Search results for: children with a disability

Authors: Arun C. Gulani, Aaishwariya A. Gulani, Amanda Southall

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Background: Laser Corneoplastique™ as a least interventional, visually promising technique for patients with vision disability from corneal scars of varied causes has been retrospectively reviewed and proves to cause a paradigm shift in mindset and approach towards corneal scars as a Refractive surgery aiming for emmetropic, unaided vision of 20;/20 in most cases. Three decades of work on this technique has been compiled in this 15-year study. Subject and Methods: The objective of this study was to determine the success of Laser Corneoplastique™ surgery as a treatment of corneal scar cases. A survey of corneal scar cases caused by various medical histories that had undergone Laser Corneoplastique™ surgery over the past twenty years by a single surgeon Arun C. Gulani, M.D. were retrospectively reviewed. The details of each of the cases were retrieved from their medical records and analyzed. Each patient had been examined thoroughly at their preoperative appointments for stability of refraction and vision, depth of scar, pachymetry, topography, pattern of the scar and uncorrected and best corrected vision potential, which were all taken into account in the patients' treatment plans. Results: 64 eyes of 53 patients were investigated for scar etiology, keratometry, visual acuity, and complications. There were 25 different etiologies seen, with the most common being a Herpetic scar. The average visual acuity post-op was, on average, 20/23.55 (±7.05). Laser parameters used were depth and pulses. Overall, the mean Laser ablation depth was 30.67 (±19.05), ranging from 2 to 73 µm. Number of Laser pulses averaged 191.85 (±112.02). Conclusion: Refractive Laser Corneoplastique™ surgery, when practiced as an art, can address all levels of ametropia while reversing complex corneas and scars from refractive surgery complications back to 20/20 vision.

Keywords: corneal scar, refractive surgery, corneal transplant, laser corneoplastique

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Authors: Eda Yakit Ak, Ergül Aslan

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The study was conducted using the quasi-experimental design to determine the influence of the nursing support program prepared according to the Health Belief Model on reproductive health behaviors of orthopedically disabled women in the physical therapy and rehabilitation clinic at a university hospital between August 2019-October, 2020. The research sample included 50 women (35 in the control group and 15 in the experimental group with orthopedic disability). A 3-week nursing support program was applied to the experimental group of women. To collect the data, Introductory Information Form and Scale for Determining the Protective Attitudes of Married Women towards Reproductive Health (SDPAMW) were applied. The evaluation was made with a follow-up form for four months. In the first evaluation, the total SDPAMW scores were 119.93±20.59 for the experimental group and 122.20±16.71 for the control group. In the final evaluation, the total SDPAMW scores were 144.27±11.95 for the experimental group and 118.00±16.43 for the control group. The difference between the groups regarding the first and final evaluations for the total SDPAMW scores was statistically significant (p<0.01). In the experimental group, between the first and final evaluations regarding the sub-dimensions of SDPAMW, an increase was found in the behavior of seeing the doctor on reproductive health issues, protection from reproductive organ and breast cancer, general health behaviors to protect reproductive health, and protection from genital tract infections (p<0.05). Consequently, the nursing support program based on the Health Belief Model applied to orthopedically disabled women positively affected reproductive health behaviors.

Keywords: orthopedically disabled, woman, reproductive health, nursing support program, health belief model

Procedia PDF Downloads 131

Authors: Zainab Zendana Shafii

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Lullabies have been broadly defined as songs that are sung to calm and soothe children. While this is true, this paper intends to show that lullabies exceed these functions. The paper, in exploring Nupe lullabies, examines the various functions that lullabies perform in terms of language development, cultural enrichment and also the retelling of history as it relates to the culture of the Nupe people of northern Nigeria. The theoretical framework used is the functionalist theory. This theory postulates that all cultural or social phenomena have a positive function and that all are indispensable. The functionalist theory is based on the premise that all aspects of a society—institutions, roles, norms, etc.—serve a purpose and that all are indispensable for the long-term survival of the society. To this end, this paper dissects the various lullabies in Nupeland with a view to exploring the meaning that these songs generate and why they are even sung at all. The qualitative research methodology has been used to gather materials.

Keywords: Nupe, lullabies, Nigeria, northern

Procedia PDF Downloads 177

Authors: Yeaji Seok, Myung Kyung Lee

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Background: Even if patients survive after a stroke, stroke patients may experience disability in mobility, sensation, cognition, and speech and language. Stroke patients require rehabilitation for functional recovery and daily life for a considerable time. During rehabilitation, the role of caregivers is important. However, the stroke patients’ quality of life may deteriorate due to family caregivers’ non-preparedness and increased role burden. Purpose: To investigate the prediction of caregivers' preparedness and role burden on stroke patients’ quality of life. Methods: The target population was stroke patients who were hospitalized for rehabilitation and their family care providers. A total of 153 patient-family caregiver dyads were recruited from June to August 2021. Data were collected from self-reported questionnaires and analyzed using descriptive statistics, t-tests, chi-squared test, one-way analysis of variance, Pearson’s correlation coefficients, and multiple regression with SPSS statistics 28 programs. Results: Family caregivers’ preparedness affected stroke patients’ mobility (β = .20, p < 0.05) and character (β = -.084, p < 0.05) and production activities (β = -.197, p < 0.05) in quality of life. The role burden of family caregivers affected language skills (β = .310, p<0.05), visual functions (β=-.357, p < 0.05), thinking skills (β = 0.443, p = 0.05), mood conditions (β = 0.565, p < 0.001), family roles (β = -0.361, p < 0.001), and social roles (β = -0.304, p < 0.001), while the caregivers’ burden of performing self-protection negatively affected patients’ social roles (β = .180, p=.048). In addition, caregivers’ role burden of personal life sacrifice affected patients’ mobility (β = .311, p < 0.05), self-care (β =.232, p < 0.05) and energy (β = .239, p < 0.05). Conclusion: This study indicated that family caregivers' preparedness and role burden affected stroke patients’ quality of life. The results of this study suggested that intervention to improve family caregivers’ preparedness and to reduce role burden should be required for quality of life in stroke patients.

