Search results for: older persons with ESRD

Authors: Cynthia Zgheib, Yonna Sacre

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Pregnancy, this particular moment in the life of a woman, requires monitoring of eating behavior changes. However, the food choices during pregnancy should be varied and healthy, including the consumption of different food groups. Nutritional status is the process of acquisition and consumption of food. Therefore, a varied diet is associated with good nutritional status. This is why the nutrition education is a strategy commonly applied to improve maternal nutrition during pregnancy. Thus, it is crucial to assess 'The eating behavior and nutritional status of pregnant women living in Keserwan Lebanon.' In order to evaluate the association of different persona, socioeconomic and sociodemographic factors with the eating behavior and nutrition in the concerned study category, a cross-sectional descriptive study was conducted on a sample of 150 pregnant women aging between 18 and 40 years randomly selected from the hospitals and clinics located in Keserwan area and equally distributed between different cities and villages of the area according to altitude. The purpose of this study was to evaluate the eating behavior of the concerned population and to compare it to the recommendation of the food guide pyramid, their level of food awareness and finally to analyze their blood tests in order to detect any nutrients deficiency that they may face during the course of their pregnancy. Sociodemographic, lifestyle, eating behaviour, health, eating patterns, awareness, and food frequency questionnaire (FFQ) were collected through a validated questionnaire specifically adapted for the purpose of the study. Statistical analysis was carried out, and multivariate models were used in order to evaluate the association between several independent variables and the eating behaviour and nutritional status of Lebanese pregnant women The final analysis has shown that 48.7% of pregnant women were aged between 30 and 40 years old, 56% had a normal BMI between 18.5 and 24.9, thus age affects the eating behavior, so the older are the pregnant women, and the healthier is their eating behavior. In fact, 80.7% had acceptable food behavior which is based on an equilibrium between both quantity and quality of food, although the recommended foods are foods found in the food pyramid and available in the Lebanese diet. In addition, 68% had an acceptable level of awareness concerning the health importance of good eating habits, therefore, it is positively affecting their food choices. Moreover, 50 % have an acceptable nutritional status which is confirmed by their biological tests. Future governmental or national studies and programs could be settled aiming to increase the awareness about the good eating behaviors and nutritional status of Lebanese pregnant women.

Keywords: eating behavior, nutritional status, level of awareness, pregnant woman

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Authors: Bao Li, Aike Qiao, Gaoyang Li, Youjun Liu

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Background: Lumped parameter model (LPM) is a common numerical model for hemodynamic calculation. LPM uses circuit elements to simulate the human blood circulatory system. Physiological indicators and characteristics can be acquired through the model. However, due to the different physiological indicators of each individual, parameters in LPM should be personalized in order for convincing calculated results, which can reflect the individual physiological information. This study aimed to develop an automatic and effective optimization method to personalize the parameters in LPM of the blood circulatory system, which is of great significance to the numerical simulation of individual hemodynamics. Methods: A closed-loop LPM of the human blood circulatory system that is applicable for most persons were established based on the anatomical structures and physiological parameters. The patient-specific physiological data of 5 volunteers were non-invasively collected as personalized objectives of individual LPM. In this study, the blood pressure and flow rate of heart, brain, and limbs were the main concerns. The collected systolic blood pressure, diastolic blood pressure, cardiac output, and heart rate were set as objective data, and the waveforms of carotid artery flow and ankle pressure were set as objective waveforms. Aiming at the collected data and waveforms, sensitivity analysis of each parameter in LPM was conducted to determine the sensitive parameters that have an obvious influence on the objectives. Simulated annealing was adopted to iteratively optimize the sensitive parameters, and the objective function during optimization was the root mean square error between the collected waveforms and data and simulated waveforms and data. Each parameter in LPM was optimized 500 times. Results: In this study, the sensitive parameters in LPM were optimized according to the collected data of 5 individuals. Results show a slight error between collected and simulated data. The average relative root mean square error of all optimization objectives of 5 samples were 2.21%, 3.59%, 4.75%, 4.24%, and 3.56%, respectively. Conclusions: Slight error demonstrated good effects of optimization. The individual modeling algorithm developed in this study can effectively achieve the individualization of LPM for the blood circulatory system. LPM with individual parameters can output the individual physiological indicators after optimization, which are applicable for the numerical simulation of patient-specific hemodynamics.

Keywords: blood circulatory system, individual physiological indicators, lumped parameter model, optimization algorithm

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Authors: Herlin Vallejo, Jhon Osorio

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Quality is a concept that has gained importance in different scenarios over time, especially in the area of health. The nursing staff is one of the actors that contributes most to the care process and the satisfaction of the users in the evaluation of quality. However, until now, there are few tools to measure the quality of care in specialized performance scenarios. Patients receiving ambulatory cancer treatments can face various problems, which can increase their level of distress, so improving the quality of outpatient care for cancer patients should be a priority for oncology nursing. The experience of the patient in relation to the care in these services has been little investigated. The purpose of this study was to understand the perception that patients have about quality care in outpatient chemotherapy services. A qualitative, exploratory, descriptive study was carried out in 9 patients older than 18 years, diagnosed with cancer, who were treated at the Institute of Cancerology, in outpatient chemotherapy rooms, with a minimum of three months of treatment with curative intention and which had given your informed consent. The total of participants was determined by the theoretical saturation, and the selection of these was for convenience. Unstructured interviews were conducted, recorded and transcribed. The analysis of the information was done under the technique of content analysis. Three categories emerged that reflect the perception that patients have regarding quality care: patient-centered care, care with love and effects of care. Patients highlighted situations that show that care is centered on them, incorporating elements of patient-centered care from the institutional, infrastructure, qualities of care and what for them, in contrast, means inappropriate care. Care with love as a perception of quality care means for patients that the nursing staff must have certain qualities, perceive caring with love as a family affair, limits on care with love and the nurse-patient relationship. Quality care has effects on both the patient and the nursing staff. One of the most relevant effects was the confidence that the patient develops towards the nurse, besides to transform the unreal images about cancer treatment with chemotherapy. On the other hand, care with quality generates a commitment to self-care and is a facilitator in the transit of oncological disease and chemotherapeutic treatment, but from the perception of a healing transit. It is concluded that care with quality from the perception of patients, is a construction that goes beyond the structural issues and is related to an institutional culture of quality that is reflected in the attitude of the nursing staff and in the acts of Care that have positive effects on the experience of chemotherapy and disease. With the results, it contributes to better understand how quality care is built from the perception of patients and to open a range of possibilities for the future development of an individualized instrument that allows evaluating the quality of care from the perception of patients with cancer.

