Search results for: Children care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 769

Search results for: Children care

649 Obstruction to Treatments Meeting International Standards for Lyme and Relapsing Fever Borreliosis Patients

Authors: J. Luché-Thayer, C. Perronne, C. Meseko

Abstract:

We reviewed how certain institutional policies and practices, as well as questionable research, are creating obstacles to care and informed consent for Lyme and relapsing fever Borreliosis patients. The interference is denying access to treatments that meet the internationally accepted standards as set by the Institute of Medicine. This obstruction to care contributes to significant human suffering, disability and negative economic effect across many nations and in many regions of the world. We note how evidence based medicine emphasizes the importance of clinical experience and patient-centered care and how these patients benefit significantly when their rights to choose among treatment options are upheld.  

Keywords: Conflicts of interest, obstacles to healthcare accessibility, patient-centered care, the right to informed consent.

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648 ACTN3 Genotype Association with Motoric Performance of Roma Children

Authors: J. Bernasovska, I. Boronova, J. Poracova, M. Mydlarova Blascakova, V. Szabadosova, P. Ruzbarsky, E. Petrejcikova, I. Bernasovsky

Abstract:

The paper presents the results of the molecular genetics analysis in sports research, with special emphasis to use genetic information in diagnosing of motoric predispositions in Roma boys from East Slovakia. The ability and move are the basic characteristics of all living organisms. The phenotypes are influenced by a combination of genetic and environmental factors. Genetic tests differ in principle from the traditional motoric tests, because the DNA of an individual does not change during life. The aim of the presented study was to examine motion abilities and to determine the frequency of ACTN3 (R577X) gene in Roma children. Genotype data were obtained from 138 Roma and 155 Slovak boys from 7 to 15 years old. Children were investigated on physical performance level in association with their genotype. Biological material for genetic analyses comprised samples of buccal swabs. Genotypes were determined using Real Time High resolution melting PCR method (Rotor-Gene 6000 Corbett and Light Cycler 480 Roche). The software allows creating reports of any analysis, where information of the specific analysis, normalized and differential graphs and many information of the samples are shown. Roma children of analyzed group legged to non-Romany children at the same age in all the compared tests. The % distribution of R and X alleles in Roma children was different from controls. The frequency of XX genotype was 9.26%, RX 46.33% and RR was 44.41%. The frequency of XX genotype was 9.26% which is comparable to a frequency of an Indian population. Data were analyzed with the ANOVA test.

Keywords: ACTN3 gene, R577X polymorphism, Roma children, Slovakia, sports performance.

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647 Music Aptitude and School Readiness in Indonesian Children

Authors: Diella Gracia Martauli

Abstract:

This study investigated the relationship between music aptitude and school readiness in Indonesian children. Music aptitude is described as children’s music potential, whereas school readiness is defined as a condition in which a child is deemed ready to enter the formal education system. This study presents a hypothesis that music aptitude is correlated with school readiness. This is a correlational research study of 17 children aged 5-6 years old (M = 6.10, SD = 0.33) who were enrolled in a kindergarten school in Jakarta, Indonesia. Music aptitude scores were obtained from Primary Measures of Music Audiation, whereas School readiness scores were obtained from Bracken School Readiness Assessment Third Edition. The analysis of the data was performed using Pearson Correlation. The result found no correlation between music aptitude and school readiness (r = 0.196, p = 0.452). Discussions regarding the results, perspective from the measures and cultures are presented. Further study is recommended to establish links between music aptitude and school readiness.

Keywords: Bracken school readiness assessment, music aptitude, primary measures of music audiation, school readiness.

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646 The Risk Factors Associated with Under-Five Mortality in Lesotho Using the 2009 Lesotho Demographic and Health Survey

Authors: T. Motsima

Abstract:

The under-5 mortality rate is high in sub-Saharan Africa with Lesotho being amongst the highest under-5 mortality rates in the world. The objective of the study is to determine the factors associated with under-5 mortality in Lesotho. The data used for this analysis come from the nationally representative household survey called the 2009 Lesotho Demographic and Health Survey. Odds ratios produced by the logistic regression models were used to measure the effect of each independent variable on the dependent variable. Female children were significantly 38% less likely to die than male children. Children who were breastfed for 13 to 18 months and those who were breastfed for more than 19 months were significantly less likely to die than those who were breastfed for 12 months or less. Furthermore, children of mothers who stayed in Quthing, Qacha’s Nek and Thaba Tseka ran the greatest risk of dying. The results suggested that: sex of child, type of birth, breastfeeding duration, district, source of energy and marital status were significant predictors of under-5 mortality, after correcting for all variables.

Keywords: Under-5 mortality, risk factors, millennium development goals, breastfeeding, logistic regression.

