Search results for: traditional physical therapy program
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15197

Search results for: traditional physical therapy program

14477 Assessing the Impact of Pharmacist-Led Medication Therapy Management on Treatment Adherence and Clinical Outcomes in Cancer Patients: A Prospective Intervention Study

Authors: Omer Ibrahim Abdallh Omer

Abstract:

Cancer patients often face complex medication regimens, leading to challenges in treatment adherence and clinical outcomes. Pharmacist-led medication therapy management (MTM) has emerged as a potential solution to optimize medication use and improve patient outcomes in oncology settings. In this prospective intervention study, we aimed to evaluate the impact of pharmacist-led MTM on treatment adherence and clinical outcomes among cancer patients. Participants were randomized to receive either pharmacist-led MTM or standard care, with assessments conducted at baseline and follow-up visits. Pharmacist interventions included medication reconciliation, adherence counseling, and personalized care plans. Our findings reveal that pharmacist-led MTM significantly improved medication adherence rates and clinical outcomes compared to standard care. Patients receiving pharmacist interventions reported higher satisfaction levels and perceived value in pharmacist involvement in their cancer care. These results underscore the critical role of pharmacists in optimizing medication therapy and enhancing patient-centered care in oncology settings. Integration of pharmacist-led MTM into routine cancer care pathways holds promise for improving treatment outcomes and quality of life for cancer patients.

Keywords: cancer, medications adherence, medication therapy management, pharmacist

Procedia PDF Downloads 64
14476 From Manipulation to Citizen Control: A Case Study Revealing the Level of Participation in the Citizen Participatory Audit

Authors: Mark Jason E. Arca, Jay Vee R. Linatoc, Rex Francis N. Lupango, Michael Joe A. Ramirez

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Participation promises an avenue for citizens to take part in governance, but it does not necessarily mean effective participation. The proper integration of participants in the decision-making process should be properly addressed to ensure effectiveness. This study explores the integration of the participants in the decision-making process to reveal the level of participation in the Solid Waste Management audit done by the Citizen Participatory Audit (CPA), a program under the supervision of the Commission on Audit. Specifically, this study will use the experience of participation to identify emerging themes that will help reveal the level of participation through the integrated ladder of participation. The researchers used key informant interviews to gather necessary data from the actors of the program. The findings revealed that the level of participation present in the CPA is at the Placation level, a level below the program’s targeted level of participation. The study also allowed the researchers to reveal facilitating factors in the program that contributed to a better understanding of the practice of participation.

Keywords: citizen participation, culture of participation, ladder of participation, level of participation

Procedia PDF Downloads 411
14475 A Robotic “Puppet Master” Application to ASD Therapeutic Support

Authors: Sophie Sakka, Rénald Gaboriau

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This paper describes a preliminary work aimed at setting a therapeutic support for autistic teenagers using three humanoid robots NAO shared by ASD (Autism Spectrum Disorder) subjects. The studied population had attended successfully a first year program, and were observed with a second year program using the robots. This paper focuses on the content and the effects of the second year program. The approach is based on a master puppet concept: the subjects program the robots, and use them as an extension for communication. Twenty sessions were organized, alternating ten preparatory sessions and ten robotics programming sessions. During the preparatory sessions, the subjects write a story to be played by the robots. During the robot programming sessions, the subjects program the motions to be realized to make the robot tell the story. The program was concluded by a public performance. The experiment involves five ASD teenagers aged 12-15, who had all attended the first year robotics training. As a result, a progress in voluntary and organized communication skills of the five subjects was observed, leading to improvements in social organization, focus, voluntary communication, programming, reading and writing abilities. The changes observed in the subjects general behavior took place in a short time, and could be observed from one robotics session to the next one. The approach allowed the subjects to draw the limits of their body with respect to the environment, and therefore helped them confronting the world with less anxiety.

Keywords: autism spectrum disorder, robot, therapeutic support, rob'autism

Procedia PDF Downloads 246
14474 Advancing the Analysis of Physical Activity Behaviour in Diverse, Rapidly Evolving Populations: Using Unsupervised Machine Learning to Segment and Cluster Accelerometer Data

Authors: Christopher Thornton, Niina Kolehmainen, Kianoush Nazarpour

Abstract:

Background: Accelerometers are widely used to measure physical activity behavior, including in children. The traditional method for processing acceleration data uses cut points, relying on calibration studies that relate the quantity of acceleration to energy expenditure. As these relationships do not generalise across diverse populations, they must be parametrised for each subpopulation, including different age groups, which is costly and makes studies across diverse populations difficult. A data-driven approach that allows physical activity intensity states to emerge from the data under study without relying on parameters derived from external populations offers a new perspective on this problem and potentially improved results. We evaluated the data-driven approach in a diverse population with a range of rapidly evolving physical and mental capabilities, namely very young children (9-38 months old), where this new approach may be particularly appropriate. Methods: We applied an unsupervised machine learning approach (a hidden semi-Markov model - HSMM) to segment and cluster the accelerometer data recorded from 275 children with a diverse range of physical and cognitive abilities. The HSMM was configured to identify a maximum of six physical activity intensity states and the output of the model was the time spent by each child in each of the states. For comparison, we also processed the accelerometer data using published cut points with available thresholds for the population. This provided us with time estimates for each child’s sedentary (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Data on the children’s physical and cognitive abilities were collected using the Paediatric Evaluation of Disability Inventory (PEDI-CAT). Results: The HSMM identified two inactive states (INS, comparable to SED), two lightly active long duration states (LAS, comparable to LPA), and two short-duration high-intensity states (HIS, comparable to MVPA). Overall, the children spent on average 237/392 minutes per day in INS/SED, 211/129 minutes per day in LAS/LPA, and 178/168 minutes in HIS/MVPA. We found that INS overlapped with 53% of SED, LAS overlapped with 37% of LPA and HIS overlapped with 60% of MVPA. We also looked at the correlation between the time spent by a child in either HIS or MVPA and their physical and cognitive abilities. We found that HIS was more strongly correlated with physical mobility (R²HIS =0.5, R²MVPA= 0.28), cognitive ability (R²HIS =0.31, R²MVPA= 0.15), and age (R²HIS =0.15, R²MVPA= 0.09), indicating increased sensitivity to key attributes associated with a child’s mobility. Conclusion: An unsupervised machine learning technique can segment and cluster accelerometer data according to the intensity of movement at a given time. It provides a potentially more sensitive, appropriate, and cost-effective approach to analysing physical activity behavior in diverse populations, compared to the current cut points approach. This, in turn, supports research that is more inclusive across diverse populations.

