Search results for: psychosocial adjustment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 766

Search results for: psychosocial adjustment

166 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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165 Implementation of Dozer Push Measurement under Payment Mechanism in Mining Operation

Authors: Anshar Ajatasatru

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The decline of coal prices over past years have been significantly increasing the awareness of effective mining operation. A viable step must be undertaken in becoming more cost competitive while striving for best mining practice especially at Melak Coal Mine in East Kalimantan, Indonesia. This paper aims to show how effective dozer push measurement method can be implemented as it is controlled by contract rate on the unit basis of USD ($) per bcm. The method emerges from an idea of daily dozer push activity that continually shifts the overburden until final target design by mine planning. Volume calculation is then performed by calculating volume of each time overburden is removed within determined distance using cut and fill method from a high precision GNSS system which is applied into dozer as a guidance to ensure the optimum result of overburden removal. Accumulation of daily to weekly dozer push volume is found 95 bcm which is multiplied by average sell rate of $ 0,95, thus the amount monthly revenue is $ 90,25. Furthermore, the payment mechanism is then based on push distance and push grade. The push distance interval will determine the rates that vary from $ 0,9 - $ 2,69 per bcm and are influenced by certain push slope grade from -25% until +25%. The amount payable rates for dozer push operation shall be specifically following currency adjustment and is to be added to the monthly overburden volume claim, therefore, the sell rate of overburden volume per bcm may fluctuate depends on the real time exchange rate of Jakarta Interbank Spot Dollar Rate (JISDOR). The result indicates that dozer push measurement can be one of the surface mining alternative since it has enabled to refine method of work, operating cost and productivity improvement apart from exposing risk of low rented equipment performance. In addition, payment mechanism of contract rate by dozer push operation scheduling will ultimately deliver clients by almost 45% cost reduction in the form of low and consistent cost.

Keywords: contract rate, cut-fill method, dozer push, overburden volume

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164 Study of the Adsorptives Properties of Zeolites X Exchanged by the Cations Cu2 + and/or Zn2+

Authors: H. Hammoudi, S. Bendenia, I. Batonneau-Gener, A. Khelifa

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Applying growing zeolites is due to their intrinsic physicochemical properties: a porous structure, regular, generating a large free volume, a high specific surface area, acidic properties of interest to the origin of their activity, selectivity energy and dimensional, leading to a screening phenomenon, hence the name of molecular sieves is generally attributed to them. Most of the special properties of zeolites have been valued as direct applications such as ion exchange, adsorption, separation and catalysis. Due to their crystalline structure stable, their large pore volume and their high content of cation X zeolites are widely used in the process of adsorption and separation. The acidic properties of zeolites X and interesting selectivity conferred on them their porous structure is also have potential catalysts. The study presented in this manuscript is devoted to the chemical modification of an X zeolite by cation exchange. Ion exchange of zeolite NaX by Zn 2 + cations and / or Cu 2 + is gradually conducted by following the evolution of some of its characteristics: crystallinity by XRD, micropore volume by nitrogen adsorption. Once characterized, the different samples will be used for the adsorption of propane and propylene. Particular attention is paid thereafter, on the modeling of adsorption isotherms. In this vein, various equations of adsorption isotherms and localized mobile, some taking into account the adsorbate-adsorbate interactions, are used to describe the experimental isotherms. We also used the Toth equation, a mathematical model with three parameters whose adjustment requires nonlinear regression. The last part is dedicated to the study of acid properties of Cu (x) X, Zn (x) X and CuZn (x) X, with the adsorption-desorption of pyridine followed by IR. The effect of substitution at different rates of Na + by Cu2 + cations and / or Zn 2 +, on the crystallinity and on the textural properties was treated. Some results on the morphology of the crystallites and the thermal effects during a temperature rise, obtained by scanning electron microscopy and DTA-TGA thermal analyzer, respectively, are also reported. The acidity of our different samples was also studied. Thus, the nature and strength of each type of acidity are estimated. The evaluation of these various features will provide a comparison between Cu (x) X, Zn (x) X and CuZn (x) X. One study on adsorption of C3H8 and C3H6 in NaX, Cu (x) X , Zn (x) x and CuZn (x) x has been undertaken.

Keywords: adsorption, acidity, ion exchange, zeolite

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163 Biofungicides in Nursery Production

Authors: Miroslava Markovic, Snezana Rajkovic, Ljubinko Rakonjac, Aleksandar Lucic

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Oak powdery mildew is a serious problem on seedlings in nurseries as well as on naturally and artificially introduced progeny. The experiments were set on oak seedlings in two nurseries located in Central Serbia, where control of oak powdery mildew Microsphaera alphitoides Griff. et Maubl. had been conducted through alternative protection measures by means of various dosages of AQ-10 biofungicide, with and without added polymer (which has so far never been used in this country for control of oak powdery mildew). Simultaneous testing was conducted on the efficiency of a chemical sulphur-based preparation (used in this area for many years as a measure of suppression of powdery mildews, without the possibility of developing resistance of the pathogen to the active matter). To date, the Republic of Serbia has registered no fungicides for suppression of pathogens in the forest ecosystems. In order to introduce proper use of new disease-fighting agents into a country, certain relevant principles, requirements and criteria prescribed by the Forest Stewardship Council (FSC) must be observed, primarily with respect to measures of assessment and mitigation of risks, the list of dangerous and highly dangerous pesticides with the possibility of alternative protection. One of the main goals of the research was adjustment of the protective measures to the FSC policy through selection of eco-toxicologically favourable fungicides, given the fact that only preparations named on the list of permitted active matters are approved for use in certified forests. The results of the research have demonstrated that AQ-10 biofungicide can be used as a part of integrated disease management programmes as an alternative, through application of several treatments during vegetation and combination with other active matters registered for these purposes, so as to curtail the use of standard fungicides for control of powdery mildews on oak seedlings in nurseries. The best results in suppression of oak powdery mildew were attained through use of AQ-10 biofungicide (dose 50 or 70g/ha) with added polymer Nu Film-17 (dose 1.0 or 1.5 l/ha). If the treatment is applied at the appropriate time, even fewer number of treatments and smaller doses will be just as efficient.

Keywords: oak powdery mildew, biofungicides, polymers, Microsphaera alphitoides

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162 Smart Signature - Medical Communication without Barrier

Authors: Chia-Ying Lin

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This paper explains how to enhance doctor-patient communication and nurse-patient communication through multiple intelligence signing methods and user-centered. It is hoped that through the implementation of the "electronic consent", the problems faced by the paper consent can be solved: storage methods, resource utilization, convenience, correctness of information, integrated management, statistical analysis and other related issues. Make better use and allocation of resources to provide better medical quality. First, invite the medical records department to assist in the inventory of paper consent in the hospital: organising, classifying, merging, coding, and setting. Second, plan the electronic consent configuration file: set the form number, consent form group, fields and templates, and the corresponding doctor's order code. Next, Summarize four types of rapid methods of electronic consent: according to the doctor's order, according to the medical behavior, according to the schedule, and manually generate the consent form. Finally, system promotion and adjustment: form an "electronic consent promotion team" to improve, follow five major processes: planning, development, testing, release, and feedback, and invite clinical units to raise the difficulties faced in the promotion, and make improvements to the problems. The electronic signature rate of the whole hospital will increase from 4% in January 2022 to 79% in November 2022. Use the saved resources more effectively, including: reduce paper usage (reduce carbon footprint), reduce the cost of ink cartridges, re-plan and use the space for paper medical records, and save human resources to provide better services. Through the introduction of information technology and technology, the main spirit of "lean management" is implemented. Transforming and reengineering the process to eliminate unnecessary waste is also the highest purpose of this project.

