Search results for: timing of intervention
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2700

Search results for: timing of intervention

1830 Gendered Economic, Social, and Health Effects of the Mobile Health and Nutritional Services of the International Medical Corps (IMC) in Vulnerable Areas of Ethiopia

Authors: Abdela Zeinu Yasin

Abstract:

The current research aimed to assess the status of IMC in providing treatment for malnourished children and programs in water, sanitation, and hygiene (WASH), food and livelihood security, and comprehensive healthcare through Mobile health and nutrition programs during the last 5 years period. We have conducted 60 in-depth interviews with women during the period from conception to a child’s birthday, health facility staff, and female community health volunteers (FCHVs), as well as 12 focus group discussions with health facility staff and other household decision-makers. We employed thematic analysis using framework matrices and analytical memorandums. The study revealed that 78% of the respondents, of whom 97% were women, have benefited from the selected vulnerable areas. The use of the clear water and sanitization program has reached the 81% of selected households. The use of a modern baby delivery system among the respondent has been 68% of the women and health facilities among the decision-makers/focal person. More than 8 in 10 participants (84%) could read and understand the health facility instructions, and the majority (82%) of women, health facility staff, and male decision-makers can also read and write bulletins and instructions. We found that decision-maker women preferred participative education, whereas health facilities and the IMC desired educational and motivational bulletins. A Mobile Health and Nutrition program intervention by the IMC is acceptable in the conditions of the Ethiopian community and has the potential to improve community health and nutrition service utilization, particularly by providing clean water and sanitization; women’s birth control, and health improvement in the vulnerable regions of the country. The current research findings shall contribute to text IMC Mobile Health and Nutritional intervention design in under-resourced settings.

Keywords: clean water, health and nutrition services, hygiene, IMC, mobile health, sanitation

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1829 Cognitive Development Theories as Determinant of Children's Brand Recall and Ad Recognition: An Indian Perspective

Authors: Ruchika Sharma

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In the past decade, there has been an explosion of research that has examined children’s understanding of TV advertisements and its persuasive intent, socialization of child consumer and child psychology. However, it is evident from the literature review that no studies in this area have covered advertising messages and its impact on children’s brand recall and ad recognition. Copywriters use various creative devices to lure the consumers and very impressionable consumers such as children face far more drastic effects of these creative ways of persuasion. On the basis of Piaget’s theory of cognitive development as a theoretical basis for predicting/understanding children’s response and understanding, a quasi-experiment was carried out for the study, that manipulated measurement timing and advertising messages (familiar vs. unfamiliar) keeping gender and age group as two prominent factors. This study also examines children’s understanding of Advertisements and its elements, predominantly - Language, keeping in view Fishbein’s model. Study revealed significant associations between above mentioned factors and children’s brand recall and ad identification. Further, to test the reliability of the findings on larger sample, bootstrap simulation technique was used. The simulation results are in accordance with the findings of experiment, suggesting that the conclusions obtained from the study can be generalized for entire children’s (as consumers) market in India.

Keywords: advertising, brand recall, cognitive development, preferences

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1828 Cross Cultural Adaptation and Content Validation of the Assessment Instrument Preschooler Awareness of Stuttering Survey

Authors: Catarina Belchior, Catarina Martins, Sara Mendes, Ana Rita S. Valente, Elsa Marta Soares

Abstract:

Introduction: The negative feelings and attitudes that a person who stutters can develop are extremely relevant when considering assessment and intervention in Speech and Language Therapy. This relates to the fact that the person who stutters can experience feelings such as shame, fear and negative beliefs when communicating. Considering the complexity and importance of integrating diverse aspects in stuttering intervention, it is central to identify those emotions as early as possible. Therefore, this research aimed to achieve the translation, adaptation to European Portuguese and to analyze the content validation of the Preschooler Awareness Stuttering Survey (Abbiati, Guitar & Hutchins, 2015), an instrument that allows the assessment of the impact of stuttering on preschool children who stutter considering feelings and attitudes. Methodology: Cross-sectional descriptive qualitative research. The following methodological procedures were followed: translation, back-translation, panel of experts and pilot study. This abstract describes the results of the first three phases of this process. The translation was accomplished by two Speech Language Therapists (SLT). Both professionals have more than five years of experience and are users of English language. One of them has a broad experience in the field of stuttering. Back-translation was conducted by two bilingual individuals without experience in health or any knowledge about the instrument. The panel of experts was composed by 3 different SLT, experts in the field of stuttering. Results and Discussion: In the translation and back-translation process it was possible to verify differences in semantic and idiomatic equivalences of several concepts and expressions, as well as the need to include new information to enhance the understanding of the application of the instrument. The meeting between the two translators and the researchers allowed the achievement of a consensus version that was used in back-translation. Considering adaptation and content validation, the main change made by the experts was the conceptual equivalence of the questions and answers of the instrument's sheets. Considering that in the translated consensus version the questions began with various nouns such as 'is' or 'the cow' and that the answers did not contain the adverb 'much' as in the original instrument, the panel agreed that it would be more appropriate if the questions all started with 'how' and that all the answers should present the adverb 'much'. This decision was made to ensure that the translate instrument would be similar to the original and so that the results obtained could be comparable between the original and the translated instrument. There was also elaborated one semantic equivalence between concepts. The panel of experts found that all other items and specificities of the instrument were adequate, concluding the adequacy of the instrument considering its objectives and its intended target population. Conclusion: This research aspires to diversify the existing validated resources in this scope, adding a new instrument that allows the assessment of preschool children who stutter. Consequently, it is hoped that this instrument will provide a real and reliable assessment that can lead to an appropriate therapeutic intervention according to the characteristics and needs of each child.

Keywords: stuttering, assessment, feelings and attitudes, speech language therapy

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1827 Working with Interpreters: Using Role Play to Teach Social Work Students

Authors: Yuet Wah Echo Yeung

Abstract:

Working with people from minority ethnic groups, refugees and asylum seeking communities who have limited proficiency in the language of the host country often presents a major challenge for social workers. Because of language differences, social workers need to work with interpreters to ensure accurate information is collected for their assessment and intervention. Drawing from social learning theory, this paper discusses how role play was used as an experiential learning exercise in a training session to help social work students develop skills when working with interpreters. Social learning theory posits that learning is a cognitive process that takes place in a social context when people observe, imitate and model others’ behaviours. The roleplay also helped students understand the role of the interpreter and the challenges they may face when they rely on interpreters to communicate with service users and their family. The first part of the session involved role play. A tutor played the role of social worker and deliberately behaved in an unprofessional manner and used inappropriate body language when working alongside the interpreter during a home visit. The purpose of the roleplay is not to provide a positive role model for students to ‘imitate’ social worker’s behaviours. Rather it aims to active and provoke internal thinking process and encourages students to critically consider the impacts of poor practice on relationship building and the intervention process. Having critically reflected on the implications for poor practice, students were then asked to play the role of social worker and demonstrate what good practice should look like. At the end of the session, students remarked that they learnt a lot by observing the good and bad example; it showed them what not to do. The exercise served to remind students how practitioners can easily slip into bad habits and of the importance of respect for the cultural difference when working with people from different cultural backgrounds.

