Search results for: childhood neglect

Authors: Maryam Firouzmandi, Moosa Miri

Abstract:

Common reasons for early tooth loss are trauma, extraction due to caries or periodontal disease and congenital missing. The remaining space after tooth loss may cause functional and esthetic problems. Therefore restorative dentists should attempt to manage these spaces using conservative methods. The goal is to restore the lost esthetic and function, prevent phonetic, self-esteem and personality problems and tongue habits. Preserving alveolar bone is also of great importance during the growth stage. Purpose: When deciding about the management of the missing tooth, space implants are contradicted until the completion of dentoalveolar development. Even in adulthood, due to systemic or periodontal problems or biological and economic issues, the implant might not be indicated. In this article, the alternative conservative restorative methods of space maintenance are going to be discussed. Essix retainers are made chair-side as easy as forming a custom bleaching tray with some modifications. They are esthetically acceptable and not expensive. These temporaries provide support for the lips but could not be used during function. Mini-screw-supported temporaries are another option for maintaining the space, especially after orthodontic treatment when there is a time lag between the termination of orthodontic treatment and definitive restoration. Two techniques will be presented for this kind of restoration: Denture tooth pontic or a composite crown. The benefits are alveolar bone preservation, Physiologic pressure on the alveolar ridge to increase its density and even can be retained until the completion of the definitive treatment. Bonded fixed partial denture includes Maryland bridge, fiber-reinforced composite bridge, resin-bonded bridge, and ceramic bonded bridge. These types of bridges are recommended to be used after a pubertal growth spurt and a recent meta-analysis considered their clinical success similar to conventional FDPs and implant-supported crowns. However, they have several advantages that are going to be discussed by presenting some clinical examples. Practical instruction on how to construct an FRC bridge and a novel chair-side Maryland bridge will be given by means of clinical cases. Clinical relevance: minimally invasive options should always be considered and destruction of healthy enamel and dentin during the preparation phase should be avoided as much as possible.

Keywords: tooth missing, fiber-reinforced composite, Maryland, Essix retainers, screw-retained restoration

Procedia PDF Downloads 198

Authors: N. C. Okoronkwo, I. E. Mbaeyi-Nwaoha, C. P. Agbata

Abstract:

Childhood malnutrition is one of the most persistent public health problems throughout developing countries, including Nigeria. Demographic and Health survey data from twenty-one developing countries indicated that poor complementary feeding of children aged 6- 23 months contributes to negative growth trends. To reduce malnutrition among children in the society, formulation of complimentary food rich in essential nutrient for optimum growth and development of infants is essential. This study focused on the evaluation of complementary food produced by solid-state fermentation of Acha and Soybean using Rhizopus oligosporus (2710) and Orange-fleshed sweet potatoes (OFSP) using Lactobacillus planterum (B-41621). The raw materials were soaked separately, each in four volumes of 0.9M acetic acid for 16 hours, rinsed with clean water, steam cooked and cooled. Solid-state fermentation (SSF) was carried out by inoculating Acha and Soybean with spore suspension (1x 10⁶spores/ml) of Rhizopus oligosporus (2710) and OFSP with spore suspension (1x 106spores/ml) of Lactobacillus planterum (B-41621). Fermentation which lasted for 72hours was carried out with 24hours sampling. The samples were blended in the following ratios: Acha and soybean 100: 100 (AS), Acha/soybean and OFSP 50: 50(ASO), made into gruel and compared with a commercial infant formula (Cerelac) which served as the control (CTRL). The samples were analyzed for proximate composition using AOAC methods and sensory attributes using a hedonic scale. Results showed that moisture, crude protein, fibre and ash content increased significantly (p<0.05) as fermentation progressed, while carbohydrate and fat content decreased. The protein, moisture, fibre and ash content ranged from 17.10-19.02%, 54.97-56.27%, 7.08-7.60% and2.09-2.38%, respectively, while carbohydrate and fat content ranged from 12.95-10.21% and 5.81-4.52%, respectively. In sensory scores, there were no significant (p>0.05) difference between the average mean scores of colours, texture and consistency of the samples. The sensory score for the overall acceptability ranged from 6.20-7.80. Sample CTRL had the highest score, while sample ASO had the least score. There was no significant (p>0.05) difference between samples CTRL and AS. Solid-state fermentation improved the nutritional content and flavour of the developed complementary food, which is needed for infant growth and development.

Keywords: Complementary food, malnutrition, proximate composition, solid-state fermentation

Procedia PDF Downloads 157

Authors: Beate Englich, Linda Schlittenbauer, Christiane Pfeifer, Isabel Kratochvil, Michael Borte, Gabriele I. Stangl, Martin von Bergen, Thorsten Reemtsma, Irina Lehmann, Kristin M. Junge

Abstract:

The worldwide production of endocrine disrupting compounds (EDC) has risen dramatically over the last decades, as so has the prevalence for obesity. Many EDCs are believed to contribute to this obesity epidemic, by enhancing adipogenesis or disrupting relevant metabolism. This effect is most tremendous in the early prenatal period when priming effects find a highly vulnerable time window. Therefore, we investigate the impact of parabens on childhood overweight development and adipogenesis in general. Parabens are ester of 4-hydroxy-benzoic acid and part of many cosmetic products or food packing. Therefore, ubiquitous exposure can be found in the westernized world, with exposure already starting during the sensitive prenatal period. We assessed maternal cosmetic product consumption, prenatal paraben exposure and infant BMI z-scores in the prospective German LINA cohort. In detail, maternal urinary concentrations (34 weeks of gestation) of methyl paraben (MeP), ethyl paraben (EtP), n-propyl paraben (PrP) and n-butyl paraben (BuP) were quantified using UPLC-MS/MS. Body weight and height of their children was assessed during annual clinical visits. Further, we investigated the direct influence of those parabens on adipogenesis in-vitro using a human mesenchymal stem cell (MSC) differentiation assay to mimic a prenatal exposure scenario. MSC were exposed to 0.1 – 50 µM paraben during the entire differentiation period. Differentiation outcome was monitored by impedance spectrometry, real-time PCR and triglyceride staining. We found that maternal cosmetic product consumption was highly correlated with urinary paraben concentrations at pregnancy. Further, prenatal paraben exposure was linked to higher BMI Z-scores in children. Our in-vitro analysis revealed that especially the long chained paraben BuP stimulates adipogenesis by increasing the expression of adipocyte specific genes (PPARγ, ADIPOQ, LPL, etc.) and triglyceride storage. Moreover, we found that adiponectin secretion is increased whereas leptin secretion is reduced under BuP exposure in-vitro. Further mechanistic analysis for receptor binding and activation of PPARγ and other key players in adipogenesis are currently in process. We conclude that maternal cosmetic product consumption is linked to prenatal paraben exposure of children and contributes to the development of infant overweight development by triggering key pathways of adipogenesis.