Keywords: nursing care, oncology service hospital, quality management, qualitative studies

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Authors: N. D'Amico, E. Grossi, B. Colombo, F. Rigiroli, M. Buscema, D. Fazzini, G. Cornalba, S. Papa

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Purpose: To characterize, through a radiomic approach, the nature of nodules considered non-specific by expert radiologists, recognized in magnetic resonance mammography (MRm) with T1-weighted (T1w) sequences with paramagnetic contrast. Material and Methods: 47 cases out of 1200 undergoing MRm, in which the MRm assessment gave uncertain classification (non-specific nodules), were admitted to the study. The clinical outcome of the non-specific nodules was later found through follow-up or further exams (biopsy), finding 35 benign and 12 malignant. All MR Images were acquired at 1.5T, a first basal T1w sequence and then four T1w acquisitions after the paramagnetic contrast injection. After a manual segmentation of the lesions, done by a radiologist, and the extraction of 150 radiomic features (30 features per 5 subsequent times) a machine learning (ML) approach was used. An evolutionary algorithm (TWIST system based on KNN algorithm) was used to subdivide the dataset into training and validation test and to select features yielding the maximal amount of information. After this pre-processing, different machine learning systems were applied to develop a predictive model based on a training-testing crossover procedure. 10 cases with a benign nodule (follow-up older than 5 years) and 18 with an evident malignant tumor (clear malignant histological exam) were added to the dataset in order to allow the ML system to better learn from data. Results: NaiveBayes algorithm working on 79 features selected by a TWIST system, resulted to be the best performing ML system with a sensitivity of 96% and a specificity of 78% and a global accuracy of 87% (average values of two training-testing procedures ab-ba). The results showed that in the subset of 47 non-specific nodules, the algorithm predicted the outcome of 45 nodules which an expert radiologist could not identify. Conclusion: In this pilot study we identified a radiomic approach allowing ML systems to perform well in the diagnosis of a non-specific nodule at MR mammography. This algorithm could be a great support for the early diagnosis of malignant breast tumor, in the event the radiologist is not able to identify the kind of lesion and reduces the necessity for long follow-up. Clinical Relevance: This machine learning algorithm could be essential to support the radiologist in early diagnosis of non-specific nodules, in order to avoid strenuous follow-up and painful biopsy for the patient.

Keywords: breast, machine learning, MRI, radiomics

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Authors: Farhad Azadi, Mohammad Mahdi Mohammadi, Mohsen Vahedi, Zahra Mahdiin

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Context: The aging population is growing all over the world and maintaining physical activity is essential for healthy aging. However, fear of falling is a major obstacle to physical activity among the elderly. The aim of this study is to investigate and compare the relationship between fear of falling and physical activity in Iranian urban and rural elderly. Research Aim: The main aim of this cross-sectional analytical study is to investigate and compare the relationship between fear of falling and physical activity in Iranian rural and urban elderly. Methodology: The study used simple non-probability sampling to select 350 participants aged 60 years and older from rural and urban areas of Konarak, Sistan and Baluchistan provinces in Iran. The Persian versions of the Falls Efficacy Scale - International, Rapid Physical Activity Assessment, Activities of Daily Living, and Instrumental Activities of Daily Living questionnaires were used to assess fear of falling and physical activity. The data were analyzed using Pearson correlation tests. Findings: The study found a statistically significant negative correlation between fear of falling and physical activity, as measured by ADL, IADL, and RAPA1(aerobic ), in all elderly and rural and urban elderly (p<0.001). Fear of falling was higher in rural areas, while physical activity levels measured by ADL and RAPA1 were higher in urban areas. No significant difference was found between the two groups in IADL and RAPA2 (strength and flexibility) scores. Theoretical Importance: This study highlights the importance of considering the fear of falling as a significant obstacle to proper physical activity, especially among the elderly living in rural areas. Furthermore, the study provides insight into the difference between rural and urban elderly people in terms of fear of falling and physical activity. Data Collection and Analysis Procedures: Data was collected through questionnaires and analyzed using Pearson correlation tests. Questions Addressed: The study attempted to answer the following questions: Is there a relationship between fear of falling and physical activity in Iranian urban and rural elderly people? Is there a difference in fear of falling and physical activity between rural and urban elderly? Conclusion: Fear of falling is a major obstacle to physical activity among the elderly, especially in rural areas. The study found a significant negative correlation between fear of falling and physical activity in all elderly and rural and urban elderly. In addition, urban and rural elderly have differences in aerobic activity levels, but they do not differ in terms of flexibility and strength. Therefore, proper interventions are required to ensure that the elderly can maintain physical activity, especially in rural and deprived areas.

Keywords: aged, fear of falling, physical activity, urban population, rural population

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Authors: Adel S. Alanazi

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The transition of a student with a disability from school to work is the most crucial phase while moving from the stage of adolescence into early adulthood. In this process, young individuals face various difficulties and challenges in order to accomplish the next venture of life successfully. In this respect, this paper aims to examine the challenges encountered by the individuals with intellectual disabilities in transition to work in Saudi Arabia. For this purpose, this study has undertaken a qualitative research-based methodology; wherein interpretivist philosophy has been followed along with inductive approach and exploratory research design. The data for the research has been gathered with the help of semi-structured interviews, whose findings are analysed with the help of thematic analysis. Semi-structured interviews were conducted with parents of persons with intellectual disabilities, officials, supervisors and specialists of two vocational rehabilitation centres providing training to intellectually disabled students, in addition to that, directors of companies and websites in hiring those individuals. The total number of respondents for the interview was 15. The purposive sampling method was used to select the respondents for the interview. This sampling method is a non-probability sampling method which draws respondents from a known population and allows flexibility and suitability in selecting the participants for the study. The findings gathered from the interview revealed that the lack of awareness among their parents regarding the rights of their children who are intellectually disabled; the lack of adequate communication and coordination between various entities; concerns regarding their training and subsequent employment are the key difficulties experienced by the individuals with intellectual disabilities. Training in programmes such as bookbinding, carpentry, computing, agriculture, electricity and telephone exchange operations were involved as key training programmes. The findings of this study also revealed that information technology and media were playing a significant role in smoothing the transition to employment of individuals with intellectual disabilities. Furthermore, religious and cultural attitudes have been identified to be restricted for people with such disabilities in seeking advantages from job opportunities. On the basis of these findings, it can be implied that the information gathered through this study will serve to be highly beneficial for Saudi Arabian schools/ rehabilitation centres for individuals with intellectual disability to facilitate them in overcoming the problems they encounter during the transition to work.

Keywords: intellectual disability, transition services, rehabilitation centre, employment

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Authors: Antoine Villa, Moustapha Mohamedou, Florence Pilliere, Catherine Verdun-Esquer, Mathieu Molimard, Mohamed Sidatt Cheikh El Moustaph, Mireille Canal-Raffin

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Context: In Mauritania, the activity of the National Center of Oncology (NCO) has steadily risen leading to an increase in the handling of antineoplastic drugs (AD) by healthcare professionals. In this context, the AD contamination of those professionals is a major concern for occupational physicians. It has been evaluated using biological monitoring of occupational exposure (BMOE). Methods: The intervention took place in 2015, in 2 care units, and evaluated nurses preparing and/or infusing AD and agents in charge of hygiene. Participants provided a single urine sample, at the end of the week, at the end of their shift. Five molecules were sought using specific high sensitivity methods (UHPLC-MS/MS) with very low limits of quantification (LOQ) (cyclophosphamide (CP), Ifosfamide (IF), methotrexate (MTX): 2.5ng/L; doxorubicin (Doxo): 10ng/L; α-fluoro-β-alanine (FBAL, 5-FU metabolite): 20ng/L). A healthcare worker was considered as 'contaminated' when an AD was detected at a urine concentration equal to or greater than the LOQ of the analytical method or at trace concentration. Results: Twelve persons participated (6 nurses, 6 agents in charge of hygiene). Twelve urine samples were collected and analyzed. The percentage of contamination was 66.6% for all participants (n=8/12), 100% for nurses (6/6) and 33% for agents in charge of hygiene (2/6). In 62.5% (n=5/8) of the contaminated workers, two to four of the AD were detected in the urine. CP was found in the urine of all contaminated workers. FBAL was found in four, MTX in three and Doxo in one. Only IF was not detected. Urinary concentrations (all drugs combined) ranged from 3 to 844 ng/L for nurses and from 3 to 44 ng/L for agents in charge of hygiene. The median urinary concentrations were 87 ng/L, 15.1 ng/L and 4.4 ng/L for FBAL, CP and MTX, respectively. The Doxo urinary concentration was found 218ng/L. Discussion: There is no current biological exposure index for the interpretation of AD contamination. The contamination of these healthcare professionals is therefore established by the detection of one or more AD in urine. These urinary contaminations are higher than the LOQ of the analytical methods, which must be as low as possible. Given the danger of AD, the implementation of corrective measures is essential for the staff. Biological monitoring of occupational exposure is the most reliable process to identify groups at risk, tracing insufficiently controlled exposures and as an alarm signal. These results show the necessity to educate professionals about the risks of handling AD and/or to care for treated patients.

