Search results for: visually impaired adolescents
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1113

Search results for: visually impaired adolescents

303 Effectiveness of Impairment Specified Muscle Strengthening Programme in a Group of Disabled Athletes

Authors: A. L. I. Prasanna, E. Liyanage, S. A. Rajaratne, K. P. A. P. Kariyawasam, A. A. J. Rajaratne

Abstract:

Maintaining or improving the muscle strength of the injured body part is essential to optimize performance among disabled athletes. General conditioning and strengthening exercises might be ineffective if not sufficiently intense enough or targeted for each participant’s specific impairment. Specific strengthening programme, targeted to the affected body part, are essential to improve the strength of impaired muscles and increase in strength will help reducing the impact of disability. Methods: The muscle strength of hip, knee and ankle joints was assessed in a group of randomly selected disabled athletes, using the Medical Research Council (MRC) grading. Those having muscle strength of grade 4 or less were selected for this study (24 in number) and were given and a custom made exercise program designed to strengthen their hip, knee or ankle joint musculature, according to the muscle or group of muscles affected. Effectiveness of the strengthening program was assessed after a period of 3 months. Results: Statistical analysis was done using the Minitab 16 statistical software. A Mann-Whitney U test was used to compare the strength of muscle group before and after exercise programme. A significant difference was observed after the three month strengthening program for knee flexors (Left and Right) (P =0.0889, 0.0312) hip flexors (left and right) (P=0.0312, 0.0466), hip extensors (Left and Right) (P=0.0478, 0.0513), ankle plantar flexors (Left and Right) (P=0.0466, 0.0423) and right ankle dorsiflexors (P= 0.0337). No significant difference of strength was observed after the strengthening program in the knee extensors (left and right), hip abductors (left and right) and left ankle dorsiflexors. Conclusion: Impairment specific exercise programme appear to be beneficial for disabled athletes to significantly improve the muscle strength of the affected joints.

Keywords: muscle strengthening programme, disabled athletes, physiotherapy, rehabilitation sciences

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302 Self-Determination and Mental Disorders: Phenomenological Approach

Authors: Neringa Bagdonaite

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Background: The main focus of this paper is to explore how self-determination interplays in suicidal and addictive context leading one to autonomously choose self-destructive addictive behaviour or suicidal intentions. Methods: Phenomenological descriptions of the experiential structure of self-determination in addiction and suicidal mental life are used. The phenomenological method describes structures of mental life from the first-person-perspective, with a focus on how an experienced object is given in a subject’s conscious experience. Results: A sense of self-determination in the context of suicidal and addictive behaviour is possibly impaired. In the context of suicide, it's proposed that suicide is always experienced at least minimally self-determined, as it's the last freely discovered self-efficient behaviour, in terms of radically changing one's desperate mental state. Suicide can never be experienced as fully self-determined because no future retrospective re-evaluation of behaviour is possible. Understanding self-determination in addiction is challenging because addicts perceive themselves and experience situations differently depending on: (I) their level of intoxication; (II) whether the situation is in the moment or in retrospect; and (III) the goals set out in that situation. Furthermore, within phenomenology addiction is described as an embodied custom, which‘s acquired and established while performing 'psychotropic technique'. The main goal of performing such a technique is to continue 'floating in an indifference state' or being 'comfortably numb'. Conclusions: Based on rich phenomenological descriptions of the studied phenomenon, this paper draws on the premise that to experience self-determination in both suicide and addiction, underlying desperate or negative emotional states are needed. Such underlying desperate or negative mental life experiences are required for one to pre-reflectively evaluate suicide or addictive behaviours as positive, relieving or effective in terms of changing one's emotional states. Such pre-reflective positive evaluations serve as the base for the continuation of behaviour and later are identified reflectively.

Keywords: addiction, phenomenology, self-determination, self-effectivity, suicide

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301 Risk Factors for Diabetic Foot: Upper Egypt Experience

Authors: Ali Kassem, Mohamed Alsenbasy, Ahmed Nagaah

Abstract:

Background: Diabetic foot is one of the often neglected complications of diabetes mellitus It was reported that patients of diabetic foot ulcer (DFU) have considerable morbidity and mortality. Due to arterial abnormalities, diabetic neuropathy, as well as the tendency to delayed wound healing, foot infection and or gangrene is relatively common in diabetic patients. Foot related problems are responsible for up to 50% of diabetic related hospital admissions. Aim of work: The aim of the present study is to assess the risk factors for DFU in diabetic patients attending Sohag University Hospitals (Upper Egypt) Material and methods: The present study includes 100 diabetic foot patients attending the diabetic outpatient clinic of Sohag University Hospitals. For all of the studied patients the following were done: Full medical history and clinical examination; thorough foot examination; Laboratory tests including: Blood glucose level, HBA1c, serum lipids and renal function tests, ECG and Echocardiography, Doppler study on the lower limbs. Results: Sixty eight percent of the affected patients were males versus 32 % female patients. All male patients and none of the female were smoker. Seventy nine percent of patients were living in rural areas versus 14 % in urban areas. Duration of diabetes was more than 12 years in 74%, less than 12 years in 26% of patients. Fifty percent of patients have associated hypertension, 46% have dyslipidemia, 18% have ischemic heart disease or old myocardial infarction and 8% have impaired renal function. History of previous foot ulcers was reported in 11 % and foot amputation in 2% of patients. Conclusion: Male gender, low socioeconomic status, smoking, long duration of diabetes, other cardiovascular risk factors particularly hypertension and previous history of foot ulceration are the major risk factors for diabetic foot in our locality.

