Search results for: perceived risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7471

Search results for: perceived risk

4801 Mitochondrial DNA Copy Number in Egyptian Patients with Hepatitis C Virus Related Hepatocellular Carcinoma

Authors: Doaa Hashad, Amany Elyamany, Perihan Salem

Abstract:

Introduction: Hepatitis C virus infection (HCV) constitutes a serious dilemma that has an impact on the health of millions of Egyptians. Hepatitis C virus related hepatocellular carcinoma (HCV-HCC) is a crucial consequence of HCV that represents the third cause of cancer-related deaths worldwide. Aim of the study: assess the use of mitochondrial DNA (mtDNA) content as a non-invasive molecular biomarker in hepatitis c virus related hepatocellular carcinoma (HCV-HCC). Methods: A total of 135 participants were enrolled in the study. Volunteers were assigned to one of three groups equally; a group of HCV related cirrhosis (HCV-cirrhosis), a group of HCV-HCC and a control group of age- and sex- matched healthy volunteers with no evidence of liver disease. mtDNA was determined using a quantitative real-time PCR technique. Results: mtDNA content was lowest in HCV-HCC cases. No statistically significant difference was observed between the group of HCV-cirrhosis and the control group as regards mtDNA level. HCC patients with multi-centric hepatic lesions had significantly lower mtDNA content. On using receiver operating characteristic curve analysis, a cutoff of 34 was assigned for mtDNA content to distinguish between HCV-HCC and HCV-cirrhosis patients who are not yet complicated by malignancy. Lower mtDNA was associated with greater HCC risk on using healthy controls, HCV-cirrhosis, or combining both groups as a reference group. Conclusions: mtDNA content might constitute a non-invasive molecular biomarker that reflects tumor burden in HCV-HCC cases and could be used as a predictor of HCC risk in patients of HCV-cirrhosis. In addition, the non significant difference of mtDNA level between HCV-cirrhosis patients and healthy controls could eliminate the grey zone created by the use of AFP in some cirrhotic patients.

Keywords: DNA copy number, HCC, HCV, mitochondrial

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4800 Enhancing Knowledge and Teaching Skills of Grade Two Teachers who Work with Children at Risk of Dyslexia

Authors: Rangika Perera, Shyamani Hettiarachchi, Fran Hagstrom

Abstract:

Dyslexia is the most common reading reading-related difficulty among the school school-aged population and currently, 5-10% are showing the features of dyslexia in Sri Lanka. As there is an insufficient number of speech and language pathologists in the country and few speech and language pathologists working in government mainstream school settings, these children who are at risk of dyslexia are not receiving enough quality early intervention services to develop their reading skills. As teachers are the key professionals who are directly working with these children, using them as the primary facilitators to improve their reading skills will be the most effective approach. This study aimed to identify the efficacy of a two and half a day of intensive training provided to fifteen mainstream government school teachers of grade two classes. The goal of the training was to enhance their knowledge of dyslexia and provide full classroom skills training that could be used to support the development of the students’ reading competencies. A closed closed-ended multiple choice questionnaire was given to these teachers pre and -post-training to measure teachers’ knowledge of dyslexia, the areas in which these children needed additional support, and the best strategies to facilitate reading competencies. The data revealed that the teachers’ knowledge in all areas was significantly poorer prior to the training and that there was a clear improvement in all areas after the training. The gain in target areas of teaching skills selected to improve the reading skills of children was evaluated through peer feedback. Teachers were assigned to three groups and expected to model how they were going to introduce the skills in recommended areas using researcher developed, validated and reliability reliability-tested materials and the strategies which were introduced during the training within the given tasks. Peers and the primary investigator rated teachers’ performances and gave feedback on organizational skills, presentation skills of materials, clarity of instruction, and appropriateness of vocabulary. After modifying their skills according to the feedback the teachers received, they were expected to modify and represent the same tasks to the group the following day. Their skills were re-evaluated by the peers and primary investigator using the same rubrics to measure the improvement. The findings revealed a significant improvement in their teaching skills development. The data analysis of both knowledge and skills gains of the teachers was carried out using quantitative descriptive data analysis. The overall findings of the study yielded promising results that support intensive training as a method for improving teachers’ knowledge and teaching skill development for use with children in a whole class intervention setting who are at risk of dyslexia.

Keywords: Dyslexia, knowledge, teaching skills, training program

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4799 Recognising the Importance of Smoking Cessation Support in Substance Misuse Patients

Authors: Shaine Mehta, Neelam Parmar, Patrick White, Mark Ashworth

Abstract:

Patients with a history of substance have a high prevalence of comorbidities, including asthma and chronic obstructive pulmonary disease (COPD). Mortality rates are higher than that of the general population and the link to respiratory disease is reported. Randomised controlled trials (RCTs) support opioid substitution therapy as an effective means for harm reduction. However, whilst a high proportion of patients receiving opioid substitution therapy are smokers, to the author’s best knowledge there have been no studies of respiratory disease and smoking intensity in these patients. A cross sectional prevalence study was conducted using an anonymised patient-level database in primary care, Lambeth DataNet (LDN). We included patients aged 18 years and over who had records of ever having been prescribed methadone in primary care. Patients under 18 years old or prescribed buprenorphine (because of uncertainty about the prescribing indication) were excluded. Demographic, smoking, alcohol and asthma and COPD coding data were extracted. Differences between methadone and non-methadone users were explored with multivariable analysis. LDN contained data on 321, 395 patients ≥ 18 years; 676 (0.16%) had a record of methadone prescription. Patients prescribed methadone were more likely to be male (70.7% vs. 50.4%), older (48.9yrs vs. 41.5yrs) and less likely to be from an ethnic minority group (South Asian 2.1% vs. 7.8%; Black African 8.9% vs. 21.4%). Almost all those prescribed methadone were smokers or ex-smokers (97.3% vs. 40.9%); more were non-alcohol drinkers (41.3% vs. 24.3%). We found a high prevalence of COPD (12.4% vs 1.4%) and asthma (14.2% vs 4.4%). Smoking intensity data shows a high prevalence of ≥ 20 cigarettes per day (21.5% vs. 13.1%). Risk of COPD, adjusted for age, gender, ethnicity and deprivation, was raised in smokers: odds ratio 14.81 (95%CI 11.26, 19.47), and in the methadone group: OR 7.51 (95%CI: 5.78, 9.77). Furthermore, after adjustment for smoking intensity (number of cigarettes/day), the risk was raised in methadone group: OR 4.77 (95%CI: 3.13, 7.28). High burden of respiratory disease compounded by the high rates of smoking is a public health concern. This supports an integrated approach to health in patients treated for opiate dependence, with access to smoking cessation support. Further work may evaluate the current structure and commissioning of substance misuse services, including smoking cessation. Regression modelling highlights that methadone as a ‘risk factor’ was independently associated with COPD prevalence, even after adjustment for smoking intensity. This merits further exploration, as the association may be related to unexplored aspects of smoking (such as the number of years smoked) or may be related to other related exposures, such as smoking heroin or crack cocaine.

