Search results for: persons with mental illness
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2897

Search results for: persons with mental illness

797 Socio-Economic Status and Quality of Life of Construction Workers in Bengaluru Sub-Urban Area in Pre and Post COVID-19

Authors: Priyanka R. Sagar

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Social economic status (SES) is a variable that denotes the social standing of a person in society, and quality of life is a measure of health, happiness, and comfort of an individual. During early 2020, the world was stuck by the blow of the COVID-19 pandemic resulting in minimal or no economic activities to takes place. The present research paper is an attempt to analyze the socioeconomic status and quality of life of construction workers dwelling in the sub-urban areas of Hoskote located in the Bengaluru rural district pre and post-COVID-19. It also tries to analyze the difference in these variables pre and post-COVID-19. The study uses a retrospective design and data collected through a questionnaire survey from the respondents of Hoskote. A total of 100 samples were collected, out of which 73% were men and 27% were women. The mean age group of the participants is 41.04 ± 6.97 years. The overall analysis of the study shows that there is a significant difference in the socioeconomic status of construction workers pre and post-COVID-19. The study shows SES of the workers pre-pandemic is higher than post-pandemic. The other variable is quality of life which consists of physical health, psychological health, social relationships, and environmental domains. The study depicts that the psychological domain alone has been impacted by the pandemic; workers had better mental health pre-COVID-19. The other domains, i.e., physical health, social relationship, and environment, remain unaffected.

Keywords: socio-economic status, quality of life, construction workers, COVID-19

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796 Deniplant Nutraceuticals for Endometriosis Pain

Authors: Gheorghe Giurgiu, Manole Cojocaru, Mihnea Andrei Nicodin

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Background: Inflammation has the main role in the progression of endometriosis. The mechanisms by which endometriosis induces a chronic pain state remain poorly understood. Unfortunately, there is no known cure for endometriosis. But you can manage it with medication and at-home treatments. Some findings have highlighted the main role of inflammation in endometriosis by acting on proliferation, apoptosis, and angiogenesis. The introduction of new agents can be effective in improving the condition of patients; for example, plants are promising sources of bioactive natural components. Objectives: These natural compounds could be interesting strategies in therapy. While there is no absolute cure for this condition, some home remedies can relieve the pain and discomfort it brings. The purpose of this study is to summarize the potential action of Deniplant nutraceuticals in endometriosis by acting on inflammation. Materials and Methods: The primary symptoms of endometriosis are pelvic pain and infertility. The use of Deniplant nutraceuticals could be interesting in disease management for women. Results: Treating pain-related aspects of endometriosis would contribute to the improvement of mental health and daytime function. Because the microbiome can influence inflammation, new therapies can develop through its natural modulation. There are other options, including natural remedies, herbs like cinnamon twigs or licorice root, or supplements such as thiamine, magnesium, or omega-3 fatty acids. Conclusion: Deniplant nutraceuticals can downregulate inflammation in endometriosis. Nevertheless, the limited number of studies focusing on the different interactions of Deniplant nutraceuticals in endometriosis restricts its clear and immediate use in a therapeutic strategy.

Keywords: endometriosis, diet, Deniplant nutraceuticals, pain

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795 The Status and Role of Women in Indian IT Industry and Relevant Role and Scope of HRM

Authors: Shivani Kolarkar

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Splendid growth in Indian IT has generated women employment on a large scale in India and continues to do it. Indian IT industry has achieved this in spite of total masculine dominance in other Indian engineering industries, where the ratio of women employment is almost negligible as compared to men. Indian IT today proudly enjoys a strong pool of technically educated, intellectual, and skillful women employees. IT industry has encouraged technical education for women in India, to a great extent. The software industry has definitely contributed to developing a positive and dignified role and status of women employees in Indian IT industry. It has promoted women’s social and economic role and status. In spite of all, gender discrimination still persists in Indian IT, also, which is low as compared to other industries, but it is a matter of concern. An Indian woman is bound to carry dual roles which are equally over-stressed for IT women employees. Long working hours, night shifts, work pressures and insufficient safety majors and necessary facilities for women contributes to making her physical-mental life, family and married life troublesome. Which forces her either to cluster at low-end jobs in IT/elsewhere or to sacrifice her career. Nature, role and status of HRM needs to be broadened, deepened and shaped into research-oriented multidimensional perspective in the context of really enhancing role and status of Indian IT women with high appreciation of women employees’ dignity and entity.

Keywords: attrition, gender discrimination, HRM, Indian IT, software industry, job satisfaction, safety, technical education, women employment

Procedia PDF Downloads 645
794 The Meaning of the Best Interests of the Child in Indonesia’s Rampant Phenomenon of Child Marriage

Authors: Elisabeth Sundari, Anny Retnowati

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This research aims to examine the meaning of 'the best interests of the child' in Indonesia's rampant phenomenon of child marriage. The methodology used empirical and normative legal research by examining the parent's reason and the judges' considerations in granting child marriage dispensation applications. It takes data samples from judges' decisions purposively in two courts that differ in geographical and religious backgrounds to see data variation. Namely, the District Court and Religious Court of Yogyakarta City, as well as Gunung Kidul Regency, in the last three years (2020-2022). It analyses the data qualitatively to explore how judges interpreted 'the best interests of the child' in their decision. The results show that judges granted 100% of all child marriage dispensation applications filed by parents. The three reasons parents gave for applying for dispensation were that they were ashamed of having a pregnant child without being married, followed religious teachings, and obtained legal status for the baby. The judges supported those reasons by granting the dispensation application. The external factor of the child itself influenced the meaning of 'The best interests of the child' in marrying off children in Indonesia, such as cultural taboos, religious teachings, and obtaining legal status for the baby, rather than internal factors of the child, such as the will to marry, the mental and psychological readiness of the child to become a mother, as well as a wife. This research contributes to the finding that external factors, such as local culture and religion, can influence the meaning of 'the best interests of the child.'

