Search results for: narrative therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2459

Search results for: narrative therapy

689 Peculiarities of the Clinical Course of the Osteoarthritis in Shift-Workers: Analysis of Clinical Data and Questionnaries

Authors: Oksana Mykytyuk

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Chronic desynchronosis is an important factor of progression of osteoarthritis in shift workers. 80 patients with primary osteoarthritis (female:male ratio = 3:1, average age: 57.6 years, average disease duration: 6.4 years, radiological stage: II-III) were examined, 42% reported systematic night shift-work for more than two years. Full clinical examination was performed, all patients filled in SF-36, WOMAC questonnaries, marked visual analog scales for estimation of pain intensity and general well-being. Patients who had been exposed to night work had significantly worse clinical course of osteoarthritis marked by more (27.5%, p < 0.05) extensive pain syndrome, especially at night hours, (10.00 pm-2.00 am period) and estimated life quality as poorer comparing those working at day time. Osteoarthritis initiation occurred at earlier age in them comparing those who worked in non-shifted regimen. They showed a trend to generalized affliction of bigger quantity of joint groups, higher frequency of synovitis as well. Shift-workers administered higher doses of non-steroid anti-inflammatory drugs (NSAIDs) and estimated their effect as lower (39.6% average daily relief vs 62.5% in non-shift workers after 10 days of regular application of therapy). Frequency of chronic NSAID-induced gastropathy was 25% higher among night-workers. Shift-workers are predisposed to worse course of osteoarthritis with marked clinical symptoms, requiring higher doses on NSAIDs and with inclination towards bigger frequency of complication. That should be kept in mind while developing individual treatment and secondary prophylaxis strategy.

Keywords: desynchronosis, osteoarthritis, questionnaries, shift-work

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688 Sociology Perspective on Emotional Maltreatment: Retrospective Case Study in a Japanese Elementary School

Authors: Nozomi Fujisaka

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This sociological case study analyzes a sequence of student maltreatment in an elementary school in Japan, based on narratives from former students. Among various forms of student maltreatment, emotional maltreatment has received less attention. One reason for this is that emotional maltreatment is often considered part of education and is difficult to capture in surveys. To discuss the challenge of recognizing emotional maltreatment, it's necessary to consider the social background in which student maltreatment occurs. Therefore, from the perspective of the sociology of education, this study aims to clarify the process through which emotional maltreatment was embraced by students within a Japanese classroom. The focus of this study is a series of educational interactions by a homeroom teacher with 11- or 12-year-old students at a small public elementary school approximately 10 years ago. The research employs retrospective narrative data collected through interviews and autoethnography. The semi-structured interviews, lasting one to three hours each, were conducted with 11 young people who were enrolled in the same class as the researcher during their time in elementary school. Autoethnography, as a critical research method, contributes to existing theories and studies by providing a critical representation of the researcher's own experiences. Autoethnography enables researchers to collect detailed data that is often difficult to verbalize in interviews. These research methods are well-suited for this study, which aims to shift the focus from teachers' educational intentions to students' perspectives and gain a deeper understanding of student maltreatment. The research results imply a pattern of emotional maltreatment that is challenging to differentiate from education. In this study's case, the teacher displayed calm and kind behavior toward students after a threat and an explosion of anger. Former students frequently mentioned this behavior of the teacher and perceived emotional maltreatment as part of education. It was not uncommon for former students to offer positive evaluations of the teacher despite experiencing emotional distress. These findings are analyzed and discussed in conjunction with the deschooling theory and the cycle of violence theory. The deschooling theory provides a sociological explanation for how emotional maltreatment can be overlooked in society. The cycle of violence theory, originally developed within the context of domestic violence, explains how violence between romantic partners can be tolerated due to prevailing social norms. Analyzing the case in association with these two theories highlights the characteristics of teachers' behaviors that rationalize maltreatment as education and hinder students from escaping emotional maltreatment. This study deepens our understanding of the causes of student maltreatment and provides a new perspective for future qualitative and quantitative research. Furthermore, since this research is based on the sociology of education, it has the potential to expand research in the fields of pedagogy and sociology, in addition to psychology and social welfare.

Keywords: emotional maltreatment, education, student maltreatment, Japan

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687 The Impact of Regulatory Changes on the Development of Mobile Medical Apps

Authors: M. McHugh, D. Lillis

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Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.

Keywords: agile, applications, FDA, medical, mobile, regulations, software engineering, standards

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686 Behavioral Response of Dogs to Interior Environment: An Exploratory Study on Design Parameters for Designing Dog Boarding Centers in Indian Context

Authors: M. R. Akshaya, Veena Rao

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Pet population in India is increasing phenomenally owing to the changes in urban lifestyle with increasing number of single professionals, single parents, delayed parenthood etc. The animal companionship as a means of reducing stress levels, deriving emotional support, and unconditional love provided by dogs are a few reasons attributed for increasing pet ownership. The consequence is the booming of the pet care products and dog care centers catering to the different requirements of rearing the pets. Dog care centers quite popular in tier 1 metros of India cater to the requirement of the dog owners providing space for the dogs in absence of the owner. However, it is often reported that the absence of the owner leads to destructive and exploratory behavior issues; the main being the anxiety disorders. In the above context, it becomes imperative for a designer to design dog boarding centers that help in reducing the separation anxiety in dogs keeping in mind the different interior design parameters. An exploratory research with focus group discussion is employed involving a group of dog owners, behaviorists, proprietors of day care as well as boarding centers, and veterinarians to understand their perception on the significance of different interior parameters of color, texture, ventilation, aroma therapy and acoustics as a means of reducing the stress levels in dogs sent to the boarding centers. The data collected is organized as thematic networks thus enabling the listing of the interior design parameters that needs to be considered in designing dog boarding centers. 

