Search results for: neurocognitive impairment

Authors: Gunjita Shami, Noopur Anand

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The pilot run of 50 days was undertaken to test employability potential of people with visual and hearing & speech impairment. Various roles in an apparel manufacturing set up like spreading of fabric for cutting, folding, sealing and labeling cartons, pasting size barcode stickers on packed garments, removing tickets from the garments in the finishing stage were studied. Their performance was quantified basis timesheets for all the days and improvement per day was quantified. Their final day output was compared to that of the able-bodied worker. For example in the carton making activity on day one visually impaired worker was making one box every three minutes which improved to four boxes per minute on day 28 displaying 91.6% improvement compared or an improvement of 3.6% per day which was comparable to the able-bodied seasoned workers, who were making 5 boxes per minute. The performance of persons with hearing and speech impairment in the finishing department was 10% higher than that of able-bodied seasoned workers in the same process. Overall in all the activities the differently abled showed day to day improvement of 65% while able bodied displayed improvement of 52%. On the first day performance of able-bodied worker was 75% better than that of differently abled while on the 50th day it was only 20% better. Therefore the performance of persons with disabilities was found comparable to the able bodied person. The results, though on a small scale, showed a big promise of employment of persons with disability in the apparel industry. Armed with the promising result a full-scale study has been undertaken to identify the roles suitable for certain kind of disability in apparel production, work-aids required to assist the differently abled to improve performance and measures to be undertaken to make production floor 'friendlier' for them. The results have been discussed in this paper which opens doors for integrating differently abled into the world projected and assumed for only able-bodied.

Keywords: apparel sector, differently abled, employability, performance, work-aid

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Authors: Tom S. Owens, Tom A. Calverley, Benjamin S. Stacey, Christopher J. Marley, George Rose, Lewis Fall, Gareth L. Jones, Priscilla Williams, John P. R. Williams, Martin Steggall, Damian M. Bailey

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Introduction and aims: Sports-related concussion (SRC) represents a significant and growing public health concern in rugby union, yet remains one of the least understood injuries facing the health community today. Alongside increasing SRC incidence rates, there is concern that prior recurrent concussion may contribute to long-term neurologic sequelae in later-life. This may be due to an accelerated decline in cerebral perfusion, a major risk factor for neurocognitive decline and neurodegeneration, though the underlying mechanisms remain to be established. The present study hypothesised that recurrent concussion in current professional rugby union players would result in elevated systemic oxidative-nitrosative stress, reflected by a free radical-mediated reduction in nitric oxide (NO) bioavailability and impaired cerebrovascular and cognitive function. Methodology: A longitudinal study design was adopted across the 2017-2018 rugby union season. Ethical approval was obtained from the University of South Wales Ethics Committee. Data collection is ongoing, and therefore the current report documents result from the pre-season and first half of the in-season data collection. Participants were initially divided into two subgroups; 23 professional rugby union players (aged 26 ± 5 years) and 22 non-concussed controls (27 ± 8 years). Pre-season measurements were performed for cerebrovascular function (Doppler ultrasound of middle cerebral artery velocity (MCAv) in response to hypocapnia/normocapnia/hypercapnia), cephalic venous concentrations of the ascorbate radical (A•-, electron paramagnetic resonance spectroscopy), NO (ozone-based chemiluminescence) and cognition (neuropsychometric tests). Notational analysis was performed to assess contact in the rugby group throughout each competitive game. Results: 1001 tackles and 62 injuries, including three concussions were observed across the first half of the season. However, no associations were apparent between number of tackles and any injury type (P > 0.05). The rugby group expressed greater oxidative stress as indicated by increased A•- (P < 0.05 vs. control) and a subsequent decrease in NO bioavailability (P < 0.05 vs. control). The rugby group performed worse in the Ray Auditory Verbal Learning Test B (RAVLT-B, learning, and memory) and the Grooved Pegboard test using both the dominant and non-dominant hands (visuomotor coordination, P < 0.05 vs. control). There were no between-group differences in cerebral perfusion at baseline (MCAv: 54 ± 13 vs. 59 ± 12, P > 0.05). Likewise, no between-group differences in CVRCO2Hypo (2.58 ± 1.01 vs. 2.58 ± 0.75, P > 0.05) or CVRCO2Hyper (2.69 ± 1.07 vs. 3.35 ± 1.28, P > 0.05) were observed. Conclusion: The present study identified that the rugby union players are characterized by impaired cognitive function subsequent to elevated systemic-oxidative-nitrosative stress. However, this appears to be independent of any functional impairment in cerebrovascular function. Given the potential long-term trajectory towards accelerated cognitive decline in populations exposed to SRC, prophylaxis to increase NO bioavailability warrants consideration.

Keywords: cognition, concussion, mild traumatic brain injury, rugby

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Authors: Vassilis Argyropoulos, Magda Nikolaraizi, Maria Papazafiri

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This study describes a series of learning workshops, which took place within CUIDAR project. The workshops aimed to empower children to share their experiences and views in relation to natural hazards and disasters. The participants in the workshops were ten primary school students who had severe visual impairments or multiple disabilities and visual impairments (MDVI). The main objectives of the workshops were: a) to promote access of the children through the use of appropriate educational material such as texts in braille, enlarged text, tactile maps and the implementation of differentiated instruction, b) to make children aware regarding their rights to have access to information and to participate in planning and decision-making especially in relation to disaster education programs, and c) to encourage children to have an active role during the workshops through child-led and experiential learning activities. The children expressed their views regarding the meaning of hazards and disasters. Following, they discussed their experiences and emotions regarding natural hazards and disasters, and they chose to place the emphasis on a hazard, which was more pertinent to them, their community and their region, namely fires. Therefore, they recalled fires that have caused major disasters, and they discussed about the impact that these fires had on their community or on their country. Furthermore, they were encouraged to become aware regarding their own role and responsibility to prevent a fire or get prepared and know how to behave if a fire occurs. They realized that prevention and preparation are a matter of personal responsibility. They also felt the responsibility to inform their own families. Finally, they met important people involved in fire protection such as rescuers and firefighters and had the opportunity to carry dialogues. In conclusion, through child led workshops, experiential and accessible activities, the students had the opportunity to share their own experiences, to express their views and their questions, to broaden their knowledge and to realize their personal responsibility in disaster risk reduction, specifically in relation to fires.

Keywords: accessibility, children, disasters, visual impairment

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Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu

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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).

Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium

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Authors: Marlene Rosa, Susana Lopes

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There are few studies that explore the potential of board games as a performance measure, despite it can be an interesting strategy in the context of frailty populations. In fact, board games are immersive strategies than can inhibit the pressure of being evaluated. This study aimed to test the ability of gamed-base strategies to assess executive function in elderly population. Sixteen old participants were included: 10 with affected executive functions (G1 – 85.30±6.00 yrs old; 10 male); 6 with executive functions with non-clinical important modifications (G2 - 76.30±5.19 yrs old; 6 male). Executive tests were assessed using the Frontal Assessment Battery (FAB), which is a quick-applicable cognitive screening test (score<12 means impairment). The board game used in this study was the TATI Hand Game, specifically for training rhythmic coordination of the upper limbs with multiple cognitive stimuli. This game features 1 table grid, 1 set of Single Game cards (to play with one hand); Double Game cards (to play simultaneously with two hands); 1 dice to plan Single Game mode; cards to plan the Double Game mode; 1 bell; 2 cups. Each participant played 3 single game cards, and the following data were collected: (i) variability in time during board game challenges (SD); (ii) number of errors; (iii) execution speed (sec). G1 demonstrated: high variability in execution time during board game challenges (G1 – 13.0s vs G2- 0.5s); a higher number of errors (1.40 vs 0.67); higher execution velocity (607.80s vs 281.83s). These results demonstrated the potential of implementing board games as a functional assessment strategy in geriatric care. Future studies might include larger samples and statistical methodologies to find cut-off values for impairment in executive functions during performance in TATI game.

Keywords: board game, aging, executive function, evaluation

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Authors: Arunima Datta, Prathama Guha Chaudhuri, Ashis Mukhopadhyay

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Background: Acceptance and commitment therapy (ACT) is one of the newer forms (third wave) therapy. This therapy helps a cancer patient to increase acceptance level about their disease as well as their present situation. Breast cancer patients are known to suffer from depression and mild cognitive impairment; both affect their quality of life. Objectives:The present study had assessed effect of structured ACT intervention on cognitive function and acceptance level among breast cancer patients who were undergoing chemotherapy. Method: Data was collected from 123 breast cancer patients those who were undergoing chemotherapy were willing to undergo psychological treatment, with no history of past psychiatric illness. Their baseline of cognitive function and acceptance levels were assessed using validated tools. The effect of sociodemographic factors and clinical factors on cognitive function was determined at baseline.The participants were randomly divided into two groups: experimental (ACT, 4 sessions over 2 months) and control group. Cognitive function and acceptance level were measured during post intervention on 2months follow-up. Appropriate statistical analyses were performed to determine the effect on cognitive function and acceptance level in two groups. Result: At baseline, the factors that significantly influenced slower speed of task performance were ER PR HER2 status; number of chemo cycle, treatment type (Adjuvant and neo-adjuvant) was related with that. Sociodemographic characteristics did not show any significant difference between slow and fast performance. Per and post intervention analysis showed that ACT intervention resulted in significant difference both in terms of speed of cognitive performance and acceptance level. Conclusion: ACT is an effective therapeutic option for treating mild cognitive impairment and improve acceptance level among breast cancer patients undergoing chemotherapy.

Keywords: acceptance and commitment therapy, breast cancer, quality of life, cognitive function

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Authors: Viktorya Sargsyan, Arax Hovhannesyan, Karine Abelyan

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Introduction: During the last decade, scientific studies have proven the importance of Early Childhood Development (ECD) interventions. These interventions are shown to create strong foundations for children’s intellectual, emotional and physical well-being, as well as the impact they have on learning and economic outcomes for children as they mature into adulthood. Many children in rural Armenia fail to reach their full development potential due to lack of early brain stimulation (playing, singing, reading, etc.) from their parents, and lack of community tools and services to follow-up children’s neurocognitive development. This is exacerbated by high rates of stunting and anemia among children under 3(CU3). This research study tested the effectiveness of an integrated ECD and Maternal, Newborn and Childhood Health (MNCH) model, called “Go Baby, Go!” (GBG), against the traditional (MNCH) strategy which focuses solely on preventive health and nutrition interventions. The hypothesis of this quasi-experimental study was: Children exposed to GBG will have better neurocognitive and nutrition outcomes compared to those receiving only the MNCH intervention. The secondary objective was to assess the effect of GBG on parental child care and nutrition practices. Methodology: The 14 month long study, targeted all 1,300 children aged 0 to 23 months, living in 43 study communities the in Gavar and Vardenis regions (Gegharkunik province, Armenia). Twenty-three intervention communities, 680 children, received GBG, and 20 control communities, 630 children, received MCHN interventions only. Baseline and evaluation data on child development, nutrition status and parental child care and nutrition practices were collected (caregiver interview, direct child assessment). In the intervention sites, in addition to MNCH (maternity schools, supportive supervision for Health Care Providers (HCP), the trained GBG facilitators conducted six interactive group sessions for mothers (key messages, information, group discussions, role playing, video-watching, toys/books preparation, according to GBG curriculum), and two sessions (condensed GBG) for adult family members (husbands, grandmothers). The trained HCPs received quality supervision for ECD counseling and screening. Findings: The GBG model proved to be effective in improving ECD outcomes. Children in the intervention sites had 83% higher odd of total ECD composite score (cognitive, language, motor) compared to children in the control sites (aOR 1.83; 95 percent CI: 1.08-3.09; p=0.025). Caregivers also demonstrated better child care and nutrition practices (minimum dietary diversity in intervention site is 55 percent higher compared to control (aOR=1.55, 95 percent CI 1.10-2.19, p =0.013); support for learning and disciplining practices (aOR=2.22, 95 percent CI 1.19-4.16, p=0.012)). However, there was no evidence of stunting reduction in either study arm. he effect of the integrated model was more prominent in Vardenis, a community which is characterised by high food insecurity and limited knowledge of positive parenting skills. Conclusion: The GBG model is effective and could be applied in target areas with the greatest economic disadvantages and parenting challenges to improve ECD, care practices and developmental outcomes. Longitudinal studies are needed to view the long-term effects of GBG on learning and school readiness.

Keywords: early childhood development, integrated interventions, parental practices, quasi-experimental study

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Authors: Ritesh Verma, Manisha Rathi, Chand Singh Dhull, Sumit Sachdeva, Jitender Phogat

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A Rathke's cleft cyst is a benign growth found on the pituitary gland in the brain, specifically a fluid-filled cyst in the posterior portion of the anterior pituitary gland. It occurs when the Rathke's pouch does not develop properly and ranges in size from 2 to 40mm in diameter. A 38-year-old male presented to the outpatient department with loss of vision in the inferior quadrant of the left eye since 15 days. Visual acuity was 6/6 in the right eye and 6/9 in the left eye. Visual field analysis by HFA-24-2 revealed an inferior field defect extending to the supero-temporal quadrant in the left eye. MRI brain and orbit was advised to the patient and it revealed a well defined cystic pituitary adenoma indenting left optic nerve near optic chiasm consistent with the diagnosis of Rathke’s cleft cyst (RCC). The patient was referred to neurosurgery department for further management. Symptoms vary greatly between individuals having RCCs. RCCs can be non-functioning, functioning, or both. Besides headaches, neurocognitive deficits are almost always present but have a high rate of immediate reversal if the cyst is properly treated or drained.