Keywords: diabetic foot, diabetic neuropathy, foot gangrene, risk factors for diabetic complications

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300 Rendering Cognition Based Learning in Coherence with Development within the Context of PostgreSQL

Authors: Manuela Nayantara Jeyaraj, Senuri Sucharitharathna, Chathurika Senarath, Yasanthy Kanagaraj, Indraka Udayakumara

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PostgreSQL is an Object Relational Database Management System (ORDBMS) that has been in existence for a while. Despite the superior features that it wraps and packages to manage database and data, the database community has not fully realized the importance and advantages of PostgreSQL. Hence, this research tends to focus on provisioning a better environment of development for PostgreSQL in order to induce the utilization and elucidate the importance of PostgreSQL. PostgreSQL is also known to be the world’s most elementary SQL-compliant open source ORDBMS. But, users have not yet resolved to PostgreSQL due to the facts that it is still under the layers and the complexity of its persistent textual environment for an introductory user. Simply stating this, there is a dire need to explicate an easy way of making the users comprehend the procedure and standards with which databases are created, tables and the relationships among them, manipulating queries and their flow based on conditions in PostgreSQL to help the community resolve to PostgreSQL at an augmented rate. Hence, this research under development within the context tends to initially identify the dominant features provided by PostgreSQL over its competitors. Following the identified merits, an analysis on why the database community holds a hesitance in migrating to PostgreSQL’s environment will be carried out. These will be modulated and tailored based on the scope and the constraints discovered. The resultant of the research proposes a system that will serve as a designing platform as well as a learning tool that will provide an interactive method of learning via a visual editor mode and incorporate a textual editor for well-versed users. The study is based on conjuring viable solutions that analyze a user’s cognitive perception in comprehending human computer interfaces and the behavioural processing of design elements. By providing a visually draggable and manipulative environment to work with Postgresql databases and table queries, it is expected to highlight the elementary features displayed by Postgresql over any other existent systems in order to grasp and disseminate the importance and simplicity offered by this to a hesitant user.

Keywords: cognition, database, PostgreSQL, text-editor, visual-editor

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299 Hospital Acquired Bloodstream Infections Among Patients With Hematological and Solid Malignancies: Epidemiology, Causative Pathogens and Mortality

Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

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The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

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298 Protective Effects of Coenzyme Q10 and N-Acetylcysteine on Myocardial Oxidative Stress, Inflammation, and Impaired Energy metabolism in Carbon Tetrachloride Intoxicated Rats

Authors: Nayira A. Abd Elbaky, Amal J. Fatani, Hazar Yaqub, Nouf M. Al-Rasheed, Naglaa El-Orabi, Mai Osman

Abstract:

The present work is aimed to evaluate the protective effect of N-acetyl cystiene (NAC), coenzyme Q10 (CoQ10), and their combination against carbon tetrachloride (CCl4)-induced cardiotoxicity in rats. CCl4 treatment significantly elevated the levels of cardiac oxidative stress bio markers including nitric oxide (NO) and malondialdehyde (MDA). A concomitant decrease in the level of reduced glutathione and the activity of membrane bound enzyme, calcium-adenosine triphosphatase were observed in the hearts of rats exposed to CCl4 compared to respective values in normal group. Quantitative analysis of myocardial energy metabolism revealed a significant decrease in the glucose content coupled with depletion in the activities of myocardial glycolytic enzymes as hexokinase (HK), phosphofructokinase (PFK) and lactate dehydrogenase (LDH) after CCl4 treatment. In addition, a significant elevation in myocardial hydroxyproline level was observed in CCl4 intoxicated rats indicating interstitial collagen accumulation. Pretreatment with either NAC, CoQ10 or their combination successively alleviated the alterations in myocardial oxidative stress and antioxidant markers, as well as effectively up-regulated the decrease in cardiac energetic biomarkers in CCl4 intoxicated rats. Moreover, these antioxidants markedly reduced myocardial hydroxyproline level versus that of CCl4-treated animals. In conclusion, the present results illustrated that the prophylactic use of the current antioxidant resulted in a remarkable cardioprotective effect against CCl4 induced myocardial damage, which suggest that they may candidates as prophylactic agents against different cardio-toxins.

Keywords: carbon tetrachloride, lipid peroxidation, antioxidant, energy metabolism, hydroxyproline

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297 Service Blueprint for Improving Clinical Guideline Adherence via Mobile Health Technology

Authors: Y. O’Connor, C. Heavin, S. O’ Connor, J. Gallagher, J. Wu, J. O’Donoghue

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Background: To improve the delivery of paediatric healthcare in resource-poor settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which outlines how (a) this process can be digitised and (b) adherence could be improved as a result. Aim: To explore how an electronic mobile version of CCM (eCCM) can overcome issues associated with the paper-based CCM protocol (poor adherence to guidelines) vis-à-vis service blueprinting. This service blueprint will outline how (a) the CCM process can be digitised using mobile Clinical Decision Support Systems software to support clinical decision-making and (b) adherence can be improved as a result. Method: Development of a single service blueprint for a standalone application which visually depicts the service processes (eCCM) when supporting the CHWs, using an application known as Supporting LIFE (Low cost Intervention For disEase control) as an exemplar. Results: A service blueprint is developed which illustrates how the eCCM solution can be utilised by CHWs to assist with the delivery of healthcare services to children. Leveraging smartphone technologies can (a) provide CHWs with just-in-time data to assist with their decision making at the point-of-care and (b) improve CHW adherence to CCM guidelines. Conclusions: The development of the eCCM opens up opportunities for the CHWs to leverage the inherent benefit of mobile devices to assist them with health service delivery in rural settings. To ensure that benefits are achieved, it is imperative to comprehend the functionality and form of the eCCM service process. By creating such a service blueprint for an eCCM approach, CHWs are provided with a clear picture regarding the role of the eCCM solution, often resulting in buy-in from the end-users.

Keywords: adherence, community health workers, developing countries, mobile clinical decision support systems, CDSS, service blueprint

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296 Postural Balance And Falls Risk In Persons With Multiple Sclerosis: Effect Of Gender Differences

Authors: Sonda Jallouli, Sameh Ghroubi, Salma Sakka, Abdelmoneem Yahia, Mohamed Habib Elleuch, Imen Ben Dhia, Chokri Mhiri, Omar Hammouda

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The pathophysiology, prevalence, and progression of MS are gender dependent. Indeed, the inflammation is more pronounced in women, but the neurodegeneration is more important in men. In addition, women have more sleep disorders while men suffer more from cognitive decline. These non-physical disorders can negatively affect postural balance and fall risk. However, no study has examined the difference between men and women in those physical parameters in MS. Our objective was to determine the effect gender difference on postural balance and fall risk in MS persons. Methods: Eight men and twelve women with relapsing remitting-MS participated in this study. The assessment includes a posturographic examination to assess static (with eyes opened (EO) and eyes closed (EC)) and dynamic (with EO) postural balance. Unipedal balance and fall risk were assessed by a clinical unipedal balance test and the Four Square Step Test, respectively. Sleep quality was assessed using Spiegel's questionnaire, and cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA) and the Simple Reaction Time Test. Results: Compared to men, women showed an increase in CdPVm in static bipedal condition with EC (p=0.037; d=0.71) and a decrease in MoCA scores (p=0.028; d=1.06). No gender differences were found in the other tests. Discussion: Static postural balance was more impaired in women compared to men. This result could be explained by the more pronounced cognitive decline observed in women compared to men. Indeed, cognitive disorders have been shown to be predictive factors of postural balance impairment. Conclusion: women were less stable than men in the static condition, possibly due to their lower cognitive performance. This gender difference could be taken into account by therapists in training programs.

