Search results for: chronic respiratory questionnaire (CRQ)

Authors: Samar Mohamed Magdy Abdelrahim

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This study is an attempt to investigate the phenomenon of code-switching that takes place between Arabic and English in social discourse among high, well-educated, and young people in Egypt. The study aims at digging deeper to extract the trigger factors of such occurrences, namely when people encounter embarrassing situations in their daily conversations. Nowadays, most young Egyptians tend to use English words in certain situations that might make them feel embarrassed. To disguise their feelings and soften the impact of these words in the context, they code-switch (CS) from Arabic into English. To obtain accurate results, the study utilized a quantitative analysis approach that combines personal observations and a questionnaire to examine the phenomenon appropriately. The questionnaire was designed to categorize different types of embarrassing topics to be evaluated by participants. These topics include certain parts of the human body, types of clothes, taboo words, and specific medical conditions. Many studies have examined the use of CS as a prestigious way of communicating and expressing solidarity between Arabic and English. Other studies have dealt with switches that take place in classrooms. However, not many studies have paid attention to this angle of CS, especially in Egypt. The results conclude that gender and the circumstances that surround the conversation are essential factors of CS since females tend to switch codes more than males in embarrassing situations. According to the study, CS serves the socio-pragmatic function in terms of helping young, well-educated bilinguals express themselves in a second language that would be distressing in the first.

Keywords: code-switching, embarrassment, Arabic, English

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Authors: Kingkan Chumjamras

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There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

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Authors: Mahsa Kallhor Mohammadi, Hamideh Reshadatjoo

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This study verified the relationship between in-service training and employees’ feeling of psychological ownership. This research applied a descriptive survey that investigated a correlation between variables. The target population was 140 employees of a Drilling Fluid and Waste Management Service Company, and the sample was 123 employees who were selected randomly and encouraged to complete an electronic questionnaire which was designed based on standard questionnaires for research variables covering 62 questions. The face validity of the questionnaire was supported by an experimental test, and its content validity was approved by the thesis supervisor and consulting advisor. For the descriptive statistics frequency tables and diagrams, measures of central tendency such as mode, median, and mean and measures of variability such as variance, standards deviation, and quartile deviation were used. In the inferential statistics section, the Pearson correlation coefficient was used to verify the relationship between the variables of the research. According to the results, all of the research hypotheses were supported. According to hypothesis 1, there was a positive and significant relationship between training policy-making and employees’ psychological ownership (r=0/408, α=0/05). According to hypothesis 2, there was a positive and significant relationship between training planning and employees’ psychological ownership (r=0/446, α=0/05). According to hypothesis 3, there was a positive and significant relationship between providing the training and employees’ psychological ownership (r=0/512, α=0/05). According to hypothesis 4, there was a positive and significant relationship between training performance management and employees’ psychological ownership (r=0/462, α=0/05). According to hypothesis 5, there was a positive and significant relationship between employees’ motivation and psychological ownership (r=0/694, α=0/05). Therefore, through systematic in-service training, which is in the same line with the strategic goals of an organization and is based on scientific needs analysis, design, implementation, and evaluation, it is possible to improve employees’ sense of psychological ownership toward an organization.

Keywords: in-service training, motivation, organizational behavior, psychological ownership

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Authors: Hsien Hua Kuo, Wen Chun Lin, Chia Chi Hsu, Hsien Wen Kuo

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Objective: Despite the high prevalence of musculoskeletal disorders (MSDs) among nurses, which has been consistently observed in the studies of Western countries, very little information regarding intensity of workload and work-related quality of life (WRQOL) related to MSDs among nurses is available in Taiwan. The objective of this study is to investigate the factors affecting musculoskeletal disorders in nurses from a hospital. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire which contained the demographic information, workplace condition and musculoskeletal disorders. Results: Response rate of nurses were 92.5% from a teaching hospital. Based on medical diagnosis by physician, neck of musculoskeletal disorders had the highest percentage in nine body portions. The higher percentage of musculoskeletal disorders in nurses found from wards of internal and surgery. Severity and symptoms of musculoskeletal disorders diagnosed by self-reported questionnaire significantly correlated with WRQOL, job satisfaction and intensity of workload among nurses based on the logistic regression model. Conclusion: The severity and symptoms of musculoskeletal disorders among nurses showed a dose-dependent with WRQOL and workload. When work characteristics in hospital were modified, the severity of musculoskeletal disorders among nurses will be decreased and alleviated. Comment: Multifaceted ergonomic intervention programme to reduce the prevalence of MSDs among nurses was by encouraging nurses to do more physical activity which will make them more flexible and increase their strength. Therefore, the head nurse should encourage nurses to regularly physical activity and to modify unfitting ergonomic environment in order to reduce the prevalence of MSDs.

Keywords: musculoskeletal disorders, nurse, WRQOL, job satisfaction

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Authors: A. Aloga, A. S. Aloga

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The study examined the influence of instructional supervision on teachers’ performance in secondary schools in Otukpo LGA of Benue State. The study was guided by four research questions and four hypotheses. The study employed a descriptive research design. The population of the study comprised of 579 teachers in 26 public secondary schools out of which 236 respondents were sampled and used as the studied population. The instrument used for data collection was a structured questionnaire, titled ‘Instructional Supervision and Teachers Performance Questionnaire (ISTPQ)’ The data was analyzed using descriptive statistics of mean and standard deviation to answer the research questions. And Chi-Square Statistics was used to test the hypotheses at 0.05 level of significance. The study found that instructional supervision has a significant influence on teachers’ lesson planning, effective teaching, teachers’ class attendance and teachers’ classroom management. The study concluded that instructional supervision influences teachers’ performance. It was recommended that; instructional supervisors should always give useful suggestions as regards the best instructional practices needed by teachers in enhancing lesson planning. The government should recruit more trained and qualified instructional supervisors to be able to meet the intending demands of instructional supervision. This will relieve the existing few qualified instructional supervisors from work overload which may result to ineffectiveness and poor performance of their duties. Conferences and seminars should be organized for instructional supervisors from time to time to cater for the professional assistance needed by teachers. The state government should always provide adequate funding for these conferences and seminars since it provides an avenue for acquiring new knowledge in educational development by teachers among others.

