Search results for: adolescents with mild intellectual disabilities
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2315

Search results for: adolescents with mild intellectual disabilities

1475 Family Depression and Its Relationship with Disability

Authors: Humara Bano, Nyla Anjum

Abstract:

Disability in any form has great impact not only for the person facing it but also for its family members too. This effect may be so severe that may lead to mal adjustment of any member of the family in society as well. This impact has also been multiplied due to negative attitudes of the society, unawareness about the needs of special needs and no legislation for the parents of children with special needs. As a result not only the separations among the parents have been reported but also the normal siblings in the home are also badly affected in their daily lives. The situation is more challenging when more than one child with disability is present in the family. The main objectives of this paper are to unfold the relationship of variety of disabilities (hearing, visual or physical impairment, mental retardation, speech impairment) in i) developing depression in home setting, ii) social exclusion, iii) anxiety and aggression and iv) development of insecure feelings among family members of the persons with disabilities, as well as, v) to identify coping strategies to manage the special needs by family members too. To reach on conclusion about fifty families (having any sort of disability in their homes) have been interviewed on basis of convenient sampling. Correlation, ANOVA and different analysis have been used to identify the relationship of disability in developing depression among family members in line of above mentioned problems. Results revealed that depression due to disability among families is a common phenomenon and adversely have affected their lives in daily routines as well as in following their life achievements. Coping with the situation and recommending various remedies by parents is the positive reflection of this study too that can help to families in managing their mental health.

Keywords: depression, anxiety and aggression, social exclusion, parents of children with special needs

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1474 Analyzing Healthy Eating Among Adolescent Teens Using the Socioecological Model

Authors: Kaavya Chandrasekar

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Healthy eating is essential to maintain good health and stable mental status regardless of age. WHO describes that a healthy diet consists of incorporating more fruits and vegetables and reducing the consumption of sugary and salty foods into a regularly scheduled healthy diet. Although this attitude is rather uncommon among all age groups, it is notably uncommon among the teens being a very vulnerable state in a man’s life. Faulty dietary habits, in the long run, interfere with health, leading to obesity, cardiovascular diseases, and mental instability. This study collates a discussion on the barriers prevailing among adolescents, to inculcate healthy eating practices by means of the socioecological model. The studies consisted of teens aged 13 to 19 years from schools and colleges of both sexes. The socio-ecological model emphasizes the interplay and interconnectedness of elements at all levels of health behavior, acknowledging that the majority of public health issues are just too complicated to be solved from a single-level perspective. As a result, it necessitates that people are not considered in isolation from bigger social groups. According to the studies retrieved from ten articles studies conducted globally, more than five articles suggest that socioeconomic class, lack of adult supervision and easy access to fast food stores and schools affect their decision of healthy eating. Awareness via personalized intervention has been tried and found successful. Future research is still needed to address various dimensions of the issue.

Keywords: socio ecological model, healthy eating, adolescents, fast food consumption, interventions.

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1473 Assessment of Hamstring, Lower Back and Upper Body Flexibility in War Disabled Individuals in Sri Lanka North and East Region

Authors: Esther Liyanage, Indrajith Liyanage, A. A. J. Rajaratne

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During the 30 year civil war in Sri Lanka, a large number of individuals were injured and disabled. These disabilities have reduced their daily physical activities which may cause reduction in flexibility of upper limb, shoulder girdle, lower back and lower limb. Muscle flexibility is important for a healthy lifestyle. The main objective of the study was to assess the upper limb, shoulder girdle and lower back, hamstring flexibility of the intact lower limb in disabled individuals in the North and Eastern parts of Sri Lanka. Back saver sits and reach test and shoulder scratch test described in FITNESS GRAM was used in the study. A total of 125 disabled soldiers with lower limb disabilities were recruited for the study. Flexibility of the lower back and hamstring muscles of uninjured lower limb was measured using back saver sit and reach test described by Wells and Dillon (1952). Upper limb and shoulder girdle flexibility was assessed using shoulder stretch test. Score 0-3 was given according to the ability to reach Superior medial angle of the opposite scapula, top of the head or the mouth. The results indicate that 31 (24.8%) disabled soldiers have lower limb flexibility less than 8, 2 (1.6 % ) have flexibility of 8, 2 (1.6 %) have flexibility of 8.5, 11 ( 8.8% ) have flexibility of 9, 14 (11.2 %) have flexibility of 9.5, 23 (18.4 %) have flexibility of 10, 17 (13.6 %) have 10.5 flexibility, 13 (10.4%) have 11 flexibility, 2 (1.6%) have 11.5 flexibility, 10 (8 %) have flexibility of 12 and 3 (2.34 %) have flexibility of 12.5. Six disabled soldiers (4.8%) have upper limb flexibility of 2 and remaining 95.2% have normal upper limb flexibility (score 3). A reduction in the flexibility of muscles in lower body and lower limbs was seen in 25% disabled soldiers which could be due to reduction in their daily physical activities.

Keywords: disability, flexibility, rehabilitation, quality of life

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1472 Breaking Barriers: Utilizing Innovation to Improve Educational Outcomes for Students with Disabilities

Authors: Emily Purdom, Rachel Robinson

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As the number of students worldwide requiring speech-language therapy, occupational therapy and mental health services during their school day increases, innovation is becoming progressively more important to meet the demand. Telepractice can be used to reach a greater number of students requiring specialized therapy while maintaining the highest quality of care. It can be provided in a way that is not only effective but ultimately more convenient for student, teacher and therapist without the added burden of travel. Teletherapy eradicates many hurdles to traditional on-site service delivery and helps to solve the pervasive shortage of certified professionals. Because location is no longer a barrier to specialized education plans for students with disabilities when teletherapy is conducted, there are many advantages that can be deployed. Increased frequency of engagement is possible along with students receiving specialized care from a clinician that may not be in their direct area. Educational teams, including parents, can work together more easily and engage in face-to-face, student-centered collaboration through videoconference. Practical strategies will be provided for connecting students with qualified therapists without the typical in-person dynamic. In most cases, better therapy outcomes are going to be achieved when treatment is most convenient for the student and educator. This workshop will promote discussion in the field of education to increase advocacy for remote service delivery. It will serve as a resource for those wanting to expand their knowledge of options for students with special needs afforded through innovation.

