Search results for: left behind parents
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2387

Search results for: left behind parents

1757 An Estimating Equation for Survival Data with a Possibly Time-Varying Covariates under a Semiparametric Transformation Models

Authors: Yemane Hailu Fissuh, Zhongzhan Zhang

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An estimating equation technique is an alternative method of the widely used maximum likelihood methods, which enables us to ease some complexity due to the complex characteristics of time-varying covariates. In the situations, when both the time-varying covariates and left-truncation are considered in the model, the maximum likelihood estimation procedures become much more burdensome and complex. To ease the complexity, in this study, the modified estimating equations those have been given high attention and considerations in many researchers under semiparametric transformation model was proposed. The purpose of this article was to develop the modified estimating equation under flexible and general class of semiparametric transformation models for left-truncated and right censored survival data with time-varying covariates. Besides the commonly applied Cox proportional hazards model, such kind of problems can be also analyzed with a general class of semiparametric transformation models to estimate the effect of treatment given possibly time-varying covariates on the survival time. The consistency and asymptotic properties of the estimators were intuitively derived via the expectation-maximization (EM) algorithm. The characteristics of the estimators in the finite sample performance for the proposed model were illustrated via simulation studies and Stanford heart transplant real data examples. To sum up the study, the bias for covariates has been adjusted by estimating density function for the truncation time variable. Then the effect of possibly time-varying covariates was evaluated in some special semiparametric transformation models.

Keywords: EM algorithm, estimating equation, semiparametric transformation models, time-to-event outcomes, time varying covariate

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1756 Subthalamic Nucleus in Adult Human Cadaveric Brain: A Morphometric Study

Authors: Mangala Kohli, P. A. Athira, Reeha Mahajan

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The subthalamic nucleus (STN) is a biconvex nucleus situated in the diencephalon. The knowledge of the morphometry of the subthalamic nucleus is essential for accurate targeting of the nucleus during Deep Brain Stimulation. The present study aims to note the morphometry of the subthalamic nucleus in both the cerebral hemispheres which will prove to be of great value to radiologists and neurosurgeons. A cross‐sectional observational study was conducted in the Departments of Anatomy and Forensic Medicine, Lady Hardinge Medical College & Associated Hospitals, New Delhi on thirty adult cadaveric brain specimens of unclaimed and donated corpses. The specimens were categorized into 3 age groups: 20-35, 35-50 and above 50 years. All samples were collected after following the standard protocol for ethical clearance. The morphometric study of 60 subthalamic nucleus was thus conducted. Transverse section of the brain was made at a plane 4mm ventral to the plane containing mid commissural point. The dimensions of the subthalamic nucleus were measured bilaterally with the aid of digital Vernier caliper and magnifying glass. In the present study, the mean length and width and AC-PC length of the subthalamic nucleus was recorded on the right and left side in Group A, B and C. On comparison of mean of subthalamic nucleus dimensions between the right and left side in Group C, no statistically significant difference was observed. The length and width of subthalamic nucleus measured in the 3 age groups were compared with each other and the p value calculated. There was no statistically significant difference between the dimensions of Group A and B, Group B and C as well as Group A and C. The present study reveals that there is no significant reduction in the size of the nucleus was noted with increasing age. Thus, the values obtained in the present study can be used as a reference for various invasive and non-invasive procedures on subthalamic nucleus.

Keywords: cerebral hemisphere, deep brain stimulation, morphometry, subthalamic nucleus

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1755 Positive Psychology and Parenting: A Case Study

Authors: Victor William Harris

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Objective. This study examined the impact of the Positive Behavioral Management Skills (PBMS) online educational program on participants (n = 624) in a Southeastern region of the United States. The PBMS program incorporates established positive psychology behavioral management principles with new research-based practices designed to promote healthy and satisfying relationships between adults and children while constructively managing and preventing problematic behavior. Additionally, the PBMS program assists parents and teachers in recognizing the motivations behind a wide range of misbehaviors. The program also offers to forewarn some of the most common mistakes (or “parent traps”) in child behavioral management and describes how they can be avoided. It also describes how to recognize and capitalize on “teachable moments,” which are indispensable in the developmental process. Design. A retrospective-pre-test-then-post-test design was used to reduce response shift bias when assessing knowledge and skill intervention outcomes for twenty-two behavioral management variables. Results. The PBMS program was shown to be effective for increasing knowledge and skills related to managing misbehavior while reinforcing interpersonal relationships and fostering a sense of responsibility and capability within the child. Large standardized mean effect size changes from before to after program intervention was documented for PBMS participants on all twenty-two variables studied. Conclusion. The PBMS program showed initial positive outcomes to assist participants in the sample studied to increase their knowledge and skills in managing child behavior successfully. Implications for parents, educators and practitioners are discussed.

Keywords: behavioral management, discipline, parent education, positive parenting, positive psychology-parenting

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1754 The Comparison of Parental Childrearing Styles and Anxiety in Children with Stuttering and Normal Population

Authors: Pegah Farokhzad

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Family has a crucial role in maintaining the physical, social and mental health of the children. Most of the mental and anxiety problems of children reflects the complex interpersonal situations among family members, especially parents. In other words, anxiety problems of the children is correlated with deficit relationships of family members and improper child rearing styles. The parental child rearing styles leads to positive and negative consequences which affect the children’s mental health. Therefore, the present research was aimed to compare the parental child rearing styles and anxiety of children with stuttering and normal population. It was also aimed to study the relationship between parental child rearing styles and anxiety of children. The research sample included 54 boys with stuttering and 54 normal boys who were selected from the children (boys) of Tehran, Iran in the age range of 5 to 8 years in 2013. In order to collect data, Baumrind Child rearing Styles Inventory and Spence Parental Anxiety Inventory were used. Appropriate descriptive statistical methods and multivariate variance analysis and t test for independent groups were used to test the study hypotheses. Statistical data analyses demonstrated that there was a significant difference between stuttering boys and normal boys in anxiety (t = 7.601, p< 0.01); But there was no significant difference between stuttering boys and normal boys in parental child rearing styles (F = 0.129). There was also not found significant relationship between parental child rearing styles and children anxiety (F = 0.135, p< 0.05). It can be concluded that the influential factors of children’s society are parents, school, teachers, peers and media. So, parental child rearing styles are not the only influential factors on anxiety of children, and other factors including genetic, environment and child experiences are effective in anxiety as well. Details are discussed.

