Search results for: narrative family therapy

Authors: Rose Hattab

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Women have been an important dynamic in religious context and the state-building process of Arab countries throughout history. During the 1970s as the movement for women’s activism and rights developed, the Iraqi state under the Ba’ath Party began to provide Iraqi women with legal and civil rights. This was done to liberate women from the grasps of social traditions and was a tangible espousing of equality between men and women in the process of nation-building. Whereas women’s rights were stronger and more supported throughout the earliest years of the Ba’ath Regime (1970-1990), the aftermath of the Gulf War and economic sanctions on the conditions of Iraqi society laid the foundation for a division of women’s rights between civil and religious authorities. Personal status codes that were secured in 1959 were being pushed back by amendments made in coordination with religious leaders. Civil laws were present on paper, but religious authority took prominence in practice. The written legal codes were inclusive of women’s rights, but there is not an active or ensured practice of these rights within Iraqi society. This is due to many different factors, such as religious, sectarian, political and conservative reasons that hold back or limit the ability for Iraqi women to have autonomy in aspects such as participation in the workforce, getting married, and ensuring social justice. This paper argues that the Personal Status Code introduced in 1959 – which replaced Sharia-run courts with personal status courts – provided Iraqi women with equality and increased mobility in social and economic dynamics. The statewide crisis felt after the Gulf War and the economic sanctions imposed by the United Nations led to a stark shift in the Ba’ath party’s political ideology. This ideological turn guided the social system to the embracement of social conservatism and religious traditions in the 1990s. The effect of this implementation continued after the establishment of a new Iraqi government during 2003-2005. Consequently, Iraqi women's rights in employment, marriage, and family became divided into paper and practice by religious authorities and civil law from that period to the present day. This paper also contributes to the literature by expanding on the gap between legal codes on paper and in practice, through providing an analysis of Iraqi women’s rights in the Iraqi Constitution of 2005 and Iraq’s Penal Code. The turn to conservative and religious traditions is derived from the multiplicity of identities that make up the Iraqi social fabric. In the aftermath of a totalitarian regime, active wars, and economic sanctions, the Iraqi people attempted to unite together through their different identities to create a sense of security in the midst of violence and chaos. This is not an excuse to diminish the importance of women’s rights, but in the process of building a new nation-state, women were lost from the narrative. Thus, the presence of gender equity is found in the written text but is not practiced and upheld in the social context.

Keywords: civil rights, Iraqi women, nation building, religion and conflict

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Authors: Shu Hui

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From 2013 to 2015, Tiny Times series gained huge commercial success. However, compared with the successful box office, these films received severe public criticism. Some scholars refer to these films as trash (lan pian) because of the fragment narrative, the non-professional photographing, and advocating money warship. Differing from other popular films, the popularity of Tiny Times series is actually generated from the fantasy that presented on screen instead of good stories or photographs. The fantasy is desired by the public and then formulates its popularity. Based on Jacques Lacan’s fantasy theory, the paper aims to explain what kind of fantast the films present. Then, according to hegemony theory, the paper will illustrate why the public desires such a fantasy and how the fantasy causes the criticism as well. The dominant ideology (patriarchy) conspires with or manipulates consumerism, which brings about the female's fantasy in Tiny Times. Because consumerism interrogates Confucianism, the film received public criticism for highlighting the former.

Keywords: fantasy, desire, ideology, popularity

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Authors: K. M. Pratap Shankar, Dattatreya Rao, Sai Prasad

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Background: Skin diseases are among the most common health problems worldwide and are associated with a considerable burden. Eczema is such a skin ailment which cause psychological, social and financial burden on the patient and their families. Management of eczema with antibiotics, antihistamines, steroids etc., are available but even after their use relapses, recurrences and other complications are very common. Aim: The aim of this study was to assess the efficacy of leech application in the management of vicarcikā (Eczema) with Histopathological study. Methods: For the present study 10 patients having the classical symptoms of Vicarcikā, were randomly selected as per the inclusion and exclusion criteria from O.P.D. & I.P.D. sections of Śalya department, S.V. Āyurvedic Hospital, Tirupati. Minimum 4 sittings of Leech application was carried out with seven days interval. Total duration of treatment was 6 weeks. Biopsy samples were collected from the lesion site before and after treatment. Histopathological examination was done by the pathologist. Results: In eczema (dermatitis) the leech application therapy gives excellent response by reducing the inflammatory component, hyperkeratosis, spongiosis, irregular acanthosis and by evoking a granulation tissue response in the dermis and in most of the cases with complete recovery from the lesion. Most of the cases in the study were chronic dermatitis and sebhoric keratosis, almost all local/focal pigmented lesions is totally relieved by leech therapy especially in cases of sebhoric keratosis. Conclusion: In the present study it was found that, leech application evokes significant changes at histological level specifically in reduction of inflammatory component, hyperkeratosis, spongiosis and irregular acanthosis. It was also found that there was a considerable formation of granulation tissue, which helps in formation of healthy new tissues.

Keywords: acanthosis, eczema, hyperkeratosis, leech application, spongiosis

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Authors: Venuste Kayinamura, V. Iyamuremye, A. Ngirabakunzi

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Anti-retroviral therapy (ART) for HIV patient can cause a deficiency in glucose metabolism by promoting insulin resistance, glucose intolerance, and diabetes, diabetes mellitus keep increasing among HIV-infected patients worldwide but there is limited data on levels of blood glucose and its relationship with antiretroviral drugs (ARVs) and HIV-infection worldwide, particularly in Rwanda. A convenient sampling strategy was used in this study and it involved 323 HIV patients (n=323). Patients who are HIV positive under ARVs were involved in this study. The patient’s blood glucose was analyzed using an automated machine or glucometer (COBAS C 311). Data were analyzed using Microsoft Excel and SPSS V. 20.0 and presented in percentages. The highest diabetes mellitus prevalence was 93.33 % in people aged >40 years while the lowest diabetes mellitus prevalence was 6.67% in people aged between 21-and 40 years. The P-value was (0.021). Thus, there is a significant association between age and diabetes occurrence. The highest diabetes mellitus prevalence was 28.2% in patients under ART treatment for more than 10 years, 16.7% were <5years while 20% of patients were on ART treatment between 5-10 years. The P-value here is (0.03), thus the incidence of diabetes is associated with long-term ART use in HIV-infected patients. This study assessed the prevalence of diabetes among HIV-infected patients under ARVs attending the University Teaching Hospital of Butare (CHUB), it shows that the prevalence of diabetes is high in HIV-infected patients under ARTs. This study found no significant relationship between gender and diabetes mellitus growth. Therefore, regular assessment of diabetes mellitus especially among HIV-infected patients under ARVs is highly recommended to control other health issues caused by diabetes mellitus.

