Search results for: solution focused group therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 17531

Search results for: solution focused group therapy

14861 Medical Nutritional Therapy in Human Immunodeficiency Virus Infection with Tuberculosis and Severe Malnutrition: A Case Report

Authors: Lista Andriyati, Nurpudji A Taslim

Abstract:

The human immunodeficiency virus (HIV) patients have potential nutritional and metabolic problems. HIV is a virus that attacks cells T helper and impairs the function of immune cells. Infected individuals gradually become immunodeficient, results in increased susceptibility to a wide range of infections such as tuberculosis (TB). Malnutrition has destructive effects on the immune system and host defense mechanisms. Effective and proper nutritional therapies are important to improve medical outcomes and quality of life, which is associated with functional improvement. A case of 38-years old man admitted to hospital with loss of consciousness and was diagnosed HIV infection and relapse lung TB with severe malnutrition, fever, oral candidiasis, anemia (6.3 g/dL), severe hypoalbuminemia (1.9 g/dL), severe hypokalemia (2.2 mmol/L), immune depletion (1085 /µL) and elevated liver enzyme (ALT 1198/AST 375 U/L). Nutritional intervention by giving 2300 kcal of energy, protein 2 g/IBW/day, carbohydrate 350 g, fat 104 g through enteral and parenteral nutrition. Supplementations administered are zinc, vitamin A, vitamin B1, vitamin B6, vitamin B12, vitamin C, vitamin D, and snakehead fish extract high content of protein albumin (Pujimin®). After 46 days, there are clinical and metabolic improvement in Hb (6.3 to 11.2 g/dL), potassium (2.2 to 3.4 mmol/L), albumin (1.9 to 2.3 g/dL), ALT 1198 to 47/AST 375 to 68 U/L) and improved awareness. In conclusion, nutritional therapy in HIV infection with adequate macronutrients and micronutrients fulfillment and immunonutrition is very important to avoid cachexia and to improve nutritional status and immune disfunction.

Keywords: HIV, hypoalbuminemia, malnutrition, tuberculosis

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14860 Nose Macroneedling Tie Suture Hidden Technique

Authors: Mohamed Ghoz, Hala Alsabeh

Abstract:

Context: Macroscopic Nose Macroneedling (MNM) is a new non-surgical procedure for lifting and tightening the nose. It is a tissue-non-invasive technique that uses a needle to create micro-injuries in the skin. These injuries stimulate the production of collagen and elastin, which results in the tightening and lifting of the skin. Research Aim: The research aim of this study was to investigate the efficacy and safety of MNM for the treatment of nasal deformities. Methodology A total of 100 patients with nasal deformities were included in this study. The patients were randomly assigned to either the MNM group or the control group. The MNM group received a single treatment of MNM, while the control group received no treatment. The patients were evaluated at baseline, 6 months, and 12 months after treatment. Findings: The results of this study showed that MNM was effective in improving the appearance of the nose in patients with nasal deformities. At 6 months after treatment, the patients in the MNM group had significantly improved nasal tip projection, nasal bridge height, and nasal width compared to the patients in the control group. The improvements in nasal appearance were maintained at 12 months after treatment. Theoretical Importance: The findings of this study provide support for the use of MNM as a safe and effective treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities. Data Collection: Data was collected from the patients using a variety of methods, including clinical assessments, photographic assessments, and patient-reported outcome measures. Analysis Procedures: The data was analyzed using a variety of statistical methods, including descriptive statistics, inferential statistics, and meta-analysis. Question Addressed: The research question addressed in this study was whether MNM is an effective and safe treatment for nasal deformities. Conclusion: The findings of this study suggest that MNM is an effective and safe treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities.

Keywords: nose, surgery, tie, suture

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14859 Improving the Quality of Higher Education for Students with Disability in Universities of Pakistan

Authors: Nasir Sulman

Abstract:

In Pakistan, the inclusion of persons with disabilities in higher education institutions has significantly been increased with every passing year and anyone can observe a sizeable number of these students in each faculty. The study executes to conduct a baseline survey for measuring faculty understanding about the special needs, experiences of students with disabilities and support provided by university administration in order to teach these students effectively. The researcher has used mixed methods and the University of Karachi was selected through non-probability-based sampling method. This university is one of the largest universities in Pakistan where more than 40,000 students have been enrolled. Data was gathered through a questionnaire and focused group discussion from three stakeholders including students with disabilities, faculty members and members of the university administration. The key findings show that students with disabilities experience a number of problems related to accommodating their special needs. However, the most encouraging factors identified are the attitude, support, and motivation they received from various faculty members and university administration. On the basis of the findings of the study the researcher has prepared a faculty guidebook and established a ‘Model Learning Assistance Centre for Students with Disabilities’ in the Department of Special Education, University of Karachi. Both these efforts will be helpful for improving the support services for students with disabilities to strengthen the existing laws, policies, and practices in institutions of higher education.

Keywords: persons with disabilities, higher education, learning assistance center, faculty guidebook

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14858 Association Nephropathy and Hypertension in Diabetic Patients

Authors: Bahlous Afef, Bouzid Kahena, Bardkis Ahlem, Mrad Mehdi, Kalai Eya, Sonia Bahri, Abdelmoula Jaouida

Abstract:

Diabetic nephropathy is the first cause of chronic renal failure and hemodialysis use in several countries including Tunisia. The role of hypertension (HT) as major risk factor for nephropathy is undeniable. The aim of our study was to determine the relationship between blood pressure and nephropathy in a population of diabetic type 2 recently discovered. Materials and methods: We conducted a prospective study focused on 60 patients with type 2 diabetes recently discovered (<5 years). Each patient have benefited from: -a full clinical examination with measurement of blood pressure - exploring a blood-glucose control and renal function -urinary exploration with the determination of proteinuria microalbuminumie of 24 hours with a immunoturbidimetric method using Architect (ABBOTT CI 8200). Results and discussion: Hypertension was present in 46.7% of cases. Twenty patients, 35% of the study population showed nephropathy. Four of these patients (6.66% of cases) had proteinuria, while 16 (26.6% of patients) had microalbuminuria (> 30mg/24 hours). Systolic blood pressure was significantly (p < 0.05) associated with the presence of nephropathy (139 +19.44) vs. for the group with normal renal function (128.65 +15.12 mmHg). Conclusion: The etiology of diabetic nephropathy is multifactorial. However, systolic blood pressure and glycemic control remains the major risk factors. Better glycemic control and treatment of hypertension allowed preventing and slowing the progression of diabetic nephropathy.

