Search results for: child removal
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3096

Search results for: child removal

2256 The Relationship between Level of Anxiety and the Development of Children with Growth Hormone Deficiency

Authors: Ewa Mojs, Katarzyna Wiechec, Maia Kubiak, Wlodzimierz Samborski

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Interactions between mother’s psychological condition and child’s health status are complex and derive from the nature of the mother-child relationship. The aim of the study was to analyze the issue of anxiety amongst mothers of short children in the aspect of growth hormone therapy. The study was based on a group of 101 mothers of originally short-statured children – 70 with growth hormone deficiency (GHD) treated with recombinant human growth hormone (rhGH) and 31 undergoing the diagnostic process, without any treatment. Collected medical data included child's gender, height and weight, chronological age, bone age delay, and rhGH therapy duration. For all children, the height SDS and BMI SDS were calculated. To evaluate anxiety in mothers, the Spielberger State-Trait Anxiety Inventory (STAI) was used. Obtained results revealed low trait anxiety levels, with no statistically significant differences between the groups. State anxiety levels were average when mothers of all children were analyzed together, but when divided into groups, statistical differences appeared. Mothers of children without diagnosis and treatment had significantly higher levels of state anxiety than mothers of children with GHD receiving appropriate therapy. These results show, that the occurrence of growth failure in children is not related to high maternal trait anxiety, but the lack of diagnosis and lack of appropriate treatment generates higher levels of maternal state anxiety than the process of rh GH therapy in the offspring. Commencement of growth hormone therapy induce a substantial reduction of the state anxiety in mothers, and the duration of treatment causes its further decrease.

Keywords: anxiety, development, growth hormone deficiency, motherhood

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2255 Ecological Systems Theory, the SCERTS Model, and the Autism Spectrum, Node and Nexus

Authors: C. Surmei

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Autism Spectrum Disorder (ASD) is a complex developmental disorder that can affect an individual’s (but is not limited to) cognitive development, emotional development, language acquisition and the capability to relate to others. Ecological Systems Theory is a sociocultural theory that focuses on environmental systems with which an individual interacts. The SCERTS Model is an educational approach and multidisciplinary framework that addresses the challenges confronted by individuals on the autism spectrum and other developmental disabilities. To aid the understanding of ASD and educational philosophies for families, educators, and the global community alike, a Comparative Analysis was undertaken to examine key variables (the child, society, education, nurture/care, relationships, communication). The results indicated that the Ecological Systems Theory and the SCERTS Model were comparable in focus, motivation, and application, attaining to a viable and notable relationship between both theories. This paper unpacks two child development philosophies and their relationship to each other.

Keywords: autism spectrum disorder, ecological systems theory, education, SCERTS model

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2254 Promoting Resilience in Adolescents: Integrating Adolescent Medicine and Child Psychology Perspectives

Authors: Xu Qian

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This abstract examines the concept of resilience in adolescents from both adolescent medicine and child psychology perspectives. It discusses the role of healthcare providers in fostering resilience among adolescents, encompassing physical, psychological, and social aspects. The paper highlights evidence-based interventions and practical strategies for promoting resilience in this population. Introduction: Resilience plays a crucial role in the healthy development of adolescents, enabling them to navigate through the challenges of this transitional period. This abstract explores the concept of resilience from the perspectives of adolescent medicine and child psychology, shedding light on the collective efforts of healthcare providers in fostering resilience. By integrating the principles and practices of these two disciplines, this abstract emphasizes the multidimensional nature of resilience and its significance in the overall well-being of adolescents. Methods: A comprehensive literature review was conducted, encompassing research articles, empirical studies, and expert opinions from both adolescent medicine and child psychology fields. The search included databases such as PubMed, PsycINFO, and Google Scholar, focusing on publications from the past decade. The review aimed to identify evidence-based interventions and practical strategies employed by healthcare providers to promote resilience among adolescents. Results: The review revealed several key findings regarding the promotion of resilience in adolescents. Firstly, resilience is a dynamic process influenced by individual characteristics, environmental factors, and the interaction between the two. Secondly, healthcare providers play a critical role in fostering resilience by addressing the physical, psychological, and social needs of adolescents. This entails comprehensive healthcare services that integrate medical care, mental health support, and social interventions. Thirdly, evidence-based interventions such as cognitive-behavioral therapy, social skills training, and positive youth development programs have shown promising outcomes in enhancing resilience. Discussion: The integration of adolescent medicine and child psychology perspectives provides a comprehensive framework for promoting resilience in adolescents. By acknowledging the interplay between physical health, psychological well-being, and social functioning, healthcare providers can tailor interventions to address the specific needs and challenges faced by adolescents. Collaborative efforts between medical professionals, psychologists, educators, and families are vital in creating a supportive environment that fosters resilience. Additionally, the findings highlight the importance of early identification and intervention, emphasizing the need for routine screening and assessment to identify adolescents at risk and provide timely support. Conclusion: Promoting resilience in adolescents requires a holistic approach that integrates adolescent medicine and child psychology perspectives. By recognizing the multifaceted nature of resilience, healthcare providers can implement evidence-based interventions and practical strategies to enhance the well-being of adolescents. The collaboration between healthcare professionals from different disciplines, alongside the involvement of families and communities, is crucial for creating a resilient support system. By investing in the promotion of resilience during adolescence, we can empower young individuals to overcome adversity and thrive in their journey toward adulthood.

Keywords: psychology, clinical psychology, child psychology, adolescent psychology, adolescent

Procedia PDF Downloads 63
2253 Adherence Induced Formwork Removal in Small-Scale Pull-Off Tensile Tests

Authors: Nicolas Spitz, Nicolas Coniglio, Mohamed El Mansori, Alex Montagne, Sabeur Mezghani

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Nowadays buildings' construction is performed by pouring concrete into molds referred to as formworks that are usually prefabricated metallic modules. Defects such as stripping may possibly form during the removal of the formwork if the interfacial bonding between the concrete and the formwork is high. A new pull-off tensile test was developed in our laboratory to simulate small-scale formwork removals. The concrete-to-formwork adherence force was measured on bare and coated formworks with different surface signatures. The used concrete was a mixture largely used on building sites and contains CEM I Portland cement and calcareous filler. The concrete surface appearance and the type of failures at the concrete-formwork interface have been investigated. The originality of this near-to-surface test was to compare the laboratory-measured adherence forces to the on-site observations. Based upon the small-scale laboratory test results, functional formwork specifications with low adherence to concrete was proposed in terms of superficial signature characteristics.

