Search results for: group counseling
Commenced in January 2007
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Edition: International
Paper Count: 8240

Search results for: group counseling

6620 Cultural Barriers in the Communication of Breast Cancer in Sub-Saharan Africa

Authors: Kayum Fokoue Carole

Abstract:

This paper aims at verifying the effectiveness of reaching target populations while paying attention to their cultural background when communicating new knowledge, ideas or technology in a multicultural world. Our case study is an experiment on the communication of knowledge on breast cancer in three sub-Saharan countries (Ghana, Tchad, and Cameroon health). The methodology consisted of submitting a semi-structured questionnaire to local populations in some localities in these target countries in order to determine the cultural barriers hindering the effective communication of knowledge on breast cancer. Once this done, sensitization documents on breast cancer were translated into Ewe (Ghana), Mbaye (Tchad), Ghomala’, Ewondo, and Fufulde (Cameroon). In each locality, a sensitization programme was organised for two groups. For one group, the cultural barriers discovered were taken into consideration while communicating during the programme whereas in the other group, they were not. Another questionnaire was disseminated after three months to verify the level of appropriation of those who attended the campaign based on Chumbow’s appropriation theory. This paper, therefore, discusses some spiritual beliefs, representations and practices in the target African communities hindering effective communication of issues on breast cancer in the target localities. Findings reveal that only 38% of respondents in the group of those for whom cultural barriers were not taken into account during the programme had a high level of appropriation while for the other group, 86% had a high level of appropriation. This is evidence that the communication of issues on breast cancer can be more effective by reaching different populations in a language they best master while paying attention to their culture. Therefore, international communication of new knowledge should be culturally contextualised. Suggestions at the end of the paper are directed towards the achievement of these goals. The present work promotes international partnership in addressing and resolving global health preoccupations since research findings from one community/country can be mutualized in partnership with other communities and countries.

Keywords: cultural barriers, communication, health, breast cancer

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6619 Endometrial Thickness Cut-Off for Evacuation of Retained Product of Conception

Authors: Nambiar Ritu, Ali Ban, Munawar Farida, Israell Imelda, T. Farouk Eman Rasheeda, Jangalgi Renuka, S. Boma Nellie

Abstract:

Aim: To define the ultrasonographic endometrial thickness (USG ET) cutoff for evacuation of retained pieces of conception (ERPC). Background: Studies of conservative management of 1st trimester miscarriage have questioned the need for post miscarriage curettage. Therapeutic decision making with transvaginal scan post miscarriage endometrial thickness in patients clinically thought to be incomplete miscarriage is often not clear. Method: Retrospective analysis of all 1ST trimester ERPC at Al Rahba Hospital from June 2012 to July 2013 was done. Total of 164 patients underwent ERPC. All cases were reviewed for pre-operative USG ET and post ERPC histopathological examination. TVS was done to evaluate the maximum ET of the uterine cavity along the long axis of the uterus and features of retained products was noted. All cases without preoperative USG ET measurement were excluded from the study, therefore only 62 out of 164 cases were included in the study. The patients were divided into three groups: o Group A: have retained products within endometrial cavity. o Group B: endometrial thickness equal or more than 20 mm. o Group C: endometrial thickness equal or less than 19.9 mm. o Post ERPC product was sent for HPE and the results were compared. Transvaginal sonographic findings can be used as a deciding factor in the management of patients with 1st trimester miscarriage who need ERPC. Our proposed cutoff in clinically stable patients requiring ERPC is more than 20 mm.

Keywords: ERPC, histopathological examination, long axis of the uterus, USG ET

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6618 A Longitudinal Study of Psychological Capital, Parent-Child Relationships, and Subjective Well-Beings in Economically Disadvantaged Adolescents

Authors: Chang Li-Yu

Abstract:

Purposes: The present research focuses on exploring the latent growth model of psychological capital in disadvantaged adolescents and assessing its relationship with subjective well-being. Methods: Longitudinal study design was utilized and the data was from Taiwan Database of Children and Youth in Poverty (TDCYP), using the student questionnaires from 2009, 2011, and 2013. Data analysis was conducted using both univariate and multivariate latent growth curve models. Results: This study finds that: (1) The initial state and growth rate of individual factors such as parent-child relationships, psychological capital, and subjective wellbeing in economically disadvantaged adolescents have a predictive impact; (2) There are positive interactive effects in the development among factors like parentchild relationships, psychological capital, and subjective well-being in economically disadvantaged adolescents; and (3) The initial state and growth rate of parent-child relationships and psychological capital in economically disadvantaged adolescents positively affect the initial state and growth rate of their subjective well-being. Recommendations: Based on these findings, this study concretely discusses the significance of psychological capital and family cohesion for the mental health of economically disadvantaged youth and offers suggestions for counseling, psychological therapy, and future research.

Keywords: economically disadvantaged adolescents, psychological capital, parent-child relationships, subjective well-beings

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6617 Group Attachment Based Intervention® Reduces Toddlers' Fearfulness

Authors: Kristin Lewis, Howard Steele, Anne Murphy, Miriam Steele, Karen Bonuck, Paul Meissner

Abstract:

The present study examines data collected during the randomized control trial (RCT) of the Group Attachment-Based Intervention (GABI©), a trauma-informed, attachment-based intervention aimed at promoting healthy parent-child relationships that support child development. Families received treatment at Treatment Center and were randomly assigned to either the GABI condition or the treatment as usual condition, a parenting class called Systematic Training for Effective Parenting (STEP). Significant improvements in the parent-child relationship have been reported for families participating in GABI, but not in the STEP control group relying on Coding Interactive Behavior (CIB) as applied to 5-minute video-films of mothers and their toddlers in a free play context. This report considers five additional attachment-relevant 'clinical codes' that were also applied to the 5-minute free play sessions. Seventy-two parent-child dyads (38 in GABI and 34 in STEP) were compared to one another at intake and end-of-treatment, on these five-point dimensions: two-parent codes—the dissociation and ignoring; two child codes—simultaneous display of contradictory behavior and fear; and one parent-child code, i.e., role reversal. Overall, scores were low for these clinical codes; thus, a binary measure was computed contrasting no evidence with some evidence of each clinical code. Crosstab analyses indicate that child fear at end-of-treatment was significantly lower among children who participated in GABI (7% or 3 children) as compared to those whose mothers participated in STEP (29% or 10 children) Chi Sq= 6.57 (1), p < .01. Discussion focuses on the potential for GABI to reduce childhood fearfulness and so enhance the child's health.

