Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 169

Search results for: Chronic illness

169 Consumption Insurance against the Chronic Illness: Evidence from Thailand

Authors: Yuthapoom Thanakijborisut

Abstract:

This paper studies consumption insurance against the chronic illness in Thailand. The study estimates the impact of household consumption in the chronic illness on consumption growth. Chronic illness is the health care costs of a person or a household’s decision in treatment for the long term; the causes and effects of the household’s ability for smooth consumption. The chronic illnesses are measured in health status when at least one member within the household faces the chronic illness. The data used is from the Household Social Economic Panel Survey conducted during 2007 and 2012. The survey collected data from approximately 6,000 households from every province, both inside and outside municipal areas in Thailand. The study estimates the change in household consumption by using an ordinary least squares (OLS) regression model. The result shows that the members within the household facing the chronic illness would reduce the consumption by around 4%. This case indicates that consumption insurance in Thailand is quite sufficient against chronic illness.

Keywords: Consumption insurance, chronic illness, health care, Thailand.

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168 Self-Care Behavior and Performance Level Associated with Algerian Chronically Ill Patients

Authors: S. Aberkane, N. Djabali, S. Fafi, A. Baghezza

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Chronic illnesses affect many Algerians. It is possible to investigate the impact of illness representations and coping on quality of life and whether illness representations are indirectly associated with quality of life through their influence on coping. This study aims at investigating the relationship between illness perception, coping strategies and quality of life with chronic illness. Illness perceptions are indirectly associated with the quality of life through their influence on coping mediation. A sample of 316 participants with chronic illness living in the region of Batna, Algeria, has been adopted in this study. A correlation statistical analysis is used to determine the relationship between illness perception, coping strategies, and quality of life. Multiple regression analysis was employed to highlight the predictive ability of the dimensions of illness perception and coping strategies on the dependent variables of quality of life, where mediation analysis is considered in the exploration of the indirect effect significance of the mediator. This study provides insights about the relationship between illness perception, coping strategies and quality of life in the considered sample (r = 0.39, p < 0.01). Therefore, it proves that there is an effect of illness identity perception, external and medical attributions related to emotional role, physical functioning, and mental health perceived, and these were fully mediated by the asking for assistance (c’= 0.04, p < 0.05), the guarding (c’= 0.00, p < 0.05), and the task persistence strategy (c’= 0.05, p < 0.05). The findings imply partial support for the common-sense model of illness representations in a chronic illness population. Directions for future research are highlighted, as well as implications for psychotherapeutic interventions which target unhelpful beliefs and maladaptive coping strategies (e.g., cognitive behavioral therapy).

Keywords: Chronic illness, coping, illness perception, quality of life, self-regulation model.

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167 Health Care Ethics in Vulnerable Populations: Clinical Research through the Patient's Eyes

Authors: Alexander V. Libin, Manon Schladen, Assya Pascalev, Nawar Shara, Miriam Philmon, Yuri Millo, Joseph Verbalis

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Chronic conditions carry with them strong emotions and often lead to charged relationships between patients and their health providers and, by extension, patients and health researchers. Persons are both autonomous and relational and a purely cognitive model of autonomy neglects the social and relational basis of chronic illness. Ensuring genuine informed consent in research requires a thorough understanding of how participants perceive a study and their reasons for participation. Surveys may not capture the complexities of reasoning that underlies study participation. Contradictory reasons for participation, for instance an initial claim of altruism as rationale and a subsequent claim of personal benefit (therapeutic misconception), affect the quality of informed consent. Individuals apply principles through the filter of personal values and lived experience. Authentic autonomy, and hence authentic consent to research, occurs within the context of patients- unique life narratives and illness experiences.

Keywords: ethical dilemmas, open source technology, patient education, psychology of decision making

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166 ME/CFS Health Outcomes: The Interaction of Mode of Illness Onset and Psychiatric Comorbidity

Authors: Mary Gloria C. Njoku, Leonard A. Jason, Nicole Porter, Molly Brown

Abstract:

The objective of this study was to examine the interaction between mode of illness onset and psychiatric comorbidity on the health outcomes of persons with ME/CFS. A total of 114 individuals with ME/CFS participated in this study. Individuals completed a battery of baseline measures including the fatigue severity scale and measures of disability. Findings indicated that those with sudden illness onset had more impaired physical health functioning. In addition, among individuals with sudden onset, those without psychiatric comorbidity had greater fatigue severity and lower overall physical health than those with psychiatric comordibity. In contrast, among individuals with gradual illness onset, those with psychiatric comorbity had higher fatigue severity than those without comorbid psychiatric disorders. The health outcomes of individuals who have ME/CFS with or without psychiatric comorbidity are impacted by the mode of illness onset and this suggest that it is important to examine these factors in future research.

Keywords: Health Outcomes, ME/CFS, Mode of Illness Onset, Psychiatric Comorbidity.

