Search results for: disability adjusted life Years

Authors: Ruth Nalugya, Claire Nimusiima, Elizabeth Kawesa, Harriet Nambejja, Geert van Hove, Janet Seeley, Femke Bannink Mbazzi

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Background: ‘Obuntu bulamu’, an intervention for children, parents, and teachers to improve the participation and inclusion of children with disabilities (CwD) through peer-to-peer support, was developed and tested in central Uganda between 2017 and 2019. The intervention consisted of children, parents, and teachers' training sessions and peer to peer support activities directed at disability inclusion using an African disability framework. In this paper, we discuss parent participation in and parent evaluation of the ‘Obuntu bulamu’ intervention. Methods: This qualitative Afrocentric intervention study was implemented in 10 communities in the Wakiso district in Central Uganda. We purposely selected children aged 8 to 14 years with different impairments, their peers, and parents, with different levels of household income and familial support, who were enrolled in primary schools in the ten communities with on average three children with disabilities per community. Sixty four parents (33 parents of CwDs and 31 peers) participating in the ‘Obuntu bulamu’ study were interviewed at baseline and endline. Two focus group discussions were held with parents at the midline. Parents also participated in a consultative meeting about the intervention design at baseline, and two evaluation workshops held at midline and endline. Thematic data analysis of the interview and focus group data was conducted. Results: Findings showed parents found the group-based activities inspiring and said they built hope and confidence. Parents felt the intervention was acceptable, culturally appropriate, and supportive as it built on values and practices from their own traditions. Parents reported the intervention enhanced a sense of togetherness and belonging through the group meetings and follow-up activities. Parents also mentioned that the training helped them develop more positive attitudes towards CwD and disability inclusion. Parents felt that the invention increased a child’s participation and inclusion at home, school, and in communities. Conclusion: The Obuntu bulamu peer to peer support intervention is an acceptable, culturally appropriate intervention that has the potential to improve the inclusion of CwD. A larger randomized control trial is needed to evaluate the impact of the intervention model.

Keywords: inclusion, participation, inclusive education, peer support, belonging, Ubuntu, ‘Obuntu bulamu’

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Authors: Sarah Reker, Christiane H. Kellner

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From the perspective of people with disabilities, inequalities can also emerge from spatial segregation, the lack of social contacts or limited economic resources. In order to reduce or even eliminate these disadvantages and increase general well-being, community-based participation as well as decentralisation efforts within exclusively residential homes is essential. Therefore, the new research project “Index for participation development and quality of life for persons with disabilities”(TeLe-Index, 2014-2016), which is anchored at the Technische Universität München in Munich and at a large residential complex and service provider for persons with disabilities in the outskirts of Munich aims to assist the development of community-based living environments. People with disabilities should be able to participate in social life beyond the confines of the institution. Since a diverse society is a society in which different individual needs and wishes can emerge and be catered to, the ultimate goal of the project is to create an environment for all citizens–regardless of disability, age or ethnic background–that accommodates their daily activities and requirements. The UN-Convention on the Rights of Persons with Disabilities, which Germany also ratified, postulates the necessity of user-centered design, especially when it comes to evaluating the individual needs and wishes of all citizens. Therefore, a multidimensional approach is required. Based on this insight, the structure of the town-like center will be remodeled to open up the community to all people. This strategy should lead to more equal opportunities and open the way for a much more diverse community. Therefore, macro-level research questions were inspired by quality of life theory and were formulated as follows for different dimensions: •The user dimension: what needs and necessities can we identify? Are needs person-related? Are there any options to choose from? What type of quality of life can we identify? The economic dimension: what resources (both material and staff-related) are available in the region? (How) are they used? What costs (can) arise and what effects do they entail? •The environment dimension: what “environmental factors” such as access (mobility and absence of barriers) prove beneficial or impedimental? In this context, we have provided academic supervision and support for three projects (the construction of a new school, inclusive housing for children and teenagers with disabilities and the professionalization of employees with person-centered thinking). Since we cannot present all the issues of the umbrella-project within the conference framework, we will be focusing on one project more in-depth, namely “Outpatient Housing Options for Children and Teenagers with Disabilities”. The insights we have obtained until now will enable us to present the intermediary results of our evaluation. The most central questions pertaining to this part of the research were the following: •How have the existing network relations been designed? •What meaning (or significance) does the existing service offers and structures have for the everyday life of an external residential group? These issues underpinned the environmental analyses as well as the qualitative guided interviews and qualitative network analyses we carried out.

Keywords: decentralisation, environmental analyses, outpatient housing options for children and teenagers with disabilities, qualitative network analyses

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Authors: Takeo Shibata, Arihito Endo, Chika Hiraga, Akemi Kunimatsu, Yoko Shimizu

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Introduction: A health promotion program, Yuzawa family health plan, was initiated in 2002. It has been held for fifteen years. Yuzawa Town is famous with hot springs and ski resorts. We evaluated the changes in mental status in elementary school children. Methods: questionnaires survey had been held every five years. 196 questionnaires were corrected (94 boys and 102 girls). Changes for their anxieties, loneliness, confiding, problem-solving, risk breaching, communications, happiness, and life satisfaction were evaluated by chi-square test. Results: The rate of loneliness and life dissatisfactions decreased. The rates of happiness, confiding in grandparents, and risk breaching, increased. Especially, happiness rates increased for boys, loneliness rate decreased for girls, confiding in grandparents and risk breaching rate increased for girls. Conclusion: Our health promotion programs could increase mental health status in elementary school children.

Keywords: health promotion, mental status, elementary school, loneliness, happiness

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Authors: Haoyu Zhao, Qianshu Ma, Min Xie, Yunqi Huang, Yunjia Liu, Huan Song, Hongsheng Gui, Mingli Li, Qiang Wang