Keywords: methadone, respiratory disease, smoking cessation, substance misuse

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4798 Window Display Design of Thai Craft Product Affecting Perceptions of Thai and Foreign Tourists

Authors: Kanokwan Somoon, Chumporn Moorapun

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A product’s perceived value may increase purchase intention. Value perceptions may differ among cultures. Window displays can be used to increase products’ information and value. This study aims to investigate the relationship between window display design elements and value perceptions of local products between two different cultures. The research methodology is based on survey research. Several window displays in favorite of tourist spots were selected as a unit of study. Also, 100 tourists (56 Thai tourists and 44 foreign tourists) were asked to complete a questionnaire. T-Tests were used to analyze the comparison. Then, the results were compared to Thai and foreign tourists. Finally, the results find that Thai and foreign tourists have different perception towards three design elements that are size of the window, props and colour lighting. The differences of their perceptions signify the different cultural values they adhere to.

Keywords: cross-culture, window display, Thai craft product, environmental perception

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4797 Cerebral Venous Thrombosis at High Altitude: A Rare Presentation by Sub-Arachnoid Hemorrhage

Authors: Eman G. Alayad, Mazen G. Aleyad, Mohammed Alshahrani, Ibrahim Alnaami

Abstract:

Introduction: Cerebral venous thrombosis (CVT) is a rare type of cerebrovascular disease that can occur at any age. Patients with CVT commonly present with headache, focal neurological deficit, decreased level of consciousness and seizures. Many etiologic risk factors have been reported for CVT, high altitude and oral contraceptive pill some of them. Case Presentation: A 37-year-old woman living in Abha city in the southeastern area of Saudi Arabia. (about 10,000 feet-3000 m) over the sea. complaining acute onset of severe diffuse headache and generalized tonic clonic convulsions. Followed by loss of consciousness. She was on contraceptive pills for the last 3 years. No significant Medical or surgical history. Brain CT revealed subarachnoid hemorrhage, with MRI findings showing thrombosis in transvers sinus. There was no vascular malformations such as aneurysm, arteriovenous malformation (AVM), or dural arteriovenous fistula. A CVT with subarachnoid hemorrhage was our final diagnosis based on clinical presentation and radiographic findings. Discussion: Patients with CVT had evidence of cortical SAH by 10 of 233, others found 3% of SAH was caused by CVT, indicating that the presence of cortical SAH without involvement of the basal cisterns may provide an early sign of underlying CVT. However, what is more interesting in this case, is the relationship of high altitude with CVT and SAH, which previously undescribed. Conclusion: High-altitude climbing per se was described as a risk factor for the development of CVT, though its occurrence was probably rare. Whether it is primary in etiology due to high altitude induced hypercoagulable state of unknown origin or due to cerebrovascular disturbances there is a need for further investigation especially at this unusual presentation of subarachnoid hemorrhage.

Keywords: cerebral venous thrombosis, high-altitude, subarachnoid hemorrhage, stroke

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4796 Craving Intensity Measurements in Opiate Addicts to Objectify the Opioid Substitution Therapy Dose and Reduce the Relapse Risk

Authors: Igna Brajevic-Gizdic, Magda Pletikosa Pavić

Abstract:

Introduction: Research in opiate addiction is increasingly indicating the importance of substitution therapy in opiate addicts. Opiate addiction is a chronic relapsing disease that includes craving as a criterion. Craving has been considered a predictor of a relapse, which is defined as a strong desire with an excessive need to take a substance. The study aimed to measure the intensity of craving using the VAS (visual analog scale) in opioid addicts taking Opioid Substitution Therapy (OST). Method: The total sample compromised of 30 participants in outpatient treatment. Two groups of opiate addicts were considered: Methadone-maintenance and buprenorphine-maintenance addicts. The participants completed the survey questionnaire during the outpatient treatment. Results: The results indicated high levels of cravings in patients during the treatment of OST, which is considered an important destabilization factor in abstinence. Thus, the use of methadone/buprenorphine dose should be considered. Conclusion: These findings provided an objective measurement of methadone /buprenorphine dosage and therapy options. The underdoes of OST can put patients at high risk of relapse, resulting in high levels of craving. Thus, when determining the therapeutic dose of OST, it is crucial to consider patients' cravings. This would achieve stabilization more quickly and avoid relapse in abstinence. Subjective physician assessment and patients' statement are the main criteria to determine OST dosage. Future studies should use larger sample sizes and focus on the importance of intensity craving measurement on OST to objectify methadone /buprenorphine dosage.

Keywords: buprenorphine, craving, heroin addicts, methadone, OST

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4795 Emotional, Behavioral and Social Problems in Children with Fecal Incontinence by Child Behavior Checklist (CBCL): A Cross-sectional Study

Authors: Roshanak Farjad, Amirhossein Hosseini

Abstract:

Fecal incontinence (FI) is a stressful condition for children and their parents that may affect the patient’s psychological well-being. Evaluating the patients’ psychological status may help physicians manage the disease effectively. This study aimed to assess the emotional and behavioral disturbances in children with FI who were referred to the pediatric gastroenterology clinic in Mofid Children’s Hospital from April 2021 to 2022. This cross-sectional study included children (over four years old) with chronic constipation and fecal incontinence. The diagnosis of chronic constipation and FI were made according to Rome-IV criteria. The Child Behavior Checklist (CBCL) evaluated patients’ emotional, behavioral, and social problems. One hundred one patients with a mean age of 7.96 years were enrolled in the study; 67.32% were males. According to CBCL, 12% (12 patients) indicated emotional and behavioral problems, with CBCL scores in the clinical or at-risk range. We detected anxious/depressed problems in five (4.95%), withdrawn/depressed problems in eight (7.92%), somatic complaints in seven (6.93%), social problems in eight (7.92%), thought problems in nine (8.91%), attention problems in seven (6.93%), rule-breaking behavior in two (1.98%), and aggressive behavior in nine (8.91%) patients. The risk of internalizing and externalizing disorders was reported in four (3.96%) and five (4.95%) patients. Also, eight (7.92%) and seven (6.93%) patients had clinical symptoms of internalizing and externalizing disorders, respectively. There was no significant relationship between patients’ age and gender with the CBCL scores in any subscales. However, there was a significant difference in the total score among the age groups (P = 0.04). The relatively high prevalence of emotional, behavioral, and social problems in our study corroborates the importance of psychological screening of children with FI during the treatment process.