Keywords: influence, instructional supervision, teachers’ performance, secondary schools

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Authors: Navah Z. Ratzon, Shlomit Cohen, Sigal Portnoy

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This work focuses on posture and risk factors for the musculoskeletal disorder in guitarists, which constitutes the largest group of musicians today. The source of the problems experienced by these musicians is linked to physical, psychosocial and personal risk factors. These muscular problems are referred to as Playing Related Musculoskeletal Disorder (PRMD). There is not enough research that specifically studies guitar players, and to the extent of our knowledge, there is almost no reference to the characteristics of their movement patterns while they play. This is in spite of the high prevalence of PRMD in this population. Kinematic research may provide a basis for the development of a prevention plan for this population and their unique characteristics of playing patterns. The aim of the study was to investigate the correlation between risk factors for PRMD among guitar players and self-reporting of pain in the skeletal muscles, and specifically to test whether there are differences in the kinematics of the upper body while playing in a sitting or standing posture. Twenty-five guitarists, aged 18-35, participated in the study. The methods included a motion analysis using a motion capture system, anthropometric measurements and questionnaires relating to risk factors. The questionnaires used were the Standardized Nordic Questionnaire for the Analysis of Musculoskeletal Symptoms and the Demand Control Support Questionnaire, as well as a questionnaire of personal details. All of the study participants complained of musculoskeletal pain in the past year; the most frequent complaints being in the left wrist. Statistically significant correlations were found between biodemographic indices and reports of pain in the past year and the previous week. No significant correlations were found between the physical posture while playing and reports of pain among professional guitarists. However, a difference was found in several kinematic parameters between seated and standing playing postures. In a majority of the joints, the joint angles while playing in a seated position were more extreme than those during standing. This finding may suggest a higher risk for musculoskeletal disorder while playing in a seated position. In conclusion, the results of the present research highlight the prevalence of musculoskeletal problems in guitar players and its correlation with various risk factors. The finding supports the need for intervention in the form of prevention through identifying the risk factors and addressing them. Relating to the person, to their occupation and environment, which are the basis of proper occupational therapy, can help meet this need.

Keywords: body posture, motion tracking, PRMD, guitarists

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Authors: Mhaned Oubounyt, Jan Baumbach

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Differences in co-expression networks between two or multiple cells (sub)types across conditions is a pressing problem in single-cell RNA sequencing (scRNA-seq). A key challenge is to define those co-variations that differ between or among cell types and/or conditions and phenotypes to examine small regulatory networks that can explain mechanistic differences. To this end, we developed SCANet, an all-in-one Python package that uses state-of-the-art algorithms to facilitate the workflow of a combined single-cell GCN (Gene Correlation Network) and GRN (Gene Regulatory Networks) pipeline, including inference of gene co-expression modules from scRNA-seq, followed by trait and cell type associations, hub gene detection, co-regulatory networks, and drug-gene interactions. In an example case, we illustrate how SCANet can be applied to identify regulatory drivers behind a cytokine storm associated with mortality in patients with acute respiratory illness. SCANet is available as a free, open-source, and user-friendly Python package that can be easily integrated into systems biology pipelines.

Keywords: single-cell, co-expression networks, drug-gene interactions, co-regulatory networks

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Authors: B. S. Premalatha, Mereen Rose Babu, Vaishali Prabhu

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Background: Dysphagia must be assessed, either subjectively or objectively, in order to properly address the swallowing difficulty. Providing therapeutic care to patients with dysphagia via tele mode was one approach for providing clinical services during the COVID-19 epidemic. As a result, the teleassessment of dysphagia has increased in India. Aim: This study aimed to identify challenges faced by Indian SLPs while providing teleassessment to individuals with dysphagia during the outbreak of COVID-19 from 2020 to 2021. Method: After receiving approval from the institute's institutional review board and ethics committee, the current study was carried out. The study was cross-sectional in nature and lasted from 2020 to 2021. The study enrolled participants who met the inclusion and exclusion criteria of the study. It was decided to recruit roughly 246 people based on the sample size calculations. The research was done in three stages: questionnaire development and content validation, questionnaire administration. Five speech and hearing professionals' content verified the questionnaire for faults and clarity. Participants received questionnaires via various social media platforms such as e-mail and WhatsApp, which were written in Microsoft Word and then converted to Google Forms. SPSS software was used to examine the data. Results: In light of the obstacles that Indian SLPs encounter, the study's findings were examined. Only 135 people responded. During the COVID-19 lockdowns, 38% of participants said they did not deal with dysphagia patients. After the lockout, 70.4% of SLPs kept working with dysphagia patients, while 29.6% did not. From the beginning of the oromotor examination, the main problems in completing tele evaluation of dysphagia have been highlighted. Around 37.5% of SLPs said they don't undertake the OPME online because of difficulties doing the evaluation, such as the need for repeated instructions from patients and family members and trouble visualizing structures in various positions. The majority of SLPs' online assessments were inefficient and time-consuming. A bigger percentage of SLPs stated that they will not advocate tele evaluation in dysphagia to their colleagues. SLPs' use of dysphagia assessment has decreased as a result of the epidemic. When it came to the amount of food, the majority of people proposed a small amount. Apart from placing the patient for assessment and gaining less cooperation from the family, most SLPs found that Internet speed was a source of concern and a barrier. Hearing impairment and the presence of a tracheostomy in patients with dysphagia proved to be the most difficult conditions to treat online. For patients with NPO, the majority of SLPs did not advise tele-evaluation. In the anterior region of the oral cavity, oral meal residue was more visible. The majority of SLPs reported more anterior than posterior leakage. Even while the majority of SLPs could detect aspiration by coughing, many found it difficult to discern the gurgling tone of speech after swallowing. Conclusion: The current study sheds light on the difficulties that Indian SLPs experience when assessing dysphagia via tele mode, indicating that tele-assessment of dysphagia is still to gain importance in India.

