically significant. Furthermore, 34.4%, 9.7%, and 4.9% of patients taking Fremanezumab, Galcanezumab, and Erenumab, respectively, continued therapy beyond 12 months. Of those who attempted drug holidays following 12 months of treatment, migraine symptoms relapsed in 100% of cases. Conclusion: We observed a significant improvement in HDPM amongst episodic and chronic migraine patients following treatment with Fremanezumab or Galcanezumab.

Keywords: migraine, CGRP, fremanezumab, galcanezumab, erenumab

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Authors: TM Clark, SJ Coggins, R korman, J King, R Malik

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Objective To evaluate the clinical applications and treatment outcomes using molnupiravir (MPV) for the treatment of naturally occurring feline infectious peritonitis. Methods , 92 client-owned cats with confirmed or presumptive FIP were retrospectively recruited from 35 veterinary practices between February 2023 and March 2024, primarily in Australia. Cats were categorised based on treatment received: Cohort A: Molnupiravir treatment: monotherapy, maintenance, and rescue therapy. Cohort B: Nucleoside analogue treatment: remdesivir and/or GS-441524. Seventy-eight cats were enrolled. Molnupiravir was administered orally for a median of 84 days, at a median dose of 13.3 mg/kg BID. Remission was defined as (i) the resolution of FIP-related clinical signs and normalisation of serum globulin concentrations and A:G ratio (to ≥0.6) or (ii) sustained clinical remission for at least 100 days post-treatment. Cure rate was defined as the percentage of cats achieving sustained remission, without requiring rescue therapy or experiencing a relapse event. Results Molnuparivir monotherapy resulted in a cure rate of 72% (13/18) while maintenance therapy resulted in a cure rate of 86% (25/29). Molnupiravir, utilised as rescue therapy, resulted in a cure rate of 100% (7/7). Treatment with remdesivir and/or GS-441524 resulted in a cure rate of 71% (17/24). Survival analysis revealed no significant difference in outcomes between cats treated with MPV monotherapy and those treated with nucleoside analogues. Adverse effects were uncommon but included neutropenia, and transient elevations in hepatic enzymes. Conclusion and Relevance In our study, molnupiravir demonstrated comparable outcomes to treatment with remdesivir and/or GS-441524 for treating FIP and serves as an accessible, effective option across various presentations, including ocular and neurological forms.

Keywords: FIP, molnupiravir, antiviral, nucleoside analogue

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Authors: Mariya Yeldhos, G. Hema, Sowmya Narayanan, L. Dhiviyalakshmi

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Insomnia is one of the most prevalent psychological disorders worldwide. Some of the deficiencies of the current treatments of insomnia are: side effects in the case of sleeping pills and high costs in the case of psychotherapeutic treatment. In this paper, we propose a device which provides a combination of audio visual entrainment and acupressure based compression therapy for insomnia. This device provides drug-free treatment of insomnia through a user friendly and portable device that enables relaxation of brain and muscles, with certain advantages such as low cost, and wide accessibility to a large number of people. Tools adapted towards the treatment of insomnia: -Audio -Continuous exposure to binaural beats of a particular frequency of audible range -Visual -Flash of LED light -Acupressure points -GB-20 -GV-16 -B-10

Keywords: insomnia, acupressure, entrainment, audio-visual entrainment

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Authors: Salim Cerig, Fatime Geyikoglu, Pınar Akpulat, Suat Colak, Hasan Turkez, Murat Bakir, Mirkhalil Hosseinigouzdagani, Kubra Koc

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This study was designed to evaluate whether carvacrol (CAR) could provide protection against lung injury by acute pancreatitis development. The rats were randomized into groups to receive (I) no therapy; (II) 50 μg/kg cerulein at 1h intervals by four intraperitoneal injections (i.p.); (III) 50, 100 and 200 mg/kg CAR by one i.p.; and (IV) cerulein+CAR after 2h of cerulein injection. 12h later, serum samples were obtained to assess pancreatic function the lipase and amylase values. The animals were euthanized and lung samples were excised. The specimens were stained with hematoxylin-eosin (H&E), periodic acid–Schif (PAS), Mallory's trichrome and amyloid. Additionally, oxidative DNA damage was determined by measuring as increases in 8-hydroxy-deoxyguanosine (8-OH-dG) adducts. The results showed that the serum activity of lipase and amylase in AP rats were significantly reduced after the therapy (p<0.05). We also found that the 100 mg/kg dose of CAR significantly decreased 8-OH-dG levels. Moreover, the severe pathological findings in the lung such as necrosis, inflammation, congestion, fibrosis, and thickened alveolar septum were attenuated in the AP+CAR groups when compared with AP group. Finally, the magnitude of the protective effect on lung is certain, and CAR is an effective therapy for lung injury caused by AP.

Keywords: antioxidant activity, acute pancreatitis, carvacrol, experimental, lung injury, oxidative DNA damage

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Authors: Honey Bryant, Elvina Chu