Keywords: smart signature, electronic consent, electronic medical records, user-centered, doctor-patient communication, nurse-patient communication

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161 Heat Loss Control in Stave Cooled Blast Furnace by Optimizing Gas Flow Pattern through Burden Distribution

Authors: Basant Kumar Singh, S. Subhachandhar, Vineet Ranjan Tripathi, Amit Kumar Singh, Uttam Singh, Santosh Kumar Lal

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Productivity of Blast Furnace is largely impacted by fuel efficiency and controlling heat loss is one of the enabling parameters for achieving lower fuel rate. 'I' Blast Furnace is the latest and largest Blast Furnace of Tata Steel Jamshedpur with working volume of 3230 m³ and with rated capacity of 3.055 million tons per annum. Optimizing heat losses in Belly and Bosh zone remained major challenge for blast furnace operators after its commissioning. 'I' Blast has installed Cast Iron & Copper Staves cooling members where copper staves are installed in Belly, Bosh & Lower Stack whereas cast iron staves are installed in upper stack area. Stave cooled Blast Furnaces are prone to higher heat losses in Belly and Bosh region with an increase in coal injection rate as Bosh gas volume increases. Under these conditions, managing gas flow pattern through proper burden distribution, casting techniques & by maintaining desired raw material qualities are of utmost importance for sustaining high injection rates. This study details, the burden distribution control by Ore & Coke ratio adjustment at wall and center of Blast Furnace as the coal injection rates increased from 140 kg/thm to 210 kg/thm. Control of blowing parameters, casting philosophy, specification for raw materials & devising operational practice for controlling heat losses is also elaborated with the model that is used to visualize heat loss pattern in different zones of Blast Furnace.

Keywords: blast furnace, staves, gas flow pattern, belly/bosh heat losses, ore/coke ratio, blowing parameters, casting, operation practice

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160 Montelukast Doesn’t Decrease the Risk of Cardiovascular Disease in Asthma Patients in Taiwan

Authors: Sheng Yu Chen, Shi-Heng Wang

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Aim: Based on human, animal experiments, and genetic studies, cysteinyl leukotrienes, LTC4, LTD4, and LTE4, are inflammatory substances that are metabolized by 5-lipooxygenase from arachidonic acid, and these substances trigger asthma. In addition, the synthetic pathway of cysteinyl leukotriene is relevant to the increase in cardiovascular diseases such as myocardial ischemia and stroke. Given the situation, we aim to investigate whether cysteinyl leukotrienes receptor antagonist (LTRA), montelukast which cures those who have asthma has potential protective effects on cardiovascular diseases. Method: We conducted a cohort study, and enrolled participants which are newly diagnosed with asthma (ICD-9 CM code 493. X) between 2002 to 2011. The data source is from Taiwan National Health Insurance Research Database Patients with a previous history of myocardial infarction or ischemic stroke were excluded. Among the remaining participants, every montelukast user was matched with two randomly non-users by sex, and age. The incident cardiovascular diseases, including myocardial infarction and ischemic stroke, were regarded as outcomes. We followed the participants until outcomes come first or the end of the following period. To explore the protective effect of montelukast on the risk of cardiovascular disease, we use multivariable Cox regression to estimate the hazard ratio with adjustment for potential confounding factors. Result: There are 55876 newly diagnosed asthma patients who had at least one claim of inpatient admission or at least three claims of outpatient records. We enrolled 5350 montelukast users and 10700 non-users in this cohort study. The following mean (±SD) time of the Montelukast group is 5 (±2.19 )years, and the non-users group is 6.2 5.47 (± 2.641) years. By using multivariable Cox regression, our analysis indicated that the risk of incident cardiovascular diseases between montelukast users (n=43, 0.8%) and non-users (n=111, 1.04%) is approximately equal. [adjusted hazard ratio 0.992; P-value:0.9643] Conclusion: In this population-based study, we found that the use of montelukast is not associated with a decrease in incident MI or IS.

Keywords: asthma, inflammation, montelukast, insurance research database, cardiovascular diseases

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159 Association of Daily Physical Activity with Diabetes Control in Patients with Type II Diabetes

Authors: Chia-Hsun Chang

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Background: Combination of drug treatment, dietary management, and regular exercise can effectively control type II diabetes mellitus (T2DM). Performing daily physical activities other than structured exercise is much easier and whether daily physical activities including work, walking, housework, gardening, leisure exercise, or transportation have a similar effect on diabetes control is not well studied.Aims and Objectives: This study aims to determine whether daily physical activity undertaken by patients with T2DM is associated with their diabetes control. Design: A correlation study with prospective design. Methods: Purposive sampling of 206 patients with T2DM was recruited from a medical center in Central Taiwan. The International Physical Activity Questionnaire was used to assess daily levels of physical activities, and the Diabetes Compliance Questionnaire was used to assess medication and dietary compliance. Data of diabetes control (hemoglobin A1c, HbA1c)were followed up every three months for one year after recruitment. Results: In this study, the average age of the participants was 62.5 years (±10.4 years), and the average duration of diabetes since diagnosis was 13.2 years (±7.8), 112 of the participants were women (54.4%) and 94 of the participants were men (45.6%). The mean HbA1c level was 7.8% (±1.4), and 78.2% of the participants presented with unsatisfactory diabetes control. Because the participants were distributed across a wide age range, and their physical health, activity levels, and comorbidities might have varied with age, the participants were divided into two groups: 121 participants who were younger than 65 years (58.7%) and 85 participants who were older than 65 years (41.3%). Both younger (< 65 years) and older (> 65 years) patients with diabetes engaged in more moderate and low levels of physical activity (89.3% and 87%, respectively). Results showed that the levels of daily physical activity were not significantly associated with diabetes control after adjustment for medication and dietary compliance in both groups. Conclusion: Performing daily physical activity is not significantly correlated with diabetes control. Daily physical activity cannot completely replace exercise. Relevance to Clinical Practice: Health personnel must encourage patients to engage in exercise that is planned, structured, and repetitive for improving diabetes control.