Keywords: quality of life, preparedness, role burden, caregivers, stroke

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Authors: Isabella Schwartz, Ori Safran, Naama Karniel, Michal Abel, Adina Berko, Martin Seyres, Tamir Tsoar, Sigal Portnoy

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Virtual Reality allows to manipulate the patient’s perception, thereby providing a motivational addition to real-time biofeedback exercises. We aimed to test the effect of manipulated virtual kinematic intervention on measures of active and passive Range of Motion (ROM), pain, and disability level in individuals with traumatic stiff shoulder. In a double-blinded study, patients with stiff shoulder following proximal humerus fracture and non-operative treatment were randomly divided into a non-manipulated feedback group (NM-group; N=6) and a manipulated feedback group (M-group; N=7). The shoulder ROM, pain, and the Disabilities of the Arm, Shoulder and Hand (DASH) scores were tested at baseline and after the 6 sessions, during which the subjects performed shoulder flexion and abduction in front of a graphic visualization of the shoulder angle. The biofeedback provided to the NM-group was the actual shoulder angle and the feedback provided to the M-group was manipulated so that 10° were constantly subtracted from the actual angle detected by the motion capture system. The M-group showed greater improvement in the active flexion ROM, with median and interquartile range of 197.1 (140.5-425.0) compared to 142.5 (139.1-151.3) for the NM-group (p=.046). Also, the M-group showed greater improvement in the DASH scores, with median and interquartile range of 67.7 (52.8-86.2) compared to 89.7 (83.8-98.3) for the NM-group (p=.022). Manipulated intervention is beneficial in individuals with traumatic stiff shoulder and should be further tested for other populations with orthopedic injuries.

Keywords: virtual reality, biofeedback, shoulder pain, range of motion

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Authors: Niragira Donatien

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The progress of technology creates new expectations for patients. The world of deafness is no exception. In recent years, there have been considerable advances in the field of technologies aimed at assisting failing hearing. According to the usual medical vocabulary, hearing aids are actually orthotics. They do not replace an organ but compensate for a functional impairment. The amplifier hearing amplification is useful for a large number of people with hearing loss. Hearing aids restore speech audibility. However, their benefits vary depending on the quality of residual hearing. The hearing aid is not a "cure" for deafness. It cannot correct all affected hearing abilities. It should be considered as an aid to communicate who the best candidates for hearing aids are. The urge to judge from the audiogram alone should be resisted here, as audiometry only indicates the ability to detect non-verbal sounds. To prevent hearing aids from ending up in the drawer, it is important to ensure that the patient's disability situations justify the use of this type of orthosis. If the problems of receptive pre-fitting counselling are crucial, the person with hearing loss must be informed of the advantages and disadvantages of amplification in his or her case. Their expectations must be realistic. They also need to be aware that the adaptation process requires a good deal of patience and perseverance. They should be informed about the various models and types of hearing aids, including all the aesthetic, functional, and financial considerations. If the person's motivation "survives" pre-fitting counselling, we are in the presence of a good candidate for amplification. In addition to its relevance, hearing aids raise other questions: Should one or both ears be fitted? In short, all these questions show that the results found in this study significantly improve the quality of audibility in the patient, from where this technology must be made accessible everywhere in the world. So we want to progress with the technology.

Keywords: audiology, influence, hearing, madicaly, treatable

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Authors: Aswathy Sampath

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The study examined the levels of self esteem and attachment among adolescents of divorced and non-divorced parents. Adolescent is a period which is most prodigious yet stressful period of development in a human’s life hence it is important to study the effects on them. The study was conducted on total 60 adolescents, 30 in each group, from the area of Trivandrum, Kerala as it is the top rated in the number of divorce cases in India. The data was collected using Rosenberg’s self esteem scale and IPPA (father, mother and peer) The results of this study were analyzed using t test and found that there is no significance difference in the level of self esteem and attachment (father, mother and peer). This is due to the cultural elements that give support to the individual and also the type of family as it is much different from the west. Although, there was no significant result, there were higher mean scores in the attachment towards peer for children who are from separated family background or in other words adolescents whose parents were divorced. This tells us the essence of social support.

Keywords: adolescent, attachment, self esteem, separation

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Authors: Ratnawati Mohd Asraf, Hazlina Abdullah

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Numerous studies on boys’ performance relative to girls’ have been conducted around the globe. However, little has been done in relation to the literacy of primary school boys in the Malaysian context. This paper discusses the results of a study that sought to determine the literacy performance of Grades 1, 2, and 3 primary school students in the state of Selangor, Malaysia. Data on approximately 85,000 students from each grade level were obtained from the Ministry of Education Malaysia, which conducts national screening on literacy and numeracy, or LINUS, in all government primary schools. Teachers’ views were also sought through focus group interviews and journal entries. The results show that although there is an overall improvement in literacy performance in the Malay language among the students as they go into Grades 2 and 3, girls are found to outperform boys in every screening for all grade levels.

