Search results for: individuals with spinal cord injuries
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3807

Search results for: individuals with spinal cord injuries

1167 Evolving Paradigm of Right to Development in International Human Rights Law and Its Transformation into the National Legal System: Challenges and Responses in Pakistan

Authors: Naeem Ullah Khan, Kalsoom Khan

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No state can be progressive and prosperous in which a large number of people is deprived of their basic economic rights and freedoms. In the contemporary world of globalization, the right to development has gained a momentum force in the domain of International Development Law (IDL) and has integrated into the National Legal System (NLS) of the major developed states. The international experts on human rights argued that the right to development (RTD) is called a third-generation human right which tends to enhance the welfare and prosperity of individuals, and thus, it is a right to a process whose outcomes are human rights despite the controversy on the implications of RTD. In the Pakistan legal system, the RTD has not been expressly stated in the constitution of the Islamic Republic of Pakistan, 1973. However, there are some implied constitutional provisions which reflect the concept of RTD. The jurisprudence on RTD is still an evolving paradigm in the contextual perspective of Pakistan, and the superior court of diverse jurisdiction acts as a catalyst regarding the protection and enforcement of RTD in the interest of the public at large. However, the case law explores the positive inclination of the courts in Pakistan on RTD be incorporated as an express provision in the chapters of fundamental rights; in this scenario, the high court’s of Pakistan under Article 199 and the supreme court of Pakistan under Article 184(3) have exercised jurisdiction on the enforcement of RTD. This paper inter-alia examines the national dimensions of RTD from the standpoint of state practice in Pakistan and it analyzes the experience of judiciary in the protection and enforcement of RTD. Moreover, the paper highlights the social and cultural challenges to Pakistan in the implementation of RTD and possible solution to improve the conditions of human rights in Pakistan. This paper will also highlight the steps taken by Pakistan regarding the awareness, incorporation, and propagation of RTD at the national level.

Keywords: globalization, Pakistan, RTD, third-generation right

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1166 Wellbeing Warriors: A Randomized Controlled Trial Examining the Effect of Martial Arts Training on Mental Health Outcomes

Authors: Brian Moore, Stuart Woodcock, Dean Dudley

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Mental health problems have significant social and economic consequences; however, many individuals do not seek traditional assistance for mental health difficulties. Martial arts training may provide an inexpensive alternative to traditional psychological therapy. While limited research has suggested martial arts training may be an efficacious intervention, the validity and reliability of this are questionable given the small number of relevant studies and other methodological problems. The study examined the effects of 10-week martial arts-based psycho-social intervention which was evaluated using a randomized controlled trial. The intervention was delivered to 283 secondary school students, aged between 12-14 years, who were recruited from government and catholic secondary schools in New South Wales, Australia. The intervention was delivered in a group format onsite at participating schools and had an intervention dose of 10 x 50-60 minute sessions, once per week for 10 weeks. Data were collected at baseline, post-intervention, and 12-week follow-up. Results found a consistent pattern for strength based wellbeing outcomes. All primary and secondary measures relating to resilience and self-efficacy improved for the intervention group and declined for the control group. As these findings were derived from a robust design and rigorous evaluation, they provide valid and reliable evidence that martial arts-based psycho-social interventions can be considered as an efficacious method of improving strength and wellbeing outcomes.

Keywords: martial arts, mental health, resilience, self-efficacy

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1165 Shared Decision-Making in Holistic Healthcare: Integrating Evidence-Based Medicine and Values-Based Medicine

Authors: Ling-Lang Huang

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Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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1164 A Case Report on Diaphragm Disease of Small Bowel Following Usage of Non-Steroidal Anti-Inflammatory Drugs

Authors: Shivani Kuttuva, Bridget Fergie, Andrew Mishreki, Shovkat Mir, Fintan Bergin

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Diaphragm disease (DD) of the small bowel is a condition wherein the bowel lumen is divided into a series of short compartments by multiple circumferential membranes of mucosa and submucosa, leading to pinhole lumen and subsequent obstruction. It is a rare condition commonly attributed to non-steroidal anti-inflammatory drugs (NSAIDs) usage. Herein we present a 31-yr-old-female with a history of NSAIDs usage for one year following neurosurgery, who presented with recurrent idiopathic small bowel obstruction, recalcitrant anaemia, and impaction of capsule endoscope on investigating for anaemia. The capsule endoscopy images demonstrated multiple circumferential strictures with ulcers at its tip and villous atrophy in the proximal bowel, suggestive of NSAIDs related damage. However, due to the lack of awareness of the detrimental effects of NSAIDs on bowel mucosa distal to the duodenum, the underlying aetiology of this clinical presentation remained a mystery for a significant duration. The patient had to undergo repeated laparotomies in order to relieve the symptoms of recurring acute small bowel obstruction. Upon examining the resected specimen under microscopy, the histopathological hallmark of expanded, fibrotic, and congested submucosa was picked up, leading to the confirmation of diaphragm disease. Thus, this case report aims to widen the awareness among clinicians and aid surgeons in devising a management plan for young individuals presenting with recurring episodes of obstruction due to Diaphragm disease.

Keywords: capsule endoscopy, diaphragm disease, NSAIDs, recurrent small bowel obstruction

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1163 Improving Healthcare Readiness to Respond to Human Trafficking: A Case Study

Authors: Traci A. Hefner

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Limited research exists on the readiness of emergency departments to respond to human trafficking (HT). The purpose of this qualitative case study was to improve the readiness of a Department of Emergency Medicine (ED), located in the southeast region of the United States, in identifying, assessing, and responding to trafficked individuals. The research objectives were to 1) provide an organizing framework to understand the ED’s readiness to respond to HT, using the Transtheoretical Model’s stages of change construct, 2) explain the readiness of the ED through a three-pronged contextual approach that included policies and procedures, patient data collection processes, and clinical practice methods, and 3) develop recommendations to respond to HT. Content analysis was used for document reviews and on-site observations, while thematic analysis identified themes of staff perceptions of the ED’s readiness in interviews of over 30 clinical and non-clinical healthcare professionals. Results demonstrated low levels of readiness to identify HT through the ED’s policies and procedures, data collection processes, and clinical practice methods. Clinical practice-related factors consisted of limited awareness of HT warning signs and low-levels of knowledge about community resources for possible HT referrals. Policy and practice recommendations to increase the ED’s readiness to respond to HT included: developing staff trainings across the ED system to enhance awareness of HT warning signs, incorporating HT into current policies and procedures for vulnerable patient populations as well as creating a HT protocol that addresses policies and procedures, screening tools, and community referrals.