Keywords: dysphagia, teleassessment, challenges, Indian SLP

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Authors: Olugbenga S. Alebiosu, Olusola H. Adekanmbi, Oluwatoyin T. Ogundipe

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Pollen and spores have been identified as major airborne bio-particles inducing respiratory disorders such as asthma, allergic rhinitis and atopic dermatitis among hypersensitive individuals. An aeropalynological study was conducted within a one year sampling period with a view to investigating the monthly depositional rate of atmospheric pollen and spores; influence of the immediate vegetation on airborne pollen distribution; allergenic potentials of dominant atmospheric pollen types at selected study locations in Bauchi and Taraba states, Northwestern Nigeria. A tauber-like pollen trap was employed in aerosampling with the sampler positioned at a height of 5 feet above the ground, followed by a monthly collection of the recipient solution for the sampling period. The collected samples were subjected to acetolysis treatment, examined microscopically with the identification of pollen grains and spores using reference materials and published photomicrographs. Plants within the surrounding vegetation were enumerated. Crude protein contents extracted from pollen types found to be commonly dominant at both study locations; Senna siamea, Terminalia cattapa, Panicum maximum and Zea mays were used to sensitize Musmusculus. Histopathological studies of bronchi and lung sections from certain dead M.musculus in the test groups was conducted. Blood samples were collected from the pre-orbital vein of M.musculus and processed for serological and haematological (differential and total white blood cell counts) studies. ELISA was used in determining the levels of serological parameters: IgE and cytokines (TNF-, IL-5, and IL-13). Statistical significance was observed in the correlation between the levels of serological and haematological parameters elicited by each test group, differences between the levels of serological and haematological parameters elicited by each test group and those of the control, as well as at varying sensitization periods. The results from this study revealed dominant airborne pollen types across the study locations; Syzygiumguineense, Tridaxprocumbens, Elaeisguineensis, Mimosa sp., Borreria sp., Terminalia sp., Senna sp. and Poaceae. Nephrolepis sp., Pteris sp. and a trilete fern also produced spores. This study also revealed that some of the airborne pollen types were produced by local plants at the study locations. Bronchi sections of M.musculus after first and second sensitizations, as well as lung section after first sensitization with Senna siamea, showed areas of necrosis. Statistical significance was recorded in the correlation between the levels of some serological and haematological parameters produced by each test group and those of the control, as well as at certain sensitization periods. The study revealed some candidate pollen allergens at the study locations allergy sufferers and also established a complexity of interaction between immune cells, IgE and cytokines at varied periods of mice sensitization and forming a paradigm of human immune response to different pollen allergens. However, it is expedient that further studies should be conducted on these candidate pollen allergens for their allergenicity potential in humans within their immediate environment.

Keywords: airborne, hypersensitive, mus musculus, pollen allergens, respiratory, tauber-like

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Authors: Mahdi Akhbardeh

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Synchronization of neuronal firing is a hallmark of several neurological diseases. Recently, stimulation techniques have been developed which make it possible to desynchronize oscillatory neuronal activity in a mild and effective way, without suppressing the neurons' firing. As yet, these techniques are being used to establish demand-controlled deep brain stimulation (DBS) techniques for the therapy of movement disorders like severe Parkinson's disease or essential tremor. We here present a first conceptualization suggesting that the nucleus accumbens is a promising target for the standard, that is, permanent high-frequency, DBS in patients with severe and chronic obsessive-compulsive disorder (OCD). In addition, we explain how demand-controlled DBS techniques may be applied to the therapy of OCD in those cases that are refractory to behavioral therapies and pharmacological treatment.

Keywords: stereotactic neurosurgery, deep brain stimulation, obsessive-compulsive disorder, phase resetting

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Authors: Monika Skura

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People with physical disabilities, as with other people with differences in appearance or style of functioning come under negative social mechanisms. Therefore, it is worth asking what the relationship of the group is, who experience psychosocial effects because of their physical disability, towards people with intellectual disabilities, hearing impairments, visual impairments, mental illnesses, and their own physically disabled group. To analyse the perception of people with a physical disability, the study explores three areas: the acceptance or rejection of society’s stigmatization towards persons with disabilities; the importance of their own experience regarding their disability, in relation to another kind of disability; their level of acceptance to social interactions, in relation to various types of disabilities. The research sample consisted of 90 people with physical disabilities, who suffer from damage to the locomotor system. The data was collected using a questionnaire and the Adjective Check List by H. B. Gough and A. B. Heilbrun. This study utilized focus interviews to develop survey items for the questionnaire. The findings highlight that the response from those who were physically disabled agreed with the opinions of general society, not only with the issue of promoting integrated solutions and offering assistance but also having the same preferences and opinions about specific types of disability. However, their perception regarding their own group was noticeably different from that of general society. In the light of the study, for people with physical disabilities, just as for able-bodied people, it can be challenging to develop a meaningful relationship with people who have disabilities. All forms of disability suffer from negative attitudes and opinions that exist in society. The majority of those who were researched were focused primarily on their own problems, this inevitably hinders the integrity of the entire group, making it more difficult for it to find a cohesive voice, in which to promote their place within society.

Keywords: general society’s opinions about disability, people with different kinds of disability, perception, physical disability

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Authors: Doctor Akanle Florence Foluso

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Access to health care and people’s ability to having a responsible, satisfying and safe sexual life is clearly a defined human right of people with hearing impairment and others with disabilities this paper looks at disability and sexuality: a human right approach to sexual and reproductive health of the hearing impaired adolescents in developing countries. This paper investigates the extent to which the hearing impaired has a satisfying, safe sexual life and whether their human right in regards to information education is violated. The study population consists of all hearing impaired adolescents and young adults aged 10-24 years who are currently enrolled in the primary and secondary schools in Nigeria. A sample of 389 hearing impaired adolescents was selected, an adapted version of the illustrative questionnaire for interview – survey by Johncleland was used to collect the data. A correlation of 0.80 was obtained at p<0.05 level of significance. Teachers in the schools of the deaf who used sign language were used in the administration of the questionnaire. The data generated were analyzed using Frequency Counts, Percentages, Means and Standard Deviation to give a Summary on responses on access to information, education, voluntary testing and counselling and other reproductive services. This is to investigate if the sexual and reproductive right violated or protected. Findings show that a gap exists in the level of knowledge of SRH services, voluntary counselling because more than half the respondents are not aware of these services in their community. Access to information, education and health services are rights denied the hearing impaired. So their SRH rights are violated.