Keywords: pituitary tumors, rathke’s cleft cyst, visual field defects, vision loss

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Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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The present study was aimed to find out the prevalence of DD's in Visakhapatnam, one of the north coastal districts of Andhra Pradesh, India during a span of five years. A cross-sectional investigation was held at District early intervention center (DEIC), Visakhapatnam from 2016 to 2020. To identify the pattern and trend of different DD's including seasonal variations, a retrospective analysis of the health center's inpatient database for the past 5 years was done. Male and female children aged 2 months-18 years are included in the study with the prior permission of the concerned medical officer. The screening tool developed by the Ministry of health and family welfare, India, was used for the study. Among 26,423 cases, children with birth defects are 962, 2229 with deficiencies, 7516 with diseases, and 15716 with disabilities were admitted during the study period. From birth defects, congenital deafness occurred in large numbers with 22.66%, and neural tube defect observed in a small number of cases with 0.83% during the period. From the side of deficiencies, severe acute malnutrition has mostly occurred (66.80 %) and a small number of children were affected with goiter (1.70%). Among the diseases, dental carriers (67.97%) are mostly found and these cases were at peak during the years 2016 and 2019. From disabilities, children with vision impairment (20.55%) have mostly approached the center. Over the past 5 years, the admission rate of down's syndrome and congenital deafness cases showed a rising trend up to 2019 and then declined. Hearing impairment, motor delay, and learning disorder showed a steep rise and gradual decline trend, whereas severe anemia, vitamin-D deficiency, otitis media, reactive airway disease, and attention deficit hyperactivity disorder showed a declining trend. However, congenital heart diseases, dental caries, and vision impairment admission rates showed a zigzag pattern over the past 5 years. This center had inadequate diagnostic facilities related to genetic disease management. For advanced confirmation, the cases are referred to a district government hospital or private diagnostic laboratories in the city for genetic tests. Information regarding the overall burden and pattern of admissions in the health center is obtained by the review of DEIC records. Through this study, it is observed that the incidence of birth defects, as well as genetic disease burden, is high in the Visakhapatnam district. Hence there is a need for strengthening of management services for these diseases in this region.

Keywords: child health screening, developmental delays, district early intervention center, genetic disease management, infrastructural facility, Visakhapatnam district

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Authors: Ezat Vahidian, Babak Eshrati

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Introduction: Elder abuse, a very complex issue with diverse definitions and names, has been very slow to capture the public eye and public policy since it is manifested at many levels. It requires the involvement of different types of professionals. While elder abuse is not a new phenomenon, the speed of population ageing world-wide is likely to lead to an increase in its incidence and prevalence. Elder abuse has devastating consequences for older persons such as poor quality of life, psychological distress, and loss of property and security. It is also associated with increased mortality and morbidity. Elder abuse is a problem that manifests itself in both rich and poor countries and at all levels of society. Purpose: The purpose of this study is to determine the prevalence of elder abuse and effects of social factor on it in Markazi Province. Materials and methods: The society of the study was all of the elders in Markazi Province that were available by geographical address in the table of rural and urban household societies. The study was cross sectional and multi phases in sampling the first one was classification according rural and urban area and the second one was cluster sampling with equal cluster. Estimation of samples were 472 persons and increased by design effect to 1110 persons. Collection data was done by questionnaire and analyzed by SPSS and chi 2 exam. Results: This study showed 70 persons were abused (42/8% male and 57/2% female) mean of ages was 74/7 years. 64% were marred and 31% were widows. There were not any significant meaningful association between elder abuse and area of living (pv=0.299),occupation (p.v=0.104), education (pv=0.358) and age (P.value=0.104) there were significant meaningful association between physical impairment (pv=0.08), and movement impairment (P.value=0.008). Conclusion: Results verify that maltreatment occurred in the aged persons. Analysis of data indicated that elder abuse exist in every socioeconomic group with any context of education in urban area and rural area and in men and women. Prevalence of elder abuse was 6.3% (70 persons) that verify the data of developed countries with limited sample.

Keywords: elder abuse, education, occupation, area of living

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Authors: Chimeri Muzano Leonard

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The study was carried out to investigate the perceptions of male and female Ordinary Level students on the effects of alcohol abuse at Gatsi Secondary School. The study showed that alcohol abuse has academic, social, psychological and health effects on Ordinary Level students. The negative effects comprises of death, dropping out, poor grades, poor concentration, risky behaviors, impairment of the brain and central nervous system , risky behaviors and Impairment of reproductive functioning Only students who enrolled for Ordinary Level in the 2014 academic year participated in this study. Fifty students (25 males and 25 females) were randomly selected to participate in the study. A formal survey questionnaire was used to collect data. The respondents were asked to use a scale of 0 (totally disagree) to 10 (completely agree) to indicate the extent to which they agreed with each perception. The Statistical Package for Social Sciences (SPSS) version 19.0 was used for data analysis. The Mann Whitney U test was used to test for the significance of differences in the perceptions of male and female students. No statistically significant differences were detected between males and females in most of their perceptions regarding the effects of alcohol abuse on Ordinary Level students. However, there were three perceptions found to be significantly different between male and female. They comprises of “Peers influence one to drink alcohol”, “Alcohol abuse is a major problem among male students compared to their female peers” and “ Female students should not drink beer”.It was evident from this study that Gatsi Secondary School needs to implement more effective interventions that combat alcohol abuse. A deeper analysis of the issues that predispose Ordinary Level students to alcohol abuse should inform the interventions. Consequently, unravelling the problem of negative effects of alcohol abuse was desirable because of its potential usefulness in developing strategies that might help curb the problem and presumably improve the performance of Ordinary Level students and above all the quality of education at Gatsi Secondary School.

Keywords: perceived effects, alcohol, Gatsi Secondary School, alcohol abuse

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Authors: Sohaib Raza, Parvez Mantry

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Frailty is a multi-system impairment associated with stressors such as age, disease, and invasive surgical procedures. This multi-system impairment can lead to increased post-transplant mortality and functional decline. Additionally, the prevalence and/or severity of frailty increases when patient pre-habilitation is unsatisfactory or lacking. We conducted a retrospective study to examine whether the COVID-19 Pandemic, and subsequent lack of patient access to pre-habilitation and physical therapy resources, led to an increase in the prevalence and severity of frailty, sarcopenia, and other comorbidities including diabetes, hypertension, and COPD. Secondarily, we examined the correlation between patient survival rate and liver frailty index as well as muscle wasting/sarcopenia. Data were analyzed in order to correlate variables associated with these parameters. Three hundred sixty-nine liver transplant candidates at Methodist Dallas Medical Center were administered pre-transplant frailty assessments, which consisted of chair stands, grip strength, and position balance time. A frailty score less than 3.2 indicated a robust condition, a score from 3.3 to 4.4 indicated a pre-frail condition, and a score greater than 4.5 indicated a frail condition. Greater than 50 percent of patients were found to have muscle wasting in the COVID-19 period (March 13, 2020 to February 28, 2022), an increase of 16.5 percent from the pre-COVID period (April 1st, 2018 to March 12, 2020). Additionally, sarcopenia was associated with a two-fold increase in patient mortality rate. Furthermore, high liver frailty index scores were associated with increased patient mortality. However, there was no significant difference in liver frailty index or number of comorbidities between patients in the two cohorts. Conclusion: The COVID-19 Pandemic exacerbated sarcopenia-related muscle wasting in liver transplant candidates, and patient survival rate was directly correlated with liver frailty index score and the presence of sarcopenia.