Keywords: physical activity, machine learning, under 5s, disability, accelerometer

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14473 Immunoliposomes for Co-Delivery of Doxorubicin and Ribonucleotide Reductase M2 Sirna Inhibit of Gastric Cancer Growth

Authors: Jie Gao

Abstract:

The combination of chemotherapy with gene therapy is highly effective in cancer therapy. To achieve combined therapeutic effects in human gastric cancer over expressing EGFR, we developed targeted LPD (liposome-polycation-DNA complex) conjugated with anti-EGFR (epidermal growth factor receptor) Fab’ for co-delivery of doxorubicin (DOX) and ribonucleotide reductase M2 (RRM2) siRNA (DOX-RRM2-TLPD). The results showed that EGFR was over expressed in several gastric cancer cell lines and gastric cancer tissues. Gene Expression Omnibus (GEO) results showed that RRM2 expression was significantly higher in gastric cancer than in non-gastric cancer tissue, and RRM2 siRNA inhibited the proliferation of several gastric cancer cells, indicating that RRM2 is a candidate target for gastric cancer therapy. Confocal studies and flow cytometry showed that DOX-RRM2-TLPD delivered DOX and RRM2 siRNA to EGFR over expressing gastric cancer cells specifically and efficiently both in vitro and in vivo, resulting in enhanced therapeutic effects (cytotoxicity and apoptosis) compared with single-drug loaded or non-targeted controls, including DOX-NC-TLPD (targeted LPD co-delivering DOX and negative control siRNA), RRM2-TLPD (targeted LPD delivering RRM2 siRNA) and DOX-RRM2-NTLPD (non-targeted LPD co-delivering DOX and RRM2 siRNA). The in vivo antitumor assay showed that the average weight of the gastric cancer in mice treated with DOX-RRM2-TLPD was significantly lighter than that of mice treated with other controls. DOX-RRM2-TLPD represents an effective approach for combined therapy of gastric cancer over expressing EGFR.

Keywords: gene therapy, chemotherapy, immunoliposomes, gastric cancer

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14472 Changing the Traditional Role of CFOs

Authors: Seyedmohammad Mousavian

Abstract:

Technological advancements are becoming unprecedentedly dominant everywhere. This dominance requires drastic chTechnological advancements are becoming unprecedentedly dominant everywhere. This dominance requires drastic changes in traditional thinking, procedures, and responsibilities. Chief Financial Officers (CFOs) have long played a key role in every organization around the globe and must adapt themselves to the disruptive technology which brings positive and negative points. This paper will discuss the shift of the traditional role of CFOs from just reporting toward more innovative roles like “Storytelling”, business partnering, and strategic planning.

Keywords: accounting information system, technology, data, CFO, finance

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14471 Continuity and Changes on Traditional Puppetry in Java: The Existences of Wayang Hip Hop

Authors: Taufik Hidayah

Abstract:

Wayang is a traditional puppet show originated from Java. This traditional art is characterized by distinctive Hinduism influence. Wayang reflects the social life of the Javanese society. It contains Javanese philosophy, myths, magical stories, and religion, as well as educational media and transmission for noble values of Javanese society conveyed through the story. Nowadays, the performance of wayang has faced a new challenge to maintain its existence in the public life of Javanese society. Modernity has penetrated into every shape of culture. Many people consider traditional culture as old fashioned, particularly the young generation. That is one of the reasons why many people have left traditional culture. For maintaining the existence of wayang, a new art called ‘wayang hip hop’ has arisen. Wayang hip hop seeks to modify wayang show into a more modern form, but without removing any principles and main functions of wayang art. This article will discuss theoretically the changes and traditional continuity in wayang hip hop based on a literature review and qualitative approaches. Wayang hip hop uses hip-hop music as the background music in the show. It will discuss about the impact that comes with the existential strengthening of wayang hip hop especially among the Javanese society and discuss the opportunities that arise regarding the function of wayang hip-hop as a medium of education, social criticism, and cultural revitalization of the Javanese society.

Keywords: cultural revitalization, social criticism, education, continuity and change

Procedia PDF Downloads 241
14470 Sociocultural and Critical Approach for Summer Study Abroad Program in Higher Education

Authors: Magda Silva

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This paper presents the empirical and the theoretical principles associated with the Duke in Brazil Summer Program. Using a sociocultural model and critical theory, this study abroad maximizes students’ ability to enrich language competence, intercultural skills, and critical thinking. The fourteen-year implementation of this project demonstrates the global importance of foreign language teaching as the program unfolds into real life scenarios within the cultures of distinct regions of Brazil; Cosmopolitan Rio, in the southeast, and rural Belém, northern Amazon region.