Keywords: adipogenesis, endocrine disruptors, paraben, prenatal exposure

Procedia PDF Downloads 274

Authors: Tessa Sellis, Marike A. Wierda, Elke Tichelman, Mirjam T. Van Lohuizen, Marjolein Berger, François Schellevis, Claudi Bockting, Lilian Peters, Huib Burger

Abstract:

Introduction: Most women develop a healthy bond with their children, however, adequate mother-to-infant bonding cannot be taken for granted. Mother-to-infant bonding refers to the feelings and emotions experienced by the mother towards her child. It is an ongoing process that starts during pregnancy and develops during the first year postpartum and likely throughout early childhood. The prevalence of inadequate bonding ranges from 7 to 11% in the first weeks postpartum. An impaired mother-to-infant bond can cause long-term complications for both mother and child. Very little research has been conducted on the direct relationship between the personality of the mother and mother-to-infant bonding. This study explores the associations between maternal personality and postnatal mother-to-infant bonding. The main hypothesis is that there is a relationship between neuroticism and mother-to-infant bonding. Methods: Data for this study were used from the Pregnancy Anxiety and Depression Study (2010-2014), which examined symptoms of and risk factors for anxiety or depression during pregnancy and the first year postpartum of 6220 pregnant women who received primary, secondary or tertiary care in the Netherlands. The study was expanded in 2015 to investigate postnatal mother-to-infant bonding. For the current research 3836 participants were included. During the first trimester of gestation, baseline characteristics, as well as personality, were measured through online questionnaires. Personality was measured by the NEO Five Factor Inventory (NEO-FFI), which covers the big five of personality (neuroticism, extraversion, openness, altruism and conscientiousness). Mother-to-infant bonding was measured postpartum by the Postpartum Bonding Questionnaire (PBQ). Univariate linear regression analysis was performed to estimate the associations. Results: 5% of the PBQ-respondents reported impaired bonding. A statistically significant association was found between neuroticism and mother-to-infant bonding (p < .001): mothers scoring higher on neuroticism, reported a lower score on mother-to-infant bonding. In addition, a positive correlation was found between the personality traits extraversion (b: -.081), openness (b: -.014), altruism (b: -.067), conscientiousness (b: -.060) and mother-to-infant bonding. Discussion: This study is one of the first to demonstrate a direct association between the personality of the mother and mother-to-infant bonding. A statistically significant relationship has been found between neuroticism and mother-to-infant bonding, however, the percentage of variance predictable by a personality dimension is very small. This study has examined one part of the multi-factorial topic of mother-to-infant bonding and offers more insight into the rarely investigated and complex matter of mother-to-infant bonding. For midwives, it is important recognize the risks for impaired bonding and subsequently improve policy for women at risk.

Keywords: mother-to-infant bonding, personality, postpartum, pregnancy

Procedia PDF Downloads 364

Authors: Zdravko Trivic, John Chye Fung, Ruzica Bozovic-Stamenovic

Abstract:

Within the context of rapidly ageing population in Singapore and the pressing demands on both caregivers and care providers, an integrated approach to ageing-friendly and ability-sensitive enabling environment becomes an imperative. This particularly applies to nursing home environments and their immediate surroundings, as they are becoming one of the main available options of long-term care for many senior adults who are unable to age at home. Yet, despite the considerable efforts to break the still predominant clinical approach to eldercare and to introduce more home-like design and person-centric care model, nursing homes keep being stigmatised and perceived as not so desirable environments to grow old in. The challenges are further emphasised by the associated physical, sensorial, psychological and cognitive declines that are the common consequences of ageing. Such declines have an immense impact on almost all aspects of older adults’ daily functioning, including problems with mobility and spatial orientation, difficulties in communication, withdrawal from social interaction, higher level of depression and decreased sense of independence and autonomy. However, typical nursing home designs tend to neglect the full capacities of balanced and carefully integrated multisensory stimuli as active component of care and ability building. This paper outlines part of a larger multi-disciplinary study of six nursing homes in Singapore, with overarching objectives to create new models of supportive nursing home environments that go beyond the clinical care model and encourage community integration with the nursing home settings. The paper focuses on the largely neglected aspects of sensorial comfort and multi-sensorial properties of nursing homes, including both indoor and immediate outdoor spaces (boundaries). The objective was to investigate the sensory rhythms and explore their role in nursing home users’ daily routine and therapeutic capacities. Socio-sensory rhythms were captured and analysed through a combination of on-site sensory recordings of “objective” quantitative sensory data (air temperature and humidity, sound level and luminance) using multi-function environment meter, perceived experienced data, spatial mapping, first-person observations of nursing home users’ activity patterns, and interviews. This was done in addition to employment of available assessment tools, such as Wisconsin Person Directed Care assessment tool, Dementia Quality of Life [DQoL] instrument, and Resident Environment Impact Scale [REIS], as these tools address the issues of sensorial experience insufficiently and selectively. Key findings indicate varied levels of sensory comfort, as well as diversity, intensity, and customisation of multi-sensory conditions within different nursing home spaces. Sensory stimulation is typically concentrated in communal living areas of the nursing homes or in the areas that often provide controlled or limited access, including specifically designed sensory rooms and outdoor green spaces (gardens and terraces). Opportunities for sensory stimulation are particularly limited for bed-bound senior residents and within more functional areas, such as corridors. This suggests that the capacities of nursing home designs to provide more diverse and better integrated pleasant sensory conditions as integrated “therapeutic devices” to build nursing home residents’ physical and mental abilities, encourage activity and improve wellbeing are far from exhausted.

Keywords: ageing-supportive environment, enabling design, multi-sensory assessment, nursing home environment

Procedia PDF Downloads 173

Authors: Benedicta N. Nkeh-Chungag, Constance R. Sewani-Rusike, Isaac M. Malema, Daniel T. Goon, Oladele V. Adeniyi, Idowu A. Ajayi

Abstract:

Background: Childhood and adolescent obesity is an important predictor of adult cardiometabolic diseases. Current data on age- and gender-specific cardiometabolic risk factors are lacking in the peri-urban Eastern Cape Province, South Africa. However, such information is important in designing innovative strategies to promote healthy living among children and adolescents. The purpose of this pilot study was to compare and determine the extent of cardiometabolic risk factors between samples of lean and overweight/obese adolescent population in a peri-urban township of South Africa. Methods: In this case-control study, age-matched, non-pregnant and non-lactating female adolescents consisting of equal number of cases (50 overweight/obese) and control (50 lean) participated in the study. Fasting venous blood samples were obtained for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (Trig), highly sensitive C-reactive protein (hsCRP) and blood sugar. Anthropometric measurements included weight, height, waist and hip circumferences. Body mass index was calculated. Blood pressure was measured; and metabolic syndrome was assessed using appropriate diagnostic criteria for children and adolescents. Results: Of the 76 participants with complete data, 12/38 of the overweight/obese and 1/38 of the lean group met the criteria for adolescent metabolic syndrome. All cardiometabolic risk factors were elevated in the overweight/obese group compared with the lean group: low HDL-C (RR = 2.21), elevated TC (RR = 1.23), elevated LDL-C (RR = 1.42), elevated Trig (RR = 1.73), and elevated hsCRP (RR = 1.9). There were significant atherosclerotic indices among the overweight/obese group compared with the lean group: TC/HDL and LDL/HDL (2.99±0.91 vs 2.63±0.48; p=0.016 and 1.73±0.61 vs 1.41±0.46; p= 0.014, respectively). Conclusion: There are multiple cardiometabolic risk factors among the overweight/obese female adolescent group compared with lean adolescent group in the study. Female adolescent who are overweight and obese have higher relative risks of developing cardiometabolic diseases compared with their lean counterparts in the peri-urban Mthatha, South Africa. School health programme focusing on promoting physical exercise, healthy eating and keeping appropriate weight are needed in the country.

