Search results for: dental fear
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 845

Search results for: dental fear

185 Children of Quarantine: A Post COVID-19 Mental Health Dilemma

Authors: Salman Abdul Majeed, Vidur Solanki, Ruqiya Shama Tareen

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BACKGROUND: The COVID-19 pandemic has affected the way of living as we have known for all strata of society. While disease containment measures imposed by governmental agencies have been instrumental in controlling the spread of the virus, it has had profound collateral impacts on all populations. However, the disruption caused in the lives of one segment of population has been far more damaging than most others: the emotional wellbeing of our child and adolescent populations. This impact was even more pronounced in children who already suffered from neurodevelopmental or psychiatric disorders. In particular, school closures have not only led to profound social isolation, but also negative impacts on normal developmental opportunities and interruptions in mental health services obtained through school systems. It is too soon to understand the full impacts of quarantine, isolation, stress of social detachment and fear of pandemic, but we have started to see the devastating impact on C&A already. This review intends to shed light on the current understanding of psychiatric wellbeing of C&A during COVID-19 pandemic. METHOD: Literature search utilizing key words COVID-19 and children, quarantine and children, social isolation, Loneliness, pandemic stress and children, and mental health of children, disease containment measures was carried out. Over 200 articles were identified, out of which 81 articles were included in this review article. RESULTS: The disruption caused by COVID-19 in the lives of C&A is much more damaging and its impact is far reaching. The C&A ED visits for possible suicide attempts have jumped to 22.3% in 2020 and 39.1% during 2021. One study utilizing T1-weighted structural images, computed the thickness of cortical and subcortical structures including amygdala, hippocampus, and nucleus accumbens. The Peri-COVID group showed reduced cortical and subcortical thickness and more advanced brain aging compared to pre pandemic studies. CONCLUSION: Mental health resources for C&A remain under funded, neglected, and inaccessible to population that needs it most. Children with ongoing mental health disorders were impacted worst, along with those with predisposed biopsychosocial risk factors.

Keywords: COVID-19 and children, quarantine and children, social isolation, Loneliness, pandemic stress and children, disease containment measures, mental health of children

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184 Service Strategy And Innovation In The Food Service Industry: Basis For Designing A Competitive Advantage Model

Authors: Ma. Dina Datiles Jimenez

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Service strategy and service Innovation has something to do with the success of the foodservice business. The foodservice business nowadays has become more competitive, and technology driven. This study aimed to determine and investigate the service innovation and strategies of the food service industry and the challenges during the pandemic to serve as the basis for a competitive advantage model. The study used mixed methods, including descriptive quantitative and qualitative methods. The Metro Manila foodservice managers were the target population of the study, which consisted of an estimated 1500 respondents from the selected cities. The assessment of service innovation for the following dimensions: product-related dimension; market-related dimension; process-related dimension; and organization-related dimension, when classified according to profile, was very large for age, gender, and educational attainment. When respondents are classified according to profile, the service strategy in terms of customer service strategy, after-sales service strategy, maintenance service strategy, research and development-oriented service strategy, and operational services strategy were all assessed with a very large extent of implementation. There was a significant difference in all four aspects of service innovation when classified based on age. However, for gender, only the market and process dimensions showed significant differences, while the product and organization conveyed no significant differences. Consequently, the evidence was not enough to prove that educational attainment differs from one another on the four aspects of service innovation. There was sufficient evidence to prove that the ages differ from one another in all aspects of service strategies. While gender and educational attainment showed no significant difference in the assessment of service strategies, Training on the trends in the foodservice industry during the pandemic is offered; technical maintenance is evident; the company allotted budget for outsourcing training; the quality control system; and online customer feedback were revealed as major indicators for service strategy. Fear of viruses, limited customers, a minimal work force, and low revenues were identified as challenges faced by the foodservice industry.

Keywords: foodservice industry, service innovation, service strategy, competitive advantage, sustainability, technology

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183 The Role of Women in Criminal Organizations

Authors: Rossella Marzullo

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Family plays a central role in the Calabrian criminal organization, which draws its strength from blood ties and gender stereotypes that still impose a strong verticalization of intra-family relationships for the benefit of men. However, female figures are of great importance in the organizational structure of the 'Ndrangheta families, despite the fact that they appear to be formally suffocated by the culture of gender subordination still strongly present in the archaic world of criminal organizations. And this is so much true that over time, the women of the 'Ndrangheta have added to the function of ‘internal containment’, the increasingly explicit function of intermediaries in the ‘external’ activities of the clan. But what happens in the 'Ndrangheta if women break the bond and decide to speak? The results are shocking. When a woman starts talking to ask the institutions for help, the system ‘goes crazy’, because the woman is considered the means of consolidating and transmitting family codes: she educates, forges, holds the structure together. If a woman from the 'Ndrangheta decides to speak out and get out of the family bottlenecks of the clan, she does not exclusively destroy the family; she destroys the system. This happens because, while not playing the same roles as men within organizations, women carry out support activities as intermediaries for the circulation of communications, thus ensuring the operability of the gang in practice and on a daily basis. Crossing the border means breaking the bonds of belonging, thus questioning one's own identity and reconstructing it according to other points of reference. How much these disruptive choices are feared by the men of the 'Ndrangheta has been seen in the dramatic stories of Lea Garofalo and Maria Concetta Cacciola: the fear of the breaking of the family pact, of the earthquake that arises from within, has marked their fate of death, useful both to stop the judicial action and to recompose the organization's estate under the aegis of terror. With physical, psychological violence, underhanded torture, and moral blackmail, the men of the mafia family tried to heal the shock caused by the voices of women, relying on violence and yet another attempt to subordinate them. This proves that the 'Ndrangheta is really afraid of them. The female voices of the 'Ndrangheta, who have shaken a consolidated and considered intangible system, represent the anti-'ndrangheta par excellence; in their choices, there is an even stronger desire to break with the mafia world.

Keywords: families, gender, ‘Ndrangheta, stereotypes

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182 Gender, Sexual Diversity and Professional Practice Learning: Promoting the Equality of University Students

Authors: Caroline Bradbury-Jones, Maria Clark, Eleanor Molloy, Nicki Ward

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Background: Significant developments in the protection of Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) rights culminated in their inclusion in the Equality Act 2010. This provides legal protection against discrimination including the Public Sector Equality Duty requiring public bodies to consider all individuals when carrying out their day-to-day work. In the UK, whilst the Higher Education sector has made some commitment to eliminating discrimination and addressing LGBTQ inclusivity, there are two particular problems specifically affecting students on professional programmes: -All students will come into contact with LGBTQ patients/clients/students and need to be equipped to respond appropriately to their diverse needs but evidence suggests that this is not always the case. -Many LGBTQ students have specific concerns on professional placements; often ‘going back in the closet’ or feeling uncertain how to respond to questions about their personal lives and being reticent to challenge discrimination against LGBTQ patients/clients/students for fear of reprisal. Study aim: To investigate how best to prepare all students to deal with the issue of gender and sexual diversity and to support LGBTQ students in negotiating (non) disclosure in practice placements. Methods: This multi-method study was conducted in 2017 in the UK. It comprised a student survey, focus group interview with students and a national benchmarking exercise. Findings: Preliminary findings are that there is considerable variation across professional programmes regarding the preparation of students to respond to LGBTQ issues. Similarly, there is considerable difference between the level of preparedness experienced by students irrespective of whether they identify as LGBTQ. Discussion: Nationally there are a number of ‘best practice’ examples that we share in this presentation. These contain important details and guidance about how to better prepare university students for professional practice, and to contribute to eliminating discrimination and addressing LGBTQ inclusivity. Conclusions: The presentation will appeal to delegates who are interested in the equality agenda regarding LGBTQ people. The study findings will be discussed and debated to explore their impact on higher education and learning and to identify ways to integrate best practice into professional curricula across the UK and beyond.