Keywords: daily physical activity, diabetes control, international physical activity questionnaire (IPAQ), type II diabetes mellitus (T2DM)

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158 Short-Term Association of In-vehicle Ultrafine Particles and Black Carbon Concentrations with Respiratory Health in Parisian Taxi Drivers

Authors: Melissa Hachem, Maxime Loizeau, Nadine Saleh, Isabelle Momas, Lynda Bensefa-Colas

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Professional drivers are exposed inside their vehicles to high levels of air pollutants due to the considerable time they spend close to motor vehicle emissions. Little is known about ultrafine particles (UFP) or black carbon (BC) adverse respiratory health effects compared to the regulated pollutants. We aimed to study the short-term associations between UFP and BC concentrations inside vehicles and (1) the onset of mucosal irritation and (2) the acute changes in lung function of Parisian taxi drivers during a working day. An epidemiological study was carried out on 50 taxi drivers in Paris. UFP and BC were measured inside their vehicles with DiSCmini® and microAeth®, respectively. On the same day, the frequency and the severity of nose, eye, and throat irritations were self-reported by each participant and a spirometry test was performed before and after the work shift. Multivariate analysis was used to evaluate the associations between in-taxis UFP and BC concentrations and mucosal irritation and lung function, after adjustment for potential confounders. In-taxis UFP concentrations ranged from 17.9 to 37.9 × 103 particles/cm³ and BC concentrations from 2.2 to 3.9 μg/m³, during a mean of 9 ± 2 working hours. Significant dose-response relationships were observed between in-taxis UFP concentrations and both nasal irritation and lung function. The increase of in-taxis UFP (for an interquartile range of 20 × 103 particles/cm3) was associated to an increase in nasal irritation (adjusted OR = 6.27 [95% CI: 1.02 to 38.62]) and to a reduction in forced expiratory flow at 25–75% by −7.44% [95% CI: −12.63 to −2.24], forced expiratory volume in one second by −4.46% [95% CI: −6.99 to −1.93] and forced vital capacity by −3.31% [95% CI: −5.82 to −0.80]. Such associations were not found with BC. Incident throat and eye irritations were not related to in-vehicle particles exposure; however, they were associated with outdoor air quality (estimated by the Atmo index) and in-vehicle humidity, respectively. This study is the first to show a significant association, within a short-period of time, between in-vehicle UFP exposure and acute respiratory effects in professional drivers.

Keywords: black carbon, lung function, mucosal irritation, taxi drivers, ultrafine particles

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157 An Evaluation of a Student Peer Mentoring Program

Authors: Nazeema Ahmed

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This paper reports on the development of a student peer mentoring programme at a higher education institution. The programme is dependent on volunteering senior undergraduate students who are trained to mentor first-year students studying towards an engineering degree. The evaluation of the programme took the form of first-year students completing a self-report paper questionnaire at the onset of a lecture and mentors completing their questionnaire electronically. The evaluation yielded mixed findings. Peer mentoring clearly benefited some students in their adjustment to the institution. Specific mentors’ personal attributes enabled the establishment of successful mentoring relationships, where encouragement, advice and academic assistance was provided. Gains were reciprocal with mentors reporting that the programme contributed towards their personal development. Confidence in the programme was expressed in mentors feeling that it was an initiative worth continuing and first-year students agreeing that it be recommended to future first-year students. This was despite many unfavourable experiences of mentors where their professionalism and commitment to the programme was suspect. It is evident that while mentors began with noble intentions they appear either to lose interest or become overwhelmed with their own workload as the academic year progresses. On the other hand, some mentors reported feeling challenged by the apathy of first-year students who failed to maximise the opportunity available to them. The different attitudes towards mentoring that manifested as a mentoring culture in some departments were particularly pertinent to its successful implementation. The findings point to the key role of academic staff in the mentoring programme who model the mentoring relationship in their interaction with student mentors. While their involvement in the programme may be perceived as a drain on resources in an already demanding academic teaching environment, it is imperative that structural changes be put in place for the programme to be both efficient and sustainable. A pervasive finding concerns the evolving institutional culture of student development in the faculty. Mentors and first-year students alike alluded to the potential of the mentoring programme provided it is seriously endorsed at both the departmental and faculty level. The findings provide a foundation from which to develop the programme further and to begin improving its capacity for maximizing student retention in South African higher education.

Keywords: engineering students, first-year students, peer mentoring

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156 Photovoltaic Solar Energy in Public Buildings: A Showcase for Society

Authors: Eliane Ferreira da Silva

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This paper aims to mobilize and sensitize public administration leaders to good practices and encourage investment in the PV system in Brazil. It presents a case study methodology for dimensioning the PV system in the roofs of the public buildings of the Esplanade of the Ministries, Brasilia, capital of the country, with predefined resources, starting with the Sustainable Esplanade Project (SEP), of the exponential growth of photovoltaic solar energy in the world and making a comparison with the solar power plant of the Ministry of Mines and Energy (MME), active since: 6/10/2016. In order to do so, it was necessary to evaluate the energy efficiency of the buildings in the period from January 2016 to April 2017, (16 months) identifying the opportunities to reduce electric energy expenses, through the adjustment of contracted demand, the tariff framework and correction of existing active energy. The instrument used to collect data on electric bills was the e-SIC citizen information system. The study considered in addition to the technical and operational aspects, the historical, cultural, architectural and climatic aspects, involved by several actors. Identifying the reductions of expenses, the study directed to the following aspects: Case 1) economic feasibility for exchanges of common lamps, for LED lamps, and, Case 2) economic feasibility for the implementation of photovoltaic solar system connected to the grid. For the case 2, PV*SOL Premium Software was used to simulate several possibilities of photovoltaic panels, analyzing the best performance, according to local characteristics, such as solar orientation, latitude, annual average solar radiation. A simulation of an ideal photovoltaic solar system was made, with due calculations of its yield, to provide a compensation of the energy expenditure of the building - or part of it - through the use of the alternative source in question. The study develops a methodology for public administration, as a major consumer of electricity, to act in a responsible, fiscalizing and incentive way in reducing energy waste, and consequently reducing greenhouse gases.