Keywords: chronic constipation, child behavior checklist (CBCL), fecal incontinence, rome-IV criteria

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4794 Effects of Environmental Parameters on Salmonella Contaminated in Harvested Oysters (Crassostrea lugubris and Crassostrea belcheri)

Authors: Varangkana Thaotumpitak, Jarukorn Sripradite, Saharuetai Jeamsripong

Abstract:

Environmental contamination from wastewater discharges originated from anthropogenic activities introduces the accumulation of enteropathogenic bacteria in aquatic animals, especially in oysters, and in shellfish harvesting areas. The consumption of raw or partially cooked oysters can be a risk for seafood-borne diseases in human. This study aimed to evaluate the relationship between the presence of Salmonella in oyster meat samples, and environmental factors (ambient air temperature, relative humidity, gust wind speed, average wind speed, tidal condition, precipitation and season) by using the principal component analysis (PCA). One hundred and forty-four oyster meat samples were collected from four oyster harvesting areas in Phang Nga province, Thailand from March 2016 to February 2017. The prevalence of Salmonella of each site was ranged from 25.0-36.11% in oyster meat. The results of PCA showed that ambient air temperature, relative humidity, and precipitation were main factors correlated with Salmonella detection in these oysters. Positive relationship was observed between positive Salmonella in the oysters and relative humidity (PC1=0.413) and precipitation (PC1=0.607), while the negative association was found between ambient air temperature (PC1=0.338) and the presence of Salmonella in oyster samples. These results suggested that lower temperature and higher precipitation and higher relative humidity will possibly effect on Salmonella contamination of oyster meat. During the high risk period, harvesting of oysters should be prohibited to reduce pathogenic bacteria contamination and to minimize a hazard of humans from Salmonellosis.

Keywords: oyster, Phang Nga Bay, principal component analysis, Salmonella

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4793 The Impact of COVID-19 on Reconstructive Breast Surgery and Future Prospective

Authors: Amenah Galo, Mohammed Farid, Kareem Alsharkawy, Robert Warner, Karthikeyan Srinivasan, Haitham Khalil, Ruth Waters

Abstract:

Introduction: The cessation of elective surgery, particularly breast reconstruction, continue to be affected by the COVID-19 pandemic. The restructuring of medical services and staff redeployment severely affected the ability to return to normality for surgical specialties. The aim of this study is to determine the decline in breast reconstruction affected by the COVID-19 pandemic in a tertiary center. Methods: A retrospective review of breast reconstruction cases (autologous, non-autologous) or mastectomies Pre- COVID (March 2019-March 2020) and during COVID (March 2020- March 2021) at Queen Elizabeth Hospital, Birmingham, were collated. Data included patient demographics, BMI, previous and recent reconstruction, length of hospital stay, and mastectomies, including risk-reducing. Results: The number of patients who had breast reconstruction was significantly lower during COVID (n=62) compared to pre-COVID (n=199). The mean age (pre-COVID 51, COVID 59 years), BMI (Pre-COVID and COVID = 27), previous reconstruction (pre-COVID n=101, 51%, COVID n=33, 53%) and length hospital stay was less during COVID (3 days) compared to Pre-COVID (4 days). The proportion of risk-reducing mastectomies and reconstruction during COVID (32%, n=20) were higher than pre-COVID (21%, n=41). A higher proportion rate of autologous reconstruction (DIEP 56, TRAM 17) Pre-COVID compared to COVID (DIEP 22, TRAM 7). Implant reconstructions were higher during COVID (n=19, 31%) than pre-COVID (n=31, 16%). Conclusion: The lack of regular provision for breast reconstruction continues to decline during the pandemic. This will have a tremendous impact on waiting lists without a timeline for reconstruction to offer patients. An international survey highlights the disparities in offering breast reconstruction and strategies to rectify this issue.

Keywords: breast reconstruction, COVID-19 pandemic, mastectomy, autologous, implant

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4792 Factors Associated with Non-Adherence to Antiretroviral Treatment among HIV Infected Patients in Ukraine

Authors: Larissa Burruano, Sergey Grabovyj, Irina Nguen

Abstract:

The study aimed to assess the level of adherence to anti retroviral therapy (ART) and to examine the relationship between adherence and risk behavior factor (drug use) among patients infected with HIV. The patients with newly diagnosed or established HIV infection under follow-up at the Sumskij Regional Centre for AIDS Prevention in Ukraine were eligible for this study. Medical records were used to measure the patient’s adherence to medication. Measurements were obtained at month 6 and at month 12 to calculate the number of medication omission during the past 30 days: (on a 2-point scale – once until three in a month – were considered adherent, three and more in a month – were considered non-adherent). Of the 50 study participants, 27 (54.0%) were men and 23 (46.0%) women. The mean age is 35.2 years (SD= 5.1). A majority of the patients (82.0%) is in the age group of 25-30 years. The main level of adherence was 74.0% and 66.0% at 6 and 12 months, respectively. The main routes of HIV transmission were drug injection among men 12 (44.4%) and sexual contact among women 11 (47.8%). Univariate analyses indicated that patients who had lower level of education were more likely to have been non-adherent at month 6- (X2 =5.1, n=50, p < .05) and at month 12 (X2 = 4.34, n=50, p < .05). Multivariate tests showed that only age (OR= 1.163 [95% CI 0.98–1.370]) was significant independent predictor of treatment adherence, while gender, education, employment status were not predictive for the risk of developing non-compliance. There was not a significant interaction between non-adherence and intravenous drug use. Consistent with these findings, younger people were more likely to have missed a dose of their medication because they had a greater sense of invulnerability than older patients. The study indicates that the socio demographic characteristic should be taken into an account in the future research regarding adherence in the case of HIV infection. If the patient anti retroviral adherence can be improved by qualitatively better medical care in all regions of the Ukraine, behavioral changes in the population can to be expected in the long term.

