Search results for: group intervention

Authors: Malak Shawky

Abstract:

Introduction: Colorectal cancer constitutes about 7% of al cancers. Abdominal perineal resection remains the standard operation against which the results of lesser procedures are measured Patients and methods : This study included 48 patients presented With pathologically proved carcinoma of the lower third of the rectum and scheduled for abdominal perineal resection With total excision of the mesorectum. They were randomized into two groups as regard the technique of colostomy after abdominal perineal resection. A study group of 24 patients underwent this new technique in which the rectus abdomnal muscle was used for wrapping the distal end of the colon in a 270 degrees and fixing the muscle to the anterior rectus sheath. A control group of 24 patients who underwent colostomy by the classical transrectal technique. Results : The use of a distal rectus muscle sling surrounding the stoma by 270 degrees achieved continence for solid stool in 12 patients of the study group compared to no patients In control group. 10 patients were able to avoid wearing colostomy appliance by day but still have to wear them by night, Patients have to wear the colostomy bags when they had diarrhea especially when they were receiving chemotherapy. One case had post post operative wound infection and gaping managed by debridment and secondary sutures without the need to remove the mesh. Manometrc studies for both control and study group showed : The average resting pressure was 40 mmHg in the study group compared to 15 mmHg in the control group. Conclusion : Continent Colostomy is a promising tool for quality of ife for abdomnal oerineal resection oatlents and a hooe of normal life for them.

Keywords: colostomy, rectum, resection, rectus

Procedia PDF Downloads 5

Authors: Dawid Jakimiuk, Krzysztof Mitura, Leszek Szpakowski, Sławomir Pilip, Daniel Celiński

Abstract:

The Emergency Medical Teams (EMS) of the Ambulance Service in Siedlce serve the population living in the Mazowieckie Voivodeship (the area of eastern Poland with approximately 550,000 inhabitants). They provide health services at the pre-hospital stage to all life-threatening patients. The analysis covered the interventions of emergency medical teams in cases of suicide attempts that occurred in the years 2015-2018. The study was retrospective. The data was obtained on the basis of digital medical records of completed call-outs. When defining the disease entity, the International Statistical Classification of Diseases and Health Problems ICD-10 prepared by WHO was used. The relationship between selected disease entities and the area of EMT intervention, the patient's sex and age, and the time of occurrence of the event were investigated. Non-urban area was defined as the area inhabited by a population below 10,000 residents. Statistical analysis was performed using Pearson's Chi ^ 2 test and presenting the percentage of cases in the study group. Of all the suicide attempts, drug abuse cases were the most frequent, including: X60 (Intentional self-poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics); X61 (Intentional self-poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonian and psychotropic drugs, not elsewhere classified); X62 (Intentional self-poisoning by and exposure to narcotics and psycholeptics [hallucinogens], not elsewhere classified); X63 (Intentional self-poisoning by and exposure to other drugs acting on the autonomic nervous system); X64 (Intentional self-poisoning by and exposure to other and unspecified drugs, medicaments and biological substance) oraz X70 (Intentional self-harm by hanging, strangulation and suffocation). In total, they accounted for 69.4% of all interventions to suicide attempts in the studied period. Statistical analysis shows significant differences (χ2 = 39.30239, p <0.0001, n = 561) between the area of EMT intervention and the type of suicide attempt. In non-urban areas, a higher percentage of X70 diagnoses was recorded (55.67%), while in urban areas, X60-X64 (72.53%). In non-urban areas, a higher proportion of patients attempting suicide was observed compared to patients living in urban areas. For X70 and X60 - X64 in total, the incidence rates in non-urban areas were 80.8% and 56%, respectively. Significant differences were found (χ2 = 119.3304, p <0.0001, n = 561) depending on the method of attempting suicide in relation to the patient's sex. The percentage of women diagnosed with X60-X64 versus X70 was 87.50%, which was the largest number of patients (n = 154) as compared to men. In the case of X70 in relation to X60-X64, the percentage of men was 62.08%, which was the largest number of patients (n = 239) as compared to women (n = 22). In the case of X70, the percentage of men compared to women was as high as 92%. Significant differences were observed (χ2 = 14.94848, p <0.01058) between the hour of EMT intervention and the type of suicide attempt. The highest percentage of X70 occurred between 04:01 - 08:00 (64.44%), while X60-X64 between 00:01 - 04:00 (70.45%). The largest number of cases of all tested suicide attempts was recorded between 16:01 - 20:00 for X70 (n = 62), X60 - X64 (n = 82), respectively. The highest percentage of patients undertaking all suicide attempts studied at work was observed in the age range of 18-30 (31.5%), while the lowest was in the age group over 60 years of age. (11%). There was no significant correlation between the day of the week or individual months of the year and the type of suicide attempt - respectively (χ2 = 6.281729, p <0.39238, n = 561) and (χ2 = 3.348913, p <0.9857, n = 561). There were also no significant differences in the incidence of suicide attempts for each year in the study period (χ2 = 3.348913, p <0.9857 n = 561). The obtained results suggest the necessity to undertake preventive measures in order to minimize the number of suicide attempts. Such activities should be directed especially at young patients living in non-urban areas.

Keywords: emergency med, emergency medical team, attempted suicide, pre-hospital

Procedia PDF Downloads 92

Authors: Masoud Abbasalipour

Abstract:

In this study, the impact of family status on individuals, involving factors such as parents' literacy level, family size, individuals' blood group, and susceptibility to addiction, was investigated. Statistical tests were employed to scrutinize the relationships among these specified factors. The statistical population of the study consisted of 338 samples divided into two groups: individuals with addiction and those without addiction in the city of Amol. The addicted group was selected from individuals visiting the substance abuse treatment center in Amol, and the non-addicted group was randomly selected from individuals in urban and rural areas. The Chi-square test was used to examine the presence or absence of relationships among the variables, and Kramer's V test was employed to determine the strength of the relationship between them. Excel software facilitated the initial entry of data, and SPSS software was utilized for the desired statistical tests. The research results indicated a significant relationship between the variable of parents' education level and individuals' addiction. The analysis showed that the education level of their parents was significantly lower compared to non-addicted individuals. However, the variables of the number of family members and blood group did not significantly impact individuals' susceptibility to addiction.