Keywords: interests, child, Indonesia, marriage

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793 Insights into The Oversight Functions of The Legislative Power Under The Nigerian Constitution

Authors: Olanrewaju O. Adeojo

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The constitutional system of government provides for the federating units of the Federal Republic of Nigeria, the States and the Local Councils under a governing structure of the Executive, the Legislature and the Judiciary with attendant distinct powers and spheres of influence. The legislative powers of the Federal Republic of Nigeria and of a State are vested in the National Assembly and House of Assembly of the State respectively. The Local council exercises legislative powers in clearly defined matters as provided by the Constitution. Though, the executive as constituted by the President and the Governor are charged with the powers of execution and administration, the legislature is empowered to ensure that such powers are duly exercised in accordance with the provisions of the Constitution. The vast areas do not make oversight functions indefinite and more importantly the purpose for the exercise of the powers are circumscribed. It include, among others, any matter with respect to which it has power to make laws. Indeed, the law provides for the competence of the legislature to procure evidence, examine all persons as witnesses, to summon any person to give evidence and to issue a warrant to compel attendance in matters relevant to the subject matter of its investigation. The exercise of functions envisaged by the Constitution seem to an extent to be literal because it lacks power of enforcing the outcome. Furthermore, the docility of the legislature is apparent in a situation where the agency or authority being called in to question is part of the branch of government to enforce sanctions. The process allows for cover up and obstruction of justice. The oversight functions are not functional in a situation where the executive is overbearing. The friction, that ensues, between the Legislature and the Executive in an attempt by the former to project the spirit of a constitutional mandate calls for concern. It is needless to state a power that can easily be frustrated. To an extent, the arm of government with coercive authority seems to have over shadowy effect over the laid down functions of the legislature. Recourse to adjudication by the Judiciary had not proved to be of any serious utility especially in a clime where the wheels of justice grinds slowly, as in Nigeria, due to the nature of the legal system. Consequently, the law and the Constitution, drawing lessons from other jurisdiction, need to insulate the legislative oversight from the vagaries of the executive. A strong and virile Constitutional Court that determines, within specific time line, issues pertaining to the oversight functions of the legislative power, is apposite.

Keywords: constitution, legislative, oversight, power

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792 Cost-Effectiveness of a Certified Service or Hearing Dog Compared to a Regular Companion Dog

Authors: Lundqvist M., Alwin J., Levin L-A.

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Background: Assistance dogs are dogs trained to assist persons with functional impairment or chronic diseases. The assistance dog concept includes different types: guide dogs, hearing dogs, and service dogs. The service dog can further be divided into subgroups of physical services dogs, diabetes alert dogs, and seizure alert dogs. To examine the long-term effects of health care interventions, both in terms of resource use and health outcomes, cost-effectiveness analyses can be conducted. This analysis can provide important input to decision-makers when setting priorities. Little is known when it comes to the cost-effectiveness of assistance dogs. The study aimed to assess the cost-effectiveness of certified service or hearing dogs in comparison to regular companion dogs. Methods: The main data source for the analysis was the “service and hearing dog project”. It was a longitudinal interventional study with a pre-post design that incorporated fifty-five owners and their dogs. Data on all relevant costs affected by the use of a service dog such as; municipal services, health care costs, costs of sick leave, and costs of informal care were collected. Health-related quality of life was measured with the standardized instrument EQ-5D-3L. A decision-analytic Markov model was constructed to conduct the cost-effectiveness analysis. Outcomes were estimated over a 10-year time horizon. The incremental cost-effectiveness ratio expressed as cost per gained quality-adjusted life year was the primary outcome. The analysis employed a societal perspective. Results: The result of the cost-effectiveness analysis showed that compared to a regular companion dog, a certified dog is cost-effective with both lower total costs [-32,000 USD] and more quality-adjusted life-years [0.17]. Also, we will present subgroup results analyzing the cost-effectiveness of physicals service dogs and diabetes alert dogs. Conclusions: The study shows that a certified dog is cost-effective in comparison with a regular companion dog for individuals with functional impairments or chronic diseases. Analyses of uncertainty imply that further studies are needed.

Keywords: service dogs, hearing dogs, health economics, Markov model, quality-adjusted, life years

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791 The Trauma Suffered by Left behind Children and Its Impact on Their Emotional Development: A Pilot Study with Brazilian Immigrants in the United States

Authors: Liliane Clark

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Immigrating to a different country may imply having to handle many difficult exertions. There is a particular issue that has to be endured by some immigrants: the children they had to leave behind. It is a phenomenon that occurs with certain frequency. Surprisingly, despite the fact that immigration in the United States is such a large proceeding, there is not much research about the topic in America exploring the trauma of the abandonment caused by this separation and its consequences on the mental health of those children. The term “left behind children” is usually applied to children who were left behind by their parents in their original nation under the care of a noteworthy relative, frequently the grandparents, when they moved to another country. This preliminary research, which is a partial study projected for a doctoral thesis, investigated whether the trauma of abandonment experienced by ten left behind children had affected their emotional development. The Strengths and Difficulties Questionnaire (SDQ) and a brief interview were utilized to assess the information. The SDQ explored scales such as emotional symptoms, conduct problems, hyperactivity, peer problems and prosocial behavior. In this pilot study, the results indicated that all these issues had some sort of significant correlation between them. During the interviews, the participants or their parents identified a range of symptoms: anxiety disorder, eating disorders, panic attacks, psychotic-like experiences, drug use and depression. Hence, it seems that there is a connection between the trauma of abandonment suffered due to the separation and the children’s consequent symptomatic behavior. Further studies are indeed necessary to validate the initial results of this investigation.

Keywords: abandonment, parent migration, psychological problems, trauma

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790 Implementing a Screening Tool to Assist with Palliative Care Consultation in Adult Non-ICU Patients

Authors: Cassey Younghans

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Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

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789 Anxiety Sensitivity and Coping Motives Predict Substance Use Craving and Relapse

Authors: Ruhollah Heydari Sheikh Ahmad, Sara Alaie Khoraem

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Introduction: Substance use disorder is conceptualized as a chronic relapsing condition where relapse is usually defined as the return to problematic substance use following treatment. An issue of great importance is the identification of the predictors of relapse and the development of treatments that may help prevent relapse. One of the strongest predictors of relapse is craving. The purpose of the present study was to study the effect of anxiety, anxiety sensitivity, and coping motives on craving. Materials and method: Participants (n=74) were male opiate users recruited from a semi-private clinic providing de-toxification and treatment services for substance users. Anxiety, anxiety sensitivity, coping motives and craving were assessed using relevant questionnaires. The addiction severity index was used to assess addiction severity. Results: All patients were methadone maintained and one year after detoxification, 36 patients (48.64%) relapsed. Stress and anxiety, anxiety sensitivity, addiction severity and coping motives predicted craving and relapse. Anxiety sensitivity specifically predicted early relapse. Conclusion: Substance use is a severe mental disorder, with high relapse rates. Substance users high in anxiety sensitivity are particularly prone to relapse during the first six months of treatment. Addiction severity and coping motives need to be taken into account when providing interventional services for substance users. Findings imply the significance of additional psychological attention to methadone maintained patients to prevent craving and relapse.