Keywords: concrete-formwork adherence, interfacial bonding, skin formwork functionality, small-scale pull-off tensile test

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2252 Nurse Practitioner Led Pediatric Primary Care Clinic in a Tertiary Care Setting: Improving Access and Health Outcomes

Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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2251 Association between Eating Behavior in Children Aged 7-10 Years Old and Their Mother’s Feeding Practice: A Study among the Families in Isfahan, Iran

Authors: Behnaz Farahani, Razieh Sotoudeh, Ali Vahdani, Hamed Abdi

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Individual differences in eating behavior can cause underweight or overweight and obesity. Thus influencing factors on children’s eating behavior such as mothers’ feeding practices are needed to be more investigated. The goals of this survey are to evaluate the association of (i) parental pressure and children’s food avoidant tendency, (ii) parental restriction and children’s food approach tendency, (iii) modeling of healthy eating in front of children and their children’s eating behavior. 760 mothers of children aged 7-10 from schools in Isfahan were asked to complete questionnaires including Child Feeding Questionnaire, Children’s Eating Behavior Questionnaire, Modeling Questionnaire, and self-administered demographic questionnaire in which mothers reported their children’s height and weight as well. Of those mothers, 745 completed the questionnaires for the children’s index (mean age: 8.513±1.112) during the 2011-2012 school year. The results of this quantitative, descriptive, cross-sectional analysis indicated that “parental restriction” was positively associated with child food responsiveness (P,0.000) and food enjoyment (P,0.000) and surprisingly, it was positively associated with Food Fussiness(0.000) .Parental pressure to eat was positively associated with child satiety responsiveness (P,0.000), slowness (P,0.000), and fussiness (P,0.00) and negatively associated with Food responsiveness(p,0.000)and Enjoyment of food (p,0.002), modeling of healthy eating were positively associated with Enjoyment of food / q (p,0.000) and negatively with food fussiness (P,0.000). The results of this survey will improve interventions and maternal guidance on their feeding practices and their association with children’s eating behavior and weight.

Keywords: feeding practices, eating behavior, pressure to eat, restriction, modeling, satiety responsiveness, slowness in eating, food fussiness, food responsiveness, enjoyment of food

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2250 Synthesis of Magnetic Chitosan Beads and Its Cross-Linked Derivatives for Sorption of Zinc Ions from Water Samples of Yamuna and Hindon Rivers in India

Authors: Priti Rani, Rajni Johar, P. S. Jassal

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The magnetic chitosan beads (MCB) were synthesized using co-precipitation method and made to react with epichlorohydrin (ECH) to get the cross-linked derivative (ECH-MCB). The beads were characterized by FTIR, SEM, EDX, and TGA. It is found that zinc metal ion sorption efficiency of ECH-MCB is significantly higher than MCB. Various factors affecting the uptake behavior of metal ions, such as pH, adsorbent dosage, contact time, and temperature effects, were investigated. The adsorption parameters fitted well with Langmuir and Freundlich isotherms. The equilibrium parameter RL values support that the adsorption (0 < RL < 1) is favorable and spontaneous process. The thermodynamic parameters confirm that it is an endothermic reaction, which results in an increase in the randomness of adsorption process. The beads were regenerated using ethylene diamine tetraacetic acid (EDTA) for further use. These beads prove as promising materials for the removal of pollutants from industrial wastewater. Water samples from Yamuna and Hindon rivers were analysed for the detection of Zn (II) ions.

Keywords: chitosan magnetic beads, EDTA, epichlorohydrin, removal efficiency

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2249 Removal of Rhodamine B from Aqueous Solution Using Natural Clay by Fixed Bed Column Method

Authors: A. Ghribi, M. Bagane

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The discharge of dye in industrial effluents is of great concern because their presence and accumulation have a toxic or carcinogenic effect on living species. The removal of such compounds at such low levels is a difficult problem. The adsorption process is an effective and attractive proposition for the treatment of dye contaminated wastewater. Activated carbon adsorption in fixed beds is a very common technology in the treatment of water and especially in processes of decolouration. However, it is expensive and the powdered one is difficult to be separated from aquatic system when it becomes exhausted or the effluent reaches the maximum allowable discharge level. The regeneration of exhausted activated carbon by chemical and thermal procedure is also expensive and results in loss of the sorbent. The focus of this research was to evaluate the adsorption potential of the raw clay in removing rhodamine B from aqueous solutions using a laboratory fixed-bed column. The continuous sorption process was conducted in this study in order to simulate industrial conditions. The effect of process parameters, such as inlet flow rate, adsorbent bed height, and initial adsorbate concentration on the shape of breakthrough curves was investigated. A glass column with an internal diameter of 1.5 cm and height of 30 cm was used as a fixed-bed column. The pH of feed solution was set at 8.5. Experiments were carried out at different bed heights (5 - 20 cm), influent flow rates (1.6- 8 mL/min) and influent rhodamine B concentrations (20 - 80 mg/L). The obtained results showed that the adsorption capacity increases with the bed depth and the initial concentration and it decreases at higher flow rate. The column regeneration was possible for four adsorption–desorption cycles. The clay column study states the value of the excellent adsorption capacity for the removal of rhodamine B from aqueous solution. Uptake of rhodamine B through a fixed-bed column was dependent on the bed depth, influent rhodamine B concentration, and flow rate.

Keywords: adsorption, breakthrough curve, clay, fixed bed column, rhodamine b, regeneration

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2248 Challenging Perceptions of Disability: Exploring the Link between Ableism, Social Stigma, Vision Impairment, and Autism Spectrum Disorder

Authors: Aikaterini Tavoulari

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This research aims to address the types of repetitive behaviours (RBs) observed by adults in children with vision impairment (VI) or autism spectrum disorder (ASD), the explanations the adults employ to interpret these behaviours, and the impact RBs have on the child, the caregiver, the professional and society. The underlying reason for this is an attempt to discover any potential differences between two different disabilities in a comparative fashion. The study is based on the interpretivism paradigm and follows a qualitative approach. A comparative case study design based on the ecological systems theory (EST) is adopted. Thirty-five caregivers and accredited professionals were recruited (17 for the VI group, out of whom 8 were caregivers and 9 were professionals, and 18 for the ASD group, out of whom 9 were caregivers and 9 were professionals). Following the completion of a pilot study, all participants were interviewed regarding one specific child – their own child/student – via semi-structured interviews. During the interviews, the researcher used a research diary as a methodological tool and video elicitation as a facilitation tool. A cross-case analysis was conducted, and data were analysed according to the method of thematic analysis. A link has been indicated between VI and ASD, which concerns perceptions about the socially constructed manner in which an RB is perceived. ASD is perceived by the participants as a disability with challenging characteristics, such as an RB. The ASD group perceived RB as linked to ableism, social stigmatisation, and taboo, in contrast to VI, where the existence of RB seems to be a consequence of sensory loss. Bi-directionality of EST seems to have been lost completely, and the macrosystem seems to drive the interactions between the ecological systems.