Keywords: anti-retroviral, diabetes mellitus, antiretroviral therapy, human immune deficiency virus

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Authors: A. M. Bumbea, A. Musetescu, P. Ciurea, A. Bighea

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Objectives: The authors present a Parsonage Turner syndrome, a rare disease characterized by onset in apparently healthy person with shoulder and/or arm pain, sensory deficit, motor deficit. The causes are not established, could be determinate by vaccination, postoperative, immunologic disease, post traumatic etc. Methods: The authors present a woman case, 32 years old, (in 2006), no medical history, with arm pain and no other symptom. The onset was sudden with pain at very high level quantified as 10 to a 0 to 10 scale, with no response to classical analgesic and corticoids. The only drugs which can reduce the intensity of pain were oxycodone hydrochloride, 60 mg daily and pregabalinum150 mg daily. After two weeks the intensity of pain was reduced to 5. The patient started a rehabilitation program. After 6 weeks the patient associated sensory and motor deficit. We performed electromyography for upper limb that showed incomplete denervation with reduced neural transmission speed. The patient receives neurotrophic drugs and painkillers for a long period and physical and kinetic therapy. After 6 months the pain was reduced to level 2 and the patient maintained only 150 mg pregabalinum for another 6 months. Then, the evaluation showed no pain but general amiotrophy in upper limb. Results: At the evaluation in 2009, the patient developed a rheumatoid syndrome with tender and swelling joints, but no positive inflammation test, no antibodies or rheumatoid factor. After two years, in 2011 the patient develops an increase of antinuclear antibodies. This context certifies the diagnosis of lupus and the patient receives the specific therapy. Conclusions: This case is not a typical case of onset of lupus with PTS, but the onset of PTS could include the onset of an immune disease.

Keywords: lupus, arm pain, patient, swelling

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Authors: Rabia Khaliala, Adi Vitman-Schorr

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Background: The increase in longevity of people on one hand, and on the other hand the fact that the social networks in later life become increasingly narrower, highlight the importance of Internet use to enhance quality of life (QoL). However, whether Internet use increases or decreases social networks, loneliness and quality of life is not clear-cut. Purposes: To explore the direct and/or indirect effects of Internet use on QoL, and to examine whether ethnicity and time the elderly spent with family moderate the mediation effect of Internet use on quality of life throughout loneliness. Methods: This descriptive-correlational study was carried out in 2016 by structured interviews with a convenience sample of 502 respondents aged 50 and older, living in northern Israel. Bootstrapping with resampling strategies was used for testing mediation a model. Results: Use of the Internet was found to be positively associated with QoL. However, this relationship was mediated by loneliness, and moderated by the time the elderly spent with family members. In addition, respondents' ethnicity significantly moderated the mediation effect between Internet use and loneliness. Conclusions: Internet use can enhance QoL of older adults directly or indirectly by reducing loneliness. However, these effects are conditional on other variables. The indirect effect moderated by ethnicity, and the direct effect moderated by the time the elderly spend with their families. Researchers and practitioners should be aware of these interactions which can impact loneliness and quality of life of older persons differently.

Keywords: internet use, loneliness, quality of life, social contacts

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Authors: Stephanie Duval

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The concept of educational success, combined with the overall development of the child in kindergarten, is at the center of current interests, both in research and in the environments responsible for the education of young children. In order to promote it, researchers emphasize the importance of studying the executive functions [EF] of children in preschool education. More precisely, the EFs, which refers to working memory [WM], inhibition, mental flexibility and planning, would be the pivotal element of the child’s educational success. In order to support the EFs of the child, and even his educational success, the quality of the environments is beginning to be explored more and more. The question that arises now is how to promote EFs for young children in the educational environment, in order to support their educational success? The objective of this study is to investigate the link between the quality of interactions in 5-year-old kindergarten and child’s EFs. The sample consists of 118 children (70 girls, 48 boys) in 12 classes. The quality of the interactions is observed from the Classroom Assessment Scoring System [CLASS], and the EFs (i.e., working memory, inhibition, cognitive flexibility, and planning) are measured with administered tests. The hypothesis of this study was that the quality of teacher-child interactions in preschool education, as measured by the CLASS, was associated with the child’s EFs. The results revealed that the quality of emotional support offered by adults in kindergarten, included in the CLASS tool, was positively and significantly related to WM and inhibition skills. The results also suggest that WM is a key skill in the development of EFs, which may be associated with the educational success of the child. However, this hypothesis remains to be clarified, as is the link with educational success. In addition, results showed that factors associated to the family (ex. parents’ income) moderate the relationship between the domain ‘instructional support’ of the CLASS (ex. concept development) and child’s WM skills. These data suggest a moderating effect related to family characteristics in the link between ‘quality of classroom interactions’ and ‘EFs’. This project proposes, as a future avenue, to check the distinctive effect of different environments (familial and educational) on the child’s EFs. More specifically, future study could examine the influence of the educational environment on EF skills, as well as whether or not there is a moderating effect of the family environment (ex. parents' income) on the link between the quality of the interactions in the classroom and the EFs of the children, as anticipated by this research.

Keywords: executive functions [EFs], environmental factors, quality of interactions, preschool education

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Authors: Yuan-Chung Tsai, Masao Kamimura, Kohei Soga, Hsin-Cheng Chiu

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In order to enhance the photodynamic/photothermal therapeutic efficacy on glioblastoma, the functionized upconversion nanoparticles with the capability of converting the deep tissue penetrating near-infrared light into visible wavelength for activating photochemical reaction were developed. The drug-loaded nanoparticles (NPs) were obtained from the self-assembly of oleic acid-coated upconversion nanoparticles along with maleimide-conjugated poly(ethylene glycol)-cholesterol (Mal-PEG-Chol), as the NP stabilizer, and hydrophobic photosensitizers, IR-780 (for photothermal therapy, PTT) and mTHPC (for photodynamic therapy, PDT), in aqueous phase. Both the IR-780 and mTHPC were loaded into the hydrophobic domains within NPs via hydrophobic association. The peptide targeting ligand, angiopep-2, was further conjugated with the maleimide groups at the end of PEG adducts on the NP surfaces, enabling the affinity coupling with the low-density lipoprotein receptor-related protein-1 of tumor endothelial cells and malignant astrocytes. The drug-loaded NPs with the size of ca 80 nm in diameter exhibit a good colloidal stability in physiological conditions. The in vitro data demonstrate the successful targeting delivery of drug-loaded NPs toward the ALTS1C1 cells (murine astrocytoma cells) and the pronounced cytotoxicity elicited by combinational effect of PDT and PTT. The in vivo results show the promising brain orthotopic tumor targeting of drug-loaded NPs and sound efficacy for brain tumor dual-modality treatment. This work shows great potential for improving photodynamic/photothermal therapeutic efficacy of brain cancer.