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Stroke is the leading cause of disability in adults in Canada and directly related to depression, anxiety, and sleep disorders; with an estimated annual cost of $50 billion in health care. Strokes not only impact the individual but society as a whole. Current stroke rehabilitation does not include Music Therapy, although it has success in clinical research in the use of stroke rehabilitation. This study examines the use of neurologic music therapy (NMT) in conjunction with stroke rehabilitation to improve sleep quality, reduce stress levels, and promote neurogenesis. Existing research on NMT in stroke is limited, which means any conclusive information gathered during this study will be significant. My novel hypotheses are a.) stroke patients will become less depressed and less anxious with improved sleep following NMT. b.) NMT will reduce stress levels and promote neurogenesis in stroke patients admitted for rehabilitation. c.) Beneficial effects of NMT will be sustained at least short-term following treatment. Participants were recruited from the in-patient stroke rehabilitation program at Providence Care Hospital in Kingston, Ontario, Canada. All participants-maintained stroke rehabilitation treatment as normal. The study was spilt into two groups, the first being Passive Music Listening (PML) and the second Neurologic Music Therapy (NMT). Each group underwent 10 sessions of intensive music therapy lasting 45 minutes for 10 consecutive days, excluding weekends. Psychiatric Assessments, Epworth Sleepiness Scale (ESS), Hospital Anxiety & Depression Rating Scale (HADS), and Music Engagement Questionnaire (MusEQ), were completed, followed by a general feedback interview. Physiological markers of stress were measured through blood pressure measurements and heart rate variability. Serum collections reviewed neurogenesis via Brain-derived neurotrophic factor (BDNF) and stress markers of cortisol levels. As this study is still on-going, a formal analysis of data has not been fully completed, although trends are following our hypotheses. A decrease in sleepiness and anxiety is seen upon the first cohort of PML. Feedback interviews have indicated most participants subjectively felt more relaxed and thought PML was useful in their recovery. If the hypothesis is supported, larger external funding which will allow for greater investigation of the use of NMT in stroke rehabilitation. As we know, NMT is not covered under Ontario Health Insurance Plan (OHIP), so there is limited scientific data surrounding its uses as a clinical tool. This research will provide detailed findings of the treatment of neuropsychiatric aspects of stroke. Concurrently, a passive music listening study is being designed to further review the use of PML in rehabilitation as well.

Keywords: music therapy, psychotherapy, neurologic music therapy, passive music listening, neuropsychiatry, counselling, behavioural, stroke, stroke rehabilitation, rehabilitation, neuroscience

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Authors: Muhammad Maqsood, Yasir Nawab, Syed Talha Ali Hamdani

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Stretchable fabrics have diverse applications ranging from casual apparel to performance sportswear and compression therapy. Compression therapy is the universally accepted treatment for the management of hypertrophic scarring after severe burns. Mostly stretchable knitted fabrics are used in compression therapy but in the recent past, some studies have also been found on bi-stretch woven fabrics being used as compression garments as they also have been found quite effective in the treatment of oedema. Therefore, the objective of the present study is to compare the compression properties of stretchable knitted and bi-stretch woven fabrics for compression garments. For this purpose four woven structures and four knitted structures were produced having the same areal density and their compression, comfort and mechanical properties were compared before and after 5, 10 and 15 washes. Four knitted structures used were single jersey, single locaste, plain pique and the honeycomb, whereas four woven structures produced were 1/1 plain, 2/1 twill, 3/1 twill and 4/1 twill. The compression properties of the produced samples were tested by using kikuhime pressure sensor and it was found that bi-stretch woven fabrics possessed better compression properties before and after washes and retain their durability after repeated use, whereas knitted stretchable fabrics lost their compression ability after repeated use and the required sub garment pressure of the knitted structures after 15 washes was almost half to that of woven bi-stretch fabrics.

Keywords: compression garments, knitted structures, medical textiles, woven bi-stretch

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Authors: Rukhsana Kausar, Nida Zafar

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The present research investigated socio-demographic predictors of divorce adjustment in Pakistani women. The sample comprised of 80 divorced women from different areas of Lahore. Self developed Socio-Demographic predictor scale and Divorce Adjustment Scale by (Fisher, 2001) was used for assessment. Analyses showed that working divorced women living with joint family system are more adjusted as compared to non-working divorced women living with joint family system. Women having one child are more adjusted as compared to women having more than one child. Findings highlight importance of presence of father for healthy development of adolescents. Adjustment of divorcee women was positively associated with income, social support from the family, having favorable attitudes toward marital dissolution prior to divorce, and being the partner who initiated the divorce. In addition, older women showed some evidence of poorer adjustment than did younger women. Findings highlight importance of support for divorce adjustment.

Keywords: socio-demographic, adjustment, women, divorce

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Authors: Kyra Kannen, Sonja D. Roelen, Sebastian Schnieder, Jarek Krajewski, Steffen Holsteg, André Karger, Johanna Askeridis, Celina Slawik, Philip Mildner, Jens Piesk, Ruslan David, Holger Kürten, Benjamin Oster, Robert Malzan, Mike Ludemann

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Virtual Reality (VR) is increasingly recognized for its potential in transforming mental disorder treatment, offering advantages such as cost-effectiveness, time efficiency, accessibility, reduced stigma, and scalability. While the application of VR in the context of anxiety disorders has been extensively evaluated and demonstrated to be effective, the utilization of VR as a therapeutic treatment for depression remains under-investigated. Our goal is to pioneer immersive VR therapy modules for treating major depression, alongside a web-based system for home use. We develop a modular digital therapy platform grounded in psychodynamic therapy interventions which addresses stress reduction, exploration of social situations and relationship support, social skill training, avoidance behavior analysis, and psychoeducation. In addition, an automated depression monitoring system, based on acoustic voice analysis, is implemented in the form of a speech-based diary to track the affective state of the user and depression severity. The use of immersive VR facilitates patient immersion into complex and realistic interpersonal interactions with high emotional engagement, which may contribute to positive treatment acceptance and satisfaction. In a proof-of-concept study, 45 depressed patients were assigned to VR or web-platform modules, evaluating user experience, usability and additional metrics including depression severity, mindfulness, interpersonal problems, and treatment satisfaction. The findings provide valuable insights into the effectiveness and user-friendliness of VR and web modules for depression therapy and contribute to the refinement of more tailored digital interventions to improve mental health.