Keywords: child rearing styles, anxiety, stuttering, Iran

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1753 The Effectiveness of Using Picture Storybooks on Young English as a Foreign Language Learners for English Vocabulary Acquisition and Moral Education: A Case Study

Authors: Tiffany Yung Hsuan Ma

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The Whole Language Approach, which gained prominence in the 1980s, and the increasing emphasis on multimodal resources in educational research have elevated the utilization of picture books in English as a foreign language (EFL) instruction. This approach underscores real-world language application, providing EFL learners with a range of sensory stimuli, including visual elements. Additionally, the substantial impact of picture books on fostering prosocial behaviors in children has garnered recognition. These narratives offer opportunities to impart essential values such as kindness, fairness, and respect. Examining how picture books enhance vocabulary acquisition can offer valuable insights for educators in devising engaging language activities conducive to a positive learning environment. This research entails a case study involving two kindergarten-aged EFL learners and employs qualitative methods, including worksheets, observations, and interviews with parents. It centers on three pivotal inquiries: (1) The extent of young learners' acquisition of essential vocabulary, (2) The influence of these books on their behavior at home, and (3) Effective teaching strategies for the seamless integration of picture storybooks into EFL instruction for young learners. The findings can provide guidance to parents, educators, curriculum developers, and policymakers regarding the advantages and optimal approaches to incorporating picture books into language instruction. Ultimately, this research has the potential to enhance English language learning outcomes and promote moral education within the Taiwanese EFL context.

Keywords: EFL, vocabulary acquisition, young learners, picture book, moral education

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1752 The Invisible Labour of Informal Care: Parentified Caregiving in David Chariandy's Soucouyant

Authors: Walter Rafael Ramos Villanueva

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The overwhelming majority of scholarship on David Chariandy’s novel Soucouyant focuses on how Adele’s dementia represents the preservation of “cultural memory” and the perniciousness of “historical trauma.” However, by metaphorizing Adele’s mental condition, these critics risk treating her dementia as mostly figurative, and they thus elide a more detailed discussion of the literal ramifications of her dementia diagnosis. To move beyond these readings, then, my paper will approach Adele’s disorder as a literal medical condition and explore how her caregiving needs affect not only her but also those around her. Soucouyant subverts traditional caregiving narratives by depicting the difficult and typically invisible labour of informal caregiving that is undertaken by the families and friends of those who are ill or otherwise disabled. Because Adele’s family is unable to access proper public healthcare resources within the community, the burden of care falls upon the protagonist and his brother, who become “parentified children.” Parentified children, according to Nancy D. Chase, are “parents to their parents, and fulfill this role at the expense of their own developmentally appropriate needs and pursuits.” The novel provides a depiction of informal caregiving that is multi-faceted and asks us to question why is it exactly that we place the burden of care on those who are not equipped to handle such pressures instead of putting the onus on the government and the public healthcare system to take care of its most vulnerable members. Ageing Studies scholar Larry Polvika notes that although policymakers often offer “pious expressions of appreciation” and acknowledge that informal caregiving is “the backbone of our long-term care system,” governmental support for these caregivers remains inadequate. It is my belief that, by showcasing the struggles of informal caregivers, Chariandy’s text combats this dangerous and empty political rhetoric.

Keywords: caregiving, dementia, literature, parentified children

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1751 Body Composition Analyser Parameters and Their Comparison with Manual Measurements

Authors: I. Karagjozova, B. Dejanova, J. Pluncevic, S. Petrovska, V. Antevska, L. Todorovska

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Introduction: Medical checking assessment is important in sports medicine. To follow the health condition in subjects who perform sports, body composition parameters, such as intracellular water, extracellular water, protein and mineral content, muscle and fat mass might be useful. The aim of the study was to show available parameters and to compare them to manual assessment. Material and methods: A number of 20 subjects (14 male and 6 female) at age of 20±2 years were determined in the study, 5 performed recreational sports, while others were professional ones. The mean height was 175±7 cm, the mean weight was 72±9 cm, and the body mass index (BMI) was 23±2 kg/m2. The measured compartments were as following: intracellular water (IW), extracellular water (EW), protein component (PC), mineral component (MC), skeletal muscle mass (SMM) and body fat mass (BFM). Lean balance were examined for right and left arm (LA), trunk (T), right leg (RL) and left leg (LL). The comparison was made between the calculation derived by manual made measurements, using Matejka formula and parameters obtained by body composition analyzer (BCA) - Inbody 720 BCA Biospace. Used parameters for the comparison were muscle mass (SMM), body fat mass (BFM). Results: BCA obtained values were for: IW - 22.6±5L, EW - 13.5±2 L, PC - 9.8±0.9 kg, MC - 3.5±0.3, SMM - 27±3 kg, BFM - 13.8±4 kg. Lean balance showed following values for: RA - 2.45±0.2 kg, LA - 2.37±0.4, T - 20.9±5 kg, RL - 7.43±1 kg, and LL - 7.49 ±1.5 kg. SMM showed statistical difference between manual obtained value, 51±01% to BCA parameter 45.5±3% (p<0.001). Manual obtained values for BFM was lower (17±2%) than BCA obtained one, 19.5±5.9% (p<0.02). Discussion: The obtained results showed appropriate values for the examined age, regarding to all examined parameters which contribute to overview the body compartments, important for sport performing. Due to comparison between the manual and BCA assessment, we may conclude that manual measurements may differ from the certain ones, which is confirmed by statistical significance.

Keywords: athletes, body composition, bio electrical impedance, sports medicine

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1750 The Cultural Adaptation of a Social and Emotional Learning Program for an Intervention in Saudi Arabia’s Preschools

Authors: Malak Alqaydhi

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A problem in the Saudi Arabia education system is that there is a lack of curriculum- based Social, emotional learning (SEL) teaching practices with the pedagogical concept of SEL yet to be practiced in the Kingdom of Saudi Arabia (KSA). Furthermore, voices of teachers and parents have not been captured regarding the use of SEL, particularly in preschools. The importance of this research is to help determine, with the input of teachers and mothers of preschoolers, the efficacy of a culturally adapted SEL program. The purpose of this research is to determine the most appropriate SEL intervention method to appropriately apply in the cultural context of the Saudi preschool classroom setting. The study will use a mixed method exploratory sequential research design, applying qualitative and quantitative approaches including semi-structured interviews with teachers and parents of preschoolers and an experimental research approach. The research will proceed in four phases beginning with a series of interviews with Saudi preschool teachers and mothers, whose voices and perceptions will help guide the second phase of selection and adaptation of a suitable SEL preschool program. The third phase will be the implementation of the intervention by the researcher in the preschool classroom environment, which will be facilitated by the researcher’s cultural proficiency and practical experience in Saudi Arabia. The fourth and final phase will be an evaluation to assess the effectiveness of the trialled SEL among the preschool student participants. The significance of this research stems from its contribution to knowledge about SEL in culturally appropriate Saudi preschools and the opportunity to support initiatives for Saudi early childhood educators to consider implementing SEL programs. The findings from the study may be useful to inform the Saudi Ministry of Education and its curriculum designers about SEL programs, which could be beneficial to trial more widely in the Saudi preschool curriculum.

