Search results for: timing of intervention

Authors: Nayera E. Hassan, Sahar A. El-Masry, Rokia El-Banna, Mohamed S. El Hussieny

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There are several different modalities for treatment of obesity. Common intervention methods for obesity include low-calorie diet, exercise. Also acupuncture has shown good therapeutic results in the treatment of obesity. A recent clinical observation showed that laser acupuncture could reduce body weight and body mass index in obese persons. So, the aim of this research is focused on body composition changes as related to type of intervention, before and after intentional weight loss in overweight and obesity. 76 subjects were included in the study analysis. The present study recommended that every obese female must do lipid profile and fasting blood sugar analysis before weight-loss intervention to take the decision of which method should be used.

Keywords: obesity, weight-loss, body composition, modalities

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Authors: Ihuarulam A. Ikenna

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In the past few decades, the field of chemistry education has grown tremendously and researches indicated that after traditional chemistry instruction students often lacked deep conceptual understanding and failed to integrate their ideas into coherent conceptual framework. For several concepts in chemistry, students at all levels have demonstrated difficulty in changing their initial perceptions. Their perceptions are most often wrong and do not agree with correct scientific concepts. This study explored the effectiveness of intervention discussion sections for a college general chemistry course designed to apply research on students preconceptions, knowledge integration and student explanation. Three interventions discussions lasting three hours on bond energy and spontaneity were done tested and intervention (treatment) students’ performances were compared with that of control group which did not use the experimental pedagogy. Results indicated that this instruction which was capable of identifying students' misconceptions, initial conceptions and integrating those ideas into class discussion led to enhanced conceptual understanding and better achievement for the experimental group.

Keywords: remedying, students’ misconceptions, learning, intervention discussion, learning model

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Authors: Saud Al Mahdi

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Traditionally,portfolio managers have been discouraged from timing the market. This means, for example, that equity managers have been forced to adhere strictly to a benchmark with static or relatively stable components, such as the SP 500 or the Russell 3000. This means that the portfolio’s exposures to all risk factors should mimic as closely as possible the corresponding exposures of the benchmark. The main risk factor, of course, is the market itself. Effectively, a long-only portfolio would be constrained to have a beta 1. More recently, however, managers have been given greater discretion to adjust their portfolio’s risk exposures (in particular, the beta of their portfolio) dynamically to match the manager’s beliefs about future performance of the risk factors themselves. This freedom translates into the manager’s ability to adjust the portfolio’s beta dynamically. These strategies have come to be known as smart beta strategies. Adjusting beta dynamically amounts to attempting to "time" the market; that is, to increase exposure when one anticipates that the market will rise, and to decrease it when one anticipates that the market will fall. Traditionally, market timing has been believed to be impossible to perform effectively and consistently. Moreover, if a majority of market participants do it, their combined actions could destabilize the market. The aim of this project is to investigate so-called smart beta strategies to determine if they really can add value, or if they are merely marketing gimmicks used to sell dubious investment strategies.

Keywords: beta, alpha, active portfolio management, trading strategies

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Authors: Emad M.Abdullat, Hasan A. Ader-Rahman, Rayyan Al Ali, Arwa.A.Hudaib

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This retrospective study aims to determine the epidemiological features of such deaths in one of the general teaching hospitals in Jordan with a focus on weaning practices and its relation to sucking as major factors underlying the mechanism of choking in infants and young children. The study utilized a retrospective design to review the records of forensic cases due to foreign body aspiration examined at the forensic department at the Jordan University Hospital. A total of 27 cases of choking in the pediatric age group were retrieved from the reports of the autopsy cases dissected. All cases of children who died due to chocking by foreign bodies were under 11 years old. Choking by food materials constituted (44.4%) of cases under 3 years of age while choking by non-food material were less prevalent under 3 years of age and comprising 18.5% of the cases. Health care personnel and parents need to be aware that introduction of solid food, unlike exclusive breast or formula-milk feeding, can have serious consequences if occurring in inappropriate timing or consistency during early childhood physical and functional development. Parents need to be educated regarding the appropriate timing and process of weaning.

Keywords: chocking, infants, weaning practices, young children

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Authors: Ashleigh Beales, Anne Whitworth, Jade Cartwright

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Background: While significant benefits of lexical retrieval intervention are evident within the Primary Progressive Aphasia (PPA) and Alzheimer’s disease (AD) literature, an understanding of the mechanisms that underlie change or improvement is limited. Change mechanisms have been explored in the non-progressive post-stroke literature that may offer insight into how interventions affect change with progressive language disorders. The potential influences of cognitive factors may also play a role here, interacting with the aims of intervention. Exploring how such processes have been applied is likely to grow our understanding of how interventions have, or have not, been effective, and how and why generalisation is likely, or not, to occur. Aims: This review of the literature aimed to (1) investigate the proposed mechanisms of change which underpin lexical interventions, mapping the PPA and AD lexical retrieval literature to theoretical accounts of mechanisms that underlie change within the broader intervention literature, (2) identify whether and which nonlinguistic cognitive functions have been engaged in intervention with these populations and any proposed influence, and (3) explore evidence of linguistic generalisation, with particular reference to change mechanisms employed in interventions. Main contribution: A search of Medline, PsycINFO, and CINAHL identified 36 articles that reported data for individuals with PPA or AD following lexical retrieval intervention. A review of the mechanisms of change identified 10 studies that used stimulation, 21 studies utilised relearning, three studies drew on reorganisation, and two studies used cognitive-relay. Significant treatment gains, predominantly based on linguistic performance measures, were reported for all client groups for each of the proposed mechanisms. Reorganisation and cognitive-relay change mechanisms were only targeted in PPA. Eighteen studies incorporated nonlinguistic cognitive functions in intervention; these were limited to autobiographical memory (16 studies), episodic memory (three studies), or both (one study). Linguistic generalisation outcomes were inconsistently reported in PPA and AD studies. Conclusion: This review highlights that individuals with PPA and AD may benefit from lexical retrieval intervention, irrespective of the mechanism of change. Thorough application of a theory of intervention is required to gain a greater understanding of the change mechanisms, as well as the interplay of nonlinguistic cognitive functions.