Keywords: boys’ underperformance, literacy, literacy performance, reading

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Authors: Horea-Serban Raluca-Ioana, Istrate Marinela

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The first part of the paper analyzes the dynamics of the total fertility rate both at the national and regional level, pointing out the regional disparities in the distribution of this indicator. At the same time, we also focus on the collapse of the number of live births, on the changes in the fertility rate by birth rank, as well as on the failure of acquiring the desired number of children. The second part of the study centres upon a survey applied to urban families with 3 and more than 3 offspring. The preliminary analysis highlights the fact that an increased fertility (more than 3rd rank) is triggered by the parents’ above the average material condition and superior education. The current situation of Romania, which is still passing through a period of relatively rapid demographic changes, marked by numerous convulsions, requires a new approach, in compliance with the recent interpretations appropriate to a new post-transitional demographic regime.

Keywords: fertility rate, family size intention, third birth rank, regional disparities

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Authors: Amita Rana

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From the ancient to modern times, the nature of fitness activities has varied. We can choose any form of exercise that is suitable for our particular need. Watchers of fitness trends say that the road to better health is paved with new possibilities along with some old ones that are poised to make a comeback. Educated, certified and experienced fitness professionals; strength training; fitness programmes for older adults; exercise and weight loss; children and obesity; personal training; core training; group personal training; Zumba and other dance workouts; functional fitness; yoga; comprehensive health promotion programmes at worksite; boot-camp; outdoor activities; reaching new markets; spinning; sport-specific training; worker incentive programmes; wellness coaching; and physician referrals are among the fitness trends included in worldwide surveys. However, trends related to fitness in India could be the same or different. Hence, the present paper makes an attempt to analyze the latest fitness trends in India. A total of eighteen (18) surveys were shortlisted on the basis of their relevance to the present topic of study and were arranged in descending order of their chronology. Content analysis was done after the preliminary set of data collection, which formed the basis of a group of data. Further, frequency and percentage were used to statistically represent the data. It can be concluded from the analysis of data regarding recent fitness trends in India that yoga dominates the fitness activity list, followed by numerous other activities including running, Zumba and sh’bam, boot camp, boxing, kickboxing, cycling, swimming, TRX, ass-pocalypse, ballet, biking, bokwa fitness, dance-iso-bic, masala bhangra, outdoor activities, pilates, planks, push-ups, sofa workouts, stairs Workouts, tabata training, and twerking. The body weight/ gym-specified/ strength training as well as high intensity interval training dominate the preferred workouts; followed by mixed work-outs, cross training work-outs, express work-outs, functional fitness, natural body movements, personalized training, and stay-at-home workouts. General areas that featured in the latest fitness trends in India demonstrates that the fitness is making an impact on all sections of the society be it children, women, older adults, senior citizens, worksite fitness. Fitness is becoming the lifestyle of the masses. People are doing exercise for weight-loss, combining diet with exercising; prefer sweating, making groups participate in fitness activities and wellness programmes. Technology is another area which has a high impact on the lives of people. They are using wearable technology for workout tracking and following numerous mobile friendly apps.

Keywords: fitness, India, survey, trend

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Authors: Mark Linden, Trisha Forbes, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes

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Background The COVID-19 pandemic resulted in a reduction of health care services for many family carers of people with profound and multiple intellectual disabilities (PMID). Due to lack of services, family carers turned to charities for support during the pandemic. We explored the views of charity workers across the UK and Ireland who supported family carers during the COVID-19 pandemic and explored their views on effective online support programmes for family carers. Methods This was a qualitative study using online focus groups with participants (n = 24) from five charities across the UK and Ireland. Questions focused on challenges, supports, coping and resources which helped during lockdown restrictions. Focus groups were audio recorded, transcribed verbatim, and analysed through thematic analysis. Findings Four themes were identified (i) ‘mental and emotional health’, (ii) ‘they who shout the loudest’ (fighting for services), (iii) ‘lack of trust in statutory services’ and (iv) ‘creating an online support programme’. Mental and emotional health emerged as the most prominent theme and included three subthemes named as ‘isolation’, ‘fear of COVID-19’ and ‘the exhaustion of caring’. Conclusions The withdrawal of many services during the COVID-19 pandemic further isolated and placed strain on family carers. Even after the end of the pandemic family cares continue to report on the struggle to receive adequate support. There is a critical need to design services, including online support programmes, in partnership with family carers which adequately address their needs.

Keywords: intellectual disability, family carers, COVID-19, charities

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Authors: Wesam Darawsheh

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Purpose: There is an absence of studies directed to evaluate the effectiveness of Community Based Rehabilitation (CBR) programs in Jordan. This research study is aimed at investigating the effectiveness of the services of CBR programmes in Jordan. Method: A questionnaire anonymized survey was carried out with forty-seven participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised eighteen questions that collected both qualitative and quantitative data with both closed- and open-ended questions. The survey assessed participants’ knowledge of CBR and perception of the effectiveness of services provided. The quantitative data were analyzed using SPSS Version 22.0 (2016, IBM Corporation New York). Qualitative data were analyzed through thematic content and analysis and open coding to identify emergent themes. Results: The ROC curve revealed that the AUC for questions of the survey to be (AUC=0.846) which indicated a good specificity and sensitivity of the questions of the survey. The MANOVA revealed insignificant results in the effect of the CBR site (p= 0.157), and the level of education of participants (p=0.549), on the perception of the effectiveness of CBR services. There were insignificant differences between the scores of PWDs and volunteers (p=0.781). 40.4% evaluated the effectiveness of CBR services to be low. This mainly stemmed out from the lack of efforts of the CBR programmes to raise the knowledge of the local community about CBR, disability and the role toward PWDs. Conclusions: A speculation for priorities of CBR programmes in Jordan was offered where efforts need to be directed at promoting livelihood and the empowerment components, in order to actualize the main three principles of CBR mainly by promoting multispectral collaboration as a way of operation.