Keywords: multiple sclerosis, bipedal postural balance, fall risk, sleep disturbance, cognitive deficiency

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295 Nursing Experience for a Lung Cancer Patient Undergoing First Time Concurrent Chemotherapy and Radiation Therapy

Authors: Hui Ling Chen

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This article describes the experience of caring for a 68-year-old lung cancer patient undergoing the initial stage of concurrent chemotherapy and radiation therapy during the period of October 21 to November 16. In this study, the author collected data through observation, interviews, medical examination, and the use of Roy’s adaptation model as a guide for data collection and assessment. This study confirmed that chemotherapy induced nausea and vomiting, and radiation therapy impaired skin integrity. At the same time, the patient experienced an anxious reaction to the initial cancer diagnosis and the insertion of subcutaneous infusion ports at the start of medical treatment. Similarly, the patient’s wife shares his anxiety, not to mention the feeling of inadequacy from the lack of training in cancer care. In response, the nursing intervention strategy has included keeping the patient and his family informed of his treatment progress, transfer of cancer care knowledge, and providing them with spiritual support. For example, the nursing staff has helped them draw up a mutually agreeable dietary plan that best suits the wife’s cooking skills, provided them with knowledge in pre- and post-radiation skin care, as well as means to cope with nausea and vomiting reactions. The nursing staff has also worked on building rapport with the patient and his spouse, providing them with encouragement, caring attention and companionship. After the patient was discharged from the hospital, the nursing staff followed up with caring phone calls to help the patient and his family make life-style adjustments to normalcy. The author hopes that his distinctive nursing experience can be useful as a reference for the clinical care of lung cancer patients undergoing the initial stage of concurrent chemotherapy and radiation therapy treatment.

Keywords: lung cancer, initiate diagnosis, concurrent chemotherapy and radiation therapy, nursing care

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294 Facile Surfactant-Assisted Green Synthesis of Stable Biogenic Gold Nanoparticles with Potential Antibacterial Activity

Authors: Sneha Singh, Abhimanyu Dev, Vinod Nigam

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The major issue which decides the impending use of gold nanoparticles (AuNPs) in nanobiotechnological applications is their particle size and stability. Often the AuNPs obtained biomimetically are considered useless owing to their instability in the aqueous medium and thereby limiting the widespread acceptance of this facile green synthesis procedure. So, the use of nontoxic surfactants is warranted to stabilize the biogenic nanoparticles (NPs). But does the surfactant only play a role in stabilizing by being adsorbed to the NPs surface or can it have any other significant contribution in synthesis process and controlling their size as well as shape? Keeping this idea in mind, AuNPs were synthesized by using surfactant treated (lechate) and untreated (cell lysate supernatant) Bacillus licheniformis cell extract. The cell extracts mediated reduction of chloroauric acid (HAuCl 4) in the presence of non-ionic surfactant, Tween 20 (TW20), and its effect on the AuNPs stability was studied. Interestingly, the surfactant used in the study served as potential alternative to harvest cellular enzymes involved in bioreduction process in a hassle free condition. The surfactants ability to solubilize/leach membrane proteins and simultaneously stabilizing the AuNPs could have advantage from process point of view as it will reduce the time and economics involve in the nanofabrication of biogenic NPs. The synthesis was substantiated with UV-Vis spectroscopy, Dynamic light scattering study, FTIR spectroscopy, and Transmission electron microscopy. The Zeta potential of AuNPs solutions was measured routinely to corroborate the stability observations recorded visually. Highly stable, ultra-small AuNPs of 2.6 nm size were obtained from the study. Further, the biological efficacy of the obtained AuNPs as potential antibacterial agent was evaluated against Bacilllus subtilis, Pseudomonas aeruginosa, and Escherichia coli by observing the zone of inhibition. This potential of AuNPs of size < 3 nm as antibacterial agent could pave way for development of new antimicrobials and overcoming the problems of antibiotics resistance

Keywords: antibacterial, bioreduction, nanoparticles, surfactant

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293 Psychopathic Disorders and Judges Sentencing: Can Neurosciences Change this Aggravating Factor in a Mitigating Factor?

Authors: Kevin Moustapha

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Psychopathy is perceived today as being «the most important concept in the criminal justice system» and as «the most important legal notion of the early 21 th century». The explosion of research related to psychopathy seems to perfectly illustrate this trend. Traditionally, many studies tend to focus on links between insanity defense and psychopathy. That is why our purpose in this article is to analyze psychopathic disorders in the scope of judges sentencing in Canada. Indeed, in every Canadian case related to dangerous offenders, judges must balance between fairness and protection of the individuals rights of the accused and protection of society from dangerous predators who may commit future acts of physical or sexual violence. Increasingly, psychopathic disorders are taking an important part in judge sentencing, especially in Canada. This phenomenon can be illustrated by the high proportion of psychopath offenders incarcerated in North American prisons. Many decisions in Canadians courtrooms seem to point out that psychopathy is often used as a strong argument by the judges to preserve public safety. The fact that psychopathy is often associated with violence, recklessness and recidivism, it could explain why many judges consider psychopathic disorders as an aggravating factor. Generally, the judge reasoning is based on article 753 of Canadian Criminal Code related to dangerous offenders, which is used for individuals who show a pattern of repetitive and persistent aggressive behaviour. However, with cognitive neurosciences, the psychopath’s situation in courtrooms would probably change. Cerebral imaging and news data provided by the neurosciences show that emotional and volitional functions in psychopath’s brains are impaired. Understanding these new issues could enable some judges to recognize psychopathic disorders as a mitigating factor. Two important questions ought to be raised in this article: can exploring psychopaths ‘brains really change the judge sentencing in Canadian courtrooms? If yes, can judges consider psychopathy more as a mitigating factor than an aggravating factor?