Keywords: Alzheimer's disease, lexical retrieval, mechanisms of change, primary progressive aphasia

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Authors: Sonal Khosla

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A research is proposed in the present paper to explore the role of flow in coping with traumatic experiences and attaining post-traumatic growth. A grounded theory research is proposed to be carried by analyzing memoirs of people who have been through trauma. A pilot study was carried out on two memoirs of women who were held captive for over ten years and were sexually assaulted repeatedly. The role of flow in their coping experiences was explored by analyzing the books. Some of the flow activities that were used by them were- drawing and daydreaming. Their narratives show the evidence for flow as having cathartic and healing effects on them. Applicability of the findings can take two forms: 1. Flow can be applied as a preventive technique to help the people who are going through trauma, 2. Flow can be adopted into a positive intervention to help people suffering from PTSD.

Keywords: flow, positive intervention, PTSD, PTG

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Authors: Sultana Razia

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The purpose of this study was to investigate the effect of early therapeutic intervention for the children with autism spectrum disorder. Participants were 63 children with autism spectrum disorder from Autism Corner in a selected rehabilitation center of Bangladesh. The hypothesis of the study was that participants would demonstrate significant improvement in social skills, speech and sensory skills following a 3-month intensive therapeutic protocol. This study included children who are at age of 18-month to 36-month and who were taking occupational therapy and speech and language therapy from the autism center. They were primarily screened using M-CHAT; however, children with other physical disability or medical conditions excluded. 3-months interventions of 6 sessions per week are a minimum of 45-minutes long per session, one to one interaction followed by parent-led structured home-based therapy was provided. The results indicated that early intensive therapeutic intervention improve understanding, social skills and sensory skills. It can be concluded that therapeutic early intervention a positive effect on Autism Spectrum Disorder.

Keywords: M-CHAT, ASD, sensory cheeklist, OT

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Authors: Muqadis Shazia Rajpar, Lawrence Mitelberg, Rubaiat S. Ahmed, Jemer Garrido, Rukhsana Hossain, Sergey M. Motov

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Distraction techniques have been used as a means to reduce pain, anxiety, and stress in various healthcare settings to facilitate care and make visits less unpleasant. Using virtual reality (VR) in the pediatric emergency setting can be a valuable, effective, and safe non-pharmacological alternative to the current standard of care for pain and anxiety management in pediatric patients. Our pilot study aimed to evaluate the effectiveness of a VR-based intervention as an alternative distraction modality to alleviate pain and anxiety associated with pediatric emergency department (ED) visits and acute pain conditions. The pilot study period was from November 16 to December 9, 2022, for pediatric ED visits for pain, anxiety, or both. Patients were selected based on a novel VR protocol to receive the VR intervention with the administration of pre and post-intervention surveys concerning pain/anxiety ratings and pain scores (Wong-Baker FACES/NRS). Descriptive statistics, paired t-test, and a Fisher Exact Test were used for data analysis, assuming a p-value of 0.05 for significance. A total of 33 patients (21 females, 12 males), ages 5-20 (M = 10.5, SD = 3.43) participated in this study – 12 patients had pain, 2 patients had anxiety, and 19 patients had both pain and anxiety. There was a statistically significant decrease in post-intervention pain scores of less than one point on the rating scale (6.48 vs. 5.62, p < .001). There was a statistically significant reduction in the percentage of patients suffering from “considerable” or “great” pain after the VR intervention (51.6% to 42.3%, p < .001). Similarly, we noticed an increase in the number of patients with “slight” or “moderate” pain post–VR intervention (48.4% to 57.7%, p < .001). Lastly, we demonstrated a decrease in anxiety among patients after utilizing VR (63.6% vs. 36.4%, p < .001). To conclude, VR can alleviate pain and anxiety in pediatric patients and be a useful non-pharmacological tool in the emergency setting.

Keywords: anxiety, emergency room, pain management, pediatric emergency medicine, virtual reality

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Authors: Crisostomo Hart A., Cruz Anna Cecilia R., Cruz Bianca Isabelle A., Cruz John Edward Ligzurc M., Cruz Mikaela Denise P.

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Aim/purpose: The researchers aimed to determine the effect of Ylang-ylang aroma in decreasing the anxiety levels of parents with hospitalized toddlers diagnosed with pneumonia. Method: Quantitative Quasi-experimental one-group pre-test post-test design was utilized in the study. The study includes a pretest, an intervention, and a posttest on the same experimental group. Participants are parents aged 20 – 35 years old with a hospitalized toddler who is diagnosed with pneumonia. Anxiety levels were measured before the intervention using the State Trait Anxiety Inventory by Spielberger. Those who scored 41-120 proceeded to receive the intervention. The intervention was a 3-day course of aromatherapy where the participants inhaled the Ylang-ylang flower at a distance of 10 – 15 cm away from the face for 10 minutes. The post-test using the same instrument measured the levels of anxiety after the 3-day aromatherapy. Paired T-test of SPSS 21.0 was used to analyze the pre-test and post-test scores. Results: Study yielded a p value of 0.047 which shows significant difference between the levels of anxiety before and after the intervention. Conclusions: Based on the data analysis, the researchers concluded that inhalation of Ylang-ylang aroma is effective in reducing the anxiety level of the parents of hospitalized toddlers diagnosed with Pneumonia.