Keywords: virtual reality therapy, digital health, depression, psychotherapy

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Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

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Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

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Authors: Uwe C. Fischer

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Mental health and well-being for employees working in the human service system are getting more and more important given the increasing rate of absenteeism at work. Besides individual capacities, social and community factors seem to be important in the working setting. Starting from a demand resource framework including the classical demand control aspects, social support systems, specific demands and resources of the client work, and work-family conflict were considered in the present study. We state hypothetically, that these factors have a meaningful association with the mental quality of life of employees working in the field of social, educational and health sectors. 1140 employees, working in human service organizations (education, youth care, nursing etc.) were asked for strains and resources at work (selected scales from Salutogenetic Subjective Work Assessment SALSA and own new scales for client work), work-family conflict, and mental quality of life from the German Short Form Health Survey. Considering the complex influences of the variables, we conducted a multiple hierarchical regression analysis. One third of the whole variance of the mental quality of life can be declared by the different variables of the model. When the variables concerning social influences were included in the hierarchical regression, the influence of work related control resource decreased. Excessive workload, work-family conflict, social support by supervisors, co-workers and other persons outside work, as well as strains and resources associated with client work had significant regression coefficients. Conclusions: Social support systems are crucial in the social, educational and health related service sector, regarding the influence on mental well-being. Especially the work-family conflict focuses on the importance of the work-life balance. Also the specific strains and resources of the client work, measured with new constructed scales, showed great impact on mental health. Therefore occupational health promotion should focus more on the social factors within and outside the working place.

Keywords: client interaction, human service system, mental health, social support, work-family conflict

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Authors: Ana Luiza Blanco, Luiza de Pádua Penteado, Daniella Pires Nunes

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Ageism is a widespread and prevalent phenomenon that affects older adults and directly affects healthy aging. Identifying the factors that contribute to ageism is important to discuss interventions that minimizes its social and emotional impact. To identify factors related with ageism in Brazilians older adults. Quantitative study, with a cross-sectional and analytical design. 134 older adults completed an online questionnaire about Sociodemographic and Health Characteristics, Discrimination (Ageism Survey), Depressive Symptoms (The Geriatric Depression Scale), Family Function (Family APGAR) and Loneliness. The Mann Whitney and Kruskal Wallis tests were used for data analysis, with a significance level of 5%. The mean age was 66.93 years (sd=0.50), mostly women (84.20%), married (52.60%) and with more than 12 years of schooling (75.93%). The results showed that older adults with a regular self-perception of health had higher median ageism scores when compared to individuals who rated their health as very good or good (p=0.006). The same occurred for individuals with depressive symptoms when compared to those without signs of depression (p=0.001). Regarding family function, it was observed that people with low family functionality tend to suffer more ageism than those with high functionality (p=0.017). Loneliness was also a factor related with the experience of ageism in this study. Lonely individuals had higher median ageism scores (p=0.002). There was relationship between ageism and self-perception of health, depressive symptoms, loneliness and dysfunctional family. Such findings demonstrate the importance of considering the psychosocial determinants of aging to reduce discrimination and promote healthy aging, focusing on social support and educational interventions.

Keywords: ageism, age stereotypes, healthy aging, social conditions

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Authors: Avigail Moor, Michal Otmazgin, Hagar Tsiddon, Avivit Mahazri

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The goal of the present study was to refine sexual assault therapy through the examination of the level of agreement between survivor and therapist assessments of key recovery-promoting therapeutic interventions. This is the first study to explore the level of agreement between those who partake in the treatment process from either position. Semi structured interviews were conducted in this qualitative study with 10 survivors and 10 experienced therapists. The results document considerable concurrence between them regarding relational and trauma processing treatment components alike. Together, these reports outline key effective interventions, both common and specific in nature, concomitantly supported by both groups.

Keywords: sexual assault, rape treatment, therapist training, psychotherapy

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Authors: Guna Raj Dhungana, Roshan Nepal, Apshara Parajuli, , Archana Maharjan, Shyam K. Mishra, Pramod Aryal, Rajani Malla

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Introduction: Klebsiella pneumoniae is a well-known opportunistic human pathogen, primarily causing healthcare-associated infections. The global emergence of carbapenemase-producing K. pneumoniaeis a major public health burden, which is often extensively multidrug resistant.Thus, because of the difficulty to treat these ‘superbug’ and menace and some term as ‘apocalypse’ of post antibiotics era, an alternative approach to controlling this pathogen is prudent and one of the approaches is phage mediated control and/or treatment. Objective: In this study, we aimed to isolate novel bacteriophage against carbapenemase-producing K. pneumoniaeand characterize for potential use inphage therapy. Material and Methods: Twenty lytic phages were isolated from river water using double layer agar assay and purified. Biological features, physiochemical characters, burst size, host specificity and activity spectrum of phages were determined. One most potent phage: Phage TU_Kle10O was selected and characterized by electron microscopy. Whole genome sequences of the phage were analyzed for presence/absence of virulent factors, and other lysin genes. Results: Novel phage TU_Kle10O showed multiple host range within own genus and did not induce any BIM up to 5th generation of host’s life cycle. Electron microscopy confirmed that the phage was tailed and belonged to Caudovirales family. Next generation sequencing revealed its genome to be 166.2 Kb. bioinformatical analysis further confirmed that the phage genome ‘did not’ contain any ‘bacterial genes’ within phage genome, which ruled out the concern for transfer of virulent genes. Specific 'lysin’ enzyme was identified phages which could be used as 'antibiotics'. Conclusion: Extensively multidrug resistant bacteria like carbapenemase-producing K. pneumoniaecould be treated efficiently by phages.Absence of ‘virulent’ genes of bacterial origin and presence of lysin proteins within phage genome makes phages an excellent candidate for therapeutics.

