Search results for: cognitive pain modulation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3401

Search results for: cognitive pain modulation

1031 Narrative Inquiry into Teachers’ Experiences of Empathy in English Language Teaching

Authors: Yao Chen

Abstract:

Empathy is crucial for teachers working with teenagers in secondary school. Despite that, little attention was paid to English language teachers’ experiences of empathy in class. Empathy contains cognitive, emotional, and behavioral components that are manifested in the teaching practice. The qualitative study focused on how Chinese ELT teachers expressed empathy in interaction with students in public high schools and private institutions and what factors might lead them to show empathy in different ways. Four participants were invited to attend the individual interviews to share their stories about their empathic experiences. Classroom observation was conducted to investigate teachers’ language use in teaching and non-verbal communication with students to witness their behavior of expressing empathy. Through thematic analysis, three main themes relevant to different types of empathy in teachers’ interaction with students were generated: 1) perspective taking, 2) emotional connections, 3) action taking. Based on the participants’ statements of their personal experiences, the discussion concluded the reasons for their differences in expressing empathy. The result underlined the significance of the role of empathy in building a rapport with students and motivating their language learning. Further implications for the role of empathy in ELT teachers’ professional development are also discussed.

Keywords: teacher empathy, experiences, interaction with students, ELT class

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1030 Combine Resection of Talocalcaneal Tarsal Coalition and Calcaneal Lengthening Osteotomy. Short-to-Intermediate Term Results

Authors: Naum Simanovsky, Vladimir Goldman, Michael Zaidman

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Background: The optimal algorithm for the management of symptomatic tarsal coalition is still under discussion in pediatric literature. It's debatable what surgical steps are essential to achieve the best outcome. Method: The investigators retrospectively reviewed the records of twelve patients with symptomatic tarsal coalition that were treated operatively between 2017 and 2019. Only painful flat feet were operated. Two patients were excluded from the study due to lack of sufficient follow-up. Ten of eleven feet were treated with the combination of calcaneal lengthening osteotomy (CLO) and resection of coalition (RC). Only one foot was operated with CLO alone. In half of our patients, Achilles lengthening was performed. For two children, medial plication was added. Short leg cast was applied to all children for 6-8 weeks, and soft shoe insoles for medial arch support were prescribed after. Demographic, clinical, and radiographic records were reviewed. The outcome was evaluated using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results: There were seven boys and three girls. The mean age at the time of surgery was 13.9 (range 12 to 17) years, and the mean follow-up was 18 (range 8 to 34) months. The early complications included one superficial wound infection and dehiscence. Late complication includes two children with residual forefoot supination. None of our patients required additional operations during the follow-up period. All feet achieved complete deformity correction or dramatic improvement. In the last follow-up, seven feet were painless, and four children had some mild pain after intensive activities. All feet achieved excellent and good scoring on AOFAS. Conclusions: Many patients with talocalcaneal coalition also have rigid or stiff, painful, flat feet. For these patients, the resection of coalition with concomitant CLO can be safely recommended.

Keywords: Tarsal coalition, calcaneal lengthening osteotomy., flat foot, coalition resection

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1029 Efficacy of Topical Ectoin Therapy for Acute Radiodermatitis Associated with Breast Cancer Radiotherapy: A Randomized Controlled Study

Authors: Nagwa E. Abd Elazim, Maha S. El-naggar, Rania H. Mohamed, Sara M. Awad

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Background: Radiodermatitis is a common side effect of radiation therapy for breast cancer. However, there is no current consensus about effective standard therapy for the prevention and management of radiation dermatitis. Topical ectoine has demonstrated efficacy in the treatment of atopic dermatitis owing to its anti-inflammatory activity. Objective: To evaluate the efficacy of topical ectoine in comparison to traditional topical dexpanthenol treatment in the management of acute radiodermatitis in breast cancer patients undergoing adjuvant radiotherapy. Methods: Fifty patients were randomized to use either dexpanthenol 0.5% cream (25 patients), or ectoin 7% cream (25 patients), applied twice daily to the irradiated area during the radiation period and continued for 2 weeks after cessation of radiotherapy. Assessment of radiation skin toxicity using Common Terminology Criteria of Adverse Events (CTCAE) v4.0, radiation-associated symptoms, and adverse events were undertaken weekly during radiotherapy and 2 weeks after the end of radiotherapy. Results: Topical ectoine showed some clinical benefit over dexpanthenol, as shown by delayed time to onset (at week 3 versus week 2, respectively) and larger number of patients who reached grade 0 at the end of treatment (64% vs. 48%, respectively). The clinical symptoms of pain (p = 0.003) and itching (p = 0.001) attributable to radiation were less pronounced with ectoine than with dexpanthenol. Burning and hyperpigmentation were the most common side effects with ectoine. However, no significant difference between dexpanthenol and ectoine treatments was found in any of the side effects (p = 0.1). Conclusion: Ectoin was overall more effective in improving radiation dermatitis than topical dexpanthenol in breast cancer patients. Ectoin could be proposed as a preventive or curative treatment for patients undergoing postoperative irradiation for breast cancer. Further clinical studies with a larger number of patients are recommended for the confirmation of these preliminary results.