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165 The Stigma of Mental Illness and the Way of Destigmatization: The Effects of Interactivity and Self-Construal

Authors: Doori Song, Hyun-Ji Lim, Yoo Jin Chung

Abstract:

Some believe that stigma is the worst side effect of the people who have mental illness. Mental illness researchers have focused on the influence of mass media on the stigmatization of the people with mental illness. However, no studies have investigated the effects of the interactive media, such as blogs, on the stigmatization of mentally ill people, even though the media have a significant influence on people in all areas of life. The purpose of this study is to investigate the use of interactivity in destigmatization of the mentally ill and the moderating effect of self-construal (independent versus interdependent self-construal) on the relation between interactivity and destigmatization. The findings suggested that people in the human-human interaction condition had less social distance toward people with mental illness. Additionally, participants with higher independence showed more favorable affection and less social distance toward mentally ill people. Finally, direct contact with mentally ill people increased a person-s positive affect toward people with mental illness. The current study should provide insights for mental health practitioners by suggesting how they can use interactive media to approach the public that stigmatizes the mentally ill.

Keywords: Mental health, destigmatization, interactivity, selfconstrual

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164 Eradication of Mental Illness through Buddhism

Authors: Deshar Bashu Dev

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In this modern age, most people in developed and developing countries are affected by mental illness. There are many mental illnesses, and their differing symptoms impact peoples’ lives in different ways. These illnesses affect the way people think and feel, as well as how they behave with others. Mental illness results from compound interactions between the mind, body, and environment. New technologies and sciences make the world a better place. These technologies are becoming smarter and are being developed every day to help make daily life easier However, people suffer from mental illness in every part of the world. The philosophy propounded by the Buddha, Buddhism, teaches that all life is connected, from the microcosm to macrocosm. In the 2,500 years that elapsed since the death of the Buddha, his disciples have spread his teachings and developed sophisticated psycho-therapeutic methodologies. We can find many examples in Buddhist texts and in the modern age where Buddhist philosophy modern science could not solve. The Noble Eightfold Path, which is one of the main philosophies of Buddhism; it eradicates hatred and ill will and cultivates good deeds, kindness, and compassion. Buddhism, as a practice of dialectic conversation and mindfulness training, is full of rich therapeutic tools that the mental health community has adopted to help people. Similarly, Buddhist meditation is very necessary; it purifies thoughts and avoids unnecessary thinking. This research aims to study different causes of mental illness; analyzes the different approaches to eradicate mental illness problems and provides conclusions and recommendations present solutions through Buddhism in this modern age.

Keywords: Mental illness, Buddhism, mindfulness, Buddhist practices.

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163 Resilience in Patients with Chronic Kidney Disease in Hemodialysis

Authors: Gomes C. C. Izabel, Lanzotti B. Rafaela, Orlandi S. Fabiana

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Chronic Kidney Disease is considered a serious public health problem. The exploitation of resilience has been guided by studies conducted in various contexts, especially in hemodialysis, since the impact of diagnosis and restrictions produced during the treatment process because, despite advances in treatment, remains the stigma of the disease and the feeling of pain, hopelessness, low self-esteem and disability. The objective was to evaluate the level of resilience of patients in chronic renal dialysis. This is a descriptive, correlational, cross and quantitative research. The sample consisted of 100 patients from a Renal Replacement Therapy Unit in the countryside of São Paulo. For data collection were used the characterization instrument of Participants and the Resilience Scale. There was a predominance of males (70.0%) were Caucasian (45.0%) and had completed elementary education (34.0%). The average score obtained through the Resilience Scale was 131.3 (± 20.06) points. The resiliency level submitted may be considered satisfactory. It is expected that this study will assist in the preparation of programs and actions in order to avoid possible situations of crises faced by chronic renal patients.

Keywords: Hemodialysis units, hospital, renal dialysis, renal insufficiency chronic, resilience psychological.

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162 Pain and Lumbar Muscle Activation before and after Functional Task in Nonspecific Chronic Low Back Pain

Authors: Lídia E. O. Cruz, Adriano P. C. Calvo, Renato J. Soares, Regiane A. Carvalho

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Individuals with non-specific chronic low back pain may present altered movement patterns during functional activities. However, muscle behavior before and after performing a functional task with different load conditions is not yet fully understood. The aim of this study is to analyze lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground (with and without load) in individuals with nonspecific chronic low back pain. 20 subjects with nonspecific chronic low back pain and 20 healthy subjects participated in this study. A surface electromyography was performed in the ilio-costal, longissimus and multifidus muscles to evaluate lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground, with and without load. The symptomatic participants had greater lumbar muscle activation compared to the asymptomatic group, more evident in performing the task without load, with statistically significant difference (p = 0,033) between groups for the right multifidus muscle. This study showed that individuals with nonspecific chronic low back pain have higher muscle activation before and after performing a functional task compared to healthy participants.

Keywords: Chronic low back pain, functional task, lumbar muscles, muscle activity.