Keywords: behavioral response, design parameters, dog boarding centers, interior environment

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685 Immobilized Iron Oxide Nanoparticles for Stem Cell Reconstruction in Magnetic Particle Imaging

Authors: Kolja Them, Johannes Salamon, Harald Ittrich, Michael Kaul, Tobias Knopp

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Superparamagnetic iron oxide nanoparticles (SPIONs) are nanoscale magnets which can be biologically functionalized for biomedical applications. Stem cell therapies to repair damaged tissue, magnetic fluid hyperthermia for cancer therapy and targeted drug delivery based on SPIONs are prominent examples where the visualization of a preferably low concentrated SPION distribution is essential. In 2005 a new method for tomographic SPION imaging has been introduced. The method named magnetic particle imaging (MPI) takes advantage of the nanoparticles magnetization change caused by an oscillating, external magnetic field and allows to directly image the time-dependent nanoparticle distribution. The SPION magnetization can be changed by the electron spin dynamics as well as by a mechanical rotation of the nanoparticle. In this work different calibration methods in MPI are investigated for image reconstruction of magnetically labeled stem cells. It is shown that a calibration using rotationally immobilized SPIONs provides a higher quality of stem cell images with fewer artifacts than a calibration using mobile SPIONs. The enhancement of the image quality and the reduction of artifacts enables the localization and identification of a smaller number of magnetically labeled stem cells. This is important for future medical applications where low concentrations of functionalized SPIONs interacting with biological matter have to be localized.

Keywords: biomedical imaging, iron oxide nanoparticles, magnetic particle imaging, stem cell imaging

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684 Bedouin of Silicon Wadi: A Case Study Analysis of the Multi-Level Perspectives and Factors Affecting Bedouin Entrepreneurialism as Obstacles to Entry into the Israeli High-Tech Industry

Authors: Frazer G. Thompson

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Israel is a nation of cultural and historical diversity, yet the success factors for a modern Bedouin-Arab high-tech entrepreneur seem to be different from those of other Jewish-Israeli citizens. The purpose of this descriptive narrative case study is to explore how an Arab-Israeli all Negev-Bedouin technology company has succeeded in the Israeli high-tech industry by utilizing technology and engineering career opportunities available to Bedouin youth for ‘Sadel Tech,’ at Be’er-Sheva, the Negev, Israel. Methods: The strategy of inquiry seeks to explore real-life contextual understandings, multi-level perspectives, and the cultural influences of personal, community, educational, and entrepreneurial factors. The research methodology includes in-depth one-on-one interviews, focus group sessions, and overt observation to explore the meaning and understanding of the constructs toward determining the effect all or a few of the elements may have on the overall success factors of the company. Results: Study results indicate that the state-run educational system in Israel fails to adequately integrate important aspects of Bedouin culture into the learning environment. However, Bedouin entrepreneurs are finding ways to compensate for these inadequacies by utilizing non-traditional methods of teaching, learning, and doing business. Government incentives for Bedouin start-ups are also recognized as contributors. Employees of Sadel live and work in the Negev, the Gaza Strip, and the West Bank, further informing the study that the traditions of tribal etiquette continue to contribute to modern Bedouin-Arab business culture. Conclusion: Bedouin's business success in Israel is a multi-dimensional concept. While cultural acumen plays a prominent and unique role for both Arab-Israelis and Jewish-Israelis in economic and entrepreneurial pursuits, the marginalization of the Bedouin continues to contribute to the lack of educational and professional opportunities for Bedouin in Israel. Although recognized as important at the government level, programs necessary to implement the infrastructure required to support Bedouin entrepreneurship in Israel remain infantile. The Israeli Government is providing opportunities through grants and other incentives for Bedouin entrepreneurial start-ups, indicating that Israel has recognized the impact of this growing demographic. However, although many Bedouin graduates from University each year with advanced degrees, opportunities for Bedouin within the Israeli high-tech sector remain scarce.

Keywords: Bedouin education, Bedouin entrepreneur, economic anthropology, ethnic business opportunities, Israeli tech, Silicon Wadi

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683 Therapeutical Role of Copper Oxide Nanoparticles (CuO NPs) for Breast Cancer Therapy

Authors: Dipranjan Laha, Parimal Karmakar

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Metal oxide nanoparticles are well known to generate oxidative stress and deregulate normal cellular activities. Among these, transition metals copper oxide nanoparticles (CuO NPs) are more compelling than others and able to modulate different cellular responses. In this work, we have synthesized and characterized CuO NPs by various biophysical methods. These CuO NPs (~30 nm) induce autophagy in human breast cancer cell line, MCF7 in a time and dose-dependent manner. Cellular autophagy was tested by MDC staining, induction of green fluorescent protein light chain 3 (GFP-LC3B) foci by confocal microscopy, transfection of pBABE-puro mCherry-EGFP-LC3B plasmid and western blotting of autophagy marker proteins LC3B, beclin1, and ATG5. Further, inhibition of autophagy by 3-Methyladenine (3-MA) decreased LD50 doses of CuO NPs. Such cell death was associated with the induction of apoptosis as revealed by FACS analysis, cleavage of PARP, dephosphorylation of Bad and increased cleavage product of caspase3. siRNA-mediated inhibition of autophagy-related gene beclin1 also demonstrated similar results. Finally, induction of apoptosis by 3-MA in CuO NPs treated cells were observed by TEM. This study indicates that CuO NPs are a potent inducer of autophagy which may be a cellular defense against the CuO NPs mediated toxicity and inhibition of autophagy switches the cellular response into apoptosis. A combination of CuO NPs with the autophagy inhibitor is essential to induce apoptosis in breast cancer cells. Acknowledgments: The authors would like to acknowledge for financial support for this research work to the Department of Biotechnology (No. BT/PR14661/NNT/28/494/2010), Government of India.

Keywords: nanoparticle, autophagy, apoptosis, siRNA-mediated inhibition

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682 Thinking Historiographically in the 21st Century: The Case of Spanish Musicology, a History of Music without History