Keywords: breast cancer, dexapanthenol, ectoin, radiation dermatitis

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1028 Investigating the Effect of the Pedagogical Agent on Visual Attention in Attention Deficit Hyperactivity Disorder Students

Authors: Nasrin Mohammadhasani, Rosa Angela Fabio

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The attention to relevance information is the key element for learning. Otherwise, Attention Deficit Hyperactivity Disorder (ADHD) students have a fuzzy visual pattern that prevents them to attention and remember learning subject. The present study aimed to test the hypothesis that the presence of a pedagogical agent can effectively support ADHD learner's attention and learning outcomes in a multimedia learning environment. The learning environment was integrated with a pedagogical agent, named Koosha as a social peer. This study employed a pretest and posttest experimental design with control group. The statistical population was 30 boys students, age 10-11 with ADHD that randomly assigned to learn with/without an agent in well designed environment for mathematic. The results suggested that experimental and control groups show a significant difference in time when they participated and mathematics achievement. According to this research, using the pedagogical agent can enhance learning of ADHD students by gaining and guiding their attention to relevance information part on display, so it can be considered as asocial cue that provides theme cognitive supports.

Keywords: attention, computer assisted instruction, multimedia learning environment, pedagogical agent

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1027 'I Broke the Line Back to the Ancient Ones': Rethinking Intersectional Theory through Wounded Histories in Once Were Warriors (1994) and Whale Rider (2002).

Authors: Kerry Mackereth

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Kimberle Crenshaw’s theory of intersectionality has become immensely influential in the fields of women’s and gender studies. However, intersectionality’s widespread use among feminist scholars and activists has been accompanied by critiques of its reliance upon subject categorization. These critiques are of particular import when connected to Wendy Brown’s characterization of identity politics as static 'wounded attachments'. Together, these critiques show how the gridlock model proposed by intersectionality’s primary metaphor, the traffic accident at the intersection, is useful for identifying discrimination but not for remembering historical injustices or imagining feminist and anti-racist resistance. Through the lens of New Zealand Maori film, focusing upon Once Were Warriors (1994) and Whale Rider (2002), this article examines how wounded histories need not be passively reproduced by contemporaneously oppressed groups. Instead, the metaphor of the traffic intersection should be complemented by the metaphor of the wound. Against Brown’s characterization of wounded attachments as negative, static identities, Gloria Anzaldua’s account of the borderland between the United States and Mexico as “una herida abierta”, an open wound, offers an alternative reading of the wound. Through Anzaldua’s and Hortense Spillers’ political thought, the wound is reconceptualized as not only a site of suffering but also as a regenerative space. The coexistence of deterioration and regeneration at the site of the wound underpins the narrative arc of both Once Were Warriors and Whale Rider. In both films, the respective child protagonists attempt to reconcile the pain of wounded histories with the imagination of cultural regeneration. The metaphor of the wound thus serves as an alternative theoretical resource for mapping experiences of oppression, one that enriches feminist theory by balancing the remembrance of historical grievance with the forging of hopeful political projects.

Keywords: gender theory, historical grievance, intersectionality, New Zealand film, postcolonialism

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1026 A Study of Career Suitability Among Medical Students

Authors: Nurul Azmawati Mohamed, Zarini Ismail, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, K. Omar

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Choosing a career is one of the most important decisions in our life. A right career leads a person to grow with that career and achieve success through the decision. Thus, career suitability assessment is important to help individuals to understand how a variety of personal attributes can impact their potential success and satisfaction with different career options and work environments. Some career needs specific personality trait that relates to attributes of job requirements and commitments. For medicine, being caring, approachable, inquisitive, able to listen and understand patients’ pain, anxiety and sorrow are important. The aim of this study was to evaluate the career suitability of pre-clinical students. This was a cross sectional study conducted among pre-clinical medical students in Universiti Sains Islam Malaysia. 'Sidek Career Interest Inventory’ was used to assess the students’ suitability for the course. This instrument had been validated locally to suit the local social and cultural context. It assessed the students’ personality trait based on Holland’s theory and their interests. For students to pursue in the medical course, two main personality trait are believed to be essential namely investigative and social trait personalities. Some of the characteristics of investigative trait are analytical, rational, intellectual and curious, while the characteristics of social trait personality include empathy, friendly, understanding and accommodating. The score for each personality trait were categorized as low (0-3.99), moderate (4-6.99) and high (7-10). A total of 81 pre-clinical medical students were included in this study. About two third (93.8%) of them were female and all of them are from 20 to 21 of age. Approximately, half of the students (47.5%) scored high and another 46.3% scored moderate for investigative trait. For social trait, only 13.8% scored high while 31.3% scored moderate. Only 12.5% (10) students had high scores for both investigative and social traits. Most of the pre-clinical medical students scored high in the investigative sections, however their social values were inadequate (low scores). For them to become good medical doctors, they should be good in both investigative and social skills to enhance their suitability for this career. Therefore, there is a need to nurture these medical students with appropriate social values and soft skills.

Keywords: career suitability, career interest, medical students, personality trait

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1025 Combined Tarsal Coalition Resection and Arthroereisis in Treatment of Symptomatic Rigid Flat Foot in Pediatric Population

Authors: Michael Zaidman, Naum Simanovsky

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Introduction. Symptomatic tarsal coalition with rigid flat foot often demands operative solution. An isolated coalition resection does not guarantee pain relief; correction of co-existing foot deformity may be required. The objective of the study was to analyze the results of combination of tarsal coalition resection and arthroereisis. Patients and methods. We retrospectively reviewed medical records and radiographs of children operatively treated in our institution for symptomatic calcaneonavicular or talocalcaneal coalition between the years 2019 and 2022. Eight patients (twelve feet), 4 boys and 4 girls with mean age 11.2 years, were included in the study. In six patients (10 feet) calcaneonavicular coalition was diagnosed, two patients (two feet) sustained talonavicular coalition. To quantify degrees of foot deformity, we used calcaneal pitch angle, lateral talar-first metatarsal (Meary's) angle, and talonavicular coverage angle. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results. The mean follow-up was 28 month. The preoperative mean talonavicular coverage angle was 17,75º as compared with postoperative mean angle of 5.4º. The calcaneal pitch angle improved from mean 6,8º to 16,4º. The mean preoperative Meary’s angle of -11.3º improved to mean 2.8º. The preoperative mean AOFAS score improved from 54.7 to 93.1 points post-operatively. In nine of twelve feet, overall clinical outcome judged by AOFAS scale was excellent (90-100 points), in three feet was good (80-90 points). Six patients (ten feet) obviously improved their subtalar range of motion. Conclusion. For symptomatic stiff or rigid flat feet associated with tarsal coalition, the combination of coalition resection and arthroereisis leads to normalization of radiographic parameters, clinical and functional improvement with good patient’s satisfaction and likely to be more effective than the isolated procedures.