Keywords: community based rehabilitation (CBR), people with disabilities (PWDS), CBR centres, rehabilitation services, Jordan, mixed-methods, evaluative study

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Authors: Sandra Landy

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Traumatic experiences in youth are a major risk factor for future suicidality. With suicide steadily increasing over the last 20 years as one of the top three leading causes of death in children and adolescents, it is essential to examine the aspects of trauma that contribute to suicidality. A quantitative secondary data analysis of a prospective, multicenter 24-month observational study of youth who have experienced traumatic experiences was utilized to determine the relationship between bullying and suicide attempts, cyberbullying and suicide attempts, and number of traumas and suicide attempts. Data was analyzed with the Spearman-rank correlation test to determine the relationships. Findings supported past research establishing a relationship between bulling, including cyberbullying, and suicide attempts, as well as increasing number of traumatic experiences and suicide attempts. Further large scale studies may be beneficial to support these findings.

Keywords: adolescent(s), suicide, trauma, bullying, cyberbullying

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Authors: Jennifer E Simpson

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Background and purpose: The ubiquitous use of the Internet and social media by children and young people has had a dual effect. The first is to open a world of possibilities and promise that is characterized by the ability to consume and create content, connect with friends, explore and experiment. The second relates to risks such as unsolicited requests, sexual exploitation, cyberbullying and commercial exploitation. This duality poses significant difficulties for a generation of foster carers and social workers who have no childhood experience to draw on in terms of growing up using the Internet, social media and digital devices. This presentation is concerned with the findings of a small qualitative study about the use of digital devices and the Internet by care-experienced young people to stay in touch with their families and the way this was managed by foster carers and social workers using specific parental mediation strategies. The findings highlight that restrictive strategies were used by foster carers and endorsed by social workers. An argument is made for an approach that develops a series of balanced solutions that move foster carers from such restrictive approaches to those that are grounded in co-use and are interpretive in nature. Methods: Using a purposive sampling strategy, 12 triads consisting of care-experienced young people (aged 13-18 years), their foster carers and allocated social workers were recruited. All respondents undertook a semi-structured interview, with the young people detailing what social media apps and other devices they used to contact their families via an Ecomap. The foster carers and social workers shared details of the methods and approaches they used to manage digital devices and the Internet in general. Data analysis was performed using a Framework analytic method to explore the various attitudes, as well as complementary and contradictory perspectives of the young people, their foster carers and allocated social workers. Findings: The majority of foster carers made use of parental mediation strategies that erred on the side of typologies that included setting rules and regulations (restrictive), ad-hoc checking of a young person’s behavior and device (monitoring), and software used to limit or block access to inappropriate websites (technical). It was noted that minimal use was made by foster carers of parental mediation strategies that included talking about content (active/interpretive) or sharing Internet activities (co-use). Amongst the majority of the social workers, they also had a strong preference for restrictive approaches. Conclusions and implications: Trepidations on the part of both foster carers and social workers about the use of digital devices and the Internet meant that the parental strategies used were weighted more towards restriction, with little use made of approaches such as co-use and interpretative. This lack of balance calls for solutions that are grounded in co-use and an interpretive approach, both of which can be achieved through training and support, as well as wider policy change.

Keywords: parental mediation strategies, risk, children in state care, online safety

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Authors: Naheed Khan

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A non-experimental study was conducted to evaluate the prevalence of anxiety and depression in middle-class women in Karachi, a metropolitan city of Pakistan. The Aga Khan University Anxiety and Depression Scale (AKUADS) was self -administered by a sample of 50 housewives and 50 professional women between the ages of 24 and 54 years. All the participants were at least graduates, married, had children, and were living in joint family systems. Results showed a 48% prevalence of anxiety and depression in housewives as compared to 34% in professional women. The data showed significant difference in mean of total scores on AKUADS and the calculated t-value of 1.957 with a df = 98 and α = 0.05. Two variables, that is, profession and a higher level of education were significantly related to the outcome. Hence acquiring higher education and taking up a job, even a part time one, may alleviate the symptoms of anxiety and depression in housewives. Other factors responsible for the relief of such symptoms, such as quality of relationship with husbands, may be investigated for both categories of women.

Keywords: anxiety, depression, housewives, professional women

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Authors: Chee Wee Gan, Anthony Herr Cheun Ng, Yee Shan Wong, Subbu Venkatraman, Lynne Hsueh Yee Lim