Keywords: social emotional learning, preschool children, saudi Arabia, child behavior

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1749 Contribution of Elderly Widows Orphans Family Support in reducing vulnerability among children affected by HIV in Kapchorwa District

Authors: Vicent Lwanga

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Background: Elderly Widows Orphans Family Support, a Community Based Organization operating in Kapchorwa with the main focus of reducing economic and social vulnerability among children affected by HIV/AIDS. The survey on reducing vulnerability targeted HIV/AIDS affected households, which included 111 adults and 185 children. The broad objective of the study was to determine how the needs of the children affected by HIV/AIDS could be appropriately met by specifically examining the situation of children affected by HIV/AIDS and establishing their needs. Methodology: The survey applied a structured questionnaire. Parents whose consent for the interview of the children had been obtained then communicated to the selected child/children. If the child consented, an arrangement for the interview was made as regards the time and place of the interview. Lessons: Adult respondents included 22.2% males and 77.8% females. Child respondents were males, 49.5%, and females 50.5%. The majority of the households are from lower economic strata. 74.1% and 63.0% of males and females, respectively, indicated that their illness had affected their income-earning activities; some of the adults have lost their jobs due to AIDS. A fair number of the children are engaged in economic activity: some of those still in school worked after school for wages and looked after their siblings. The income earned was spent mostly on household needs and school fees — one-fifth of children linked parents` inability to do more of what they desired to their ill-health. Elderly Widows Orphans Family Support secured sponsors to educate 22 girls and 16 boys in the community. Income-generating projects like piggery and skill training are given to orphans. The specific vulnerability of HIV/AIDS orphan's needs is responded to now more than ever. Community organisations interventions such as financial support to orphans introduced to moderate the impact of the disease on orphans and families.

Keywords: aids, children, needs, vulnerability

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1748 Shared Heart with a Common Atrial Complex and Persistent Right Dorsal Aorta in Conjoined Twins

Authors: L. C. Prasanna, Antony Sylvan D’Souza, Kumar M. R. Bhat

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Although life as a conjoined twin would seem intolerable, there has recently been an increased interest in this subject because of the increasing number of cases where attempts have been made to separate them surgically. We have reviewed articles on cardiovascular anomalies in conjoined twins and presenting rarest anomaly in dicephalus parapagus fetus having two heads attached to one body from the neck or upper chest downwards, with a pair of limbs and a set of reproductive organs. Both the twins shared a common thoracic cavity with a single sternum. When the thoracic cavity was opened, a common anterior mediastinum was found. On opening the pericardium, two separate, closely apposed hearts were exposed. The two cardia are placed side by side. The left heart was slightly larger than the right and were joined at the atrial levels. Four atrial appendages were present, two for each twin. The atrial complex was a common chamber posterior to the ventricles. A single large tributary which could be taken as inferior vena cava drains into the common atrial chamber. In this case, the heart could not be assigned to either twin and therefore, it is referred to as the shared heart within a common pericardial sac. The right and left descending thoracic aorta have joined with each other just above the diaphragm to form a common descending thoracic aorta which has an opening in the diaphragm to be continued as common abdominal aorta which has a normal branching pattern. Upon an interior dissection, it is observed that the two atria have a wide communication which could be a wide patent foramen ovale and this common atrial cavity has a communication with a remnant of a possible common sinus venosus.

Keywords: atrium, congenital anomaly, conjoined twin, sinus venosus

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1747 Multi-Modality Imaging of Aggressive Hoof Wall Neoplasia in Two Horses

Authors: Hannah Nagel, Hayley Lang, Albert Sole Guitart, Natasha Lean, Rachel Allavena, Cleide Sprohnie-Barrera, Alex Young

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Aggressive neoplasia of the hoof is a rare occurrence in horses and has been only sporadically described in the literature. In the few cases reported intra-hoof wall, aggressive neoplasia has been documented radiographically and has been described with variable imaging characteristics. These include a well-defined osteolytic area, a smoothly outlined semi-circular defect, an extensive draining tract beneath the hoof wall, as well as an additional large area of osteolysis or an extensive central lytic region. A 20-year-old Quarterhorse gelding and a 10-year-old Thoroughbred gelding were both presented for chronic reoccurring lameness in the left forelimb and left hindlimb, respectively. Both of the cases displayed radiographic lesions that have been previously described but also displayed osteoproliferative expansile regions of additional bone formation. Changes associated with hoof neoplasia are often non-specific due to the nature and capacity of bone to react to pathological insult, which is either to proliferate or be absorbed. Both cases depict and describe imaging findings seen on radiography, contrast radiography, computed tomography, and magnetic resonance imaging before reaching a histological diagnosis of malignant melanoma and squamous cell carcinoma. Although aggressive hoof wall neoplasia is rare, there are some imaging features which may raise our index of suspicion for an aggressive hoof wall lesion. This case report documents two horses with similar imaging findings who underwent multiple assessments, surgical interventions, and imaging modalities with a final diagnosis of malignant neoplasia.

Keywords: horse, hoof, imaging, radiography, neoplasia

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1746 Control of Asthma in Children with Asthma during the Containment Period following the Covid-19 Pandemic

Authors: Meryam Labyad, Karima Fakiri, Widad Lahmini, Ghizlane Draiss, Mohamed Bouskraoui, Nadia Ouzennou