Keywords: rigid flat foot, tarsal coalition resection, arthroereisis, outcome

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1024 A Mixed Method Study Investigating Dyslexia and Students Experiences of Anxiety and Coping

Authors: Amanda Abbott-Jones

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Adult students with dyslexia can receive support for cognitive needs but may also experience anxiety, which is less understood. This study aims to test the hypothesis that dyslexic learners in higher education have a higher prevalence of academic and social anxiety than their non-dyslexic peers and explores wider emotional consequences of studying with dyslexia and the ways that adults with dyslexia cope cognitively and emotionally. A mixed-method approach was used in two stages. Stage one compared survey responses from students with dyslexia (N = 102) and students without dyslexia (N = 72) after completion of an anxiety inventory. Stage two explored the emotional consequences of studying with dyslexia and the types of coping strategies used through semi-structured interviews with 20 dyslexic students. Results revealed a statistically significant effect for academic anxiety but not for social anxiety. Findings for stage two showed that: (1) students’ emotional consequences were characterised by a mixture of negative and positive responses, yet negative responses were more frequent in response to questions about academic tasks than positive responses; (2) participants had less to say on coping emotionally, than coping cognitively.

Keywords: dyslexia, higher education, anxiety, emotion

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1023 Antineoplastic Effect of Tridham and Penta Galloyl Glucose in Experimental Mammary Carcinoma Bearing Rats

Authors: Karthick Dharmalingam, Stalin Ramakrishnan, Haseena Banu Hedayathullah Khan, Sachidanandanam Thiruvaiyaru Panchanadham, Shanthi Palanivelu

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Background: Breast cancer is arising as the most dreadful cancer affecting women worldwide. Hence, there arises a need to search and test for new drugs. Herbal formulations used in Siddha preparations are proved to be effective against various types of cancer. They also offer advantage through synergistic amplification and diminish any possible adverse effects. Tridham (TD) is a herbal formulation prepared in our laboratory consisting of Terminalia chebula, Elaeocarpus ganitrus and Prosopis cineraria in a definite ratio and has been used for the treatment of mammary carcinoma. Objective: To study the restorative effect of Tridham and penta galloyl glucose (a component of TD) on DMBA induced mammary carcinoma in female Sprague Dawley rats. Materials and Methods: Rats were divided into seven groups of six animals each. Group I (Control) received corn oil. Group II– mammary carcinoma was induced by DMBA dissolved in corn oil single dose orally. Group III and Group IV were induced with DMBA and subsequently treated with Tridham and penta galloyl glucose, respectively for 48 days. Group V was treated with DMBA and subsequently with a standard drug, cyclophosphamide. Group VI and Group VII were given Tridham and penta galloyl glucose alone, respectively for 48 days. After the experimental period, the animals were sacrificed by cervical decapitation. The mammary gland tissue was excised and levels of antioxidants were determined by biochemical assay. p53 and PCNA expression were accessed using immunohistochemistry. Nrf-2, Cox-2 and caspase-3 protein expression were studied by Western Blotting analysis. p21, Bcl-2, Bax, Bad and caspase-8 gene expression were studied by RT-PCR. Results: Histopathological studies confirmed induction of mammary carcinoma in DMBA induced rats and treatment with TD and PGG resulted in regression of tumour. The levels of enzymic and non-enzymic antioxidants were decreased in DMBA induced rats when compared to control rats. The levels of cell cycle inhibitory markers and apoptotic markers were decreased in DMBA induced rats when compared to control rats. These parameters were restored to near normal levels on treatment with Tridham and PGG. Conclusion: The results of the present study indicate the antineoplastic effect of Tridham and PGG are exerted through the modulation of antioxidant status and expression of cell cycle regulatory markers as well as apoptotic markers. Acknowledgment: Financial assistance provided in the form of ICMR-SRF by Indian Council of Medical Research (ICMR), India is gratefully acknowledged here.

Keywords: antioxidants, Mammary carcinoma, pentaGalloyl glucose, Tridham

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1022 Understanding Workplace Behavior through Organizational Culture and Complex Adaptive Systems Theory

Authors: Péter Restás, Andrea Czibor, Zsolt Péter Szabó

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Purpose: This article aims to rethink the phenomena of employee behavior as a product of a system. Both organizational culture and Complex Adaptive Systems (CAS) theory emphasize that individual behavior depends on the specific system and the unique organizational culture. These two major theories are both represented in the field of organizational studies; however, they are rarely used together for the comprehensive understanding of workplace behavior. Methodology: By reviewing the literature we use key concepts stemming from organizational culture and CAS theory in order to show the similarities between these theories and create an enriched understanding of employee behavior. Findings: a) Workplace behavior is defined here as social cognition issue. b) Organizations are discussed here as complex systems, and cultures which drive and dictate the cognitive processes of agents in the system. c) Culture gives CAS theory a context which lets us see organizations not just as ever-changing and unpredictable, but as such systems that aim to create and maintain stability by recurring behavior. Conclusion: Applying the knowledge from culture and CAS theory sheds light on our present understanding of employee behavior, also emphasizes the importance of novel ways in organizational research and management.