Keywords: Ylang-ylang, Pneumonia, Toddlers, Aromatherapy

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Authors: Michael Nolte, Iwona Kasior, Kala Flagg, Spiro Karavatas

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Background: Cryotherapy has been used as a post-exercise recovery modality for decades. Whole-body cryotherapy (WBC) is an intervention which involves brief exposures to extremely cold air in order to induce therapeutic effects. It is currently being investigated for its effectiveness in treating certain exercise-induced impairments. Purpose: The purpose of this systematic review was to determine whether WBC as a recovery intervention is more, less, or equally as effective as other interventions at reducing perceived levels of muscle soreness and promoting recovery of muscle function after exercise-induced muscle damage (EIMD) from running. Methods: A systematic review of the current literature was performed utilizing the following MeSH terms: cryotherapy, whole-body cryotherapy, exercise-induced muscle damage, muscle soreness, muscle recovery, and running. The databases utilized were PubMed, CINAHL, EBSCO Host, and Google Scholar. Articles were included if they were published within the last ten years, had a CEBM level of evidence of IIb or higher, had a PEDro scale score of 5 or higher, studied runners as primary subjects, and utilized both perceived levels of muscle soreness and recovery of muscle function as dependent variables. Articles were excluded if subjects did not include runners, if the interventions included PBC instead of WBC, and if both muscle performance and perceived muscle soreness were not assessed within the study. Results: Two of the four articles revealed that WBC was significantly more effective than treatment interventions such as far-infrared radiation and passive recovery at reducing perceived levels of muscle soreness and restoring muscle power and endurance following simulated trail runs and high-intensity interval running, respectively. One of the four articles revealed no significant difference between WBC and passive recovery in terms of reducing perceived muscle soreness and restoring muscle power following sprint intervals. One of the four articles revealed that WBC had a harmful effect compared to CWI and passive recovery on both perceived muscle soreness and recovery of muscle strength and power following a marathon. Discussion/Conclusion: Though there was no consensus in terms of WBC’s effectiveness at treating exercise-induced muscle damage following running compared to other interventions, it seems as though WBC may at least have a time-dependent positive effect on muscle soreness and recovery following high-intensity interval runs and endurance running, marathons excluded. More research needs to be conducted in order to determine the most effective way to implement WBC as a recovery method for exercise-induced muscle damage, including the optimal temperature, timing, duration, and frequency of treatment.

Keywords: cryotherapy, physical therapy intervention, physical therapy, whole body cryotherapy

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Authors: Suzy Pereira, Alberto Rocha, Ana Almeida, Catarina Figueiredo, Helena Fonseca, Leonor Moreira, Carla Blum Vestena, Cristina Costa-Lobo

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The socio-educational support to parents, through parental education intervention programs, is part of European social policies, aiming to respond to the needs of education, promotion of well-being and development of children and young people. The purpose of this research is to evaluate the impact of the Positive Parenting Program on the subjective well-being of the parents of gifted children. The Positive Parenting Program is authored and is conducted by the National Association of Study and Intervention in Giftedness, Portuguese Association. The central question to be explored in this research is: Does the promotion of positive parenting in parents of gifted children have a positive impact on the subjective well-being? The sample consisted of 30 parents, non-probabilistic sampling of convenience, of which 15 parents belong to the intervention group and the rest to the control group. One dimension will be evaluated - subjective well-being, through the PANAS questionnaire - before and after the sessions of this program. The aim is to contribute to the understanding of the process and results of the positive parenting program in parents of gifted children.

Keywords: positive parenting, subjective well-being, giftedness, parental education intervention programs

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Authors: Stephen Hernandez, Nikita Sharma

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The Coronavirus disease (COVID-19) emerged as a worldwide pandemic at the beginning of 2020. The pandemic and its impact reached the shores of the United States by the second week of March. Once infections started to grow in numbers, early intervention programs, including those providing home-based services, recognized that to reduce the spread of the virus, many traditional in-person therapeutic interventions were going to be impossible due to social distancing and self-quarantine requirements. Initially, infants, toddlers, and their families were left without any services from their educators and therapists, but within a few weeks of the public health emergency, various states, including New York, approved the use of teletherapy/virtual visits for early intervention service provision. This paper will detail the results of a survey from over 400 E.I. service providers about their experiences utilizing teletherapy to deliver services to children in early intervention programs. The survey questions focused on how did COVID-19 stay-at-home orders impact E.I. services for young children with special needs? Sub-questions included topics such as availability of the parents, the amount of time that babies remained engaged, as well as the perceived success of teletherapy as a viable option to provide service by both parent and professional. The results of this study found that therapists found teletherapy to be a viable manner of providing services and could be very effective on a case by case basis.

Keywords: early intervention, teletheraphy, telehealth, COVID-19

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Authors: Nuraisyah H. Zulkifley, Suriani Ismail, Rosliza Abdul Manaf, Poh Y. Lim

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Taking care of a person with dementia (PWD) is one of the most problematic and challenging caregiving situations. Without proper support, caregiver would need to deal with the impact of caregiving that would lead to caregiver burden. One of the most common tools used to measure caregiver burden among caregivers of PWD is Zarit Burden Interview (ZBI). A systematic review has been conducted through searching Medline, Science Direct, Cochrane Library, Embase, PsycINFO, ProQuest, and Scopus databases to identify relevant articles that elaborate on intervention and outcomes on ZBI among informal caregiver of PWD. The articles were searched in October 2019 with no restriction on language or publication status. Inclusion criteria are randomized control trial (RCT) studies, participants were informal caregivers of PWD, ZBI measured as outcomes, and intervention group was compared with no intervention control or usual care control. Two authors reviewed and extracted the data from the full-text articles. From a total of 344 records, nine studies were selected and included in this narrative review, and eight studies were included in the meta-analysis. The types of interventions that were implemented to ease caregiver burden are psychoeducation, physical activity, psychosocial, and computer-based intervention. The meta-analysis showed that there is a significant difference in the mean score of ZBI (p = 0.006) in the intervention group compared to the control group after implementation of intervention. In conclusion, interventions such as psychoeducation, psychosocial, and physical activity can help to reduce the burden experiencing by the caregivers of PWD.