Keywords: hypertension, nephropathy, hemodialysis, diabetes

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14857 Effects of Injectable Thermosensitive Hydrogel Containing Chitosan as a Barrier for Prevention of Post-operative Peritoneal Adhesion in Rats

Authors: Sara Javanmardi, Sepehr Aziziz, Baharak Divband, Masoumeh Firouzamandi

Abstract:

Post-operative adhesions are the most common cause of intestinal obstruction, female infertility and chronic abdominal pain. We developed a novel approach for preventing post-operative peritoneal adhesions using a biodegradable and thermosensitive curcumin hydrogel in rats. Thirteen male Sprague-Dawley rats were assigned randomly into five groups of six animals each: In SHAM group, the cecum was exteriorized, gently manipulated and sent back into the abdomen. In CONTROL group, the surgical abrasion was performed with no further treatment. In Hydrogel group, surgical abrasion was performed with local application of blank hydrogel (1 mL). In Curcumin group, surgical abrasion was performed with local application of curcumin (1 mL). In CUR/HGEL group, surgical abrasion was performed with local application of curcumin hydrogel (1 mL). On day 10, adhesions were assessed using a standardized scale (Evans model), and samples were collected for the Real-time PCR. Real-time PCR was performed to determine mRNA levels of VCAM-1, ICAM-1 and GAPDH. The macroscopic adhesion intensity showed statistically significant differences between the CUR/HGEL and other groups (P=0.0005). The findings of the present study revealed there were statistically significant differences between the groups regarding adhesion band length and numbers (P<0.0001). The protein and mRNA expression of VCAM-1 and ICAM-1 in secal tissues were significantly down regulated due to curcumin-hydrogel application in CUR/HGEL compared to other groups (p<0.05). The thermosensitive hydrogel could reduce the severity and even prevent formation of intra-abdominal adhesion. Curcumin hydrogel could serve as a potential barrier agent to prevent post-operative peritoneal adhesion in rats.

Keywords: peritoneal adhesion, hydrogel, curcumijn, ICAM-1, VCAM-1

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14856 Integrating Individual and Structural Health Risk: A Social Identity Perspective on the HIV/AIDS Pandemic in Sub-Saharan Africa

Authors: Orla Muldoon, Tamaryn Nicolson, Mike Quayle, Aisling O'Donnell

Abstract:

Psychology most often considers the role of experience and behaviour in shaping health at the individual level. On the other hand epidemiology has long considered risk at the wider group or structural level. Here we use the social identity approach to integrate group-level risk with individual level behaviour. Using a social identity approach we demonstrate that group or macro-level factors impact implicitly and profoundly in everyday ways at the level of individuals, via social identities. We illustrate how identities related to race, gender and inequality intersect to affect HIV/AIDS risk and AIDS treatment behaviours; how social identity processes drive stigmatising consequences of HIV and AIDS, and promote positive and effective interventions. We conclude by arguing that the social identity approach offers the field an explanatory framework that conceptualizes how social and political forces intersect with individual identity and agency to affect human health.

Keywords: social identity approach, HIV/AIDS, Africa, HIV risk, race, gender

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14855 Derivational Morphology Training Improves Spelling in School-Aged Children

Authors: Estelle Ardanouy, Helene Delage, Pascal Zesiger

Abstract:

Morphological awareness contributes to the acquisition of reading and spelling in typical learners as well as in children with learning disorders. Indeed, the acquisition of phoneme-grapheme correspondences is not sufficient to master spelling, especially in inconsistent orthographic systems such as English or French. Several meta-analyses show the benefit of explicit training in derivational morphology on reading and spelling in old children (who have already learned the main grapheme-phoneme correspondences), but highlight the lack of studies with younger children, particularly in French. In this study, we chose to focus on the efficiency of an intensive training in derivational morphology on spelling skills in French-speaking four-graders (9-10 years of age). The training consisted of 1) learning how to divide words into morphemes (ex: para/pente in French, paraglider in English), as well as 2) working on the meaning of affixes in relation to existing words (ex: para/pente: to protect against – para - the slope -pente). One group of pupils (N = 37, M age = 9.5) received this experimental group training in morphology while an alternative training group (N = 34, M age = 9.6) received a visuo-semantic training based on visual cues to memorize the spelling difficulties of complex words (such as the doubling of “r” in “verre” in French -or "glass" in English-which are represented by the drawing of two glasses). Both trainings lasted a total of 15 hours at a rate of four 45 minutes sessions per week, resulting in five weeks of training in the school setting. Our preliminary results show a significant improvement in the experimental group in the spelling of affixes on the trained (p < 0.001) and untrained word lists (p <0.001), but also in the root of words on the trained (p <0.001) and untrained word lists group (p <0.001). The training effect is also present on both trained and untrained morphologically composed words. By contrast, the alternative training group shows no progress on these previous measures (p >0.15). Further analyses testing the effects of both trainings on other measures such as morphological awareness and reading of morphologically compose words are in progress. These first results support the effectiveness of explicitly teaching derivational morphology to improve spelling in school-aged children. The study is currently extended to a group of children with developmental dyslexia because these children are known for their severe and persistent spelling difficulties.

Keywords: developmental dyslexia, derivational morphology, reading, school-aged children, spelling, training

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14854 Effect of Fatty Acids in Feed on Levels of Antibody Titers and CD4 and CD8 T-Lymphocyte against Newcastle Disease Virus of Vaccinated Broiler Chicken

Authors: Alaa A. Shamaun Al-Abboodi, Yunis A. A. Bapeer

Abstract:

400 one-day-old male broiler chicks (Ross-308) randomly divided to 2 main groups, 1st main group (GA) was feeding basal diet with medium chain fatty acid (MCFA) at rate of 0.15% and divided to four subgroups, 3 subgroups vaccinated with different routes with Newcastle Disease Virus (NDV) and non-vaccinated group. The 2nd main group (GB) feeding basal diet without MCFA and divided the same as 1st main group. The parameters used in this study included: ND antibody titers at 1, 10, 21, 28, 35 and 42 days of age and values of CD4 and CD8 at 1, 20, 30 and 42 days of age. This experiment detected increase in ND antibodies titers in (G1, G2, G3) groups were fed on basal diet MCFA comparing to groups were fed without adding MCFA (G5, G6, G7) and control groups (G4, G8). The results of cellular immune response (CD4 and CD8) T-cells in broiler chicks indicated that there was obviously significant relationship between dietary Fatty Acid (FA) versus the diet without FA on the level of CD4 parameter, for the entire experimental period. The effect of different ages was statistically significant in creating different values of CD4 level, whereas the CD4 level decreases markedly with age. However, analyzing the data of different vaccination methods, oculonasal method of vaccination led to the highest value of CD4 compared with the oral, S/C and control groups. There were statistical differences in CD8 values due to supplementation of FA versus the basal diet and due to the effect of different age periods. As for the age effect, the CD8 value at 20 days of age was significantly higher than at 42 and 30 days.