Keywords: diversity, equality, practice, sexuality, students, university

Procedia PDF Downloads 179
181 The Effectiveness of Virtual Reality Training for Improving Interpersonal Communication Skills: An Experimental Study

Authors: Twinkle Sara Joseph

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Virtual reality technology has emerged as a revolutionary power that can transform the education sector in many ways. VR environments can break the boundaries of the traditional classroom setting by immersing the students in realistic 3D environments where they can interact with virtual characters without fearing being judged. Communication skills are essential for every profession, and studies suggest the importance of implementing basic-level communication courses at both the school and graduate levels. Interpersonal communication is a skill that gains prominence as it is required in every profession. Traditional means of training have limitations for trainees as well as participants. The fear of being judged, the audience interaction, and other factors can affect the performance of a participant in a traditional classroom setting. Virtual reality offers a unique opportunity for its users to participate in training that does not set any boundaries that prevent the participants from performing in front of an audience. Specialised applications designed in VR headsets offer a range of training and exercises for participants without any time, space, or audience limitations. The present study aims at measuring the effectiveness of VR training in improving interpersonal communication skills among students. The study uses a mixed-method approach, in which a pre-and post-test will be designed to measure effectiveness. A preliminary selection process involving a questionnaire and a screening test will identify suitable candidates based on their current communication proficiency levels. Participants will undergo specialised training through the VR application Virtual Speech tailored for interpersonal communication and public speaking, designed to operate without the traditional constraints of time, space, or audience. The training's impact will subsequently be measured through situational exercises to engage the participants in interpersonal communication tasks, thereby assessing the improvement in their skills. The significance of this study lies in its potential to provide empirical evidence supporting VR technology's role in enhancing communication skills, thereby offering valuable insights for integrating VR-based methodologies into educational frameworks to prepare students more effectively for their professional futures.

Keywords: virtual reality, VR training, interpersonal communication, communication skills, 3D environments

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180 Age Estimation from Upper Anterior Teeth by Pulp/Tooth Ratio Using Peri-Apical X-Rays among Egyptians

Authors: Fatma Mohamed Magdy Badr El Dine, Amr Mohamed Abd Allah

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Introduction: Age estimation of individuals is one of the crucial steps in forensic practice. Different traditional methods rely on the length of the diaphysis of long bones of limbs, epiphyseal-diaphyseal union, fusion of the primary ossification centers as well as dental eruption. However, there is a growing need for the development of precise and reliable methods to estimate age, especially in cases where dismembered corpses, burnt bodies, purified or fragmented parts are recovered. Teeth are the hardest and indestructible structure in the human body. In recent years, assessment of pulp/tooth area ratio, as an indirect quantification of secondary dentine deposition has received a considerable attention. However, scanty work has been done in Egypt in terms of applicability of pulp/tooth ratio for age estimation. Aim of the Work: The present work was designed to assess the Cameriere’s method for age estimation from pulp/tooth ratio of maxillary canines, central and lateral incisors among a sample from Egyptian population. In addition, to formulate regression equations to be used as population-based standards for age determination. Material and Methods: The present study was conducted on 270 peri-apical X-rays of maxillary canines, central and lateral incisors (collected from 131 males and 139 females aged between 19 and 52 years). The pulp and tooth areas were measured using the Adobe Photoshop software program and the pulp/tooth area ratio was computed. Linear regression equations were determined separately for canines, central and lateral incisors. Results: A significant correlation was recorded between the pulp/tooth area ratio and the chronological age. The linear regression analysis revealed a coefficient of determination (R² = 0.824 for canine, 0.588 for central incisor and 0.737 for lateral incisor teeth). Three regression equations were derived. Conclusion: As a conclusion, the pulp/tooth ratio is a useful technique for estimating age among Egyptians. Additionally, the regression equation derived from canines gave better result than the incisors.

Keywords: age determination, canines, central incisors, Egypt, lateral incisors, pulp/tooth ratio

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179 Understanding the Basics of Information Security: An Act of Defense

Authors: Sharon Q. Yang, Robert J. Congleton

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Information security is a broad concept that covers any issues and concerns about the proper access and use of information on the Internet, including measures and procedures to protect intellectual property and private data from illegal access and online theft; the act of hacking; and any defensive technologies that contest such cybercrimes. As more research and commercial activities are conducted online, cybercrimes have increased significantly, putting sensitive information at risk. Information security has become critically important for organizations and private citizens alike. Hackers scan for network vulnerabilities on the Internet and steal data whenever they can. Cybercrimes disrupt our daily life, cause financial losses, and instigate fear in the public. Since the start of the pandemic, most data related cybercrimes targets have been either financial or health information from companies and organizations. Libraries also should have a high interest in understanding and adopting information security methods to protect their patron data and copyrighted materials. But according to information security professionals, higher education and cultural organizations, including their libraries, are the least prepared entities for cyberattacks. One recent example is that of Steven’s Institute of Technology in New Jersey in the US, which had its network hacked in 2020, with the hackers demanding a ransom. As a result, the network of the college was down for two months, causing serious financial loss. There are other cases where libraries, colleges, and universities have been targeted for data breaches. In order to build an effective defense, we need to understand the most common types of cybercrimes, including phishing, whaling, social engineering, distributed denial of service (DDoS) attacks, malware and ransomware, and hacker profiles. Our research will focus on each hacking technique and related defense measures; and the social background and reasons/purpose of hacker and hacking. Our research shows that hacking techniques will continue to evolve as new applications, housing information, and data on the Internet continue to be developed. Some cybercrimes can be stopped with effective measures, while others present challenges. It is vital that people understand what they face and the consequences when not prepared.

Keywords: cybercrimes, hacking technologies, higher education, information security, libraries

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178 Peer Group Approach: An Oral Health Intervention from Children for Children at Primary School in Klungkung, Bali, Indonesia

Authors: Regina Tedjasulaksana, Maria Martina Nahak, A. A. Gede Agung, Ni Made Widhiasti

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Strategic effort to realize the empowerment of community in school is through the peer group approach so that it needs to choose the students who are trained as the’ little dentist’ in order to have the cognitive and skills to participate in the school dental health effort (UKGS) program, such as providing oral health education to the other students. Aim: To assessed the effectiveness of peer group approach to enhance the oral health knowledge level of schoolchildren at primary school in Klungkung, Bali. Methods: Experimental study using the pre-post test without control group design. The differences of knowledge levels, tooth brushing behavior and oral hygiene status (using PHP-M index) of 10 students before and after trained as the little dentists were analyzed using paired t-test. The correlations between knowledge level and tooth brushing behavior and correlations between tooth brushing behavior and oral hygiene before and after trained as the little dentists were analyzed using Spearman. Furthermore, the trained little dentists provide oral health education to 102 students of grade 1 to 5 at their school once a week for 3 months. The students’ knowledge level scores of each grade were taken every 21 days as many as three times The difference of it was analyzed using Repeated Measured. Result: The mean scores among all little dentists before and after training for each of knowledge level were each 63.05 + 5.62 and 85.00 + 7.81, tooth brushing behavior were each 31.00 + 14.49 and 100.00 + 0.00 and oral hygiene status using PHP-M index were each 32.80 + 10.17 and 11.40 + 8.01. The knowledge level, tooth brushing behavior and oral hygiene status of 10 students before and after trained as the little dentists were different significantly (p<0.05). Before and after trained as the little dentists it showed that significant correlations between knowledge level with tooth brushing behavior (p<0.05) and significant correlations between tooth brushing behavior and oral hygiene (p<0.05). The mean scores of knowledge level among all students before (pre-test) and after (post-test (1),(2),(3)) getting oral health education from little dentists for each, of grade 1 were 40.00 + 17.97; 67.85 + 18.88; 81.72 +26.48 and 70.00 + 22.87, grade 2 were 40.00 + 17.97; 67.85 + 18.88; 81.72 + 26.48 and 70.00 + 22.87, grade 3 were 65.83 + 23.94; 72.50 + 26.08; 80.41 + 24.93 and 83.75 + 19.74, grade 4 were 88.57 + 12.92; 90.71 + 9.97; 92.85 + 10.69 and 93.57 + 6.33 and grade 5 were 86.66 + 13.40; 93.33 + 9.16; 94.16 + 10.17 and 98.33 + 4.81. The students’ knowledge level of grade 1,2 and 3 before and after getting oral health education from little dentists showed significant different (p<0.05), meanwhile there was no significant different on grade 4 and 5 (p<0.05) although mean scores showed an increase. Conclusion: Peer group approach can be used to enhance the oral health knowledge level of schoolchildren at primary school in Klungkung, Bali.