Keywords: education technology, innovation, student support services, telepractice

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1471 Implementing Peer Mediated Interventions with Visual Supports for Social Skills Development in a School-Based Work Setting with Secondary Students with Autism

Authors: Karen Eastman

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More youths and young adults with autism spectrum disorder (ASD) have been entering the workforce in recent years. Historically, students with ASD struggle after leaving high school and experience lower rates of employment, with social skills continuing to be the most problematic area of concern. Special education teachers may find it challenging to identify effective combinations of evidence-based practices (EBPs) and supports to best guide these students. One EBP, Peer Mediated Instruction and Intervention (PMII) has been well documented in the literature as being effective for younger students with autism but not researched as much with older students and adults, particularly in work settings. A need to combine PMII with other EBPs has been identified as a way to achieve a greater positive impact rather than any practice alone. A multiple baseline across skills design was used in this research project with two participants in different settings. PMII was combined with Visual Supports, with typical peers being trained in both practices. PMII is an evidence-based practice used to address social concerns by training peers without disabilities as to how they can provide feedback to and support, the student with ASD with social interactions in structured settings. The peers without disabilities were the instructors, while the adults facilitated the social situations and provided support to both the peers and students with ASD when needed. Because many individuals with ASD learn best with visual input, rather than using only the spoken word (verbal directions and feedback), Visual Supports were used in conjunction with PMII. Visual Supports can include written words, pictures, symbols, videos, or objects. In this project, the Visual Supports used were written social scripts, videos, Stop and Think signs, written reminder cards, a school map, and a pictorial task analysis of work tasks. Variables that may affect intervention outcomes in this project included attendance at school and school-based work settings for both the students with ASD and the peers without disabilities and behaviors and responses from others in the settings. Qualitative data was also collected from observations and surveys with peers about the process and their role. Data indicated that the students with ASD responded more positively to redirection and support from their peers than to teachers and staff and showed an increase in positive interactions with others. Those surveyed indicated a positive attitude toward and response to the use of peer interventions with visual supports.

Keywords: autism, social skills, vocational training, peer interventions

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1470 A Critical Review of the Success Model of Indian Pharmaceutical Industry

Authors: Ekta Pandey

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The Indian Pharmaceutical Industry is ranked third largest by volume and fourteenth by value. It thus accounts for 10% of world’s production by volume and 1.5% by value according to Department of Pharmaceuticals, Government of India. The industry has shown phenomenal growth over past few years, moving from US $ 1 billion turnover in 1990 to a turnover of around US $30 billion in 2015. The Indian pharmaceutical sector is ranked seventeenth in terms of export value of active pharmaceutical ingredients and dosage forms to more than 200 countries around the globe. It has shown tremendous changes especially after Trade Related Aspects of Intellectual Property Rights (TRIPS) agreement. Recognizing the immense potential for growth and its direct impact on Indian economy, it is important to look up the industrial policies adopted since Indian independence which turnaround the Indian pharmaceutical industry. A systematic review of changes in market structure of Indian pharmaceutical industry due to shift in policy regimes is done from 1850 to 2015 using secondary peer reviewed published research work. The aim is to understand the impact of anti-trust laws, intellectual property rights, industry competition acts and regulations are quite crucial in determining effective economic policy and have overall lasting effects on international trade and ties. The proposed paper examines the position of Indian domestic firms relative to multinational pharmaceutical firms tries to throw some light on the growth curve of Indian pharmaceutical sector.

Keywords: active pharmaceutical ingredients, competition act, pharmaceutical industry, TRIPS

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1469 The Efficacy of Vestibular Rehabilitation Therapy for Mild Traumatic Brain Injury: A Systematic Review and Meta-Analysis

Authors: Ammar Aljabri, Alhussain Halawani, Alaa Ashqar, Omar Alageely

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Objective: mild Traumatic Brain Injury (mTBI) or concussion is a common yet undermanaged and underreported condition. This systematic review and meta-analysis aim to determine the efficacy of VRT as a treatment option for mTBI. Method: This review and meta-analysis was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included RCTs and pre-VRT/post-VRT retrospective chart reviews. Records meeting the inclusion criteria were extracted from the following databases: Medline, Embase, and Cochrane Register of Controlled Trials (CENTRAL). Results: Eight articles met the inclusion criteria, and six RCTs were included in the meta-analysis. VRT demonstrated significant improvement in decreasing perceived dizziness at the end of the intervention program, as shown by DHI scores (SMD= -0.33, 95% CI -0.62 to -0.03, p=0.03, I2= 0%). However, no significant reduction in DHI was evident after two months of follow-up (SMD= 0.15, 95% CI -0.23 to 0.52, p=0.44, I2=0%). Quantitative analysis also depicts significant reduction in both VOMS (SMD=-0.40, 95% CI -0.60 to -0.20, p<0.0001, I2=0%) and PCSS (SMD= -0.39, 95% CI -0.71 to -0.07, p=0.02, I2=0%) following the intervention. Lastly, there was no significant difference between intervention groups on BESS scores (SMD= -31, 95% CI -0.71 to 0.10, p=0.14, I2=0%) and return to sport/function (95% CI 0.32 to 30.80, p=0.32, I2=82%). Conclusions: Current evidence on the efficacy of VRT for mTBI is limited. This review and analysis provide evidence that supports the role of VRT in improving perceived symptoms following concussion. There is still a need for high-quality trials evaluating the benefit of VRT using a standardized approach.

Keywords: concussion, traumatic brain injury, vestibular rehabilitation, neurorehabilitation

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1468 Early Depression Detection for Young Adults with a Psychiatric and AI Interdisciplinary Multimodal Framework

Authors: Raymond Xu, Ashley Hua, Andrew Wang, Yuru Lin

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During COVID-19, the depression rate has increased dramatically. Young adults are most vulnerable to the mental health effects of the pandemic. Lower-income families have a higher ratio to be diagnosed with depression than the general population, but less access to clinics. This research aims to achieve early depression detection at low cost, large scale, and high accuracy with an interdisciplinary approach by incorporating clinical practices defined by American Psychiatric Association (APA) as well as multimodal AI framework. The proposed approach detected the nine depression symptoms with Natural Language Processing sentiment analysis and a symptom-based Lexicon uniquely designed for young adults. The experiments were conducted on the multimedia survey results from adolescents and young adults and unbiased Twitter communications. The result was further aggregated with the facial emotional cues analyzed by the Convolutional Neural Network on the multimedia survey videos. Five experiments each conducted on 10k data entries reached consistent results with an average accuracy of 88.31%, higher than the existing natural language analysis models. This approach can reach 300+ million daily active Twitter users and is highly accessible by low-income populations to promote early depression detection to raise awareness in adolescents and young adults and reveal complementary cues to assist clinical depression diagnosis.