Keywords: broiler, CD4 and CD8, fatty acids, Newcastle Disease

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14853 Project Paulina: A Human-Machine Interface for Individuals with Limited Mobility and Conclusions from Research and Development

Authors: Radoslaw Nagay

Abstract:

The Paulina Project aims to address the challenges faced by immobilized individuals, such as those with multiple sclerosis, muscle dystrophy, or spinal cord injuries, by developing a flexible hardware and software solution. This paper presents the research and development efforts of our team, which commenced in 2019 and is now in its final stage. Recognizing the diverse needs and limitations of individuals with limited mobility, we conducted in-depth testing with a group of 30 participants. The insights gained from these tests led to the complete redesign of the system. Our presentation covers the initial project ideas, observations from in-situ tests, and the newly developed system that is currently under construction. Moreover, in response to the financial constraints faced by many disabled individuals, we propose an affordable business model for the future commercialization of our invention. Through the Paulina Project, we strive to empower immobilized individuals, providing them with greater independence and improved quality of life.

Keywords: UI, human-machine interface, social inclusion, multiple sclerosis, muscular dystrophy, spinal cord injury, quadriplegic

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14852 Single Machine Scheduling Problem to Minimize the Number of Tardy Jobs

Authors: Ali Allahverdi, Harun Aydilek, Asiye Aydilek

Abstract:

Minimizing the number of tardy jobs is an important factor to consider while making scheduling decisions. This is because on-time shipments are vital for lowering cost and increasing customers’ satisfaction. This paper addresses the single machine scheduling problem with the objective of minimizing the number of tardy jobs. The only known information is the lower and upper bounds for processing times, and deterministic job due dates. A dominance relation is established, and an algorithm is proposed. Several heuristics are generated from the proposed algorithm. Computational analysis indicates that the performance of one of the heuristics is very close to the optimal solution, i.e., on average, less than 1.5 % from the optimal solution.

Keywords: single machine scheduling, number of tardy jobs, heuristi, lower and upper bounds

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14851 Priming through Open Book MCQ Test: A Tool for Enhancing Learning in Medical Undergraduates

Authors: Bharti Bhandari, Bharati Mehta, Sabyasachi Sircar

Abstract:

Medical education is advancing in India, with its advancement newer innovations are being incorporated in teaching and assessment methodology. Our study focusses on a teaching innovation that is more student-centric than teacher-centric and is the need of the day. The teaching innovation was carried out in 1st year MBBS students of our institute. Students were assigned control and test groups. Priming was done for the students in the test group with an open-book MCQ based test in a particular topic before delivering formal didactic lecture on that topic. The control group was not assigned any such exercise. This was followed by formal didactic lecture on the same topic. Thereafter, both groups were assessed on the same topic. The marks were compiled and analysed using appropriate statistical tests. Students were also given questionnaire to elicit their views on the benefits of “self-priming”. The mean marks scored in theory assessment by the test group were statistically higher than the marks scored by the controls. According to students’ feedback, the ‘self-priming “process was interesting, helped in better orientation during class-room lectures and better understanding of the topic. They want it to be repeated for other topics with moderate difficulty level. Better performance of the students in the primed group validates the combination of student-centric priming model and didactic lecture as superior to the conventional, teacher-centric methods alone. If this system is successfully followed, the present teacher-centric pedagogy should increasingly give way to student-centric activities where the teacher is only a facilitator.

Keywords: medical education, open-book test, pedagogy, priming

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14850 Application of Liquid Emulsion Membrane Technique for the Removal of Cadmium(II) from Aqueous Solutions Using Aliquat 336 as a Carrier

Authors: B. Medjahed, M. A. Didi, B. Guezzen

Abstract:

In the present work, emulsion liquid membrane (ELM) technique was applied for the extraction of cadmium(II) present in aqueous samples. Aliquat 336 (Chloride tri-N-octylmethylammonium) was used as carrier to extract cadmium(II). The main objective of this work is to investigate the influence of various parameters affected the ELM formation and its stability and testing the performance of the prepared ELM on removal of cadmium by using synthetic solution with different concentrations. Experiments were conducted to optimize pH of the feed solution and it was found that cadmium(II) can be extracted at pH 6.5. The influence of the carrier concentration and treat ratio on the extraction process was investigated. The obtained results showed that the optimal values are respectively 3% (Aliquat 336) and a ratio (feed: emulsion) equal to 1:1.

Keywords: cadmium, carrier, emulsion liquid membrane, surfactant

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14849 The Negative Impact of Mindfulness on Creativity: An Experimental Test

Authors: Marine Agogue, Beatrice Parguel, Emilie Canet

Abstract:

Defined as receptive attention to and awareness of present events and experience, mindfulness has grown in popularity over the past 30 years to become a trendy buzzword in business media, which regularly reports on its organizational benefits. Mindfulness would enhance or impede creative thinking depending on the type of meditation. Specifically, focused-attention meditation (focusing attention on one object instead of being open to perceive and observe any sensation or thought) would not be or negatively correlated to creativity. This research explores whether mood, in its two dimensions (i.e., hedonic tone, activation level), could mediate this potentially negative effect. The rationale is that focused-attention meditation is likely to improve hedonic tone but, in the meantime, damage activation level, resulting in opposite effects on creativity through the mediation effect of creative self-efficacy, i.e., the belief that one can perform successfully in an ideation setting. To test this conceptual model, a survey was administered to 97 subjects (53% women, mean age: 25 years), randomly assigned to three conditions (a 10-minute focused-attention meditation session vs. a 10-minute psychometric tests session vs. a control condition) and asked to participate in the egg creative task. Creativity was measured in terms of fluency, expansivity, and originality, the other variables using existing scales: hedonic tone (e.g., joyful, happy), activation level (e.g., passive, sluggish), creative self-efficacy (e.g., ‘I felt confident in my ability to do the task effectively’) and self-perceived creativity (e.g., ‘I have lots of original ideas’). The chains of mediation were tested using PROCESS macro (model 6) and controlled for subjects’ gender, age, and self-perceived creativity. Comparing the mindfulness and the control conditions, no difference appeared in terms of creativity, nor any mediation chain by hedonic tone. However, subjects who participated in the meditation session felt less active than those in the control condition, which decreased their creative self-efficacy, and creativity (whatever the indicator considered). Comparing the mindfulness and the psychometric tests conditions, analyses showed that creativity was higher in the psychometric tests condition. As previously, no mediation chain appeared by hedonic tone. However, subjects who participated in the meditation session felt less active than those in the psychometric tests condition, which decreased their creative self-efficacy, and creativity. These findings confirm that focused-attention meditation does not enhance creativity. They demonstrate an emotional underlying mechanism based on activation level and suggest that both positive and active mood states have the potential to enhance creativity through creative self-efficacy. In the end, they should discourage organizations from trying to nudge creativity using mindfulness ad hoc devices.

Keywords: creativity, mindfulness, creative self-efficacy, experiment

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14848 Modeling of Drug Distribution in the Human Vitreous

Authors: Judith Stein, Elfriede Friedmann

Abstract:

The injection of a drug into the vitreous body for the treatment of retinal diseases like wet aged-related macular degeneration (AMD) is the most common medical intervention worldwide. We develop mathematical models for drug transport in the vitreous body of a human eye to analyse the impact of different rheological models of the vitreous on drug distribution. In addition to the convection diffusion equation characterizing the drug spreading, we use porous media modeling for the healthy vitreous with a dense collagen network and include the steady permeating flow of the aqueous humor described by Darcy's law driven by a pressure drop. Additionally, the vitreous body in a healthy human eye behaves like a viscoelastic gel through the collagen fibers suspended in the network of hyaluronic acid and acts as a drug depot for the treatment of retinal diseases. In a completely liquefied vitreous, we couple the drug diffusion with the classical Navier-Stokes flow equations. We prove the global existence and uniqueness of the weak solution of the developed initial-boundary value problem describing the drug distribution in the healthy vitreous considering the permeating aqueous humor flow in the realistic three-dimensional setting. In particular, for the drug diffusion equation, results from the literature are extended from homogeneous Dirichlet boundary conditions to our mixed boundary conditions that describe the eye with the Galerkin's method using Cauchy-Schwarz inequality and trace theorem. Because there is only a small effective drug concentration range and higher concentrations may be toxic, the ability to model the drug transport could improve the therapy by considering patient individual differences and give a better understanding of the physiological and pathological processes in the vitreous.

Keywords: coupled PDE systems, drug diffusion, mixed boundary conditions, vitreous body

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14847 Effects of Kinesio Taping on Postural Stability in Young Soccer Players

Authors: Mustafa Gulsen, Nihan Pekyavas, Emine Atıcı

Abstract:

Purpose: The aim of this study is to investigate the effects of Kinesio taping on postural stability and in young soccer players. Subjects and Methods: 62 volunteered soccer players from Cayyolu Sports Club were included in our study. Permissions were also taken from the club directors about the inclusion of their players to our study. Soccer players between the age of 12 and 16 were included in our study. Players that had previous injury on lower extremities were excluded from the study. Players were randomly divided into two groups: Kinesio taping (KT) (n=31), and control group (n = 31). KT application including gastrocnemius and quadriceps femoris muscle facilitation techniques were applied to the first group. A rest time for 45 minutes was given in order to see the best effectiveness of the tape. The second group was set as the control group and no application was made. All participants were assessed before the application and 45 minutes later. In order to provide the double-blind design of the study, an experienced physiotherapist has done the assessments and another experienced physiotherapist has done the taping. The patients were randomly assigned to one of the two groups using an online random allocation software program. Postural stability was assessed by using Tetrax Interactive Balance System. Thermographic assessment was done by using FLIR E5 (FLIR Systems AB, Sweden) thermal camera in order to see which muscles have the most thermal activity while maintaining postural stability. Results: Statistically significant differences were found in all assessment parameters in both Kinesio Taping and control groups (all p<0.05) except thermal imaging of dominant gastrocnemius muscle results (p=0.668) (Table 1). In comparison of the two groups, statistically significant differences were found in all parameters (all p<0.05). Conclusion: In this study, we investigated the effects of Kinesio taping on postural stability in young soccer players and found that KT application on Quadriceps and Gastrocnemius muscles may have decreased the risk of falling more than the control group. According to thermal imaging assessments, both Quadriceps and Gastrocnemius muscles may be active in maintaining postural stability but in KT group, the temperature of these muscles are higher which leads us to think that they are more activated.

Keywords: Kinesio taping, fall risk, muscle temperature, postural stability

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14846 Implementation of Nutritional Awareness Programme on Eating Habits of Primary School Children

Authors: Gulcin Satir, Ahmet Yildirim

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Globally, including Turkey, health problems associated with malnutrition and nutrient deficiencies in childhood will remain major public health problems in future. Nutrition is a major environmental influence on physical and mental growth and development in early life. Many studies support the fact that nutritional knowledge makes contribution to wellbeing of children and their school performance. The purpose of this study was to examine nutritional knowledge and eating habits of primary school children and to investigate differences in these variables by socioeconomic status. A quasi-experimental one group pretest/posttest design study was conducted in five primary schools totaling 200 children aging 9-10 years in grade 4 to determine the effect of nutritional awareness programme on eating habits of primary school children. The schools were chosen according to parents’ social and demographic characteristics. The implemented nutritional awareness education programme focused on healthy lifestyle such as beneficial foods, eating habits, personal hygiene, physical activity and the programme consisted of eight lessons. The teaching approaches used included interactive teaching, role-playing, demonstration, small group discussions, questioning, and feedback. The lessons were given twice a week for four weeks totaling eight lessons. All lessons lasted 45-60 minutes and first 5 minutes of this was pre-assessment and last 5 minutes post assessment evaluation. The obtained data were analyzed for normality, and the distribution of the variables was tested by the Kolmogorov-Smirnov test. Paired t-test was used to evaluate the effectiveness of education programme and to compare the above-mentioned variables in each school separately before and after the lessons. The result of the paired t-test conducted separately for each school showed that on average after eight lessons, there was a 25-32% increase in nutritional knowledge of students regardless of the school they attend to and this rate was significant (P < 0.01). This shows that increase in nutritional awareness in these five schools having different socio-economic status was similar to each other. This study suggests that having children involved directly in lessons help to achieve nutritional awareness leading to healthy eating habits. It is concluded that nutritional awareness is a valuable tool to change eating habits. Study findings will provide information for developing nutrition education programmes for the healthy life and obesity prevention in children.