Keywords: small dentists, oral health, peer group approach, school children

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177 Exploring the Correlation between Human Security, Human Rights and Justice in Addressing and Remedying Contemporary Challenges in Africa

Authors: Sikhumbuzo Zondi, Serges A. Kamga

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Human security and human rights are mutually reinforcing concepts given that human security addresses questions related to human conditions such as the safety of individuals and the protection of individual rights and civil liberties. It does this by suggesting that the proper referent for security should be the individual and not the nation-state, due to the individual’s vulnerability to threats such as malnutrition and poverty, conflicts, exploitation and marginalization, despotism and climate change. Due to the primacy of the individual, human security comfortably expand to the notion of social justice, given that for far too-long, many individuals around the world have been denied of their basic human rights through racial discrimination, unfair labour and segregation policies and as a result encountered widespread social, environmental and economic injustices which are evident in the current structural division of the world between the developed north and the underdeveloped or developing south. In light of this view, ensuring freedom from want and freedom from fear, for all individuals is arguably the sound route to addressing and remedying the global ills of our time and a way to promoting human rights for all. The promotion of human security provides an important part of human/societal progress because inclusive security facilitates development and human rights protection, while insecurity reduces people’s growth and investment prospects and prolongs historical injustices. Therefore, this paper seeks to show that human security and human rights complements one another and that this correlation provides the necessary mechanisms for addressing and remedying the historical injustices that still affect most of the world’s population. It will look at linkages between human security and the individual right to equality and freedom from discrimination, right to life, liberty, and personal security; development; own property; adequate living standard; education; desirable work and to join trade unions; participate in government and in free elections; social security and equality before the law. The paper considers these human rights and liberties as vital for securing the core values of human life while at the same addressing socio-economic injustices that still persist in the contemporary world. The paper will be a desktop study using qualitative research methods on two case studies in Africa namely Cameroun and South Africa.

Keywords: justice, human security, human rights, injustices

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176 Therapeutic Power of Words through Reading Writing and Storytelling

Authors: Sakshi Kaul, Sundeep Verma

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The focus of the current paper is to evaluate the therapeutic power of words. This will be done by critically evaluating the impact reading, writing and storytelling have on individuals. When we read, tell or listen to a story we are exercising our imagination. Imagination becomes the source of activation of thoughts and actions. This enables and helps the reader, writer or the listener to express the suppressed emotions or desires. The stories told, untold may bring various human emotions and attributes to forth such as hope, optimism, fear, happiness. Each story narrated evokes different emotions, at times they help us unravel ourselves in the world of the teller thereby bringing solace. Stories heard or told add to individual’s life by creating a community around, giving wings of thoughts that enable individual to be more imaginative and creative thereby fostering positively and happiness. Reading if looked at from the reader’s point of view can broaden the horizon of information and ideas about facts and life laws giving more meaning to life. From ‘once upon a time’ to ‘to happily ever after’, all that stories talk about is life’s learning. The power of words sometimes may be negated, this paper would reiterate the power of words by critically evaluating how words can become powerful and therapeutic in various structures and forms in the society. There is a story behind every situation, action and reaction. Hence it is of prime importance to understand each story, to enable a person to deal with whatever he or she may be going through. For example, if a client is going through some trauma in his or her life, the counsellor needs to know exactly what is the turmoil that is being faced so that the client can be assisted accordingly. Counselling is considered a process of healing through words or as Talk therapy, where merely through words we try to heal the client. In a counselling session, the counsellor focuses on working with the clients to bring a positive change. The counsellor allows the client to express themselves which is referred to as catharsis. The words spoken, written or heard transcend to heal and can be therapeutic. The therapeutic power of words has been seen in various cultural practices and belief systems. The underlining belief that words have the power to heal, save and bring change has existed from ages. Many religious and spiritual practices also acclaim the power of the words. Through this empirical paper, we have tried to bring to light how reading, writing, and storytelling have been used as mediums of healing and have been therapeutic in nature.

Keywords: reading, storytelling, therapeutic, words

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175 The Effectiveness of Psychosocial Intervention in Reducing Career Anxiety among Nigerian University Students

Authors: Mkpoikanke Sunday Otu

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Introduction: Career anxiety is a common issue among university students, particularly in developing countries like Nigeria. This anxiety can significantly impact students' academic performance, overall well-being, and future career prospects. Therefore, it is crucial to explore effective interventions that can alleviate career anxiety among university students. The primary aim of this study was to determine the effectiveness of a psychosocial intervention in reducing career anxiety among Nigerian university students. The study employed a group randomized trial research design to further analyze the impact on career anxiety. Methodology: A total of 306 university students from various universities in Akwa Ibom State, Nigeria, were recruited for this study. The participants were purposively selected to ensure diversity and represent a range of academic disciplines. A group randomized trial research design was employed, with participants randomly assigned to either the treatment group or the control group. The treatment group received a comprehensive psychosocial intervention, while the control group served as a comparison group. The Career Anxiety Questionnaire (CAQ) was used to assess career anxiety levels among the participants. The CAQ is a validated and reliable tool that assesses various aspects of career-related anxiety, including uncertainty, fear, and self-doubt. It was administered to the participants at baseline (before the intervention), immediately after the intervention, and at follow-up (after the intervention). Results: Data analysis was conducted using statistical techniques, including analysis of variance (ANOVA). The results demonstrated that the treatment group showed a significantly lower mean score of career anxiety compared to the control group (p-value<0.05). This finding suggests that the psychosocial intervention was effective in reducing the career anxiety levels of the participants at post-test and follow-up. Conclusion: The findings of this study provide compelling evidence that psychosocial interventions have a significant impact on the reduction of career anxiety among Nigerian university students. The treatment group demonstrated a significant reduction in career anxiety scores, indicating the effectiveness of this intervention. Additionally, this study highlights the importance of addressing the career anxiety challenges faced by university students. By implementing targeted interventions, educational institutions can play a vital role in supporting the overall well-being and success of their students, both academically and professionally.