Keywords: dementia, informal caregiver, randomized control trial, Zarit burden interview

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Authors: Ioanna Koumi

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The aim of the intervention presented is to show the positive effects a mindfulness programme can have on the behaviour of preschoolers (years 4-6). The programme was implemented as part of the psychologist's work in 5 preschool units on the Greek island of Chios. Classroom-based activities of mindfulness were shown and practiced in 5 sessions, in collaboration with teachers, in order to make preschoolers aware of how their brain affects their behaviour, as well as of how they can have more positive behaviours, especially in instances of negative feelings. The outcomes of the intervention were assessed via questionnaire completion before and after the sessions by the teachers, as well as focus groups procedures with students, teachers, and parents. Implications of how mindfulness programmes can also be implemented at home are further discussed. School year in which the programme is being implemented: 2022-23 Intervention method: based on basic mindfulness theory and practice, the 220 students (age 4-6) in 11 classes of the 5 preschools that participated were given lessons of how to become aware of their states of focusing, regulation, attention, emotional situation, as well as body and social situations. Furthermore, the preschoolers were encouraged to make more mindful choices when it came to negative situations and emotions. Assessment method: The school as a caring community Profile II – Questionnaire completed by 20 preschool teachers prior to and after the intervention, Focus group sessions with teachers, students, parents at the end of the intervention Results: the assessment will be completed in May 2023.

Keywords: preschool, mindfulness training, self-awareness, social-emotional development

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Authors: Mkpoikanke Sunday Otu

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Introduction: Career anxiety is a common issue among university students, particularly in developing countries like Nigeria. This anxiety can significantly impact students' academic performance, overall well-being, and future career prospects. Therefore, it is crucial to explore effective interventions that can alleviate career anxiety among university students. The primary aim of this study was to determine the effectiveness of a psychosocial intervention in reducing career anxiety among Nigerian university students. The study employed a group randomized trial research design to further analyze the impact on career anxiety. Methodology: A total of 306 university students from various universities in Akwa Ibom State, Nigeria, were recruited for this study. The participants were purposively selected to ensure diversity and represent a range of academic disciplines. A group randomized trial research design was employed, with participants randomly assigned to either the treatment group or the control group. The treatment group received a comprehensive psychosocial intervention, while the control group served as a comparison group. The Career Anxiety Questionnaire (CAQ) was used to assess career anxiety levels among the participants. The CAQ is a validated and reliable tool that assesses various aspects of career-related anxiety, including uncertainty, fear, and self-doubt. It was administered to the participants at baseline (before the intervention), immediately after the intervention, and at follow-up (after the intervention). Results: Data analysis was conducted using statistical techniques, including analysis of variance (ANOVA). The results demonstrated that the treatment group showed a significantly lower mean score of career anxiety compared to the control group (p-value<0.05). This finding suggests that the psychosocial intervention was effective in reducing the career anxiety levels of the participants at post-test and follow-up. Conclusion: The findings of this study provide compelling evidence that psychosocial interventions have a significant impact on the reduction of career anxiety among Nigerian university students. The treatment group demonstrated a significant reduction in career anxiety scores, indicating the effectiveness of this intervention. Additionally, this study highlights the importance of addressing the career anxiety challenges faced by university students. By implementing targeted interventions, educational institutions can play a vital role in supporting the overall well-being and success of their students, both academically and professionally.

Keywords: psychosocial intervention, career anxiety, psychoeducation, university students

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Authors: Ayelet Hersch, Corrine Serfaty, Sigal Portnoy

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Stroke survivors commonly report persistent fatigue and sleep disruptions during rehabilitation and post-recovery. While limited research has explored the impact of stroke on a patient's chronotype, there is a gap in understanding the differences in cognitive performance based on treatment timing. Study objectives: (a) To characterize the sleep chronotype in sub-acute post-stroke individuals. (b) Explore cognitive task performance differences during preferred and non-preferred hours. (c) Examine the relationships between sleep quality and cognitive performance. For this intra-subject study, twenty participants (mean age 60.2±8.6) post-first stroke (6-12 weeks post stroke) underwent assessments at preferred and non-preferred chronotypic times. The assessment included demographic surveys, the Munich Chronotype Questionnaire, Montreal Cognitive Assessment (MoCA), Rivermead Behavioral Memory Test (RBMT), a fatigue questionnaire, and 4-5 days of actigraphy (wrist-worn wGT3X-BT, ActiGraph) to record sleep characteristics. Four sleep quality indices were extracted from actigraphy wristwatch recordings: The average of total sleep time per day (minutes), the average number of awakenings during the sleep period per day, the efficiency of sleep (total hours of sleep per day divided by hours spent in bed per day, averaged across the days and presented as percentage), and the Wake after Sleep Onset (WASO) index, indicating the average number of minutes elapsed from the onset of sleep to the first awakening. Stroke survivors exhibited an earlier sleep chronotype post-injury compared to pre-injury. Enhanced attention, as indicated by higher RBMT scores, occurred during preferred hours. Specifically, 30% of the study participants demonstrated an elevation in their final scores during their preferred hours, transitioning from the category of "mild memory impairment" to "normal memory." However, no significant differences emerged in executive functions, attention tasks, and MoCA scores between preferred and non-preferred hours. The Wake After Sleep Onset (WASO) index correlated with MoCA/RBMT scores during preferred hours (r=0.53/0.51, p=0.021/0.027, respectively). The number of awakenings correlated with MoCA letter task performance during non-preferred hours (r=0.45, p=0.044). Enhanced attention during preferred hours suggests a potential relationship between chronotype and cognitive performance, highlighting the importance of personalized rehabilitation strategies in stroke care. Further exploration of these relationships could contribute to optimizing the timing of cognitive interventions for stroke survivors.

