Search results for: culturally-sensitive intervention

Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun

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Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.

Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance

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Authors: Diaa Othman, Muhammad Adil Khan, Muhammad Riaz

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Without an early intervention to correct the unilateral complete cleft lip and palate deformity, nasal architecture can progress to an exaggerated cleft nose deformity. We present the results of a modified unilateral cleft rhinoplasty procedure ‘the Gujrat technique’ to correct this deformity. Ninety pediatric and adult patients with non-syndromic unilateral cleft lip underwent primary and secondary composite cleft rhinoplasty using the Gujrat technique as a single stage operation over a 10-year period. The technique involved an open rhinoplasty with Tennison lip repair, and employed a combination of three autologous cartilage grafts, seven cartilage-molding sutures and a prolene mesh graft for alar base support. Post-operative evaluation of nasal symmetry was undertaken using the validated computer program ‘SymNose’. Functional outcome and patient satisfaction were assessed using the NOSE scale and ROE (rhinoplasty outcome evaluation) questionnaires. The single group study design used the non-parametric matching pairs Wilcoxon Sign test (p < 0.001), and showed overall good to excellent functional and aesthetic outcomes, including nasal projection and tip definition, and higher scores of the digital SymNose grading system. Objective assessment of the Gujrat cleft rhinoplasty technique demonstrates its aesthetic appeal and functional versatility. Overall it is a simple and reproducible technique, with no significant complications.

Keywords: cleft lip and palate, congenital rhinoplasty, nasal deformity, secondary rhinoplasty

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Authors: Elnaz Alimi, Keriakoula Andriopoulos, Sam Boyer, Weronika Zuczek

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Occupational therapists can use coaching strategies to guide parents in providing therapy for their children with developmental disabilities. Evidence from various fields has shown increased parental self-efficacy and positive child outcomes as benefits of home and community-based parent coaching models. A literature review was conducted to investigate the effectiveness of parent coaching interventions delivered in home and community settings for children with developmental disabilities ages 0-12, on a variety of parent and child outcomes. CINAHL Plus, PsycINFO, PubMed, OTseeker were used as databases. The inclusion criteria consisted of: children with developmental disabilities ages 0-12 and their parents, parent coaching models conducted in the home and community, and parent and child outcomes. Studies were excluded if they were in a language other than English and published before 2000. Results showed that parent coaching interventions led to more positive therapy outcomes in child behaviors and symptoms related to their diagnosis or disorder. Additionally, coaching strategies had positive effects on parental satisfaction with therapy, parental self-efficacy, and family dynamics. Findings revealed decreased parental stress and improved parent-child relationships. Further research on parent coaching could involve studying the feasibility of coaching within occupational therapy specifically, incorporating cultural elements into coaching, qualitative studies on parental satisfaction with coaching, and measuring the quality of life outcomes for the whole family.

Keywords: coaching model, developmental disabilities, occupational therapy, pediatrics

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Authors: Parul Suraia, Harshit Sosan Lakra

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Indigenous communities represent some of the most marginalized populations globally, with India labeled as tribals, experiencing particularly pronounced marginalization and a concerning decline in their numbers. These communities often inhabit geographically challenging regions characterized by low population densities, posing significant challenges to providing essential infrastructure services. Jharkhand, a Schedule 5 state, is infamous for its low-level health status due to disparities in access to health care. The primary objective of this study is to investigate the spatial inequalities in healthcare accessibility among tribal populations within the state and pinpoint critical areas requiring immediate attention. Health indicators were selected based on the tribal perspective and association of Sustainable Goal 3 (Good Health and Wellbeing) with other SDGs. Focused group discussions in which tribal people and tribal experts were done in order to finalize the indicators. Employing Principal Component Analysis, two essential indices were constructed: the Tribal Health Index (THI) and the Tribal Health Intervention Index (THII). Index values were calculated based on the district-wise secondary data for Jharkhand. The bivariate spatial association technique, Moran’s I was used to assess the spatial pattern of the variables to determine if there is any clustering (positive spatial autocorrelation) or dispersion (negative spatial autocorrelation) of values across Jharkhand. The results helped in facilitating targeting policy interventions in deprived areas of Jharkhand.

Keywords: tribal health, health spatial disparities, health status, Jharkhand

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Authors: Christina Zourna, Ioanna Papavassiliou-Alexiou

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The purpose of this multi-phased action research PhD study in Greece was to investigate if and how Drama in Education (DiE) – used as an innovative group counselling method – may have positive effects on secondary education students’career self-efficacy and career decision-making skills development. Using both quantitative and qualitative research tools, high quality data were gathered at various stages of the research and were analysed through multivariate methods and open-source computer aided data analysis software such as R Studio, QualCoder, and SPSS packages. After a five-month-long educational intervention based on DiE method, it was found that 9th, 10th, and 11th gradersameliorated their self-efficacy and learned the process of making an informed career decision – through targeted information gathering about themselves and possible study paths – thus, developing career problem-solving and career management skills. Gender differences were non statistically important, while differences in grades showed a minor influence on some of the measured factorssuch as general career indecisiveness and self-evaluation. Students in the 11th grade scored significantly higher than younger students in the career self-efficacy scale and have stronger faith in their abilities e.g., choosing general over vocational school and major study orientation. The study has shown that DiE can be effective in group career guidance, especially concerning the pillars of self-awareness, self-efficacy, and career decision-making processes.