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Otitis media with effusion (OME) is the leading cause of hearing loss in children worldwide. Surgery to insert grommet tube into the eardrum is usually indicated for OME unresponsive to antimicrobial therapy. It is the most common surgery for children. However, current commercially available grommet tubes are non-bioresorbable, not drug-treated, with unpredictable duration of retention on the eardrum to ventilate middle ear. Their functionality is impaired when clogged or chronically infected, requiring additional surgery to remove/reinsert grommet tubes. We envisaged that a novel fully bioresorbable grommet tube with sustained antibiotic release technology could address these drawbacks. In this study, drug-loaded bioresorbable poly(L-lactide-co-ε-caprolactone)(PLC) copolymer grommet tubes were fabricated by microinjection moulding technique. In vitro drug release and degradation model of PLC tubes were studied. Antibacterial property was evaluated by incubating PLC tubes with P. aeruginosa broth. Surface morphology was analyzed using scanning electron microscopy. A preliminary animal study was conducted using guinea pigs as an in vivo model to evaluate PLC tubes with and without drug, with commercial Mini Shah grommet tube as comparison. Our in vitro data showed sustained drug release over 3 months. All PLC tubes revealed exponential degradation profiles over time. Modeling predicted loss of tube functionality in water to be approximately 14 weeks and 17 weeks for PLC with and without drug, respectively. Generally, PLC tubes had less bacteria adherence, which were attributed to the much smoother tube surfaces compared to Mini Shah. Antibiotic from PLC tube further made bacteria adherence on surface negligible. They showed neither inflammation nor otorrhea after 18 weeks post-insertion in the eardrums of guinea pigs, but had demonstrated severe degree of bioresorption. Histology confirmed the new PLC tubes were biocompatible. Analyses on the PLC tubes in the eardrums showed bioresorption profiles close to our in vitro degradation models. The bioresorbable antibiotic-loaded grommet tubes showed good predictability in functionality. The smooth surface and sustained release technology reduced the risk of tube infection. Tube functional duration of 18 weeks allowed sufficient ventilation period to treat OME. Our ongoing studies include modifying the surface properties with protein coating, optimizing the drug dosage in the tubes to enhance their performances, evaluating their functional outcome on hearing after full resoption of grommet tube and healing of eardrums, and developing animal model with OME to further validate our in vitro models.

Keywords: bioresorbable polymer, drug release, grommet tube, guinea pigs, otitis media with effusion

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Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

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Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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Authors: Marta Maria Aguilar Carceles, Ginesa Torrente Hernandez

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The goal of the current study is focused on giving an interdisciplinary comprehension of an increased phenomenon in recent years: violence against parents. Violence can take different forms depending on the context and the vulnerability of the victims, but in this kind of situations, the relationship between parents and young people can become abusive and uncontrollable. Taking a sample from the Spanish Criminal Courts, this study explores those psychological and sociological factors that can contribute to the appearance and continuity of this kind of behaviors in minors. It is considered factors like the type of offence, presence or absence of psychopathology in the subjects, family aspects, or sociodemographic factors, getting a criminal profile of the minor and evaluating which measures are more efficient or adequate in each particular case. Finally, it will be discussed on how getting effective interventions and restorative responses to address teen violence against their parents within the Spanish Legal System.

Keywords: criminality, legal system, parents, tyrant sons, violence

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Authors: Lugyi No

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This research delves into how students from two different backgrounds in a conflict-affected area, one group being internally displaced (IDP) and the other residing in permanent homes, express their emotions through art. Two experiments were conducted involving guided drawing to understand their emotional experiences. In the first experiment, where no specific instructions were given, both groups mostly used dark and dull colors, which suggests feelings of sadness and anxiety. Positive emotions were rarely depicted. In the second experiment, students were asked to express their emotions and provide reasons for their drawings. Here, we observed distinct variations: IDP students leaned towards vibrant colors, reflecting resilience, while town students tended to use monochromatic shades, likely due to their experiences with conflict. This abstract highlights the differing emotional expressions of these groups and the influence of instructions on their artwork.

Keywords: art therapy, conflict-affected areas, education in conflict zones, children's drawings

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Authors: Parul Jindal, Shubhi Singh, Priya Ramakrishnan, Shailender Raghuvanshi

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Background: Knowledge of the influence of the age of the child on laryngeal dimensions is essential for all practitioners who are dealing with paediatric airway. Choosing the correct endotracheal tube (ETT) size is a crucial step in pediatric patients because a large-sized tube may cause complications like post-extubation stridor and subglottic stenosis. On the other hand with a smaller tube, there will be increased gas flow resistance, aspiration risk, poor ventilation, inaccurate monitoring of end-tidal gases and reintubation may also be required with a different size of the tracheal tube. Recent advancement in ultrasonography (USG) techniques should now allow for accurate and descriptive evaluation of pediatric airway. Aims and objectives: This study was planned to determine the accuracy of Ultrasonography (USG) to assess the appropriate ETT size and compare it with physical indices based formulae. Methods: After obtaining approval from Institute’s Ethical and Research committee, and parental written and informed consent, the study was conducted on 100 subjects of either sex between 12-60 months of age, undergoing various elective surgeries under general anesthesia requiring endotracheal intubation. The same experienced radiologist performed ultrasonography. The transverse diameter was measured at the level of cricoids cartilage by USG. After USG, general anesthesia was administered using standard techniques followed by the institute. An experienced anesthesiologist performed the endotracheal intubations with uncuffed endotracheal tube (Portex Tracheal Tube Smiths Medical India Pvt. Ltd.) with Murphy’s eye. He was unaware of the finding of the ultrasonography. The tracheal tube was considered best fit if air leak was satisfactory at 15-20 cm H₂O of airway pressure. The obtained values were compared with the values of endotracheal tube size calculated by ultrasonography, various age, height, weight-based formulas and diameter of right and left little finger. The correlation of the size of the endotracheal tube by different modalities was done and Pearson's correlation coefficient was obtained. The comparison of the mean size of the endotracheal tube by ultrasonography and by traditional formula was done by the Friedman’s test and Wilcoxon sign-rank test. Results: The predicted tube size was equal to best fit and best determined by ultrasonography (100%) followed by comparison to left little finger (98%) and right little finger (97%) and age-based formula (95%) followed by multivariate formula (83%) and body length (81%) formula. According to Pearson`s correlation, there was a moderate correlation of best fit endotracheal tube with endotracheal tube size by age-based formula (r=0.743), body length based formula (r=0.683), right little finger based formula (r=0.587), left little finger based formula (r=0.587) and multivariate formula (r=0.741). There was a strong correlation with ultrasonography (r=0.943). Ultrasonography was the most sensitive (100%) method of prediction followed by comparison to left (98%) and right (97%) little finger and age-based formula (95%), the multivariate formula had an even lesser sensitivity (83%) whereas body length based formula was least sensitive with a sensitivity of 78%. Conclusion: USG is a reliable method of estimation of subglottic diameter and for prediction of ETT size in children.