Keywords: adolescents, cardiometabolic risk factors, obesity, peri-urban South Africa

Procedia PDF Downloads 474

Authors: Lilia Edit Aparicio Pico, Paulo Cesar Coronado Sánchez, Roberto Ferro Escobar

Abstract:

This paper presents the implementation of telemedicine services for physiotherapy, occupational therapy, and speech therapy rehabilitation, utilizing telebroadcasting of audiovisual content to enhance comprehensive patient recovery in rural areas of San Vicente del Caguán municipality, characterized by high levels of social conflict in Colombia. The region faces challenges such as dysfunctional problems, physical rehabilitation needs, and a high prevalence of hearing diseases, leading to neglect and substandard health services. Limited access to healthcare due to communication barriers and transportation difficulties exacerbates these issues. To address these challenges, a research initiative was undertaken to leverage information and communication technologies (ICTs) to improve healthcare quality and accessibility for this vulnerable population. The primary objective was to develop a tele-rehabilitation system to provide asynchronous online therapies and teleconsultation services for patient follow-up during the recovery process. The project comprises two components: Communication systems and human development. A technological component involving the establishment of a wireless network connecting rural centers and the development of a mobile application for video-based therapy delivery. Communications systems will be provided by a radio link that utilizes internet provided by the Colombian government, located in the municipality of San Vicente del Caguán to connect two rural centers (Pozos and Tres Esquinas) and a mobile application for managing videos for asynchronous broadcasting in sidewalks and patients' homes. This component constitutes an operational model integrating information and telecommunications technologies. The second component involves pedagogical and human development. The primary focus is on the patient, where performance indicators and the efficiency of therapy support were evaluated for the assessment and monitoring of telerehabilitation results in physical, occupational, and speech therapy. They wanted to implement a wireless network to ensure audiovisual content transmission for tele-rehabilitation, design audiovisual content for tele-rehabilitation based on services provided by the ESE Hospital San Rafael in physiotherapy, occupational therapy, and speech therapy, develop a software application for fixed and mobile devices enabling access to tele-rehabilitation audiovisual content for healthcare personnel and patients and finally to evaluate the technological solution's contribution to the ESE Hospital San Rafael community. The research comprised four phases: wireless network implementation, audiovisual content design, software application development, and evaluation of the technological solution's impact. Key findings include the successful implementation of virtual teletherapy, both synchronously and asynchronously, and the assessment of technological performance indicators, patient evolution, timeliness, acceptance, and service quality of tele-rehabilitation therapies. The study demonstrated improved service coverage, increased care supply, enhanced access to timely therapies for patients, and positive acceptance of teletherapy modalities. Additionally, the project generated new knowledge for potential replication in other regions and proposed strategies for short- and medium-term improvement of service quality and care indicators

Keywords: e-health, medical informatics, telemedicine, telerehabilitation, virtual therapy

Procedia PDF Downloads 58

Authors: Li Wang, Dan Shu, Shiguang Pang, Lixiu Wang, Bing Xiang Yang, Qian Liu

Abstract:

Background: Cancer is one of the most severe diseases in childhood; long-term treatment and its side effects significantly impact the patient's physical, psychological, social functioning and quality of life while also placing substantial physical and psychological burdens on caregivers and families. Family resilience is crucial for children with cancer, helping them cope better with the disease and supporting the family in facing challenges together. As a family-level variable, family resilience requires information from multiple family members. However, to our best knowledge, there is currently no research investigating family resilience from both the perspectives of pediatric cancer patients and their caregivers. Therefore, this study aims to investigate the family resilience and quality of life of pediatric cancer patients from a patient–caregiver dyadic perspective. Methods: A total of 149 dyads of patients diagnosed with pediatric cancer patients and their principal caregivers were recruited from oncology departments of 4 tertiary hospitals in Wuhan and Taiyuan, China. All participants completed questionnaires that identified their demographic and clinical characteristics as well as assessed their family resilience and quality of life for both the patients and their caregivers. K-means cluster analysis was used to identify different clusters of family resilience based on the reports from patients and caregivers. Multivariate logistic regression and linear regression are used to analyze the factors influencing family resilience and quality of life, as well as the relationship between the two. Results: Three clusters of family resilience were identified: a cluster of high family resilience (HR), a cluster of low family resilience (LR), and a cluster of discrepant family resilience (DR). Most (67.1%) families fell into the cluster with low resilience. Characteristics such as the types of caregivers perceived social support of the patient were different among the three clusters. Compared to the LR group, families where the mother is the caregiver and where the patient has high social support are more likely to be assigned to the HR. The quality of life for caregivers was consistently highest in the HR cluster and lowest in the LR cluster. The patient's quality of life is not related to family resilience. In the linear regression analysis of the patient's quality of life, patients who are the first-born have higher quality of life, while those living with their parents have lower quality of life. The participants' characteristics were not associated with the quality of life for caregivers. Conclusions: In most families, family resilience was low. Families with maternal caregivers and patients receiving high levels of social support are more inclined to be higher levels of family resilience. Family resilience was linked to the quality of life of caregivers of pediatric cancer patients. The clinical implications of this findings suggest that healthcare and social support organizations should prioritize and support the participation of mothers in caregiving responsibilities. Furthermore, they should assist families in accessing social support to enhance family resilience. This study also emphasizes the importance of promoting family resilience for enhancing family health and happiness, as well as improving the quality of life for caregivers.

Keywords: pediatric cancer, cluster analysis, family resilience, quality of life

Procedia PDF Downloads 37

Authors: Qiang Guo, Ruying Qi

Abstract:

This project aims to trace the developmental patterns of a child's Mandarin and English from China to Australia from age 3; 03 till 5; 06. In childhood bilingual studies, there is an assumption that age 3 is the dividing line between simultaneous bilinguals and sequential bilinguals. Determining similarities and differences between Bilingual First Language Acquisition, Early Second Language Acquisition, and Second Language Acquisition is of great theoretical significance. Studies on Bilingual First Language Acquisition, hereafter, BFLA in the past three decades have shown that the grammatical development of bilingual children progresses through the same developmental trajectories as their monolingual counterparts. Cross-linguistic interaction does not show changes of the basic grammatical knowledge, even in the weaker language. While BFLA studies show consistent results under the conditions of adequate input and meaningful interactional context, the research findings of Early Second Language Acquisition (ESLA) have demonstrated that this cohort proceeds their early English differently from both BFLA and SLA. The different development could be attributed to the age of migration, input pattern, and their Environmental Languages (Lε). In the meantime, the dynamic relationship between the two languages is an issue to invite further attention. The present study attempts to fill this gap. The child in this case study started acquiring L1 Mandarin from birth in China, where the environmental language (Lε) coincided with L1 Mandarin. When she migrated to Australia at 3;06, where the environmental language (Lε) was L2 English, her Mandarin exposure was reduced. On the other hand, she received limited English input starting from 1; 02 in China, where the environmental language (Lε) was L1 Mandarin, a non-English environment. When she relocated to Australia at 3; 06, where the environmental language (Lε) coincided with L2 English, her English exposure significantly increased. The child’s linguistic profile provides an opportunity to explore: (1) What does the child’s English developmental route look like? (2) What does the L1 Mandarin developmental pattern look like in different environmental languages? (3) How do input and environmental language interact in shaping the bilingual child’s linguistic repertoire? In order to answer these questions, two linguistic areas are selected as the focus of the investigation, namely, subject realization and wh-questions. The chosen areas are contrastive in structure but perform the same semantic functions in the two linguistically distant languages and can serve as an ideal testing ground for exploring the developmental path in the two languages. The longitudinal case study adopts a combined approach of qualitative and quantitative analysis. Two years’ Mandarin and English data are examined, and comparisons are made with age-matched monolinguals in each language in CHILDES. To the author’s best knowledge, this study is the first of this kind examining a Mandarin-English bilingual child's bilingual development at a critical age, in different input patterns, and in different environmental languages (Lε). It also expands the scope of the theory of Lε, adding empirical evidence on the relationship between input and Lε in bilingual acquisition.

