Search results for: minority groups
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7256

Search results for: minority groups

6326 Clustering for Detection of the Population at Risk of Anticholinergic Medication

Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

Abstract:

Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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6325 Comparative Study Between Oral and Intralesional Injection of Beta Blocker in the Treatment of Infantile Capillary Hemangioma

Authors: Nadeen Eltoukhy, Sahar S. Sheta, Walaa Elnaggar, Karim Bakr

Abstract:

Purpose: The aim of this study is to compare the clinical efficacy and side effects of oral versus intralesional propranolol treatment of infantile capillary hemangiomas in infants. Methods: The study enrolled 40 infants diagnosed with infantile capillary hemangiomas. Patients were divided into 2 groups: Group A (Non-invasive group) included 20 infants who received oral propranolol hydrochloride starting at a dose of 1 mg/kg/day BID, then increased to a max of 2 mg/kg/day BID gradually over 2 weeks for 3 months. Group B (Invasive group) included 20 infants who received intralesional propranolol injection at a dose of 1 mg/mL; the volume of the injected drug depended on the size of the lesion (0.2 mL injected per cm of lesion diameter), with a maximum volume of 1 mL for a lesion of 5 cm diameter under complete aseptic conditions in the operating theater. Results: At three months after initiating treatment, the circumferential size of the hemangioma showed a statistically significant decrease in both groups; in Group A from 3.66±2.89 cm to 1.56±1.26 cm with p-value <0.05 and in Group B from 2.99±2.73 cm to 1.32±1.18 cm with p-value <0.05. There is no statistically significant comparative difference between the two groups (p-value = 0.538 = insignificant). Regarding the complications of oral propranolol, one patient (5%) had bradycardia, and one patient (5%) had diarrhea. In the injection group, 20 patients (100%) had local edema, and one patient (5%) had a local infection. Conclusions: Both oral non-invasive and intralesional invasive propranolol are safely used to successfully treat and decrease the size of infantile hemangioma while showing no statistically comparative difference between both treatment techniques.

Keywords: hemangioma, oral beta blocker, intralesional beta blocker, infants

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6324 Change in Value System: The Way Forward for Africa

Authors: Awe Ayodeji Samson, Adeuja Yetunde Omowunmi

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Corruption is a ‘monster’ that can consume a whole nation, continent and even the world if it is not destroyed while it is still immature; It grows in the mind of the people, takes over their thinking and guides their decision-making process. Corruption snowballs into socio-economic catastrophe that might be difficult to deal with. Corruption which is a disease of the mind can be alleviated in Africa and the world at large by transforming a Corruption-Prone Mind to a Corruption-Immune Mind and to achieve this, we have to change our value system because the use of anti-graft agencies alone is not enough. Therefore, we have to fight corruption from the inside and the outside. Value System is the principle of right and wrong that are accepted by an individual or a social group; the reviewing and reordering of our value system is the solution to the problem of corruption as proposed by this research because the African society has become a ‘Money and Power Driven Society’ where the ‘I am worth concept’ which is a problematic concept has created an ‘Aggressive Society’ with grasping and money-grabbing individuals. We place more priority on money and the display of opulence. Hence, this has led to a ‘Triangular Society’ where minority is lavishing in plenty and majority is gasping for little. The get rich quick syndrome, the ethnicity syndrome, weakened educational system are signs of the prevalence of corruption in Africa This research has analyzed role and impact of the change in our value system in the fight against corruption in Africa and has therefore proposed the change in our value system as the way forward in the fight against corruption in Africa.

Keywords: corruption-prone mind, corruption-immune mind, triangular society, aggressive society, money and power-driven society

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6323 Natural Disaster Tourism as a Type of Dark Tourism

Authors: Dorota Rucińska

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This theoretical paper combines the academic discourse regarding a specific part of dark tourism. Based on the literature analysis, distinction of natural disasters in thanatourism was investigated, which is connected with dynamic geographical conditions. Natural disasters used to play an important role in social life by their appearance in myths and religions. Nowadays, tourists pursuing natural hazards can be divided into three groups: Those interested in natural hazards themselves; those interested in landscape deformation and experiencing emotions shortly after extreme events - natural disasters - occur; and finally those interested in historic places log after an extreme event takes place. An important element of the natural disaster tourism is quick access to information on the location of a disaster and the destination of a potential excursion. Natural disaster tourism suits alternative tourism, yet it is opposed culture tourism, and sustainable tourism. The paper compares types and groups of tourists. It also considers the contradictions that describe dualism, which exists in dark tourism.

Keywords: dark tourism, dualism, natural disasters, natural hazards, thanatoursim

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6322 Preliminary Report on the Assessment of the Impact of the Kinesiology Taping Application versus Placebo Taping on the Knee Joint Position Sense

Authors: Anna Hadamus, Patryk Wasowski, Anna Mosiolek, Zbigniew Wronski, Sebastian Wojtowicz, Dariusz Bialoszewski

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Introduction: Kinesiology Taping is a very popular physiotherapy method, often used for healthy people, especially athletes, in order to stimulate the muscles and improve their performance. The aim of this study was to determine the effect of the muscle application of Kinesiology Taping on the joint position sense in active motion. Material and Methods: The study involved 50 healthy people - 30 men and 20 women, mean age was 23.2 years (range 18-30 years). The exclusion criteria were injuries and operations of the knee, which could affect the test results. The participants were divided randomly into two equal groups. The first group consisted of individuals with the applied Kinesiology Taping muscle application (KT group), whereas in the rest of the individuals placebo application from red adhesive tape was used (placebo group). Both applications were to enhance the effects of quadriceps muscle activity. Joint position sense (JPS) was evaluated in this study. Error of Active Reproduction of the Joint Position (EARJP) of the knee was measured in 45° flexion. The test was performed prior to applying the patch, with the applied application, then 24 hours after wearing, and after removing the tape. The interval between trials was not less than 30 minutes. Statistical analysis was performed using Statistica 12.0. We calculated distribution characteristics, Wilcoxon test, Friedman‘s ANOVA and Mann-Whitney U test. Results. In the KT group and the placebo group average test score of JPS before applying application KT were 3.48° and 5.16° respectively, after its application it was 4.84° and 4.88°, then after 24 hours of experiment JPS was 5.12° and 4.96°, and after application removal we measured 3.84° and 5.12° respectively. Differences over time in any of the groups were not statistically significant. There were also no significant differences between the groups. Conclusions: 1. Applying Kinesiology Taping to quadriceps muscle had no significant effect on the knee joint proprioception. Its use in order to improve sensorimitor skills seems therefore to be unreasonable. 2. No differences between applications of KT and placebo indicates that the clinical effect of stretch tape is minimal or absent. 3. The results are the basis for the continuation of prospective, randomized trials of numerous study groups.