Keywords: drug delivery, orthotopic brain tumor, photodynamic/photothermal therapies, upconversion nanoparticles

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Authors: W. Zekri

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This paper explores Zohra Drif’s memoir, Inside the Battle of Algiers, which narrates her desires as a student to become a revolutionary activist. She exemplified, in her narrative, the different roles, she and her fellows performed as combatants in the Casbah during the Algerian Revolution 1954-1962. This book review aims to evaluate the concept of women’s agency through education and language learning, and its impact on empowering women’s desires. Close-reading method and thematic analysis are used to explore the text. The analysis identified themes that refine the meaning of agency which are social and cultural supports, education, and language proficiency. These themes aim to contribute to the representation in Inside the Battle of Algiers of a woman guerrilla who engaged herself to perform national acts of resistance.

Keywords: agency, education, learning, women

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Authors: Elvin P. Chizenga, Heidi Abrahamse

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Cancer cell resistance to therapy is the main cause of treatment failures and the poor prognosis of cancer convalescence. The progression of cervical cancer to other parts of the genitourinary system and the reported recurrence rates are overwhelming. Current treatments, including surgery, chemo and radiation have been inefficient in eradicating the tumor cells. These treatments are also associated with poor prognosis and reduced quality of life, including fertility loss. This has inspired the need for the development of new treatment modalities to eradicate cervical cancer successfully. Photodynamic Therapy (PDT) is a modern treatment modality that induces cell death by photochemical interactions of light and a photosensitizer, which in the presence of molecular oxygen, yields a set of chemical reactions that generate Reactive Oxygen Species (ROS) and other free radical species causing cell damage. Enhancing PDT using modified drug delivery can increase the concentration of the photosensitizer in the tumor cells, and this has the potential to maximize its therapeutic efficacy. In cervical cancer, all infected cells constitutively express genes of the E6 and E7 HPV viral oncoproteins, resulting in high concentrations of E6 and E7 in the cytoplasm. This provides an opportunity for active targeting of cervical cancer cells using immune-mediated drug delivery to maximize therapeutic efficacy. The use of nanoparticles in PDT has also proven effective in enhancing therapeutic efficacy. Gold nanoparticles (AuNps) in particular, are explored for their use in biomedicine due to their biocompatibility, low toxicity, and enhancement of drug uptake by tumor cells. In this present study, a biomolecule comprising of AuNPs, anti-E6 monoclonal antibodies, and Aluminium Phthalocyanine photosensitizer was synthesized for use in targeted PDT of cervical cancer. The AuNp-Anti-E6-Sulfonated Aluminium Phthalocyanine mix (AlPcSmix) photosensitizing biomolecule was synthesized by coupling AuNps and anti-E6 monoclonal antibodies to the AlPcSmix via Polyethylene Glycol (PEG) chemical links. The final product was characterized using Transmission Electron Microscope (TEM), Zeta Potential, Uv-Vis Spectrophotometry, Fourier Transform Infrared Spectroscopy (FTIR), and X-ray diffraction (XRD), to confirm its chemical structure and functionality. To observe its therapeutic role in treating cervical cancer, cervical cancer cells, HeLa cells were seeded in 3.4 cm² diameter culture dishes at a concentration of 5x10⁵ cells/ml, in vitro. The cells were treated with varying concentrations of the photosensitizing biomolecule and irradiated using a 673.2 nm wavelength of laser light. Post irradiation cellular responses were performed to observe changes in morphology, viability, proliferation, cytotoxicity, and cell death pathways induced. Dose-Dependent response of the cells to treatment was demonstrated as significant morphologic changes, increased cytotoxicity, and decreased cell viability and proliferation This study presented a synthetic biomolecule for targeted PDT of cervical cancer. The study suggested that PDT using this AuNp- Anti-E6- AlPcSmix photosensitizing biomolecule is a very effective treatment method for the eradication of cervical cancer cells, in vitro. Further studies in vivo need to be conducted to support the use of this biomolecule in treating cervical cancer in clinical settings.

Keywords: anti-E6 monoclonal antibody, cervical cancer, gold nanoparticles, photodynamic therapy

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Authors: Shahzad Karim Bhatti

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Background: Ozone is a combination of oxygen and can be used in treatment of low back pain due to herniated disc. It is a minimally invasive procedure using biochemical properties of ozone resulting in reduced volume of disc and inflammation resulting in significant pain relief. Aim: The purpose of this study was to evaluate the effectiveness of ozone therapy in combination with peri-ganglionic injection of local anesthetic and corticosteroid. Material and Methods: This retrospective study was done at the Interventional Radiology Department of Mayo Hospital, Lahore. A total of 49000 patients were included from January 2008 to March 2022. All the patients presented with clinical signs and symptoms of lumber disc herniation, which was confirmed by a MRI scan of the lumbar sacral spine. The pain reduction was calculated using modified MacNab method. All the patients underwent percutaneous injection of ozone at a concentration of 27 micrograms/ml to lumber disc under fluoroscopic guidance with combination of local anesthetic and corticosteroid in peri-ganglionic space. Results were evaluated by two expert observers who were blinded to patient treatment. Results A satisfactory therapeutic outcome was obtained. 55% of the patients showed complete recovery with resolution of symptoms. 20% of the patients complained of occasional episodic pain with no limitation of occupational activity. 15% of cases showed insufficient improvement. 5% of cases had insufficient improvement and went for surgery. 10% of cases never turned up after the first visit. Conclusion Intradiscal ozone for the treatment of herniated discs has revolutionized percutaneous approach to nerve root compression making it safer, economical and easier to repeat without any side effects than treatments currently used in Pakistan.