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Rationale: Bipolar disorder (BD) and major depressive disorder (MDD), as severe chronic illnesses that restrict patients’ psychosocial functioning and reduce their quality of life, are both categorized into mood disorders. Emerging evidence has suggested that the reliability of self-rated health (SRH) was wellvalidated and that the risk of various health outcomes, including mortality and health care costs, could be predicted by SRH. Compared with other lengthy multi-item patient-reported outcomes (PRO) measures, SRH was proven to have a comparable predictive ability to predict mortality and healthcare utilization. However, to our knowledge, no study has been conducted to assess the association between SRH and hospitalization among people with mental disorders. Therefore, our study aims to determine the association between SRH and subsequent all-cause hospitalizations in patients with BD and MDD. Methods: We conducted a prospective cohort study on people with BD or MDD in the UK from 2006 to 2010 using UK Biobank touchscreen questionnaire data and linked administrative health databases. The association between SRH and 2-year all-cause hospitalizations was assessed using proportional hazard regression after adjustment for sociodemographics, lifestyle behaviors, previous hospitalization use, the Elixhauser comorbidity index, and environmental factors. Results: A total of 29,966 participants were identified, experiencing 10,279 hospitalization events. Among the cohort, the average age was 55.88 (SD 8.01) years, 64.02% were female, and 3,029 (10.11%), 15,972 (53.30%), 8,313 (27.74%), and 2,652 (8.85%) reported excellent, good, fair, and poor SRH, respectively. Among patients reporting poor SRH, 54.19% had a hospitalization event within 2 years compared with 22.65% for those having excellent SRH. In the adjusted analysis, patients with good, fair, and poor SRH had 1.31 (95% CI 1.21-1.42), 1.82 (95% CI 1.68-1.98), and 2.45 (95% CI 2.22, 2.70) higher hazards of hospitalization, respectively, than those with excellent SRH. Conclusion: SRH was independently associated with subsequent all-cause hospitalizations in patients with BD or MDD. This large study facilitates rapid interpretation of SRH values and underscores the need for proactive SRH screening in this population, which might inform resource allocation and enhance high-risk population detection.

Keywords: severe mental illnesses, hospitalization, risk prediction, patient-reported outcomes

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Authors: Ingrid Van Der Heijden, Naeemah Abrahams, Jane Harries

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Background: Women with disabilities are largely missing from global research on violence prevention, yet research shows that women with disabilities are a particularly marginalised group who experience heightened levels and unique forms of violence than men with disabilities, and women without disabilities. They face heightened stigma, discrimination, and violence due to their gender and their disability. Including women with disabilities in violence, research helps inform policy and prevention interventions that are relevant and inclusive. To ensure their inclusion in violence research, we need ethical guidelines that are sensitive to their heightened risk and vulnerability, that recognize the diversity in the disabled population, but that also promote disabled people’s agency in defining their own violence prevention needs and agendas. Objective: To highlight pertinent ethical issues around women with disabilities’ inclusion and participation in violence research. Methodology: Considering the lack of formalized guidelines for research of people with disabilities, we draw from the literature on international ethics guidelines for researching violence against women, and the Emancipatory Disability Research paradigm, as well as drawing from our own experiences from the field in applying the guidelines when doing research with disabled women. Findings: Following the guiding ethical principles of respect, benefit, justice, and do no harm, we argue that reasonable accommodation, capacity, and equal participation need to be considered in conceptualizing and conducting ethical violence research with women with disabilities. We conclude that disability research in the area of violence is highly politicized and must be carefully scrutinized to ensure justice and the contribution of women with disabilities to their own welfare. Implications: We suggest that these issues are practically applied in the field and tested and critiqued to enhance best practice for undertaking ethical research with this particular group. It is important that not only researchers and ethics committees, but also disabled women and disabled organizations, are involved in enhancing and formalizing ethical research guidelines for marginalized populations.

Keywords: capacity, emancipatory disability research paradigm equal participation, reasonable accommodation, research ethics, violence against women with disabilities

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Authors: Ali Fuad Ashour

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Introduction: Multiple sclerosis (MS) is a chronic, progressive and degenerative disease that affects the central nervous system (CNS). MS has been described to result in the debilitating symptom of the disease. It is reported to have a negative impact on the patient’s mental activities, brings a lower quality of life, leads to unemployment, causes distress and psychological disorders, generates low levels of motivation and self-esteem, and result in disability and neurological impairment. The aim of this study was to compare the effects of MS on patients from Britain and Kuwait. Methodology: A questionnaire was distributed to 200 individuals with MS (100 Kuwaiti and 100 British). The questionnaire consists of three parts; 1. General demographics, 2. Disease-specific data (symptoms, severity levels, relapse frequency, and support system), and 3. Attitudes towards physical exercise. Results: A response rate of 62% from the British sample and 50% from the Kuwaiti sample was achieved. 84% of the sample (n=52) were 41 years old or over. The duration of the disease was less than 10 years in 43.4% of British and 68% of Kuwaiti respondents. The majority of British respondents (56.5%) reported the disease severity to be moderate, while the majority of Kuwaitis was mild (72%). The annual relapse rates in Kuwait were relatively low, with 82% of the Kuwaiti sample had one relapse per year, compared to the 64.5% of British. The most common symptoms reported by British respondents were balance (75.8%), fatigue (74.2%), and weakness (71%), and by Kuwaiti respondents were fatigue (86%), balance (76%), and weakness (66%). The help and support for MS were by far more diverse for the British than Kuwaiti respondents. Discussion: The results unveiled marked differences between two groups of British and Kuwaiti MS patients in terms of patients’ age and disease duration, and severity. The overwhelming majority of Kuwaiti patients are young individuals who have been with the disease for a relatively short period of time, and their MS in most cases was mild. On the other hand, British patients were relatively older, many have been with the disease for a long period of time, and their average MS condition was more serious than that of their Kuwaiti counterparts. The main support in Kuwait comes from the neurologist, who primarily prescribe medications and advise patients to try to be active. The Kuwaiti respondents thought that lack of encouragement was the main reason for them not to engage in social activities.