Keywords: criminal law, judges sentencing, neurosciences, psychopathy

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292 Statistical Approach to Identify Stress and Biases Impairing Decision-Making in High-Risk Industry

Authors: Ph. Fauquet-Alekhine

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Decision-making occurs several times an hour when working in high risk industry and an erroneous choice might have undesirable outcomes for people and the environment surrounding the industrial plant. Industrial decisions are very often made in a context of acute stress. Time pressure is a crucial stressor leading decision makers sometimes to boost up the decision-making process and if it is not possible then shift to the simplest strategy. We thus found it interesting to update the characterization of the stress factors impairing decision-making at Chinon Nuclear Power Plant (France) in order to optimize decision making contexts and/or associated processes. The investigation was based on the analysis of reports addressing safety events over the last 3 years. Among 93 reports, those explicitly addressing decision-making issues were identified. Characterization of each event was undertaken in terms of three criteria: stressors, biases impairing decision making and weaknesses of the decision-making process. The statistical analysis showed that biases were distributed over 10 possibilities among which the hypothesis confirmation bias was clearly salient. No significant correlation was found between criteria. The analysis indicated that the main stressor was time pressure and highlights an unexpected form of stressor: the trust asymmetry principle of the expert. The analysis led to the conclusion that this stressor impaired decision-making from a psychological angle rather than from a physiological angle: it induces defensive bias of self-esteem, self-protection associated with a bias of confirmation. This leads to the hypothesis that this stressor can intervene in some cases without being detected, and to the hypothesis that other stressors of the same kind might occur without being detected too. Further investigations addressing these hypotheses are considered. The analysis also led to the conclusion that dealing with these issues implied i) decision-making methods being well known to the workers and automated and ii) the decision-making tools being well known and strictly applied. Training was thus adjusted.

Keywords: bias, expert, high risk industry, stress.

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291 “Fake It Till You Make It”: A Qualitative Study into the Well-being of Autistic Women

Authors: Kathleen Seers, Rachel Hogg

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Diagnosis of Autism Spectrum Disorder (ASD) in women is increasing, prompting research into the presentation of female ASD and exploring why females are failing to meet the diagnostic threshold. One explanation is the use of masking behaviors, where traits of ASD are suppressed and gender-appropriate behaviors are mimicked to reduce the visibility and victimization of ASD girls. Current research explores ASD presentation and the lived experiences of ASD girls and adolescents; however, there is a paucity of literature in relation to the intra- and inter- psychic experiences of ASD women. Through a social constructionist framework, this qualitative study sought to understand how the construction of gender and the medicalisation of ASD influences women’s experiences of ASD. This study also explored the use and consequence of masking strategies and the impact this has on well-being. Eight women were interviewed, and three major themes were identified. The themes outline the influence of gender expectations and social norms on the women’s experiences, the significance of diagnosis to their identity, and the influence of the medicalization of ASD. Participants shared experiences of feeling different and internalizing blame for this difference. The feeling of difference was a major contributor to the women’s positive or negative mental well-being. The process of diagnosis allowed participants to create and confirm their identity. Diagnosis also led to improvements in well-being, however, the findings also explore the complexity of labeling individuals with a disorder and the difficulties that arise from the construct of ‘functionality’ for those with Autism. The study also explores the temporal nature of ASD and the changing experiences of women as they mature. It is hoped this study promotes discussion and provides clinicians and those connected to ASD women with insights into the support ASD women require to live authentic lives.

Keywords: female autism, gender, masking, social constructionism

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290 Students with Hearing Impairment and Their Access to Inclusive Education in Nagpur City, India: An Exploratory Study

Authors: Avanika Gupta

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Education plays a significant and remedial role in balancing the socio-economic fabric of a country. Inclusive education is considered as the most appropriate mode of teaching students with hearing impairment (SwHI) by various national and international legislations. But inclusive education is still an evolving concept among the disability studies scholars and policy makers in India. The study aimed to examine accessibility of SwHI in mainstream schools if there are special provisions for SwHI. The study also intended to identify if the provisions are same for deaf and hard-of-hearing students. Using stratified random sampling technique, a school was selected from each of the six administrative zones of Nagpur city. All the selected schools had primary and secondary level education and were co-educational in nature. Interview with principals of these schools and focused-group- observation method showcased lack of accessibility for SwHI in attending schools. Not even a single school had a hearing impaired student, either deaf or hard-of-hearing depicting the double marginalization of SwHI. This is despite the fact that the right to education is a fundamental right in India, and national legislation on disability has special provisions for ensuring educational opportunities to SwHI. None of the schools even had an Indian Sign Language (ISL) instructor. Both observations seemed cause and effect of one another. One of the principals informed that they have seats for all students with disabilities but they usually lie vacant due to lack of awareness among the parents. One school had 2 students with locomotive impairment while another had a student with visual impairment. Principals of two special schools were also interviewed to understand the reason behind the low enrollment rate of SwHI in mainstream schools. Guardian preference, homogeneity, relatable faculty, familiar environment were some of the chief reasons mentioned. Few suggestions for the policymakers, teachers, guardians and the students are also recommended so that Indian education system could become inclusive in true sense.

Keywords: deaf, hard-of-hearing, inclusive education, India, Nagpur, students with hearing impairment

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289 The Role of Physical Education and Fitness for Active Ageing

Authors: A. Lakshya

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The main aim of this paper is to interpret physical education for children from 5 to 18 years. Schools have the ability to promote positive mental health by developing physical education, which helps to build individual growth, goal setting, decision making, helps in muscular development, self-discipline, stresses relief, leadership qualities that can arise with new skills, prosocial behavior and problem-solving skills. But mostly the children at these early ages ought to hold the disorders as heart attack, diabetes and obesity disorders may increase in large number. The data of P.E has got a very least place, where children are with feeble minds and they acquired a state of inactiveness. Globally, 81% of adolescents aged 11-18 years were insufficiently physically active in the year 2016. Adolescent girls were less active than boys, with the percentage of 85% vs. 78% as well. A recent study of California schools found that students are sedentary most of the time during PE classes, with just four minutes of every half-hour spent in vigorous physical activity. Additionally, active PE time decreases with larger class sizes. Students in classes with more than forty-five students are half as active as students in smaller class sizes. The children in adolescence age they acquire more creative ideas hence they create new hairstyles, cooking styles and dressing styles. Instead, all the children are engaging themselves to TV (television) and video games. The development of physical quality not only improves students ’ physical fitness but is also conducive to the psychological development of the students. Physical education teaching should pay more attention to the training of physical quality in the future.