Keywords: study abroad, critical thinking, sociocultural theory, foreign language, empirical, theoretical

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14469 Pre-Malignant Breast Lesions, Methods of Treatment and Outcome

Authors: Ahmed Mostafa, Mohamed Mahmoud, Nesreen H. Hafez, Mohamed Fahim

Abstract:

This retrospective study includes 60 patients with pre-invasive breast cancer. Aim of the study: Evaluation of premalignant lesions of the breast (DCIS), different treatment methods and outcome. Patients and methods: 60 patients with DCIS were studied from the period between 2005 to 2012, for 38 patients the primary surgical method was wide local resection (WLE) (63.3%) and the other cases (22 patients, 36.7%) had mastectomy, fourteen cases from those who underwent local excision received radiotherapy, while no adjuvant radiotherapy was given for those who underwent mastectomy. In case of hormonal receptor positive DCIS lesions hormonal treatment (Tamoxifen) was given after local control. Results: No difference in overall survival between mastectomy & breast conserving therapy (wide local excision and adjuvant radiotherapy), however local recurrence rate is higher in case of breast conserving therapy, also no role of Axillary evacuation in case of DCIS. The use of hormonal therapy decreases the incidence of local recurrence by about 98%. Conclusion: The main management of DCIS is local treatment (wide local excision and radiotherapy) with hormonal treatment in case of hormone receptor positive lesions.

Keywords: ductal carcinoma in situ, surgical treatment, radiotherapy, breast conserving therapy, hormonal treatment

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14468 Development and Effects of Transtheoretical Model Exercise Program for Elderly Women with Chronic Back Pain

Authors: Hyun-Ju Oh, Soon-Rim Suh, Mihan Kim

Abstract:

The steady and rapid increase of the older population is a global phenomenon. Chronic diseases and disabilities are increased due to aging. In general, exercise has been known to be most effective in preventing and managing chronic back pain. However, it is hard for the older women to initiate and maintain the exercise. Transtheoretical model (TTM) is one of the theories explain behavioral changes such as exercise. The application of the program considering the stage of behavior change is effective for the elderly woman to start and maintain the exercise. The purpose of this study was to develop TTM based exercise program and to examine its effect for elderly women with chronic back-pain. For the program evaluation, the non-equivalent control pre-posttest design was applied. The independent variable of this study is exercise intervention program. The contents of the program were constructed considering the characteristics of the elderly women with chronic low back pain, focusing on the process of change, the stage of change by the previous studies. The developed exercise program was applied to the elderly women with chronic low back pain in the planning stage and the preparation stage. The subjects were 50 older women over 65 years of age with chronic back-pain who did not practice regular exercise. The experimental group (n=25) received the 8weeks TTM based exercise program. The control group received the book which named low back pain management. Data were collected at three times: before the exercise intervention, right after the intervention, and 4weeks after the intervention. The dependent variables were the processes of change, decisional balance, exercise self-efficacy, back-pain, depression and muscle strength. The results of this study were as follows. Processes of change (<.001), pros of decisional balance (<.001), exercise self-efficacy (<.001), back pain (<.001), depression (<.001), muscle strength (<.001) were higher in the experimental group than in the control group right after the program and 4weeks after the programs. The results of this study show that applying the TTM based exercise program increases the use of the change process, increases the exercise self-efficacy, increases the stage of changing the exercise behavior and strengthens the muscular strength by lowering the degree of pain and depression Respectively. The significance of the study was to confirm the effect of continuous exercise by maintaining regular exercise habits by applying exercise program of the transtheoretical model to the chronic low back pain elderly with exercise intention.

Keywords: chronic back pain, elderly, exercise, women

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14467 Cardio-respiratory Rehabilitation in Patients With Chronic or Post-acute Cardiomyopathy and COPD

Authors: Ledi Neçaj

Abstract:

Introduction: Cardio-respiratory rehabilitation is the set of coordinated interventions needed to provide the best physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years, ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity, AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4. ±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01). The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily activities.

Keywords: cardio-respiratory rehabilitation, physical exercise, quality of life, diseases

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14466 Application of Costing System in the Small and Medium Sized Enterprises (SME) in Turkey

Authors: Hamide Özyürek, Metin Yılmaz

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Standard processes, similar and limited production lines, the production of high direct costs will be more accurate than the use of parts of the traditional cost systems in the literature. However, direct costs, overhead expenses, in turn, decreases the burden of increasingly sophisticated production facilities, a situation that led the researchers to look for the cost of traditional systems of alternative techniques. Variety cost management approaches for example Total quality management (TQM), just-in-time (JIT), benchmarking, kaizen costing, targeting cost, life cycle costs (LLC), activity-based costing (ABC) value engineering have been introduced. Management and cost applications have changed over the past decade and will continue to change. Modern cost systems can provide relevant and accurate cost information. These methods provide the decisions about customer, product and process improvement. The aim of study is to describe and explain the adoption and application of costing systems in SME. This purpose reports on a survey conducted during 2014 small and medium sized enterprises (SME) in Ankara. The survey results were evaluated using SPSS package program.