Keywords: complex adaptive systems theory, employee behavior, organizational culture, stability

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1021 The Appearance of Identity in the Urban Landscape by Enjoying the Natural Factors

Authors: Mehrdad Karimi, Farshad Negintaji

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This study has examined the appearance of identity in the urban landscape and its effects on the natural factors. For this purpose, the components of place identity, emotional attachment, place dependence and social bond which totally constitute place attachment, measures it in three domains of cognitive (place identity), affective (emotional attachment) and behavioral (place dependence and social bond). In order to measure the natural factors, three components of the absolute elements, living entities, natural elements have been measured. The study is descriptive and the statistical population has been Yasouj, a city in Iran. To analyze the data the SPSS software has been used. The results in two level of descriptive and inferential statistics have been investigated. In the inferential statistics, Pearson correlation coefficient test has been used to evaluate the research hypotheses. In this study, the variable of identity is in high level and the natural factors are also in high level. These results indicate a positive relationship between place identity and natural factors. Development of environment and reaching the quality level of the personality or identity will develop the individual and society.

Keywords: identity, place identity, landscape, urban landscape, landscaping

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1020 Impact of SES and Culture on Well-Being of Adolescent

Authors: Shraddha B. Rai, Mahipatsinh D. Chavda, Bharat S. Trivedi

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The aim of the present research is to study the effect of education and social belonging on well-being of youth. Well-being is one of the most important aspects of human being and the state of well-being can be attained in terms of healthy body with healthy mind. Well-being has been defined as encompassing people’s cognitive and affective evaluations of their lives. Well-being has been interchangeably used with health and quality of life. According to the WHO, the main determinants of health include the social, economic, and the physical environment and the persons individual characteristics and behaviors. WHO lists other factors that can influence the well-being of a person such as the gender, education, social support networks and health services. The main objective of the present investigation is to know the effect of education and social belonging on well-being of youth. The sample of 180 students belonging to Gujarati and English (convent) culture were selected randomly from Guajarati and English (convent) schools of Ahmedabad City of Gujarat (India). General well-being Scale by Dr. Ashok Kalia and Ms. Anita Deswal was administered to measure the Physical, Emotional, and Social and school well-being. The result shows that there is significant different found between Gujarati and English (convent) culture on Well-being in school students. SES is also affect significantly to wellbeing of students.

Keywords: culture, SES, well-being, health, quality of life

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1019 Integrating HOTS Activities with Geogebra in Pre-Service Teachers' Preparation

Authors: Wajeeh Daher, Nimer Baya'a

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High Order Thinking Skills (HOTS) are suggested today as essential for the cognitive development of students and as preparing them for real life skills. Teachers are encouraged to use HOTS activities in the classroom to help their students develop higher order skills and deep thinking. So it is essential to prepare pre-service teachers to write and use HOTS activities for their students. This paper describes a model for integrating HOTS activities with GeoGebra in pre-service teachers’ preparation. This model describes four aspects of HOTS activities and working with them: Activity components, preparation procedure, strategies and processes used in writing a HOTS activity and types of the HOTS activities. In addition, the paper describes the pre-service teachers' difficulties in preparing and working with HOTS activities, as well as their perceptions regarding the use of these activities and GeoGebra in the mathematics classroom. The paper also describes the contribution of a HOTS activity to pupils' learning of mathematics, where this HOTS activity was prepared and taught by one pre-service teacher.

Keywords: high order thinking skills, HOTS activities, pre-service teachers, professional development

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1018 Sleep Health Management in Residential Aged Care Facilities

Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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1017 Liaison Psychiatry in Baixo Alentejo, Portugal: Reality and Perspectives

Authors: Mariana Mangas, Yaroslava Martins, M. Suárez, Célia Santos, Ana Matos Pires

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Baixo Alentejo is a region of Portugal characterized by an aging population, geographic isolation, social deprivation and a lack of medical staff. It is one of the most problematic regions in regards to mental health, particularly due to the factors mentioned. The aim of this study is a presentation of liaison psychiatry in Hospital José Joaquim Fernandes; a sample of the work done, the current situation and future perspectives. The aim is to present a retrospective study of internal psychiatric emergencies from January 1st, 2016 to August 31st, 2016. Liaison psychiatry of Department of Psychiatry and Mental Health (Psychiatry Service) of ULSBA includes the following activities: internal psychiatry emergencies, HIV consultation (comprised in the general consultation) and liaison psychology (oncology and pain), consisting of a total of 111 internal psychiatry emergencies during the identified period. Gender distribution was uniform. The most prevalent age group was 71-80 years, and 66,6% of patients were 60 years old and over. The majority of the emergency observations was requested by hospital services of medicine (56,8%) and surgery (24,3%). The most frequent reasons for admission were: respiratory disease (18,0%); tumors (15.3%); other surgical and orthopedic pathology (14,5%) and stroke (11,7%). The most frequent psychiatric diagnoses were: neurotic and organic depression (24,3%); delirium (26,1%) and adjustment reaction (14,5%). Major psychiatric pathology (schizophrenia and affective disorders) was found in 10,8%. Antidepressive medication was prescribed in 37,8% patients; antipsychotics in 34,2%. In 9.9% of the cases, no psychotropic drug was prescribed, and 5,4% of patients received psychologic support. Regarding hospital discharge, 42,4% of patients were referred to the general practitioner or to the medical specialist; 22,5% to outpatient gerontopsychiatry; 17,1% to psychiatric outpatient and 14,4% deceased. A future perspective is to start liaison in areas of HIV and psycho oncology in multidisciplinary approach and to improve collaboration with colleagues of other specialties for refining psychiatric referrals.