Keywords: role play, social learning theory, social work practice, working with interpreters

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1826 Comparative Study of Analgesic Efficacy of Ultrasound Guided Femoral Nerve Block Versus Intravenous Fentanyl Injection in Fracture Femur Patients at Emergency Department

Authors: Asmaa Hamdy, Israa Nassar, Tarek Aly

Abstract:

Introduction: Femoral fractures are the most common presentation in the Emergency Department (ED), and they can present as isolated injuries or as part of a polytrauma situation. To provide optimum pain management care to these patients, practitioners must be well prepared and current with utilizing modern evidence-based knowledge and practices. Management of pain associated with fracture femur in the emergency department has a critical role in the satisfaction of patients and preventing further complications. This study aimed to evaluate the analgesic efficacy of ultrasound-guided femoral nerve block compared with intravenous fentanyl in fractures of the femur in patients presented to the Emergency Department. Patients and Methods: Fifty patients with femur fractures were divided into two groups: Group A: In this group (twenty-five patients) were given intravenous fentanyl 2 micro-grams/kg and re-assessed for pain by Visual Analogue Score (VAS). Group B: In this group (twenty-five patients) underwent ultrasonography-guided femoral nerve block and were re-assessed for pain by VAS. Results: VAS score on the movement of the fractured limb between group A and group B at a 10-minute post-intervention period shows P= 0.043, and hence the difference is significant. VAS score on the movement of the fractured limb between group A and group B during a 10-minute post-intervention period showed a significant difference. Seventeen patients in group A had major PID with a percentage of 63% VS 10 patients in group B with a percentage of 37%. conclusion: both femoral nerve block and intravenous fentanyl are effective in relieving pain in patients with femur fractures. But femoral nerve block provides better and more intense analgesia and major pain intensity difference in less time. Moreover, the use of FNB had fewer side effects and more Hemodynamics stability compared to opioids.

Keywords: femur fracture, nerve block, fentanyl, ultrasound guided

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1825 Reducing Inequalities for the Uptake of Long-Term Reversible Contraceptive Methods through Special Family Planning Camps: A High Impact Service Delivery Model of Family Planning Practices

Authors: Ghulam Mustafa Halepota, Zaib Dahar

Abstract:

Background: Low acceptance of FP services, particularly in hard to reach areas where geographic, economic, or social barriers limit-service uptake. Moreover, limited resources appeared to be a reflection of dismal contraceptive use in Pakistan. People’s Primary Health Care Initiative (PPHI) is a Public Private Partnership Program of Government of Sindh which aims to improve maternal child health through accessible family planning services in far flung areas. In 2015 PPHI launched special family planning camps to have achieved a rapid improvement in CPR. On quarterly basis, these camps focus on Long Acting Reversible Contraceptives (LARC). These camps are arranged at 250 BHU Plus (24/7 MCHCs). The Organization manages 1140 primary health care facilities all over Sindh province and focuses on maternal, newborn and child health which includes antenatal care, labor/delivery, postnatal care, family planning, immunization, nutrition, BEmONC, CEmONC, diagnostic laboratories, ambulance services. Under the FPRH program, the organization launched special family planning camps in far flung areas to achieve a rapid improvement in CPR-committed to FP 2020 goal. Objective: To assess the performance of special FP camps for the improvement of long acting reversible contraceptive in hard to reach areas. Methodology: Outreach camps are organized on quarterly basis in 250 BHUs and maternal and child health centers (available-24/7). Using observational study design, the study reports 2 years data of special FP camps conducted in 23 various districts of Sindh during April 2015-April 2017. These special camps served a range of modern contraceptive methods including IUCDs, implants, condoms, pills, and injections. Moreover, 125 male medical officers are trained across Sindh in LARC and 554 female have been trained in implants and IUCD insertions. MSI Impact calculator was used to determine health and demographic impact of services. Results: This intervention has brought exceptional results, and the response has been overwhelming in time. Total 2048 special camps during 2015 till April 2017 have been carried out. 231796 MWRAs visited camps 91% opted modern FP, of which 45% opted Implants, 6% selected IUCDs from LARC (long term reversible contraceptive) from short term, 17% opted injectable 18% choose pills, and 12% used condoms. This intervention created a high contraceptive impact in rural Sindh an estimated 125048 FP users have been created, of this 111846 LARC users and 13498 are SARC users, through this intervention an estimated 55774 unintended pregnancies, 36299 live births, 9394, 80 maternal deaths, 926 and 6077 unsafe abortion have been averted. Moreover, the intervention created an economic impact and saved 2,409,563 direct health expenditure on each woman with reproductive age. Conclusion: Special FP Camps along with routine services is an effective and acceptable model for increase in provision of long-acting and permanent methods in hard to reach areas. This innovative approach by PHHI-Sindh has also been adopted in other provinces of Pakistan.

Keywords: inequalities, special camps, family planning services, hard to reach areas

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1824 Monitoring and Evaluation in Community-Based Tourism: An Analysis and Model

Authors: Ivan Gunass Govender, Andrea Giampiccoli

Abstract:

A developmental state should use community engagement to facilitate socio-economic development for disadvantaged groups and individual members of society through empowerment, social justice, sustainability, and self-reliance. In this regard, community-based tourism (CBT) as a growing market should be an indigenous effort aided by external facilitation. Since this form of tourism presents its own preconditions, characteristics, and challenges, it could be guided by higher education institutions engagement. In particular, the facilitation should not only serve to assist the community members to reach their own goals; but rather also focus on learning through knowledge creation and sharing with the engagement of higher education institutions. While the increased relevance of CBT has produced various CBT manuals (or handbooks/guidelines) documents aimed to ‘teach’ and assist various entities in CBT development, this research aims to analyse the current monitoring & evaluation (M&E) manuals and thereafter, propose an M&E model for CBT. It is important to mention that all too often effective monitoring is seldom carried out thus risking the long-term sustainability and improvement of the CBT ventures. Therefore, the proposed model will also consider some inputs external to the tourism field, but in relation to local economic development (LED) matters from the previously proposed development monitoring and evaluation system framework. M&E should be seen as fundamental components of any CBT initiative, and the whole CBT intervention should be evaluated. In this context, M&E in CBT should go beyond strict ‘numerical’ economic matters and should be understood in a holistic development. In addition, M&E in CBT should not consider issues in various ‘compartments’ such as tourists, tourism attractions, CBT owners/participants, and stakeholder engagement but as interdependent components of a macro-ecosystem. Finally, the external facilitation process should be structured in a way to promote community self-reliance in both the intervention and the M&E process. The research will attempt to propose an M&E model for CBT so as to enhance the CBT possibilities of long-term growth and success through effective collaborations with key stakeholders.