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645 Kinematic Gait Analysis of Upper and Lower Limbs Joints in Hemiplegic Children

Authors: Zeinab A.Hussein, Manal S. Abd El-Wahab, Shorouk A. W. El-Shennawy

Abstract:

Children with hemiplgic cerebral palsy often walk with diminished reciprocal arm swing so the purpose of this study was to describe kinematic characteristics in children with hemiplegic cerebral palsy (CP) during the gait suphases, and find if there is a correlation between upper(shoulder and elbow) and lower(hip, knee, and ankle) limb joints either in involved or uninvolved.48 children with hemiplegic cerebral palsy (18boys, 30girls) with an average age of (5.1±0.87) years were selected randomly to evaluate joint angles during gait by 3D motion analysis system with 6 pro reflex cameras in a sagittal plane for both sides of the body. The results showed increased shoulder and elbow flexion, increased hip angular displacement, decreased knee and ankle arcs during gait cycle, also there is correlation between shoulder and elbow to hip, knee, and ankle joints during various subphases of gait.

Keywords: Cerebral palsy, Gait, Hemiplegia, Motion analysis.

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644 An Obesity Index Derived from Waist and Hip Circumferences Well-Matched with Other Indices in Children with Obesity

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Indices derived from anthropometric measurements [waist-to-hip ratio (WHR)] or body fat mass compositions [trunk-to-leg fat ratio (TLFR)] are used for the evaluation of obesity. The best for clinical practices is still being investigated. The aim of this study is to derive an index, which best suits the purpose for the discrimination of children with normal body mass index (N-BMI) from obese (OB) children. 83 children participated in the study. Groups 1 and 2 comprised 42 children with N-BMI and 41 OB children, whose age- and sex-adjusted BMI percentile values vary between 15-85 and 95-99, respectively. The institutional ethics committee approved the study protocol. Informed consent forms were filled by the parents of the participants. Anthropometric measurements (weight, height (Ht), waist circumference (WC), hip circumference (HC), neck circumference (NC) values) were taken. BMI, WHR, (WC+HC)/2, WC/Ht, (WC/HC)/Ht, WC*NC were calculated. Bioelectrical impedance analysis was performed to obtain body’s fat compartments in terms of total fat, trunk fat, leg fat, arm fat masses. TLFR, trunk-to-appendicular fat ratio (TAFR), (trunk fat+leg fat)/2 ((TF+LF)/2), fat mass index (FMI) and diagnostic obesity notation model assessment-II (D2I) index values were calculated. Statistical analysis was performed. Significantly higher values of (WC+HC)/2, (TF+LF)/2, D2I and FMI were observed in OB group than N-BMI group. Significant correlations were found between BMI and WC, (WC+HC)/2, (TF+LF)/2, TLFR, TAFR, D2I, FMI in both groups. Similar correlations were obtained for WC. (WC+HC)/2 was correlated with TLFR, TAFR, (TF+LF)/2, D2I and FMI in N-BMI group. In OB group, the correlations were the same except those with TLFR and TAFR. These correlations were not present with WHR. Correlations were observed between TLFR as well as TAFR and BMI, WC, (WC+HC)/2, (TF+LF)/2, D2I, FMI in N-BMI group. In OB group, correlations between TLFR or TAFR and BMI, WC as well as (WC+HC)/2 were missing. None was noted with WHR. In conclusion, the only correlation valid in both groups was that exists between (TF+LF)/2 and (WC+HC)/2, which was suggested as a link between fat-based and anthropometric indices. (WC+HC)/2, but not WHR, was much more suitable as an anthropometric obesity index.

Keywords: Children, hip circumference, obesity, waist circumference.

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643 Predictors of Social Participation of Children with Cerebral Palsy in Primary Schools in Czech Republic

Authors: Marija Zulić, Vanda Hájková, Nina Brkić-Jovanović, Linda Rathousová, Sanja Tomić

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Cerebral palsy is primarily reflected in the disorder of the development of movement and posture, which may be accompanied by sensory disturbances, disturbances of perception, cognition and communication, behavioural disorders and epilepsy. According to current inclusive attitudes towards people with disabilities implies that full social participation of children with cerebral palsy means inclusion in all activities in family, peer, school and leisure environments in the same scope and to the same extent as is the case with the children of proper development and without physical difficulties. Due to the fact that it has been established that the quality of children's participation in primary school is directly related to their social inclusion in future life, the aim of the paper is to identify predictors of social participation, respectively, and in particular, factors that could to improve the quality of social participation of children with cerebral palsy, in the primary school environment in Czech Republic. The study includes children with cerebral palsy (n = 75) in the Czech Republic, aged between six and 12 years who attend mainstream or special primary schools to the sixth grade. The main instrument used was the first and third part of the School function assessment questionnaire. It will also take into account the type of damage assessed according to a scale the Gross motor function classification system, five–level classification system for cerebral palsy. The research results will provide detailed insight into the degree of social participation of children with cerebral palsy and the factors that would be a potential cause of their levels of participation, in regular and special primary schools, in different socioeconomic environments in Czech Republic.

Keywords: Cerebral palsy, social participation, Czech Republic, school function assessment.

