Search results for: narrative family therapy

Authors: Stefano A. Denes, Riccardo Tieghi, Giovanni Elia

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The buccal fat pad is a well-established tool in oral and maxillofacial surgery and its use has proved of value for the closure of oroantral communications. Oroantral communication may be a common complication after sequestrectomy in "Bisphosphonate-related osteonecrosis of the jaws". We report a clinical case of a 70-year-old female patient in bisphosphonate therapy presented with right maxillary sinusitis and oroantral communication after implants insertion. The buccal fat pad was used to close the defect. The case had an uneventful postoperative healing without dehiscence, infection and necrosis. We postulate that the primary closure of the site with buccal fat pad may ensure a sufficient blood supply and adequate protection for an effective bone-healing response to occur.

Keywords: buccal fat pad, oroantral communication, oral surgery, dehiscence

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Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

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Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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Authors: Mukesh K. Dwivedi, Rajeshwar N. Srivastava, Amit K. Bhagat, Saloni Raj

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Introduction: Management of Pressure Ulcer (PU) is an ongoing clinical challenge particularly in traumatic paraplegia patients in developing countries where socio economic conditions often dictate treatment modalities. When negative pressure wound therapy (NPWT) was introduced, there were a series of devices (V.A.C., KCI, San Antonio, TX) manufactured. These devices for NPWT are costly and hard to afford by patients in developing countries like India. Considering this limitation, this study was planned to design an RCT to compare NPWT by an indigenized locally constructed NPD and conventional gauze dressing for the treatment of PU. Material and Methods: This RCT (CTRI/2014/09/0050) was conducted in the Department of Orthopaedic Surgery at King George’s Medical University (KGMU), India. Thirty-four (34) subjects of traumatic paraplegia having PU of stage 3 or 4, were enrolled and randomized in two treatment groups (NPWT Group & Conventional dressing group). The outcome measures of this study were surface area and depth of PU, exudates, microorganisms and matrix metalloproteinase-8 (MMP-8) during 0 to 9 weeks follow-ups. Levels of MMP-8 were analyzed in the tissues of PU at week 0, 3, 6 and week 9 by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Significantly reduced length of PU in NPWT group was observed at week 6 (p=0.04) which further reduced at week 9 (p=0.001) as compared to conventionally treated group. Similarly significant reduction of width and depth of PU was observed in NPWT at week 9 (p<0.05). The exudate became significantly (p=0.001) lower in NPWT group as compared with conventionally treated group from 6th to 9th week. Clearance and conversion of slough into red granulation tissue was significantly higher in NPWT group (p=0.001). At week 9, the wound culture was negative in all the subjects of NPWT group, while it was positive in 10 (41⋅6%) subjects of conventional group. Significantly lower level of MMP-8 was observed in subjects of NPWT group at week 6 (0.006**), and continually more reduction was observed at week 9 (<0.0001**) as compared to the conventional group. Conclusion: NPWT by locally constructed NPD is better wound care procedure for management of PU. Our device gave similar results as commercially available devices. Reduction of level of MMP-8 and increased rate of healing was achieved by negative pressure wound therapy (NPWT) as compared to conventional dressing.

Keywords: NPWT, NPD, MMP8, ELISA

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Authors: Julie A. Carberry, Victor Maddalena

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Animal-Assisted Interventions (AAIs) have existed in various forms for centuries. In the past 30 years, there has been a dramatic increase in popularity. AAIs are now part of the lives of persons of all ages in many types of institutions. Anecdotal evidence of the benefits of AAIs have led to widespread adoption, yet there remains a lack of solid research base for support. The research question was, what are the lived experiences of AAI volunteer handlers are? An interpretive phenomenological methodology was used for this qualitative study. Data were collected from 1 - 2 hour-long semi-structured interviews and 1 observational field visit. All interviews were conducted, transcribed, and coded for themes by the principal investigator. Participants must have been an active St. John Ambulance Therapy Dog Program volunteer for a least one year. In total, 14 volunteer handlers, along with some of their dogs, were included. The St. John Ambulance is a not for profit organization that provides training and community services to Canadians. The Therapy Dog Program is 1 of the 4 nationally recognized core community service programs. The program incorporates dogs in the otherwise traditional therapeutic intervention of friendly visitation with clients. The lack of formal objectives and goals, and a trained therapist defines the program as an Animal-Assisted Activity (AAA), which is a type of AAI. Since the animals incorporated are dogs, the program is specifically a Canine-Assisted Activity (CAA), which is a type of Canine-Assisted Intervention (CAI). Six themes emerged from the analysis of the data: (a) a win-win-win situation for all parties involved – volunteer handlers, clients, and the dogs, (b) being on the other end of the leash: functions of the role of volunteer handler, (c) the importance of socialization: from spreading smiles to creating meaningful connections, (d) the role of the dog: initiating interaction and providing comfort, (e) an opportunity to feel good and destress, and (f) altruism versus personal rewards. Other insights were found regarding the program, clients, and staff. Possible implications from this research include increased organizational recruitment and retention of volunteer handlers and as well as increased support for CAAs and other CAIs that incorporate teams of volunteer handlers and their dogs. This support could, in turn, add overall support for the acceptance and broad implementation of AAIs as an alternative and or complementary non-pharmaceutical therapeutic intervention.

Keywords: animal-assisted activity, animal-assisted intervention, canine-assisted activity, canine-assisted intervention, perspective, qualitative, volunteer handler

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Authors: Chaiyaset Promsri

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Based on the synthesis of related literatures, this research found thirteen related dimensions that involved the development of natural disaster preparedness awareness including hazard knowledge, hazard attitude, training for disaster preparedness, rehearsal and practice for disaster preparedness, cultural development for preparedness, public relations and communication, storytelling, disaster awareness game, simulation, past experience to natural disaster, information sharing with family members, and commitment to the community (time of living).  The 40-item of natural disaster preparedness awareness questionnaire was developed based on these thirteen dimensions. Data were collected from 595 participants in Bangkok metropolitan and vicinity. Cronbach's alpha was used to examine the internal consistency for this instrument. Reliability coefficient was 97, which was highly acceptable.  Exploratory Factor Analysis where principal axis factor analysis was employed. The Kaiser-Meyer-Olkin index of sampling adequacy was .973, indicating that the data represented a homogeneous collection of variables suitable for factor analysis. Bartlett's test of Sphericity was significant for the sample as Chi-Square = 23168.657, df = 780, and p-value < .0001, which indicated that the set of correlations in the correlation matrix was significantly different and acceptable for utilizing EFA. Factor extraction was done to determine the number of factors by using principal component analysis and varimax.  The result revealed that four factors had Eigen value greater than 1 with more than 60% cumulative of variance. Factor #1 had Eigen value of 22.270, and factor loadings ranged from 0.626-0.760. This factor was named as "Knowledge and Attitude of Natural Disaster Preparedness".  Factor #2 had Eigen value of 2.491, and factor loadings ranged from 0.596-0.696. This factor was named as "Training and Development". Factor #3 had Eigen value of 1.821, and factor loadings ranged from 0.643-0.777. This factor was named as "Building Experiences about Disaster Preparedness".  Factor #4 had Eigen value of 1.365, and factor loadings ranged from 0.657-0.760. This was named as "Family and Community". The results of this study provided support for the reliability and construct validity of natural disaster preparedness awareness for utilizing with populations similar to sample employed.