Keywords: community-based tourism, community-engagement, monitoring and evaluation, stakeholders

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1823 Community Crèche Is a Measure to Prevent Child Injuries: Its Challenges and Measures for Improvement

Authors: Rabbya Ashrafi, Mohammad Tarikul Islam , Al-Amin Bhuiyan, Aminur Rahman

Abstract:

Injury is the leading killer of children in Bangladesh. Anchal (community crèche) is an effective intervention to prevent injuries among children under 5. Through the SoLiD project, 1,600 Anchals are in place in three sub-districts in Bangladesh. The objectives of the Anchal are to provide supervision and early childhood development stimulations (ECD) to the children. A locally trained caregiver supervises 20-25 children, 9 to 59 months old, from 9 a.m. to 1 p.m., six days a week. Although it was found effective, during its implementation phase several challenges were noticed. To identify challenges and means to overcome those to improve the Anchal activities. In-depth interviews were conducted with Anchal caregivers, their supervisors, and trainers. Focus group discussions were conducted with the mothers of the Anchal children. The study was conducted in the Manohardi sub-district in November 2015. Decay of knowledge and skills after 2-3 months of training, lack of formal certification and inappropriate selection of women as Anchal caregivers, and enrollment of small children (less than 12 months) were the important challenges. The reluctance of parents to send children to the Anchal at the proper time, failure to engage children in various ECD activities, ineffective conduction of parents and community leaders meeting by the Anchal caregivers, insufficient accommodation, and poor supply of logistics for children were also the important challenges. The suggestion for improvement was to recruit caregivers as per standard criteria, provide them refreshers training at three months intervals, train them on effective conduction of parents and community leaders meetings, provide a formal certificate, and ensure regular supply of logistics. The identified challenges are needed to be addressed by utilizing the suggestions obtained from the IDIs and FGDs to make the Anchal intervention more effective in preventing childhood injuries.

Keywords: comunity crech, earlychildhood development, measures for improvement, childhood injury

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1822 Chest Trauma and Early Pulmonary Embolism: The Risks

Authors: Vignesh Ratnaraj, Daniel Marascia, Kelly Ruecker

Abstract:

Purpose: Pulmonary embolism (PE) is a major cause of morbidity and mortality in trauma patients. Data suggests PE is occurring earlier in trauma patients, with attention being turned to possible de novo events. Here, we examine the incidence of early PE at a level 1 trauma center and examine the relationship with a chest injury. Method: A retrospective analysis was performed from a prospective trauma registry at a level 1 trauma center. All patients admitted from 1 January 2010 to 30 June 2019 diagnosed with PE following trauma were included. Early PE was considered a diagnosis within 72 hours of admission. The severity of the chest injury was determined by the Abbreviated Injury Score (AIS). Analysis of severe chest injury and incidence of early PE was performed using chi-square analysis. Sub-analysis on the timing of PE and PE location was also performed using chi-square analysis. Results: Chest injury was present in 125 of 184 patients diagnosed with PE. Early PE occurred in 28% (n=35) of patients with a chest injury, including 24.39% (n=10) with a severe chest injury. Neither chest injury nor severe chest injury determined the presence of early PE (p= > 0.05). Sub-analysis showed a trend toward central clots in early PE (37.14%, n=13) compared to late (27.78%, n=25); however, this was not found to be significant (p= > 0.05). Conclusion: PE occurs early in trauma patients, with almost one-third being diagnosed before 72 hours. This analysis does not support the paradigm that chest injury, nor severe chest injury, results in statistically significant higher rates of early PE. Interestingly, a trend toward early central PE was noted in those suffering chest trauma.

Keywords: trauma, PE, chest injury, anticoagulation

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1821 Economics of Conflict: Core Economic Dimensions of the Georgian-South Ossetian Context

Authors: V. Charaia

Abstract:

This article presents SWOT analysis for Georgian - South Ossetian conflict. The research analyzes socio-economic aspects and considers future prospects for all sides including neighbor countries and regions. Also it includes the possibilities of positive intervention of neighbor countries to solve the conflict or to mitigate its negative results. The main question of the article is: What will it take to award Georgians and South Ossetians with a peace dividend?

Keywords: conflict economics, investments, trade, remittances

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1820 Translation and Adaptation of the Assessment Instrument “Kiddycat” for European Portuguese

Authors: Elsa Marta Soares, Ana Rita Valente, Cristiana Rodrigues, Filipa Gonçalves

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Background: The assessment of feelings and attitudes of preschool children in relation to stuttering is crucial. Negative experiences can lead to anxiety, worry or frustration. To avoid the worsening of attitudes and feelings related to stuttering, it is important the early detection in order to intervene as soon as possible through an individualized intervention plan. Then it is important to have Portuguese instruments that allow this assessment. Aims: The aim of the present study is to realize the translation and adaptation of the Communication Attitude Test for Children in Preschool Age and Kindergarten (KiddyCat) for EP. Methodology: For the translation and adaptation process, a methodological study was carried out with the following steps: translation, back translation, assessment by a committee of experts and pre-test. This abstract describes the results of the first two phases of this process. The translation was accomplished by two bilingual individuals without experience in health and any knowledge about the instrument. One of them was an English teacher and the other one a Translator. The back-translation was conducted by two Senior Class Teachers that live in United Kingdom without any knowledge in health and about the instrument. Results and Discussion: In translation there were differences in semantic equivalences of various expressions and concepts. A discussion between the two translators, mediated by the researchers, allowed to achieve the consensus version of the translated instrument. Taking into account the original version of KiddyCAT the results demonstrated that back-translation versions were similar to the original version of this assessment instrument. Although the back-translators used different words, they were synonymous, maintaining semantic and idiomatic equivalences of the instrument’s items. Conclusion: This project contributes with an important resource that can be used in the assessment of feelings and attitudes of preschool children who stutter. This was the first phase of the research; expert panel and pretest are being developed. Therefore, it is expected that this instrument contributes to an holistic therapeutic intervention, taking into account the individual characteristics of each child.

Keywords: assessment, feelings and attitudes, preschool children, stuttering

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1819 Effects of Supplementation with Annatto (Bixa Orellana)-Derived δ-Tocotrienol on the Nicotine-Induced Reduction in Body Weight and 8-Cell Preimplantation Embryonic Development in Mice

Authors: M. H. Rajikin, S. M. M. Syairah, A. R. Sharaniza

Abstract:

Effects of nicotine on pre-partum body weight and preimplantation embryonic development has been reported previously. Present study was conducted to determine the effects of annatto (Bixa orellana)-derived delta-tocotrienol (TCT) (with presence of 10% gamma-TCT isomer) on the nicotine-induced reduction in body weight and 8-cell embryonic growth in mice. Twenty four 6-8 weeks old (23-25g) female balb/c mice were randomly divided into four groups (G1-G4; n=6). Those groups were subjected to the following treatments for 7 consecutive days: G1 (control) were gavaged with 0.1 ml tocopherol stripped corn oil, G2 was subcutaneously (s.c.) injected with 3 mg/kg/day of nicotine, G3 received concurrent treatment of nicotine (3 mg/kg/day) and 60 mg/kg/day of δ-TCT mixture (contains 90% delta & 10% gamma isomers) and G4 was given 60 mg/kg/day of δ-TCT mixture alone. Body weights were recorded daily during the treatment. On Day 8, females were superovulated with 5 IU Pregnant Mare’s Serum Gonadotropin (PMSG) for 48 hours followed with 5 IU human Chorionic Gonadotropin (hCG) before mated with males at the ratio of 1:1. Females were sacrificed by cervical dislocation for embryo collection 48 hours post-coitum. Collected embryos were cultured in vitro. Results showed that throughout Day 1 to Day 7, the body weight of nicotine treated group (G2) was significantly lower (p<0.05) than that of G1, G3 and G4. Intervention with δ-TCT mixture (G3) managed to increase the body weight close to the control group. This is also observed in the group treated with δ-TCT mixture alone (G4). The development of 8-cell embryos following in vitro culture (IVC) was totally inhibited in G2. Intervention with δ-TCT mixture (G3) resulted in the production of 8-cell embryos, although it was not up to that of the control group. Treatment with δ-TCT mixture alone (G4) caused significant increase in the average number of produced 8-cell embryo compared to G1. Present data indicated that δ-TCT mixture was able to reverse the body weight loss in nicotine treated mice and the development of 8-cell embryos was also improved.

Keywords: δ-tocotrienol, body weight, nicotine, preimplantation embryonic development

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1818 Nationalization of the Social Life in Argentina: Accumulation of Capital, State Intervention, Labor Market, and System of Rights in the Last Decades

Authors: Mauro Cristeche

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This work begins with a very simple question: How does the State spend? Argentina is witnessing a process of growing nationalization of social life, so it is necessary to find out the explanations of the phenomenon on the specific dynamic of the capitalist mode of production in Argentina and its transformations in the last decades. Then the new question is: what happened in Argentina that could explain this phenomenon? Since the seventies, the capital growth in Argentina faces deep competitive problems. Until that moment the agrarian wealth had worked as a compensation mechanism, but it began to find its limits. In the meantime, some important demographical and structural changes had happened. The strategy of the capitalist class had to become to seek in the cheapness of the labor force the main source of compensation of its weakness. As a result, a tendency to worsen the living conditions and fragmentation of the working class started to develop, manifested by unemployment, underemployment, and the fall of the purchasing power of the salary as a highlighted fact. As a consequence, it is suggested that the role of the State became stronger and public expenditure increased, as a historical trend, because it has to intervene to face the contradictions and constant growth problems posed by the development of capitalism in Argentina. On the one hand, the State has to guarantee the process of buying the cheapened workforce and at the same time the process of reproduction of the working class. On the other hand, it has to help to reproduce the individual capitals but needs to ‘attack’ them in different ways. This is why the role of the State is said to be the general political representative to the national portion of the total social capital. What will be studied is the dynamic of the intervention of the Argentine State in the context of the particular national process of capital growth, and its dynamics in the last decades. What this paper wants to show are the main general causes that could explain the phenomenon of nationalization of the social life and how it has impacted the life conditions of the working class and the system of rights.

Keywords: Argentina, nationalization, public policies, rights, state

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1817 An Integrative Review on Effects of Educational Interventions for Children with Eczema

Authors: Nam Sze Cheng, P. C. Janita Chau

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Background: Eczema is a chronic inflammatory disease with high global prevalence rates in many childhood populations. It is also the most common paediatric skin problem. Although eczema education and proper skin care were effective in controlling eczema symptoms, the lack of both sufficient time for patient consultation and structured eczema education programme hindered the transferability of knowledge to patients and their parents. As a result, these young patients and their families suffer from a significant physical disability and psychological distress, which can substantially impair their quality of life. Objectives: This integrative review is to examine the effects of educational interventions for children with eczema and identify the core elements associated with an effective intervention. Methods: This integrative review targeted all articles published in 10 databases between May 2016 and February 2017 that reported the outcomes of disease interventions of any format for children and adolescents with the clinical diagnosis of eczema who were under 18 years of age. Five randomized controlled trials (RCT) and one systematic review of 10 RCTs were identified for review. All these publications had high methodological quality, except one study of web-based eczema education that was limited by selection bias and poor subject blinding. Findings: This review found that most studies adopted nurse-led or multi-disciplinary parental eczema education programme at the outpatient clinic setting. The format of these programmes included individual lectures, demonstration and group sharing, and the educational materials covered basic eczema knowledge and management as well as methods to interrupt itch-scratch cycle. The main outcome measures of these studies included severity of eczema symptoms, treatment adherence and quality of life of both patients and their families. Nine included studies reported statistically significant improvement in the primary outcome of symptom severity of these eczematous children. On the other hand, all these reviews failed to identify an effective dosage of intervention under these educational programmes that was attributed to the heterogeneity of the interventions. One study that was designed based on the social cognitive theory to guide the interventional content yielded statistically significant results. The systematic review recommended the importance of measuring parental self-efficacy. Implication: This integrative review concludes that structured educational programme can help nurses understand the theories behind different health interventions. They can then deliver eczema education to their patients in a consistent manner. These interventions also result in behavioral changes through patient education. Due to the lack of validated educational programmes in Chinese, it is imperative to conduct an RCT of eczema educational programme to investigate its effects on eczema severity, quality of life and treatment adherence in Hong Kong children as well as to promote the importance of parental self-efficacy.

Keywords: children, eczema, education, intervention

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1816 Fish Markets in Sierra Leone: Size, Structure, Distribution Networks and Opportunities for Aquaculture Development

Authors: Milton Jusu, Moses Koroma

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Efforts by the Ministry of Fisheries and Marine Resources and its development partners to introduce “modern” aquaculture in Sierra Leone since the 1970s have not been successful. A number of reasons have been hypothesized, including the suggestion that the market infrastructure and demand for farmed fish were inadequate to stimulate large-scale and widespread aquaculture production in the country. We have assessed the size, structure, networks and opportunities in fish markets using a combination of Participatory Rural Appraisals (PRAs) and questionnaire surveys conducted in a sample of 29 markets (urban, weekly, wholesale and retail) and two hundred traders. The study showed that the local fish markets were dynamic, with very high variations in demand and supply. The markets sampled supplied between 135.2 and 9947.6 tonnes/year. Mean prices for fresh fish varied between US$1.12 and US$3.89/kg depending on species, with smoked catfish and shrimps commanding prices as high as US$7.4/kg. It is unlikely that marine capture fisheries can increase their current production levels, and these may, in fact, already be over-exploited and declining. Marine fish supplies are particularly low between July and September. More careful attention to the timing of harvests (rainy season, not dry season) and to species (catfish, not tilapia) (could help in the successful adoption of aquaculture.