Keywords: children, nutritional awareness, obesity, socioeconomic status

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14845 An Integrated Fuzzy Inference System and Technique for Order of Preference by Similarity to Ideal Solution Approach for Evaluation of Lean Healthcare Systems

Authors: Aydin M. Torkabadi, Ehsan Pourjavad

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A decade after the introduction of Lean in Saskatchewan’s public healthcare system, its effectiveness remains a controversial subject among health researchers, workers, managers, and politicians. Therefore, developing a framework to quantitatively assess the Lean achievements is significant. This study investigates the success of initiatives across Saskatchewan health regions by recognizing the Lean healthcare criteria, measuring the success levels, comparing the regions, and identifying the areas for improvements. This study proposes an integrated intelligent computing approach by applying Fuzzy Inference System (FIS) and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). FIS is used as an efficient approach to assess the Lean healthcare criteria, and TOPSIS is applied for ranking the values in regards to the level of leanness. Due to the innate uncertainty in decision maker judgments on criteria, principals of the fuzzy theory are applied. Finally, FIS-TOPSIS was established as an efficient technique in determining the lean merit in healthcare systems.

Keywords: lean healthcare, intelligent computing, fuzzy inference system, healthcare evaluation, technique for order of preference by similarity to ideal solution, multi-criteria decision making, MCDM

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14844 Powering Pacemakers from Heart Pressure Variation with Piezoelectric Energy Harvesters

Authors: A. Mathieu, B. Aubry, E. Chhim, M. Jobe, M. Arnaud

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Present project consists in a study and a development of piezoelectric devices for supplying power to new generation pacemakers. They are miniaturized leadless implants without battery placed directly in right ventricle. Amongst different acceptable energy sources in cardiac environment, we choose the solution of a device based on conversion of the energy produced by pressure variation inside the heart into electrical energy. The proposed energy harvesters can meet the power requirements of pacemakers, and can be a good solution to solve the problem of regular surgical operation. With further development, proposed device should provide enough energy to allow pacemakers autonomy, and could be good candidate for next pacemaker generation.

Keywords: energy harvester, heart, leadless pacemaker, piezoelectric cells, pressure variation

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14843 Antihypertensive Effect of Formulated Apium graveolens: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Authors: Maryam Shayani Rad, Seyed Ahmad Mohajeri, Mohsen Mouhebati, Seyed Danial Mousavi

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High blood pressure is one of the most important and serious health-threatening because of no symptoms in most people, which can lead to sudden heart attack, heart failure, and stroke. Nowadays, herbal medicine is one of the best and safest strategies for treatment that have no adverse effects. Apium graveolens (celery) can be used as an alternative treatment for many health conditions such as hypertension. Natural compounds reduce blood pressure via different mechanisms in which Apium graveolens extract provides potent calcium channel blocking properties. A randomized, double-blind, placebo-controlled, cross-over clinical trial was done to evaluate the efficacy of formulated Apium graveolens extract with a maximum yield of 3-n-butylphthalide to reduce systolic and diastolic blood pressure in patients with hypertension. 54 hypertensive patients in the range of 20-68 years old were randomly assigned to the treatment group (26 cases) and the placebo control group (26 cases) and were crossed over after washout duration. The treatment group received at least 2 grams of formulated powder in hard capsules orally, before each meal, 2 times daily. The control group received 2 grams of placebo in hard capsules orally, exactly as the same as shape, time, and doses of treatment group. Treatment was administrated in 12 weeks with 4 weeks washout period at the middle of the study, meaning 4 weeks drug consumption for the treatment group, 4 weeks washout and 4 weeks placebo consumption, and vice versa for the placebo control group. The clinical assessment was done 4 times, including at the beginning and ending of the drug and placebo consumption period by 24-hour ambulatory blood pressure monitoring (ABPM) holter, which measured blood pressure every 15 minutes continuously. There was a statistically significant decrease in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the end of drug duration compared to baseline. The changes after 4 weeks on average was about 12.34 mm Hg for the SBP (P < 0.005) and 7.83 mm Hg for the DBP (P < 0.005). The results from this clinical trial study showed this Apium graveolens extract formulation in the mentioned dosage had a significant effect on blood pressure-lowering for hypertensive patients.

Keywords: Apium graveolens extract, clinical trial, cross-over, hypertension

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14842 Effects of Hydrogen Bonding and Vinylcarbazole Derivatives on 3-Cyanovinylcarbazole Mediated Photo-Cross-Linking Induced Cytosine Deamination

Authors: Siddhant Sethi, Yasuharu Takashima, Shigetaka Nakamura, Kenzo Fujimoto

Abstract:

Site-directed mutagenesis is a renowned technique to introduce specific mutations in the genome. To achieve site-directed mutagenesis, many chemical and enzymatic approaches have been reported in the past like disulphite induced genome editing, CRISPR-Cas9, TALEN etc. The chemical methods are invasive whereas the enzymatic approaches are time-consuming and expensive. Most of these techniques are unusable in the cellular application due to their toxicity and other limitations. Photo-chemical cytosine deamination, introduced in 2010, is one of the major technique for enzyme-free single-point mutation of cytosine to uracil in DNA and RNA, wherein, 3-cyanovinylcarbazole nucleoside (CNVK) containing oligodeoxyribonucleotide (ODN) having CNVK at -1 position to that of target cytosine is reversibly crosslinked to target DNA strand using 366 nm and then incubated at 90ºC to accommodate deamination. This technique is superior to enzymatic methods of site-directed mutagenesis but has a disadvantage that it requires the use of high temperature for the deamination step which restricts its applicability in the in vivo applications. This study has been focused on improving the technique by reducing the temperature required for deamination. Firstly, the photo-cross-linker, CNVK has been modified by replacing cyano group attached to vinyl group with methyl ester (OMeVK), amide (NH2VK), and carboxylic acid (OHVK) to observe the acceleration in the deamination of target cytosine cross-linked to vinylcarbazole derivative. Among the derivatives, OHVK has shown 2 times acceleration in deamination reaction as compared to CNVK, while the other two derivatives have shown deceleration towards deamination reaction. The trend of rate of deamination reaction follows the same order as that of hydrophilicity of the vinylcarbazole derivatives. OHVK being most hydrophilic has shown highest acceleration while OMeVK is least hydrophilic has proven to be least active for deamination. Secondly, in the related study, the counter-base of the target cytosine, guanine has been replaced by inosine, 2-aminopurine, nebularine, and 5-nitroindole having distinct hydrogen bonding patterns with target cytosine. Among the ODNs with these counter bases, ODN with inosine has shown 12 fold acceleration towards deamination of cytosine cross-linked to CNVK at physiological conditions as compared to guanosine. Whereas, when 2-aminopurine, nebularine, and 5-nitroindole were used, no deamination reaction took place. It can be concluded that inosine has potential to be used as the counter base of target cytosine for the CNVK mediated photo-cross-linking induced deamination of cytosine. The increase in rate of deamination reaction has been attributed to pattern and number of hydrogen bonding between the cytosine and counter base. One of the important factor is presence of hydrogen bond between exo-cyclic amino group of cytosine and the counter base. These results will be useful for development of more efficient technique for site-directed mutagenesis for C → U transformations in the DNA/RNA which might be used in the living system for treatment of various genetic disorders and genome engineering for making designer and non-native proteins.

Keywords: C to U transformation, DNA editing, genome engineering, ultra-fast photo-cross-linking

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14841 Exploring the Influence of Normative, Financial and Environmental Decision Frames in Nudging 'Green' Behaviour, and Increasing Uptake of Energy-Efficient Technologies

Authors: Rebecca Hafner, Daniel Read, David Elmes

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The persuasive potential of normative and feedback (financial vs. environmental) information in ‘nudging’ people towards making environmentally sound decisions was explored in a hypothetical choice experiment. The research was specifically focused on determining how subtle variations in the decision frame could be used to increase the selection of energy efficient vs. standard technologies, using the context of home heating choice. Participants were given a choice of a standard heating system (a gas boiler) and a relatively more-energy efficient option (a heat pump). The experiment had a 2 (normative vs. no normative information) by 3 feedback type (financial, environmental, none) design. The last group constituted the control. Half of the participants were given normative information about what the majority of others in their neighbourhood had opted to do when faced with the same choice set, prior to making their decision. The other half received no such information. Varying feedback frames were incorporated by providing participants with information on either financial or environmental savings that could be achieved by choosing the heat pump. No such information was provided in the control group. A significant interaction was found between normative information and feedback frame type. Specifically, the impact of feedback frames was found to be reduced when normative information was provided; illustrating the overriding influence of normative information on option preference. Participants were significantly more likely to select the heat pump if they were vs. were not given normative information. Yet when no normative information was provided, the persuasive influence of the financial frame was increased – highlighting this as an effective means of encouraging uptake of new technologies in this instance. Conversely, the environmental frame was not found to differ significantly from the control. Marginal carryover effects were also found for stated future real-life decision-making behaviour, with participants who were versus were not given normative information being marginally more likely to state they would consider installing a heat pump when they next need to replace their heating system in real life. We conclude that normative and financial feedback framing techniques are highly effective in increasing uptake of new, energy efficient heating technologies involving significant upfront financial outlay. The implications for researchers looking to promote ‘green’ choice in the context of new technology adoption are discussed.

Keywords: energy-efficient technology adoption, environmental decision making, financial vs. environmental feedback framing techniques, social norms

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14840 An Exploratory Case Study of the Interference of Erotic Transference in the Longevity of Psychoanalytic Treatment

Authors: Mehravar Javid, Rohma Hassan, J. DeSilva

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In this exploratory case study, a 37-year-old male patient who previously terminated treatment after four months of therapy with a different therapist begins anew with a 38-year-old female therapist and undergoes a similar cycle of premature termination, with added discourse caused by erotic transference. Process notes and records of the therapy treatment indicate that during the short course of treatment, the patient explored his difficulties navigating personal relationships, both current and past, and his difficulties coping with hypochondriasis. The therapist becomes tasked with not only navigating the patient’s inner conflict but also how she relates to the patient in the countertransference process while maintaining professional boundaries. This includes empathizing with the patient while also experiencing discomfort in the erotic transference from a professional standpoint. When the patient terminates once more, the therapist reflects on the possible reasons for termination. This includes the patient’s difficulties with tolerating interpretations, which cause him to blame himself for past events. These interpretations were also very frequent, contributing to the emotional burden the patient experienced. The therapist reflected on the use of interpretation versus exploration of the patient’s feelings and how exploring his feelings, including his feelings towards her, would have allowed for an opportunity to explore the emotions that troubled him more deeply. This includes exploring the patient’s anger and fear, which stem from unresolved conflicts from his childhood. Moreover, the erotic transference served as an enactment of previous experiences in which the patient feared losing what he loved, leading him to opt for premature termination instead of losing his ability to control the relationship and experience loss.

Keywords: countertransference, erotic transference, premature termination, therapist-client boundaries, transference

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14839 12-Week Comparative Clinical Trial with Low Dose Phentermine/Topiramate with Liraglutide on Obesity in Korea

Authors: Kyu Rae Lee

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The aim of the study is to investigate the clinical efficacy of combination therapeutic modalities using liraglutide (1.2mg/d) add on low-dose phentermine (7.5 mg/d)/topiramate (50mg/d) medication on the obese patient in the bariatric clinic. We assessed the retrospective cohort clinical analyses to the clinical efficacy of medication and combination in the patients who visited the bariatric clinic. We measured all participants’ body fat (bioelectric impedance analysis), weight, height, and the cross-sectional areas of adipose tissues (umbilicus level) after keep fasting for 8 hours at 0, 4, 12 weeks. The design of the study was opened, paired t-test and Wilcoxon test were performed using SPSS for windows (ver.18, IL, USA) for comparison of weight, body fat, and adipose tissues. The participants were one hundred twenty-eight subjects aged 44.67 (1.18) years, 28.95 (0.39) kg/m², and female (82.7%). Their body fat was 40.57 (2.23%), and waist to hip ratio was 0.96 (0.01). The mean cross-sectional area of visceral adipose tissue was 142.59 (7.06) mm², and that of subcutaneous adipose was 274.37 (9.18) mm². 73 of them (57.5%) took medication only, 54 of them took medication with liraglutide for 12 weeks. The subjects in the medication group lost 5.4165 kg, 6.8069%, and those of the combination group did 6.2481 kg, 3.564%. The mean cross-sectional areas of visceral, subcutaneous adipose tissue in the medication group significantly decreased (p=.043), even more in the combination group. (p=.028). Further controlled clinical trials should be considered in the future. We conclude that the low dose of phentermine/topiramate with liraglutide therapeutic modalities would be more effective than phentermine/topiramate medication only in obesity treatment for 12 weeks.