Keywords: HIV, antiretroviral therapy, adherence, Ukraine, Eastern Europe

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4791 Competitor Analysis to Quantify the Benefits and for Different Use of Transport Infrastructure

Authors: Dimitrios J. Dimitriou, Maria F. Sartzetaki

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Different transportation modes have key operational advantages and disadvantages, providing a variety of different transport options to users and passengers. This paper reviews key variables for the competition between air transport and other transport modes. The aim of this paper is to review the competition between air transport and other transport modes, providing results in terms of perceived cost for the users, for destinations high competitiveness for all transport modes. The competitor analysis variables include the cost and time outputs for each transport option, highlighting the level of competitiveness on high demanded Origin-Destination corridors. The case study presents the output of a such analysis for the OD corridor in Greece that connects the Capital city (Athens) with the second largest city (Thessaloniki) and the different transport modes have been considered (air, train, road). Conventional wisdom is to present an easy to handle tool for planners, managers and decision makers towards pricing policy effectiveness and demand attractiveness, appropriate to use for other similar cases.

Keywords: competitor analysis, transport economics, transport generalized cost, quantitative modelling

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4790 Efficacy of a Social-Emotional Learning Curriculum for Kindergarten and First Grade Students to Improve Social Adjustment within the School Culture

Authors: Ann P. Daunic, Nancy Corbett

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Background and Significance: Researchers emphasize the role that motivation, self-esteem, and self-regulation play in children’s early adjustment to the school culture, including skills such as identifying their own feelings and understanding the feelings of others. As social-emotional growth, academic learning, and successful integration within culture and society are inextricably connected, the Social-Emotional Learning Foundations (SELF) curriculum was designed to integrate social-emotional learning (SEL) instruction within early literacy instruction (specifically, reading) for Kindergarten and first-grade students at risk for emotional and behavioral difficulties. Storybook reading is a typically occurring activity in the primary grades; thus SELF provides an intervention that is both theoretically and practically sound. Methodology: The researchers will report on findings from the first two years of a three-year study funded by the US Department of Education’s Institute of Education Sciences to evaluate the effects of the SELF curriculum versus “business as usual” (BAU). SELF promotes the development of self-regulation by incorporating instructional strategies that support children’s use of SEL related vocabulary, self-talk, and critical thinking. The curriculum consists of a carefully coordinated set of materials and pedagogy designed specifically for primary grade children at early risk for emotional and behavioral difficulties. SELF lessons (approximately 50 at each grade level) are organized around 17 SEL topics within five critical competencies. SELF combines whole-group (the first in each topic) and small-group lessons (the 2nd and 3rd in each topic) to maximize opportunities for teacher modeling and language interactions. The researchers hypothesize that SELF offers a feasible and substantial opportunity within the classroom setting to provide a small-group social-emotional learning intervention integrated with K-1 literacy-related instruction. Participating target students (N = 876) were identified by their teachers as potentially at risk for emotional or behavioral issues. These students were selected from 122 Kindergarten and 100 first grade classrooms across diverse school districts in a southern state in the US. To measure the effectiveness of the SELF intervention, the researchers asked teachers to complete assessments related to social-emotional learning and adjustment to the school culture. A social-emotional learning related vocabulary assessment was administered directly to target students receiving small-group instruction. Data were analyzed using a 3-level MANOVA model with full information maximum likelihood to estimate coefficients and test hypotheses. Major Findings: SELF had significant positive effects on vocabulary, knowledge, and skills associated with social-emotional competencies, as evidenced by results from the measures administered. Effect sizes ranged from 0.41 for group (SELF vs. BAU) differences in vocabulary development to 0.68 for group differences in SEL related knowledge. Conclusion: Findings from two years of data collection indicate that SELF improved outcomes related to social-emotional learning and adjustment to the school culture. This study thus supports the integration of SEL with literacy instruction as a feasible and effective strategy to improve outcomes for K-1 students at risk for emotional and behavioral difficulties.

Keywords: Socio-cultural context for learning, social-emotional learning, social skills, vocabulary development

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4789 Impact of Moderating Role of e-Administration on Training, Perfromance Appraisal and Organizational Performance

Authors: Ejaz Ali, Muhammad Younas, Tahir Saeed

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In this age of information technology, organizations are revisiting their approach in great deal. E-administration is the most popular area to proceed with. Organizations in order to excel over their competitors are spending a substantial chunk of its resources on E-Administration as it is the most effective, transparent and efficient way to achieve their short term as well as long term organizational goals. E-administration being a tool of ICT plays a significant role towards effective management of HR practices resulting into optimal performance of an organization. The present research was carried out to analyze the impact of moderating role of e-administration in the relationships training and performance appraisal aligned with perceived organizational performance. The study is based on RBV and AMO theories, advocating that use of latest technology in execution of human resource (HR) functions enables an organization to achieve and sustain competitive advantage which leads to optimal firm performance.

Keywords: e-administration, human resource management, ict, performance appraisal, training

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4788 The Role of Islam in the Political Thought of Muhammad Abduh

Authors: Mehdi Beyad

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Muhammad Abduh stands as a founding thinker of Islamic revivalism and modernism, the political phenomenon which began with him and Jamal al-Din al-Afghani in the 19th century which sought to address the perceived regression of Islamic societies in the face of western colonialism and the onslaught of modernity. The scholarship on Abduh and al-Afghani, and Islamic modernism in general, is vast. This paper, however, provides a critical approach to some of this scholarship and attempts to re-think the epistemic framework of Abduh's political thought and the place of Islam therein. Much of the current work on Abduh falls into the trap of seeing his task as one of "compromising" Islam for the values of European modernity. This paper argues that for Abduh, Islam was not just a compartmentalised theological framework: it was at the nexus of societal emancipation, intellectual and cultural rejuvenation, and political progress. Far from “modernising” and diluting Islam to the extent that it became irrelevant in the face of rationality as defined by European modernity, Islam remained central to Abduh’s political framework.