Keywords: anxiety sensitivity, coping motives, relapse, substance use craving

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788 Inhibition Theory: The Development of Subjective Happiness and Life Satisfaction after Experiencing Severe, Traumatic Life Events (Paraplegia)

Authors: Tanja Ecken, Laura Fricke, Anika Steger, Maren M. Michaelsen, Tobias Esch

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Studies and applied experiences evidence severe and traumatic accidents to not only require physical rehabilitation and recovery but also to necessitate a psychological adaption and reorganization to the changed living conditions. Neurobiological models underpinning the experience of happiness and satisfaction postulate life shocks to potentially enhance the experience of happiness and life satisfaction, i.e., posttraumatic growth (PTG). This present study aims to provide an in-depth understanding of the underlying psychological processes of PTG and to outline its consequences on subjective happiness and life satisfaction. To explore the aforementioned, Esch’s (2022) ABC Model was used as guidance for the development of a questionnaire assessing changes in happiness and life satisfaction and for a schematic model postulating the development of PTG in the context of paraplegia. Two-stage qualitative interview procedures explored participants’ experiences of paraplegia. Specifically, narrative, semi-structured interviews (N=28) focused on the time before and after the accident, the availability of supportive resources, and potential changes in the perception of happiness and life satisfaction. Qualitative analysis (Grounded Theory) indicated an initial phase of reorganization was followed by a gradual psychological adaption to novel, albeit reduced, opportunities in life. Participants reportedly experienced a ‘compelled’ slowing down and elements of mindfulness, subsequently instilling a sense of gratitude and joy in relation to life’s presumed trivialities. Despite physical limitations and difficulties, participants reported an enhanced ability to relate to oneself and others and a reduction of perceived every day nuisances. Concluding, PTG can be experienced in response to severe, traumatic life events and has the potential to enrich the lives of affected persons in numerous, unexpected and yet challenging ways. PTG appears to be spectrum comprised of an interplay of internal and external resources underpinned by neurobiological processes. Participants experienced PTG irrelevant of age, gender, marital status, income or level of education.

Keywords: inhibition theory, posttraumatic growth, trauma, stress, life satisfaction, subjective happiness, traumatic life events, paraplegia

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787 Factors Predicting Symptom Cluster Functional Status and Quality of Life of Chronic Obstructive Pulmonary Disease Patients

Authors: D. Supaporn, B. Julaluk

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The purposes of this study were to study symptom cluster, functional status and quality of life of patients with chronic obstructive pulmonary disease (COPD), and to examine factors related to and predicting symptom cluster, functional status and quality of life of COPD patients. The sample was 180 COPD patients multi-stage random sampling from 4 hospitals in the eastern region, Thailand. The research instruments were 8 questionnaires and recorded forms measuring personal and illness data, co-morbidity, physical and psychological symptom, health status perception, social support, and regimen adherence, functional status and quality of life. Spearman rank and Pearson correlation coefficient, exploratory factors analysis and standard multiple regression were used to analyzed data. The findings revealed that two symptom clusters were generated: physical symptom cluster including dyspnea, fatigue and insomnia; and, psychological symptom cluster including anxiety and depression. Scores of physical symptom cluster was at moderate level while that of psychological symptom cluster was at low level. Scores on functional status, social support and overall regimen adherence were at good level whereas scores on quality of life and health status perception were at moderate level. Disease severity was positively related to physical symptom cluster, psychological symptom cluster and quality of life, and was negatively related to functional status at a moderate level (rs = .512, .509, .588 and -.611, respectively). Co-morbidity was positively related to physical symptom cluster and psychological symptom cluster at a low level (r = .179 and .176, respectively). Regimen adherence was negatively related to quality of life and psychological symptom cluster at a low level (r=-.277 and -.309, respectively), and was positively related to functional status at a moderate level (r=.331). Health status perception was negatively related to physical symptom cluster, psychological symptom cluster and quality of life at a moderate to high level (r = -.567, -.640 and -.721, respectively) and was positively related to functional status at a high level (r = .732). Social support was positively related to functional status (r=.235) and was negatively related to quality of life at a low level (r=-.178). Physical symptom cluster was negatively related to functional status (r= -.490) and was positively related to quality of life at a moderate level (r=.566). Psychological symptom cluster was negatively related to functional status and was positively related to quality of life at a moderate level (r= -.566 and .559, respectively). Disease severity, co-morbidity and health status perception could predict 40.2% of the variance of physical symptom cluster. Disease severity, co-morbidity, regimen adherence and health status perception could predict 49.8% of the variance of psychological symptom cluster. Co-morbidity, regimen adherence and health status perception could predict 65.0% of the variance of functional status. Disease severity, health status perception and physical symptom cluster could predict 60.0% of the variance of quality of life in COPD patients. The results of this study can be used for enhancing quality of life of COPD patients.

Keywords: chronic obstructive pulmonary disease, functional status, quality of life, symptom cluster

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786 Improving Collective Health and Social Care through a Better Consideration of Sex and Gender: Analytical Report by the French National Authority for Health

Authors: Thomas Suarez, Anne-Sophie Grenouilleau, Erwan Autin, Alexandre Biosse-Duplan, Emmanuelle Blondet, Laurence Chazalette, Marie Coniel, Agnes Dessaigne, Sylvie Lascols, Andrea Lasserre, Candice Legris, Pierre Liot, Aline Metais, Karine Petitprez, Christophe Varlet, Christian Saout

Abstract:

Background: The role of biological sex and gender identity -whether assigned or chosen- as health determinants are far from a recent discovery: several reports have stressed out how being a woman or a man could affect health on various scales. However, taking it into consideration beyond stereotypes and rigid binary assumptions still seems to be a work in progress. Method: The report is a synthesis on a variety of specific topics, each of which was studied by a specialist from the French National Authority for Health (HAS), through an analysis of existing literature on both healthcare policy construction process and instruments (norms, data analysis, clinical trials, guidelines, and professional practices). This work also implied a policy analysis of French recent public health laws and a retrospective study of guidelines with a gender mainstreaming approach. Results: The analysis showed that though sex and gender were well-known determinants of health, their consideration by both public policy and health operators was often incomplete, as it does not incorporate how sex and gender interact, as well as how they interact with other factors. As a result, the health and social care systems and their professionals tend to reproduce some stereotypical and inadequate habits. Though the data available often allows to take sex and gender into consideration, such data is often underused in practice guidelines and policy formulation. Another consequence is a lack of inclusiveness towards transgender or intersex persons. Conclusions: This report first urges for raising awareness of all the actors of health, in its broadest definition, that sex and gender matter beyond first-look conclusions. It makes a series of recommendations in order to reshape policy construction in the health sector on the one hand and to design public health instruments to make them more inclusive regarding sex and gender on the other hand. The HAS finally committed to integrate sex and gender preoccupations in its workings methods, to be a driving force in the spread of these concerns.