Keywords: bilingual development, age, input, environmental language (Le)

Procedia PDF Downloads 151

Authors: Divya SY. Ang, Mark B. Tan, Nicholas EM. Yeo, Siti RB. Sudirman, Khong Yik Chew

Abstract:

Introduction: The importance of the amalgamation of technological and engineering advances with surgical principles of reconstruction cannot be overemphasized. With earlier detection of cancer, consequences of high-speed living and neglect, like traumatic injuries and infection, resulting in increasingly younger patients with bone defects. This may result in malformations and suboptimal function that is more noticeable and palpable in the younger, active demographic. Our team proposes a technique that encapsulates a mesh of multidisciplinary effort, tissue engineering and reconstructive principles. Methods/Materials: Our patient was a young competitive footballer in his early 30s who was diagnosed with submandibular adenoid cystic carcinoma with bony involvement. He was thus counselled for a right hemi mandibulectomy, the floor of mouth resection, right selective neck dissection, tracheostomy, and free fibular flap reconstruction of his mandible and required post-operative radiotherapy. Being young and in his prime sportsman years, he was unable to accept the morbidities associated with using his fibula to reconstruct his mandible despite it being the gold standard reconstructive option. The fibula is an ideal vascularized bone flap because it’s reliable and easily shaped with relatively minimal impact on functional outcomes. The fibula contributes to 30% of weightbearing and is the attachment for the lateral compartment muscles; it is stronger in footballers concerning lateral bending. When harvesting the fibula, the distal 6-8cm and up to 10% of the total length is preserved to maintain the ankle’s stability, thus, minimizing the impact on daily activities. There are studies that have noted gait variability post-operatively. Therefore, returning to a premorbid competitive level may be doubtful. To improve his functional outcomes, the decision was made to try and restore the fibula's form and function. Using the concept of Fused Deposition Modelling (FDM), our team comprising of Plastics, Otolaryngology, Orthopedics and Radiology, worked with Osteopore to design a 3D bioresorbable implant to regenerate the fibula defect (14.5cm). Bone marrow was harvested via reaming the contralateral hip prior to the wide resection. 30mls of his blood was obtained for extracting platelet rich plasma. These were packed into the Osteopore 3D-printed bone scaffold. This was then secured into the fibula defect with titanium plates and screws. The flexor hallucis longus and soleus were anchored along the construct and intraosseous membrane, done in a single setting. Results: He was reviewed closely as an outpatient over 10 months post operatively. He reported no discernable loss or difference in ankle function. He is satisfied and back in training and our team has video and photographs that substantiate his progress. Conclusion: FDM allows regeneration of long bone defects. However, we aimed to also restore his eversion and inversion that is imperative for footballers and hence reattached his previously dissected muscles along the length of the Osteopore implant. We believe that the reattachment of the muscle stabilizes not only the construct but allows optimum muscle tensioning when moving his ankle. This is a simple but effective technique in restoring complete function and form in a young patient whose minute muscle control is imperative to life.

Keywords: fused deposition modelling, functional reconstruction, lower limb bony defects, regenerative surgery, 3D printing, tissue engineering

Procedia PDF Downloads 73

Authors: Güler Duru Aşiret

Abstract:

Introduction: Poor sleep quality is a common problem among the older people living in nursing homes. Our study aimed at assessing the effect of individual reminiscence therapy on the sleep quality of the elderly living in nursing homes. Methods: The study had 22 people in the intervention group and 24 people in the control group. The intervention group had reminiscence therapy once a week for 12 weeks in the form of individual sessions of 25-30 minutes. In our study, we first determined the dates suitable for the intervention group and researcher and planned the date and time of individual reminiscence therapies, which would take 12 weeks. While preparing this schedule, we considered subjects’ time schedules for their regular visits to health facilities and the arrival of their visitors. At this stage, the researcher informed the participants that their regular attendance in sessions would affect the intervention outcome. One topic was discussed every week. Weekly topics included: introduction in the first week; childhood and family life, school days, starting work and work life (a day at home for housewives), a fun day out of home, marriage (friendship for the singles), plants and animals they loved, babies and children, food and cooking, holidays and travelling, special days and celebrations, assessment and closure, in the following weeks respectively. The control group had no intervention. Study data was collected by using an introductory information form and the Pittsburgh Sleep Quality Index (PSQI). Results: In our study, participants’ average age was 76.02 ± 7.31. 58.7% of them were male and 84.8% were single. All of them had at least one chronic disease. 76.1% did not need help for performing their daily life activities. The length of stay in the institution was 6.32 ± 3.85 years. According to the participants’ descriptive characteristics, there was no difference between groups. While there was no statistically significant difference between the pretest PSQI median scores (p > 0.05) of both groups, PSQI median score had a statistically significant decrease after 12 weeks of reminiscence therapy (p < 0.05). There was no statistically significant change in the median scores of the subcomponents of sleep latency, sleep duration, sleep efficiency, sleep disturbance and use of sleep medication before and after reminiscence therapy. After the 12-weeks reminiscence therapy, there was a statistically significant change in the median scores for the PSQI subcomponents of subjective sleep quality (p<0.05). Conclusion: Our study found that reminiscence therapy increased the sleep quality of the elderly living in nursing homes. Acknowledgment: This study (project no 2017-037) was supported by the Scientific Research Projects Coordination Unit of Aksaray University. We thank the elderly subjects for their kind participation.

Keywords: nursing, older people, reminiscence therapy, sleep

Procedia PDF Downloads 131

Authors: Mohamed El Fares Djellatou, Fracoise Filion

Abstract:

The Ashukin program that means bridge in Naskapi or Atikamekw language, has been designed to offer a partnership between nursing students and an indigenous community. The students design a health promotion project tailored to the needs of the community. The issues of intimidation in primary school and cyber-dependence in high school were some concerns in a rural Atikamekw community. The goal of the project was to have a conversation with indigenous youths, aged 10-16 years old, on the challenges presented by intimidation and cyber dependence as well as promoting healthy relationships online and within the community. Methods: Multiple progressive inquiry questions (PIQs) were used to assess the feasibility and importance of this project for the Atikamekw nation, and to determine a plan to follow. The theoretical foundations to guide the conception of the project were the Population Health Promotion Model (PHPM), the First Nations Holistic Lifelong Learning Model, and the Medicine Wheel. A broad array of social determinants of health were addressed, including healthy childhood development, personal health practices, and coping skills, and education. The youths were encouraged to participate in interactive educational sessions, using PowerPoint presentations and pamphlets as the main effective strategies. Additional tools such as cultural artworks and physical activities were introduced to strengthen the inter-relational and team spirit within the Indigenous population. A quality assurance tool (QAT) was developed specifically to determine the appropriateness of these health promotion tools. Improvements were guided by the feedback issued by the indigenous schools’ teachers and social workers who filled the QATs. Post educational sessions, quantitative results have shown that 93.48% of primary school students were able to identify the different types of intimidation, 72.65% recognized more than two strategies, and 52.1% were able to list at least four resources to diffuse intimidation. On the other hand, around 75% of the adolescents were able to name at least three negative effects, and 50% listed three strategies to reduce cyber-dependence. This project was meant to create a bridge with the First Nation through health promotion, a population that is known to be disadvantaged due to systemic health inequity and disparities. Culturally safe care was proposed to deal with the two identified priority issues, and an educational toolkit was given to both schools to ensure the sustainability of the project. The project was self-financed through fundraising activities, and it yielded better results than expected.

Keywords: indigenous, first nation, bullying, cyber-dependence, internet addiction, intimidation, youth, adolescents, school, community nursing, health promotion

Procedia PDF Downloads 98

Authors: Hanan Bin Nakhi, Asaad M. Albadrawi, Maged Al Shahat, ‎Entesar Mandani

Abstract:

Background:‎ Kawasaki disease (KD) is one of the most common vasculitis of childhood. ‎It is considered the leading cause of acquired heart disease in children. The ‎peak age of occurrence is 6 to 24 months, with 80% of affected children being ‎less than 5 years old. There are only a few reports of KD in infants younger ‎than 6 months. Infants had a higher incidence of atypical KD and of coronary ‎artery complications. This case report from Kuwait will reinforce considering ‎atypical KD in case of sepsis like condition with negative cultures and ‎unresponding to systemic antibiotics. Early diagnosis allows early treatment ‎with intravenous immune globulin (IVIG) and so decreases the incidence of ‎cardiac aneurysm.‎ Case Report:‎ A 2 month old female infant, product of full term normal delivery to ‎consanguineous parents, presented with fever and poor feeding. She was ‎admitted and treated as urinary tract infection as her urine routine revealed ‎pyurea. The baby continued to have persistent fever and hypoactivity inspite ‎of using intravenous antibiotics. Latter, she developed non purulent ‎conjunctivitis, skin mottling, oedema of the face / lower limb and was treated ‎in intensive care unit as a case of septic shock. In spite of her partial general ‎improvement, she continued to look unwell, hypoactive and had persistent ‎fever. Septic work up, metabolic, and immunologic screen were negative. KD ‎was suspected when the baby developed polymorphic erythematous rash and ‎noticed to have peeling of skin at perianal area and periangular area of the ‎fingers of the hand and feet. IVIG was given in dose of 2 gm/kg/day in single ‎dose and aspirin 100 mg/kg/day in four divided doses. The girl showed marked ‎clinical improvement. The fever subsided dramatically and the level acute ‎phase reactant markedly decreased but the platelets count increased to ‎‎1600000/mm3. Echo cardiography showed mild dilatation of mid right ‎coronary artery. Aspirin was continued in a dose of 5 mg/kg/d till repeating ‎cardiac echo. ‎Conclusion:‎ A high index of suspicion of KD must be maintained in young infants with ‎prolonged unexplained fever. Accepted criteria should be less restrictive to ‎allow early diagnosis of a typical KD in infants less than 6 months of age. ‎Timely appropriate treatment with IVIG is essential to avoid severe coronary ‎sequels.‎

Keywords: Kawasaki disease, atypical Kawasaki disease, infantile Kawasaki disease, hypo activity‎ ‎

Procedia PDF Downloads 320

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

Abstract:

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

Procedia PDF Downloads 185

Authors: Shahzadi Laibah Burq, Gina Scarpete Walters

Abstract:

Piipaash, representing one large family of North American languages, Yuman, is reported as one of the seriously endangered languages in the Salt River Pima-Maricopa Indian Community of Arizona. In a collaborative venture between Arizona State University (ASU) and Salt River Pima-Maricopa Indian Community (SRPMIC), efforts have been made to revitalize and preserve the Piipaash language and its cultural heritage. The present study is one example of several other language documentation and revitalization initiatives that Humanities Lab ASU has taken. This study was approved to receive a “Beyond the lab” grant after the researchers successfully created a Teaching Guide for Early Childhood Piipaash storybook during their time working in the Humanities Lab. The current research is an extension of the previous project and focuses on creating customized teaching materials and tools for the teachers and parents of the students of the Early Enrichment Program at SRPMIC. However, to determine and maximize the usefulness of the teaching materials with regards to their reliability, validity, and practicality in the given context, this research aims to conduct Environmental Analysis and Need Analysis. Environmental Analysis seeks to evaluate the Early Enrichment Program situation and Need Analysis to investigate the specific and situated requirements of the teachers to assist students in building target language skills. The study employs a qualitative methods approach for the collection of the data. Multiple data collection strategies are used concurrently to gather information from the participants. The research tools include semi-structured interviews with the program administrators and teachers, classroom observations, and teacher shadowing. The researchers utilize triangulation of the data to maintain validity in the process of data interpretation. The preliminary results of the study show a need for culturally appropriate materials that can further the learning of students of the target language as well as the culture, i.e., clay pots and basket-making materials. It was found that the course and teachers focus on developing the Listening and Speaking skills of the students. Moreover, to assist the young learners beyond the classroom, the teachers could make use of send-home teaching materials to reinforce the learning (i.e., coloring books, including illustrations of culturally relevant animals, food, and places). Audio language resources are also identified as helpful additional materials for the parents to assist the learning of the kids.

Keywords: indigenous education, materials development, need analysis, piipaash language revitalizaton

Procedia PDF Downloads 90

Authors: Bharti Singh, Shri K. Singh

Abstract:

Child malnutrition is a multifaceted issue that transcends geographical boundaries. Malnutrition not only stunts physical growth but also leads to a spectrum of morbidities and child mortality. It is one of the leading causes of death (~50 %) among children under age five. Despite economic progress and advancements in healthcare, child malnutrition remains a formidable challenge for India. The objective is to investigate the impact of women's empowerment on child nutrition outcomes in India from 2006 to 2021. A composite index of women's empowerment was constructed using Confirmatory Factor Analysis (CFA), a rigorous technique that validates the measurement model by assessing how well-observed variables represent latent constructs. This approach ensures the reliability and validity of the empowerment index. Secondly, kernel density plots were utilised to visualise the distribution of key nutritional indicators, such as stunting, wasting, and overweight. These plots offer insights into the shape and spread of data distributions, aiding in understanding the prevalence and severity of malnutrition. Thirdly, linear polynomial graphs were employed to analyse how nutritional parameters evolved with the child's age. This technique enables the visualisation of trends and patterns over time, allowing for a deeper understanding of nutritional dynamics during different stages of childhood. Lastly, multilevel analysis was conducted to identify vulnerable levels, including State-level, PSU-level, and household-level factors impacting undernutrition. This approach accounts for hierarchical data structures and allows for the examination of factors at multiple levels, providing a comprehensive understanding of the determinants of child malnutrition. Overall, the utilisation of these statistical methodologies enhances the transparency and replicability of the study by providing clear and robust analytical frameworks for data analysis and interpretation. Our study reveals that NFHS-4 and NFHS-5 exhibit an equal density of severely stunted cases. NFHS-5 indicates a limited decline in wasting among children aged five, while the density of severely wasted children remains consistent across NFHS-3, 4, and 5. In 2019-21, women with higher empowerment had a lower risk of their children being undernourished (Regression coefficient= -0.10***; Confidence Interval [-0.18, -0.04]). Gender dynamics also play a significant role, with male children exhibiting a higher susceptibility to undernourishment. Multilevel analysis suggests household-level vulnerability (intra-class correlation=0.21), highlighting the need to address child undernutrition at the household level.

Keywords: child nutrition, India, NFHS, women’s empowerment

Procedia PDF Downloads 34

Authors: Manali Chakraborty

Abstract:

In the developing countries the most prevalent pathological state is malnutrition and under nutrition due to deficiency of essential nutrients. This condition is more seen between the woman population, especially in the adolescent girls. It is causing childhood deaths along with others cognitive, degenerative diseases. Born of low weight babies and stillbirth are also major problems associated with the malnutrition. Along with the increased level of population, people not only should concern about their quantity of food but also for the quality of the food to be healthy. Lethargy, depression caused due to iron deficiency often quoted as normal or unimportant issues. Children of malnourished women are more likely associated with cognitive impairment, immune dysfunction leading to a higher risk of being attacked by diseases. Malnourishment also affects the productivity of women. Low social status, lack of proper nutritional education is an important cause of this nutrient deficiency among women. Iron deficiency and anemia are mostly famous nutritional deficiencies among women worldwide. Mostly women from below poverty lined area are anemic due to less consumption of iron-rich foods or having foods that might inhibit the iron absorption. Growing females like adolescents or lactating females need more iron supply. Less supplement causes iron deficiency. Though malaria also might cause anemia, it is more likely endemic one in some specific areas. Folate deficiency in females also may cause neurological defects in the infants. Other Vitamin B, A deficiencies along with low iodine level is also noted in malnourished women. According to tradition, still in some areas in developing countries females have their food at the end. According to some survey and collected data, these females are often into the risk zone of being malnourished. Regularly they have the very lesser amount, or food sometimes may start to lose its nutrients. Women are the one who maintains the responsibility to cook foods in the home. Lack of proper nutritional education and proper food preparation not only make those foods lose the nutrients leading to impairment in proper nutrient intake of the family members but also impairing own nutritional status. Formulation and development of food products from iron or other nutrient affluent sources viz., traditional herbs can be helpful in the prevention of such malnutrition condition in females. Keeping low cost and smooth maintenance of the food product development from the natural sources like pulses, cereals or other vegetation also can be beneficial to sustain socio-economic condition. Consumption of such kind of foodstuff is much healthier rather than taking continuous supplements like capsules. Utilization of proper scientific and cost-effective techniques for this food product development and their distribution among rural women population might be an enormous initiative.