Keywords: career decision-making skills, career self-efficacy, CDDQ scale, CDMSE-SF scale, drama in education method

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Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

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Authors: Ali Kassem, Yaser Kamal, Mohamed Abdel Wahab, Mohamed Hussen

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Introduction: Atherosclerosis is one of the leading causes of death all over the world. Recently, there is an increasing interest in Carotid Intima-Medial Thickness (CIMT) and Ankle Brachial Index (ABI) as non-invasive tools for identifying subclinical atherosclerosis. We aim to examine the role of CIMT and ABI as predictors of the severity of angiographically documented coronary artery disease (CAD). Methods: A cross-sectional study conducted on 60 patients who were investigated by coronary angiography at Sohag University Hospital, Egypt. CIMT: After the carotid arteries were located by transverse scans, the probe was rotated 90 ° to obtain and record longitudinal images of bilateral carotid arteries ABI: Each patient was evaluated in the supine position after resting for 5 min. ABI was measured in each leg using a Doppler Ultrasound while the patient remained in the same position. The lowest ABI obtained for either leg was taken as the ABI measurement for the patient. Results: Patients with carotid mean IMT ≥ 0.9 mm had significantly more severe coronary artery disease than patients without thickening (mean IMT > 0.9 mm). Similarly, patients with low ABI (< 0.9) had significantly more severe coronary artery disease than patients with ABI ≥ 0.9. When the patients were divided into 4 groups (group A, n = 15, mean IMT < 0.9 mm, ABI ≥ 0.9; group B, n = 25, mean IMT < 0.9 mm, low ABI; group C, n = 5, mean IMT ≥ 0.9 mm, ABI ≥ 0.9; group D, n = 19, mean IMT ≤ 0.9 mm, low ABI), the presence of significant coronary stenosis (> 50%) of the groups were significantly different (group A, n = 5: (33.3%); group B, n = 11: (52.4%); group C, n = 4: (60%); group D, n=15, (78.9%), P = 0.001). Conclusion: CIMT and ABI provide useful information on the severity of CAD. Early and aggressive intervention should be considered in patients with CAD and abnormalities in one or both of these non-invasive modalities.

Keywords: ankle brachial index, carotid intima media thickness, coronary artery disease, predictors of severity

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Authors: Kawthar F. Albasri, Abdullah M. AlHudaithi, Dana B. AlTurairi, Abdullaziz S. AlQuraini, Adoub Y. AlDerazi, Reem A. Hubail, Haitham A. Jahrami

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Several studies have found that medical students have a significant prevalence of anxiety. The purpose of this review paper is to carefully evaluate the current research on anxiety among medical students in the MENA region and, as a result, estimate the prevalence of these disturbances. Multiple databases, including the CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, Embase, MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed, PsycINFO (Psychological Information Database), Scopus, Web of Science, UpToDate, ClinicalTrials.gov, WHO Global Health Library, EbscoHost, ProQuest, JAMA Network, and ScienceDirect, were searched. The retrieved article reference lists were rigorously searched and rated for quality. A random effects meta-analysis was performed to compute estimates. The current meta-analysis revealed an alarming estimated pooled prevalence of anxiety (K = 46, N = 27023) of 52.5% [95%CI: 43.3%–61.6%]. A total of 62.0% [95% CI 42.9%; 78.0%] of the students (K = 18, N = 16466) suffered from anxiety during the COVID-19 pandemic, while 52.5% [95% CI 43.3%; 61.6%] had anxiety before COVID-19. Based on the GAD-7 measure, a total of 55.7% [95%CI 30.5%; 78.3%] of the students (K = 10, N = 5830) had anxiety, and a total of 54.7% of the students (K = 18, N = 12154) [95%CI 42.8%; 66.0%] had anxiety using the DASS-21 or 42 measure. Anxiety is a common issue among medical students, making it a genuine problem. Further research should be conducted post-COVD 19, with a focus on anxiety prevention and intervention initiatives for medical students.

Keywords: anxiety, medical students, MENA, meta-analysis, prevalence

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Authors: Muhammad Zafarullah Khan, Sumeera Abbasi

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The Farmers Field School (FFS) learning approach aims to improve knowledge of the farmers through integrated crop management and provide leadership in their decision making process. The study was conducted to assess the impact of FFS on vegetables production before and after FFS intervention in four villages of district Peshawar in cropping season 2012, by interviewing 80 FFS respondents, twenty from each selected village. It was observed from the study results that all the respondents were satisfied from the impact of FFS and they informed an increased in production in vegetables. It was further observed that after the implementation of FFS the sowing seed rate of tomato and cucumber were decreased from 0.185kg/kanal to 0.100 kg/ kanal and 0.120kg/kanal to 0.010kg/kanal where as the production of tomato and cucumber were increased from 8158.75kgs/kanal to 10302. 5kgs/kanal and 3230kgs/kanal to 5340kgs/kanal, respectively. The cost of agriculture inputs per kanal including seed cost, crop management, Farm Yard Manure, and weedicides in case of tomato were reduced by Rs.28, Rs. 3170, Rs.658and Rs 205 whereas in cucumber reduced by Rs.35, Rs.570, Rs 80 and Rs.430 respectively. Only fertilizers cost was increased by Rs. 2200 in case of tomato and Rs 465 in case of cucumber. Overall the cost was reduced to Rs 545 in tomato and Rs 490 in cucumber production.FFS provided a healthy vegetables and also reduced input cost by adopting integrated crop management. Therefore the promotion of FFS is needed to be planned for farmers to reduce cost of production, so that the more farmers should be benefited.