Keywords: bacteriophage, Klebsiella pneumoniae, MDR, phage therapy, carbapenemase,

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Authors: Chinyama Lukama, Million Phiri, Namuunda Mutombo

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Background: Improving access and utilization to high-quality sexual and reproductive health (SRH) information and services, including family planning (FP) commodities, is central to the global developmental agenda of sub-Saharan Africa (SSA). Despite the importance of family planning use in enhancing maternal health outcomes and fertility reduction, the prevalence of adolescents and young women using modern contraception is generally low in SSA. Zambia is one of the countries in Southern Africa with a high prevalence of teenage pregnancies and fertility rates. Despite many initiatives that have been implemented to improve access and demand for family planning commodities, utilization of FP, especially among adolescents and young women, has generally been low. The objective of this research agenda was to better understand the determinants of modern contraceptive use in adolescents and young women in Zambia. This analysis produced findings that will be critical for informing the strengthening of sexual and reproductive health policy strategies aimed at bolstering the provision and use of maternal health services in order to further improve maternal health outcomes in the country. Method: The study used the recent data from the Demographic and Health Survey of 2018. A sample of 3,513 adolescents and young women (ADYW) were included in the analysis. Multilevel logistic regression models were employed to examine the association of individual and contextual factors with modern contraceptive use among adolescents and young women. Results: The prevalence of modern contraception among sexually active ADYW in Zambia was 38.1% [95% CI, 35.9, 40.4]. ADYW who had secondary or higher level education [aOR = 2.16, 95% CI=1.35–3.47], those with exposure to listening to the radio or watching television [aOR = 1.26, 95% CI=1.01–1.57], and those who had decision-making power at household level [aOR = 2.18, 95% CI=1.71–2.77] were more likely to use modern contraceptives. Conversely, strong neighborhood desire for large family size among ADYW [aOR = 0.65 95% CI = 0.47–0.88] was associated with less likelihood to use modern contraceptives. Community access to family planning information through community health worker visits increased the likelihood [aOR = 1.48, 95% CI=1.16–1.91] of using modern contraception among ADYW. Conclusion: The study found that both individual and community factors were key in influencing modern contraceptive use among adolescents and young women in Zambia. Therefore, when designing family planning interventions, the Government of Zambia, through its policymakers and sexual reproductive health program implementers at the Ministry of Health, in collaboration with stakeholders, should consider the community context. There should also be deliberate actions to encourage family planning education through the media.

Keywords: adolescents, young women, modern contraception use, fertility, family planning

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Authors: Jawaria Zafaror, Najma Iqbal Malik

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The present study has been undertaken to explore the relationship among mild cognitive impairment, loneliness and depression among a convenient sample of old people (N = 100) living in old age homes (n = 50) and family home residence (n = 50). Mild Cognitive Impairment Questionnaire, Depression Subscale of Depression Anxiety Stress Scale and UCLA Loneliness Scales were used. Results revealed that Mild cognitive impairment had a significant positive relationship with depression and loneliness among old people both living in old age homes and family home residences. Results also showed that loneliness was the significant positive predictor of depression. However, t-test analysis revealed that old females had higher depression as compared to old males, but old males suffered a significantly high level of cognitive distortions and loneliness as compared to old females. Mediation analysis suggests that loneliness was the partial mediator between mild cognitive impairment and loneliness among old people. Limitations, suggestions and implications were also discussed.

Keywords: loneliness, mild cognitive impairment, depression, old age

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Authors: Jilu David

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Background: Schizophrenia is one of the most misunderstood mental illnesses across the globe. Lack of understanding about mental illnesses often delay treatment, severely affects the functionality of the person, and causes distress to the family. The study, Video-based Psychoeducation for Caregivers of Persons with Schizophrenia, consisted of developing a psychoeducational video about Schizophrenia, its symptoms, causes, treatment, and the importance of family support. Methodology: A quasi-experimental pre-post design was used to understand the feasibility of the study. Qualitative analysis strengthened the feasibility outcomes. Knowledge About Schizophrenia Interview was used to assess the level of knowledge of 10 participants, before and after the screening of the video. Results: Themes of usefulness, length, content, educational component, format of the intervention, and language emerged in the qualitative analysis. There was a statistically significant difference in the knowledge level of participants before and after the video screening. Conclusion: The statistical and qualitative analysis revealed that the video-based psychoeducation program was feasible and that it facilitated a general improvement in knowledge of the participants.

Keywords: Schizophrenia, mental illness, psychoeducation, video-based psychoeducation, family support

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Authors: Nadezda Sergunicheva, Victoria Vasilenko

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The emotional sphere is one of the most important aspects of the child's development and significant factor in his psychological well-being. Present research aims to identify the relationships between emotional characteristics of preschoolers and parameters of family interaction: emotional interaction, parental styles, family adaptation, and cohesion. The study involved 40 people from Saint-Petersburg: 20 children (10 boys and 10 girls) from 5 to 6 years, Mage = 5 years 4 months and 20 mothers. Methods used were: Test 'Emotional identification' by E.Izotova, Empathy test by T. Gavrilova, Children's fears test by A. Zakharov, M. Panfilova, 'Parent-child emotional interaction questionnaire' by E. Zakharova, 'Analysis of family relationships questionnaire by E. Eidemiller and V. Yustitskis, Family Adaptation and Cohesion Scales (FACES III) by D. X. Olson, J. Portner, I. Lavi. Сorrelation analysis revealed that the higher index of underdevelopment of parental feelings, the lower the child’s ability to identify emotions (p < 0,05), but at the same time, the higher ability to understand emotional states (p < 0,01), as in the case of hypoprotection (p < 0,05). Two last correlations can be explained by compensatory mechanism. This is also confirmed by negative correlations between maternal educational uncertainty and child’s ability to understand emotional states and between indulgence and child’s ability to perceive emotional states (p < 0,05). The more pronounced the phobia of a child's loss, the higher egocentric nature of child’s empathy (p < 0,05). The child’s fears have the greatest number of relationships with the characteristics of family interaction. The more pronounced mother’s positive feelings in interaction, emotional support, acceptance of himself as a parent, desire for physical contact with child and the more adaptive the family system, the less the total number of child’s fears (p < 0,05). The more the mother's ability to perceive the child's state, positive feelings in interaction, emotional support (p < 0,01), unconditional acceptance of the child, acceptance of himself as a parent and the desire for physical contact (p < 0,05), the less the amount child’s spatial fears. Socially-mediated fears are associated with less pronounced mother's positive feelings in interaction, less emotional support and deficiency of demands, obligations (p < 0,05). Fears of animals and fairy-tale characters positively correlated with the excessive demands, obligations and excessive sanctions (p < 0,05). The more emotional support (p < 0,01), mother's ability to perceive the child's state, positive feelings in interaction, unconditional acceptance of the child, acceptance of himself as a parent (p < 0,05), the less the amount child’s fears of nightmares. This kind of fears is positively correlated with excessive demands, prohibitions (p < 0,05). The more adaptive the family system (p < 0,01), the higher family cohesion, mother's acceptance of himself as a parent and preference to childish traits (p < 0,05), the less fear of death. Thus, the children's fears have the closest relationships with the characteristics of family interaction. The severity of fears, especially spatial, is connected, first of all, with the emotional side of the mother-parent interaction. Fears of animals and fairy-tale characters are associated with some characteristics of the parental styles, connected with the rigor of mothers. Correlations of the emotional identification are contradictory and require further clarification. Research is supported by RFBR №18-013-00990.