Keywords: sexual right diability, family planning, pregnancy, diability

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Authors: Qingyu Zhang, Helin Ma, Lili Weng, Mei Cao

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Green supply chain management has been an important organizational strategy to reduce environmental risks and improve financial performance. Firms have to adopt green supply chain practices to meet the official regulations and reduce peer pressure in China. This paper exhibits an empirical study of the drivers of green supply chain management practices and the environmental and economic performance of green supply chain management implementation in Chinese firms. While China is the fastest-growing emerging economy, it has paid a high ecological price. It is reported that China hosts 7 of the world’s 10 most polluted cities. The continued environmental deterioration and the resultant heightened regulatory control and public scrutiny have posed new operating challenges to firms conducting business in China. These challenges make the country an ideal setting to conduct the present study. A research questionnaire was developed to gather data in China. The questionnaire targeted managers and employees in Chinese companies. The data were collected in the last quarter of 2015, involving industries such as electronic & communicational equipment, textile & clothing, pharmaceutical & healthcare, and so on. This study confirms and validates that (1) both internal and external drivers play a significant role in the implementation of green supply chain management practices; (2) green purchase and investment recovery have a significant impact on firms’ environmental and economic performance; (3) with the improvement of the firms’ environmental performance, their economic performance will improve.

Keywords: economic performance, environmental performance, external driver, green supply chain management

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Authors: Nelson R. Osungbemiro, Rafiu O. Sanni, Rotimi F. Olaniyan, Abayomi O. Olajuyigbe

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Bacteria flora of Clarias gariepinus collected from two natural habitats namely Owena River (freshwater) and Igbokoda lagoon (brackish water) were examined using standard microbiological procedures. Thirteen bacterial species were identified. The result indicated that from the identified bacteria isolated, Vibrio sp, Proteus sp. Shigella sp. and E. coli were present in both habitats (fresh and brackish waters). Others were habitat-selective such as Salmonella sp., Pseudomonas sp, Enterococcus sp, Staphylococcus sp. that were found only in freshwater habitat. While Branhamella sp, Streptococcus sp. and Micrococcus sp. were found in brackish water habitat. Bacteria load from Owena river (freshwater) was found to be the highest load recorded at 6.21 x 104cfu. T-test analysis also revealed that there was a marked significant difference between bacterial load in guts of sampled Clarias from fresh water and brackish water habitats.

Keywords: bacteria flora, gut, Clarias gariepinus, Owena river

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Authors: Mayowa Adeyeye

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This study was conducted to investigate the psychological variables motivating sport participation and involvement among student-athletes of tertiary institutions in south-west Nigeria. One thousand three hundred and fifty (N-1350) student-athletes were randomly selected in all sports from nine tertiary institutions in south-west Nigeria. These tertiary institutions include University of Lagos, Lagos State University, Obafemi Awolowo University, Osun State University, University of Ibadan, University of Agriculture Abeokuta, Federal University of Technology Akungba, University of Ilorin, and Kwara State University. The descriptive survey research method was adopted while a self developed validated likert type questionnaire named Sport Participation Scale (SPS) was used to elicit opinion from respondents. The test-retest reliability value obtained for the instrument, using Pearson Product Moment Correlation Co-efficient was 0.96. Out of the one thousand three hundred and fifty (N-1350) questionnaire administered, only one thousand two hundred and five (N-1286) were correctly filled, coded and analysed using inferential statistics of Chi-Square (X2) while all the tested hypotheses were set at .05 alpha level. Based on the findings of this study, the result revealed that several psychological factors influence student athletes to continue participation in sport, which includes love for the game, famous athletes as role model and family support. However, the analysis further revealed that the stipends the student-athletes get from their universities have no influence on their participation and involvement in sport.

Keywords: sport participation, involvement, student-athletes, role model, family, peer

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Authors: Lu Yang, Meiyang Song, Xiang Yu, Wenhao Zhou, Chuntao Feng

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To address the problem that the FM continuous-wave radar (FMCW) extracts human vital sign signals which are susceptible to noise interference and low reconstruction accuracy, a new detection scheme for the sign signals is proposed. Firstly, an improved complete ensemble empirical modal decomposition with adaptive noise (ICEEMDAN) algorithm is applied to decompose the radar-extracted thoracic signals to obtain several intrinsic modal functions (IMF) with different spatial scales, and then the IMF components are optimized by a BP neural network improved by immune genetic algorithm (IGA). The simulation results show that this scheme can effectively separate the noise and accurately extract the respiratory and heartbeat signals and improve the reconstruction accuracy and signal-to-noise ratio of the sign signals.

Keywords: frequency modulated continuous wave radar, ICEEMDAN, BP neural network, vital signs signal

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Authors: Elizabeth Adebomi Akinlotan, Olukemi Odukoya

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INTRODUCTION: Physical Activity is defined as activity that involves bodily movement which is done as a part of daily activity in the form of working, playing, active transportation such as walking and also as a form of recreational activity. Physical inactivity has been identified as the fourth leading risk factor for global mortality and morbidity causing an estimated 3.2 million deaths globally and 5.5% of total deaths and it remains a pressing public health issue. There is a shift in the major causes of death from communicable to non-communicable diseases in many developed countries and this is fast becoming the case in developing countries. Physical activity is an important determinant of health and has been associated with lower mortality rates as it reduces the risk of developing chronic diseases such as diabetes mellitus, hypertension, stroke, cancer and osteoporosis. It improves musculoskeletal health, controls weight and reduces symptoms of depression. AIM: The aim is to study the knowledge, attitude and practices of physical activity among adults in Alimosho local government area. METHODOLOGY: This was a descriptive cross sectional survey designed to study the knowledge, attitude and practice of physical activity among adults in Alimosho Local Government Area. The study population were 250 adults aged 18-65 who were residents of the area of more than 6 months duration and had no chronic disease condition or physical disability. A multistage sampling method was used to select the respondents and data was collected using interviewer administered questionnaires. The data was analyzed with the use of EPI-info 2007 statistical software. Chi Square was thereafter used to test the association between selected variables. The level of statistical significance was set at 5% (p<0.05). RESULTS: In general, majority (61.6%) of the respondents had a good knowledge of what physical activity entails, 34.0% had fair knowledge and 4.4% had poor knowledge. There was a favorable attitude towards physical activity among the respondents with 82.4% having an overall positive attitude. Below a third of the respondents (26.4%) reported having a high physical activity (METS > 3001) while 40.0% had moderate (601-3000 METS) levels of activity and 33.6% were inactive (<600METS). There is statistical significance between the gender of the respondent and the levels of physical activity (p=0.0007); 75.2% males reached the minimum recommendations while 24.8% were inactive and 55.0% females reached the minimum recommendations while 45.0% were inactive. Results also showed that of 95 respondents who were satisfied with their levels of physical activity, 33.7% were insufficiently active while 66.3% were either minimally active or highly active and of 110 who were unsatisfied with their levels of physical activity, 72.0% were above the minimum recommendations while 38.0% were insufficiently active. CONCLUSION: In contrast to the high level of knowledge and favorable attitude towards physical activity, there was a lower level of practice of high or moderate physical activities. It is recommended that more awareness should be created on the recommended levels of physical activity especially for the vigorous intensity and moderate intensity physical activity.