Keywords: joint position sense, kinesiology taping, kinesiotaping, knee

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6321 The Effects of Chamomile on Serum Levels of Inflammatory Indexes to a Bout of Eccentric Exercise in Young Women

Authors: K. Azadeh, M. Ghasemi, S. Fazelifar

Abstract:

Aim: Changes in stress hormones can be modify response of immune system. Cortisol as the most important body corticosteroid is anti-inflammatory and immunosuppressive hormone. Normal levels of cortisol in humans has fluctuated during the day, In other words, cortisol is released periodically, and regulate through the release of ACTH circadian rhythm in every day. Therefore, the aim of this study was to determine the effects of Chamomile on serum levels of inflammatory indexes to a bout of eccentric exercise in young women. Methodology: 32 women were randomly divided into 4 groups: high dose of Chamomile, low dose of Chamomile, ibuprofen and placebo group. Eccentric exercise included 5 set and rest period between sets was 1 minute. For this purpose, subjects warm up 10 min and then done eccentric exercise. Each participant completed 15 repetitions with optional 20 kg weight or until can’t continue moving. When the subject was no longer able to continue to move, immediately decreased 5 kg from the weight and the protocol continued until cause exhaustion or complete 15 repetitions. Also, subjects received specified amount of ibuprofen and Chamomile capsules in target groups. Blood samples in 6 stages (pre of starting pill, pre of exercise protocol, 4, 24, 48 and 72 hours after eccentric exercise) was obtained. The levels of cortisol and adrenocorticotropic hormone levels were measured by ELISA way. K-S test to determine the normality of the data and analysis of variance for repeated measures was used to analyze the data. A significant difference in the p < 0/05 accepted. Results: The results showed that Individual characteristics including height, weight, age and body mass index were not significantly different among the four groups. Analyze of data showed that cortisol and ACTH basic levels significantly decreased after supplementation consumption, but then gradually significantly increased in all stages of post exercise. In High dose of Chamomile group, increasing tendency of post exercise somewhat less than other groups, but not to a significant level. The inter-group analysis results indicate that time effect had a significant impact in different stages of the groups. Conclusion: The results of this study, one session of eccentric exercise increased cortisol and ACTH hormone. The results represent the effect of high dose of Chamomile in the prevention and reduction of increased stress hormone levels. As regards use of medicinal plants and ibuprofen as a pain medication and inflammation has spread among athletes and non-athletes, the results of this research can provide information about the advantages and disadvantages of using medicinal plants and ibuprofen.

Keywords: chamomile, inflammatory indexes, eccentric exercise, young girls

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6320 Influence of Non-Formal Physical Education Curriculum, Based on Olympic Pedagogy, for 11-13 Years Old Children Physical Development

Authors: Asta Sarkauskiene

Abstract:

The pedagogy of Olympic education is based upon the main idea of P. de Coubertin, that physical education can and has to support the education of the perfect person, the one who was an aspiration in archaic Greece, when it was looking towards human as a one whole, which is composed of three interconnected functions: physical, psychical and spiritual. The following research question was formulated in the present study: What curriculum of non-formal physical education in school can positively influence physical development of 11-13 years old children? The aim of this study was to formulate and implement curriculum of non-formal physical education, based on Olympic pedagogy, and assess its effectiveness for physical development of 11-13 years old children. The research was conducted in two stages. In the first stage 51 fifth grade children (Mage = 11.3 years) participated in a quasi-experiment for two years. Children were organized into 2 groups: E and C. Both groups shared the duration (1 hour) and frequency (twice a week) but were different in their education curriculum. Experimental group (E) worked under the program developed by us. Priorities of the E group were: training of physical powers in unity with psychical and spiritual powers; integral growth of physical development, physical activity, physical health, and physical fitness; integration of children with lower health and physical fitness level; content that corresponds children needs, abilities, physical and functional powers. Control group (C) worked according to NFPE programs prepared by teachers and approved by school principal and school methodical group. Priorities of the C group were: motion actions teaching and development; physical qualities training; training of the most physically capable children. In the second stage (after four years) 72 sixth graders (Mage = 13.00) attended in the research from the same comprehensive schools. Children were organized into first and second groups. The curriculum of the first group was modified and the second - the same as group C. The focus groups conducted anthropometric (height, weight, BMI) and physiometric (VC, right and left handgrip strength) measurements. Dependent t test indicated that over two years E and C group girls and boys height, weight, right and left handgrip strength indices increased significantly, p < 0.05. E group girls and boys BMI indices did not change significantly, p > 0.05, i.e. height and weight ratio of girls, who participated in NFPE in school, became more proportional. C group girls VC indices did not differ significantly, p > 0.05. Independent t test indicated that in the first and second research stage differences of anthropometric and physiometric measurements of the groups are not significant, p > 0.05. Formulated and implemented curriculum of non-formal education in school, based on olympic pedagogy, had the biggest positive influence on decreasing 11-13 years old children level of BMI and increasing level of VC.

Keywords: non – formal physical education, olympic pedagogy, physical development, health sciences

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6319 The Effect of Santolina Plant Extract on Nitro-Oxidative Stress

Authors: Sabrina Sebbane, Alina Elena Parvu

Abstract:

Introduction: Santolina rosmarinifolia is a plant of the Santolina genus, a family made of medicinal plants widely used. Some of the Santolina species have been proven to have potent anti-inflammatory and anti-oxidant effects. However, no in vivo study has been made to demonstrate this in Santolina rosmarinifolia. The aim of our study is to experimentally evaluate the potential anti-inflammatory and anti-oxidant effects of Santolina rosmarinifolia plant extracts on acute inflammation in rats. These effects are defined by measuring the modifications on nitric oxide, reactive oxygen species and anti-oxidant response in serum. Materials and Methods: Rats were divided into 5 groups (n=6). Three groups were given Santolina rosmarinifolia extract by gavage in different concentrations(100%, 50%, 25%) for a week. Inflammation was induced by i.m injection of turpentine oil on the 8th day. One group was only given turpentine oil and the fifth group acted as control and was given only saline solution. Blood was collected and serum separated. Global tests were used to measure the oxidative stress, total oxidative status (TOS), total antioxidant reactivity (TAR) and the modified method of Griess assay to measure NO synthesis. Malondilaldehyde (MDA) and thiols levels were also assessed. Results: Santolina rosmarinifolia did not significantly change the TOS levels (p > 0.05). Santolina rosmarinifolia 25% and 50% decreased significantly the TAR levels (p < 0.001). Santolina 100% didn't have a significant effect on TAR (p > 0.05). All concentrations of Santolina rosmarinifolia increased the oxidative stress index (OSI) significantly(p < 0.05). Santolina rosmarinifolia 100% significantly decreased NO synthesis (p value < 0.05). In the diluted Santolina groups, no significant effect on NO synthesis was observed. In the groups treated with Santolina 100% and Santolina rosmarinifolia 50%, thiols concentration were significantly higher compared to the inflammation group (p < 0.02). A higher stimulatory effect was found in the Santolina 25% group (p value < 0.05). MDA levels were not significantly modified by the administration of Santolina rosmarinifolia (p > 0.05). Conclusion: All three solutions of Santolina rosmarinifolia had no important effect on oxidant production. However, Santolina rosmarinifolia solutions had a positive effect by increasing the thiols concentration in the serum of the models. The sum of all the effects produced by the administration of Santolina did not show a significant decrease of nitro-oxidative stress. Further experiments including smaller concentrations of Santolina rosmarinifolia will be made. Santolina rosmarinifolia should also be tested as a curative treatment.

Keywords: inflammation, MDA, nitric oxide, santolina rosmarinifolia, thiols, TAR, TOS

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6318 Solanum Nigrum Show Anti-Obesity Effects on High Fat Diet Fed Sprague Dawley Rats

Authors: Kathryn Nderitu, Atunga Nyachieo, Ezekiel Mecha

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Introduction: Solanum nigrum , also known as black nightshade, biosynthesizes various phytochemical compounds with various pharmacological activities, including treating cardiovascular diseases and type 2 diabetes, among others. Materials and Methods: To assess the anti-obesity effects of Solanum nigrum using high-fat-fed diet rats, Sprague Dawley male rats (n = 35) of weights 160–180 g were assigned randomly into seven groups comprising n = 5 rats each. Each group was fed for 11 weeks as follows: normal group (normal chow rat feed); high-fat diet control (HFD); HFD and standard drug (Orlistat 30 mg/kg bw); HFD and methanolic extract 150 mg/kgbw; HFD and methanolic extract 300 mg/kgbw; HFD and dichloromethane extract 150 mg/kgbw; HFD and dichloromethane extract 300 mg/kgbw. Body mass index and food intake were monitored per week, and an oral glucose tolerance test was measured in weeks 5 and 10. Lipid profiles, liver function tests, adipose tissue, liver weights, and phytochemical analysis of Solanum nigrum were later carried out. Results: High-fat diet control group rats exhibited a significant increase in body mass index (BMI), while rats administered with leaf extracts of Solanum nigrum showed a reduction in BMI. Both low doses of dichloromethane (150 mg/kgbw) and high doses of methanol extracts (300 mg/kgbw) showed a better reduction in BMI than the other treatment groups. A significant decrease (p <0.05) in low-density lipoprotein-cholesterol, triglycerides, and cholesterol was observed among the rats administered with Solanum nigrum extracts compared to those of HFD control. Moreover, the HFD control group significantly increased liver and adipose tissue weights compared to other treatment groups (p<0.05). Solanum nigrum also decreased glycemic levels and normalized the hepatic enzymes of HFD control. However, food intake among the groups showed no significant difference (p>0.05). Qualitative analysis of Solanum nigrum leaf extracts indicated the presence of various bioactive compounds associated with anti-obesity. Conclusion: These results validate the use of Solanum nigrum in controlling obesity.

Keywords: solanum nigrum, High fat diet, phytocompounds, obesity

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6317 The Effect of Physical Exercise to Level of Nuclear Factor Kappa B on Serum, Macrophages and Myocytes

Authors: Eryati Darwin, Eka Fithra Elfi, Indria Hafizah

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Background: Physical exercise induces a pattern of hormonal and immunological responses that prevent endothelial dysfunction by maintaining the availability of nitric oxide (NO). Regular and moderate exercise stimulates NO release, that can be considered as protective factor of cardiovascular diseases, while strenuous exercise induces increased levels in a number of pro-inflammatory and anti-inflammatory cytokines. Pro-inflammatory cytokines tumor necrosis factor-α (TNF-α) triggers endothelial activation which results in an increased vascular permeability. Nuclear gene factor kappa B (NF-κB) activates biological effect of TNF-α. Aim of Study: To determine the effect of physical exercise on the endothelial and skeletal muscle, we measured the level of NF-κB on rats’ serum, macrophages, and myocytes after strenuous physical exercise. Methods: 30 male Rattus norvegicus in the age of eight weeks were randomly divided into five groups (each containing six), and there were treated groups (T) and control group (C). The treated groups obtain strenuous physical exercise by ran on treadmill at 32 m/minutes for 1 hour or until exhaustion. Blood samples, myocytes of gastrocnemius muscle, and intraperitoneal macrophages were collected sequentially. There were investigated immediately, 2 hours, 6 hours, and 24 hours (T1, T2, T3, and T4) after sacrifice. The levels of NF-κB were measured by ELISA methods. Results: From our study, we found that the levels of NF-κB on myocytes in treated group from which its specimen was taken immediately (T1), 2 hours after treadmill (T2), and 6 hours after treadmill (T3) were significantly higher than control group (p<0.05), while the group from which its specimen was taken 24 hours after treadmill, was no significantly different (p>0.05). Also on macrophages, NF-κB in treated groups T1, T2, and T3 was significantly higher than control group (p<0.05), but there was no difference between T4 and control group (p>0.05). The level of serum NF-κB was not significantly different between treatment group as well as compared to control group (p>0.05). Serum NF-κB was significantly higher than the level on macrophages and myocytes (p<0.05). Conclusion: This study demonstrated that strenuous physical exercise stimulates the activation of NF-κB that plays a role in vascular inflammation and muscular damage, and may be recovered after resting period.