Keywords: antineoplastic drugs, Mauritania, biological monitoring of occupational exposure, contamination

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Authors: Nahela Nowshin, Rafia Sultana, Farzana Misha, Sabina F. Rashid

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Sexual and reproductive health and rights (SRHR) are currently an area of neglect for males (aged 15-24 years) in Bangladesh. The lack of focus on the male youth population has consequences not only for their own health and wellbeing, but the patriarchal structure of Bangladeshi society and socio-cultural norms mean that the male population’s SRH behavior can severely impact the lives of their female counterparts. A majority of sexual and reproductive health and rights-related research and interventions in the country are female-centric. Although the Government of Bangladesh has taken many initiatives to improve the SRHR of the general population, the male youth segment has not been prioritized in most of these interventions. There is an urgent need for male-youth-focused SRHR interventions in Bangladesh, but due to a lack of evidence-based research on this issue, there exist data gaps on how such interventions could be better designed and implemented. Therefore, to ascertain strategies for better program design and smoother implementation of male-youth-focused sexual and reproductive health and rights interventions, we carried out 25 key informant interviews with experts as well as focal persons involved in more than 20 ongoing and recently-ended SRHR-related interventions of national and international non-government organizations in which male youth were targeted or engaged. The results show that program implementers face several challenges at the field, organizational and policy levels. Some of the most common field challenges include high sensitivity to SRHR topics due to cultural reasons, difficulties in acquiring access to boys and young men due to their high mobility and engagement in labor for commercial purposes, as well as accessing them in hard-to-reach areas due to transportation and communication issues. Common organizational-level challenges include a lack of skilled manpower. Policy-level challenges include the prohibition of SRH service provision to unmarried adolescents and youth and lack of readiness of local governments to implement existing action plans. Some ways in which male-youth-focused SRHR interventions can be made more effective are through sensitization of service providers, awareness-raising at the community level to engage parents, advocacy to increase donor interest, and generating data on SRHR of male youth.

Keywords: Bangladesh, intervention, male, SRHR

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Authors: Julie A. Carberry, Victor Maddalena

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Animal-Assisted Interventions (AAIs) have existed in various forms for centuries. In the past 30 years, there has been a dramatic increase in popularity. AAIs are now part of the lives of persons of all ages in many types of institutions. Anecdotal evidence of the benefits of AAIs have led to widespread adoption, yet there remains a lack of solid research base for support. The research question was, what are the lived experiences of AAI volunteer handlers are? An interpretive phenomenological methodology was used for this qualitative study. Data were collected from 1 - 2 hour-long semi-structured interviews and 1 observational field visit. All interviews were conducted, transcribed, and coded for themes by the principal investigator. Participants must have been an active St. John Ambulance Therapy Dog Program volunteer for a least one year. In total, 14 volunteer handlers, along with some of their dogs, were included. The St. John Ambulance is a not for profit organization that provides training and community services to Canadians. The Therapy Dog Program is 1 of the 4 nationally recognized core community service programs. The program incorporates dogs in the otherwise traditional therapeutic intervention of friendly visitation with clients. The lack of formal objectives and goals, and a trained therapist defines the program as an Animal-Assisted Activity (AAA), which is a type of AAI. Since the animals incorporated are dogs, the program is specifically a Canine-Assisted Activity (CAA), which is a type of Canine-Assisted Intervention (CAI). Six themes emerged from the analysis of the data: (a) a win-win-win situation for all parties involved – volunteer handlers, clients, and the dogs, (b) being on the other end of the leash: functions of the role of volunteer handler, (c) the importance of socialization: from spreading smiles to creating meaningful connections, (d) the role of the dog: initiating interaction and providing comfort, (e) an opportunity to feel good and destress, and (f) altruism versus personal rewards. Other insights were found regarding the program, clients, and staff. Possible implications from this research include increased organizational recruitment and retention of volunteer handlers and as well as increased support for CAAs and other CAIs that incorporate teams of volunteer handlers and their dogs. This support could, in turn, add overall support for the acceptance and broad implementation of AAIs as an alternative and or complementary non-pharmaceutical therapeutic intervention.

Keywords: animal-assisted activity, animal-assisted intervention, canine-assisted activity, canine-assisted intervention, perspective, qualitative, volunteer handler

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Authors: Priyanka V. Janbandhu, Santosh B. Phad, Dhananjay W. Bansod

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The current changing scenario of the family is a compelling aged group not only to be alone in a nuclear family but also to join the old age institutions. The consequences of it are feeling of neglected or left alone by the children, adding a touch of helpless in the absence of lack of expected care and support. The accretion of all these feelings and unpleasant events ignite a question in their mind that – who is there for me? The efforts have taken to highlight the issues of the elderly after joining the old age home and their perception about the current life as an institutional inmate. This attempt to cover up the condition, adjustment, changed lifestyle and perspective in the association with several issues of the elderly, which have an essential effect on their well-being. The present research piece has collected the information about institutionalized elderly with the help of a semi-structured questionnaire. This study interviewed 500 respondents from 22 old age homes of Pune city of Maharashtra State, India. This data collection methodology consists of Multi-stage random sampling. In which the stratified random sampling adopted for the selection of old age homes and sample size determination, sample selection probability proportional to the size and simple random sampling techniques implemented. The study provides that around five percent of the elderly shifted to old age home along with their spouse, whereas ten percent of the elderly are staying away from their spouse. More than 71 percent of the elderly have children, and they are an involuntary inmate of the old age institution, even less than one-third of the elderly consulted to the institution before the joining it. More than sixty percent of the elderly have children, but they joined institution due to the unpleasant response of their children only. Around half of the elderly responded that there are issues while adjusting to this environment, many of them are still persistent. At least one elderly out of ten is there who is suffering from the feeling of loneliness and left out by children and other family members. In contrast, around 97 percent of the elderly are very happy or satisfied with the institutional facilities. It illustrates that the issues are associated with their children and other family members, even though they left their home before a year or more. When enquired about this loneliness feeling few of them are suffering from it before leaving their homes, it was due to lack of interaction with children, as they are too busy to have time for the aged parents. Additionally, the conflicts or fights within the family due to the presence of old persons in the family contributed to establishing another feeling of insignificance among the elderly parents. According to these elderly, have more than 70 percent of the share, the children are ready to spend money indirectly for us through these institutions, but not prepared to provide some time and very few amounts of all this expenditure directly for us.