Keywords: energy efficiency, esplanade of ministries, photovoltaic solar energy, public buildings, sustainable building

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155 An Open Trial of Mobile-Assisted Cognitive Behavioral Therapy for Negative Symptoms in Schizophrenia: Pupillometry Predictors of Outcome

Authors: Eric Granholm, Christophe Delay, Jason Holden, Peter Link

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Negative symptoms are an important unmet treatment needed for schizophrenia. We conducted an open trial of a novel blended intervention called mobile-assisted cognitive behavior therapy for negative symptoms (mCBTn). mCBTn is a weekly group therapy intervention combining in-person and smartphone-based CBT (CBT2go app) to improve experiential negative symptoms in people with schizophrenia. Both the therapy group and CBT2go app included recovery goal setting, thought challenging, scheduling of pleasurable activities and social interactions, and pleasure savoring interventions to modify defeatist attitudes, a target mechanism associated with negative symptoms, and improve experiential negative symptoms. We tested whether participants with schizophrenia or schizoaffective disorder (N=31) who met prospective criteria for persistent negative symptoms showed improvement in experiential negative symptoms. Retention was excellent (87% at 18 weeks) and severity of defeatist attitudes and motivation and pleasure negative symptoms declined significantly in mCBTn with large effect sizes. We also tested whether pupillary responses, a measure of cognitive effort, predicted improvement in negative symptoms mCBTn. Pupillary responses were recorded at baseline using a Tobii pupillometer during the digit span task with 3-, 6- and 9-digit spans. Mixed models showed that greater dilation during the task at baseline significantly predicted a greater reduction in experiential negative symptoms. Pupillary responses may provide a much-needed prognostic biomarker of which patients are most likely to benefit from CBT. Greater pupil dilation during a cognitive task predicted greater improvement in experiential negative symptoms. Pupil dilation has been linked to motivation and engagement of executive control, so these factors may contribute to benefits in interventions that train cognitive skills to manage negative thoughts and emotions. The findings suggest mCBTn is a feasible and effective treatment for experiential negative symptoms and justify a larger randomized controlled clinical trial. The findings also provide support for the defeatist attitude model of experiential negative symptoms and suggest that mobile-assisted interventions like mCBTn can strengthen and shorten intensive psychosocial interventions for schizophrenia.

Keywords: cognitive-behavioral therapy, mobile interventions, negative symptoms, pupillometry schizophrenia

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154 Prisoners for Sexual Offences: Custodial Regime, Prison Experience and Reintegration Interventions

Authors: Nikolaos Koulouris, Anna Kasapoglou, Dimitris Koros

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The paper aims to present the course of ongoing research concerning the treatment of pretrial detainees, convicted or released prisoners for sexual offenses, an area that has not received much attention in Greece in terms of the prison experience and the reintegration potentials regarding this specific category of prisoners. The study plan provides for the use of a combination of research methods (focus groups with prisoners, structured individual interviews with prisoners and prison staff). Also, interviews with ex-prisoners detained regarding sexual offenses will take place. In Greece, there are no special provisions for the treatment of sexual offenders in prison, nor are there any special programs in place for their rehabilitation. Sexual offenders are usually separated from other prisoners, as the informal code of the social organization of the prison community dictates, despite no relevant legal framework. The study aims to explore the reasons for the separate detention of sexual offenders and discuss their special (non) treatment from different points of view, namely the legality and legitimacy of this discriminatory practice in terms of prisoners’ protection, safety, stigmatization, and possible social exclusion, as well as their post-release expectations and social reintegration potentials. The purpose of the research is the exploration of the prison experience of sexual offenders, the exercise of their legal rights, their adjustment to the demands of social life in prison, as well as the role of prison officers and various interventions aiming to their preparation for reentry to society. The study will take into consideration the European and international prison/penitentiary standards and best practices in order to examine the issue comparatively, while the contribution of the United Nations and the Council of Europe and its standards will be used to assess the treatment of sexual offenders in terms of its compatibility to international and European model-rules and trends. The outcome will be utilized to form main directions and propositions for a coherent and consistent human rights-based and social integration-oriented penal policy regarding the treatment of persons accused or convicted of sexual offenses in Greece.

Keywords: prisoners’ treatment, sex offenders, social exclusion, social reintegration

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153 Internalized HIV Stigma, Mental Health, Coping, and Perceived Social Support among People Living with HIV/AIDS in Aizawl District, Mizoram

Authors: Mary Ann L. Halliday, Zoengpari Gohain

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The stigma associated with HIV-AIDS negatively affect mental health and ability to effectively manage the disease. While the number of People living with HIV/AIDS (PLHIV) has been increasing day by day in Mizoram (a small north-eastern state in India), research on HIV/AIDS stigma has so far been limited. Despite the potential significance of Internalized HIV Stigma (IHS) in the lives of PLHIV, there has been very limited research in this area. It was therefore, felt necessary to explore the internalized HIV stigma, mental health, coping and perceived social support of PLHIV in Aizawl District, Mizoram. The present study was designed with the objectives to determine the degree of IHS, to study the relationship between the socio-demographic characteristics and level of IHS, to highlight the mental health status, coping strategies and perceived social support of PLHIV and to elucidate the relationship between these psychosocial variables. In order to achieve the objectives of the study, six hypotheses were formulated and statistical analyses conducted accordingly. The sample consisted of 300 PLWHA from Aizawl District, 150 males and 150 females, of the age group 20 to 70 years. Two- way classification of “Gender” (male and female) and three-way classification of “Level of IHS” (High IHS, Moderate IHS, Low IHS) on the dependent variables was employed, to elucidate the relationship between Internalized HIV Stigma, mental health, coping and perceived social support of PLHIV. The overall analysis revealed moderate level of IHS (67.3%) among PLHIV in Aizawl District, with a small proportion of subjects reporting high level of IHS. IHS was found to be significantly different on the basis of disclosure status, with the disclosure status of PLHIV accounting for 9% variability in IHS.  Results also revealed more or less good mental health among the participants, which was assessed by minimal depression (50.3%) and minimal anxiety (45%), with females with high IHS scoring significantly higher in both depression and anxiety (p<.01). Examination of the coping strategies of PLHIV found that the most frequently used coping styles were Acceptance (91%), Religion (84.3%), Planning (74.7%), Active Coping (66%) and Emotional Support (52.7%). High perception of perceived social support (48%) was found in the present study. Correlation analysis revealed significant positive relationships between IHS and depression as well as anxiety (p<.01), thus revealing that IHS negatively affects the mental health of PLHIV. Results however revealed that this effect may be lessened by the use of various coping strategies by PLHIV as well as their perception of social support.

Keywords: Aizawl, anxiety, depression, internalized HIV stigma, HIV/AIDS, mental health, mizoram, perceived social support

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152 Comparative Study of Static and Dynamic Representations of the Family Structure and Its Clinical Utility

Authors: Marietta Kékes Szabó

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The patterns of personality (mal)function and the individuals’ psychosocial environment influence the healthy status collectively and may lie in the background of psychosomatic disorders. Although the patients with their diversified symptoms usually do not have any organic problems, the experienced complaint, the fear of serious illness and the lack of social support often lead to increased anxiety and further enigmatic symptoms. The role of the family system and its atmosphere seem to be very important in this process. More studies explored the characteristics of dysfunctional family organization: inflexible family structure, hidden conflicts that are not spoken about by the family members during their daily interactions, undefined role boundaries, neglect or overprotection of the children by the parents and coalition between generations. However, questionnaires that are used to measure the properties of the family system are able to explore only its unit and cannot pay attention to the dyadic interactions, while the representation of the family structure by a figure placing test gives us a new perspective to better understand the organization of the (sub)system(s). Furthermore, its dynamic form opens new perspectives to explore the family members’ joint representations, which gives us the opportunity to know more about the flexibility of cohesion and hierarchy of the given family system. In this way, the communication among the family members can be also examined. The aim of my study was to collect a great number of information about the organization of psychosomatic families. In our research we used Gehring’s Family System Test (FAST) both in static and dynamic forms to mobilize the family members’ mental representations about their family and to get data in connection with their individual representations as well as cooperation. There were four families in our study, all of them with a young adult person. Two families with healthy participants and two families with asthmatic patient(s) were involved in our research. The family members’ behavior that could be observed during the dynamic situation was recorded on video for further data analysis with Noldus Observer XT 8.0 program software. In accordance with the previous studies, our results show that the family structure of the families with at least one psychosomatic patient is more rigid than it was found in the control group and the certain (typical, ideal, and conflict) dynamic representations reflected mainly the most dominant family member’s individual concept. The behavior analysis also confirmed the intensified role of the dominant person(s) in the family life, thereby influencing the family decisions, the place of the other family members, as well as the atmosphere of the interactions, which could also be grasped well by the applied methods. However, further research is needed to learn more about the phenomenon that can open the door for new therapeutic approaches.