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Background: Asthma is the most common chronic disease in children, affecting nearly 235 million people worldwide (OMS). In Morocco, asthma is much more common in children than in adults; the prevalence rate in children between 13 and 14 years of age is 20%.1 This pathology is marked by high morbidity, a significant impact on the quality of life and development of children 2 This requires a rigorous management strategy in order to achieve clinical control and reduce any risk to the patient 3 A search for aggravating factors is mandatory if a child has difficulty maintaining good asthma control. The objective of the present study is to describe asthma control during this confinement period in children aged 4 to 11 years followed by a pneumo-paediatric consultation. For children whose asthma is not controlled, a search for associations with promoting factors and adherence to treatment is also among the objectives of the study. Knowing the level of asthma control and influencing factors is a therapeutic priority in order to reduce hospitalizations and emergency care use. Objective: To assess asthma control and determine the factors influencing asthma levels in children with asthma during confinement following the COVID 19 pandemic. Method: Prospective cross-sectional study by questionnaire and structured interview among 66 asthmatic children followed in pediatric pneumology consultation at the CHU MED VI of Marrakech from 13/06/2020 to 13/07/2020, asthma control was assessed by the Childhood Asthma Control Test (C-ACT). Results: 66 children and their parents were included (mean age is 7.5 years), asthma was associated with allergic rhinitis (13.5% of cases), conjunctivitis (9% of cases), eczema (12% of cases), occurrence of infection (10.5% of cases). The period of confinement was marked by a decrease in the number of asthma attacks translated by a decrease in the number of emergency room visits (7.5%) of these asthmatic children, control was well controlled in 71% of the children, this control was significantly associated with good adherence to treatment (p<0.001), no infection (p<0.001) and no conjunctivitis (p=002) or rhinitis (p<0.001). This improvement in asthma control during confinement can be explained by the measures taken in the Kingdom to prevent the spread of COVID 19 (school closures, reduction in industrial activity, fewer means of transport, etc.), leading to a decrease in children's exposure to triggers, which justifies the decrease in the number of children having had an infection, allergic rhinitis or conjunctivitis during this period. In addition, the close monitoring of parents resulted in better therapeutic adherence (42.4% were fully observant). Confinement was positively perceived by 68% of the parents; this perception is significantly associated with the level of asthma control (p<0.001). Conclusion: Maintaining good control can be achieved through improved therapeutic adherence and avoidance of triggers, both of which were achieved during the containment period following the VIDOC pandemic 19.

Keywords: Asthma, control , COVID-19 , children

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1745 Childhood Sensory Sensitivity: A Potential Precursor to Borderline Personality Disorder

Authors: Valerie Porr, Sydney A. DeCaro

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TARA for borderline personality disorder (BPD), an education and advocacy organization, helps families to compassionately and effectively deal with troubling BPD behaviors. Our psychoeducational programs focus on understanding underlying neurobiological features of BPD and evidence-based methodology integrating dialectical behavior therapy (DBT) and mentalization based therapy (MBT,) clarifying the inherent misunderstanding of BPD behaviors and improving family communication. TARA4BPD conducts online surveys, workshops, and topical webinars. For over 25 years, we have collected data from BPD helpline callers. This data drew our attention to particular childhood idiosyncrasies that seem to characterize many of the children who later met the criteria for BPD. The idiosyncrasies we observed, heightened sensory sensitivity and hypervigilance, were included in Adolf Stern’s 1938 definition of “Borderline.” This aspect of BPD has not been prioritized by personality disorder researchers, presently focused on emotion processing and social cognition in BPD. Parents described sleep reversal problems in infants who, early on, seem to exhibit dysregulation in circadian rhythm. Families describe children as supersensitive to sensory sensations, such as specific sounds, heightened sense of smell, taste, textures of foods, and an inability to tolerate various fabrics textures (i.e., seams in socks). They also exhibit high sensitivity to particular words and voice tones. Many have alexithymia and dyslexia. These children are either hypo- or hypersensitive to sensory sensations, including pain. Many suffer from fibromyalgia. BPD reactions to pain have been studied (C. Schmahl) and confirm the existence of hyper and hypo-reactions to pain stimuli in people with BPD. To date, there is little or no data regarding what comprises a normative range of sensitivity in infants and children. Many parents reported that their children were tested or treated for sensory processing disorder (SPD), learning disorders, and ADHD. SPD is not included in the DSM and is treated by occupational therapists. The overwhelming anecdotal data from thousands of parents of children who later met criteria for BPD led TARA4BPD to develop a sensitivity survey to develop evidence of the possible role of early sensory perception problems as a pre-cursor to BPD, hopefully initiating new directions in BPD research. At present, the research community seems unaware of the role supersensory sensitivity might play as an early indicator of BPD. Parents' observations of childhood sensitivity obtained through family interviews and results of an extensive online survey on sensory responses across various ages of development will be presented. People with BPD suffer from a sense of isolation and otherness that often results in later interpersonal difficulties. Early identification of supersensitive children while brain circuits are developing might decrease the development of social interaction deficits such as rejection sensitivity, self-referential processes, and negative bias, hallmarks of BPD, ultimately minimizing the maladaptive methods of coping with distress that characterizes BPD. Family experiences are an untapped resource for BPD research. It is hoped that this data will give family observations the critical credibility to inform future treatment and research directions.

Keywords: alexithymia, dyslexia, hypersensitivity, sensory processing disorder

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1744 Free Secondary Education in Tanzania: Prospects, Challenges, and Proposals

Authors: Yazidu Saidi Mbalamula

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Free Basic Education (FBE) policy implementation in Secondary Schools has been one of thrilled undertaking both to the government and household in Tanzania. On the one hand, the government has achieved citizenry acceptance to responsibility and accountability, and on the other hand, the household has been relieved from social costs that were unbearable and deprived many Tanzanians access to basic education and secondary education in particular. Specifically, this study presents a descriptive survey conducted in two districts of Kagera region located at the northern part of Tanzania. Three objectives were pursued to identify achievements realized and challenges in the FBE implementation, and also stakeholders’ proposals were explored on how to improve FBE implementation. A sample of 91 respondents, including school managers, teachers, students, and parents, were involved in the study. Both questionnaires and interviews were used whereby the quantitative data were analyzed using Statistical Package for Social Sciences (SPSS), and content analysis was used to analyze the qualitative data. The results show that implementation of free education policy in secondary schools had far positive impact on the improvement of school management, school attendance, reduced school drop-out, reduced parents-school managers conflicts, and increased enrollment rates. Notwithstanding that, the political machinery remains instrumental to instigate policy reforms in education sector. Nevertheless, the alienating interests of politibureau, often top-down and blanketed by superficial government redness, can hardly be feasible to wield such huge programme given staggering stakeholders’ awareness of the actual requirements and unlatching resources to back up policy implementation. The study recommends that further studies on stakeholders’ conceptions on the FBE and equity of financing of basic education in Tanzania.