Keywords: fisheries and aquaculture, fish market, marine fish supplies, harvests

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1815 Improving Physical, Social, and Mental Health Outcomes for People Living with an Intellectual Disability through Cycling

Authors: Sarah Faulkner, Patrick Faulkner, Caroline Ellison

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Improved mental and physical health, community connection, and increased life satisfaction has been strongly associated with bike riding for those with and without a disability. However, much evidence suggests that people living with a disability face increased barriers to engaging in cycling compared to members of the general population. People with an intellectual disability often live more sedentary and socially isolated lives that negatively impact their mental and physical health, as well as life satisfaction. This paper is based on preliminary findings from a three-year intervention cycling project funded by the South Australian Government. The cycling project was developed in partnership with community stakeholders that provided weekly instruction, training, and support to individuals living with intellectual disabilities to increase their capacity in cycling. This project aimed to support people living with intellectual disabilities to foster and facilitate improved physical and mental health, confidence, and independence and enhance social networking through their engagement in community cycling. The program applied principles of social role valorisation (SRV) theory as its guiding framework. Preliminary data collected is based on qualitative interviews with over 50 program participants, results from two participant wellness questionnaires, as well as a perceptually regulated exercise test administered throughout the project implementation. Preliminary findings are further supplemented with ethnographic analyses by the researchers who took a phenology of life experience approach. Preliminary findings of the program suggest a variety of social motivations behind participants' desire to learn cycling that acknowledges previous barriers to engagement and cycling’s role to address feelings of loneliness and social isolation. Meaningful health benefits can be achieved as demonstrated by increases in predicted V02 max measures, suggesting that physical intervention can not only improve physical health outcomes but also provide a variety of other social benefits. Initial engagement in the project has demonstrated an increase in participants' sense of confidence, well-being, and physical fitness. Implementation of the project in partnership with a variety of community stakeholders has identified a number of critical factors and processes necessary for future service replication, sustainability, and success. Findings from this intervention study contribute to the development of a knowledge base on how best to support individuals living with an intellectual disability to partake in bike riding and increase positive outcomes associated with their capacity building, social interaction, increased physical activity, physical health, and mental well-being. The initial findings of this study provide critical academic insights into the social and physical benefits of cycling for people living with a disability, as well as practical advice for future human service applications.

Keywords: cycling, disability, social inclusion, capacity building

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1814 Outcomes of Pain Management for Patients in Srinagarind Hospital: Acute Pain Indicator

Authors: Chalermsri Sorasit, Siriporn Mongkhonthawornchai, Darawan Augsornwan, Sudthanom Kamollirt

Abstract:

Background: Although knowledge of pain and pain management is improving, they are still inadequate to patients. The Nursing Division of Srinagarind Hospital is responsible for setting the pain management system, including work instruction development and pain management indicators. We have developed an information technology program for monitoring pain quality indicators, which was implemented to all nursing departments in April 2013. Objective: To study outcomes of acute pain management in process and outcome indicators. Method: This is a retrospective descriptive study. The sample population was patients who had acute pain 24-48 hours after receiving a procedure, while admitted to Srinagarind Hospital in 2014. Data were collected from the information technology program. 2709 patients with acute pain from 10 Nursing Departments were recruited in the study. The research tools in this study were 1) the demographic questionnaire 2) the pain management questionnaire for process indicators, and 3) the pain management questionnaire for outcome indicators. Data were analyzed and presented by percentages and means. Results: The process indicators show that nurses used pain assessment tool and recorded 99.19%. The pain reassessment after the intervention was 96.09%. The 80.15% of the patients received opioid for pain medication and the most frequency of non-pharmacological intervention used was positioning (76.72%). For the outcome indicators, nearly half of them (49.90%) had moderate–severe pain, mean scores of worst pain was 6.48 and overall pain was 4.08. Patient satisfaction level with pain management was good (49.17%) and very good (46.62%). Conclusion: Nurses used pain assessment tools and pain documents which met the goal of the pain management process. Patient satisfaction with pain management was at high level. However the patients had still moderate to severe pain. Nurses should adhere more strictly to the guidelines of pain management, by using acute pain guidelines especially when pain intensity is particularly moderate-high. Nurses should also develop and practice a non-pharmacological pain management program to continually improve the quality of pain management. The information technology program should have more details about non-pharmacological pain techniques.

Keywords: outcome, pain management, acute pain, Srinagarind Hospital

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1813 A Profile of Out-of-Hospital Cardiac Arrest in ‘Amang’ Rodriguez Memorial Medical Center: A Prospective Cohort Study

Authors: Donna Erika E. De Jesus

Abstract:

Introduction: Cardiac arrest occurs when abrupt cessation of cardiac function results in loss of effective circulation and complete cardiovascular collapse. For every minute of cardiac arrest without early intervention (cardiopulmonary resuscitation [CPR], defibrillation), chances of survival drop by 7-10%. It is crucial that CPR be initiated within 4-6 minutes to avoid brain death. Most out-of-hospital cardiac arrests (OHCA) occur in a residential setting where access to trained personnel and equipment is not readily available, resulting in poor victim outcomes. Methods: This is a descriptive study done from August to November 2021 using a prospective cohort design. Participants of the study include adult patients aged 18 years and above brought to the emergency room who suffered from out-of-hospital cardiac arrest. Out of the total 102 cases of OHCA, 63 participants were included in the study. Descriptive statistics were used to summarize the demographic and clinical characteristics of the patients. Results: 43 were male patients, comprising the majority at 73.02%. Hypertension was identified as the top co-morbidity, followed by diabetes mellitus, heart failure, and chronic kidney disease (CKD). Medical causes of arrest were identified in 96.83% of the cases. 90.48% of cardiac arrests occurred at home. Only 26 patients (41.27%) received pre-hospital intervention prior to ER arrival, which comprised only hands-only CPR. Twenty-three of which were performed by individuals with background knowledge of CPR. 60.32% were brought via self-conduction, the remainder by ambulances, which were noted to have no available equipment necessary to provide proper resuscitation. The average travel time from dispatch to ER arrival is 20 minutes. Conclusion: Overall survival of OHCA in our local setting remains dismal, as a return of spontaneous circulation was not achieved in any of the patients. The small number of patients having pre-hospital CPR indicates the need for emphasis on training and community education.

Keywords: out-of-hospital cardiac arrest, cardiopulmonary resuscitation, basic life support, emergency medical services

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1812 Effects of Branched-Chain Amino Acid Supplementation on Sarcopenic Patients with Liver Cirrhosis

Authors: Deepak Nathiya1, Ramesh Roop Rai, Pratima Singh1, Preeti Raj1, Supriya Suman, Balvir Singh Tomar

Abstract:

Background: Sarcopenia is a catabolic state in liver cirrhosis (LC), accelerated with a breakdown of skeletal muscle to release amino acids which adversely affects survival, health-related quality of life, and response to any underlying disease. The primary objective of the study was to investigate the long-term effect of branched-chain amino acids (BCAA) supplementations on parameters associated with improved prognosis in sarcopenic patients with LC, as well as to evaluate its impact on cirrhotic-related events. Methods: We carried out a 24 week, single-center, randomized, open-label, controlled, two cohort parallel-group intervention trial comparing the efficacy of BCAA against lactoalbumin (L-ALB) on 106 sarcopenic liver cirrhotics. The BCAA (intervention) group was treated with 7.2 g BCAA per whereas, the lactoalbumin group was also given 6.3 g of L-Albumin. The primary outcome was to assess the impact of BCAA on parameters of sarcopenia: muscle mass, muscle strength, and physical performance. The secondary outcomes were to study combined survival and maintenance of liver function changes in laboratory and clinical markers in the duration of six months. Results: Treatment with BCAA leads to significant improvement in sarcopenic parameters: muscle strength, muscle function, and muscle mass. The total cirrhotic-related complications and cumulative event-free survival occurred fewer in the BCAA group than in the L-ALB group. Prognostic markers also improved significantly in the study. Conclusion: The current clinical trial demonstrated that long-term BCAAs supplementation improved sarcopenia and prognostic markers in patients with advanced liver cirrhosis.