Keywords: impact, farmer field schools, vegetable production, Peshawar Khyber Pakhtunkhwa

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Authors: Yu-Chi Chou

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The purpose of this study was to establish a logical path of an instructional model of empathy and social regulation, providing feasibility evidence on the model implementation in students with autism spectrum disorder (ASD). This newly developed Emotional Bug-Out Bag (BoB) curriculum was designed to enhance the empathy and socially shared regulation of students with ASD. The BoB model encompassed three instructional phases of basic theory lessons (BTL), action plan practices (APP), and final theory practices (FTP) during implementation. Besides, a learning flow (teacher-directed instruction, student self-directed problem-solving, group-based task completion, group-based reflection) was infused into the progress of instructional phases to deliberately promote the social regulatory process in group-working activities. A total of 23 junior high school students with ASD were implemented with the BoB curriculum. To examine the logical path for model implementation, data was collected from the participating students’ self-report scores on the learning nodes and understanding questions. Path analysis using structural equation modeling (SEM) was utilized for analyzing scores on 10 learning nodes and 41 understanding questions through the three phases of the BoB model. Results showed (a) all participants progressed throughout the implementation of the BoB model, and (b) the models of learning nodes and phases were positive and significant as expected, confirming the hypothesized logic path of this curriculum.

Keywords: autism spectrum disorder, empathy, regulation, socially shared regulation

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Authors: Nuralam Sam, Irawan Yusuf, Irfan Idris, Endi Adnan

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The most case in the shoulder in the the adult is the frozen shoulder. It make an uncomfortable sensation which disturbance daily activity. The studies of frozen shoulder are still limited. This study used a true experimental pre and post test design with a group design. The participant underwent dextrose prolotherapy injection in the rotator cuff, intraarticular glenohumeral joint, long head tendon biceps, and acromioclavicular joint injections with 15% dextrose, respectively, at week 2, week 4, and week 6. Participants were followed for 12 weeks. The specific biomarker MMP and TIMP, ROM, DASH score were measured at baseline, at week 6, and week 12. The data were analyzed by multivariate analysis (repeated measurement ANOVA, Paired T-Test, and Wilcoxon) to determine the effect of the intervention. The result showed a significant decrease in The Disability of the Arm, Shoulder, and Hand (DASH) score in prolo injection patients in each measurement week (p < 0.05). While the measurement of Range of Motion (ROM), each direction of shoulder motion showed a significant difference in average each week, from week 0 to week 6 (p <0.05).Dextrose prolotherapy injection results give a significant improvement in functional outcome of the shoulder joint, and ROMand did not show significant results in assessing the specific biomarker, MMP-1, and TIMP-1 in tissue repair. This study suggestion an alternative to the use of injection prolotherapy in Frozen shoulder patients, which has fewer side effects and better effectiveness than the use of corticosteroid injections.

Keywords: frozen shoulder, ROM, DASH score, prolotherapy, MMP-1, TIMP-1

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Authors: Tri Nguyen

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Background: Female sex workers (FSWs) are at heightened risk of sexually transmitted infections (STIs) and HIV. The purpose of the research is to study FSWs socio-demographic and behavioral characteristics and their HIV/STIs prevalence in Ba Ria – Vung Tau, Vietnam. Methods: A cross-sectional survey of 420 direct and indirect FSWs between January and May, 2014 from 2 cities and 6 districts in Ba Ria – Vung Tau were collected using sampling methods. FSWs were interviewed using the structured questionnaire and biological samples were tested for syphilis, gonorrhoea, chlamydia and HIV in the study. A database was constructed and entered using Epidata 3.1 software and analyzed using the SPSS 20.0 statistical package. Results: A total of 420 FSWs participated in the survey, with a median age of 27 years within a range of 18 – 43 years. Education levels were low with 33.1% only completing all seven major indicators. The median age of first sexual intercourse of the FSWs was 18 years. Most (88.8%) of the FSWs had oral sex. A high proportion (82.4 %) of the FSWs had consumed alcohol. Among them, 51.2% of the FSWs have had sex after drunk. Of the 177 FSWs have reported that they have had sex after drunk, almost half of direct FSWs have had unprotected sex. Among the 420 FSWs who participated in the survey, 2.6 % (11/420) were found to be HIV positive. There was a difference in HIV prevalence among direct and indirect FSWs (4.8 % and 1.2%, p= 0,022). Nearly 7 percent of the FSWs were infected with Syphilis. Similarly, the percentage (7.9 %) of the FSWs was found with Gonorrhoea and a doubly higher percentage (16.4%) of them was suffering from Chlamydia. On the aggregate, the percentage of FSWs with any one of the STIs (Gonorrhoea or Chlamydia) was highest 21.4 %. Conclusions: FSWs in Ba Ria – Vung Tau, Vietnam are highly vulnerable to STIs and need to enhance the existing STIs treatment and intervention programs in order to reduce the risk of HIV infections. HIV/STIs health education and a 100% condom use program should be implemented, and sex industry should be regulated by law.