Keywords: modern costing systems, managerial accounting, cost accounting, costing

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14465 Rural Territorial Sustainable Development: Interinstitutional Dialogue and Transition to Sustainable Livelihoods

Authors: Aico Nogueira

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This paper examines the interinstitutional dialogues within the Brazilian federal structures, which comprises federal, state and local levels, around the themes of new approaches and interventions aimed to promote sustainable rural development, particularly rural development as part of a territorial approach. The work seeks to understand to what extent the various levels of the state interact with these strategies, particularly with the locally constituted powers, focusing on the importance of the transition of traditional agriculture methods to more sustainable agroecological systems and its effects on food security and sustainable rural development. The research analyses as case studies the Sustainable Rural Territories Development Program (PRONAT) of the Ministry of Agrarian Development at the federal level, as well as the State of São Paulo and the Vale do Ribeira Territory, an area characterized by environmental and social vulnerability, restrictive environmental laws and attempts to promote sustainable development. In order to examine how the interrelationships between different levels of governance and civil society, in addition to the neo-institutionalist polity centered literature, the research uses an adaptation of the concept of arena in Ostrom and Hannigan, produced at different scales of decision-making processes, as well as the multilevel governance literature. Document analysis, interviews, focus groups and direct observation techniques are also used. The main findings of this study are that how different levels of governance understand and organize themselves for this work and have a direct impact on the actions taken. Consequently, programs formulated for this purpose are not associated with the creation of institutions capable of breaking with a traditional sectoral view that has historically prevailed in policymaking. And the transition from traditional agriculture to agroecological production systems is hampered by a sectorial foundation, based on large-scale production and the strengthening of the traditional country's land concentration model.

Keywords: agroecology, food security, inter-institutional dialogue, rural poverty, sustainable rural development, territorial development

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14464 Site Selection and Construction Mechanism of the Island Settlements in China Based on CFD-GIS Technology

Authors: Weng Jiantao, Wu Yiqun

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The efficiency of natural ventilation, wind pressure distribution on building surface, wind comfort for pedestrians and buildings’ wind tolerance in traditional settlements are closely related to the pattern of terrain. On the basis of field research on the typical island terrain in China, the physical and mathematical models are established by using CFD software, and then the simulation results of the wind field are exported. We discuss the relationship between wind direction and wind field results. Furthermore simulation results are imported into ArcGIS platform. The evaluation model of island site selection is established with considering slope factor. We realize the visual model of site selection on complex island terrain. The multi-plans of certain residential are discussed based on wind simulation; at last the optimal project is selected. Results can provide the theory guidance for settlement planning and construction in China's traditional island.

Keywords: CFD, island terrain, site selection, construction mechanism

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14463 An iTunes U App for Development of Metacognition Skills Delivered in the Enrichment Program Offered to Gifted Students at the Secondary Level

Authors: Maha Awad M. Almuttairi

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This research aimed to measure the impact of the use of a mobile learning (iTunes U) app for the development of metacognition skills delivered in the enrichment program offered to gifted students at the secondary level in Jeddah. The author targeted a group of students on an experimental scale to evaluate the achievement. The research sample consisted of a group of 38 gifted female students. The scale of evaluation of the metacognition skills used to measure the performance of students in the enrichment program was as follows: Satisfaction scale for the assessment of the technique used and the final product form after completion of the program. Appropriate statistical treatment used includes Paired Samples T-Test Cronbach’s alpha formula and eta squared formula. It was concluded in the results the difference of α≤ 0.05, which means the performance of students in the skills of metacognition in favor of using iTunes U. In light of the conclusion of the experiment, a number of recommendations and suggestions were present; the most important benefit of mobile learning applications is to provide enrichment programs for gifted students in the Kingdom of Saudi Arabia, as well as conducting further research on mobile learning and gifted student teaching.

Keywords: enrichment program, gifted students, metacognition skills, mobile learning

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14462 Development of Industry Oriented Undergraduate Research Program

Authors: Sung Ryong Kim, Hyung Sup Han, Jae-Yup Kim

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Many engineering students feel uncomfortable in solving the industry related problems. There are many ways to strengthen the engineering student’s ability to solve the assigned problem when they get a job. Korea National University of Transportation has developed an industry-oriented undergraduate research program (URP). An URP program is designed for engineering students to provide an experience of solving a company’s research problem. The URP project is carried out for 6 months. Each URP team consisted of 1 company mentor, 1 professor, and 3-4 engineering students. A team of different majors is strongly encouraged to integrate different perspectives of multidisciplinary background. The corporate research projects proposed by companies are chosen by the major-related student teams. A company mentor gives the detailed technical background of the project to the students, and he/she also provides a basic data, raw materials and so forth. The company allows students to use the company's research equipment. An assigned professor has adjusted the project scope and level to the student’s ability after discussing with a company mentor. Monthly meeting is used to check the progress, to exchange ideas, and to help the students. It is proven as an effective engineering education program not only to provide an experience of company research but also to motivate the students in their course work. This program provides a premier interdisciplinary platform for undergraduate students to perform the practical challenges encountered in their major-related companies and it is especially helpful for students who want to get a job from a company that proposed the project.

Keywords: company mentor, industry oriented, interdisciplinary platform, undergraduate research program

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14461 Simulating an Interprofessional Hospital Day Shift: A Student Interprofessional (IP) Collaborative Learning Activity