Authors: Carmen Noheda

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This text provides a reflection on the way of thinking about the study of the history of music by examining the production of historiography in Spain at the turn of the century. Based on concepts developed by the historical theorist Jörn Rüsen, the article focuses on the following aspects: the theoretical artifacts that structure the interpretation of the limits of writing the history of music, the narrative patterns used to give meaning to the discourse of history, and the orientation context that functions as a source of criteria of significance for both interpretation and representation. This analysis intends to show that historical music theory is not only a means to abstractly explore the complex questions connected to the production of historical knowledge, but also a tool for obtaining concrete images about the intellectual practice of professional musicologists. Writing about the historiography of contemporary Spanish music is a task that requires both a knowledge of the history that is being written and investigated, as well as a familiarity with current theoretical trends and methodologies that allow for the recognition and definition of the different tendencies that have arisen in recent decades. With the objective of carrying out these premises, this project takes as its point of departure the 'immediate historiography' in relation to Spanish music at the beginning of the 21st century. The hesitation that Spanish musicology has shown in opening itself to new anthropological and sociological approaches, along with its rigidity in the face of the multiple shifts in dynamic forms of thinking about history, have produced a standstill whose consequences can be seen in the delayed reception of the historiographical revolutions that have emerged in the last century. Methodologically, this essay is underpinned by Rüsen’s notion of the disciplinary matrix, which is an important contribution to the understanding of historiography. Combined with his parallel conception of differing paradigms of historiography, it is useful for analyzing the present-day forms of thinking about the history of music. Following these theories, the article will in the first place address the characteristics and identification of present historiographical currents in Spanish musicology to thereby carry out an analysis based on the theories of Rüsen. Finally, it will establish some considerations for the future of musical historiography, whose atrophy has not only fostered the maintenance of an ingrained positivist tradition, but has also implied, in the case of Spain, an absence of methodological schools and an insufficient participation in international theoretical debates. An update of fundamental concepts has become necessary in order to understand that thinking historically about music demands that we remember that subjects are always linked by reciprocal interdependencies that structure and define what it is possible to create. In this sense, the fundamental aim of this research departs from the recognition that the history of music is embedded in the conditions that make it conceivable, communicable and comprehensible within a society.

Keywords: historiography, Jörn Rüssen, Spanish musicology, theory of history of music

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681 Techno-Psych Serv: Technology-Based Psychological Services Extended to Adults Experiencing Symptoms of Mild Anxiety and Depression

Authors: Marissa C. Esperal

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This university-based research project attempted to determine the relevance and effectiveness of the technology-based psychological services extended to selected adults experiencing symptoms of mild anxiety and depression. Ninety-seven participants who voluntarily availed the free online psychological services advertised through a Facebook page (Techno-Psych Serv) signed up for the Informed Consent and Psychological Services Contract Agreement form. These clients availed a maximum of 5 online sessions devoted to online assessment, online counseling and brief therapy sessions using the Google Meet App. Participants who, upon evaluation, were found to still be needing extended psychological and other services were referred to other mental health services institutions. Post-evaluations were conducted using Google Forms upon termination. Findings showed that with a mean of 4.87 (n=97), it was noted that the services provided through the online platform were effective. However, it was noted that the majority of those who availed the services were professionals and skilled workers, thus defeating the objective of extending free psychological services to the marginalized group. It was concluded that offering free technology-based psychological services, though proven effective, is found to be less relevant if the intention is to reach out to the less fortunate and marginalized group. It was further concluded that there is still a need for psychoeducation and mental health promotion among the marginalized sectors. It was recommended that if mental health services are extended to the community of marginalized group, providing physical services are still a better option.

Keywords: technology-based psychological services, adults, mild anxiety, depression

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680 Exploring the Benefits of Hiring Individuals with Disabilities in the Workplace

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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679 Advanced Magnetic Resonance Imaging in Differentiation of Neurocysticercosis and Tuberculoma

Authors: Rajendra N. Ghosh, Paramjeet Singh, Niranjan Khandelwal, Sameer Vyas, Pratibha Singhi, Naveen Sankhyan

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Background: Tuberculoma and neurocysticercosis (NCC) are two most common intracranial infections in developing country. They often simulate on neuroimaging and in absence of typical imaging features cause significant diagnostic dilemmas. Differentiation is extremely important to avoid empirical exposure to antitubercular medications or nonspecific treatment causing disease progression. Purpose: Better characterization and differentiation of CNS tuberculoma and NCC by using morphological and multiple advanced functional MRI. Material and Methods: Total fifty untreated patients (20 tuberculoma and 30 NCC) were evaluated by using conventional and advanced sequences like CISS, SWI, DWI, DTI, Magnetization transfer (MT), T2Relaxometry (T2R), Perfusion and Spectroscopy. rCBV,ADC,FA,T2R,MTR values and metabolite ratios were calculated from lesion and normal parenchyma. Diagnosis was confirmed by typical biochemical, histopathological and imaging features. Results: CISS was most useful sequence for scolex detection (90% on CISS vs 73% on routine sequences). SWI showed higher scolex detection ability. Mean values of ADC, FA,T2R from core and rCBV from wall of lesion were significantly different in tuberculoma and NCC (P < 0.05). Mean values of rCBV, ADC, T2R and FA for tuberculoma and NCC were (3.36 vs1.3), (1.09x10⁻³vs 1.4x10⁻³), (0.13 x10⁻³ vs 0.09 x10⁻³) and (88.65 ms vs 272.3 ms) respectively. Tuberculomas showed high lipid peak, more choline and lower creatinine with Ch/Cr ratio > 1. T2R value was most significant parameter for differentiation. Cut off values for each significant parameters have proposed. Conclusion: Quantitative MRI in combination with conventional sequences can better characterize and differentiate similar appearing tuberculoma and NCC and may be incorporated in routine protocol which may avoid brain biopsy and empirical therapy.

Keywords: advanced functional MRI, differentiation, neurcysticercosis, tuberculoma

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678 SEM Detection of Folate Receptor in a Murine Breast Cancer Model Using Secondary Antibody-Conjugated, Gold-Coated Magnetite Nanoparticles

Authors: Yasser A. Ahmed, Juleen M Dickson, Evan S. Krystofiak, Julie A. Oliver

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Cancer cells urgently need folate to support their rapid division. Folate receptors (FR) are over-expressed on a wide range of tumor cells, including breast cancer cells. FR are distributed over the entire surface of cancer cells, but are polarized to the apical surface of normal cells. Targeting of cancer cells using specific surface molecules such as folate receptors may be one of the strategies used to kill cancer cells without hurting the neighing normal cells. The aim of the current study was to try a method of SEM detecting FR in a murine breast cancer cell model (4T1 cells) using secondary antibody conjugated to gold or gold-coated magnetite nanoparticles. 4T1 cells were suspended in RPMI medium witth FR antibody and incubated with secondary antibody for fluorescence microscopy. The cells were cultured on 30mm Thermanox coverslips for 18 hours, labeled with FR antibody then incubated with secondary antibody conjugated to gold or gold-coated magnetite nanoparticles and processed to scanning electron microscopy (SEM) analysis. The fluorescence microscopy study showed strong punctate FR expression on 4T1 cell membrane. With SEM, the labeling with gold or gold-coated magnetite conjugates showed a similar pattern. Specific labeling occurred in nanoparticle clusters, which are clearly visualized in backscattered electron images. The 4T1 tumor cell model may be useful for the development of FR-targeted tumor therapy using gold-coated magnetite nano-particles.