Keywords: psychosocial intervention, career anxiety, psychoeducation, university students

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174 Assessment of Factors Influencing Adoption of Agroforestry Technologies in Halaba Special Woreda, Southern Ethiopia

Authors: Mihretu Erjabo

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Halaba special district is characterized by drought, soil erosion, high population pressure, poor livestock production, lack of feed for livestock, very deep water table, very low productivity of crops and food insufficiency. In order to address these problems, the woreda agricultural development office along with other management practices such as soil physical conservation measures agroforestry was introduced decades ago as a means to alleviate the problem. However, the level of agroforestry adoption remains low. Objective of this study was to identify the factors that influence adoption of agroforestry technologies by farmers in the district. Random sampling was employed to select two kebele administrations and respondents. Data collection was conducted by rural household questionnaire survey, participatory rural appraisal, questionnaires for local and woreda extension staff, secondary data resources and field observation. A sample of 12 key informants, 6 extension staffs, and 182 households, were used in the data collection. Chi square test used to determine significant relationships between adoption of agroforestry and 15 selected variables. Out of which eleven were found to be significant to affect farmers’ adoptiveness. These were frequency of visits of farmers (13.39%), participation in training (11.49%), farmers’ attitude towards agroforestry practices (10.61%), frequency of visits of extensionists (10.38%), participation in extension meeting (10.34%), participation in field day (10.28%), land holding size (9.29%), level of literacy (8.78%), awareness about the importance of agroforestry technology packages (7.06%), time taken from their residence to nearest extension (5.04%) and gender of respondents (3.34%). This study also identified various factors that result in low adoption rates of agroforestry including fear of competition, seedling, rainfall and labour shortage, free grazing, financial problem, expecting trees as soil degrader and long span of trees and lack of need ranking. To improve farmers’ adoption, the factors identified should be well addressed by launching a series and recurrent outreach extension program appropriate and suitable to farmers need.

Keywords: farmers attitude, farmers participation, soil degradation, technology packages

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173 Re-Victimization of Sex Trafficking Victims in Canada: Literature Review

Authors: Adrianna D. Hendricks

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This paper examines the factors that contribute to the re-traumatization of victims of sex trafficking within the Canadian context. Sex trafficking occurring domestically in Canada is severely under-researched, stigmatized, and under-prosecuted, leading to the re-traumatization of victims by various levels of government. This is in part due to the Canadian criminal justice system unethically utilizing prostitution laws in cases of sex trafficking and partially due to the unaddressed stigmatization victims face within the justice system itself. Utilizing evidence from a current literature review, personal correspondence, and personal life experiences, this paper will demonstrate the need for victim involvement in policy reform. The current literature review was done through an academic database search using the terms: “Sex Trafficking, Exploitation, Canada”, with the limitation of articles written within the last 5 years and written within the Canadian context. Overall, from the results, only eight articles precisely matched the criteria. The current literature argues strongly and unanimously for more research and education of professionals who have close contact with high-risk populations (doctors, police officers, social workers, etc.) to protect both minors and adults from being sexually trafficked. Additionally, for women and girls who do not have Canadian citizenship, the fear of deportation becomes a barrier to disclosing exploitation experiences to professionals. There is a desperate need for more research done in tandem with survivors and victims to inform policymaking in a meaningful way. The researcher is a survivor of sex trafficking both as a youth and as an adult, giving the researcher a unique insight into the realities of the criminal justice system for victims of sex trafficking. There is a clear need for professionals in positions of power to be re-educated about the realities of sex-trafficking, and what it means for the victims. Congruent to the current research the author calls for: standardized professional training for people in healthcare, police officers, court officials, and victim services; with the additional layers of victim involvement in creation of professional education training, and victim involvement in research. Justice for victims/survivors can only be obtained if they have been consulted and believed. Without meaningful consultation with survivors, victims who are both minors and adults will continue to fall through the cracks in policy.

Keywords: Canadian policy, re-traumatization, sex-trafficking, stigmatization

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172 WILCKO-PERIO, Periodontally Accelerated Orthodontics

Authors: Kruttika Bhuse

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Aim: Synergism between periodontists and orthodontists (periodontal accelerated osteogenic orthodontics- PAOO) creates crucial opportunities to enhance clinical outcomes of combined therapies regarding both disciplines and has made adult orthodontics a reality. Thus, understanding the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. Wilckodontics can be an attractive treatment option and be a “win-win” situation for both the dental surgeon and patient by reducing the orthodontic treatment time in adults. Materials and methods: In this review, data related to the clinical aspects, steps of procedure, biomechanics of bone, indications and contraindications and final outcome of wilckodontic shall be discussed. 50 supporting articles from various international journals and 70 clinical cases were reviewed to get a better understanding to design this wilckodontic - meta analysis. Various journals like the Journal Of Clinical And Diagnostic Research, Journal Of Indian Society Of Periodontology, Journal Of Periodontology, Pubmed, Boston Orthodontic University Journal, Good Practice Orthodontics Volume 2, have been referred to attain valuable information on wilckodontics which was then compiled in this single review study. Result: As a promising adjuvant technique based on the transient nature of demineralization-remineralisation process in healthy tissues, wilckodontics consists of regional acceleratory phenomenon by alveolar corticotomy and bone grafting of labial and palatal/lingual surfaces, followed by orthodontic force. The surgical wounding of alveolar bone potentiates tissue reorganization and healing by a way of transient burst of localized hard and soft tissue remodelling.This phenomenon causes bone healing to occur 10-50 times faster than normal bone turnover. Conclusion: This meta analysis helps understanding that the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. The main benefits being reduced orthodontic treatment time, increased bone volume and post-orthodontic stability.

Keywords: periodontal osteogenic accelerated orthodontics, alveolar corticotomy, bone augmentation, win-win situation

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171 Youth Conflict-Related Trauma through Generations: An Ethnography on the Relationship between Health and Society in Post-Conflict Northern Ireland

Authors: Chiara Magliacane

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This project aims to analyse the relationship between the post-conflict Northern Irish environment and youth trauma in deprived areas. Using an anthropological perspective and methodology, the study investigates the possible contribution that a socio-cultural perspective can give to the current research on the field, with a special focus on the role of transgenerational trauma. The recognition of the role that socio-economic determinants have on health is usually a challenge for social researchers. In post-conflict Northern Ireland, the overall lack of research about connections between the social context and youth trauma opens the way to the present project. Anthropological studies on social implications of mental disorders have achieved impressive results in many societies; they show how conditions of sufferance and poverty are not intrinsically given, but are the products of historical processes and events. The continuum of violence and the politics of victimhood sustains a culture of silence and fear in deprived areas; this implies the need of investigating the structural and symbolic violence that lies behind the diffusion of mental suffering. The project refers to these concepts from Medical Anthropology and looks at connections between trauma and social, political and economic structures. Accordingly, the study considers factors such as poverty, unemployment, social inequality and gender and class perspectives. At the same time, the project problematises categories such as youth and trauma. 'Trauma' is currently debated within the social sciences since the 'invention' of the Post-Traumatic Stress Disorder (PTSD) in 1980. Current critics made to its clinical conception show how trauma has been mainly analysed as a memory of the past. On the contrary, medical anthropological research focuses on wider perspectives on society and its structures; this is a new and original approach to the study of youth trauma considering that, to author’s best knowledge, there is no research of this kind regarding Northern Ireland. Methods: Qualitative interviews, participant observation. Expected Impact: Local Northern Ireland organizations, i.e. specific charities that provide mental health support. Ongoing and present connections will ensure they will hear about this research.

Keywords: health and social inequalities, Northern Ireland, structural violence, youth

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170 Balance Control Mechanisms in Individuals With Multiple Sclerosis in Virtual Reality Environment

Authors: Badriah Alayidi, Emad Alyahya

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Background: Most people with Multiple Sclerosis (MS) report worsening balance as the condition progresses. Poor balance control is also well known to be a significant risk factor for both falling and fear of falling. The increased risk of falls with disease progression thus makes balance control an essential target of gait rehabilitation amongst people with MS. Intervention programs have developed various methods to improve balance control, and accumulating evidence suggests that exercise programs may help people with MS improve their balance. Among these methods, virtual reality (VR) is growing in popularity as a balance-training technique owing to its potential benefits, including better compliance and greater user happiness. However, it is not clear if a VR environment will induce different balance control mechanisms in MS as compared to healthy individuals or traditional environments. Therefore, this study aims to examine how individuals with MS control their balance in a VR setting. Methodology: The proposed study takes an empirical approach to estimate and determine the role of balance response in persons with MS using a VR environment. It will use primary data collected through patient observations, physiological and biomechanical evaluation of balance, and data analysis. Results: The preliminary systematic review and meta-analysis indicated that there was variability in terms of the outcome assessing balance response in people with MS. The preliminary results of these assessments have the potential to provide essential indicators of the progression of MS and contribute to the individualization of treatment and evaluation of the interventions’ effectiveness. The literature describes patients who have had the opportunity to experiment in VR settings and then used what they have learned in the real world, suggesting that this VR setting could be more appealing than conditional settings. The findings of the proposed study will be beneficial in estimating and determining the effect of VR on balance control in persons with MS. In previous studies, VR was shown to be an interesting approach to neurological rehabilitation, but more data are needed to support this approach in MS. Conclusions: The proposed study enables an assessment of balance and evaluations of a variety of physiological implications related to neural activity as well as biomechanical implications related to movement analysis.