Keywords: natural disaster, disaster preparedness, disaster awareness, Thai citizens

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Authors: Malvina Hoxha, Valerie Capra, Carola Buccellati, Angelo Sala, Clara Cena, Roberta Fruttero, Massimo Bertinaria, G. Enrico Rovati

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Today COXIBs are used in the treatment of arthritis and many other painful conditions in selected patients with high gastrointestinal risk and low CV risk. Previously we found a new mechanism of action of a traditional NSAID (diclofenac) and a COXIB (lumiracoxib) that possess weak competitive antagonism at the TP receptor. We hypothesize that modifying the structure of a known specific inhibitor of cyclooxygenase-2 (COXIB), so that it becomes also a more potent thromboxane antagonist will preserve the anti-inflammatory and gastrointestinal safety typical of COXIBs and prevent the cardiovascular risk associated with long term therapy.

Keywords: cyclooxygenase, inflammation, lumiracoxib, thromboxane A2

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Authors: Gali Pesin, Yuliya Lipshits-Braziler, Sima Amram-Vaknin, Moshe Tatar

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The present study introduces four different patterns of seeking and providing help online among adolescents: (I) ‘Transceivers’ - adolescents who both seek as well as provide help online; (II) ‘Receivers’ - adolescents who seek help online, yet don’t provide it; (III) ‘Transmitters’ - adolescents who provide help online, yet don’t seek it; and (IV) ‘Idles’ - adolescents who refrain from seeking and providing help online. The study examined differences in seeking and providing help online between possible combinations of the four patterns, as well as gender differences within each pattern. Data was collected from 528 adolescents in Israel (59% were girls). Findings revealed that Transceivers are the largest group (45%) in this study, with higher representation of girls (65%). These adolescents seek help mainly around social difficulties, and they turn to peers who are both known and unknown to them. In addition, their preferred way to seek and provide help is through social network sites. Moreover, they often accept and give others emotional support. Receivers are the smallest group (5%) in this study. They turn to both known and unknown professionals more often than to friends and family. In addition, they seek help mostly around health and nutrition issues, and they usually receive instrumental support. For Receivers, the most important factor for seeking help online is anonymity, and the least important factor is familiarity with the help giver. Transmitters represent 16% of the adolescents in this study, with a greater representation of boys (52%). Their main reason to refrain from seeking help online is self-reliance. Nevertheless, these adolescents provide help to others online, mainly to those known to them through posting or responding to posts on social network sites. Idles represent 34% of the adolescents in this study. They refrain from seeking help online mainly due to their preference to seek help face to face, and due to their lack of trust in the internet or those using it. Idles and Transmitters are willing to seek help online mostly from friends and family. In addition, they are willing seek help online mainly regarding questions concerning military or civil service. They consider the most important facilitators for seeking help online as confidentiality and reliability. The present study’s main contribution is exploring the role of providing online help in understanding the adolescent behavior of seeking help online. In addition, the results of the present study have practical implications for the work of mental health providers, such as counseling psychologists and online mental health support.

Keywords: adolescents, counseling, online help-seeking, online help-providing

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Authors: Beatriz Suárez López, Gabriela Forman

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Kombucha (a symbiotic culture of bacteria and yeast) produces material capable of acquiring multiple shapes and textures that change significantly under different environment or temperature variations (e.g., when it is exposed to wet conditions), properties that may be explored in the scenic industry. This paper presents an analysis of its specific characteristics, exploring them as a non-conventional material for arts and performance. Costume Design uses surfaces as a powerful way of expression to represent concepts and stories; it may apply the unique features of nano bacterial cellulose (NBC) as assets in this artistic context. A mix of qualitative and quantitative (interventionist) methodology approaches were used -review of relevant literature to deepen knowledge on the research topic (crossing bibliography from different fields of studies: Biology, Art, Costume Design, etc.); as well as descriptive methods: laboratorial experiments, document quantities, observation to identify material properties and possibilities used to express a multiple narrative ideas, concepts and feelings. The results confirmed that NBC is an interactive and versatile material viable to be used in an alternative scenic context; its unique aesthetic and performative qualities, which change in contact to moisture, is a resource that can be used to show a visual and poetic impact on stage.

Keywords: biotechnological materials, contemporary dance, costume design, nano bacterial cellulose, performing arts

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Authors: Zurina Shafii, Mohamed Obaidullah, Rochania Ayu Yunanda, Nor Farha Zubair

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Cooperative members (also known as user-owners) are responsible in running the cooperative businesses in order to improve their socio economic well-being. Cooperatives have always been recognized as a vehicle to elevate the standard of living of the poor and low-income earners by improving their ability to mobilize resources among the people within the urban and rural sectors of the population. To improve its performance and role, the cooperative should ensure the existence of its specific governance. Using narrative analysis and quasi-statistics, this paper describes the state of operation, growth and nature of products and services offered in Sakofah Savings Co-op (the largest Islamic cooperative in Krabi), Koperasi Muslimin Malaysia Berhad (KMMB) in Malaysia and KOSPIN Jasa Keuangan in Indonesia. Furthermore, it identifies and evaluates the current governance system in each cooperatives and proposes governance framework which may enhance the performance of the cooperatives. The paper, in turn discusses the challenges to cooperative growth and investment from the aspects of governance and monitoring, transparency and human capital. The paper will be useful for regulators and governance organs of cooperatives, namely Board of Members, Management and Shariah Committee in order for these parties to strengthen the governance within cooperatives to further grow this economic sector.

Keywords: Islamic cooperatives, governance, Shariah governance, case study

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Authors: A. Zuchowska, A. Buta, M. Mazurkiewicz-Pawlicka, A. Malolepszy, L. Stobinski, Z. Brzozka

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In recent years, graphene-based materials are finding more and more applications in biological science. As a thin, tough, transparent and chemically resistant materials, they appear to be a very good material for the production of implants and biosensors. Interest in graphene derivatives also resulted at the beginning of research about the possibility of their application in cancer therapy. Currently, the analysis of their potential use in photothermal therapy and as a drug carrier is mostly performed. Moreover, the direct anticancer properties of graphene-based materials are also tested. Nowadays, cytotoxic studies are conducted on in vitro cell culture in standard culture vessels (macroscale). However, in this type of cell culture, the cells grow on the synthetic surface in static conditions. For this reason, cell culture in macroscale does not reflect in vivo environment. The microfluidic systems, called Lab-on-a-chip, are proposed as a solution for improvement of cytotoxicity analysis of new compounds. Here, we present the evaluation of cytotoxic properties of graphene oxide (GO) on breast, liver and colon cancer cell line in a microfluidic system in two spatial models (2D and 3D). Before cell introduction, the microchambers surface was modified by the fibronectin (2D, monolayer) and poly(vinyl alcohol) (3D, spheroids) covering. After spheroid creation (3D) and cell attachment (2D, monolayer) the selected concentration of GO was introduced into microsystems. Then monolayer and spheroids viability/proliferation using alamarBlue® assay and standard microplate reader was checked for three days. Moreover, in every day of the culture, the morphological changes of cells were determined using microscopic analysis. Additionally, on the last day of the culture differential staining using Calcein AM and Propidium iodide were performed. We were able to note that the GO has an influence on all tested cell line viability in both monolayer and spheroid arrangement. We showed that GO caused higher viability/proliferation decrease for spheroids than a monolayer (this was observed for all tested cell lines). Higher cytotoxicity of GO on spheroid culture can be caused by different geometry of the microchambers for 2D and 3D cell cultures. Probably, GO was removed from the flat microchambers for 2D culture. Those results were also confirmed by differential staining. Comparing our results with the studies conducted in the macroscale, we also proved that the cytotoxic properties of GO are changed depending on the cell culture conditions (static/ flow).