Keywords: biological sex, determinants of health, gender, healthcare policy instruments, social accompaniment

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785 The Latency-Amplitude Binomial of Waves Resulting from the Application of Evoked Potentials for the Diagnosis of Dyscalculia

Authors: Maria Isabel Garcia-Planas, Maria Victoria Garcia-Camba

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Recent advances in cognitive neuroscience have allowed a step forward in perceiving the processes involved in learning from the point of view of the acquisition of new information or the modification of existing mental content. The evoked potentials technique reveals how basic brain processes interact to achieve adequate and flexible behaviours. The objective of this work, using evoked potentials, is to study if it is possible to distinguish if a patient suffers a specific type of learning disorder to decide the possible therapies to follow. The methodology used, is the analysis of the dynamics of different areas of the brain during a cognitive activity to find the relationships between the different areas analyzed in order to better understand the functioning of neural networks. Also, the latest advances in neuroscience have revealed the existence of different brain activity in the learning process that can be highlighted through the use of non-invasive, innocuous, low-cost and easy-access techniques such as, among others, the evoked potentials that can help to detect early possible neuro-developmental difficulties for their subsequent assessment and cure. From the study of the amplitudes and latencies of the evoked potentials, it is possible to detect brain alterations in the learning process specifically in dyscalculia, to achieve specific corrective measures for the application of personalized psycho pedagogical plans that allow obtaining an optimal integral development of the affected people.

Keywords: dyscalculia, neurodevelopment, evoked potentials, Learning disabilities, neural networks

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784 Determinants of Psychological Distress in Teenagers and Young Adults Affected by Cancer: A Systematic Review

Authors: Anna Bak-Klimek, Emily Spencer, Siew Lee, Karen Campbell, Wendy McInally

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Background & Significance: Over half of Teenagers and Young Adults (TYAs) say that they experience psychological distress after cancer diagnosis and TYAs with cancer are at higher risk of developing distress compared to other age groups. Despite this there are no age-appropriate interventions to help TYAs manage distress and there is a lack of conceptual understanding of what causes distress in this population group. This makes it difficult to design a targeted, developmentally appropriate intervention. This review aims to identify the key determinants of distress in TYAs affected by cancer and to propose an integrative model of cancer-related distress for TYAs. Method: A literature search was performed in Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, CINAHL, EMBASE and PsycArticles in May-June, 2022. Quantitative literature was systematically reviewed on the relationship between psychological distress experienced by TYAs affected by cancer and a wide range of factors i.e. individual (demographic, psychological, developmental, and clinical factors) and contextual (social/environmental) factors. Evidence was synthesized and correlates were categorized using the Biopsychosocial Model. The full protocol is available from PROSPERO (CRD42022322069) Results: Thirty eligible quantitative studies met criteria for the review. A total of twenty-six studies were cross-sectional, three were longitudinal and one study was a case control study. The evidence on the relationship between the socio-demographic, illness and treatment-related factors and psychological distress is inconsistent and unclear. There is however consistent evidence on the link between psychological factors and psychological distress. For instance, the use of cognitive and defence coping, negative meta-cognitive beliefs, less optimism, a lack of sense of meaning and lower resilience levels were significantly associated with higher psychological distress. Furthermore, developmental factors such as poor self-image, identity issues and perceived conflict were strongly associated with higher distress levels. Conclusions: The current review suggests that psychological and developmental factors such as ineffective coping strategies, poor self-image and identity issues may play a key role in the development of psychological distress in TYAs affected by cancer. The review proposes a Positive Developmental Psychology Model of Distress for Teenagers and Young Adults affected by cancer. The review highlights that implementation of psychological interventions that foster optimism, improve resilience and address self-image may result in reduced distress in TYA’s with cancer.

Keywords: cancer, determinant, psychological distress, teenager and young adult, theoretical model

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783 Code Mixing and Code-Switching Patterns in Kannada-English Bilingual Children and Adults Who Stutter

Authors: Vasupradaa Manivannan, Santosh Maruthy

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Background/Aims: Preliminary evidence suggests that code-switching and code-mixing may act as one of the voluntary coping behavior to avoid the stuttering characteristics in children and adults; however, less is known about the types and patterns of code-mixing (CM) and code-switching (CS). Further, it is not known how it is different between children to adults who stutter. This study aimed to identify and compare the CM and CS patterns between Kannada-English bilingual children and adults who stutter. Method: A standard group comparison was made between five children who stutter (CWS) in the age range of 9-13 years and five adults who stutter (AWS) in the age range of 20-25 years. The participants who are proficient in Kannada (first language- L1) and English (second language- L2) were considered for the study. There were two tasks given to both the groups, a) General conversation (GC) with 10 random questions, b) Narration task (NAR) (Story / General Topic, for example., A Memorable Life Event) in three different conditions {Mono Kannada (MK), Mono English (ME), and Bilingual (BIL) Condition}. The children and adults were assessed online (via Zoom session) with a high-quality internet connection. The audio and video samples of the full assessment session were auto-recorded and manually transcribed. The recorded samples were analyzed for the percentage of dysfluencies using SSI-4 and CM, and CS exhibited in each participant using Matrix Language Frame (MLF) model parameters. The obtained data were analyzed using the Statistical Package for the Social Sciences (SPSS) software package (Version 20.0). Results: The mean, median, and standard deviation values were obtained for the percentage of dysfluencies (%SS) and frequency of CM and CS in Kannada-English bilingual children and adults who stutter for various parameters obtained through the MLF model. The inferential results indicated that %SS significantly varied between population (AWS vs CWS), languages (L1 vs L2), and tasks (GC vs NAR) but not across free (BIL) and bound (MK, ME) conditions. It was also found that the frequency of CM and CS patterns varies between CWS and AWS. The AWS had a lesser %SS but greater use of CS patterns than CWS, which is due to their excessive coping skills. The language mixing patterns were more observed in L1 than L2, and it was significant in most of the MLF parameters. However, there was a significantly higher (P<0.05) %SS in L2 than L1. The CS and CS patterns were more in conditions 1 and 3 than 2, which may be due to the higher proficiency of L2 than L1. Conclusion: The findings highlight the importance of assessing the CM and CS behaviors, their patterns, and the frequency of CM and CS between CWS and AWS on MLF parameters in two different tasks across three conditions. The results help us to understand CM and CS strategies in bilingual persons who stutter.