Keywords: multiple sclerosis, Kuwait, exercise, demographic

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Authors: Rosilyn Sanders

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This qualitative study examined the impact of hiring people with intellectual disabilities (ID). The research questions were: What defines a disability? What accommodations are needed to ensure the success of a person with a disability? As a leader, what benefits do people with intellectual disabilities bring to the organization? What are the benefits of hiring people with intellectual disabilities in retail organizations? Moreover, how might people with intellectual disabilities contribute to the organizational culture of retail organizations? A narrative strength approach was used as a theoretical framework to guide the discussion and uncover the benefits of hiring individuals with intellectual disabilities in various retail organizations. Using qualitative interviews, the following themes emerged: diversity and inclusion, accommodations, organizational culture, motivation, and customer service. These findings put to rest some negative stereotypes and perceptions of persons with ID as being unemployable or unable to perform tasks when employed, showing instead that persons with ID can work efficiently when given necessary work accommodations and support in an enabling organizational culture. All participants were recruited and selected through various forms of electronic communication via social media, email invitations, and phone; this was conducted through the methodology of snowball sampling with the following demographics: age, ethnicity, gender, number of years in retail, number of years in management, and number of direct reports. The sample population was employed in several retail organizations throughout Arkansas and Texas. The small sample size for qualitative research in this study helped the researcher develop, build, and maintain close relationships that encouraged participants to be forthcoming and honest with information (Clow & James, 2014 ). Participants were screened to ensure they met the researcher's study; and screened to ensure that they were over 18 years of age. Participants were asked if they recruit, interview, hire, and supervise individuals with intellectual disabilities. Individuals were given consent forms via email to indicate their interest in participating in this study. Due to COVID-19, all interviews were conducted via teleconferencing (Zoom or Microsoft Teams) that lasted approximately 1 hour, which were transcribed, coded for themes, and grouped based on similar responses. Further, the participants were not privy to the interview questions beforehand, and demographic questions were asked at the end, including questions concerning age, education level, and job status. Each participant was assigned random numbers using an app called ‘The Random Number Generator ‘to ensure that all personal or identifying information of participants were removed. Regarding data storage, all documentation was stored on a password-protected external drive, inclusive of consent forms, recordings, transcripts, and researcher notes.

Keywords: diversity, positive psychology, organizational development, leadership

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Authors: Aria Vitkova, Hanna Sykulska-Lawrence

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In recent years, Europa has been one of the major focus points in astrobiology due to its high potential of harbouring life in the vast ocean underneath its icy crust. However, the detection of life on Europa faces many challenges due to the harsh environmental conditions and mission constraints. Raman spectroscopy is a highly capable and versatile in-situ characterisation technique that does not require any sample preparation. It has only been used on Earth to date; however, recent advances in optical and laser technology have also allowed it to be considered for extraterrestrial exploration. So far, most efforts have been focused on the exploration of Mars, the most imminent planetary target. However, as an emerging technology with high miniaturization potential, Raman spectroscopy also represents a promising tool for the exploration of Europa. In this study, the capabilities of Raman technology in terms of life detection on Europa are explored and assessed. Spectra of biosignatures identified as high priority molecular targets for life detection on Europa were acquired at various excitation wavelengths and conditions analogous to Europa. The effects of extremely low temperatures and low concentrations in water ice were explored and evaluated in terms of the effectiveness of various configurations of Raman instruments. Based on the findings, a design of a miniaturized Raman instrument optimized for in-situ detection of life on Europa is proposed.

Keywords: astrobiology, biosignatures, Europa, life detection, Raman Spectroscopy

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Authors: Harihara Prakash Ramanathan, Daksha Mishra, Ankita Dhaduk

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Relevance: This qualitative study will educate the clinician in putting into practice the advanced method of movement science in restoring the function. Purpose: The purpose of this study is to compare the effectiveness of Active Release Technique and myofascial release technique on range of motion, neck function and pain in patients with upper trapezius spasm. Methods/Analysis: The study was approved by the institutional Human Research and Ethics committee. This study included sixty patients of age group between 20 to 55 years with upper trapezius spasm. Patients were randomly divided into two groups receiving Active Release Technique (Group A) and Myofascial Release Technique (Group B). The patients were treated for 1 week and three outcome measures ROM, pain and functional level were measured using Goniometer, Visual analog scale(VAS), Neck disability Index Questionnaire(NDI) respectively. Paired Sample 't' test was used to compare the differences of pre and post intervention values of Cervical Range of motion, Neck disability Index, Visual analog scale of Group A and Group B. Independent't' test was used to compare the differences between two groups in terms of improvement in cervical range of motion, decrease in visual analogue scale(VAS), decrease in Neck disability index score. Results: Both the groups showed statistically significant improvements in cervical ROM, reduction in pain and in NDI scores. However, mean change in Cervical flexion, cervical extension, right side flexion, left side flexion, right side rotation, left side rotation, pain, neck disability level showed statistically significant improvement (P < 0. 05)) in the patients who received Active Release Technique as compared to Myofascial release technique. Discussion and conclusions: In present study, the average improvement immediately post intervention is significantly greater as compared to before treatment but there is even more improvement after seven sessions as compared to single session. Hence, this proves that several sessions of Manual techniques are necessary to produce clinically relevant results. Active release technique help to reduce the pain threshold by removing adhesion and promote normal tissue extensibility. The act of tensioning and compressing the affected tissue both with digital contact and through the active movement performed by the patient can be a plausible mechanism for tissue healing in this study. This study concluded that both Active Release Technique (ART) and Myofascial release technique (MFR) are equally effective in managing upper trapezius muscle spasm, but more improvement can be achieved by Active Release Technique (ART). Impact and Implications: Active Release Technique can be adopted as mainstay of treatment approach in treating trapezius spasm for faster relief and improving the functional status.

Keywords: trapezius spasm, myofascial release, active release technique, pain

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Authors: Chrysoula Karathanasi, Senad Karavdic, Angela Odero, Michèle Baumann

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It is not only the economic determinants that impact on life conditions, but maintaining a good level of life satisfaction (LS) may also be an important challenge currently. In Luxembourg, university students receive financial aid from the government. They are then registered at the Centre for Documentation and Information on Higher Education (CEDIES). Luxembourg is built on migration with almost half its population consisting of foreigners. It is upon this basis that our research aims to analyze the associations with mental health factors (health satisfaction, psychological quality of life, worry), perceived financial situation, career attitudes (adaptability, optimism, knowledge, planning) and LS, for non-Luxembourgish and native postgraduate students. Between 2012 and 2013, postgraduates registered at CEDIES were contacted by post and asked to participate in an online survey with either the option of English or French. The study population comprised of 644 respondents. Our statistical analysis excluded: those born abroad who had Luxembourgish citizenship, or those born in Luxembourg who did not have citizenship. Two groups were formed one consisting 147 non-Luxembourgish and the other 284 natives. A single item measured LS (1=not at all satisfied to 10=very satisfied). Bivariate tests, correlations and multiple linear regression models were used in which only significant relationships (p<0.05) were integrated. Among the two groups no differences were found between LS indicators (7.8/10 non-Luxembourgish; 8.0/10 natives) as both were higher than the European indicator of 7.2/10 (for 25-34 years). In the case of non-Luxembourgish students, they were older than natives (29.3 years vs. 26.3 years) perceived their financial situation as more difficult, and a higher percentage of their parents had an education level higher than a Bachelor's degree (father 59.2% vs 44.6% for natives; mother 51.4% vs 33.7% for natives). In addition, the father’s education was related to the LS of postgraduates and the higher was the score, the greater was the contribution to LS. Whereas for native students, when their scores of health satisfaction and career optimism were higher, their LS’ score was higher. For both groups their LS was linked to mental health-related factors, perception of their financial situation, career optimism, adaptability and planning. The higher the psychological quality of life score was, the greater the LS of postgraduates’ was. Good health and positive attitudes related to the job market enhanced their LS indicator.