Keywords: psychosomatic families, family structure, family system test (FAST), static and dynamic representations, behavior analysis

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151 Trehalose Application Increased Membrane Stability and Cell Viability to Affect Growth of Wheat Genotypes under Heat Stress

Authors: S. K. Thind, Aparjot Kaur

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Heat stress is one of the major environmental factors drastically reducing wheat production. Crop heat tolerance can be enhanced by preconditioning of plants by exogenous application of osmoprotectants. Presently, the effect of trehalose pretreatment (at 1 mM, and 1.5 nM) under heat stress of 35±2˚C (moderate) and 40±2˚ (severe) for four and eight hour was conducted in wheat (Tricticum aestivum L.) genotypes viz. HD2967, PBW 175, PBW 343, PBW 621, and PBW 590. Heat stress affects wide spectrum of physiological processes within plants that are irreversibly damaged by stress. Membrane thermal stability (MTS) and cell viability was significantly decreased under heat stress for eight hours. Pretreatment with trehalose improved MTS and cell viability under stress and this effect was more promotory with higher concentration. Thermal stability of photosynthetic apparatus differed markedly between genotypes and Hill reaction activity was recorded more in PBW621 followed by C306 as compared with others. In all genotypes photolysis of water showed decline with increase in temperature stress. Trehalose pretreatment helped in sustaining Hill reaction activity probably by stabilizing the photosynthetic apparatus against heat-induced photo inhibition. Both plant growth and development were affected by temperature in both shoot and root under heat stress. The reduction was compensated partially by trehalose (1.5 mM) application. Adaption to heat stress is associated with the metabolic adjustment which led to accumulation of soluble sugars including non-reducing and reducing for their role in adaptive mechanism. Higher acid invertase activity in shoot of tolerant genotypes appeared to be a characteristic for stress tolerance. As sucrose synthase play central role in sink strength and in studied wheat genotype was positively related to dry matter accumulation. The duration of heat stress for eight hours had more severe effect on these parameters and trehalose application at 1.5 mM ameliorated it to certain extent.

Keywords: heat stress, Triticum aestivum, trehalose, membrane thermal stability, triphenyl tetrazolium chloride, reduction test, growth, sugar metabolism

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150 Evaluation of the Effect of Lactose Derived Monosaccharide on Galactooligosaccharides Production by β-Galactosidase

Authors: Yenny Paola Morales Cortés, Fabián Rico Rodríguez, Juan Carlos Serrato Bermúdez, Carlos Arturo Martínez Riascos

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Numerous benefits of galactooligosaccharides (GOS) as prebiotics have motivated the study of enzymatic processes for their production. These processes have special complexities due to several factors that make difficult high productivity, such as enzyme type, reaction medium pH, substrate concentrations and presence of inhibitors, among others. In the present work the production of galactooligosaccharides (with different degrees of polymerization: two, three and four) from lactose was studied. The study considers the formulation of a mathematical model that predicts the production of GOS from lactose using the enzyme β-galactosidase. The effect of pH in the reaction was studied. For that, phosphate buffer was used and with this was evaluated three pH values (6.0.6.5 and 7.0). Thus it was observed that at pH 6.0 the enzymatic activity insignificant. On the other hand, at pH 7.0 the enzymatic activity was approximately 27 times greater than at 6.5. The last result differs from previously reported results. Therefore, pH 7.0 was chosen as working pH. Additionally, the enzyme concentration was analyzed, which allowed observing that the effect of the concentration depends on the pH and the concentration was set for the following studies in 0.272 mM. Afterwards, experiments were performed varying the lactose concentration to evaluate its effects on the process and to generate the data for the adjustment of the mathematical model parameters. The mathematical model considers the reactions of lactose hydrolysis and transgalactosylation for the production of disaccharides and trisaccharides, with their inverse reactions. The production of tetrasaccharides was negligible and, because of that, it was not included in the model. The reaction was monitored by HPLC and for the quantitative analysis of the experimental data the Matlab programming language was used, including solvers for differential equations systems integration (ode15s) and nonlinear problems optimization (fminunc). The results confirm that the transgalactosylation and hydrolysis reactions are reversible, additionally inhibition by glucose and galactose is observed on the production of GOS. In relation to the production process of galactooligosaccharides, the results show that it is necessary to have high initial concentrations of lactose considering that favors the transgalactosylation reaction, while low concentrations favor hydrolysis reactions.

Keywords: β-galactosidase, galactooligosaccharides, inhibition, lactose, Matlab, modeling

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149 Clinicians' and Nurses' Documentation Practices in Palliative and Hospice Care: A Mixed Methods Study Providing Evidence for Quality Improvement at Mobile Hospice Mbarara, Uganda

Authors: G. Natuhwera, M. Rabwoni, P. Ellis, A. Merriman

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Aims: Health workers are likely to document patients’ care inaccurately, especially when using new and revised case tools, and this could negatively impact patient care. This study set out to; (1) assess nurses’ and clinicians’ documentation practices when using a new patients’ continuation case sheet (PCCS) and (2) explore nurses’ and clinicians’ experiences regarding documentation of patients’ information in the new PCCS. The purpose of introducing the PCCS was to improve continuity of care for patients attending clinics at which they were unlikely to see the same clinician or nurse consistently. Methods: This was a mixed methods study. The cross-sectional inquiry retrospectively reviewed 100 case notes of active patients on hospice and palliative care program. Data was collected using a structured questionnaire with constructs formulated from the new PCCS under study. The qualitative element was face-to-face audio-recorded, open-ended interviews with a purposive sample of one palliative care clinician, and four palliative care nurse specialists. Thematic analysis was used. Results: Missing patients’ biogeographic information was prevalent at 5-10%. Spiritual and psychosocial issues were not documented in 42.6%, and vital signs in 49.2%. Poorest documentation practices were observed in past medical history part of the PCCS at 40-63%. Four themes emerged from interviews with clinicians and nurses-; (1) what remains unclear and challenges, (2) comparing the past with the present, (3) experiential thoughts, and (4) transition and adapting to change. Conclusions: The PCCS seems to be a comprehensive and simple tool to be used to document patients’ information at subsequent visits. The comprehensiveness and utility of the PCCS does paper to be limited by the failure to train staff in its use prior to introducing. The authors find the PCCS comprehensive and suitable to capture patients’ information and recommend it can be adopted and used in other palliative and hospice care settings, if suitable introductory training accompanies its introduction. Otherwise, the reliability and validity of patients’ information collected by this PCCS can be significantly reduced if some sections therein are unclear to the clinicians/nurses. The study identified clinicians- and nurses-related pitfalls in documentation of patients’ care. Clinicians and nurses need to prioritize accurate and complete documentation of patient care in the PCCS for quality care provision. This study should be extended to other sites using similar tools to ensure representative and generalizable findings.