Keywords: coding interactive behavior, clinical codes, group attachment based intervention, GABI, attachment, fear

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6616 Bone Mineral Density in Egyptian Children with Familial Mediterranean Fever

Authors: S. Salah, S. A. El-Masry, H. F. Sheba, R. A. El-Banna, W. Saad

Abstract:

Background: Familial Mediterranean fever (FMF) has episodic or subclinical inflammation that may lead to a decrease in bone mineral density (BMD). Objective: To assess BMD in Egyptian children with FMF on genetic basis. Subjects and Methods: A cross sectional study included 45 FMF patients and 25 control children of both sexes, with age range between 3-16 years old. The patients were reclassified into 2 groups: Group I (A) 23 cases used colchicines for 1 month or less, and Group I (B) 22 cases used colchicines for more than 6 months. For both patients and control, MEFV mutations were defined using molecular genetics technique and BMD was measured by DXA at 2 sites: proximal femur and the lumber spines. Results: four frequent gene mutations were found in the patient group: E148Q (35.6%), V726A (33.3%), M680I (28.9.0%) and M694V (2.2%). There were also 4 heterozygous gene mutations in 40% of control children. Patients received colchicines treatment for less than 1 month had highly significant lower values of BMD at femur and lumber spines than control children (p<0.05). Patients received colchicines treatment for more than 6 months had improved values of BMD at femur compared to control, but there were still significant differences between them at lumbar spine (p>0.05). There are insignificant effect of type of gene mutation on BMD and the risk of osteopenia among the patients. Conclusion: FMF had significant effect on BMD. However, regular use of colchicines treatment improves this effect mainly at femur.

Keywords: familial mediterranean fever, bone mineral density, genes, children

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6615 Utility of Range of Motion Measurements on Classification of Athletes

Authors: Dhiraj Dolai, Rupayan Bhattacharya

Abstract:

In this study, a comparison of Range Of Motion (ROM) of middle and long-distance runners and swimmers has been made. The mobility of the various joints is essential for the quick movement of any sportsman. Knowledge of a ROM helps in preventing injuries, in repeating the movement, and in generating speed and power. ROM varies among individuals, and it is influenced by factors such as gender, age, and whether the motion is performed actively or passively. ROM for running and swimming, both performed with due consideration on speed, plays an important role. The time of generation of speed and mobility of the particular joints are very important for both kinds of athletes. The difficulties that happen during running and swimming in the direction of motion is changed. In this study, data were collected for a total of 102 subjects divided into three groups: control group (22), middle and long-distance runners (40), and swimmers (40), and their ages are between 12 to 18 years. The swimmers have higher ROM in shoulder joint flexion, extension, abduction, and adduction movement. Middle and long-distance runners have significantly greater ROM from Control Group in the left shoulder joint flexion with a 5.82 mean difference. Swimmers have significantly higher ROM from the Control Group in the left shoulder joint flexion with 24.84 mean difference and swimmers have significantly higher ROM from the Middle and Long distance runners in left shoulder flexion with 19.02 mean difference. The picture will be clear after a more detailed investigation.

Keywords: range of motion, runners, swimmers, significance

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6614 The Effect of Core Training on Physical Fitness Characteristics in Male Volleyball Players

Authors: Sibel Karacaoglu, Fatma Ç. Kayapinar

Abstract:

The aim of the study is to investigate the effect of the core training program on physical fitness characteristics and body composition in male volleyball players. 26 male university volleyball team players aged between 19 to 24 years who had no health problems and injury participated in the study. Subjects were divided into training (TG) and control groups (CG) as randomly. Data from twenty-one players who completed all training sessions were used for statistical analysis (TG,n=11; CG,n=10). A core training program was applied to the training group three days a week for 10 weeks. On the other hand, the control group did not receive any training. Before and after the 10-week training program, pre- and post-testing comprised of body composition measurements (weight, BMI, bioelectrical impedance analysis) and physical fitness measurements including flexibility (sit and reach test), muscle strength (back, leg and grip strength by dynamometer), muscle endurance (sit-ups and push-ups tests), power (one-legged jump and vertical jump tests), speed (20m sprint, 30m sprint) and balance tests (one-legged standing test) were performed. Changes of pre- and post- test values of the groups were determined by using dependent t test. According to the statistical analysis of data, no significant difference was found in terms of body composition in the both groups for pre- and post- test values. In the training group, all physical fitness measurements improved significantly after core training program (p<0.05) except 30m speed and handgrip strength (p>0.05). On the hand, only 20m speed test values improved after post-test period (p<0.05), but the other physical fitness tests values did not differ (p>0.05) between pre- and post- test measurement in the control group. The results of the study suggest that the core training program has positive effect on physical fitness characteristics in male volleyball players.

Keywords: body composition, core training, physical fitness, volleyball

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6613 Effects of Mental Skill Training Programme on Direct Free Kick of Grassroot Footballers in Lagos, Nigeria

Authors: Mayowa Adeyeye, Kehinde Adeyemo

Abstract:

The direct free kick is considered a great opportunity to score a goal but this is not always the case amidst Nigerian and other elite footballers. This study, therefore, examined the extent to which an 8 weeks mental skill training programme is effective for improving accuracy in direct free kick in football. Sixty (n-60) students of Pepsi Football Academy participated in the study. They were randomly distributed into two groups of positive self-talk group (intervention n-30) and control group (n-30). The instrument used in the collection of data include a standard football goal post while the research materials include a dummy soccer wall, a cord, an improvised vanishing spray, a clipboard, writing materials, a recording sheet, a self-talk log book, six standard 5 football, cones, an audiotape and a compact disc. The Weinberge and Gould (2011) mental skills training manual was used. The reliability coefficient of the apparatus following a pilot study stood at 0.72. Before the commencement of the mental skills training programme, the participants were asked to take six simulated direct free kick. At the end of each physical skills training session after the pre-test, the researcher spent at least 15 minutes with the groups exposing them to the intervention. The mental skills training programme alongside physical skills training took place in two different locations for the different groups under study, these included Agege Stadium Main bowl Football Pitch (Imagery Group), and Ogba Ijaye (Control Group). The mental skills training programme lasted for eight weeks. After the completion of the mental skills training programme, all the participants were asked to take another six simulated direct free kick attempts using the same field used for the pre-test to determine the efficacy of the treatments. The pre-test and post-test data were analysed using inferential statistics of t-test, while the alpha level was set at 0.05. The result revealed significant differences in t-test for positive self-talk and control group. Based on the findings, it is recommended that athletes should be exposed to positive self-talk alongside their normal physical skills training for quality delivery of accurate direct free kick during training and competition.