Keywords: cancer cell, nanoparticles, cell culture, SEM

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677 The Destruction of Memory: Ataturk Cultural Centre

Authors: Birge Yildirim Okta

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This paper aims to narrate the story of Atatürk Cultural Center in Taksim Square, which was demolished in 2018, and discuss its architectonic as a social place of memory and its existence and demolishment as the space of politics. Focusing on the timeline starting from early republican period till today, the paper uses narrative discourse analysis to research Atatürk Cultural Center as a place of memory and a space of politics in its existence. After the establishment of Turkish Republic, one of most important implementation in Taksim Square, reflecting the internationalist style, was the construction of Opera Building in Prost Plan. The first design of the opera building belonged to Aguste Perret, which could not be implemented due to economic hardship during World War II. Later the project was designed by architects Feridun Kip and Rüknettin Güney in 1946 but could not be completed due to 1960 military coup. Later the project was shifted to another architect Hayati Tabanlıoglu, with a change in its function as a cultural center. Eventually, the construction of the building was completed in 1969 in a completely different design. AKM became a symbol of republican modernism not only with its modern architectural style but also with it is function as the first opera building of the republic, reflecting the western, modern cultural heritage by professional groups, artists and the intelligentsia. In 2005, Istanbul’s council for the protection of cultural heritage decided to list AKM as a grade 1 cultural heritage, ending a period of controversy which saw calls for the demolition of the center as it was claimed it ended its useful lifespan. In 2008 the building was announced to be closed for repairs and restoration. Over the following years, the building was demolished piece by piece silently while Taksim mosque has been built just in front of Atatürk Cultural Center. Belonging to the early republican period, AKM was a representation of a cultural production of a modern society for the emergence and westward looking, secular public space in Turkey. Its erasure from Taksim scene under the rule of the conservative government, Justice and Development Party and the construction of Taksim mosque in front of AKM’s parcel is also representational. The question of governing the city through space has always been an important aspect for governments, those holding political power since cities are the chaotic environments that are seen as a threat for the governments, carrying the tensions of proletariat or the contradictory groups. The story of AKM as a dispositive or a regulatory apparatus demonstrates how space itself is becoming a political medium, to transform the socio-political condition. The article aims to discuss the existence and demolishment of Atatürk Cultural Center by discussing the constructed and demolished building as a place of memory and a space of politics.

Keywords: space of politics, place of memory, atatürk cultural center, taksim square

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676 Assessment of Delirium, It's Possible Risk Factors and Outcome in Patient Admitted in Medical Intensive Care Unit

Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda

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Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.

Keywords: delirium, risk factors, outcome, intervention

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675 Retrospective Analysis of Facial Skin Cancer Patients Treated in the Department of Oral and Maxillofacial Surgery Kiel

Authors: Abdullah Saeidi, Aydin Gülses, Christan Flörke

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Skin cancer of the face region is the most common type of malignancy and surgical excision is the preferred approach. However, the clinical long term results reported in the literature are still controversial. Objectives: To describe; 1. Demographical characteristics 2. Affected site, distribution and TNM classification regarding tumor type 3. Surgical aspects • Surgical removal: excision principles, safety margins, the need for secondary resection, primary reconstruction/ defect closure, anesthesia protocol, duration of hospital stay (if any) • Secondary intervention for defect closure/reconstruction: Flap technique, anesthesia protocol, duration of hospital stay (if any), postoperative wound management etc. 4. Tumor recurrences 5. Clinical outcomes 6. Studying the possible therapy approach throw Biostatistical relation and correlation between multiple Histological, diagnostics and clinical Faktors. following surgical ablation of the skin cancer of the head and neck region. Methods: Selection and statistical analysis of medical records of patients who had admitted to the Department of Oral and Maxillofacial Surgery, Universitätsklinikum Schleswig Holstein, Campus Kiel during the period of 2015-2019 will be retrospectively evaluated. Data will be collected via ORBIS Information-Management-System (ORBIS AG, Saarbrücken, Germany).

Keywords: non melanoma skin cancer, face skin cancer, skin reconstruction, non melanoma skin cancer recurrence, non melanoma skin cancer metastases

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674 Mealtime Talk as a Context of Learning: A Multiple Case Study of Australian Chinese Parents' Interaction with Their Preschool Aged Children at Dinner Table

Authors: Jiangbo Hu, Frances Hoyte, Haiquan Huang

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Research identifies that mealtime talk can be a significant learning context that provides children with rich experiences to foster their language and cognitive development. Middle-classed parents create an extended learning discourse for their children through sophisticated vocabulary, narrative and explanation genres at dinner table. However, mealtime opportunities vary with some parents having little interaction with their children and some parents focusing on directive of children’s behaviors. This study investigated five Chinese families’ parent-child interaction during mealtime that was rarely reported in the literature. The five families differ in terms of their living styles. Three families are from professional background where both mothers the fathers work in Australian companies and both of them present at dinner time. The other two families own business. The mothers are housemakers and the fathers are always absent at dinner time due to their busy business life. Employing case study method, the five Chinese families’ parent-child interactions at dinner table were recorded using a video camera. More than 3000 clauses were analyzed with the framework of 'systems of clause complexing' from systemic functional linguistic theory. The finding shows that mothers played a critical role in the interaction with their children by initiating most conversations. The three mothers from professional background tended to use more language in extending and expanding pattern that is beneficial for children’s language development and high level of thinking (e.g., logical thinking). The two house making mothers’ language focused more on the directive of their children’s social manners and dietary behaviors. The fathers though seemed to be less active, contributing to the richness of the conversation through their occasional props such as asking open questions or initiating a new topic. In general, the families from professional background were more advantaged in providing learning opportunities for their children at dinner table than the families running business were. The home experiences of Chinese children is an important topic in research due to the rapidly increasing number of Chinese children in Australia and other English speaking countries. Such research assist educators in the education of Chinese children with more awareness of Chinese children experiences at home that could be very unlike the settings in English schools. This study contributes to the research in this area through the analysis of language in parent-child interaction during mealtime, which is very different from previous research that mainly investigated Chinese families through survey and interview. The finding of different manners in language use between the professional families and business families has implication for the understanding of the variation of Chinese children’s home experiences that is influenced not only by parents’ socioeconomic status but their lifestyles.