Authors: Fiona Jensen, Barb Goodwin, Nancy Kleiman, Rhonda Usunier

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Background: Clinical simulation is now a common component in many health profession curricula in preparation for clinical practice. In the Rady Faculty of Health Sciences (RFHS) college leads in simulation and interprofessional (IP) education, planned an eight hour simulated hospital day shift, where seventy students from six health professions across two campuses, learned with each other in a safe, realistic environment. Learning about interprofessional collaboration, an expected competency for many health professions upon graduation, was a primary focus of the simulation event. Method: Faculty representatives from the Colleges of Nursing, Medicine, Pharmacy and Rehabilitation Sciences (Physical Therapy, Occupation Therapy, Respiratory Therapy) and Pharmacy worked together to plan the IP event in a simulation facility in the College of Nursing. Each college provided a faculty mentor to guide the same profession students. Students were placed in interprofessional teams consisting of a nurse, physician, pharmacist, and then sharing respiratory, occupational, and physical therapists across the team depending on the needs of the patients. Eight patient scenarios were role played by health profession students, who had been provided with their patient’s story shortly before the event. Each team was guided by a facilitator. Results and Outcomes: On the morning of the event, all students gathered in a large group to meet mentors and facilitators and have a brief overview of the six competencies for effective collaboration and the session objectives. The students assuming their same profession roles were provided with their patient’s chart at the beginning of the shift, met with their team, and then completed professional specific assessments. Shortly into the shift, IP team rounds began, facilitated by the team facilitator. During the shift, each patient role-played a spontaneous health incident, which required collaboration between the IP team members for assessment and management. The afternoon concluded with team rounds, a collaborative management plan, and a facilitated de-brief. Conclusions: During the de-brief sessions, students responded to set questions related to the session learning objectives and expressed many positive learning moments. We believe that we have a sustainable simulation IP collaborative learning opportunity, which can be embedded into curricula, and has the capacity to grow to include more health profession faculties and students. Opportunities are being explored in the RFHS at the administrative level, to offer this event more frequently in the academic year to reach more students. In addition, a formally structured event evaluation tool would provide important feedback and inform the qualitative feedback to event organizers and the colleges about the significance of the simulation event to student learning.

Keywords: simulation, collaboration, teams, interprofessional

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14460 Just a Heads Up: Approach to Head Shape Abnormalities

Authors: Noreen Pulte

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Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.

Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags

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14459 Validating Chronic Kidney Disease-Specific Risk Factors for Cardiovascular Events Using National Data: A Retrospective Cohort Study of the Nationwide Inpatient Sample

Authors: Fidelis E. Uwumiro, Chimaobi O. Nwevo, Favour O. Osemwota, Victory O. Okpujie, Emeka S. Obi, Omamuyovbi F. Nwoagbe, Ejiroghene Tejere, Joycelyn Adjei-Mensah, Christopher N. Ekeh, Charles T. Ogbodo

Abstract:

Several risk factors associated with cardiovascular events have been identified as specific to Chronic Kidney Disease (CKD). This study endeavors to validate these CKD-specific risk factors using up-to-date national-level data, thereby highlighting the crucial significance of confirming the validity and generalizability of findings obtained from previous studies conducted on smaller patient populations. The study utilized the nationwide inpatient sample database to identify adult hospitalizations for CKD from 2016 to 2020, employing validated ICD-10-CM/PCS codes. A comprehensive literature review was conducted to identify both traditional and CKD-specific risk factors associated with cardiovascular events. Risk factors and cardiovascular events were defined using a combination of ICD-10-CM/PCS codes and statistical commands. Only risk factors with specific ICD-10 codes and hospitalizations with complete data were included in the study. Cardiovascular events of interest included cardiac arrhythmias, sudden cardiac death, acute heart failure, and acute coronary syndromes. Univariate and multivariate regression models were employed to evaluate the association between chronic kidney disease-specific risk factors and cardiovascular events while adjusting for the impact of traditional CV risk factors such as old age, hypertension, diabetes, hypercholesterolemia, inactivity, and smoking. A total of 690,375 hospitalizations for CKD were included in the analysis. The study population was predominantly male (375,564, 54.4%) and primarily received care at urban teaching hospitals (512,258, 74.2%). The mean age of the study population was 61 years (SD 0.1), and 86.7% (598,555) had a CCI of 3 or more. At least one traditional risk factor for CV events was present in 84.1% of all hospitalizations (580,605), while 65.4% (451,505) included at least one CKD-specific risk factor for CV events. The incidence of CV events in the study was as follows: acute coronary syndromes (41,422; 6%), sudden cardiac death (13,807; 2%), heart failure (404,560; 58.6%), and cardiac arrhythmias (124,267; 18%). 91.7% (113,912) of all cardiac arrhythmias were atrial fibrillations. Significant odds of cardiovascular events on multivariate analyses included: malnutrition (aOR: 1.09; 95% CI: 1.06–1.13; p<0.001), post-dialytic hypotension (aOR: 1.34; 95% CI: 1.26–1.42; p<0.001), thrombophilia (aOR: 1.46; 95% CI: 1.29–1.65; p<0.001), sleep disorder (aOR: 1.17; 95% CI: 1.09–1.25; p<0.001), and post-renal transplant immunosuppressive therapy (aOR: 1.39; 95% CI: 1.26–1.53; p<0.001). The study validated malnutrition, post-dialytic hypotension, thrombophilia, sleep disorders, and post-renal transplant immunosuppressive therapy, highlighting their association with increased risk for cardiovascular events in CKD patients. No significant association was observed between uremic syndrome, hyperhomocysteinemia, hyperuricemia, hypertriglyceridemia, leptin levels, carnitine deficiency, anemia, and the odds of experiencing cardiovascular events.