Keywords: endothelial function, inflammation, NFkB, physical exercise

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6316 Attachment and Emotion Regulation among Adults with versus without Somatic Symptom Disorder

Authors: Natalia Constantinescu

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This cross-sectional study aims to explore the differences among adults with somatic symptom disorder (SSD) versus adults without SSD in terms of attachment and emotion regulation strategies. A total sample of 80 participants (40 people with SSD and 40 healthy controls), aged 20-57 years old (M = 31.69, SD = 10.55), were recruited from institutions and online groups. They completed the Romanian version of the Experiences in Close Relationships Scale – Short Form (ECR-S), Regulation of Emotion Systems Survey (RESS), Patient Health Questionnaire-15 (PHQ-15) and Somatic Symptom Disorder – B Criteria Scale (SSD-12). The results indicate significant differences between the two groups in terms of attachment and emotion regulation strategies. Adults with SSD have a higher level of attachment anxiety and avoidance compared to the nonclinical group. Moreover, people with SSD are more prone to use rumination and suppression and less prone to use reevaluation compared to healthy people. Implications for SSD prevention and treatment are discussed.

Keywords: adult attachment, emotion regulation strategies, psychosomatic disorders, somatic symptom disorder

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6315 The Effectiveness of ICT-Assisted PBL on College-Level Nano Knowledge and Learning Skills

Authors: Ya-Ting Carolyn Yang, Ping-Han Cheng, Shi-Hui Gilbert Chang, Terry Yuan-Fang Chen, Chih-Chieh Li

Abstract:

Nanotechnology is widely applied in various areas so professionals in the related fields have to know more than nano knowledge. In the study, we focus on adopting ICT-assisted PBL in college general education to foster professionals who possess multiple abilities. The research adopted a pretest and posttest quasi-experimental design. The control group received traditional instruction, and the experimental group received ICT-assisted PBL instruction. Descriptive statistics will be used to describe the means, standard deviations, and adjusted means for the tests between the two groups. Next, analysis of covariance (ANCOVA) will be used to compare the final results of the two research groups after 6 weeks of instruction. Statistics gathered in the end of the research can be used to make contrasts. Therefore, we will see how different teaching strategies can improve students’ understanding about nanotechnology and learning skills.

Keywords: nanotechnology, science education, project-based learning, information and communication technology

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6314 Tax Evasion with Mobility between the Regular and Irregular Sectors

Authors: Xavier Ruiz Del Portal

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This paper incorporates mobility between the legal and black economies into a model of tax evasion with endogenous labor supply in which underreporting is possible in one sector but impossible in the other. We have found that the results of the effects along the extensive margin (number of evaders) become more robust and conclusive than those along the intensive margin (hours of illegal work) usually considered by the literature. In particular, it is shown that the following policies reduce the number of evaders: (a) larger and more progressive evasion penalties; (b) higher detection probabilities; (c) an increase in the legal sector wage rate; (d) a decrease in the moonlighting wage rate; (e) higher costs for creating opportunities to evade; (f) lower opportunities to evade, and (g) greater psychological costs of tax evasion. When tax concealment and illegal work also are taken into account, the effects do not vary significantly under the assumptions in Cowell (1985), except for the fact that policies (a) and (b) only hold as regards low- and middle-income groups and policies (e) and (f) as regards high-income groups.

Keywords: income taxation, tax evasion, extensive margin responses, the penalty system

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6313 Effect of Tissue Preservation Chemicals on Decomposition in Different Soil Types

Authors: Onyekachi Ogbonnaya Iroanya, Taiye Abdullahi Gegele, Frank Tochukwu Egwuatu

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Introduction: Forensic taphonomy is a multifaceted area that incorporates decomposition, chemical and biological cadaver exposure in post-mortem event chronology and reconstruction to predict the Post Mortem Interval (PMI). The aim of this study was to evaluate the integrity of DNA extracted from the remains of embalmed decomposed Sus domesticus tissues buried in different soil types. Method: A total of 12 limbs of Sus domesticus weighing between 0.7-1.4 kg were used. Each of the samples across the groups was treated with 10% formaldehyde, absolute methanol and 50% Pine oil for 24 hours before burial except the control samples, which were buried immediately. All samples were buried in shallow simulated Clay, Sandy and Loamy soil graves for 12 months. The DNA for each sample was extracted and quantified with Nanodrop Spectrophotometer (6305 JENWAY spectrometers). The rate of decomposition was examined through the modified qualitative decomposition analysis. Extracted DNA was amplified through PCR and bands visualized via gel electrophoresis. A biochemical enzyme assay was done for each burial grave soil. Result: The limbs in all burial groups had lost weight over the burial period. There was a significant increase in the soil urease level in the samples preserved in formaldehyde across the 3 soil type groups (p≤0.01). Also, the control grave soils recorded significantly higher alkaline phosphatase, dehydrogenase and calcium carbonate values compared to experimental grave soils (p≤0.01). The experimental samples showed a significant decrease in DNA concentration and purity when compared to the control groups (p≤0.01). Obtained findings of the soil biochemical analysis showed the embalming treatment altered the relationship between organic matter decomposition and soil biochemical properties as observed in the fluctuations that were recorded in the soil biochemical parameters. The PCR amplified DNA showed no bands on the gel electrophoresis plates. Conclusion: In criminal investigations, factors such as burial grave soil, grave soil biochemical properties, antemortem exposure to embalming chemicals should be considered in post-mortem interval (PMI) determination.

Keywords: forensic taphonomy, post-mortem interval (PMI), embalmment, decomposition, grave soil

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6312 Impact of Obesity on Female Fertility

Authors: A. Chennai, M. Yahia, H. Boussenan

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Our study was designed to highlight changes in certain biochemical parameters such as (CH, TG, HDL, TGO, TGP, LDL, and CRP), hormones (FSH, LH, PRL, TSH, and leptin), in women who suffer from over weight and fertile controls as well as the research for potential pathophysiological link between obesity and infertility in this population of women. This practical work has been focused on a population of 24 over weight infertile women, compared to control subjects without any pathology causing disturbance parameters to be studied to determine the contribution of obesity in the etiology of infertility. The assay results revealed a highly significant difference between the two groups in the serum levels of CH, TG, HDL, and TGO TGP (P <0.0001) as well as the rate of LDL (p=0.0017) and CRP (p=0.02). Hormonal profile also shows a significant difference between the two groups (P<0.0001) for LH and leptin but no difference was found for serum TSH. A significant correlation between leptin and FSH, LH, and FSH, age and LH, PRL and age and between HDL and CRP. The present study suggests that obesity is associated with infertility, but no direct pathophysiological link between obesity and infertility has been determined. More in-depth studies are needed to determine the exact mechanism by which overweight leads to female infertility.