Keywords: ableism, social stigma, disability, repetitive behaviour, vision impairment, autism spectrum disorder, perceptions

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2247 Electrochemical Coagulation of Synthetic Textile Dye Wastewater

Authors: H. B. Rekha, Usha N. Murthy, Prashanth, Ashoka

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Dyes are manufactured to have high chemical resistance because they are normally species, very difficult to degrade (reactive dyes). It damages flora and fauna. Furthermore, coloured components are highly hazardous. So removal of dyes becomes a challenge for both textile industry and water treatment facility. Dyeing wastewater is usually treated by conventional methods such as biological oxidation and adsorption but nowadays them becoming in-adequate because of large variability of composition of waste water. In the present investigation, mild steel electrodes of varying surface area were used for treatment of synthetic textile dye. It appears that electro-chemical coagulation could be very effective in removing coloured from wastewater; it could also be used to remove other parameters like chlorides, COD, and solids to some extent. In the present study, coloured removal up to 99% was obtained for surface area of mild steel electrode of 80 cm2 and 96% of surface area of mild steel electrode of 50 cm2. The findings from this study could be used to improve the design of electro-chemical treatment systems and modify existing systems to improve efficiency.

Keywords: electrochemical coagulation, mild steel, colour, environmental engineering

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2246 Study of Synergetic Effect by Combining Dielectric Barrier Discharge (DBD) Plasma and Photocatalysis for Abatement of Pollutants in Air Mixture System: Influence of Some Operating Conditions and Identification of Byproducts

Authors: Wala Abou Saoud, Aymen Amine Assadi, Monia Guiza, Abdelkrim Bouzaza, Wael Aboussaoud, Abdelmottaleb Ouederni, Dominique Wolbert

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Volatile organic compounds (VOCs) constitute one of the most important families of chemicals involved in atmospheric pollution, causing damage to the environment and human health, and need, consequently, to be eliminated. Among the promising technologies, dielectric barrier discharge (DBD) plasma - photocatalysis coupling reveals very interesting prospects in terms of process synergy of compounds mineralization’s, with low energy consumption. In this study, the removal of organic compounds such butyraldehyde (BUTY) and dimethyl disulfide (DMDS) (exhaust gasses from animal quartering centers.) in air mixture using DBD plasma coupled with photocatalysis was tested, in order to determine whether or not synergy effect was present. The removal efficiency of these pollutants, a selectivity of CO₂ and CO, and byproducts formation such as ozone formation were investigated in order to evaluate the performance of the combined process. For this purpose, a series of experiments were carried out in a continuous reactor. Many operating parameters were also investigated such as the specific energy of discharge, the inlet concentration of pollutant and the flowrate. It appears from this study that, the performance of the process has enhanced and a synergetic effect is observed. In fact, we note an enhancement of 10 % on removal efficiency. It is interesting to note that the combined system leads to better CO₂ selectivity than for plasma. Consequently, intermediates by-products have been reduced due to various other species (O•, N, OH•, O₂•-, O₃, NO₂, NOx, etc.). Additionally, the behavior of combining DBD plasma and photocatalysis has shown that the ozone can be easily also decomposed in presence of photocatalyst.

Keywords: combined process, DBD plasma, photocatalysis, pilot scale, synergetic effect, VOCs

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2245 Integrating Reactive Chlorine Species Generation with H2 Evolution in a Multifunctional Photoelectrochemical System for Low Operational Carbon Emissions Saline Sewage Treatment

Authors: Zexiao Zheng, Irene M. C. Lo

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Organic pollutants, ammonia, and bacteria are major contaminants in sewage, which may adversely impact ecosystems without proper treatment. Conventional wastewater treatment plants (WWTPs) are operated to remove these contaminants from sewage but suffer from high carbon emissions and are powerless to remove emerging organic pollutants (EOPs). Herein, we have developed a low operational carbon emissions multifunctional photoelectrochemical (PEC) system for saline sewage treatment to simultaneously remove organic compounds, ammonia, and bacteria, coupled with H2 evolution. A reduced BiVO4 (r-BiVO4) with improved PEC properties due to the construction of oxygen vacancies and V4+ species was developed for the multifunctional PEC system. The PEC/r-BiVO4 process could treat saline sewage to meet local WWTPs’ discharge standard in 40 minutes at 2.0 V vs. Ag/AgCl and completely degrade carbamazepine (one of the EOPs), coupled with significant evolution of H2. A remarkable reduction in operational carbon emissions was achieved by the PEC/r-BiVO4 process compared with large-scale WWTPs, attributed to the restrained direct carbon emissions from the generation of greenhouse gases. Mechanistic investigation revealed that the PEC system could activate chloride ions in sewage to generate reactive chlorine species and facilitate •OH production, promoting contaminants removal. The PEC system exhibited operational feasibility at different pH and total suspended solids concentrations and has outstanding reusability and stability, confirming its promising practical potential. The study combined the simultaneous removal of three major contaminants from saline sewage and H2 evolution in a single PEC process, demonstrating a viable approach to supplementing and extending the existing wastewater treatment technologies. The study generated profound insights into the in-situ activation of existing chloride ions in sewage for contaminants removal and offered fundamental theories for applying the PEC system in sewage remediation with low operational carbon emissions. The developed PEC system can fit well with the future needs of wastewater treatment because of the following features: (i) low operational carbon emissions, benefiting the carbon neutrality process; (ii) higher quality of the effluent due to the elimination of EOPs; (iii) chemical-free in the operation of sewage treatment; (iv) easy reuse and recycling without secondary pollution.

Keywords: contaminants removal, H2 evolution, multifunctional PEC system, operational carbon emissions, saline sewage treatment, r-BiVO4 photoanodes

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2244 Engineered Bio-Coal from Pressed Seed Cake for Removal of 2, 4, 6-Trichlorophenol with Parametric Optimization Using Box–Behnken Method

Authors: Harsha Nagar, Vineet Aniya, Alka Kumari, Satyavathi B.