Keywords: emergency medicine, human trafficking, organizational assessment, stages of change

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1162 Limitations of Recent National Enactments on International Crimes: The Case of Kenya, Uganda and Sudan

Authors: Emma Charlene Lubaale

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The International Criminal Court (ICC) operates based on the principle of complementarity. On the basis of this principle, states enjoy the primary right to prosecute international crimes, with the ICC intervening only when a state with jurisdiction over an international crime is unable or unwilling to prosecute. To ably exercise their primary right to prosecute international crimes domestically, a number of states are taking steps to criminalise international crimes in their national laws. Significant to note, many of the laws enacted are not being applied in the prosecution of the international crimes allegedly committed. Kenya, Uganda and Sudan are some notable states where commission of international crimes is documented. All these states have recently enacted laws on international crimes. Kenya enacted the International Crimes Act in 2008, Uganda enacted the International Criminal Court Act in 2010 and in 2007, Sudan made provision for international crimes under its Armed Forces Act. However, in all these three states, the enacted national laws on international crimes have thus far not featured in any of the proceedings before these states’ courts. Instead, these states have either relied on ordinary crimes to prosecute international crimes or not prosecuted international crimes altogether. This paper underscores the limitations of the enacted laws, explaining why, even with efforts taken by these states to enact national laws on international crimes, these laws cannot be relied on to advance accountability for the international crimes. Notably, the laws in Kenya and Uganda do not have retroactive application. In Sudan, despite the 2007 reforms, the structure of military justice in Sudan has the effect of placing certain categories of individuals beyond the reach of international criminal justice. For Kenya and Uganda, it is concluded that the only benefit that flows from these enactments is reliance on them to prosecute future international crimes. For Sudan, the 2007 reforms will only have the desired impact if reforms are equally made to the structure of military justice.

Keywords: complementarity, national laws, Kenya, Sudan, Uganda, international crimes, limitations

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1161 The Effects of Transcranial Direct Current Stimulation on Brain Oxygenation and Pleasure during Exercise

Authors: Alexandre H. Okano, Pedro M. D. Agrícola, Daniel G. Da S. Machado, Luiz I. Do N. Neto, Luiz F. Farias Junior, Paulo H. D. Nascimento, Rickson C. Mesquita, John F. Araujo, Eduardo B. Fontes, Hassan M. Elsangedy, Shinsuke Shimojo, Li M. Li

Abstract:

The prefrontal cortex is involved in the reward system and the insular cortex integrates the afferent inputs arriving from the body’ systems and turns into feelings. Therefore, modulating neuronal activity in these regions may change individuals’ perception in a given situation such as exercise. We tested whether transcranial direct current stimulation (tDCS) change cerebral oxygenation and pleasure during exercise. Fourteen volunteer healthy adult men were assessed into five different sessions. First, subjects underwent to a maximum incremental test on a cycle ergometer. Then, subjects were randomly assigned to a transcranial direct current stimulation (2mA for 15 min) intervention in a cross over design in four different conditions: anode and cathode electrodes on T3 and Fp2 targeting the insular cortex, and Fpz and F4 targeting prefrontal cortex, respectively; and their respective sham. These sessions were followed by 30 min of moderate intensity exercise. Brain oxygenation was measured in prefrontal cortex with a near infrared spectroscopy. Perceived exertion and pleasure were also measured during exercise. The asymmetry in prefrontal cortex oxygenation before the stimulation decreased only when it was applied over this region which did not occur after insular cortex or sham stimulation. Furthermore, pleasure was maintained during exercise only after prefrontal cortex stimulation (P > 0.7), while there was a decrease throughout exercise (P < 0.03) during the other conditions. We conclude that tDCS over the prefrontal cortex changes brain oxygenation in ventromedial prefrontal cortex and maintains perceived pleasure during exercise. Therefore, this technique might be used to enhance effective responses related to exercise.

Keywords: affect, brain stimulation, dopamine neuromodulation, pleasure, reward, transcranial direct current stimulation

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1160 Altered Expression of Ubiquitin Editing Complex in Ulcerative Colitis

Authors: Ishani Majumdar, Jaishree Paul

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Introduction: Ulcerative Colitis (UC) is an inflammatory disease of the colon resulting from an autoimmune response towards individual’s own microbiota. Excessive inflammation is characterized by hyper-activation of NFkB, a transcription factor regulating expression of various pro-inflammatory genes. The ubiquitin editing complex consisting of TNFAIP3, ITCH, RNF11 and TAX1BP1 maintains homeostatic levels of active NFkB through feedback inhibition and assembles in response to various stimuli that activate NFkB. TNFAIP3 deubiquitinates key signaling molecules involved in NFkB activation pathway. ITCH, RNF11 and TAX1BP1 provide substrate specificity, acting as adaptors for TNFAIP3 function. Aim: This study aimed to find expression of members of the ubiquitin editing complex at the transcript level in inflamed colon tissues of UC patients. Materials and Methods: Colonic biopsy samples were collected from 30 UC patients recruited at Department of Gastroenterology, AIIMS (New Delhi). Control group (n= 10) consisted of individuals undergoing examination for functional disorders. Real Time PCR was used to determine relative expression with GAPDH as housekeeping gene. Results: Expression of members of the ubiquitin editing complex was significantly altered during active disease. Expression of TNFAIP3 was upregulated while concomitant decrease in expression of ITCH, RNF11, TAX1BP1 was seen in UC patients. Discussion: This study reveals that increase in expression of TNFAIP3 was unable to control inflammation during active UC. Further, insufficient upregulation of ITCH, RNF11, TAX1BP1 may limit the formation of the ubiquitin complex and contribute to pathogenesis of UC.