Keywords: bilinguals, code mixing, code switching, stuttering

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782 Beyond Sport: Understanding the Retirement Experiences and Support Needs of Retired Elite Athletes

Authors: Nadia Jurkovic, Sarven McLinton, Alyson Crozier, Amber Mosewich, Ed O'Connor

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Retiring from elite sport can have detrimental effects on the mental health and life satisfaction of retired elite athletes. To aid in this transition, sporting organisations use retirement interventions. The aim of this study is to understand the experience of elite sport retirement from a holistic perspective, exploring the experiences of retiring athletes, retired athletes, and sport support staff. A secondary aim is used to uncover any recommendations both retiring/retired athletes and sport support staff suggest towards improving retirement programs or interventions. A total of N=15 participants took part in semi-structured interviews to explore their experiences with sport retirement. Retiring and retired elite athletes were asked about how they felt during their transition into retirement, and sport support staff were asked about their experience working with retiring athletes. Data collection and iterative qualitative analysis are still ongoing; however, it is anticipated that the final key themes to emerge will include isolation, identity loss, and lack of support, with varying sub-themes such as organisational support and family support. Relationships across and within themes will be explored within the study. The anticipated findings present retiring from elite sports as a challenging life and career transition; however, current support and resources for elite athletes are not addressing the core difficulties experienced by retiring elite athletes. The findings of this study will inform future development of new co-designed elite sport retirement interventions.

Keywords: elite athlete, retired elite athlete, retirement interventions, transition into retirement, interviews

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781 Emotional Awareness and Working Memory as Predictive Factors for the Habitual Use of Cognitive Reappraisal among Adolescents

Authors: Yuri Kitahara

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Background: Cognitive reappraisal refers to an emotion regulation strategy in which one changes the interpretation of emotion-eliciting events. Numerous studies show that cognitive reappraisal is associated with mental health and better social functioning. However the examination of the predictive factors of adaptive emotion regulation remains as an issue. The present study examined the factors contributing to the habitual use of cognitive reappraisal, with a focus on emotional awareness and working memory. Methods: Data was collected from 30 junior high school students, using a Japanese version of the Emotion Regulation Questionnaire (ERQ), the Levels of Emotional Awareness Scale for Children (LEAS-C), and N-back task. Results: A positive correlation between emotional awareness and cognitive reappraisal was observed in the high-working-memory group (r = .54, p < .05), whereas no significant relationship was found in the low-working-memory group. In addition, the results of the analysis of variance (ANOVA) showed a significant interaction between emotional awareness and working memory capacity (F(1, 26) = 7.74, p < .05). Subsequent analysis of simple main effects confirmed that high working memory capacity significantly increases the use of cognitive reappraisal for high-emotional-awareness subjects, and significantly decreases the use of cognitive reappraisal for low-emotional-awareness subjects. Discussion: These results indicate that under the condition when one has an adequate ability for simultaneous processing of information, explicit understanding of emotion would contribute to adaptive cognitive emotion regulation. The findings are discussed along with neuroscientific claims.

Keywords: cognitive reappraisal, emotional awareness, emotion regulation, working memory

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780 Access to the Community and Needed Supports among People with Physical Disabilities Receiving Long-Term Services and Supports in the United States

Authors: Stephanie Giordano, Eric Lam, Rosa Plasencia

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An important piece of active aging is ensuring people have the right support to meet individual needs. Using NCI-AD data, we will look at measures of satisfaction with community access and needed services among people with physical disabilities receiving LTSS in the US. National Core Indicators—Aging and Disabilities (NCI-AD) is a voluntary effort by State Medicaid, aging, and disability agencies across the US to measure and track their own performance. NCI-AD uses a standardized survey – the Adult Consumer Survey (ACS), to hear directly from people receiving services about the quality of services and supports they receive. Data from the 2018-19 ACS found that compared to people without a physical disability, those with a physical disability were more likely to make choices about the services they receive, including when and how often they receive those services. Yet people with a physical disability were less likely to report they get enough assistance with everyday activities (e.g., shopping, housework, and taking medications) and self-care (e.g., dressing or bathing) and more likely to report that services and supports do not fully meet their needs and goals. A further breakdown by age shows that people 40-65 years old with a physical disability experienced even greater barriers to being as active in the community as they would like to be, indicating a need to better support people as they age with or into a disability. We will explore how these and other outcomes were affected by COVID-19, take a closer look at outcomes by demographics (e.g., race/ethnicity, gender, and mental health diagnoses) and discuss implications on the future needs of service systems.

Keywords: quality-of-life, long-term services and supports, person-centered, community

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779 International Retirement Migration of Westerners to Thailand: Well-Being and Future Migration Plans