Keywords: career attributes, father's education level, life satisfaction, mental health

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Authors: Faris Algahtani

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The current study aimed to reveal the extent to which evidence-based practices are applied in programs to integrate students with intellectual disabilities from the point of view of their teachers in Yanbu Governorate, and to reveal statistically significant differences in their application of evidence-based practices according to the following variables: gender, educational qualification, experience and training courses. The researcher used the descriptive approach, and accordingly; she designed a questionnaire consisting of 22 phrases applied it to a random sample of (97) teachers of intellectual disability in the integration programs of the Ministry of Education in the government sector in Yanbu Governorate, with (49) male teachers and (48) female teachers. The study showed that teachers of students with intellectual disabilities apply evidence-based practices in programs to integrate students with intellectual disabilities to a large extent. Among the most prominent of these practices came reinforcement in the first place, followed by using visual stimuli/aids, and in the third-place came starting with less complex or challenging skills then moving to more difficult skills. The results also showed no statistically significant differences over the extent of the application attributed to the variables of experience, qualification or training. On the other hand, there were statistically significant differences over the extent of the application attributed to gender in favor of females.

Keywords: evidence-based practices, intellectual disability, inclusion programs, teachers of students with intellectual disabilities

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Authors: Sung-mo Seo, Chang-u Chae

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The Product Carbon Footprint Labeling has been run for more than four years by the Ministry of Environment and there are number of products labeled by KEITI, as for declaring products with their carbon emission during life cycle stages. There are several categories for certifying products by the characteristics of usage. Building products which are applied to a building as combined components. In this paper, current status of PCF labeling has been compared with LCI DB for data composition. By this comparative analysis, we suggest carbon labeling development.

Keywords: carbon labeling, LCI DB, building materials, life cycle assessment

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Authors: Cindy de Frias, Erum Whyne

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Objectives: The current study examined whether the link between stress and health-related quality of life was buffered by protective factors, namely mindfulness, in a sample of middle-aged and older adults. Method: In this cross-sectional study, 134 healthy, community-dwelling adults (aged 50–85 years) were recruited from Dallas, Texas. The participants were screened for depressive symptoms and severity (using the Patient Health Questionnaire [PHQ-9]). All participants completed measures of self-reported health status (i.e., SF-36v2: mental and physical health composites), life stress (using the Elder’s Life Stress Inventory [ELSI]), and trait mindfulness (i.e., Mindful Attention Awareness Scale). Results: Hierarchical regressions (covarying for age, gender, and education) showed that life stress was inversely related to physical and mental health. Mindfulness was positively related to mental health. The negative effect of life stress on mental health was weakened for those individuals with greater trait mindfulness. Discussion: The results suggest that mindfulness is a powerful, adaptive strategy that may protect middle-aged and older adults from the well-known harmful effects of stress on healthy aging.

Keywords: health, stress, mindfulness, aging

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Authors: Vivian Polak, Lena Verdeli, Wendy Lou, Caroline Lovett

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Postnatal depression (PND) is a common complication of childbirth that increases the risk of future depressive episodes in women, postpartum depression in partners, as well as social, emotional, behavioural, language, and cognitive problems in offspring. Although psychotherapy, and in particular Group Interpersonal Psychotherapy (IPT-G), has been proven effective in treating PND, it remains largely inaccessible. However, research has indicated that online synchronous group therapy can be equally as effective as in-person therapy and is a more affordable and accessible modality of treatment. This study aimed to ascertain whether delivering IPT-G virtually when compared to treatment as usual, could more effectively reduce depressive and anxiety symptoms, enhance mother-infant attachment, improve the couple relationship, augment social support, improve overall functioning, and enhance the quality of life for women in rural and northern Ontario who are suffering from PND. By bridging the gap in access to mental health services during the postpartum period, this study seeks to improve the well-being of mothers and their families in rural and northern Ontario, Canada. A randomized controlled trial was conducted to determine whether virtual IPT-G plus treatment as usual would be more effective than treatment as usual alone in treating women with PND in Ontario, Canada. Preliminary results indicate that women who received virtual IPT-G had a clinically and statistically significant decrease in overall depressive symptoms compared to their counterparts who received only the treatment as usual. As such, providing online synchronous IPT-G in the perinatal period not only has the potential to improve women's outcomes in the present but also to decrease future health costs, reduce the burden on the educational and justice systems, and decrease the number of disability life years lost to postnatal depression.

Keywords: family wellbeing, group psychotherapy, interpersonal psychotherapy, postnatal depression, virtual psychotherapy

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Authors: Sarwat Sultan, Muhammad Saleem, Frasat Kanwal

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Adolescence is a transition period of life that brings physical and psychological changes and always results in several challenges for an adolescent. An adolescent must learn life skills for a healthy transition from adolescence period to adulthood. Therefore this study was planned to examine the effects of life skill education on adolescents' mental health and academic benefits. A random sample of 720 school students aged between 13-17 years was categorized into two groups; experimental (n=360) and control (n=360). Life skill education was given to the students of the intervention group with repeated assessments of mental health and academic benefits at pre-intervention (T1) and post-intervention (T2) for both groups. Both groups were compared on scores of mental health and academic benefits across two times T1 and T2 by employing a mixed between-within-subjects analysis of variance. Findings showed the main effect of time suggesting the largest changes in mental health and academic benefits over time. Interaction effects between time and both groups were also found significant indicating the largest changes across time between both groups. Results of between-group comparisons showed significant values for Wilks’ Lambda and partial eta squared for students of the intervention group who scored higher on mental health and academic benefits after receiving life skills training than the students of the control group. Results of the present study determined the efficacy of life skill education and have implications for both teachers and psychotherapists to improve the students’ mental health and academic performance.