Keywords: accuracy, direct free kick, pepsi football academy, positive self-talk

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6612 Improvement of Healthcare Quality and Psychological Stress Relieve for Transition Program in Intensive Care Units

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

Abstract:

Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

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6611 Empowerment Model: A Strategy for Supporting Creative Economy through Traditional Weaving in Anajiaka Village

Authors: Sita Yuliastuti Amijaya, Wiyatiningsih Wiyatiningsih, Paulus Bawole

Abstract:

Weaving skills were not originally a way to earn money for the traditional people on Sumba Island. Weaving is a leisure activity carried out between farming and caring for families. It is quite understandable if the weavers are women. At this time, weaving crafts become a unique potential inherent in an area, so that the weaver women also have the potential to drive economic activity in regional tourism sector. This study aims to measure the sustainability of traditional weaving business activities in Anajiaka Village, Umbu Ratu Nggay Barat, Central Sumba Regency, which is able to support the creative economy. The analysis was performed using qualitative descriptive methods by comparing the criteria of smart living and smart economy in the study of smart city. This study found that business sustainability will be better maintained if it is bound in a joint commitment, for example by forming a group of craftsmen. Other challenges besides the commitment of the group members are aspects of local government support and related agencies, in the form of guidance, funding, and promotion. In addition, fabric order targets, maintaining family and community balance, are recognized as obstacles for craftsmen. The modern marketing model is not yet mastered by the craftsmen group, so it needs assistance for future development.

Keywords: agriculture, craftsmen, creativepreneur, smart economy, smart living

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6610 Synthesis of 5'-Azidonucleosides as Building Blocks for the Preparation of Biologically Active Bioconjugates

Authors: Brigitta Bodnár, Lajos Kovács, Zoltán Kupihár

Abstract:

The cancer cells require higher amount of nucleoside building blocks for their proliferation, therefore they have significantly higher uptake of nucleosides by the different nucleoside transporters. Therefore, the conjugation with nucleosides may significantly increase the efficiency and selectivity of potential active pharmaceutical ingredients. On the other hand, the advantage of using a nucleoside could be either the higher activity on targeted enzymes overrepresented in cancer cells or an enhanced cellular uptake of the bioconjugates in these cells compared to the healthy ones. This fact can be used to make the nucleosides, as targeting moieties covalently bound to anti-cancer drug molecules which can selectively accumulate in cancer cells. However, in order to form the nucleoside-drug conjugates, such nucleoside building blocks are needed, which can selectively be coupled to the drug molecules containing even a high number of diverse functional groups. One of the most selective conjugation techniques is the copper-catalyzed azide-alkyne click reaction that requires the presence of an alkyl group on one of the conjugated molecules and an azide group on the other. In case of nucleosides, the development of azide group is simpler for which the replacement of the 5'-hydroxy group is the most suitable. This transformation generally involves many side reactions and result in very low yields. In addition, during our experiments, the transformation of the 2'-deoxyguanosine to the corresponding 5'-deoxy-5’-azido-2’-deoxyguanosine could not be performed with any of the methods described in the literature. Therefore, we have tried to overcome these difficulties with not only using the traditional process based on the 2 step exchange of tosyl to azide, but also using the Mitsunobu reaction which requires only one step. However, this path proved to be unsuccessful in spite of the optimizing the reaction conditions. Finally, a method has been developed whereby the azide groups were incorporated into the 5’-position resulting in significantly better yields compared to all other previous methods, and we were able to produce all the four nucleoside derivatives.

Keywords: 5'-azidonucleosides, bioconjugate, click reaction, proliferation

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6609 The Effects of Mirror Therapy on Clinical Improvement in Hemiplegic Lower Extremity Rehabilitation in Subjects with Chronic Stroke

Authors: Hassan Abo-Salem, Huang Xiaolin

Abstract:

Background and Purpose: The effectiveness of mirror therapy (MT) has been investigated in acute hemiplegia. The present study examines whether MT, given during chronic stroke, was more effective in promoting motor recovery of the lower extremity and walking speed than standard rehabilitation alone. Methods: The study enrolled 30 patients with chronic stroke. Fifteen patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received mirror therapy for 4 weeks, 5 days a week. Main measures: Passive ankle joint dorsiflexion range of motion, gait speed, Brunnstrom stages of motor recovery, plantarflexor muscle tone by Modified Ashworth Scale. Results: Results: No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation, mirror therapy improved Ankle ROM, Brunnstrom stages and waking speed (p < 0.05). However, there were no significant differences between two groups on MAS (P > 0.05). Conclusions: Mirror therapy combined with a conventional stroke rehabilitation program enhances lower-extremity motor recovery and walking speed in chronic stroke patients.

Keywords: mirror therapy, stroke, MAS, walking speed

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6608 Comparison of Gait Variability in Individuals with Trans-Tibial and Trans-Femoral Lower Limb Loss: A Pilot Study

Authors: Hilal Keklicek, Fatih Erbahceci, Elif Kirdi, Ali Yalcin, Semra Topuz, Ozlem Ulger, Gul Sener

Abstract:

Objectives and Goals: The stride-to-stride fluctuations in gait is a determinant of qualified locomotion as known as gait variability. Gait variability is an important predictive factor of fall risk and useful for monitoring the effects of therapeutic interventions and rehabilitation. Comparison of gait variability in individuals with trans-tibial lower limb loss and trans femoral lower limb loss was the aim of the study. Methods: Ten individuals with traumatic unilateral trans femoral limb loss(TF), 12 individuals with traumatic transtibial lower limb loss(TT) and 12 healthy individuals(HI) were the participants of the study. All participants were evaluated with treadmill. Gait characteristics including mean step length, step length variability, ambulation index, time on each foot of participants were evaluated with treadmill. Participants were walked at their preferred speed for six minutes. Data from 4th minutes to 6th minutes were selected for statistical analyses to eliminate learning effect. Results: There were differences between the groups in intact limb step length variation, time on each foot, ambulation index and mean age (p < .05) according to the Kruskal Wallis Test. Pairwise analyses showed that there were differences between the TT and TF in residual limb variation (p=.041), time on intact foot (p=.024), time on prosthetic foot(p=.024), ambulation index(p = .003) in favor of TT group. There were differences between the TT and HI group in intact limb variation (p = .002), time on intact foot (p<.001), time on prosthetic foot (p < .001), ambulation index result (p < .001) in favor of HI group. There were differences between the TF and HI group in intact limb variation (p = .001), time on intact foot (p=.01) ambulation index result (p < .001) in favor of HI group. There was difference between the groups in mean age result from HI group were younger (p < .05).There were similarity between the groups in step lengths (p>.05) and time of prosthesis using in individuals with lower limb loss (p > .05). Conclusions: The pilot study provided basic data about gait stability in individuals with traumatic lower limb loss. Results of the study showed that to evaluate the gait differences between in different amputation level, long-range gait analyses methods may be useful to get more valuable information. On the other hand, similarity in step length may be resulted from effective prosthetic using or effective gait rehabilitation, in conclusion, all participants with lower limb loss were already trained. The differences between the TT and HI; TF and HI may be resulted from the age related features, therefore, age matched population in HI were recommended future studies. Increasing the number of participants and comparison of age-matched groups also recommended to generalize these result.

Keywords: lower limb loss, amputee, gait variability, gait analyses

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6607 The Mediating Effect of Taxpayers’ Compliance on Internal Business Process-Tax Revenue Relationship: A Case Study at the Directorate General of Taxation in Indonesia

Authors: Efrizal, Ferdiansyah, Noorlailie Soewarno, Bambang Tjahjadi

Abstract:

Tax revenue plays an important role in the State Budget of the Government of Indonesia (GOI). The GOI keeps raising tax revenue portion of the Budget from year to year. The low tax ratio of 11 percent in Indonesia shows a big opportunity to collect taxes in the future. The Directorate General of Taxation (DGT) is the institution mandated by the Law to collect tax revenue. This is a case study using quantitative and qualitative approaches. This study introduces contingent factors of taxpayers’ compliance as the mediating variable and internal business process as the independent variable. This study aims to empirically test the contingency theory, especially the mediating effect of taxpayers’ compliance on internal business process-tax revenue relationship. Internal business processes of the DGT include servicing, counseling, expanding, supervising, inspecting, and enforcing. The secondary data of 31 regional offices representing 293 tax offices in Indonesia was collected and analyzed using Partial Least Square. The result showed the following: (1) internal business process affected tax revenue; (2) taxpayers’ compliance did not mediate internal business processes - tax revenue relationship, and (3) taxpayers’ compliance affected tax revenue. In-depth interviews revealed that the DGT needs to make more innovations in business processes in the future.

Keywords: innovations, internal business process, taxpayers’ compliance, tax revenue

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6606 Molecular Dynamic Simulation of CO2 Absorption into Mixed Aqueous Solutions MDEA/PZ

Authors: N. Harun, E. E. Masiren, W. H. W. Ibrahim, F. Adam

Abstract:

Amine absorption process is an approach for mitigation of CO2 from flue gas that produces from power plant. This process is the most common system used in chemical and oil industries for gas purification to remove acid gases. On the challenges of this process is high energy requirement for solvent regeneration to release CO2. In the past few years, mixed alkanolamines have received increasing attention. In most cases, the mixtures contain N-methyldiethanolamine (MDEA) as the base amine with the addition of one or two more reactive amines such as PZ. The reason for the application of such blend amine is to take advantage of high reaction rate of CO2 with the activator combined with the advantages of the low heat of regeneration of MDEA. Several experimental and simulation studies have been undertaken to understand this process using blend MDEA/PZ solvent. Despite those studies, the mechanism of CO2 absorption into the aqueous MDEA is not well understood and available knowledge within the open literature is limited. The aim of this study is to investigate the intermolecular interaction of the blend MDEA/PZ using Molecular Dynamics (MD) simulation. MD simulation was run under condition 313K and 1 atm using NVE ensemble at 200ps and NVT ensemble at 1ns. The results were interpreted in term of Radial Distribution Function (RDF) analysis through two system of interest i.e binary and tertiary. The binary system will explain the interaction between amine and water molecule while tertiary system used to determine the interaction between the amine and CO2 molecule. For the binary system, it was observed that the –OH group of MDEA is more attracted to water molecule compared to –NH group of MDEA. The –OH group of MDEA can form the hydrogen bond with water that will assist the solubility of MDEA in water. The intermolecular interaction probability of –OH and –NH group of MDEA with CO2 in blended MDEA/PZ is higher than using single MDEA. This findings show that PZ molecule act as an activator to promote the intermolecular interaction between MDEA and CO2.Thus, blend of MDEA with PZ is expecting to increase the absorption rate of CO2 and reduce the heat regeneration requirement.

Keywords: amine absorption process, blend MDEA/PZ, CO2 capture, molecular dynamic simulation, radial distribution function

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6605 Efficacy of Self-Assessment Metacognitive Strategy on Academic Performance Among Upper Basic Students in Ankpa, Kogi State, Nigeria

Authors: Daodu Joshua Rotimi

Abstract:

This study investigated the Efficacy of Self-Assessment Metacognitive Strategy on Academic performance in Energy Concepts among Upper Basic Science Students in Ankpa, Kogi State, Nigeria. The research design adopted for the study was a Quasi-experimental control group design which employed a pretest, posttest of the experimental and control groups. The population of the study consisted of one hundred and twenty-four (124) JSSII Students; sixty-five (65) for the experimental group and (59) for the control group. The instrument used for the study was the Energy Concept Performance Test (ECPT), with a reliability coefficient of 0.80. Two research questions were answered using descriptive statistics of mean and standard deviation, while two hypotheses were tested using a t-test at P≤0.05 level of significance. The findings of the study revealed that the use of the Self-Assessment Metacognitive Strategy has a positive effect on students’ performance in energy concepts among upper Basic Science Students leading to high academic performance; also, there is no significant difference in the mean Academic Performance scores between Male and Female students taught Energy Concept using Self-Assessment Metacognitive Strategy. Based on the research findings, recommendations were made, which include that Secondary school teachers should be encouraged the use Self-Assessment Metacognitive strategy so as to make the learning process attractive, interactive and enriching to the learners.