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642 Needs of Omani Children in First Grade during Their Transition from Kindergarten to Primary School: An Ethnographic Study

Authors: Zainab Algharibi, Julie McAdam, Catherine Fagan

Abstract:

The purpose of this paper is to shed light on how Omani children in the first grade experience their needs during their transition to primary school. Theoretically, the paper was built on two perspectives: Dewey's concept of continuity of experience and the boundary objects introduced by Vygotsky (CHAT). The methodology of the study is based on the crucial role of children’s agency which is a very important activity as an educational tool to enhance the child’s participation in the learning process and develop their ability to face various issues in their life. Thus, the data were obtained from 45 children in grade one from four different primary schools using drawing and visual narrative activities, in addition to researcher observations during the start of the first weeks of the academic year for the first grade. As the study dealt with children, all of the necessary ethical laws were followed. This paper is considered original since it seeks to deal with the issue of children's transition from kindergarten to primary school not only in Oman, but in the Arab region. Therefore, it is expected to fill an important gap in this field and present a proposal that will be a door for researchers to enter this research field later. The analysis of drawing and visual narrative was performed according to the social semiotics approach in two phases. The first is to read out the surface message “denotation,” while the second is to go in-depth via the symbolism obtained from children while they talked and drew letters and signs. This stage is known as “signified”; a video was recorded of each child talking about their drawing and expressing themself. Then, the data were organised and classified according to a cross-data network. Regarding the researcher observation analyses, the collected data were analysed according to the "grounded theory". It is based on comparing the recent data collected from observations with data previously encoded by other methods in which children were drawing alongside the visual narrative in the current study, in order to identify the similarities and differences, and also to clarify the meaning of the accessed categories and to identify sub-categories of them with a description of possible links between them. This is a kind of triangulation in data collection. The study came up with a set of findings, the most vital being that the children's greatest interest goes to their social and psychological needs, such as friends, their teacher, and playing. Also, their biggest fears are a new place, a new teacher, and not having friends, while they showed less concern for their need for educational knowledge and skills.

Keywords: Children’s academic needs, children’s social needs, children transition, primary school.

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641 Structure of the Working Time of Nurses in Emergency Departments in Polish Hospitals

Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: Emergency nurses, nursing care, workload, work sampling.

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640 Study of Reporting System for Adverse Events Related to Common Medical Devices at a Tertiary Care Public Sector Hospital in India

Authors: S. Kurien, S. Satpathy, S. K. Gupta, S. K. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: Adverse events, health care technology, public sector hospital, reporting systems.

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639 Association of Sensory Processing and Cognitive Deficits in Children with Autism Spectrum Disorders – Pioneer Study in Saudi Arabia

Authors: Rana M. Zeina, Laila AL-Ayadhi, Shahid Bashir

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The association between sensory problems and cognitive abilities has been studied in individuals with Autism Spectrum Disorders (ASDs). In this study, we used a Neuropsychological Test to evaluate memory and attention in ASDs children with sensory problems compared to the ASDs children without sensory problems. Four visual memory tests of Cambridge Neuropsychological Test Automated Battery (CANTAB) including Big/little circle (BLC), Simple Reaction Time (SRT) Intra /Extra dimensional set shift (IED), Spatial recognition memory (SRM), were administered to 14 ASDs children with sensory problems compared to 13 ASDs without sensory problems aged 3 to 12 with IQ of above 70. ASDs individuals with sensory problems performed worse than the ASDs group without sensory problems on comprehension, learning, reversal and simple reaction time tasks, and no significant difference between the two groups was recorded in terms of the visual memory and visual comprehension tasks. The findings of this study suggest that ASDs children with sensory problems are facing deficits in learning, comprehension, reversal, and speed of response to a stimulus.

Keywords: Visual memory, Attention, Autism Spectrum Disorders (ASDs).

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638 Fetal and Infant Mortality in Botucatu City, São Paulo State, Brazil: Evaluation of Maternal - Infant Health Care

Authors: Noda L. M., Salvador I. C, C. M. L. G. Parada, Fonseca C. R. B.

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In Brazil, neonatal mortality rate is considered incompatible with the country development conditions, and has been a Public Health concern. Reduction in infant mortality rates has also been part of the Millennium Development Goals, a commitment made by countries, members of the Organization of United Nations (OUN), including Brazil. Fetal mortality rate is considered a highly sensitive indicator of health care quality. Suitable actions, such as good quality and access to health services may contribute positively towards reduction in these fetal and neonatal rates. With appropriate antenatal follow-up and health care during gestation and delivery, some death causes could be reduced or even prevented by means of early diagnosis and intervention, as well as changes in risk factors and interventions. Objectives: To study the quality of maternal and infant health care based on fetal and neonatal mortality, as well as the possible actions to prevent those deaths in Botucatu (Brazil). Methods: Classification of prevention according to the International Classification of Diseases and the modified Wigglesworth´s classification. In order to evaluate adequacy, indicators of quality of antenatal and delivery care were established by the authors. Results: Considering fetal deaths, 56.7% of them occurred before delivery, which reveals possible shortcomings in antenatal care, and 38.2% of them were a result of intra- labor changes, which could be prevented or reduced by adequate obstetric management. These findings were different from those in the group of early neonatal deaths which were also studied. Adequacy of health services showed that antenatal and childbirth care was appropriate for 24% and 33.3% of pregnant women, respectively, which corroborates the results of prevention. These results revealed that shortcomings in obstetric and antenatal care could be the causes of deaths in the study. Early and late neonatal deaths have similar characteristics: 76% could be prevented or reduced mainly by adequate newborn care (52.9%) and adequate health care for gestational women (11.7%). When adequacy of care was evaluated, childbirth and newborn care was adequate in 25.8% and antenatal care was adequate in 16.1%. In conclusion, direct relationship was found between adequacy and quality of care rendered to pregnant women and newborns, and fetal and infant mortality. Moreover, our findings highlight that deaths could be prevented by an adequate obstetric and neonatal management.