Keywords: frailty, sarcopenia, covid-19, patient mortality, pre-habilitation, liver transplant candidates

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Authors: Chalise Kiran

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The prime idea of inclusive education is to mainstream every child in education. However, it will be challenging for implementation when there are policy and practice gaps. It will be even more challenging when children have disabilities. Generally, the focus will be on the policy gap, but the problem may not always be with policy. The proper practice could be a challenge in the countries like Nepal. In determining practice, the teachers’ perceptions toward inclusive will play a vital role. Nepal has categorized disability in 7 types (physical, visual, hearing, vision/hearing, speech, mental, and multiple). Out of these, hearing impairment is the study realm. In the context of a limited number of researches on children with disabilities and rare researches on CWHI and their education in Nepal, this study is a pioneering effort in knowing basically the problems and challenges of CWHI focused on inclusive education in the schools including gaps and barriers in its proper implementation. Philosophically, the paradigm of the study is post-positivism. In the post-positivist worldview, the quantitative approach with the description of the situation and inferential relationship are revealed out in the study. This is related to the natural model of objective reality. The data were collected from an individual survey with the teachers and head teachers of 35 schools in Nepal. The survey questionnaire was prepared and filled by the respondents from the schools where the CWHI study in 7 provincial 20 districts of Nepal. Through these considerations, the perceptions of CWHI focused inclusive education were explored in the study. The data were analyzed using both descriptive and inferential tools on which the Likert scale-based analysis was done for descriptive analysis, and chi-square mathematical tool was used to know the significant relationship between dependent variables and independent variables. The descriptive analysis showed that the majority of teachers have positive perceptions toward implementing CWHI focused inclusive education, and the majority of them have positive perceptions toward CWHI focused inclusive education, though there are some problems and challenges. The study has found out the major challenges and problems categorically. Some of them are: a large number of students in a single class; availability of generic textbooks for CWHI and no availability of textbooks to all students; less opportunity for teachers to acquire knowledge on CWHI; not adequate teachers in the schools; no flexibility in the curriculum; less information system in schools; no availability of educational consular; disaster-prone students; no child abuse control strategy; no disabled-friendly schools; no free health check-up facility; no participation of the students in school activities and in child clubs and so on. By and large, it is found that teachers’ age, gender, years of experience, position, employment status, and disability with him or her show no statistically significant relation to successfully implement CWHI focused inclusive education and perceptions to CWHI focused inclusive education in schools. However, in some of the cases, the set null hypothesis was rejected, and some are completely retained. The study has suggested policy implications, implications for educational authority, and implications for teachers and parents categorically.

Keywords: children with hearing impairment, disability, inclusive education, perception

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Authors: Sachin, Shantanu Arya, Gunjan Mehta, Md. Shamim Ansari

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The cross-modal influence of visual information on speech perception can be illustrated by the McGurk effect which is an illusion of hearing of syllable /ta/ when a listener listens one syllable, e.g.: /pa/ while watching a synchronized video recording of syllable, /ka/. The McGurk effect is an excellent tool to investigate multisensory integration in speech perception in both normal hearing and hearing impaired populations. As the visual cue is unaffected by noise, individuals with hearing impairment rely more than normal listeners on the visual cues.However, when non congruent visual and auditory cues are processed together, audiovisual interaction seems to occur differently in normal and persons with hearing impairment. Therefore, this study aims to observe the audiovisual interaction in speech perception in Cochlear Implant users compares the same with normal hearing children. Auditory stimuli was routed through calibrated Clinical audiometer in sound field condition, and visual stimuli were presented on laptop screen placed at a distance of 1m at 0 degree azimuth. Out of 4 presentations, if 3 responses were a fusion, then McGurk effect was considered to be present. The congruent audiovisual stimuli /pa/ /pa/ and /ka/ /ka/ were perceived correctly as ‘‘pa’’ and ‘‘ka,’’ respectively by both the groups. For the non- congruent stimuli /da/ /pa/, 23 children out of 35 with normal hearing and 9 children out of 35 with cochlear implant had a fusion of sounds i.e. McGurk effect was present. For the non-congruent stimulus /pa/ /ka/, 25 children out of 35 with normal hearing and 8 children out of 35 with cochlear implant had fusion of sounds.The children who used cochlear implants for less than three years did not exhibit fusion of sound i.e. McGurk effect was absent in this group of children. To conclude, the results demonstrate that consistent fusion of visual with auditory information for speech perception is shaped by experience with bimodal spoken language during early life. When auditory experience with speech is mediated by cochlear implant, the likelihood of acquiring bimodal fusion is increased and it greatly depends on the age of implantation. All the above results strongly support the need for screening children for hearing capabilities and providing cochlear implants and aural rehabilitation as early as possible.

Keywords: cochlear implant, congruent stimuli, mcgurk effect, non-congruent stimuli

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Authors: Pinhas Dannon, Aviv Weinstein

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Impulsivity is raising major interest clinically because it is associated with various clinical conditions such as delinquency, antisocial behavior, suicide attempts, aggression, and criminal activity. The evolutionary perspective argued that impulsivity relates to self-regulation and it has predicted that female individuals should have evolved a greater ability to inhibit pre-potent responses. There is supportive evidence showing that female individuals have better performance on cognitive tasks measuring impulsivity such as delay in gratification and delayed discounting mainly in childhood. During adolescence, brain imaging studies using diffusion tensor imaging on white matter architecture indicated contrary to the evolutionary perspective hypothesis, that young adolescent male individuals may be less vulnerable than age-matched female individuals to risk- and reward- related maladaptive behaviors. In adults, the results are mixed presumably owing to hormonal effects on neuro-biological mechanisms of reward. Consequently, female individuals were less impulsive than male individuals only during fertile stages of the menstrual cycle. Finally, there is evidence the serotonin (5-HT) system is more involved in the impulsivity of men than in that of women. Overall, there seem to be sex differences in impulsivity but these differences are more pronounced in childhood and they are later subject to maturational and hormonal changes during adolescence and adulthood and their effects on the brain, cognition, and behavior.

