Search results for: politically exposed persons
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2541

Search results for: politically exposed persons

2481 Absence of Malignancy in Oral Epithelial Cells from Individuals Occupationally Exposed to Organic Solvents Working in the Shoe Industry

Authors: B. González-Yebra, B. Flores-Nieto, P. Aguilar-Salinas, M. Preciado Puga, A. L. González Yebra

Abstract:

The monitoring of populations occupationally exposed to organic solvents has been an important issue for several shoe factories for years since the International Agency for Research on Cancer (IARC) has advised on the potential carcinogenic risk of chemicals related to occupations. In order to detect if exposition to organic solvents used in some Mexican shoe factories contributes to oral carcinogenesis, we performed monitoring in three factories. Occupational exposure was determined by using monitors 3M. Organic solvents were assessed by gas chromatography. Then, we recruited 30 shoe workers (30.2 ± 8.4 years) and 10 unexposed subjects (43.3 ± 11.2 years) for the micronuclei (MN) test and immunodetection of some cancer biomarkers (ki-67, p16, caspase-3) in scraped oral epithelial cells. Monitored solvents detected were acetone, benzene, hexane, methyl ethyl ketone, and toluene in acceptable levels according to Official Mexican Norm. We found by MN test higher incidence of nuclear abnormalities (karyorrhexis, pycnosis, karyolysis, condensed chromatin, and macronuclei) in the exposed group than the non-exposed group. On the other hand, we found, a negative expression for Ki-67 and p16 in exfoliated epithelial cells from exposed and non-exposed to organic solvents subjects. Only caspase-3 shown positive patter of expression in 9/30 (30%) exposed subjects, and we detected high karyolysis incidence in caspase-3 subjects (p = 0.021). The absence of expression of proliferation markers p16 and ki-67 and presence of apoptosis marker caspase-3 are indicating the absence of malignancy in oral epithelial cells and low risk for oral cancer. It is a fact that the MN test is a very effective method to detect nuclear abnormalities in exfoliated buccal cells from subjects that have been exposed to organic solvents in the shoe industry. However, in order to improve this tool and predict cancer risk is it is mandatory to implement complementary tests as other biomarkers that can help to detect malignancy in individuals occupationally exposed.

Keywords: biomarkers, oral cancer, organic solvents, shoe industries

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2480 The Socio-Demographics of HIV-Infected Persons with Psychological Morbidity in Zaria, Nigeria

Authors: Obiageli Helen Ezeh, Chuks Clement Ezeh

Abstract:

Background: It is estimated that more than 330 million persons are living with HIV-infection globally and in Nigeria about 3.4 persons are living with the infection, with an annual death rate of 180,000. Psychological morbidity often accompany chronic illnesses and may be associated with substance abuse, poor health seeking behavior and adherence to treatment program; it may worsen existing health problems and the overall quality of life. Until the burden is effectively identified, intervention cannot be planned. Until there is a cure, the goal is to manage and cope effectively with HIV-infection. Little if any studies have been done in this area in the North West geo-political zone of Nigeria. The study would help to identify high risk groups and prevent the progression and spread of the infection. Aim: To identify HIV-infected persons with psychological morbidity, accessing HIV- clinic at Shika Hospital, Zaria, Kaduna State; and analyze their socio-demographic profile. Methods: A cross sectional descriptive study was carried out to assess and analyze the socio-demographic characteristics of HIV-infected persons attending Shika hospital Zaria Nigeria, who screened positive for psychological morbidity. A total of 109 HIV-infected persons receiving HAART at Shika clinic, Zaria, Kaduna State, Nigeria, were administered questionnaires, the General Health Questionnaire (GHQ-12)measuring psychological morbidity and socio-demographic data. The participants ranged in age between 18 and 75 years. Results: Data were analyzed using SPSS software 15. Both descriptive and inferential Statistics were performed on the data. Results indicate a total prevalent rate of psychological morbidity of 78 percent among participants. Of this, about 16.2 percent were severely distressed, 25.1 percent moderately distressed and 36.7percent were mildly distressed. More females (65 percent of those with psychological morbidity) were found to be distressed than their male (55 percent) counterparts. It was (44 percent) for patients whose HIV-infection was of relatively shorter duration(2-4 years) than those of longer duration(5-9 years; and 10 years/above). The age group (21-30 years) was the most affected (35 percent). The rate was also 55 percent for Christians and 45 percent for Muslims. For married patients with partners it was 20 percent and for singles 30 percent; for the widowed (12 percent) and divorced (38 percent). At the level of tribal/ethnic groups, it was 13 percent for Ibos, 22 percent for Yorubas, 27 percent for Hausas and 33 percent for all the other minority tribes put together. Conclusion/Recommendation: The study has been able to identify the presence of psychological morbidity among HIV-infected persons as high and analyze the socio-demographic factors associated with it as significant. Periodic screening of HIV-infected persons for psychological morbidity and psychosocial intervention was recommended.

Keywords: socio-demographics, psychological morbidities, HIV-Infection, HAART

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2479 The Affect of Ethnic Minority People: A Prediction by Gender and Marital Status

Authors: A. K. M. Rezaul Karim, Abu Yusuf Mahmud, S. H. Mahmud

Abstract:

The study aimed to investigate whether the affect (experience of feeling or emotion) of ethnic minority people can be predicted by gender and marital status. Toward this end, positive affect and negative affect of 103 adult indigenous persons were measured. Analysis of data in multiple regressions demonstrated that both gender and marital status are significantly associated with positive affect (Gender: β=.318, p < .001; Marital status: β=.201, p < .05), but not with negative affect. Results indicated that the indigenous males have 0.32 standard deviations increased positive affect as compared to the indigenous females and that married individuals have 0.20 standard deviations increased positive affect as compared to their unmarried counterparts. These findings advance our understanding that gender and marital status inequalities in the experience of emotion are not specific to the mainstream society; rather it is a generalized picture of all societies. In general, men possess more positive affect than females; married persons possess more positive affect than the unmarried persons.