Keywords: Fetal Mortality, Infant Mortality, Maternal-Child Health Services, Program Evaluation.

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637 The Investment of Islamic Education Values toward Children in the Early Age through Story-Telling Method

Authors: Abdul Rofiq Badril Rizal Muzammil

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Education is an absolute necessity for human’s life that one must fulfill for the entire life. Without education it is impossible for human to develop her/himself well. The education process is an effort to maintain a good behavior within one’s life. Good behavior will be absolutely achieved if it is taught to early-aged children. This paper focuses on how the story telling method enables teachers to make the students have the construction of good behavior and obtain the goal of national education in Indonesia. The targeted students would involve students in As-Solihin kindergarten, Salafiyah-Syafi’iyah Mumbulsari, Jember, Indonesia. Story is what early-aged children like most. Thus, it is a gorgeous chance to make story telling activity as a method to invest Islamic education values to children. This paper, however, also focuses on some deliberately important aspects which of course teachers need to consider including objectives and strategies of the method’s implementation. The teachers will be in need of knowing each student’s characteristic in the classroom so that it would enable them to select appropriate stories that fit best to early aged students. The selected stories are taken from Islamic stories that tell the life of Prophet and heroes of Islam as well as well-known persons in Islam. In addition, there will be a number of activities done in the classroom after the delivery of the story is over on purpose of leading students to have the fundamental foundation of how to build self-awareness in order they could understand better about the importance of being a well-behaved person. After reviewing relevant theories, secondary research and scholars’ opinion involved in all aspects of early-aged children behavior, the author concludes that by leveraging trusted sources, a proactive, co-operative and creative strategy, the teacher can successfully build up children’s good behavior by instilling the Islamic value toward early-aged children through story telling method.

Keywords: Story, Islam, children, early age.

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636 Graphic Animation: Innovative Language Learning for Autistic Children

Authors: Norfishah Mat Rabi, Rosma Osman, Norziana Mat Rabi

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It is difficult for autistic children to mix with and be around with other people. Language difficulties are a problem that affects their social life. A lack of knowledge and ability in language are factors that greatly influence their behavior, and their ability to communicate and interact. Autistic children need to be assisted to improve their language abilities through the use of suitable learning resources. This study is conducted to identify weather graphic animation resources can help autistic children learn and use transitive verbs more effectively. The study was conducted in a rural secondary school in Penang, Malaysia. The research subject comprised of three autistic students ranging in age from 14 years to 16 years. The 14-year-old student is placed in A Class and two 16-year-old students placed in B Class. The class placement of the subjects is based on the diagnostic test results conducted by the teacher and not based on age. Data collection is done through observation and interviews for the duration of five weeks; with the researcher allocating 30 minutes for every learning activity carried out. The research finding shows that the subjects learn transitive verbs better using graphic animation compared to static pictures. It is hoped that this study will give a new perspective towards the learning processes of autistic children.

Keywords: Autistic, graphic animation, language learning, transitive verbs.

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635 Theoretical Literature Review on Lack of Cardiorespiratory Fitness and Its Effects on Children

Authors: E. Abdi

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The purpose of this theoretical literature review is to study the relevant academic literature on lack of cardiorespiratory fitness and its effects on children. The total of thirty eight relevant documents were identified and considered for this review which nineteen of those were original research articles published in peer reviewed journals. The other nineteen articles were statistical documents. This literature review is structured to examine 5 effects in deficiency of cardiorespiratory fitness in school aged children (A) Relative Age Effect (RAE), (B) Obesity, (C) Inadequate fitness level (D) Unhealthy life style, and (E) Academics. The categories provide a theoretical framework for future studies where results are driven from the literature review. The study discusses that regular physical fitness assists children and adolescents to develop healthy physical activity behaviors which can be sustained throughout adult life. Conclusion suggests that advocacy for increasing physical activity and decreasing sedentary behaviors at school and home are necessary.

Keywords: Cardiorespiratory, endurance, physical activity, physical fitness.

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634 Understanding the Nature of Blood Pressure as Metabolic Syndrome Component in Children

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.

Keywords: Blood pressure, children, index, metabolic syndrome, obesity.

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633 Qualitative Data Analysis for Health Care Services

Authors: Taner Ersoz, Filiz Ersoz

Abstract:

This study was designed enable application of multivariate technique in the interpretation of categorical data for measuring health care services satisfaction in Turkey. The data was collected from a total of 17726 respondents. The establishment of the sample group and collection of the data were carried out by a joint team from The Ministry of Health and Turkish Statistical Institute (Turk Stat) of Turkey. The multiple correspondence analysis (MCA) was used on the data of 2882 respondents who answered the questionnaire in full. The multiple correspondence analysis indicated that, in the evaluation of health services females, public employees, younger and more highly educated individuals were more concerned and complainant than males, private sector employees, older and less educated individuals. Overall 53 % of the respondents were pleased with the improvements in health care services in the past three years. This study demonstrates the public consciousness in health services and health care satisfaction in Turkey. It was found that most the respondents were pleased with the improvements in health care services over the past three years. Awareness of health service quality increases with education levels. Older individuals and males would appear to have lower expectancies in health services.