Keywords: impulse control, male population, female population, gender differences, reward, neurocognitive tests

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Authors: Kamila Troper, Pedro Mestre, Maria Lurdes Menano, Joana Mendonça, Maria João Costa, Sandra Demel

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Introduction: Visual impairment is a problem that has an influence on hundreds of thousands of people all over the world. Although it is possible for a Visually Impaired person to do most jobs, the right training, technological assistance, and emotional support are essential. Ergonomics be able to solve many of the problems/issues with the relative ease of positioning, lighting and design of the workplace. A little forethought can make a tremendous difference to the ease with which a person with an impairment function. Objectives: Review the main ergonomic adaptation measures reported in the literature in order to promote better working conditions and safety measures for the visually impaired. Methodology: This was an exploratory-descriptive, qualitative literature systematic review study. The main databases used were: PubMed, BIREME, LILACS, with articles and studies published between 2000 and 2021. Results: Based on the principles of the theoretical references of ergonomic analysis of work, the main restructuring of the physical space of the workstations were: Accessibility facilities and assistive technologies; A screen reader that captures information from a computer and sends it in real-time to a speech synthesizer or Braille terminal; Installations of software with voice recognition, Monitors with enlarged screens; Magnification software; Adequate lighting, magnifying lenses in addition to recommendations regarding signage and clearance of the places where the visually impaired pass through. Conclusions: Employability rates for people with visual impairments(both those who are blind and those who have low vision)are low and continue to be a concern to the world and for researchers as a topic of international interest. Although numerous authors have identified barriers to employment and proposed strategies to remediate or circumvent those barriers, people with visual impairments continue to experience high rates of unemployment.

Keywords: ergonomic adaptations, visual impairments, ergonomic analysis of work, systematic review

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Authors: Suliman Al-Fayoumi, Sherri Amberg, Huafeng Zhou, Jack W. Singer, James P. Dean

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Pacritinib is an oral kinase inhibitor with specificity for JAK2, FLT3, IRAK1, and CSF1R. In clinical studies, pacritinib was well tolerated with clinical activity in patients with myelofibrosis. The most frequent adverse events (AEs) observed with pacritinib are gastrointestinal (diarrhea, nausea, and vomiting; mostly grade 1-2 in severity) and typically resolve within 2 weeks. A human ADME mass balance study demonstrated that pacritinib is predominantly cleared via hepatic metabolism and biliary excretion (>85% of administered dose). The major hepatic metabolite identified, M1, is not thought to materially contribute to the pharmacological activity of pacritinib. Hepatic diseases are known to impair hepatic blood flow, drug-metabolizing enzymes, and biliary transport systems and may affect drug absorption, disposition, efficacy, and toxicity. This phase 1 study evaluated the pharmacokinetics (PK) and safety of pacritinib and the M1 metabolite in study subjects with mild, moderate, or severe hepatic impairment (HI) and matched healthy subjects with normal liver function to determine if pacritinib dosage adjustments are necessary for patients with varying degrees of hepatic insufficiency. Study participants (aged 18-85 y) were enrolled into 4 groups based on their degree of HI as defined by Child-Pugh Clinical Assessment Score: mild (n=8), moderate (n=8), severe (n=4), and healthy volunteers (n=8) matched for age, BMI, and sex. Individuals with concomitant renal dysfunction or progressive liver disease were excluded. A single 400 mg dose of pacritinib was administered to all participants. Blood samples were obtained for PK evaluation predose and at multiple time points postdose through 168 h. Key PK parameters evaluated included maximum plasma concentration (Cmax), time to Cmax (Tmax), area under the plasma concentration time curve (AUC) from hour zero to last measurable concentration (AUC0-t), AUC extrapolated to infinity (AUC0-∞), and apparent terminal elimination half-life (t1/2). Following treatment, pacritinib was quantifiable for all study participants at 1 h through 168 h postdose. Systemic pacritinib exposure was similar between healthy volunteers and individuals with mild HI. However, there was a significant difference between those with moderate and severe HI and healthy volunteers with respect to peak concentration (Cmax) and plasma exposure (AUC0-t, AUC0-∞). Mean Cmax decreased by 47% and 57% respectively in participants with moderate and severe HI vs matched healthy volunteers. Similarly, mean AUC0-t decreased by 36% and 45% and mean AUC0-∞ decreased by 46% and 48%, respectively in individuals with moderate and severe HI vs healthy volunteers. Mean t1/2 ranged from 51.5 to 74.9 h across all groups. The variability on exposure ranged from 17.8% to 51.8% across all groups. Systemic exposure of M1 was also significantly decreased in study participants with moderate or severe HI vs. healthy participants and individuals with mild HI. These changes were not significantly dissimilar from the inter-patient variability in these parameters observed in healthy volunteers. All AEs were grade 1-2 in severity. Diarrhea and headache were the only AEs reported in >1 participant (n=4 each). Based on these observations, it is unlikely that dosage adjustments would be warranted in patients with mild, moderate, or severe HI treated with pacritinib.

Keywords: pacritinib, myelofibrosis, hepatic impairment, pharmacokinetics

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Authors: Aikaterini Tavoulari, Michael Proulx, Karin Petrini

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Objective: This study aims to explore the unique challenges faced by young individuals with vision impairment (VI) during key life transitions, utilizing a community-based participatory research (CBPR) approach to identify limitations and positive aspects of existing support systems, with a focus on accessibility and diversity. Design: The study employs a qualitative CBPR design, engaging young participants with VI through online and in-person working groups over six months, prioritizing their active involvement and diverse perspectives. Methods: Twenty-one young individuals with VI from across the UK and with different VI conditions were recruited to participate in the study via a climbing and virtual reality event and stakeholders’ support. Data collection methods included open discussions, forum exchanges, and qualitative questionnaires. The data were analyzed with NVivo using inductive thematic analysis to identify key themes and patterns related to the challenges and experiences of life transitions for this diverse population. Results: The analysis revealed barriers to accessibility, such as assumptions about what a person with VI can do, inaccessibility to material, noisy environments, and insufficient training with assistive technologies. Enablers included guidance from diverse professionals and peers, multisensory approaches (beyond tactile), and peer collaborations. This study underscores the need for developing accessible and tailored strategies together with these young people to address the specific needs of this diverse population during critical life transitions (e.g., to independent living, employment and higher education). Conclusion: Engaging and co-designing effective approaches and tools with young people with VI is key to tackling the specific accessibility barriers they encounter. These approaches should be targeted at different transitional periods of their life journey, promoting diversity and inclusion.