Keywords: sleep chronotype, chronobiology, circadian rhythm, rehabilitation timing

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Authors: P. Y. Chiang, Y. H. Chen, Y. J. Lin, C. C. Chang, W. C. Hsu

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The number of the elderly in the world population and the rate of falls in this increasing numbers of older people are increasing. Decreasing muscle strength and an increasing risk of falling are associated with the ageing process. Because the effects of seated stepping training on the walking performance in the elderly remain unclear, the main purpose of the proposed study is to perform electromyography analysis during walking and seated stepping in the elderly. Four surface EMG electrodes were sticked on the surface of lower limbs muscles, including vastus lateralis (VL), and gastrocnemius (GT) of both sides. Before test, maximal voluntary contraction (MVC) of the respective muscle was obtained using manual muscle testing. The analog raw data of EMG signals were digitized with a sampling frequency of 2000 Hz. The signals were fully rectified and the linear envelope were calculated. Stepping motion cycle was separated into two phases by stepping timing (ST) and pedal return timing (PRT). ST refer to the time when the pedal marker reached the highest height, representing the contra-lateral leg was going to release the pedal. PRT refer to the time when the pedal marker reached the lowest height, representing the contra-lateral leg was going to step the pedal. We assumed that ST acted the same role in initial contact during walking, and PRT for toe-off. The period from ST to next PRT was called pushing phase (PP), during which the leg would start to step with resistance, and we compare this phase with the stance phase in level walking. The period from PRT to next ST was called returning phase (RP), during which leg would not have any resistance in this phase, and we compare this phase with the swing phase in level walking. VL and Gastro muscular activation had similar patterns in both side. The ability may transfer to those needed during loading response, mid-stance and terminal swing phase. User needed to make more effort in stepping compared with walking with similar timing; thus the strengthening of the VL and Gastro may be helpful to improve the walking endurance and efficiency for the elderly.

Keywords: elderly, electromyography, seated stepping, walking

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Authors: Ruth Nalugya, Claire Nimusiima, Elizabeth Kawesa, Harriet Nambejja, Geert van Hove, Janet Seeley, Femke Bannink Mbazzi

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Background: ‘Obuntu bulamu’, an intervention for children, parents, and teachers to improve the participation and inclusion of children with disabilities (CwD) through peer-to-peer support, was developed and tested in central Uganda between 2017 and 2019. The intervention consisted of children, parents, and teachers' training sessions and peer to peer support activities directed at disability inclusion using an African disability framework. In this paper, we discuss parent participation in and parent evaluation of the ‘Obuntu bulamu’ intervention. Methods: This qualitative Afrocentric intervention study was implemented in 10 communities in the Wakiso district in Central Uganda. We purposely selected children aged 8 to 14 years with different impairments, their peers, and parents, with different levels of household income and familial support, who were enrolled in primary schools in the ten communities with on average three children with disabilities per community. Sixty four parents (33 parents of CwDs and 31 peers) participating in the ‘Obuntu bulamu’ study were interviewed at baseline and endline. Two focus group discussions were held with parents at the midline. Parents also participated in a consultative meeting about the intervention design at baseline, and two evaluation workshops held at midline and endline. Thematic data analysis of the interview and focus group data was conducted. Results: Findings showed parents found the group-based activities inspiring and said they built hope and confidence. Parents felt the intervention was acceptable, culturally appropriate, and supportive as it built on values and practices from their own traditions. Parents reported the intervention enhanced a sense of togetherness and belonging through the group meetings and follow-up activities. Parents also mentioned that the training helped them develop more positive attitudes towards CwD and disability inclusion. Parents felt that the invention increased a child’s participation and inclusion at home, school, and in communities. Conclusion: The Obuntu bulamu peer to peer support intervention is an acceptable, culturally appropriate intervention that has the potential to improve the inclusion of CwD. A larger randomized control trial is needed to evaluate the impact of the intervention model.

Keywords: inclusion, participation, inclusive education, peer support, belonging, Ubuntu, ‘Obuntu bulamu’

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Authors: Rajlakshmi Guha, Sajjad Ansari, Shazia Nasreen, Hirak Banerjee, Jiaul Paik

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Dyslexia is a neurocognitive disorder, affecting around fifteen percent of the Indian population. The symptoms include difficulty in reading alphabet, words, and sentences. This can be difficult at the phonemic or recognition level and may further affect lexical structures. Therapeutic intervention of dyslexic children post assessment is generally done by special educators and psychologists through one on one interaction. Considering the large number of children affected and the scarcity of experts, access to care is limited in India. Moreover, unavailability of resources and timely communication with caregivers add on to the problem of proper intervention. With the development of Educational Technology and its use in India, access to information and care has been improved in such a large and diverse country. In this context, this paper proposes an ICT enabled home-based intervention program for dyslexic children which would support the child, and provide an interactive interface between expert, parents, and students. The paper discusses the details of the database design and system layout of the program. Along with, it also highlights the development of different technical aids required to build out personalized android applications for the Indian dyslexic population. These technical aids include speech database creation for children, automatic speech recognition system, serious game development, and color coded fonts. The paper also emphasizes the games developed to assist the dyslexic child on cognitive training primarily for attention, working memory, and spatial reasoning. In addition, it talks about the specific elements of the interactive intervention tool that makes it effective for home based intervention of dyslexia.

Keywords: Android applications, cognitive training, dyslexia, intervention

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Authors: Navah Z. Ratzon, Rachel Shichrur