Keywords: sex workers, female sex workers, HIV, STIs

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Authors: Miriam Schäffer, Vinayak Mudgal, Wolfram Remlinger

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The functions of automated driving will initially be limited to certain so-called Operating Driving Domains (ODD). Within the ODDs, the automated vehicle can handle all situations autonomously. In the event of a critical system failure, the vehicle will establish a condition of minimal risk or offer the driver to take over control of the vehicle. When the vehicle leaves the ODD, the driver is also prompted to take over vehicle control. During automated driving, the driver is legally allowed to perform non-driving-related activities (NDRAs) for the first time. When requested to take over, the driver must return from the NDRA state to a driving-ready state. The driver’s NDRA state may imply the use of items that are necessary for the NDRA or interior modifications. Since perceived comfort is an important factor in both manual and automated driving, a study was conducted in a static driving simulator to investigate factors that influence perceived comfort during the take-over process. Based on a literature review of factors influencing perceived comfort in different domains, selected parameters such as the TOR modality or elements to support handing over the item used for the NDRA to the interior were varied. Perceived comfort and discomfort were assessed using an adapted version of a standardized comfort questionnaire, as well as other previously identified aspects of comfort. The NDRA conducted was Using a Smartphone (playing Tetris) because of its high relevance as a future NDRA. The results show the potential to increase perceived comfort through interior adaptations and support elements. Further research should focus on different layouts of the investigated factors, as well as under different conditions, such as time budget, actions required within the intervention in the vehicle control system, and vehicle interior dimensions.

Keywords: automated driving, comfort, take-over, vehicle interior

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Authors: Desta Brhanu Gebrehiwot

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The purpose of this review was to analyze the overall or combined effect of scholarly studies conducted on the impacts of Food for work (FFW) and Productive Safety Net Program (PSNP) on farm households’ livelihood (agricultural investment on the adoption of fertilizer, food security, livestock holding, nutrition and its’ disincentive effect) in Ethiopia. In addition, to make a critical assessment of the internal and external validity of the existing studies, the review also indicates the possibility to redesign the program. The method of selecting eligible studies for review was PICOS (Participants, Intervention, Comparison, Outcomes, and Settings) framework. The method of analysis was the fixed effects model under Meta-Analysis. The findings of this systematic review confirm the overall or combined positive significant impact of PSNP on fertilizer adoption (combined point estimate=0.015, standard error=0.005, variance=0.000, lower limit 0.004 up to the upper limit=0.026, z-value=2.726, and p-value=0.006). And the program had a significant positive impact on the child nutrition of rural households and had no significant disincentive effect. However, the program had no significant impact on livestock holdings. Thus, PSNP is important for households whose livelihood depends on rain-fed agriculture and are exposed to rainfall shocks. Thus, better to integrate the program into the national agricultural policy. In addition, most of the studies suggested that PSNP needs more attention to the design and targeting issued in order to be effective and efficient in social protection.

Keywords: meta-analysis, fixed effect model, PSNP, rural-livelihood, Ethiopia

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Authors: Antwi Kwaku Dei, Lyford Conrad Power

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This paper investigates the outcome of participating in the government of Ghana block farm program on rural households’ farm productivity, income, food security and nutritional status in Northern Ghana using cross-sectional data. Data analysis was done using the Instrumental Variable and the Heckman Selection Bias procedures. Our analysis indicates that participation in the block farm program significantly increased directly the productivity of maize, rice, and soybean by 21.3 percent, 15.8 percent, and 12.3 percent respectively. Also, the program participation was found to increase households’ farm income by 20 percent in northern Ghana. Furthermore, program participation was found to improve household food security and nutrition by 19 percent and 14 percent respectively through income effect. Based on the benefit-cost ratio of 1.59 the results from the study recommends that the program is expanded to other communities in the northern region. Further analysis indicates that rural households’ decision to participate in food security intervention programs is significantly influenced by factors including the gender of the household head, the age of the household head, and household size. Results of the study further show that gender of household head, household size, household monthly income, household assets, women educational status, the age of women, marital status of women, are significant determinants of food security and nutrition status in Northern Ghana.

Keywords: block farm program, farm productivity, , household food security, Northern Ghana

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Authors: Vincent Gauthier, Om Rangacharya, Jordan Lemorande, Senthil Sundaram, James Green, Ghada Alsaleh

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Introduction: Cellular senescence and autophagy are critical processes in aging and age-related diseases. This study examines the effects of Cellular Recharge Technology 8 (CRT8), a proprietary blend of certain supplements on both two-dimensional Human dermal fibroblasts (HDF) and three-dimensional organoid models. Some of the individual ingredients of CRT8 are known to individually have an effect on cellular senescence and autophagy, but their overall effect in the proprietary blend is unknown. The focus of this study is on the impact of CRT8 on cellular senescence and autophagy. Methods: Human dermal fibroblasts (HDF) were treated with CRT8 in 2D cellular studies, assessing effects on p16 (senescence marker) Mean Fluorescence Intensity (MFI), and LC3 (autophagy marker) MFI. The same CRT8 mix was applied to 3D organoid models, composed of HDF and endothelial cells, with results measured after 6 weeks of treatment, focusing on autophagy and senescence markers. Results: In 2D cellular models, CRT8 significantly reduced p16 MFI levels by 40%, indicating a potential decrease in cellular senescence, and increased LC3 MFI by more than 2-fold, demonstrating enhanced autophagic activity. Similarly, in the 3D organoid models, CRT8 significantly reduced p16 MFI levels by 63% and increased autophagic flux by 1.62-fold, further reinforcing its potential to reduce senescence and promote autophagy. Conclusion: CRT8 effectively reduces p16 levels and enhances autophagy in both 2D and 3D models, highlighting its potential as a powerful anti-aging intervention. CRT8 may be valuable in promoting cellular health and longevity.