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In the present study, engineered bio-coal was produced from pressed seed cake, which otherwise is non-edible in origin. The production process involves a slow pyrolysis wherein, based on the optimization of process parameters; a substantial reduction in H/C and O/C of 77% was achieved with respect to the original ratio of 1.67 and 0.8, respectively. The bio-coal, so the product was found to have a higher heating value of 29899 kJ/kg with surface area 17 m²/g and pore volume of 0.002 cc/g. The functional characterization of bio-coal and its subsequent modification was carried out to enhance its active sites, which were further used as an adsorbent material for removal of 2,4,6-Trichlorophenol (2,4,6-TCP) herbicide from the aqueous stream. The point of zero charge for the bio-coal was found to be pH < 3 where its surface is positively charged and attracts anions resulting in the maximum 2, 4, 6-TCP adsorption at pH 2.0. The parametric optimization of the adsorption process was studied based on the Box-Behken design with the desirability approach. The results showed optimum values of adsorption efficiency of 74.04% and uptake capacity of 118.336 mg/g for an initial metal concentration of 250 mg/l and particle size of 0.12 mm at pH 2.0 and 1 g/L of bio-coal loading. Negative Gibbs free energy change values indicated the feasibility of 2,4,6-TCP adsorption on biochar. Decreasing the ΔG values with the rise in temperature indicated high favourability at low temperatures. The equilibrium modeling results showed that both isotherms (Langmuir and Freundlich) accurately predicted the equilibrium data, which may be attributed to the different affinity of the functional groups of bio-coal for 2,4,6-TCP removal. The possible mechanism for 2,4,6-TCP adsorption is found to be physisorption (pore diffusion, p*_p electron donor-acceptor interaction, H-bonding, and van der Waals dispersion forces) and chemisorption (phenolic and amine groups chemical bonding) based on the kinetics data modeling.

Keywords: engineered biocoal, 2, 4, 6-trichlorophenol, box behnken design, biosorption

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2243 Exertainment: Designing Active Video Games to Get Youth Moving

Authors: Geoff Skinner, Ilung Pranata

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The advancement of ICT innovations provides us with a comfortable and convenient modern lifestyle. However, this modern easy lifestyle is proving to have some serious health consequences. Such technological advancements that have dramatically increased ones time in front of screens have been a contributing factor to increasing rates of obesity. In particular the youth obesity issue has gained more and more attention from researchers and health institutions around the world. Although technology innovations may lead to a sedate modern life, they also have a potential to solve the obesity issue in children. This paper provides a review of the issues in child obesity and the potential of active video games to mitigate these issues. Additionally, the paper also discusses the key requirements to develop an active video game that hopes to help combat child obesity through motivating youth to exergame. A framework is introduced to meet the requirements, from which a prototype was implemented. Discussion of the simulation and testing that were performed to verify the attainment of objectives is also detailed.

Keywords: e-video games, exergaming, health informatics, human computer interaction

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2242 A Report of 5-Months-Old Baby with Balanced Chromosomal Rearrangements along with Phenotypic Abnormalities

Authors: Mohit Kumar, Beklashwar Salona, Shiv Murti, Mukesh Singh

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We report here a case of five-months old male baby, born as second child of non-consanguineous parents with no considerable history of genetic abnormality which was referred to our cytogenetic laboratory for chromosomal analysis. Physical dysmorphic facial features including mongoloid face, cleft palate, simian crease, and developmental delay were observed. We present this case with unique balanced autosomal translocation of t(3;10)(p21;p13). The risk of phenotypic abnormalities based on de novo balanced translocation was estimated to be 7%. The association of balanced chromosomal rearrangement with Down syndrome features such as multiple congenital anomalies, facial dysmorphism and congenital heart anomalies are very rare in a 5-months old male child. Trisomy-21 is not uncommon in chromosomal abnormality with the birth defect and balanced translocations are frequently observed in patients with secondary infertility or recurrent spontaneous abortion (RSA). Two ml heparinized peripheral blood cells cultured in RPMI-1640 for 72 hours supplemented with 20% fetal bovine serum, phytohemagglutinin (PHA), and antibiotics were used for chromosomal analysis. A total 30 metaphases images were captured using Olympus-BX51 microscope and analyzed using Bio-view karyotyping software through GTG-banding (G bands by trypsin and Giemsa) according to International System for Human Cytogenetic Nomenclature 2016. The results showed balanced translocation between short arm of chromosome # 3 and short arm of chromosome # 10. The karyotype of the child was found to be 46,XY,t(3;10)(p21; p13). Chromosomal abnormalities are one of the major causes of birth defect in new born babies. Also, balanced translocations are frequently observed in patients with secondary infertility or recurrent spontaneous abortion. The index case presented with dysmorphic facial features and had a balanced translocation 46,XY,t(3;10)(p21;p13). This translocation with break points at (p21; p13) has not been reported in the literature in a child with facial dysmorphism. To the best of our knowledge, this is the first report of novel balanced translocation t(3;10) with break points in a child with dysmorphic features. We found balanced chromosomal translocation instead of any trisomy or unbalanced aberrations along with some phenotypic abnormalities. Therefore, we suggest that such novel balanced translocation with abnormal phenotype should be reported in order to enable the pathologist, pediatrician, and gynecologist to have a better insight into the intricacies of chromosomal abnormalities and their associated phenotypic features. We hypothesized that dysmorphic features as seen in this case may be the result of change in the pattern of genes located at the breakpoint area in balanced translocations or may be due to deletion or mutation of genes located on the p-arm of chromosome # 3 and p-arm of chromosome # 10.