Keywords: capitation grant, CCM, free basic education, kagera, education policy

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1743 Mental Health Promotion for Children of Mentally Ill Parents in Schools. Assessment and Promotion of Teacher Mental Health Literacy in Order to Promote Child Related Mental Health (Teacher-MHL)

Authors: Dirk Bruland, Paulo Pinheiro, Ullrich Bauer

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Introduction: Over 3 million children, about one quarter of all students, experience at least one parent with mental disorder in Germany every year. Children of mentally-ill parents are at considerably higher risk of developing serious mental health problems. The different burden patterns and coping attempts often become manifest in children's school lives. In this context, schools can have an important protective function, but can also create risk potentials. In reference to Jorm, pupil-related teachers’ mental health literacy (Teacher-MHL) includes the ability to recognize change behaviour, the knowledge of risk factors, the implementation of first aid intervention, and seeking professional help (teacher as gatekeeper). Although teachers’ knowledge and increased awareness of this topic is essential, the literature provides little information on the extent of teachers' abilities. As part of a German-wide research consortium on health literacy, this project, launched in March for 3 years, will conduct evidence-based mental health literacy research. The primary objective is to measure Teacher-MHL in the context of pupil-related psychosocial factors at primary and secondary schools (grades 5 & 6), while also focussing on children’s social living conditions. Methods: (1) A systematic literature review in different databases to identify papers with regard to Teacher-MHL (completed). (2) Based on these results, an interview guide was developed. This research step includes a qualitative pre-study to inductively survey the general profiles of teachers (n=24). The evaluation will be presented on the conference. (3) These findings will be translated into a quantitative teacher survey (n=2500) in order to assess the extent of socio-analytical skills of teachers as well as in relation to institutional and individual characteristics. (4) Based on results 1 – 3, developing a training program for teachers. Results: The review highlights a lack of information for Teacher-MHL and their skills, especially related to high-risk-groups like children of mentally ill parents. The literature is limited to a few studies only. According to these, teacher are not good at identifying burdened children and if they identify those children they do not know how to handle the situations in school. They are not sufficiently trained to deal with these children, especially there are great uncertainties in dealing with the teaching situation. Institutional means and resources are missing as well. Such a mismatch can result in insufficient support and use of opportunities for children at risk. First impressions from the interviews confirm these results and allow a greater insight in the everyday school-life according to critical life events in families. Conclusions: For the first time schools will be addressed as a setting where children are especially "accessible" for measures of health promotion. Addressing Teacher-MHL gives reason to expect high effectiveness. Targeting professionals' abilities for dealing with this high-risk-group leads to a discharge for teacher themselves to handle those situations and increases school health promotion. In view of the fact that only 10-30% of such high-risk families accept offers of therapy and assistance, this will be the first primary preventive and health-promoting approach to protect the health of a yet unaffected, but particularly burdened, high-risk group.

Keywords: children of mentally ill parents, health promotion, mental health literacy, school

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1742 Polarisation in Latin America: Examining the Role of Social Media in Ideological Positioning Based on 2018 Census Data

Authors: Sarah Ledoux

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This paper analyses the quantitative effects of political content consumption in social media platforms on self-reported ideological preference across the Latin American region. Initially praising the democratic potential of the internet and its social networking websites, digital politics scholars have transitioned their discourse to warning against the undemocratic side-effects it cultivates, such as hate speech, filter bubbles, and ideological polarisation. Holding technology solely responsible for political trends worldwide is an oversimplification of the factors influencing social change. Nonetheless, widespread use of social media in new democracies raises questions on the reproduction of recent trends that have been observed in the US and Western Europe. Through the analysis of ordered logistic regressions on data from the 2018 AmericasBarometer survey, this study examines the extent to which the relationship between the consumption of political content on social media is related to ideological polarisation in Latin America. The findings indicate that there is a close link between consumption of political information on social media, specifically on Facebook and WhatsApp, and ideological positioning on the extremes of the political left- and right-wings. This relation holds when controlling for individual-level demographic and attitudinal factors, as well as country-level effects. These results demonstrate with empirical evidence that viewing political content on social media has a significant positive effect on the likelihood that citizens position themselves on the extreme ends of the left-right ideological spectrum and implies that political polarisation is a phenomenon that accompanies politically driven social media use.

Keywords: Latin America, polarisation, political consumption, political ideology, social media, survey

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1741 Development of a System for Measuring the Three-axis Pedal Force in Cycling and Its Applications

Authors: Joo-Hack Lee, Jin-Seung Choi, Dong-Won Kang, Jeong-Woo Seo, Ju-Young Kim, Dae-Hyeok Kim, Seung-Tae Yang, Gye-Rae Tack

Abstract:

For cycling, the analysis of the pedal force is one of the important factors in the study of exercise ability assessment and overuse injuries. In past studies, a two-axis measurement sensor was used at the sagittal plane to measure the force only in the anterior, posterior, and vertical directions and to analyze the loss of force and the injury on the frontal plane due to the forces in the right and left directions. In this study, which is a basic study on diverse analyses of the pedal force that consider the forces on the sagittal plane and the frontal plane, a three-axis pedal force measurement sensor was developed to measure the anterior-posterior (Fx), medio-lateral (Fz), and vertical (Fy) forces. The sensor was fabricated with a size and shape similar to those of the general flat pedal, and had a 550g weight that allowed smooth pedaling. Its measurement range was ±1000 N for Fx and Fz and ±2000 N for Fy, and its non-linearity, hysteresis, and repeatability were approximately 0.5%. The data were sampled at 1000 Hz using a signal collector. To use the developed sensor, the pedaling efficiency (index of efficiency, IE) and the range of left and right (medio-lateral, ML) forces were measured with two seat heights (low and high). The results of the measurement showed that the IE was higher and the force range in the ML direction was lower with the high position than with the low position. The developed measurement sensor and its application results will be useful in understanding and explaining the complicated pedaling technique, and will enable diverse kinematic analyses of the pedal force on the sagittal plane and the frontal plane.

Keywords: cycling, pedal force, index of effectiveness, measuring

Procedia PDF Downloads 656
1740 The Development of Space-Time and Space-Number Associations: The Role of Non-Symbolic vs. Symbolic Representations

Authors: Letizia Maria Drammis, Maria Antonella Brandimonte

Abstract:

The idea that people use space representations to think about time and number received support from several lines of research. However, how these representations develop in children and then shape space-time and space-number mappings is still a debated issue. In the present study, 40 children (20 pre-schoolers and 20 elementary-school children) performed 4 main tasks, which required the use of more concrete (non-symbolic) or more abstract (symbolic) space-time and space-number associations. In the non-symbolic conditions, children were required to order pictures of everyday-life events occurring in a specific temporal order (Temporal sequences) and of quantities varying in numerosity (Numerical sequences). In the symbolic conditions, they were asked to perform the typical time-to-position and number-to-position tasks by mapping time-related words and numbers onto lines. Results showed that children performed reliably better in the non-symbolic Time conditions than the symbolic Time conditions, independently of age, whereas only pre-schoolers performed worse in the Number-to-position task (symbolic) as compared to the Numerical sequence (non-symbolic) task. In addition, only older children mapped time-related words onto space following the typical left-right orientation, pre-schoolers’ performance being somewhat mixed. In contrast, mapping numbers onto space showed a clear left-right orientation, independently of age. Overall, these results indicate a cross-domain difference in the way younger and older children process time and number, with time-related tasks being more difficult than number-related tasks only when space-time tasks require symbolic representations.