Keywords: emotional characteristics, family interaction, fears, parental styles, preschoolers

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Authors: F. Nur Baran Aksakal, Özge Dinç, H. Tanju Besler, Begüm Mutuş, Özlem Üliç Çatar, Orhan Aydoğdu, Serhat Ünal

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Healthy eating habits are associated not only with the newborn, child, and maternal health but also with longer life expectancy by acting as a protective factor against non-communicable diseases such as obesity, diabetes, cardiovascular diseases, and cancer. The role of nutrition in medical education is to provide information about the relationship between healthy nutrition and malnutrition as well as diet-related non-communicable diseases. Considering the information pollution experienced in the field of nutrition and health in the society, it is seen that more than half of the population receives information from family physicians as the closest counseling unit. However, postgraduate nutrition education programs for physicians and other health professionals who wish to improve their current knowledge of the role of nutrition communication in the prevention and management of chronic diseases are limited worldwide. However, nutrition courses are either not included in the undergraduate medical education curriculum of physicians or they are insufficient. Based on this need, the main aim of the study group was to develop a "Nutrition and Nutrition Communication Training for Physicians" program that would be conducted in cooperation with the Sabri Ülker Foundation and the Federation of Family Physicians Associations (AHEF). This program is the first online nutrition and nutrition communication information platform for physicians in Turkey. This program aims to present the concept of adequate and balanced nutrition to physicians, the importance of nutrition in diseases with scientific data, and to gain communication skills that may be necessary while transferring scientific information to the public. A needs assessment questionnaire was applied to identify pre-program training needs. A study plan was made to allow the participation of all family physicians in the population, and a complete inventory was targeted. In other words, we aimed to reach the whole source without taking a section of the population. Participation in the training is based on volunteerism. The needs assessment study is conducted using 25,102 family physicians for whom email addresses are available. The online questionnaire was sent to all the family physicians with a reminder email one week after the first one, and 1308 responded. Considering the topics determined, a training program was prepared for family physicians under eight online training titles, starting in March 2022, and conducted once every two weeks. The number of audience members present at each session was between 1217 and 1673, and a minimum of 17 and a maximum of 53 questions were received in each session. We strongly believe that to prevent individuals' health problems and to have better control over chronic diseases, the information level of physicians should be increased via these kinds of interventions, and better collaboration between family physicians and dieticians should be established.

Keywords: nutrition communication, nutrition training, communication, nutrition

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Authors: Saad Khalid Niaz, Arif Mahmood Siddiqui, Afzal Haqi

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Background: Estimated prevalence of Hepatitis C in Pakistan is 5% of which 78 % are Genotype 3, in which Response to conventional interferon is reported to be 70%. Objective: To determine the efficacy of pegylated interferon 20 kDa (Unipeg) plus ribavirin (Ribazole) in HCV genotype 3 patients who relapsed to conventional interferon. Methods: This is an ongoing study of 20 enrolled patients. Pegylated interferon alfa-2a 20 kDa 180 mcg weekly with ribavirin, were administered for a period of 24 weeks. Virological Responses were measured by Qualitative HCV RNA at weeks 4, 12, 24 and 48 to determine Rapid Virological Response (RVR), Early Virological Response (EVR), End of Treatment (ETR) and Sustained Virological Response (SVR), respectively. EVR was done for those who didn’t achieve RVR. Results: Males were 12 (60%) and mean age was 38.5 ±7.62 years. Out of 20 recruited patients, all completed 4 weeks therapy; RVR was achieved in 8 (40%) patients. One patient was lost to follow up and one yet to visit at 12 weeks. From 10 patients, 8 (80%) patients achieved EVR. Out of intent-to-treat patients, 15 completed 24 weeks therapy, ETR was achieved in 14 (93%) patients and 9 patients completed post therapy follow-up, of which, 8 (89%) patients achieved SVR. Conclusion: Our interim data demonstrates that Pegylated Interferon alfa-2a 20 kDa 180 mcg (Unipeg) in combination with Ribavirin (Ribazole) has shown promising results in treating HCV Genotype 3 patients who relapsed to conventional interferon. We recommend use of Pegylated Interferon in Relapsers with Genotype 3 when financial constraints limit the use of oral antivirals.