Keywords: academic benefits, life skills, mental health, adolescents

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Authors: Laetitia Fourie

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Dangerous myths and stereotypes contribute to the fact that persons living with albinism are amongst the most vulnerable groups in society. The prevalence of albinism varies around the world and the World Health Organization estimates that around 1 in 5000 people in Sub-Saharan Africa are affected by this genetic disorder. Persons who are living with the condition usually experience a lack of melanin in their skin, eyes and hair that results in possible physical impairments such as poor eyesight and skin cancers. Being affected by such disorders and consequently classified as an albino, give way for unequal treatment which ultimately requires safeguarding these persons against unfair discrimination - not only on the basis of their race and color (or lack thereof), but also on the basis of their disability. The Constitution of the Republic of South Africa provides that everyone is equal before the law and prohibits unfair discrimination on the grounds of race, color and disability. This right is given effect to by the Employment Equity Act, which strives to eliminate unfair discrimination on similar grounds within any employment policy or practice. An essential non-discrimination measure that can be implemented in the labor market to achieve equality is the duty of reasonable accommodation that rests upon employers. However, reasonable accommodation is only introduced as an affirmative action measure in order to provide equal employment opportunities to the identified designated groups who include black people (defined to include Indians, Chinese and Colored), women and people with disabilities. Even though this duty exists, South African law does not elaborate on the scope of the duty, except for a Disability Code, which does not hold the force of law. Furthermore, in respect of applying affirmative action measures to people with disabilities, the law does not elaborate on the meaning of disability. Considering that persons living with albinism will find it difficult to show that they are black or disabled in order to be acknowledged as part of the designated groups, their access to reasonable accommodation will be limited to a great extent. This paper will aim to illustrate to which extent South African law currently fails to implement its international obligations as a State Party to the Conventions of the United Nations, and how these failures should be corrected in order to serve the needs of all South Africans, including albinos.

Keywords: albinism, disability, equality, South Africa, United Nations

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Authors: Rukhsana Kausar, Nida Zafar

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The present research investigated socio-demographic predictors of divorce adjustment in Pakistani women. The sample comprised of 80 divorced women from different areas of Lahore. Self developed Socio-Demographic predictor scale and Divorce Adjustment Scale by (Fisher, 2001) was used for assessment. Analyses showed that working divorced women living with joint family system are more adjusted as compared to non-working divorced women living with joint family system. Women having one child are more adjusted as compared to women having more than one child. Findings highlight importance of presence of father for healthy development of adolescents. Adjustment of divorcee women was positively associated with income, social support from the family, having favorable attitudes toward marital dissolution prior to divorce, and being the partner who initiated the divorce. In addition, older women showed some evidence of poorer adjustment than did younger women. Findings highlight importance of support for divorce adjustment.

Keywords: socio-demographic, adjustment, women, divorce

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Authors: John Olav Bjornestad, Bjorn Tore Johansen

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The number of people suffering from mental illnesses is increasing, and such illness is currently one of the major causes of disability and poor health. The reason for this is most likely a lack of physical activity. The purpose of this study was to discover if physical activity was an effective mode of treatment for psychiatric patients at an out-patient treatment facility. The study included an exploration of whether or not patients having physical activity included as an integral part of their treatment (to a greater degree than do patients who are physically inactive) would achieve 1) an improvement in their physical condition 2) a reduction in symptomatic pressure and 3) an increase in their health-related quality of life. The intervention period lasted a total of 12 weeks. The training group completed a minimum of 2 training sessions per week with an intensity of 60-75% of maximum heart rate. The participants’ health-related quality of life (SF-36), symptomatic pressure (SCL-90-R) and physical condition (UKK-walking test) were measured before and after intervention. Twenty participants were pre-tested, and out of this initial group, nine patients completed the intervention program and participated thereafter in post-testing. The results showed that participants on average improved their physical condition, reduced their symptomatic pressure and increased their health-related quality of life over the course of the intervention period. The training group experienced significant changes in their symptomatic pressure (the anxiety dimension) and health-related quality of life (the mental health dimension) from the pre-testing stage to the post-testing one. Furthermore, there was a significant connection between symptomatic pressure and health-related quality of life. The patients who were admitted to the psychiatric out-patient clinic were in a physical condition that was significantly poorer than that of persons of the same age in the remainder of the population. Experiences from the study and the relatively large defection from it demonstrate that there is a great need for close follow-up of psychiatric patients’ physical activity levels when physical activity and lifestyle changes are included as part of their treatment program.

Keywords: health-related quality, mental health, physical activity, physical condition

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Authors: Maheshwari Payal, Shapurkar Mayaan

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The present research aimed at studying the awareness and attitudes of teachers towards inclusive education. The sample consisted of 60 teachers, teaching in the primary section (1st – 4th) of regular schools affiliated to the SSC board in Mumbai. The sample was selected by Multi-stage cluster sampling technique. A semi-structured self-constructed interview schedule and a self-constructed attitude scale were used to study the awareness of teachers about disability and Inclusive education, and their attitudes towards inclusive education respectively. Themes were extracted from the interview data and quantitative data was analyzed using SPSS package. Results revealed that teachers had some amount of awareness but an inadequate amount of information on disabilities and inclusive education. Disability to most (37) teachers meant “an inability to do something”. The difference between disability and handicap was stated by most as former being cognitive while handicap being physical in nature. With regard to Inclusive education, a large number (46) stated that they were unaware of the term and did not know what it meant. The majority (52) of them perceived maximum challenges for themselves in an inclusive set up, and emphasized on the role of teacher training courses in the area of providing knowledge (49) and training in teaching methodology (53). Although, 83.3% of teachers held a moderately positive attitude towards inclusive education, a large percentage (61.6%) of participants felt that being in inclusive set up would be very challenging for both children with special needs and without special needs. Though, most (49) of the teachers stated that children with special needs should be educated in a regular classroom, but they further clarified that only those should be in a regular classroom who have physical impairments of mild or moderate degree.

Keywords: attitude, awareness, inclusive education, teachers

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Authors: Mulligan T., Barker-Collo S., Gobson K., Jones K.

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There is a relatively scarce body of literature regarding adolescent experiences of traumatic brain injury (TBI). This qualitative study explored how sustaining a TBI at this unique stage of development might impact a young person as they navigate the challenges of adolescence and transition to adulthood, and what might support recovery. Thirteen young adults who sustained a mild-moderate TBI as an adolescent (aged 13 – 17 years), approximately 7.7 years (range = 6.7 – 8.0 years) prior, participated in the research. Semi-structured individual interviews were conducted to explore participants’ experiences surrounding and following their TBIs. Thematic analysis of interview data produced five key categories of findings: (1) Following their TBIs, many participants experienced problems with cognitive (e.g., forgetfulness, concentration difficulties), physical (e.g., migraines, fatigue) and emotional (e.g., depression, anxiety) functioning, which were often endured into adulthood. (2) TBI-related problems often adversely affected important areas of life for the participant, including school, work and friendships. (3) Changes following TBI commonly impacted identity formation. (4) Recovery processes evolved over time as the participants coped initially by just ‘getting on with it’, before learning to accept new limitations and, ultimately, growing from their TBI experiences. (5) While the presence of friends and family assisted recovery, struggles were often exacerbated by a lack of emotional support from others, in addition to the absence of any assistance or information-provision from professionals regarding what to expect following TBI. The findings suggest that even mild TBI sustained during adolescence can have consequences for an individual’s functioning, engagement in life and identity development, whilst also giving rise to post-traumatic growth. Recovery following adolescent TBI might be maximised by facilitating greater understanding of the injury and acknowledging its impacts on important areas of life, as well as the provision of emotional support and facilitating self-reflection and meaning-making.