Keywords: cellular senescence, autophagy, aging, supplements

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Authors: Shah Md. Imran Kabir, Md. Mostafa Ali

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Karnafuli is one of the most important rivers of Bangladesh which is playing a vital role in our national economy. The major sea port of Bangladesh is the Chittagong port located on the right bank of Karnafuli River Bangladesh. Karnafuli river port is considered as the lifeline of the economic activities of the country. Therefore, it is always necessary to keep the river active and live in terms of its navigability. Due to man-made intervention, the river flow becomes interrupted and thereby may cause the change in the river morphology. The specific objective of this study is the application of 2D model to assess different hydrodynamic and morphological characteristics of the river due to normal flow condition and sea level rise condition. The model has been set with the recent bathymetry data collected from CPA hydrography division. For model setup, the river reach is selected between Kalurghat and Khal no-18. Time series discharge and water level data are used as boundary condition at upstream and downstream. Calibration and validation have been carried out with the recent water level data at Khal no-10 and Sadarghat. The total reach length of the river has been divided into four parts to determine different hydrodynamic and morphological assessments like variation of velocity, sediment erosion and deposition and bed level changes also have been studied. This model has been used for the assessment of river response due sediment transport and sea level rise. Model result shows slight increase in velocity. It also changes the rate of erosion and deposition at some location of the selected reach. It is hoped that the result of the model simulation will be helpful to suggest the effect of possible future development work to be implemented on this river.

Keywords: CCHE 2D, hydrodynamic, morphology, sea level rise

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Authors: Stephanie Cheng, Benjamin Poh, Vivyan Tay, Sachin Mathur

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Aim: Diabetes mellitus (DM) is a worldwide pandemic affecting 500 million people. It is known to be associated with increased susceptibility to soft tissue infections (STI). Despite being a major public health burden, the literature relating the effects of DM and the presentation, severity and healing of STIs in general surgical patients remain limited. Methods: We conducted a retrospective review of all patients admitted with STI in a tertiary teaching hospital over a 12-month period. Patient demographics and surgical outcomes were collected and analyzed. Results: During the study period, 1059 patients were admitted for STIs, of which 936 (88%) required surgical intervention. Diabetic patients were presented with a higher body-mass index (BMI) (28 vs 26), larger abscess size (24 vs 14 cm²) and a longer length of stay (LOS)(4.4 days vs 2.9 days). They also underwent a higher proportion of wide debridement as well as application of negative pressure wound therapy (NPWT) (42% vs 35%). More diabetic patients underwent subsequent re-operation within the same sitting (8 vs 4). There were no differences in re-admission rates within 30 days nor subsequent abscess formation in those followed for 6 months. Conclusion: The incidence of STIs among DM patients represents a significant disease burden; surgeons should consider intensive patient counseling and partnering with primary care providers in order to help reduce the incidence of future STI admissions based on lifestyle modification and glucose control.

Keywords: general surgery, emergency general surgery, acute care surgery, soft tissue infections, diabetes mellitus

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Authors: Reza Johari Fard, Najmeh Cheraghi, Parvin Ehtesham Zadeh, Parviz Asgari

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The aim of this study was to investigate and comparison of the effectiveness of schema mode therapy and emotionally focused couples therapy in attachment styles (secure, avoidant, and anxious) in couples with marital conflict in a quasiexperimental method in a pretest, posttest, and follow up design with a control group. The statistical population of the study included all the couples with marital conflict who visited the Mehrana counseling center in 2019 in Ahvaz, Iran 45 couples were selected by voluntary sampling method and randomly divided into two experimental groups and one control group (15 pairs in each group). The participants completed the Adult Attachment Scale (Hazan and Shaver). The experimental groups underwent schema mode therapy and emotionally focused couples therapy for 12 sessions, but the control group did not receive any intervention. The data were analyzed by the statistical analysis of repeated measures in SPSS-19 software. The results showed that both schema mode therapy and emotionally focused couples therapy are effective in increasing the secure attachment style and reducing avoidant and ambivalent attachment styles in couples with marital conflict. There was no significant difference between the schema mode therapy group and the emotionally focused couple's therapy group in attachment styles. Therefore, it is recommended that therapists and family counselors use these therapies along with other therapeutic interventions to increase secure attachment styles and reduce marital conflicts.