Keywords: addiction, blood group, parents' literacy level, family status

Procedia PDF Downloads 69

Authors: P. G. Romeo

Abstract:

A Lie group is a highly sophisticated structure which is a smooth manifold whose underlying set of elements is equipped with the structure of a group such that the group multiplication and inverse-assigning functions are smooth. This structure was introduced by the Norwegian mathematician So- phus Lie who founded the theory of continuous groups. The Lie groups are well developed and have wide applications in areas including Mathematical Physics. There are several advances and generalizations for Lie groups and Lie groupoids is one such which is termed as a "many-object generalization" of Lie groups. A groupoid is a category whose morphisms are all invertible, obviously, every group is a groupoid but not conversely. Definition 1. A Lie groupoid G ⇒ M is a groupoid G on a base M together with smooth structures on G and M such that the maps α, β: G → M are surjective submertions, the object inclusion map x '→ 1x, M → G is smooth, and the partial multiplication G ∗ G → G is smooth. A bundle is a triple (E, p, B) where E, B are topological spaces p: E → B is a map. Space B is called the base space and space E is called total space and map p is the projection of the bundle. For each b ∈ B, the space p−1(b) is called the fibre of the bundle over b ∈ B. Intuitively a bundle is regarded as a union of fibres p−1(b) for b ∈ B parametrized by B and ’glued together’ by the topology of the space E. A cross-section of a bundle (E, p, B) is a map s: B → E such that ps = 1B. Example 1. Given any space B, a product bundle over B with fibre F is (B × F, p, B) where p is the projection on the first factor. Definition 2. A principal bundle P (M, G, π) consists of a manifold P, a Lie group G, and a free right action of G on P denoted (u, g) '→ ug, such that the orbits of the action coincide with the fibres of the surjective submersion π : P → M, and such that M is covered by the domains of local sections σ: U → P, U ⊆ M, of π. Definition 3. A Lie group bundle, or LGB, is a smooth fibre bundle (K, q, M ) in which each fibre (Km = q−1(m), and the fibre type G, has a Lie group structure, and for which there is an atlas {ψi: Ui × G → KUi } such that each {ψi,m : G → Km}, is an isomorphism of Lie groups. A morphism of LGB from (K, q, M ) to (K′, q′, M′) is a morphism (F, f ) of fibre bundles such that each Fm: Km → K′ is a morphism of Lie groups. In this paper, we will be discussing the Lie groupoid bundles. Here it is seen that to a Lie groupoid Ω on base B there is associated a collection of principal bundles Ωx(B, Ωx), all of which are mutually isomorphic and conversely, associated to any principal bundle P (B, G, p) there is a groupoid called the Ehresmann groupoid which is easily seen to be Lie. Further, some interesting properties of the category of Lie groupoids and bundles will be explored.

Keywords: groupoid, lie group, lie groupoid, bundle

Procedia PDF Downloads 77

Authors: R. N. Nataria, A. D. Paryuni, R. Wasito

Abstract:

Layer farms in Indonesia have still obstacles to increasing their productivity, especially due to poultry diseases. The red onion (Allium ascalonicum L.) is a plant that contains flavonoid and saponin. Flavonoid is useful as anti-inflammatory and antioxidant while saponin is useful as antivirus, anti-inflammatory, antifungal, and immunomodulator. This study aimed to know and determine the effect of onion extracts to pulmonary histopathological lesions in layer chickens which raised in the battery cage. This study used eighteen layer chickens at seventeen days old. The eighteen layer chickens were divided into three groups of six each, namely without administration of red onion extract (Group I), with administration red onion extract through drinking water (Group II) and with administration red onion extract peroral (Group III). Every ten days, six chickens were necropsied and then the lungs were processed for histopathological preparations and stained with routine hematoxylin and eosin. The results showed that the lungs of the Group I had severe congestion and diffuse hemorrhages. In Group II, lungs had moderate congestion and hemorrhages. In group III, lungs had mild congestion and hemorrhages. It is concluded, that red onion extract apparently has reduced the lungs lesions in layer chickens.

Keywords: histopathological lesions, layers, lungs, poultry diseases, red onion extract

Procedia PDF Downloads 448

Authors: Farah Ali, Tehreem Fiayyaz, Laeeq Akbar Lodhi, Imran Mirza

Abstract:

The present work was undertaken to investigate effects of various extracts of W. somnifera (WS) for anti-diabetic activity in alloxan induced diabetic rabbits. Animals were divided into nine groups of six rabbits each. The animals of group 1 and 2 were given lactose (250 mg/kg, p.o) and WS root powder (100 mg/kg, p.o) respectively daily from day 1-20. Animals of group 3 were given alloxan (100 mg/kg, i.v) as a single dose on day 1. Powdered root of WS in the doses of 100, 150, 200 mg/kg and its aqueous (AWS) and ethanol extracts (EWS) (equivalent to 200 mg/kg of crude drug) were given to the treated animals (groups 4-8), respectively orally for three weeks (day 1-20 o.d), along with alloxan (100 mg/kg, i.v) as a single dose on day 1. Group 9 was given metformin (200 mg/kg) daily from day 1-20, along with a single dose of alloxan (100 mg/ kg, i.v) on day 1. Fasting serum glucose concentration in groups 3-9 was increased significantly (p<0.05) on day 3 as compared to normal control (NC) group (1). WS (100, 150, 200 mg/kg, p.o) decreased the fasting serum glucose concentration, with a maximum decrease (88.3 mg/dl) in group 2 (treated control) on day 21 of the experiment. These results indicate that metformin (reference control), (AWS) and (EWS) significantly antagonized the diabetic effects of alloxan.