Keywords: balanced translocation, karyotyping, phenotypic abnormalities, facial dimorphisms

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2241 Phytoremediation of Textile Wastewater Laden with 1,4-Dioxane Using Eichhornia crassipes: A Sustainable Development Approach

Authors: Hadeer Ibrahiem, Mahmoud Nasr, Masarrat M. M. Migahid, Mohamed A. Ghazy

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The release of textile wastewater loaded with 1,4 dioxane into aquatic ecosystems has been associated with various human health risks and adverse environmental impacts. In parallel, phytoremediation has been recently employed to treat highly polluted wastewater because various plant species tend to produce certain enzymes as a defense mechanism against a toxic environment. To our best knowledge, this study is the first to investigate the ability of phytoremediation using Eichhornia crassipes for the removal of various pollutants, including 1,4 dioxane, from textile wastewater. A phytoremediation system composed of Eichhornia crassipes was acclimatized for 10 d, and then operated in four lab-scale hydroponic systems, viz., negative control, positive control, and two different 1,4 dioxane concentration (400 and 500 mg/L). After 11 d of operation, the phytoremediation system achieved removal efficiencies of 67.5±3.4%, 89.4±4.4%, 83.6±3.8% for 1,4 dioxane (at initial concentration 400 mg/L), chemical oxygen demand (COD) (at initial concentration 679 mg/L), and cumulative heavy metals, respectively. The removal of these pollutants was mainly supported by the phyto-sorption and phytodegradation mechanisms. The economic feasibility of this phytoremediation system was validated by estimating the capital and operating costs, requiring 4.6 USD for the treatment of 1 m3 textile wastewater. The study concluded that the phytoremediation process could be used as a practical and economical approach to treat textile wastewater laden with various organic and inorganic pollutants. Due to the observed pollution reduction and human health protection, the study objectives would fulfill the targets of SDG 3 “Good Health and Well-being” and SDG 6 “Clean Water and Sanitation”. Further studies are required to (i) investigate the ability of plant species to withstand higher concentrations of 1,4 dioxane for an extended operation time and (ii) understand the biochemical pathways for the degradation of 1,4 dioxane via the action of plant enzymes and the associated microbial community.

Keywords: 1, 4 dioxane concentrations, hydrophytes, Eichhornia crassipes, phytoremediation effectiveness, SDGs, textile industrial effluent

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2240 Food Safety in Wine: Removal of Ochratoxin a in Contaminated White Wine Using Commercial Fining Agents

Authors: Antònio Inês, Davide Silva, Filipa Carvalho, Luís Filipe-Riberiro, Fernando M. Nunes, Luís Abrunhosa, Fernanda Cosme

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The presence of mycotoxins in foodstuff is a matter of concern for food safety. Mycotoxins are toxic secondary metabolites produced by certain molds, being ochratoxin A (OTA) one of the most relevant. Wines can also be contaminated with these toxicants. Several authors have demonstrated the presence of mycotoxins in wine, especially ochratoxin A. Its chemical structure is a dihydro-isocoumarin connected at the 7-carboxy group to a molecule of L-β-phenylalanine via an amide bond. As these toxicants can never be completely removed from the food chain, many countries have defined levels in food in order to attend health concerns. OTA contamination of wines might be a risk to consumer health, thus requiring treatments to achieve acceptable standards for human consumption. The maximum acceptable level of OTA in wines is 2.0 μg/kg according to the Commission regulation No. 1881/2006. Therefore, the aim of this work was to reduce OTA to safer levels using different fining agents, as well as their impact on white wine physicochemical characteristics. To evaluate their efficiency, 11 commercial fining agents (mineral, synthetic, animal and vegetable proteins) were used to get new approaches on OTA removal from white wine. Trials (including a control without addition of a fining agent) were performed in white wine artificially supplemented with OTA (10 µg/L). OTA analyses were performed after wine fining. Wine was centrifuged at 4000 rpm for 10 min and 1 mL of the supernatant was collected and added of an equal volume of acetonitrile/methanol/acetic acid (78:20:2 v/v/v). Also, the solid fractions obtained after fining, were centrifuged (4000 rpm, 15 min), the resulting supernatant discarded, and the pellet extracted with 1 mL of the above solution and 1 mL of H2O. OTA analysis was performed by HPLC with fluorescence detection. The most effective fining agent in removing OTA (80%) from white wine was a commercial formulation that contains gelatin, bentonite and activated carbon. Removals between 10-30% were obtained with potassium caseinate, yeast cell walls and pea protein. With bentonites, carboxymethylcellulose, polyvinylpolypyrrolidone and chitosan no considerable OTA removal was verified. Following, the effectiveness of seven commercial activated carbons was also evaluated and compared with the commercial formulation that contains gelatin, bentonite and activated carbon. The different activated carbons were applied at the concentration recommended by the manufacturer in order to evaluate their efficiency in reducing OTA levels. Trial and OTA analysis were performed as explained previously. The results showed that in white wine all activated carbons except one reduced 100% of OTA. The commercial formulation that contains gelatin, bentonite and activated carbon reduced only 73% of OTA concentration. These results may provide useful information for winemakers, namely for the selection of the most appropriate oenological product for OTA removal, reducing wine toxicity and simultaneously enhancing food safety and wine quality.

Keywords: wine, ota removal, food safety, fining

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2239 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

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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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2238 Emotional, Behavioral and Social Problems in Children with Fecal Incontinence by Child Behavior Checklist (CBCL): A Cross-sectional Study

Authors: Roshanak Farjad, Amirhossein Hosseini

Abstract:

Fecal incontinence (FI) is a stressful condition for children and their parents that may affect the patient’s psychological well-being. Evaluating the patients’ psychological status may help physicians manage the disease effectively. This study aimed to assess the emotional and behavioral disturbances in children with FI who were referred to the pediatric gastroenterology clinic in Mofid Children’s Hospital from April 2021 to 2022. This cross-sectional study included children (over four years old) with chronic constipation and fecal incontinence. The diagnosis of chronic constipation and FI were made according to Rome-IV criteria. The Child Behavior Checklist (CBCL) evaluated patients’ emotional, behavioral, and social problems. One hundred one patients with a mean age of 7.96 years were enrolled in the study; 67.32% were males. According to CBCL, 12% (12 patients) indicated emotional and behavioral problems, with CBCL scores in the clinical or at-risk range. We detected anxious/depressed problems in five (4.95%), withdrawn/depressed problems in eight (7.92%), somatic complaints in seven (6.93%), social problems in eight (7.92%), thought problems in nine (8.91%), attention problems in seven (6.93%), rule-breaking behavior in two (1.98%), and aggressive behavior in nine (8.91%) patients. The risk of internalizing and externalizing disorders was reported in four (3.96%) and five (4.95%) patients. Also, eight (7.92%) and seven (6.93%) patients had clinical symptoms of internalizing and externalizing disorders, respectively. There was no significant relationship between patients’ age and gender with the CBCL scores in any subscales. However, there was a significant difference in the total score among the age groups (P = 0.04). The relatively high prevalence of emotional, behavioral, and social problems in our study corroborates the importance of psychological screening of children with FI during the treatment process.