Keywords: schema mode therapy, emotional focused couple therapy, attachment styles, marital conflict

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Authors: Eman Ahmed Alsaleh

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Background: Many studies published in other countries identified certain perceived benefits and barriers to physical activity among patients with coronary heart disease. Nevertheless, there is no data about the issue relating to Jordanian patients with coronary heart disease. Objective: This study aimed to describe the prevalence of level of physical activity, benefits of and barriers to physical activity as perceived by Jordanian patients with coronary heart disease, and the relationship between physical activity and perceived benefits of and barriers to physical activity. In addition, it focused on examining the influence of selected sociodemographic and health characteristics on physical activity and the perceived benefits of and barriers to physical activity. Methods: A cross-sectional design was performed on a sample of 400 patients with coronary heart disease. They were given a list of perceived benefits and barriers to physical activity and asked to what extent they disagreed or agreed with each. Results: Jordanian patients with coronary heart disease perceived various benefits and barriers to physical activity. Most of these benefits were physiologically related (average mean = 5.7, SD = .7). The most substantial barriers to physical activity as perceived by the patients were: feeling anxiety, not having enough time, lack of interest, bad weather, and feeling of being uncomfortable. Sociodemographic and health characteristics that significantly influenced perceived barriers to physical activity were age, gender, health perception, chest pain frequency, education, job, caring responsibilities, ability to travel alone, smoking, and previous and current physical activity behaviour. Conclusion: This research demonstrates that patients with coronary heart disease have perceived physiological benefits of physical activity, and they have perceived motivational, physical health, and environmental barriers to physical activity, which is significant in developing intervention strategies that aim to maximize patients' participation in physical activity and overcome barriers to physical activity.

Keywords: prevalence, coronary heart disease, physical activity, perceived barriers

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Authors: Fernanda F. Zimmermann, Beverley Burrell, Jennifer Jordan

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Introduction: Supportive care for people affected by cancer is recognised as a priority for research but yet there is little solid evidence of the effectiveness of psychological treatments for those with advanced cancer. The literature suggests that mindfulness-based interventions may be acceptable and beneficial for this population. This study aims to develop a mindfulness intervention to provide emotional support for advanced cancer population. The treatment package includes mindfulness meditation, developing an acceptance attitude and reflections on meaning in life. Methods: This study design is a one-group pre-post test with a mixed methods approach. Participants are recruited through public and private hospitals in Christchurch, NZ. Quantitative measures are the Acceptance and Action Questionnaire-II, Mindful Coping Scale and, the Meaning in Life Questionnaire. Qualitative semi-structured interviews enquire about emotional support before and after the diagnosis, participants’ thoughts about meaning in life, expectations and reflections on the mindfulness training. Qualitative data will be analysed using thematic analysis. Treatment consists of one to one 30 minutes session weekly for 4 weeks using a pre-recorded CD/podcast of the mindfulness training. This research is part of the presenter’s PhD study. Findings: This project is currently underway. The presenter will provide preliminary data on the acceptability of the mindfulness training package being delivered to participants along with the recruitment strategies. We anticipate that this novel treatment used as a self-management tool will reduce psychological distress and enable better coping for patients with advanced cancer.

Keywords: acceptance, cancer, meaning in life, mindfulness

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Authors: Bo Yan, Amy Y. M. Chow

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Bereavement is recognized as a universal challenging experience. It is important to gather research evidence on protective factors in bereavement. Hope is considered as one of the protective factors in previous coping studies. The present study aims to add knowledge by investigating hope at the first month after death to predict psychological symptoms altogether including complicated grief (CG), anxiety, and depressive symptoms at the seventh month. The data were collected via one-on-one interview survey in a longitudinal project with Hong Kong hospice users (sample size 105). Most participants were at their middle age (49-year-old on average), female (72%), with no religious affiliation (58%). Bayesian Structural Equation Modeling (BSEM) analysis was conducted on the longitudinal dataset. The BSEM findings show that hope at the first month of bereavement negatively predicts both CG and anxiety symptoms at the seventh month but not for depressive symptoms. Age and gender are controlled in the model. The overall model fit is good. The current study findings suggest assessing hope at the first month of bereavement. Hope at the first month after the loss is identified as an excellent predictor for complicated grief and anxiety symptoms at the seventh month. The result from this sample is clear, so it encourages cross-cultural research on replicated modeling and development of further clinical application. Particularly, practical consideration for early intervention to increase the level of hope has the potential to reduce the psychological symptoms and thus to improve the bereaved persons’ wellbeing in the long run.

Keywords: anxiety, complicated grief, depressive symptoms, hope, structural equational modeling

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Authors: Lista Andriyati, Nurpudji A Taslim

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The human immunodeficiency virus (HIV) patients have potential nutritional and metabolic problems. HIV is a virus that attacks cells T helper and impairs the function of immune cells. Infected individuals gradually become immunodeficient, results in increased susceptibility to a wide range of infections such as tuberculosis (TB). Malnutrition has destructive effects on the immune system and host defense mechanisms. Effective and proper nutritional therapies are important to improve medical outcomes and quality of life, which is associated with functional improvement. A case of 38-years old man admitted to hospital with loss of consciousness and was diagnosed HIV infection and relapse lung TB with severe malnutrition, fever, oral candidiasis, anemia (6.3 g/dL), severe hypoalbuminemia (1.9 g/dL), severe hypokalemia (2.2 mmol/L), immune depletion (1085 /µL) and elevated liver enzyme (ALT 1198/AST 375 U/L). Nutritional intervention by giving 2300 kcal of energy, protein 2 g/IBW/day, carbohydrate 350 g, fat 104 g through enteral and parenteral nutrition. Supplementations administered are zinc, vitamin A, vitamin B1, vitamin B6, vitamin B12, vitamin C, vitamin D, and snakehead fish extract high content of protein albumin (Pujimin®). After 46 days, there are clinical and metabolic improvement in Hb (6.3 to 11.2 g/dL), potassium (2.2 to 3.4 mmol/L), albumin (1.9 to 2.3 g/dL), ALT 1198 to 47/AST 375 to 68 U/L) and improved awareness. In conclusion, nutritional therapy in HIV infection with adequate macronutrients and micronutrients fulfillment and immunonutrition is very important to avoid cachexia and to improve nutritional status and immune disfunction.