Keywords: physical education, prosocial behavior, leadership, goal setting

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288 Childhood Trauma and Borderline Personality: An Analysis of the Root Causes and Treatment Plans

Authors: Sidika McNeil

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Borderline personality disorder (BPD) is a personality disorder that has been found to have strong origins in childhood trauma. One of the key symptoms of BPD is an association with irregular moods swings, as well as suicidal ideation (SI). Owing to the typically severe trauma patients experience during childhood, it is hard for them to control their emotions and thus makes it hard to emotionally regulate. It is then very common for those suffering from BPD to turn to unhealthy coping mechanisms, such as substance use, unhealthy relationships, and more, often unsuccessfully creating experiences that facilitate safety which leads to further negative experiences. With the high suicide rating among children, adolescents, and teens, and an ever-increasing number of children being diagnosed with BPD, it is very important that more research is done to find further treatments for patients who are currently suffering. Methods: Utilizing data found in prior studies, this paper will analyze the literature to focus on a comprehensive treatment plan for those with DBT. It is currently suggested that with the use of dialectical behavioral therapy (DBT), a therapy that focuses on changing negative thinking patterns and pushes for more positive ones is helpful for treatment for those with BPD. Though this therapy is not a cure to BPD, it does help mitigate the risk; this essay will explore other options that can further the treatment process, such as cognitive analytical therapy (CAT), which focuses on delving into the past to find the root causes of an issue to create coping strategies and harm reduction, a type of therapy used to aid patients in lowering the use of substances without complete cessation. Results: The research provides enough evidence to link between the treatment of BPD with the utilization of CAT.

Keywords: borderline personality disorder, cognitive analytical therapy, dialectical behavioral therapy, harm reduction, suicidal ideation

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287 Early-Onset Asthma and Early Smoking Increase Risk of Bipolar Disorder in Adolescents and Young Adults

Authors: Meng-Huan Wu, Wei-Er Wang, Tsu-Nai Wang, Wei-Jian Hsu, Vincent Chin-Hung Chen

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Objective: Studies have reported a strong link between asthma and bipolar disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and bipolar disorder during adolescence and early adulthood. Methods: A total of 162,766 participants aged 11–16 years were categorized into asthma and non-asthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant’s gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and bipolar disorder. Results: Our findings revealed that asthma increased the risk of bipolar disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.31, 95% CI: 1.12-1.53). Hospitalizations or visits to the emergency department for asthma exhibited a dose–response effect on bipolar disorder (adjusted HR: 1.59, 95% CI: 1.22-2.06). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for bipolar disorder (adjusted HR: 3.10, 95% CI: 1.29-7.44). Conclusions: Patients newly diagnosed with asthma had a 1.3 times higher risk of developing bipolar disorder. Smoking during late childhood or adolescence increases the risk of developing bipolar disorder in patients with asthma.

Keywords: adolescence, asthma, smoking, bipolar disorder, early adulthood

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286 Variants of Fat Mass Obesity Associated rs 9939609 Associated with Obesity and Eating Behavior in Adolescent of Minangkabau Ethnic

Authors: Susmiati, Ingrid S. Surono, Jamsari, Nur Indrawati Lipoeto

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There are two contradicting opinions on the relationship between fat mass obesity associated (FTO) rs 9939609 variants and obesity on various ethnics and races. The first opinion agrees that there is an association between the two variables, yet another one disagree. Minangkabau ethnic had a different dietary pattern with other ethnics in Indonesia. They had higher fat and low fiber intakes compared to the other ethnics groups. There is little research in genetic factors that influence eating behavior (food preference or food selection). The objective of this study was to investigate the association between FTO rs 9939609 variants with obesity and eating behavior in adolescent girls of Minangkabau Ethnic. The research design was case control study. A total of 275 adolescent girls aged 12-15 years old (130 obese and 145 normal) were randomly chosen from four districts at West Sumatera (Padang, Padang Pariaman, Padang Panjang and Tanah Datar). Genetic variants of FTO rs 9939609 were analyzed with Tetra-primer Amplification Refractory Mutation System-Polimerase Chain Reaction (AMRS PCR), eating behavior were gathered using eating habits questionnaire, and Body Mass Index (BMI) was calculated according to BMI Z-score (WHO). The result showed that genetic variants of FTO rs 9939609 (TT, TA and AA genotype) had associated with obesity (p = 0,013), whereas subject with An Allele was significantly associated with obesity (odds ratio 1,62 [95% confidential interval, 1,00-2,60]). Subjects with An Allele carrier reported a higher consumption of fried food (p < 0.05) as compared to TT genotypes carriers. There is no association between genetic variants and meal frequency, fruit and fiber intakes p > 0.05. The genetic variants of FTO rs 9939609 are associated with obesity and eating behavior in adolescent of Minangkabau Ethics.

Keywords: FTO rs9939609, obesity, eating behavior, adolescents

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285 Perception of Neighbourhood-Level Built Environment in Relation to Youth Physical Activity in Malaysia

Authors: A. Abdullah, N. Faghih Mirzaei, S. Hany Haron

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Neighbourhood environment walkability on reported physical activity (PA) levels of students of Universiti Sains Malaysia (USM) in Malaysia. Compared with previous generations, today’s young people spend less time playing outdoors and have lower participation rates in PA. Research suggests that negative perceptions of neighbourhood walkability may be a potential barrier to adolescents’ PA. The sample consisted of 200 USM students (to 24 years old) who live outside of the main campus and engage in PA in sport halls and sport fields of USM. The data were analysed using the t-test, binary logistic regression, and discriminant analysis techniques. The present study found that youth PA was affected by neighbourhood environment walkability factors, including neighbourhood infrastructures, neighbourhood safety (crime), and recreation facilities, as well as street characteristics and neighbourhood design variables such as facades of sidewalks, roadside trees, green spaces, and aesthetics. The finding also illustrated that active students were influenced by street connectivity, neighbourhood infrastructures, recreation facilities, facades of sidewalks, and aesthetics, whereas students in the less active group were affected by access to destinations, neighbourhood safety (crime), and roadside trees and green spaces for their PAs. These results report which factors of built environments have more effect on youth PA and they message to the public to create more awareness about the benefits of PA on youth health.