Keywords: cytotoxicity, graphene oxide, monolayer, spheroid

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Authors: Ilse Gonzalez-Rivera, Rolando Diaz-Loving

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Family, and parents in particular, are the main agents of socialization of children since they transmit values, beliefs, and cultural norms based on their own guidelines, so that children acquire the knowledge on how to interact with others in terms of the interaction with their parents. One way to measure socialization parenting is through parenting styles. Parenting styles are the set of parental behaviors that have a direct effect on the development of specific behaviors of children. The ideal parenting style depends on the cultural characteristics where people develop. In Mexico, the hierarchical structure of the family is built on a model in which men are dominant over women and their power is legitimized. This research explores the effect of parenting styles and the culture of the ambivalent sexism in the Mexican population. 150 men and 150 women participated. The instrument of individualism-collectivism was used to measure culture; participants also answered the instrument of ambivalent sexism and the parenting styles questionnaire. Regression analyses were done using sexism as the dependent variable and individualism-collectivism and parenting styles as independent variables. In addition, an analysis of variance between parental styles and gender of the participants was performed. The results indicate that the permissive style and authoritarian style are predictors of ambivalent sexism and higher levels of collectivism predict higher levels of sexism in both men and women. It is also found that parents tend to use authoritarian parenting style with women and permissive style with males. These results confirm the findings of other studies that indicate that parenting is an important variable that influences the interaction of adults. On the other hand, the effect of collectivism on sexism may be related to the fact that gender Mexican rules are rigid and for people with higher levels of collectivism, the social rules are more important than individual interests. In conclusion, these results indicate that both culture and parenting styles contribute to the maintenance of the status quo and prejudice towards women. Therefore, it is necessary to create proposals that break with this cultural paradigm and to further develop democratic styles of parenting with the aim of reducing prejudice and the legitimization of gender roles.

Keywords: culture, gender, parenting style, sexism

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Authors: Mahsa Houshdar, Seyed Mehdi Samimi Ardestani , ُSeyed Saeed Sadr

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Introduction: Online Medicare is a method in which parts of a medical process - whether its diagnostics, monitoring or the treatment itself will be done by using online services. This system has been operated in one boy’s high school, one girl’s high school and one high school in deprived aria. Method: At the first step the students registered for using the system. It was not mandatory and not free. They participated in estimating depression scale, anxiety scale and clinical interview by online medical care system. During this estimation, we could find the existence and severity of depression and anxiety in each one of the participants, also we could find the consequent needs of each one, such as supportive therapy in mild depression or anxiety, need to visited by psychologist in moderate cases, need to visited by psychiatrist in moderate-severe cases, need to visited by psychiatrist and psychologist in severe cases and need to perform medical lab examination tests. The lab examination tests were performed on persons specified by the system. The lab examinations were included: serum level of vitamin D, serum level of vitamin B12, serum level of calcium, fasting blood sugar, HbA1c, thyroid function tests and CBC. All of the students were solely treated by vitamins or minerals therapy and/ or treatment of medical problem (such as hypothyroidism). After a few months, we came back to high schools and estimated the existence and severity of depression and anxiety in treated students. With comparing these results, the affectability of the system could be prof. Results: Totally, we operate this project in 1077 participants in 243 of participant, the lab examination test were performed. In girls high schools: the existence and severity of depression significantly deceased (P value= 0.018<0.05 & P value 0.004< 0.05), but results about anxiety was not significant. In boys high schools: the existence and severity of depression significantly decreased (P value= 0.023<0.05 & P value = 0.004< 0.05 & P value= 0.049< 0.05). In boys high schools: the existence and severity of anxiety significantly decreased (P value= 0.041<0.05 & P value = 0.046< 0.05 &) but in one high school results about anxiety was not significant. In high school in deprived area the students did not have any problem paying for participating in the project, but they could not pay for medical lab examination tests. Thus, operation of the system was not possible in deprived area without a sponsor. Conclusion: This online medical system was successful in creating medical and psychiatric profile without attending physician. It was successful in decreasing depression without using antidepressants, but it was partially successful in decreasing anxiety.

Keywords: depression, diabetes, online medicare, vitamin D deficiency

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Authors: Pablo Cid Galache, Laura Zamorano Bonilla

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Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is rela-ted to low insulin concentrations. Therefore is a complication mainly found in developing countries. The main clinical features are hepatomegaly, edema, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The MS incidence is de-creasing due to the new types of insulin and intensive glycemic control. Therefore is a rare diagnosis in Europe nowadays, being described mainly in developing countries or with so-cioeconomic limitations to guarantee an adequate management of diabetes. Edema secondary to fluid retention is a rare complication of insulin treatment, especially in young patients. Its severity is variable and is mainly related to the start of a proper treatment and the improvement in glycemic control after diagnosis or after periods of poor metabolic control. Edema resolves spontaneously without requiring treatment in most cases. The Pediatric Endocrinology Unit of Hospital Motril could diagnose a 14-year-old girl who presented very poor metabolic control during the last 3 years as a consequence of the socioeconomic conditions of the country of origin during the last years. Presents up to 4 admissions for ketoacidosis during the last 12 months. After the family moved to Spain our patient began to be followed up in our Hospital. Initially presented glycated hemoglobin figures of 11%. One week after the start of treatment, the patient was admitted in the emergency room due to the appearance of generalized edema and pain in the limbs. The main laboratory abnormalities include: blood glucose 225mg/dl; HbA1C 10.8% triglycerides 543 mg/dl, total cholesterol 339 mg/dl (LDL 225) GOT 124 U/l, GPT 89U/l. Abdominal ultrasound shows mild hepatomegaly and no signs of ascites were shown. The patient presented a progressive improvement with resolution of the edema and analitical abnormalities during the next two weeks. During admission, the family received diabetes education, achieving adequate glycemic control at discharge. Nowadays the patient has a good glycemic control having glycated hemoglobin levels around 7%.