Keywords: metacognition, self-assessment, performance, efficacy

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6604 Improvements of the Difficulty in Hospital Acceptance at the Scene by the Introduction of Smartphone Application for Emergency-Medical-Service System: A Population-Based Before-And-After Observation Study in Osaka City, Japan

Authors: Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Sumito Hayashida, Taku Iwami, Takashi Kawamura, Takeshi Shimazu

Abstract:

Background: Recently, the number of ambulance dispatches has been increasing in Japan and it is, therefore, difficult to accept emergency patients to hospitals smoothly and appropriately because of the limited hospital capacity. To facilitate the request for patient transport by ambulances and hospital acceptance, the emergency information system using information technology has been built up and introduced in various communities. However, its effectiveness has not been insufficiently revealed in Japan. In 2013, we developed a smartphone application system that enables the emergency-medical-service (EMS) personnel to share information about on-scene ambulance and hospital situation. The aim of this study was to assess the introduction effect of this application for EMS system in Osaka City, Japan. Methods: This study was a retrospective study with population-based ambulance records of Osaka Municipal Fire Department. This study period was six years from January 1, 2010 to December 31, 2015. In this study, we enrolled emergency patients that on-scene EMS personnel conducted the hospital selection for them. The main endpoint was difficulty in hospital acceptance at the scene. The definition of difficulty in hospital acceptance at the scene was to make >=5 phone calls by EMS personnel at the scene to each hospital until a decision to transport was determined. The definition of the smartphone application group was emergency patients transported in the period of 2013-2015 after the introduction of this application, and we assessed the introduction effect of smartphone application with multivariable logistic regression model. Results: A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 smartphone application group (50.0%) in 2010-2012 and 300,395 non-smartphone application group (50.0%) in 2013-2015. The proportion of the difficulty in hospital acceptance was 14.2% (42,585/300,131) in the smartphone application group and 10.9% (32,819/300,395) in the non-smartphone application group, and the difficulty in hospital acceptance significantly decreased by the introduction of the smartphone application (adjusted odds ration; 0.730, 95% confidence interval; 0.718-0.741, P<0.001). Conclusions: Sharing information between ambulance and hospital by introducing smartphone application at the scene was associated with decreasing the difficulty in hospital acceptance. Our findings may be considerable useful for developing emergency medical information system with using IT in other areas of the world.

Keywords: difficulty in hospital acceptance, emergency medical service, infomation technology, smartphone application

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6603 The Effect of Trans-Cranial Direct Current Stimulation (tDCS) on Cognitive Flexibility and Social Decision-Making in Football Players

Authors: Erfan Izadpanah

Abstract:

The present study was conducted to investigate the effect of the Trans-Cranial Direct Current Stimulation (tDCS) on cognitive flexibility and social decision-making in skilled, semi-skilled and novice football players. The present quasi-experimental pretest-posttest study was conducted on 60 randomly-selected subjects divided into trial and placebo groups (n=30 per group). The trial group received three 20-minute sessions of anodic stimulation at the intensity of 2 mA. The placebo group also received three sessions of sham anodic stimulation. Data were collected using the Wisconsin, Grant and Berg Card-Sorting Test (1948) and the ultimatum game and were then analyzed using the ANCOVA. The results showed significant differences between the skilled, semi-skilled and novice football players in the trial and placebo groups in terms of cognitive flexibility and social decision-making (P<0.01). TDCS appears to be able to improve cognitive flexibility and consequently social decision-making in football players and is recommended to sport psychologists and coaches as a useful intervention to increase cognitive flexibility and improve social decision-making in players.

Keywords: TDCS, cognitive flexibility, social decision-making, skilled, semi-skilled and novice football players

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6602 The Antecedents of Facebook Check in Adoption Intention: The Perspective of Social Influence

Authors: Hsiu-Hua Cheng

Abstract:

Recently, the competition between websites becomes intense. How to make users “adopt” their websites is an issue of urgent importance for online communities companies. Social procedures (such as social influence) can possibly explain how and why users’ technologies usage behaviors affect other people to use the technologies. This study proposes two types of social influences on the initial usage of Facebook Check In-friends and group members. Besides, this study indicates that Facebook friends’ previous usage of Facebook Check In and Facebook group members’ previous usage of Facebook Check In will positively influence focal actors’ Facebook Check In adoption intention. The article concludes with contributions to academic research and practice.

Keywords: social influence, adoption intention, facebook check in, previous usage behavior

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6601 Raw Japanese Quail Egg Produces Analgesic, Anti-Inflammatory and Gastro-Protective Effects in Rats

Authors: Sani Ismaila, Shafiu Yau, Abubakar Salisu, Buhari Salisu, Sharifat Balogun, Mustapha Abubakar, Biobaku Khalid, Agaie Bello

Abstract:

Over the years, Japanese quail egg has been in use in the management of diseases. The objective of this study was to evaluate the analgesic, anti-inflammatory and gastroprotective effects of raw Quail egg (yolk + albumin) in rats. Pain was assessed in rats by recording the latent period and writing reflex, anti-inflammatory effect was determined using both motility and compression test, while the gastro-protective effects were assessed by observing the histology of the stomach after diclofenac-induced gastric ulcers and subsequent treatment with the quail egg, Rats were randomly assigned into 4 groups; Groups I: were the control non-treated (NT), Group II were treated with Tramadol 50 mg/kg/Os (TMD) or Indomethacin (IND) 5mg/kg/Os (positive control for the writhing reflex determination), while group III and IV were treated with 3 and 6g/kg of raw quail egg respectively). Groups treated with quail egg in both doses showed a significant increase in the latent period (p <0 .05) when compared to the control NT, but lower than the group treated with tramadol at 20mins interval (p<0.05). Writing reflexes decrease in groups II, III, and IV compared to the NT group (p < 0.05). While motility increases significantly (p < 0.05) in groups II, compared to I (p<0.05). Control non-treated rats showed a quicker and extensive response to compression using the Vanier calliper on the inflamed paw compared to groups II-IV (p < 0.05). Histological studies of the stomach revealed sloughing of the epithelia, cellular infiltration with micro abscesses in the non-treated, while groups treated concurrently with quail egg showed proliferation of the glandular epithelia and goblet cells, and those treated 30 minutes before diclofenac administration showed proliferation of glands and thickening of the squamous epithelia. This study showed that quail egg has analgesic, anti-inflammatory and gastro-protective potentials and can be used as adjuvant treatment whenever COX-2 enzymes inhibitors are indicated.