Keywords: fear of crime, neighbourhood built environment, physical activities, street characteristics design

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284 Digital Rehabilitation for Navigation Impairment

Authors: Milan N. A. Van Der Kuil, Anne M. A. Visser-Meily, Andrea W. M. Evers, Ineke J. M. Van Der Ham

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Navigation ability is essential for autonomy and mobility in daily life. In patients with acquired brain injury, navigation impairment is frequently impaired; however, in this study, we tested the effectiveness of a serious gaming training protocol as a tool for cognitive rehabilitation to reduce navigation impairment. In total, 38 patients with acquired brain injury and subjective navigation complaints completed the experiment, with a partially blind, randomized control trial design. An objective navigation test was used to construct a strengths and weaknesses profile for each patient. Subsequently, patients received personalized compensation training that matched their strengths and weaknesses by addressing an egocentric or allocentric strategy or a strategy aimed at minimizing the use of landmarks. Participants in the experimental condition received psychoeducation and a home-based rehabilitation game with a series of exercises (e.g., map reading, place finding, and turn memorization). The exercises were developed to stimulate the adoption of more beneficial strategies, according to the compensatory approach. Self-reported navigation ability (wayfinding questionnaire), participation level, and objective navigation performance were measured before and after 1 and 4 weeks after completing the six-week training program. Results indicate that the experimental group significantly improved in subjective navigation ability both 1 and 4 weeks after completion of the training, in comparison to the score before training and the scores of the control group. Similarly, goal attainment showed a significant increase after the first and fourth week after training. Objective navigation performance was not affected by the training. This navigation training protocol provides an effective solution to address navigation impairment after acquired brain injury, with clear improvements in subjective performance and goal attainment of the participants. The outcomes of the training should be re-examined after implementation in a clinical setting.

Keywords: spatial navigation, cognitive rehabilitation, serious gaming, acquired brain injury

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283 Cross-Cultural Adaptation and Validation of the Child Engagement in Daily Life in Greek

Authors: Rigas Dimakopoulos, Marianna Papadopoulou, Roser Pons

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Background: Participation in family, recreational activities and self-care is an integral part of health. It is also the main outcome of rehabilitation services for children and adolescents with motor disabilities. There are currently no tools in Greek to assess participation in young children. Purpose: To culturally adapt and validate the Greek version of the Child Engagement in Daily Living (CEDL). Method: The CEDL was cross-culturally translated into Greek using forward-backward translation, review by the expert committee, pretest application and final review. Internal consistency was evaluated using the Cronbach alpha and test-retest reliability using the intra-class correlation coefficient (ICC). Parents of children aged 18 months to 5 years and with motor disabilities were recruited. Participants completed the CEDL and the children’s gross motor function was classified using the Gross Motor Function Classification System (GMFCS). Results: Eighty-three children were included, GMFCS I-V. Mean ± standard deviation of the CEDL domains “frequency of participation” “enjoyment of participation” and “self-care” were 58.4±14.0, 3.8±1.0 and 49.9±24, respectively. Internal consistency of all domains was high; Cronbach alpha for “frequency of participation” was 0.83, for “enjoyment of participation” was 0.76 and for “self-care” was 0.92. Test-retest reliability (ICC) was excellent for the “self-care” (0.95) and good for “frequency of participation” and “enjoyment of participation” domains (0.90 and 0.88, respectively). Conclusion: The Greek CEDL has good reliability. It can be used to evaluate participation in Greek young children with motor disabilities GMFCS levels I-V.

Keywords: participation, child, disabilities, child engagement in daily living

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282 Drama Education: Towards Building Multicultural Adolescent Peer Relationships

Authors: Tahnee West

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Drama education is increasingly understood as a useful tool in promoting positive social change and cultural awareness. The effects of both positive and negative peer relationships are also a researched facet of education systems. Despite this, very little research has been conducted in the intersection of these two areas, even given current, significant public interest surrounding multicultural relationships. This research addresses a problem faced by educators and students: facilitating meaningful multicultural relationships. The research explores the following question in an Australian context: in what ways does Drama education affect peer relationships between culturally diverse students? In doing so, the study explores the various challenges and experiences of a multicultural group of adolescents, in terms of forming and maintaining effective intercultural friendships, while participating in a series of drama workshops. The project presents a starting point for providing educators with strategies for inclusivity and relationship development amongst diverse student populations. Findings show that Drama education can positively affect culturally diverse young people’s peer relationships; interactions between participants and data collected in focus groups throughout the eight-week Drama program show a steady improvement in sense of trust, support, tolerance, empathy, familiarity with other participants, and enjoyment. Data also points to a positive correlation between the Drama activities and improved conflict resolution and communication skills, as well as an improved understanding of the other participants’ cultures. Diversities and commonalities within the group were explored, with similarities encouraging social cohesion, and decreasing cultural ‘cliques’.

Keywords: cultural diversity, drama education, friendship, multicultural, peer relationships

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281 Concepts of Instrumentation Scheme for Thought Transfer

Authors: Rai Sachindra Prasad

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Thought is physical force. This has been well recognized but hardly translated visually or otherwise in the sense of its transfer from one individual to another. In the present world of chaos and disorder with yawning gaps between right and wrong thinking individuals, if it is possible to transfer the right thoughts to replace the wrong ones it would indeed be a great achievement in the present situation of the world which is torn with violence with dangerous thoughts of individuals. Moreover, such a possibility would completely remove the barrier of language between two persons, which at times proves to be a great obstacle in realizing a desired purpose. If a proper instrumentation scheme containing appropriate transducers and electronics is designed and implemented to realize this thought ransfer phenomenon, this would prove to be extremely useful when properly used. Considering the advancements already made in recording the nerve impulses in the brain, which are electrical events of very short durations that move along the axon, it is conceivable that this may be used to good effect in implementing the scheme. In such a proposition one shoud consider the roles played by pineal body, pituitary gland and ‘association’ areas. Pioneer students of brain have thought that associations or connections between sensory input and motor output were made in these areas. It is currently believed that rather than being regions of simple sensory-motor connections, the association areas process and integrate sensory information relayed to them from the primary sensory areas of the cortex and from the thalamus, after the information has been processed, it may be sent to motor areas to be acted upon. Again, even though the role played by pineal body is not known fully to neurologists its interconnection with pituitary gland is a matter of great significance to the ‘Rishis’ and; Seers’ s described in Vedas and Puranas- the ancient Holy books of Hindus. If the pineal body is activated through meditation it would control the pituitary gland thereby the individual’s thoughts and acts. Thus, if thoughts can be picked up by special transducers, these can be connected to suitable electronics circuitry to amplify the signals. These signals in the form of electromagnetic waves can then be transmitted using modems for long distance transmission and eventually received by or passed on to a subject of interest through another set of electronics circuit and devices.