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Background: Many studies have assessed and identified the risk factors of safe driving, but there is relatively little research-based evidence concerning the ability to improve the driving skills of drivers in general and in particular of bus drivers, who are defined as a population at risk. Accidents involving bus drivers can endanger dozens of passengers and cause high direct and indirect damages. Objective: To examine the effectiveness of a metacognitive-functional intervention program for the reduction of risk factors among professional drivers relative to a control group. Methods: The study examined 77 bus drivers working for a large public company in the center of the country, aged 27-69. Twenty-one drivers continued to the intervention stage; four of them dropped out before the end of the intervention. The intervention program we developed was based on previous driving models and the guiding occupational therapy practice framework model in Israel, while adjusting the model to the professional driving in public transportation and its particular risk factors. Treatment focused on raising awareness to safe driving risk factors identified at prescreening (ergonomic, perceptual-cognitive and on-road driving data), with reference to the difficulties that the driver raises and providing coping strategies. The intervention has been customized for each driver and included three sessions of two hours. The effectiveness of the intervention was tested using objective measures: In-Vehicle Data Recorders (IVDR) for monitoring natural driving data, traffic accident data before and after the intervention, and subjective measures (occupational performance questionnaire for bus drivers). Results: Statistical analysis found a significant difference between the degree of change in the rate of IVDR perilous events (t(17)=2.14, p=0.046), before and after the intervention. There was significant difference in the number of accidents per year before and after the intervention in the intervention group (t(17)=2.11, p=0.05), but no significant change in the control group. Subjective ratings of the level of performance and of satisfaction with performance improved in all areas tested following the intervention. The change in the ‘human factors/person’ field, was significant (performance : t=- 2.30, p=0.04; satisfaction with performance : t=-3.18, p=0.009). The change in the ‘driving occupation/tasks’ field, was not significant but showed a tendency toward significance (t=-1.94, p=0.07,). No significant differences were found in driving environment-related variables. Conclusions: The metacognitive-functional intervention significantly improved the objective and subjective measures of safety of bus drivers’ driving. These novel results highlight the potential contribution of occupational therapists, using metacognitive functional treatment, to preventing car accidents among the healthy drivers population and improving the well-being of these drivers. This study also enables familiarity with advanced technologies of IVDR systems and enriches the knowledge of occupational therapists in regards to using a wide variety of driving assessment tools and making the best practice decisions.

Keywords: bus drivers, IVDR, human risk factors, metacognitive-functional intervention

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Authors: Esmaeil Sarikhani

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Objectives: Considering the importance of introducing new methods of improving self-compassion and compassion to the others in nursing students, this study intends to evaluate the effect of self-compassion training on nursing students. Methods: This is a field trial study in which 52 nursing interns from Isfahan University of Medical Sciences were selected using convenience sampling method and divided in two experimental and control groups. The sampling was done during two phases: before and after the intervention. The intervention consisted of eight sessions over eight weeks of self-compassion training. The data were collected using the self-compassion standard questionnaire with 26 questions before and after the intervention. Data were then analyzed by the SPSS18 software and independent and paired T-tests, and also Chi-square and Mann-Whitney tests. Results: The results obtained from the independent t-test showed that the mean score of self-compassion and its components in the experimental group was significantly increased compared to the control group (p < 0.001). Comparing the groups, the mean overall score difference of self-compassion and its components had also a statistically significant change after the intervention (p < 0.001). Conclusion: Self-compassion training program, leads to improving nursing students' self-compassion. As it seems, this method can be used as an important training course in order to improve compassion of nursing students to themselves and the others.

Keywords: self-compassion, student, nursing students, field trial

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Authors: Hsin-Yu Lin, Ching-Hsia Hung

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Obstructive sleep apnea (OSA) is characterized by a complete or partial obstruction of the upper airway during sleep. The vulnerable sites of upper airway collapses are consequences of sleep state-dependent reductions in tone in specific pharyngeal dilators. Clinical examinations reveal multilevel collapses of the upper airway among the patients with OSA. Therefore, an anatomically-based oropharyngeal rehabilitation should comprise a multilevel approach, including retropalatal, retroglossal, hypopharyngeal, temporomandibular, and facial levels, all of which involve different muscle groups and contribute to multifunctional interaction and coordination, such as swallowing, breathing, and phonation. The purpose of the study was to exam the effects of this rehabilitation program with a multilevel approach. In this study, fifteen subjects with newly diagnosed moderate or severe OSA (Apnea-Hypopnea-Index≥15) were randomized into an intervention group and control group. The intervention group (N=8) underwent a 12-week-intervention of a hospital-based rehabilitation program, while the control group (N=7) was kept on the waiting list. The 12-week-intervention comprised an anatomically based multilevel approach. The primary outcome was Polysomnography (PSG) data, and the secondary outcome was oropharyngeal and respiratory muscle function. In the intervention group, Apnea-Hypopnea-Index significantly improved (46.96±19.45 versus 32.78±10.78 events/h, p=0.017) compared with control group (35.77±17.49 versus 42.96±17.32 events/h, p=0.043). While the control group remained no change, the intervention group demonstrated other PSG outcomes significantly improvement, including arousal index (46.04±18.9 versus 32.98±8.35/h, p=0.035), mean SpO2 (92.88±2.1 versus 94.13±1.46%, p=0.039). Besides, the intervention group demonstrated significant improvement in oropharyngeal and respiratory muscle function compared to the control group. This anatomically-based oropharyngeal rehabilitation with a multilevel approach can be proven as a non-invasive therapy for patients with OSA.

Keywords: obstructive sleep apnea, upper airway, oropharyngeal rehabilitation, multilevel approach

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Authors: Nazlı Üstünes Demirhan

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International norms are subject to pressures of change through contestation during the course of their lifetimes. The nature of the contestation is one of the factors that are likely to have a determinative role in the direction of this change towards a stronger or weaker norm. This paper aims to understand the relation between the legality of contestation and the direction of change in norm strength. Based on a multidimensional norm strength conceptualization, it is hypothesized that use of legal logic and rhetoric of argumentation would have a positive influence for norm strength, whereas non-legal nature of contestation would lack this and weaken the norm. In order to show this, the evolution of the human protection norm between 1999 and 2018 will be examined with reference to two major contestation periods; Kosovo intervention of 1999, which led to the development of R2P doctrine, and Libya intervention of 2011, which is followed by the demise of the norm. The comparative analysis will be conducted through process tracing method with a document analysis on the Security Council meeting minutes, resolutions, and press releases. This study aims to contribute to the norm contestation literature with the introduction of legal process analysis. It also relates to further questions in IR/IL nexus, relating to the value added of norm legality as well as the politics of legalization.