Keywords: positive affect, negative affect, ethnic minority, gender, marital status

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2478 Coping Strategies Used by Persons with Spinal Cord Injury: A Rehabilitation Hospital Based Qualitative Study

Authors: P. W. G. D. P. Samarasekara, S. M. K. S. Seneviratne, D. Munidasa, S. S. Williams

Abstract:

Sustaining a spinal cord injury (SCI) causes severe disruption of all aspects of a person’s life, resulting in the difficult process of coping with the distressing effects of paralysis affecting their ability to lead a meaningful life. These persons are hospitalized in the acute stage of injury and subsequently for rehabilitation and the treatment of complications. The purpose of this study was to explore coping strategies used by persons with SCI during their rehabilitation period. A qualitative study was conducted among persons with SCI, undergoing rehabilitation at the Rheumatology and Rehabilitation Hospitals, Ragama and Digana Sri Lanka. Twelve participants were selected purposively to represent both males and females, with cervical, thoracic or lumbar levels of injuries due to traumatic and non-traumatic causes as well as from different socioeconomic backgrounds. Informed consent was taken from the participants. In-depth interviews were conducted using an interview guide to collect data. Probes were used to get more information and to encourage participants. Interviews were audio taped and transcribed verbatim. Qualitative content analysis was conducted. Ethical approval for this study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya. Five themes were identified in the content analysis: social support, religious beliefs, determination, acceptance and making comparisons. Participants indicated that the support from their family members had been an essential factor in coping, after sustaining an SCI and they expressed the importance of emotional support from family members during their rehabilitation. Many participants had a strong belief towards the God, who had a personal interest in their lives, played an important role in their ability to cope with the injury. They believed that what happens to them in this life results from their actions in previous lives. They expressed that determination was essential as a factor that helps them cope with their injury. They indicated their focus on the positive aspects of the life and accepted the disability. They made comparisons to other persons who were worse off than them to help lift them out of unpleasant experience. Even some of the most severely injured and disabled participants presented evidence of using this coping strategy. Identification of coping strategies used by persons with SCI will help nurses and other health-care professionals in reinforcing the most effective coping strategies among persons with SCI. The findings recommend that engagement coping positively influences psychosocial adaptation.

Keywords: content analysis, coping strategies, rehabilitation, spinal cord injury

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2477 Emergency Management of Poisoning Tracery Care Hospital in India

Authors: Rajiv Ratan Singh, Sachin Kumar Tripathi, Pradeep Kumar Yadav

Abstract:

The timely evaluation, diagnosis, and treatment of people who have been exposed to toxic chemicals is a crucial component of emergency poison management in the medical field. The various substances that can poison include chemicals, medications, and naturally occurring poisons. The toxicology of the particular drug involved, as well as the symptoms and indicators of poisoning, must be thoroughly understood to handle poisoning emergencies effectively. One of the most important aspects of emergency poison management in medicine is the prompt examination, diagnosis, and treatment of persons who have been exposed to dangerous substances. To properly manage poisoning crises, one must have a good understanding of the toxicology of the particular medication concerned, as well as the signs and indicators of poisoning. Emergency management of poisoning includes not only prompt medical attention but also patient education, follow-up care, and monitoring for any long-term consequences. To achieve the greatest results for patients, the management of poisoning is a complicated and dynamic process that calls for collaboration between medical professionals, first responders, and toxicologists. All poisoned patients who present to the emergency room are assessed and diagnosed based on a collection of symptoms and a biochemical diagnosis, and they are then provided targeted, specialized treatment for the toxin identified. This article focuses on the loxodromic strategy as the primary method of treatment for poisoned patients. The authors of this article conclude that mortality and morbidity can be reduced if patients visit the emergency room promptly and receive targeted treatment.

Keywords: antidotes, blood poisoning, emergency medicine, gastric lavage, medico-legal aspects, patient care

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2476 Basic Examination of Easily Distinguishable Tactile Symbols Attached to Containers and Packaging

Authors: T. Nishimura, K. Doi, H. Fujimoto, Y. Hoshikawa, T. Wada

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In Japan, it is expected that reasonable accommodation for persons with disabilities will progress further. In particular, there is an urgent need to enhance information support for visually impaired persons who have difficulty accessing information. Recently, tactile symbols have been attached to various surfaces, such as the content labels of containers and packaging of various everyday products. The advantage of tactile symbols is that they are useful for visually impaired persons who cannot read Braille. The method of displaying tactile symbols is prescribed by the International Organization for Standardization (ISO). However, the quantitative data on the shapes and dimensions of tactile symbols is insufficient. In this study, through an evaluation experiments, we examine the easy-to-distinguish shapes and dimensions of tactile symbols used for various applications, including the content labels on containers and packaging. Visually impaired persons participated in the experiments. They used tactile symbols on a daily basis. The details and processes of the experiments were orally explained to the participants prior to the experiments, and the informed consent of the participants was obtained. They were instructed to touch the test pieces of tactile symbols freely with both hands. These tactile symbols were selected because they were likely to be easily distinguishable symbols on the content labels of top surfaces of containers and packaging based on a hearing survey that involved employees of an organization of visually impaired and a social welfare corporation, as well as academic experts of support technology for visually impaired. The participants then answered questions related to ease of distinguishing of tactile symbols on a scale of 5 (where 1 corresponded to ‘difficult to distinguish’ and 5 corresponded to ‘easy to distinguish’). Hearing surveys were also performed in an oral free answer manner with the participants after the experiments. This study revealed the shapes and dimensions regarding easily distinguishable tactile symbols attached to containers and packaging. We expect that this knowledge contributes to improvement of the quality of life of visually impaired persons.

Keywords: visual impairment, accessible design, tactile symbol, containers and packaging

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2475 Call Me By My Name: Portrayal of Albinism in Kiswahili Literature

Authors: Elizabeth Godwin Mahenge

Abstract:

This study seeks to investigate the portrayal of albinism in Swahili literature. People with albinism have faced many life-threatening challenges, from being hunted for their body parts of being assigned derogatory names that depict them as ghosts as or less than humans. Many studies have been conducted on the perception of people towards Persons with Albinism [PWA] worldwide. Findings showed there is negative perception or negative portrayal of PWA in different societies worldwide. These negative connotations raised hot debates around the world among different societies and associations of/for PWA. People with disability in different parts of the world started arguing the labeling and name calling same applied to persons with disability in Tanzania (albinism included). They went the same debate about name calling hence in 2010, the Tanzanian Parliament passed the bill on Persons with Disability Act which banned derogative names attached to disability in general and to albinism in particular. In Tanzanian societies, there have been a mixed feelings with regards to albinism. Some do have negative perceptions because of the killings with connection to superstitious believes, while in other societies are perceived positively as blessed children a family. From these two contradictory perceptions that exist in this society, the study seeks to find out how Swahili literature portrays albinism.