Keywords: fertility, obesity, hormones, biochemical, pathophysiological

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6311 The Characteristics of the Chairman of Board of Directors That Are Associated with Better Levels of Performance

Authors: Abilio Pires Zacarias

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Analyzing company boards of directors is a relevant and timely topic. As the representative of shareholders, the board is the most senior management body of this type of company. Therefore, ascertaining the best kind of candidates to nominate, namely the most appropriate characteristics for leading the board to achieve better levels of performance, is certainly of great interest. The companies selected for this study were the 1,000 largest non-financial companies and the 100 largest financial companies in Portugal according to the Instituto Nacional de Estatística for 2010. The information stemmed from a questionnaire addressed to the person in charge of daily company management and then processed through STATA 17 with the multivariate analysis of variables - MANOVA. The study may correspondingly report that the vast majority of boards in the sample operate a dual leadership structure. By in terms of its prevalence, unitary leadership represents only a minority. Agency theory and stewardship theory postulate different characteristics for the ideal chairman but neither receive confirmation from our results. On the other hand, our findings do validate the behavioral theory of firms (BToF), concluding that experience is associated with organizational performance. This study is also relevant due to its analysis of companies not listed on the financial markets not only because of their weighting in the economy but also because they remain only very poorly studied in this field and thus also correspondingly contributing to deepening the literature.

Keywords: agency theory, behavioral theory of the firm, board of directors, corporate governance, stewardship theory

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6310 Peer Support Groups as a Tool to Increase Chances of Passing General Practice UK Qualification Exams

Authors: Thomas Abraham, Garcia de la Vega Felipe, Lubna Nishath, Nzekwe Nduka, Powell Anne-Marie

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Introduction: The purpose of this paper is to discuss the effectiveness of a peer support network created to provide medical education, pastoral support, and reliable resources to registrars to help them pass the MRCGP exams. This paper will include a description of the network and its purpose, discuss how it has been used by trainees since its creation, and explain how this methodology can be applied to other areas of medical education and primary care. Background: The peer support network was created in February 2021, using Facebook, Telegram, and WhatsApp platforms to facilitate discussion of cases and answer queries about the exams, share resources, and offer peer support from qualified GPs and specialists. The network was created and is maintained by the authors of this paper and is open to anyone who is registered with the General Medical Council (GMC) and is studying for the MRCGP exams. Purpose: The purpose of the network is to provide medical education, pastoral support, and reliable resources to registrars to help them pass the exams. The network is free to use and is designed to take the onus away from a single medical educator and collate a vast amount of information from multiple medical educators/trainers; thereby creating a digital library of information for all trainees - exam related or otherwise. Methodology The network is managed by a team of moderators who respond to queries and facilitate discussion. Smaller study groups are created from the main group and provide a platform for trainees to work together, share resources, and provide peer support. The network has had thousands of trainees using it since February 2021, with positive feedback from all trainees. Results: The feedback from trainees has been overwhelmingly positive. Word of mouth has spread rapidly, growing the groups exponentially. Trainees add colleagues to the groups and often stay after they pass their exams to 'give back' to their fellow trainees. To date, thousands of trainees have passed the MRCGP exams using the resources and support provided by the network. Conclusion The success of this peer support network demonstrates the effectiveness of creating a network of thousands of doctors to provide medical education and support.

Keywords: peer support, medical education, pastoral support, MRCGP exams

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6309 Variations and Anomalies of the Posterior Cerebral Artery in a South African Population

Authors: Karen Cilliers, Benedict J. Page

Abstract:

Limited research focuses on the anatomy of the posterior cerebral artery (PCA) and its cortical branches, even though there can be variation in the presence, size, and origin. The PCA branching pattern has not been adequately reported, and the true division point remains unclear. Anomalies of the PCA have been described in the previous literature; however, few examples have been reported. Furthermore, possible differences between right and left, sex, population and age groups may exist. Therefore, the aim of this study was to report on these aspects from a South African population. One hundred and twenty-six hemispheres were obtained consisting of 86 males and 38 females, between the ages of 22 and 84 (average 45 years of age). This comprised of three population groups, namely coloured (n=74), black (n=38), white (n=10) and two unknown cases. The PCA was injected with an isotonic saline and a colored silicone. The external diameter was measured with a digital micrometer, and length was measured with a string and a ruler. Presence and origins of the cortical branches were similar to the literature; however, duplications, triplications, and unusual origins were observed. The diameter and lengths indicated significant differences between the right and left sides, sex, population and age groups. Branching patterns were identified and compared to the prevalence from previous studies. Two fenestrations were observed in the P2A segment. The presence, size, origin, branching pattern and anomalies of the PCA were investigated in this study. The diameter and length can be significantly different, especially between the right and left-hand side. Changes in the diameter and length can be indicative of certain neuropathological conditions and can play a role in aneurysms formation. Adequate knowledge of the normal and abnormal PCA anatomy is crucial for surgery in the vicinity of the PCA. Therefore, future studies should focus on these aspects.

Keywords: branching, cortical branches, fenestration, posterior cerebral artery

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6308 Egg Production Performance of Old Laying Hen Fed Dietary Turmeric Powder

Authors: D. P. Rahardja, M. Rahman Hakim, V. Sri Lestari

Abstract:

An experiment was conducted to elucidate the effects of turmeric powder supplementation on egg production performance of old laying hens (104 weeks of age). There were 40 hens of Hysex Brown strain used in the study. They were caged individually, and randomly divided into 4 treatment groups of diet containing 0 (control), 1, 2 and 4 % oven dried turmeric powder for 3 periods of 4 weeks; Egg production (% hen day) and feed intake of the 4 treatment groups at the commencement of the experiment were not significantly different. In addition to egg production performance (%HD and egg weight), feed and water intakes were measured daily. The results indicated that feed intakes of the hen were significantly lowered when 4% turmeric powder supplemented, while there were no significant changes in water intakes. Egg production (%HD) were significantly increased and maintained at a higher level by turmeric powder supplementation up to 4% compared with the control, while the weight of eggs were not significantly affected. The research markedly demonstrated that supplementation of turmeric powder up to 4% could improve and maintain egg production performance of the old laying hen.