Keywords: chronic constipation, child behavior checklist (CBCL), fecal incontinence, rome-IV criteria

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2237 Maternal Care Practices on Nutritional Status of Pre School Children in Dass Local Government Area of Bauchi State, Nigeria

Authors: Adebusoye Michael, Okunola Olayinka, Owolabi Abdulateef, Jacob Anayo

Abstract:

Introduction: Child undernutrition remains one of Africa’s most fundamental challenges for improved human development because the time and capacities of caregivers are limited; far too many children are unable to access effectively amenities they need for a healthy life. Methods and procedures: This cross-sectional, descriptive study evaluated the maternal care practices on nutritional status of pre-school children, 150 mothers were selected by systematic random sampling in Dass L.G.A., Bauchi-State, Nigeria. Information on relevant parameters were collected by questionaire, analysed by various indices of descriptive statistics using SPSS version 16.0.Spearman’s rank correlation was used to test for associations between the variables. Results: Thirty-five (23.3%) of the respondents were aged 21-25 years. Thirty-three (28.0%) had secondary education, while forty-nine (32.7%) were full housewives. Majority 79(52.7) earned NI,000- N10,000 monthly versus 10(6.7%) who earned N11,000- N20,000.113(75.3%) married while 7(4.7%) of respondents were separated. Sixty-one (40.7%) practiced exclusive breastfeeding within six months. Only seventy-one (47.3%) initiated breastfeeding between 7 and 13 months. Five (3.3%) of children were mildly underweight while nine (6.0%) were severely stunted. Conclusion: The outcome suggested that working time of mothers is a major determinant on their child nutritional status. However, there is a significant relationship on the working time of mothers, income level and educational level of mothers to the nutritional status of their children (P<0.05). Recommendation: Good policy programmes should aim at eradicating poverty, better child care practices that would reduce malnutrition among under-five children.

Keywords: maternal care, nutritional status, preschool children, Dass L.G.A.

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2236 Monitoring the Phenomenon of Black Sand in Hurghada’s Artificial Lakes from Sources of Groundwater and Removal Techniques

Authors: Ahmed M. Noureldin, Khaled M. Naguib

Abstract:

This experimental investigation tries to identify the root cause of the black sand issue in one of the man-made lakes in a well-known Hurghada resort. The lake is nourished by the underground wells' source, which continuously empties into the Red Sea. Chemical testing was done by looking at spots of stinky black sand beneath the sandy lake surface. The findings on samples taken from several locations (wells, lake bottom sand samples, and clean sand with exact specifications as bottom sand) indicated the existence of organic sulfur bacteria that are responsible for the phenomena of black sand. Approximately 39.139 mg/kg of sulfide in the form of hydrogen sulfide was present in the lake bottom sand, while 1.145 mg/kg, before usage, was in the bare sand. The study also involved modeling with the GPS-X program for cleaning bottom sand that uses hydro cyclones as a physical-mechanical treatment method. The modeling findings indicated a Total Organic Carbon (TOC) removal effectiveness of 0.65%. The research recommended using hydro cyclones to routinely mechanically clear the sand from lake bottoms.

Keywords: man-made lakes, organic sulfur bacteria, total organic carbon, hydro cyclone

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2235 Adsorptive Desulfurization of Using Cu(I) – Y Zeolite via π-Complexation

Authors: Moshe Mello, Hilary Rutto, Tumisang Seodigeng, Itumeleng Kohitlhetse

Abstract:

The accelerating requirement to reach 0% sulfur content in liquid fuels demand researchers to seek efficient alternative technologies to challenge the predicament. In this current study, the adsorption capabilities of modified Cu(I)-Y zeolite were tested for the removal of organosulfur compounds (OSC) present in tire pyrolytic oil (TPO). The π-complexation-based adsorbent was obtained by ion exchanging Y-zeolite with Cu+ cation using liquid phase ion exchange (LPIE). Preparation of the adsorbent involved firstly ion exchange between Na-Y zeolite with a Cu(NO₃)₂ aqueous solution of 0.5M for 48 hours followed by reduction of Cu²⁺ to Cu+. Fixed-bed breakthrough studies for TPO in comparison with model diesel comprising of sulfur compounds such as thiophene, benzothiophenes (BT), and dibenzothiophenes (DBT) showed that modified Cu(I)-Y zeolite is an effective adsorbent for removal of OSC in liquid fuels. The effect of operating conditions such as adsorbent dosage and reaction time were studied to optimize the adsorptive desulfurization process. For model diesel fuel, the selectivity for adsorption of sulfur compounds followed the order DBT> BT> Thiophene. The Cu(I)-Y zeolite is fully regeneratable and this is achieved by a simple procedure of blowing the adsorbent with air at 350 °C, followed by reactivation at 450 °C in a rich helium surrounding.

Keywords: adsorption, desulfurization, TPO, zeolite

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2234 Performance Evaluation and Dear Based Optimization on Machining Leather Specimens to Reduce Carbonization

Authors: Khaja Moiduddin, Tamer Khalaf, Muthuramalingam Thangaraj

Abstract:

Due to the variety of benefits over traditional cutting techniques, the usage of laser cutting technology has risen substantially in recent years. Hot wire machining can cut the leather in the required shape by controlling the wire by generating thermal energy. In the present study, an attempt has been made to investigate the effects of performance measures in the hot wire machining process on cutting leather specimens. Carbonization and material removal rates were considered as quality indicators. Burning leather during machining might cause carbon particles, reducing product quality. Minimizing the effect of carbon particles is crucial for assuring operator and environmental safety, health, and product quality. Hot wire machining can efficiently cut the specimens by controlling the current through it. Taguchi- DEAR-based optimization was also performed in the process, which resulted in a required Carbonization and material removal rate. Using the DEAR approach, the optimal parameters of the present study were found with 3.7% prediction error accuracy.