Keywords: artificial intelligence, COVID-19, depression detection, psychiatric disorder

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1467 The Analysis of Movement Pattern during Reach and Grasp in Stroke Patients: A Kinematic Approach

Authors: Hyo Seon Choi, Ju Sun Kim, DY Kim

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Introduction: This study was aimed to evaluate temporo-spatial patterns during the reach and grasp task in hemiplegic stroke patients and to identify movement pattern according to severity of motor impairment. Method: 29 subacute post-stroke patients were enrolled in this study. The temporo-spatial and kinematic data were obtained during reach and grasp task through 3D motion analysis (VICON). The reach and grasp task was composed of four sub-tasks: reach (T1), transport to mouth (T2), transport back to table (T3) and return (T4). The movement time, joint angle and sum of deviation angles from normative data were compared between affected side and unaffected side. They were also compared between two groups (mild to moderate group: 28~66, severe group: 0~27) divided by upper-Fugl-Meyer Assessment (FMA) scale. Result: In affected side, total time and durations of all four tasks were significantly longer than those in unaffected side (p < 0.001). The affected side demonstrated significant larger shoulder abduction, shoulder internal rotation, wrist flexion, wrist pronation, thoracic external rotation and smaller shoulder flexion during reach and grasp task (p < 0.05). The significant differences between mild to moderate group and severe group were observed in total duration, durations of T1, T2, and T3 in reach and grasp task (p < 0.01). The severe group showed significant larger shoulder internal rotation during T2 (p < 0.05) and wrist flexion during T2, T3 (p < 0.05) than mild to moderate group. In range of motion during each task, shoulder abduction-adduction during T2 and T3, shoulder internal-external rotation during T2, elbow flexion-extension during T1 showed significant difference between two groups (p < 0.05). The severe group had significant larger total deviation angles in shoulder internal-external rotation and wrist extension-flexion during reach and grasp task (p < 0.05). Conclusion: This study suggests that post-stroke hemiplegic patients have an unique temporo-spatial and kinematic patterns during reach and grasp task, and the movement pattern may be related to affected upper limb severity. These results may be useful to interpret the motion of upper extremity in stroke patients.

Keywords: Fugl-Meyer Assessment (FMA), motion analysis, reach and grasp, stroke

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1466 Intellectual Property Rights Reforms and the Quality of Exported Goods

Authors: Gideon Ndubuisi

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It is widely acknowledged that the quality of a country’s export matters more decisively than the quantity it exports. Hence, understanding the drivers of exported goods’ quality is a relevant policy question. Among other things, product quality upgrading is a considerable cost uncertainty venture that can be undertaken by an entrepreneur. Once a product is successfully upgraded, however, others can imitate the product, and hence, the returns to the pioneer entrepreneur are socialized. Along with this line, a government policy such as intellectual property rights (IPRs) protection which lessens the non-appropriability problem and incentivizes cost discovery investments becomes both a panacea in addressing the market failure and a sine qua non for an entrepreneur to engage in product quality upgrading. In addendum, product quality upgrading involves complex tasks which often require a lot of knowledge and technology sharing beyond the bounds of the firm thereby creating rooms for knowledge spillovers and imitations. Without an institution that protects upstream suppliers of knowledge and technology, technology masking occurs which bids up marginal production cost and product quality fall. Despite these clear associations between IPRs and product quality upgrading, the surging literature on the drivers of the quality of exported goods has proceeded almost in isolation of IPRs protection as a determinant. Consequently, the current study uses a difference-in-difference method to evaluate the effects of IPRs reforms on the quality of exported goods in 16 developing countries over the sample periods of 1984-2000. The study finds weak evidence that IPRs reforms increase the quality of all exported goods. When the industries are sorted into high and low-patent sensitive industries, however, we find strong indicative evidence that IPRs reform increases the quality of exported goods in high-patent sensitive sectors both in absolute terms and relative to the low-patent sensitive sectors in the post-reform period. We also obtain strong indicative evidence that it brought the quality of exported goods in the high-patent sensitive sectors closer to the quality frontier. Accounting for time-duration effects, these observed effects grow over time. The results are also largely consistent when we consider the sophistication and complexity of exported goods rather than just quality upgrades.

Keywords: exports, export quality, export sophistication, intellectual property rights

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1465 Prognosis of Interstitial Lung Disease (ILD) Based on Baseline Pulmonary Function Test (PFT) Results in Omani Adult Patients Diagnosed with ILD In Sultan Qaboos University Hospital

Authors: Manal Al Bahri, Saif Al Mubahisi, Shamsa Al Shahaimi, Asma Al Qasabi, Jamal Al Aghbari

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Introduction: ILD is a common disease worldwide and in Oman. No previous Omani study was published regarding ILD prognosis based on baseline PFT results and other factors. This study aims to determine the severity of ILD by the baseline PFT, correlate between baseline PFT and outcome, and study other factors that influence disease mortality. Method: It is a retrospective cohort study; data was collected from January 2011 to December 2021 from electronic patient records (EPR). Means, Standard Deviations, frequencies, and Chi-square tests were used to examine the different variables in the study. Results: The total population of the study was 146 patients; 87 (59.6%) were females, and 59 (40.4%) were males. The median age was 59 years. Age at diagnosis, CVA, rheumatological disease, and baseline FVC were found to be statistically significant predictors of mortality .59.6% of the patients are diagnosed with IPF. Most of our study patients had mild disease based on baseline FVC. Death was higher with the more severe disease based on FVC. In mild disease (FVC >70%), 26.9% of the patients died. In moderate disease (FVC 50-69%),55.7% of the patients died, and in the severe group (FVC <50 %), 55.1% died. This was statistically significant with a P value of 0. 001. There is no statistically significant difference in the overall survival distribution between the different groups of DLCO. Conclusion: In our study, we found that ILD is more common among females, but death is more common among males. Based on baseline PFT, we can predict mortality by FVC level, as moderate to severe limitation is associated with a lower survival rate. DLCO was not a statistically significant parameter associated with mortality.