Keywords: documentation, information case sheet, palliative care, quality improvement

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148 Asymmetric Price Transmission in Rice: A Regional Analysis in Peru

Authors: Renzo Munoz-Najar, Cristina Wong, Daniel De La Torre Ugarte

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The literature on price transmission usually deals with asymmetries related to different commodities and/or the short and long term. The role of domestic regional differences and the relationship with asymmetries within a country are usually left out. This paper looks at the asymmetry in the transmission of rice prices from the international price to the farm gate prices in four northern regions of Peru for the last period 2001-2016. These regions are San Martín, Piura, Lambayeque and La Libertad. The relevance of the study lies in its ability to assess the need for policies aimed at improving the competitiveness of the market and ensuring the benefit of producers. There are differences in planting and harvesting dates, as well as in geographic location that justify the hypothesis of the existence of differences in the price transition asymmetries between these regions. Those differences are due to at least three factors geography, infrastructure development, and distribution systems. For this, the Threshold Vector Error Correction Model and the Autoregressive Vector Model with Threshold are used. Both models, collect asymmetric effects in the price adjustments. In this way, it is sought to verify that farm prices react more to falls than increases in international prices due to the high bargaining power of intermediaries. The results of the investigation suggest that the transmission of prices is significant only for Lambayeque and La Libertad. Likewise, the asymmetry in the transmission of prices for these regions is checked. However, these results are not met for San Martin and Piura, the main rice producers nationwide. A significant price transmission is verified only in the Lambayeque and La Libertad regions. San Martin and Piura, in spite of being the main rice producing regions of Peru, do not present a significant transmission of international prices; a high degree of self-sufficient supply might be at the center of the logic for this result. An additional finding is the short-term adjustment with respect to international prices, it is higher in La Libertad compared to Lambayeque, which could be explained by the greater bargaining power of intermediaries in the last-mentioned region due to the greater technological development in the mills.

Keywords: asymmetric price transmission, rice prices, price transmission, regional economics

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147 Psychological and Emotional Functioning of Elderly in Pakistan a Comparison in Punjab and Gilgit-Baltistan

Authors: Najma Najam, Rukhsana Kausar, Rabia Hussain Kanwal, Saira Batool, Anum Javed

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In Pakistan, elderly population though increasing but it has been neglected by the researchers and policy makers which resulted in compromised quality of life of the ageing population. Two regions, Punjab and Gilgit-Baltistan (GB) were selected for comparison as Lahore and Multan (Punjab) are highly urbanized, large cities whereas Gilgit and Skardu are remote and mountain bounded valleys in GB. This study focuses on psychological and emotional functioning of elderly and a series of measures translated and adapted in Urdu language was used to assess quality of life, psychological and mental well-being, actual and perceived social support, attachment patterns, forgiveness, affects, geriatric depression, and emotional disturbance patterns (depression, anxiety, and stress) in elderly. A gender-equated sample of 201 elderly participants, 93 from GB (60 from Gilgit, 33 from Skardu) and 108 from Punjab (61 from Lahore, 47 from Multan) with over 60 years age was collected from the multiethnic community of Punjab and GB through purposive convenient sampling technique. Findings revealed that elderly from Multan have better psychological and emotional functioning, higher levels of social support, tendency to forgive, better mental wellbeing and quality of life and lower levels of stress, anxiety, depression, negative affect and attachment avoidance and anxiety related to partner as compared to the elderly from Lahore. Furthermore, both elderly male of Gilgit & Skardu have adequate mental well-being including subjective well-being and psychological functioning which showed positive aspects of mental health but elderly female are more attached to their home and neighbourhood which shows their social and environmental mastery. Gilgiti elderly male reported more degree of positive affect such as enthusiasm, active, alertness, excitement and strong whereas among elderly from Skardu shows more negative affect i.e. aversive mood states, irritability, hostility, and general distress. The need of psychosocial therapy and family counseling for the elderly in urban areas has been identified, which can facilitate in reducing or preventing the depressive and stressful tendencies. The findings are expected to have implications for improving quality of life of the elderly, designing interventions, support system and rehabilitation services to help them. However, findings may attract attention of policy makers and researchers as currently this is the most neglected population in Pakistan.

Keywords: psychological, emotional, aging, elderly, quality of life

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146 Causal-Explanatory Model of Academic Performance in Social Anxious Adolescents

Authors: Beatriz Delgado

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Although social anxiety is one of the most prevalent disorders in adolescents and causes considerable difficulties and social distress in those with the disorder, to date very few studies have explored the impact of social anxiety on academic adjustment in student populations. The aim of this study was analyze the effect of social anxiety on school functioning in Secondary Education. Specifically, we examined the relationship between social anxiety and self-concept, academic goals, causal attributions, intellectual aptitudes, and learning strategies, personality traits, and academic performance, with the purpose of creating a causal-explanatory model of academic performance. The sample consisted of 2,022 students in the seven to ten grades of Compulsory Secondary Education in Spain (M = 13.18; SD = 1.35; 51.1% boys). We found that: (a) social anxiety has a direct positive effect on internal attributional style, and a direct negative effect on self-concept. Social anxiety also has an indirect negative effect on internal causal attributions; (b) prior performance (first academic trimester) exerts a direct positive effect on intelligence, achievement goals, academic self-concept, and final academic performance (third academic trimester), and a direct negative effect on internal causal attributions. It also has an indirect positive effect on causal attributions (internal and external), learning goals, achievement goals, and study strategies; (c) intelligence has a direct positive effect on learning goals and academic performance (third academic trimester); (d) academic self-concept has a direct positive effect on internal and external attributional style. Also, has an indirect effect on learning goals, achievement goals, and learning strategies; (e) internal attributional style has a direct positive effect on learning strategies and learning goals. Has a positive but indirect effect on achievement goals and learning strategies; (f) external attributional style has a direct negative effect on learning strategies and learning goals and a direct positive effect on internal causal attributions; (g) learning goals have direct positive effect on learning strategies and achievement goals. The structural equation model fit the data well (CFI = .91; RMSEA = .04), explaining 93.8% of the variance in academic performance. Finally, we emphasize that the new causal-explanatory model proposed in the present study represents a significant contribution in that it includes social anxiety as an explanatory variable of cognitive-motivational constructs.