Keywords: pegylated interferon (unipeg), hepatitis c, relapsers, Pakistan

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Authors: Zuhrotun Ulya, Muchammad Syamsulhadi, Debree Septiawan

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Patients with bipolar disorder are three times more likely to suffer cardiovascular disorders than the general population, which will influence their level of morbidity and rate of mortality. Bipolar disorder also affects the pulmonary system. The choice of long term-monotherapy and other combinative therapies have clinical impacts on patients. This study investigates the case of a woman who has been suffering from bipolar disorder for 16 years, and who has a history of Steven Johnson Syndrome. At present she is suffering also from cardiovascular and pulmonary disorder. An analysis of the results of this study suggests that there is a relationship between cardiovascular disorder, drug therapies, Steven Johnson Syndrome and mood stabilizer obtained from the PubMed, Cochrane, Medline, and ProQuest (publications between 2005 and 2015). Combination therapy with mood stabilizer is recommended for patients who do not have side effect histories from these drugs. The replacement drugs and combinations may be applied, especially for those with bipolar disorders, and the combination between atypical antipsychotic groups and mood stabilizers is often made. Clinicians, however, should be careful with the patients’ physical and metabolic changes, especially those who have experienced long-term therapy and who showed a history of Steven Johnson Syndrome (for which clinicians probably prescribed one type of medicine).

Keywords: cardiopulmonary disease, bipolar disorder, SJS, therapy

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Authors: Ali Ramezani

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Balancing feeding system of plastic injection molding has overriding importance as it minimizes the process’s product defects such as weld line, shrinkage, sink marks and warpage. This article presents the difference between optimization of feeding system in identical multi-cavity molding and family molding using Moldflow Plastic Insight software. In this work, the effect of dimension, shape, position and type of gates and runners on the products quality was studied. The optimization was carried out by analyzing plastic injection molding process parameters, including melt temperature, mold temperature, cooling time, cooling temperature packing time and packing pressure. It was found that symmetrical feeding system is the most efficient shape for diminishing defects in identical multi-cavity molding. However, the same results were not concluded for family molding due to the differences between volume, mass, thickness and shape of cavities.

Keywords: balancing feeding system, family molding, multi-cavity, Moldflow, plastic injection

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Authors: Mohadeseh Shojaei Shahrokhabadi, Ding-Geng (Din) Chen

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Positive continuous outcomes with a substantial number of zero values and incomplete longitudinal follow-up are quite common in medical cost data. To jointly model semi-continuous longitudinal cost data and survival data and to provide marginalized covariate effect estimates, a marginalized two-part joint model (MTJM) has been developed for outcome variables with lognormal distributions. In this paper, we propose MTJM models for outcome variables from a generalized gamma (GG) family of distributions. The GG distribution constitutes a general family that includes approximately all of the most frequently used distributions like the Gamma, Exponential, Weibull, and Log Normal. In the proposed MTJM-GG model, the conditional mean from a conventional two-part model with a three-parameter GG distribution is parameterized to provide the marginal interpretation for regression coefficients. In addition, MTJM-gamma and MTJM-Weibull are developed as special cases of MTJM-GG. To illustrate the applicability of the MTJM-GG, we applied the model to a set of real electronic health record data recently collected in Iran, and we provided SAS code for application. The simulation results showed that when the outcome distribution is unknown or misspecified, which is usually the case in real data sets, the MTJM-GG consistently outperforms other models. The GG family of distribution facilitates estimating a model with improved fit over the MTJM-gamma, standard Weibull, or Log-Normal distributions.

Keywords: marginalized two-part model, zero-inflated, right-skewed, semi-continuous, generalized gamma

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Authors: M. Yaqoob, C. S. O’Neill, S. Faraj, C. L. O’Neill

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This paper presents the preliminary findings from a study exploring nurse’s contributions to end of life decisions and to the care of dying patients in ICU units in the Kingdom of Bahrain. The process of dying is complex as medical clinicians are frequently unable to say with certainty when death will occur. It is generally accepted that end of life care begins when it is possible to know that death is imminent. Nurses do not make medical treatment decisions when caring for a dying patient. There are, however, many other types of decisions made when a patient is approaching the end of life and nurses are either formally or informally part of these decision making processes. This study explored nurses care practices at the end of life, in two ICU units in large hospitals in the Kingdom of Bahrain. The research design was a grounded theory approach. Ten nurses participated, six of whom were Bahraini nationals and four were Indian. A core category death avoidance talk was supported by three major subcategories, degrees of involvement in decision making; signalling and creating an awareness of death; care shifting from dying patients to family. Despite nurses asserting that they carried out the orders of doctors and had no role in decision making processes at end of life this study showed that there were degrees of nurse involvement. Doctors frequently discussed the patient’s clinical condition with nurses and also sought information regarding the family. Information about the family was of particular relevance if the doctor was considering a DNR order, which the nurses equated with dying. Families were not always informed when a DNR decision was made. When families were not informed the nurses engaged in sophisticated rituals signalling and creating awareness to family members that the death of their loved one was near. This process also involved a subtle shifting of care from the dying patient to the family. This seminar paper will focus particularly on how nurses signal and create an awareness of death in an ICU setting. The findings suggest that despite the avoidance of death talk in the ICU nurses indirectly convey and create an awareness that death is near to family members.

Keywords: decision making, dying patients, end of life, intensive care unit

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Authors: Uraporn Vongvatcharanon, Kochakorn Sukjan, Wandee Udomuksorn, Ekkasit Kumarnsit, Surapong Vongvatcharanon