Authors: Kanokwan Tangchitnusorn, Patcharawalai Wongboonsin

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Following the ‘Golden Age of Welfare’ which enabled post-war prosperity to European citizens in 1950s, the world has witnessed the increasing mobility across borders of older citizens of First World countries. Then, in 1990s, the international retirement migration (IRM) of older persons has become a prominent trend, in which, it requires the integration of several fields of knowledge to explain, i.e. migration studies, tourism studies, as well as, social gerontology. However, while the studies of the IRM to developed destinations in Europe (e.g. Spain, Malta, Portugal, Italy), and the IRM to developing countries like Mexico, Panama, and Morocco have been largely studied in recent decades due to their massive migration volume, the study of the IRM to remoter destinations has been far more relatively sparse and incomplete. Developing countries in Southeast Asia have noticed the increasing number of retired expats, particularly to Thailand, where the number of foreigners applying for retirement visa increased from 10,709 in 2005 to 60,046 in 2014. Additionally, it was evident that the majority of Thailand’s retirement visa applicants were Westerners, i.e. citizens of the United Kingdom, the United States, Germany, and the Nordic countries, respectively. As such trend just becoming popular in Thailand in recent decades, little is known about the IRM populations, their well-being, and their future migration plans. This study aimed to examine the subjective wellbeing or the self-evaluations of own well-being among Western retirees in Thailand, as well as, their future migration plans as whether they planned to stay here for life or otherwise. The author employed a mixed method to obtain both quantitative and qualitative data during October 2015 – May 2016, including 330 self-administered questionnaires (246 online and 84 hard-copied responses), and 21 in-depth interviews of the Western residents in Nan (2), Pattaya (4), and Chiang Mai (15). As derived from the integration of previous subjective well-being measurements (i.e. Personal Wellbeing Index (PWI), Global AgeWatch Index, and OECD guideline on measuring subjective wellbeing), this study would measure the subjective well-being of Western retirees in Thailand in 7 dimensions, including standard of living, health status, personal relationships, social connections, environmental quality, personal security and local infrastructure.

Keywords: international retirement migration, ageing, mobility, wellbeing, Western, Thailand

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778 Finding a Redefinition of the Relationship between Rural and Urban Knowledge

Authors: Bianca Maria Rulli, Lenny Valentino Schiaretti

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The considerable recent urbanization has increasingly sharpened environmental and social problems all over the world. During the recent years, many answers to the alarming attitudes in modern cities have emerged: a drastic reduction in the rate of growth is becoming essential for future generations and small scale economies are considered more adaptive and sustainable. According to the concept of degrowth, cities should consider surpassing the centralization of urban living by redefining the relationship between rural and urban knowledge; growing food in cities fundamentally contributes to the increase of social and ecological resilience. Through an innovative approach, this research combines the benefits of urban agriculture (increase of biological diversity, shorter and thus more efficient supply chains, food security) and temporary land use. They stimulate collaborative practices to satisfy the changing needs of communities and stakeholders. The concept proposes a coherent strategy to create a sustainable development of urban spaces, introducing a productive green-network to link specific areas in the city. By shifting the current relationship between architecture and landscape, the former process of ground consumption is deeply revised. Temporary modules can be used as concrete tools to create temporal areas of innovation, transforming vacant or marginal spaces into potential laboratories for the development of the city. The only permanent ground traces, such as foundations, are minimized in order to allow future land re-use. The aim is to describe a new mindset regarding the quality of space in the metropolis which allows, in a completely flexible way, to bring back the green and the urban farming into the cities. The wide possibilities of the research are analyzed in two different case-studies. The first is a regeneration/connection project designated for social housing, the second concerns the use of temporary modules to answer to the potential needs of social structures. The intention of the productive green-network is to link the different vacant spaces to each other as well as to the entire urban fabric. This also generates a potential improvement of the current situation of underprivileged and disadvantaged persons.

Keywords: degrowth, green network, land use, temporary building, urban farming

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777 Health Trajectory Clustering Using Deep Belief Networks

Authors: Farshid Hajati, Federico Girosi, Shima Ghassempour

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We present a Deep Belief Network (DBN) method for clustering health trajectories. Deep Belief Network (DBN) is a deep architecture that consists of a stack of Restricted Boltzmann Machines (RBM). In a deep architecture, each layer learns more complex features than the past layers. The proposed method depends on DBN in clustering without using back propagation learning algorithm. The proposed DBN has a better a performance compared to the deep neural network due the initialization of the connecting weights. We use Contrastive Divergence (CD) method for training the RBMs which increases the performance of the network. The performance of the proposed method is evaluated extensively on the Health and Retirement Study (HRS) database. The University of Michigan Health and Retirement Study (HRS) is a nationally representative longitudinal study that has surveyed more than 27,000 elderly and near-elderly Americans since its inception in 1992. Participants are interviewed every two years and they collect data on physical and mental health, insurance coverage, financial status, family support systems, labor market status, and retirement planning. The dataset is publicly available and we use the RAND HRS version L, which is easy to use and cleaned up version of the data. The size of sample data set is 268 and the length of the trajectories is equal to 10. The trajectories do not stop when the patient dies and represent 10 different interviews of live patients. Compared to the state-of-the-art benchmarks, the experimental results show the effectiveness and superiority of the proposed method in clustering health trajectories.

Keywords: health trajectory, clustering, deep learning, DBN

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776 Evaluation of the Surveillance System for Rift Valley Fever in Ruminants in Mauritania, 2019

Authors: Mohamed El Kory Yacoub, Ahmed Bezeid El Mamy Beyatt, Djibril Barry, Yanogo Pauline, Nicolas Meda

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Introduction: Rift Valley Fever is a zoonotic arbovirosis that severely affects ruminants, as well as humans. It causes abortions in pregnant females and deaths in young animals. The disease occurs during heavy rains followed by large numbers of mosquito vectors. The objective of this work is to evaluate the surveillance system for Rift Valley Fever. Methods: We conducted an evaluation of the Rift Valley Fiver surveillance system. Data were collected from the analysis of the national database of the Mauritanian Network of Animal Disease Epidemiological Surveillance at the Ministry of Rural Development, of RVF cases notified from the whole national territory, of questionnaires and interviews with all persons involved in RVF surveillance at the central level. The quality of the system was assessed by analyzing the quantitative attributes defined by the Centers for Disease Control and Prevention. Results: In 2019, 443 cases of RVF were notified by the surveillance system, of which 36 were positive. Among the notified cases of Rift Valley Fever, the 0- to the 3-year-old age group of small ruminants was the most represented with 49.21% of cases, followed by 33.33%, which was recorded in large ruminants in the 0 to 7-year-old age group, 11.11% of cases were older than seven years. The completeness of the data varied between 14.2% (age) and 100% (species). Most positive cases were recorded between October and November 2019 in seven different regions. Attribute analysis showed that 87% of the respondents were able to use the case definition well, and 78.8% said they were familiar with the reporting and feedback loop of the Rift Valley Fever data. 90.3% of the respondents found it easy, while 95% of them responded that it was easy for them to transmit their data to the next level. Conclusions: The epidemiological surveillance system for Rift Valley Fever in Mauritania is simple and representative. However, data quality, stability, and responsiveness are average, as the diagnosis of the disease requires laboratory confirmation and the average delay for this confirmation is long (13 days). Consequently, the lack of completeness of the recorded data and of description of cases in terms of time-place-animal, associated with the delay between the stages of the surveillance system can make prevention, early detection of epidemics, and the initiation of measures for an adequate response difficult.