Keywords: altered expression, inflammation, ubiquitin editing complex, ulcerative colitis

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1159 Development of the New York Misophonia Scale: Implications for Diagnostic Criteria

Authors: Usha Barahmand, Maria Stalias, Abdul Haq, Esther Rotlevi, Ying Xiang

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Misophonia is a condition in which specific repetitive oral, nasal, or other sounds and movements made by humans trigger impulsive aversive reactions of irritation or disgust that instantly become anger. A few measures exist for the assessment of misophonia, but each has some limitations, and evidence for a formal diagnosis is still lacking. The objective of this study was to develop a reliable and valid measure of misophonia for use in the general population. Adopting a purely descriptive approach, this study focused on developing a self-report measure using all triggers and reactions identified in previous studies on misophonia. A measure with two subscales, one assessing the aversive quality of various triggers and the other assessing reactions of individuals, was developed. Data were gathered from a large sample of both men and women ranging in age from 18 to 65 years. Exploratory factor analysis revealed three main triggers: oral/nasal sounds, hand and leg movements, and environmental sounds. Two clusters of reactions also emerged: nonangry attempts to avoid the impact of the aversive stimuli and angry attempts to stop the aversive stimuli. The examination of the psychometric properties of the scale revealed its internal consistency and test-retest reliability to be excellent. The scale was also found to have very good concurrent and convergent validity. Significant annoyance and disgust in response to the triggers were reported by 12% of the sample, although for some specific triggers, rates as high as 31% were also reported. These findings have implications for the delineation of the criteria for identifying misophonia as a clinical condition.

Keywords: adults, factor analysis, misophonia, psychometric properties, scale

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1158 Influence of Social, Economic, Political and Legal Environment of Sport Organizations on Sport Development in Zone Ten (10) of National Zonal Sport Offices in Nigeria

Authors: Ejeh Benjamin Ijuo

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The purpose of this study was to investigate the influence of social, economic, political, and legal environment of sport organizations on sport development in zone ten (10) national zonal sport offices in Nigeria (Plateau, Nasarawa, Benue and F.C.T Abuja). To achieve this purpose, a structured 26 item questionnaire (ISEPLESOQ) designed by the researcher was used for this study. Related literature to this study was reviewed. 311 copies of questionnaire were administered to randomly selected respondents. Out of this number, 306 was dully completed and returned representing 98.4%. The respondents included: Athletes, games masters/ mistresses, coaches in state sport councils, zonal sport coordinators, team managers, directors of state sports council. Four research questions were answered using the mean and standard deviation, while the inferential statistics of chi-square(x2) test of goodness of fit was used to test the four hypotheses at 0.05 alpha levels. The findings of this study revealed that the social, economic, political and legal environment of sport organizations significantly influenced sport development in zone ten (10) national zonal sport offices in Nigeria. It was also established that the general environment of sport organizations influences people’s participation in sport, funding and sponsorship of sports, sitting of equipment and facilities at different locations, selection of athletes. It was therefore, recommended among other things that government should privatize and commercialized sport programmes to enable corporate organizations and individuals participation. Lt was further suggested that the federal government should harness her social, economic, political and legal environment to improve sport development in Nigeria.

Keywords: sport organization, sport development, sport environment, zonal sport offices

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1157 Use of Social Media in PR: A Change of Trend

Authors: Tang Mui Joo, Chan Eang Teng

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The use of social media has become more defined. It has been widely used for the purpose of business. More marketers are now using social media as tools to enhance their businesses. Whereas on the other hand, there are more and more people spending their time through mobile apps to be engaged in the social media sites like YouTube, Facebook, Twitter and others. Social media has even become common in Public Relations (PR). It has become number one platform for creating and sharing content. In view to this, social media has changed the rules in PR where it brings new challenges and opportunities to the profession. Although corporate websites, chat-rooms, email customer response facilities and electronic news release distribution are now viewed as standard aspects of PR practice, many PR practitioners are still struggling with the impact of new media though the implementation of social media is potentially reducing the cost of communication. It is to the point that PR practitioners are not fully embracing new media, they are ill-equipped to do so and they have a fear of the technology. Somehow that social media has become a new style of communication that is characterized by conversation and community. It has become a platform that allows individuals to interact with one another and build relationship among each other. Therefore, in the use of business world, consumers are able to interact with those companies that have joined any social media. Based on their experiences with social networking site interactions, they are also exposed to personal interaction while communicating. This paper is to study the impact of social media to PR. This paper discovers the potential changes of PR practices in a developing country like Malaysia. Eventually the study reflects on how PR practitioners are actually using social media in the country. This paper is based on two theories in its development of this research foundation. Media Ecology Theory is to support the impact and changes to PR. Social Penetration Theory is to reflect on how the use of social media is among PRs. This research is using survey with PR practitioners in its data collection. The results have shown that PR professionals value social media more than they actually use it and the way of organizations communicate had been changed due to the transformation of social media.

Keywords: new media, social media, PR, change of trend, communication, digital culture

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1156 To Assess Variables Related to Self-Efficacy for Increasing Physical Activity in Advanced-Stage Cancer Patients

Authors: S. Nikpour, S. Vahidi, H. Haghani

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Introduction: Exercise has mental and physical health benefits for patients with advanced stage cancer who actively receive chemotherapy, yet little is known about patients’ levels of interest in becoming more active or their confidence in increasing their activity level. Methods and materials: A convenience sample of 200 patients with advanced-stage cancer who were receiving chemotherapy completed self-report measures assessing physical activity level, mood, and quality-of-life variables. Qualitative data on patient-perceived benefits of, and barriers to, physical activity also were collected, coded by independent raters, and organized by predominant themes. Results: Current physical activity level, physical activity outcome expectations, and positive mood were significantly associated with self-efficacy. Fatigue was the most frequently listed barrier to physical activity; improved physical strength and health were the most commonly listed benefits. Participants identified benefits related to both general health and cancer-symptom management that were related to exercise. 59.5% of participants reported that they were seriously planning to increase or maintain their physical activity level, and over 40% reported having interest in receiving an intervention to become more active. Conclusion: These results suggested that many advanced-stage cancer patients who receive chemotherapy are interested in maintaining or increasing their physical activity level and in receiving professional support for exercise. In addition, these individuals identified general health and cancer-specific benefits of, and barriers to, physical activity. Future research will investigate how these findings may be incorporated into physical activity interventions for advanced-stage oncology patients receiving medical treatment.