Keywords: endotracheal intubation, pediatric airway, subglottic diameter, traditional formulas, ultrasonography

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Authors: Elena Petersen, Inna Kornienko, Svetlana Guryeva, Sergey Dobdin, Anatoly Skripal, Andrey Usanov, Dmitry Usanov

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One of the most important unsolved problems in modern medicine is the increase of chronic diseases that lead to organ dysfunction or even complete loss of function. Current methods of treatment do not result in decreased mortality and disability statistics. Currently, the best treatment for many patients is still transplantation of organs and/or tissues. Therefore, finding a way of correct artificial matrix biofabrication in case of limited number of natural organs for transplantation is a critical task. One important problem that needs to be solved is development of a nondestructive and noninvasive method to analyze dynamic changes of mechanical characteristics of a matrix with minimal side effects on the growing cells. This research was focused on investigating the properties of matrix as a marker of graft condition. In this study, the collagen gel with human primary dermal fibroblasts in suspension (60, 120, 240*103 cells/mL) and collagen gel with cell spheroids were used as model objects. The stiffness and elasticity characteristics were evaluated by a semiconductor laser autodyne. The time and cell concentration dependency of the stiffness and elasticity were investigated. It was shown that these properties changed in a non-linear manner with respect to cell concentration. The maximum matrix stiffness was observed in the collagen gel with the cell concentration of 120*103 cells/mL. This study proved the opportunity to use the mechanical properties of matrix as a marker of graft condition, which can be measured by noninvasive semiconductor laser autodyne technique.

Keywords: graft, matrix, noninvasive method, regenerative medicine, semiconductor laser autodyne

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Authors: Limor Gadot, Orly Sarid

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Integration of young adults with disabilities (YAWD) into workplaces provides an opportunity for social and occupational mobility, enabling them to financial independence. To enhance integration, it is important to understand their occupational preferences as well as the factors that influencing it such as demographic variables, self-assessed health, beliefs about work, subjective norms, and self-efficacy. Planned behavior theory was chosen as a basis for this study. A cross-sectional study, based on preliminary sample of 37 YAWD who have been recognized by the National Insurance Institute and are engaged in a year of national service. The finding shows that most of the participants were single (97%) women (60%); average age was 22(+ 2) years, approximately half were secular. Most of the participants had disabilities resulting from CP (96%). Self-assessed health was correlated positively and significantly with behavioral intentions to work in the free market (r = .33, p = .05), and significant negative correlation with behavioral intentions to work in supported settings (r =.-40, p = .01), and sheltered settings (r =-.36, p = .03): individuals who perceived themselves as having more severe disabilities showed a greater tendency to choose a workplace with more rehabilitative inputs. Furthermore, women showed a greater tendency than men to perceive their disability as impairing their future intention to work: t (36) = 2.23, p < .05. Beliefs about work were positively associated with normative beliefs (r = .308, p = .06). The findings indicate that, especially with women, perceptions of health are related to occupational preferences. Moreover, the findings indicate that the relationship between subjective norms about work and normative beliefs about integrating in a workplace that prevail in the individual's environment affects occupational preferences. The contribution of the study lies in the development of new responses and interventions to encourage adults with disabilities to work.

Keywords: young adults, disabilities, work preferences, occupational preferences

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Authors: Elena Kokkoni, Prasanna Kannappan, Ashkan Zehfroosh, Effrosyni Mavroudi, Kristina Strother-Garcia, James C. Galloway, Jeffrey Heinz, Rene Vidal, Herbert G. Tanner

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Early immobility affects the motor, cognitive, and social development. Current pediatric rehabilitation lacks the technology that will provide the dosage needed to promote mobility for young children at risk. The addition of socially assistive robots in early interventions may help increase the mobility dosage. The aim of this study is to examine the feasibility of an early intervention paradigm where non-walking infants experience independent mobility while socially interacting with robots. A dynamic environment is developed where both the child and the robot interact and learn from each other. The environment involves: 1) a range of physical activities that are goal-oriented, age-appropriate, and ability-matched for the child to perform, 2) the automatic functions that perceive the child’s actions through novel activity recognition algorithms, and decide appropriate actions for the robot, and 3) a networked visual data acquisition system that enables real-time assessment and provides the means to connect child behavior with robot decision-making in real-time. The environment was tested by bringing a two-year old boy with Down syndrome for eight sessions. The child presented delays throughout his motor development with the current being on the acquisition of walking. During the sessions, the child performed physical activities that required complex motor actions (e.g. climbing an inclined platform and/or staircase). During these activities, a (wheeled or humanoid) robot was either performing the action or was at its end point 'signaling' for interaction. From these sessions, information was gathered to develop algorithms to automate the perception of activities which the robot bases its actions on. A Markov Decision Process (MDP) is used to model the intentions of the child. A 'smoothing' technique is used to help identify the model’s parameters which are a critical step when dealing with small data sets such in this paradigm. The child engaged in all activities and socially interacted with the robot across sessions. With time, the child’s mobility was increased, and the frequency and duration of complex and independent motor actions were also increased (e.g. taking independent steps). Simulation results on the combination of the MDP and smoothing support the use of this model in human-robot interaction. Smoothing facilitates learning MDP parameters from small data sets. This paradigm is feasible and provides an insight on how social interaction may elicit mobility actions suggesting a new early intervention paradigm for very young children with motor disabilities. Acknowledgment: This work has been supported by NIH under grant #5R01HD87133.