Keywords: modems, pituitary gland, pineal body, thought transfer

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280 Seroprevalence of Toxoplasmosis among Hemato-Oncology Patients in Tertiary Hospital of East Cost Malaysia

Authors: Aisha Khodijah Kholib Jati, Suharni Mohamad, Azlan Husin, Wan Suriana Wan Ab Rahman

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Introduction: Toxoplasmosis is caused by an obligate intracellular parasite, Toxoplasma gondii (T. gondii). It is commonly asymptomatic in normal individual, but it can be fatal to immunocompromised patients as it can lead to severe complications such as encephalitis, chorioetinitis and myocarditis. Objective: The aim of the study was to determine the seroprevalence of toxoplasmosis and its association with socio-demographic and behavioral characteristics among hemato-oncology patients in Hospital USM. Methods: In this cross-sectional study, 56 hemato-oncology patients were screened for immunoglobulin M (IgM) antibodies, immunoglobulin G (IgG) antibodies, and IgG avidity of T. gondii by using ELISA Kit (BioRad, USA). For anti-T. gondii IgG antibody, titer ≥ 9 IU/ml was considered as recent infection, while for IgM, ratio ≥ 1.00 was considered as reactive for the anti-T. gondii IgM antibodies. Low avidity index is considered as recent infection within 20 weeks while high avidity considered as past infection. T. gondii exposure, socio-demographic and behavioral characteristics was assessed by a questionnaire and interview. Results: A total of 28 (50.0%) hemato-oncology patients were seropositive for T. gondii antibodies. Out of that total, 27 (48.21%) patients were IgG+/IgM- and one patient (1.79%) was IgG+/IgM+ with high avidity index. Univariate analysis showed that age, gender, ethnicity, marital status, educational level, employment status, stem cell transplant, blood transfusion, close contact with cats, water supply, and consumption of undercooked meat were not significantly associated with Toxoplasma seropositivity rate. Discussion: The seropositivity rate of IgG anti-T. gondii was high among hemato-oncology patients in Hospital USM. With impaired immune system, these patients might have a severe consequence if the infection reactivated. Therefore, screening for anti-T. gondii may be considered in the future. Moreover, health programme towards healthy food and good hygiene practice need to be implemented.

Keywords: immunocompromised, seroprevalence, socio-demographic, toxoplasmosis

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279 The Counselling Practice of School Social Workers in Swedish Elementary Schools - A Focus Group Study

Authors: Kjellgren Maria, Lilliehorn Sara, Markström Urban

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This article describes the counselling practice of school social workers (SSWs) with individual children. SSWs work in the school system’s pupil health team, whose primary task is health promotion and prevention. The work of SSWs is about helping children and adolescents who, for various reasons, suffer from mental ill-health, school absenteeism, or stress that make them unable to achieve their intended goals. SSWs preferably meet these children in individual counselling sessions. The aim of this article is to describe and analyse SSWs’ experience of counselling with children and to examine the characteristics of counselling practice. The data collection was conducted through four semi-structured focus group interviews with a total of 22 SSWs in four different regions in Sweden. SSWs provide counselling to children in order to bring about improved feelings or behavioural changes. It can be noted that SSWs put emphasis on both the counselling process and the alliance with the child. The interviews showed a common practice among SSWs regarding the structure of the counselling sessions, with certain steps and approaches being employed. However, the specific interventions differed and were characterised by an eclectic standpoint in which SSWs utilise a broad repertoire of therapeutic schools and techniques. Furthermore, a relational perspective emerged as a most prominent focus for the SSWs by re-emerging throughout the material. We believe that SSWs could benefit from theoretical perspectives on ‘contextual model’ and ‘attachment theory’ as ‘models of the mind’. Being emotionally close to the child and being able to follow their development requires a lot from SSWs, as both professional caregivers and as “safe havens”.

Keywords: school social conselling, school social workers, contextual model, attachment thory

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278 Rates of Hematophagous Ectoparasite Consumption during Grooming by an Endemic Madagascar Fruit Bat

Authors: Riana V. Ramanantsalama, Aristide Andrianarimisa, Achille P. Raselimanana, Steven M. Goodman

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Few details are available on the consumption of ectoparasites, specifically bat flies (Diptera: Nycteribiidae and Streblidae), by their chiropteran hosts while grooming. Such details could provide information on the dynamics of host-parasite interactions. This study presents data on ectoparasite ingestion rates for an endemic Malagasy fruit bat (Pteropodidae: Rousettus madagascariensis) occupying a cave day roost colony in northern Madagascar. Using quantified behavioral analyses, grooming and associated ingestion rates were measured from infrared videos taken in close proximity to day-roosting bats. The recorded individual bats could be visually identified to age (adult, juvenile) and sex (male, female), allowing analyses of the proportion of time these different classes allocated to consuming ectoparasites via auto-grooming (self) or allo-grooming (intraspecific) per 10 min video recording session. These figures could then be extrapolated to estimates of individual daily consumption rates. Based on video recordings, adults spent significantly more time auto-grooming and allo-grooming than juveniles. The latter group was not observed consuming ectoparasites. Grooming rates and the average number of ectoparasites consumed per day did not differ between adult males and females. The mean extrapolated number consumed on a daily basis for individual adults was 37 ectoparasites. When these figures are overlaid on the estimated number of adult Rousettus occurring at the roost site during the dry season, the projected daily consumption rate was 57,905 ectoparasites. To the best knowledge of the authors of this study, the details presented here represent the first quantified data on bat consumption rates of their ectoparasites, specifically dipterans. These results provide new insights into host-parasite predation dynamics. More research is needed to explore the mechanism zoonotic diseases isolated from bat flies might be transmitted to their bat hosts, specifically those pathogens that can be communicated via an oral route.

Keywords: diptera, host-parasite interactions, Madagascar, nycteribiidae, pteropodidae, Rousettus madagascariensis

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277 Comparison of Illuminance Levels in Old Omani and Portuguese Forts in Oman

Authors: Maatouk Khoukhi

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Nowadays the reduction of the energy consumed by buildings to achieve mainly the thermal comfort for the occupants represent the main concern for architects and building designers. The common and traditional solution to achieve this target is the design of a highly insulated envelope and reduce the opening and the transparent elements such windows. However, this will lead to the artificial lighting system to consume more energy to compensate the lack of natural lighting coming through the glazed parts of the building envelope. Therefore, a good balance between sufficient daylight and control thermal heat through the building envelope should be considered for energy saving purpose. To achieve a better indoor environment the windows size and spacing including the interior finishing and the location of the partition must be assessed accurately. Daylighting is the controlled admission of natural light into space through windows and transparent elements of the building envelope which helps create a visually stimulating and productive environment for building occupants. The main concern is not to provide enough daylight to an occupied space, but how to achieve this without any undesirable side effect. Indeed, the glare is a major problem in glazed façade buildings, and this could be reduced by using tinted windows. The main target of this research is to investigate the daylight adequacy of functional needs in old Omani Forts and how they have been designed and built to avoid glare and overheating with the appropriate window-to-floor ratio. Because more windows do not automatically result in more daylighting but that is natural light has been controlled and distributed properly throughout the space. Spaces from different Omani and Portuguese Forts under the same climate conditions are considered in order to compare the daylight illuminance levels and examine the similarities and differences in visual attributes between them. The result of this study indicates that lighting preference is not universal and people from different geographical locations are adapted to certain illuminance levels. Therefore, the standards could not be generalized for the entire world. This would be useful to practitioners who are designing to effectively address the diversity of user’s lighting levels preferences in our globally connected society.