Keywords: analgesia, anti-inflammatory, gastroprotective effect, japanese quail egg

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6600 The Relationship between Vitamin D and Vitamin B12 Concentrations in Cataract Patients (Senile vs Diabetic)

Authors: Ali Showail Ali Alasmari

Abstract:

Introduction: Cataract is the loss of transparency of the lens inside the eye. It is the most common cause of visual loss and blindness worldwide. This study provides a systemic review of the recent findings on the association of vitamin D, and vitamin B12, and their possible role in preventing cataracts in senile (S) and diabetic mellitus (DM) patient groups. Objective: This study was intended to establish and investigate if there is any role between vitamin D and vitamin B12? Secondly, the connection between serum level of vitamin D and vitamin B12 in cataract incidence senile (s) vs. diabetic mellitus (DM) cataract patient groups. Furthermore, to evaluate and analyze cataract occurrence regarding vitamin D and vitamin B12 levels with other risk factors. Finally, to evaluate lens opacities pre and post treatment with vitamin D and vitaminB12 linked to age and visual acuity loss in both senile(S) and diabetic mellitus (DM) cataract patients’ groups. Methods: This study conducted at the ophthalmology clinic at Muhyail General Hospital. Select a prospective case-control to study the effect of vitamin D and Vit B12 on senile(S) cataracts that caused by age and diabetic mellitus (DM)cataract patients; then we compare these two groups. This study prospectively enrolled a total of 50 samples, 25 with senile cataract and 25 with diabetic cataract, from ophthalmology clinic at Muhyail General Hospital. Measuring 25-hydroxy vitamin D and vitamin B12 level concentrations in the assigned samples. Analyses were performed using SAS (statistical analysis software) program. Results: The most important finding in this study was that the senile(s) cataract patients’ group greatly benefited by the combination therapy of vitamin D, and Vitamin B12 reached (28.5±1.50 and 521.1±21.10) respectively; on the contrary, the diabetic cataract patient group hardly shows any significant improvement (21.5 ± 1.00 and 197.2 ± 7.20) respectively. This is because of the Metformin, the first line drug for treating diabetes, has been reported to potentially decrease vitamin B-12 status. This epigenetic modification was correlated with the diabetic mellitus (DM) cataract patients’ group not responding. Vitamin B12 deficiency also leads to an impairment of the conversion of methylmalonyl-CoA to succinyl-CoA, which has been associated with insulin resistance. There was no significant difference between the age, body mass index (BMI), the mean of Vit-D pre-treatments, and the mean values of Hemoglobin A1C of both senile (S) and diabetic mellitus (DM) cataract patient groups. On other hand, there was a highly significant difference between the mean values of glucose levels in both senile (S) and diabetic mellitus (DM) cataract patient groups. Conclusion: Here we conclude that diabetic mellitus (DM) cataract patient group hardly benefited from this combination therapy vitamin D and vitamin B12; on the other hand senile patient group (s) benefited a lot from the therapy.

Keywords: cataract patients, senile, diabetes mellitus, vitamin B12, vitamin D, Muhyail General Hospital, Saudi Arabia

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6599 Preparing Curved Canals Using Mtwo and RaCe Rotary Instruments: A Comparison Study

Authors: Mimoza Canga, Vito Malagnino, Giulia Malagnino, Irene Malagnino

Abstract:

Objective: The objective of this study was to compare the effectiveness of Mtwo and RaCe rotary instruments, in cleaning and shaping root canals curvature. Material and Method: The present study was conducted on 160 simulated canals in resin blocks, with an angle curvature 15°-30°. These 160 simulated canals were divided into two groups, where each group consisted of 80 blocks. Each group was divided into two subgroups (n=40 canals each). The simulated canals subgroups were prepared with Mtwo and RaCe rotary nickel-titanium instruments. The root canals were measured at four different points of reference, starting at 13 mm from the orifice. In the first group, the canals were prepared using Mtwo rotary system (VDW, Munich, Germany). The Mtwo files used were: 10/0.04, 15/0.05, 20/0.06, and 25/0.06. These instruments entered in the full length of the canal. Each file was rotated in the canal until it reached the apical point. In the second group, the canals were prepared using RaCe instruments (La Chaux-De-Fonds, Switzerland), performing the crown down technique, using the torque electric control motor (VDWCO, Munich, Germany), with 600 RPM and 2n/cm as follow: ≠40/0.10, ≠35/0.08, ≠30/0.06, ≠25/0.04, ≠25/0.02. The data were recorded using SPSS version 23 software (Microsoft, IL, USA). Data analysis was done using ANOVA test. Results: The results obtained by using the Mtwo rotary instruments, showed that these instruments were able to clean and shape in the right-to-left motion curved canals, at different levels, without any deviation, and in perfect symmetry, with a P-value=0.000. The data showed that the greater the depth of the root canal, the greater the deviations of the RaCe rotary instruments. These deviations occurred in three levels, which are: S2(P=0.004), S3( P=0.007), S4(P=0.009). The Mtwo files can go deeper and create a greater angle in S4 level (21°-28°), compared to RaCe instruments with an angle equal to 19°-24°. Conclusion: The present study noted a clinically significant difference between Mtwo rotary instruments and RaCe rotary files used for the canal preparation and indicated that Mtwo instruments are a better choice for the curved canals.