Keywords: multiple sclerosis, virtual reality, postural control, balance

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169 Sustainable Development in Orthodontics: Orthodontic Archwire Waste

Authors: Saarah Juman, Ilona Johnson, Stephen Richmond, Brett Duane, Sheelagh Rogers

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Introduction: Researchers suggest that within 50 years or less, the available supply of a range of metals will be exhausted, potentially leading to increases in resource conflict and largescale production shortages. The healthcare, dental and orthodontic sectors will undoubtedly be affected as stainless steel instruments are generally heavily relied on. Although changing orthodontic archwires are unavoidable and necessary to allow orthodontic tooth movement through the progression of an archwire sequence with fixed appliances, they are thought to be manufactured in excess of what is needed. Furthermore, orthodontic archwires require trimming extraorally to allow safe intraoral insertion, thus contributing to unnecessary waste of natural resources. Currently, there is no evidence to support the optimisation of archwire length according to orthodontic fixed appliance stage. As such, this study aims to quantify archwire excess (extraoral archwire trimmings) for different stages of orthodontic fixed appliance treatment. Methodology: This prospective, observational, quantitative study observed trimmings made extraorally against pre-treatment study models by clinicians over a 3-month period. Archwires were categorised into one of three categories (initial aligning, sequence, working/finishing arcwhires) within the orthodontic fixed appliance archwire sequence. Data collection included archwire material composition and the corresponding length and weight of excess archwire. Data was entered using a Microsoft Excel spreadsheet and imported into statistical software to obtain simple descriptive statistics. Results: Measurements were obtained for a total of 144 archwires. Archwire materials included nickel titanium and stainless steel. All archwires observed required extraorally trimming to allow safe intraoral insertion. The manufactured lengths of orthodontic initial aligning, sequence, and working/finishing arcwhires were at least 31%, 26%, and 39% in excess, respectively. Conclusions: Orthodontic archwires are manufactured to be excessively long at all orthodontic archwire sequence stages. To conserve natural resources, this study’s findings support the optimisation of orthodontic archwire lengths by manufacturers according to the typical stages of an orthodontic archwire sequence.

Keywords: archwire, orthodontics, sustainability, waste

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168 Waste Management Option for Bioplastics Alongside Conventional Plastics

Authors: Dan Akesson, Gauthaman Kuzhanthaivelu, Martin Bohlen, Sunil K. Ramamoorthy

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Bioplastics can be defined as polymers derived partly or completely from biomass. Bioplastics can be biodegradable such as polylactic acid (PLA) and polyhydroxyalkonoates (PHA); or non-biodegradable (biobased polyethylene (bio-PE), polypropylene (bio-PP), polyethylene terephthalate (bio-PET)). The usage of such bioplastics is expected to increase in the future due to new found interest in sustainable materials. At the same time, these plastics become a new type of waste in the recycling stream. Most countries do not have separate bioplastics collection for it to be recycled or composted. After a brief introduction of bioplastics such as PLA in the UK, these plastics are once again replaced by conventional plastics by many establishments due to lack of commercial composting. Recycling companies fear the contamination of conventional plastic in the recycling stream and they said they would have to invest in expensive new equipment to separate bioplastics and recycle it separately. This project studies what happens when bioplastics contaminate conventional plastics. Three commonly used conventional plastics were selected for this study: polyethylene (PE), polypropylene (PP) and polyethylene terephthalate (PET). In order to simulate contamination, two biopolymers, either polyhydroxyalkanoate (PHA) or thermoplastic starch (TPS) were blended with the conventional polymers. The amount of bioplastics in conventional plastics was either 1% or 5%. The blended plastics were processed again to see the effect of degradation. The results from contamination showed that the tensile strength and the modulus of PE was almost unaffected whereas the elongation is clearly reduced indicating the increase in brittleness of the plastic. Generally, it can be said that PP is slightly more sensitive to the contamination than PE. This can be explained by the fact that the melting point of PP is higher than for PE and as a consequence, the biopolymer will degrade more quickly. However, the reduction of the tensile properties for PP is relatively modest. Impact strength is generally a more sensitive test method towards contamination. Again, PE is relatively unaffected by the contamination but for PP there is a relatively large reduction of the impact properties already at 1% contamination. PET is polyester, and it is, by its very nature, more sensitive to degradation than PE and PP. PET also has a much higher melting point than PE and PP, and as a consequence, the biopolymer will quickly degrade at the processing temperature of PET. As for the tensile strength, PET can tolerate 1% contamination without any reduction of the tensile strength. However, when the impact strength is examined, it is clear that already at 1% contamination, there is a strong reduction of the properties. The thermal properties show the change in the crystallinity. The blends were also characterized by SEM. Biphasic morphology can be seen as the two polymers are not truly blendable which also contributes to reduced mechanical properties. The study shows that PE is relatively robust against contamination, while polypropylene (PP) is sensitive and polyethylene terephthalate (PET) can be quite sensitive towards contamination.

Keywords: bioplastics, contamination, recycling, waste management

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167 Public Opinion Polls as an Instrument of Propaganda of the Invasion of Ukraine

Authors: Daria Lozovskaia

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This paper is focused on the news coverage of public opinion polls about Russian full-scale invasion of Ukraine in Russian state-controlled media. After the announcement of the start of the so-called “Special Military Operation” on February 24, 2022, the number of publications of the results of public opinion polls increased many times over, and the poll numbers began to be discussed on social media and in the Kremlin’s official informational agenda. Headlines like "72 Percent of Russian Citizens Support the Operation " or "Russians Believe in Victory in the Special Military Operation" have become prominent parts of Russian state propaganda news stories and newspapers. At the same time, public opinion in Russia, as a concept and model, differs from the generally accepted democratic concept and has its own specifics. As a result, public opinion polls and their results, especially after February 24, have a number of features in the form of the dominance of the discourse of political elites in the media, which leads to a decrease in public awareness, the prevalence of the effect of joining the majority and a high number of non-responses due to fear of reprisals. The aim of this study was to determine the role of public opinion polls in the system of Russian war propaganda in Ukraine. For this purpose, were selected publications of the Russian media, the agenda of which corresponds to the official information policy of the Russian authorities. First, using frame analysis for the categories "Explicit trust", "Implicit trust", "Implicit distrust" and "Explicit distrust", provided by Irina Dusakova, the broadcast level of trust in the data of public opinion polls was determined. The results of this phase of the study showed that the Russian media broadcast an absolute level of confidence in public opinion polls regarding support for the war in Ukraine. The second stage of the study was the content analysis of publications. The categories of this analysis were derived from Anna Morelli's 10 Principles of Military Propaganda and Haavard Koppang's Definition of Propaganda to determine the purposes of the use of public opinion polls by Russian propaganda. The results of the study not only confirmed the widespread hypothesis that public opinion polls in Russia are used as a tool of state propaganda, but also showed that their purpose is to demonstrate the consolidation of society in support of the war and President Vladimir Putin.