Keywords: diabetes, serum, glucose, blood, sugar, rabbits

Procedia PDF Downloads 653

Authors: Karitikeya Sonker

Abstract:

Religion as a discrete system through its lawful internal working produces an output in the form of realised spatial order with its social logic and a social order with its spatial logic. Thus, it appears to exhibit its duality of spatial and trans-spatial. The components of this system share a relevance forming a collective. This shared relevance creates meaning forming a group where all collectives share one identity. This group with its new social order and its spatial logic revive the already existing spatial order. These religious groups do so having a tendency to expand resulting in the production of space in a situation of encounter where they have found relevance. But an encounter without a lawful internal working of a discrete system results in anomaly because groups do not find relevance due to the absence of collective identity. Events happen all around. One of the main reasons we could say that something became an event is because of conflict. Conflict not in its definitive sense but any occurrence that happens because of an intervention that creates an event worth remembering. The unfolding of such events creates Cities and Urban spaces which exhibit their duality of spatial and trans-spatial by behaving as a discrete system. This system through its lawful internal working produces an output in the form of realized spatial order with its social logic and a social order with spatial logic. The components of this system form a collective through a shared a relevance. This shared relevance creates meaning forming a group where all collectives share one identity. This group with its new social order and its spatial logic revives the already existing spatial order. These groups do so having a tendency to expand resulting in the production of space in a situation of encounter where they have found relevance. But an encounter without a lawful internal working of the discrete system results in anomaly because groups do not find relevance due to the absence of collective identity. This paper makes an effort to explore one such even in the case of Babri Mosque and Ramjanmabhumi, Ayodhya to explain the anomaly as transposition of social and spatial. The paper through the case studies makes an attempt to generate an equation explaining the two different situations of religious encounters, former reviving the social and spatial order and the other resulting in anomaly. Through the case study, it makes an attempt to generate an equation explaining the two different situations of religious encounters, former reviving the social and spatial order and the other resulting in anomaly.

Keywords: Babri Masjid, Ayodhya, conflict, religion

Procedia PDF Downloads 275

Authors: Mazin Alqhazo, Ayat Bani Rashaid

Abstract:

This study examines the levels of dopamine and serotonin in blood samples of children who stutter compared with normal fluent speakers. Blood specimens from 50 children who stutter (6 females, 44 males) and 50 normal children matched age and gender were collected for the purpose of the current study. The concentrations of dopamine and serotonin were measured using the 1100 series high-performance liquid chromatography coupled with ultraviolet detector instrument (HPLC-UV). It was revealed that dopamine level in the blood samples of stuttering group and fluent group was not significant (P = 0.769), whereas the level of serotonin was significantly higher in the blood samples of stuttering group than the blood samples of fluent normal group (P = 0.015). It is concluded that serotonin blockers could be used in future studies to evaluate its role as a medication for the treatment of stuttering.

Keywords: dopamine, serotonin, stuttering, fluent speakers

Procedia PDF Downloads 159

Authors: Ali Kamal M. Sami, Safa Almukhtar, Alaa Al-Krush, Ismael Hama-Amin Akha Weas, Ruqaya Ahmed Alqais

Abstract:

Introduction and Objectives Lower urinary tract symptoms (LUTS) are common among men with benign prostatic hyperplasia (BPH). The combination of 5 alpha-reductase inhibitors and alpha-blockers has been used as a conservative treatment of male LUTS secondary to BPH. Nanotechnology structured water magnalife is a type of water that is produced by modulators and specific frequency and energy fields that transform ordinary water into this Nanowater. In this study, we evaluated the use of Nano-water with the conservative treatment and to see if it improves the outcome and gives better results in those patients with LUTS/BPH. Material and methods For a period of 3 months, 200 men with International Prostate Symptom Score (IPSS)≥13, maximum flow rate (Qmax)≤ 15ml/s, and prostate volume > 30 and <80 ccs were randomly divided into two groups. Group A 100 men were given Nano-water with the (tamsulosindutasteride) and group B 100 men were given ordinary bottled water with the (tamsulosindutasteride). The water bottles were unlabeled and were given in a daily dose of 20ml/kg body weight. Dutasteride 0.5mg and tamsulosin 0.4 mg daily doses. Both groups were evaluated for the IPSS, Qmax, Residual Urine (RU), International Index of Erectile Function–Erectile Function (IIEF-EF) domain at the beginning (baseline data), and at the end of the 3 months. Results Of the 200 men with LUTS who were included in this study, 193 men were followed, and 7 men dropped out of the study for different reasons. In group A which included 97 men with LUTS, IPSS decreased by 16.82 (from 20.47 to 6.65) (P<0.00001) and Qmax increased by 5.73 ml/s (from 11.71 to 17.44) (P<0.00001) and RU <50 ml in 88% of patients (P<0.00001) and IIEF-EF increased to 26.65 (from 16.85) (P<0.00001). While in group B, 96 men with LUTS, IPSS decreased by 8.74(from 19.59 to 10.85)(P<0.00001) and Qmax increased by 4.67 ml/s(from 10.74 to 15.41)(P<0.00001), RU<50 ml in 75% of patients (P<0.00001), and IIEF-EF increased to 21(from 15.87)(P<0.00001). Group A had better results than group B. IPSS in group A decreased to 6.65 vs 10.85 in group B(P<0.00001), also Qmax increased to 17.44 in group A vs 15.41 in group B(P<0.00001), group A had RU <50 ml in 88% of patients vs 75% of patients in group B(P<0.00001).Group A had better IIEF-EF which increased to 26.65 vs 21 in group B(P<0.00001). While the differences between the baseline data of both groups were statistically not significant. Conclusion The use of nanotechnology structured water magnalife gives a better result in terms of LUTS and scores in patients with BPH. This combination is showing improvements in IPSS and even in erectile function in those men after 3 months.

Keywords: nano water, lower urinary tract symptoms, benign prostatic hypertrophy, erectile dysfunction

Procedia PDF Downloads 71

Authors: Sergio Luna, Raquel Rodríguez-Carvajal

Abstract:

This research examines the effectiveness of a mindfulness-based intervention in optimizing psychological well-being, with a particular focus on self-esteem, due to the rapid growth and consolidation of social network use and the increased frequency and intensity of upward comparisons of the self. The study aims to assess the potential of a mindfulness-based intervention to improve self-esteem and, in particular, to contribute to its greater stability by reducing levels of contingent self-esteem. Results show that an 8-week mindfulness-based stress reduction program was effective in increasing participants' (n=206) trait mindfulness, explicit self-esteem, and well-being, while decreasing contingent self-esteem. Furthermore, the study found that improvements in both explicit and contingent self-esteem were significantly correlated with increases in psychological well-being, but that contingent self-esteem had a stronger effect on well-being than explicit self-esteem. These findings highlight the importance of considering additional dimensions of self-esteem beyond levels, and suggest that mindfulness-based interventions may be a valuable tool for promoting a healthier form of self-esteem that contributes to personal well-being.