Keywords: METS, physical activity, physical inactivity, public health

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Authors: I. Hua Chu, Hsiang-Chi Yu, Hsuan Su

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Purpose: To examine the associations between self-determined motivation and physical activity in patients with coronary heart disease (CHD) in a longitudinal study. Methods: Patients with CHD were recruited for this study. Their motivations for exercise were measured by the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2). Physical activity was assessed using the 7-day physical activity recall questionnaire. Duration and energy expenditure of moderate to vigorous physical activity (MVPA) were used in data analysis. All outcome measures were assessed at baseline and 12 months follow up. Data were analyzed using Pearson correlation analysis and regression analysis. Results: The results of the 45 participants (mean age 60.24 yr; 90.2% male) revealed that there were significant negative correlations between amotivation at baseline and duration (r=-.295, p=.049) and energy expenditure (r=-.300, p=.045) of MVPA at 12 months. In contrast, there were significant positive correlations between calculated relative autonomy index (RAI) at baseline and duration (r=.377, p=.011) and energy expenditure (r=.382, p=.010) of MVPA at 12 months. There was no significant correlation between other subscales of the BREQ-2 and duration or energy expenditure of MVPA. Regression analyses revealed that RAI was a significant predictor of duration (p=.011) and energy expenditure (p=.010) of MVPA at 12 months follow-up. Conclusions: These results suggest that the relative degree of self-determined motivation could predict long-term MVPA behaviors in CHD patients. Physical activity interventions are recommended to target enhancing one’s identified and intrinsic motivation to increase the likelihood of physical activity participation in this population.

Keywords: self-determined motivation, physical activity, coronary heart disease, relative autonomy index (RAI)

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Authors: Jiaqi XU, Qingru Sun

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Accent plays a crucial role in second language (L2) learners’ performance in the schooling context in the era of globalization, where English is adopted as a lingua franca (ELF). Previous studies found that Chinese mainland students prefer American English accents, whereas the young generations in Hong Kong prefer British accents. However, these studies neglect the non-native accents of English and fail to elaborate much about why the L2 learners differ in accent preferences between the two regions. Therefore, this research aims to bridge the research gap by 1) including both native and non-native varieties of English accents: American accent, British accent, Chinese Mandarin English accent, and Hong Kong English accent; and 2) uncovering and comparing the deeper reasons for the similar or/and different accent preferences between the Chinese mainland and Hong Kong speakers. This research designed a questionnaire including objective and subjective questions to investigate the students’ accent inclinations and the attitudes and reasons behind their linguistic choices. The questionnaire was distributed to eight participants (4 Chinese mainland students and 4 Hong Kong students) who were postgraduate students at a Hong Kong university. Based on the data collection, this research finds out one similarity and two differences between the Chinese mainland and Hong Kong students’ attitudes. The theories of identity construction and standard language ideology are further applied to analyze the reasons behind the similarities and differences and to evaluate how language attitudes intertwine with their identity construction and language ideology.

Keywords: accent, language attitudes, identity construction, language ideology, ELF communication

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Authors: Sakae Suzuki

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Although Japanese students study English for six years in secondary schools, they demonstrate little success with it when they enter higher education. Learners’ beliefs can predict the future behavior of students, so it may be effective to investigate how learners’ beliefs limit their success and how beliefs might be nudged in a positive direction. While many researchers still depend on a questionnaire called BALLI to reveal explicit beliefs, alternative approaches, especially those designed to reveal implicit beliefs, might be helpful for promoting learning. The present study seeks to identify beliefs with a discursive approach using visual metaphors and narratives. Employing a sociocultural framework, this study investigates how students’ beliefs are revealed by drawings of themselves and their surrounding environments and artifacts while they are engaged in language learning. Research questions are: (1) Can we identify beliefs through an analysis of students’ visual narratives? (2) What environments and artifacts can be found in students’ drawings, and what do they mean? (3) To what extent do students see language learning as a solitary, rather than a social, activity? Participants are university students majoring in science and technology in Japan. The questionnaire was administered to 70 entering students in April, 2014. Data included students drawings of themselves as learners of English as well as written descriptions of students’ backgrounds, English-learning experiences, and analogies and metaphors that they used in written descriptions of themselves as learners. Data will be analyzed qualitatively and quantitatively. Anticipated results include students’ perceptions of themselves as language learners, including their sense of agency, awareness of artifacts, and social contexts of language learning. Comments will be made on implications for teaching, as well as the use of visual narratives as research tools, and recommended further research.

Keywords: drawings, learners' beliefs, metaphors, BALLI

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Authors: Milena Trojanowska

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Disability is a phenomenon for which meanings and definitions have evolved over the decades. This became the trigger to start a project to answer the question of what disability constitutes in the course of an incurable chronic disease. The chosen research group are people living with multiple sclerosis.The contextual phase of the research was participant observation at the Polish Multiple Sclerosis Society, the largest NGO in Poland supporting people living with MS and their relatives. The research techniques used in the project are (in order of implementation): group interviews with people living with MS and their relatives, narrative interviews, asynchronous technique, participant observation during events organised for people living with MS and their relatives.The researcher is currently conducting follow-up interviews, as inaccuracies in the respondents' narratives were identified during the data analysis. Interviews and supplementary research techniques were used over the four years of the research, and the researcher also benefited from experience gained from 12 years of working with NGOs (diaries, notes). The research was carried out in Poland with the participation of people living in this country only.The research has been based on grounded theory methodology in a constructivist perspectivedeveloped by Kathy Charmaz. The goal was to follow the idea that research must be reliable, original, and useful. The aim was to construct an interpretive theory that assumes temporality and the processualityof social life. TheAtlas.ti software was used to collect research material and analyse it. It is a program from the CAQDAS(Computer-Assisted Qualitative Data Analysis Software) group.Several key factors influencing the construction of a disability identity by people living with multiple sclerosis was identified:-course of interaction with significant relatives,- the expectation of identification with disability (expressed by close relatives),- economic profitability (pension, allowances),- institutional advantages (e.g. parking card),- independence and autonomy (not equated with physical condition, but access to adapted infrastructure and resources to support daily functioning),- the way a person with MS construes the meaning of disability,- physical and mental state,- medical diagnosis of illness.In addition, it has been shown that making an assumption about the experience of disability in the course of MS is a form of cognitive reductionism leading to further phenomenon such as: the expectation of the person with MS to construct a social identity as a person with a disability (e.g. giving up work), the occurrence of institutional inequalities. It can also be a determinant of the choice of a life strategy that limits social and individual functioning, even if this necessity is not influenced by the person's physical or psychological condition.The results of the research are important for the development of knowledge about the phenomenon of disability. It indicates the contextuality and complexity of the disability phenomenon, which in the light of the research is a set of different phenomenon of heterogeneous nature and multifaceted causality. This knowledge can also be useful for institutions and organisations in the non-governmental sector supporting people with disabilities and people living with multiple sclerosis.