Keywords: humanitarian intervention, legality, norm contestation, norm dynamics, norm strength, responsibility to protect

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Authors: Sushila Pareek, Divya Shekhawat

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Music has been shown as a therapeutic agent in depression, anxiety, and stress. A pilot study was carried out to see the therapeutic effects of Indian classical instrumental Raga Todi on depression, anxiety, and stress. 50 individuals diagnosed with depression, anxiety, and stress with DSM-V were taken for the study. Subjects were randomly divided into two groups: the experimental group and the control group. The experimental group received the instrumental raga Todi whereas the other control group didn't receive any intervention. DASS-21 was used on the baseline and after the intervention to measure depression, anxiety, and stress. The result indicates that anxiety, stress, and depression level was reduced after listening to the raga desi Todi. It was concluded that raga desi Todi is an effective intervention for reducing depression, anxiety, and stress.

Keywords: raga, anxiety, stress, depression, DASS-21, mental health

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Authors: Adela Penesova, Zofia Radikova, Boris Bajer, Andrea Havranova, Miroslav Vlcek

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Background: The aim of our study was to compare the effect of intensified lifestyle intervention on insulin resistance (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and Fibroblast growth factor (FGF) 21 after 8 weeks of lifestyle intervention. Methods: A group of 43 obese patients (13M/30F; 43.0±12.4 years; BMI (body mass index) 31.2±6.3 kg/m2 participated in a weight loss interventional program (NCT02325804) following an 8-week hypocaloric diet (-30% energy expenditure) and physical activity 150 minutes/week. Insulin sensitivity was evaluated according to the homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity indices according to Matsuda and Cederholm were calculated (ISImat and ISIced). Plasma ALT, AST, Fetuin-A, FGF 21, and physical fitness were measured. Results: The average reduction of body weight was 6.8±4.9 kg (0-15 kg; p=0.0006), accompanied with a significant reduction of body fat amount of fat mass (p=0.03), and waist circumference (p=0.02). Insulin sensitivity has been improved (IR HOMA 2.71±3.90 vs 1.24±0.83; p=0.01; ISIMat 6.64±4.38 vs 8.93±5.36 p ≤ 0.001). Total, LDL cholesterol, and triglycerides decreased (p=0.05, p=0.04, p=0.04, respectively). Physical fitness significantly improved after intervention (as measure VO2 max (maximal oxygen uptake) (p ≤ 0.001). ALT decreased significantly (0.44±0.26 vs post 0.33±0.18 ukat/l, p=0.004); however, AST not (pre 0.40±0.15 vs 0.35±0.09 ukat/l, p=0.07). Hepatokine Fetuin-A significantly decreased after intervention (43.1±10.8 vs 32.6±8.6 ng/ml, p < 0.001); however, FGF 21 levels tended to decrease (146±152 vs 132±164 pg/ml, p=0.07). Conclusion: 8-weeks of diet and physical activity intervention program in obese otherwise healthy subjects led to an improvement of insulin resistance parameters and liver marker profiles, as well as increased physical fitness. This study was supported by grants APVV 15-0228; VEGA 2/0161/16.

Keywords: obesity, diet, exercice, insulin sensitivity

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Authors: Esabelle Lo Yan Yam, Pheak Chhoun, Sovannary Tuot, Emily Lancsar, Siyan Yi

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Persons living with HIV (PLHIV) need lifelong antiretroviral treatment (ART) to keep their viral load suppressed to an undetectable level, maintain a healthy immune system, and reduce the risk of transmitting HIV to others. However, many factors affect PLHIV's adherence to ART, including access to antiretrovirals (ARV), stigma, lack of social support, and the burden of seeking lifelong care. Community-based care has been shown to be instrumental in the experience of PLHIV in many countries, including Cambodia. In this study based in Cambodia, a community-based ART delivery (CAD) intervention involving community action workers (CAWs) who are PLHIVs was introduced. These workers collect pre-packaged ARVs from the ART clinics and dispense them to PLHIVs in the communities. The quasi-experimental study involved approximately 2000 stable PLHIV in the intervention arm and another 2000 PLHIV in the control arm (receiving usual care). A cost-effectiveness analysis is currently conducted to complement the clinical effectiveness of the CAD intervention on the care continuum and treatment outcomes for stable PLHIV, as well as the operational effectiveness in increasing the efficiency of the ART clinics and the health system. The analysis will consider health system and societal perspectives based on primary outcomes, including retention in care, viral load suppression, and adherence to ART. Additionally, a consultation with the National Centre for HIV/AIDS, Dermatology, and STD under the Cambodia Ministry of Health will be done to discuss the conduct of a budget impact analysis that can quantify the financial impact on the government's budget when adopting the CAD intervention at the provincial and national levels. The budget impact analysis will take into consideration various scaling-up scenarios for the interventions in the country. The research will assess the cost-effectiveness of the CAD intervention to support national stakeholders in Cambodia to make an informed decision on the adoption and scaling up of the intervention in Cambodia. The results are currently being analyzed and will be available at the time of the conference.

Keywords: Cambodia, community intervention, economic evaluation, global health, HIV/AIDs, implementation research

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Authors: Abdul Rahim Razalli, Nordin Mamat, Lee Kean Low

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The objective of the study is to examine the acquisition of Bahasa Melayu hand coded and Malaysian Sign Language of hearing impaired children and the factors that influencing the acquisition of Malay language at early intervention. A qualitative research design was chosen to answer two research questions. Two sets of instruments have been used to obtain information of proficiency and factors that influence it. Five children with hearing problems, four teachers and three parents were selected as the respondents through purposive sampling technique. The findings show that pupils with hearing problems who mastered Bahasa Melayu hand coded have better acquisition of Bahasa Melayu as compared to those who acquired Malaysian Sign Language. The study also found that the parents, pupils, teachers and environmental factors have an impact on the acquisition of Bahasa Melayu hand coded. The implications of this study show that early intervention of Bahasa Melayu hand coded and the parents, pupils, teachers and environmental factors do help in the language proficiency of children with hearing problems. A more comprehensive study should be undertaken at a higher level to see the impact on an early intervention program for Malay language acquisition of hearing impaired children.