Keywords: vision impairement, life transitions, qualitative research, community-based participatory design, accessibility

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Authors: Hsin-Chieh Lee, Fen-Ling Kuo, Jui-Chi Lin

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Background: Upper extremity functional impairment that occurs after stroke includes hemiplegia, synergy movement, muscle hypertonicity, and somatosensory impairment, which result in inefficient and inaccurate movement. Robot-assisted rehabilitation is an intensive training approach that is effective in sensorimotor and hand function recovery. However, these systems mostly focused on the proximal part of the upper limb rather than the distal part. The device used in our study was Gloreha Sinfonia, which focuses on the distal part of the upper limb and uses a dynamic support system to facilitate the whole limb function. The objective of this study was to investigate the effects of robot-assisted therapy (RT) with Gloreha device on sensorimotor, and ADLs in patients with stroke. Method: Patients with stroke (N=25) participated AB or BA (A = 12 RT sessions and B = 12 conventional therapy (CT) sessions) for 6 weeks (60 min at each session, twice a week), with 1-month break for washout period. The performance of the patients was assessed by a blinded assessor at 4 time points (pretest 1, posttest 1, pretest 2, posttest 2) which including the Fugl–Meyer Assessment-upper extremity (FMA-UE), box and block test, electromyography of the extensor digitorum communis (EDC) and brachioradialis, a grip dynamometer for motor evaluation; Semmes–Weinstein hand monofilament and Revision of the Nottingham Sensory Assessment for sensory evaluation; and the Modified Barthel Index (MBI) for assessing the ADL ability. Result: RT group significantly improved FMA-UE proximal scores (p = 0.038), FMA-UE total scores (p = 0.046), and MBI (p = 0.030). The EDC exhibited higher efficiency during the small block grasping task in the RT group than in the CT group (p = 0.050). Conclusions: RT with the Gloreha device might lead to beneficial effects on arm motor function, ADL ability, and EDC muscle recruitment efficacy in patients with subacute to chronic stroke.

Keywords: activities of daily living, hand function, robotic rehabilitation, stroke

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Authors: K. Hariohm, V. Prakash, J. Saravana Kumar

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Introduction and Rationale: Increased scope of Physiotherapy (PT) practice also has contributed to research in the field of PT. It is essential to determine the production and quality of the clinical trials from India since, it may reflect the scientific growth of the profession. These trends can be taken as a baseline to measure our performance and also can be used as a guideline for the future trials. Objective: To quantify and analyze qualitatively the RCT’s from India from the period 2000-2013’ May, and classify data for the information process. Methods: Studies were searched in the Medline database using the key terms “India”, “Indian”, “Physiotherapy”. Clinical trials only with PT authors were included. Trials out of scope of PT practice and on animals were excluded. Retrieved valid articles were analyzed for published year, type of participants, area of study, PEDro score, outcome measure domains of impairment, activity, participation; ‘a priori’ sample size calculation, region, and explanation of the intervention. Result: 45 valid articles were retrieved from the year 2000-2013’ May. The majority of articles were done on symptomatic participants (81%). The frequencies of conditions repeated more were low back pain (n-7) and diabetes (n-4). PEDro score with mode 5 and upper limit of 8 and lower limit 4 was found. 97.2% of studies measure the outcome at the impairment level, 34% in activity level, and 27.8% in participation level. 29.7% of studies did ‘a priori’ sample size calculation. Correlation of year trend and PEDro score found to be not significant (p>.05). Individual PEDro item analysis showed, randomization (100%), concealment (33%) baseline (76%), blinding-subject, therapist, assessor (9.1%, 0%, 10%), follow-up (89%) ITT (15%), statistics between groups (100%), measures of variance (88 %). Conclusion: The trend shows an upward slope in terms of RCTs published from India which is a good indicator. The qualitative analysis showed some gaps in the clinical trial design, which can be expected to be, fulfilled by the future researchers.

Keywords: RCT, PEDro, physical therapy, rehabilitation

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Authors: Govindan Sudha, Mathumitha Subramaniam, Alamelu Govindasamy, Sasikala Gunasekaran

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The aim of this study was to investigate the protective effect of Hypsizygus ulmarius polysaccharides (HUP) on reducing oxidative stress, cognitive impairment and neurotoxicity in D-galactose induced aging mice. Mice were subcutaneously injected with D-galactose (150 mg/kg per day) for 6 weeks and were administered HUP simultaneously. Aged mice receiving vitamin E (100 mg/kg) served as positive control. Chronic administration of D-galactose significantly impaired cognitive performance oxidative defence and mitochondrial enzymes activities as compared to control group. The results showed that HUP (200 and 400 mg/kg) treatment significantly improved the learning and memory ability in Morris water maze test. Biochemical examination revealed that HUP significantly increased the decreased activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione-S-transferase (GST), mitochondrial enzymes-NADH dehydrogenase, malate dehydrogenase (MDH), isocitrate dehydrogenase (ICDH), Na+K+, Ca2+, Mg2+ATPase activities, elevated the lowered total anti-oxidation capability (TAOC), glutathione (GSH), vitamin C and decreased the raised acetylcholinesterase (AChE) activities, malondialdehyde (MDA), hydroperoxide (HPO), protein carbonyls (PCO), advanced oxidation protein products (AOPP) levels in brain of aging mice induced by D-gal in a dose-dependent manner. In conclusion, present study highlights the potential role of HUP against D-galactose induced cognitive impairment, biochemical and mitochondrial dysfunction in mice. In vitro studies on the effect of HUP on scavenging DPPH, ABTS, DMPD, OH radicals, reducing power, B-carotene bleaching and lipid peroxidation inhibition confirmed the free radical scavenging and antioxidant activity of HUP. The results suggest that HUP possesses anti-aging efficacy and may have potential in treatment of neurodegenerative diseases.

Keywords: aging, antioxidants, mushroom, neurotoxicity

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Authors: K. M. Damodara Gowda

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Background: Maternal health and nutrition are considered as the predominant factors influencing brain functional development. If the mother is free of illness and genetic defects, maternal nutrition would be one of the most critical factors affecting the brain development. Calorie restrictions cause significant impairment in spatial learning ability and the levels of Brain Derived Neurotrophic Factor (BDNF) in rats. But, the mechanism by which the prenatal under-nutrition leads to impairment in brain learning and memory function is still unclear. In the present study, prenatal Astaxanthin supplementation on BDNF level, spatial learning and memory performance in the offspring’s of normal, calorie restricted and Astaxanthin supplemented rats was investigated. Methodology: The rats were administered with 6mg and 12 mg of astaxanthin /kg bw for 21 days following which acquisition and retention of spatial memory was tested in a partially-baited eight arm radial maze. The BDNF level in different regions of the brain (cerebral cortex, hippocampus and cerebellum) was estimated by ELISA method. Results: Calorie restricted animals treated with astaxanthin made significantly more correct choices (P < 0.05), and fewer reference memory errors (P < 0.05) on the tenth day of training compared to offsprings of calorie restricted animals. Calorie restricted animals treated with astaxanthin also made significantly higher correct choices (P < 0.001) than untreated calorie restricted animals in a retention test 10 days after the training period. The mean BDNF level in cerebral cortex, Hippocampus and cerebellum in Calorie restricted animals treated with astaxanthin didnot show significant variation from that of control animals. Conclusion: Findings of the study indicated that memory and learning was impaired in the offspring’s of calorie restricted rats which was effectively modulated by astaxanthin at the dosage of 12 mg/kg body weight. In the same way the BDNF level at cerebral cortex, Hippocampus and Cerebellum was also declined in the offspring’s of calorie restricted animals, which was also found to be effectively normalized by astaxanthin.