Keywords: Multiple correspondence analysis, optimal scaling, multivariate categorical data, health care services, health satisfaction survey, statistical visualizing, Turkey.

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632 Outcomes of Teenage Mothers at Dankhunthot Hospital, Nakhon Ratchasima

Authors: Nareelux Suwannobol, Supap Chobkhayan

Abstract:

The aim of this study was to investigate the pregnancy outcomes of teenage mothers at DanKhunThot hospital, Nakhon Ratchasima, Thailand. A retrospective descriptive study was conducted in 573 of teenage pregnant from charts reviewed from 1st October 2010-31st March, 2012. Data were analyzed by frequency distribution, mean and Standard Deviation. The results shown several problems and negatives outcomes of pregnancy in teenager such as not attended prenatal care, Low birth weight infants, death fetus in utero and other complications. The results of this study can be utilized in the development of prenatal, perinatal and post natal care services, especially in DanKhunthot Hospital contexts. Moreover, the results were present to the District Health Care committees in order to enhance health care service system for teenage pregnancy of DanKhunthot District in further.

Keywords: Teenage mothers, Pregnancy outcome, Neonatal outcomes, Maternal outcomes.

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631 Health Post A Sustainable Prototype for the Third World

Authors: Chizzoniti Domenico, Beggiora Klizia, Cattani Letizia, Moscatelli Monica

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This paper concerns the study of sustainable construction materials applied on the "Health Post", a prototype for the primary health care situated in alienated areas of the world. It's suitable for social and climatic Sub-Saharan context; however, it could be moved in other countries of the world with similar urgent needs. The idea is to create a Health Post with local construction materials that have a low environmental impact and promote the local workforce allowing reuse of traditional building techniques lowering production costs and transport. The aim of Primary Health Care Centre is to be a flexible and expandable structure identifying a modular form that can be repeated several times to expand its existing functions. In this way it could be not only a health care centre but also a socio-cultural facility.

Keywords: Low costs building, sustainable construction materials, green construction system, prototype, health care, emergency.

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630 Levels and Trends of Under-Five Mortality in South Africa from 1998 to 2012

Authors: T. Motsima, K. Zuma, E Rapoo

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Childhood mortality is a key sign of the coverage of child survival interventions, social and economic progressions. Although the level of under-five mortality has been declining, it is still unacceptably high. The primary aim of this paper is to establish and analyse the levels and trends of under-five mortality for the periods 1998, 2003 and 2012 in South Africa. Methods: The data used for analysis came from the 1998 SADHS, the 2003 SADHS and the 2012 SABSSM which collected information on the survival status of children. The Kaplan-Meier estimate of the survival function method was used to determine the probabilities of failure (death) from birth up to 59 months. Results and Conclusion: The overall U5MR declined by 28.2% from 53.1 in 1998 to 38.1 in 2012. The U5MR of male children declined from 59.2 in 1998 to 46.2 in 2003 and dropped further to 41.4 in 2012. The U5MR of children of mothers aged 40 years and older increased from 64.0 in 1998 to 89.0 in 2003 and rose further to 129.9 in 2012. The U5MR of children of mothers with education level of 12 years or more increased from 32.2 in 1998 to 35.2 in 2003 and declined substantially to 17.5 in 2012.

Keywords: Demographic and health survey, Kaplan-Meier, levels and trends, under-five mortality.

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629 Financial Burden of Family for the Children with Autism Spectrum Disorder

Authors: M. R. Bhuiyan, S. M. M. Hossain, M. Z. Islam

Abstract:

Autism Spectrum Disorder (ASD) is the fastest growing serious developmental disorder characterized by social deficits, communicative difficulties, and repetitive behaviors. ASD is an emerging public health issue globally which is associated with huge financial burden to the family, community and the nation. The aim of this study was to assess the financial burden of family for the children with Autism spectrum Disorder. This cross-sectional study was carried out from July 2015 to June 2016 among 154 children with ASD to assess the financial burden of family. Data were collected by face-to-face interview with semi-structured questionnaire following systematic random sampling technique. Majority (73.4%) children were male and mean (±SD) age was 6.66 ± 2.97 years. Most (88.8%) of the children were from urban areas with average monthly family income Tk. 41785.71±23936.45. Average monthly direct cost of the children was Tk.17656.49 ± 9984.35, while indirect cost was Tk. 13462.90 ± 9713.54 and total treatment cost was Tk. 23076.62 ± 15341.09. Special education cost (Tk. 4871.00), cost of therapy (Tk. 4124.07) and travel cost (Tk. 3988.31) were the major types of direct cost, while loss of income (Tk.14570.18) was the chief indirect cost incurred by the families. The study found that majority (59.8%) of the children attended special schools were incurred Tk.20001-78700 as total treatment cost, which were statistically significant (p<0.001). Again, families with higher monthly family income incurred higher treatment cost (r=0.526, p<0.05). Difference between mean direct and indirect cost was found significant (t=4.190, df=61, p<0.001). According to the analysis of variance, mean difference of father’s educational status among direct cost (F=10.337, p<0.001) and total treatment cost (F=7.841, p<0.001), which were statistically significant. The study revealed that maximum children with ASD were under five years, three-fourth were male. According to monthly family income, maximum family were in middle class. The study recommends cost effective interventions and financial safety-net measures to reduce the financial burden of families for the children with ASD.