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Sarcopenia is a loss of muscle mass, and strength frequently found in menopause. Estrogen replacement has been shown to improve such a loss of muscle functions. However, there is an increased risk of cancer that has to be considered because of the estrogen replacement therapy. Thus, phytoestrogen supplementation has been suggested as an alternative therapy. Pueraria mirifica (PM) is a plant in the family Leguminosae, that is known to be phytoestrogen-rich and has been traditionally used for the treatment of menopausal symptoms. It contains isoflavones and other compounds such as miroestrol and its derivatives. Parvalbumin (PV) is a calcium binding protein and functions as a relaxing factor in fast twitch muscle fibers. A decrease of the PV level results in a reduction of the speed of the twitch relaxation. Therefore, this study aimed to investigate the effect of an ethanolic extract from Pueraria mirifica on the estrogen levels, skeletal muscle functions and PV levels in the extensor digitorum longus (EDL) and gastrocnemius of ovariectomized rats. Twelve-week old female Wistar rats (200-250 g) were divided into 6 groups: SHAM (un-ovariectomized rats, that received double distilled water), PM-0 (ovariectomized rats, OVX, receiving double distilled water), E (OVX, receiving an estradiol benzoate dose of 0.04 mg/kg), PM-50 (OVX receiving PM 50 mg/kg), PM-500 (OVX receiving PM 500 mg/kg), PM-1000 (OVX receiving PM 1000 mg/kg) all for 90 days. The PM-0 group had estrogen levels, uterus weights, muscle mass, myofiber cross-section areas, peak tension, fatigue resistance, speed of relaxation and parvalbumin levels of both EDL and gastrocnemius that were significantly reduced compared to those of the SHAM group (p<0.05). Also the α and β estrogen receptor immunoreactivities and the parvalbumin immunoreactivities of both EDL and gastrocnemius were decreased in the PM-0 group. In contrast the E, PM-50, PM-500 and PM-1000 group had estrogen levels, uterus weights, muscle mass, myofiber cross-section areas, peak tension, fatigue resistance, speed of relaxation of both EDL and gastrocnemius that were significantly increased compared with PM-0 group (p<0.05). In addition, the α and β estrogen receptor immunoreactivities and parvalbumin immunoreactivity of both the EDL and gastrocnemius were increased in the E, PM-50, PM-500 and PM-1000 group. In addition the extract of Pueraria mirifica replacement group at 50 and 500 mg/kg had significantly increased parvalbumin levels in the EDL muscle but in the gastrocnemius, only the dose of 500 mg/kg increased the parvalbumin levels (p<0.05). These results have demonstrated that the use of the Pueraria mirifica extract as a replacement therapy for estrogen produced estrogenic activity that was similar to that produced by the estradiol benzoate replacement. It seems that the phytoestrogens could bind with the estrogen receptors and stimulate the transcriptional activity to synthesise muscle protein that caused an increase in muscle mass and parvalbumin levels. Thus, muscle synthesis may restore parvalbumin levels resulting in an enhanced relaxation efficiency that would lead to a shortened latent period before the next contraction.

Keywords: Puereria mirifica, Parvalbumin, estrogen, ovariectomized rats

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Authors: Ohoud Abdullatif Alshaiji

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Child-rearing is considered as the most important family role and with the modern lifestyle and busy families social institutions has taken this role from the family to encourage the individuals active's role in the social life, this study aimed to acknowledge the contributions of the social institutions in child-rearing the Saudi children and to acknowledge The Role of the community's partnership in activating the social child-rearing for the Saudi children. The research main question was how much the community's partnership is actually participating in activating the process of the social development of the Saudi children. The importance of this study comes from the massive care that has been given from all over the world, children international organizations, and this research is focusing on the participating of five social organization in child-rearing the Saudi children. The study was limited on the mothers of the children who are enrolled in the government's kindergarten the tool that has been used was the Questionnaire, using the descriptive and analytical approach. The important role of the family in encouraging the social development for the Saudi child, and the results has shown the importance of the mosque in encouraging the good social behaviors. And the kindergarten role has shown after the mosque because of the changes that made most of the families relying on the educational institutions to help the child to adapt in a different cultures. To spread the community's partnership in all the social actions, to support and encourage the role of community's partnership in activating the process of the social development of the Saudi children, to minimize the difficulties and the provide the need to fully support the community's partnership.

Keywords: child-rearing, social development, acknowledge the contributions

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Authors: Syeda Faiza Gardazi, Syed Ahsan Ali Gardazi, Ajmal Waheed

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The trend of overtime is increasing among workers due to more pressure to perform workloads, job insecurity, and financial issues. Overtime work affects the work-life balance conflict negatively as well positively. Work-life balance conflict has become an important issue as traditional work and family roles have changed. The purpose of the current research was to study the impact of overtime work on work-life balance conflict along with the moderating role of job satisfaction. For this purpose, data is collected from the employees working in different public and private sectors of Pakistan using simple random sampling technique. Descriptive statistics was used for data presentation and analysis. Correlation and regression analysis were used to test four research hypotheses proposed on the basis of research framework. The findings led to the acceptance of four hypotheses. The results show that high working hours and overtime in general lead to high work-life balance conflict. Moreover, job satisfaction moderates the relationship between overtime work and work-life balance conflict.

Keywords: family to work conflict, overtime work, work to family conflict, work-life balance conflict

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Authors: Rojan Afrouz

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The main aim of this study is understanding Afghan women’s perception of domestic violence and their experience of abuse by their family members. The voice of Afghan women has not been heard much particularly in Australia. Their families and communities have silenced some of them in the name of family honour and reputation, and others have not had the opportunity to talk about the issue. Although domestic violence is an issue in every country, research suggests that this is more likely to be considered acceptable behaviour in Afghanistan than elsewhere. Given the high public visibility of initiatives which aim to tackle domestic violence in Australia, it is entirely possible that Afghan women’s perceptions and beliefs about domestic violence will have changed since their arrival in this country. Thus, their understandings, perceptions and their experience of domestic violence have been investigated to improve the Afghan women’s situation in Australia. Methods: This qualitative study has been conducted among Afghan women who have lived in Australia less than ten years. Semi-structured interviews either face to face or by phone have been used to collect data for this study. The interviews have been audio-recorded and transcribed verbatim. Nvivo software has been used for data analysis. Findings: Participants’ definitions of domestic violence vary. They defined domestic violence in relation to their educational levels, their personal life and experience of domestic violence. Some women tended to change the definitions to be more relevant to their own life and experience. Many women had the knowledge of different domestic violence acts that have been distinguished as violent acts in Australia or other western countries. Some of the participants stated that they had the experience of domestic violence from their partner or one of the family members. Those who have been abused, their experiences were diverse and had been perpetrated by different family members. Majority of participants revealed the story of other women in their family and community that have been abused. Conclusion: Moving to Australia helped women to be aware of the issues and recognising that they are in the abusive relationships. However, intersecting multiple identities in a complex system of oppression, domination or discrimination makes the experience of domestic violence more complicated among Afghan community in Australia that cannot be addressed easily.