Keywords: MBSR, contingent self-esteem, explicit self-esteem, well-being

Procedia PDF Downloads 85

Authors: Genziana Lay

Abstract:

A wide majority of older children and adolescents who enter the juvenile court system present with an array of problematic symptoms and behaviors including anxiety, depression, aggressive acting out, detachment, and substance abuse. Attachment theory offers a framework for understanding normative and pathological functioning, which during development is influenced by emotional, social and cognitive elements. There is clear evidence that children and adolescents with the highest risk of developing adaptation problems present an insecure attachment profile. Most offending minors have experienced dysfunctional family relationships as well as social and/or economic deprivation. Their maladaptive attachment develops not only through their relationship with caregivers but with the environment at large. Activation of their faulty attachment system leads them to feel emotionally overwhelmed and engage in destructive behaviors and decision-making. A psycho-social intervention with this population conceptualized as attachment therapy is a multi-faceted, practical approach that has shown excellent results in terms of increased psychological well-being and drastically reduced rates of re-offense/ destructive behavior. Through several; components including psychotherapy, monitoring, volunteering, meditation and socialization, the program focuses on seven dimensions: self-efficacy, responsibility, empathy/reparation, autonomy/security, containment/structure, insight building, and relational health. This paper presents the program and illustrates how the framework of attachment theory practically applied to psycho-social intervention has great therapeutic and social reparation potential. Preliminary evidence drawn from the Sassari Juvenile Court is very promising; this paper will illustrate these results and propose an even more comprehensive, applicable approach to psycho-social reparative intervention that leads to greater psychological health and reduced recidivism in the child and adolescent population.

Keywords: attachment, child, adolescent, crime, juvenile, psychosocial

Procedia PDF Downloads 172

Authors: Lourenço José, Elsa Melo, Sandra Viera, Ana Pinheiro

Abstract:

Introduction: People with stroke in Angola face challenges in accessing appropriate healthcare and rehabilitation services. There is a lack of information on the quality of care provided and the development of early intervention plans Methods: Two different methods will be chosen. The exploratory, descriptive, and longitudinal study (E1) to characterize health care for people with stroke, housed in 2 hospitals in Luanda; the quality and transverse study (E2) concerning the development and evaluation of a strategic early intervention plan for a stroke patient. Ethical and deontological principles for an investigation will be proposed. Results: Contributor to the knowledge of the reality of providing care to the person after a stroke, in Angola; Propose and develop an early action plan. Contribute to integration to influence policy makers on the need for assistance with stroke, aiming at their functional, family and social rehabilitation, particularly in the labor market.

Keywords: stroke, functional recovery, quality of life, health

Procedia PDF Downloads 35

Authors: Yea-Pyng Lin

Abstract:

Evidence-based nursing (EBN) can improve quality of patient care and reduce medical expenses. Development of training and consultation program according to nurses’ needs and difficulties is essential to promote their competence and self-efficacy in EBN. However, limited research evaluated the effects of EBN program on EBN self-efficacy among nurses. This study aimed to evaluate the effects of an EBN consultation program on self-efficacy and outcome expectancy of evidence-based practice (EBP) among nurses. A two-group pretest-posttest quasi-experimental design was used. A purposive sample of full-time nurses was recruited from a hospital. Experimental group (n=28) received the EBN consultation program including 18-hour EBN training courses, hand-on practices and group discussion by faculty mentors. Control group (n=33) received regular in-service education with no EBN program. All participants received baseline and post-test assessment using Chinese version of Self-Efficacy in EBP scale (SE-EBP) and Outcome Expectancy for EBP scale (OE-EBP). After receiving EBN consultation program, experimental group’s posttest scores of SE-EBP (t=-4.98, p<0.001) and OE-SEP (t=-3.65, p=0.001) were significantly higher than those of the pretests. By controlling the age and years of nursing work experience, the experimental group‘s SE-EBP(F=10.47, p=0.002) and OE-SEP(F=9.53, p=0.003) scores were significantly improved compared to those of the control group. EBN program focus on hand-on practice and group discussion by faculty mentors in addition to EBN training courses can improve EBP self-efficacy and outcome expectancy among nurses. EBN program focus on English literature reading, database searching, and appraisal practice according to nurses’ needs and difficulties can promote implementation of EBN.

Keywords: evidence-based nursing, evidence-based practice, consultation program, self-efficacy, outcome expectancy

Procedia PDF Downloads 500

Authors: Shenaz Ahmed, Hussain Jafri, Muhammed Faran, Wajeeha Naseer Ahmed, Yasmin Rashid, Yasmin Ehsan, Shabnam Bashir, Mushtaq Ahmed

Abstract:

Low uptake of cascade screening for βeta-Thalassaemia Major (β-TM) in the ‘Punjab Thalassaemia Prevention Project’ (PTPP) in Pakistan led to the development of a ‘decision support intervention for relatives’ (DeSIRe). This paper presents the experiences of relatives of children with β-TM of the DeSIRe following its use by PTPP field officers in routine clinical practice. Fifty-four semi-structured qualitative interviews were conducted (April to June 2021) with relatives in seven cities in the Punjab province (Lahore, Sheikhupura, Nankana Sahab, Kasur, Gujranwala, Multan, and Faisalabad). Thematic analysis shows that participants were satisfied with the content of the DeSIRe and its delivery by the field officers in a family meeting. They understood the main purpose of the DeSIRe was to improve their knowledge of β-TM and its inheritance, to enable them to make decisions about thalassemia carrier testing, particularly before marriage. While participants raised concerns about the stigma of testing positive, they believed the DeSIRe was an appropriate intervention, which supported relatives to make informed decisions. Our findings show the DeSIRe is appropriate for use by healthcare professionals in routine practice in a low-middle income country and has the potential to facilitate shared decision-making about cascade screening for thalassemia. Further research is needed to prove the efficacy of the DeSIRe.