Keywords: albinism, portrayal, disability, Kiswahili literature

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2474 Exposure to Violence and Its Association with Mental Health in Swedish Prospective Exchange Students and Campus Students

Authors: Emil Danehorn, Ulla Peterson, Marie Oscarsson, Goldina Smirthwaite, Katarina Swahnberg

Abstract:

Swedish students who choose to study abroad are common, but there has been limited research on exchange students. There are indications that some Swedish exchange students have been exposed to violence, but it is not known if they, already before their semester abroad, are more exposed to violence than students who remain on campus. Our aim was to investigate potential differences in exposure to physical, sexual, and emotional violence between prospective exchange students and campus students and between male and female students in general, as well as to determine any associations between mental health and exposure to violence among students in the total sample. Method: Comparative cross-sectional design using an online survey containing the NorVold Abuse Questionnaire and the General Health Questionnaire 12. A total of 565 participants took part in the study. Results: Prospective exchange students were less exposed to emotional violence compared to campus students. About one-half of all the participating female students had been exposed to sexual violence and about one-third of all the male students had been exposed to physical violence. The results also indicated that exposure to more than one form of violence was associated with poor mental health for students as a group. Conclusion: Prospective exchange students as a group do not report more exposure to physical and sexual violence than campus students but do report less exposure to emotional violence. However, the overall frequency of exposure to violence among the students was high. This highlights the need for proactive efforts for everyone, not least for exchange students who will be staying in a new environment unknown to them.

Keywords: sexual violence, physical violence, emotional violence, exchange students, mental health

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2473 DNA Damage and Apoptosis Induced in Drosophila melanogaster Exposed to Different Duration of 2400 MHz Radio Frequency-Electromagnetic Fields Radiation

Authors: Neha Singh, Anuj Ranjan, Tanu Jindal

Abstract:

Over the last decade, the exponential growth of mobile communication has been accompanied by a parallel increase in density of electromagnetic fields (EMF). The continued expansion of mobile phone usage raises important questions as EMF, especially radio frequency (RF), have long been suspected of having biological effects. In the present experiments, we studied the effects of RF-EMF on cell death (apoptosis) and DNA damage of a well- tested biological model, Drosophila melanogaster exposed to 2400 MHz frequency for different time duration i.e. 2 hrs, 4 hrs, 6 hrs,8 hrs, 10 hrs, and 12 hrs each day for five continuous days in ambient temperature and humidity conditions inside an exposure chamber. The flies were grouped into control, sham-exposed, and exposed with 100 flies in each group. In this study, well-known techniques like Comet Assay and TUNEL (Terminal deoxynucleotide transferase dUTP Nick End Labeling) Assay were used to detect DNA damage and for apoptosis studies, respectively. Experiments results showed DNA damage in the brain cells of Drosophila which increases as the duration of exposure increases when observed under the observed when we compared results of control, sham-exposed, and exposed group which indicates that EMF radiation-induced stress in the organism that leads to DNA damage and cell death. The process of apoptosis and mutation follows similar pathway for all eukaryotic cells; therefore, studying apoptosis and genotoxicity in Drosophila makes similar relevance for human beings as well.

Keywords: cell death, apoptosis, Comet Assay, DNA damage, Drosophila, electromagnetic fields, EMF, radio frequency, RF, TUNEL assay

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2472 Ideation, Plans, and Attempts for Suicide among Adolescents with Disability

Authors: Nyla Anjum, Humaira Bano

Abstract:

Disability, regardless of its type and nature limits one or two significant life activities. These limitations constitute risk factors for suicide. Rate and intensity of problem upsurges in critical age of adolescence. Researches in the field of mental health over look problem of suicide among persons with disability. Aim of the study was to investigate prevalence and risk factors for suicide among adolescents with disability. The study constitutes purposive sample of 106 elements of both gender with four major categories of disability: hearing impairment, physical impairment, visual impairment and intellectual disabilities. Face to face interview technique was opted for data collection. Other variable are: socio-economic status, social and family support, provision of services for persons with disability, education and employment opportunities. For data analysis independent sample t-test was applied to find out significant differences in gender and One Way Analysis of variance was run to find out differences among four types of disability. Major predictors of suicide were identified with multiple regression analysis. It is concluded that ideation, plans and attempts of suicide among adolescents with disability is a multifaceted and imperative concern in the area of mental health. Urgent research recommendations contains valid measurement of suicide rate and identification of more risk factors for suicide among persons with disability. Study will also guide towards prevention of this pressing problem and will bring message of happy and healthy life not only for persons with disability but also for their families. It will also help to reduce suicide rate in society.

Keywords: suicide, risk factors, adolescent, disability, mental health

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2471 An Assessment on Awareness of Public Transport Policies for Persons with Disabilities in Three South-West Nigerian States

Authors: Julius A. Ademokoya, Grace C. Ilori

Abstract:

Extreme public transport difficulty for persons with disabilities (PWDs) has always been one of the challenges which these individuals experience on a daily basis in Nigeria. Private and public transport vehicles are not disability- friendly. Operators of public transport are often very intolerant of PWDs' conditions. Indeed, many Nigerians believe it is luxury for PWDs to engage in public transport. They are rarely expected to be seen in public much less going to places via public transport means. Initiatives by a few Nigerian states to develop and implement public transport policies for PWDs, therefore, were a huge relief for them and some concerned Nigerians. A few years ago, three southwest Nigerian states (Lagos, Ondo, and Ekiti) came up with some legislative welfare provisions (including transport programmes) for PWDs. This study, therefore, sought to ascertain levels of awareness and implementation of public policies among the PWDs and those expected to implement the policies. The study adopted a mixed method research. Findings across the three states showed that: (1) awareness of public policies among PWDs is low and (2) a considerable scope of the policies is not yet implemented. Recommendations are, therefore, made on how to improve on awareness and implementation of transport policies for PWDs in three south-west Nigerian states.