Keywords: adolescent, brain Injury, qualitative, post-traumatic growth

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Authors: Muhammad Kamran Hanif Khan, Fahad Mushtaq

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Globally, the death rate from cardiovascular disease has risen over the past 20 years, but especially in low and middle-income countries (LMICS), reports the World Health Organization (WHO). Around 17.5 million deaths, or 31% of all deaths worldwide in 2012, were attributed to CVD, 80% of which occurred in low- and middle-income nations, and eighty five percent of all worldwide disability is attributable to cardiovascular disease. This study assessed the dietary habit and Cardiovascular Risk factors among the patients of coronary artery disease against matched controls. The research was a case-control study. Sample size for this case-control study was 410 CAD cases and 410 healthy controls. The case-control ratio was 1:1. Patients diagnosed with coronary artery disease were recruited from the outpatient departments and emergency rooms of four hospitals in Pakistan. The ages of people who were diagnosed with coronary artery disease were not significantly different from (mean 57.97 7.39 years) the healthy controls (mean 57.12 6.73 years). In order to determine the relationship between food consumption and the two binary outcomes, logistic regression analysis was carried out. Chicken (0.340 (0.245-0.47), p-value 0.0001), beef (0.38 (0.254-0.56), p-value 0.0001), eggs (0.297 (0.208-0.426), p-value 0.0001), and junk food (0.249 (0.167-0.372), p-value 0.0001)) were protective, while yogurt consumption more than twice weekly was risk. Conclusion: In conclusion, poor dietary habits are closely linked to the risk of CAD. Investigations based on dietary trends offer vital and practical knowledge about societal patterns.

Keywords: dietary habbits, cardiovasculardisease, CVD risk factors, hypercholesterolemia

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Authors: Chiao-Cheng Huang, Pei-Te Chiueh, Ya-Hsuan Liou

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Chromium-contaminated wastewater from electroplating industrial activity has been a long-standing environmental issue, as it can degrade surface water quality and is harmful to soil ecosystems. The traditional method of treating chromium-contaminated wastewater has been to use chemical coagulation processes. However, this method consumes large amounts of chemicals such as sulfuric acid, sodium hydroxide, and sodium bicarbonate in order to remove chromium. However, a series of new methods for treating chromium-containing wastewater have been developed. This study aimed to compare the environmental impact of four different lab scale chromium removal processes: 1.) chemical coagulation process (the most common and traditional method), in which sodium metabisulfite was used as reductant, 2.) electrochemical process using two steel sheets as electrodes, 3.) reduction by iron-copper bimetallic powder, and 4.) photocatalysis process by TiO2. Each process was run in the lab, and was able to achieve 100% removal of chromium in solution. Then a Life Cycle Assessment (LCA) study was conducted based on the experimental data obtained from four different case studies to identify the environmentally preferable alternative to treat chromium wastewater. The model used for calculating the environmental impact was TRACi, and the system scope includes the production phase and use phase of chemicals and electricity consumed by the chromium removal processes, as well as the final disposal of chromium containing sludge. The functional unit chosen in this study was the removal of 1 mg of chromium. Solution volume of each case study was adjusted to 1 L in advance and the chemicals and energy consumed were proportionally adjusted. The emissions and resources consumed were identified and characterized into 15 categories of midpoint impacts. The impact assessment results show that the human ecotoxicity category accounts for 55 % of environmental impact in Case 1, which can be attributed to the sulfuric acid used for pH adjustment. In Case 2, production of steel sheet electrodes is an energy-intensive process, thus contributed to 20 % of environmental impact. In Case 3, sodium bicarbonate is used as an anti-corrosion additive, which results mainly in 1.02E-05 Comparative Toxicity Unit (CTU) in the human toxicity category and 0.54E-05 (CTU) in acidification of air. In Case 4, electricity consumption for power supply of UV lamp gives 5.25E-05 (CTU) in human toxicity category, 1.15E-05 (kg Neq) in eutrophication. In conclusion, Case 3 and Case 4 have higher environmental impacts than Case 1 and Case 2, which can be attributed mostly to higher energy and chemical consumption, leading to high impacts in the global warming and ecotoxicity categories.

Keywords: chromium, lab scale, life cycle assessment, wastewater

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Authors: Maha E. Ibrahim, Mona Abdel Aziz

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Background: Chronic low back pain (CLBP) in urban communities represents a challenge to healthcare systems worldwide. The traditional biomedical approach to back pain has been particularly inadequate. Failure of the biomedical model to explain the poor correlation between pain and disability on the one hand, and biological and physical factors that explain those symptoms on the other has led to the adoption of the biopsychosocial model, to recognize the reciprocal influence of physical, social and psychological factors implicated in CLBP, a condition that shows higher prevalence among women residing in urban areas. Urban design of the built community has been shown to exert a significant influence on physical and psychological health. However, little research has investigated the relationship between elements of the built environment, and the level of pain and disability of women with CLBP. As Egypt embarks on building a new capital city, and new settlements proliferate, better understanding of this relationship could greatly reduce the economic and human costs of this widespread medical problem for women. Methods: This study was designed as an exploratory mixed qualitative and quantitative study. Twenty-Six women with CLBP living in two neighborhoods in Cairo, different in their urban structure, but adjacent in their locations (Old Maadi and New Maadi) were interviewed using semi-structured interviews (8 from Old Maadi and 18 from New Maadi). Located in the South of Cairo, New Maadi is a neighborhood with the characteristic modern urban style (narrow streets and tall, adjacent buildings), while Old Maadi is known for being greener, quieter and more relaxed than the usual urban districts of Cairo. The interviews examined their perceptions of the built environment, including building shapes and colors and street light, as well as their sense of safety and comfort, and how it affects their physical and psychological health in general, and their back condition in particular. In addition, they were asked to rate their level of pain and to fill the Oswestry Disability Index (ODI), and the General Health Questionnaire (GHQ-12) to rate their level of disability and psychological status, respectively. Results: Women in both districts had moderate to severe pain and moderate disability with no significant differences between the two districts. However, those living in New Maadi had significantly worse scores on the GHQ-12 than those living in Old Maadi. Most women did not feel that specific elements of the built environment affected their back pain, however, they expressed distress of the elements that were ugly, distorted or damaged, especially where there were no ways of avoiding or fixing them. Furthermore, most women affirmed that the unsightly and uncomfortable elements of their neighborhoods affected their mood states and were a constant source of stress. Conclusion: This exploratory study concludes that elements of the urban built environment do not exert a direct effect on CLBP. However, the perception of women regarding these elements does affect their mood states, and their levels of stress, making them a possible indirect cause of increased suffering in these women.