Keywords: Chinese children, Chinese parents, mealtime talk, parent-child interaction

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673 The Generation of Insulin Producing Cells from Human Mesenchymal Stem Cells by miR-375 and Anti-miR-9

Authors: Arefeh Jafarian, Mohammad Taghikani, Saied Abroun, Amir Allahverdi, Masoud Soleimani

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Introduction: The miRNAs have key roles in control of pancreatic islet development and insulin secretion. In this regards, current study investigated the pancreatic differentiation of human bone marrow mesenchymal stem cells (hBM-MSCs) by up-regulation of miR-375 and down-regulation of miR-9 by lentiviruses containing miR-375 and anti-miR-9. Findings: After 21 days of induction, islet-like clusters containing insulin producing cells (IPCs) were confirmed by dithizone (DTZ) staining. The IPCs and β cell specific related genes and proteins were detected using qRT-PCR and immunofluorescence on days 7, 14 and 21 of differentiation. Glucose challenge test was performed at different concentrations of glucose as well as extracellular and intracellular insulin and C-peptide were assayed using ELISA kit. In derived IPCs by miR-375 alone are capable to express insulin and other endocrine specific transcription factors, the cells lack the machinery to respond to glucose. The differentiated hMSCs by miR-375 and anti-miR-9 lentiviruses could secrete insulin and c-peptide in a glucose-regulated manner. Conclusion: It was found that over-expression of miR-375 led to a reduction in levels of Mtpn protein in derived IPCs, while treatment with anti-miR-9 following miR-375 over-expression had synergistic effects on MSCs differentiation and insulin secretion in a glucose-regulated manner. The researchers reported that silencing of miR-9 increased OC-2 protein in IPCs that may contribute to the observed glucose-regulated insulin secretion. These findings highlight miRNAs functions in stem cells differentiation and suggest that they could be used as therapeutic tools for gene-based therapy in diabetes mellitus.

Keywords: diabetes, differentiation, MSCs, insulin producing cells, miR-375, miR-9

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672 Exploring Identity of Female British Pakistani Student with Shifting and Re-shifting of Cultures

Authors: Haleema Sadia

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The study is aimed at exploring the identity construction of female British born Pakistani postgraduate student who shifted to Pakistan at the age of 12, stayed there for 8 years and re-shifted to UK for Higher Education. Research questions are: 1. What is the academic and socio-cultural background of the participant prior to joining the UoM as a postgrad student? 2. How the participant talk, see herself and act in relation to cultural and social norms and practices? Participant’ identity is explored through positioning theory of Holland et al. (1998), referring to the ways people understand and enact their social positions in the figured world. The research is a case study based on narrative interview of Shabana, a British-born Pakistani female postgraduate student, who has recently joined the university of Manchester. Shabana received her primary education in UK during the first twelve years of her life. She is the youngest among the three sisters, with only one brother younger to her. Her father, although not well educated is a successful entrepreneur, maintaining offices in UK and Pakistan. Her mother is a housewife with no formal education. Shabana’s elder sister got involved in a relationship with a Pakistani boy against cultural norms of arranged marriage. Resultantly the three sisters were shifted to Pakistan to be equated with socio-religious norms. Shabana termed her first year in Pakistan as disgusting and she hated her father for the decision. However after a year’s time and shifting from an orthodox city to the provincial capital Lahore, she developed liking for the Pakistani culture. She gradually developed a new socio-religious identity during her stay, which she expressed as a turning point in her life. After completing O level Shabana returned back to UK and joined the University of Hull as undergraduate Student. At Hull she remained isolated, missed the religious environment and relished the memories of Lahore. She would visit Pakistan almost three times a year. After obtaining her BSc degree from Hull she went back to Pakistan. Soon after she decided to improve her academic qualification. She came to UK to join her parents and got admission in the MSc chemistry program at UoM. Presently Shabana talks about the dominant role of male members in the family culture in decision-making. She strongly feels to struggle hard and attain equal status with males in education, employment, earning, authority and freedom. She sees herself in a position to share the authority with her (would be) husband in important family and other matters. Shabana has developed a new identity of a mix of both Pakistani and UK culture. She is appreciative of the socio-cultural values of UK while still regarding the cultural and religious values of Pakistan in high esteem.

Keywords: postgraduate students, identity construction, cultural shifts, female british pakistani student

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671 Life at the Fence: Lived Experiences of Navigating Cultural and Social Complexities among South Sudanese Refugees in Australia

Authors: Sabitra Kaphle, Rebecca Fanany, Jenny Kelly

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Australia welcomes significant numbers of humanitarian arrivals every year with the commitment to provide equal opportunities and the resources required for integration into the new society. Over the last two decades, more than 24,000 South Sudanese people have come to call Australia home. Most of these refugees experienced several challenges whilesettlinginto the new social structures and service systems in Australia. The aim of the research is to explore the factors influencing social and cultural integration of South Sudanese refugees who have settled in Australia. Methodology: This studyused a phenomenological approach based on in-depth interviews designed to elicit the lived experiences of South Sudanese refugees settled in Australia. It applied the principles of narrative ethnography, allowing participants an opportunity to speak about themselves and their experiences of social and cultural integration-using their own words. Twenty-six participants were recruited to the study. Participants were long-term residents (over 10 years of settlement experience)who self-identified as refugees from South Sudan. Participants were given an opportunity to speak in the language of their choice, and interviews were conducted by a bilingual interviewer in their preferred language, time, and location. Interviews were recorded and transcribed verbatim and translated to Englishfor thematic analysis. Findings: Participants’ experiences portray the complexities of integrating into a new society due tothe daily challenges that South Sudaneserefugees face. Themes emerged from narrativesindicated that South Sudanese refugees express a high level of association with a Sudanese identity while demonstrating a significant level of integration into the Australian society. Despite this identity dilemma, these refugees show a high level of consensus about the experiencesof living in Australia that is closely associated with a group identity. In the process of maintaining identity andsocial affiliation, there are significant inter-generational cultural conflicts that participants experience in adapting to Australian society. It has been elucidated that identityconflict often emerges centeringon what constitutes authentic cultural practice as well as who is entitled to claim to be a member of the South Sudanese culture. Conclusions: Results of this study suggest that the cultural identity and social affiliations of South Sudanese refugees settling into Australian society are complex and multifaceted. While there are positive elements of theirintegration into the new society, inter-generational conflictsand identity confusion require further investigation to understand the context that will assist refugees to integrate more successfully into their new society. Given the length of stay of these refugees in Australia, government and settlement agencies may benefit from developing appropriate resources and process that are adaptive to the social and cultural context in which newly arrived refugees will live.