Keywords: Mauriac, diabetes, complication, developing countries

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Authors: Amir Seyfoori, Ehsan Samiei, Mohsen Akbari

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The use of microtechnology for detection and high yield isolation of circulating tumor cells (CTCs) has shown enormous promise as an indication of clinical metastasis prognosis and cancer treatment monitoring. The Immunomagnetic assay has been also coupled to microtechnology to improve the selectivity and efficiency of the current methods of cancer biomarker isolation. In this way, generation and configuration of the local high gradient magnetic field play essential roles in such assay. Additionally, considering the intrinsic heterogeneity of cancer cells, real-time analysis of isolated cells is necessary to characterize their responses to therapy. Totally, on-chip isolation and monitoring of the specific tumor cells is considered as a pressing need in the way of modified cancer therapy. To address these challenges, we have developed a bi-layer magnetic-based microfluidic chip for enhanced CTC detection and capturing. Micromagnet arrays at the bottom layer of the chip were fabricated using a new method of magnetic nanoparticle paste deposition so that they were arranged at the center of the chain microchannel with the lowest fluid velocity zone. Breast cancer cells labelled with EPCAM-conjugated smart microgels were immobilized on the tip of the micromagnets with greater localized magnetic field and stronger cell-micromagnet interaction. Considering different magnetic nano-powder usage (MnFe2O4 & gamma-Fe2O3) and micromagnet shapes (ellipsoidal & arrow), the capture efficiency of the systems was adjusted while the higher CTC capture efficiency was acquired for MnFe2O4 arrow micromagnet as around 95.5%. As a proof of concept of on-chip tumor cell monitoring, magnetic smart microgels made of thermo-responsive poly N-isopropylacrylamide-co-acrylic acid (PNIPAM-AA) composition were used for both purposes of targeted cell capturing as well as cell monitoring using antibody conjugation and fluorescent dye loading at the same time. In this regard, magnetic microgels were successfully used as cell tracker after isolation process so that by raising the temperature up to 37⁰ C, they released the contained dye and stained the targeted cell just after capturing. This microfluidic device was able to provide a platform for detection, isolation and efficient real-time analysis of specific CTCs in the liquid biopsy of breast cancer patients.

Keywords: circulating tumor cells, microfluidic, immunomagnetic, cell isolation

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Authors: Yu-Mei Tseng, Chih-Chun Wu

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As information and communication technology (ICT) has become a part of people’s lives, most teenagers born after the 1980s and grew up in internet generation are called digital natives. Meanwhile, those teenagers’ parents are called digital immigrants. They need to keep learning new skills of ICT. This study investigated that high school students helped their parents set up social network services (SNS) and taught them how to use ICT. This study applied paper and pencil anonymous questionnaires that asked the ICT learning and ICT products using in high school students’ parents. The sample size was 2,621 high school students, including 1,360 (51.9%) males and 1,261 (48.1%) females. The sample was from 12 high school and vocational high school in central Taiwan. Results from paired sample t-tests demonstrated regardless genders, both male and female high school students help mothers set up Facebook and LINE more often than fathers. In addition, both male and female high school students taught mothers to use ICT more often than fathers. Meanwhile, both male and female high school students teach mothers to use SNS more often than fathers. The results showed that intergenerational ICT teaching occurred more often between mothers and her children than fathers. It could imply that mothers play a more important role in family ICT learning than fathers, or it could be that mothers need more help regarding ICT than fathers. As for gender differences, results from the independent t-tests showed that female high school students were more likely than male ones to help their parents setup Facebook and LINE. In addition, compared to male high school students, female ones were more likely to teach their parents to use smartphone, Facebook and LINE. However, no gender differences were detected in teaching mothers. The gender differences results suggested that female teenagers offer more helps to their parents regarding ICT learning than their male counterparts. As for area differences, results from the independent t-tests showed that the high school in remote area students were more likely than metropolitan ones to teach parents to use computer, search engine and download files of audio and video. The area differences results might indicate that remote area students were more likely to teach their parents how to use ICT. The results from this study encourage children to help and teach their parents with ICT products.

Keywords: adult ICT learning, family ICT learning, ICT learning, urban-rural gap

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Authors: Angela Maria Fenu

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The aim of this study was to better characterize the nature of word association responses in people with aphasia. The participants selected for the experimental group were 4 individuals with mild Broca’s aphasia. The control group consisted of 51 cognitively intact age- and gender-matched individuals. The participants were asked to perform a word association task in which they had to say the first word they thought of when hearing each cue. The cue words (n= 16) were the translation in Italian of the set of English cue words of a published study. The participants from the experimental group were administered the word association test every two weeks for a period of two months when they received speech-language therapy A combination of analytical approaches to measure the data was used. To analyse different patterns of word association responses in both groups, the nature of the relationship between the cue and the response was examined: responses were divided into five categories of association. To investigate the similarity between aphasic and non-aphasic subjects, the stereotypy of responses was examined.While certain stimulus words (nouns, adjectives) elicited responses from Broca’s aphasics that tended to resemble those made by non-aphasic subjects; others (adverbs, verbs) showed the tendency to elicit responses different from the ones given by normal subjects. This suggests that some mechanisms underlying certain types of associations are degraded in aphasics individuals, while others display little evidence of disruption. The high number of paradigmatic associations given in response to a noun or an adjective might imply that the mechanisms, largely semantic, underlying paradigmatic associations are relatively preserved in Broca’s aphasia, but it might also mean that some words are more easily processed depending on their grammatical class (nouns, adjectives). The most significant variation was noticed when the grammatical class of the cue word was an adverb. Unlike the normal individuals, the experimental subjects gave the most idiosyncratic associations, which are often produced when the attempt to give a paradigmatic response fails. In turn, the failure to retrieve paradigmatic responses when the cue is an adverb might suggest that Broca’s aphasics are more sensitive to this grammatical class.The findings from this study suggest that, from research on word associations in people with aphasia, important data can arise concerning the specific lexical retrieval impairments that characterize the different types of aphasia and the various treatments that might positively influence the kinds of word association responses affected by language disruption.

Keywords: aphasia therapy, clinical linguistics, word-association behaviour, mental lexicon

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Authors: C. Treadgold, S. Sivaraman

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The Starlight Children's Foundation (Starlight) is an Australian non-profit organisation that delivers programs, in partnership with health professionals, to support children, adolescents, and their families who are living with a serious illness. While supporting children and adolescents with life-limiting conditions has always been a feature of Starlight's work, providing a dedicated program, specifically targeting and meeting the needs of the paediatric palliative population, is a recent area of focus. Recognising the challenges in providing children’s palliative services, Starlight initiated a research and development project to better understand and meet the needs of this group. The aim was to create a program which enhances the wellbeing of children, adolescents, and their families receiving paediatric palliative care in their community through the provision of on-going, tailored, positive experiences or 'moments'. This paper will present the results of the formative evaluation of this unique program, highlighting the development processes and outcomes of the pilot. The pilot was designed using an innovation methodology, which included a number of research components. There was a strong belief that it needed to be delivered in partnership with a dedicated palliative care team, helping to ensure the best interests of the family were always represented. This resulted in Starlight collaborating with both the Victorian Paediatric Palliative Care Program (VPPCP) at the Royal Children's Hospital, Melbourne, and the Sydney Children's Hospital Network (SCHN) to pilot the 'Moments' program. As experts in 'positive disruption', with a long history of collaborating with health professionals, Starlight was well placed to deliver a program which helps children, adolescents, and their families to experience moments of joy, connection and achieve their own sense of accomplishment. Building on Starlight’s evidence-based approach and experience in creative service delivery, the program aims to use the power of 'positive disruption' to brighten the lives of this group and create important memories. The clinical and Starlight team members collaborate to ensure that the child and family are at the centre of the program. The design of each experience is specific to their needs and ensures the creation of positive memories and family connection. It aims for each moment to enhance quality of life. The partnership with the VPPCP and SCHN has allowed the program to reach families across metropolitan and regional locations. In late 2019 a formative evaluation of the pilot was conducted utilising both quantitative and qualitative methodologies to document both the delivery and outcomes of the program. Central to the evaluation was the interviews conducted with both clinical teams and families in order to gain a comprehensive understanding of the impact of and satisfaction with the program. The findings, which will be shared in this presentation, provide practical insight into the delivery of the program, the key elements for its success with families, and areas which could benefit from additional research and focus. It will use stories and case studies from the pilot to highlight the impact of the program and discuss what opportunities, challenges, and learnings emerged.