Keywords: propaganda, public opinion, public opinion polls, Russian studies

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166 Walls against Legal Identity: A Qualitative Study on Children of Refugees without Birth Registration in Malaysia

Authors: Rodziana M. Razali, Tamara J. Duraisingham

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Malaysia is not a signatory to the 1951 Refugee Convention and its 1967 Protocol despite receiving the largest share of refugee inflows in Southeast Asia aside from Thailand. In Peninsular Malaysia, the majority of refugees and asylum seekers are from Myanmar, with Rohingya refugees recording the highest number compared to all other ethnicities. In the eastern state of Sabah, the presence of refugees who have long established themselves in the state is connected to those who escaped military persecution in southern Philippines in the 1970’s and 1980’s. A combination of legal and non-legal factors has created and sustained an adverse atmosphere of deprivation of legal identity for children of migrants including refugees born in Malaysia. This paper aims to qualitatively analyse the barriers to birth registration as the cornerstone of every person’s legal identity for children of refugees born in this country, together with the associated human rights implications. Data obtained through semi-structured interviews with refugees in Kota Kinabalu, Sabah and Rohingya refugees in Peninsular Malaysia shall be studied alongside secondary sources. Results show that births out of medical facilities, suspension of birth records, illiteracy, lack of awareness on the importance and procedures of birth registration, inability to meet documentary requirements, as well as fear of immigration enforcement, are the key factors hindering birth registration. These challenges exist against the backdrop of restrictive integration policy to avoid destabilising demographic and racial balance, political sentiment stirring xenophobic prejudices, as well as other economic and national security considerations. With no proof of their legal identity, the affected children grow up in a legal limbo, facing multiple human rights violations across generations. This research concludes that the country’s framework and practice concerning birth registration is in need of serious reform and improvement to reflect equality and universality of access to its birth registration system. Such would contribute significantly towards meeting its commitments to the post-2015 sustainable development agenda that pledges to 'Leave no one behind', as well as its recently announced National Human Rights Action Plan.

Keywords: birth registration, children, Malaysia, refugees

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165 Politics in Academia: How the Diffusion of Innovation Relates to Professional Capital

Authors: Autumn Rooms Cypres, Barbara Driver

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The purpose of this study is to extend discussions about innovations and career politics. Research questions that grounded this effort were: How does an academic learn the unspoken rules of the academy? What happens politically to an academic’s career when their research speaks against the grain of society? Do professors perceive signals that it is time to move on to another institution or even to another career? Epistemology and Methods: This qualitative investigation was focused on examining perceptions of academics. Therefore an open-ended field study, based on Grounded Theory, was used. This naturalistic paradigm (Lincoln & Guba,1985) was selected because it tends to understand information in terms of whole, of patterns, and in relations to the context of the environment. The technique for gathering data was the process of semi-structured, in-depth interviewing. Twenty five academics across the United States were interviewed relative to their career trajectories and the politics and opportunities they have encountered in relation to their research efforts. Findings: The analysis of interviews revealed four themes: Academics are beholden to 2 specific networks of power that influence their sense of job security; the local network based on their employing university and the national network of scholars who share the same field of research. The fights over what counts as research can and does drift from the intellectual to the political, and personal. Academic were able to identify specific instances of shunning and or punishment from their colleagues related directly to the dissemination of research that spoke against the grain of the local or national networks. Academics identified specific signals from both of these networks indicating that their career was flourishing or withering. Implications: This research examined insights from those who persevered when the fights over what and who counts drifted from the intellectual to the political, and the personal. Considerations of why such drifts happen were offered in the form of a socio-political construct called Fit, which included thoughts on hegemony, discourse, and identity. This effort reveals the importance of understanding what professional capital is relative to job security. It also reveals that fear is an enmeshed and often unspoken part of the culture of Academia. Further research to triangulate these findings would be helpful within international contexts.

Keywords: politics, academia, job security, context

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164 Development of the Squamate Egg Tooth on the Basis of Grass Snake Natrix natrix Studies

Authors: Mateusz Hermyt, Pawel Kaczmarek, Weronika Rupik

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The egg tooth is a crucial structure during hatching of lizards and snakes. In contrast to birds, turtles, crocodiles, and monotremes, egg tooth of squamate reptiles is a true tooth sharing common features of structure and development with all the other teeth of vertebrates. The egg tooth; however, due to its function, exhibits structural differences in relation to regular teeth. External morphology seems to be important in the context of phylogenetic relationships within Squamata but up to date, there is scarce information concerning structure and development of the egg tooth at the submicroscopical level. In presented studies detailed analysis of the egg tooth development in grass snake has been performed with the usage of light (including fluorescent), transmission and scanning electron microscopy. Grass snake embryo’s heads have been used in our studies. Grass snake is common snake species occurring in most of Europe including Poland. The grass snake is characterized by the presence of single unpaired egg tooth (as in most squamates) in contrast to geckos and dibamids possessing paired egg teeth. Studies show changes occurring on the external morphology, tissue and cellular levels of differentiating egg tooth. The egg tooth during its development changes its curvature. Initially, faces directly downward and in the course of its differentiation, it gradually changes to rostro-ventral orientation. Additionally, it forms conical dentinal protrusions on the sides. Histological analysis showed that egg tooth development occurs in similar steps in relation to regular teeth. It undergoes initiation, bud, cap and bell morphological stages. Analyses focused on describing morphological changes in hard tissues (mainly dentin and predentin) of egg tooth and in cells which enamel organ consists of. It included: outer enamel epithelium, stratum intermedium, inner enamel epithelium, odontoblasts, and cells of dental pulp. All specimens used in the study were captured according to the Polish regulations concerning the protection of wild species. Permission was granted by the Local Ethics Commission in Katowice (41/2010; 87/2015) and the Regional Directorate for Environmental Protection in Katowice (WPN.6401.257.2015.DC).

Keywords: hatching, organogenesis, reptile, Squamata

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163 Turkish College Students’ Attitudes toward Homophobia; Relations with, Right-Wing Authoritarianism, Social Dominance Orientation and Just World Beliefs

Authors: Melek Göregenli, Işık Gürşimşek

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There has been a great deal of research in the past few decades examining attitudes toward homosexuals.Theoretic research has demonstrated that antihomosexual attitudes are expressed in cognitive, affective, behavioral and cultural components. Homophobia is generally defined as hostility towards or fear of LGBTI people, but can also refer to social and cultural ideologies which stigmatize homosexuality. Negative feelings or attitudes towards non-heterosexual behavior, identity, relationships and community can lead to homophobic behavior and is the root of the discrimination experienced by many lesbian, gay, bisexual and transgender (LGBTI) people. Since the increase in number of hate crimes during the last decade, there has been a sense of urgency to respond to the problem of hate violence in Turkey. The LGBTI Rights Association KAOS-GL indicated that the most of lesbian, gay, bisexual, travesty and transsexuals reported some form of victimization in their lifetimes based on their sexual orientation in Turkey. This study explored the relations between homophobia, right-wing authoritarianism, social dominance orientation and just world belief attitudes towards LGBTI individuals in a sample of 393 Turkish college students from Ege University in Izmir, Turkey. Data were collected with a questionnaire including the Homosexism Scale, the Right-Wing Authoritarianism Scale, Social Dominance Orientation Scale and Just World Belief Scale. Participants completed a questionnaire containing the attitude measures and other several questions related with the socio-demographic variables. Consistent with the previous finding males were more homophobic than females. Contrary to this finding the main effects of other demographic variables (age, income, place of birth, class) were not statistically significant except the department of participants. These findings imply that efforts to garner wide-ranging support for policies designed to change negative attitudes to LGBT people and to enhance the given awareness on homophobia. The results of the study were discussed in cross-cultural and social psychological perspective considering cultural and social values of Turkey and current political circumstances of the country.