Keywords: cultural integration, inter-generational conflict, lived experiences, refugees, South sudanese

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670 Analyses of Adverse Drug Reactions Reported of Hospital in Taiwan

Authors: Yu-Hong Lin

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Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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669 ISIS and Social Media

Authors: Neda Jebellie

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New information and communication technologies (ICT) not only has revolutionized the world of communication but has also strongly impacted the state of international terrorism. Using the potential of social media, the new wave of terrorism easily can recruit new jihadi members, spread their violent ideology and garner financial support. IS (Islamic State) as the most dangerous terrorist group has already conquered a great deal of social media space and has deployed sophisticated web-based strategies to promote its extremist doctrine. In this respect the vastly popular social media are the perfect tools for IS to establish its virtual Caliphate (e-caliphate) and e-Ommah (e-citizen).Using social media to release violent videos of beheading journalists, burning their hostages alive and mass killing of prisoners are IS strategies to terrorize and subjugate its enemies. Several Twitter and Facebook accounts which are IS affiliations have targeted young generation of Muslims all around the world. In fact IS terrorists use modern resources of communication not only to share information and conduct operations but also justify their violent acts. The strict Wahhabi doctrine of ISIS is based on a fundamental interpretation of Islam in which religious war against non Muslims (Jihad) and killing infidels (Qatal) have been praised and recommended. Via social media IS disseminates its propaganda to inspire sympathizers across the globe. Combating this new wave of terrorism which is exploiting new communication technologies is the most significant challenge for authorities. Before the rise of internet and social media governments had to control only mosques and religious gathering such as Friday sermons(Jamaah Pray) to prevent spreading extremism among Muslims community in their country. ICT and new communication technologies have heighten the challenge of dealing with Islamic radicalism and have amplified its threat .According to the official reports even some of the governments such as UK have created a special force of Facebook warriors to engage in unconventional warfare in digital age. In compare with other terrorist groups, IS has effectively grasped social media potential. Their horrifying released videos on YouTube easily got viral and were re-twitted and shared by thousands of social media users. While some of the social media such as Twitter and Facebook have shut down many accounts alleged to IS but new ones create immediately so only blocking their websites and suspending their accounts cannot solve the problem as terrorists recreate new accounts. To combat cyber terrorism focusing on disseminating counter narrative strategies can be a solution. Creating websites and providing online materials to propagate peaceful and moderate interpretation of Islam can provide a cogent alternative to extremist views.

Keywords: IS-islamic state, cyber terrorism, social media, terrorism, information, communication technologies

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668 Numerical Simulation of Phase Transfer during Cryosurgery for an Irregular Tumor Using Hybrid Approach

Authors: Rama Bhargava, Surabhi Nishad

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The infusion of nanofluids has dramatically enhanced the heat-carrying capacity of the fluids, applicable to many engineering and medical process where the temperature below freezing is required. Cryosurgery is an efficient therapy for the treatment of cancer, but sometimes the excessive cooling may harm the nearby healthy cells. Efforts are therefore done to develop a model which can cause to generate the low temperature as required. In the present study, a mathematical model is developed based on the bioheat transfer equation to simulate the heat transfer from the probe on a tumor (with irregular domain) using the hybrid technique consisting of element free Galerkin method with αα-family of approximation. The probe is loaded will nano-particles. The effects of different nanoparticles, namely Al₂O₃, Fe₃O₄, Au on the heat-producing rate, is obtained. It is observed that the temperature can be brought to (60°C)-(-30°C) at a faster freezing rate on the infusion of different nanoparticles. Besides increasing the freezing rate, the volume of the nanoparticle can also control the size and growth of ice crystals formed during the freezing process. The study is also made to find the time required to achieve the desired temperature. The problem is further extended for multi tumors of different shapes and sizes. The irregular shape of the frozen domain and the direction of ice growth are very sensitive issues, posing a challenge for simulation. The Meshfree method has been one of the accurate methods in such problems as a domain is naturally irregular. The discretization is done using the nodes only. MLS approximation is taken in order to generate the shape functions. Sufficiently accurate results are obtained.

Keywords: cryosurgery, EFGM, hybrid, nanoparticles

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667 Corticomotor Excitability after Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Ischemic Stroke Patients

Authors: Asrarul Fikri Abu Hassan, Muhammad Hafiz bin Hanafi, Jafri Malin Abdullah

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This study is to compare the motor evoked potential (MEP) changes using different settings of repetitive transcranial magnetic stimulation (rTMS) in the post-haemorrhagic stroke patient which treated conservatively. The goal of the study is to determine changes in corticomotor excitability and functional outcome after repetitive transcranial magnetic stimulation (rTMS) therapy regime. 20 post-stroke patients with upper limb hemiparesis were studied due to haemorrhagic stroke. One of the three settings; (I) Inhibitory setting, or (II) facilitatory setting, or (III) control group, no excitatory or inhibitory setting have been applied randomly during the first meeting. The motor evoked potential (MEP) were recorded before and after application of the rTMS setting. Functional outcomes were evaluated using the Barthel index score. We found pre-treatment MEP values of the lesional side were lower compared to post-treatment values in both settings. In contrast, we found that the pre-treatment MEP values of the non-lesional side were higher compared to post-treatment values in both settings. Interestingly, patients with treatment, either facilitatory setting and inhibitory setting have faster motor recovery compared to the control group. Our data showed both settings might improve the MEP of the upper extremity and functional outcomes in the haemorrhagic stroke patient.