Keywords: Islamic political thought, Islamic revivalism, modernism, Muhammad Abduh, epistemology

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4787 An Empirical Investigation of Mobile Banking Services Adoption in Pakistan

Authors: Aijaz A. Shaikh, Richard Glavee-Geo, Heikki Karjaluoto

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Adoption of Information Systems (IS) is receiving increasing attention such that its implications have been closely monitored and studied by the IS management community, industry and professional gatekeepers. Building on previous research regarding the adoption of technology, this paper develops and validates an integrated model of the adoption of mobile banking. The model originates from the Technology Acceptance Model (TAM) and the Theory of Planned Behaviour (TPB). This paper intends to offer a preliminary scrutiny of the antecedents of the adoption of mobile banking services in the context of a developing country. Data was collected from Pakistan. The findings showed that an integrated TAM and TPB model greatly explains the adoption intention of mobile banking; and perceived behavioural control and its antecedents play a significant role in predicting adoption Theoretical and managerial implications of findings are presented and discussed.

Keywords: developing country, mobile banking service adoption, technology acceptance model, theory of planned behavior

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4786 Irritable Bowel Syndrome Prevalence and Associated Risk Factors Among Medical Students And Intern Doctors in Sudan

Authors: Zainab Alghali Elsaid Muhammed

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Background : IBS is a gastrointestinal disorder characterized by a variety of symptoms that occur concurrently. It is very common and is associated with high levels of psychiatric comorbidities, all of which have a negative impact on the patient's quality of life. Abdominal pain, diarrhea, constipation, excess gas, and bloating are common symptoms of IBS. Objectives : The purpose of this study is to determine the prevalence of IBS among medical students and intern doctors in Sudan, as well as the risk factors associated with it. Study design: This cross-sectional study was carried out in Sudan from April to July 2022. All participants completed a six-part online questionnaire. The ROME IV criteria questionnaire was used to make an IBS diagnosis. Participants completed the hospital anxiety and depression questionnaire in order to be diagnosed with anxiety and depression. Results : 600 participants filled out the questionnaire. The overall prevalence of IBS was found to be 42%, with females being the most affected. Intern doctors had higher IBS rates (30.0%) than medical students, but this was not statistically significant. Single status (p =0.079), good GPAs (p =0.00), had significant associations with IBS occurrence. Other significantly associated habits were sleeping less than 8 hours (p =0.013), two cups or less of coffee per day (p = 0.109), No smoking (p =0.001), and No exercise (p =0.00, IBS participants were also found to have a significant relationship with abnormal anxiety (p =0.00) and borderline depression (p=0.0156). Conclusion : The high prevalence of IBS in this study suggests that medical students and interns are unable to recognize their symptoms. The main IBS predictors in this study were suffering from anxiety or depression, having an insufficient income, sleeping less than 8 hours per day, working/ studying more than 8 hours per day, and not performing any type of exercise.

Keywords: irritable bowel syndrome, sudan, HADS, rome IV, medical students

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4785 A Study on Game Theory Approaches for Wireless Sensor Networks

Authors: M. Shoukath Ali, Rajendra Prasad Singh

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Game Theory approaches and their application in improving the performance of Wireless Sensor Networks (WSNs) are discussed in this paper. The mathematical modeling and analysis of WSNs may have low success rate due to the complexity of topology, modeling, link quality, etc. However, Game Theory is a field, which can efficiently use to analyze the WSNs. Game Theory is related to applied mathematics that describes and analyzes interactive decision situations. Game theory has the ability to model independent, individual decision makers whose actions affect the surrounding decision makers. The outcome of complex interactions among rational entities can be predicted by a set of analytical tools. However, the rationality demands a stringent observance to a strategy based on measured of perceived results. Researchers are adopting game theory approaches to model and analyze leading wireless communication networking issues, which includes QoS, power control, resource sharing, etc.

Keywords: wireless sensor network, game theory, cooperative game theory, non-cooperative game theory

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4784 Long Term Examination of the Profitability Estimation Focused on Benefits

Authors: Stephan Printz, Kristina Lahl, René Vossen, Sabina Jeschke

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Strategic investment decisions are characterized by high innovation potential and long-term effects on the competitiveness of enterprises. Due to the uncertainty and risks involved in this complex decision making process, the need arises for well-structured support activities. A method that considers cost and the long-term added value is the cost-benefit effectiveness estimation. One of those methods is the “profitability estimation focused on benefits – PEFB”-method developed at the Institute of Management Cybernetics at RWTH Aachen University. The method copes with the challenges associated with strategic investment decisions by integrating long-term non-monetary aspects whilst also mapping the chronological sequence of an investment within the organization’s target system. Thus, this method is characterized as a holistic approach for the evaluation of costs and benefits of an investment. This participation-oriented method was applied to business environments in many workshops. The results of the workshops are a library of more than 96 cost aspects, as well as 122 benefit aspects. These aspects are preprocessed and comparatively analyzed with regards to their alignment to a series of risk levels. For the first time, an accumulation and a distribution of cost and benefit aspects regarding their impact and probability of occurrence are given. The results give evidence that the PEFB-method combines precise measures of financial accounting with the incorporation of benefits. Finally, the results constitute the basics for using information technology and data science for decision support when applying within the PEFB-method.

Keywords: cost-benefit analysis, multi-criteria decision, profitability estimation focused on benefits, risk and uncertainty analysis

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4783 International Solar Alliance: A Case for Indian Solar Diplomacy

Authors: Swadha Singh

Abstract:

International Solar Alliance is the foremost treaty-based global organization concerned with tapping the potential of sun-abundant nations between the Tropics of Cancer and Capricorn and enables co-operation among them. As a founding member of the International Solar Alliance, India exhibits its positioning as an upcoming leader in clean energy. India has set ambitious goals and targets to expand the share of solar in its energy mix and is playing a proactive role both at the regional and global levels. ISA aims to serve multiple goals- bring about scale commercialization of solar power, boost domestic manufacturing, and leverage solar diplomacy in African countries, amongst others. Against this backdrop, this paper attempts to examine the ways in which ISA as an intergovernmental organization under Indian leadership can leverage the cause of clean energy (solar) diplomacy and effectively shape partnerships and collaborations with other developing countries in terms of sharing solar technology, capacity building, risk mitigation, mobilizing financial investment and providing an aggregate market. A more specific focus of ISA is on the developing countries, which in the absence of a collective, are constrained by technology and capital scarcity, despite being naturally endowed with solar resources. Solar rich but finance-constrained economies face political risk, foreign exchange risk, and off-taker risk. Scholars argue that aligning India’s climate change discourse and growth prospects in its engagements, collaborations, and partnerships at the bilateral, multilateral and regional level can help promote trade, attract investments, and promote resilient energy transition both in India and in partner countries. For developing countries, coming together in an action-oriented way on issues of climate and clean energy is particularly important since it is developing and underdeveloped countries that face multiple and coalescing challenges such as the adverse impact of climate change, uneven and low access to reliable energy, and pressing employment needs. Investing in green recovery is agreed to be an assured way to create resilient value chains, create sustainable livelihoods, and help mitigate climate threats. If India is able to ‘green its growth’ process, it holds the potential to emerge as a climate leader internationally. It can use its experience in the renewable sector to guide other developing countries in balancing multiple similar objectives of development, energy security, and sustainability. The challenges underlying solar expansion in India have lessons to offer other developing countries, giving India an opportunity to assume a leadership role in solar diplomacy and expand its geopolitical influence through inter-governmental organizations such as ISA. It is noted that India has limited capacity to directly provide financial funds and support and is not a leading manufacturer of cheap solar equipment, as does China; however, India can nonetheless leverage its large domestic market to scale up the commercialization of solar power and offer insights and learnings to similarly placed abundant solar countries. The paper examines the potential of and limits placed on India’s solar diplomacy.

Keywords: climate diplomacy, energy security, solar diplomacy, renewable energy

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4782 Manganese and Other Geothermal Minerals Exposure to Residents in Ketenger Village, Banyumas, Indonesia

Authors: Rita Yuniatun, Dewi Fadlilah Firdausi, Anida Hanifah, Putrisuvi Nurjannah Zalqis, Erza Nur Afrilia, Akrima Fajrin Nurimani, Andrew Luis Krishna

Abstract:

Manganese (Mn) is one of the potential contaminants minerals geothermal water. Preliminary studies conducted in Ketenger village, the nearest village with Baturaden hot spring, showed that the concentration of Mn in water supply has exceeded the reference value. Mineral contamination problem in Ketenger village is not only Mn, but also other potential geothermal minerals, such as chromium (Cr), iron (Fe), sulfide (S2-), nickel (Ni), cobalt (Co), and zinc (Zn). It becomes a concern because generally the residents still use ground water as the water source for their daily needs, including drinking and cooking. Therefore, this study aimed to determine the distribution of mineral contamination in drinking water and food and to estimate the health risks possibility from the exposure. Four minerals (Mn, Fe, S2-, and Cr6+) were analyzed in drinking water, carbohydrate sources, vegetables, fishes, and fruits. The test results indicate that Mn concentration in drinking water is 0.35 mg/L, has exceeded the maximum contaminant level (MCL) according to the US EPA (MCL = 0.005 mg/L), whereas other minerals still comply with the standards. In addition, we found that the average of Mn concentration in the carbohydrate sources is quite high (1.87 mg/Kg). Measurement results in Chronic Daily Intake (CDI) and the Risk Quotient (RQ) found that exposure to manganese and other geothermal minerals in drinking water and food are safe from the non-carcinogenic effects in each age group (RQ<1). So, geothermal mineral concentrations in drinking water and food has no effect on non-carcinogenic risk in Ketenger’s residents because of CDI is also influenced by other parameters such as the duration of exposure and the rate of consumption. However, it was found that intake of essential minerals (Mn and Fe) are deficient in every age group. So that, the addition of Mn and Fe intake is recommended.

Keywords: CDI, contaminant, geothermal minerals, manganese, RQ

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4781 The Effect of Closed Circuit Television Image Patch Layout on Performance of a Simulated Train-Platform Departure Task

Authors: Aaron J. Small, Craig A. Fletcher

Abstract:

This study investigates the effect of closed circuit television (CCTV) image patch layout on performance of a simulated train-platform departure task. The within-subjects experimental design measures target detection rate and response latency during a CCTV visual search task conducted as part of the procedure for safe train dispatch. Three interface designs were developed by manipulating CCTV image patch layout. Eye movements, perceived workload and system usability were measured across experimental conditions. Task performance was compared to identify significant differences between conditions. The results of this study have not been determined.

Keywords: rail human factors, workload, closed circuit television, platform departure, attention, information processing, interface design

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4780 Developing Methodology of Constructing the Unified Action Plan for External and Internal Risks in University

Authors: Keiko Tamura, Munenari Inoguchi, Michiyo Tsuji

Abstract:

When disasters occur, in order to raise the speed of each decision making and response, it is common that delegation of authority is carried out. This tendency is particularly evident when the department or branch of the organization are separated by the physical distance from the main body; however, there are some issues to think about. If the department or branch is too dependent on the head office in the usual condition, they might feel lost in the disaster response operation when they are face to the situation. Avoiding this problem, an organization should decide how to delegate the authority and also who accept the responsibility for what before the disaster. This paper will discuss about the method which presents an approach for executing the delegation of authority process, implementing authorities, management by objectives, and preparedness plans and agreement. The paper will introduce the examples of efforts for the three research centers of Niigata University, Japan to arrange organizations capable of taking necessary actions for disaster response. Each center has a quality all its own. One is the center for carrying out the research in order to conserve the crested ibis (or Toki birds in Japanese), the endangered species. The another is the marine biological laboratory. The third one is very unique because of the old growth forests maintained as the experimental field. Those research centers are in the Sado Island, located off the coast of Niigata Prefecture, is Japan's second largest island after Okinawa and is known for possessing a rich history and culture. It takes 65 minutes jetfoil (high-speed ferry) ride to get to Sado Island from the mainland. The three centers are expected to be easily isolated at the time of a disaster. A sense of urgency encourages 3 centers in the process of organizational restructuring for enhancing resilience. The research team from the risk management headquarters offer those procedures; Step 1: Offer the hazard scenario based on the scientific evidence, Step 2: Design a risk management organization for disaster response function, Step 3: Conduct the participatory approach to make consensus about the overarching objectives, Step 4: Construct the unified operational action plan for 3 centers, Step 5: Simulate how to respond in each phase based on the understanding the various phases of the timeline of a disaster. Step 6: Document results to measure performance and facilitate corrective action. This paper shows the result of verifying the output and effects.