Keywords: disability, multiple sclerosis, grounded theory, poland

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Authors: Yuta Chishima, Tatsuya Murakami, Michael McKay

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Temporal focus is described as one component of an individual’s time perspective and defined as the attention individuals devote to thinking about the past, present, and future. It affects how people incorporate perceptions about past experiences, current situations, and future expectations into their attitudes, cognitions, and behavior. The 12-item Temporal Focus Scale (TFS) is comprised of three-factors (past, current and future focus). The purpose of this study was to examine the reliability and validity of TFS scores in Japanese adolescents and young adults. The TFS was translated into Japanese by a professional translator, and the original author confirmed the back translated items. Study 1 involved 979 Japanese university students aged 18-25 years old in a questionnaire-based study. The hypothesized three-factor structure (with reliability) was confirmed, although there were problems with item 10. Internal consistency estimates for scores without item 10 were over .70, and test-retest reliability was also adequate. To verify the concurrent and convergent validity, we tested the relationship between TFS scores and life satisfaction, time perspective, self-esteem, and career efficacy. Results of correlational analyses supported our hypotheses. Specifically, future focus was strongly correlated to career efficacy, while past and current focus was not. Study 2 involved 1030 Japanese junior and junior high school students aged 12-18 years old in a questionnaire-based study, and results of multigroup analyses supported the age invariance of the TFS.

Keywords: Japanese, reliability, scale, temporal focus, validity

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Authors: Alok Bapatla, Pamela Lutting, Mariastella Serrano

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Background: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain associated with altered bowel habits in the absence of an underlying organic cause. Although the exact etiology of IBS is not fully understood, one of the leading theories postulates a pathology within the Brain-Gut Axis that leads to an overall increase in gastrointestinal sensitivity and pejorative changes in gastrointestinal motility. Research and clinical practice have shown that Gut Directed Hypnotherapy (GDH) has a beneficial clinical role in improving Mind-Gut control and thereby comorbid conditions such as anxiety, abdominal pain, constipation, and diarrhea. Aims: This study presents a 17-year old male with underlying anxiety and a one-year history of IBS-Constipation Predominant Subtype (IBS-C), who has demonstrated impressive improvement of symptoms following GDH treatment following refractory trials with medications including bisacodyl, senna, docusate, magnesium citrate, lubiprostone, linaclotide. Method: The patient was referred to a licensed clinical psychologist specializing in clinical hypnosis and cognitive-behavioral therapy (CBT), who implemented “The Standardized Hypnosis Protocol for IBS” developed by Dr. Olafur S. Palsson, Psy.D at the University of North Carolina at Chapel Hill. The hypnotherapy protocol consisted of a total of seven weekly 45-minute sessions supplemented with a 20-minute audio recording to be listened to once daily. Outcome variables included the GAD-7, PHQ-9 and DCI-2, as well as self-ratings (ranging 0-10) for pain (intensity and frequency), emotional distress about IBS symptoms, and overall emotional distress. All variables were measured at intake prior to administration of the hypnosis protocol and at the conclusion of the hypnosis treatment. A retrospective IBS Questionnaire (IBS Severity Scoring System) was also completed at the conclusion of the GDH treatment for pre-and post-test ratings of clinical symptoms. Results: The patient showed improvement in all outcome variables and self-ratings, including abdominal pain intensity, frequency of abdominal pain episodes, emotional distress relating to gut issues, depression, and anxiety. The IBS Questionnaire showed a significant improvement from a severity score of 400 (defined as severe) prior to GDH intervention compared to 55 (defined as complete resolution) at four months after the last session. IBS Questionnaire subset questions that showed a significant score improvement included abdominal pain intensity, days of pain experienced per 10 days, satisfaction with bowel habits, and overall interference of life affected by IBS symptoms. Conclusion: This case supports the existing research literature that GDH has a significantly beneficial role in improving symptoms in patients with IBS. Emphasis is placed on the numerical results of the IBS Questionnaire scoring, which reflects a patient who initially suffered from severe IBS with failed response to multiple medications, who subsequently showed full and sustained resolution

Keywords: pediatrics, constipation, irritable bowel syndrome, hypnotherapy, gut-directed hypnosis

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Authors: Goutom K. Pall

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At the very heart of the power system, power transmission (PT) acts as an essential link between power generation and distribution. Timely completion of PT infrastructures is therefore crucial to support the development of power system as a whole. Yet despite the importance, studies on PT infrastructure development projects are embryonic and, hence, PT projects undergoing widespread delays worldwide. These delay factors are idiosyncratic and identifying the critical delay factors is essential if the PT industry professionals are to complete their projects efficiently and within the expected timeframes. This study identifies and categorizes 46 causes of PT project delay under ten major groups using six sector expert’s recommendations studied by a preliminary questionnaire survey. Based on the experts’ strong recommendations, two new groups are introduced in the final questionnaire survey: sector specific factors (SSF) and general factors (GF). SSF pertain to delay factors applicable only to the PT projects, while GF represents less biased samples with shared responsibilities of all project parties involved in a project. The study then uses 112 data samples from the contractors to rank the delay factors using relative importance index (RII). The results reveal that SSF, GF and external factors are the most critical groups, while the highest ranked delay factors include the right of way (RoW) problems of transmission lines (TL), delay in payments, frequent changes in TL routes, poor communication and coordination among the project parties and accessibility to TL tower locations. Finally, recommendations are made to minimize the identified delay. The findings are expected to be of substantial benefit to professionals in minimizing time overrun in PT projects implementation, as well as power generation, power distribution, and non-power linear construction projects worldwide.