Keywords: children, families, memory making, pediatric palliative care, support

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Authors: Arefeh Hesaraki

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The application of photovoltaic-thermal hybrids (PVT), which delivers both electricity and heat simultaneously from the same system, has become more popular during the past few years. This study addresses techno-economic and environmental impacts assessment of photovoltaic/thermal systems combined with a ground-source heat pump (GSHP) for three single-family houses located in Stockholm, Sweden. Three case studies were: (1) A renovated building built in 1936, (2) A renovated building built in 1973, and (3) A new building built-in 2013. Two simulation programs of SimaPro 9.1 and IDA Indoor Climate and Energy 4.8 (IDA ICE) were applied to analyze environmental impacts and energy usage, respectively. The cost-effectiveness of the system was evaluated using net present value (NPV), internal rate of return (IRR), and discounted payback time (DPBT) methods. In addition to cost payback time, the studied PVT system was evaluated using the energy payback time (EPBT) method. EPBT presents the time that is needed for the installed system to generate the same amount of energy which was utilized during the whole lifecycle (fabrication, installation, transportation, and end-of-life) of the system itself. Energy calculation by IDA ICE showed that a 5 m² PVT was sufficient to create a balance between the maximum heat production and the domestic hot water consumption during the summer months for all three case studies. The techno-economic analysis revealed that combining a 5 m² PVT with GSHP in the second case study possess the smallest DPBT and the highest NPV and IRR among the three case studies. It means that DPBTs (IRR) were 10.8 years (6%), 12.6 years (4%), and 13.8 years (3%) for the second, first, and the third case study, respectively. Moreover, environmental assessment of embodied energy during cradle- to- grave life cycle of the studied PVT, including fabrication, delivery of energy and raw materials, manufacture process, installation, transportation, operation phase, and end of life, revealed approximately two years of EPBT in all cases.

Keywords: life-cycle cost, life-cycle assessment, photovoltaic/thermal, IDA ICE, net present value

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Authors: Latife Merve Oktay, Berrin Tugrul

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Hydroxytyrosol (HT) is a phenolic phytochemical molecule derived from the hydrolysis of oleuropein, which originates during the maturation of the olives. It has recently received particular attention because of its antioxidant, anti-proliferative, pro-apoptotic and anti-inflammatory activities. In this study, we investigated the cytotoxic and apoptotic effects of hydroxytyrosol and its effects on phosphatidylinositol 3-kinase/Akt (PI3K/Akt) and extracellular signal-regulated kinase 1/2 (ERK 1/2) signaling pathways in human ovarian cancer cell lines OVCAR-3 and MDAH-2774. XTT cell proliferation kit, Cell Death Detection Elisa Plus Kit (Roche) and Human Apoptosis Array (R&D Systems) were used to determine the cytotoxic and apoptotic effects of HT in OVCAR-3 and MDAH-2774 cell lines at 24, 48, 72, and 96 h. Effect of HT on PI3K/Akt and ERK 1/2 signaling pathways were investigated by using specific inhibitors of these pathways. IC50 values of HT were found to be 102.3 µM in MDAH-2774 cells at 72 h and 51.5 µM in OVCAR-3 cells at 96 h. Apoptotic effect of HT in MDAH-2774 cells was the highest at 50 µM at 72 h, and kept decreasing at 100 and 150 µM concentrations and was not seen at 200 µM and higher concentrations. Highest apoptotic effect was seen at 100 µM concentration in OVCAR-3 cells at 96 h, however apoptotic effect was decreased over 100 µM concentrations. According to antibody microarray results, HT increased the levels of pro-apoptotic molecules Bad, Bax, active caspase-3, Htra2/Omi by 2.0-, 1.4-, 1.2-, 4.2-fold, respectively and also increased the levels of pro-apoptotic death receptors TRAIL R1/DR4, TRAIL R2/DR5, FAS/TNFRSF6 by 2.1-, 1.7-, 1.6-fold, respectively, however, it decreased the level of Survivin by 1.6-fold which is one of the inhibitor of apoptosis protein (IAP) family in MDAH-2774 cells. In OVCAR-3 cells, HT decreased the levels of anti-apoptotic proteins Bcl-2, pro-caspase 3 by 3.1-, 8.2-fold, respectively and IAP family proteins CIAP-1, CIAP-2, XIAP, Livin, Survivin by 6.5-, 6.0-, 3.2-, 2.2-, 2.7-fold, respectively and increased the level of cytochrome-c by 1.2-fold. We have shown that HT shows its cytotoxic and apoptotic effect through inhibiting ERK 1/2 signaling pathway in both OVCAR-3 and MDAH-2774 cells. Further studies are needed to investigate molecular mechanisms and modulatory effects of hydroxytyrosol.

Keywords: apoptosis, cytotoxicity, hydroxytyrosol, ovarian cancer

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Authors: Sudkhanoung Ritruechai, Somrak Choovanichwong, Kruawon Tiengtom, Peanchanan Leeudomwong

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The purposes of this qualitative research were to study the recovery experience of people with bipolar disorder and also to propose a development approach to the Bipolar Friends Club. The participants were eight people with bipolar disorder for six to twenty years (four women and four men). They have been members of the Bipolar Friends Club for two to ten years. They have no mental symptoms in order to provide sufficient information about their recovery experiences and have returned to everyday life with their family, community, and work. The data were collected by doing an in-depth interview. Two interviews were done, each from 45-90 minutes and four to five weeks apart. The researcher sent the results of the preliminary data analysis to the participants two to three days beforehand. Confirmation of the results of the preliminary data analysis from the first interview was done at the second interview. The research study found that the participants had a positive experience of being a Bipolar Club member. The club continued its activities following Recovery Oriented Service: ROS to the participants. As a result, they recovered in eight areas as follows. 1) Intellectual: The wisdom of joining the group has brought knowledge and experiences from an exchange with others in self-care as well as a positive thinking in life. 2) Social: The participants have set up a group to take care of each other and to do activities which have brought warmth. Their social network which was normally little has also been increased. 3) Spiritual: The concept of religion has been used to lead the life of the participants. 4) Occupational: One participant is a student while the others do work. All of them have done well. 5) Environmental: The participants would be able to adapt to the environment and cope with their problems better. 6) Physical: Most female participants have difficulties with losing weight which leads them saying that they are ‘not fully recovered’. 7) Emotional: The participants feel calmer than before entering the club. They have also developed more tolerance to problems. 8) Financial: The participants would be able to control their spending by themselves and with the help of their family members. The people with bipolar disorder have suggested that the services of the club are perfect and should be continued. The results of the study encourage the Bipolar Friends Club, as well as other clubs/associations that support the recovery of patients. Consideration of the recovery has highlighted the need for ongoing and various life-enhancing programs for the caregivers and their loved ones with bipolar disorder. Then, they would be able to choose the program that suits their needs to improve their life.