Keywords: cardiovascular events, cardiovascular risk factors in CKD, chronic kidney disease, nationwide inpatient sample

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14458 Evaluation of Apolipoprotein Profile in HIV/Aids Subjects in Pre and Post 12 Months Antiretroviral Therapy Using 1.5 NG/ML Troponin Diagnostic Cut-off for Myocardial Infarction in Nauth Nnewi, South Eastern Nigeria

Authors: I. P. Ezeugwunne, C. C. Onyenekwe, J. E. Ahaneku, G. I. Ahaneku

Abstract:

Introduction: It has been reported that acute myocardial infarction (AMI) might occur at 1.5 ng/ml troponin level. HIV infection has been documented to influence antiviral drugs, stimulate the production of proteins that enhance fatty acids synthesis. Information on cardiac status in HIV-infected subjects in Nigeria is scanty. Aim: To evaluate the Apolipoprotein profile of HIV subjects in pre-and-post 12 months of antiretroviral therapy (ART) using 1.5 ng/ml troponin diagnostic cut-off for myocardial infarction (MI) in Nnewi, South Eastern, Nigeria. Methodology: A total of 30 symptomatic HIV subjects without malaria co-infection with a mean age of 40.70 ±10.56 years were randomly recruited for this prospective case-controlled study. Serum apolipoproteins (Apo A1, A2, B, C2,C3 and Apo E), troponin and CD4 counts were measured using standard laboratory methods. Parameters were re-classified based on 1.5 ng/ml troponin diagnostic cut-off for MI. Analysis of variance and student paired t-tests were used for data analyses. Results: paired-wise comparison showed that there were significantly higher levels of CD4 counts, Apo A2, Apo C2, Apo E but lower levels of ApoA1, ApoB and ApoC3 in symptomatic HIV subjects before antiretroviral therapy (ART) when compared with after therapy at p<0.05 respectively. The troponin value was significantly higher amongst the group studied at p<0.05, respectively. Conclusion: The increased values of troponin observed among the groups were higher than the diagnostic cut-off for AMI. This may imply that AMI may occur at any group of studies. But the significant reduction in the serum levels of Apo A2, Apo B, Apo C3, Apo E and a significant increase in serum levels of Apo A1, Apo C2 and blood CD4 counts as the length of therapy lengthened may indicate possible cardio-protective effects of the ART on the heart, which may connote recovery.

Keywords: ART, apolipoprotein, HIV, myocardial infarction

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14457 Changing Emphases in Mental Health Research Methodology: Opportunities for Occupational Therapy

Authors: Jeffrey Chase

Abstract:

Historically the profession of Occupational Therapy was closely tied to the treatment of those suffering from mental illness; more recently, and especially in the U.S., the percentage of OTs identifying as working in the mental health area has declined significantly despite the estimate that by 2020 behavioral health disorders will surpass physical illnesses as the major cause of disability worldwide. In the U.S. less than 10% of OTs identify themselves as working with the mentally ill and/or practicing in mental health settings. Such a decline has implications for both those suffering from mental illness and the profession of Occupational Therapy. One reason cited for the decline of OT in mental health has been the limited research in the discipline addressing mental health practice. Despite significant advances in technology and growth in the field of neuroscience, major institutions and funding sources such as the National Institute of Mental Health (NIMH) have noted that research into the etiology and treatment of mental illness have met with limited success over the past 25 years. One major reason posited by NIMH is that research has been limited by how we classify individuals, that being mostly on what is observable. A new classification system being developed by NIMH, the Research Domain Criteria (RDoc), has the goal to look beyond just descriptors of disorders for common neural, genetic, and physiological characteristics that cut across multiple supposedly separate disorders. The hope is that by classifying individuals along RDoC measures that both reliability and validity will improve resulting in greater advances in the field. As a result of this change NIH and NIMH will prioritize research funding to those projects using the RDoC model. Multiple disciplines across many different setting will be required for RDoC or similar classification systems to be developed. During this shift in research methodology OT has an opportunity to reassert itself into the research and treatment of mental illness, both in developing new ways to more validly classify individuals, and to document the legitimacy of previously ill-defined and validated disorders such as sensory integration.

Keywords: global mental health and neuroscience, research opportunities for ot, greater integration of ot in mental health research, research and funding opportunities, research domain criteria (rdoc)

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14456 Analysis of Kilistra (Gokyurt) Settlement within the Context of Traditional Residential Architecture

Authors: Esra Yaldız, Tugba Bulbul Bahtiyar, Dicle Aydın

Abstract:

Humans meet their need for shelter via housing which they structure in line with habits and necessities. In housing culture, traditional dwelling has an important role as a social and cultural transmitter. It provides concrete data by being planned in parallel with users’ life style and habits, having their own dynamics and components as well as their designs in harmony with nature, environment and the context they exist. Textures of traditional dwelling create a healthy and cozy living environment by means of adaptation to natural conditions, topography, climate, and context; utilization of construction materials found nearby and usage of traditional techniques and forms; and natural isolation of construction materials used. One of the examples of traditional settlements in Anatolia is Kilistra (Gökyurt) settlement of Konya province. Being among the important centers of Christianity in the past, besides having distinctive architecture, culture, natural features, and geographical differences (climate, geological structure, material), Kilistra can also be identified as a traditional settlement consisting of family, religious and economic structures as well as cultural interaction. The foundation of this study is the traditional residential texture of Kilistra with its unique features. The objective of this study is to assess the conformity of traditional residential texture of Kilistra with present topography, climatic data, and geographical values within the context of human scale construction, usage of green space, indigenous construction materials, construction form, building envelope, and space organization in housing.

Keywords: traditional residential architecture, Kilistra, Anatolia, Konya

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14455 The Role of Physical Capital on the Accessibility of Livelihood of Indigenous People

Authors: Anjli Pathak, Harshit Sosan Lakra, Smriti Mishra

Abstract:

The increasing urbanization affects the external environment in which people exist and imposes livelihood vulnerability to shocks and stresses. Although research on the linkages between urbanization and vulnerability has been increasing, only a few studies have examined the caste/ethnicity in livelihood vulnerability. In this study, we explore how physical capital influences vulnerability among indigenous people in the context of livelihood. The study identifies the dimensions and indicators of physical capital that influence the profile of household vulnerability in the livelihood-building process. The result identified five dimensions and 19 indicators of livelihood vulnerability. The study also visualizes the inter-relationship between physical capital and other livelihood capital in formulating the livelihood vulnerability framework.