Keywords: psychiatry, liaison, internal emergency, psychiatric referral

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1016 A Review of the Effects of Exercise in Preventing Migraine Headaches

Authors: Afsaneh Soltani, Zahra Mohajer

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Migraine is one of the most common chronic neurological diseases. Migraines affect different aspects of life. Severe migraine headaches lead to dysfunction, a reduced presence at work, and decreased ability to think and make decisions. Non-pharmacological treatments play a very important role in controlling and preventing migraine headaches. A healthy lifestyle helps control migraine headaches. Migraine headaches can be reduced by following these steps: Avoiding stress, eating regularly and avoiding hunger and thirst, avoiding stimulants such as chocolate, caffeine, and cigarettes, following a regular bedtime routine, or avoiding sleep deprivation. Exercise a lot, and do regular exercise (and prevent obesity). Non-pharmacological treatment is especially important in pregnant women and children because in these cases, medical treatments are not preferred due to the many side effects. Exercise is one of the most effective and uncomplicated non-pharmacological alternatives in the treatment of migraine headaches. Exercising for episodic migraines is a safe, effective, and promising complementary treatment option. Numerous studies have shown that aerobic exercise reduces the severity and duration of migraine headaches. Effective aerobic exercise includes cycling and brisk walking. Exercise improves the quality of life and reduces the use of medication in people with migraines. Patients who exercise have fewer migraine days, resulting in better personal, social, and occupational performance. Several studies have shown that pain intensity and frequency in patients who exercise regularly decreased significantly after exercise compared to controls who did not exercise. According to a study, regular exercise reduces the levels of interleukins, especially IL-12P70, which reduces anxiety and reduces the number of days of migraine in patients. An article has shown that endurance exercise reduces the number of migraine days and also increases cerebrovascular health in migraine patients. According to studies, the minimum duration of exercise to achieve a positive effect of exercise in patients with migraine is 3 months (12 weeks) and 40 minutes three times a week.

Keywords: exercise, headache, migraine, physical activity

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1015 Understanding the First Mental Breakdown from the Families’ Perspective Through Metaphors

Authors: Eli Buchbinder

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Introduction. Language is the basis to our experience as human being. We use language in describing our experiences and construct meaning and narratives from experiences. Metaphors are a valuable linguistic tool commonly use. Metaphors link two domains that are ordinarily not related. Metaphors achieve simultaneously multi-level integration: abstract and concrete, rational and imaginative, familiar and the unfamiliar, conscious and preconscious/unconscious. As such, metaphors epistemological and ontological tool that are important in social work in every field and domain. Goals and Methods The presentation’s aim is to validate the value of metaphors through the first psychiatric breakdown is a traumatic for families. The presentation is based on two pooled qualitative studies. The first study focused on 12 spouses: 7 women and 5 men, between the ages of 22 and 57, regarding their experiences and meanings of the first psychiatric hospitalization of their partners diagnosed with affective disorders. The second study focused on 10 parents, between the ages of 47 and 62, regarding their experiences and meanings following their child's first psychotic breakdown during young adulthood. Results Two types of major metaphors evolved from the interviews in farming the trauma of the first mental breakdown. The first mode - orientation (spatial) metaphors, reflect symbolic expression of the loss of a secure base, represented in the physical environment, e.g., describing hospitalization as "falling into an abyss." The second mode- ontological metaphors, reflect how parents and spouses present their traumatic experiences of hospitalization in terms of discrete, powerful and coherent entities, e.g., describing the first hospitalization as "swimming against the tide." The two metaphors modes reflect the embodiment of the unpredictability, being mired in distress, shock, intense pain and the experience the collapse of continuity on the life course and cuts off the experience of control. Conclusions Metaphors are important and powerful guide in assessing individuals and families’ phenomenological reality. As such, metaphors are useful for understanding and orientated therapeutic intervening, in the studies above, with the first psychiatric hospitalization experienced, as well as in others social workers’ interventions.

Keywords: first mental breakdown, metaphors, family perspective, qualitative research

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1014 Development of a Real-Time Brain-Computer Interface for Interactive Robot Therapy: An Exploration of EEG and EMG Features during Hypnosis

Authors: Maryam Alimardani, Kazuo Hiraki

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This study presents a framework for development of a new generation of therapy robots that can interact with users by monitoring their physiological and mental states. Here, we focused on one of the controversial methods of therapy, hypnotherapy. Hypnosis has shown to be useful in treatment of many clinical conditions. But, even for healthy people, it can be used as an effective technique for relaxation or enhancement of memory and concentration. Our aim is to develop a robot that collects information about user’s mental and physical states using electroencephalogram (EEG) and electromyography (EMG) signals and performs costeffective hypnosis at the comfort of user’s house. The presented framework consists of three main steps: (1) Find the EEG-correlates of mind state before, during, and after hypnosis and establish a cognitive model for state changes, (2) Develop a system that can track the changes in EEG and EMG activities in real time and determines if the user is ready for suggestion, and (3) Implement our system in a humanoid robot that will talk and conduct hypnosis on users based on their mental states. This paper presents a pilot study in regard to the first stage, detection of EEG and EMG features during hypnosis.