Keywords: delay, project delay, power transmission projects, time-overruns

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Authors: Bahram Siavashpor, Zeynab Haji Abdolhadi

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The issue of the worn out textures is one of the urban community challenges in which, undoubtedly, the intervention is impossible without the social involvement. Some believe that in the worn out areas the most important intervention challenge is the social issues, and the most important social issue, in the intervention in the worn out areas, is how to attract public participation. Participation by itself has a widespread literature and despite relative acceptance, it should be said that planners, managers and designers are not always successful in attracting public participation. If participation means the intervention of all the residents in the neighborhood, women’s community forms half of these residents, but they are neglected in the participatory planning. It is important to know that to what extent the presence of women’s community in the related participation to the worn out textures affects the success of the projects. The present study hypotheses emphasize the effectiveness of women than men in involvement of the renovation and reforming projects. A case study was selected to investigate this hypothesis in order to test it through doing a questionnaire and visiting the place. Tehran Helal Ahmar region located in district 11 has 2740 households in which 51% are men and 49% women. The statistical population consists of 150 men and women of this area selected randomly. In the present study, interview technique with the executives was used as well as questionnaire along collecting the related research. The hypothesis analysis was carried out through SPSS and Excel software, in which two tests ‘Man-Whitney’ and ‘chi-square’ were used. The results indicate that women are empowered in the participation and renovation of the area, but it is necessary to rectify men’s attitude towards women’s ability in terms of women participation.

Keywords: renovation, social involvement, women’s participation, worn out texture

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Authors: S. Ramteke, K. S. Patel

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Aerosols are complex mixture of particulate matters (PM) inclusive of carbons, silica, elements, various salts, etc. Aerosols get deep into the human lungs and cause a broad range of health effects, in particular, respiratory and cardiovascular illnesses. They are one of the major culprits for the climate change. They are emitted by the high thermal processes i.e. vehicles, steel, sponge, cement, thermal power plants, etc. Raipur (22˚33'N to 21˚14'N and 82˚6'E) to 81˚38'E) is a growing industrial city in central India with population of two million. In this work, the distribution of inorganics (i.e. Cl⁻, NO³⁻, SO₄²⁻, NH₄⁺, Na⁺, K⁺, Mg²⁺, Ca²⁺, Al, Cr, Mn, Fe, Ni, Cu, Zn, and Pb) associated to the PM in the ambient air is described. The PM₁₀ in ambient air of Raipur city was collected for duration of one year (December 2014 - December 2015). The PM₁₀ was segregated into nine modes i.e. PM₁₀.₀₋₉.₀, PM₉.₀₋₅.₈, PM₅.₈₋₄.₇, PM₄.₇₋₃.₃, PM₃.₃₋₂.₁, PM₂.₁₋₁.₁, PM₁.₁₋₀.₇, PM₀.₇₋₀.₄ and PM₀.₄ to know their emission sources and health hazards. The analysis of ions and metals was carried out by techniques i.e. ion chromatography and TXRF. The PM₁₀ concentration (n=48) was ranged from 100-450 µg/m³ with mean value of 73.57±20.82 µg/m³. The highest concentration of PM₄.₇₋₃.₃, PM₂.₁₋₁.₁, PM₁.₁₋₀.₇ was observed in the commercial, residential and industrial area, respectively. The effect of meteorology i.e. temperature, humidity, wind speed and wind direction in the PM₁₀ and associated elemental concentration in the air is discussed.

Keywords: ambient aerosol, ions, metals, segregation

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Authors: Magdalena Hasplova, Katerina Ivanova

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Perinatal palliative care is a relatively young and developing field that includes the care of a fetus or newborn with a life-threatening or limiting defect and his family. However, the training of midwives in perinatal palliative care is insufficient and midwives do not feel prepared for this aspect of their work. This fact can affect the barriers to communication with the mother or family of the endangered child. The main aim was to analyze the awareness of midwifery students on the issue of perinatal palliative care in the Czech Republic. Based on the analysis, draw attention to possible communication barriers that may be caused by insufficient information. The research was carried out using a qualitative method, the method of data collection was a semi-structured interview. Eleven female students took part in the research, and the respondents were selected using the Snowballing method. Some methods of grounded theory (open coding and category creation) were used to analyze the data. Based on the results of the research, questions were set in a questionnaire focused on communication barriers between mothers (family) and health care professionals in the care of newborns with life-threatening or limiting disabilities. Based on the analysis of data, categories 1 were determined. Knowledge of perinatal palliative care 2. Education 3. Practical experience 4. Readiness and concerns in the provision of perinatal palliative care 6. Supervision. The questions in the questionnaire were then derived taking into account the data obtained, and the operationalization of health literacy in the field of perinatal palliative care was performed. The analysis of the interviews revealed that the education of midwives in the Czech Republic in the issue of perinatal palliative care is not uniform. The research confirmed the insufficient knowledge and skills of midwifery students preparing to provide perinatal palliative care. Respondents reported feelings of unpreparedness in the areas of communication with a woman after perinatal loss, psychological support for a woman and her family, the care of a stillborn or dying child, or self-coping with death. The questions in the questionnaire then develop these areas. We assumed that by analyzing and interpreting the data obtained from our research, we will help to better understand the concerns and motivations of students in providing holistic perinatal palliative care. We came to the conclusion that it would be appropriate to set up a unified and comprehensive education on this issue in the Czech Republic. Healthcare professionals are in a unique position that can positively or negatively affect the intensity of perinatal loss. Already properly set up education of health professionals leads to overcoming barriers in communication between health professionals and the family, experiencing perinatal loss.

Keywords: midwife, perinatal loss, perinatal palliative care, communication, barriers, mothers, family

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Authors: Azusa Katsumata

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Several universities in Japan have introduced activities aimed at the mutual enlightenment of a diversity of people in career education. However, several programs emphasize on delivering results, and on practicing the prepared materials as planned. Few programs focus on unexpected failures and setbacks. This way of learning is important in career education so that classmates can help each other, overcome difficulties, draw out each other’s strengths, and learn from them. Seijo University in Tokyo offered excursion focusing Various Problems of Society, as second year career education course, Students will learn about contraception, infertility, homeless people, LGBT, and they will discuss based on the excursion. This paper aims to study the ‘learning platform’ created by a series of processes such as the excursion, the discussion, and the presentation. In this course, students looked back on their lives and imagined the future in concrete terms, performing tasks in groups. The students came across a range of values through lectures and conversations, thereby developing feelings of self-efficacy. We conducted a questionnaire to measure the development of career in class. From the results of the questionnaire, we can see, in the example of this class, that students respected diversity and understood the importance of uncertainty and discontinuity. Whereas the students developed career awareness, they actually did not come across that scene and would do so only in the future when it became necessary. In this class, students consciously considered social problems, but did not develop the practical skills necessary to deal with these. This is appropriate for one of project, but we need to consider how this can be incorporated into future courses. University constitutes only a single period in life-long career formation. Thus, further research may be indicated to determine whether the positive effects of career education at university continue to contribute to individual careers going forward.