Keywords: physical activity, cancer, self-efficacy

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1155 Student's Difficulties with Classes That Involve Laboratory Education Approach

Authors: Kayondoamunmose Kamafrika

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Experimental based Engineering education approach plays a vital role in the development of student’s deep understanding of both social and physical sciences. Experimental based education approach through laboratory class activities prepare students to meet national demand for high-tech skilled individuals in the government and private sector. However, students across the country are faced with difficulties in classes that involve laboratory activities: poor experimental based exposure in their early development of student’s education-life-cycle, lack of student engagement in scientific method practical thinking approach, lack of communication between students and the instructor during class, a large number of students in one classroom, lack of instruments and improper equipment calibration. The purpose of this paper is to help students develop their own scientific knowledge and understanding, develop their methodologies in the design of experiments, collect and analyze data, write laboratory reports, present and explain their findings. Experimental based laboratory activities allow students to learn with high-level understanding as well as engage in the design processes of constructing knowledge through practical means of doing science. Experimental based education systems approach will act as a catalyst in the development of practical-based-educational methodologies in social and physical science and engineering domain of learning; thereby, converting laboratory classes into pilot industries and students into professional experts in finding a solution for complex problems, research, and development of super high- tech systems.

Keywords: experimental, engineering, innovation, practicability

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1154 Pluripotent Stem Cells as Therapeutic Tools for Limbal Stem Cell Deficiencies and Drug Testing

Authors: Aberdam Edith, Sangari Linda, Petit Isabelle, Aberdam Daniel

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Background and Rationale: Transparent avascularised cornea is essential for normal vision and depends on limbal stem cells (LSC) that reside between the cornea and the conjunctiva. Ocular burns or injuries may destroy the limbus, causing limbal stem cell deficiency (LSCD). The cornea becomes vascularised by invaded conjunctival cells, the stroma is scarring, resulting in corneal opacity and loss of vision. Grafted autologous limbus or cultivated autologous LCS can restore the vision, unless the two eyes are affected. Alternative cellular sources have been tested in the last decades, including oral mucosa or hair follicle epithelial cells. However, only partial success has been achieved by the use of these cells since they were not able to uniformly commit into corneal epithelial cells. Human pluripotent stem cells (iPSC) display both unlimited growth capacity and ability to differentiate into any cell type. Our goal was to design a standardized and reproducible protocol to produce transplantable autologous LSC from patients through cell reprogramming technology. Methodology: First, keratinocyte primary culture was established from a small number of plucked hair follicles of healthy donors. The resulting epithelial cells were reprogrammed into induced pluripotent stem cells (iPSCs) and further differentiate into corneal epithelial cells (CEC), according to a robust protocol that recapitulates the main step of corneal embryonic development. qRT-PCR analysis and immunofluorescent staining during the course of differentiation confirm the expression of stage specific markers of corneal embryonic lineage. First appear ectodermal progenitor-specific cytokeratins K8/K18, followed at day 7 by limbal-specific PAX6, TP63 and cytokeratins K5/K14. At day 15, K3/K12+-corneal cells are present. To amplify the iPSC-derived LSC (named COiPSC), intact small epithelial colonies were detached and cultivated in limbal cell-specific medium. In that culture conditions, the COiPSC can be frozen and thaw at any passage, while retaining their corneal characteristics for at least eight passages. To evaluate the potential of COiPSC as an alternative ocular toxicity model, COiPSC were treated at passage P0 to P4 with increasing amounts of SDS and Benzalkonium. Cell proliferation and apoptosis of treated cells was compared to LSC and the SV40-immortalized human corneal epithelial cell line (HCE) routinely used by cosmetological industrials. Of note, HCE are more resistant to toxicity than LSC. At P0, COiPSC were systematically more resistant to chemical toxicity than LSC and even to HCE. Remarkably, this behavior changed with passage since COiPSC at P2 became identical to LSC and thus closer to physiology than HCE. Comparative transcriptome analysis confirmed that COiPSC from P2 are similar to a mixture of LSC and CEC. Finally, by organotypic reconstitution assay, we demonstrated the ability of COiPSC to produce a 3D corneal epithelium on a stromal equivalent made of keratocytes. Conclusion: COiPSC could become valuable for two main applications: (1) an alternative robust tool to perform, in a reproducible and physiological manner, toxicity assays for cosmetic products and pharmacological tests of drugs. (2). COiPSC could become an alternative autologous source for cornea transplantation for LSCD.

Keywords: Limbal stem cell deficiency, iPSC, cornea, limbal stem cells

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1153 Applied Spatial Mapping and Monitoring of Illegal Landfills for Deprived Urban Areas in Romania

Authors: Șercăianu Mihai, Aldea Mihaela, Iacoboaea Cristina, Luca Oana, Nenciu Ioana

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The rise and mitigation of unauthorized illegal waste dumps are a significant global issue within waste management ecosystems, impacting disadvantaged communities. Globally, including in Romania, many individuals live in houses without legal recognition, lacking ownership or construction permits, in areas known as "informal settlements." An increasing number of regions and cities in Romania are struggling to manage their illegal waste dumps, especially in the context of increasing poverty and lack of regulation related to informal settlements. One such informal settlement is located at the end of Bistra Street in Câlnic, within the Reșița Municipality of Caras Severin County. The article presents a case study that focuses on employing remote sensing techniques and spatial data to monitor and map illegal waste practices, with subsequent integration into a geographic information system tailored for the Reșița community. In addition, the paper outlines the steps involved in devising strategies aimed at enhancing waste management practices in disadvantaged areas, aligning with the shift toward a circular economy. Results presented in the paper contain a spatial mapping and visualization methodology calibrated with in situ data collection applicable for identifying illegal landfills. The emergence and neutralization of illegal dumps pose a challenge in the field of waste management. These approaches, which prove effective where conventional solutions have failed, need to be replicated and adopted more wisely.