Keywords: elderly, old age homes, life style changes and adjustment, India

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Authors: K. Rawojć, J. Miszczyk, A. Możdżeń, A. Panek, J. Swakoń, M. Rydygier

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Due to the mitotic delay, poor mitotic index and disappearance of lymphocytes from peripheral blood circulation, assessing the DNA damage after high dose exposure is less effective. Conventional chromosome aberration analysis or cytokinesis-blocked micronucleus assay do not provide an accurate dose estimation or radiosensitivity prediction in doses higher than 6.0 Gy. For this reason, there is a need to establish reliable methods allowing analysis of biological effects after exposure in high dose range i.e., during particle radiotherapy. Lately, Premature Chromosome Condensation (PCC) has become an important method in high dose biodosimetry and a promising treatment modality to cancer patients. The aim of the study was to evaluate the usefulness of drug-induced PCC scoring procedure in an experimental mode, where 100 G2/M cells were analyzed in different dose ranges. To test the consistency of obtained results, scoring was performed by 3 independent persons in the same mode and following identical scoring criteria. Whole-body exposure was simulated in an in vitro experiment by irradiating whole blood collected from healthy donors with 60 MeV protons and 250 keV X-rays, in the range of 4.0 – 20.0 Gy. Drug-induced PCC assay was performed on human peripheral blood lymphocytes (HPBL) isolated after in vitro exposure. Cells were cultured for 48 hours with PHA. Then to achieve premature condensation, calyculin A was added. After Giemsa staining, chromosome spreads were photographed and manually analyzed by scorers. The dose-effect curves were derived by counting the excess chromosome fragments. The results indicated adequate dose estimates for the whole-body exposure scenario in the high dose range for both studied types of radiation. Moreover, compared results revealed no significant differences between scores, which has an important meaning in reducing the analysis time. These investigations were conducted as a part of an extended examination of 60 MeV protons from AIC-144 isochronous cyclotron, at the Institute of Nuclear Physics in Kraków, Poland (IFJ PAN) by cytogenetic and molecular methods and were partially supported by grant DEC-2013/09/D/NZ7/00324 from the National Science Centre, Poland.

Keywords: cell response to radiation exposure, drug induced premature chromosome condensation, premature chromosome condensation procedure, proton therapy

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Authors: Sebastian Wójtowicz, Anna Mosiołek, Anna Słupik, Zbigniew Wroński, Dariusz Białoszewski

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Introduction: In whole-body vibration (WBV) high-frequency mechanical stimuli is generated by a vibration plate and is transferred through bone, muscle and connective tissues to the whole body. The research has shown that the implementation of a vibration plate training over a long period of time leads to improvement of neuromuscular facilitation, especially in afferent neural pathways, which are responsible for the conduction of vibration and proprioceptive stimuli, muscle function, balance, and proprioception. The vibration stimulus is suggested to briefly inhibit the conduction of afferent signals from proprioceptors and may hinder the maintenance of body balance. The purpose of this study was to evaluate the result of a single set of exercises connected with whole-body vibration on the proprioception. Material and Methods: The study enrolled 60 people aged 19-24 years. These individuals were divided into a test group (group A) and a control group (group B). Both groups consisted of 30 persons and performed the same set of exercises on a vibration plate. The following vibration parameters: frequency of 20Hz and amplitude of 3mm, were used in the group A. The vibration plate was turned off while the control group did their exercises. All participants performed six dynamic 30-seconds-long exercises with a 60-second resting period between them. Large muscle groups of the trunk, pelvis, and lower limbs were involved while taking the exercises. The results were measured before and immediately after the exercises. The proprioception of lower limbs was measured in a closed kinematic chain using a Humac 360®. Participants were instructed to perform three squats with biofeedback in a defined range of motion. Then they did three squats without biofeedback which were measured. The final result was the average of three measurements. Statistical analysis was performed using Statistica 10.0 PL software. Results: There were no significant differences between the groups, both before and after the exercise (p > 0.05). The proprioception did not change in both the group A and the group B. Conclusions: 1. Deterioration in proprioception was not observed immediately after the vibration stimulus. This suggests that vibration-induced blockage of proprioceptive stimuli conduction can only have a short-lasting effect occurring only in the presence of the vibration stimulus. 2. Short-term use of vibration seems to be safe for patients with proprioceptive impairment due to the fact that the treatment does not decrease proprioception. 3. There is a need for supplementing the results with evaluation of proprioception while vibration stimuli are being applied. Moreover, the effects of vibration parameters used in the exercises should be evaluated.

Keywords: joint position sense, proprioception, squat, whole body vibration

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Authors: Ahmed Gonnah, Omar Masoud, Mohamed Abdel-Wahab, Ahmed ElMosalamy, Abdulrahman Al-Naseem

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Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with the highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30-75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging and mammography, as well as core needle biopsies. Current management includes observation for 6-12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple-areolar distortion, scarring and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases EMBASE. MEDLINE/PubMed, Google scholar and Ovid, for English language papers published between 1st of January 2000 and 17th of March 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were ‘HIFU’, ‘High-Intensity Focused Ultrasound’, ‘Fibroadenoma’, ‘Breast’, ‘Lesion’. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, High Intensity Focused Ultrasound (HIFU), was found to be a safe, non-invasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated with a low risk of complications that can potentially include erythema, skin discoloration and bruising, with the majority of this self-resolving shortly after the procedure.

Keywords: ultrasound, HIFU, breast, efficacy, side effects, fibroadenoma

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Authors: Mahsa Houshdar, Seyed Mehdi Samimi Ardestani , ُSeyed Saeed Sadr

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Introduction: Online Medicare is a method in which parts of a medical process - whether its diagnostics, monitoring or the treatment itself will be done by using online services. This system has been operated in one boy’s high school, one girl’s high school and one high school in deprived aria. Method: At the first step the students registered for using the system. It was not mandatory and not free. They participated in estimating depression scale, anxiety scale and clinical interview by online medical care system. During this estimation, we could find the existence and severity of depression and anxiety in each one of the participants, also we could find the consequent needs of each one, such as supportive therapy in mild depression or anxiety, need to visited by psychologist in moderate cases, need to visited by psychiatrist in moderate-severe cases, need to visited by psychiatrist and psychologist in severe cases and need to perform medical lab examination tests. The lab examination tests were performed on persons specified by the system. The lab examinations were included: serum level of vitamin D, serum level of vitamin B12, serum level of calcium, fasting blood sugar, HbA1c, thyroid function tests and CBC. All of the students were solely treated by vitamins or minerals therapy and/ or treatment of medical problem (such as hypothyroidism). After a few months, we came back to high schools and estimated the existence and severity of depression and anxiety in treated students. With comparing these results, the affectability of the system could be prof. Results: Totally, we operate this project in 1077 participants in 243 of participant, the lab examination test were performed. In girls high schools: the existence and severity of depression significantly deceased (P value= 0.018<0.05 & P value 0.004< 0.05), but results about anxiety was not significant. In boys high schools: the existence and severity of depression significantly decreased (P value= 0.023<0.05 & P value = 0.004< 0.05 & P value= 0.049< 0.05). In boys high schools: the existence and severity of anxiety significantly decreased (P value= 0.041<0.05 & P value = 0.046< 0.05 &) but in one high school results about anxiety was not significant. In high school in deprived area the students did not have any problem paying for participating in the project, but they could not pay for medical lab examination tests. Thus, operation of the system was not possible in deprived area without a sponsor. Conclusion: This online medical system was successful in creating medical and psychiatric profile without attending physician. It was successful in decreasing depression without using antidepressants, but it was partially successful in decreasing anxiety.