Keywords: pain, prolapse, Ozone, backpain

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Authors: Soumi Banerjee

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In this research paper we will go deep into understanding Benedict Anderson’s definition of the nation as an imagined community and we will analyze why and how national identities were created through long and complex processes, and how there can exist strong emotional bonds between people within an imagined community, given the fact that these people have never known each other personally, but will still feel some form of imagined unity. Such identity construction on the part of an individual or within societies are always in some sense in a state of flux as imagined communities are ever changing, which provides us with the ontological foundation for reaching on this paper. This sort of identity crisis among individuals living in the Western world, who are in search for psychological comfort and security, illustrates a possible need for spatially dislocated, ontologically insecure and vulnerable individuals to have a secure identity. To create such an identity there has to be something to build upon, which could be achieved through what may be termed as ‘homesteading’. This could in short, and in my interpretation of Kinnvall and Nesbitt’s concept, be described as a search for security that involves a search for ‘home’, where home acts as a secure place, which one can build an identity around. The next half of the paper will then look into how populism and identity have played an increasingly important role in the political elections in the so-called western democracies of the world, using the U.S. as an example. Notions of ‘us and them’, the people and the elites will be looked into and analyzed through a social constructivist theoretical lens. Here we will analyze how such narratives about identity and the nation state affects people, their personality development and identity in different ways by studying the U.S. President Donald Trump’s speeches and analyze if and how he used different identity creating narratives for gaining political and popular support. The reason to choose narrative analysis as a method in this research paper is to use the narratives as a device to understand how the perceived notions of 'us and them' can initiate huge identity crisis with a community or a nation-state. This is a relevant subject as results and developments such as rising populist rightwing movements are being felt in a number of European states, with the so-called Brexit vote in the U.K. and the election of Donald Trump as president are two of the prime examples. This paper will then attempt to argue that these mechanisms are strengthened and gaining significance in situations when humans in an economic, social or ontologically vulnerable position, imagined or otherwise, in a general and broad meaning perceive themselves to be under pressure, and a sense of insecurity is rising. These insecurities and sense of being under threat have been on the rise in many of the Western states that are otherwise usually perceived to be some of the safest, democratically stable and prosperous states in the world, which makes it of interest to study what has changed, and help provide some part of the explanation as to how creating a ‘them’ in the discourse of national identity can cause massive security crisis.

Keywords: identity crisis, migration, ontological security(in), nation-states

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Authors: M. R. Akbari, H. Yousefnia, A. Ghasemi

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Al2O3:C,Mg fluorescent nuclear track detector (FNTD) and Al2O3:C optically stimulated luminescence detector (OSLD) are becoming two of the applied detectors in ion dosimetry. Therefore, the response of these detectors to hadron beams is highly of interest in radiation therapy (RT) using ion beams. In this study, these detectors' responses to proton and Helium-4 ion beams were compared using Monte Carlo simulations. The calculated data for proton beams were compared with Markus ionization chamber (IC) measurement (in water phantom) from M.D. Anderson proton therapy center. Monte Carlo simulations were performed via the FLUKA code (version 2011.2-17). The detectors were modeled in cylindrical shape at various depths of the water phantom without shading each other for obtaining relative depth dose in the phantom. Mono-energetic parallel ion beams in different incident energies (100 MeV/n to 250 MeV/n) were collided perpendicularly on the phantom surface. For proton beams, the results showed that the simulated detectors have over response relative to IC measurements in water phantom. In all cases, there were good agreements between simulated ion ranges in the water with calculated and experimental results reported by the literature. For proton, maximum peak to entrance dose ratio in the simulated water phantom was 4.3 compared with about 3 obtained from IC measurements. For He-4 ion beams, maximum peak to entrance ratio calculated by both detectors was less than 3.6 in all energies. Generally, it can be said that FLUKA is a good tool to calculate Al2O3:C,Mg FNTD and Al2O3:C OSLD detectors responses to therapeutic proton and He-4 ion beams. It can also calculate proton and He-4 ion ranges with a reasonable accuracy.

Keywords: comparison, FNTD and OSLD detectors response, light ion beams, Monte Carlo simulations

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Authors: Nivedita Paul

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The changing character of marriage be it arranged marriage, love marriage, polygamy, informal unions, all signify different gender relations in everyday lives. Marriages in India are part and parcel of the kinship and cultural practices. Arranged marriage is still the dominant form of marriage where spouse selection is the initiative and decision of the parents; but its form is changing, as women are now actively participating in spouse selection but with parental consent. Spouse selection related decision making is important because marriage as an institution brings social change and gender inequality; especially in a women’s life as marriages in India are mostly patrilocal. Moreover, the amount of say in spouse selection can affect a woman’s reproductive rights, domestic violence issues, household resource allocation, communication possibilities with the spouse/husband, marital life, etc. The present study uses data from Indian Human Development Survey II (2011-12) which is a nationally representative multitopic survey that covers 41,554 households. Currently, married women of age group 15-49 in their first marriage; whose year of marriage is from 1970s to 2000s have been taken for the study. Based on spouse selection experiences, the sample of women has been divided into three marriage categories-self, semi and family arranged. Women in self arranged or love marriage is the sole decision maker in choosing the partner, in semi arranged marriage or arranged marriage with consent both parents and women together take the decision, whereas in family arranged or arranged marriage without consent only parents take the decision. The main aim of the study is to find the relationship between spouse selection experiences and women’s autonomy in India. Decision making in economic matters, child and health related decision making, mobility and access to resources are taken to be proxies of autonomy. Method of ordinal regression has been used to find the relationship between spouse selection experiences and autonomy after marriage keeping other independent variables as control factors. Results show that women in semi arranged marriage have more decision making power regarding financial matters of the household, health related matters, mobility and accessibility to resources, when compared to women in family, arranged marriages. For freedom of movement and access to resources women in self arranged marriage have the highest say or exercise greatest power. Therefore, greater participation of women (even though not absolute control) in spouse selection may lead to greater autonomy after marriage.

Keywords: arranged marriage, autonomy, consent, spouse selection

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Authors: Barbara A. Perry

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In 1996, the New Zealand government and the Ministry of Education announced that they were setting up a "world class system of inclusive education". As a parent of a son with high and complex needs, a teacher, school Principal and Disability studies Lecturer, this author will track the changes in the journey towards inclusive education over the last 20 years. Strategies for partnering with families to ensure educational success along with insights from one of those on the crest of the wave will be presented. Using a narrative methodology the author will illuminate how far New Zealand has come towards this world class system of inclusion promised and share from personal experience some of the highlights and risks in the system. This author has challenged the old structures and been part of the setting up of new structures particularly for providing parent voice and insight; this paper provides a unique view from an insider’s voice as well as a professional in the system.