Keywords: anemia, food supplements, malnutrition, rural places, women population

Procedia PDF Downloads 117

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is known to be associated with many clinically important diseases including metabolic syndrome (MetS). Vitamin B₁₂ plays essential roles in fat and protein metabolisms and its cooperation with vitamin B₉ is well-known. The aim of this study is to investigate the possible contributions as well as associations of these micronutrients upon obesity and MetS during childhood. A total of 128 children admitted to Namik Kemal University, Medical Faculty, Department of Pediatrics Outpatient Clinics were included into the scope of this study. The mean age±SEM of 92 morbid obese (MO) children and 36 with MetS were 118.3±3.8 months and 129.5±6.4 months, respectively (p > 0.05). The study was approved by Namık Kemal University, Medical Faculty Ethics Committee. Written informed consent forms were obtained from the parents. Demographic features and anthropometric measurements were recorded. WHO BMI-for age percentiles were used. The values above 99 percentile were defined as MO. Components of MetS [waist circumference (WC), fasting blood glucose (FBG), triacylglycerol (TRG), high density lipoprotein cholesterol (HDL-Chol), systolic pressure (SP), diastolic pressure (DP)] were determined. Routine laboratory tests were performed. Serum vitamin B₁₂ concentrations were measured using electrochemiluminescence immunoassay. Vitamin B₉ was analyzed by an immunoassay analyzer. Values for vitamin B₁₂ < 148 pmol/L, 148-221 pmol/L, > 221 pmol/L were accepted as low, borderline and normal, respectively. Vitamin B₉ levels ≤ 4 mcg/L defined deficiency state. Statistical evaluations were performed by SPSSx Version 16.0. p≤0.05 was accepted as statistical significance level. Statistically higher body mass index (BMI), WC, hip circumference (C) and neck C were calculated in MetS group compared to children with MO. No difference was noted for head C. All MetS components differed between the groups (SP, DP p < 0.001; WC, FBG, TRG p < 0.01; HDL-Chol p < 0.05). Significantly decreased vitamin B₉ and vitamin B₁₂ levels were detected (p < 0.05) in children with MetS. In both groups percentage of folate deficiency was 5.5%. No cases were below < 148 pmol/L. However, in MO group 14.3% and in MetS group 22.2% of the cases were of borderline status. In MO group B₁₂ levels were negatively correlated with BMI, WC, hip C and head C, but not with neck C. WC, hip C, head C and neck C were all negatively correlated with HDL-Chol. None of these correlations were observed in the group of children with MetS. Strong positive correlation between FBG and insulin as well as strong negative correlation between TRG and HDL-Chol detected in MO children were lost in MetS group. Deficiency state end-products of both B₉ and B₁₂ may interfere with the expected profiles of MetS components. In this study, the alterations in MetS components affected vitamin B₁₂ metabolism and also its associations with anthropometric body measurements. Further increases in vitamin B₁₂ and vitamin B₉ deficiency in MetS associated with the increased vitamin B₁₂ as well as vitamin B₉ deficiency metabolites may add to MetS parameters.

Keywords: children, cobalamin, folate, metabolic syndrome, obesity

Procedia PDF Downloads 193

Authors: Ioanna Taouki, Marie Lallier, David Soto

Abstract:

Metacognition refers to the capacity to reflect upon our own cognitive processes. Although there is an ongoing discussion in the literature on the role of metacognition in learning and academic achievement, little is known about its neurodevelopmental trajectories in early childhood, when children begin to receive formal education in reading. Here, we evaluate the metacognitive ability, estimated under a recently developed Signal Detection Theory model, of a cohort of children aged between 6 and 7 (N=60), who performed three two-alternative-forced-choice tasks (two linguistic: lexical decision task, visual attention span task, and one non-linguistic: emotion recognition task) including trial-by-trial confidence judgements. Our study has three aims. First, we investigated how metacognitive ability (i.e., how confidence ratings track accuracy in the task) relates to performance in general standardized tasks related to students' reading and general cognitive abilities using Spearman's and Bayesian correlation analysis. Second, we assessed whether or not young children recruit common mechanisms supporting metacognition across the different task domains or whether there is evidence for domain-specific metacognition at this early stage of development. This was done by examining correlations in metacognitive measures across different task domains and evaluating cross-task covariance by applying a hierarchical Bayesian model. Third, using robust linear regression and Bayesian regression models, we assessed whether metacognitive ability in this early stage is related to the longitudinal learning of children in a linguistic and a non-linguistic task. Notably, we did not observe any association between students’ reading skills and metacognitive processing in this early stage of reading acquisition. Some evidence consistent with domain-general metacognition was found, with significant positive correlations between metacognitive efficiency between lexical and emotion recognition tasks and substantial covariance indicated by the Bayesian model. However, no reliable correlations were found between metacognitive performance in the visual attention span and the remaining tasks. Remarkably, metacognitive ability significantly predicted children's learning in linguistic and non-linguistic domains a year later. These results suggest that metacognitive skill may be dissociated to some extent from general (i.e., language and attention) abilities and further stress the importance of creating educational programs that foster students’ metacognitive ability as a tool for long term learning. More research is crucial to understand whether these programs can enhance metacognitive ability as a transferable skill across distinct domains or whether unique domains should be targeted separately.

Keywords: confidence ratings, development, metacognitive efficiency, reading acquisition

Procedia PDF Downloads 150

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is associated with cardiovascular disease risk factors and metabolic syndrome (MetS). In this study, associations between adipokines and adipokine as well as obesity indices were evaluated. Plasma adipokine levels may exhibit variations according to body adipose tissue mass. Besides, upon consideration of obesity as an inflammatory disease, adipokines may play some roles in this process. The ratios of proinflammatory adipokines to adiponectin may act as highly sensitive indicators of body adipokine status. The aim of the study is to present some adipokine indices, which are thought to be helpful for the evaluation of childhood obesity and also to determine the best discriminators in the diagnosis of MetS. 80 prepubertal children (aged between 6-9.5 years) included in the study were divided into three groups; 30 children with normal weight (NW), 25 morbid obese (MO) children and 25 MO children with MetS. Physical examinations were performed. Written informed consent forms were obtained from the parents. The study protocol was approved by Ethics Committee of Namik Kemal University Medical Faculty. Anthropometric measurements, such as weight, height, waist circumference (C), hip C, head C, neck C were recorded. Values for body mass index (BMI), diagnostic obesity notation model assessment Index-II (D2 index) as well as waist-to-hip, head-to-neck ratios were calculated. Adiponectin, resistin, leptin, chemerin, vaspin, progranulin assays were performed by ELISA. Adipokine-to-adiponectin ratios were obtained. SPSS Version 20 was used for the evaluation of data. p values ≤ 0.05 were accepted as statistically significant. Values of BMI and D2 index, waist-to-hip, head-to-neck ratios did not differ between MO and MetS groups (p ≥ 0.05). Except progranulin (p ≤ 0.01), similar patterns were observed for plasma levels of each adipokine. There was not any difference in vaspin as well as resistin levels between NW and MO groups. Significantly increased leptin-to-adiponectin, chemerin-to-adiponectin and vaspin-to-adiponectin values were noted in MO in comparison with those of NW. The most valuable adipokine index was progranulin-to-adiponectin (p ≤ 0.01). This index was strongly correlated with vaspin-to-adiponectin ratio in all groups (p ≤ 0.05). There was no correlation between vaspin-to-adiponectin and chemerin-to--adiponectin in NW group. However, a correlation existed in MO group (r = 0.486; p ≤ 0.05). Much stronger correlation (r = 0.609; p ≤ 0.01) was observed in MetS group between these two adipokine indices. No correlations were detected between vaspin and progranulin as well as vaspin and chemerin levels. Correlation analyses showed a unique profile confined to MetS children. Adiponectin was found to be correlated with waist-to-hip (r = -0.435; p ≤ 0.05) as well as head-to-neck (r = 0.541; p ≤ 0.05) ratios only in MetS children. In this study, it has been investigated if adipokine indices have priority over adipokine levels. In conclusion, vaspin-to-adiponectin, progranulin-to-adiponectin, chemerin-to-adiponectin along with waist-to-hip and head-to-neck ratios were the optimal combinations. Adiponectin, waist-to-hip, head-to-neck, vaspin-to-adiponectin, chemerin-to-adiponectin ratios had appropriate discriminatory capability for MetS children.