Keywords: PFT, ILD, FVC, DLCO, mortality

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1464 Teenage Pregnancy: The Unmet Needs of Female Adolescents in Uganda

Authors: M. Weller Jones, J. Moffat, J. Taylor, J. Hartland, M. Natarajan

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Background: Uganda’s teenage pregnancy rate remains a significant problem for female and maternal health in the country. Teenage pregnancy is linked to higher rates of maternal and neonatal mortality and morbidity, including preterm labour, obstructed labour, vesicovaginal fistulae, infections, and maternal mental health morbidity. In 2015, the National Strategy to End Child Marriage and Teenage Pregnancy was launched in Uganda. Research is needed so that the interventions in this Strategy can be effectively applied at a local level. This study at Kitovu and Villa Maria Hospitals, two local community hospitals near Masaka, Uganda, aimed to measure change in the local teenage pregnancy rate over the past 5 years; and to explore the awareness and attitudes of teenagers and healthcare professionals towards 1) teenage pregnancy and, 2) the challenges female adolescents still currently face. Method: Teenage delivery rate, type of delivery, incidence of complications in labour and neonatal and maternal outcomes were collected from the labour ward admission books, at both hospitals, for a six month time period in 2011 and 2016. At Kitovu Hospital, qualitative data regarding the experience of, and attitudes towards teenage pregnancy was collected from interviews conducted with 12 maternity staff members and with eight female teenagers, aged 16-19, who were pregnant or post-partum. Results: The proportion of total births to teenage mothers fell from 14% in 2011 to 7% in 2016 (Kitovu), but it remains higher in rural locations (19%, Villa Maria). Beliefs about exacerbating factors included: poor access to contraception; misconceptions that contraception is damaging to women’s health; failing sex education in schools; and poor awareness of national campaigns to reduce teenage pregnancy. Staff felt that the best way to tackle teenage pregnancy was to improve sex education in schools and to sensitise families to these issues. Six of the eight teenagers wanted more frequent sex education and easier, cheap access to contraception. Only one teenager saw positive consequences stating that teenage pregnancy would ‘avoid operations later in life.’ Discussion: Teenage pregnancy is a recognised problem and strategies in the Masaka region should focus on improving sex education in schools and initiating an organisation that educates and supplies free contraception to teenagers.

Keywords: adolescents, attitudes, teenage pregnancy, Uganda

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1463 Correlation between Creatinine Level with Erectile Dysfunction among Diabetics in Temerloh Health Clinic

Authors: Mohammad Zainie Bin Hassan

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Background: Erectile dysfunction (ED) is a complication commonly seen among men with diabetes which can be assessed based upon International Index of Erectile Function (IIEF-5) questionnaire. Creatinine level is a blood test that indicates kidney functionality. Object: To evaluate the association between ED, determined by the IIEF-5scores and Creatinine level in diabetic men attending Temerloh Health Clinic, Pahang, Malaysia.Hence, to identify raising Creatinine level related with ED or not. Methods: All married diabetic patients will be investigated face to face after consented for answering the IIEF-5 questionnaire. Creatinine level will be taken by using standard method.Patients with no sexual partner, refuse to answer the questionnaire, cancer, stroke, heart disease and language barrier will be excluded.Data obtained from IIEF-5 score and Creatinine level will be analyzed by using Pearson correlation. All statistical value determined by p=0.05. ED will be categorized accordingly to IIEF-5 scores: no ED (22-25), mild (17-21), moderate (12-16), severe (8-11) and very severe (1-7). Results: A total of 450 patients were investigated with 385 patients were included (85.6% respondant rate) and 65 patients were excluded in this study with age range from 29 to 85 years old. 7% had no ED, 28% mild ED, 34% moderate ED, 16% severe ED and 15% had very severe ED. There was a significant negative correlation between Creatinine level and IIEF-5 scores (r=-0.218, p <0.001). This result implicated that poor kidney function which indicated by high Creatinine level associated significantly with erectile dysfunction. 93% had ED with a different range of severity which triggers for appropriate aggressive ED management among diabetics. Conclusion: The high level of Creatinine is associated with erectile dysfunction among diabetics in Temerloh Health Clinic.

Keywords: correlation, creatinine level, erectile dysfunction, ED, diabetes

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1462 Anxiety and Depression in Parents of Children with Developmental Disabilities in Early Childhood

Authors: S. Bagur, S. Verger, B. Mut

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Early childhood intervention (ECI) is the set of actions aimed at children aged 0-6 years with special needs, the family, and the environment that aim to improve child development and family well-being. Socio-educational intervention with children with disabilities and their families should be understood through the principles of family-centered practice (FCP). The multidisciplinary team of professionals carries out the intake, assessment, and intervention, understanding that families may experience mental health problems, parental role incompetence, or feelings of exclusion. This study examines the relationship between caregivers' levels of anxiety and depression and child development during the fostering and assessment phase. The design is quantitative, non-experimental, and cross-sectional. The sample consisted of 135 family members (78.5% female, 21.5% male) users of child development services in the Balearic Islands (Spain). Three questionnaires were completed: Anxiety and Depression Scale, Child Behavior Checklist (CBCL 1½-5), and sociodemographic questionnaire. The main results show that parents of children with special needs score higher on anxiety than on depression. It should be noted that professional discipline is a variable to be taken into account in relation to parents' perception of the improvement of their child's development. In addition, there is an association between the developmental subscales, where the more the child is affected, the more the parents' mental health is affected. In short, we propose a reflection on the application of FCP during the intervention, understanding the lack of professional training as a predictor of quality in early intervention. Likewise, future lines of research are proposed to improve early care practices.

Keywords: anxiety, depression, early childhood intervention, family

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1461 Studying in Private Muslim Schools in Australia: Implications for Identity, Religiosity, and Adjustment

Authors: Hisham Motkal Abu-Rayya, Maram Hussein Abu-Rayya

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Education in religious private schools raises questions regarding identity, belonging and adaptation in multicultural Australia. This research project aimed at examined cultural identification styles among Australian adolescent Muslims studying in Muslim schools, adolescents’ religiosity and the interconnections between cultural identification styles, religiosity, and adaptation. Two Muslim high school samples were recruited for the purposes of this study, one from Muslim schools in metropolitan Sydney and one from Muslim schools in metropolitan Melbourne. Participants filled in a survey measuring themes of the current study. Findings revealed that the majority of Australian adolescent Muslims showed a preference for the integration identification style (55.2%); separation was less prevailing (26.9%), followed by assimilation (9.7%) and marginalisation (8.3%). Supporting evidence suggests that the styles of identification were valid representation of the participants’ identification. A series of hierarchical regression analyses revealed that while adolescents’ preference for integration of their cultural and Australian identities was advantageous for a range of their psychological and socio-cultural adaptation measures, marginalisation was consistently the worst. Further hierarchical regression analyses showed that adolescent Muslims’ religiosity was better for a range of their adaptation measures compared to their preference for an integration acculturation style. Theoretical and practical implications of these findings are discussed.