Keywords: hypnosis, EEG, robotherapy, brain-computer interface (BCI)

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1013 Effectiveness of Integrative Behavioral Couples Therapy on the Communication Patterns of Couples Applying for Divorce

Authors: Sakineh Abbasi Bourondaragh

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The aim of this research is effectiveness of integrative behavioral couples therapy on the communication patterns of couples applying for divorce. We selected (N=20) reports from Tabriz Family Judicial Complex (FJC) of couples which have conflict in their marital relationships. All of reports were released during 2012. First, they were randomly divided into two experimental and control groups and all the couples were given pre-test. They participated in twelve therapy sessions. Then the experimental group was exposed to an experimental intervention, but the control group was not received experimental intervention. The subjects were treated. At the end of treatment, a post-test was performed about subjects (each of two groups).The results showed that integrative behavioral couple therapy could increase and improve communication patterns. The findings also showed that integrative behavioral couples therapy had increased mutual constructive pattern and decreased demand/withdraw pattern and mutual avoidance pattern of CPQ sub-scale. Steady change indicator showed that the difference is clinically meaningful.

Keywords: integrative behavioral couple therapy, communication patterns, cognitive sciences, Family Judicial Complex

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1012 Role-Governed Categorization and Category Learning as a Result from Structural Alignment: The RoleMap Model

Authors: Yolina A. Petrova, Georgi I. Petkov

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The paper presents a symbolic model for category learning and categorization (called RoleMap). Unlike the other models which implement learning in a separate working mode, role-governed category learning and categorization emerge in RoleMap while it does its usual reasoning. The model is based on several basic mechanisms known as reflecting the sub-processes of analogy-making. It steps on the assumption that in their everyday life people constantly compare what they experience and what they know. Various commonalities between the incoming information (current experience) and the stored one (long-term memory) emerge from those comparisons. Some of those commonalities are considered to be highly important, and they are transformed into concepts for further use. This process denotes the category learning. When there is missing knowledge in the incoming information (i.e. the perceived object is still not recognized), the model makes anticipations about what is missing, based on the similar episodes from its long-term memory. Various such anticipations may emerge for different reasons. However, with time only one of them wins and is transformed into a category member. This process denotes the act of categorization.

Keywords: analogy-making, categorization, category learning, cognitive modeling, role-governed categories

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1011 Traumatic Spinal Cord Injury; Incidence, Prognosis and the Time-Course of Clinical Outcomes: A 12 Year Review from a Tertiary Hospital in Korea

Authors: Jeounghee Kim

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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

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1010 Inclusion of Students with Disabilities (SWD) in Higher Education Institutions (HEIs): Self-Advocacy and Engagement as Central

Authors: Tadesse Abera

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This study aimed to investigate the contribution of self-advocacy and engagement in the inclusion of SWDs in HEIs. A convergent parallel mixed methods design was employed. This article reports the quantitative strand. A total of 246 SWDs were selected through stratified proportionate random sampling technique from five public HEIs in Ethiopia. Data were collected through Self-advocacy questionnaire, student engagement scale, and college student experience questionnaire and analyzed through frequency, percentage, mean, standard deviation, correlation, one sample t-test and multiple regression. Both self-advocacy and engagement were found to have a predictive power on inclusion of respondents in the HEIs, where engagement was found to be more predictor. From the components of self-advocacy, knowledge of self and leadership and from engagement dimensions sense of belonging, cognitive, and valuing in their respective orders were found to have a stronger predictive power on the inclusion of respondents in the institutions. Based on the findings it was concluded that, if students with disabilities work hard to be self-determined, strive for realizing social justice, exert quality effort and seek active involvement, their inclusion in the institutions would be ensured.

Keywords: self-advocacy, engagement, inclusion, students with disabilities, higher education institution

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1009 CICAP: Promising Wound Healing Gel from Bee Products and Medicinal Plants

Authors: Laïd Boukraâ

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Complementary and Alternative Medicine is an inclusive term that describes treatments, therapies, and modalities that are not accepted as components of mainstream education or practice, but that are performed on patients by some practitioners. While these treatments and therapies often form part of post-graduate education, study and writing, they are generally viewed as alternatives or complementary to more universally accepted treatments. Ancient civilizations used bee products and medicinal plants, but modern civilization and ‘education’ have seriously lessened our natural instinctive ability and capability. Despite the fact that the modern Western establishment appears to like to relegate apitherapy and aromatherapy to the status of 'folklore' or 'old wives' tales', they contain a vast spread of pharmacologically-active ingredients and each one has its own unique combination and properties. They are classified in modern herbal medicine according to their spheres of action. Bee products and medicinal plants are well-known natural product for their healing properties and their increasing popularity recently as they are widely used in wound healing. Honey not only has antibacterial properties which can help as an antibacterial agent but also has chemical properties which may further help in the wound healing process. A formulation with honey as its main component was produced into a honey gel. This new formulation has enhanced texture and is more user friendly for usage as well. This new formulation would be better than other formulas as it is hundred percent consisting of natural products and has been made into a better formulation. In vitro assay, animal model study and clinical trials have shown the effectiveness of LEADERMAX for the treatment of diabetic foot, burns, leg ulcer and bed sores. This one hundred percent natural product could be the best alternative to conventional products for wound and burn management. The advantages of the formulation are: 100% natural, affordable, easy to use, strong power of absorption, dry surface on the wound making a film, will not stick to the wound bed; helps relieve wound pain, inflammation, edema and bruising while improving comfort.