Keywords: academic performance, adolescence, cognitive-motivational variables, social anxiety

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145 Prevalence and Correlates of Complementary and Alternative Medicine Use among Diabetic Patients in Lebanon: A Cross-Sectional Study

Authors: Farah Naja, Mohamad Alameddine

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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

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144 The Correlation between Musculoskeletal Disorders and Body Postures during Playing among Guitarists

Authors: Navah Z. Ratzon, Shlomit Cohen, Sigal Portnoy

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This work focuses on posture and risk factors for the musculoskeletal disorder in guitarists, which constitutes the largest group of musicians today. The source of the problems experienced by these musicians is linked to physical, psychosocial and personal risk factors. These muscular problems are referred to as Playing Related Musculoskeletal Disorder (PRMD). There is not enough research that specifically studies guitar players, and to the extent of our knowledge, there is almost no reference to the characteristics of their movement patterns while they play. This is in spite of the high prevalence of PRMD in this population. Kinematic research may provide a basis for the development of a prevention plan for this population and their unique characteristics of playing patterns. The aim of the study was to investigate the correlation between risk factors for PRMD among guitar players and self-reporting of pain in the skeletal muscles, and specifically to test whether there are differences in the kinematics of the upper body while playing in a sitting or standing posture. Twenty-five guitarists, aged 18-35, participated in the study. The methods included a motion analysis using a motion capture system, anthropometric measurements and questionnaires relating to risk factors. The questionnaires used were the Standardized Nordic Questionnaire for the Analysis of Musculoskeletal Symptoms and the Demand Control Support Questionnaire, as well as a questionnaire of personal details. All of the study participants complained of musculoskeletal pain in the past year; the most frequent complaints being in the left wrist. Statistically significant correlations were found between biodemographic indices and reports of pain in the past year and the previous week. No significant correlations were found between the physical posture while playing and reports of pain among professional guitarists. However, a difference was found in several kinematic parameters between seated and standing playing postures. In a majority of the joints, the joint angles while playing in a seated position were more extreme than those during standing. This finding may suggest a higher risk for musculoskeletal disorder while playing in a seated position. In conclusion, the results of the present research highlight the prevalence of musculoskeletal problems in guitar players and its correlation with various risk factors. The finding supports the need for intervention in the form of prevention through identifying the risk factors and addressing them. Relating to the person, to their occupation and environment, which are the basis of proper occupational therapy, can help meet this need.

Keywords: body posture, motion tracking, PRMD, guitarists

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143 Evaluation of Relationship between Job Stress Dimensions with Occupational Accidents in Industrial Factories in Southwest of Iran

Authors: Ali Ahmadi, Maryam Abbasi, Mohammad Mehdi Parsaei

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Background: Stress in the workplace today is one of the most important public health concerns and a serious threat to the health of the workforce worldwide. Occupational stress can cause occupational events and reduce quality of life. As a result, it has a very undesirable impact on the performance of organizations, companies, and their human resources. This study aimed to evaluate the relationship between job stress dimensions and occupational accidents in industrial factories in Southwest Iran. Materials and Methods: This cross-sectional study was conducted among 200 workers in the summer of 2023 in the Southwest of Iran. To select participants, we used a convenience sampling method. The research tools in this study were the Health and Safety Executive (HSE) stress questionnaire with 35 questions and 7 dimensions and demographic information. A high score on this questionnaire indicates that there is low job stress and pressure. All workers completed the informed consent form. Univariate analysis was performed using chi-square and T-test. Multiple regression analysis was used to estimate the odds ratios (OR) and 95% confidence interval (CI) for the association of stress-related factors with job accidents in participants. Stata 14.0 software was used for analysis. Results: The mean age of the participants was 39.81(6.36) years. The prevalence of job accidents was 28.0% (95%CI: 21.0, 34.0). Based on the results of the multiple logistic regression with the adjustment of the effect of the confounding variables, one increase in the score of the demand dimension had a protective impact on the risk of job accidents(aOR=0.91,95%CI:0.85-0.95). Additionally, an increase in one of the scores of the managerial support (aOR=0.89, 95% CI: 0.83-0.95) and peer support (aOR=0.76, 95%CI: 0.67-87) dimensions was associated with a lower number of job accidents. Among dimensions, an increase in the score of relationship (aOR=0.89, 95%CI: 0.80-0.98) and change (aOR=0.86, 95%CI: 0.74-0.96) reduced the odds of the accident's occurrence among the workers by 11% and 16%, respectively. However, there was no significant association between role and control dimensions and the job accident (p>0.05). Conclusions: The results show that the prevalence of job accidents was alarmingly high. Our results suggested that an increase in scores of dimensions HSE questioners is significantly associated with a decrease the accident occurrence in the workplace. Therefore, planning to address stressful factors in the workplace seems necessary to prevent occupational accidents.

Keywords: HSE, Iran, job stress occupational accident, safety, occupational health

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142 Multilevel of Factors Affected Optimal Adherence to Antiretroviral Therapy and Viral Suppression amongst HIV-Infected Prisoners in South Ethiopia: A Prospective Cohort Study

Authors: Terefe Fuge, George Tsourtos , Emma Miller

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Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression

Procedia PDF Downloads 101
141 Adaptation of the Scenario Test for Greek-speaking People with Aphasia: Reliability and Validity Study

Authors: Marina Charalambous, Phivos Phylactou, Thekla Elriz, Loukia Psychogios, Jean-Marie Annoni

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Background: Evidence-based practices for the evaluation and treatment of people with aphasia (PWA) in Greek are mainly impairment-based. Functional and multimodal communication is usually under assessed and neglected by clinicians. This study explores the adaptation and psychometric testing of the Greek (GR) version of The Scenario Test. The Scenario Test assesses the everyday functional communication of PWA in an interactive multimodal communication setting with the support of an active communication facilitator. Aims: To define the reliability and validity of The Scenario Test GR and discuss its clinical value. Methods & Procedures: The Scenario Test-GR was administered to 54 people with chronic stroke (6+ months post-stroke): 32 PWA and 22 people with stroke without aphasia. Participants were recruited from Greece and Cyprus. All measures were performed in an interview format. Standard psychometric criteria were applied to evaluate reliability (internal consistency, test-retest, and interrater reliability) and validity (construct and known – groups validity) of the Scenario Test GR. Video analysis was performed for the qualitative examination of the communication modes used. Outcomes & Results: The Scenario Test-GR shows high levels of reliability and validity. High scores of internal consistency (Cronbach’s α = .95), test-retest reliability (ICC = .99), and interrater reliability (ICC = .99) were found. Interrater agreement in scores on individual items fell between good and excellent levels of agreement. Correlations with a tool measuring language function in aphasia (the Aphasia Severity Rating Scale of the Boston Diagnostic Aphasia Examination), a measure of functional communication (the Communicative Effectiveness Index), and two instruments examining the psychosocial impact of aphasia (the Stroke and Aphasia Quality of Life questionnaire and the Aphasia Impact Questionnaire) revealed good convergent validity (all ps< .05). Results showed good known – groups validity (Mann-Whitney U = 96.5, p < .001), with significantly higher scores for participants without aphasia compared to those with aphasia. Conclusions: The psychometric qualities of The Scenario Test-GR support the reliability and validity of the tool for the assessment of functional communication for Greek-speaking PWA. The Scenario Test-GR can be used to assess multimodal functional communication, orient aphasia rehabilitation goal setting towards the activity and participation level, and be used as an outcome measure of everyday communication. Future studies will focus on the measurement of sensitivity to change in PWA with severe non-fluent aphasia.