Keywords: adaptation, identity, multiculturalism, religious school education

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1460 Towards a Comprehensive Framework on Civic Competence Development of Teachers: A Systematic Review of Literature

Authors: Emilie Vandevelde, Ellen Claes

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This study aims to develop a comprehensive model for the civic socialization process of teachers. Citizenship has become one of the main objectives for the European education systems. It is expected that teachers are well prepared and equipped with the necessary knowledge, skills, and attitudes to also engage students in democratic citizenship. While a lot is known about young peoples’ civic competence development and how schools and teachers (don’t) support this process, less is known about how teachers themselves engage with (the teaching of) civics. Other than the civic socialization process of young adolescents that focuses on personal competence development, the civic socialization process of teachers includes the development of professional, civic competences. These professional competences make that they are able to prepare pupils to carry out their civic responsibilities in thoughtful ways. Existing models for the civic socialization process of young adolescents do not take this dual purpose into account. Based on these observations, this paper will investigate (1)What personal and professional civic competences teachers need to effectively teach civic education and (2) how teachers acquire these personal and professional civic competences. To answer the first research question, a systematic review of literature of existing civic education frameworks was carried out and linked to literature on teacher training. The second research question was addressed by adapting the Octagon model, developed by the International Association for the Evaluation of Educational Achievement (IEA), to the context of teachers. This was done by carrying out a systematic review of the recent literature linking three theoretical topics involved in teachers’ civic competence development: theories about the civic socialization process of young adolescents, Schulmans (1987) theoretical assumptions on pedagogical content knowledge (PCK), and Nogueira & Moreira’s (2012) framework for civic education teachers’ knowledge and literature on teachers’ professional development. This resulted in a comprehensive conceptual framework describing the personal and professional civic competences of civic education teachers. In addition, this framework is linked to the OctagonT model: a model that describes the processes through which teachers acquire these personal and professional civic competences. This model recognizes that teachers’ civic socialization process is influenced by interconnected variables located at different levels in a multi-level structure (the individual teacher (e.g., civic beliefs), everyday contacts (e.g., teacher educators, the intended, informal and hidden curriculum of the teacher training program, internship contacts, participation opportunities in teacher training, etc.) and the influence of the national educational context (e.g., vision on civic education)). Furthermore, implications for teacher education programs are described.

Keywords: civic education, civic competences, civic socialization, octagon model, teacher training

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1459 Trajectories of Depression Anxiety and Stress among Breast Cancer Patients: Assessment at First Year of Diagnosis

Authors: Jyoti Srivastava, Sandhya S. Kaushik, Mallika Tewari, Hari S. Shukla

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Little information is available about the development of psychological well being over time among women who have been undergoing treatment for breast cancer. The aim of this study was to identify the trajectories of depression anxiety and stress among women with early-stage breast cancer. Of the 48 Indian women with newly diagnosed early-stage breast cancer recruited from surgical oncology unit, 39 completed an interview and were assessed for depression anxiety and stress (Depression Anxiety Stress Scale-DASS 21) before their first course of chemotherapy (baseline) and follow up interviews at 3, 6 and 9 months thereafter. Growth mixture modeling was used to identify distinct trajectories of Depression Anxiety and Stress symptoms. Logistic Regression analysis was used to evaluate the characteristics of women in distinct groups. Most women showed mild to moderate level of depression and anxiety (68%) while normal to mild level of stress (71%). But one in 11 women was chronically anxious (9%) and depressed (9%). Young age, having a partner, shorter education and receiving chemotherapy but not radiotherapy might characterize women whose psychological symptoms remain strong nine months after diagnosis. By looking beyond the mean, it was found that several socio-demographic and treatment factors characterized the women whose depression, anxiety and stress level remained severe even nine months after diagnosis. The results suggest that support provided to cancer patients should have a special focus on a relatively small group of patient most in need.

Keywords: psychological well being, growth mixture modeling, logistic regression analysis, socio-demographic factors

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1458 The Strategic Importance of Technology in the International Production: Beyond the Global Value Chains Approach

Authors: Marcelo Pereira Introini

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The global value chains (GVC) approach contributes to a better understanding of the international production organization amid globalization’s second unbundling from the 1970s on. Mainly due to the tools that help to understand the importance of critical competences, technological capabilities, and functions performed by each player, GVC research flourished in recent years, rooted in discussing the possibilities of integration and repositioning along regional and global value chains. Regarding this context, part of the literature endorsed a more optimistic view that engaging in fragmented production networks could represent learning opportunities for developing countries’ firms, since the relationship with transnational corporations could allow them build skills and competences. Increasing recognition that GVCs are based on asymmetric power relations provided another sight about benefits, costs, and development possibilities though. Once leading companies tend to restrict the replication of their technologies and capabilities by their suppliers, alternative strategies beyond the functional specialization, seen as a way to integrate value chains, began to be broadly highlighted. This paper organizes a coherent narrative about the shortcomings of the GVC analytical framework, while recognizing its multidimensional contributions and recent developments. We adopt two different and complementary perspectives to explore the idea of integration in the international production. On one hand, we emphasize obstacles beyond production components, analyzing the role played by intangible assets and intellectual property regimes. On the other hand, we consider the importance of domestic production and innovation systems for technological development. In order to provide a deeper understanding of the restrictions on technological learning of developing countries’ firms, we firstly build from the notion of intellectual monopoly to analyze how flagship companies can prevent subordinated firms from improving their positions in fragmented production networks. Based on intellectual property protection regimes we discuss the increasing asymmetries between these players and the decreasing access of part of them to strategic intangible assets. Second, we debate the role of productive-technological ecosystems and of interactive and systemic technological development processes, as concepts of the Innovation Systems approach. Supporting the idea that not only endogenous advantages are important for international competition of developing countries’ firms, but also that the building of these advantages itself can be a source of technological learning, we focus on local efforts as a crucial element, which is not replaceable for technology imported from abroad. Finally, the paper contributes to the discussion about technological development as a two-dimensional dynamic. If GVC analysis tends to underline a company-based perspective, stressing the learning opportunities associated to GVC integration, historical involvement of national States brings up the debate about technology as a central aspect of interstate disputes. In this sense, technology is seen as part of military modernization before being also used in civil contexts, what presupposes its role for national security and productive autonomy strategies. From this outlook, it is important to consider it as an asset that, incorporated in sophisticated machinery, can be the target of state policies besides the protection provided by intellectual property regimes, such as in export controls and inward-investment restrictions.

Keywords: global value chains, innovation systems, intellectual monopoly, technological development

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1457 The Specificity of Mother's Attitude to a Preschool Child Having Complex Disorders: The Key to Adaptive Functioning

Authors: Alla Tvardovskaya

Abstract:

The family of a child with disabilities is an important mechanism of socialization. The relationship of mother and child with developmental difficulties is a significant predictor of the emergence, development and interiorization of various forms of mental activity. Complex impairments of the child form nonconstructive maternal attitude and destructive behavior strategies that complicate the dyadic relationship ‘mother-child’. The study of psychological characteristics of mother's personality was conducted within four years, and adaptive abilities of a child with a complex disorder were evaluated as well. 25 diads (25 mothers and 25 preschool children aged between 4-7 years with complex developmental disorders) took part in the study. Typological features of mothers rearing deafblind preschoolers are described. Constructive and non-constructive types of mothers’ attitude to a pre-school child with complex disorders are specified. The research shows that mothers of deafblind children are more depressed, they are engaged in children’s rearing more, and at the same time they experience difficulties to control negative emotions towards children or demonstrate impulsive behavior with a high level of anxiety. The correlation analysis of relationships between Vineland scales and the dominant type of mothers’ attitude to a child shows the presence of both general and specific links. Adaptive profile analysis of a child with complex disabilities allows to plan specific ways to increase their adaptation by developing a dyadic constructive relationship system. Techniques to develop constructive parental attitudes toward the child are proposed.