Keywords: bed sore bee products, burns, diabetic foot, medicinal plants, leg ulcer, wounds

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1008 The Effect of Radish (Raphanus Sativus L.) Leaves Ethanol Extract on Blood Glucose Levels in Streptozotocin-Nicotinamide-Induced Type-2 Diabetic Rats

Authors: Satria B. Mahathma, Asri Hendrawati

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Background: Diabetes mellitus (DM) is a metabolic disorder syndrome characterized by chronic hyperglycemia. The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014. In general, almost 90% of the prevalence of DM is type 2 DM which marked by insulin resistance and decreased receptor sensitivity. Aside from conventional antidiabetic therapy, the utilization of medicinal plants as alternative medicine has beneficial effects in diabetic patients. Flavonoid contents in radish leaves such as quercetin, pelargonidin, and kaempferol are thought to have antidiabetic activity on decreasing blood glucose levels by tricyclic nucleotide modulation of pancreatic beta cells and ameliorating insulin resistance. This study aimed to determine the effect of variant concentration of radish leaves ethanol extract on blood glucose levels in diabetic rats. Method: This study used pretest-posttest control group design by using 16 male Wistar rats which were induced type-2 diabetic by streptozotocin 60 mg/kg BW-nicotinamide 120 mg/kg BW intraperitoneally. Rats who had developed type-2 DM later divided randomly into 4 groups; negative control received placebo, positive control received glibenclamide 5 mg/kg BW/day, rats intervention I and intervention II received 100% and 50% of radish leaves ethanol extract, respectively. Treatments were administered orally for four weeks. The blood glucose levels were measured using the Enzymatic Colorimetric Test “GOD-PAP”. Data were analyzed by the dependent t-test for pretest-posttest intervention difference and one-way ANOVA followed by post hoc test to determine the significant difference of each treatment to obtain the significant data. Result: The result revealed that intervention group had lower blood glucose levels mean than control group which the lowest was intervention II group (negative control: 540,9 ± 191,7 mg/dl, positive control: 494, 97 ± 64,91 mg/dl, intervention I: 301,92 ± 165,70 mg/dl, and intervention II group: 276,1 ± 139,02 mg/dl. Intervention II group had the highest antidiabetic activity, followed by the intervention I group with the amount of decrease in blood glucose levels were -151,85 ± 77,43 mg/dl and -11,08 ± 186,62 mg/dl, however negative and positive control group didn’t have antidiabetic activity. The dependent t-test result showed there is a significant difference in decreasing blood glucose levels in the intervention II pretest-posttest intervention (p=0,03) while the other group didn’t. Data analyzed by one-way ANOVA also revealed the intervention II group significantly declined blood glucose levels compared to the negative and positive control group (p = 0,033 and p=0,032, respectively). Conclusion: There is a significant effect of radish leaves ethanol extract on blood glucose levels in streptozotocin-nicotinamide-induced diabetic rats with the optimal therapeutic effect at a concentration of 50%.

Keywords: blood glucose levels, medicinal plant, radish leaves, type-2 diabetes mellitus

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1007 A Peer-Produced Community of Learning: The Case of Second-Year Algerian Masters Students at a Distance

Authors: Nihad Alem

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Nowadays, distance learning (DL) is widely perceived as a reformed type of education that takes advantage of technology to give more appealing opportunities especially for learners whose life conditions impede their attendance to regular classrooms however, creating interactional environment for students to expand their learning community and alleviate the feeling of loneliness and isolation should receive more attention when designing a distance learning course. This research aims to explore whether the audio/video peer learning can offer pedagogical add-ons to the Algerian distance learners and what are the pros and cons of its application as an educational experience in a synchronous environment mediated by Skype. Data were collected using video recordings of six sessions, reflective logs, and in-depth semi-structured interviews and will be analyzed by qualitatively identifying and measuring the three constitutional elements of the educational experience of peer learning namely the social presence, the cognitive presence, and the facilitation presence using a modified community of inquiry coding template. The findings from this study will provide recommendations for effective peer learning educational experience using the facilitation presence concept.

Keywords: audio/visual peer learning, community of inquiry, distance learning, facilitation presence

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1006 Cost-Effectiveness Analysis of the Use of COBLATION™ Knee Chondroplasty versus Mechanical Debridement in German Patients

Authors: Ayoade Adeyemi, Leo Nherera, Paul Trueman, Antje Emmermann

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Background and objectives: Radiofrequency (RF) generated plasma chondroplasty is considered a promising treatment alternative to mechanical debridement (MD) with a shaver. The aim of the study was to perform a cost-effectiveness analysis comparing costs and outcomes following COBLATION chondroplasty versus mechanical debridement in patients with knee pain associated with a medial meniscus tear and idiopathic ICRS grade III focal lesion of the medial femoral condyle from a payer perspective. Methods: A decision-analytic model was developed comparing economic and clinical outcomes between the two treatment options in German patients following knee chondroplasty. Revision rates based on the frequency of repeat arthroscopy, osteotomy and conversion to total knee replacement, reimbursement costs and outcomes data over a 4-year time horizon were extracted from published literature. One-way sensitivity analyses were conducted to assess uncertainties around model parameters. Threshold analysis determined the revision rate at which model results change. All costs were reported in 2016 euros, future costs were discounted at a 3% annual rate. Results: Over a 4 year period, COBLATION chondroplasty resulted in an overall net saving cost of €461 due to a lower revision rate of 14% compared to 48% with MD. Threshold analysis showed that both options were associated with comparable costs if COBLATION revision rate was assumed to increase up to 23%. The initial procedure costs for COBLATION were higher compared to MD and outcome scores were significantly improved at 1 and 4 years post-operation versus MD. Conclusion: The analysis shows that COBLATION chondroplasty is a cost-effective option compared to mechanical debridement in the treatment of patients with a medial meniscus tear and idiopathic ICRS grade III defect of the medial femoral condyle.