Keywords: domestic violence, intersectionality, immigration, afghan women

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Authors: Lugean K. Alomari, Rahaf K. Sharif, Basil K. Alomari, Hind M. Aljabri, Faisal F. Aljahdali, Amal A. Alomari, Saeed A. Alghamdi

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Background: The thermal pulsation system is a therapy that uses heat and massage to treat dry eye disease; thus, some trials have been published to compare it with the conventional treatment. The aim of this study is to conduct a systematic review and meta-analysis comparing the efficacy of thermal pulsation systems with conventional treatment in patients undergoing cataract surgery. Methods: Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for eligible trials. We included three randomized controlled trials (RCTs) that compared the thermal pulsation system with the conventional treatment in patients undergoing cataract surgery. A table of characteristics was plotted, and the Quality of the studies was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). Forest plots were plotted using the Random-effect Inverse Variance method. χ2 test and the Higgins-I-squared (I2) model were used to assess heterogeneity. A total of 201 cataract surgery patients were included, with 105 undergoing preoperative pulsation therapy and 96 receiving conventional treatment. Demographic analysis revealed comparable distributions across groups. Results: All the studies in our analysis are of good quality with a low risk of bias. A total of 201 patients were included in the analysis, out of which 105 underwent pulsation therapy, and 95 were in the control group. Tear Break-up Time (TBUT) analysis revealed no significant baseline differences, except pulsation therapy being better at 1 month. (SMD 0.42 [95%CI 0.14 - 0.70] p=0.004). This positive trend continued at three months (SMD 0.52 [95% CI (0.20 – 0.84)] p=0.002). Corneal fluorescein staining scores and Meibomian gland-yielding secretion scores showed no significant differences at baseline. However, at one month, pulsation therapy significantly improved Meibomian gland function (SMD -0.86 [95% CI (-1.20 - -0.53)] p<0.00001), indicating a reduced risk of dry eye syndrome. Conclusion: Preoperative pulsation therapy appears to enhance post-cataract surgery outcomes, particularly in terms of tear film stability and Meibomian gland secretory function. The sustained positive effects observed at one and three months post-surgery suggest the potential for long-term benefits.

Keywords: lipiflow, cataract, thermal pulsation, dry eye

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Authors: Shirajul Islam Khan, Muhammad Ashraful Alam Bhuiyan, Syeda Tania Begum

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Introduction: Acne vulgaris is one of the most common dermatologic conditions and affects the vast majority of people at some point during their lifetime, so effective treatment is of major importance. The failure of usual treatment modalities, teratogenic effects with some severe side effects, and resistance to P.Acne by Retinoides have been focusing on new therapeutic options for the treatment of acne. More recently, pulsed dye laser therapy has been reported to reduce acne lesion counts. The negligible morbidity of these treatment modalities and some other benefits of subsequent acne scar management lead this therapy more attractive. Objective: The objective of this study is to assess the efficacy and safety of pulsed dye laser therapy in the treatment of inflammatory acne vulgaris. Materials and Methods: A prospective clinical trial was done in the Department of Dermatology and Venereology, Combined Military Hospital (CMH), Dhaka, to find out the role of pulse dye laser in the treatment of inflammatory acne vulgaris. The study was carried out with 60 patients with mild to moderate acne vulgaris, and those were treated with pulsed dye laser therapy at baseline and after 4, 8, and 12 weeks. Results: Among 60 patients with inflammatory acne, 42(70%) were in the age group of less than 20 years, and 36(60%) were female. Regarding the number of inflammatory lesions, the baseline mean number (± SD) was 12.77 ± 4.01; after 4 weeks of treatment of inflammatory acne by pulsed dye laser was 7.80 ± 4.11; after 8 weeks of treatment, 6.10 ± 4.03 and after 12 weeks of treatment was 4.17 ± 4.02. After 4 weeks of treatment by pulse dye laser, the level of improvement was excellent at 3.3%, good at 10%, fair at 60%, and poor at 26.7%; after 8 weeks of treatment, excellent was 13.3%, good was 46.7%, the fair was 30% and poor 10% and after 12 weeks of treatment, excellent was 56.7%, good 13.3%, fair 23.3% and poor 6.7%. Regarding safety level, out of 60 patients of inflammatory acne vulgaris treated by pulsed dye laser, about 52(86.7%) patients did not observe any side effects. Conclusions: On the basis of the study results, it can be concluded that pulsed-dye laser is highly effective and well tolerated by patients in the treatment of inflammatory acne.

Keywords: pulsed-dye laser, inflammatory acne, acne vulgaris, retinoids

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Authors: Qingli Lei

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This study investigates the impact of family socioeconomic status and parental involvement on the academic performance of elementary school students, specifically focusing on migrant students in China. The findings reveal that gender has a stronger influence on academic performance compared to local status and parental tutoring time. Female students tend to achieve higher scores than males. Parental education level does not significantly predict academic performance, while parent tutoring time does have a significant impact. Furthermore, there is a significant interaction between local status and parental education level, indicating that migrant students with lower-educated parents perform better than their local counterparts, while local children excel when their parents' education levels are higher. These results emphasize the importance of parental involvement, particularly for immigrant students, and highlight the need for interventions that enhance parental engagement in education to improve academic outcomes.

Keywords: academic performance, family socioeconomic status, migrant students, parental involvement

Procedia PDF Downloads 102