Keywords: space-time associations, space-number associations, orientation, children

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1739 Time-dependent Association between Recreational Cannabinoid Use and Memory Performance in Healthy Adults: A Neuroimaging Study of Human Connectome Project

Authors: Kamyar Moradi

Abstract:

Background: There is mixed evidence regarding the association between recreational cannabinoid use and memory performance. One of the major reasons for the present controversy is different cannabinoid use-related covariates that influence the cognitive status of an individual. Adjustment of these confounding variables provides accurate insight into the real effects of cannabinoid use on memory status. In this study, we sought to investigate the association between recent recreational cannabinoid use and memory performance while correcting the model for other possible covariates such as demographic characteristics and duration, and amount of cannabinoid use. Methods: Cannabinoid users were assigned to two groups based on the results of THC urine drug screen test (THC+ group: n = 110, THC- group: n = 410). THC urine drug screen test has a high sensitivity and specificity in detecting cannabinoid use in the last 3-4 weeks. The memory domain of NIH Toolbox battery and brain MRI volumetric measures were compared between the groups while adjusting for confounding variables. Results: After Benjamini-Hochberg p-value correction, the performance in all of the measured memory outcomes, including vocabulary comprehension, episodic memory, executive function/cognitive flexibility, processing speed, reading skill, working memory, and fluid cognition, were significantly weaker in THC+ group (p values less than 0.05). Also, volume of gray matter, left supramarginal, right precuneus, right inferior/middle temporal, right hippocampus, left entorhinal, and right pars orbitalis regions were significantly smaller in THC+ group. Conclusions: this study provides evidence regarding the acute effect of recreational cannabis use on memory performance. Further studies are warranted to confirm the results.

Keywords: brain MRI, cannabis, memory, recreational use, THC urine test

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1738 The Negative Effects of Controlled Motivation on Mathematics Achievement

Authors: John E. Boberg, Steven J. Bourgeois

Abstract:

The decline in student engagement and motivation through the middle years is well documented and clearly associated with a decline in mathematics achievement that persists through high school. To combat this trend and, very often, to meet high-stakes accountability standards, a growing number of parents, teachers, and schools have implemented various methods to incentivize learning. However, according to Self-Determination Theory, forms of incentivized learning such as public praise, tangible rewards, or threats of punishment tend to undermine intrinsic motivation and learning. By focusing on external forms of motivation that thwart autonomy in children, adults also potentially threaten relatedness measures such as trust and emotional engagement. Furthermore, these controlling motivational techniques tend to promote shallow forms of cognitive engagement at the expense of more effective deep processing strategies. Therefore, any short-term gains in apparent engagement or test scores are overshadowed by long-term diminished motivation, resulting in inauthentic approaches to learning and lower achievement. The current study focuses on the relationships between student trust, engagement, and motivation during these crucial years as students transition from elementary to middle school. In order to test the effects of controlled motivational techniques on achievement in mathematics, this quantitative study was conducted on a convenience sample of 22 elementary and middle schools from a single public charter school district in the south-central United States. The study employed multi-source data from students (N = 1,054), parents (N = 7,166), and teachers (N = 356), along with student achievement data and contextual campus variables. Cross-sectional questionnaires were used to measure the students’ self-regulated learning, emotional and cognitive engagement, and trust in teachers. Parents responded to a single item on incentivizing the academic performance of their child, and teachers responded to a series of questions about their acceptance of various incentive strategies. Structural equation modeling (SEM) was used to evaluate model fit and analyze the direct and indirect effects of the predictor variables on achievement. Although a student’s trust in teacher positively predicted both emotional and cognitive engagement, none of these three predictors accounted for any variance in achievement in mathematics. The parents’ use of incentives, on the other hand, predicted a student’s perception of his or her controlled motivation, and these two variables had significant negative effects on achievement. While controlled motivation had the greatest effects on achievement, parental incentives demonstrated both direct and indirect effects on achievement through the students’ self-reported controlled motivation. Comparing upper elementary student data with middle-school student data revealed that controlling forms of motivation may be taking their toll on student trust and engagement over time. While parental incentives positively predicted both cognitive and emotional engagement in the younger sub-group, such forms of controlling motivation negatively predicted both trust in teachers and emotional engagement in the middle-school sub-group. These findings support the claims, posited by Self-Determination Theory, about the dangers of incentivizing learning. Short-term gains belie the underlying damage to motivational processes that lead to decreased intrinsic motivation and achievement. Such practices also appear to thwart basic human needs such as relatedness.

Keywords: controlled motivation, student engagement, incentivized learning, mathematics achievement, self-determination theory, student trust

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1737 Revitalization of the Chinese Residential at Lasem, Indonesia

Authors: Nurtati Soewarno, Dian Duhita

Abstract:

The existence of civilization from the past is recognized by the left objects such as monuments, buildings or even a town. The relics were designed and made well, using the good quality material so it could persist a long period of time. At this moment, those relics are cultural heritage that must be preserved and the authenticity maintained. Indonesia, a country consist of various tribes with many cultural heritages, one of them is the city of Lasem. Lasem city lies in the northern part of Central Java since the Majapahit kingdom era (13th century) poses as a busy harbor city and a trading center. Lasem is one of the residences of Chinese immigrants in Java, seen by the domination of Chinese architectural building styles. The residential was built since the 15th century and the building has the courtyard which is different from other China’s building in another part of Java. This city loses ground since the trade activity experience difficulties during the Japanese colonial era and continues after the Indonesian independence time. Many Chinese people left Lasem city and let the buildings empty not maintained. This paper will present the result of observation to Chinese architectural style buildings in Lasem city which still hold out until this moment. Using typo morphology method, the case study is chosen based on the transformation type. The occurring transformation is parallel with adaptive reuse concept as an effort to revitalize the existence of the buildings. With this concept, it is expected that the buildings could be re functioned and the glory of the foretime Lasem city could be experienced again. Intervention from the local government is expected, issuing regulations, hoping the new building functions won’t ruin the cultural heritage but instead beautifies it.