Keywords: people with bipolar disorder, recovery, club, experience

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Authors: Sharon Millen, Sarah Miller, Laura Dunne, Clare McGeady, Laura Neeson

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This paper presents the findings from a randomised controlled trial (RCT) and process evaluation of the Lifestart parenting programme. Lifestart is a structured child-centred programme of information and practical activity for parents of children aged from birth to five years of age. It is delivered to parents in their own homes by trained, paid family visitors and it is offered to parents regardless of their social, economic or other circumstances. The RCT evaluated the effectiveness of the programme and the process evaluation documented programme delivery and included a qualitative exploration of parent and child outcomes. 424 parents and children participated in the RCT: 216 in the intervention group and 208 in the control group across the island of Ireland. Parent outcomes included: parental knowledge of child development, parental efficacy, stress, social support, parenting skills and embeddedness in the community. Child outcomes included cognitive, language and motor development and social-emotional and behavioural development. Both groups were tested at baseline (when children were less than 1 year old), mid-point (aged 3) and at post-test (aged 5). Data were collected during a home visit, which took two hours. The process evaluation consisted of interviews with parents (n=16 at baseline and end-point), and focus groups with Lifestart Coordinators (n=9) and Family Visitors (n=24). Quantitative findings from the RCT indicated that, compared to the control group, parents who received the Lifestart programme reported reduced parenting-related stress, increased knowledge of their child’s development, and improved confidence in their parenting role. These changes were statistically significant and consistent with the hypothesised pathway of change depicted in the logic model. There was no evidence of any change in parents’ embeddedness in the community. Although four of the five child outcomes showed small positive change for children who took part in the programme, these were not statistically significant and there is no evidence that the programme improves child cognitive and non-cognitive skills by immediate post-test. The qualitative process evaluation highlighted important challenges related to conducting trials of this magnitude and design in the general population. Parents reported that a key incentive to take part in study was receiving feedback from the developmental assessment, which formed part of the data collection. This highlights the potential importance of appropriate incentives in relation to recruitment and retention of participants. The interviews with intervention parents indicated that one of the first changes they experienced as a result of the Lifestart programme was increased knowledge and confidence in their parenting ability. The outcomes and pathways perceived by parents and described in the interviews are also consistent with the findings of the RCT and the theory of change underpinning the programme. This hypothesises that improvement in parental outcomes, arising as a consequence of the programme, mediate the change in child outcomes. Parents receiving the Lifestart programme reported great satisfaction with and commitment to the programme, with the role of the Family Visitor being identified as one of the key components of the programme.

Keywords: parent-child relationship, parental self-efficacy, parental stress, school readiness

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Authors: Min Ju Kim, Beom Jin Park, Deuk Jae Sung, Na Yeon Han, Kichoon Sim

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Purpose: The purpose of this study is to determine the significant magnetic resonance (MR) imaging factors of lateral pelvic lymph node (LPLN) on the assessment of survival outcomes of neoadjuvant combined chemotherapy and radiation therapy (CRT) in patients with mid/low rectal cancer. Materials and Methods: The institutional review board approved this retrospective study of 63 patients with mid/low rectal cancer who underwent MR before and after CRT and patient consent was not required. Surgery performed within 4 weeks after CRT. The location of LPLNs was divided into following four groups; 1) common iliac, 2) external iliac, 3) obturator, and 4) internal iliac lymph nodes. The short and long axis diameters, numbers, shape (ovoid vs round), signal intensity (homogenous vs heterogenous), margin (smooth vs irregular), and diffusion-weighted restriction of LPLN were analyzed on pre- and post-CRT images. For treatment response using size, lymph node groups were defined as group 1) short axis diameter ≤ 5mm on both MR, group 2) > 5mm change into ≤ 5mm after CRT, and group 3) persistent size > 5mm before and after CRT. Clinical findings were also evaluated. The disease-free survival and overall survival rate were evaluated and the risk factors for survival outcomes were analyzed using cox regression analysis. Results: Patients in the group 3 (persistent size >5mm) showed significantly lower survival rates than the group 1 and 2 (Disease-free survival rates of 36.1% and 78.8, 88.8%, p < 0.001). The size response (group 1-3), multiplicity of LPLN, the level of carcinoembryonic antigen (CEA), patient’s age, T and N stage, vessel invasion, perineural invasion were significant factors affecting disease-free survival rate or overall survival rate using univariate analysis (p < 0.05). The persistent size (group 3) and multiplicity of LPLN were independent risk factors among MR imaging features influencing disease-free survival rate (HR = 10.087, p < 0.05; HR = 4.808, p < 0.05). Perineural invasion and T stage were shown as independent histologic risk factors (HR = 16.594, p < 0.05; HR = 15.891, p < 0.05). Conclusion: The persistent size greater than 5mm and multiplicity of LPLN on both pre- and post-MR after CRT were significant MR factors affecting survival outcomes in the patients with mid/low rectal cancer.

Keywords: rectal cancer, MRI, lymph node, combined chemoradiotherapy

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Authors: Steven D. Capener

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The 1997 Asian financial crisis was a watershed event in Korea as it necessitated changes that begin an unravelling of many of the norms and traditions that had served to underpin society. Divorce skyrocketed; the era of lifetime employment was over; women came out the home to become, in many cases, the main breadwinners; competitive forces were exacerbated; and traditional sources of authority began to crumble. All of these changes weekend the power to structure human relations of the Confucian Three Bonds and Five Relationships (삼강오륜). Since then, this “de-confucianization” has only become more pronounced with women increasingly refusing to marry, partly in protest to what they perceive as entrenched gender inequality, married couples eschewing childbirth resulting in the lowest birthrate in the world, and diminishing inheritances eroding the traditionally strong sense of filial piety (효) of children toward parents. The result of all this can be seen in the continued weakening or outright crumbling of the hierarchies codified in the Three Bonds and Five Relationship, which have served as a social template in Korea for centuries. In his 2004 work “Oppa Came Back,” writer Kim Yong Ha depicts what he apparently sees as the “post-Confucian” family in a wickedly funny portrayal of what Korean society could look like if traditional bulwarks of prescriptive values suddenly collapse and are not replaced with tenable alternatives. In the short story, Kim subverts all the traditional hierarchies while leaving the desire to dominate these hierarchies intact. This produces the picture of a Korean family governed by the new values of money and physical power. After lying out what can be identified as major cultural changes in what could be called “traditional” society,” the article uses a close reading of Kim’s story for its implications regarding a possible new, dysfunctional version of Korean society. It seems apparent that Kim’s story is a cautionary tale of the pitfalls that lie athwart the late-modern Korean landscape. These changes have important implications in the areas of education and socio-political philosophy. The conclusion focuses on possible alternatives to this post-Confucian conundrum.