Keywords: urbanization, livelihood vulnerability, indigenous people, physical capital

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14454 Response of Diaphragmatic Excursion to Inspiratory Muscle Trainer Post Thoracotomy

Authors: H. M. Haytham, E. A. Azza, E.S. Mohamed, E. G. Nesreen

Abstract:

Thoracotomy is a great surgery that has serious pulmonary complications, so purpose of this study was to determine the response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy. Thirty patients of both sexes (16 men and 14 women) with age ranged from 20 to 40 years old had done thoracotomy participated in this study. The practical work was done in cardiothoracic department, Kasr-El-Aini hospital at faculty of medicine for individuals 3 days Post operatively. Patients were assigned into two groups: group A (study group) included 15 patients (8 men and 7 women) who received inspiratory muscle training by using inspiratory muscle trainer for 20 minutes and routine chest physiotherapy (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Group B (control group) included 15 patients (8 men and 7 women) who received the routine chest physiotherapy only (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Ultrasonography was used to evaluate the changes in diaphragmatic excursion before and after training program. Statistical analysis revealed a significant increase in diaphragmatic excursion in the study group (59.52%) more than control group (18.66%) after using inspiratory muscle trainer post operatively in patients post thoracotomy. It was concluded that the inspiratory muscle training device increases diaphragmatic excursion in patients post thoracotomy through improving inspiratory muscle strength and improving mechanics of breathing and using of inspiratory muscle trainer as a method of physical therapy rehabilitation to reduce post-operative pulmonary complications post thoracotomy.

Keywords: diaphragmatic excursion, inspiratory muscle trainer, ultrasonography, thoracotomy

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14453 Understanding Traditional Healing Practices and the Categories of Practices from Fijian iTaukei’s Perspectives

Authors: Dan Frederick Orcherton, Maria Orcherton, Matthew Kensen

Abstract:

This study takes an in-depth look at how traditional healing practices (THPs) are perceived by the iTaukei people living in villages and periurban areas in Fiji Islands. The research used both qualitative and quantitative knowledge/data gathered from six villages in Viti Levu, Fiji Islands, to determine, first, the perception(s) of THPs among the iTaukei; second, what THPs successfully survive and are still important to the iTaukei way of life; and third, what factors influence the iTaukei’s health-seeking behavior or choices between Western and traditional medical systems in their villages. Results confirm that the knowledge healers used to hold to cure common illnesses is now more dispersed and shared with community members; healers/elders’ roles in iTaukei villages are important for cultural–spiritual–social causes of illnesses, and for more complex cases, there are specialized iTaukei healers. Recommendations in the form of categories of practices are offered for practitioners to work more effectively and affectively with the iTaukei.

Keywords: iTaukei peoples, traditional healing practices, traditional healers, categories of practice

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14452 Dry Needling Treatment in 38 Cases of Chronic Sleep Disturbance

Authors: P. Gao, Z. Q. Li, Y. G. Jin

Abstract:

In the past 10 years, computers and cellphones have become one of the most important factors in our lives, and one which has a tremendously negative impact on our muscles. Muscle tension may be one of the causes of sleep disturbance. Tension in the shoulders and neck can affect blood circulation to the muscles. This research uses a dry needling treatment to reduce muscle tension in order to determine if the strain in the head and shoulders can influence sleep duration. All 38 patients taking part in the testing suffered from tinnitus and have been experiencing disturbed sleep for at least one to five years. Even after undergoing drug therapy treatments and traditional acupuncture therapies, their sleep disturbances have not shown any improvement. After five to 10 dry needling treatments, 24 of the patients reported an improvement in their sleep duration. Five patients considered themselves to be completely recovered, while 12 patients experienced no improvement. This study investigated these pathogenic and therapeutic problems. The standard treatment for sleep disturbances is drug-based therapy; the results of most standard treatments are unfortunately negative. The result of this clinical research has demonstrated that: The possible cause of sleep disturbance for a lot of patients is the result of tensions in the neck and shoulder muscles. Blood circulation to those muscles is also influenced by the duration of sleep. Hypertonic neck and shoulder muscles are considered to impact sleeping patterns and lead to disturbed sleep. Poor posture, often adopted while speaking on the phone, is one of the main causes of hypertonic neck and shoulder muscle problems. The dry needling treatment specifically focuses on the release of muscle tension.

Keywords: dry needling, muscle tension, sleep duration, hypertonic muscles

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14451 To Assess Variables Related to Self-Efficacy for Increasing Physical Activity in Advanced-Stage Cancer Patients

Authors: S. Nikpour, S. Vahidi, H. Haghani

Abstract:

Introduction: Exercise has mental and physical health benefits for patients with advanced stage cancer who actively receive chemotherapy, yet little is known about patients’ levels of interest in becoming more active or their confidence in increasing their activity level. Methods and materials: A convenience sample of 200 patients with advanced-stage cancer who were receiving chemotherapy completed self-report measures assessing physical activity level, mood, and quality-of-life variables. Qualitative data on patient-perceived benefits of, and barriers to, physical activity also were collected, coded by independent raters, and organized by predominant themes. Results: Current physical activity level, physical activity outcome expectations, and positive mood were significantly associated with self-efficacy. Fatigue was the most frequently listed barrier to physical activity; improved physical strength and health were the most commonly listed benefits. Participants identified benefits related to both general health and cancer-symptom management that were related to exercise. 59.5% of participants reported that they were seriously planning to increase or maintain their physical activity level, and over 40% reported having interest in receiving an intervention to become more active. Conclusion: These results suggested that many advanced-stage cancer patients who receive chemotherapy are interested in maintaining or increasing their physical activity level and in receiving professional support for exercise. In addition, these individuals identified general health and cancer-specific benefits of, and barriers to, physical activity. Future research will investigate how these findings may be incorporated into physical activity interventions for advanced-stage oncology patients receiving medical treatment.