Keywords: adaptive behavior, complex disorder, constructive maternal attitude, deaf-blindness, pre-school child

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1456 Working With Accessibility in Latvian Contemporary Art: Research, Barriers, and Implementation From a Curator’s and Production Manager’s Perspective

Authors: Agnese Zviedre

Abstract:

In 2010 Latvia ratified the United Nations Convention on the Rights of Persons with Disabilities, which states that the state will recognize the importance of accessibility to the physical, social, and cultural environment. Nevertheless, accessibility of art and culture in Latvia has become a focal point only since 2020. A study on the impact of cultural consumption and participation done by the Latvian Academy of Culture and the research center “SKDS” results show that art and cultural institutions lack knowledge and understanding of needs and required accessibility measures for people with disabilities to participate in cultural and art events. At the same time, even if art institutions want to create accessible events for people with diverse bodies and minds, many barriers exist, such as budget, lack of time, and lack of knowledge. Even though disability is still largely invisible in the public space, due to recent public campaigns and awareness of the need for accessibility, the media and society are starting to speak about disability as a social issue, not a medical one. Thus, this paper focuses on the first-hand experience of implementing different Western accessibility guidelines and working with communities as a production manager for the multidisciplinary exhibition project “Invisible Lives” in Riga and curator of the education program of Riga Photography Biennial’s 2022 Central Event - Exhibition “Screen Age III: Still Life”. Analyzing two events from the Disability studies perspective, this paper focuses on working with existing knowledge and budget to achieve accessibility.

Keywords: accessibility, contemporary art, curatorial practices, disability studies

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1455 Effect of Muscle Energy Technique on Anterior Pelvic Tilt in Lumbar Spondylosis Patients

Authors: Enas El Sayed Abutaleb, Mohamed Taher Eldesoky, Shahenda Abd El Rasol

Abstract:

Background: Muscle energy techniques (MET) have been widely used by manual therapists over the past years, but still limited research validated its use and there was limited evidence to substantiate the theories used to explain its effects. Objective: To investigate the effect of muscle energy technique (MET) on anterior pelvic tilt in patients with lumbar spondylosis. Design: Randomized controlled trial. Subjects: Thirty patients with anterior pelvic tilt from both sexes were involved, aged between 35 to 50 years old and they were divided into MET and control groups with 15 patients in each. Methods: All patients received 3 sessions/week for 4 weeks where the study group received MET, Ultrasound and Infrared, and the control group received U.S and I.R only. Pelvic angle was measured by palpation meter, pain severity by the visual analogue scale and functional disabilities by the Oswestry disability index. Results: Both groups showed significant improvement in all measured variables. The MET group was significantly better than the control group in pelvic angle, pain severity, and functional disability as p-value were (0.001, 0.0001, 0.0001) respectively. Conclusion and implication: The study group fulfilled greater improvement in all measured variables than the control group which implies that application of MET in combination with U.S and I.R were more effective in improving pelvic tilting angle, pain severity and functional disabilities than using electrotherapy only.

Keywords: anterior pelvic tilt, lumbar spondylosis, muscle energy technique exercise, pelvic tilting angle

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1454 Copyright Infringement for Academic Authorship in Uganda: Implications on Exemptions of Fair Use for Educational Purposes in Universities

Authors: Elisam Magara

Abstract:

Like any other property, Intellectual Property (IP) must be regarded, respected, and remunerated to address the historical, ethical, economical and informational needs of society. Article 26 of the Constitution of the Republic of Uganda 1995, the Copyright and Neighbouring Rights (CNR) Act 2006 and CNR Regulations 2010 guide copyright protection in Uganda. However, an unpredictable environment has negatively impact on certain author/intellectual freedoms; and the infringements on academic works that affect the economic rights of authors that limit authors from fully enjoying the benefits of authorship. Notwithstanding the different licensing systems and copyright protection avenues, educational institutions and custodians of copyright works (libraries, archives) have continued to advocate for open access to information resources, under the legal exceptions of fair use for educational purposes. Thus, a study was conducted in educational institutions, libraries and archives in Uganda to assess the state of copyright infringement in Uganda in an increased use of academic authored works. The study attempted to establish the nature and forms of Copyright Infringement, the circumstances for copyright infringement, assessed the opinions from the custodians on strategies for balancing copyright protection for economic and moral gains by authors and increased access to information for educational purposes and fair-use. Through a survey, using a self-administered questionnaire, interviews and physical visits, the study was conducted in higher education institutions, libraries and archives among the officers that manage and keep copyright works. It established that the uncontrolled reproduction of copyright works in educational institutions and information institutions, have contributed copyright infringement robbing authors of their potential economic earnings and limiting their academic innovativeness and creativity. The study also established that lack of consciousness and awareness on copyright issues by lecturers, universities and libraries has made copyright works in Universities highly susceptible to copyright infringement. Thus the increased access to materials without restrictions has resulted in copyright infringement among the educational institutions, libraries and archives. A strategic alliance by the collecting Society (Uganda Reproduction Rights Organisation (URRO), government, Universities and right holders organisations (UTANA) to work together and institute a programme to address copyright protection and access to information is pertinently required.