Keywords: Autism spectrum disorder, financial burden, direct cost, indirect cost, Special education.

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628 Efficacy of Selected Mobility Exercises and Participation in Special Games on Psychomotor Abilities, Functional Abilities and Game Performance among Intellectually Disabled Children of Under 14 Age

Authors: J. Samuel Jesudoss

Abstract:

The purpose of the study was to find out the efficacy of selected mobility exercises and participation in special games on psychomotor abilities, functional abilities and skill performance among intellectually disabled children of age group under 14. Thirty male students who were studying in Balar Kalvi Nilayam and YMCA College Special School, Chennai, acted as subjects for the study. They were only mild and moderate in intellectual disability. These students did not undergo any special training or coaching programme apart from their regular routine physical activity classes as a part of the curriculum in the school. They were attached at random, based on age in which 30 belonged to under 14 age group, which was divided into three equal group of ten for each experimental treatment. 10 students (Treatment group I) underwent calisthenics and special games participation, 10 students (Treatment group II) underwent aquatics and special games participation, 10 students (Treatment group III) underwent yoga and special games participation. The subjects were tested on selected criterion variables prior (pre test) and after twelve weeks of training (post test). The pre and post test data collected from three groups on functional abilities(self care, learning, capacity for independent living), psychomotor variables(static balance, eye hand coordination, simple reaction time test) and skill performance (bocce skill, badminton skill, table tennis skill) were statistically examined for significant difference, by applying the analysis ANACOVA. Whenever an 'F' ratio for adjusted test was found to be significant for adjusted post test means, Scheffe-s test was followed as a post-hoc test to determine which of the paired mean differences was significant. The result of the study showed that among under 14 age groups there was a significant improvement on selected criterion variables such as, Balance, Coordination, self-care and learning and also in Bocce, Badminton & Table Tennis skill performance, due to mobility exercises and participation in special games. However there were no significant differences among the groups.

Keywords: Functional ability, intellectually disabled, Mobility exercises, Psychomotor ability.

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627 A Program Based on Artistic and Musical Activities to Acquire Educational Concepts for Children with Learning Difficulties

Authors: Ahmed Amin Mousa, Huda Mazeed, Eman Saad

Abstract:

The study aims to identify the extent of effectiveness of the artistic formation program using some types of pastes to reduce the hyperactivity of the kindergarten children with learning difficulties. The researchers have discussed the aforesaid topic, where the research sample included 120 children of ages between 5 to 6 years, from five schools for special needs, learning disability section, Cairo Governorate. The study used the quasi-empirical method, which depends on designing one group using the pre& post application measurements for the group to validate both, hypothesis and effectiveness of the program. The variables of the study were specified as follows; artistic formation program using Paper Mache as an independent variable, and its effect on the skills of kindergarten child with learning disabilities, as a dependent variable. The researchers utilized the application of an artistic formation program consisting of artistic and musical skills for kindergarten children with learning disabilities. The tools of the study, designed by the researchers, included: observation card used for recording the culling paper using pulp molding skills for kindergarten children with learning difficulties during practicing the artistic formation activity. Additionally, there was a program utilizing Artistic and Musical Activities for kindergarten children with learning disabilities to acquire educational concepts. The study was composed of 20 lessons for fine art activities and 20 lessons for musical activities, with obligation of giving the musical lesson with art lesson in one session to cast on the kindergarten child some educational concepts.

Keywords: musical activities, developing skills, early childhood, educational concepts, learning difficulties

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626 Music for Peace, a Model for Socialization

Authors: Mina Fenercioglu

Abstract:

This study discusses a Turkish music education model similar to its Venezuelan counterpart El Sistema, in which socialization and human development are the main goals. The Music for Peace (Baris Icin Muzik) model, founded in 2005 by an idealist humanitarian in Istanbul, started as a pilot project with accordion and today makes symphonic music education. The program aims to offer social change through free-of-charge. In such a big city like Istanbul, in a deprived inner city center people have poor economic, social and cultural conditions. In that Edirnekapi district people don’t have opportunities to join the cultural and social life, like music or sports. It is believed that this initiative covered a part of this gap by giving children the opportunities to participate in social and cultural life. In this study it is planned to understand what social changes could music education could make in children’s lives. In the complimentary music lessons children works in groups, which helps them to learn the feelings of solidarity, friendship, communion and sharing. By Music for Peace project children connect with the community, they have the belief to succeed in life because they feel that they are loved by their friends, instructors and families. In short they feel that they are important, thus brings the success in life. Additionally, it is believed that, this program has achieved success. Today approximately 400 children participate in this programs orchestras and choirs. Some of the students get into the conservatories. And the center is not just a place where they get music lessons but also a place where they get socialized. And music education helps children to have strong sense of identity, self-confidence and self-esteem.

Keywords: El Sistema, music education, Music for Peace, socialization.