Keywords: post-confucian, three bonds and five relationships, traditional society, hierarchies

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Authors: Riham Debian

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This paper deals with the translational mystic in Arabic aesthetics and their linguistic and narrative revelation and mediation across textual spaces. The paper particularly engages with the nature of the Egyptian Sufi Madad, its relation to spaces/places, its intergenerational and intertextual manifestations, and its intersection with questions of identity—the historical spaces and geographical places one inhabits and embodies. Opening a repertoire between contextualized stylistics and poetics semiology (Boise-Bier2011; Jackobson 1960), the paper reads in al-Ghitany’s Kitab al-Tagiliat (The Book of Revelation1983), Bassiouny’s Sabil Al-Ghareq (2018) and its translation (Fountain of the Drowning2022). The paper examines the stylistic and poetical encoding and recoding of the Sufi Madads from Ghitany to Bassiouny and their entanglement in the question of Egyptian identity-politics through the embodiment of historical places and geographical spaces. The paper argues for the intergenerational intertextuality of Arabic aesthetics that stylistically and poetically enacts the mysticism of Sufi Madad through historical and geographical semioticization of the Egyptian character continuity across time and space. Both Ghitany and Bassiouny engage with the historical novel as a form of delivery of their Egyptian mystical relation with time and place. Both novelist-historians are involved with the question of place and the life-worlds that spaces generate across time and gender.

Keywords: intertextuality, interdiscusivity, madad, egyptian identity

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Authors: Luyin Liang

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Although sibling relationship has been viewed as one of the most important family relationships that significantly impacted on the quality of life of both adults with Intellectual Disability (AWID) and their brothers/sisters, very few research have been done to investigate this relationship in China. This study investigated Chinese siblings of AWID’s relational motivations in sibling relationship and their determining factors. Quantitative research method has been adopted and 284 samples were recruited in this study. Siblings of AWID’s two types of relational motivations, including obligatory motivations and discretionary motivations were examined. Their emotional closeness, senses of responsibility, experiences of ID stigma, and expectancy of self-reward in sibling relationship were measured by validated scales. Personal, and familial-social demographic characteristics were also investigated. Linear correlation test and standard multiple regression analysis were the major statistical methods that have been used to analyze the data. The findings of this study showed that all the measured factors, including siblings of AWID’s emotional closeness, their senses of responsibility, experiences of ID stigma, and self-reward expectations had significant relationships with their both types of motivations. However, when these factors were grouped together to measure each type of these motivations, the prediction results were varied. The order of factors that best predict siblings of AWID’s obligatory motivations was: their senses of responsibility, emotional closeness, experiences of ID stigma, and their expectancy of self-reward, whereas the order of these factors that best determine siblings of AWID’s discretionary motivations was: their self-reward expectations, experiences of ID stigma, senses of responsibility, and emotional closeness. Among different demographic characteristics, AWID’s disability condition, their siblings’ age, gender, marital status, number of children, both siblings’ living arrangements and family financial status were found to have significant impacts on siblings of AWID’s both types of motivations in sibling relationship. The results of this study could enhance social work practitioners’ understandings about the needs and challenges of siblings of AWID. Suggestions on advocacies for policy changes and services improvements for these siblings were discussed in this study.

Keywords: sibling relationship, intellectual disability, adults, China

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Authors: Damian Winczewski

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Carl von Clausewitz’s political theory of war was criticized in the 20th century in several ways. It was also the source of many disagreements over readings of its most popular theses. Among them, the reflections of thinkers categorized as part of the broader postmodern current stand out, such as Michael Foucault and his successors, who presented a nuanced and critical approach to strategy theory. Foucault viewed it as part of a broader political–legal discourse of sovereignty rooted in the Middle Ages, which underlies modern biopower. Clausewitz’s theory of strategy underpinned a new humanist discourse rationalizing the phenomenon of war while, in a methodological sense, becoming an epistemic model of how Foucault conceived power strategy. Foucault’s contemporary commentators try to develop his position by arguing the analogy between the discourse prevailing in Clausewitz’s time and the contemporary neoliberal discourse and technological revolution on the battlefield, which create a new order of power. Meanwhile, they recognize that the modern development of strategy was to make Clausewitz’s understanding of war obsolete. However, postmodernists focusing on showy stylistics in their assessments rely on a mythologized narrative about Clausewitz, reducing his theories to a discourse of war as a way for nation-states to conduct foreign policy. In this article, Clausewitz shows that his theory goes much deeper and provides a critical perspective on the relationship between war and politics. The dialectical structure makes it possible to understand war as a historically variable but constantly policy-dependent phenomenon.

Keywords: Clausewitz, Foucault, Virilio, postmodernism, war and politics, power

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Authors: Gina Longo

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Social media, internet technology, and affordable travel have created avenues like tourism and internet chatrooms for Western women to meet foreign partners without paid, third-party intermediaries in regions like the Middle East/North Africa (MENA) and Sub-Saharan Africa (SSA), where men from mid-level developing countries meet and marry Western women and try to relocate. Foreign nationals who marry U.S. citizens have an expedited track to naturalization. U.S. immigration officials require that “green card” petitioning couples demonstrate that their relationships are “valid and subsisting” (i.e., for love) and not fraudulent (i.e., for immigration papers). These requirements are ostensibly gender- and racially-neutral, but migration itself is not; black and white women petitioners who seek partners from these regions and solicit advice from similar others about the potential obstacles to their petitions’ success online. Using an online ethnography and textual analysis of conversation threads on a large on-line immigration forum where U.S. petitioners exchange such information, this study examines how gendered and racialized standards of legitimacy are applied to family and sexuality and used discursively online among women petitioners differently to achieve “genuineness” and define “red flags” indicating potential marriage fraud. This paper argues that forum-women members police immigration requests even before cases reach an immigration officer, and use this social media platform to reconstruct gendered and racialized hierarchies of U.S. citizenship. Women petitioners use the formal criteria of U.S. immigration in ways that reveal gender and racial ideologies, expectations for conformity to a gendered hegemonic family ideal, and policing of women’s sexual agency, fertility, and desirability. These intersectional norms shape their online discussions about the suitability of marriages and of the migration of non-citizen male partners of color to the United States.