Keywords: curcumin, feed and water intake, old laying hen, egg production

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6307 The Impact of Task-Based Language Teaching on Iranian Female Intermediate EFL Learners’ Writing Performance

Authors: Gholam Reza Parvizi, Hossein Azad, Ali Reza Kargar

Abstract:

This article investigated the impact of task-based language teaching (TBLT) on writing performance of the Iranian intermediate EFL learners. There were two groups of forty students of the intermediate female learners studying English in Jahad-e-Daneshgahi language institute, ranging in age from thirteen to nineteen. They participated in their regular classes in the institute and were assigned to two groups including an experimental group of task-based language teaching and a control group for the purpose of homogeneity, all students in two groups took an achievement test before the treatment. As a pre-test; students were assigned to write a task at the beginning of the course. One of the classes was conducted through talking a TBLT approach on their writing, while the other class followed regular patterns of teaching, namely traditional approach for TBLT group. There were some tasks chosen from learners’ textbook. The task selection was in accordance with learning standards for ESL and TOFEL writing sections. At the end of the treatment, a post-test was administered to both experimental group and the control group. Scoring was done on the basis of scoring scale of “expository writing quality scale”. The researcher used paired samples t-test to analyze the effect of TBLT teaching approach on the writing performance of the learners. The data analysis revealed that the subjects in TBLT group performed better on the writing performance post-test than the subjects in control group. The findings of the study also demonstrated that TBLT would enhance writing performance in the group of learners. Moreover, it was indicated that TBLT has been effective in teaching writing performance to Iranian EFL learners

Keywords: task-based language teaching, task, language teaching approach, writing proficiency, EFL learners

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6306 Integrating Flipped Instruction to Enhance Second Language Acquisition

Authors: Borja Ruiz de Arbulo Alonso

Abstract:

This paper analyzes the impact of flipped instruction in adult learners of Spanish as a second language in a face-to-face course at Boston University. Given the limited amount of contact hours devoted to studying world languages in the American higher education system, implementing strategies to free up classroom time for communicative language practice is key to ensure student success in their learning process. In an effort to improve the way adult learners acquire a second language, this paper examines the role that regular pre-class and web-based exposure to Spanish grammar plays in student performance at the end of the academic term. It outlines different types of web-based pre-class activities and compares this approach to more traditional classroom practice. To do so, this study works for three months with two similar groups of adult learners in an intermediate-level Spanish class. Both groups use the same course program and have the same previous language experience, but one receives an additional set of instructor-made online materials containing a variety of grammar explanations and online activities that need to be reviewed before attending class. Since the online activities cover material and concepts that have not yet been studied in class, students' oral and written production in both groups is measured by means of a writing activity and an audio recording at the end of the three-month period. These assessments will ascertain the effects of exposing the control group to the grammar of the target language prior to each lecture throughout and demonstrate where flipped instruction helps adult learners of Spanish achieve higher performance, but also identify potential problems.

Keywords: educational technology, flipped classroom, second language acquisition, student success

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6305 Beneficial Effect of Biotin in Combination with Canagliflozin on High Fat Diet Induced Diabetes in Rats

Authors: Rayhana Begum, HongBin Wang, Nur Alam Siddiquee, Md.Yasin Ahmed

Abstract:

Biotin treatment has significant effects on blood glucose, and pharmacological doses of biotin improve hyperglycemia. The present study was aimed to investigate the efficacy and safety of biotin in combination with canagliflozin in improving glycemic control on High Fat Diet-induced diabetes in Rats. Thirty male rats were divided into five groups (six rats /group): control, high fat diet (HFD), canagliflozin (CAG), biotin (BIO), and CAG + BIO. The treatments with CAG and /or BIO significantly reduced the body weight gain, blood glucose and HbA1c levels, whereas CAG in combination with BIO revealed greater glycemic improvement than CAG monotherapy. The treatment with CAG and /or BIO causes significant change in lipid profile and CK level while the treatment with CAG in combination with BIO showed better results as compared with CAG monotherapy. Furthermore, combination of biotin with CAG improved the pancreatic and cardiac damage when compared with other treated groups.

Keywords: canagliflozin, biotin, HbA1c, lipid profile

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6304 The Political Economy of Fiscal and Monetary Interactions in Brazil

Authors: Marcos Centurion-Vicencio

Abstract:

This study discusses the idea of ‘dominance’ in economic policy and its practical influence over monetary decisions. The discretionary use of repurchase agreements in Brazil over the period 2006-2016 and its effects on the overall price level are the specific issues we will be focusing on. The set of in-depth interviews carried out with public servants at the Brazilian central bank and national treasury, alongside data collected from the National Institution of Statistics (IBGE), suggest that monetary and fiscal dominance do not differ in nature once the assumption of depoliticized central bankers is relaxed. In both regimes, the pursuit of private gains via public institutions affects price stability. While short-sighted politicians in the latter are at the origin of poor monetary decisions, the action of short-sighted financial interest groups is likely to generate a similar outcome in the former. This study then contributes to rethinking monetary policy theory as well as the nature of public borrowing.

Keywords: fiscal and monetary interactions, interest groups, monetary capture, public borrowing

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6303 Evaluation of Anti-Pruritus Effect of Melatonin on Hemodialysis Patients with Uremic Pruritus: A Randomized Clinical Trial

Authors: Paria Baharvand, Mohammad Reza Abbasi, Soha Namazi

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Introduction: Uremic pruritus (UP) is one of the major complaints in hemodialysis patients. The aim of this randomized clinical trial study was the evaluation of the anti-pruritus effect of Melatonin on hemodialysis patients with UP. Methods: This multi-centered double, blinded randomized clinical trial study was conducted on hemodialysis patients with UP that referred to the dialysis department of Imam Khomeini Hospital, Labbafinezhad Hospital and Ghiasi Hospital in Tehran, Iran, in 2018. Forty participants were enrolled and block randomization was performed by using a randomized list and divided into 2 groups of twenty patients. Evaluation of the 12-Item Pruritus Severity Scale (12-PSS), Visual analog scale (VAS), and Calculation of the affected body surface area for pruritus extent (BSA %) was performed every week. The Melatonin group received a 10 mg soft gel capsule, and the placebo group received a soft gel capsule placebo after dinner. For statistical analysis used by SPSS version 21(IRCT20180714040462N1). Results: 38 hemodialysis patients enrolled in this study. The mean age in the placebo group and in the Melatonin group was 55.88 ± 11.70 and 54.52 ± 13.00 years (p> 0.05). Also, 46% of all participants were female. Aspartate transaminase, alanine transaminase and C-reactive protein have significant differences between the two groups (p< 0.05). VAS score reduction in the two groups had a statistically significant (CI 95% = -1.71, P= 0.015(.The results of BSA% showed Melatonin had a significant effect on the decrease of the pruritus extent compared to placebo (CI 95% = -22.82, P= 0.001(. Conclusion: According to the results of this study and the preliminary effects of Melatonin on uremic pruritus, we suggest performing advanced clinical trials studies.