Keywords: activity recognition, human-robot interaction, machine learning, pediatric rehabilitation

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Authors: Khadija Al Farei, Prakash Kumar, Vikas Rao Naidu

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Games are being developed with different genres for different age groups, for many decades. In many places, educational games are playing a vital role for active classroom environment and better learning among students. Currently, the educational games have assumed an important place in children and teenagers lives. The role of educational games is important for improving the learning capability among the students especially of this generation, who really live among electronic gadgets. Hence, it is now important to make sure that in our educational system, we are updated with all such advancement in technologies. Already much research is going on in this area of edutainment. This research paper will review around ten different research papers to find the relation between the education learning techniques and games. The result of this review provides guidelines for enhanced teaching and learning solutions in education. In-house developed educational games proved to be more effective, compared to the one which is readily available in the market.

Keywords: education, education game, educational technology, edutainment, game genres, gaming in education

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Authors: N. Zeinalzadeh, Mahdi Sadeghi

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Enterotoxigenic Escherichia coli (ETEC) is the most common cause of non-inflammatory diarrhea in the developing countries, resulting in approximately 20% of all diarrheal episodes in children in these areas. ST is one of the most important virulence factors and CFA/I is one of the frequent colonization factors that help to process of ETEC infection. ST and CfaB (CFA/I subunit) are among vaccine candidates against ETEC. So, ST because of its small size is not a good immunogenic in the natural form. However to increase its immunogenic potential, here we explored candidate positions for ST insertion in CfaB sequence. After bioinformatics analysis, one of the candidate positions was selected and the chimeric gene (cfaB*st) sequence was synthesized and expressed in E. coli BL21 (DE3). The chimeric recombinant protein was purified with Ni-NTA columns and characterized with western blot analysis. The residue 74-75 of CfaB sequence could be a good candidate position for ST and other epitopes insertion.

Keywords: bioinformatics, CFA/I, enterotoxigenic E. coli, ST toxoid

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Authors: Tadaaki Tomiie, Hiroki Shinkawa

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The present study was aimed to examine the structure of children’s adaptation during school transition and to identify a commonality and dissimilarity at the elementary and junior high school. 1,983 students in the 6th grade and 2,051 students in the 7th grade were extracted by stratified two-stage random sampling and completed the ASSESS that evaluated the school adaptation from the view point of ‘general satisfaction’, ‘teachers’ support’, ‘friends’ support’, ‘anti-bullying relationship’, ‘prosocial skills’, and ‘academic adaptation’. The 7th graders tend to be worse adaptation than the 6th graders. A structural equation modeling showed the goodness of fit for each grades. Both models were very similar but the 7th graders’ model showed a lower coefficient at the pass from ‘teachers’ support’ to ‘friends’ support’. The role of ‘teachers’ support’ was decreased to keep a good relation in junior high school. We also discussed how we provide a continuous assistance for prevention of the 7th graders’ gap.

Keywords: school transition, social support, psychological adaptation, K-12

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Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

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Background: Family carers of people with intellectual disabilities (ID) face ongoing challenges in accessing services and often experience poor mental health. Online support programmes may prove effective in addressing the mental health and well-being needs of family carers. This study sought to test the acceptability of a newly developed online support programme for carers of people with intellectual disabilities called Carers-ID. Methods A sequential mixed-methods explanatory design was utilised. An adapted version of the Acceptability of Health Apps among Adolescents (AHAA) Scale was distributed to family carers who had viewed the Carers-ID.com intervention. Following this, participants were invited to take part in an online interview. Interview questions focused on participants’ experiences of using the programme and its acceptability. Qualitative and quantitative data were analysed separately and then brought together through the triangulation protocol developed by Farmer et al (2006). Findings: Seventy family carers responded to the acceptability survey, whilst 10 took part in interviews. Six themes were generated from interviews with family carers. Based on our triangulation, four areas of convergence were identified, these included, programme usability and ease, attitudes towards the programme, perceptions of effectiveness, and programme relatability. Conclusions: In order to be acceptable, online interventions for carers of people with ID need to be accessible, understandable and easy to use, as carers time is precious. Further research is needed to investigate the effectiveness of online interventions for family carers, specifically considering which carers the intervention works for, and for whom it may not.