Keywords: homophobia, just world belief, right-wing authoritarianism, social dominance orientation, Turkey

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162 Silent Culminations in Operas Aida and Mazeppa

Authors: Stacy Jarvis

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A silent culmination is a musical technique that creates or increases tension in a piece of music. It is a type of cadence in which the music gradually builds to a climax but suddenly stops without any resolution. This technique can create suspense and anticipation in the listener as they wait to find out what will happen next. It can also draw attention to a particular element of the music, such as a particular instrument or vocal line. Silent culminations can evoke a sense of mystery or ambiguity by not resolving the tension created. This technique has been used by composers of all musical genres, from classical to jazz, as well as in film scores. Silent culminations can also make a piece of music more dynamic and exciting. Verdi’s Aida is a classic example of the use of silent culminations to create tension and suspense. Throughout the opera, Verdi uses a technique of gradually building to a climax, only to abruptly stop without any resolution. This technique brings out the story's drama and intensity and creates anticipation for the climactic moments. For example, at the end of the second act, Verdi reaches a crescendo of tension as Aida and Radamès swear their undying love for one another, only to stop with a moment of silence. This technique also helps to draw attention to the important moments in the story, such as the duets between Aida and Radamès. By stopping the music just before it resolves, Verdi can create an atmosphere of anticipation and suspense that carries through to the opera's end. Silent culminations are used greatly in Aida and are integral to Verdi’s dramatic style. In his symphonic poem Mazeppa, Tchaikovsky uses silent culminations to emphasize the piece's drama and powerful emotions. The piece begins with a gentle introduction but quickly builds to a powerful climax. Throughout the piece, Tchaikovsky uses silent culminations to create tension and suspense, drawing the listener in and heightening the intensity of the music 2. The most dramatic moment of the piece comes when the music builds to a frantic climax and then suddenly cuts out, leaving the listener hanging in anticipation of what will happen next. This technique creates an intense atmosphere and leaves the listener eager to hear what comes next. In addition, the use of silent culminations helps to emphasize the strong emotions of the piece, such as fear, horror, and despair. By not resolving the tension with a resolution, the listener is left with a feeling of uneasiness and uncertainty that helps to convey the story of Mazeppa’s tragic fate.

Keywords: Verdi, Tchaikovsky, opera, culmination

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161 Application of Artificial Intelligence in Market and Sales Network Management: Opportunities, Benefits, and Challenges

Authors: Mohamad Mahdi Namdari

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In today's rapidly changing and evolving business competition, companies and organizations require advanced and efficient tools to manage their markets and sales networks. Big data analysis, quick response in competitive markets, process and operations optimization, and forecasting customer behavior are among the concerns of executive managers. Artificial intelligence, as one of the emerging technologies, has provided extensive capabilities in this regard. The use of artificial intelligence in market and sales network management can lead to improved efficiency, increased decision-making accuracy, and enhanced customer satisfaction. Specifically, AI algorithms can analyze vast amounts of data, identify complex patterns, and offer strategic suggestions to improve sales performance. However, many companies are still distant from effectively leveraging this technology, and those that do face challenges in fully exploiting AI's potential in market and sales network management. It appears that the general public's and even the managerial and academic communities' lack of knowledge of this technology has caused the managerial structure to lag behind the progress and development of artificial intelligence. Additionally, high costs, fear of change and employee resistance, lack of quality data production processes, the need for updating structures and processes, implementation issues, the need for specialized skills and technical equipment, and ethical and privacy concerns are among the factors preventing widespread use of this technology in organizations. Clarifying and explaining this technology, especially to the academic, managerial, and elite communities, can pave the way for a transformative beginning. The aim of this research is to elucidate the capacities of artificial intelligence in market and sales network management, identify its opportunities and benefits, and examine the existing challenges and obstacles. This research aims to leverage AI capabilities to provide a framework for enhancing market and sales network performance for managers. The results of this research can help managers and decision-makers adopt more effective strategies for business growth and development by better understanding the capabilities and limitations of artificial intelligence.

Keywords: artificial intelligence, market management, sales network, big data analysis, decision-making, digital marketing

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160 Utilizing Literature Review and Shared Decision-Making to Support a Patient Make the Decision: A Case Study of Virtual Reality for Postoperative Pain

Authors: Pei-Ru Yang, Yu-Chen Lin, Jia-Min Wu

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Background: A 58-year-old man with a history of osteoporosis and diabetes presented with chronic pain in his left knee due to severe knee joint degeneration. The knee replacement surgery was recommended by the doctor. But the patient suffered from low pain tolerance and wondered if virtual reality could relieve acute postoperative wound pain. Methods: We used the PICO (patient, intervention, comparison, and outcome) approach to generate indexed keywords and searched systematic review articles from 2017 to 2021 on the Cochran Library, PubMed, and Clinical Key databases. Results: The initial literature results included 38 articles, including 12 Cochrane library articles and 26 PubMed articles. One article was selected for further analysis after removing duplicates and off-topic articles. The eight trials included in this article were published between 2013 and 2019 and recruited a total of 723 participants. The studies, conducted in India, Lebanon, Iran, South Korea, Spain, and China, included adults who underwent hemorrhoidectomy, dental surgery, craniotomy or spine surgery, episiotomy repair, and knee surgery, with a mean age (24.1 ± 4.1 to 73.3 ± 6.5). Virtual reality is an emerging non-drug postoperative analgesia method. The findings showed that pain control was reduced by a mean of 1.48 points (95% CI: -2.02 to -0.95, p-value < 0.0001) in minor surgery and 0.32 points in major surgery (95% CI: -0.53 to -0.11, p-value < 0.03), and the overall postoperative satisfaction has improved. Discussion: Postoperative pain is a common clinical problem in surgical patients. Research has confirmed that virtual reality can create an immersive interactive environment, communicate with patients, and effectively relieve postoperative pain. However, virtual reality requires the purchase of hardware and software and other related computer equipment, and its high cost is a disadvantage. We selected the best literature based on clinical questions to answer the patient's question and used share decision making (SDM) to help the patient make decisions based on the clinical situation after knee replacement surgery to improve the quality of patient-centered care.

Keywords: knee replacement surgery, postoperative pain, share decision making, virtual reality

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159 Oral Supplementation of Sweet Orange Extract “Citrus Sinensis” as Substitute for Synthetic Vitamin C on Transported Pullets in Humid Tropics

Authors: Mathew O. Ayoola, Foluke Aderemi, Tunde E. Lawal, Opeyemi Oladejo, Micheal A. Abiola

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Food animals reared for meat require transportation during their life cycle. The transportation procedures could initiate stressors capable of disrupting the physiological homeostasis. Such stressors associated with transportation may include; loading and unloading, crowding, environmental temperature, fear, vehicle motion/vibration, feed / water deprivation, and length of travel. This may cause oxidative stress and damage to excess free radicals or reactive oxygen species (ROS). In recent years, the application of natural products as a substitute for synthetic electrolytes and tranquilizers as anti-stress agents during the transportation is yet under investigation. Sweet orange, a predominant fruit in humid tropics, has been reported to have a good content of vitamin C (Ascorbic acid). Vitamin C, which is an active ingredient in orange juice, plays a major role in the biosynthesis of Corticosterone, a hormone that enhances energy supply during transportation and heat stress. Ninety-six, 15weeks, Isa brown pullets were allotted to four (4) oral treatments; sterile water (T1), synthetic vit C (T2), 30ml orange/liter of water (T3), 50ml orange/1 liter (T4). Physiological parameters; body temperature (BTC), rectal temperature (RTC), respiratory rate (RR), and panting rate (PR) were measured pre and post-transportation. The birds were transported with a specialized vehicle for a distance of 50km at a speed of 60 km/hr. The average environmental THI and within the vehicle was 81.8 and 74.6, respectively, and the average wind speed was 11km/hr. Treatments and periods had a significant (p>0.05) effect on all the physiological parameters investigated. Birds on T1 are significantly (p<0.05) different as compared to T2, T3, and T4. Values recorded post-transportation are significantly (p<0.05) higher as compared to pre-transportation for all parameters. In conclusion, this study showed that transportation as a stressor can affect the physiological homeostasis of pullets. Oral supplementation of electrolytes or tranquilizers is essential as an anti-stress during transportation. The application of the organic product in form of sweet orange could serve as a suitable alternative for the synthetic vitamin C.