Keywords: informal settlements, GIS, waste dumps, waste management, monitoring

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1152 Working with Children and Young People as a much Neglected Area of Education within the Social Studies Curriculum in Poland

Authors: Marta Czechowska-Bieluga

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Social work education in Poland focuses mostly on developing competencies that address the needs of individuals and families affected by a variety of life's problems. As a result of the ageing of the Polish population, much attention is equally devoted to adults, including the elderly. However, social work with children and young people is the area of education which should be given more consideration. Social work students are mostly trained to cater to the needs of families and the competencies aimed to respond to the needs of children and young people do not receive enough attention and are only offered as elective classes. This paper strives to review the social work programmes offered by the selected higher education institutions in Poland in terms of social work training aimed at helping children and young people to address their life problems. The analysis conducted in this study indicates that university education for social work focuses on training professionals who will provide assistance only to adults. Due to changes in the social and political situation, including, in particular, changes in social policy implemented for the needy, it is necessary to extend this area of education to include the specificity of the support for children and young people; especially, in the light of the appearance of new support professions within the area of social work. For example, family assistants, whose task is to support parents in performing their roles as guardians and educators, also assist children. Therefore, it becomes necessary to equip social work professionals with competencies which include issues related to the quality of life of underage people living in families. Social work curricula should be extended to include the issues of child and young person development and the patterns governing this phase of life.

Keywords: social work education, social work programmes, social worker, university

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1151 Impact of Human Resources Accounting on Employees' Performance in Organization

Authors: Hamid Saremi, Shida Hanafi

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In an age of technology and economics, human capital has important and axial role in the organization and human resource accounting has a wide perception to key resources of organization i.e. human resources. Human resources accounting is new branch of accounting that has Short-lived and generally deals to a range of policies and measures that are related to various aspects of human resources and It gives importance to an organization's most important asset is its human resources and human resource management is the key to success in an organization and to achieve this important matter must review and evaluation of human resources data be with knowledge of accounting based on empirical studies and methods of measurement and reporting of human resources accounting information. Undoubtedly human resource management without information cannot be done and take decision and human resources accounting is practical way to inform the decision makers who are committed to harnessing human resources,, human resources accounting with applying accounting principles in the organization and is with conducting basic research on the extent of the of human resources accounting information" effect of employees' personal performance. In human resource accounting analysis and criteria and valuation of cost and manpower valuating is as the main resource in each Institute. Protection of human resources is a process that according to human resources accounting is for organization profitability. In fact, this type of accounting can be called as a major source in measurement and trends of costs and human resources valuation in each institution. What is the economic value of such assets? What is the amount of expenditures for education and training of professional individuals to value in asset account? What amount of funds spent should be considered as lost opportunity cost? In this paper, according to the literature of human resource accounting we have studied the human resources matter and its objectives and topic of the importance of human resource valuation on employee performance review and method of reporting of human resources according to different models.

Keywords: human resources, human resources, accounting, human capital, human resource management, valuation and cost of human resources, employees, performance, organization

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1150 I Look Powerful So You Will Yield to Me: The Effects of Embodied Power and the Perception of Power on Conflict Management

Authors: Fai-Ho E. Choi, Wing-Tung Au

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This study investigated the effects of embodiment on conflict management. As shown in the research literature, the physiological (i.e. bodily postures) can affect the emotional and cognitive proceedings of human beings, but little has been shown on whether such effects would have ramifications in decision-making related to other individuals. In this study, conflict is defined as when two parties have seemingly incompatible goals, and the two have to deal with each other in order to maximize one’s own gain. In a matched-gender experiment, university undergraduate students were randomly assigned to either the high power condition or the low power condition, with participants in each condition instructed to perform a fix set of bodily postures that would either embody them with a high sense of power or a low sense of power. One high-power participant would pair up with a low-power participant to engage in an integrative bargaining task and a dictator game. Participants also filled out a pre-trial questionnaire and a post-trial questionnaire measuring general sense of power, self-esteem and self-efficacy. Personality was controlled for. Results are expected to support our hypotheses that people who are embodied with power will be more unyielding in a conflict management situation, and that people who are dealing with another person embodied with power will be more yielding in a conflict management situation. As conflicts arise frequently both within and between organizations, a better understanding of how human beings function in conflicts is important. This study should provide evidence that bodily postures can influence the perceived sense of power of the parties involved and hence influence the conflict outcomes. Future research needs to be conducted to investigate further how people perceive themselves and how they perceive their opponents in conflicts, such that we can come up with a behavioral theory of conflict management.

Keywords: conflict management, embodiment, negotiation, perception

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1149 Oral Health Status in Sickle Cell Anemia Subjects

Authors: Surekha Rathod

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Sickle cell disease is a vascular disorder characterized by chronic, ongoing organ damage that is punctuated by episodes of acutely painful vascular complications.1 It is the most common genetic blood disorder in the United States, with about 2000 infants being identified through routine blood screenings annually, and an estimated 104,000-138,000 affected individuals living in the United States. Approximately 0.3%-1.3% of African American are affected by Sickle Cell Diseases (SCD).3 The aim of this paper is to present oral health status of patients with SCD. A total of 200 subjects of both sexes in the age group 18- 40 years were included in this study. The subjects were examined and the following indices were recorded • Oral hygiene index – Simplified (OHI-S). • Probing depths (PD). • Clinical Attachment Levels (CAL). • Gingival Index - Loe and Sillness. • Turesky Gillmore Glickman Modification of the Quigley Hein Plaque Index. (1970) • DMFT index. • Sickle Cell Disease Severity Index. A total of 1478 patients were screened of which 200 subjects were found to be diagnosed with SCD by electrophoresis. The study thus, included 200 subjects (111 females & 89 males) diagnosed with Sickle Cell Disease in the age group of 18-40 years. The probing pocket depths (PPD) were measured in millimeters. 36% had PPD in the range of 2-4mm, 48% had PPD in the range of 4-6mm while 16% had PPD of more than 6mm. Similar results were obtained for the Clinical Attachment Levels (CAL). 29.5 % subjects had CAL 2-4mm, 44.5% had 4-6mm & 26% had CAL 6mm & above. We can thus conclude that although oral health is not a priority for patients with SCD, it is supported by increased plaque accumulation. Because of the chronic anemic state of the patients with SCD, they should be encouraged to pay strict attention to oral hygiene instructions and practice.