Keywords: access to information, academic Writing, copyright, copyright infringement, copyright protection, exemptions of fair use, intellectual property rights

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1453 Risk and Protective Factors for the Health of Primary Care-Givers of Children with Autism Spectrum Disorders or Intellectual Disability: A Narrative Review and Discussion

Authors: Jenny Fairthorne, Yuka Mori, Helen Leonard

Abstract:

Background: Primary care-givers of children with autism spectrum disorder (ASD) or intellectual disability (ID) have poorer health and quality of life (QoL) than primary care-givers (hereafter referred to as just care-givers) of typically developing children. We aimed to review original research which described factors impacting the health of care-givers of children with ASD or ID and to discuss how these factors might influence care-giver health. Methods: We searched Web of Knowledge, Medline, Scopus and Google Scholar using selections of words from each of three groups. The first comprised terms associated with ASD and ID and included autism, pervasive development disorder, intellectual disability, mental retardation, disability, disabled, Down and Asperger. The second included terms related to health such as depression, physical, mental, psychiatric, psychological and well-being. The third was terms related to care-givers such as mother, parent and care-giver. We included an original paper in our review if it was published between 1st January 1990 and 31st December, 2016, described original research in a peer-reviewed journal and was written in English. Additional criteria were that the research used a study population of 15 persons or more; described a risk or protective factor for the health of care-givers of a child with ASD, ID or a sub-type (such as ASD with ID or Down syndrome). Using previous research, we developed a simple and objective five-level tool to assess the strength of evidence provided by the reviewed papers. Results: We retained 33 papers. Factors impacting primary care-giver health included child behaviour, level of support, socio-economic status (SES) and diagnostic issues. Challenging child behaviour, the most commonly identified risk factor for poorer care-giver health and QoL was reported in ten of the studies. A higher level of support was associated with improved care-giver health and QoL. For example, substantial evidence indicated that family support reduced care-giver burden in families with a child with ASD and that family and neighbourhood support was associated with improved care-giver mental health. Higher socio-economic status (SES) was a protective factor for care-giver health and particularly maternal health. Diagnostic uncertainty and an unclear prognosis are factors which can cause the greatest concern to care-givers of children with ASD and those for whom a cause of their child’s ID has not been identified. We explain how each of these factors might impact caregiver health and how they might act differentially in care-givers of children with different types of ASD or ID (such as Down syndrome and ASD without ID). Conclusion: Care-givers of children with ASD may be more likely to experience many risk factors and less likely to experience the protective factors we identified for poorer mental health. Interventions to reduce risk factors and increase protective factors could pave the way for improved care-giver health. For example, workshops to train care-givers to better manage challenging child behaviours and earlier diagnosis of ASD (and particularly ASD without ID) would seem likely to improve care-giver well-being. Similarly, helping to expand support networks might reduce care-giver burden and stress leading to improved health.

Keywords: autism, caregivers, health, intellectual disability, mothers, review

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1452 Determination of Slope of Hilly Terrain by Using Proposed Method of Resolution of Forces

Authors: Reshma Raskar-Phule, Makarand Landge, Saurabh Singh, Vijay Singh, Jash Saparia, Shivam Tripathi

Abstract:

For any construction project, slope calculations are necessary in order to evaluate constructability on the site, such as the slope of parking lots, sidewalks, and ramps, the slope of sanitary sewer lines, slope of roads and highways. When slopes and grades are to be determined, designers are concerned with establishing proper slopes and grades for their projects to assess cut and fill volume calculations and determine inverts of pipes. There are several established instruments commonly used to determine slopes, such as Dumpy level, Abney level or Hand Level, Inclinometer, Tacheometer, Henry method, etc., and surveyors are very familiar with the use of these instruments to calculate slopes. However, they have some other drawbacks which cannot be neglected while major surveying works. Firstly, it requires expert surveyors and skilled staff. The accessibility, visibility, and accommodation to remote hilly terrain with these instruments and surveying teams are difficult. Also, determination of gentle slopes in case of road and sewer drainage constructions in congested urban places with these instruments is not easy. This paper aims to develop a method that requires minimum field work, minimum instruments, no high-end technology or instruments or software, and low cost. It requires basic and handy surveying accessories like a plane table with a fixed weighing machine, standard weights, alidade, tripod, and ranging rods should be able to determine the terrain slope in congested areas as well as in remote hilly terrain. Also, being simple and easy to understand and perform the people of that local rural area can be easily trained for the proposed method. The idea for the proposed method is based on the principle of resolution of weight components. When any object of standard weight ‘W’ is placed on an inclined surface with a weighing machine below it, then its cosine component of weight is presently measured by that weighing machine. The slope can be determined from the relation between the true or actual weight and the apparent weight. A proper procedure is to be followed, which includes site location, centering and sighting work, fixing the whole set at the identified station, and finally taking the readings. A set of experiments for slope determination, mild and moderate slopes, are carried out by the proposed method and by the theodolite instrument in a controlled environment, on the college campus, and uncontrolled environment actual site. The slopes determined by the proposed method were compared with those determined by the established instruments. For example, it was observed that for the same distances for mild slope, the difference in the slope obtained by the proposed method and by the established method ranges from 4’ for a distance of 8m to 2o15’20” for a distance of 16m for an uncontrolled environment. Thus, for mild slopes, the proposed method is suitable for a distance of 8m to 10m. The correlation between the proposed method and the established method shows a good correlation of 0.91 to 0.99 for various combinations, mild and moderate slope, with the controlled and uncontrolled environment.

Keywords: surveying, plane table, weight component, slope determination, hilly terrain, construction

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1451 The Physically Handicapped in the City

Authors: Bekhemmas Youcef

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The category of the disabled, like other social groups, is considered to have been affected by fate with a disability that led to a reduction in the fulfillment of its social roles to the fullest extent or led to its complete abandonment. Psychological, and until we understand its behavioral methods that express a lot of this complexity and intertwining, and despite all that, this category has not yet received the appropriate great interest from specialized researchers, and even officials, and it is natural that the category of people with disabilities has psychological and social requirements in order to regains their capabilities or some From her, it also needs to prepare the environment in which she lives in order to integrate into society As the motor disability is one of the most common types of disability in the world, and it is constantly increasing, considering the increase in the causes leading to it, such as the traffic accident, and the motor disability often affects individuals from a psychological point of view, but it also affects their social surroundings, whether close or extended, and thus it draws limits and quality For their way of life, as well as determining roles for them as actors of a special kind within their societies. The methodology is similar to the organizational framework for the production of any scientific knowledge and based on the fact that sociology is a project that aims to understand and interpret the social reality scientifically and through the nature of the subject studied in the framework of the reality of the disabled in the city and in order to get closer to the daily life of the physically disabled within the urban center, we adopted the qualitative approach A choice that complies with the spirit of Viberian sociology, especially since Max Weber insists on the need to search for the meaning that the social actor gives to his behavior. Through the results reached in this study, it was found that the city still suffers from several deficiencies at the level of equipment and urban planning in a way that keeps pace with the number of people with disabilities in the city.