Keywords: thalassemia, Pakistan, cascade screening, decision support

Procedia PDF Downloads 240

Authors: Jayeon Kim, Eunjung Yu, Taeki Yoon

Abstract:

Most spontaneous miscarriage is believed to be a consequence of embryo aneuploidies. Transferring eukaryotic embryos selected by PGS is expected to decrease the miscarriage rate. Current PGS indications include advanced maternal age, recurrent pregnancy loss, repeated implantation failure. Recently, use of PGS for healthy women without above indications for the purpose of improving in vitro fertilization (IVF) outcomes is on the rise. However, it is still controversy about the beneficial effect of PGS in this population, especially, in women with a history of no more than 2 miscarriages or miscarriage of eukaryotic abortus. This study aimed to investigate if karyotyping result of abortus is a good indicator of preimplantation genetic screening (PGS) in subsequent IVF cycle in women with a history of spontaneous abortion. A single-center retrospective cohort study was performed. Women who had spontaneous abortion(s) (less than 3) and dilatation and evacuation, and subsequent IVF from January 2016 to November 2016 were included. Their medical information was extracted from the charts. Clinical pregnancy was defined as presence of a gestational sac with fetal heart beat detected on ultrasound in week 7. Statistical analysis was performed using SPSS software. Total 234 women were included. 121 out of 234 (51.7%) underwent karyotyping of the abortus, and 113 did not have the abortus karyotyped. Embryo biopsy was performed on 3 or 5 days after oocyte retrieval, followed by embryo transfer (ET) on a fresh or frozen cycle. The biopsied materials were subjected to microarray comparative genomic hybridization. Clinical pregnancy rate per ET was compared between PGS and non-PGS group in each study group. Patients were grouped by two criteria: karyotype of the abortus from previous miscarriage (unknown fetal karyotype (n=89, Group 1), eukaryotic abortus (n=36, Group 2) or aneuploidy abortus (n=67, Group 3)), and pursuing PGS in subsequent IVF cycle (pursuing PGS (PGS group, n=105) or not pursuing PGS (non-PGS group, n=87)). The PGS group was significantly older and had higher number of retrieved oocytes and prior miscarriages compared to non-PGS group. There were no differences in BMI and AMH level between those two groups. In PGS group, the mean number of transferable embryos (eukaryotic embryo) was 1.3 ± 0.7, 1.5 ± 0.5 and 1.4 ± 0.5, respectively (p = 0.049). In 42 cases, ET was cancelled because all embryos biopsied turned out to be abnormal. In all three groups (group 1, 2, and 3), clinical pregnancy rates were not statistically different between PGS and non-PGS group (Group 1: 48.8% vs. 52.2% (p=0.858), Group 2: 70% vs. 73.1% (p=0.730), Group 3: 42.3% vs. 46.7% (p=0.640), in PGS and non-PGS group, respectively). In both groups who had miscarriage with eukaryotic and aneuploidy abortus, the clinical pregnancy rate between IVF cycles with and without PGS was not different. When we compare miscarriage and ongoing pregnancy rate, there were no significant differences between PGS and non-PGS group in all three groups. Our results show that the routine application of PGS in women who had less than 3 miscarriages would not be beneficial, even in cases that previous miscarriage had been caused by fetal aneuploidy.

Keywords: preimplantation genetic diagnosis, miscarriage, kpryotyping, in vitro fertilization

Procedia PDF Downloads 181

Authors: László L. Lippai

Abstract:

In addition to the fact that mental health bears great significance to a particular individual, it can also be regarded as an organizational, community and societal resource. Within the Szeged Health Promotion Research Group, we conducted mental health surveys on two levels: The inhabitants of a medium-sized Hungarian town and students of a Hungarian university with a relatively big headcount were requested to participate in surveys whose goals were to define local government priorities and organization-level health promotion programmes, respectively. To facilitate professional decision-making, we defined three, pragmatically relevant, groups of the target population: the mentally healthy, the vulnerable and the endangered. In order to determine which group a person actually belongs to, we designed a simple and quick measurement tool, which could even be utilised as a smoothing method, the Mental State Questionnaire validity of the above three categories was verified by analysis of variance against psychological quality of life variables. We demonstrate the pragmatic significance of our method via the analyses of the scores of our two mental health surveys. On town level, during our representative survey in Hódmezővásárhely (N=1839), we found that 38.7% of the participants was mentally healthy, 35.3% was vulnerable, while 16.3% was considered as endangered. We were able to identify groups that were in a dramatic state in terms of mental health. For example, such a group consisted of men aged 45 to 64 with only primary education qualification and the ratios of the mentally healthy, vulnerable and endangered were 4.5, 45.5 and 50%, respectively. It was also astonishing to see to what a little extent qualification prevailed as a protective factor in the case of women. Based on our data, the female group aged 18 to 44 with primary education—of whom 20.3% was mentally healthy, 42.4% vulnerable and 37.3% was endangered—as well as the female group aged 45 to 64 with university or college degree—of whom 25% was mentally healthy, 51.3 vulnerable and 23.8% endangered—are to be handled as priority intervention target groups in a similarly difficult position. On organizational level, our survey involving the students of the University of Szeged, N=1565, provided data to prepare a strategy of mental health promotion for a university with a headcount exceeding 20,000. When developing an organizational strategy, it was important to gather information to estimate the proportions of target groups in which mental health promotion methods; for example, life management skills development, detection, psychological consultancy, psychotherapy, would be applied. Our scores show that 46.8% of the student participants were mentally healthy, 42.1% were vulnerable and 11.1% were endangered. These data convey relevant information as to the allocation of organizational resources within a university with a considerable headcount. In conclusion, The Mental State Questionnaire, as a valid smoothing method, is adequate to describe a community in a plain and informative way in the terms of mental health. The application of the method can promote the preparation, design and implementation of mental health promotion interventions. 

Keywords: health promotion, mental health promotion, mental state questionnaire, psychological well-being

Procedia PDF Downloads 295

Authors: Corbel Camille, Le Cerf Flora, Capriz Françoise, Vaillant-Ciszewicz Anne-Julie, Breaud Jean, Guerin Olivier, Corveleyn Xavier

Abstract:

Background: The medical environment can generate stressful and anxiety-provoking situations for patients, particularly during painful care procedures for the older population. These stressful environments have deleterious effects on the quality of care and can even put the patient at risk and set the care team up for failure. The search for a solution is, therefore, imperative. The development of new technologies, such as virtual reality (VR), seems to be an answer to this problem. Objectives: The objective of this study is to compare the effects of virtual reality on pain and anxiety when caring for older hospitalized people with the effects of usual care. More precisely, different individual factors (age, cognitive level, individual preferences, etc.) and different virtual reality universes (personalized or non-personalized) are studied to understand the role of these factors in reducing pain and anxiety during care procedures. The aim of this study is to improve the quality of life of patients and caregivers in their work environment. Method: This mono-centered, randomized, controlled study was conducted from September 2023 to September 2024 on 120 participants recruited from the geriatric departments of the Cimiez Hospital, Nice, France. Participants are randomized into three groups: a control group, a personalized VR group and a non-personalized VR group. Each participant is followed during a painful care session. Data are collected before, during and after the care, using measures of pain (Algoplus and numerical scale) and anxiety (Hospital anxiety scale and numerical scale). Physiological assessments with an oximeter are also performed to collect both heart and respiratory rate measurements. The implementation of the care will be assessed among healthcare providers to evaluate its effects on the difficulty and fatigue associated with the care. Additionally, a questionnaire (System Usability Scale) will be administered at the conclusion of the study to determine the willingness of healthcare providers to integrate VR into their daily care practices. Result: The preliminary results indicate significant effects on anxiety (p=.001) and pain (p=<.001) following the VR intervention during care, as compared to the control group. Conclusion: The preliminary results suggest that VRI appears to be a suitable and effective method for reducing anxiety and pain among older hospitalized individuals compared with standard care. Finally, the experiences of healthcare professionals involved will also be considered to assess the impact of these interventions on working conditions and patient support.