Keywords: disability studies, inclusive education, special education, working with families with children with disability

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Authors: Chutamas Thepmalee, Aussara Panya, Mutita Junking, Jatuporn Sujjitjoon, Nunghathai Sawasdee, Pa-Thai Yenchitsomanus

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Cholangiocarcinoma (CCA) is an aggressive malignancy of bile duct epithelial cells in which the standard treatments, including surgery, radiotherapy, chemotherapy, and targeted therapy are partially effective. Many solid tumors including CCA escape host immune responses by creating tumor microenvironment and generating immunosuppressive cytokines such as interleukin-10 (IL-10) and transforming growth factor-β (TGF-β). These cytokines can inhibit dendritic cell (DC) differentiation and function, leading to decreased activation and response of effector CD4+ and CD8+ T cells for cancer cell elimination. To overcome the effects of these immunosuppressive cytokines and to increase ability of DC to activate effector CD4+ and CD8+ T cells, we generated self-differentiated DCs (SD-DCs) with down-regulation of IL-10 and TGF-β receptors for activation of effector CD4+ and CD8+ T cells. Human peripheral blood monocytes were initially transduced with lentiviral particles containing the genes encoding GM-CSF and IL-4 and then secondly transduced with lentiviral particles containing short-hairpin RNAs (shRNAs) to knock-down mRNAs of IL-10 and TGF-β receptors. The generated SD-DCs showed up-regulation of MHC class II (HLA-DR) and co-stimulatory molecules (CD40 and CD86), comparable to those of DCs generated by convention method. Suppression of IL-10 and TGF-β receptors on SD-DCs by specific shRNAs significantly increased levels of IFN-γ and also increased cytolytic activity of DC-activated effector T cells against CCA cell lines (KKU-213 and KKU-100), but it had little effect to immortalized cholangiocytes (MMNK-1). Thus, SD-DCs with down-regulation of IL-10 and TGF-β receptors increased activation of effector T cells, which is a recommended method to improve DC function for the preparation of DC-activated effector T cells for adoptive T-cell therapy.

Keywords: cholangiocarcinoma, IL-10 receptor, self-differentiated dendritic cells, TGF-β receptor

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Authors: Arfan Riasat, M. Iqbal Zafar, Gulfam Riasat

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Pakistani women actively participate in livestock management activities, along with their normal domestic chores. The study was designed to measure the position and contribution of rural women, their constraints in livestock management activities and mainly how the rural women contribute for development in the district Faisalabad. It was envisioned that women participation in livestock activities have rarely been investigated. A multistage random sampling technique was used to collect the data from Tehsil Summandry of the district selected at random. Two union councils were taken by using simple random sampling technique. Four Chak (village) from each union council were selected at random and fifteen woman were further selected randomly from each selected chak. The results show that a vast majority of women were illiterate, having annual family income of one to two lac. They are living in joint family system. Their main occupation is agriculture and they spend long hours in whole livestock related activities to support their families. A large proportion of the respondents reported that they had to face problems and constraints in livestock activities in the context of decision making, medication, awareness, training along with social and economic issues. Analysis indicated that education level of women, income of household, age were significantly associated with level of participation. Women participation in livestock activities increased production and they were involved in income generating activities for better economic conditions of their families.

Keywords: women, participation, livestock, management, rural development

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Authors: Meki Detamo, Ahmed

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Access to improved sanitation facilities is crucial for promoting community sanitation worldwide. In Ethiopia, however, sanitation remains a major development challenge despite growing attention and efforts by governments and donors. This study aimed to assess the availability of improved sanitation facilities and associated factors in urban kebeles of Dire Dawa City, Eastern Ethiopia, in 2022. A community-based cross-sectional study was conducted from March 6 to 30, 2022, using a multi-stage sampling technique to select 508 households. Data was collected through structured and pre-tested questionnaires using face-to-face interviews and observations and analyzed using SPSS Version 23. The availability of improved sanitation facilities was found to be remarkably high at 98.2% (95% CI: 97.0, 99.2), with 60.8% of households having a handwashing facility in or around the latrine, 86.0% using soap and water, and 89.0% using an improved water source for drinking. Logistic regression analysis revealed that households with a family size of less than four, those who owned their own house, and those who had self-initiated latrine construction were significantly associated with the availability of improved sanitation facilities. The study recommends the implementation of continuous refreshment training to emphasize the benefits of improved sanitation facilities in the urban community and family planning. This study provides valuable insights into the high availability of improved sanitation facilities in urban areas of Ethiopia and can inform future efforts to improve community sanitation.

Keywords: sanitation facilities, availability, improved, Dire Dawa, Ethiopia

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Authors: Kristine Kalnica-Dorosenko, Aiga Svede

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Amblyopia or 'lazy eye' is impaired or dim vision without obvious defect or change in the eye. It is often associated with abnormal visual experience, most commonly strabismus, anisometropia or both, and form deprivation. The main task of amblyopia treatment is to ameliorate etiological factors to create a clear retinal image and, to ensure the participation of the amblyopic eye in the visual process. The treatment of amblyopia and eccentric fixation is usually associated with problems in the therapy. Eccentric fixation is present in around 44% of all patients with amblyopia and in 30% of patients with strabismic amblyopia. In Latvia, amblyopia is carefully treated in various clinics, but eccentricity diagnosis is relatively rare. Conflict which has developed relating to the relationship between the visual disorder and the degree of eccentric fixation in amblyopia should to be rethoughted, because it has an important bearing on the cause and treatment of amblyopia, and the role of the eccentric fixation in this case. Visuoscopy is the most frequently used method for determination of eccentric fixation. With traditional visuoscopy, a fixation target is projected onto the patient retina, and the examiner asks to look straight directly at the center of the target. An optometrist then observes the point on the macula used for fixation. This objective test provides clinicians with direct observation of the fixation point of the eye. It requires patients to voluntarily fixate the target and assumes the foveal reflex accurately demarcates the center of the foveal pit. In the end, by having a very simple method to evaluate fixation, it is possible to indirectly evaluate treatment improvement, as eccentric fixation is always associated with reduced visual acuity. So, one may expect that if eccentric fixation in amlyopic eye is found with visuoscopy, then visual acuity should be less than 1.0 (in decimal units). With occlusion or another amblyopia therapy, one would expect both visual acuity and fixation to improve simultaneously, that is fixation would become more central. Consequently, improvement in fixation pattern by treatment is an indirect measurement of improvement of visual acuity. Evaluation of eccentric fixation in the child may be helpful in identifying amblyopia in children prior to measurement of visual acuity. This is very important because the earlier amblyopia is diagnosed – the better the chance of improving visual acuity.