Keywords: calorie restiction, learning, Memory, Cerebral cortex, Hippocampus, Cerebellum, BDNF, Astaxanthin

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Authors: A. Raj Kumar, S. Bilaloglu

Abstract:

Stroke is a leading cause of adult disability worldwide. We depend on our hands for our activities of daily living(ADL). Although many patients regain the ability to walk, they continue to experience long-term hand motor impairments. As the number of individuals with young stroke is increasing, there is a critical need for effective approaches for rehabilitation of hand function post-stroke. Motor relearning for dexterity requires task-specific kinesthetic, tactile and visual feedback. However, when a stroke results in both sensory and motor impairment, it becomes difficult to ascertain when and what type of sensory substitutions can facilitate motor relearning. In an ideal situation, real-time task-specific data on the ability to learn and data-driven feedback to assist such learning will greatly assist rehabilitation for dexterity. We have found that kinesthetic and tactile information from the unaffected hand can assist patients re-learn the use of optimal fingertip forces during a grasp and lift task. Measurement of fingertip grip force (GF), load forces (LF), their corresponding rates (GFR and LFR), and other metrics can be used to gauge the impairment level and progress during learning. Currently ATI mini force-torque sensors are used in research settings to measure and compute the LF, GF, and their rates while grasping objects of different weights and textures. Use of the ATI sensor is cost prohibitive for deployment in clinical or at-home rehabilitation. A cost effective mechatronic device is developed to quantify GF, LF, and their rates for stroke rehabilitation purposes using off-the-shelf components such as load cells, flexi-force sensors, and an Arduino UNO microcontroller. A salient feature of the device is its integration with an interactive gaming environment to render a highly engaging user experience. This paper elaborates the integration of kinesthetic and tactile sensing through computation of LF, GF and their corresponding rates in real time, information processing, and interactive interfacing through augmented reality for visual feedback.

Keywords: feedback, gaming, kinesthetic, rehabilitation, tactile

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Authors: Muhammad Shahid Shah, Akram Maqbool, Samina Ashraf

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Since start of this century, world has adopted inclusion as a trend in special education. To meet the challenges of inclusion response, the Punjab government has developed a progressive policy to implement inclusive education. The objectives of this research were to analyze the administration and implementation process by consideration on the management, student’s admission process, screening and assessment, adaptations in curriculum and instruction along with an evaluation, government and nonprofit organizations support. The sample consisted of 50 schools both public and private with a total of 3000 students, 9 percent of which (270) were students with disabilities. Among all the students with disabilities, 63 percent (170) were male and 37 percent (100) were female. The concluded remarks regarding management revealed that a large number of inclusive schools was lacking in terms of developing a certain model for inclusion, including the managerial breakup of staff, the involvement of stakeholders, and conducted frequent meetings. Many of schools are not able to restructure their school organizations due to lack of financial resources, consultations, and backup. As for as student’s admission/identification/assessment was concerned, only 12 percent schools applied a selection process regarding student admission, half of which used different procedures for disable candidates. Approximately 5 percent of inclusive schools had modified their curriculum, including a variety of standards. In terms of instruction, 25 percent of inclusive schools reported that they modified their instructional process. Only a few schools, however, provided special equipment for students with visual impairment, physical impairment, speech and hearing problems, students with mild intellectual disabilities, and autism. In a student evaluation, more than 45 percent reported that test items, administration, time allocations, and students’ reports were modified. For the primary board examination conducted by the Education Department of Government of Punjab, this number decreased dramatically. Finally, government and nonprofit organizations support in the forms of funding, coaching, and facilities were mostly provided by provincial governments and by Ghazali Education Trust.

Keywords: inclusion, identification, assessment, funding, facilities, evaluation

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Authors: Elsa Reethu, S. Karthik Babu, N. Syed

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Background: Studies in the past focused on the additional benefits of action observation in improving upper and lower limb functions and improving activities of daily living when administered along with conventional therapy. Nevertheless, there is a paucity of literature proving the effects of motor imagery of truncal exercise in improving trunk control in patients with stroke. Aims/purpose: To study the effect of motor imagery of truncal exercises on trunk function and balance in early stroke. Methods: A total of 24 patients were included in the study. 12 were included in the experimental group and 12 were included in control group Trunk function was measured using Trunk Control Test (TCT), Trunk Impairment Scale Verheyden (TIS Verheyden) and Trunk Impairment Scale Fujiwara (TIS Fujiwara). The balance was assessed using Brunel Balance Assessment (BBA) and Tinetti POMA. For the experimental group, each session was for 30 minutes of physical exercises and 15 minutes of motor imagery, once a day, six times a week for 3 weeks and prior to the exercise session, patients viewed a video tape of all the trunk exercises to be performed for 15minutes. The control group practiced the trunk exercises alone for the same duration. Measurements were taken before, after and 4 weeks after intervention. Results: The effect of treatment in motor imagery group showed better improvement when compared with control group when measured after 3 weeks on values of static sitting balance, dynamic balance, total TIS (Verheyden) score, BBA, Tinetti balance and gait with a large effect size of 0.86, 1.99, 1.69, 1.06, 1.63 and 0.97 respectively. The moderate effect size was seen in values of TIS Fujiwara (0.58) and small effect size was seen on TCT (0.12) and TIS coordination component (0.13).at the end of 4 weeks after intervention, the large effect size was identified on values of dynamic balance (2.06), total TIS score (1.59) and Tinetti balance (1.24). The moderate effect size was observed on BBA (0.62) and Tinetti gait (0.72). Conclusion: Trunk motor imagery is effective in improving trunk function and balance in patients with stroke and has a carryover effect in the aspects of mobility. The therapy gain that was observed during the time of discharge was seen to be maintained at the follow-up levels.

Keywords: stroke, trunk rehabilitation, trunk function, balance, motor imagery

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Authors: Deepthy Ann Joy, N. Sreedevi