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625 Reasons for Doing Job outside Household and Difficulties Faced by the Working Women of Bangladesh

Authors: Md. Sayeed Akhter, Md. Akhtar Hossain Mazumder, Syeda Afreena Mamun

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Bangladesh is a patriarchal and male dominated country. Traditional, cultural, social, and religious values and practices have reinforced the lower status of women accorded to them in society and have limited their opportunities for education, technical and vocational training, and involvement with earning activities outside their households. After independence numbers of women are doing job outside their households. This study attempts to find out the reasons of engaging in earning activities outside households and difficulties faced by upper and lower class working women in Bangladesh. To explore the objectives and research questions of the study descriptive techniques had been used. Survey was conducted among the women who were working in Rajshahi city of Bangladesh and face-to-face interviews were conducted to collect data. Findings of the study illustrates that most of the upper class working women engaged into job because they wanted to utilized their education and to bring solvency in the family, and they spend their income for meeting the needs of all the members of the family. On the other hand, most of the lower class working women involved into earning activities outside their households because they want to bring solvency in their families and spend their income on household expenditure. Both classes became tensed for their children because they had to stay at their working place for long time. Therefore, day care center should be established besides their working place for their children.

Keywords: Working Women, Reasons for Doing Jobs, Working Environment, Difficulties Faced.

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624 An Index for the Differential Diagnosis of Morbid Obese Children with and without Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Metabolic syndrome (MetS) is a severe health problem caused by morbid obesity, the severest form of obesity. The components of MetS are rather stable in adults. However, the diagnosis of MetS in morbid obese (MO) children still constitutes a matter of discussion. The aim of this study was to develop a formula, which facilitated the diagnosis of MetS in MO children and was capable of discriminating MO children with and without MetS findings. The study population comprised MO children. Age and sex-dependent body mass index (BMI) percentiles of the children were above 99. Increased blood pressure, elevated fasting blood glucose (FBG), elevated triglycerides (TRG) and/or decreased high density lipoprotein cholesterol (HDL-C) in addition to central obesity were listed as MetS components for each child. Two groups were constituted. In the first group, there were 42 MO children without MetS components. Second group was composed of 44 MO children with at least two MetS components. Anthropometric measurements including weight, height, waist and hip circumferences were performed during physical examination. BMI and homeostatic model assessment of insulin resistance (HOMA-IR) values were calculated. Informed consent forms were obtained from the parents of the children. Institutional Non-Interventional Clinical Studies Ethics Committee approved the study design. Routine biochemical analyses including FBG, insulin (INS), TRG, HDL-C were performed. The performance and the clinical utility of Diagnostic Obesity Notation Model Assessment Metabolic Syndrome Index (DONMA MetS index) [(INS/FBG)/(HDL-C/TRG)*100] was tested. Appropriate statistical tests were applied to the study data. p value smaller than 0.05 was defined as significant. MetS index values were 41.6 ± 5.1 in MO group and 104.4 ± 12.8 in MetS group. Corresponding values for HDL-C values were 54.5 ± 13.2 mg/dl and 44.2 ± 11.5 mg/dl. There was a statistically significant difference between the groups (p < 0.001). Upon evaluation of the correlations between MetS index and HDL-C values, a much stronger negative correlation was found in MetS group (r = -0.515; p = 0.001) in comparison with the correlation detected in MO group (r = -0.371; p = 0.016). From these findings, it was concluded that the statistical significance degree of the difference between MO and MetS groups was highly acceptable for this recently introduced MetS index. This was due to the involvement of all of the biochemically defined MetS components into the index. This is particularly important because each of these four parameters used in the formula is a cardiac risk factor. Aside from discriminating MO children with and without MetS findings, MetS index introduced in this study is important from the cardiovascular risk point of view in MetS group of children.

Keywords: Fasting blood glucose, high density lipoprotein cholesterol, insulin, metabolic syndrome, morbid obesity, triglycerides.

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623 Association of Zinc with New Generation Cardiovascular Risk Markers in Childhood Obesity

Authors: Mustafa M. Donma, Orkide Donma

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Zinc (Zn) is a vital element required for growth and development particularly in children. It exhibits some protective effects against cardiovascular diseases (CVDs). Zn may be a potential biomarker of cardiovascular health. High sensitive cardiac troponin T (hs-cTnT) and cardiac myosin binding protein C (cMyBP-C) are new generation markers used for prediagnosis, diagnosis and prognosis of CVDs. The aim of this study is to determine Zn as well as new generation cardiac markers’ profiles in children with normal body mass index (N-BMI), obese (OB), morbid obese (MO) children and children with metabolic syndrome (MetS) findings. The association among them will also be investigated. Four study groups were constituted. The study protocol was approved by the institutional Ethics Committee of Tekirdag Namik Kemal University. Parents of the participants filled informed consent forms to participate in the study. Group 1 is composed of 44 children with N-BMI. Group 2 and Group 3 comprised 43 OB and 45 MO children, respectively. 45 MO children with MetS findings were included in Group 4. World Health Organization age- and sex-adjusted BMI percentile tables were used to constitute groups. These values were 15-85, 95-99 and above 99 for N-BMI, OB and MO, respectively. Criteria for MetS findings were determined. Routine biochemical analyses including Zn were performed. hs-cTnT and cMyBP-C concentrations were measured by enzyme-linked immunosorbent assay. Data were analyzed by using SPSS software. p < 0.05 was accepted as significant. Four groups were matched for age and gender. Decreased Zn concentrations were measured in Groups 2, 3 and 4 compared to Group 1. Groups did not differ from one another in terms of hs-cTnT. There were statistically significant differences between cMyBP-C levels of MetS group and N-BMI as well as OB groups. There was an increasing trend going from N-BMI group to MetS group. There were statistically significant negative correlations between Zn and hs-cTnT as well as cMyBP-C concentrations in MetS group. In conclusion, inverse correlations detected between Zn and new generation cardiac markers (hs-TnT and cMyBP-C) have pointed out that decreased levels of Zn accompany increased levels of hs-cTnT as well as cMyBP-C in children with MetS. This finding emphasizes that both Zn and these new generation cardiac markers may be evaluated as biomarkers of cardiovascular health during severe childhood obesity precipitated with MetS findings and also suggested as the messengers of the future risk in the adulthood periods of children with MetS.