Keywords: sarcopenia, liver cirrhosis, BCAA, quality of life

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1811 Ethical Issues around Online Marketing to Children

Authors: Chris Preston

Abstract:

As we devise ever more sophisticated methods of on-line marketing, devising systems that are able to reach into the everyday lives of consumers, we are confronted by a generation of children who face unprecedented intervention by commercial organisations into young minds, via electronic devices, and whether by computer, tablet or phone, such children have been somehow reduced to the status of their devices, with little regard for their well being as individuals. This discussion paper seeks to draw attention to such practice and questions the ethics of digital marketing methods.

Keywords: online marketing to children, online research of children, online targeting of children, consumer rights, ethics

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1810 Case Report and Discussion of Natural History of Bouveret Syndrome

Authors: Parul Garg

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Bouveret Syndrome is a rare presentation described as Gastric Outlet Obstruction secondary to Gallstone Ileus. Here we describe the 3-year progression of disease from cholelithiasis to gallstone ileus with relevant imaging findings. The patient was treated under an Upper Gastrointestinal Surgery service with surgical intervention in the form of a laparoscopic assisted procedure with midline laparotomy. She recovered well and was discharged 1 week post operatively. No complications occurred.

Keywords: Cholelithiasis, Bouveret syndrome, Gallstone Ileus, gastric outlet obstruction

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1809 Management of Mycotoxin Production and Fungicide Resistance by Targeting Stress Response System in Fungal Pathogens

Authors: Jong H. Kim, Kathleen L. Chan, Luisa W. Cheng

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Control of fungal pathogens, such as foodborne mycotoxin producers, is problematic as effective antimycotic agents are often very limited. Mycotoxin contamination significantly interferes with the safe production of foods or crops worldwide. Moreover, expansion of fungal resistance to commercial drugs or fungicides is a global human health concern. Therefore, there is a persistent need to enhance the efficacy of commercial antimycotic agents or to develop new intervention strategies. Disruption of the cellular antioxidant system should be an effective method for pathogen control. Such disruption can be achieved with safe, redox-active compounds. Natural phenolic derivatives are potent redox cyclers that inhibit fungal growth through destabilization of the cellular antioxidant system. The goal of this study is to identify novel, redox-active compounds that disrupt the fungal antioxidant system. The identified compounds could also function as sensitizing agents to conventional antimycotics (i.e., chemosensitization) to improve antifungal efficacy. Various benzo derivatives were tested against fungal pathogens. Gene deletion mutants of the yeast Saccharomyces cerevisiae were used as model systems for identifying molecular targets of benzo analogs. The efficacy of identified compounds as potent antifungal agents or as chemosensitizing agents to commercial drugs or fungicides was examined with methods outlined by the Clinical Laboratory Standards Institute or the European Committee on Antimicrobial Susceptibility Testing. Selected benzo derivatives possessed potent antifungal or antimycotoxigenic activity. Molecular analyses by using S. cerevisiae mutants indicated antifungal activity of benzo derivatives was through disruption of cellular antioxidant or cell wall integrity system. Certain benzo analogs screened overcame tolerance of Aspergillus signaling mutants, namely mitogen-activated protein kinase mutants, to fludioxonil fungicide. Synergistic antifungal chemosensitization greatly lowered minimum inhibitory or fungicidal concentrations of test compounds, including inhibitors of mitochondrial respiration. Of note, salicylaldehyde is a potent antimycotic volatile that has some practical application as a fumigant. Altogether, benzo derivatives targeting cellular antioxidant system of fungi (along with cell wall integrity system) effectively suppress fungal growth. Candidate compounds possess the antifungal, antimycotoxigenic or chemosensitizing capacity to augment the efficacy of commercial antifungals. Therefore, chemogenetic approaches can lead to the development of novel antifungal intervention strategies, which enhance the efficacy of established microbe intervention practices and overcome drug/fungicide resistance. Chemosensitization further reduces costs and alleviates negative side effects associated with current antifungal treatments.

Keywords: antifungals, antioxidant system, benzo derivatives, chemosensitization

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1808 The Impacts of an Adapted Literature Circle Model on Reading Comprehension, Engagement, and Cooperation in an EFL Reading Course

Authors: Tiantian Feng

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There is a dearth of research on the literary circle as a teaching strategy in English as a Foreign Language (EFL) classes in Chinese colleges and universities and even fewer empirical studies on its impacts. In this one-quarter, design-based project, the researcher aims to increase students’ engagement, cooperation, and, on top of that, reading comprehension performance by utilizing a researcher-developed, adapted reading circle model in an EFL reading course at a Chinese college. The model also integrated team-based learning and portfolio assessment, with an emphasis on the specialization of individual responsibilities, contributions, and outcomes in reading projects, with the goal of addressing current issues in EFL classes at Chinese colleges, such as passive learning, test orientation, ineffective and uncooperative teamwork, and lack of dynamics. In this quasi-experimental research, two groups of students enrolled in the course were invited to participate in four in-class team projects, with the intervention class following the adapted literature circle model and team members rotating as Leader, Coordinator, Brain trust, and Reporter. The researcher/instructor used a sequential explanatory mixed-methods approach to quantitatively analyze the final grades for the pre-and post-tests, as well as individual scores for team projects and will code students' artifacts in the next step, with the results to be reported in a subsequent paper(s). Initial analysis showed that both groups saw an increase in final grades, but the intervention group enjoyed a more significant boost, suggesting that the adapted reading circle model is effective in improving students’ reading comprehension performance. This research not only closes the empirical research gap of literature circles in college EFL classes in China but also adds to the pool of effective ways to optimize reading comprehension performance and class performance in college EFL classes.