Keywords: depression, diabetes, online medicare, vitamin D deficiency

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Authors: B. M. M. D. Mendis, L. I. Rajapaksa, P. S. K. Gunathunga, R. C. Fernando, M. Jayalath

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Background / introduction: During the year 2011, 8511 males received services from the sexual health clinics island wide. At present there is only limited information on the risk behaviours of male attendees. Information on risk behaviours related to STI /HIV transmission is helpful in planning suitable prevention interventions. Aim(s)/objectives: The objectives were to determines the sexual partners (other than the marital partner and regular partners) responsible for transmitting STI( Sexually transmitted infections)/ HIV and to understand the practice of safer sex. Methods: Study was a clinic based prospective study conducted for a one year period using an interviewer administered questionnaire. Results: 983 attendees were interviewed. . Mean age was 34.02 years. 75% of the sample had completed GCE O/L (ordinary level examination). Skilled labourers, drivers and forces/police comprised 40% of the sample. 50% admitted sex with a casual female, 12% with a casual male, and 13% with CSW (commercial sex workers) while MSW (male sex workers) exposures were minimal. It was identified that younger males had more contacts with males, and regular female partners while more older males with CSW. Anal sex among males was reported by 11.5%. 20.5% used alcohol frequently and 5.9% used drugs and 1.4% injected. Common STI were genital herpes (7.9%), Non gonococcal urethritis (6.2%) and gonorrhoea (6.2%). Among those who had contacts with FSW 6.7% gonorrhoea (GC), 8.2% non gonococcal urethritis (NGU), 7.5% genital herpes and 0.7% HIV. Non regular partner exposures 3.7% had gonorrhoea, 8.3% NGU, 6.6% genital herpes and 0.8% HIV. Among MSM contacts 10.6% had GC, 4.5% NGU, 5.3% genital herpes, 5.3% secondary syphilis and 0.8% HIV. Only 9.0% used condoms correctly. Friends, doctors, newspapers, internet, and forces were important sources of information on condoms. Non use of condoms were due to worry about satisfaction (24.6%) and faith in the partner (25.6%). Discussion/conclusion: Casual partners for unsafe sex is a concern. MSM and CSW are remained as an important source of infection. Early Syphilis and gonorrhoea infections were mostly seen among MSM exposures. The findings indicate that the male population in the sample had satisfactory education. However, still the unsafe sexual contacts are common. . Newspapers, internet were more important sources of information on condoms. Low condom use remains another concern.. More males contracted STI through casual partners. Therefore strategies used for prevention need to be revisited also emphasizing on general population where casual partners represent. . Increasing awareness of men and women through mass media and primary health care teams may be important strategies that can be used to keep the HIV epidemic in a low level.

Keywords: STI, HIV, Males, safe sex practices

Procedia PDF Downloads 337

Authors: Alexandra Emmanuelle Membangbi, Jacky Njiki Bikoï, Esther Del-florence Moni Ndedi, Marie Joseph Nkodo Mindimi, Donatien Serge Mbaga, Elsa Nguiffo Makue, André Chris Mikangue Mbongue, Martha Mesembe, George Ikomey Mondinde, Eric Walter Perfura-yone, Sara Honorine Riwom Essama

Abstract:

Background: Tuberculosis (TB) is one of the top lethal infectious diseases worldwide. In recent years, interferon-γ (INF-γ) release assays (IGRAs) have been established as routine tests for diagnosing TB infection. However, produced INF-γ assessment failed to distinguish active TB (ATB) from latent TB infection (LTBI), especially in TB epidemic areas. In addition to IFN-γ, interleukin-2 (IL-2), another cytokine secreted by activated T cells, is also involved in immune response against Mycobacterium tuberculosis. The aim of the study was to assess the capacity of IFN-γ and IL2 to evaluate the therapeutic response of patients on anti-tuberculosis treatment. Material and Methods: We conducted a cross-sectional study in the Pneumonology Departments of the Jamot Hospital in Yaoundé between May and August 2021. After signed the informed consent, the sociodemographic data, as well as 5 mL of blood, were collected in the crook of the elbow of each participant. Sixty-one subjects were selected (n= 61) and divided into 4 groups as followed: group 1: resistant tuberculosis (n=13), group 2: active tuberculosis (n=19), group 3 cured tuberculosis (n=16), and group 4: presumed healthy persons (n=13). The cytokines of interest were determined using an indirect Enzyme-linked Immuno-Sorbent Assay (ELISA) according to the manufacturer's recommendations. P-values < 0.05 were interpreted as statistically significant. All statistical calculations were performed using SPSS version 22.0 Results: The results showed that men were more 14/61 infected (31,8%) with a high presence in active and resistant TB groups. The mean age was 41.3±13.1 years with a 95% CI = [38.2-44.7], the age group with the highest infection rate was ranged between 31 and 40 years. The IL-2 and INF-γ means were respectively 327.6±160.6 pg/mL and 26.6±13.0 pg/mL in active tuberculosis patients, 251.1±30.9 pg/mL and 21.4±9.2 pg/mL in patients with resistant tuberculosis, while it was 149.3±93.3 pg/mL and 17.9±9.4 pg/mL in cured patients, 15.1±8.4 pg/mL and 5.3±2.6 pg/mL in participants presumed healthy (p <0.0001). Significant differences in IFN-γ and IL-2 rates were observed between the different groups. Conclusion: Monitoring the serum levels of INF-γ and IL-2 would be useful to evaluate the therapeutic response of anti-tuberculosis patients, particularly in the both cytokines association case, that could improve the accuracy of routine examinations.

Keywords: antibiotic therapy, interferon gamma, interleukin 2, tuberculosis

Procedia PDF Downloads 116

Authors: Hsiu-Tsu Cho

Abstract:

Collective efficacy refers to a group’s sense of its capacity to complete a task successfully or to reach objectives. Little effort has been expended on investigating the relationship between the emotion expression of a leader and collective efficacy. In this study, we examined the impact of the different emotions and emotion expression of a group leader on collective efficacy and explored whether the emotion–expressive effects differed under conditions of negative and positive emotions. A total of 240 undergraduate and graduate students recruited using Facebook and posters at a university participated in this research. The participants were separated randomly into 80 groups of four persons consisting of three participants and a confederate. They were randomly assigned to one of five conditions in a 2 (pride vs. guilt) × 2 (emotion expression of group leader vs. no emotion expression of group leader) factorial design and a control condition. Each four-person group was instructed to get the reward in a group competition of solving the five-disk Tower of Hanoi puzzle and making decisions on an investment case. We surveyed the participants by employing the emotional measure revised from previous researchers and collective efficacy questionnaire on a 5-point scale. To induce an emotion of pride (or guilt), the experimenter announced whether the group performance was good enough to have a chance of getting the reward (ranking the top or bottom 20% among all groups) after group task. The leader (confederate) could either express or not express a feeling of pride (or guilt) following the instruction according to the assigned condition. To check manipulation of emotion, we added a control condition under which the experimenter revealed no results regarding group performance in maintaining a neutral emotion. One-way ANOVAs and post hoc pairwise comparisons among the three emotion conditions (pride, guilt, and control condition) involved assigning pride and guilt scores (pride: F(1,75) = 32.41, p < .001; guilt: F(1,75) = 6.75, p < .05). The results indicated that manipulations of emotion were successful. A two-way between-measures ANOVA was conducted to examine the predictions of the main effects of emotion types and emotion expression as well as the interaction effect of these two variables on collective efficacy. The experimental findings suggest that pride did not affect collective efficacy (F(1,60) = 1.90, ns.) more than guilt did and that the group leader did not motivate collective efficacy regardless of whether he or she expressed emotion (F(1,60) = .89, ns.). However, the interaction effect of emotion types and emotion expression was statistically significant (F(1,60) = 4.27, p < .05, ω2 = .066); the effects accounted for 6.6% of the variance. Additional results revealed that, under the pride condition, the leader enhanced group efficacy when expressing emotion, whereas, under the guilt condition, an expression of emotion could reduce collective efficacy. Overall, these findings challenge the assumption that the effect of expression emotion are the same on all emotions and suggest that a leader should be cautious when expressing negative emotions toward a group to avoid reducing group effectiveness.