Keywords: Cardiac myosin binding protein-C, cardiovascular diseases, children, high sensitive cardiac troponin T, obesity.

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622 Evaluation of Systemic Immune-Inflammation Index in Obese Children

Authors: Mustafa M. Donma, Orkide Donma

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A growing list of cancers might be influenced by obesity. Obesity is associated with an increased risk for the occurrence and development of some cancers. Inflammation can lead to cancer. It is one of the characteristic features of cancer and plays a critical role in cancer development. C-reactive protein (CRP) is under evaluation related to the new and simple prognostic factors in patients with metastatic renal cell cancer. Obesity can predict and promote systemic inflammation in healthy adults. BMI is correlated with hs-CRP. In this study, SII index and CRP values were evaluated in children with normal BMI and those within the range of different obesity grades to detect the tendency towards cancer in pediatric obesity. A total of one hundred and ninety-four children; thirty-five children with normal BMI, twenty overweight (OW), forty-seven obese (OB) and ninety-two morbid obese (MO) participated in the study. Age- and sex-matched groups were constituted using BMI-for age percentiles. Informed consent was obtained. Ethical Committee approval was taken. Weight, height, waist circumference (C), hip C, head C and neck C of the children were measured. The complete blood count test was performed. C-reactive protein analysis was performed. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. SII index values were progressively increasing starting from normal weight (NW) to MO children. There is a statistically significant difference between NW and OB as well as MO children. No significant difference was observed between NW and OW children, however, a correlation was observed between NW and OW children. MO constitutes the only group, which exhibited a statistically significant correlation between SII index and CRP. Obesity-related bladder, kidney, cervical, liver, colorectal, endometrial cancers are still being investigated. Obesity, characterized as a chronic low-grade inflammation, is a crucial risk factor for colon cancer. Elevated childhood BMI values may be indicative of processes leading to cancer, initiated early in life. Prevention of childhood adiposity may decrease the cancer incidence in adults. To authors’ best knowledge, this study is the first to introduce SII index values during obesity of varying degrees of severity. It is suggested that this index seems to affect all stages of obesity with an increasing tendency and may point out the concomitant status of obesity and cancer starting from very early periods of life.

Keywords: Children, c- reactive protein, systemic immune-inflammation index, obesity.

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621 Survey of Cerebral Palsy Cases in Tripoli Children Hospital in the Period between (2009-2010)

Authors: W. Astiata, N. Elmesrati, N. Elmesrati, A. Abo Reyana

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The aim of this study is to survey the incidence, prevalence, types and associated impairments of CP in children at the Tripoli children hospital (T.C.H). The study covered all the cases the hospital had diagnosed in the period between (1.1.2009) and (31.12.2010), during which 38 cases of ages between 2 months to 3 years were diagnosed in the mentioned period. The incidence of CP was (17.42 per one thousand) out of (2143) of different neurological cases and came with a result of 23 cases of spastic CP which represented about (60.53%) out of the total number of cases, and the most associated impairment is convulsion. Medical information was collected from the patients’ files at the registration department from the neurology department. The data has been collected by a questionnaire, which had been set to finely organize the patient’s files.

Keywords: Physiotherapy, Rehabilitation, Libya, Cerebral Palsy, hospital, survey.

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620 Interface Terminologies: A Case Study on the International Classification of Primary Care

Authors: Laurent Letrilliart, Anne-Katty Bacis, François Mennerat, Cyrille Colin

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The International Classification of Primary Care (ICPC), which belongs to the WHO Family of International Classifications (WHO-FIC), has a low granularity, which is convenient for describing general medical practice. However, its lack of specificity makes it useful to be used along with an interface terminology. An international survey has been performed, using a questionnaire sent by email to experts from 25 countries, in order to describe the terminologies interfacing with ICPC. Eleven interface terminologies have been identified, developed in Argentina, Australia, Belgium (2), Canada, Denmark, France, Germany, Norway, South Africa, and The Netherlands. Globally, these systems have been poorly assessed until now.

Keywords: Terminology, controlled vocabulary, thesaurus, classification, International Classification of Primary Care.

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