Keywords: evaluation, epidemiological surveillance system, rift valley fever, mauritania, ruminants

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775 The Effect of Rowing Exercise on Elderly Health

Authors: Rachnavy Pornthep, Khaothin Thawichai

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The purpose of this paper was to investigate the effects of rowing ergometer exercise on older persons health. The subjects were divided into two groups. Group 1 was control group (10 male and 10 female) Group 2 was experimental group (10 male and 10 female). The time for study was 12 week. Group 1 engage in normal daily activities Group 2 Training with rowing machine for 20 minutes three days a week. The average age of the experimental group was 73.7 years old, mean weight 55.4 kg, height 154.8 cm in the control group, mean age was 74.95 years, mean weight 48.6 kg, mean height 153.85 cm. Physical fitness test composted of body size, flexibility, Strength, muscle endurance and cardiovascular endurance. The comparison between the experimental and control groups before training showed that body weight, body mass index and waist to hip ratio were significantly different. The flexibility, strength, cardiovascular endurance was not significantly different. The comparison between the control group and the experimental group after training showed that body weight, body mass index and cardiovascular endurance were significantly different. The ratio of waist to hips, flexibility and muscular strength were not significantly different. Comparison of physical fitness before training and after training of the control group showed that body weight, flexibility (Sit and reach) and muscular strength (30 – Second chair stand) were significantly different. Body mass index, waist to hip ratio, muscles flexible (Shoulder girdle flexibility), muscle strength (30 – Second arm curl) and the cardiovascular endurance were not significantly difference. Comparison of physical fitness before training and after training the experimental group showed that waist to hip ratio, flexibility (sit and reach) muscle strength (30 – Second chair stand), cardiovascular endurance (Standing leg raises - up to 2 minutes) were significantly different. The Body mass index and the flexibility (Shoulder girdle flexibility) no significantly difference. The study found that exercising with rowing machine can improve the physical fitness of the elderly, especially the cardiovascular endurance, corresponding with the past research on the effects of exercise in the elderly with different exercise such as cycling, treadmill, walking on the elliptical machine. Therefore, we can conclude that exercise by using rowing machine can improve cardiovascular system and flexibility in the elderly.

Keywords: effect, rowing, exercise, elderly

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774 Clinical Nursing Experience in Managing a Uterine Cancer Patient with Psychogenic Shock During the Extracorporeal Membrane Oxygenation Weaning Process

Authors: Syue-Wen Lin

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Objective: This article discusses the nursing experience of caring for a uterine cancer patient who experienced cardiogenic shock and was weaned off ECMO. The patient was placed on ECMO due to cardiogenic shock and initially struggled with anxiety caused by the physical discomfort from the disease and multiple medical devices, as well as the isolation in the ICU and restrictions on physical activity. Over time, the patient was able to wean off ECMO and perform daily activities and rehabilitation independently. Methods: The nursing period was from January 6 to January 9. Through observation, direct care, interviews, physical assessments, and case reviews, the intensive care team and bypass personnel conducted a comprehensive assessment using Gordon's 11 functional health patterns. The assessment identified three main nursing health problems: pain, anxiety, and decreased cardiac tissue perfusion. Results: The author consulted a psychologist to employ open communication techniques and empathetic care to build a trusting nurse-patient relationship. A patient-centered intensive cancer care plan was developed. Pain was assessed using a pain scale, and pain medications were adjusted in consultation with a pharmacist. Lavender essential oil therapy, light music, and pillows were used to distract and alleviate pain. The patient was encouraged to express feelings and family members were invited to increase visits and provide companionship to reduce the uncertainty caused by cancer and illness. Vital signs were closely monitored, and nursing interventions were provided to maintain adequate myocardial perfusion. Post-ECMO, the patient was encouraged to engage in rehabilitation and cardiopulmonary training. Conclusion: A key takeaway from the care process is the importance of observing not only the patient's vital signs but also their psychological state, especially when dealing with cancer patients on ECMO. The patient's greatest source of comfort was the presence of family, which helped alleviate anxiety. Healthcare providers play multiple critical roles as advocates, coordinators, educators, and counselors, listening to and accepting the patient’s emotional responses. The report aims to provide clinical cancer nurses with a reference to improve the quality of care and alleviate cancer-related discomfort.

Keywords: ECMO, uterine cancer, palliative care, Gordon's 11 functional health patterns

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773 Islamic Finance and Trade Promotion in the African Continental Free Trade Area: An Exploratory Study

Authors: Shehu Usman Rano Aliyu

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Despite the significance of finance as a major trade lubricant, evidence in the literature alludes to its scarcity and increasing cost, especially in developing countries where small and medium-scale enterprises are worst affected. The creation of the African Continental Free Trade Area (AFCFTA) in 2018, an organ of the African Union (AU), was meant to serve as a beacon for deepening economic integration through the removal of trade barriers inhibiting intra-African trade and movement of persons, among others. Hence, this research explores the role Islamic trade finance (ITF) could play in spurring intra- and inter-African trade. The study involves six countries; Egypt, Kenya, Malaysia, Morocco, Nigeria, and Saudi Arabia, and employs survey research, a total of 430 sample data, and SmartPLS Structural Equation Modelling (SEM) techniques in its analyses. We find strong evidence that Shari’ah, legal and regulatory compliance issues of the ITF institutions rhythm with the internal, national, and international compliance requirements equally as the unique instruments applied in ITF. In addition, ITF was found to be largely driven by global economic and political stability, socially responsible finance, ethical and moral considerations, risk-sharing, and resilience of the global Islamic finance industry. Further, SMEs, Governments, and Importers are the major beneficiary sectors. By and large, AfCFTA’s protocols align with the principles of ITF and are therefore suited for the proliferation of Islamic finance in the continent. And, while AML/KYC and BASEL requirements, compliance to AAOIFI and IFSB standards, paucity of Shari'ah experts, threats to global security, and increasing global economic uncertainty pose as major impediments, the future of ITF would be shaped by a greater need for institutional and policy support, global economic cum political stability, robust regulatory framework, and digital technology/fintech. The study calls for the licensing of more ITF institutions in the continent, participation of multilateral institutions in ITF, and harmonization of Shariah standards.