Keywords: collective efficacy, group leader, emotion expression, pride, guilty

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Authors: Adnan Celik

Abstract:

Entrepreneurs are people who attempt to do a business and do not hesitate to do so. They are involved in the production of economic goods and services through factors of production. They also find the financial resources necessary for production and the markets where the production will be evaluated. After all, they create economic values. The main function of the entrepreneur in contemporary societies is to realize innovations. From this point, the power of the modern entrepreneur is based on her/his capacity to innovate and transform his innovations into tangible commercial products. In this context, the concept of an entrepreneur is used to mean the person or persons who constantly innovate. Successful entrepreneurs take on the role of the locomotive in the development of their countries. They support economic development with their activities. In addition to production and marketing activities, it also has important contributions to employment. Along with the development of the country, they also try to make the income distribution more balanced. Especially developed country entrepreneurs intensely perform the following functions; “to produce new goods and services or to increase the quality and quality of known goods and services; ability to develop and apply new production methods; establishing new organizations in the industry; reach new markets; to find new sources from which raw materials and similar materials can be obtained”. Entrepreneurs who fully implement business functions are easier to achieve economic efficiency. Thus, they provide great advantages to the business and the national economy. Successful entrepreneurs are people who make money by creating economic values. These revenues are; on the one hand, it is distributed to individuals in the business as wages, premiums, or dividends; It is also used in the growth of companies. Thus, employees, managers, entrepreneurs and the whole country can benefit greatly. In the least developed countries, the guiding effect of traditional value patterns on individuals' attitudes and behaviors varies depending on the socio-economic characteristics of individuals. It is normal for an entrepreneur with a low level of education, who was brought up in a traditional structure, to behave in accordance with traditional value patterns. In fact, this is the primary problem of all countries in the development effort. The solution to this problem will be possible by giving the necessary importance to the social dimension as well as the technical dimension of development. This study mainly focuses on the importance of entrepreneurship for the national economy. This issue has been handled separately in terms of developed and least developed countries. As a result of the study, entrepreneurship suggestions were made, especially to least developed countries, with the goal of national economy and development.

Keywords: entrepreneur, entrepreneurship, national economy, entrepreneurship in developed and least developed countries

Procedia PDF Downloads 137

Authors: Leja Salciute

Abstract:

Mental health difficulties are one of the reasons for abnormal feeding behaviour. This is especially evident in a crisis situation. Abnormal feeding behaviour occurs when individuals use food as a method to provide relief for these negative emotions. The study aimed to discover an association between emotional regulation, mental health difficulties and disruption in feeding behaviours in the UK in times of crisis. A mixed-methods design was used. Abnormal feeding behaviour was measured using the Binge Eating Disorder Screener-7, SCOFF scale, Crisis impact scale, Difficulties in Emotion Regulation Scale and demographics. The sample comprised 342 participants with a history of excessive overeating. The participants (male= 198, female= 141 and other= 3) came from the general population and they were aged 16 and over. Participants ranged in age from 16 to 89. Findings from the survey concluded that difficulties with emotion regulation were found to be associated with abnormal feeding behaviours. Mental health difficulties correlated significantly with changes in individuals’ lives, such as work or routines. Individuals differed in their abnormal feeding behaviour in terms of their age, that is, younger individuals showed less struggle with their eating patterns while older individuals faced greater struggles with their abnormal feeding behaviour. Emotion regulation significantly influenced abnormal feeding behaviour. Results from qualitative data suggest four common themes that were identified: demonstration of gratitude, negative emotions, disruptions to social life, and financial loss. For example, participants developed and gained an awareness of being grateful for the simple things in life even when participants experienced hardships. The results also suggested that emotional eating acted like a sedative that allowed the participant to run away from their painful reality. Crisis situation negatively affected relationships among participants and induced negativity related to social interaction. Finally, the respondents highlighted that the presence of uncertainty made it hard to plan ahead and look forward to the future. Although respondents experienced negative emotions and financial losses, some of them still managed to allocate time for themselves and enjoy their time off during crisis. However, majority of respondents referred to their inability to control their external circumstances and turned to and relied upon food overconsumption instead. This had a negative effect on their mental health and presented disruptions in feeding behaviour. It was recommended for individuals in times of crisis to seek psychological support in the form of Cognitive Behavioural Therapy (CBT).

Keywords: binge eating, maladaptive eating behaviours, mental health, negative emotions in crisis

Procedia PDF Downloads 71

Authors: Baqir Khawari

Abstract:

This study critically examines the influence of remittances on household poverty and income inequality in Mazar-i-Sharif, Balkh Province, Afghanistan, utilizing robust OLS and Logit models with a rigorous multi-random sampling method. The empirical findings reveal that a 1% increase in per capita international remittances is associated with a substantial 0.071% and 0.059% rise in per capita income during the fiscal years 2019/20 and 2020/21, respectively. Furthermore, this increase significantly mitigates the per capita depth of poverty by 0.0272% and 0.025% and the severity of poverty by 0.0149% and 0.0145% over the same periods. Notably, the impact of international remittances on poverty alleviation surpasses that of internal remittances. In addressing income inequality, the analysis demonstrates that remittances contribute to a reduction in the Gini coefficient by 2% in 2019/20 and 7% in 2020/21, underscoring their pivotal role in promoting equitable economic distribution. However, the COVID-19 pandemic has posed significant challenges, diminishing remittance flows and, consequently, their positive effects on household welfare. The logistic regression results further corroborate these findings, indicating that increased per capita remittances, both international and internal, markedly decrease the likelihood of households falling below the poverty line. Specifically, a 1% rise in per capita external remittances reduces this likelihood by 4.5% in 2019/20 and by 3.7% in 2020/21, while internal remittances decrease it by 3% and 2.4%, respectively. The study also explores the demographic determinants of poverty. Larger household sizes and older household heads correlate positively with poverty, whereas higher education levels among household heads and members, and a greater proportion of male members, correlate negatively with poverty incidence and severity. Female-headed households are disproportionately affected by poverty, exacerbated by socio-cultural restrictions. Despite these adversities, the data suggest that remittances are a crucial instrument for poverty alleviation and income inequality reduction in Afghanistan. The findings advocate for policy interventions aimed at enhancing formal remittance channels, promoting education, and empowering women. Effective governance and sustained international assistance are essential to harness the full potential of remittances in combating poverty and inequality. This study highlights the need for strategic, multifaceted approaches to foster sustainable economic development in Afghanistan’s challenging socio-political context.