Keywords: anxiety, care, pain, older adults, virtual reality

Procedia PDF Downloads 73

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

Procedia PDF Downloads 423

Authors: Alison Ryan, Himani Chhabra, Mohammed Dungarwalla, Judith Jones

Abstract:

Background: Impacted and ectopic teeth present in 1-2% of orthodontic patients and often require joint surgical and orthodontic management. The authors present two patients undergoing orthodontic treatment, where the impacted teeth, in a hopeless position, spontaneously erupted during the period of cessation of general anaesthetic lists during the COVID-19 pandemic. Patient information: A healthy 11-year-old boy was referred to the Department of Oral and Maxillofacial Surgery for the management of a mesioangular impacted LR7. The patient was seen by the joint oral surgery/orthodontic team, who planned for the removal of the LR7 under general anaesthetic. A healthy 13-year-old boy was referred to the same Department and team for surgical extraction of unerupted and buccally impacted UL3 and UR3 under general anaesthetic. Management and outcome: The majority of elective dental-alveolar work ceased as a result of the global pandemic. On resumption of activity, the first patient was reviewed in July 2021. The LR7 had spontaneously erupted in a favourable position, and following MDT review, a decision was made to forgo any further surgical intervention. The second patient was reviewed in July 2021. The UL3 had clinically erupted, and there was radiographic evidence of favourable movement of UR3. Due to the nature of the patient’s malocclusion, the decision was made to proceed with the extractions as previously planned. Key Learning Points: Severely impacted teeth do have a prospect of spontaneous eruption or alignment without clinical intervention, and current literature states the initial location, axial inclination, degree of root formation, and relation of the impacted tooth to adjacent teeth roots may influence spontaneous eruption. There is potential to introduce a period of observation to account for this possibility in the developing dentition, with the aim of reducing the unnecessary need for surgical intervention. This could help prevent episodes of general anaesthetic and allocate theatre space more appropriately.

Keywords: spontaneous eruption, impaction, observation, hopeless position, surgical, orthodontic, change in treatment plan

Procedia PDF Downloads 81

Authors: Sam Teek Ling, Norhashidah Hj. Mohd. Ali

Abstract:

We investigate the formulation and implementation of new explicit group iterative methods in solving the two-dimensional Poisson equation with Dirichlet boundary conditions. The methods are derived from a fourth order compact nine point finite difference discretization. The methods are compared with the existing second order standard five point formula to show the dramatic improvement in computed accuracy. Numerical experiments are presented to illustrate the effectiveness of the proposed methods.

Keywords: explicit group iterative method, finite difference, fourth order compact, Poisson equation

Procedia PDF Downloads 432

Authors: Jingjing Li, Shifu Wang

Abstract:

After the irreversible consequences of the traditional renewal mode of ‘function first and then beautification’, such as the constructive destruction, social differentiation, and cultural, ecological imbalance, the renewal of the historical urban area began to pay attention to the excavation of cultural connotation, and entered a new stage from the pursuit of ‘quantity’ growth to the promotion of ‘quality’, expecting to rejuvenate the old city through the intervention of public art. This paper interprets the cases at home and abroad, summarizes the different forms of expression and application strategies of public art in the renewal of historical urban areas, and combs the limitations of the existing practice in Guangzhou through observation. Finally, it puts forward suggestions from three aspects of the system, implementation strategy, and implementation path, respectively, and explores the path of simultaneous rejuvenation of material space and cultural space in historical urban areas under the intervention of public art.

Keywords: public art, historic city, public space, renewal activation

Procedia PDF Downloads 135

Authors: R. Echeverría Echeverría, C. Carrillo Trujillo, N. Evia Alamilla

Abstract:

Today, bullying is an expression of violence. It is a present problem in different contexts. Bullying and harassment have become subject matter of professional psychology , anthropology and other social sciences and related areas. However, most research on bullying have focused on peer violence and basic education. There is little attention to harassment in higher education. It also has little generation of research and interventions in universities, undergraduate and postgraduate level. The aim of this paper is to present a proposal for intervention to the attention of college students who have had an experience of harassment and / or bullying in a Public University of Merida, Yucatan, Mexico. The methodology was qualitative phenomenological. Semiestructura interview techniques and focus groups were used. 6 students participated who have lived harassment or bullying. Also they are participating teachers and university leaders who play an important role in the presence of such cases. The purpose is to analyze the presence of policies for the prevention, treatment and punishment of those problems. The qualitative data analysis will be based on the general proposal of Rodriguez Gomez Gil Flores and García Jiménez (1999). The results show the need to create a body entrusted to provide timely attention to cases of bullying or harassment that are reported. It is important to take legal and psychological support of the University authorities. It is proposed to create a mechanism to ensure timely care and not victimized who has had the experience; in addition to the punishment of those who exercised to ensure that violence. In discussing the successes and failures of the proposal are highlighted. And the processes that have been facilitated or hampered progress for the project.

Keywords: bullying, harassment, intervention, public university

Procedia PDF Downloads 303

Authors: A. K. Srivastva

Abstract:

Body weight is considered as an important factor in health and fitness. It is an index of one's health. Considering significance of body weight and its wider application in various fields in general and sports in particular, it is made a point of enquiry in the present study. The purpose of the study to observe over all weight pattern of Indian youths in the age group of 15 through 20 years. Total 7500 samples pooled from ten Indian states ranging in their age 15 to 20 years were examined in six age categories. Conclusion: 1. The period between 15 to 20 year of age is a growing period and that body weight is gained during this period. 2. Statewise difference is observed in body-weight during the period, which is significant. 3. PRG indicated by higher rate of weight gain varies from state to state. 4. Sportsman possess comparatively higer level of body-weight than other student of same age group. 5. Tribal youths show comparatively better status in their weight gain than the untrained uraban dwellers.