Keywords: physically, handicapped, in, the city

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1450 Preliminary Flow Sheet for Recycling of Spent Lithium-Ion Batteries

Authors: Mohammad Ali Rajaeifar, Oliver Heidrich

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Nowadays, Li-ion batteries are vastly disseminated and the battery market is expected to experience a huge growth during next decade especially in terms of traction batteries. As the automotive industry moving towards the electrification of the powertrain, more raw/critical materials and energy are extracted while on the other hand, concerns are made regarding the scarcity of the materials as well as environmental issues regarding the destiny of the spent batteries. In this regards, recycling could play a vital role in the supply chain, leading reutilization of key battery materials and also reducing environmental burden related to the use of batteries. The aim of this paper is to review the previous and state-of-the-art treatments for recycling of Li-ion batteries. All the treatments method from mechanical, mild-thermal, pyrometallurgical and hydrometallurgical as well as combined methods for recycling of Li-ion batteries were considered in the study. There are various treatment methods that are economical, but they are not environmentally friendly or vice versa. This is due to the fact that the benefits of the Li-ion batteries recycling could be affected by different factors such as the amount of spent batteries available, the quality of the recovered material, the energy and material consumption by the process itself and environmental burdens caused by required logistics. Finally, a preliminary work sheet of possible route for recycling of spent Li-ion batteries was presented through the course of this study. Overall, it is worth quoting that recycling processes generally consumes a great deal of energy and auxiliary materials. Moreover, the collection of spent products from waste streams represents additional environmental efforts. Therefore, developing and optimizing efficient collection and separation technologies is essential to achieve sustainability goals.

Keywords: hydrometallurgical treatment, Li-ion batteries, mild-thermal treatment, mechanical treatment, recycling, pyrometallurgical treatment

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1449 An Analysis of Miguel Syjuco’s Ilustrado: The Reconstructed Oriental Image

Authors: Christine Ivy A. Nogot

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Under the colony of Spain for more than three centuries, the Philippines has a deep-rooted structure of Western ideologies and colonialism. The late 19th century, the period of Enlightenment, created a significant impact on our history when a group of middle-class Filipino men were sent to Europe to study. They were called Ilustrados, a Spanish word for erudite. They were the enlightened; the well-educated, intellectual scholars. Their writings provide intellectual grounds for the awakening of national consciousness that eventually prompted national movements and revolutions. They helped to establish a postcolonial society. In the modern era, Miguel Syjuco, a Filipino expatriate, wrote a novel and titled it Ilustrado. It is a representation of the liberal mind of the diasporic author in contemporary discourse. It provides a critical examination of the ilustrado in transition through the character of Miguel, who is also an expatriate writer. Using Syjuco’s award-winning novel as the primary text and anchored on Said’s concept of Orientalism, this paper examines how the depiction of features of the Eastern world is presented in the literary discourse. This paper looks into Said’s concept of orientalism as a hegemonic discursive structure and shows how Western superiority influences the Eastern culture in literary discourse. It explores Gramsci’s theory of cultural hegemony to explore Said’s argument that Western powers conquer the orient through culture and ideology. This paper presents how dominant ideologies and the social context redefine the ilustrado in the contemporary era.

Keywords: cultural hegemony, ilustrado, orientalism, postcolonial

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1448 Surgical School Project: Implementation Educational Plan for Adolescents Awaiting Bariatric Surgery

Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

Abstract:

Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

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1447 Differentiated Instruction for All Learners: Strategies for Full Inclusion

Authors: Susan Dodd

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This presentation details the methodology for teachers to identify and support a population of students who have historically been overlooked in regards to their educational needs. The twice exceptional (2e) student is a learner who is considered gifted and also has a learning disability, as defined by the Individuals with Disabilities Education Act (IDEA). Many of these students remain underserved throughout their educational careers because their exceptionalities may mask each other, resulting in a special population of students who are not achieving to their fullest potential. There are three common scenarios that may make the identification of a 2e student challenging. First, the student may have been identified as gifted, and her disability may go unnoticed. She could also be considered an under-achiever, or she may be able to compensate for her disability under the school works becomes more challenging. In the second scenario, the student may be identified as having a learning disability and is only receiving remedial services where his giftedness will not be highlighted. His overall IQ scores may be misleading because they were impacted by his learning disability. In the third scenario, the student is able to compensate for her ability well enough to maintain average scores, and she goes undetected as both gifted and learning disabled. Research in the area identifies the complexity involved in identifying 2e students, and how multiple forms of assessment are required. It is important for teachers to be aware of the common characteristics exhibited by many 2e students, so these learners can be identified and appropriately served. Once 2e students have been identified, teachers are then challenged to meet the varying needs of these exceptional learners. Strength-based teaching entails simultaneously providing gifted instruction as well as individualized accommodations for those students. Research in this field has yielded strategies that have proven helpful for teaching 2e students, as well as other students who may be struggling academically. Differentiated instruction, while necessary in all classrooms, is especially important for 2e students, as is encouragement for academic success. Teachers who take the time to really know their students will have a better understanding of each student’s strengths and areas for growth, and therefore tailor instruction to extend the intellectual capacities for optimal achievement. Teachers should also understand that some learning activities can prove very frustrating to students, and these activities can be modified based on individual student needs. Because 2e students can often become discouraged by their learning challenges, it is especially important for teachers to assist students in recognizing their own strengths and maintaining motivation for learning. Although research on the needs of 2e students has spanned across two decades, this population remains underserved in many educational institutions. Teacher awareness of the identification of and the support strategies for 2e students is critical for their success.

Keywords: gifted, learning disability, special needs, twice exceptional

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1446 Liver Histopathological Findings after Treatment with Anastrazole and Letrozole in Ovariectomized Rats

Authors: Ioannis Boutas, Vasilios Pergialiotis, Nicolaos Salakos, George Agrogiannis, Panagiotis Konstantopoulos, Laskarina-Maria Korou, Theodoros Kalampokas, Odysseas Gregoriou, George Creatsas, Despina Perrea

Abstract:

Introduction: The effect of third generation aromatase inhibitors in the lipid profile among women with breast cancer, present diversities. It has been also shown that low levels of estrogens affect liver metabolism in mice in numerous ways, such as lipid accumulation and hepatic steatosis. Materials and Methods: Forty-five female Wistar rats underwent surgical ovariectomy. The animals were anesthetized with a combination of ketamine (75 mg/kg) and xylazine (10 mg/kg) which were administered intraperitoneally. After the ovariectomy, the operated animals were randomized in three groups. The first group did not receive any drug regimen (ovariectomized control group). The second group received Anastrazole and the third group received Letrozole. Four months after the initiation of the study, the animals were euthanized and livers were dissected immediately for further histopathological analysis. The histological features were grouped into 4 broad categories: steatosis, ballooning, portal inflammation and lobular activity. A score from 0 (absence) to 3 (severe) was assigned to each parameter. Results: The liver pathology analysis revealed significant differences among groups with favored mild steatosis and ballooning among animals that received Anastrazole or Letrozole. Conclusion: The effect of Anastrazole and Letrozole on liver function have not yet been clarified. In our study mild histological liver alterations seem also to occur and these alterations should be taken in mind in future clinical studies

Keywords: anastrazole, letrozole, liver, rats

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