Keywords: awareness, disability rights, implementation persons with disability, transport policies

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2470 Occupational Challenges and Adjustment Strategies of Internally Displaced Persons in Abuja, Nigeria

Authors: David Obafemi Adebayo

Abstract:

An occupational challenge has been identified as one of the factors that could cripple set goals and life ambitions of an Internally Displaced Person (IDP). The main thrust of this study is therefore, explore the use of life support/adjustment strategy with a view to repositioning these internally displaced persons in Nigeria in revamping their goals and achieving their life-long ambitions. The study intends to investigate whether there exist, on the basis of gender, religion, years of working experience and educational qualification any significant difference in the occupational challenges and adjustment strategies of IDPs. The study being descriptive of survey type adopted a multi-stage sampling technique to select the minimum of 400 internally displaced persons from IDP camps in Yimitu Village, Waru District in the Federal Capital Territory (FCT), Abuja. The research instrument used for the study was a researcher-designed questionnaire entitled “Questionnaire on Occupational Challenges and Adjustment Strategy of Internally Displaced Persons (QOCASIDPs)”. Eight null hypotheses were tested at 0.05 alpha levels of significance. Frequency counts and percentages, means and rank order, t-test, Analysis of Variance (ANOVA) and Duncan Multiple Range Test (DMRT) (where applicable) were employed to analyze the data. The Study determined whether occupational challenges of internally displaced persons included loss of employment, vocational discrimination, marginalization by employers of labour, isolation due to joblessness, lack of occupational freedom, which were found to be true. The results were discussed in line with the findings. The study established the place of notable adjustment strategies adopted by internally displaced person like engaging in petty trading, sourcing soft loans from NGOs, setting up small-scale businesses in groups, acquiring new skills, engaging in further education, among others. The study established that there was no significant difference in the occupational challenges of IDPs on the basis of years of working experience and highest educational qualifications, though there was significant difference on the basis of gender as well as religion. Based on the findings of the study, recommendations were made.

Keywords: internally displaced persons, occupational challenges, adjustment strategies, Abuja-Nigeria

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2469 Expert-Based Validated Measures for Improving Quality Healthcare Services Utilization among Elderly Persons: A Cross-Section Survey

Authors: Uchenna Cosmas Ugwu, Osmond Chukwuemeka Ene

Abstract:

Globally, older adults are considered the most vulnerable groups to age-related diseases including diabetes mellitus, obesity, cardiovascular diseases, cancer and osteoporosis. With improved access to quality healthcare services, these complications can be prevented and the incidence rates reduced to the least occurrence. The aim of this study is to validate appropriate measures for improving quality healthcare services utilization among elderly persons in Nigeria and also to determine the significant association within demographic variables. A cross-sectional survey research design was adopted. Using a convenient sampling technique, a total of 400 experts (150 registered nurses and 250 public health professionals) with minimum of doctoral degree qualification were sampled and studied. A structured instrument titled “Expert-Based Healthcare Services Utilization Questionnaire (EBHSUQ) with .83 reliability index was used for data collection. All the statistical data analysis was completed using frequency counts, percentage scores and chi-square statistics. The results were significant at p≤0.05. It was found that quality healthcare services utilization by elderly persons in Nigeria would be improved if the services are: available (83%), affordable (82%), accessible (79%), suitable (77%), acceptable (77%), continuous (75%) and stress-free (75%). Statistically, significant association existed on quality healthcare services utilization with gender (p=.03<.05) and age (p=.01<.05) while none was observed on work experience (p=.23>.05), marital status (p=.11>.05) and employment category (p=.09>.05). To improve quality healthcare services utilization for elderly persons in Nigeria, the adoption of appropriate measures by Nigerian government and professionals in healthcare sectors are paramount. Therefore, there is need for collaborative efforts by the Nigerian government and healthcare professionals geared towards educating the general public through mass sensitization, awareness campaign, conferences, seminars and workshops for the importance of accessing healthcare services.

Keywords: elderly persons, healthcare services, cross-sectional survey research design, utilization.

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2468 Induced Emotional Empathy and Contextual Factors like Presence of Others Reduce the Negative Stereotypes Towards Persons with Disabilities through Stronger Prosociality

Authors: Shailendra Kumar Mishra

Abstract:

In this paper, we focus on how contextual factors like the physical presence of other perceivers and then developed induced emotional empathy towards a person with disabilities may reduce the automatic negative stereotypes and then response towards that person. We demonstrated in study 1 that negative attitude based on negative stereotypes assessed on ATDP-test questionnaires on five points Linkert-scale are significantly less negative when participants were tested with a group of perceivers and then tested alone separately by applying 3 (positive, indifferent, and negative attitude levels) X 2 (physical presence condition and alone) factorial design of ANOVA test. In the second study, we demonstrate, by applying regression analysis, in the presence of other perceivers, whether in a small group, participants showed more induced emotional empathy through stronger prosociality towards a high distress target like a person with disabilities in comparison of that of other stigmatized persons such as racial biased or gender-biased people. Thus results show that automatic affective response in the form of induced emotional empathy in perceiver and contextual factors like the presence of other perceivers automatically activate stronger prosocial norms and egalitarian goals towards physically challenged persons in comparison to other stigmatized persons like racial or gender-biased people. This leads to less negative attitudes and behaviour towards a person with disabilities.

Keywords: contextual factors, high distress target, induced emotional empathy, stronger prosociality

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2467 A Two-Week and Six-Month Stability of Cancer Health Literacy Classification Using the CHLT-6

Authors: Levent Dumenci, Laura A. Siminoff

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Health literacy has been shown to predict a variety of health outcomes. Reliable identification of persons with limited cancer health literacy (LCHL) has been proved questionable with existing instruments using an arbitrary cut point along a continuum. The CHLT-6, however, uses a latent mixture modeling approach to identify persons with LCHL. The purpose of this study was to estimate two-week and six-month stability of identifying persons with LCHL using the CHLT-6 with a discrete latent variable approach as the underlying measurement structure. Using a test-retest design, the CHLT-6 was administered to cancer patients with two-week (N=98) and six-month (N=51) intervals. The two-week and six-month latent test-retest agreements were 89% and 88%, respectively. The chance-corrected latent agreements estimated from Dumenci’s latent kappa were 0.62 (95% CI: 0.41 – 0.82) and .47 (95% CI: 0.14 – 0.80) for the two-week and six-month intervals, respectively. High levels of latent test-retest agreement between limited and adequate categories of cancer health literacy construct, coupled with moderate to good levels of change-corrected latent agreements indicated that the CHLT-6 classification of limited versus adequate cancer health literacy is relatively stable over time. In conclusion, the measurement structure underlying the instrument allows for estimating classification errors circumventing limitations due to arbitrary approaches adopted by all other instruments. The CHLT-6 can be used to identify persons with LCHL in oncology clinics and intervention studies to accurately estimate treatment effectiveness.