Keywords: migration, remittances, poverty, inequality, COVID-19, Afghanistan

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Authors: Marina Wagdy Nageeb Eskander

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

Procedia PDF Downloads 59

Authors: Eva Maged Hosni Sadek

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

Procedia PDF Downloads 58

Authors: Meera Tandan, Mohan Timilsina, Martin Cormican, Akke Vellinga

Abstract:

Background: In general practice, many infections are treated empirically without microbiological confirmation. Understanding susceptibility of antimicrobials during empirical prescribing can be helpful to reduce inappropriate prescribing. This study aims to apply a prediction model using a decision tree approach to predict the antimicrobial resistance (AMR) of urinary tract infections (UTI) based on non-clinical features of patients over 65 years. Decision tree models are a novel idea to predict the outcome of AMR at an initial stage. Method: Data was extracted from the database of the microbiological laboratory of the University Hospitals Galway on all antimicrobial susceptibility testing (AST) of urine specimens from patients over the age of 65 from January 2011 to December 2014. The primary endpoint was resistance to common antimicrobials (Nitrofurantoin, trimethoprim, ciprofloxacin, co-amoxiclav and amoxicillin) used to treat UTI. A classification and regression tree (CART) model was generated with the outcome ‘resistant infection’. The importance of each predictor (the number of previous samples, age, gender, location (nursing home, hospital, community) and causative agent) on antimicrobial resistance was estimated. Sensitivity, specificity, negative predictive (NPV) and positive predictive (PPV) values were used to evaluate the performance of the model. Seventy-five percent (75%) of the data were used as a training set and validation of the model was performed with the remaining 25% of the dataset. Results: A total of 9805 UTI patients over 65 years had their urine sample submitted for AST at least once over the four years. E.coli, Klebsiella, Proteus species were the most commonly identified pathogens among the UTI patients without catheter whereas Sertia, Staphylococcus aureus; Enterobacter was common with the catheter. The validated CART model shows slight differences in the sensitivity, specificity, PPV and NPV in between the models with and without the causative organisms. The sensitivity, specificity, PPV and NPV for the model with non-clinical predictors was between 74% and 88% depending on the antimicrobial. Conclusion: The CART models developed using non-clinical predictors have good performance when predicting antimicrobial resistance. These models predict which antimicrobial may be the most appropriate based on non-clinical factors. Other CART models, prospective data collection and validation and an increasing number of non-clinical factors will improve model performance. The presented model provides an alternative approach to decision making on antimicrobial prescribing for UTIs in older patients.

Keywords: antimicrobial resistance, urinary tract infection, prediction, decision tree

Procedia PDF Downloads 253

Authors: Maisa Haj-Tas, Jehad Alaraifi

Abstract:

The significance of the study: This retrospective study examined the speech and language profiles of patients who received clinical services at the University of Jordan Hearing and Speech Clinic (UJ-HSC) from 2009 to 2014. The UJ-HSC clinic is located in the capital Amman and was established in the late 1990s. It is the first hearing and speech clinic in Jordan and one of first speech and hearing clinics in the Middle East. This clinic provides services to an annual average of 2000 patients who are diagnosed with different communication disorders. Examining the speech and language profiles of patients in this clinic could provide an insight about the most common disorders seen in patients who attend similar clinics in Jordan. It could also provide information about community awareness of the role of speech therapists in the management of speech and language disorders. Methodology: The researchers examined the clinical records of 1140 patients (797 males and 343 females) who received clinical services at the UJ-HSC between the years 2009 and 2014 for the purpose of data analysis for this study. The main variables examined in the study were disorder type and gender. Participants were divided into four age groups: children, adolescents, adults, and older adults. The examined disorders were classified as either speech disorders, language disorders, or dysphagia (i.e., swallowing problems). The disorders were further classified as childhood language impairments, articulation disorders, stuttering, cluttering, voice disorders, aphasia, and dysphagia. Results: The results indicated that the prevalence for language disorders was the highest (50.7%) followed by speech disorders (48.3%), and dysphagia (0.9%). The majority of patients who were seen at the JU-HSC were diagnosed with childhood language impairments (47.3%) followed consecutively by articulation disorders (21.1%), stuttering (16.3%), voice disorders (12.1%), aphasia (2.2%), dysphagia (0.9%), and cluttering (0.2%). As for gender, the majority of patients seen at the clinic were males in all disorders except for voice disorders and cluttering. Discussion: The results of the present study indicate that the majority of examined patients were diagnosed with childhood language impairments. Based on this result, the researchers suggest that there seems to be a high prevalence of childhood language impairments among children in Jordan compared to other types of speech and language disorders. The researchers also suggest that there is a need for further examination of the actual prevalence data on speech and language disorders in Jordan. The fact that many of the children seen at the UJ-HSC were brought to the clinic either as a result of parental concern or teacher referral indicates that there seems to an increased awareness among parents and teachers about the services speech pathologists can provide about assessment and treatment of childhood speech and language disorders. The small percentage of other disorders (i.e., stuttering, cluttering, dysphasia, aphasia, and voice disorders) seen at the UJ-HSC may indicate a little awareness by the local community about the role of speech pathologists in the assessment and treatment of these disorders.

Keywords: clinic, disorders, language, profile, speech

Procedia PDF Downloads 310

Authors: Rania Melad Kamel Hakim

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. These have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these ‘syndrome’ forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or ‘non-syndrome’ autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way to improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co-morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties (‘sticky attention’), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

Procedia PDF Downloads 53

Authors: Ana L. Gonzalez-Celis, Edgardo Ruiz-Carrillo, Karina Reyes-Jarquin, Margarita Chavez-Becerra

Abstract:

Since recent decades, the aging has been viewed from a more positive perspective, where is not only about losses and damage, but also about being on a stage where you can enjoy life and live with well-being and quality of life. The challenge to feel better is to find those resources that seniors have. For that reason, psychological well-being has shown interest in the study of the affect and life satisfaction (hedonic well-being), while from a more recent tradition, focus on the development of capabilities and the personal growth, considering both as the main indicators of the quality of life. A resource that can be used in the later age is generativity, which refers to the ability of older people to develop and grow through activities that contribute with the improvement of the context in which they live and participate. In this way the generative interest is understood as a favourable attitude that contribute to the common benefit while strengthening and enriching the social institutions, to ensure continuity between generations and social development. On the other hand, generative behavior, differentiating from generative interest, is the expression of that attitude reflected in activities that make a social contribution and a benefit for generations to come. Hence the purpose of the research was to test if there is an association between the generative behaviour type and the psychological well-being with their dimensions. For this reason 188 Mexican adults from 60 to 94 years old (M = 69.78), 67% women, 33% men, completed two instruments: The Ryff’s Well-Being Scales to measure psychological well-being with 39 items with two dimensions (Hedonic and Eudaimonic well-being), and the Loyola’s Generative Behaviors Scale, grouped in five categories: Knowledge transmitted to the next generation, things to be remember, creativity, be productive, contribution to the community, and responsibility of other people. In addition, the socio-demographic data sheet was tested, and self-reported health status. The results indicated that the psychological well-being and its dimensions were significantly associated with the presence of generative behavior, where the level of well-being was higher when the frequency of some generative behaviour excelled; finding that the behavior with greater psychological well-being (M = 81.04, SD = 8.18) was "things to be remembered"; while with greater hedonic well-being (M = 73.39, SD = 12.19) was the behavior "responsibility of other people"; and with greater Eudaimonic well-being (M = 84.61, SD = 6.63), was the behavior "things to be remembered”. The most important findings highlight the importance of generative behaviors in adulthood, finding empirical evidence that the generativity in the last stage of life is associated with well-being. However, by finding differences in the types of generative behaviors at the level of well-being, is proposed the idea that generativity is not situated as an isolated construct, but needs other contextualized and related constructs that can simultaneously operate at different levels, taking into account the relationship between the environment and the individual, encompassing both the social and psychological dimension.