Keywords: day lighting, energy, forts, thermal comfort

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276 Human Health Risk Assessment of Mercury-Contaminated Soils in Alebediah Mining Community, Sudan

Authors: Ahmed Elwaleed, Huiho Jeong, Ali H. Abdelbagi, Nguyen Thi Quynh, Koji Arizono, Yasuhiro Ishibashi

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Artisanal and small-scale gold mining (ASGM) poses substantial risks to both human health and the environment, particularly through contamination of soil, water, and air. Prolonged exposure to ASGM-contaminated soils can lead to acute or chronic mercury toxicity. This study assesses the human health risks associated with mercury-contaminated soils and tailings in the Alebediah mining community in Sudan. Soil samples were collected from various locations within Alebediah, including ASGM areas, farmlands, and residential areas, along with tailings samples commonly found within ASGM sites. The evaluation of potential health risks to humans included the computation of the estimated daily intake (AvDI), the hazard quotient (HQ), and the hazard index (HI) for both adults and children. The primary exposure route identified as potentially posing a significant health risk was the volatilization of mercury from tailings samples, where mercury concentrations reached up to 25.5 mg/kg. In contrast, other samples within the ASGM area showed elevated mercury levels but did not present significant health risks, with HI values below 1. However, all areas indicated HI values above 1 for the remaining exposure routes. The study observed a decrease in mercury concentration with increasing distance from the ASGM community. Additionally, soil samples revealed elevated mercury levels exceeding background values, prompting an assessment of contamination levels using the enrichment factor (EF). The findings indicated that farmlands and residential areas exhibited depleted EF, while areas surrounding the ASGM community showed none to moderate pollution. In contrast, ASGM areas exhibited significant to extreme pollution. A GIS map was generated to visually depict the extent of mercury pollution, facilitating communication with stakeholders and decision-makers.

Keywords: mercury pollution, artisanal and small-scale gold mining, health risk assessment, hazard index, soil and tailings, enrichment factor

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275 Teenagers in Conflict with Law: Exploratory Study about Psychic Suffering

Authors: Carolina Alcântara, Ileno Costa

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This study had the objective to systemize the main psycho-social and socioeducational aspects that related with the psychic suffering of adolescents in conflict of law and freedom privation. This research wanted to verify the signals and symptoms identified trough themselves perceptions related to their condition of health/insanity. In a similar way, it was objectified to know the opinions of the ambient conditions of the institution the use of the currently available resources for Health Service and Educational Service. The methodological proposal is based on the quant-qualitative analysis of interviews half-structuralized carried through with 36 teenagers was using psychiatric medication continuously. The data had pointed the experiences of sleeplessness and nightmares, associates or not with experiences of loss of reality (hallucinations) had constituted the illness most frequent. The self-punishment behavior appeared at second place. With regard to the ambient factors, it was verified that institution had, in general way, guaranteed the physical integrity and the maintenance of the health. Amongst the current available resources of Health Service, the administration of anticonvulsivants, in association with other psychotropic drugs has been widely used. The school was viewed as important device of available in the institution. By means of the adolescent’s understanding who do not like to go to the school, they don’t disqualify the knowledge, in contrast, they wanted for knowledge, however, they were frustrated for not having their educational supplies adequately, affirming that the school is weak or they do not learn. Finally, among the possible conclusions guided for the Winnicott’s thought, it was observed that institution in analysis is a representative of the paternal function. However, to begin the self-cure process is necessary that formation of therapeutical bonds. The group of teachers is identified as the main tool of change.

Keywords: serious psychic suffering, adolescent in conflict with the law, delinquency, privation of freedom

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274 Pioglitazone Ameliorates Methotrexate-Induced Renal Endothelial Dysfunction via Amending Detrimental Changes in Antioxidant Profile, Systemic Cytokines and Apoptotic Factors

Authors: Sahar M. El-Gowilly, Mai M. Helmy, Hanan M. El-Gowelli

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Methotrexate (MTX) is widely used in treatment of cancers and autoimmune diseases. However, nephrotoxicity is one of the most important side effects of MTX. The peroxisome proliferator-activated receptor gamma agonist, pioglitazone (PIO), is known to exert anti-inflammatory and reno-protective effects in various kidney injuries. The purpose of this study was to investigate the potential involvement of endothelial damage in MTX-induced renal injury and to elaborate the possible protective effect of PIO against MTX-induced nephropathy. Compared with saline-treated rats, treatment with MTX (7 mg/kg for 3 day) caused significant elevations in serum levels of urea and creatinine, increased renal nitrate/nitrite level and impaired renovascular responsiveness of isolated perfused kidney to endothelium-dependent vasodilations induced by acetylcholine (0.01-2.43 nmol) and isoprenaline (1µmol). These effects were abolished by concurrent treatment with PIO (2.5 mg/kg, for 5 days starting two days before MTX). Alternatively, MTX treatment did not affect endothelium-independent renovascular relaxation induced by sodium nitroprusside (1-30 μmole). The possibility that alterations in renal antioxidants, circulating cytokine and apoptotic factor (Fas) levels contributed to MTX-PIO interaction was assessed. PIO treatment abrogated renal oxidative stress (decreased reduced glutathione and catalase activity and increased malondialdehyde), elevated serum cytokine (interleukin-6, interleukin-10, tumor necrosis factor-alpha and transforming growth factor-beta1) and Fas induced by MTX. Histologically, MTX caused defused tubular cells swelling and vacuolization associated with endothelial damage in renal arterioles. These effects disappeared upon co-treated with PIO. Collectively, PIO abolished MTX-induced endothelium dysfunction and nephrotoxicity via ameliorating oxidative stress and rectifying cytokines and Fas abnormalities caused by MTX.

Keywords: methotrexate, pioglitazone, endothelium, kidney

Procedia PDF Downloads 293