Keywords: Melatonin, Uremic Pruritus, hemodialysis, anti-pruritus

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6302 First Step into a Smoke-Free Life: The Effectivity of Peer Education Programme of Midwifery Students

Authors: Rabia Genc, Aysun Eksioglu, Emine Serap Sarican, Sibel Icke

Abstract:

Today the habit of cigarette smoking is among one of the most important public health concerns because of the health problems it leads to. The most important and hazardous group to use tobacco and tobacco products is adolescents and teenagers. And one of the most effective ways to prevent them from starting to smoke is education. This research is a kind of educational intervention study which was carried out in order to evaluate the effect of peer education on the teenagers' knowledge about smoking. The research was carried out between October 15, 2013 and September 9, 2015 at Ege University Ataturk Vocational Health School. The population of the research comprised of the students that have been studying at Ege University Atatürk Vocational Health School, Midwifery Department (N=390). The peer educator group that would give training on smoking consisted of 10 people, and the peer groups that would be trained were divided into two groups via simple randomization as experimental group (n=185) and control group (n=185). Questionnaire, information evaluation form, and informed consent forms were used as date collection tools. The analysis of the data which were collected in the study was carried out on Statistical Package for Social Science (SPSS 15.0). It was found out that 62.5 % of the students who were in peer educator group had smoked in some period of their lives; however, none of them continued to smoke. When they were asked about their reasons to start smoking, 25% said they just wanted to try it, and 25% of them answered that it was because of their friend groups. When the pre-peer education and post-peer education point averages of peer educator group were evaluated, the results showed that there was a significant difference between the point averages (p < 0.05). When the cigarette use of experimental group and the control group were evaluated, it was clear that 18.2% of the experimental group and 24.2%of the control group still smokes. 9.1% of the experimental group and 14.8% of control group stated that they started smoking because of their friend groups. Among the students who smoke 15.9% of the ones who belongs to the experimental group and 21.9% of the ones who belong to the control group stated they are thinking of quitting smoking. It was clear that there is a significant difference between the pre-education and post-education point averages of experimental group statistically (p ≤ 0.05); however, in terms of control group, there were no significant differences between the pre-test post-test averages statistically. Between the pre-test post-test averages of experimental and control groups there were not any statistically significant differences (p > 0.05). It was found out in the study that the peer education programme is not effective on the smoking habit of Vocational Health School students. When the future studies are being planned in order to evaluate the peer education activity, it can be taken into consideration that the peer education takes a long term and the students in the educator group will be more enthusiastic and a kind of leader in their environment.

Keywords: midwifery, peer, peer education, smoking

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6301 The Role of HPV Status in Patients with Overlapping Grey Zone Cancer in Oral Cavity and Oropharynx

Authors: Yao Song

Abstract:

Objectives: We aimed to explore the clinicodemographic characteristics and prognosis of grey zone squamous cell cancer (GZSCC) located in the overlapping or ambiguous area of the oral cavity and oropharynx and to identify valuable factors that would improve its differential diagnosis and prognosis. Methods: Information of GZSCC patients in the Surveillance, Epidemiology, and End Results (SEER) database was compared to patients with an oral cavity (OCSCC) and oropharyngeal (OPSCC) squamous cell carcinomas with corresponding HPV status, respectively. Kaplan-Meier method with log-rank test and multivariate Cox regression analysis were applied to assess associations between clinical characteristics and overall survival (OS). A predictive model integrating age, gender, marital status, HPV status, and staging variables was conducted to classify GZSCC patients into three risk groups and verified internally by 10-fold cross validation. Results: A total of 3318 GZSCC, 10792 OPSCC, and 6656 OCSCC patients were identified. HPV-positive GZSCC patients had the best 5-year OS as HPV-positive OPSCC (81% vs. 82%). However, the 5-year OS of HPV-negative/unknown GZSCC (43%/42%) was the worst among all groups, indicating that HPV status and the overlapping nature of tumors were valuable prognostic predictors in GZSCC patients. Compared with the strategy of dividing GZSCC into two groups by HPV status, the predictive model integrating more variables could additionally identify a unique high-risk GZSCC group with the lowest OS rate. Conclusions: GZSCC patients had distinct clinical characteristics and prognoses compared with OPSCC and OCSCC; integrating HPV status and other clinical factors could help distinguish GZSCC and predict their prognosis.

Keywords: GZSCC, OCSCC, OPSCC, HPV

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6300 Refusal Speech Acts in French Learners of Mandarin Chinese

Authors: Jui-Hsueh Hu

Abstract:

This study investigated various models of refusal speech acts among three target groups: French learners of Mandarin Chinese (FM), Taiwanese native Mandarin speakers (TM), and native French speakers (NF). The refusal responses were analyzed in terms of their options, frequencies, and sequences and the contents of their semantic formulas. This study also examined differences in refusal strategies, as determined by social status and social distance, among the three groups. The difficulties of refusal speech acts encountered by FM were then generalized. The results indicated that Mandarin instructors of NF should focus on the different reasons for the pragmatic failure of French learners and should assist these learners in mastering refusal speech acts that rely on abundant cultural information. In this study, refusal policies were mainly classified according to the research of Beebe et al. (1990). Discourse completion questionnaires were collected from TM, FM, and NF, and their responses were compared to determine how refusal policies differed among the groups. This study not only emphasized the dissimilarities of refusal strategies between native Mandarin speakers and second-language Mandarin learners but also used NF as a control group. The results of this study demonstrated that regarding overall strategies, FM were biased toward NF in terms of strategy choice, order, and content, resulting in pragmatic transfer under the influence of social factors such as 'social status' and 'social distance,' strategy choices of FM were still closer to those of NF, and the phenomenon of pragmatic transfer of FM was revealed. Regarding the refusal difficulties among the three groups, the F-test in the analysis of variance revealed statistical significance was achieved for Role Playing Items 13 and 14 (P < 0.05). A difference was observed in the average number of refusal difficulties between the participants. However, after multiple comparisons, it was found that item 13 (unrecognized heterosexual junior colleague requesting contacts) was significantly more difficult for NF than for TM and FM; item 14 (contacts requested by an unrecognized classmate of the opposite sex) was significantly more difficult to refuse for NF than for TM. This study summarized the pragmatic language errors that most FM often perform, including the misuse or absence of modal words, hedging expressions, and empty words at the end of sentences, as the reasons for pragmatic failures. The common social pragmatic failures of FM include inaccurately applying the level of directness and formality.