Keywords: career education of university, excursion, learning platform, problems of society

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Authors: Farrah Putri Salmanida, Mei-Li Wu, Rika Wahyuningtyas, Wen-Bin Chung, Hso-Chi Chaung, Ko-Tung Chang

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Within the field of immunotherapy, oncolytic virotherapy (OVT) employs dual approaches that directly eliminate tumor cells while preserving healthy ones and indirectly reprogram the tumor microenvironment (TME) to elicit antitumor responses. Within the TME, tumor associated macrophages (TAMs) manifest characteristics akin to those of anti-inflammatory M2 macrophages, thus earning the designation of M2-like TAMs. In prior research, two antigens denoted as A1 (g6Ld10T) and A3 (ORF6L5), derived from a complete sequence of ORF5 with partial sequence of ORF6 in Porcine Reproductive and Respiratory Syndrome Virus Genotype 2 (PRRSV-2), demonstrated the capacity to repolarize M2-type porcine alveolar macrophages (PAMs) into M1 phenotypes. In this study, we sought for utilizing OVT strategies by introducing A1 or A3 on TAMs to endow them with the anti-tumor traits of M1 macrophages while retaining their capacity to target cancer cells. Upon exposing human THP-1-derived M2 macrophages to a cross-species test with 2 µg/ml of either A1 or A3 for 24 hours, real time PCR revealed that A3, but not A1, treated cells exhibited upregulated gene expressions of M1 markers (CCR7, IL-1ß, CCL2, Cox2, CD80). These cells reacted to virus-derived antigen, as evidenced by increased expression of pattern-recognition receptors TLR3, TLR7, and TLR9, subsequently providing feedback in the form of type I interferon responses like IFNAR1, IFN-ß, IRF3, IRF7, OAS1, Mx1, and ISG15. Through an MTT assay, only after 15 µg/ml of A3 treatment could the cell viability decrease, with a predicted IC50 of 16.96 µg/ml. Interestingly, A3 caused dose-dependent toxicity to a rat C6 glial cancer cell line even at doses as low as 2.5 µg/ml and reached its IC50 at 9.419 µg/ml. Using Annexin V/7AAD staining and PCR test, we deduced that a significant proportion of C6 cells were undergoing the early apoptosis phase predominantly through the intrinsic apoptosis cascade involving Bcl-2 family proteins. Following this stage, we conducted a test on A3’s repolarization ability, which revealed a significant rise in M1 gene expression markers, such as TNF, CD80, and IL-1ß, in M2-like TAMs generated in vitro from murine RAW264.7 macrophages grown with conditioned medium of 4T1 breast cancer cells. This was corroborated by the results of transcriptome analysis, which revealed that the primary subset among the top 10 to top 30 significantly upregulated differentially expressed genes (DEGs) dominantly consisted of M1 macrophages profiles, including Ccl3, Ccl4, Csf3, TNF, Bcl6b, Stc1, and Dusp2. Our findings unveiled the remarkable potential of the PRRSV-derived antigen A3 to repolarize macrophages while also being capable of selectively inducing apoptosis in cancerous cells. While further in vivo study is needed for A3, it holds promise as an adjuvant by its dual effects in cancer therapy modalities.

Keywords: cancer cell apoptosis, interferon responses, macrophage repolarization, recombinant protein

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Authors: Desjardin, Michaels, Martinez, Ulmann

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Copper IUD is one of the most efficient and cost-effective contraception. However, pain at insertion hampers the use of this method. This is especially unfortunate in nulliparous women, often younger, who are excellent candidates for this contraception, including Emergency Contraception. Standard insertion procedure of a copper IUD usually involves measurement of uterine cavity with an hysterometer and the use of a tenaculum in order to facilitate device insertion. Both procedures lead to patient pain which often constitutes a limitation of the method. To overcome these issues, we have developed a modified insertor combined with a copper IUD. The singular design of the inserter includes a flexible inflatable membrane technology allowing an easy access to the uterine cavity even in case of abnormal uterine positions or narrow cervical canal. Moreover, this inserter makes possible a direct IUD insertion with no hysterometry and no need for tenaculum. To assess device effectiveness and patient-reported pain, a study was conducted at two clinics in Fance with 31 individuals who wanted to use a copper IUD as contraceptive method. IUD insertions have been performed by four healthcare providers. Operators completed questionnaire and evaluated effectiveness of the procedure (including IUD correct fundal placement and other usability questions) as their satisfaction. Patient also completed questionnaire and pain during procedure was measured on a 10-cm Visual Analogue Scale (VAS). Analysis of the questionnaires indicates that correct IUD placement took place in more than 93% of women, which is a standard efficacy rate. It also demonstrates that IUD insertion resulted in no, light or moderate pain predominantly in nulliparous women. No insertion resulted in severe pain (none above 6cm on a 10-cm VAS). This translated by a high level of satisfaction from both patients and practitioners. In addition, this modified inserter allowed a simplification of the insertion procedure: correct fundal placement was ensured with no need for hysterometry (100%) prior to insertion nor for cervical tenaculum to pull on the cervix (90%). Avoidance of both procedures contributed to the decrease in pain during insertion. Taken together, the results of the study demonstrate that this device constitutes a significant advance in the use of copper IUDs for any woman. It allows a simplification of the insertion procedure: there is no need for pre-insertion hysterometry and no need for traction on the cervix with tenaculum. Increased comfort during insertion should allow a wider use of the method for nulliparous women and for emergency contraception. In addition, pain is often underestimated by practitioners, but fear of pain is obviously one of the blocking factors as indicated by the analysis of the questionnaire. This evaluation brings interesting information on the use of this modified inserter for standard copper IUD and promising perspectives to set up a changement in the standard of IUD insertion procedure.

Keywords: contraceptio, IUD, innovation, pain

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