Keywords: amblyopia, eccentric fixation, visual acuity, visuoscopy

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Authors: Muhammad Samiullah

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Unquestionably, Human life has been complex from the beginning. In the modern era, with all advancements in science and technology, this complexity is increasing day by day, and human life is becoming more and more difficult its survive. The world has become more mysterious than before. Human beings are facing unusual happenings and blockages in their lives in the form of illnesses, diseases, relationship problems, and hurdles in the economy with all their advanced knowledge, information, and exposure to the universe and themselves as well. This paper will discuss and analyze the underlying spiritual causes and their effects on human life and also suggests their remedies from an Islamic perspective, i.e., in the light of Theology and Islamic literature. Hermeneutics, narrative, and case study approach are adopted within the qualitative methodology in our findings throughout the research. In our outcomes, we will see that Islam eloquently and adequately describes the spiritual causes and factors regarding the unusual foundations and their effects on human life and also provides the remedies and cures to overcome these blockages.

Keywords: religious psychology, spiritual theology, Islam and spirituality, unusual happenings

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Authors: Jian-Na Zhang, Xiao-Li Chen, Si-Jian Li

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Objective: In order to investigate current status on knowledge of disaster prevention and reduction in rural pupils, to explore education method on disaster prevention and reduction for rural pupils. Method: A questionnaire was designed based on literature review. Convenient sampling was used in the survey. The questionnaire survey was conducted among 180 students from Huodehong town central primary school which located in Ludian county of Zhaotong city in Yunnan province, where 6.5 magnitude earthquake happened in 2014. The result indicated that the pupils’ knowledge and skills on disaster prevention and reduction relevant poor. The source for them to obtain the knowledge of disaster prevention and reduction included TV (68.9%), followed by their parents (43.9%), while only 24.4% of knowledge is from the teachers. The scores about different natural disaster are ranking in descending order: earthquake (5.39 ±1.27), floods (3.77 ±1.17); debris flow (2.81 ±1.05), family fire (2.16± 0.96). And the disaster experience did not help the pupils enhance the knowledge reserves. There is no statistical significance (P > 0.05) in knowledge scores of disaster prevention and reduction between experienced and non-experienced group. Conclusion: The local disaster experiences did not draw the attention of parents and schools. Knowledge popularization of disaster for local pupils is extremely urgent. It is necessary to take advantage of more mediums to popularize the knowledge and skills about disaster prevention and reduction, for example, family education, school education, newspapers, brochures, etc. The training courses on disaster prevention and reduction which are based on the characteristics of the local rural pupils and the characteristics of the local disasters would be useful.

Keywords: rural, pupils, disaster prevention and reduction knowledge, popularization

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Authors: Sasan Khademnematolahi, Kevine Kamga Silihe, Katarína Pružinská, Martina Chrastina, Elisabeth Louise Ndjengue Mindang, František Dráfi, Katarína Bauerová

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Background: In ethnomedicine, plant parts and compounds are traditionally utilized to treat many disorders. Azadirachta indica, known as Neem, has been traditionally used in medicinal practices. Due to the presence of bioactive substances such as nimbolide, azadirachtin, and gedunin, Neem offers a variety of medicinal properties, including anti-inflammatory and antioxidant properties. Through its effect on pathological inflammatory processes, supplementation with it could alleviate the symptoms of rheumatoid arthritis (RA). Methods: This research aimed to assess Neem seed oil's impact on rats with adjuvant arthritis. Three doses in monotherapy and two in combination with methotrexate (MTX) have been studied, and their effect was compared. Neem p.o. doses of 100, 200, and 300 mg/kg and MTX p.o. doses of 0.3 mg/kg were examined. After clinical parameters assessment, biochemical analysis was performed in plasma. Results: During the acute phase of the experimental arthritis (Day21), levels of MMP-9, MCP-1, and cytokines IL-1beta and IL-17A were measured. The positive results of inflammatory mediators evaluation in plasma encourage additional analysis also in related tissues to prove if Neem seed oil can be used as an adjuvant therapy for RA. Conclusion: In this study, the combination therapy of Neem with MTX was the most effective of all therapies investigated. Acknowledgement: SAIA PROJECT of Kevine Kamga Silihe, Slovakia-Cameroon 2023: “The effect of Crocus sativus L (Saffron), Azadirachta indica (Neem) and their main bioactives compounds in combinatory treatment with methotrexate on experimental arthritis”, VEGA 2/0079/24, VEGA 2/0136/20, VEGA 2/0126/23 and VEGA 2/0091/23.

Keywords: adjuvant, Neem, methotrexate, arthritis

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Authors: Mandy Wilson, Emma Vieira, Jocelyn Jones, Alice V. Brown, Lindey Andrews, Louise Southalan, Jackie Oakley, Dorothy Bagshaw, Patrick Egan, Laura Dent, Duc Dau, Lucy Spanswick

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Alcohol and drug dependency are pertinent issues for those experiencing homelessness. This includes Aboriginal and Torres Strait Islander people, Australia’s traditional owners, living in Perth, Western Australia (WA). Societal narratives around the drivers behind drug and alcohol dependency in Aboriginal communities, particularly those experiencing homelessness, have been biased and unchanging, with little regard for complexity. This can include the idea that Aboriginal people have ‘chosen’ to use alcohol or other drugs without consideration for intergenerational trauma and the trauma of homelessness that may influence their choices. These narratives have flow-on impacts on policies and services that directly impact Aboriginal people experiencing homelessness. In 2021, we commenced a project which aimed to listen to and elevate the voices of 70-90 Aboriginal people experiencing homelessness in Perth. The project is community-driven, led by an Aboriginal Community Controlled Organisation in partnership with a university research institute. A community-ownership group of Aboriginal Elders endorsed the project’s methods, chosen to ensure their suitability for the Aboriginal community. In this paper, we detail these methods, including semi-structured interviews influenced by an Aboriginal yarning approach – an important style of conversation for Aboriginal people which follows cultural protocols; and photovoice – supporting people to share their stories through photography. Through these engagements, we detail the reasons Aboriginal people in Perth shared for using alcohol or other drugs while experiencing homelessness. These included supporting their survival on the streets, managing their mental health, and coping while on the journey to finding support. We also detail why they sought to discontinue alcohol and other drug use, including wanting to reconnect with family and changing priorities. Finally, we share how Aboriginal people experiencing homelessness have said they are impacted by their family’s alcohol and other drug use, including feeling uncomfortable living with a family who is drug and alcohol-dependent and having to care for grandchildren despite their own homelessness. These findings provide a richer understanding of alcohol and drug use for Aboriginal people experiencing homelessness in Perth, shedding light on potential changes to targeted policy and service approaches.