Keywords: chronic, genetic, oral, sickle cell disease, vascular

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1148 The Assessment of Natural Ventilation Performance for Thermal Comfort in Educational Space: A Case Study of Design Studio in the Arab Academy for Science and Technology, Alexandria

Authors: Alaa Sarhan, Rania Abd El Gelil, Hana Awad

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Through the last decades, the impact of thermal comfort on the working performance of users and occupants of an indoor space has been a concern. Research papers concluded that natural ventilation quality directly impacts the levels of thermal comfort. Natural ventilation must be put into account during the design process in order to improve the inhabitant's efficiency and productivity. One example of daily long-term occupancy spaces is educational facilities. Many individuals spend long times receiving a considerable amount of knowledge, and it takes additional time to apply this knowledge. Thus, this research is concerned with user's level of thermal comfort in design studios of educational facilities. The natural ventilation quality in spaces is affected by a number of parameters including orientation, opening design, and many other factors. This research aims to investigate the conscious manipulation of the physical parameters of the spaces and its impact on natural ventilation performance which subsequently affects thermal comfort of users. The current research uses inductive and deductive methods to define natural ventilation design considerations, which are used in a field study in a studio in the university building in Alexandria (AAST) to evaluate natural ventilation performance through analyzing and comparing the current case to the developed framework and conducting computational fluid dynamics simulation. Results have proved that natural ventilation performance is successful by only 50% of the natural ventilation design framework; these results are supported by CFD simulation.

Keywords: educational buildings, natural ventilation, , mediterranean climate, thermal comfort

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1147 Dissection of Genomic Loci for Yellow Vein Mosaic Virus Resistance in Okra (Abelmoschus esculentas)

Authors: Rakesh Kumar Meena, Tanushree Chatterjee

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Okra (Abelmoschus esculentas L. Moench) or lady’s finger is an important vegetable crop belonging to the Malvaceae family. Unfortunately, production and productivity of Okra are majorly affected by Yellow Vein mosaic virus (YVMV). The AO: 189 (resistant parent) X AO: 191(susceptible parent) used for the development of mapping population. The mapping population has 143 individuals (F₂:F₃). Population was characterized by physiological and pathological observations. Screening of 360 DNA markers was performed to survey for parental polymorphism between the contrasting parents’, i.e., AO: 189 and AO: 191. Out of 360; 84 polymorphic markers were used for genotyping of the mapping population. Total markers were distributed into four linkage groups (LG1, LG2, LG3, and LG4). LG3 covered the longest span (106.8cM) with maximum number of markers (27) while LG1 represented the smallest linkage group in terms of length (71.2cM). QTL identification using the composite interval mapping approach detected two prominent QTLs, QTL1 and QTL2 for resistance against YVMV disease. These QTLs were placed between the marker intervals of NBS-LRR72-Path02 and NBS-LRR06- NBS-LRR65 on linkage group 02 and linkage group 04 respectively. The LOD values of QTL1 and QTL2 were 5.7 and 6.8 which accounted for 19% and 27% of the total phenotypic variation, respectively. The findings of this study provide two linked markers which can be used as efficient diagnostic tools to distinguish between YVMV resistant and susceptible Okra cultivars/genotypes. Lines identified as highly resistant against YVMV infection can be used as donor lines for this trait. This will be instrumental in accelerating the trait improvement program in Okra and will substantially reduce the yield losses due to this viral disease.

Keywords: Okra, yellow vein mosaic virus, resistant, linkage map, QTLs

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1146 A Computational Framework for Load Mediated Patellar Ligaments Damage at the Tropocollagen Level

Authors: Fadi Al Khatib, Raouf Mbarki, Malek Adouni

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In various sport and recreational activities, the patellofemoral joint undergoes large forces and moments while accommodating the significant knee joint movement. In doing so, this joint is commonly the source of anterior knee pain related to instability in normal patellar tracking and excessive pressure syndrome. One well-observed explanation of the instability of the normal patellar tracking is the patellofemoral ligaments and patellar tendon damage. Improved knowledge of the damage mechanism mediating ligaments and tendon injuries can be a great help not only in rehabilitation and prevention procedures but also in the design of better reconstruction systems in the management of knee joint disorders. This damage mechanism, specifically due to excessive mechanical loading, has been linked to the micro level of the fibred structure precisely to the tropocollagen molecules and their connection density. We argue defining a clear frame starting from the bottom (micro level) to up (macro level) in the hierarchies of the soft tissue may elucidate the essential underpinning on the state of the ligaments damage. To do so, in this study a multiscale fibril reinforced hyper elastoplastic Finite Element model that accounts for the synergy between molecular and continuum syntheses was developed to determine the short-term stresses/strains patellofemoral ligaments and tendon response. The plasticity of the proposed model is associated only with the uniaxial deformation of the collagen fibril. The yield strength of the fibril is a function of the cross-link density between tropocollagen molecules, defined here by a density function. This function obtained through a Coarse-graining procedure linking nanoscale collagen features and the tissue level materials properties using molecular dynamics simulations. The hierarchies of the soft tissues were implemented using the rule of mixtures. Thereafter, the model was calibrated using a statistical calibration procedure. The model then implemented into a real structure of patellofemoral ligaments and patellar tendon (OpenKnee) and simulated under realistic loading conditions. With the calibrated material parameters the calculated axial stress lies well with the experimental measurement with a coefficient of determination (R2) equal to 0.91 and 0.92 for the patellofemoral ligaments and the patellar tendon respectively. The ‘best’ prediction of the yielding strength and strain as compared with the reported experimental data yielded when the cross-link density between the tropocollagen molecule of the fibril equal to 5.5 ± 0.5 (patellofemoral ligaments) and 12 (patellar tendon). Damage initiation of the patellofemoral ligaments was located at the femoral insertions while the damage of the patellar tendon happened in the middle of the structure. These predicted finding showed a meaningful correlation between the cross-link density of the tropocollagen molecules and the stiffness of the connective tissues of the extensor mechanism. Also, damage initiation and propagation were documented with this model, which were in satisfactory agreement with earlier observation. To the best of our knowledge, this is the first attempt to model ligaments from the bottom up, predicted depending to the tropocollagen cross-link density. This approach appears more meaningful towards a realistic simulation of a damaging process or repair attempt compared with certain published studies.