Keywords: adipokine indices, metabolic syndrome, obesity indices, pediatric obesity

Procedia PDF Downloads 205

Authors: Klaus Froehlich-Gildhoff, Ullrich Boettinger, Katharina Rauh, Angela Schickler

Abstract:

The Prevention Network Ortenaukreis, PNO, funded by the German Ministry of Education and Research, aims to promote physical and mental health as well as the social inclusion of 3 to 10 years old children and their families in the Ortenau district. Within a period of four years starting 11/2014 a community network will be established. One regional and five local prevention representatives are building networks with stakeholders of the prevention and health promotion field bridging the health care, educational and youth welfare system in a multidisciplinary approach. The regional prevention representative implements regularly convening prevention and health conferences. On a local level, the 5 local prevention representatives implement round tables in each area as a platform for networking. In the setting approach, educational institutions are playing a vital role when gaining access to children and their families. Thus the project will offer 18 month long organizational development processes with specially trained coaches to 25 kindergarten and 25 primary schools. The process is based on a curriculum of prevention and health promotion which is adapted to the specific needs of the institutions. Also to ensure that the entire region is reached demand oriented advanced education courses are implemented at participating day care centers, kindergartens and schools. Evaluation method: The project is accompanied by an extensive research design to evaluate the outcomes of different project components such as interview data from community prevention agents, interviews and network analysis with families at risk on their support structures, data on community network development and monitoring, as well as data from kindergarten and primary schools. The latter features a waiting-list control group evaluation in kindergarten and primary schools with a mixed methods design using questionnaires and interviews with pedagogues, teachers, parents, and children. Results: By the time of the conference pre and post test data from the kindergarten samples (treatment and control group) will be presented, as well as data from the first project phase, such as qualitative interviews with the prevention coordinators as well as mixed methods data from the community needs assessment. In supporting this project, the Federal Ministry aims to gain insight into efficient components of community prevention and health promotion networks as it is implemented and evaluated. The district will serve as a model region, so that successful components can be transferred to other regions throughout Germany. Accordingly, the transferability to other regions is of high interest in this project.

Keywords: childhood research, health promotion, physical health, prevention network, psychological well-being, social inclusion

Procedia PDF Downloads 222

Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha

Abstract:

Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.

Keywords: C-peptide, insulin, large for gestational age, maternal weight

Procedia PDF Downloads 168

Authors: Helen J. Spray, Karina J. Linnell

Abstract:

Local-global bias in adulthood is strongly dependent on environmental factors and a global bias is not the universal characteristic of adult perception it was once thought to be: whilst Western adults typically demonstrate a global bias, Namibian adults living in traditional villages possess a strong local bias. Furthermore, environmental effects on local-global bias have been shown to be highly gender-specific; whereas urbanisation promoted a global bias in urbanised Namibian women but not men, education promoted a global bias in urbanised Namibian men but not women. Adult populations, however, provide only a snapshot of the gene-environment interactions which shape perceptual bias. Yet, to date, there has been little work on the development of local-global bias across environmental settings. In the current study, local-global bias was assessed using a similarity-matching task with Navon figures in children aged between 4 and 15 years from across three populations: traditional Namibians, urban Namibians, and urban British. For the two Namibian groups, measures of urbanisation and education were obtained. Data were subjected to both between-group and within-group analyses. Between-group analyses compared developmental trajectories across population and gender. These analyses revealed a global bias from even as early as 4 in the British sample, and showed that the developmental onset of a global bias is not fixed. Urbanised Namibian children ultimately developed a global bias that was indistinguishable from British children; however, a global bias did not emerge until much later in development. For all populations, the greatest developmental effects were observed directly following the onset of formal education. No overall gender effects were observed; however, there was a significant gender by age interaction which was difficult to reconcile with existing biological-level accounts of gender differences in the development of local-global bias. Within-group analyses compared the effects of urbanisation and education on local-global bias for traditional and urban Namibian boys and girls separately. For both traditional and urban boys, education mediated all effects of age and urbanisation; however, this was not the case for girls. Traditional Namibian girls retained a local bias regardless of age, education, or urbanisation, and in urbanised girls, the development of a global bias was not attributable to any one factor specifically. These results are broadly consistent with aforementioned findings that education promoted a global bias in urbanised Namibian men but not women. The development of local-global bias does not follow a fixed trajectory but is subject to environmental control. Understanding how variability in the development of local-global bias might arise, particularly in the context of gender, may have far-reaching implications. For example, a number of educationally important cognitive functions (e.g., spatial ability) are known to show consistent gender differences in childhood and local-global bias may mediate some of these effects. With education becoming an increasingly prevalent force across much of the developing world it will be important to understand the processes that underpin its effects and their implications.

Keywords: cross-cultural, development, education, gender, local-global bias, perception, urbanisation, urbanization

Procedia PDF Downloads 139

Authors: Vilma Zydziunaite, Monika Kelpsiene

Abstract:

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

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

Procedia PDF Downloads 43

Authors: Celestine Odigwe, Epoke Lincoln, Rhoda-Dara Ephraim

Abstract:

Background; Immunization against the childhood killer diseases is the cardinal strategy for the prevention of these diseases all over the world in under five children, these diseases include; Tuberculosis, Measles, Polio, Tetanus, Diphthria, Pertusis, Yellow Fever, Hepatitis B, Haemophilus Influenza type B. 6.9 million children die before their fifth birthday , 80% of the worlds death in children under 5 years occur in 25 countries most in Africa and Asia and 2 million children can be saved each year with routine immunization Therefore failure to achieve total immunization coverage puts several children at risk. Aim; The aim of the study was to ascertain the prevalence, Investigate the various reasons and causes why several under five children in a suburb of calabar municipal county fail to get the required immunizations as at and when due and possibly the consequences, so that efforts can be re-directed towards the solution of the problems so identified. Methods; the study was a community based cross sectional study. The respondents were the mothers/guardians of the sampled children who were all aged 0-59 months. To be eligible for recruitment into the study, the parent or guardian was required to give an informed consent, reside within the Calabar South County with his/her children aged 0-59 months. We calculated our sample size using the Leslie-Kish formula and we used a two-staged sampling method, first to ballot for the wards to be involved and then to select four of the most populated ones in the wards chosen. Data collection was by interviewer administered structured questionnaire (Appendix I), Data collected was entered and analyzed using Statistical Package for the Social Sciences (SPSS) Version 20. Percentages were calculated and represented using charts and tables Results; The number of children sampled was 159. We found that 150 were fully immunized and 9 were not, the prevalence of missed opportunity was 32% from the study. The reasons for missed opportunities were varied, ranging from false contraindications, logistical problems resulting in very poor access roads to health facilities and poor organization of health centers together with negative health worker attitudes. Some of the consequences of these missed opportunities were increased susceptibility to vaccine preventable diseases, resurgence of the above diseases and increased morbidity and mortality of children aged less than 5 years. Conclusion; We found that ignorance on the part of both parents/guardians and health care staff together with infrastructural inadequacies in the county such as- roads, poor electric power supply for storage of vaccines were hugely responsible for most missed opportunities for immunization. The details of these and suggestions for improvement and the way forward are discussed.