Keywords: limited cancer health literacy, the CHLT-6, discrete latent variable modeling, latent agreement

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2466 The Metaproteomic Analysis of HIV Uninfected Exposed Infants’ Gut Microbiome to Help Understand Their Poor Health Statuses in An African Cohort

Authors: Tara Miller, Tariq Ganief, Jonathan Blackburn

Abstract:

Millions of babies are still born to HIV-infected mothers each year despite the ramped-up HAART use. However, these infants are HIV uninfected but exposed, which is now a growing population that has weakened immune systems and poorer outcomes. Due to HIV exposure and possible ARV exposure during pregnancy and breastfeeding, these infants are believed to have altered immune responses and microbiomes when compared to their healthy counterparts. The gut microbiome roles an important role in infant development, specifically in the immune system. Research has shown these HIV-exposed, uninfected infants have weaker immune responses to their neonate vaccines, and in developing countries, this leaves them vulnerable to opportunistic disease. By gaining a deeper understanding of the gut microbiome and the products of the microbes via metaproteomic analysis, we can hopefully understand and improve the immune system and health of these infants. To investigate the metaproteome of the infants’ guts, mass spectrometry will be used, followed by data analysis using DIA-NN. The hypothesized results are that the HIV-exposed, uninfected infants have an altered microbiome compared to their healthy counterparts. Additionally, the differences found are hypothesized to be involved with inflammation which would contribute to the poor health of the infants.

Keywords: HIV, mass spectrometry, metaproteomics, microbiome

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2465 Written Narrative Texts as the Indicators of Communication Competence of Pupils and Students with Hearing Impairment in the Czech Language

Authors: Marie Komorna, Katerina Hadkova

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One reason why hearing disabilities as compared to other disabilities are considered to be less serious, is the belief that deaf and hard of hearing persons can read and write without problems and can therefore fairly easily compensate for problems related to their limited ability to hear sound. However in reality this is not the case, especially as regards written Czech, deaf persons are often not able to communicate their message clearly to its recipients. Their inability to communicate fully in written language is one of the most severe problems facing a number of deaf persons, a problem which they face and which makes it difficult for them to function in a sound-based environment. Despite this fact, this issue is one which has been given only a minimum of attention in the Czech Republic. That is why we decided to focus our research on this issue, specifically targeting written communication of deaf pupils in primary and secondary schools. The paper summarizes the background and objectives of this research. The written work of deaf respondents was obtained in response to a narrative based on a series of images which depicted a continuous storyline. Based on an analysis of the obtained written work we tried to describe the specifics of the narrative abilities of the deaf authors of these texts. We also analyzed other aspects and specific traits of text written by deaf authors at a phonetic-phonological, lexical-semantic, morphological and syntactic, respectively pragmatic level. Based on the results of the project it will be possible to increase knowledge of the communication abilities of deaf persons in written Czech. The obtained data may be used during future research and for teaching purposes and/or education concepts for teaching Czech to deaf pupils.

Keywords: communication competence, deaf, narrative, written texts

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2464 The Development of Monk’s Food Bowl Production on Occupational Health Safety and Environment at Work for the Strength of Rattanakosin Local Wisdom

Authors: Thammarak Srimarut, Witthaya Mekhum

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This study analysed and developed a model for monk’s food bowl production on occupational health safety and environment at work for the encouragement of Rattanakosin local wisdom at Banbart Community. The process of blowpipe welding was necessary to produce the bowl which was very dangerous or 93.59% risk. After the employment of new sitting posture, the work risk was lower 48.41% or moderate risk. When considering in details, it was found that: 1) the traditional sitting posture could create work risk at 88.89% while the new sitting posture could create the work risk at 58.86%. 2) About the environmental pollution, with the traditional sitting posture, workers exposed to the polluted fume from welding at 61.11% while with the new sitting posture workers exposed to the polluted fume from welding at 40.47%. 3) On accidental risk, with the traditional sitting posture, workers exposed to the accident from welding at 94.44% while with the new sitting posture workers exposed to the accident from welding at 62.54%.

Keywords: occupational health safety, environment at work, Monk’s food bowl, machine intelligence

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2463 Arsenic Contamination in Drinking Water Is Associated with Dyslipidemia in Pregnancy

Authors: Begum Rokeya, Rahelee Zinnat, Fatema Jebunnesa, Israt Ara Hossain, A. Rahman

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Background and Aims: Arsenic in drinking water is a global environmental health problem, and the exposure may increase dyslipidemia and cerebrovascular diseases mortalities, most likely through causing atherosclerosis. However, the mechanism of lipid metabolism, atherosclerosis formation, arsenic exposure and impact in pregnancy is still unclear. Recent epidemiological evidences indicate close association between inorganic arsenic exposure via drinking water and Dyslipidemia. However, the exact mechanism of this arsenic-mediated increase in atherosclerosis risk factors remains enigmatic. We explore the association of the effect of arsenic on serum lipid profile in pregnant subjects. Methods: A total 200 pregnant mother screened in this study from arsenic exposed area. Our study group included 100 exposed subjects were cases and 100 Non exposed healthy pregnant were controls requited by a cross-sectional study. Clinical and anthropometric measurements were done by standard techniques. Lipidemic status was assessed by enzymatic endpoint method. Urinary As was measured by inductively coupled plasma-mass spectrometry and adjusted with specific gravity and Arsenic exposure was assessed by the level of urinary arsenic level > 100 μg/L was categorized as arsenic exposed and < 100 μg/L were categorized as non-exposed. Multivariate logistic regression and Student’s t - test was used for statistical analysis. Results: Systolic and diastolic blood pressure both were significantly higher in the Arsenic exposed pregnant subjects compared to the Non-exposed group (p<0.001). Arsenic exposed subjects had 2 times higher chance of developing hypertensive pregnancy (Odds Ratio 2.2). In parallel to the findings in Ar exposed subjects showed significantly higher proportion of triglyceride and total cholesterol and low density of lipo protein when compare to non- arsenic exposed pregnant subjects. Significant correlation of urinary arsenic level was also found with SBP, DBP, TG, T chol and serum LDL-Cholesterol. On multivariate logistic regression showed urinary arsenic had a positive association with DBP, SBP, Triglyceride and LDL-c. Conclusion: In conclusion, arsenic exposure may induce dyslipidemia like atherosclerosis through modifying reverse cholesterol transport in cholesterol metabolism. For decreasing atherosclerosis related mortality associated with arsenic, preventing exposure from environmental sources in early life is an important element.