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Hearing impairment (HI) at an early age, identified before the onset of language development can reduce the negative effect on speech and language development of children. Early rehabilitation is very important in the improvement of speech production in children with HI. Other than conventional hearing aids, Cochlear Implants are being used in the rehabilitation of children with HI. However, delay in acquisition of speech and language milestones persist in children with Cochlear Implant (CI). Delay in speech milestones are reflected through speech sound errors. These errors reflect the temporal and spectral characteristics of speech. Hence, acoustical analysis of the speech sounds will provide a better representation of speech production skills in children with CI. The present study aimed at investigating the acoustic characteristics of vowels in Malayalam speaking children with a cochlear implant. The participants of the study consisted of 20 Malayalam speaking children in the age range of four and seven years. The experimental group consisted of 10 children with CI, and the control group consisted of 10 typically developing children. Acoustic analysis was carried out for 5 short (/a/, /i/, /u/, /e/, /o/) and 5 long vowels (/a:/, /i:/, /u:/, /e:/, /o:/) in word-initial position. The responses were recorded and analyzed for acoustic parameters such as Vowel duration, Ratio of the duration of a short and long vowel, Formant frequencies (F₁ and F₂) and Formant Centralization Ratio (FCR) computed using the formula (F₂u+F₂a+F₁i+F₁u)/(F₂i+F₁a). Findings of the present study indicated that the values for vowel duration were higher in experimental group compared to the control group for all the vowels except for /u/. Ratio of duration of short and long vowel was also found to be higher in experimental group compared to control group except for /i/. Further F₁ for all vowels was found to be higher in experimental group with variability noticed in F₂ values. FCR was found be higher in experimental group, indicating vowel centralization. Further, the results of independent t-test revealed no significant difference across the parameters in both the groups. It was found that the spectral and temporal measures in children with CI moved towards normal range. The result emphasizes the significance of early rehabilitation in children with hearing impairment. The role of rehabilitation related aspects are also discussed in detail which can be clinically incorporated for the betterment of speech therapeutic services in children with CI.

Keywords: acoustics, cochlear implant, Malayalam, vowels

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Authors: Helen Pushkarskaya, David Tolin, Lital Ruderman, Ariel Kirshenbaum, J. MacLaren Kelly, Christopher Pittenger, Ifat Levy

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Obsessive-Compulsive Disorder (OCD) produces profound morbidity. Difficulties with decision making and intolerance of uncertainty are prominent clinical features of OCD. The nature and etiology of these deficits are poorly understood. We used a well-validated choice task, grounded in behavioral economic theory, to investigate differences in valuation and value-based choice during decision making under uncertainty in 20 unmedicated participants with OCD and 20 matched healthy controls. Participants’ choices were used to assess individual decision-making characteristics. Compared to controls, individuals with OCD were less consistent in their choices and less able to identify options that were unambiguously preferable. These differences correlated with symptom severity. OCD participants did not differ from controls in how they valued uncertain options when outcome probabilities were known (risk) but were more likely than controls to avoid uncertain options when these probabilities were imprecisely specified (ambiguity). These results suggest that the underlying neural mechanisms of valuation and value-based choices during decision-making are abnormal in OCD. Individuals with OCD show elevated intolerance of uncertainty, but only when outcome probabilities are themselves uncertain. Future research focused on the neural valuation network, which is implicated in value-based computations, may provide new neurocognitive insights into the pathophysiology of OCD. Deficits in decision-making processes may represent a target for therapeutic intervention.

Keywords: obsessive compulsive disorder, decision-making, uncertainty intolerance, risk aversion, ambiguity aversion, valuation

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Authors: Mai Alharthy, Agnes Shiel, Hynes Sinead

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Objectives: The objectives of the study are to translate and culturally adapt the RBMT-3 to be appropriate for use within an Arabic-speaking population and to achieve maximum equivalency between the translated and original versions and to evaluate the psychometric properties of the Arabic version of the RBMT-3. Participants' numbers are 16 (10 females and 6 males). All participants are bilingual speakers of Arabic and English, above 18 years old and with no current nor past memory impairment. Methods: The study was conducted in two stages: Translation and cultural adaptation stage: Forward and backward translations were completed by professional translators. Five out of the 14 RBMT-3 subtests required cultural adaptations. Half of the faces in the face recognition subtests were replaced with Arabic faces by a professional photographer. Pictures that are irrelevant to the Arabic culture in the picture recognition subtests were replaced. Names, story and orientations subtests were also adapted to suit the Arabic culture. An expert committee was formed to compare the translated and original versions and to advise on further changes required for test materials. Validation of the Arabic RBMT-3- pilot: 16 Participants were tested on version 1 of the English version and the two versions of the Arabic RBMT-3 ( counterbalanced ). The assessment period was 6 weeks long, with two weeks gap between tests. All assessments took place in a quiet room in the National University of Ireland Galway. Two qualified occupational therapists completed the assessments. Results: Wilcox signed-rank test was used to compare between subtest scores. Significant differences were found in the story, orientation and names subtests between the English and Arabic versions. No significant differences were found in subtests from both Arabic versions except for the story subtest. Conclusion: The story and orientation subtests should be revised by the expert committee members to make further adaptations. The rest of the Arabic RBMT-3 subtests are equivalent to the subtests of the English version. The psychometric properties of the Arabic RBMT-3 will be investigated in a larger Arabic-speaking sample in Saudi Arabia. The outcome of this research is to provide clinicians and researchers with a reliable tool to assess memory problems in Arabic speaking population.

Keywords: memory impairment, neuropsychological assessment, cultural adaptation, cognitive assessment

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Authors: T. Pradhan, P. Rijal, M. C. Regmi

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Background: Eclampsia is a multisystem disorder that involves vital organs and failure of these may lead to deterioration of maternal condition and hypoxia and acidosis of fetus resulting in high maternal and perinatal mortality and morbidity. Thus, evaluation of the contributing factors for this condition and its complications leading to maternal deaths should be the priority. Formulating the plan and protocol to decrease these losses should be our goal. Aims and Objectives: To evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia and to correlate the risk factors associated with maternal and fetal morbidity and mortality. Methods: All patients with eclampsia admitted in Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to patients, and attendants like Antenatal clinic visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate and the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition like maternal Intensive Care Unit admission, neurological impairment and mortality were noted before discharge. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS 11). Mean and percentage were calculated for demographic variables. Pearson’s correlation test and chi-square test were applied to find the relation between the risk factors and the outcomes. P value less than 0.05 was considered significant. Results: There were 10,000 antenatal deliveries during the study period. Fifty-two patients with eclampsia were admitted. All of the patients were unbooked for our institute. Thirty-nine patients were antepartum eclampsia. Thirty-one patients required mechanical ventilator support. Twenty-four patients were delivered by emergency c-section and 21 babies were Low Birth Weight and there were 9 stillbirths. There was one maternal mortality and 45 patients were discharged with improvement but 3 patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate. Conclusion: Early detection and management of hypertensive complicating pregnancy during antenatal clinic check up. Early hospitalization and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes.

Keywords: eclampsia, maternal mortality, perinatal mortality, risk factors

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Authors: Tlotlollo Sidwell Hlalele, Shengzhi Du

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High voltage transmission is the most pivotal process in the electrical power industry. It requires a robust infrastructure that can last for decades without causing impairment in human life. Due to the so-called global warming, power transmission system has started to experience some challenges which could presumably escalate more in future. These challenges are earthquake resistance, transmission power losses, and high electromagnetic field. In this paper, research efforts aim to address these challenges are discussed. We focus in particular on the research in regenerative electric energy such as: wind, hydropower, biomass and sea-waves based on the energy storage and transmission possibility. We conclude by drawing attention to specific areas that we believe need more research.

Keywords: power transmission, regenerative energy, power quality, energy storage

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