Keywords: French Mandarin, interlanguage refusal, pragmatic transfer, speech acts

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6299 Pupils' and Teachers' Perceptions and Experiences of Welsh Language Instruction

Authors: Mirain Rhys, Kevin Smith

Abstract:

In 2017, the Welsh Government introduced an ambitious, new strategy to increase the number of Welsh speakers in Wales to 1 million by 2050. The Welsh education system is a vitally important feature of this strategy. All children attending state schools in Wales learn Welsh as a second language until the age of 16 and are assessed at General Certificate of Secondary Education (GCSE) level. In 2013, a review of Welsh second language instruction in Key Stages 3 and 4 was completed. The report identified considerable gaps in teachers’ preparation and training for teaching Welsh; poor Welsh language ethos at many schools; and a general lack of resources to support the instruction of Welsh. Recommendations were made across a number of dimensions including curriculum content, pedagogical practice, and teacher assessment, training, and resources. With a new national curriculum currently in development, this study builds on this review and provides unprecedented detail into pupils’ and teachers’ perceptions of Welsh language instruction. The current research built on data taken from an existing capacity building research project on Welsh education, the Wales multi-cohort study (WMS). Quantitative data taken from WMS surveys with over 1200 pupils in schools in Wales indicated that Welsh language lessons were the least enjoyable subject among pupils. The current research aimed to unpick pupil experiences in order to add to the policy development context. To achieve this, forty-four pupils and four teachers in three schools from the larger WMS sample participated in focus groups. Participants from years 9, 11 and 13 who had indicated positive, negative and neutral attitudes towards the Welsh language in a previous WMS survey were selected. Questions were based on previous research exploring issues including, but not limited to pedagogy, policy, assessment, engagement and (teacher) training. A thematic analysis of the focus group recordings revealed that the majority of participants held positive views around keeping the language alive but did not want to take on responsibility for its maintenance. These views were almost entirely based on their experiences of learning Welsh at school, especially in relation to their perceived lack of choice and opinions around particular lesson strategies and assessment. Analysis of teacher interviews highlighted a distinct lack of resources (materials and staff alike) compared to modern foreign languages, which had a negative impact on student motivation and attitudes. Both staff and students indicated a need for more practical, oral language instruction which could lead to Welsh being used outside the classroom. The data corroborate many of the review’s previous findings, but what makes this research distinctive is the way in which pupils poignantly address generally misguided aims for Welsh language instruction, poor pedagogical practice and a general disconnect between Welsh instruction and its daily use in their lives. These findings emphasize the complexity of incorporating the educational sector in strategies for Welsh language maintenance and the complications arising from pedagogical training, support, and resources, as well as teacher and pupil perceptions of, and attitudes towards, teaching and learning Welsh.

Keywords: bilingual education, language maintenance, language revitalisation, minority languages, Wales

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6298 The Effects of Eight Weeks of Interval Endurance Training on hs-CRP Levels and Anthropometric Parameters in Overweight Men

Authors: S. Khoshemehry, M. J. Pourvaghar

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Inflammatory markers are known as the main predictors of cardiovascular diseases. This study aimed at determining the effect of 8 weeks of interval endurance training on hs-CRP level and some anthropometric parameters in overweight men. Following the call for participation in research project in Kashan, 73 volunteers participated in it and constituted the statistical population of the study. Then, 28 overweight young men from the age of 22 to 25 years old were randomly assigned into two groups of experimental and control group (n=14). Anthropometric and the blood sample was collected before and after the termination of the program for measuring hs-CRP. The interval endurance program was performed at 60 to 75% of maximum heart rate in 2 sessions per week for 8 weeks. Kolmogorov-Smirnov test was used to test whether two samples come from the same distribution and T-test was used to assess the difference of two groups which were statistically significant at the level of 0.05. The result indicated that there was a significant difference between the hs-RP, weight, BMI and W/H ratio of overweight men in posttest in the exercise group (P≤0.05) but not in the control group. Interval endurance training program causes decrease in hs-CRP level and anthropometric parameters.

Keywords: interval endurance training program, HS-CRP, overweight, anthropometric

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6297 The Effectiveness of Warm-Water Footbath on Fatigue in Cancer Patient Undergoing Chemotherapy

Authors: Yu-Wen Lin, Li-Ni Liu

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Introduction: Fatigue is the most common symptoms experienced by cancer patients undergoing chemotherapy. Patients receiving anticancer therapies develop a higher proportion of fatigue compared with patients who do not receive anticancer therapies. Fatigue has significant impacts on quality of life, daily activities, mood status, and social behaviors. A warm-water footbath (WWF) at 41℃ promotes circulation and removes metabolites resulting in improving sleep and relieving fatigue. The aim of this study is to determine the effectiveness of WWF for relieving fatigue with cancer patients undergoing chemotherapy. Materials and Methods: This is a single-center, prospective, quasi-experimental design study in the oncology ward in Taiwan. Participants in this study were assigned to WWF group as experimental group and standard care group as a control group by purposive sampling. In the WWF group, the participants were asked to soak their feet in 42-43℃ water 15 minutes for consecutive 6 days at one day before chemotherapy. Each participant was evaluated for fatigue level by the Taiwanese version of the Brief Fatigue Inventory (BFI-T). BFI-T was completed for consecutive 8 days of the study. The primary outcome was compared the BFI-T score of WWF group to the standard care group. Results: There were 60 participants enrolled in this study. Thirty participants were assigned to WWF group and 30 participants were assigned to standard care group. Both groups have comparable characteristic. The BFI-T scores of both groups were increased associated with the days of chemotherapy. The highest BFI-T scores of both groups were on the day 4 of chemotherapy. The BFI-T scores of both groups were decreased since day 5 and significantly decreased in WWF group on day 5 compared to standard care group (4.17 vs. 5.7, P < .05). At the end of the study the fatigue at its worse were significantly decreased in WWF group (2.33 vs. 4.37, P < .001). There was no adverse event reported in this study. Conclusion: WWF is an easy, safe, non-invasive, and relatively inexpensive nursing intervention for improving fatigue of cancer patients undergoing chemotherapy. In summary, this study shows the WWF is a simple complementary care method, and it is effective for improving and relieving fatigue in a short time. Through improving fatigue is a way to enhance the quality of life which is important for cancer patients undergoing chemotherapy. Larger prospective randomized controlled trial and long-term effectiveness and outcomes of WWF should be performed to confirm this study.

Keywords: chemotherapy, warm-water footbath, fatigue, Taiwanese version of the brief fatigue inventory

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