Keywords: literature circle, EFL teaching, college english reading, reading comprehension

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1807 Astronomical Panels of Measuring and Dividing Time in Ancient Egypt

Authors: Omnia Abd Elghany Zaki Mohamed Mahmoud

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The ancient Egyptian used the stars to measure time or in a more precise sense as one of the astronomical means of measuring time. These methods differed throughout the historical ages. They began with simple observations of observing astronomical phenomena and watching them, such as observing the movements of the stars in the sky. The year, to know the days, nights, and other means used to help set the time when the sky overcast, and so the researcher tries through archaeological evidence to demonstrate the knowledge of the ancient Egyptian stars of heaven, and movements through the first pre-history. It is not believed that the astronomical information possessed by the Egyptian was limited, and simple, it was reaching a level of almost optimal in terms of importance, and the goal he wanted to reach the ancient Egyptian, and also help him to know the time, and the passage of time; which ended in finally trying to find a system of timing and calculation of time. It was noted that there were signs that the stellar creed was known, and prosperous, especially since the pre-family ages, and this is evident on the inscriptions that come back to that period. The Egyptian realized that some of the stars remain visible at night, The ancient Egyptian was familiar with the daily journey of the stars. This is what was adopted in many paragraphs of the texts of the pyramids, and its references to the rise of the deceased king of the heavenly world between the stars of the eternal sky. It was noted that the ancient Egyptian link between the doctrine of the star, it find that the public The lunar was known to the ancient Egyptian, and sang it for two years: and the stellar solar; but it was based on the appearance of the star Sirius, and this is the first means used to measure time, and know the calendar stars.

Keywords: archaeology, astronomical panels, ancient Egypt, Egyptian

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1806 A Study on Human Musculoskeletal Model for Cycle Fitting: Comparison with EMG

Authors: Yoon- Ho Shin, Jin-Seung Choi, Dong-Won Kang, Jeong-Woo Seo, Joo-Hack Lee, Ju-Young Kim, Dae-Hyeok Kim, Seung-Tae Yang, Gye-Rae Tack

Abstract:

It is difficult to study the effect of various variables on cycle fitting through actual experiment. To overcome such difficulty, the forward dynamics of a musculoskeletal model was applied to cycle fitting in this study. The measured EMG data were compared with the muscle activities of the musculoskeletal model through forward dynamics. EMG data were measured from five cyclists who do not have musculoskeletal diseases during three minutes pedaling with a constant load (150 W) and cadence (90 RPM). The muscles used for the analysis were the Vastus Lateralis (VL), Tibialis Anterior (TA), Bicep Femoris (BF), and Gastrocnemius Medial (GM). Person’s correlation coefficients of the muscle activity patterns, the peak timing of the maximum muscle activities, and the total muscle activities were calculated and compared. BIKE3D model of AnyBody (Anybodytech, Denmark) was used for the musculoskeletal model simulation. The comparisons of the actual experiments with the simulation results showed significant correlations in the muscle activity patterns (VL: 0.789, TA: 0.503, BF: 0.468, GM: 0.670). The peak timings of the maximum muscle activities were distributed at particular phases. The total muscle activities were compared with the normalized muscle activities, and the comparison showed about 10% difference in the VL (+10%), TA (+9.7%), and BF (+10%), excluding the GM (+29.4%). Thus, it can be concluded that muscle activities of model & experiment showed similar results. The results of this study indicated that it was possible to apply the simulation of further improved musculoskeletal model to cycle fitting.

Keywords: musculoskeletal modeling, EMG, cycle fitting, simulation

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1805 Predicting Factors for Occurrence of Cardiac Arrest in Critical, Emergency and Urgency Patients in an Emergency Department

Authors: Angkrit Phitchayangkoon, Ar-Aishah Dadeh

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Background: A key aim of triage is to identify the patients with high risk of cardiac arrest because they require intensive monitoring, resuscitation facilities, and early intervention. We aimed to identify the predicting factors such as initial vital signs, serum pH, serum lactate level, initial capillary blood glucose, and Modified Early Warning Score (MEWS) which affect the occurrence of cardiac arrest in an emergency department (ED). Methods: We conducted a retrospective data review of ED patients in an emergency department (ED) from 1 August 2014 to 31 July 2016. Significant variables in univariate analysis were used to create a multivariate analysis. Differentiation of predicting factors between cardiac arrest patient and non-cardiac arrest patients for occurrence of cardiac arrest in an emergency department (ED) was the primary outcome. Results: The data of 527 non-trauma patients with Emergency Severity Index (ESI) 1-3 were collected. The factors found to have a significant association (P < 0.05) in the non-cardiac arrest group versus the cardiac arrest group at the ED were systolic BP (mean [IQR] 135 [114,158] vs 120 [90,140] mmHg), oxygen saturation (mean [IQR] 97 [89,98] vs 82.5 [78,95]%), GCS (mean [IQR] 15 [15,15] vs 11.5 [8.815]), normal sinus rhythm (mean 59.8 vs 30%), sinus tachycardia (mean 46.7 vs 21.7%), pH (mean [IQR] 7.4 [7.3,7.4] vs 7.2 [7,7.3]), serum lactate (mean [IQR] 2 [1.1,4.2] vs 7 [5,10.8]), and MEWS score (mean [IQR] 3 [2,5] vs 5 [3,6]). A multivariate analysis was then performed. After adjusting for multiple factors, ESI level 2 patients were more likely to have cardiac arrest in the ER compared with ESI 1 (odds ratio [OR], 1.66; P < 0.001). Furthermore, ESI 2 patients were more likely than ESI 1 patients to have cardiovascular disease (OR, 1.89; P = 0.01), heart rate < 55 (OR, 6.83; P = 0.18), SBP < 90 (OR, 3.41; P = 0.006), SpO2 < 94 (OR, 4.76; P = 0.012), sinus tachycardia (OR, 4.32; P = 0.002), lactate > 4 (OR, 10.66; P = < 0.001), and MEWS > 4 (OR, 4.86; P = 0.028). These factors remained predictive of cardiac arrest at the ED. Conclusion: The factors related to cardiac arrest in the ED are ESI 1 patients, ESI 2 patients, patients diagnosed with cardiovascular disease, SpO2 < 94, lactate > 4, and a MEWS > 4. These factors can be used as markers in the event of simultaneous arrival of many patients and can help as a pre-state for patients who have a tendency to develop cardiac arrest. The hemodynamic status and vital signs of these patients should be closely monitored. Early detection of potentially critical conditions to prevent critical medical intervention is mandatory.

Keywords: cardiac arrest, predicting factor, emergency department, emergency patient

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1804 Myocardial Reperfusion Injury during Percutaneous Coronary Intervention in Patient with Triple-Vessel Disease in Limited Resources Hospital: A Case Report

Authors: Fanniyah Anis, Bram Kilapong

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Myocardial reperfusion injury is defined as the cellular damage that results from a period of ischemia, followed by the reestablishment of the blood supply to the infarcted tissue. Ventricular tachycardia is one of the most commonly encountered reperfusion arrhythmia as one of the types of myocardial perfusion injury. Prompt and early treatment can reduce mortality, despite limited resources of the hospital in high risk patients with history of triple vessel disease. Case report, Male 53 years old has been diagnosed with NSTEMI with 3VD and comorbid disease of Hypertension and has undergone revascularization management with Percutaneous coronary intervention. Ventricular tachycardia leading to cardiac arrest occurred right after the stent was inserted. Resuscitation was performed for almost 2 hours until spontaneous circulation returned. Patient admitted in ICU with refractory cardiac shock despite using combination of ionotropic and vasopressor agents under standard non-invasive monitoring due to the limitation of the hospital. Angiography was performed again 5 hours later to exclude other possibilities of blockage of coronary arteries and conclude diagnosis of myocardial reperfusion injury. Patient continually managed with combination of antiplatelet agents and maintenance dose of anti-arrhythmia agents. The handling of the patient was to focus more on supportive and preventive from further deteriorating of the condition. Patient showed clinically improvement and regained consciousness within 24 hours. Patient was successfully discharged from ICU within 3 days without any neurological sequela and was discharge from hospital after 3 days observation in general ward. Limited Resource of hospital did not refrain the physician from attaining a good outcome for this myocardial reperfusion injury case and angiography alone can be used to confirm the diagnosis of myocardial reperfusion injury.