Keywords: cabronization, leather, MRR, current

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2233 Modeling and Optimizing of Sinker Electric Discharge Machine Process Parameters on AISI 4140 Alloy Steel by Central Composite Rotatable Design Method

Authors: J. Satya Eswari, J. Sekhar Babub, Meena Murmu, Govardhan Bhat

Abstract:

Electrical Discharge Machining (EDM) is an unconventional manufacturing process based on removal of material from a part by means of a series of repeated electrical sparks created by electric pulse generators at short intervals between a electrode tool and the part to be machined emmersed in dielectric fluid. In this paper, a study will be performed on the influence of the factors of peak current, pulse on time, interval time and power supply voltage. The output responses measured were material removal rate (MRR) and surface roughness. Finally, the parameters were optimized for maximum MRR with the desired surface roughness. RSM involves establishing mathematical relations between the design variables and the resulting responses and optimizing the process conditions. RSM is not free from problems when it is applied to multi-factor and multi-response situations. Design of experiments (DOE) technique to select the optimum machining conditions for machining AISI 4140 using EDM. The purpose of this paper is to determine the optimal factors of the electro-discharge machining (EDM) process investigate feasibility of design of experiment techniques. The work pieces used were rectangular plates of AISI 4140 grade steel alloy. The study of optimized settings of key machining factors like pulse on time, gap voltage, flushing pressure, input current and duty cycle on the material removal, surface roughness is been carried out using central composite design. The objective is to maximize the Material removal rate (MRR). Central composite design data is used to develop second order polynomial models with interaction terms. The insignificant coefficients’ are eliminated with these models by using student t test and F test for the goodness of fit. CCD is first used to establish the determine the optimal factors of the electro-discharge machining (EDM) for maximizing the MRR. The responses are further treated through a objective function to establish the same set of key machining factors to satisfy the optimization problem of the electro-discharge machining (EDM) process. The results demonstrate the better performance of CCD data based RSM for optimizing the electro-discharge machining (EDM) process.

Keywords: electric discharge machining (EDM), modeling, optimization, CCRD

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2232 Central Composite Design for the Optimization of Fenton Process Parameters in Treatment of Hydrocarbon Contaminated Soil using Nanoscale Zero-Valent Iron

Authors: Ali Gharaee, Mohammad Reza Khosravi Nikou, Bagher Anvaripour, Ali Asghar Mahjoobi

Abstract:

Soil contamination by petroleum hydrocarbon (PHC) is a major concern facing the oil and gas industry. Particularly, condensate liquids have been found to contaminate soil at gas production sites. The remediation of PHCs is a difficult challenge due to the complex interaction between contaminant and soil. A study has been conducted to enhance degradation of PHCs by Fenton oxidation and using Nanoscale Zero-Valent Iron as catalyst. The various operating conditions such as initial H2O2 concentration, nZVI dosage, reaction time, and initial contamination dose were investigated. Central composite design was employed to optimize and analyze the effect of operational parameters on the PHC removal efficiency. It was found that optimal molar ratio of H2O2/Fe0 was 58 with maximum TPH removal of 84% and 3hr reaction time and initial contaminant concentration was 15g oil /kg soil. Based on the results, combination of Nanoscale ZVI and Fenton has proved to be a promising remedy for contaminated soil.

Keywords: oil contaminated Soil, fenton oxidation, zero valent iron nano-particles

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2231 Improving Anchor Technology for Adapting the Weak Soil

Authors: Sang Hee Shin

Abstract:

The technical improving project is for using the domestic construction technology in the weak soil condition. The improved technology is applied directly under local construction site at OOO, OOO. Existing anchor technology was developed for the case of soft ground as N value 10 or less. In case of soft ground and heavy load, the attachment site per one strand is shortened due to the distributed interval so that the installation site is increased relatively and being economically infeasible. In addition, in case of high tensile load, adhesion phenomenon between wedge and block occurs. To solve these problems, it strengthens the function of the attached strands to treat a ‘bulbing’ on the strands. In the solution for minimizing the internal damage and strengthening the removal function, it induces lubricating action using the film and the attached film, and it makes the buffer structure using wedge lubricating structure and the spring. The technology is performed such as in-house testing and the field testing. The project can improve the reliability of the standardized quality technique. As a result, it intended to give the technical competitiveness.

Keywords: anchor, improving technology, removal anchor, soil reinforcement, weak soil

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2230 Moving Forward to Stand Still: Social Experiences of Children with a Parent in Prison in Ireland

Authors: Aisling Parkes, Fiona Donson

Abstract:

There is no doubt that parental imprisonment directly alters the social experiences of childhood for many children worldwide today. Indeed, the extent to which meaningful contact with a parent in prison can positively impact on the life of a child is well documented as are the benefits for the prisoner, particularly in the long term and post-release. However, despite the growing acceptance of children’s rights in Ireland over the past decade in particular, it appears that children’s rights have not yet succeeded in breaking through the walls of Irish prisons when children are visiting an incarcerated parent. In a prison system that continues to prioritise security over all other considerations, little attention has been given to the importance of recognising and protecting the rights of children affected by parental imprisonment in Ireland for children, families and society in the long term. This paper will present the findings which have emerged from a national qualitative research project (the first of its kind to be conducted in Ireland) which examines the current visiting conditions for children and families, and the related culture of visitation within the Irish Prison system. This study investigated, through semi-structured interviews and focus groups, the unique and specialist perspectives of senior prison management, prison governors, prison officers, support organisations, prison child care workers, as well as those with a family member in prison who have direct experience of prison visits in Ireland which involve children and young people. The reality of the current system of visitation that operates in Irish prisons and its impact on children’s rights is presented from a variety of perspectives. The idea of what meaningful contact means from a children’s rights based perspective is interrogated as are the benefits long term for both the child and the offender. The current system is benchmarked against well-accepted international children’s rights norms as reflected under the UN Convention on the Rights of the Child 1989. The dissonance that continues to exist between the theory of children’s rights which includes the right to maintain meaningful contact with a parent in prison and current practice and procedure in Irish Prisons will be explored. In adopting a children’s rights based perspective combined with socio-legal research, this paper will explore the added value that this approach to prison visiting might offer in responding to this particularly marginalised group of children in terms of their social experience of childhood. Finally, the question will be raised as to whether or not there is a responsibility on prisons to view children as independent rights holders when they come to visit the prison or is the prison entitled to focus solely on the prisoner with their children being viewed as a circumstance of the offender? Do the interests of the child and the prisoner have to be exclusive or is there any way of marrying the two?