Keywords: built environment, chronic back pain, disability, urban Cairo

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Authors: Mohammad Azam

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The purpose of this study is to investigate risk and real excess portfolio returns using inflation adjusted risk-free rates, a measuring technique that focuses on the momentum augmented Fama-French six-factor model and use monthly data from 1994 to 2022. With the exception of profitability, the data show that market, size, value, momentum, and investment factors are all strongly associated to excess portfolio stock returns using ordinary lease square regression technique. According to the Gibbons, Ross, and Shanken test, the momentum augmented Fama-French six-factor model outperforms the market. This technique discovery may be utilised by academics and professionals to acquire an in-depth knowledge of the Pakistan Stock Exchange across a broad stock pattern for investing decisions and portfolio construction.

Keywords: real excess portfolio returns, momentum augmented fama & french five-factor model, GRS-test, pakistan stock exchange

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Authors: Ilknur Kahriman, Hacer Kobya Bulut, Birsel C. Demirbag

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Introduction and Aim: One of the most challenging aspects of being parents of a child diagnosed with cancer is to balance their normal family life with the child's health needs and treatment requirements. Cancer covers an important part of family life and gets ahead of other matters. Families mostly feel that everything has changed in their lives with the cancer diagnosis and are obliged to make a number of adjustments in their lives. Their normal family life suddenly begins to include treatments, hospital appointments and hospitalizations. This study is a descriptive research conducted to determine the changes in the lives of families who had a child with cancer. Methods: This study was carried out with 65 families having children diagnosed with cancer in 0-17 age group at outpatient pediatric oncology clinic and polyclinic of a university hospital in Trabzon. Data were collected through survey method from August to November, 2015. In the analysis of the data, numbers, percentage and chi-square test were used. Findings: It was found out that the average age of mothers was 35.33 years, most of them were primary school graduates (44.6%) and housewives (89.2%) and the average age of fathers was 39.30 years, most of them were high school graduates (29.2%) and self-employed (43.8% ). The majority of their children were boys and their average age was 7.74 years and 77% had Acute lymphocytic leukemia (ALL) diagnosis. 87.5% of the mothers who had a child with cancer had increased fears in their lives, 84.4% had increased workload at home, 82.8% had more stressful life and 82.8% felt themselves physically tired. The mothers indicated that their healthy children could not do the social activities they had used to do before (56.5%), they no longer fed their healthy children with the food they loved eating so that the sick child did not aspire (52.3%) and their healthy children were more furious than before (53.2%). As for the fathers, the fundamental change they had was increased workload at home (82.3%), had more stressful life (80.6%) and could no longer allocate time to the activities they had been interested in and done before (77.8%). There was not a significant difference between the sick children gender and the changes in their parents lives. The communication between the mothers and their healthy children were determined to be positively affected in the families in which the sick child's disease duration was under 12 months (X2 = 6.452, p = 0.011). Conclusion: This study showed that parents having a child with cancer had more workload at home, had more stressful lives, could not allocate time to social activities, had increased fears, felt themselves tired and their healthy children became more furious and their social activities reduced.

Keywords: child, cancer, changes in lives, family

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Authors: Jonix Owino

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Aging Out of Place refers to the physical and emotional experience of growing older in a foreign or unfamiliar environment. Refugees flee their home countries and migrate to foreign countries such as the United States for safety. The emotional and psychological distress experienced by refugees who are compelled to leave their home countries can compromise their ability to adapt to new countries, thereby affecting their well-being. In particular, implications of immigration may be felt more acutely in later life stages, especially when life-long attachments have been made in the country of origin. However, aging studies in the United States have failed to conceptualize refugee aging experiences, more so for refugees who entered the country as adults. Specifically, little is known about the quality of life among aging refugees. Research studies on whether the quality of life varies among refugees by sociodemographic factors are limited. Research studies examining the role of social connectedness in aging refugees’ quality of life are also sparse. As such, the present study seeks to investigate the sociodemographic (i.e., age, sex, country of origin, and length of residence) and social connection factors associated with quality of life among aging refugees. The study consisted of a total of 108 participants from ages 50 years and above. The refugees represented in the study were from Bhutan, Burundi, and Somalia and were recruited from an upper Midwestern region of the United States. The participants completed an in-depth survey assessing social factors and well-being. Hierarchical regression was used for analysis. The results showed that females, older individuals, and refugees who were from Africa reported lower quality of life. Length of residence was not associated with quality of life. Furthermore, when controlling for sociodemographic factors, greater social integration was significantly associated with a higher quality of life, whereas lower loneliness was significantly associated with a higher quality of life. The results also indicated a significant interaction between loneliness and sex in predicting quality of life. This suggests that greater loneliness was associated with reduced quality of life for female refugees but not males. The present study highlights cultural variations within refugee groups which is important in determining how host communities can best support aging refugees’ well-being and develop social programs that can effectively cater to issues of aging among refugees.