Keywords: Arsenic Exposure, Dyslipidemia, Gestational Diabetes Mellitus, Serum lipid profile

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2462 Investigating the Effects of Two Functional and Extra-Functional Stretching Methods of the Leg Muscles on a Selection of Kinematical and Kinetic Indicators in Women with Ankle Instability

Authors: Parvin Malhami

Abstract:

The purpose of the present study was to investigate the effects of two functional and functional stretching methods of the leg muscles on a selection of kinematical and kinetic indicators among women with ankle instability. Twenty-four persons were targeted and randomly divided into the functional exercise (8 persons), extra-functional exercise (8 persons) and control (8 persons) groups on the basis of inclusion and exclusion criteria. The experimental groups received stretching for eight weeks, 3 sessions each week, and the control group merely performed its daily activities. Then, in order to measure the pre -test and post -test variables, the dorsi flexion, Plantar flexion and ground reaction force were investigated and measured. Data were analyzed using paired T-test and independent T-tests at a significant level of 0.05. All statistical analyses were conducted using SPSS 25 software. The results of the T-test showed the significant effect of eight weeks of functional and Extra functional exercises on dorsi Flexion, Plantar Flexion and ground reaction force. (P≤ 0/001). The results of this study showed that the implementation of the functional and Extra-functional exercise protocol had an impact on the amount of Ankle dorsi Flexion and the Plantar felxion of women with an ankle instability. It was also found that muscle flexibility following the stretch ability of the gastrocnemius muscles facilitates the walking of the wrist installation by affecting the amount of wrist flexion, so these people are recommended to use the functional and extra-functional exercise protocol.

Keywords: functional stretching, extra functional stretching, dorsi flexion, plantar flexion

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2461 Effect of Electromagnetic Radiation on Reproductive System of Male Rat

Authors: Rohit Gautam, Kumari Vandana Singh, Jayprakash Nirala, Nina Nancy Murmu, Ramovatar Meena, Paulraj Rajamani

Abstract:

Mobile phones have become a vital part of everyone’s life. Mobile phone and mobile phone towers emit RF-EMR (Radiofrequency Electromagnetic Radiation), which becomes a cause of concern to the general public. The study was designed to evaluate the effect of 3G (RF-EMR) on the reproductive system of male Wistar rats. Adult male Wistar rats were used for the study. Animals were divided into two groups, RF-exposed, and sham-exposed (control). RF-exposed rats were exposed to radio frequency radiation (2100 MHz) for 2 hours/day for 45 days. Emitted power density and specific absorption rate (SAR) values were measured during exposure. At the end of the exposure, testis and epididymis were excised out, and their weights were recorded. Sperm cell count, morphology, viability, and reactive oxygen species (ROS) levels were checked. Lipid peroxidation and sperm mitochondrial activity were measured. Histopathology of testis and ultrastructure analysis of sperm were also checked. Result showed a decrease in organ weight and sperm count with alteration in the sperm morphology in exposed group rats. A significant decrease in sperm viability, membrane integrity, and mitochondrial activity was found. Also, an increase in lipid peroxidation and ROS level were found in exposed group animals as compared to control. It may be concluded that exposure to radiofrequency radiation emits from mobile phones leads to oxidative stress-mediated changes in reproductive parameters.

Keywords: electromagnetic radiation, oxidative stress, reactive oxygen species, sperm

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2460 Cytotoxic Drugs: Handling Practices and Clinical Manifestations among Hospital Staff

Authors: Boularas El-Alia, Arbi Raja, Bachir Bouiadjra Sara, Rezk-Kallah Haciba, Rezkkallah Baghdad

Abstract:

Objectives : To determine the handling practices of cytotoxic drugs and to describe clinical manifestations expressed by hospital personnel of Sidi Bel Abbes during the year 2014. Methods: Sectional descriptive study conducted in 3 center university hospital units (Hematology, Oncology and Urology) and Gynecology of EHS Sidi Bel Abbes. A questionnaire was administered to hospital workers regulary exposed to cytotoxic drugs. A work-place visit was performed to have an overview about working conditions. The Cytotoxic Contact Index (CCI) was calculated for each nurse on a period of 15 working days. Treatment of the results was done using SPSS software. Results: The survey reveals that 22 men and 58 women are exposed to cytotoxic drugs for an average of 7 years. Many symptoms such as ocular irritation (38,75%), throat irritation (56,25%), headache (68,75%), dizziness (43,75%), nausea (37,5%), metallic taste (30%), were reported with high frequency. Are noted in the offspring, 3 congenital anomalies,2 diaphragmatic hernia and a cleft palate. The Cytotoxic Contact Index (CCI) was higher than 3 among Oncology nurses and higher than 1 for most of the nurses of Hematology and Gynecology service. The wearing of personal protective clothing was not respected by all workers: (22/23) wear gloves and (20/23) wear a mask,(5/23) wear a cap, (2/23) wear glasses. Only 3 nurses have benefited from continuous training on handling cytotoxic drugs. Conclusion: This study shows a high occupational exposure risk to cytotoxic drugs among persons handling these drugs and the necessity to apply rigorously all measures related to personal protection awareness and training of personnel to minimize these exposure.

Keywords: cytotoxic drugs, handling, clinical manifestations, hospital staff

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2459 Computational Methods in Official Statistics with an Example on Calculating and Predicting Diabetes Mellitus [DM] Prevalence in Different Age Groups within Australia in Future Years, in Light of the Aging Population

Authors: D. Hilton

Abstract:

An analysis of the Australian Diabetes Screening Study estimated undiagnosed diabetes mellitus [DM] prevalence in a high risk general practice based cohort. DM prevalence varied from 9.4% to 18.1% depending upon the diagnostic criteria utilised with age being a highly significant risk factor. Utilising the gold standard oral glucose tolerance test, the prevalence of DM was 22-23% in those aged >= 70 years and <15% in those aged 40-59 years. Opportunistic screening in Australian general practice potentially can identify many persons with undiagnosed type 2 DM. An Australian Bureau of Statistics document published three years ago, reported the highest rate of DM in men aged 65-74 years [19%] whereas the rate for women was highest in those over 75 years [13%]. If you consider that the Australian Bureau of Statistics report in 2007 found that 13% of the population was over 65 years of age and that this will increase to 23-25% by 2056 with a further projected increase to 25-28% by 2101, obviously this information has to be factored into the equation when age related diabetes prevalence predictions are calculated. This 10-15% proportional increase of elderly persons within the population demographics has dramatic implications for the estimated number of elderly persons with DM in these age groupings. Computational methodology showing the age related demographic changes reported in these official statistical documents will be done showing estimates for 2056 and 2101 for different age groups. This has relevance for future diabetes prevalence rates and shows that along with many countries worldwide Australia is facing an increasing pandemic. In contrast Japan is expected to have a decrease in the next twenty years in the number of persons with diabetes.