Keywords: tropocollagen, multiscale model, fibrils, knee ligaments

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1145 Assets and Health: Examining the Asset-Building Theoretical Framework and Psychological Distress

Authors: Einav Srulovici, Michal Grinstein-Weiss, George Knafl, Linda Beeber, Shawn Kneipp, Barbara Mark

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Background: The asset-building theoretical framework (ABTF) is acknowledged as the most complete framework thus far for depicting the relationships between asset accumulation (the stock of a household’s saved resources available for future investment) and health outcomes. Although the ABTF takes into consideration the reciprocal relationship between asset accumulation and health, no ABTF based study has yet examined this relationship. Therefore, the purpose of this study was to test the ABTF and psychological distress, focusing on the reciprocal relationship between assets accumulation and psychological distress. Methods: The study employed longitudinal data from 6,295 families from the 2001 and 2007 Panel Study of Income Dynamics data sets. Structural equation modeling (SEM) was used to test the reciprocal relationship between asset accumulation and psychological distress. Results: In general, the data displayed a good fit to the model. The longitudinal SEM found that asset accumulation significantly increased with a decreased in psychological distress over time, while psychological distress significantly increased with an increase in asset accumulation over time, confirming the existence of the hypothesized reciprocal relationship. Conclusions: Individuals who are less psychological distressed might have more energy to engage in activities, such as furthering their education or obtaining better jobs that are in turn associated with greater asset accumulation, while those who have greater assets may invest those assets in riskier investments, resulting in increased psychological distress. The confirmation of this reciprocal relationship highlights the importance of conducting longitudinal studies and testing the reciprocal relationship between asset accumulation and other health outcomes.

Keywords: asset-building theoretical framework, psychological distress, structural equation modeling, reciprocal relationship

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1144 Interactions between Residential Mobility, Car Ownership and Commute Mode: The Case for Melbourne

Authors: Solmaz Jahed Shiran, John Hearne, Tayebeh Saghapour

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Daily travel behavior is strongly influenced by the location of the places of residence, education, and employment. Hence a change in those locations due to a move or changes in an occupation leads to a change in travel behavior. Given the interventions of housing mobility and travel behaviors, the hypothesis is that a mobile housing market allows households to move as a result of any change in their life course, allowing them to be closer to central services, public transport facilities and workplace and hence reducing the time spent by individuals on daily travel. Conversely, household’s immobility may lead to longer commutes of residents, for example, after a change of a job or a need for new services such as schools for children who have reached their school age. This paper aims to investigate the association between residential mobility and travel behavior. The Victorian Integrated Survey of Travel and Activity (VISTA) data is used for the empirical analysis. Car ownership and journey to work time and distance of employed people are used as indicators of travel behavior. Change of usual residence within the last five years used to identify movers and non-movers. Statistical analysis, including regression models, is used to compare the travel behavior of movers and non-movers. The results show travel time, and the distance does not differ for movers and non-movers. However, this is not the case when taking into account the residence tenure-type. In addition, car ownership rate and number found to be significantly higher for non-movers. It is hoped that the results from this study will contribute to a better understanding of factors other than common socioeconomic and built environment features influencing travel behavior.

Keywords: journey to work, regression models, residential mobility, commute mode, car ownership

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1143 A Literature Review about Responsible Third Cycle Supervision

Authors: Johanna Lundqvist

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Third cycle supervision is a multifaceted and complex task for supervisors in higher education. It progresses over several years and is affected by several proximal and distal factors. It can result in positive learning outcomes for doctoral students and high-quality publications. However, not all doctoral students thrive during their doctoral studies; nor do they all complete their studies. This is problematic for both the individuals themselves as well as society at large: doctoral students are valuable and important in current research, future research and higher education. The aim of this literature review is to elucidate what responsible third cycle supervision can include and be in practice. The question posed is as follows: according to recent literature, what is it that characterises responsible third cycle supervision in which doctoral students can thrive and develop their research knowledge and skills? A literature review was conducted, and the data gathered from the literature regarding responsible third cycle supervision was analysed by means of a thematic analysis. The analysis was inspired by the notion of responsible inclusion outlined by David Mitchell. In this study, the term literature refers to research articles and regulations. The results (preliminary) show that responsible third cycle supervision is associated with a number of interplaying factors (themes). These are as follows: committed supervisors and doctoral students; a clear vision and research problem; an individual study plan; adequate resources; interaction processes and constructive feedback; creativity; cultural awareness; respect and research ethics; systematic quality work and improvement efforts; focus on overall third cycle learning goals; and focus on research presentations and publications. Thus, responsible third cycle supervision can occur if these factors are realized in practice. This literature review is of relevance to evaluators, researchers, and management in higher education, as well as third cycle supervisors.

Keywords: doctoral student, higher education, third cycle supervisors, third cycle programmes

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1142 Relevance of Brain Stem Evoked Potential in Diagnosis of Central Demyelination in Guillain Barre’ Syndrome

Authors: Geetanjali Sharma

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Guillain Barre’ syndrome (GBS) is an auto-immune mediated demyelination poly-radiculo-neuropathy. Clinical features include progressive symmetrical ascending muscle weakness of more than two limbs, areflexia with or without sensory, autonomic and brainstem abnormalities, the purpose of this study was to determine subclinical neurological changes of CNS with GBS and to establish the presence of central demyelination in GBS. The study was prospective and conducted in the Department of Physiology, Pt. B. D. Sharma Post-graduate Institute of Medical Sciences, University of Health Sciences, Rohtak, Haryana, India to find out early central demyelination in clinically diagnosed patients of GBS. These patients were referred from the department of Medicine of our Institute to our department for electro-diagnostic evaluation. The study group comprised of 40 subjects (20 clinically diagnosed GBS patients and 20 healthy individuals as controls) aged between 6-65 years. Brain Stem evoked Potential (BAEP) were done in both groups using RMS EMG EP mark II machine. BAEP parameters included the latencies of waves I to IV, inter peak latencies I-III, III-IV & I-V. Statistically significant increase in absolute peak and inter peak latencies in the GBS group as compared with control group was noted. Results of evoked potential reflect impairment of auditory pathways probably due to focal demyelination in Schwann cell derived myelin sheaths that cover the extramedullary portion of auditory nerves. Early detection of the sub-clinical abnormalities is important as timely intervention reduces morbidity.