Keywords: HIV, hypoalbuminemia, malnutrition, tuberculosis

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Authors: Huazhen Lin, Ruihua Xu, Zhibin Jiang

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In this real-world case, timetabling the LRT network as a whole is rather challenging for the operator: they are supposed to create a timetable to avoid various route conflicts manually while satisfying a given interval and the number of rolling stocks, but the outcome is not satisfying. Therefore, the operator adopts a computerised timetabling tool, the Train Plan Maker (TPM), to cope with this problem. However, with various constraints in the dual-line network, it is still difficult to find an adequate pairing of turnback time, interval and rolling stocks’ number, which requires extra manual intervention. Aiming at current problems, a one-off model for timetabling is presented in this paper to simplify the procedure of timetabling. Before the timetabling procedure starts, this paper presents how the dual-line system with a ring and several branches is turned into a simpler structure. Then, a non-linear programming model is presented in two stages. In the first stage, the model sets a series of constraints aiming to calculate a proper timing for coordinating two lines by adjusting the turnback time at termini. Then, based on the result of the first stage, the model introduces a series of inequality constraints to avoid various route conflicts. With this model, an analysis is conducted to reveal the relation between the ratio of trains in different directions and the possible minimum interval, observing that the more imbalance the ratio is, the less possible to provide frequent service under such strict constraints.

Keywords: light rail transit (LRT), non-linear programming, railway timetabling, timetable coordination

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Authors: Xu Lan, Zainor Izat Zainal

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Human intervention in Earth’s macro system has ushered in the age of the Anthropocene, prompting introspection among humans, the action agent. This epoch demands a reawakening of human conscience and inner motivation to mitigate the irreversible trend so as to shape the trajectory of the Anthropocene. Environmental virtue ethics claims that the fundamental cause of environmental crisis lies in humans themselves. Rather than focusing more on what humans should do, environmental virtue ethics seeks to specify environmental virtues to appeal to what kind of person a human should be. Renowned Pulitzer Prize-winning author Barbara Kingsolver illustrates her contentions about environmental ethics through the narrative of Codi and her sister Hallie’s environmental choices and actions in Animal Dreams (1990). This study adopts a textual analysis approach of the character traits exhibited by Codi and Hallie that are constitutive of making them environmentally virtuous, exploring how emotions and inner motivations drive actions. This paper is informed by Ronald Sandler’s (2007) virtues of sustainability, virtues of communion with nature, and virtues of environmental stewardship and activism. It aims to examine how Codi and Hallie’s character traits are built around these virtues. Furthermore, this study underscores the importance of internalizing principles and cultivating virtues for the environment and humans’ flourishing in the Anthropocene. As a tentative practice in applying environmental virtue ethics to examine environmental virtues for the Anthropocene, this study reveals Kingsolver’s endeavor of setting environmental virtue exemplars from fictional characters to inspire humans’ long-term and stable contribution to a better future.

Keywords: anthopocene, environmental ethics, environmental virtues, virtue ethics

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Authors: Cetin Arslan, Senol Tayan

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Social media is one of the most important and effective means of social interaction among people in which they create, share and exchange their ideas via photos, videos or voice messages. Although there are lots of communication tools, social media sites are the most prominent ones that allows the users articulate themselves in a matter of seconds all around the world with almost any expenses and thus, they became very popular and widespread after its emergence. As the usage of social media increases, it becomes an effective instrument in social matters. While it is possible to use social media to emphasize basic human rights and protest some failures of any government as in “Arab Spring”, it is also possible to spread propaganda and misinformation just to cause long lasting insurgency, upheaval, turmoil or disorder as an instrument of intervention to internal affairs and state sovereignty by some hostile groups or countries. It is certain that “social media” has positive effects on democracies letting people have chance to express themselves and to organize, but it is also obvious that the misuse of it, is very common that even a five-minute-long video can cause to wage a campaign against a country. Although it looks anti-democratic, when you consider the catastrophic effects of misuse of social media, it is a kind of area that serious precautions are to be taken without limiting democratic rights while allowing constant and perpetual share but preventing the criminal events. This article begins with the current developments in social media and gives some examples on misuse of it. Second part tries to put emphasize on the legal basis that can prevent criminal activities and the upheavals and insurgencies against state security. Last part makes comparison between democratic countries and international organizations’’ actions against such activities and proposes some further actions that are compatible with democratic norms.