Keywords: limited resources hospital, myocardial reperfusion injury, prolonged resuscitation, refractory cardiogenic shock, reperfusion arrhythmia, revascularization, triple-vessel disease

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1803 A Psychophysiological Evaluation of an Effective Recognition Technique Using Interactive Dynamic Virtual Environments

Authors: Mohammadhossein Moghimi, Robert Stone, Pia Rotshtein

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Recording psychological and physiological correlates of human performance within virtual environments and interpreting their impacts on human engagement, ‘immersion’ and related emotional or ‘effective’ states is both academically and technologically challenging. By exposing participants to an effective, real-time (game-like) virtual environment, designed and evaluated in an earlier study, a psychophysiological database containing the EEG, GSR and Heart Rate of 30 male and female gamers, exposed to 10 games, was constructed. Some 174 features were subsequently identified and extracted from a number of windows, with 28 different timing lengths (e.g. 2, 3, 5, etc. seconds). After reducing the number of features to 30, using a feature selection technique, K-Nearest Neighbour (KNN) and Support Vector Machine (SVM) methods were subsequently employed for the classification process. The classifiers categorised the psychophysiological database into four effective clusters (defined based on a 3-dimensional space – valence, arousal and dominance) and eight emotion labels (relaxed, content, happy, excited, angry, afraid, sad, and bored). The KNN and SVM classifiers achieved average cross-validation accuracies of 97.01% (±1.3%) and 92.84% (±3.67%), respectively. However, no significant differences were found in the classification process based on effective clusters or emotion labels.

Keywords: virtual reality, effective computing, effective VR, emotion-based effective physiological database

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1802 Emerging Positive Education Interventions for Clean Sport Behavior: A Pilot Study

Authors: Zeinab Zaremohzzabieh, Syasya Firzana Azmi, Haslinda Abdullah, Soh Kim Geok, Aini Azeqa Ma'rof, Hayrol Azril Mohammed Shaffril

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The escalating prevalence of doping in sports, casting a shadow over both high-performance and recreational settings, has emerged as a formidable concern, particularly within the realm of young athletes. Doping, characterized by the surreptitious use of prohibited substances to gain a competitive edge, underscores the pressing need for comprehensive and efficacious preventive measures. This study aims to address a crucial void in current research by unraveling the motivations that drive clean adolescent athletes to steadfastly abstain from performance-enhancing substances. In navigating this intricate landscape, the study adopts a positive psychology perspective, investigating into the conditions and processes that contribute to the holistic well-being of individuals and communities. At the heart of this exploration lies the application of the PERMA model, a comprehensive positive psychology framework encapsulating positive emotion, engagement, relationships, meaning, and accomplishments. This model functions as a distinctive lens, dissecting intervention results to offer nuanced insights into the complex dynamics of clean sport behavior. The research is poised to usher in a paradigm shift from conventional anti-doping strategies, predominantly fixated on identifying deficits, towards an innovative approach firmly rooted in positive psychology. The objective of this study is to evaluate the efficacy of a positive education intervention program tailored to promote clean sport behavior among Malaysian adolescent athletes. Representing unexplored terrain within the landscape of anti-doping efforts, this initiative endeavors to reshape the focus from deficiencies to strengths. The meticulously crafted pilot study engages thirty adolescent athletes, divided into a control group of 15 and an experimental group of 15. The pilot study serves as the crucible to assess the effectiveness of the prepared intervention package, providing indispensable insights that will meticulously guide the finalization of an all-encompassing intervention program for the main study. The main study adopts a pioneering two-arm randomized control trial methodology, actively involving adolescent athletes from diverse Malaysian high schools. This approach aims to address critical lacunae in anti-doping strategies, specifically calibrated to resonate with the unique context of Malaysian schools. The study, cognizant of the imperative to develop preventive measures harmonizing with the cultural and educational milieu of Malaysian adolescent athletes, aspires to cultivate a culture of clean sport. In conclusion, this research aspires to contribute unprecedented insights into the efficacy of positive education interventions firmly rooted in the PERMA model. By unraveling the intricacies of clean sport behavior, particularly within the context of Malaysian adolescent athletes, the study seeks to introduce transformative preventive methods. The adoption of positive psychology as an avant-garde anti-doping tool represents an innovative and promising approach, bridging a conspicuous gap in scholarly research and offering potential panaceas for the sporting community. As this study unfurls its chapters, it carries the promise not only to enrich our understanding of clean sport behavior but also to pave the way for positive metamorphosis within the realm of adolescent sports in Malaysia.

Keywords: positive education interventions, a pilot study, clean sport behavior, adolescent athletes, Malaysia

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1801 Delayed Contralateral Prophylactic Mastectomy (CPM): Reasons and Rationale for Patients with Unilateral Breast Cancer

Authors: C. Soh, S. Muktar, C. M. Malata, J. R. Benson

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Introduction Reasons for requesting CPM include prevention of recurrence, peace of mind and moving on after breast cancer. Some women seek CPM as a delayed procedure but factors influencing this are poorly understood. Methods A retrospective analysis examined patients undergoing CPM as either an immediate or delayed procedure with or without breast reconstruction (BR) between January 2009 and December 2019. A cross-sectional survey based on validated questionnaires (5 point Likert scale) explored patients’ decision-making process in terms of timing of CPM and any BR. Results A total of 123 patients with unilateral breast cancer underwent CPM with 39 (32.5%) delayed procedures with or without BR. The response rate amongst patients receiving questionnaires (n=33) was 22/33 (66%). Within this delayed CPM cohort were three reconstructive scenarios 1) unilateral immediate BR with CPM (n=12); 2) delayed CPM with concomitant bilateral BR (n=22); 3) delayed bilateral BR after delayed CPM (n=3). Two patients had delayed CPM without BR. The most common reason for delayed CPM was to complete all cancer treatments (including radiotherapy) before surgery on the unaffected breast (score 2.91). The second reason was unavailability of genetic test results at the time of therapeutic mastectomy (score 2.64) whilst the third most cited reason was a subsequent change in family cancer history. Conclusion Factors for delayed CPM are patient-driven with few women spontaneously changing their mind having initially decided against immediate CPM for reasons also including surgical duration. CPM should be offered as a potentially delayed option with informed discussion of risks and benefits.

Keywords: Breast Cancer, CPM, Prophylactic, Rationale

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