Keywords: epidemiological methods, aging, prevalence, diabetes mellitus

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2458 Barriers to Marital Expectation among Individuals with Hearing Impairment in Oyo State

Authors: Adebomi M. Oyewumi, Sunday Amaize

Abstract:

The study was designed to examine the barriers to marital expectations among unmarried persons with hearing impairment in Oyo State, Nigeria. Descriptive survey research design was adopted. Purposive sampling technique was used to select one hundred participants made up forty-four (44) males and fifty-six (56) females, all with varying degrees of hearing impairment. Eight research questions were raised and answered. The instrument used was Marital Expectations Scale with reliability coefficient of 0.86. Data was analyzed using descriptive statistics tools of frequency count and simple percentage as well as inferential statistics tools of T-TEST and ANOVA. The findings revealed that there was a significant relationship existing among the main identified barriers (environmental barrier, communication barrier, hearing loss, unemployment and poor sexuality education) to the marital expectations of unmarried persons with hearing impairment. The joint contribution of the independent variables (identified barriers) to the dependent variable (marital expectations) was significant, F = 5.842, P < 0.05, accounting for about 89% of the variance. The relative contribution of the identified barriers to marital expectations of unmarried persons with hearing impairment is as follows: environmental barrier (β = 0.808, t = 5.176, P < 0.05), communication barrier (β = 0.533, t = 3.305, P < 0.05), hearing loss (β = 0.550, t = 2.233, P < 0.05), unemployment (β = 0.431, t = 2.102, P < 0.05), poor sexuality education (β = 0.361, t = 1.985, P < 0.05). Environmental barrier proved to be the most potent contributor to the poor marital expectations among unmarried persons with hearing impairment. Therefore, it is recommended that society dismantles the nagging environmental barrier through positive identification with individuals suffering from hearing impairment. In this connection, members of society should change their negative attitudes and do away with all the wrong notions about the marital ability of individuals with hearing impairment.

Keywords: environmental barrier, hearing impairment, marriage, marital expectations

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2457 An Investigation of Suppression in Mid-19th Century Japan: Case Study of the 1855 Catfish Prints as a Product of Censorship

Authors: Vasanth Narayanan

Abstract:

The mid-nineteenth century saw the Japanese elite and townsfolk alike undergo the now-infamous Ansei Edo earthquakes. The quakes decimated Japan in the final decades of the Tokugawa Era and, perhaps more consequentially, birthed a new genre of politically inspired artwork, the most notable of which are the namazu-e. This essay advocates an understanding of the 1855 Catfish Prints (namazu-e) that prioritizes the function of iconography and anthropomorphic deity in shaping the namazu-e into a wholly political experience that makes the censorship of the time part of its argument. The visual program is defined as the creation of a politically profitable experience, crafted through the union of explicit religion, highly masked commentary, and the impositions of censorship. The strategies by which the works are designed, in the face of censorship, to engage a less educated, pedestrian audience with its theme, including considerations of iconography, depictions of the working class, anthropomorphism, and the relationship between textual and visual elements, are discussed herein. The essay then takes up the question of the role of tense Japan–United States relations in fostering censorship and as a driver of the production of namazu-e. It is ultimately understood that the marriage of hefty censorship protocol, the explicitly religious medium, and inimical sentiment towards United States efforts at diplomacy renders the production of namazu-e an offspring of the censorship and deeply held frustrations of the time, cementing its status as a primitive form of peaceful protest against a seemingly apathetic government.

Keywords: Japan, Ansei Earthquake, Namazu, prints, censorship, religion

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2456 The Rupture of Tendon Achilles During the Recreative and Sports Activities

Authors: Jasmin S. Nurkovic, Ljubisa Dj. Jovasevic, Zana C. Dolicanin, Zoran S. Bajin

Abstract:

Ruptured muscles and tendons very often must be repatriated by open operation in young persons. In young, muscles are ruptured more often than tendons, at the sane time in older persons are more exposed to rupture than muscles. Ruptured of the calcaneus are the most present of all ruptures. Sometime the rupture is complete, but very often the incomplete rupture can be noticed. During six years, from 2006 to 2012, we treated nineteen male patients and three female patients with the rupture of tendon Achilles. The youngest patient was aged thirty two, and the oldest was also managed sixty four. The youngest female patient was forty one and the oldest was forty six. One of our patients who was under corticosteroid treatment did not take any part in sport activities but she was, as she told us, going for a long walk, the same was with other two patients one man and one woman. We had nineteen male patients age 32 to 64 and three female patients age 41, 44 and 46. Conservative treatment by cast was applied in five patients and very good results were in three of them. In two patients surgical treatment failed in patient’s age 53 and 64. Only one of all patients treated by surgery had healing problems because of necrotic changes of the skin where incision was made. One of our female patients age 45 was under steroid treatment for almost 20 years because of asthmatic problems. We suggested her wearing boots with 8cm long heels by day and by night eight weeks. The final results were satisfactory and all the time she was able to work and to walk. It was the only case we had with bilateral tendon rupture. After eight weeks the cast is removed and psychiatric treatment started, patient is using crutches with partial weight bearing over a period of two weeks. Quite the same treatment conservative treatment, only the cast is not removed after two but after four weeks. Everyday activities after the surgical treatment started ten weeks and sport activities can start after fourteen to sixteen weeks. An increased activity of our patient without previous preparing for forces activity can result, as we already see, with tendon rupture. Treatment is very long and very often surgical. We find that surgical treatment resulted as safer and better solution for patients. We also had a patient with spontaneous rupture of tendon during longer walking but this patient was under prolonged corticosteroid treatment.