Keywords: low dose phentermine, topiramate, liraglutide, obesity, efficacy

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14838 Incidence and Molecular Mechanism of Human Pathogenic Bacterial Interaction with Phylloplane of Solanum lycopersicum

Authors: Indu Gaur, Neha Bhadauria, Shilpi Shilpi, Susmita Goswami, Prem D. Sharma, Prabir K. Paul

Abstract:

The concept of organic agriculture has been accepted as novelty in Indian society, but there is no data available on the human pathogens colonizing plant parts due to such practices. Also, the pattern and mechanism of their colonization need to be understood in order to devise possible strategies for their prevention. In the present study, human pathogenic bacteria were isolated from organically grown tomato plants and five of them were identified as Klebsiella pneumoniae, Enterobacter ludwigii, Serratia fonticola, Stenotrophomonas maltophilia and Chryseobacterium jejuense. Tomato plants were grown in controlled aseptic conditions with 25±1˚C, 70% humidity and 12 hour L/D photoperiod. Six weeks old plants were divided into 6 groups of 25 plants each and treated as follows: Group 1: K. pneumonia, Group 2: E. ludwigii, Group 3: S. fonticola, Group 4: S. maltophilia, Group 5: C. jejuense, Group 6: Sterile distilled water (control). The inoculums for all treatments were prepared by overnight growth with uniform concentration of 108 cells/ml. Leaf samples from above groups were collected at 0.5, 2, 4, 6 and 24 hours post inoculation for the colony forming unit counts (CFU/cm2 of leaf area) of individual pathogens using leaf impression method. These CFU counts were used for the in vivo colonization assay and adherence assay of individual pathogens. Also, resistance of these pathogens to at least 12 antibiotics was studied. Based on these findings S. fonticola was found to be most prominently colonizing the phylloplane of tomato and was further studied. Tomato plants grown in controlled aseptic conditions same as mentioned above were divided into 2 groups of 25 plants each and treated as follows: Group 1: S. fonticola, Group 2: Sterile distilled water (control). Leaf samples from above groups were collected at 0, 24, 48, 72 and 96 hours post inoculation and homogenized in suitable buffers for surface and cell wall protein isolation. Protein samples thus obtained were subjected to isocratic SDS-gel electrophoresis and analyzed. It was observed that presence of S. fonticola could induce the expression of at least 3 additional cell wall proteins at different time intervals. Surface proteins also showed variation in the expression pattern at different sampling intervals. Further identification of these proteins by MALDI-MS and bioinformatics tools revealed the gene(s) involved in the interaction of S. fonticola with tomato phylloplane.

Keywords: cell wall proteins, human pathogenic bacteria, phylloplane, solanum lycopersicum

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14837 Moral Reasoning among Croatian Adolescents with Different Levels of Education

Authors: Nataša Šimić, Ljiljana Gregov, Matilda Nikolić, Andrea Tokić, Ana Proroković

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Moral development takes place in six phases which can be divided in a pre-conventional, conventional and post-conventional level. Moral reasoning, as a key concept of moral development theories, involves a process of discernment/inference in doubtful situations. In research to date, education has proved to be a significant predictor of moral reasoning. The aim of this study was to investigate differences in moral reasoning and Kohlberg's phases of moral development between Croatian adolescents with different levels of education. In Study 1 comparisons between the group of secondary school students aged 17-18 (N=192) and the group of university students aged 21-25 (N=383) were made. Study 2 included comparison between university students group (N=69) and non-students group (N=43) aged from 21 to 24 (these two groups did not differ in age). In both studies, the Croatian Test of Moral Reasoning by Proroković was applied. As a measure of moral reasoning, the Index of Moral Reasoning (IMR) was calculated. This measure has some advantages compared to other measures of moral reasoning, and includes individual assessments of deviations from the ‘optimal profile’. Results of the Study 1 did not show differences in the IMR between secondary school students and university students. Both groups gave higher assessments to the arguments that correspond to higher phases of moral development. However, group differences were found for pre-conventional and conventional phases. As expected, secondary school students gave significantly higher assessments to the arguments that correspond to lower phases of moral development. Results of the Study 2 showed that university students, in relation to non-students, have higher IMR. Respecting to phases of moral development, both groups of participants gave higher assessments to the arguments that correspond to the post-conventional phase. Consistent with expectations and previous findings, results of both studies did not confirm gender differences in moral reasoning.

Keywords: education, index of moral reasoning, Kohlberg's theory of moral development, moral reasoning

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14836 Effects of Elastic, Plyometric and Strength Training on Selected Anaerobic Factors in Sanandaj Elite Volleyball Players

Authors: Majed Zobairy, Fardin Kalvandi, Kamal Azizbaigi

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This research was carried out for evaluation of elastic, plyometric and resistance training on selected anaerobic factors in men volleyball players. For these reason 30 elite volleyball players of Sanandaj city randomly divided into 3 groups as follow: elastic training, plyometric training and resistance training. Pre-exercise tests which include vertical jumping, 50 yard speed running and scat test were done and data were recorded. Specific exercise protocol regimen was done for each group and then post-exercise tests again were done. Data analysis showed that there were significant increases in exercise test in each group. One way ANOVA analysis showed that increases in speed records in elastic group were significantly higher than the other groups (p<0/05),based on research data it seems that elastic training can be a useful method and new approach in improving functional test and training regimen.