Keywords: AfCFTA, islamic trade finance, murabaha, letter of credit, forwarding

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772 Adaptation and Habituation to new Complete Dentures

Authors: Mohamed Khaled Ahmed Azzam

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Complete dentures, a non biological appliance, were and are still used to replace missing teeth and surrounding structures. Its main objectives are esthetics, speech, function and psychological state improvement. Dentists must realize that, just as dentate patients vary in their dental treatment complexity; edentulous patients also vary in the difficulty of their treatment plan. There are two main problems facing the removable Prosthodontist which harden his/her task how to please his patient with their new dentures being: Denture construction which however its fabrication is at the highest standards still is an unpleasant experience to all patients in the beginning and improves by time. This varies from one to several years according to the patient’s attitude, age, gender, socio-economical level and culture. The second problem of edentulous patients is both physical and psychological. Good interview, communication and note how patients present themselves for the concerns of their appearance, overall attitude and expectations concerning treatment is very important physically. On the psychological aspect patients have great difficulty to cope with new dentures to the extent of not using them at all. Hence their mind preparation should be commenced from day one by more than one method. This had a great impact on the acceptance which led to habituation to their dentures and patients were appreciative and pleased. In conclusion to successfully treat edentulous patients a great deal of information is required to complete a proper diagnosis, including patient mental attitude, past and present medical and dental conditions, and extra and intra-oral examinations. In addition to the clinical experience and skill of the whole dental team.

Keywords: complete dentures, edentulous patients, management of denture, psychological mind preparation

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771 Dimensional Investigation of Food Addiction in Individuals Who Have Undergone Bariatric Surgery

Authors: Ligia Florio, João Mauricio Castaldelli-Maia

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Background: Food addiction (FA) emerged in the 1990s as a possible contributor to the increasing prevalence of obesity and overweight, in conjunction with changing food environments and mental health conditions. However, FA is not yet listed as one of the disorders in the DSM-5 and/or the ICD-11. Although there are controversies and debates in the literature about the classification and construct of FA, the most common approach to access it is the use of a research tool - the Yale Food Addiction Scale (YFAS) - which approximates the concept of FA to the concept diagnosis of dependence on psychoactive substances. There is a need to explore the dimensional phenotypes accessed by YFAS in different population groups for a better understanding and scientific support of FA diagnoses. Methods: The primary objective of this project was to investigate the construct validity of the FA concept by mYFAS 2.0 in individuals who underwent bariatric surgery (n = 100) at the Hospital Estadual Mário Covas since 2011. Statistical analyzes were conducted using the STATA software. In this sense, structural or factor validity was the type of construct validity investigated using exploratory factor analysis (EFA) and item response theory (IRT) techniques. Results: EFA showed that the one-dimensional model was the most parsimonious. The IRT showed that all criteria contributed to the latent structure, presenting discrimination values greater than 0.5, with most presenting values greater than 2. Conclusion: This study reinforces a FA dimension in patients who underwent bariatric surgery. Within this dimension, we identified the most severe and discriminating criteria for the diagnosis of FA.

Keywords: obesity, food addiction, bariatric surgery, regain

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770 A Difficult Advertising: A Preventive Intervention for Siblings of Children with down Syndrome

Authors: Valentina Manna, Oscar Pisanti

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The term sibling has been adopted by Italian brothers and sisters of people with disabilities, to define themselves as a group with shared features. This choice is due to the importance of underlying the centrality of what being a brother/sister means to these people because of and beyond the disability. Being a sibling offers great opportunities to develop empathy and relational skills but it may also amplify the typical dynamics of fraternal relationships dealing with envy, rivalry and concern. This outlines a condition of potential developmental risk for the non-disabled sibling, being at the same time a great resource for the child with special needs, as actor of an intimate relationship usually lasting after that one with parents. However, young siblings are often unheeded in their needs for comprehension of disability and not considered as persons requiring attention themselves. Moreover, scholars have scarcely undertaken an exploration of siblings’ perspective as competent contributors for producing knowledge useful to the benefit of families with special needs children. This contribution describes a preventive intervention for young siblings (6 – 16 years) of children with Down syndrome, by means of a psychodynamic-oriented group where participants could communicate, explore and share their emotional experiences as siblings. Based on a participatory approach, the program represents an action-research project, involving siblings as key experts for our understanding of siblings’ lives. The initiative used social media and video technologies to rise children’s voice: as a final product, participants were involved in the realization of a video campaign –which they defined ‘a difficult advertising’– built on the insights generated by the program and addressed to other siblings to help them facing and recognizing resources and difficulties related to their status. The final video campaign realized by the participants summarizes the main themes emerged during the intervention; as revealed by a thematic analysis, they are related to the difficulty in feeling to have a personal identity, to face disability as a form of ‘untought known’ and to integrate ambivalent emotions. In conclusion, the group device revealed its efficacy as a preventive tool: it allowed participants to deeply reflect on their own experiences and to communicate them for the first time in a verbal and mentalized form.

Keywords: down syndrome, group, siblings, prevention

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769 Exam Stress and Emotional Eating Among Lebanese University Students: A Correlational Study

Authors: Marielle Mansour

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Background: Integrating university students into an academic environment can be intense, with significant intellectual and emotional challenges. Stress, particularly during exam periods, plays a crucial role in students' eating habits, often influencing their food choices through mechanisms such as emotional eating. Objective: This study aims to understand the impact of exam stress on emotional eating among university students in Lebanon, Methodology: A cross-sectional study was conducted among 700 students aged 18 to 25 years in Lebanon, using online questionnaires to assess perceived stress using the Perceived Stress Scale (PSS) and emotional eating behaviors with the Dutch Eating Behavior Questionnaire (DEBQ). Data was analyzed to identify correlations between stress and emotional eating. Results: A significant positive correlation was observed between levels of perceived stress and increased emotional eating, with marked differences depending on participants' gender and field of study. This trend highlights the concerning impact of academic stress on students' food choices, including an increased prevalence of emotional eating among women and those studying in demanding disciplines like health sciences and engineering. Conclusion: This research contributes to the understanding of the complex links between academic stress and emotional eating behaviors among university students in Lebanon. To improve the mental and physical health of students, it is essential to implement tailored educational and support initiatives aimed at reducing stress and promoting balanced dietary choices in learning environments.

Keywords: exam stress, emotional eating, university students, stress management, Lebanon

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768 The Nurse Practitioner’s Role Functions in Multi-Specialist Team When Caring for a Metastatic Colon Cancer Patient with Acute Intestinal Obstruction

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

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Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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