Keywords: delegation of authority, disaster response, risk management, unified command

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4779 Conceptualizing Health-Seeking Behavior among Adolescents and Youth with Substance Use Disorder in Urban Kwazulu-Natal. A Candidacy Framework Analysis

Authors: Siphesihle Hlongwane

Abstract:

Background: Globally, alcohol consumption, smoking, and the use of illicit drugs kill more than 11.8 million people each year. In sub-Saharan Africa, substance abuse is responsible for more than 6.4% of all deaths recorded and about 4.7% of all Disability Adjusted Life Years (DALYs), with numbers still expected to grow if no drastic measures are taken to curb and address drug use. In a setting where substance use is rife, understanding contextual factors that influence an individual’s perceived eligibility to seek rehabilitation is paramount. Using the candidacy framework, we unpack how situational factors influence an individual’s perceived eligibility for healthcare uptake in adolescents and youth with substance use disorder (SUD). Methods: The candidacy framework is concerned with how people consider their eligibility for accessing a health service. The study collected and analyzed primary qualitative data to answer the research question. Data were collected between January and July 2022 on participants aged between 18 and 35 for drug users and 18 to 60 for family members. Participants include 20 previous and current drug users and 20 family members that experience the effects of addiction. A pre-drafted semi-structured interview guide was administered to a conveniently sampled population supplemented with a referral sampling method. Data were thematically analyzed using the NVivo 12pro software to manage the data. Findings: Our findings show that people with substance use disorders are aware of their drug use habits and acknowledge their candidacy for health services. Candidacy for health services is also acknowledged by those around them, such as family members and peers, and as such, information on the navigation of health services for drug users is shared by those who have attended health services, those affected by drug use, and this includes health service research by family members to identify accessible health services. While participants reported willingness to quit drug use if assistance is provided, the permeability of health care services is hindered by both individual determinations to quit drug use from long-time use and the availability of health services for drug users, such as rehabilitation centers. Our findings also show that drug users are conscious and can articulate their ailments; however, the hunt for the next dose of drugs and long waiting cues for health service acquisition overshadows their claim to health services. Participants reported a mixture of treatments prescribed, with some more gruesome than others prescribed, thus serving as both a facilitator and barrier for health service uptake. Despite some unorthodox forms of treatments prescribed in health care, the majority of those who enter treatment complete the process of treatment, although some are met with setbacks and sometimes relapse after treatment has finished. Conclusion: Drug users are able to ascertain their candidacy for health services; however, individual and environmental characteristics relating to drug use hinder the use of health services. Drug use interventions need to entice health service uptake as a way to improve candidacy for health use.

Keywords: substance use disorder, rehabilitation, drug use, relapse, South Africa, candidacy framework

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4778 Investor’s Psychology in Investment Decision Making in Context of Behavioural Finance

Authors: Jhansi Rani Boda, G. Sunitha

Abstract:

Worldwide, the financial markets are influenced by several factors such as the changes in economic and political processes that occur in the country and the globe, information diffusion and approachability and so on. Yet, the foremost important factor is the investor’s reaction and perception. For an individual investor, decision-making process can be perceived as a continuous process that has significant impact of their psychology while making investment decisions. Behavioral finance relies on research of human and social recognition and emotional tolerance studies to identify and understand the investment decisions. This article aims to report the research of individual investor’s financial behavior in a historical perspective. This article uncovers the investor’s psychology in investment decision making focusing on the investor’s rationality with an explanation of psychological and emotional factors that affect investing. The results of the study are revealed by means of Graphical visualization.

Keywords: behavioral finance, psychology, investor’s behavior, psychological and emotional factors

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4777 Fall Prevention: Evidence-Based Intervention in Exercise Program Implementation for Keeping Older Adults Safe and Active

Authors: Jennifer Holbein, Maritza Wiedel

Abstract:

Background: Aging is associated with an increased risk of falls in older adults, and as a result, falls have become public health crises. However, the incidence of falls can be reduced through healthy aging and the implementation of a regular exercise and strengthening program. Public health and healthcare professionals authorize the use of evidence‐based, exercise‐focused fall interventions, but there are major obstacles to translating and disseminating research findings into healthcare practices. The purpose of this study was to assess the feasibility of an intervention, A Matter of Balance, in terms of demand, acceptability, and implementation into current exercise programs. Subjects: Seventy-five participants from rural communities, above the age of sixty, were randomized to an intervention or attention-control of the standardized senior fitness test. Methods: Subject completes the intervention, which combines two components: (1) motivation and (2) fall-reducing physical activities with protocols derived from baseline strength and balanced assessments. Participants (n=75) took part in the program after completing baseline functional assessments as well as evaluations of their personal knowledge, health outcomes, demand, and implementation interventions. After 8-weeks of the program, participants were invited to complete follow-up assessments with results that were compared to their baseline functional analyses. Out of all the participants in the study who complete the initial assessment, approximately 80% are expected to maintain enrollment in the implemented prescription. Furthermore, those who commit to the program should show mitigation of fall risk upon completion of their final assessment.

Keywords: aging population, exercise, falls, functional assessment, healthy aging

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4776 Education for Sustainable Development and Primary Education in China: A Case Study

Authors: Ronghui (Kevin) Zhou

Abstract:

This research intends to explore the enactment of Education for Sustainable Development (ESD), in term of the ESD concept, in primary schools in China, and investigate the factors that have positively or negatively impacted the outcome of ESD in urban primary schools in China. The proposed research question is: how is the ESD concept perceived and enacted by the local education stakeholders. This research is conducted in multiple primary schools in China and has questionnaired and interviewed multiple education stakeholders, including school principals, school teachers, and bureau from the municipal Ministry of Education. Factor analysis, regression analysis, and critical discourse analysis are adopted to interpret and analyze the data. The preliminary findings suggest that contested ESD definition, education system pressures, education policy enforcement, and power dynamics between stakeholders are the key factors that have determined to what degree is ESD enacted, and to what extent is ESD practiced in primary schools in China.