Keywords: Bahasa Melayu hand coded, Malaysian sign Language, hearing impaired children, early intervention

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Authors: Boguslaw Schreyer

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During the wheeled robot’s braking process, the extra dynamic vertical forces act on all wheels: left, right, front or rear. Those forces are directed downward on the front wheels while directed upward on the rear wheels. In order to maximize the deceleration, therefore, minimize the braking time and braking distance, we need to calculate a correct torque distribution: the front braking torque should be increased, and rear torque should be decreased. At the same time, we need to provide better transversal stability. In a simple case of all adhesion coefficients being the same under all wheels, the torque distribution may secure the optimal (maximal) control of the robot braking process, securing the minimum braking distance and a minimum braking time. At the same time, the transversal stability is relatively good. At any time, we control the transversal acceleration. In the case of the transversal movement, we stop the braking process and re-apply braking torque after a defined period of time. If we correctly calculate the value of the torques, we may secure the traction coefficient under the front and rear wheels close to its maximum. Also, in order to provide an optimum braking control, we need to calculate the timing of the braking torque application and the timing of its release. The braking torques should be released shortly after the wheels passed a maximum traction coefficient (while a wheels’ slip increases) and applied again after the wheels pass a maximum of traction coefficient (while the slip decreases). The correct braking torque distribution secures the front and rear wheels, passing this maximum at the same time. It guarantees an optimum deceleration control, therefore, minimum braking time. In order to calculate a correct torque distribution, a control unit should receive the input signals of a rear torque value (which changes independently), the robot’s deceleration, and values of the vertical front and rear forces. In order to calculate the timing of torque application and torque release, more signals are needed: speed of the robot: angular speed, and angular deceleration of the wheels. In case of different adhesion coefficients under the left and right wheels, but the same under each pair of wheels- the same under right wheels and the same under left wheels, the Select-Low (SL) and select high (SH) methods are applied. The SL method is suggested if transversal stability is more important than braking efficiency. Often in the case of the robot, more important is braking efficiency; therefore, the SH method is applied with some control of the transversal stability. In the case that all adhesion coefficients are different under all wheels, the front-rear torque distribution is maintained as in all previous cases. However, the timing of the braking torque application and release is controlled by the rear wheels’ lowest adhesion coefficient. The Lagrange equations have been used to describe robot dynamics. Matlab has been used in order to simulate the process of wheeled robot braking, and in conclusion, the braking methods have been selected.

Keywords: wheeled robots, braking, traction coefficient, asymmetric

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Authors: Ali Babajanzade, Hossein Bozorgian

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Cognitive load plays an important role in learning in general and L2 listening comprehension in particular. This study is an attempt to investigate the effect of metacognitive strategy intervention through dialogic interaction (MSIDI) on L2 listeners’ cognitive load. A mixed-method design with 50 participants of male and female Iranian lower-intermediate learners between 20 to 25 years of age was used. An experimental group (n=25) received weekly interventions based on metacognitive strategy intervention through dialogic interaction for ten sessions. The second group, which was control (n=25), had the same listening samples with the regular procedure without a metacognitive intervention program in each session. The study used three different instruments: a) a modified version of the cognitive load questionnaire, b) digit span tests, and c) focused group interviews to investigate listeners’ level of cognitive load throughout the process. Results testified not only improvements in listening comprehension in MSIDI but a radical shift of cognitive load rate within this group. In other words, listeners experienced a lower level of cognitive load in MSIDI in comparison with their peers in the control group.

Keywords: cognitive load theory, human mental functioning, metacognitive theory, listening comprehension, sociocultural theory

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Authors: Gemma Reynolds, Deborah Bailey Rodriguez, Maria Paula Valdivieso Rueda

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In recent years, the mental health of Higher Education (HE) students has been a growing concern. This has been further exacerbated by the stresses associated with the Covid-19 pandemic, placing students at even greater risk of developing mental health issues. Support available to students in HE tends to follow an established and traditional route. The demands for counselling services have grown, not only with the increase in student numbers but with the number of students seeking support for mental health issues. One way of improving well-being and mental health in HE students is through the use of brief interventions, such as expressive writing (EW). This intervention involves encouraging individuals to write continuously for at least 15-20 minutes for three to five sessions (often on consecutive days) about their deepest thoughts and feelings to explore significant personal experiences in a meaningful way. Given the brevity, simplicity and cost-effectiveness of EW, this intervention has considerable potential as an intervention for HE populations. The current study, therefore, employed a mixed-methods design to explore the effectiveness of EW in reducing anxiety, general stress, academic stress and depression in HE students while improving well-being. HE students at MDX were randomly assigned to one of three conditions: (1) The UniExp-EW group were required to write about their emotions and thoughts about any stressors they have faced that are directly relevant to their university experience (2) The NonUniExp-EW group were required to write about their emotions and thoughts about any stressors that are NOT directly relevant to their university experience, and (3) The Control group were required to write about how they spent their weekend, with no reference to thoughts or emotions, and without thinking about university. Participants were required to carry out the EW intervention for 15minutes per day for four consecutive days. Baseline mental health and wellbeing measures were taken before the intervention via a battery of standardised questionnaires. Following completion of the intervention on day four, participants were required to complete the questionnaires a second time and again one week later. Participants were also invited to attend focus groups to discuss their experience of the intervention. This will allow an in-depth investigation into students’ perceptions of EW as an effective intervention to determine whether they would choose to use this intervention in the future. The quantitative findings will be discussed at the conference as well as a discussion of the important implications of the findings. The study is fundamental because if EW is an effective intervention for improving mental health and well-being in HE students, its brevity and simplicity means it can be easily implemented and can be freely-available to students. Improving the mental health and well-being of HE students can have knock-on implications for improving academic skills and career development.

Keywords: mental health, wellbeing, higher education students, expressive writing

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