Keywords: physiological, pullets, sweet orange, transportation stress, and vitamin C

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158 Revolution and Political Opposition in Contemporary Arabic Poetry: A Thematic Study of Two Poems by Muzaffar Al-Nawwab

Authors: Nasser Y. Athamneh

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Muzaffar al-Nawwab (1934--) is a modern Iraqi poet, critic, and painter, well-known to Arab youth of the second half of the 20th century for his revolutionary spirit and political activism. For the greater part of his relatively long life, al-Nawwab was wanted 'dead or alive,' so to speak, by most of the Arab regimes and authorities due to his scathing, and at times unsparingly obscene attacks on them. Hence it is that the Arab masses found in his poetry the rebellious expression of their own anger and frustration, stifled by fear for their physical safety. Thus, al-Nawwab’s contemporary Arab audience loved and embraced him both as an Arab exile and as a poet. They memorized and celebrated his poems and transmitted them secretly by word of mouth and on compact cassette tapes. He himself recited his own poetry and had it recorded on compact cassette tapes for fans to smuggle from one Arab country to the other. The themes of al-Nawwab’s poems are varied, but the most predominant among them is political opposition. In most of his poems, al-Nawwab takes up politics as the major theme. Yet, he often represents it coupled with the leitmotifs of women and wine. Indeed he oscillates almost systematically between political commitment to the revolutionary cause of the masses of his nation and homeland on the one hand and love for women and wine on the other. For the persona in al-Nawwab’s poetry, love-longing for the woman and devotion to the cause of revolution and Pan-Arabism are interrelated; each of them readily evokes the other. In this paper, an attempt is made at investigating the treatment and representation of the theme of revolution and political opposition in some of al-Nawwab’s poems. This investigation will be conducted through close reading and textual analysis of representative sections of the poetic texts under consideration in the paper. The primary texts for the study are selected passages from two representative poems, namely, 'The Night Song of the Bow Strings' (Watariyyaat Layliyyah) and 'In Wine and Sorrow My Heart [Is Immersed]' (bil-khamri wa bil-huzni fu’aady). Other poems and extracts from al-Nawwab’s poetic works will be drawn upon as secondary texts to clarify the arguments in the paper and support its thesis. The discussions and textual analysis of the texts under consideration are meant to show that revolution and undaunted political opposition is a predominant theme in al-Nawwab’s poetry, often represented through the use of the leitmotifs of women and wine.

Keywords: Arabic poetry, Muzaffar al-Nawwab, politics, revolution

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157 Chronic Renal Failure Associated with Heavy Metal Contamination of Drinking Water in Hail, Kingdom of Saudi Arabia

Authors: Elsayed A. M. Shokr, A. Alhazemi, T. Naser, Talal A. Zuhair, Adel A. Zuhair, Ahmed N. Alshamary, Thamer A. Alanazi, Hosam A. Alanazi

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The main threats to human health from heavy metals are associated with exposure to Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. is mainly via intake of drinking water being the most important source in most populations. These metals have been extensively studied and their effects on human health regularly reviewed by international bodies such as the WHO. Heavy metals have been used by humans for thousands of years. Although several adverse health effects of heavy metals have been known for a long time, exposure to heavy metals continues, and is even increasing in some parts of the world, in particular in less developed countries, though emissions have declined in most developed countries over the last 100 years. A strong relationship between contaminated drinking water with heavy metals from some of the stations of water shopping in Hail, KSA and chronic diseases such as renal failure, liver cirrhosis, and chronic anemia has been identified in this study. These diseases are apparently related to contaminant drinking water with heavy metals such as Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. Renal failure is related to contaminate drinking water with lead and cadmium, liver cirrhosis to copper and molybdenum, and chronic anemia to copper and cadmium. Recent data indicate that adverse health effects of cadmium exposure may occur at lower exposure levels than previously anticipated, primarily in the form of kidney damage but possibly also bone effects and fractures. The general population is primarily exposed to mercury via drinking water being a major source of methyl mercury exposure, and dental amalgam. During the last century lead, cadmium, zinc, iron and arsenic is mainly via intake of drinking water being the most important source in most populations. Long-term exposure to lead, cadmium, zinc, iron and arsenic in drinking-water is mainly related to primarily in the form of kidney damage. Studies of these diseases suggest that abnormal incidence in specific areas is related to toxic materials in the groundwater and thereby led to the contamination of drinking water in these areas.

Keywords: heavy metals, liver functions, kidney functions and chronic renal failure, hail, renal, water

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156 Inflammatory Changes Caused by Lipopolysaccharide in Odontoblasts

Authors: Virve Pääkkönen, Heidi M. Cuffaro, Leo Tjäderhane

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Objectives: Odontoblasts are the outermost cell layer of dental pulp and form the dentin. Importance of bacterial products, e.g. lipoteichoic acid (LTA), a cell wall component of Gram-positive bacteria and lipopolysaccharide (LPS), a cell wall component of Gram-negative bacteria, have been indicated in the pathogenesis of pulpitis. Gram-positive bacteria are more prevalent in superficial carious lesion while the amount gram-negative is higher in the deep lesions. Objective of this study was to investigate the effect of these bacterial products on inflammatory response of pulp tissue. Interleukins (IL) were of special interest. Various ILs have been observed in the dentin-pulp complex of carious tooth in vivo. Methods: Tissue culture method was used for testing the effect of LTA and LPS on human odontoblasts. Enzymatic isolation technique was used to extract living odontoblasts for cell cultures. DNA microarray and quantitative PCR (qPCR) were used to characterize the changes in the expression profile of the tissue cultured odontoblasts. Laser microdissection was used to cut healthy and affected dentin and odontoblast layer directly under carious lesion for experiments. Cytokine array detecting 80 inflammatory cytokines was used to analyze the protein content of conditioned culture media as well as dentin and odontoblasts from the carious teeth. Results: LPS caused increased gene expression IL-1α, and -8 and decrease of IL-1β, 12 , -15 and -16 after 1h treatment, while after 24h treatment decrease of IL-8, -11 and 23 mRNAs was observed. LTA treatment caused cell death in the tissue cultured odontoblasts but in in the cell culture but not in cell culture. Cytokine array revealed at least 2-fold down-regulation of IL-1β, -10 and -12 in response to LPS treatment. Cytokine array of odontoblasts of carious teeth, as well as LPS-treated tissue-cultured odontoblasts, revealed increased protein amounts of IL-16, epidermal growth factor (EGF), angiogenin and IGFBP-1 as well as decreased amount of fractalkine. In carious dentin, increased amount of IL-1β, EGF and fractalkine was observed, as well as decreased level of GRO-1 and HGF. Conclusion: LPS caused marked changes in the expression of inflammatory cytokines in odontoblasts. Similar changes were observed in the odontoblasts cut directly under the carious lesion. These results help to shed light on the inflammatory processes happening during caries.

Keywords: inflammation, interleukin, lipoteichoic acid, odontoblasts

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