Keywords: eudaimonic well-being, generativity, hedonic well-being, Mexican elders, psychological well-being

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Authors: Obiageli Eze

Abstract:

Millions of Nigerian children are subjected daily to all forms of abuse, ranging from trafficking to slavery, and forced labor. These under age children are taken from different parts of the Country to be used as sex slaves and laborers in the big cities, killed for rituals, organ transplantation, or used for money laundering, begging on the streets or are put to work in the fields. These children are made to do inhuman jobs under degrading conditions and face all kinds of abuse at the hands of their owners with no hope of escape. While lots of people blame poverty or culture as a basis for human trafficking in Nigeria, the National Agency for the Prohibition and Trafficking in Persons and other Related Matters (NAPTIP) says other causes of the outrageous rate of human trafficking in the country are ignorance, desperation, and the promotion and commercialization of sex by the European Union (EU) as dozens of young Nigerian children and women are forced to work as prostitutes in European countries including the Netherlands, France, Italy, and Spain. In the cause of searching for greener pastures, they are coerced into work they have not chosen and subjected to perpetual life in bondage. The Universal Declaration of Human Rights 1948 prohibits slave trade and slavery. Despite the fact that Nigeria is a Sovereign member of the United Nations and signatory to this International instrument, Child trafficking and slavery is still on the increase. This may be caused by the fact that the punishment for this crime in Nigeria is a maximum term of 10 years imprisonment with some of the worst offenders getting off with as little as 2 years imprisonment or an option of fine. It goes without saying that this punishment is not sufficient to act as a deterrent to these modern slave traders. Another major factor oiling the wheel of trafficking in the country is voodoo. The victims are taken to shrines of voodoo priests for oath taking. There, underage girls and boys are made to swear that they would never reveal the identities of their traffickers to anyone if arrested whether in the course of the journey or in the destination countries and that they would pay off debt. Nigeria needs tougher Laws in order to be able to combat human trafficking and slave trade. Also there has to be aggressive sensitization and awareness programs designed to educate and enlighten the public as to the dangers faced by these victims and the need to report any suspicious activity to the authorities. This paper attempts to give an insight into the plight of under-age Nigerian children trafficked and sold as slaves and offer a more effective stand in the fight against it.

Keywords: child labor, slavery, slave trade, trafficking

Procedia PDF Downloads 502

Authors: Sara Asham Mahrous Kamel

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

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Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

Abstract:

Introduction: Head and neck cancers (HNC) are often associated with the development of non-HNC primaries, as the risk factors that predispose patients to HNC are often risk factors for other cancers. Aim: We sought to evaluate whether there was an increased risk of smoking and alcohol-related cancers and also other cancers in HNC patients and to evaluate whether there is a difference between the rates of non-HNC primaries in Aboriginal compared with non-Aboriginal HNC patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single center in Western Australia, identifying 80 Aboriginal and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, treatments, outcomes, and past and subsequent HNCs and non-HNC primaries. Results: In the overall study population, there were 86 patients (26.9%) with a metachronous or synchronous non-HNC primary. Non-HNC primaries were actually significantly more common in the non-Aboriginal population compared with the Aboriginal population (30% vs. 17.5%, p=0.02); however, half of these were patients with cutaneous squamous or basal cell carcinomas (cSCC/BCC) only. When cSCC/BCCs were excluded, non-Aboriginal patients had a similar rate as Aboriginal patients (16.7% vs. 15%, p=0.73). There were clearly more cSCC/BCCs in non-Aboriginal patients compared with Aboriginal patients (16.7% vs. 2.5%, p=0.001) and more patients with melanoma (2.5% vs. 0%, p value not significant (p=NS). Rates of most cancers were similar between non-Aboriginal and Aboriginal patients, including prostate (2.9% vs. 3.8%), colorectal (2.9% vs. 2.5%), kidney (1.2% vs. 1.2%), and these rates appeared comparable to Australian Age Standardised Incidence Rates (ASIR) in the general community. Oesophageal cancer occurred at double the rate in Aboriginal patients (3.8%) compared with non-Aboriginal patients (1.7%), which was far in excess of ASIRs which estimated a lifetime risk of 0.59% in the general population. Interestingly lung cancer rates did not appear to be significantly increased in our cohort, with 2.5% of Aboriginal patients and 3.3% of non-Aboriginal patients having lung cancer, which is in line with ASIRs which estimates a lifetime risk of 5% (by age 85yo). Interestingly the rate of Glioma in the non-Aboriginal population was higher than the ASIR, with 0.8% of non-Aboriginal patients developing Glioma, with Australian averages predicting a 0.6% lifetime risk in the general population. As these are small numbers, this finding may well be due to chance. Unsurprisingly, second HNCs occurred at an increased incidence in our cohort, in 12.5% of Aboriginal patients and 11.2% of non-Aboriginal patients, compared to an ASIR of 17 cases per 100,000 persons, estimating a lifetime risk of 1.70%. Conclusions: Overall, 26.9% of patients had a non-HNC primary. When cSCC/BCCs were excluded, Aboriginal and non-Aboriginal patients had similar rates of non-HNC primaries, although non-Aboriginal patients had a significantly higher rate of cSCC/BCCs. Aboriginal patients had double the rate of oesophageal primaries; however, this was not statistically significant, possibly due to small case numbers.

Keywords: head and neck cancer, synchronous and metachronous primaries, other primaries, Aboriginal

Procedia PDF Downloads 72

Authors: Gulden Aykinbaeva, Assem Umirzakova, Assel Makhadiyeva

Abstract:

The problem of studying of young married couples in connection with a change of social institute of a family and marriage is represented very actual for family consultation, considering a family role in the development of modern society. Results of numerous researchs say that one of difficult in formation and stabilization of a matrimony is the period of a young family. This period is characterized by various processes of integration, adaptation and emotional compatibility of spouses. The young family in it the period endures the first standard crisis which postpones a print for the further development of the family scenario. Emergence new, earlier not existing, systems of values render a huge value on the process of formation of a young family and each of spouses separately. Possibly to solve the set family tasks at the development of the uniform system of the family relations in which socially mature persons capable to consider a family as the creativity of each other act as subjects. Due to the research objective in work the following techniques were used: a questionnaire of satisfaction with V. V. Stolin's marriage and A. N. Volkova's technique directed on detection of coherence of family values and role installations in a married couple, and also content – the analysis. Development of an internal basis of a family on mutual clearing of values is important during the work with married couples. 'The mature view' of the partner in the marriage union provides coherence between the expected and real behavior of the partner that is important for the realization of the purposes of adaptation in a family. For research of communication of the data obtained by means of A. N. Volkova's techniques, V. V. Stolina and content – the analysis, the correlation analysis, with the application of the criterion of Spirmen was used. The analysis of results of the conducted research allowed us to determine the number of consistent patterns: 1. Nature of change of satisfaction with marriage at spouses testifies that the matrimonial relations undergo high-quality changes at different stages of formation of a young family. 2. The matrimonial relations in the course of their development, formation and functioning in young marriage undergo considerable changes on psychological, social and psychological and insignificant — at the psychophysiological and sociocultural levels. The material received by us allows to plan ways of further detailed researches of the development of the matrimonial relations not only in the young marriage but also at further stages of development of a matrimony. We believe that the results received in this research can be almost applied at creation of algorithms of selection of marriage partners, at diagnostics of character and the maintenance of matrimonial disharmonies, at the forecast of stability of marriage and a family.

Keywords: married couples, formation of the young family, psychological consultation, matrimony

Procedia PDF Downloads 394