Keywords: missed opportunity, immunization, under five, Calabar south

Procedia PDF Downloads 324

Authors: Marina Fuertes

Abstract:

Introduction: In everyday life experiences, children are solicited to cooperate with others. Often they perform cooperative tasks with their parents (e.g., setting the table for dinner) or in school. These tasks are very significant since children may learn to turn taking in interactions, to participate as well to accept others participation, to trust, to respect, to negotiate, to self-regulate their emotions, etc. Indeed, cooperative tasks contribute to children social, motor, cognitive and linguistic development. Therefore, it is important to study what learning, social and affective experiences are provided to children during these tasks. In this study, we included parents and preschool educators. Parents and educators are both significant: educative, interactive and affective figures. Rarely parents and educators behavior have been compared in studies about cooperative tasks. Parents and educators have different but complementary styles of interaction and communication. Aims: Therefore, this study aims to compare parents and educators' (of both genders) interactive behavior (cooperativity, empathy, ability to challenge the child, reciprocity, elaboration) during a play/individualized situation involving a cooperative task. Moreover, to compare parents and educators' behavior with girls and boys. Method: A quasi-experimental study with 45 dyads educators-children and 45 dyads with parents and their children. In this study, participated children between 3 and 5 years old and with age appropriate development. Adults and children were videotaped using a variety of materials (e.g., pencils, wood, wool) and tools (e.g., scissors, hammer) to produce together something of their choice during 20-minutes. Each dyad (one adult and one child) was observed and videotaped independently. Adults and children agreed and consented to participate. Experimental conditions were suitable, pleasant and age appropriated. Results: Findings indicate that parents and teachers offer different learning experiences. Teachers were more likely to challenged children to explore new concepts and to accept children ideas. In turn, parents gave more support to children actions and were more likely to use their own example to teach children. Multiple regression analysis indicates that parent versus educator status predicts their behavior. Gender of both children and adults affected the results. Adults acted differently with girls and boys (e.g., adults worked more cooperatively with girls than boys). Male participants supported more girls participation rather than boys while female adults allowed boys to make more decisions than girls. Discussion: Taking our results and past studies, we learn that different qualitative interactions and learning experiences are offered by parents, educators according to parents and children gender. Thus, the same child needs to learn different cooperative strategies according to their interactive patterns and specific context. Yet, cooperative play and individualized activities with children generate learning opportunities and benefits children participation and involvement.

Keywords: early childhood education, parenting, gender, cooperative tasks, adult-child interaction

Procedia PDF Downloads 325

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

Abstract:

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

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

Procedia PDF Downloads 299

Authors: A.D. Fredline, Beverly Stiles

Abstract:

This is a qualitative investigation that examines the social media site, Tumblr, for the goal of analyzing the controversy regarding the inclusion of asexuality in the LGBTQ+ community. As platforms such as Tumblr permit the development of communities for marginalized groups, social media serves as a core component to exclusionary practices and boundary negotiations for community membership. This research is important because there is a paucity of research on the topic and a significant gap in the literature with regards to intracommunity gatekeeping. However, discourse on the topic is blatantly apparent on social media platforms. The objectives are to begin to bridge the gap in the literature by examining attitudes towards the inclusion of asexuality within the LGBTQ+ community. In order to analyze the attitudes developed towards the inclusion of asexuality in the LGBTQ+ community, eight publicly available blogs on Tumblr.com were selected from both the “inclusionist” and “exclusionist” perspectives. Blogs selected were found through a basic search for “inclusionist” and “exclusionist” on the Tumblr website. Out of the first twenty blogs listed for each set of results, those centrally focused on asexuality discourse were selected. For each blog, the fifty most recent postings were collected. Analysis of the collected postings exposed three central themes from the exclusionist perspective as well as for the inclusionist perspective. Findings indicate that from the inclusionist perspective, asexuality belongs to the LGBTQ+ community. One primary argument from this perspective is that asexual individuals face opposition for their identity just as do other identities included in the community. This opposition is said to take a variety of forms, such as verbal shaming, assumption of illness and corrective rape. Another argument is that the LGBTQ+ community and asexuals face a common opponent in cisheterosexism as asexuals struggle with the assumed and expected sexualization. A final central theme is that denying asexual inclusion leads to the assumption of heteronormativity. Findings also indicate that from the exclusionist perspective, asexuality does not belong to the LGBTQ+ community. One central theme from this perspective is the equivalization of cisgender heteroromantic asexuals with cisgender heterosexuals. As straight individuals are not allowed in the community, exclusionists argue that asexuals engaged in opposite gender partnerships should not be included. Another debate is that including asexuality in the community sexualizes all other identities by assuming sexual orientation is inherently sexual rather than romantic. Finally, exclusionists also argue that asexuality encourages childhood labeling and forces sexual identities on children, something not promoted by the LGBTQ+ community. Conclusions drawn from analyzing both perspectives is that integration may be a possibility, but complexities add another layer of discourse. For example, both inclusionists and exclusionists agree that privileged identities do not belong to the LGBTQ+ community. The focus of discourse is whether or not asexuals are privileged. Clearly, both sides of the debate have the same vision of what binds the community together. The question that remains is who belongs to that community.

Keywords: asexuality, exclusionists, inclusionists, Tumblr

Procedia PDF Downloads 187

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

Abstract:

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

Keywords: autism, celiac, gastrointestinal, gluten

Procedia PDF Downloads 122

Authors: Mustafa Metin Donma, Orkide Donma

Abstract:

Vitamin deficiencies are common in obese individuals. Particularly, the status of vitamin B12 and its association with vitamin B9 (folate) and vitamin D is under investigation in recent time. Vitamin B12 is closely related to many vital processes in the body. In clinical studies, its involvement in fat metabolism draws attention from the obesity point of view. Obesity, in its advanced stages and in combination with metabolic syndrome (MetS) findings, may be a life-threatening health problem. Pediatric obesity is particularly important because it may be a predictor of severe chronic diseases during the adulthood period of the child. Due to its role in fat metabolism, vitamin B12 deficiency may disrupt metabolic pathways of the lipid and energy metabolisms in the body. The association of low B12 levels with obesity degree may be an interesting topic to be investigated. Obesity indices may be helpful at this point. Weight- and fat-based indices are available. Of them, body mass index (BMI) is in the first group. Fat mass index (FMI), fat-free mass index (FFMI) and diagnostic obesity notation model assessment-II (D2I) index lie in the latter group. The aim of this study is to clarify possible associations between vitamin B12 status and obesity indices in the pediatric population. The study comprises a total of one hundred and twenty-two children. Thirty-two children were included in the normal body mass index (N-BMI) group. Forty-six and forty-four children constitute groups with morbid obese children without MetS and with MetS, respectively. Informed consent forms and the approval of the institutional ethics committee were obtained. Tables prepared for obesity classification by World Health Organization were used. Metabolic syndrome criteria were defined. Anthropometric and blood pressure measurements were taken. Body mass index, FMI, FFMI, D2I were calculated. Routine laboratory tests were performed. Vitamin B9, B12, D concentrations were determined. Statistical evaluation of the study data was performed. Vitamin B9 and vitamin D levels were reduced in MetS group compared to children with N-BMI (p>0.05). Significantly lower values were observed in vitamin B12 concentrations of MetS group (p<0.01). Upon evaluation of blood pressure as well as triglyceride levels, there exist significant increases in morbid obese children. Significantly decreased concentrations of high density lipoprotein cholesterol were observed. All of the obesity indices and insulin resistance index exhibit increasing tendency with the severity of obesity. Inverse correlations were calculated between vitamin D and insulin resistance index as well as vitamin B12 and D2I in morbid obese groups. In conclusion, a fat-based index, D2I, was the most prominent body index, which shows a strong correlation with vitamin B12 concentrations in the late stage of obesity in children. A negative correlation between these two parameters was a confirmative finding related to the association between vitamin B12 and obesity degree.

Keywords: body mass index, children, D2I index, fat mass index, obesity

Procedia PDF Downloads 206