Keywords: Barthel index, corticomotor excitability, motor evoked potential, repetitive transcranial magnetic stimulation, stroke

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666 Using the Minnesota Multiphasic Personality Inventory-2 and Mini Mental State Examination-2 in Cognitive Behavioral Therapy: Case Studies

Authors: Cornelia-Eugenia Munteanu

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From a psychological perspective, psychopathology is the area of clinical psychology that has at its core psychological assessment and psychotherapy. In day-to-day clinical practice, psychodiagnosis and psychotherapy are used independently, according to their intended purpose and their specific methods of application. The paper explores how the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Mini Mental State Examination-2 (MMSE-2) psychological tools contribute to enhancing the effectiveness of cognitive behavioral psychotherapy (CBT). This combined approach, psychotherapy in conjunction with assessment of personality and cognitive functions, is illustrated by two cases, a severe depressive episode with psychotic symptoms and a mixed anxiety-depressive disorder. The order in which CBT, MMPI-2, and MMSE-2 were used in the diagnostic and therapeutic process was determined by the particularities of each case. In the first case, the sequence started with psychotherapy, followed by the administration of blue form MMSE-2, MMPI-2, and red form MMSE-2. In the second case, the cognitive screening with blue form MMSE-2 led to a personality assessment using MMPI-2, followed by red form MMSE-2; reapplication of the MMPI-2 due to the invalidation of the first profile, and finally, psychotherapy. The MMPI-2 protocols gathered useful information that directed the steps of therapeutic intervention: a detailed symptom picture of potentially self-destructive thoughts and behaviors otherwise undetected during the interview. The memory loss and poor concentration were confirmed by MMSE-2 cognitive screening. This combined approach, psychotherapy with psychological assessment, aligns with the trend of adaptation of the psychological services to the everyday life of contemporary man and paves the way for deepening and developing the field.

Keywords: assessment, cognitive behavioral psychotherapy, MMPI-2, MMSE-2, psychopathology

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665 Streptococcus anginosus Infections; Clinical and Bacteriologic Characteristics: A 6-Year Retrospective Study of Adult Patients in Qatar

Authors: Adila Shaukat, Hussam Al Soub, Muna Al Maslamani, Abdullatif Al Khal

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Background: The aim of this study was to assess clinical presentation and antimicrobial susceptibility of Streptococcus (S.) anginosus group infections in Hamad General Hospital, a tertiary care hospital in the state of Qatar, which is a multinational community. The S. anginosus group is a subgroup of viridans streptococci that consist of 3 different species: S. anginosus, S. constellatus, and S. intermedius. Although a part of the human bacteria flora, they have potential to cause suppurative infections. Method: We studied a total of 101 patients with S. anginosus group infections from January 2006 until March 2012 by reviewing medical records and identification of organisms by VITEK 2 and MALDI-TOF. Results: The most common sites of infection were skin and soft tissue, intra-abdominal, and bacteremia (28.7%, 24.8%, and 22.7%, respectively). Abscess formation was seen in approximately 30% of patients. Streptococcus constellatus was the most common isolated species (40%) followed by S. anginosus(30%) and S. intermedius(7%). In 23% of specimens, the species was unidentified. The most common type of specimen for organism isolation was blood followed by pus and tissue (50%, 22%, and 8%, respectively). Streptococcus constellatus was more frequently associated with abdominal and skin and soft tissue infections than the other 2 species, whereas S. anginosus was isolated more frequently from blood. All isolates were susceptible to penicillin, ceftriaxone, and vancomycin. Susceptibility to erythromycin and clindamycin was also good, reaching 91% and 95%, respectively. Forty percent of patients needed surgical drainage along with antibiotic therapy. Conclusions: Identification of S. anginosus group to species level is helpful in clinical practice because different species exhibit different pathogenic potentials.

Keywords: abscess, bacterial infection, bacteremia, Streptococcus anginosus

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664 Exploring the Social Health and Well-Being Factors of Hydraulic Fracturing

Authors: S. Grinnell

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A PhD Research Project exploring the Social Health and Well-Being Impacts associated with Hydraulic Fracturing, with an aim to produce a Best Practice Support Guidance for those anticipating dealing with planning applications or submitting Environmental Impact Assessments (EIAs). Amid a possible global energy crisis, founded upon a number of factors, including unstable political situations, increasing world population growth, people living longer, it is perhaps inevitable that Hydraulic Fracturing (commonly referred to as ‘fracking’) will become a major player within the global long-term energy and sustainability agenda. As there is currently no best practice guidance for governing bodies the Best Practice Support Document will be targeted at a number of audiences including, consultants undertaking EIAs, Planning Officers, those commissioning EIAs Industry and interested public stakeholders. It will offer a robust, evidence-based criteria and recommendations which provide a clear narrative and consistent and shared approach to the language used along with containing an understanding of the issues identified. It is proposed that the Best Practice Support Document will also support the mitigation of health impacts identified. The Best Practice Support Document will support the newly amended Environmental Impact Assessment Directive (2011/92/EU), to be transposed into UK law by 2017. A significant amendment introduced focuses on, ‘higher level of protection to the environment and health.’ Methodology: A qualitative research methods approach is being taken with this research. It will have a number of key stages. A literature review has been undertaken and been critically reviewed and analysed. This was followed by a descriptive content analysis of a selection of international and national policies, programmes and strategies along with published Environmental Impact Assessments and associated planning guidance. In terms of data collection, a number of stakeholders were interviewed as well as a number of focus groups of local community groups potentially affected by fracking. These were determined from across the UK. A theme analysis of all the data collected and the literature review will be undertaken, using NVivo. Best Practice Supporting Document will be developed based on the outcomes of the analysis and be tested and piloted in the professional fields, before a live launch. Concluding statement: Whilst fracking is not a new concept, the technology is now driving a new force behind the use of this engineering to supply fuels. A number of countries have pledged moratoria on fracking until further investigation from the impacts on health have been explored, whilst other countries including Poland and the UK are pushing to support the use of fracking. If this should be the case, it will be important that the public’s concerns, perceptions, fears and objections regarding the wider social health and well-being impacts are considered along with the more traditional biomedical health impacts.

Keywords: fracking, hydraulic fracturing, socio-economic health, well-being

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663 Effects of Turkish Classical Music on Cognitive Function, Depression and Quality of Life in Elderly

Authors: Rukiye Pinar Boluktas

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According to 2015 statistics, in Turkey, 46% of older people live alone in their homes, 55% have poor health perceptions, 18% face poverty, and 43% are unhappy. Prevalence of depression is between 14% and 20%. In 2013, rate of suicide was 6.5. However, the most of older people prefer to live in their community although they are lonely, they face poverty, and face limitations as a result of chronic diseases and disabilities. Community based care for older people is also encouraged by Ministry of Health as it is more cost-effective. Music therapy is a simple, effective, safe, and nonpharmacologic intervention that may be used to decrease depression and to improve cognition, and health related quality of life (HRQOL). In Turkish culture, music is typically described as ‘food for soul’. This study aimed to investigate the effect of Turkish classical music songs in 32 community dwelling older people. Participants were received interventions two or three times per week, 50-60 min per session, for 8 weeks at a day health center. Each intervention session started listening music for 15-20 min to get remember songs, then followed singing songs as a group. Participants were assessed at baseline (week 0), and two follow-up at month 1 and month 2. Compared to baseline, at two follow-up, we observed that cognition improved, depression decreased, and SF-36 scores, including 8 domains and two summary scores increased. We conclude that an intervention comprising listening and singing Turkish classical music improve cognition, depression and HRQOL in older people.