Keywords: canal curvature, canal preparation, Mtwo, RaCe, resin blocks

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6598 Effects of Fenugreek Seed Extract on in vitro Maturation and Subsequent Development of Sheep Oocytes

Authors: Ibrahim A. H. Barakat, Ahmed R. Al-Himaidi

Abstract:

The present study was conducted to determine the role and optimum concentration of fenugreek seed extract during in-vitro maturation on in-vitro maturation and developmental competence of Neaimi sheep oocytes following in-vitro fertilization. The Cumulus Oocyte Complexes (COCs) collected from sheep slaughterhouse ovaries were randomly divided into three groups, and they were matured for 24 hrs. in maturation medium containing fenugreek seed extract (0, 1 and 10 µg ml-1). Oocytes of a control group were matured in a medium containing 1 µg ml-1 estradiol 17β. After maturation, half of oocytes were fixed and stained for evaluation of nuclear maturation. The rest of oocytes were fertilized in vitro with fresh semen, then cultured for 9 days for the assessment of the developmental capacity of the oocytes. The results showed that the mean values of oocytes with expanded cumulus cells percentage were not significantly different among all groups (P < 0.05). But nuclear maturation rate of oocytes matured with 10 µg ml-1 fenugreek seed extract was significantly higher than that of the control group. The maturation rate and development to morula and blastocyst stage for oocytes matured at 10 µg ml-1 fenugreek seed extract was significantly higher than those matured at 1µg ml-1 of fenugreek seed extract and the control group. In conclusion, better maturation and developmental capacity rate to morula and blastocyst stage were obtained by the addition of 10 µg ml-1 fenugreek seed extract to maturation medium than addition of 1 µg ml-1 estradiol-17β (P < 0.05).

Keywords: fenugreek seed extract, in vitro maturation, sheep oocytes, in vitro fertilization, embryo development

Procedia PDF Downloads 374
6597 The Use of Computers in Improving the Academic Performance of Students in Mathematics

Authors: Uwaruile Austin Obuh

Abstract:

This research work focuses on the use of computers in improving the academic performance of students in mathematics in Benin City, Edo State. To guide this study, two research questions were raised, and two corresponding hypotheses were formulated. A total of one hundred and twenty (120) respondents were randomly selected from four schools in the city (60 boys and 60 girls). The instrument employed for the collation of data for the study was the multiple-choice test items on geometry (MCTIOG), drawn from past senior school certificate examinations (SSCE) questions. The instrument was validated by an expert in mathematics and measurement and evaluation. The data obtained from the pre and post-test were analysed using the mean, standard deviation, and T-test. The study revealed a non-significant difference between the experimental and control group in the pre-test, and the two groups were found to be the same before treatment began. The study also revealed that the experimental group performed better than the control group. One can, therefore, conclude that the use of computers for mathematics instruction has improved the performance of students in Geometry. Therefore, the hypothesis was rejected. The study finally revealed that there was no significant difference between the boys and girls taught mathematics using a computer. Therefore, the hypothesis which states there will be no significant difference in the performance of boys and girls taught mathematics using the computer was not rejected. Consequent upon the findings of this study, a number of recommendations were postulated that would enhance the performance of teachers in the use of computer-aided instruction.

Keywords: computer, teaching, learning, mathematics

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6596 Validation of a Placebo Method with Potential for Blinding in Ultrasound-Guided Dry Needling

Authors: Johnson C. Y. Pang, Bo Peng, Kara K. L. Reeves, Allan C. L. Fud

Abstract:

Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding is potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26 ± 5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms, and quality of life (QOL), were analyzed by repeated measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: ultrasound-guided dry needling, dry needling, knee osteoarthritis, physiotheraphy

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6595 Apollo Clinical Excellence Scorecard (ACE@25): An Initiative to Drive Quality Improvement in Hospitals

Authors: Anupam Sibal

Abstract:

Whatever is measured tends to improve. With a view to objectively measuring and improving clinical quality across the Apollo Group Hospitals, the initiative of ACE @ 25 (Apollo Clinical Excellence@25) was launched on Jan 09. ACE @ 25 is a clinically balanced scorecard incorporating 25 clinical quality parameters involving complication rates, mortality rates, one-year survival rates and average length of stay after major procedures like liver and renal transplant, CABG, TKR, THR, TURP, PTCA, endoscopy, large bowel resection and MRM covering all major specialties. Also included are hospital acquired infection rates, pain satisfaction and medication errors. Benchmarks have been chosen from the world’s best hospitals. There are weighted scores for outcomes color coded green, orange and red. The cumulative score is 100. Data is reported monthly by 43 Group Hospitals online on the Lighthouse platform. Action taken reports for parameters falling in red are submitted quarterly and reviewed by the board. An audit team audits the data at all locations every six months. Scores are linked to appraisal of the medical head and there is an “ACE @ 25” Champion Award for the highest scorer. Scores for different parameters were variable from green to red at the start of the initiative. Most hospitals showed an improvement in scores over the last four years for parameters where they had showed scores in red or orange at the start of the initiative. The overall scores for the group have shown an increase from 72 in 2010 to 81 in 2015.

Keywords: benchmarks, clinical quality, lighthouse, platform, scores

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6594 Effect of Progressive Muscle Relaxation on the Postpartum Depression and General Comfort Levels

Authors: İlknur Gökşin, Sultan Ayaz Alkaya

Abstract:

Objective: Progressive muscle relaxation (PMR) include the deliberate stretching and relaxation of the major muscle groups of the human body. This study was conducted to evaluate the effect of PMR applied in women on the postpartum depression and general comfort level. Methods: The study population of this quasi-experimental study with pre-test, post-test and control group consisted of primipara women who had vaginal delivery in the obstetric service of a university hospital. The experimental and control groups consisted of 35 women each. The data were collected by questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the General Comfort Questionnaire (GCQ). The women were matched according to their age and education level and divided into the experimental and control groups by simple random selection. Postpartum depression risk and general comfort was evaluated at the 2nd and 5th days, 10th and 15th days, fourth week and eighth week after birth. The experimental group was visited at home and PMR was applied. After the first visit, women were asked to apply PMR regularly three times a week for eight weeks. During the application, the researcher called the participants twice a week to follow up the continuity of the application. No intervention was performed in the control group. For data analysis, descriptive statistics such as number, percentage, mean, standard deviation, significance test of difference between two means and ANOVA were used. Approval of the ethics committee and permission of the institution were obtained for the study. Results: There were no significant differences between the women in the experimental and control groups in terms of age, education status and employment status (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of EPDS pre-test, 1st, 2nd and 3rd follow-up mean scores (p>0.05). There was a statistically significant difference between EPDS pre-test and 3rd follow-up scores of the experimental group (p<0.05), whereas there was no such difference in the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of mean GCQ pre-test scores (p>0.05), whereas in the 1st, 2nd and 3rd follow-ups there was a statistically significant difference between the mean GCQ scores (p<0.05). It was found that there was a significant increase in the GCQ physical, psychospiritual and sociocultural comfort sub-scales, relief and relaxation levels of the experimental group between the pre-test and 3rd follow-ups scores (p<0.05). And, a significant decrease was found between pre-test and 3rd follow-up GCQ psychospiritual, environmental and sociocultural comfort sub-scale, relief, relaxation and superiority levels (p<0.05). Conclusion: Progressive muscle relaxation was effective on reducing the postpartum depression risk and increasing general comfort. It is recommended to provide progressive muscle relaxation training to women in the postpartum period as well as ensuring the continuity of this practice.