Keywords: marriage fraud, migration, online forums, women

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Authors: Salam N. Abdo, Orien L. Tulp, George P. Einstein

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The purpose of this exploratory study was to gather the insights into psoriasis etiology, treatment, and patient experience, for developing psoriasis and psoriatic arthritis diagnostic test. Data collection methods consisted of a comprehensive meta-analysis of relevant studies and psoriasis patient survey. Established meta-analysis guidelines were used for the selection and qualitative comparative analysis of psoriasis and psoriatic arthritis research studies. Only studies that clearly discussed psoriasis etiology, treatment, and patient experience were reviewed and analyzed, to establish a qualitative data base for the study. Using the insights gained from meta-analysis, an existing psoriasis patient survey was modified and administered to collect additional data as well as triangulate the results. The hypothesis is that specific types of psoriatic disease have specific etiology and pathophysiologic pattern. The following etiology categories were identified: bacterial, environmental/microbial, genetic, immune, infectious, trauma/stress, and viral. Additional results, obtained from meta-analysis and confirmed by patient survey, were the common age of onset (early to mid-20s) and type of psoriasis (plaque; mild; symmetrical; scalp, chest, and extremities, specifically elbows and knees). Almost 70% of patients reported no prescription drug use due to severe side effects and prohibitive cost. These results will guide the development of psoriasis and psoriatic arthritis diagnostic test. The significant number of medical publications classified psoriatic arthritis disease as inflammatory of an unknown etiology. Thus numerous meta-analyses struggle to report any meaningful conclusions since no definitive results have been reported to date. Therefore, return to the basics is an essential step to any future meaningful results. To date, medical literature supports the fact that psoriatic disease in its current classification could be misidentifying subcategories, which in turn hinders the success of studies conducted to date. Moreover, there has been an enormous commercial support to pursue various immune-modulation therapies, thus following a narrow hypothesis/mechanism of action that is yet to yield resolution of disease state. Recurrence and complications may be considered unacceptable in a significant number of these studies. The aim of the ongoing study is to focus on a narrow subgroup of patient population, as identified by this exploratory study via meta-analysis and patient survey, and conduct an exhaustive work up, aiming at mechanism of action and causality before proposing a cure or therapeutic modality. Remission in psoriasis has been achieved and documented in medical literature, such as immune-modulation, phototherapy, various over-the-counter agents, including salts and tar. However, there is no psoriasis and psoriatic arthritis diagnostic test to date, to guide the diagnosis and treatment of this debilitating and, thus far, incurable disease. Because psoriasis affects approximately 2% of population, the results of this study may affect the treatment and improve the quality of life of a significant number of psoriasis patients, potentially millions of patients in the United States alone and many more millions worldwide.

Keywords: biologics, early diagnosis, etiology, immune disease, immune modulation therapy, inflammation skin disorder, phototherapy, plaque psoriasis, psoriasis, psoriasis classification, psoriasis disease marker, psoriasis diagnostic test, psoriasis marker, psoriasis mechanism of action, psoriasis treatment, psoriatic arthritis, psoriatic disease, psoriatic disease marker, psoriatic patient experience, psoriatic patient quality of life, remission, salt therapy, targeted immune therapy

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Authors: Laura Piedra-Muñoz, Ángeles Godoy-Durán, Emilio Galdeano-Gómez, Juan C. Pérez-Mesa

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The current agricultural system in some arid and semi-arid areas is not sustainable in the long term. In southeast Spain, groundwater is the main water source and is overexploited, while alternatives like desalination are still limited. The Water Plan for the Mediterranean Basins 2015-2020 indicates a global deficit of 73.42 hm3 and an overexploitation of the aquifers of 205.58hm3. In order to solve this serious problem, two major actions can be taken: increasing available water, and/or improving the efficiency of its use. This study focuses on the latter. The main aim of this study is to present the major factors related to water usage efficiency in farming. It focuses on Almería province, southeast Spain, one of the most arid areas of the country, and in particular on family farms as the main direct managers of water use in this zone. Many of these farms are among the most water efficient in Spanish agriculture, but this efficiency is not generalized throughout the sector. This work conducts a comprehensive assessment of water performance in this area, using on-farm water-use, structural, socio-economic and environmental information. Two statistical techniques are used: descriptive analysis and cluster analysis. Thus, two groups are identified: the least and the most efficient farms regarding water usage. By analyzing both the common characteristics within each group and the differences between the groups with a one-way ANOVA analysis, several conclusions can be reached. The main differences between the two clusters center on the extent to which innovation and new technologies are used in irrigation. The most water efficient farms are characterized by more educated farmers, a greater degree of innovation, new irrigation technology, specialized production and awareness of water issues and environmental sustainability. The research shows that better practices and policies can have a substantial impact on achieving a more sustainable and efficient use of water. The findings of this study can be extended to farms in similar arid and semi-arid areas and contribute to foster appropriate policies to improve the efficiency of water usage in the agricultural sector.

Keywords: cluster analysis, family farms, Spain, water-use efficiency

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Authors: Md. Samsuddin Ansari, Ashish Arora

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Every year 10 million people fall ill with one of the oldest diseases known as tuberculosis, caused by Mycobacterium tuberculosis. The success of M. tuberculosis as a pathogen is because of its ability to persist in host tissues. Multidrug resistance (MDR) mycobacteria cases increase every day, which is associated with efflux pumps controlled at the level of transcription. The transcription regulators of MDR transporters in bacteria belong to one of the following four regulatory protein families: AraC, MarR, MerR, and TetR. Phenolic acid decarboxylase repressor (PadR), like a family of transcription regulators, is closely related to the MarR family. Phenolic acid decarboxylase repressor (PadR) was first identified as a transcription factor involved in the regulation of phenolic acid stress response in various microorganisms (including Mycobacterium tuberculosis H37Rv). Recently research has shown that the PadR family transcription factors are global, multifunction transcription regulators. Rv0047c is a PadR subfamily-1 protein. We are exploring the biophysical and structural characterization of Rv0047c. The Rv0047 gene was amplified by PCR using the primers containing EcoRI and HindIII restriction enzyme sites cloned in pET-NH6 vector and overexpressed in DH5α and BL21 (λDE3) cells of E. coli following purification with Ni2+-NTA column and size exclusion chromatography. We did DSC to know the thermal stability; the Tm (transition temperature) of protein is 55.29ºC, and ΔH (enthalpy change) of 6.92 kcal/mol. Circular dichroism to know the secondary structure and conformation and fluorescence spectroscopy for tertiary structure study of protein. To understand the effect of pH on the structure, function, and stability of Rv0047c we employed spectroscopy techniques such as circular dichroism, fluorescence, and absorbance measurements in a wide range of pH (from pH-2.0 to pH-12). At low and high pH, it shows drastic changes in the secondary and tertiary structure of the protein. EMSA studies showed the specific binding of Rv0047c with its own 30-bp promoter region. To determine the effect of complex formation on the secondary structure of Rv0047c, we examined the CD spectra of the complex of Rv0047c with promoter DNA of rv0047. The functional role of Rv0047c was characterized by over-expressing the Rv0047c gene under the control of hsp60 promoter in Mycobacterium tuberculosis H37Rv. We have predicted the three-dimensional structure of Rv0047c using the Swiss Model and Modeller, with validity checked by the Ramachandra plot. We did molecular docking of Rv0047c with dnaA, through PatchDock following refinement through FireDock. Through this, it is possible to easily identify the binding hot-stop of the receptor molecule with that of the ligand, the nature of the interface itself, and the conformational change undergone by the protein pattern. We are using X-crystallography to unravel the structure of Rv0047c. Overall the studies show that Rv0047c may have transcription regulation along with providing an insight into the activity of Rv0047c in the pH range of subcellular environment and helps to understand the protein-protein interaction, a novel target to kill dormant bacteria and potential strategy for tuberculosis control.

Keywords: mycobacterium tuberculosis, phenolic acid decarboxylase repressor, Rv0047c, Circular dichroism, fluorescence spectroscopy, docking, protein-protein interaction

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