Keywords: PRG (period of rapid growth), HG (heterogeneous group), WP (weight pattern), MBW (mean body weight)

Procedia PDF Downloads 337

Authors: Mustafa Metin Donma

Abstract:

Obesity increases the risk of elevated blood pressure, which is a metabolic syndrome (MetS) component. Waist circumference (WC) is accepted as an indispensable parameter for the evaluation of these health problems. The close relationship of height with blood pressure values revealed the necessity of including height in tense indices. The association of tense indices with WC has also become an increasingly important topic. The purpose of this study was to develop a tense index that could contribute to differential diagnosis of MetS more than the indices previously introduced. One hundred and ninety-four children, aged 06-11 years, were considered to constitute four groups. The study was performed on normal weight (Group 1), overweight+obese (Group 2), morbid obese [without (Group 3) and with (Group 4) MetS findings] children. Children were included in the groups according to the recommendations of World Health Organization based on age- and gender dependent body mass index percentiles. For MetS group, MetS components well-established before were considered. Anthropometric measurements, as well as blood pressure values were taken. Tense indices were computed. The formula for the first tense index was (SP+DP)/2. The second index was Advanced Donma Tense Index (ADTI). The formula for this index was [(SP+DP)/2] * Height. Statistical calculations were performed. 0.05 was accepted as the p value indicating statistical significance. There were no statistically significant differences between the groups for pulse pressure, systolic-to-diastolic pressure ratio and tense index. Increasing values were observed from Group 1 to Group 4 in terms of mean arterial blood pressure and advanced Donma tense index (ADTI), which was highly correlated with WC in all groups except Group 1. Both tense index and ADTI exhibited significant correlations with WC in Group 3. However, in Group 4, ADTI, which includes height parameter in the equation, was unique in establishing a strong correlation with WC. In conclusion, ADTI was suggested as a tense index while investigating children with MetS.

Keywords: blood pressure, child, height, metabolic syndrome, waist circumference

Procedia PDF Downloads 56

Authors: Alaa F. A. Bakr, Sherein S. Abdelgayed, Osama. S. EL-Tawil, Adel M. Bakeer

Abstract:

Objective: This study was carried out to evaluate the cytotoxic and genotoxic effect of tartrazine in both male and female albino rats. Methodology: Forty adult male (20) and female (20) Sprague Dawley albino rats (120 - 150g) were obtained and distributed into four experimental groups; Group I; 10 untreated males, Group II; 10 untreated females, Group III; 10 treated males, and Group IV; 10 treated females. Body weight was recorded weekly, reduced glutathione (RGH), lipid peroxidation (SOD), and superoxide dismutase activity (MDA) in liver tissue were carried out, histopathological studies of brain, liver, and kidneys were performed, COMET assay was performed, all values were statistically analyzed. Results: Decrease in the activity of RGH and SOD in the treated groups were reported, but there was a more significant decrease in the female treated group. MDA was increased in treated groups with tartrazine, moreover, it was more significant in the female treated group. Multiple histological lesions were developed in brain, liver, and kidneys. COMET showed positive results. Conclusion: Our study concluded that Tartrazine has a cytotoxic and genotoxic effect on albino rats and it was more significant in females than males.

Keywords: tartrazine, cytotoxicity, genotoxicity, histopathology, albino rats

Procedia PDF Downloads 153

Authors: Jae Soo Do, Kyoung-Seok Kim

Abstract:

Radical changes in the industrial environment, and spectacular developments of IT have changed the current of managements from people-centered to technology- or IT-centered. Interpersonal emotion exchanges have long become insipid and interactive services have also come as mechanical reactions. This study offers various concepts for the emotional labor based on traditional studies on emotional labor. Especially the present day, on which human emotions are subject to being served as machinized thing, is the time when the study on human emotions comes momentous. Precedent researches on emotional labors commonly and basically dealt with the relationship between the active group who performs actions and the passive group who is done with the action. This study focuses on the passive group and tries to offer a new perspective of 'liquid emotion' as a defence mechanism for the passive group from the external environment. Especially, this addresses a concrete discussion on directions of following studies on the liquid labor as a newly suggested perspective.

Keywords: emotion labor, surface acting, deep acting, liquid emotion

Procedia PDF Downloads 346

Authors: Diana Kwok

Abstract:

Introduction: There is a rising concern on the educational needs of school guidance teachers, counselors, and sex educators to work effectively with students from multicultural groups, such as racial minorities, gender minorities, sexual minorities, and disability groups etc., and to respect cultural diversities. A specialized training model, the multicultural framework based on contact theory is recognized as necessary training model for professional training programs. Methodology: While the major focus of this project is on improving teaching and learning in teacher training courses within the department of Special Education and Counselling, it specifically aims to enhance the cultural competence of 102 participants enrolled in counseling and sexuality education courses by integrating the following teaching and learning strategies: 1) Panel presentation; 2) Case studies; 3) Experiential learning. Data sources from the participants consisted of the following: (a) questionnaires (MCKAS and ATLG) administered in classes; (b) weekly reflective journals, and c) focus group interviews with panel members. The focus group interviews with panel members were documented. Qualitatively, the weekly reflections were content analyzed. The presentation in this specific conference put focus on themes we found from qualitative content analysis of weekly reflective journals from 102 participants. Findings: Content analysis had found the following preliminary emergent themes: Theme I) Cultural knowledge and challenges to personal limitation. Students had gained a new perspective that specific cultural knowledge involved unique values and worldview. Awareness of limitation of counsellors is very important after actively acquiring the cultural knowledge. Theme 2 - Observation, engagement and active learning. Through the sharing and case studies, as well as visits to the communities, students recognized that observation and listening to the needs of cultural group members were the essential steps before taking any intervention steps. Theme 3 - Curiosity and desire for further inter-group dialogue. All students expressed their desire, curiosity, and motivation to have further inter-group dialogue in their future work settings. Theme 4: Experience with teaching and learning strategies. Students shared their perspectives on how teaching and learning strategies had facilitated their acquisition of cultural competence. Results of this analysis suggests that diverse teaching and learning strategies based on contact perspective had stimulated their curiosity to re-examine their values and motivated them to acquire cultural knowledge relevant to the cultural groups. Acknowledgment: The teaching and learning project was funded by the Teaching and Development Grant, Hong Kong Institute of Education (Project Number T0142).