Keywords: democracy, disorder, security, Social Media

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Authors: Esra Güney, Tuba Uçar

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Aim: This study has been conducted for the purpose of determining the effects of fetal movement counting on antenatal maternal attachment. Material and Method: This research was conducted on the basis of the real test model with the pre-test /post-test control groups. The study population consists of pregnant women registered in the six different Family Health Centers located in the central Malatya districts of Yeşilyurt and Battalgazi. When power analysis is done, the sample size was calculated for each group of at least 55 pregnant women (55 tests, 55 controls). The data were collected by using Personal Information Form and MAAS (Maternal Antenatal Attachment Scale) between July 2015-June 2016. Fetal movement counting training was given to pregnant women by researchers in the experimental group after the pre-test data collection. No intervention was applied to the control group. Post-test data for both groups were collected after four weeks. Data were evaluated with percentage, chi-square arithmetic average, chi-square test and as for the dependent and independent group’s t test. Result: In the MAAS, the pre-test average of total scores in the experimental group is 70.78±6.78, control group is also 71.58±7.54 and so there was no significant difference in mean scores between the two groups (p>0.05). MAAS post-test average of total scores in the experimental group is 78.41±6.65, control group is also is 72.25±7.16 and so the mean scores between groups were found to have statistically significant difference (p<0.05). Conclusion: It was determined that fetal movement counting increases the maternal antenatal attachments.

Keywords: antenatal maternal attachment, fetal movement counting, pregnancy, midwifery

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Authors: Saeideh Lotfi Nikoo, Azadeh Ghaheri, Reza Omani Samani

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Context: In most cultures around the globe, infertility is recognized as a crisis and exposed infertile couples are under psychosocial pressure. Indeed, the quality of life (QoL) for infertile women is lower in comparison with fertile control. Objective, The purpose of this study, was to investigate the impact of social support and hope on QoL in women undergoing infertility treatment. Methods: A cross-sectional study. Patient(s): In this cross-sectional study, 350 infertile women were recruited who were referred to an infertility clinic for the first time and had no history of Assisted Reproductive Techniques (ART) failure. Intervention(s): Questionnaires on the Fertility Quality of Life (FertiQoL), Multi-dimensional Scale of Perceived Social Support (family and friends), and Snyder Hope Scale (pathway and agency) were used to collect data. Data analysis was done by univariate and multivariate analysis. P value <0.05 was considered statistically significant. Result(s): Multivariate analysis indicated that infertile women with a higher score of social support (by family & friends) (b= 0.59 (CI 95%: 0.03, 1.15) (P = 0.040), b= 0.61 (CI 95%: 0.17, 1.04) (P = 0.006)) and hope (pathway & agency) (b= 0.94 (CI 95%: 0.29, 1.59) (P = 0.005), b= 1.13 (CI 95%: 0.45, 1.82) (P = 0.001) respectively) have significantly better Core FertiQoL. The result revealed that social support and hope are significantly and positively associated with other subscales of FertiQoL as well. Conclusions: According to the results, lifestyle interventions such as receiving social support, building a sound family with effective communication, and providing appropriate health education are of crucial importance to address psychological distress and improve the fertility QoL of women experiencing fertility problems.

Keywords: inertility, social support, infertile women, hope

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Authors: Farhad Shafiepour Motlagh, Narges Salehi

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Purpose: The aim of the present study was a paradigm model of educational policy review strategies for the development of Professional schools in Iran. Research Methodology: The research method was based on Grounded theory. The statistical population included all articles of the ten years 2022-2010 and the method of sampling in a purposeful manner to the extent of theoretical saturation to 31 articles. For data analysis, open coding, axial coding and selective coding were used. Results: The results showed that causal conditions include social requirements (social expectations, educational justice, social justice); technology requirements (use of information and communication technology, use of new learning methods), educational requirements (development of educational territory, Development of educational tools and development of learning methods), contextual conditions including dual dimensions (motivational-psychological context, context of participation and cooperation), strategic conditions including (decentralization, delegation, organizational restructuring), intervention conditions (poor knowledge) Human resources, centralized system governance) and outcomes (school productivity, school professionalism, graduate entry into the labor market) were obtained. Conclusion: A review of educational policy is necessary to develop Iran's Professional schools, and this depends on decentralization, delegation, and, of course, empowerment of school principals.

Keywords: school productivity, professional schools, educational policy, paradigm

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Authors: Almas Athif Fathin Wiyantoro, Fransiskus Xaverius Ivan Budiman, Fithra Faisal Hastiadi

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The growth of clothing and technology as a marketing tool has a great influence on online business owners to know how much the characteristics and psychology of consumers in influencing purchasing decisions made by Indonesian women consumers. One of the most important issues faced by Indonesian women consumers is the suitability of clothing. The suitability of clothing can affect the body cathexis, identity, and confidence. So the thematic analysis of clothing fitness and body cathexis of women consumers when and after using virtual fitting room technology to purchase decision is important to do. This research using group method of pre-post treatment and considers how the recruitment technique of snowball sampling, which uses interpersonal relations and connections between people, both includes and excludes individuals into 39 participants' social networks to access specific populations. The results obtained from the study that the results of body scans and photos of virtual fitting room results can be made an intervention in women consumers in assessing their body cathexis objectively in the process of making purchasing decisions. The study also obtained a regression equation Y = 0.830 + 0.290X1 + 0.292X2, showing a positive relationship between suitability of clothing and body cathexis which influenced purchasing decisions on women consumers and after (personal and psychological factors) using virtual fitting room, meaning that all independent variables influence Positive towards the purchasing decision of the women consumers.

Keywords: body cathexis, clothing fitness, purchasing decision making and virtual fitting room

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