Keywords: the scenario test GR, functional communication assessment, people with aphasia (PWA), tool validation

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140 An Unexpected Helping Hand: Consequences of Redistribution on Personal Ideology

Authors: Simon B.A. Egli, Katja Rost

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Literature on redistributive preferences has proliferated in past decades. A core assumption behind it is that variation in redistributive preferences can explain different levels of redistribution. In contrast, this paper considers the reverse. What if it is redistribution that changes redistributive preferences? The core assumption behind the argument is that if self-interest - which we label concrete preferences - and ideology - which we label abstract preferences - come into conflict, the former will prevail and lead to an adjustment of the latter. To test the hypothesis, data from a survey conducted in Switzerland during the first wave of the COVID-19 crisis is used. A significant portion of the workforce at the time unexpectedly received state money through the short-time working program. Short-time work was used as a proxy for self-interest and was tested (1) on the support given to hypothetical, ailing firms during the crisis and (2) on the prioritization of justice principles guiding state action. In a first step, several models using OLS-regressions on political orientation were estimated to test our hypothesis as well as to check for non-linear effects. We expected support for ailing firms to be the same regardless of ideology but only for people on short-time work. The results both confirm our hypothesis and suggest a non-linear effect. Far-right individuals on short-time work were disproportionally supportive compared to moderate ones. In a second step, ordered logit models were estimated to test the impact of short-time work and political orientation on the rankings of the distributive justice principles need, performance, entitlement, and equality. The results show that being on short-time work significantly alters the prioritization of justice principles. Right-wing individuals are much more likely to prioritize need and equality over performance and entitlement when they receive government assistance. No such effect is found among left-wing individuals. In conclusion, we provide moderate to strong evidence that unexpectedly finding oneself at the receiving end changes redistributive preferences if personal ideology is antithetical to redistribution. The implications of our findings on the study of populism, personal ideologies, and political change are discussed.

Keywords: COVID-19, ideology, redistribution, redistributive preferences, self-interest

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139 Different Approaches to Teaching a Database Course to Undergraduate and Graduate Students

Authors: Samah Senbel

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Database Design is a fundamental part of the Computer Science and Information technology curricula in any school, as well as in the study of management, business administration, and data analytics. In this study, we compare the performance of two groups of students studying the same database design and implementation course at Sacred Heart University in the fall of 2018. Both courses used the same textbook and were taught by the same professor, one for seven graduate students and one for 26 undergraduate students (juniors). The undergraduate students were aged around 20 years old with little work experience, while the graduate students averaged 35 years old and all were employed in computer-related or management-related jobs. The textbook used was 'Database Systems, Design, Implementation, and Management' by Coronel and Morris, and the course was designed to follow the textbook roughly a chapter per week. The first 6 weeks covered the design aspect of a database, followed by a paper exam. The next 6 weeks covered the implementation aspect of the database using SQL followed by a lab exam. Since the undergraduate students are on a 16 week semester, we spend the last three weeks of the course covering NoSQL. This part of the course was not included in this study. After the course was over, we analyze the results of the two groups of students. An interesting discrepancy was observed: In the database design part of the course, the average grade of the graduate students was 92%, while that of the undergraduate students was 77% for the same exam. In the implementation part of the course, we observe the opposite: the average grade of the graduate students was 65% while that of the undergraduate students was 73%. The overall grades were quite similar: the graduate average was 78% and that of the undergraduates was 75%. Based on these results, we concluded that having both classes follow the same time schedule was not beneficial, and an adjustment is needed. The graduates could spend less time on design and the undergraduates would benefit from more design time. In the fall of 2019, 30 students registered for the undergraduate course and 15 students registered for the graduate course. To test our conclusion, the undergraduates spend about 67% of time (eight classes) on the design part of the course and 33% (four classes) on the implementation part, using the exact exams as the previous year. This resulted in an improvement in their average grades on the design part from 77% to 83% and also their implementation average grade from 73% to 79%. In conclusion, we recommend using two separate schedules for teaching the database design course. For undergraduate students, it is important to spend more time on the design part rather than the implementation part of the course. While for the older graduate students, we recommend spending more time on the implementation part, as it seems that is the part they struggle with, even though they have a higher understanding of the design component of databases.

Keywords: computer science education, database design, graduate and undergraduate students, pedagogy

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138 An Automatic Large Classroom Attendance Conceptual Model Using Face Counting

Authors: Sirajdin Olagoke Adeshina, Haidi Ibrahim, Akeem Salawu

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large lecture theatres cannot be covered by a single camera but rather by a multicamera setup because of their size, shape, and seating arrangements. Although, classroom capture is achievable through a single camera. Therefore, a design and implementation of a multicamera setup for a large lecture hall were considered. Researchers have shown emphasis on the impact of class attendance taken on the academic performance of students. However, the traditional method of carrying out this exercise is below standard, especially for large lecture theatres, because of the student population, the time required, sophistication, exhaustiveness, and manipulative influence. An automated large classroom attendance system is, therefore, imperative. The common approach in this system is face detection and recognition, where known student faces are captured and stored for recognition purposes. This approach will require constant face database updates due to constant changes in the facial features. Alternatively, face counting can be performed by cropping the localized faces on the video or image into a folder and then count them. This research aims to develop a face localization-based approach to detect student faces in classroom images captured using a multicamera setup. A selected Haar-like feature cascade face detector trained with an asymmetric goal to minimize the False Rejection Rate (FRR) relative to the False Acceptance Rate (FAR) was applied on Raspberry Pi 4B. A relationship between the two factors (FRR and FAR) was established using a constant (λ) as a trade-off between the two factors for automatic adjustment during training. An evaluation of the proposed approach and the conventional AdaBoost on classroom datasets shows an improvement of 8% TPR (output result of low FRR) and 7% minimization of the FRR. The average learning speed of the proposed approach was improved with 1.19s execution time per image compared to 2.38s of the improved AdaBoost. Consequently, the proposed approach achieved 97% TPR with an overhead constraint time of 22.9s compared to 46.7s of the improved Adaboost when evaluated on images obtained from a large lecture hall (DK5) USM.

Keywords: automatic attendance, face detection, haar-like cascade, manual attendance

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137 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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