Keywords: intellectual disability, family carer, acceptability study, online intervention

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Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

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Background: The COVID-19 pandemic exacerbated the already significant strain placed on family carers of people with profound and multiple intellectual disabilities (PMID), given the withdrawal of many services during lockdown. The aim of this study was to explore the experiences of family carers of people with PMID during the COVID-19 pandemic. Methods: Online focus groups were conducted with family carers (n=126) from across the UK and the Republic of Ireland. Participants were asked about their experiences of the COVID-19 pandemic, coping strategies, and challenges faced. Focus groups were audio recorded, transcribed verbatim and analyzed through thematic analysis. Findings: Three themes emerged from our analysis of the data: (i) COVID-19 as a double-edged sword, (ii) The struggle for support (iii) the Constant nature of caring. These included 11 subthemes: (i) ‘COVID-19 as a catalyst for change’, ‘Challenges during COVID-19: dealing with change’, ‘Challenges during COVID-19: fear of COVID-19’, ‘The online environment: the new normal’ (ii) ‘Invisibility of male carers’, ‘Carers supporting carers’, ‘The only service you get is lip service: non-existent services’, ‘Knowing your rights’ (iii) ‘Emotional response to the caring role: Feeling devalued’, ‘Emotional response to the caring role: Desperation of caring’, ‘Multiple demands of the caring role.’ Conclusions: Poor or inconsistent access to services and support has been an ongoing difficulty for many family carers. The COVID-19 pandemic has only further intensified these difficulties, increasing family carers' stress. There is an urgent need to design services, such as online support programs, in partnership with family carers that adequately address their needs.

Keywords: intellectual disabilities, family carer, COVID-19, disability

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Authors: Peter R. Alfieri

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The principal aim of this research and presentation is to give global and personal perspective of the migratory diaspora and how it is perceived by a substantial majority that relies on the media’s portrayal of migratory movements. Since its Greek origins the word “diaspora” has taken on several connotations, but none has surpassed its use in regard to the human element; because since before the dawn of history, man has had to struggle for survival. That survival was a struggle against the elements and other natural enemies, but none as tenacious and relentless as other men. Many have used the term diaspora to describe the spread of certain ethnic groups resulting in new generations in new places; but has the human diaspora been as haphazard as that of spores? The quest for survival has spawned migrations that are not quite that simple, even though it has several similarities to plant spores or dandelion seeds flying throughout the atmosphere. Man kind has constantly migrated in search of food, shelter, and safety. When they were able to find food and shelter, they would inform others who would venture to the new place. Information, whether through word of mouth, written material, or visual communications, has been a moving force in man’s life; and it spurred migrants in their quest for better environments. Today we pride ourselves in being able to communicate instantly with anyone anywhere in the world, and we are privileged to see most of what is happening in the world thanks to the highly developed modern media. Is Media a “wind/force” instrumental in propelling the diaspora throughout the world? The media has been the tool that has incentive many migratory, but unfortunately it is also the means responsible for many misconceptions regarding migrants and their hosts. Has the Media presented an unbiased view of the migrant or has it been the means that generated negative or prejudiced views of the migrant and, perhaps, the host environment? Some examples were easily seen in 19th century the United States where they advertised the following, “Help needed, Irish need not apply”. How do immigrants circumvent latent barriers that are not as obvious as the ones just mentioned? Some immigrants return home and have children that decide to emigrate. It is a perpetual cycle in the search for self-improvement. The stories that are brought back might be inspiration for the new generation of emigrants. Poverty, hunger, and political turmoil spur most migrations. The majority learn from others or through the media about certain destinations that will provide one or several opportunities to improve their existence. Many of those migrants suffer untold hardships to succeed. When they succeed, they provide a great incentive for their children to obtain an education or skill that will insure them a better life. Although the new environment may contribute greatly to a successful career, most immigrants do not forget their own struggle. They see the media’s portrayal of other migrants from all over the globe. Some try to communicate to others the true feelings of despair felt by immigrants, because they are all brothers and sisters in the perennial struggle for a better life. “HOPE” for a better life drives the immigrant toward the unknown and it has helped overcome the obstacles that present themselves challenging every newcomer. Hope and perseverance strengthen the resolve of the migrant in his struggle to survive.

Keywords: media, migration, heath, education, obstacles

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Authors: Ananya Ananya, Karthik Rao

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Accurate segmentation of knee cartilage in 3-D magnetic resonance (MR) images for quantitative assessment of volume is crucial for studying and diagnosing osteoarthritis (OA) of the knee, one of the major causes of disability in elderly people. Radiologists generally perform this task in slice-by-slice manner taking 15-20 minutes per 3D image, and lead to high inter and intra observer variability. Hence automatic methods for knee cartilage segmentation are desirable and are an active field of research. This paper presents design and experimental evaluation of 2D convolutional neural networks based fully automated methods for knee cartilage segmentation in 3D MRI. The architectures are validated based on 40 test images and 60 training images from SKI10 dataset. The proposed methods segment 2D slices one by one, which are then combined to give segmentation for whole 3D images. Proposed methods are modified versions of U-net and dilated convolutions, consisting of a single step that segments the given image to 5 labels: background, femoral cartilage, tibia cartilage, femoral bone and tibia bone; cartilages being the primary components of interest. U-net consists of a contracting path and an expanding path, to capture context and localization respectively. Dilated convolutions lead to an exponential expansion of receptive field with only a linear increase in a number of parameters. A combination of modified U-net and dilated convolutions has also been explored. These architectures segment one 3D image in 8 – 10 seconds giving average volumetric Dice Score Coefficients (DSC) of 0.950 - 0.962 for femoral cartilage and 0.951 - 0.966 for tibia cartilage, reference being the manual segmentation.

Keywords: convolutional neural networks, dilated convolutions, 3 dimensional, fully automated, knee cartilage, MRI, segmentation, U-net

Procedia PDF Downloads 245