Keywords: cognitive function, depression, elderly, quality of life, Turkish classical music

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662 Exploring Artistic Creation and Autoethnography in the Spatial Context of Geography

Authors: Sinem Tas

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This research paper attempts to study the perspective of personal experience in relation to spatial dynamics and artistic outcomes within the realm of cultural identity. This article serves as a partial analysis within a broader PhD investigation that focuses on the cultural dynamics and political structures behind cultural identity through an autoethnography of narrative while presenting its correlation with artistic creation in the context of space and people. Focusing on the artistic/creative practice project AUTRUI, the primary goal is to analyse and understand the influence of personal experiences and culturally constructed identity as an artist in resulting in the compositional modality of the last image considering self-reflective experience. Referencing the works of Joyce Davidson and Christine Milligan - the scholars who emphasise the importance of emotion and spatial experience in geographical studies contribute to this work as they highlight the significance of emotion across various spatial scales in their work Embodying Emotion Sensing Space: Introducing Emotional Geographies (2004). Their perspective suggests that understanding emotions within different spatial contexts is crucial for comprehending human experiences and interactions with space. Incorporating the insights of scholars like Yi-Fu Tuan, particularly his seminal work Space and Place: The Perspective of Experience (1979), is important for creating an in-depth frame of geographical experience. Tuan's humanistic perspective on space and place provides a valuable theoretical framework for understanding the interplay between personal experiences and spatial contexts. A substantial contextualisation of the geopolitics of Turkey - the implications for national identity and cohesion - will be addressed by drawing an outline of the political and geographical frame as a methodological strategy to understand the dynamics behind this research. Besides the bibliographical reading, the methods used to study this relation are participatory observation, memory work along with memoir analysis, personal interviews, and discussion of photographs and news. The utilisation of the self as data requires the analysis of the written sources with personal engagement. By delving into written sources such as written communications or diaries as well as memoirs, the research gains a firsthand perspective, enriching the analytical depth of the study. Furthermore, the examination of photography and news articles serves as a valuable means of contextualising experiences from a journalist's background within specific geographical settings. The inclusion of interviews with close family members access provides firsthand perspectives and intimate insights rooted in shared experiences within similar geographical contexts, offering complementary insights and diversified viewpoints, enhancing the comprehensiveness of the investigation.

Keywords: art, autoethnography, place and space, Turkey

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661 Study of Demographic, Hematological Profile and Risk Stratification in Chronic Myeloid Leukemia Patients

Authors: Rajandeep Kaur, Rajeev Gupta

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Background: Chronic myeloid leukemia (CML) is the most common leukaemia in India. The annual incidence of chronic myeloid leukemia in India was originally reported to be 0.8 to 2.2 per 1,00,000 population. CML is a clonal disorder that is usually easily diagnosed because the leukemic cells of more than 95% of patients have a distinctive cytogenetic abnormality, the Philadelphia chromosome (Ph1). The approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity, has significantly reduced the mortality rate associated with chronic myeloid leukemia (CML) and revolutionized treatment. Material and Methods: 80 diagnosed cases of CML were taken. Investigations were done. Bone marrow and molecular studies were also done and with EUTOS, patients were stratified into low and high-risk groups and then treatment with Imatinib was given to all patients and the molecular response was evaluated at 6 months and 12 months follow up with BCR-ABL by RT-PCR quantitative assay. Results: In the study population, out of 80 patients in the study population, 40 were females and 40 were males, with M: F is 1:1. Out of total 80 patients’ maximum patients (54) were in 31-60 years age group. Our study showed a most common symptom of presentation is abdominal discomfort followed by fever. Out of the total 80 patients, 25 (31.3%) patients had high EUTOS scores and 55 (68.8%) patients had low EUTOS scores. On 6 months follow up 36.3% of patients had Complete Molecular Response, 16.3% of patients had Major Molecular Response and 47.5% of patients had No Molecular Response but on 12 months follow up 71.3% of patients had Complete Molecular Response, 16.25% of patients had Major Molecular Response and 12.5% patients had No Molecular Response. Conclusion: In this study, we found a significant correlation between EUTOS score and Molecular response at 6 months and 12 months follow up after Imatinib therapy.

Keywords: chronic myeloid leukemia, European treatment and outcome study score, hematological response, molecular response, tyrosine kinase inhibitor

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660 The Effects of Traditional Thai Massage Technique Delivered by Parents on Stereotypical Behaviors in Children with Autism: A Pilot Study

Authors: Chanada Aonsri, Wichai Eungpinichpong

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Stereotypical behavior is one of the learning and social skills development problems that affect children with autism. Previous studies found that traditional Thai massage (TTM) could reduce stereotypical behaviors in autistic children. However, the effects of TTM delivered by the parents of autistic children have not been explored. This pilot study investigated the effects of TTM by parents on stereotypical behaviors in children with autism. A one-group pretest-posttest design was applied for 15 children, aged 4-16 years, with their parents' permissions. They participated in the study at the Special Education program of the Special Education Center of Khon Kaen University, Thailand. After being trained in a specialized TTM for children, the parents delivered 50-minute TTM to children once a day, twice a week for eight weeks. The severity of autism and autistic behaviors were measured using the Childhood Autism Rating Scale (CARS), and the Autism Treatment Evaluation Checklist (ATEC), respectively. The functions of autonomic nervous systems were measured using Heart Rate Variability (HRV) to indicated physical and mental disorders such as stress. The data at baseline and the 8th week were analyzed using either an independent t-test or Wilcoxon signed-rank test. The study found that 16 sessions of TTM significantly improved measured data for autism in all children including the CARS (p<0.001), ATEC, speech/language/communication (p<0.001), sociability (p<0.001), sensory/cognitive awareness (p<0.001), health/physical/behavior (p < 0.001), and HRV (p<0.001). The results indicated that TTM performed by parents could be useful as an adjunct therapy for autistic children as it can reduce stereotypical behaviors and stress.

Keywords: traditional Thai massage, stereotypical behaviors, Autistic children, parent

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