Keywords: physical activity, cancer, self-efficacy

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14450 The Effects of Parent Psycho-Education Program on Problem-Solving Skills of Parents

Authors: Tuba Bagatarhan, Digdem Muge Siyez

Abstract:

The aim of this research is to examine the effects of the psycho-education program on problem-solving skills of parents of high school students in the risk group for Internet addiction. A quasi-experimental design based on the pre-test, post-test and follow up test including experimental and control groups was used in the research. The independent variable of the study was the parent psycho-education program on problem-solving skills; the dependent variable was the problem-solving skills of parents. The research was conducted with the parents of 52 tenth-grade students in the risk group for Internet addiction from two high schools and volunteer to participate research on evaluation of the effectiveness of internet addiction prevention psycho-education program within the scope of another study. In this study, as 26 students were in the experimental groups in the first-high school, the parents of these 26 students were asked if they would like to participate in the parent psycho-education program on parental problem-solving skills. The parents were volunteer to participate in parent psycho-education program assigned experimental group (n=13), the other parents assigned control group 1 (n=13) in the first high school. The parents of the 26 students were randomly assigned to the control group 2 (n=13) and control group 3 (n=13) in the second high school. The data of the research was obtained via the problem behavior scale - coping - parents form and demographic questionnaire. Four-session parent psycho-education program to cope with Internet addiction and other problem behaviors in their children was applied to the experimental group. No program was applied to the control group 1, control group 2 and control group 3. In addition, an internet addiction prevention psycho-education program was applied to the children of the parents in experimental group and control group 1 within the scope of another study. In the analysis of the obtained data, two-factor variance analysis for repeated measures on one factor was used. Bonferroni post-hoc test was used to find the source of intergroup difference. According to the findings, the psycho-education program significantly increases parents’ problem-solving abilities, and the increase has continued throughout the follow-up test.

Keywords: internet addiction, parents, prevention, psyho-education

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14449 Fostering Resilience in Early Adolescents: A Canadian Evaluation of the HEROES Program

Authors: Patricia L. Fontanilla, David Nordstokke

Abstract:

Introduction: Today’s children and youth face increasing social and behavioural challenges, leading to delays in social development and greater mental health needs. Early adolescents (aged 9 to 14) are experiencing a rise in mental health symptoms and diagnoses. This study examines the impact of HEROES, a social-emotional learning (SEL) program, on resilience and academic outcomes in early adolescents. The HEROES program is designed to enhance resilience the ability to adapt and thrive in the face of adversity, equipping youth to navigate developmental transitions and challenges. This study’s objective was to evaluate the program’s long-term effectiveness by measuring changes in resilience and academic resilience across 10 months. Methodology: This study collected data from 21 middle school students (grades 7 to 9) in a rural Canadian school. Quantitative data were gathered at four intervals: pre-intervention, post-intervention, and at 2- and 4-month follow-ups. Data were analyzed with linear mixed models (LMM). Results: Findings showed statistically significant increases in academic resilience over time and significant increases in resilience from pre-intervention to 2 and 4 months later. Limitations included a small sample size, which may affect generalizability. Conclusion: The HEROES program demonstrates promise in increasing resilience and academic resilience among early adolescents through SEL skill development.

Keywords: academic resilience, early adolescence, resilience, SEL, social-emotional learning program

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14448 Synthesis and Surface Engineering of Lanthanide Nanoparticles for NIR Luminescence Imaging and Photodynamic Therapy

Authors: Syue-Liang Lin, C. Allen Chang

Abstract:

Luminescence imaging is an important technique used in biomedical research and clinical diagnostic applications in recent years. Concurrently, the development of NIR luminescence probes / imaging contrast agents has helped the understanding of the structural and functional properties of cells and animals. Photodynamic therapy (PDT) is used clinically to treat a wide range of medical conditions, but the therapeutic efficacy of general PDT for deeper tumor was limited by the penetration of excitation source. The tumor targeting biomedical nanomaterials UCNP@PS (upconversion nanoparticle conjugated with photosensitizer) for photodynamic therapy and near-infrared imaging of cancer will be developed in our study. Synthesis and characterization of biomedical nanomaterials were completed in this studies. The spectrum of UCNP was characterized by photoluminescence spectroscopy and the morphology was characterized by Transmission Electron Microscope (TEM). TEM and XRD analyses indicated that these nanoparticles are about 20~50 nm with hexagonal phase. NaYF₄:Ln³⁺ (Ln= Yb, Nd, Er) upconversion nanoparticles (UCNPs) with core / shell structure, synthesized by thermal decomposition method in 300°C, have the ability to emit visible light (upconversion: 540 nm, 660 nm) and near-infrared with longer wavelength (downconversion: NIR: 980 nm, 1525 nm) by absorbing 800 nm NIR laser. The information obtained from these studies would be very useful for applications of these nanomaterials for bio-luminescence imaging and photodynamic therapy of deep tumor tissue in the future.

Keywords: Near Infrared (NIR), lanthanide, core-shell structure, upconversion, theranostics

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