Keywords: Aboriginal and Torres Strait Islander peoples, alcohol and other drugs, homelessness, community-led research

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Authors: Elizabeth Latham

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Billions of people worldwide profess some feeling of psychological or spiritual connection with the divine. The majority of them attribute this personal connection to the God of the Christian Bible. The objective of this research was to discover what could be known about the exact social nature of these relationships and to see if they mimic the interactions recounted in the bible; if a worldwide majority believes that the Christian Bible is a true account of God’s interactions with mankind, it is reasonable to assume that the interactions between God and the aforementioned people would be similar to the ones in the bible. This analysis required the employment of an unusual method of biblical analysis: Game Theory. Because the research focused on documented social interaction between God and man in scripture, it was important to go beyond text-analysis methods. We used stories from the New Revised Standard Version of the bible to set up “games” using economics-style matrices featuring each player’s motivations and possible courses of action, modeled after interactions in the Old and New Testaments between the Judeo-Christian God and some mortal person. We examined all relevant interactions for the objectives held by each party and their strategies for obtaining them. These findings were then compared to similar “games” created based on interviews with people subscribing to different levels of Christianity who ranged from barely-practicing to clergymen. The range was broad so as to look for a correlation between scriptural knowledge and game-similarity to the bible. Each interview described a personal experience someone believed they had with God and matrices were developed to describe each one as social interaction: a “game” to be analyzed quantitively. The data showed that in most cases, the social features of God-man interactions in the modern lives of people were like those present in the “games” between God and man in the bible. This similarity was referred to in the study as “biblical faith” and it alone was a fascinating finding with many implications. The even more notable finding, however, was that the amount of game-similarity present did not correlate with the amount of scriptural knowledge. Each participant was also surveyed on family background, political stances, general education, scriptural knowledge, and those who had biblical faith were not necessarily the ones that knew the bible best. Instead, there was a high degree of correlation between biblical faith and family religious observance. It seems that to have a biblical psychological relationship with God, it is more important to have a religious family than to have studied scripture, a surprising insight with massive implications on the practice and preservation of religion.

Keywords: bible, Christianity, game theory, social psychology

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Authors: Ke Guek Nee, Wong Siew Fan, Nigel V. Marsh

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Excessive use of the Internet has become a cause for concern in many countries, including Malaysia. Such behaviour is reported to be more prevalent amongst young adults who are reported to be spending large amount of time on the Internet. The present study has three objectives. First one is designing a manual-based Cognitive Behavioural Therapy (CBT) programme to reduce problematic Internet use among young adults in Malaysia. Second one is examining the effectiveness of a manual-based CBT programme at the pilot study stage. Thirdly, the programme focuses on reducing the level of stress and anxiety in problematic Internet users. We adopted CBT with single subject experimental design method. A total of six participants completed the entire program. They were asked to report their daily Internet use and software was installed on their devices to record actual use. The data collection involved three time frame measurements: T1 (baseline), T2 (immediately during the last session of the intervention sessions), and T3 (follow-up). Three scales were used to measure the effectiveness of the program: Depression, Anxiety, Stress Scales (DASS), Social Interaction Anxiety Scale (SIAS), and Problematic Internet Use Questionnaire (PIUQ). The results revealed that the intervention programme has significantly improved two dimensions of problematic Internet use which were obsession and control disorder. The participants’ mental health also showed a deduction in means scores for depression, anxiety and stress with depression showing the greatest improvement after the intervention programme. The participants’ social anxiety showed a slight deduction in means scores. We concluded that the intervention programme designed was effective. However, its limitations need to be addressed in future research.

Keywords: excessive internet use, cognitive behavioral thearapy (CBT), psychological well-being, young adults

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Authors: Wael Salah Shendy, Moataz Mohamed EL Semary, Hosam Salah Murad, Adham A. Mohamed

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Background: Cervicogenic headache is a major problem in many people suffering from upper cervical dysfunction with a great conflict in its physical therapy management. Objectives: To determine the effect of C1-C2 Mulligan SNAGs mobilizations on cervicogenic headache and associated dizziness symptoms. Methods: Forty-eight patients with cervicogenic headache included in the study; from the outpatient clinic of Faculty of Physical Therapy, Cairo University, and New Cairo outpatient clinics, were randomly assigned into three equal groups; group A ( Headache SNAG), group B (C1-C2 SNAG rotation) and group C (combined). Their mean age was (29.37 ± 2.6), (29.31 ± 2.54) and (29.68 ± 2.65). Neck Disability Index used to examine neck pain intensity and CEH symptoms. 6 Items Headache Impact test '6-HIT' scale used to examine headache severity and its adverse effects on social life and functions. Flexion-Rotation Test 'FRT' also used to assess rotation ROM at the level of C1-C2 by 'CROM' device. Dizziness Handicap Inventory 'DHI' scale was used to evaluate dizziness symptoms. Evaluation is done pre and post treatment, and comparison between groups was quantified. Correlations between the examined parameters were also measured. Headache SNAG and C1-C2 Rotation SNAGs were done separately in group (A- B) and combined in group C as a treatment intervention. Results: Group C has Significant improvement in whole parameters compared to group A and B, positive correlation was found between NDI and 6-HIT scores compared to negative correlation between NDI and DHI scores. Conclusion: SNAGs mobilizations used in the study were effective in reducing cervicogenic headache and dizziness symptoms in all groups with a noticeable improvement in the combined group.

Keywords: cervicogenic headache, cervical headache snag, cervical snag half rotation, cervical dizziness

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Authors: Canan Gunay Yazici, Zubeyir Sarı, Devrim Tarakci