Keywords: brainstem, demyelination, evoked potential, Guillain Barre’

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1141 Variation In Gastrocnemius and Hamstring Muscle Activity During Peak Knee Flexor Torque After Anterior Cruciate Ligament Reconstruction with Hamstring Graft

Authors: Luna Sequier, Florian Forelli, Maude Traulle, Amaury Vandebrouck, Pascal Duffiet, Louis Ratte, Jean Mazeas

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The study's objective is to compare the muscular activity of the flexor knee muscle in patients who underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals who have not undergone surgery. Methods: The participants were divided into two groups: a healthy group and an experimental group who had undergone an anterior cruciate ligament reconstruction with a hamstring graft. All participants had to perform a knee flexion strength test on an isokinetic dynamometer. The medial Gastrocnemius, lateral Gastrocnemius, Biceps femoris, and medial Hamstring muscle activity were measured during this test. Each group’s mean muscle activity was tested with statistical analysis, and a muscle activity ratio of gastrocnemius and hamstring muscles was calculated Results: The results showed a significant difference in activity of the medial gastrocnemius (p = 0,004901), the biceps femoris (p = 5,394.10-6), and the semitendinosus muscles (p = 1,822.10-6), with a higher Biceps femoris and Semitendinosus activity for the experimental group. It is however noticeable that inter-subject differences were important. Conclusion: This study has shown a difference in the gastrocnemius and hamstring muscle activity between patients who underwent an anterior cruciate ligament reconstruction surgery and healthy participants. With further results, this could show a modification of muscle activity patterns after surgery which could lead to compensatory behaviors at a return to sport and eventually explain a higher injury risk for our patients.

Keywords: anterior cruciate ligament, electromyography, muscle activity, physiotherapy

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1140 The Risk of In-work Poverty and Family Coping Strategies

Authors: A. Banovcinova, M. Zakova

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Labor market activity and paid employment should be a key factor in protecting individuals and families from falling into poverty and providing them with sufficient resources to meet the needs of their members. However, due to various processes in the labor market as well as the influence of individual factors and often insufficient social capital, there is a relatively large group of households that cannot eliminate paid employment and find themselves in a state of so-called working poverty. The aim of the research was to find out what strategies families use in managing poverty and meeting their needs and which of these strategies prevail in the Slovak population. A quantitative research strategy was chosen. The method of data collection was a structured interview focused on finding out the use of individual management strategies and also selected demographic indicators. The research sample consisted of members of families in which at least one member has a paid job. The condition for inclusion in the research was that the family's income did not exceed 60% of the national median equalized disposable income. The analysis of the results showed 5 basic areas to which management strategies are related - work, financial security, needs, social contacts and perception of the current situation. The prevailing strategies were strategies aimed at increasing and streamlining labor market activity and the planned and effective management of the family budget. Strategies that were rejected were mainly related to debt creation. The results make it possible to identify the preferred ways of managing poverty in individual areas of life, as well as the factors that influence this behavior. This information is important for working with families living in a state of working poverty and can help professionals develop positive ways of coping for families.

Keywords: copying strategies, family, in-work poverty, quantitative research

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1139 The Experiences of First-Generation Afro/Black Caribbean-American Women Navigating Sexual Pleasure and Their Bicultural Identity as a Result of Immigration

Authors: Jessie André

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In the past 10 years, more studies have begun exploring the psychological impact of those who have been subjected to and have adopted two different cultures. Currently, there is no existing literature regarding how individuals with a bicultural identity navigate their often-conflicting cultures on topics such as sexual pleasure and sexual scripts. The purpose of this study was to explore how first-generation Afro/Black Caribbean-American women navigate their multiple cultural identities with regards to sexual pleasure and sexual scripts. This study contains an exploration of participants self-described challenges, attitudes, and beliefs associated to how they navigate and experience their sexuality. This research study uses an explanatory, qualitative method design with semi structured interviews to answer the primary and secondary research question. Research findings indicate that the later the age of immigration, the stronger their ties were to the culture from their country of origin, which affected their self-assessments of sexual desirability and sexual self-esteem. Findings also suggest that even though women who immigrated at a younger age had higher rates of difficulty navigating and identifying with their adopted culture’s sexual mores. These women also reported lower ratings of comfort voicing sexual desires and concerns to their partner and had lower self-ratings of feeling connected to their cultural identity. These participants had challenges utilizing the dual and conflicting sexual mores and rules they received from U.S. society and their country of origin, resulting in less pleasurable sexual experiences. Whereas women who immigrated at an older age reported having more pleasurable sexual experiences.

Keywords: bicultural identity, sexual pleasure, first-generation immigrants, afro/black caribbean-American

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1138 Response of Diaphragmatic Excursion to Inspiratory Muscle Trainer Post Thoracotomy

Authors: H. M. Haytham, E. A. Azza, E.S. Mohamed, E. G. Nesreen

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Thoracotomy is a great surgery that has serious pulmonary complications, so purpose of this study was to determine the response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy. Thirty patients of both sexes (16 men and 14 women) with age ranged from 20 to 40 years old had done thoracotomy participated in this study. The practical work was done in cardiothoracic department, Kasr-El-Aini hospital at faculty of medicine for individuals 3 days Post operatively. Patients were assigned into two groups: group A (study group) included 15 patients (8 men and 7 women) who received inspiratory muscle training by using inspiratory muscle trainer for 20 minutes and routine chest physiotherapy (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Group B (control group) included 15 patients (8 men and 7 women) who received the routine chest physiotherapy only (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Ultrasonography was used to evaluate the changes in diaphragmatic excursion before and after training program. Statistical analysis revealed a significant increase in diaphragmatic excursion in the study group (59.52%) more than control group (18.66%) after using inspiratory muscle trainer post operatively in patients post thoracotomy. It was concluded that the inspiratory muscle training device increases diaphragmatic excursion in patients post thoracotomy through improving inspiratory muscle strength and improving mechanics of breathing and using of inspiratory muscle trainer as a method of physical therapy rehabilitation to reduce post-operative pulmonary complications post thoracotomy.

Keywords: diaphragmatic excursion, inspiratory muscle trainer, ultrasonography, thoracotomy

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