Keywords: cultural competence, Chinese teacher students, teaching and learning, contacts

Procedia PDF Downloads 240

Authors: Malgorzata Sekulowicz, Krystyna Boron-Krupinska, Paulina Morga, Blazej Cieslik

Abstract:

Burnout is highly prevalent in health care employees, especially in physicians. It significantly reduces the efficiency of these employees, which can have negative consequences for both physicians and patients. Resilience and mindfulness enhancing positive emotions, leading to sustainable development and personal commitment, can have a significant impact on burnout. Therefore, the aim of this study was to determine the relationship between burnout symptoms and mindfulness and resilience among physicians. The authors conducted a cross-sectional survey study among seventy-four polish physicians. Participants filled out the following psychometric tools: the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), Five Facet Mindfulness Questionnaire (FFMQ), Areas of Work-Life Survey (AWS), International Personality Item Pool (IPIP), the Resilience Assessment Scale (SPP-25) and the Mini-COPE Inventory. The relationship between burnout and resilience and mindfulness was assessed with path analysis. Analyzing the relationship between MBI-HSS components and mindfulness, a significant negative correlation of the FFMQ score with emotional exhaustion (-0.50, p < 0.05) and depersonalization (-0.43, p < 0.05) and a positive correlation with personal accomplishment (0.50, p < 0.05) was demonstrated. Analyzing resilience, a statistically significant relationship of SPP-25 with all tested components of MBI-HSS was demonstrated: emotional exhaustion (-0.54, p < 0.05), depersonalization (-0.31, p < 0.05) and personal accomplishment (0.35, p < 0.05). In the group of medical doctors, the higher the level of mindfulness and resilience, the lower the risk of burnout. Furthermore, the more frequently used active coping strategies (planning, acceptance), the lower the risk of burnout, while the use of passive, evasive strategies increases the risk of burnout. It may be worth considering implementing mindfulness intervention to effectively manage burnout symptoms in this group.

Keywords: burnout, medical doctors, mindfulness, physicians, resilience

Procedia PDF Downloads 105

Authors: Mahmut Ali Gökçe, Oguz Tasbozan, Celal Erbas, Zafer Akpinar, S. Surhan Tabakoglu, Mehmet Celik, Bilge Kaan Tekelioglu

Abstract:

This study was conducted to investigate proximate compositions and fatty acid profiles of marketable size striped sea bream of obtained from fish cages of aquaculture companies and fishermen. Ten fish samples were used for both groups. The average total weight of farmed and wild samples was 252,75 ± 36,78 g and 193,0 ± 32 g respectively. While the protein level of farmed samples was (23,49±0,15) higher than that of wild fish (21,80±0,18), lipid level was less (1,55±0,08) in farmed group than wild fish samples (2,52±0,07). Amount of Σ SFA was significantly higher in wild group (44,09±0,9) than the farmed (32,79±1,13) group. Total MUFA were 36,38±29,91 in wild and 29,91±1,52 in farmed fish. However, Σ PUFA (27,89±1,53) and EPA+DHA values (15,73±1,63) of farmed samples were significantly higher than the wild (14,06 ±3,67 and 9,7±0,86) counterparts. Σώ3/ώ6 rate was better in farmed group with 2,54±0,84 in comparison with (1,59±0,06) the other group. As a result, it can be speculated that the farmed striped sea bream can be preferred by the consumers. Acknowledgement: This work was supported by the Scientific Research Project Unit of the University of Cukurova, Turkey under grant no FBA-2016-5073.

Keywords: striped sea bream, Litognathus mormyrus, proximate composition, fatty acid profile

Procedia PDF Downloads 274

Authors: Amberly Brigden, Ali Heawood, Emma C. Anderson, Richard Morris, Esther Crawley

Abstract:

Background: Paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is characterised by persistent, disabling fatigue. Health services see patients below the age of 12. This age group experience high levels of disability, with low levels of school attendance, high levels of fatigue, anxiety, functional disability and pain. CFS/ME interventions have been developed for adolescents, but the developmental needs of younger children suggest treatment should be tailored to this age group. Little is known about how intervention should be delivered to this age group, and further work is needed to explore this. Qualitative research aids patient-centered design of health intervention. Methods: Five to 11-year-olds and their parents were recruited from a specialist CFS/ME service. Semi-structured interviews explored the families’ experience of the condition and perspectives on treatment. Interactive and arts-based methods were used. Interviews were audio-recorded, transcribed and analysed thematically. Qualitative Results: 14 parents and 7 children were interviewed. Early analysis of the interviews revealed the importance of the social-ecological setting of the child, which led to themes being developed in the context of Systems Theory. Theme one relates to the level of the child, theme two the family system, theme three the organisational and societal systems, and theme four cuts-across all levels. Theme1: The child’s capacity to describe, understand and manage their condition. Younger children struggled to describe their internal experiences, such as physical symptoms. Parents felt younger children did not understand some concepts of CFS/ME and did not have the capabilities to monitor and self-regulate their behaviour, as required by treatment. A spectrum of abilities was described; older children (10-11-year-olds) were more involved in clinical sessions and had more responsibility for self-management. Theme2: Parents’ responsibility for managing their child’s condition. Parents took responsibility for regulating their child’s behaviour in accordance with the treatment programme. They structured their child’s environment, gave direct instructions to their child, and communicated the needs of their child to others involved in care. Parents wanted their child to experience a 'normal' childhood and took steps to shield their child from medicalization, including diagnostic labels and clinical discussions. Theme3: Parental isolation and the role of organisational and societal systems. Parents felt unsupported in their role of managing the condition and felt negative responses from primary care health services and schools were underpinned by a lack of awareness and knowledge about CFS/ME in younger children. This sometimes led to a protracted time to diagnosis. Parents felt that schools have the potential important role in managing the child’s condition. Theme4: Complexity and uncertainty. Many parents valued specialist treatment (which included activity management, physiotherapy, sleep management, dietary advice, medical management and psychological support), but felt it needed to account for the complexity of the condition in younger children. Some parents expressed uncertainty about the diagnosis and the treatment programme. Conclusions: Interventions for younger children need to consider the 'systems' (family, organisational and societal) involved in the child’s care. Future research will include interviews with clinicians and schools supporting younger children with CFS/ME.

Keywords: chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), pediatric, qualitative, treatment

Procedia PDF Downloads 140