Keywords: tendon, Achilles, rupture, sport

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2455 A Guideline of Development of Suansunandha Rajabhat University in Order to Promote the Cultural Tourism

Authors: Weera Weerasophon

Abstract:

This research aims to study and survey a potential in the areas affecting development and study of management factors affecting cultural tourism for Suansunandha Rajabhat University in a model of a qualitative research as a survey research. The sample population includes executives, faculty members, and persons related to university management of Suansunandha Rajabhat University, the total number is 5 persons. The researcher distributed in-depth interview form for tools used in the research. The obtained data was brought to conduct content analysis by brainstorming from expert academician to persons related to university management of Suansunandha Rajabhat University in order to consider readiness in cultural tourism management for Suansunandha Rajabhat University, to analyze and develop to be a guideline for the development of Suansunandha Rajabhat University for promoting cultural tourism. From the study results, it is found that the factors of readiness in management, planning, organizing, personnel management, leadership and guiding, coordination, controlling, budgeting and marketing could influence to be a guideline for development of Suansunandha Rajabhat Universiy in order to promote cultural tourism; therefore, the university should prepare more plans concerning related matters, as well as development, determining form and policy of Suansunandha Rajabhat University.

Keywords: cultural tourism, Suansunandha Rajabhat University, tourism management, guideline of development

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2454 Vitamin D Status in Relation to Body Mass Index: Population of Carpathian Region

Authors: Vladyslav Povoroznyuk, Ivan Pankiv

Abstract:

The present research has attempted to link a higher body weight with a lower vitamin D status. Objective: Vitamin D status of Carpathian region population in Ukraine was studied to examine whether serum levels of 25-hydroxyvitamin D [25(OH)D] are associated with body mass index (BMI). Methods: Data collected from 302 adults (18–84 years) were analyzed. Variables measured included serum 25(OH)D, weight and height used to determine BMI status. Results: Mean 25(OH)D level was 23.2 ± 8.1 ng/mL for the group; 26.3 ± 8.4 ng/mL and 22.8 ± 9.1 ng/mL for males and females, respectively. Based on BMI, 3.6% were underweight, 21.2% had a normal weight, 46.4% were overweight and 28.8% obese. Only in 28 cases (9.3%), content of 25(ОН)D in the serum of blood was within the normal limits, and there were vitamin D deficiency and insufficiency observed in other cases (90.7%). Thus, severe vitamin D deficiency was revealed in 1.7% of the inspected. A significant interrelation between levels of 25(OH)D in blood and BMI was found among persons with BMI 25-29.9 kg/m2. Mean value of 25(OH)D levels among persons with obesity did not differ to a significant extent from indexes in persons with normal body weight. Conclusion: Status of vitamin D among the population of Carpathian region remains far from optimal and requires urgent measures in correction and prevention. Results confirmed a poor inverse relationship between vitamin D status and BMI. Intercommunication between maintenance of vitamin D and BMI requires further investigations.

Keywords: body mass index, Carpathian region, obesity, vitamin D

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2453 Disabilities in Railways: Proposed Changes to the Design of Railway Compartments for the Inclusion of Differently Abled Persons

Authors: Bathmajaa Muralisankar

Abstract:

As much as railway station infrastructure designs and ticket-booking norms have been changed to facilitate use by differently abled persons, the railway train compartments themselves have not been made user-friendly for differently abled persons. Owing to safety concerns, dependency on others for their travel, and fear of isolation, differently abled people do not prefer travelling by train. Rather than including a dedicated compartment open only to the differently abled, including the latter with others in the normal compartment (with the proposed modifications discussed here) will make them feel secure and make for an enhanced travel experience for them. This approach also represents the most practical way to include a particular category of people in the mainstream society. Lowering the height of the compartment doors and providing a wider entrance with a ramp will provide easy entry for those using wheelchairs. As well, removing the first two alternate rows and the first two side seats will not only widen the passage and increase seating space but also improve wheelchair turning radius. This will help them travel without having to depend on others. Seating arrangements may be done to accommodate their family members near them instead of isolating the differently abled in a separate compartment. According to present ticket-booking regulations of the Indian Railways, three to four disabled persons may travel without their family or one to two along with their family, and the numbers may be added or reduced. To help visually challenged and hearing-impaired persons, in addition to the provision of special instruments, railings, and textured footpaths and flooring, the seat numbers above the seats may be set in metal or plastic as an outward projection so the visually impaired can touch and feel the numbers. Braille boards may be included at the entrance to the compartment along with seat numbers in the aforementioned projected manner. These seat numbers may be designed as buttons, which when pressed results in an announcement of the seat number in the applicable local language as well as English. Emergency buttons, rather than emergency chains, within the easy reach of disabled passengers will also help them.

Keywords: dependency, differently abled, inclusion, mainstream society

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2452 Post-Traumatic Stress Disorder Exhibited by Secondary School Students Exposed to Conflict in Kano Metropolis: Efficacy of a Brief Intervention

Authors: Valentine Ayo Mebu

Abstract:

The study examined the efficacy of a brief intervention programme in the treatment of post-traumatic stress disorder (PTSD) symptoms exhibited by secondary school students exposed to conflict in Kano metropolis. The study tested three hypotheses that there is no significant difference between post-test re-experiencing, hyper-arousal, and avoidance mean scores of students exposed to the intervention and those who were not exposed to the intervention. The design of the study was an experimental design, specifically the pre-test and post-test control group design. The purposive sampling technique was used to select 60 research participants (male=30, female=30, Mean Age=15.50) for the study. These participants met the Diagnostic Statistical Manual of Mental Disorders (DSM-5) criteria of PTSD symptoms and were randomly assigned to experimental and control groups, respectively. Instrument for data collection was the University of California Post-Traumatic Stress Disorder Reaction Index (UCLA PTSD Index). Findings from the study indicated that there was a significant effect of the intervention on post re-experiencing symptoms scores [ F (1, 57) = 85.97, p=.00, partial eta squared η²=.60], hyper-arousal symptoms scores[ F (1, 57) = 27.81, p=.00, partial eta squared η² =.33], and avoidance symptoms scores [ F (1, 57) = 59.56, p=.00, partial eta squared η² =.51]. The efficacy of this brief psycho-educational intervention as an effective treatment in reducing PTSD symptoms among secondary school students exposed to conflict is supported by the results of this study and this will also add to the existing literature on the effectiveness of psycho-educational intervention in treating PTSD symptoms among students exposed to conflict.

Keywords: avoidance symptoms, hyper-arousal symptoms, re-experiencing symptoms, post-traumatic stress disorder, psycho-education

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