Keywords: education for sustainable development, China, primary education, case study

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4775 Transformations of River Zones in Hanoi, Vietnam: Problems of Urban Drainage and Environmental Pollution

Authors: Phong Le Ha

Abstract:

In many cities the entire world, the relationship between cities and rivers is always considered as a fundament of urban history research because of their profound interactions. This kind of relationship makes the river zones become extremely sensitive in many aspects. One of the most important aspect is their roles in the drainage of cities. In this paper we will examine an extraordinary case of Hanoi, the capital of Vietnam and Red river zones. This river has contradictory impacts to this city: It is considered as a source of life of the inhabitants who live along its two banks, however, the risk of inundation caused by the complicated hydrology system of this river is always a real threat to the cities that it flows through. Morphologically, Red river was connected to the inner rivers system that made Hanoi a complete form of a river city. This structure combined with the topography of Hanoi helps this city to assure a stable drainage system in which the river zones in the north of Hanoi play some extreme important roles. Nevertheless, in the late 20 years, Hanoi's strong urbanization and the instability of Red river's complicated hydrology make the very remarkable transformations in the relationship river-city and in the river zones: The connection between the river and the city declines; the system of inner lakes are progressively replaced by habitat land; in the river zones, the infrastructure system can't adapt to the transformations of the new quarters which have the origin of the agricultural villages. These changes bring out many chances for the urban development, but also many risks and problems, particularly in the environment and technical sides. Among these, pluvial and used water evacuation is one of the most severe problems. The disappear of inner-city lakes, the high dike and the topographical changes of Hanoi blow up the risk of inundation of this city. In consequences, the riverine zones, particularly in the north of Hanoi, where the two most important water evacuation rivers of Hanoi meet each other, are burdened with the drainage pressure. The unique water treatment plant in this zone seems to be overcharged in receiving each day about 40000m3 of used water (not include pluvial water). This kind of problem leads also to another risk related to the environmental pollution (water pollution and air pollution). So, in order to better understand the situation and to propose the solutions to resolve the problems, an interdisciplinary research covering many different fields such urban planning, architecture, geography, and especially drainage and environment has been carried out. In general, this paper will analyze an important part of the research : the process of urban transformation of Hanoi (changes in urban morphology, infrastructure system, evolution of the dike system, ...) and the hydrological changes of Red river which cause the drainage and environmental problems. The conclusions of these analyses will be the solid base of the following researches focusing on the solutions of a sustainable development.

Keywords: drainage, environment, Hanoi, infrastructure, red rivers, urbanization

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4774 The Role of HPV Status in Patients with Overlapping Grey Zone Cancer in Oral Cavity and Oropharynx

Authors: Yao Song

Abstract:

Objectives: We aimed to explore the clinicodemographic characteristics and prognosis of grey zone squamous cell cancer (GZSCC) located in the overlapping or ambiguous area of the oral cavity and oropharynx and to identify valuable factors that would improve its differential diagnosis and prognosis. Methods: Information of GZSCC patients in the Surveillance, Epidemiology, and End Results (SEER) database was compared to patients with an oral cavity (OCSCC) and oropharyngeal (OPSCC) squamous cell carcinomas with corresponding HPV status, respectively. Kaplan-Meier method with log-rank test and multivariate Cox regression analysis were applied to assess associations between clinical characteristics and overall survival (OS). A predictive model integrating age, gender, marital status, HPV status, and staging variables was conducted to classify GZSCC patients into three risk groups and verified internally by 10-fold cross validation. Results: A total of 3318 GZSCC, 10792 OPSCC, and 6656 OCSCC patients were identified. HPV-positive GZSCC patients had the best 5-year OS as HPV-positive OPSCC (81% vs. 82%). However, the 5-year OS of HPV-negative/unknown GZSCC (43%/42%) was the worst among all groups, indicating that HPV status and the overlapping nature of tumors were valuable prognostic predictors in GZSCC patients. Compared with the strategy of dividing GZSCC into two groups by HPV status, the predictive model integrating more variables could additionally identify a unique high-risk GZSCC group with the lowest OS rate. Conclusions: GZSCC patients had distinct clinical characteristics and prognoses compared with OPSCC and OCSCC; integrating HPV status and other clinical factors could help distinguish GZSCC and predict their prognosis.

Keywords: GZSCC, OCSCC, OPSCC, HPV

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4773 Association Between Advanced Parental Age and Implantation Failure: A Prospective Cohort Study in Anhui, China

Authors: Jiaqian Yin, Ruoling Chen, David Churchill, Huijuan Zou, Peipei Guo, Chunmei Liang, Xiaoqing Peng, Zhikang Zhang, Weiju Zhou, Yunxia Cao

Abstract:

Purpose: This study aimed to explore the interaction of male and female age on implantation failure from in vitro fertilisation (IVF)/ intracytoplasmic sperm injection (ICSI) treatments in couples following their first cycles using the Anhui Maternal-Child Health Study (AMCHS). Methods: The AMCHS recruited 2042 infertile couples who were physically fit for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment at the Reproductive Centre of the First Affiliated Hospital of Anhui Medical University between May 2017 to April 2021. This prospective cohort study analysed the data from 1910 cohort couples for the current paper data analysis. The multivariate logistic regression model was used to identify the effect of male and female age on implantation failure after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40; female age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40) predictors. Results: Logistic regression indicated that advanced maternal age was associated with increased implantation failure (P<0.001). There was evidence of an interaction between maternal age (30-<35 and ≥ 35) and paternal age (≥35) on implantation failure. (p<0.05). Only when the male was ≥35 years of increased maternal age was associated with the risk of implantation failure. Conclusion: In conclusion, there was an additive effect on implantation failure with advanced parental age. The impact of advanced maternal age was only seen in the older paternal age group. The delay of childbearing in both men and women will be a serious public issue that may contribute to a higher risk of implantation failure in patients needing assisted reproductive technology (ART).

Keywords: parental age, infertility, cohort study, IVF

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4772 Family Functionality in Mexican Children with Congenital and Non-Congenital Deafness

Authors: D. Estrella, A. Silva, R. Zapata, H. Rubio

Abstract:

A total of 100 primary caregivers (mothers, fathers, grandparents) with at least one child or grandchild with a diagnosis of congenital bilateral profound deafness were assessed in order to evaluate the functionality of families with a deaf member, who was evaluated by specialists in audiology, molecular biology, genetics and psychology. After confirmation of the clinical diagnosis, DNA from the patients and parents were analyzed in search of the 35delG deletion of the GJB2 gene to determine who possessed the mutation. All primary caregivers were provided psychological support, regardless of whether or not they had the mutation, and prior and subsequent, the family APGAR test was applied. All parents, grandparents were informed of the results of the genetic analysis during the psychological intervention. The family APGAR, after psychological and genetic counseling, showed that 14% perceived their families as functional, 62% moderately functional and 24% dysfunctional. This shows the importance of psychological support in family functionality that has a direct impact on the quality of life of these families.

Keywords: deafness, psychological support, family, adaptation to disability

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