Keywords: children’s rights, prisoners, sociology, visitation

Procedia PDF Downloads 241
2229 Analysis of Employed and Unemployed Mother’s Perspectives Towards Story Narration in Typically Developing Children between 2 to 5 Years

Authors: Bindu S., Malavika Anakkathil Anil, Jayashree S. Bhat

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The dyadic interaction between the parent and child during story narration facilitates the emergence of early literacy skills. Early shared reading experiences positively predict better reading and language outcomes in children who experience rich communicative and effective interactions during shared book reading. However, research is yet to systematically explore mother’s perspective towards story narration and how employment may influence their perspectives. The study analysed the perspectives of employed and unemployed mothers of typically developing children between the age ranges of 2 to 5 years through a questionnaire which covered domains on story narration exposure and parental attitudes & beliefs. The results indicate no statistical difference between employed mothers (M=8.5, SD=3.4) and unemployed mothers (M=10.1, SD=1.06). Whereas, post-hoc comparisons using the scheffe test, revealed a significant difference in scores. An increasing score was obtained as the age of the child increased. This change could be attributed due to the integration of children in preschools which could have contributed to the change of perception towards story narration. Older children’s mother perceive story narration to be an important part of their curriculum, which could facilitate rich vocabulary and language output. Younger children’s parents are however not realising the significance of story narration and its impact on the emergent literacy skills. Parent-child interaction is a significant contributor to a healthy social and cultural development. The study emphasises on the need of mothers to engage in preliteracy based activities which contribute to better academic performance in later stages.

Keywords: early literacy skill, employment, language development, mother’s perspective, story narration

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2228 Giving Children with Osteogenesis Imperfecta a Voice: Overview of a Participatory Approach for the Development of an Interactive Communication Tool

Authors: M. Siedlikowski, F. Rauch, A. Tsimicalis

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Osteogenesis Imperfecta (OI) is a genetic disorder of childhood onset that causes frequent fractures after minimal physical stress. To date, OI research has focused on medically- and surgically-oriented outcomes with little attention on the perspective of the affected child. It is a challenge to elicit the child’s voice in health care, in other words, their own perspective on their symptoms, but software development offers a way forward. Sisom (Norwegian acronym derived from ‘Si det som det er’ meaning ‘Tell it as it is’) is an award-winning, rigorously tested, interactive, computerized tool that helps children with chronic illnesses express their symptoms to their clinicians. The successful Sisom software tool, that addresses the child directly, has not yet been adapted to attend to symptoms unique to children with OI. The purpose of this study was to develop a Sisom paper prototype for children with OI by seeking the perspectives of end users, particularly, children with OI and clinicians. Our descriptive qualitative study was conducted at Shriners Hospitals for Children® – Canada, which follows the largest cohort of children with OI in North America. Purposive sampling was used to recruit 12 children with OI over three cycles. Nine clinicians oversaw the development process, which involved determining the relevance of current Sisom symptoms, vignettes, and avatars, as well as generating new Sisom OI components. Data, including field notes, transcribed audio-recordings, and drawings, were deductively analyzed using content analysis techniques. Guided by the following framework, data pertaining to symptoms, vignettes, and avatars were coded into five categories: a) Relevant; b) Irrelevant; c) To modify; d) To add; e) Unsure. Overall, 70.8% of Sisom symptoms were deemed relevant for inclusion, with 49.4% directly incorporated, and 21.3% incorporated with changes to syntax, and/or vignette, and/or location. Three additions were made to the ‘Avatar’ island. This allowed children to celebrate their uniqueness: ‘Makes you feel like you’re not like everybody else.’ One new island, ‘About Me’, was added to capture children’s worldviews. One new sub-island, ‘Getting Around’, was added to reflect accessibility issues. These issues were related to the children’s independence, their social lives, as well as the perceptions of others. In being consulted as experts throughout the co-creation of the Sisom OI paper prototype, children coded the Sisom symptoms and provided sound rationales for their chosen codes. In rationalizing their codes, all children shared personal stories about themselves and their relationships, insights about their OI, and an understanding of the strengths and challenges they experience on a day-to-day basis. The child’s perspective on their health is a basic right, and allowing it to be heard is the next frontier in the care of children with genetic diseases. Sisom OI, a methodological breakthrough within OI research, will offer clinicians an innovative and child-centered approach to capture this neglected perspective. It will provide a tool for the delivery of health care in the center that established the worldwide standard of care for children with OI.

Keywords: child health, interactive computerized communication tool, participatory approach, symptom management

Procedia PDF Downloads 143
2227 Elimination of Mother to Child Transmission of HIV/AIDS: A Study of the Knowledge, Attitudes and Perceptions of Healthcare Workers in Abuja Nigeria

Authors: Ezinne K. Okoro, Takahiko Katoh, Yoko Kawamura, Stanley C. Meribe

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HIV infection in children is largely as a result of vertical transmission (mother to child transmission [MTCT]). Thus, elimination of mother to child transmission of HIV/AIDS is critical in eliminating HIV infection in children. In Nigeria, drawbacks such as; limited pediatric screening, limited human capital, insufficient advocacy and poor understanding of ART guidelines, have impacted efforts at combating the disease, even as treatment services are free. Prevention of Mother to Child Transmission (PMTCT) program relies on health workers who not only counsel pregnant women on first contact but can competently provide HIV-positive pregnant women with accurate information about the PMTCT program such as feeding techniques and drug adherence. In developing regions like Nigeria where health care delivery faces a lot of drawbacks, it becomes paramount to address these issues of poor PMTCT coverage by conducting a baseline assessment of the knowledge, practices and perceptions related to HIV prevention amongst healthcare workers in Nigeria. A descriptive cross-sectional study was conducted amongst 250 health workers currently employed in health facilities in Abuja, Nigeria where PMTCT services were offered with the capacity to carry out early infant diagnosis testing (EID). Data was collected using a self-administered, pretested, structured questionnaire. This study showed that the knowledge of PMTCT of HIV was poor (30%) among healthcare workers who offer this service day-to-day to pregnant women. When PMTCT practices were analyzed in keeping with National PMTCT guidelines, over 61% of the respondents reported observing standard practices and the majority (58%) had good attitudes towards caring for patients with HIV/AIDS. Although 61% of the respondents reported being satisfied with the quality of service being rendered, 63% reported not being satisfied with their level of knowledge. Predictors of good knowledge were job designation and level of educational attainment. Health workers who were more satisfied with their working conditions and those who had worked for a longer time in the PMTCT service were more likely to observe standard PMTCT practices. With over 62% of the healthcare workers suggesting that more training would improve the quality of service being rendered, this is a strong pointer to stakeholders to consider a ‘healthcare worker-oriented approach’ when planning and conducting PMTCT training for healthcare workers. This in turn will increase pediatric ARV coverage, the knowledge and effectiveness of the healthcare workers in carrying out appropriate PMTCT interventions and culminating in the reduction/elimination of HIV transmission to newborns.

Keywords: attitudes, HIV/AIDS, healthcare workers, knowledge, mother to child transmission, Nigeria, perceptions

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