Keywords: elastic training, plyometric training, strength training, anaerobic power

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14835 Employee Happiness: The Influence of Providing Consumers with an Experience versus an Object

Authors: Wilson Bastos, Sigal G. Barsade

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Much of what happens in the marketplace revolves around the provision and consumption of goods. Recent research has advanced a useful categorization of these goods—as experiential versus material—and shown that, from the consumers’ perspective, experiences (e.g., a theater performance) are superior to objects (e.g., an electronic gadget) in offering various social and psychological benefits. A common finding in this growing research stream is that consumers gain more happiness from the experiences they have than the objects they own. By focusing solely on those acquiring the experiential or material goods (the consumers), prior research has remained silent regarding another important group of individuals—those providing the goods (the employees). Do employees whose jobs are primarily focused on offering consumers an experience (vs. object) also gain more happiness from their occupation? We report evidence from four experiments supporting an experiential-employee advantage. Further, we use mediation and moderation tests to unearth the mechanism responsible for this effect. Results reveal that work meaningfulness is the primary driver of the experiential-employee advantage. Overall, our findings suggest that employees find it more meaningful to provide people with an experience as compared to a material object, which in turn shapes the happiness they derive from their jobs. We expect this finding to have implications on human development, and to be of relevance to researchers and practitioners interested in how to advance human condition in the workplace.

Keywords: employee happiness, experiential versus material jobs, work meaningfulness

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14834 Nitric Oxide and Blood Based Ratios as Promising Immuno-Markers in Patients with Complicated Crohn’s Disease: Benefits for Predicting Therapy Response

Authors: Imene Soufli, Abdelkrim Hablal, Manel Amri, Moussa Labsi, Rania Sihem Boussa, Nassim Sid Idris, Chafia Touil-Boukoffa

Abstract:

Crohn’s Disease (CD) is a relapsing–remitting inflammatory bowel disease with a progressive course. The aim of our study was to evaluate the relationship between the immunomarkers: Nitric Oxide (NO), pro-inflammatory cytokines, and blood count-based ratios and the outcome of corticosteroid or anti-TNF-α therapy in patients with complicated Crohn’s Disease. In this context, we evaluated the NLR as the ratio of neutrophil count to lymphocyte count, PLR as the ratio of platelet counts to lymphocyte count, and MLR as the ratio of monocyte count to lymphocyte count in patients and controls. Furthermore, we assessed NO production by the Griess method in plasma along with iNOS and NF-κB expression by immunofluorescence method in intestinal tissues of patients and controls. In the same way, we evaluated plasma TNF-α, IL-17A, and IL-10 levels using ELISA. Our results indicate that blood count-based ratios NLR, PLR, and MLR were significantly higher in patients compared to controls. In addition, increased systemic levels of NO, TNF-α, and IL-17A and colonic expression of iNOS and NF-κB were observed in the same patients. Interestingly, the high ratio of NLR and MLR, as well as NO production, was significantly decreased in treated patients. Collectively, our findings suggest that Nitric Oxide, as well as the blood count-based ratios (NLR, PLR, MLR), could constitute useful immuno-markers in complicated Crohn’s Disease, predicting the response to treatment

Keywords: complicated crohn’s disease, nitric oxide, blood count-based ratios, treatments, pro-inflammatory cytokines

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14833 A Cognitive Training Program in Learning Disability: A Program Evaluation and Follow-Up Study

Authors: Krisztina Bohacs, Klaudia Markus

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To author’s best knowledge we are in absence of studies on cognitive program evaluation and we are certainly short of programs that prove to have high effect sizes with strong retention results. The purpose of our study was to investigate the effectiveness of a comprehensive cognitive training program, namely BrainRx. This cognitive rehabilitation program target and remediate seven core cognitive skills and related systems of sub-skills through repeated engagement in game-like mental procedures delivered one-on-one by a clinician, supplemented by digital training. A larger sample of children with learning disability were given pretest and post-test cognitive assessments. The experimental group completed a twenty-week cognitive training program in a BrainRx center. A matched control group received another twenty-week intervention with Feuerstein’s Instrumental Enrichment programs. A second matched control group did not receive training. As for pre- and post-test, we used a general intelligence test to assess IQ and a computer-based test battery for assessing cognition across the lifespan. Multiple regression analyses indicated that the experimental BrainRx treatment group had statistically significant higher outcomes in attention, working memory, processing speed, logic and reasoning, auditory processing, visual processing and long-term memory compared to the non-treatment control group with very large effect sizes. With the exception of logic and reasoning, the BrainRx treatment group realized significantly greater gains in six of the above given seven cognitive measures compared to the Feuerstein control group. Our one-year retention measures showed that all the cognitive training gains were above ninety percent with the greatest retention skills in visual processing, auditory processing, logic, and reasoning. The BrainRx program may be an effective tool to establish long-term cognitive changes in case of students with learning disabilities. Recommendations are made for treatment centers and special education institutions on the cognitive training of students with special needs. The importance of our study is that targeted, systematic, progressively loaded and intensive brain training approach may significantly change learning disabilities.

Keywords: cognitive rehabilitation training, cognitive skills, learning disability, permanent structural cognitive changes

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14832 The Effects of Extracorporeal Shock Wave Therapy on Plantar Pressure in Patients with Calcaneal Spur

Authors: Zehra Betül Karakoç

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Aim: The aim of our study is to determine the changement pf plantar pressure after extracorporeal shock wave therapy (ESWT) in a patient with calcaneal spur (CS). Method: Thirty patients with CS who received ESWT treatment at Kartal Yavuz Selim State Hospital between May 2020 and November 2022 participated in this study. Demographic information of the cases was obtained. Pain levels and plantar pressure were measured with Visuel Analog Scale (VAS) and pedobarography, respectively. Pedobarography measured the maximal strength, peak pressure level, and contact area values of the hind, middle, forefoot, and toes. The cases were re-evaluated 4 weeks after the application of 15 Hz, 2-3 bar, 2,000 beats ESWT for 3 sessions. 22 cases participated in the second evaluation. The data of all patients were evaluated bilaterally. Results: Pain intensity levels after treatment were statistically significantly decreased compared to before treatment (p=0.012). Maximum force and contact area values of total foot and forefoot increased significantly (p < 0.05). Conclusion: We consider that the increased max force value of total foot and forefoot area after ESWT is due to the normal walking rate gained related to decreased pain. ESWT treatment may have positive effects on foot pressure distribution and body biomechanics. In order to interpret the results of our study more clearly, randomized controlled studies with a larger number of cases were planned in the future.

Keywords: calcaneal spur, ESWT, plantar pressure, pain

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