Keywords: adaptive re-use, brown field area, building transformation, Lasem city

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1736 Learning Aid for Kids in India

Authors: Prabir Mukhopadhyay, Atul Kohale

Abstract:

Going to school for Indian kids is a panic situation. Many of them are unable to adjust themselves to the confinement of the school building and this problem is compounded by other factors like unknown people in the vicinity, absence of either parents etc. This project aims at addressing these issues by exposing the kids at home to the learning environment. The purpose is to design a physical model with interfaces at each surface. The model would be like a cube with interactive surfaces where the child would be able to draw, paint, complete a picture and do such fun activities.

Keywords: interface, kids, play, computer systems engineering

Procedia PDF Downloads 207
1735 The Importance of Parental Involvement in Special Education: Enhancing Student Success through Family Engagement

Authors: Adel Al Hashlan

Abstract:

Parent and family engagement plays a crucial role in supporting the success of students with special needs in educational settings. This paper explores the significance of parental involvement in special education, examining its impact on academic achievement, social-emotional development, and overall well-being. Meaningful collaboration between educators, parents, and families can promote positive outcomes for students with diverse learning needs. The study employs a mixed-methods approach, incorporating both qualitative and quantitative techniques. Data were collected through structured interviews, focus groups, and surveys involving students with special needs, their parents, and educators across diverse educational settings. The analysis identifies patterns, themes, and correlations to understand the impact of parent and family engagement on student outcomes. Major findings reveal that effective parent and family involvement initiatives, characterized by strong communication strategies, collaboration frameworks, and partnership-building approaches, significantly enhance students’ academic performance, social-emotional development, and overall well-being. The study also identifies common barriers to parental involvement, such as cultural differences and accessibility issues, and suggests strategies for overcoming these challenges. In conclusion, the study underscores the importance of systemic support and resource allocation to facilitate meaningful partnerships between schools and families. Ongoing research and professional development are crucial to enhancing the effectiveness of parent and family engagement initiatives in special education, ultimately maximizing student achievement and well-being.

Keywords: parental involvement, special education, student success, collaborative partnerships

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1734 Role of Vision Centers in Eliminating Avoidable Blindness Caused Due to Uncorrected Refractive Error in Rural South India

Authors: Ranitha Guna Selvi D, Ramakrishnan R, Mohideen Abdul Kader

Abstract:

Purpose: To study the role of Vision centers in managing preventable blindness through refractive error correction in Rural South India. Methods: A retrospective analysis of patients attending 15 Vision centers in Rural South India from a period of January 2021 to December 2021 was done. Medical records of 10,85,81 patients both new and reviewed, 79,562 newly registered patients and 29,019 review patient’s from15 Vision centers were included for data analysis. All the patients registered at the vision center underwent basic eye examination, including visual acuity, IOP measurement, Slit-lamp examination, retinoscopy, Fundus examination etc. Results: A total of 1,08,581 patients were included in the study. Of the total 1,08,581 patients, 79,562 were newly registered patients at Vision center and 29,019 were review patients. Males were 52,201(48.1%) and Females were 56,308(51.9) among them. The mean age of all examined patients was 41.03 ± 20.9 years (Standard deviation) and ranged from 01 – 113 years. Presenting mean visual acuity was 0.31 ± 0.5 in the right eye and 0.31 ± 0.4 in the left eye. Of the 1,08,581 patients 22,770 patients had refractive error in right eye and 22,721 patients had uncorrected refractive error in left eye. Glass prescription was given to 17,178 (15.8%) patients. 8,109 (7.5%) patients were referred to the base hospital for specialty clinic expert opinion or for cataract surgery. Conclusion: Vision center utilizing teleconsultation for comprehensive eye screening unit is a very effective tool in reducing the avoidable visual impairment caused due to uncorrected refractive error. Vision Centre model is believed to be efficient as it facilitates early detection and management of uncorrected refractive errors.

Keywords: refractive error, uncorrected refractive error, vision center, vision technician, teleconsultation

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1733 A PRISMA Systematic Review: Parent Sensitivity in Autism Spectrum Disorder and Its Relationship With Child and Parent Characteristics

Authors: Gabrielle Veloso, Melanie Porter, Kelsie Boulton, Adam Guastella

Abstract:

The aim of the current systematic review was to examine child and parent factors and their associations with parent sensitivity towards children with Autism Spectrum Disorder (ASD). Eight bibliographic databases were used to identify peer-reviewed journal articles examining these associations via quantitative analyses, with parent sensitivity measured via validated and reliable observation coding systems. Thirty-one studies were finalized as having met full criteria for inclusion. The review found agreement across studies that parent sensitivity was positively associated with the child’s initiations and responsiveness toward their parent, with more frequent parent-directed behaviors providing greater opportunity for parents to act and react in sensitive manner. There was also substantial evidence that parent sensitivity predicted later growth in child language ability and child social skills. Other factors such as child attachment, parent insightfulness toward their child, and parent resolution of the diagnosis were also identified across a number of studies as being positively associated with parent sensitivity, however, interpretations of these findings were limited by the absence of covariates identified in the literature as explaining much of the variance in parent sensitivity. With respect to non-significant associations, the literature reliably found that parents showed sensitivity toward their child with ASD, regardless of child age, ASD symptomology, concurrent child social skills, and concurrent child cognitive abilities. The robust associations found in this review and their potential explanations can serve as a jump off point in identifying an understanding protective and risk factors for families of children with ASD. With regard to future directions in research, assessment of the studies’ methodological quality identified points for improvement with respect to the measurement of parent sensitivity, as well as the consideration of several important methodological confounds that may be controlled for in statistical analyses.

Keywords: ASD, autism, parenting, parent sensitivity

Procedia PDF Downloads 135
1732 Quantifying Stakeholders’ Values of Technical and Vocational Education and Training Provision in Nigeria

Authors: Lidimma Benjamin, Nimmyel Gwakzing, Wuyep Nanyi

Abstract:

Technical and Vocational Education and Training (TVET) has many stakeholders, each with their own values and interests. This study will focus on the diversity of the values and interests within and across groups of stakeholders by quantifying the value that stakeholders attached to several quality attributes of TVET, and also find out to what extent TVET stakeholders differ in their values. The quality of TVET therefore, depends on how well it aligns with the values and interests of these stakeholders. The five stakeholders are parents, students, teachers, policy makers, and work place training supervisors. The 9 attributes are employer appreciation of students, graduation rate, obtained computer skills of students, mentoring hours in workplace learning/Students Industrial Work Experience Scheme (SIWES), challenge, structure, students’ appreciation of teachers, schooling hours, and attention to civic education. 346 respondents (comprising Parents, Students, Teachers, Policy Makers, and Workplace Training Supervisors) were repeatedly asked to rank a set of 4 programs, each with a specific value on the nine quality indicators. Conjoint analysis was used to obtain the values that the stakeholders assigned to the 9 attributes when evaluating the quality of TVET programs. Rank-ordered logistic regression was the statistical/tool used for ranking the respondents values assign to the attributes. The similarities and diversity in values and interests of the different stakeholders will be of use by both Nigerian government and TVET colleges, to improve the overall quality of education and the match between vocational programs and their stakeholders simultaneous evaluation and combination of information in product attributes. Such approach models the decision environment by confronting a respondent with choices that are close to real-life choices. Therefore, it is more realistically than traditional survey methods.