Keywords: aging refugees, quality of life, social integration, migration and integration

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Authors: Afentoula Mavrodi, Andreas Georgiou, Georgios Tsiotras, Vassilis Aletras

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Placing a monetary value on a quality-adjusted-life-year (QALY) is of utmost importance in economic evaluation. Identifying the population’s preferences is critical in order to understand some of the reasons driving variations in the assigned monetary value. Yet, evidence of the motives behind value assignment to a QALY by the general public is limited. Developing an instrument that would capture the population’s motives could be proven valuable to policy-makers, to guide them in allocating different values to a QALY based on users’ motivations. The aim of this study was to identify the most relevant motives and develop an appropriate instrument to assess them. To design the instrument, we employed: a) the EQ-5D-3L tool to assess participants’ current health status, and b) the Willingness-to-Pay (WTP) approach, within the Contingent Valuation (CV) Method framework, to elicit the monetary value. Advancing the open-ended approach adopted to assess solely protest bidders’ motives; a variety of follow-up item-specific statements were designed (deductive approach), aiming to evaluate motives of both protest bidders and participants willing to pay for the hypothetical treatment under consideration. The initial design of the survey instrument was the outcome of an extensive literature review. This instrument was revised based on 15 semi-structured interviews that took place in September 2018 and a pilot study held during two months (October-November) in 2018. Individuals with different educational, occupational and economical backgrounds and adequate verbal skills were recruited to complete the semi-structured interviews. The follow-up motivation statements of both protest bidders and those willing to pay were revised and rephrased after the semi-structured interviews. In total 4 statements for protest bidders and 3 statements for those willing to pay for the treatment were chosen to be included in the survey tool. Using the CATI (Computer Assisted Telephone Interview) method, a randomly selected sample of 97 persons living in Thessaloniki, Greece, completed the questionnaire on two occasions over a period of 4 weeks. Based on pilot study results, a test-retest reliability assessment was performed using the intra-class correlation coefficient (ICC). All statements formulated for protest bidders showed acceptable reliability (ICC values of 0.84 (95% CI: 0.67, 0.92) and above). Similarly, all statements for those willing to pay for the treatment showed high reliability (ICC values of 0.86 (95% CI: 0.78, 0.91) and above). Overall, the instrument designed in this study was reliable with regards to the item-specific statements assessing participants’ motivation. Validation of the instrument will take place in a future study. For a holistic WTP per QALY instrument, participants’ motivation must be addressed broadly. The instrument developed in this study captured a variety of motives and provided insight with regards to the method through which the latter are evaluated. Last but not least, it extended motive assessment to all study participants and not only protest bidders.

Keywords: contingent valuation method, instrument, motives, quality-adjusted life-year, willingness-to-pay

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Authors: Daisuke Sagiya, Ren Kamioka

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South Africa has ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) on 30th November 2007. In line with this, the Department of Social Development (DSD) revised the White Paper on the Rights of Persons with Disabilities (WPRPD), and the Cabinet approved it on 9th December 2015. The South African government is striving towards the elimination of poverty and inequality in line with UNCRPD and WPRPD. However, there are minimal programmes and services that have been provided to persons with disabilities in the rural community. In order to address current discriminative practices, disunity and limited self-representation in rural community, DSD in cooperation with the Japan International Cooperation Agency (JICA) is implementing the 'Project for the Promotion of Empowerment of Persons with Disabilities and Disability Mainstreaming' from May 2016 to May 2020. The project is targeting rural community as the project sites, namely 1) Collins Chabane municipality, Vhembe district, Limpopo and 2) Maluti-a-Phofung municipality, Thabo Mofutsanyana district, Free State. The project aims at developing good practices on Community-Based Inclusive Development (CBID) at the project sites which will be documented as a guideline and applied in other provinces in South Africa and neighbouring countries (Lesotho, Swaziland, Botswana, Namibia, Zimbabwe, and Mozambique). In cooperation with provincial and district DSD and local government, the project is currently implementing various community activities, for example: Establishment of Self-Help Group (SHG) of persons with disabilities and Peer Counselling in the villages, and will conduct Disability Equality Training (DET) and accessibility workshop in order to enhance the CBID in the project sites. In order to universalise good practices on CBID, the authors will explain lessons learned from the project by utilising the theories of disability and development studies and community psychology such as social model of disability, twin-track approach, empowerment theory, sense of community, helper therapy principle, etc. And the authors conclude that in order to realise social participation of persons with disabilities in rural community, CBID is a strong tool and persons with disabilities must play central roles in all spheres of CBID activities.

Keywords: community-based inclusive development, disability mainstreaming, empowerment of persons with disabilities, self-help group

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Authors: Ajved Ahmed

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This research paper explores the intricate relationship between sports activities and disability, aiming to shed light on the multifaceted impacts of sports participation on individuals with disabilities. As the world grapples with the challenges posed by the growing population of people with disabilities, understanding the role of sports in their lives becomes increasingly important. The paper begins by providing a comprehensive overview of the diverse forms of disabilities, emphasizing the wide spectrum of physical, sensory, and cognitive impairments. It then delves into the benefits of sports activities for individuals with disabilities, highlighting the profound physical, psychological, and social advantages that engagement in sports can offer. These benefits encompass improved physical fitness, enhanced self-esteem and mental well-being, increased social integration, and a sense of empowerment and independence. Furthermore, the paper examines the barriers and challenges that individuals with disabilities often encounter when attempting to participate in sports activities, ranging from inaccessible facilities to societal prejudices and stereotypes. It underscores the critical role of inclusive sports programs, adaptive equipment, and policy initiatives in overcoming these barriers and fostering an environment where everyone can enjoy the benefits of sports. Through a comprehensive review of existing research and case studies, the paper also explores specific sports and their suitability for various types of disabilities. It discusses adapted sports like wheelchair basketball, blind soccer, and para-swimming, showcasing how these tailored activities not only accommodate disabilities but also promote excellence and competition at the highest levels. Additionally, the research paper delves into the economic and societal implications of increased sports participation among individuals with disabilities. It explores the potential for greater inclusion in the workforce, reduced healthcare costs, and the fostering of a more inclusive and accepting society. This research paper underscores the profound impact of sports activities on individuals with disabilities, highlighting their potential to improve physical health, mental well-being, and social integration. It calls for continued efforts to break down barriers and promote inclusive sports programs to ensure that everyone, regardless of their abilities, can access the transformative power of sports. Ultimately, this study contributes to a broader understanding of disability and sports, emphasizing the importance of inclusivity and accessibility in creating a more equitable and healthier society.

Keywords: sports and health, sports and disability, curing disability through sports, health benefits of sports

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Authors: Reza Lotfalian, Sudarshan Martins, Peter Radziszewski

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The effect of reliability on life-cycle cost, including initial and maintenance cost of a system is studied. The failure probability of a component is used to calculate the average maintenance cost during the operation cycle of the component. The standard deviation of the life-cycle cost is also calculated as an error measure for the average life-cycle cost. As a numerical example, the model is used to study the average life cycle cost of an electric motor.

Keywords: initial cost, life-cycle cost, maintenance cost, reliability

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