Keywords: COBLATION, cost-effectiveness, knee chondroplasty, mechanical debridement

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1005 Online Self-Help Metacognitive Therapy for OCD: A Case Series

Authors: C. Pearcy, C. Rees

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Cognitive behavioural therapy (CBT) and exposure and response prevention (ERP) are currently the most efficacious treatments for Obsessive-compulsive disorder (OCD). Many clients, however, remain symptomatic following treatment. As a result, refusal of treatment, withdrawal from treatment, and partial adherence to treatment are common amongst ERP. Such limitations have caused few professionals to actually engage in ERP therapy, which has warranted the exploration of alternative treatments. This study evaluated an online self-help treatment program for OCD (the OCD Doctor Online); a 4-week Metacognitive Therapy (MCT) program which has implemented strategies from Wells’ Metacognitive model of OCD. The aim of the present study was to investigate whether an online self-help treatment using MCT would reduce symptoms of OCD, reduce unhelpful metacognitions and improve quality of life. Treatment effectiveness was assessed using a case series methodology in 3 consecutively referred individuals. At post-treatment, all participants showed reductions in unhelpful metacognitive beliefs (MCQ-30) and improvements in quality of life (Q-LES-Q), which were maintained through to 4 week follow-up. Two of the three participants showed reductions in OCD symptomology (OCI-R), which were further reduced at 4-week follow-up. The present study suggests that internet-based self-help treatment may be an effective means of delivering MCT to adults with OCD.

Keywords: internet-based, metacognitive therapy, obsessive-compulsive disorder, self-help

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1004 Functional Relevance of Flavanones and Other Plant Products in the Remedy of Parkinson's Disease

Authors: Himanshi Allahabadi

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Plants have found a widespread use in medicine traditionally, including the treatment of cognitive disorders, especially, neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease. In terms of indigenous medicine, it has been found that many potential drugs can be isolated from plant products, including those for dementia. Plant product is widely distributed in plant kingdom and forms a major antioxidant source in the human diet, is Polyphenols. There are four important groups of polyphenols: phenolic acids, flavonoids, stilbenes, and lignans. Due to their high antioxidant capacity, interest in their study has greatly increased. There are several methods for discovering and characterizing active compounds isolated from plant sources, now available. The results obtained so far seem fulfilling, but additionally, mechanism of functioning of polyphenols at the molecular level, as well as their application in human health need to be researched upon. Also, even though the neuroprotective effects of flavonoids have been much talked about, much of the data in support of this statement has come from animal studies rather than human studies. This review is based on a multi-faceted study of medicinal plants, i.e. phytochemicals, with special focus on flavanones and their relevance in remedy of Parkinson's disease.

Keywords: dementia, parkinson's disease, flavanones, polyphenols, substantia nigra

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1003 Business Skills Laboratory in Action: Combining a Practice Enterprise Model and an ERP-Simulation to a Comprehensive Business Learning Environment

Authors: Karoliina Nisula, Samuli Pekkola

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Business education has been criticized for being too theoretical and distant from business life. Different types of experiential learning environments ranging from manual role-play to computer simulations and enterprise resource planning (ERP) systems have been used to introduce the realistic and practical experience into business learning. Each of these learning environments approaches business learning from a different perspective. The implementations tend to be individual exercises supplementing the traditional courses. We suggest combining them into a business skills laboratory resembling an actual workplace. In this paper, we present a concrete implementation of an ERP-supported business learning environment that is used throughout the first year undergraduate business curriculum. We validate the implementation by evaluating the learning outcomes through the different domains of Bloom’s taxonomy. We use the role-play oriented practice enterprise model as a comparison group. Our findings indicate that using the ERP simulation improves the poor and average students’ lower-level cognitive learning. On the affective domain, the ERP-simulation appears to enhance motivation to learn as well as perceived acquisition of practical hands-on skills.

Keywords: business simulations, experiential learning, ERP systems, learning environments

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1002 The Potential of On-Demand Shuttle Services to Reduce Private Car Use

Authors: B. Mack, K. Tampe-Mai, E. Diesch

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Findings of an ongoing discrete choice study of future transport mode choice will be presented. Many urban centers face the triple challenge of having to cope with ever increasing traffic congestion, environmental pollution, and greenhouse gas emission brought about by private car use. In principle, private car use may be diminished by extending public transport systems like bus lines, trams, tubes, and trains. However, there are limits to increasing the (perceived) spatial and temporal flexibility and reducing peak-time crowding of classical public transport systems. An emerging new type of system, publicly or privately operated on-demand shuttle bus services, seem suitable to ameliorate the situation. A fleet of on-demand shuttle busses operates without fixed stops and schedules. It may be deployed efficiently in that each bus picks up passengers whose itineraries may be combined into an optimized route. Crowding may be minimized by limiting the number of seats and the inter-seat distance for each bus. The study is conducted as a discrete choice experiment. The choice between private car, public transport, and shuttle service is registered as a function of several push and pull factors (financial costs, travel time, walking distances, mobility tax/congestion charge, and waiting time/parking space search time). After the completion of the discrete choice items, the study participant is asked to rate the three modes of transport with regard to the pull factors of comfort, safety, privacy, and opportunity to engage in activities like reading or surfing the internet. These ratings are entered as additional predictors into the discrete choice experiment regression model. The study is conducted in the region of Stuttgart in southern Germany. N=1000 participants are being recruited. Participants are between 18 and 69 years of age, hold a driver’s license, and live in the city or the surrounding region of Stuttgart. In the discrete choice experiment, participants are asked to assume they lived within the Stuttgart region, but outside of the city, and were planning the journey from their apartment to their place of work, training, or education during the peak traffic time in the morning. Then, for each item of the discrete choice experiment, they are asked to choose between the transport modes of private car, public transport, and on-demand shuttle in the light of particular values of the push and pull factors studied. The study will provide valuable information on the potential of switching from private car use to the use of on-demand shuttles, but also on the less desirable potential of switching from public transport to on-demand shuttle services. Furthermore, information will be provided on the modulation of these switching potentials by pull and push factors.

Keywords: determinants of travel mode choice, on-demand shuttle services, private car use, public transport

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