Keywords: TVET, vignette study, conjoint analysis, quality perception, educational stakeholders

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1731 Improving Early Detection, Diagnosis And Intervention For Children With Autism Spectrum Disorder: A Cross-sectional Survey In China

Authors: Yushen Dai, Tao Deng, Miaoying Chen, Baoqin Huang, Yan Ji, Yongshen Feng, Shaofei Liu, Dongmei Zhong, Tao Zhang, Lifeng Zhang

Abstract:

Background: Detection and diagnosis are prerequisites for early interventions in the care of children with Autism Spectrum Disorder (ASD). However, few studies have focused on this topic. Aim: This study aims to characterize the timing from symptom detection to intervention in children with ASD and to identify the potential predictors of early detection, diagnosis, and intervention. Methods and procedures: A cross-sectional survey was conducted with 314 parents of children with ASD in Guangzhou, China. Outcomes and Results: This study found that most children (76.24%) were diagnosed within one year after detection, and 25.8% of them did not receive the intervention after diagnosis. Predictors to ASD diagnosis included ASD-related symptoms identified at a younger age, more serious symptoms, and initial symptoms with abnormal development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with the social deficit, sensory anomalies, and without language impairment, parents as the primary caregivers, family with lower income and less social support utilization increased the odds of the time lag between detection and diagnosis. Children whose fathers had a lower level of education were less likely to receive the intervention. Conclusions and Implications: The study described the time for detection, diagnosis, and interventions of children with ASD. Findings suggest that the ASD-related symptoms, the timing at which symptoms first become a concern, primary caregivers’ roles, father’s educational level, and the family economic status should be considered when offering support to improve early detection, diagnosis, and intervention. Helping children and their families take full advantage of support is also important.

Keywords: autism spectrum disorder, child, detection, diagnosis, intervention, social support

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1730 Left Ventricular Adaptations of Elite Volleyball Players Based on the Playing Position

Authors: Shihab Aldin Al Riyami, Khosrow Ebrahim, Sajad Ahmadizad

Abstract:

Hemodynamic changes and ventricular loading during exercise lead to left ventricular (LV) hypertrophy. In athletes, volume load induces enlargement of the LV internal diameter and a proportional increase of wall thickness; while, pressure load would induce thickening of the ventricular wall. These adaptations are not similar in all athletes and are related to the types of sport. Volleyball players have different types of activity and roles based on their playing. Therefore, their physiological adaptations and requirements are different. The aim of the current study was to investigate the LV adaptationsinelite volleyball players based on their playing position. Sixty male elite volleyball players (age, 30.55±3.64 years)from Brazil, Serbia, Poland, Iran, Colombia, Cameroon, Japan, Egypt, Qatar, and Tunisia were investigated (from all five volleyball play positions). All participants had the experience of at least 3 years of participation at a professional level and international tournaments. LV characteristics were evaluated and measured using the echocardiography technique. Statistical analyses revealed significant differences (P<0.05)among the five groups of players forLV internal dimension (LVID), posterior wall thickness (PWT), and intact ventricular septum (IVS). Post-hoc analysis showed that opposite position players had significant higher value of LVID, PWT, and IVS when compared with other players, including outside hitter, middle blocker, setter, and libero (p<0.05). Additionally, in libero players, PWT was significantly lower when compared with other players (p<0.05). Based on the findings of the present study, it is concluded that LV adaptations in volleyball players are related to their playing position and that the opposite players had the highest LV adaptations when compared to other positions.

Keywords: athletes, cardiac adaptations, echocardio graphy, heart, sport

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1729 Diagnostic and Prognostic Use of Kinetics of Microrna and Cardiac Biomarker in Acute Myocardial Infarction

Authors: V. Kuzhandai Velu, R. Ramesh

Abstract:

Background and objectives: Acute myocardial infarction (AMI) is the most common cause of mortality and morbidity. Over the last decade, microRNAs (miRs) have emerged as a potential marker for detecting AMI. The current study evaluates the kinetics and importance of miRs in the differential diagnosis of ST-segment elevated MI (STEMI) and non-STEMI (NSTEMI) and its correlation to conventional biomarkers and to predict the immediate outcome of AMI for arrhythmias and left ventricular (LV) dysfunction. Materials and Method: A total of 100 AMI patients were recruited for the study. Routine cardiac biomarker and miRNA levels were measured during diagnosis and serially at admission, 6, 12, 24, and 72hrs. The baseline biochemical parameters were analyzed. The expression of miRs was compared between STEMI and NSTEMI at different time intervals. Diagnostic utility of miR-1, miR-133, miR-208, and miR-499 levels were analyzed by using RT-PCR and with various diagnostics statistical tools like ROC, odds ratio, and likelihood ratio. Results: The miR-1, miR-133, and miR-499 showed peak concentration at 6 hours, whereas miR-208 showed high significant differences at all time intervals. miR-133 demonstrated the maximum area under the curve at different time intervals in the differential diagnosis of STEMI and NSTEMI which was followed by miR-499 and miR-208. Evaluation of miRs for predicting arrhythmia and LV dysfunction using admission sample demonstrated that miR-1 (OR = 8.64; LR = 1.76) and miR-208 (OR = 26.25; LR = 5.96) showed maximum odds ratio and likelihood respectively. Conclusion: Circulating miRNA showed a highly significant difference between STEMI and NSTEMI in AMI patients. The peak was much earlier than the conventional biomarkers. miR-133, miR-208, and miR-499 can be used in the differential diagnosis of STEMI and NSTEMI, whereas miR-1 and miR-208 could be used in the prediction of arrhythmia and LV dysfunction, respectively.

Keywords: myocardial infarction, cardiac biomarkers, microRNA, arrhythmia, left ventricular dysfunction

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1728 Staphylococcus Aureus Septic Arthritis and Necrotizing Fasciitis in a Patient With Undiagnosed Diabetes Mellitus.

Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

Abstract:

Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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