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Background: Hippotherapy considered as global techniques used in rehabilitation of children with cerebral palsy as it improved gait pattern, balance, postural control, balance and gross motor skills development but it encounters some problems (such as the excess of the cost of horses' care, nutrition, housing). Hippotherapy simulator is being developed in recent years to overcome these problems. These devices aim to create the effects of hippotherapy made with a real horse on patients by simulating the movements of a real horse. Objectives: To evaluate the efficacy of hippotherapy simulator on gross motor functions, sitting postural control and dynamic balance of children with cerebral palsy (CP). Methods: Fourteen children with CP, aged 6–15 years, seven with a diagnosis of spastic hemiplegia, five of diplegia, two of triplegia, Gross Motor Function Classification System level I-III. The Horse Riding Simulator (HRS), including four-speed program (warm-up, level 1-2-3), was used for hippotherapy simulator. Firstly, each child received Neurodevelopmental Therapy (NDT; 45min twice weekly eight weeks). Subsequently, the same children completed HRS+NDT (30min and 15min respectively, twice weekly eight weeks). Children were assessed pre-treatment, at the end of 8th and 16th week. Gross motor function, sitting postural control, dynamic sitting and standing balance were evaluated by Gross Motor Function Measure-88 (GMFM-88, Dimension B, D, E and Total Score), Trunk Impairment Scale (TIS), Pedalo® Sensamove Balance Test and Pediatric Balance Scale (PBS) respectively. Unit of Scientific Research Project of Marmara University supported our study. Results: All measured variables were a significant increase compared to baseline values after both intervention (NDT and HRS+NDT), except for dynamic sitting balance evaluated by Pedalo®. Especially HRS+NDT, increase in the measured variables was considerably higher than NDT. After NDT, the Total scores of GMFM-88 (mean baseline 62,2 ± 23,5; mean NDT: 66,6 ± 22,2; p < 0,05), TIS (10,4 ± 3,4; 12,1 ± 3; p < 0,05), PBS (37,4 ± 14,6; 39,6 ± 12,9; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 92,3 ± 5,2; p > 0,05) and Pedalo® standing balance points (80,2 ± 10,8; 82,5 ± 11,5; p < 0,05) increased by 7,1%, 2%, 3,9%, 5,2% and 6 % respectively. After HRS+NDT treatment, the total scores of GMFM-88 (mean baseline: 62,2 ± 23,5; mean HRS+NDT: 71,6 ± 21,4; p < 0,05), TIS (10,4 ± 3,4; 15,6 ± 2,9; p < 0,05), PBS (37,4 ± 14,6; 42,5 ± 12; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 93,8 ± 3,7; p > 0,05) and standing balance points (80,2 ± 10,8; 86,2 ± 5,6; p < 0,05) increased by 15,2%, 6%, 7,3%, 6,4%, and 11,9%, respectively, compared to the initial values. Conclusion: Neurodevelopmental therapy provided significant improvements in gross motor functions, sitting postural control, sitting and standing balance of children with CP. When the hippotherapy simulator added to the treatment program, it was observed that these functions were further developed (especially with gross motor functions and dynamic balance). As a result, this pilot study showed that the hippotherapy simulator could be a useful alternative to neurodevelopmental therapy for the improvement of gross motor function, sitting postural control and dynamic balance of children with CP.

Keywords: balance, cerebral palsy, hippotherapy, rehabilitation

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Authors: Alice Schittek, Isabelle Roskam, Moira Mikolajczak

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Background: Perfectionistic strivings (PS) and perfectionistic concerns (PC) are associated with an increase in parental burnout (PB), and PB causally increases violence towards the offspring. Objective: To our best knowledge, no study has ever investigated whether perfectionism (PS and PC) predicts violence towards the offspring and whether PB could explain this link. We hypothesized that an increase in PS and PC would lead to an increase in violence via an increase in PB. Method: 228 participants responded to an online survey, with three measurement occasions spaced two months apart. Results: Contrary to expectations, cross-lagged path models revealed that violence towards the offspring prospectively predicts an increase in PS and PC. Mediation models showed that PB is not a significant mediator. The results of all models did not change when controlling for social desirability. Conclusion: The present study shows that violence towards the offspring increases the risk of PS and PC in parents, which highlights the importance of understanding the effect of child maltreatment on the whole family system and not just on children. Results are discussed in light of the feeling of guilt experienced by parents. Considering the insignificant mediation effect, PB research should slowly shift towards more (quasi) causal designs, allowing to identify which significant correlations translate into causal effects. Implications: Clinicians should focus on preventing child maltreatment as well as treating parental perfectionism. Researchers should unravel the effects of child maltreatment on the family system.

Keywords: maltreatment, parental burnout, perfectionistic strivings, perfectionistic concerns, perfectionism, violence

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Authors: Joao Paulo Matheus, Renan Fangel

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Rheumatoid arthritis is a chronic, inflammatory, systemic and progressive disease that affects the synovial joints bilaterally, causing definitive orthopedic damage. It has a higher prevalence in postmenopausal female patients. It is a disabling disease that causes joint deformities that may compromise the functionality of the affected segment. The aim of this study was to evaluate the influence of low-intensity therapeutic laser on the perception of pain and quality of life in patients with rheumatoid arthritis. This is a randomized clinical study involving 6 women with a mean age of 56.8+6.3 years. Exclusion criteria: patients with acute pain, chronic infectious disease, underlying acute or chronic underlying disease. An AsGaAl laser with 808nm wavelength, 100mW power, beam output area of 0.028cm2, power density of 3.57W/cm2 was used. The laser was applied at pre-defined points in the interphalangeal and metacarpophalangeal joints, totaling 24 points, 2 times a week, for 4 weeks, totaling 8 sessions. The Pain Inventory (IBD) and Visual Analogue Scale (VAS) were used for the analysis of pain and for the WHOQOL-bref quality of life assessment. There was no statistical difference between the onset (5.67±2.66) and the final (4.67±3.78) of treatments (p=0.70). There was also no statistical difference between the beginning (5.67±2.66) and the final (4.67±3.78) of the treatments in the VAS analysis (p=0.68). The overall mean quality of life obtained by the questionnaire at the start of treatment was 42.3±7.6, while at the end of treatment it was 58.5±7.6 (p=0.01) and the domains of the questionnaire with significant differences were: psychological domain 42.9±6.8 and 66.7±12.9 (p=0.004), social domain 39.9±5.7 and 68.1±6.3 (p=0,0005) and environmental domain 36.3±7.3 and 56.3±12.5 (p=0.003). It can be concluded that the low-intensity therapeutic laser did not produce significant changes in the painful period of rheumatoid arthritis patients. However, there was an improvement in patients' quality of life in the psychological, social and environmental aspects.

Keywords: laser therapy, pain, quality of life, rheumatoid arthritis

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Authors: Naheed Malik, Marisa Smith

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This study has been undertaken as an attempt to explore the underlying reasons that cause higher employee turnover rates at the call centers of Pakistan. This research also aimed to examine the relationship among the job related variables such as job satisfaction, organizational commitment, supervisor support, self-esteem, organizational stressors (work overload, role ambiguity and work family conflict) and quitting inclination. A total of 340 call centers respondents filled the survey questionnaire. The data was analyzed through SPSS 19.0. Results reveal the significant relationship among the study variables and stress level contributing more towards employee penchant to leave the job. A significant amount of call centers employee have proclivity to quit from their jobs as soon as they would be able to find some other jobs with attractive compensation. The majority of the respondents were found to be unhappy and dissatisfied due to hectic schedule and imbalance between family and work. This research also highlighted the specific areas in which call centre management needs to emphasize deliberately that affect more sharply on employee leaving aptitude. This study also suggests some useful strategies for the well being of employees that can minimize their tendency of quitting and retention in the long run.

Keywords: call centers, stress, job satisfaction, organizational commitment, supervisor’s support, self esteem, employee turnover, employees’ intention to quit, customer service representative (CSRs)

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