Keywords: general comfort, postpartum depression, postpartum period, progressive muscle relaxation

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6593 An Investigation of How Pre-Service Physics Teachers Perceived the Results of Buoyancy Force

Authors: Ersin Bozkurt, Şükran Erdoğan

Abstract:

The purpose of the study is to explore how pre-service teachers perceive buoyancy force effecting an object in a liquid and identify their misconceptions. Pre-service teachers were interviewed to reveal their understandings of an object's floating, suspending and sinking in a liquid. In addition, they were asked about how an object -given its features- moved when it is provided with an external force and when it is released. The so-called circumstances were questioned in a different planet contexts. For this aim, focused group interview method was used. Six focused groups were formed and video recorded during the interval. Each focused group comprised of five pre-service teachers. It was found out pre-service teachers have common misunderstanding and misconceptions. In order to eliminate this conceptual misunderstandings, conceptual change texts were developed and further suggestions were made.

Keywords: computer simulations, conceptual change texts, physics education, students’ misconceptions in physics

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6592 In Working, Career Is Not Everything: A Case Study of Family Friendly Policies on Bank Company

Authors: Trias Setiawati, Rizkika Awalia

Abstract:

The study title is “In Working, Career is not everything: A Case Study of Family Friendly Policies (FFP) on Bank Company.” This study aims to describe the application of FFP in the banking, especially Bank Rakyat Indonesia or BRI (Indonesian People Bank) in Katamso Branch Office in Yogyakarta Katamso Branch Office in Yogyakarta (KBOY) as a support company to create a work-life balance, as well as the achievement of career and family harmony is seen from the work-family conflict faced by the employees. The importance of the application of FFP in an organization is basically to build competitive advantage of a company. This study used qualitative research methods with a case study approach in BRI in KBOY. Data collection techniques used non-participant observation and in-depth structured interviews with three employees. The results showed that FFP is in general adoption and not optimal yet. Optimal FFP policy is not yet implemented; it just in the in-formal policies such as the lack of flexible-time, the lack of daycare, the lack of counseling for employees of personal nature, despite it was the availability of lactation rooms for feeding. The employees found difficulties in balancing between achieving careers at work and reaching family harmony. Not pursued a career does not mean that they do not want to reach a better position, but they do not want to ignore the family harmony because of the hours of work overload.

Keywords: career, family friendly policies, work-family balance, work-family conflict

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6591 Management of Dysphagia after Supra Glottic Laryngectomy

Authors: Premalatha B. S., Shenoy A. M.

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Background: Rehabilitation of swallowing is as vital as speech in surgically treated head and neck cancer patients to maintain nutritional support, enhance wound healing and improve quality of life. Aspiration following supraglottic laryngectomy is very common, and rehabilitation of the same is crucial which requires involvement of speech therapist in close contact with head and neck surgeon. Objectives: To examine the functions of swallowing outcomes after intensive therapy in supraglottic laryngectomy. Materials: Thirty-nine supra glottic laryngectomees were participated in the study. Of them, 36 subjects were males and 3 were females, in the age range of 32-68 years. Eighteen subjects had undergone standard supra glottis laryngectomy (Group1) for supraglottic lesions where as 21 of them for extended supraglottic laryngectomy (Group 2) for base tongue and lateral pharyngeal wall lesion. Prior to surgery visit by speech pathologist was mandatory to assess the sutability for surgery and rehabilitation. Dysphagia rehabilitation started after decannulation of tracheostoma by focusing on orientation about anatomy, physiological variation before and after surgery, which was tailor made for each individual based on their type and extent of surgery. Supraglottic diet - Soft solid with supraglottic swallow method was advocated to prevent aspiration. The success of intervention was documented as number of sessions taken to swallow different food consistency and also percentage of subjects who achieved satisfactory swallow in terms of number of weeks in both the groups. Results: Statistical data was computed in two ways in both the groups 1) to calculate percentage (%) of subjects who swallowed satisfactorily in the time frame of less than 3 weeks to more than 6 weeks, 2) number of sessions taken to swallow without aspiration as far as food consistency was concerned. The study indicated that in group 1 subjects of standard supraglottic laryngectomy, 61% (n=11) of them were successfully rehabilitated but their swallowing normalcy was delayed by an average 29th post operative day (3-6 weeks). Thirty three percentages (33%) (n=6) of the subjects could swallow satisfactorily without aspiration even before 3 weeks and only 5 % (n=1) of the needed more than 6 weeks to achieve normal swallowing ability. Group 2 subjects of extended SGL only 47 %( n=10) of them could achieved satisfactory swallow by 3-6 weeks and 24% (n=5) of them of them achieved normal swallowing ability before 3 weeks. Around 4% (n=1) needed more than 6 weeks and as high as 24 % (n=5) of them continued to be supplemented with naso gastric feeding even after 8-10 months post operative as they exhibited severe aspiration. As far as type of food consistencies were concerned group 1 subject could able to swallow all types without aspiration much earlier than group 2 subjects. Group 1 needed only 8 swallowing therapy sessions for thickened soft solid and 15 sessions for liquids whereas group 2 required 14 sessions for soft solid and 17 sessions for liquids to achieve swallowing normalcy without aspiration. Conclusion: The study highlights the importance of dysphagia intervention in supraglottic laryngectomees by speech pathologist.

Keywords: dysphagia management, supraglotic diet, supraglottic laryngectomy, supraglottic swallow

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