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161 Mental Illness Stigma and Causal Beliefs: Among Potential Mental Health Professionals

Authors: Josephine S. Larkings, Patricia M. Brown

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Mental health professionals views about mental illness is an important issue which has not received enough attention. The negative stigma associated with mental illness can have many negative consequences. Unfortunately, health professionals working with the mentally ill can also exhibit stigma. It has been suggested that causal explanations or beliefs around the causes of mental illness may influence stigma. This study aims to gain a greater insight into stigma through examining stigma among potential mental health professionals. Firstly, results found that potential mental health professionals had relatively low social distance t(205) = -3.62, p <.001. Secondly, an ANOVA indicated that the participants endorsed some causal beliefs more than others, F(1.82, 311.55) = 88.47, p < .001, partial n2 = .34. Moreover, participants endorsed the biological causal explanation the most. Thirdly, results indicated that combined contact (quality and quantity) and causal beliefs (biological, psychological, and environmental) explained a significant proportion of the variance in stigma, R2 = .35, adjusted R2 = .33, F(5, 153) = 16.66, p < .001. Quality of contact was the strongest predictor, with greater quality of contact associated with lower desired social distance. Also, quantity of contact, psychological and environmental causal explanations were also significant predictors of stigma. Greater quantity of contact and higher levels of environmental causal beliefs were associated with lower levels of stigma while psychological causal explanations were associated with higher levels of stigma. A series of multiple regression analyses were conducted that showed the three causal beliefs had different impacts on four factors of stigma (Authoritarian, Benevolence, Social restrictiveness, and Community mental health ideology). These analyses showed that psychological causal beliefs had the most positive impact. More research is required on this topic as it has important implications to the treatment and recovery for people suffering from mental illness.

Keywords: Causal beliefs, contact, health professionals, mental illness stigma, social distance.

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160 Safety Study of Intravenously Administered Human Cord Blood Stem Cells in the Treatment of Symptoms Related to Chronic Inflammation

Authors: Brian M. Mehling, Louis Quartararo, Marine Manvelyan, Paul Wang, Dong-Cheng Wu

Abstract:

Numerous investigations suggest that Mesenchymal Stem Cells (MSCs) in general represent a valuable tool for therapy of symptoms related to chronic inflammatory diseases. Blue Horizon Stem Cell Therapy Program is a leading provider of adult and children’s stem cell therapies. Uniquely we have safely and efficiently treated more than 600 patients with documenting each procedure. The purpose of our study is primarily to monitor the immune response in order to validate the safety of intravenous infusion of human umbilical cord blood derived MSCs (UC-MSCs), and secondly, to evaluate effects on biomarkers associated with chronic inflammation. Nine patients were treated for conditions associated with chronic inflammation and for the purpose of antiaging. They have been given one intravenous infusion of UCMSCs. Our study of blood test markers of 9 patients with chronic inflammation before and within three months after MSCs treatment demonstrates that there is no significant changes and MSCs treatment was safe for the patients. Analysis of different indicators of chronic inflammation and aging included in initial, 24-hours, two weeks and three months protocols showed that stem cell treatment was safe for the patients; there were no adverse reactions. Moreover data from follow up protocols demonstrates significant improvement in energy level, hair, nails growth and skin conditions. Intravenously administered UC-MSCs were safe and effective in the improvement of symptoms related to chronic inflammation. Further close monitoring and inclusion of more patients are necessary to fully characterize the advantages of UC-MSCs application in treatment of symptoms related to chronic inflammation.

Keywords: Chronic inflammatory diseases, intravenous infusion, mesenchymal stem cells (MSCs), umbilical cord blood.

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159 The Prevalence of Transfusion-Transmitted Virus (TTV) Infection inIranian Patients with Chronic Hepatitis B

Authors: P. Ghasemi Dehkordi, A. Doosti, M. R. Hajimirzaei

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TTV is an unenveloped circular single-stranded DNA virus with a diameter of 30-32 nm that first was described in 1997 in Japan. TTV was detected in various populations without proven pathology, including blood donors and in patients with chronic HBV and HCV hepatitis. The aim of this study was to determine the prevalence of TTV DNA in Iranian patients with chronic hepatitis B and C. Viral TTV-DNA was studied in 442 samples (202 with HBV, 138 with HCV and 102 controls) collected from west south of Iran. All extracted serum DNA was amplified by TTV ORF1 gene specific primers using the semi nested PCR technique. TTV DNA was detected in the serum of 8.9% and 10.8% patients with chronic hepatitis B and C, respectively. Prevalence of TTV-DNA in the serum of 102 controls was 2.9%. Results showed significant relation of TTV with HBV and HCV in patients by using T test examination (P<0.01). The prevalence of TTV-DNA in Iranian hepatitis B and C patients is rather high, and compare with other countries. To control and prevention of the distribution of TT-virus, examination of the blood and blood products it seems to be necessary.

Keywords: Transfusion-transmitted virus (TTV), Hepatitis Cvirus (HCV), Hepatitis B virus (HBV), ORF1 gene, Semi nested PCR, Iran.

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158 The Emotional Life of Patients with Chronic Diseases: A Framework for Health Promotion Strategies

Authors: Leslie Beale

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Being a patient with a chronic disease is both a physical and emotional experience. The ability to recognize a patient’s emotional health is an important part of a health care provider’s skills. For the purposes of this paper, emotional health is viewed as the way that we feel, and the way that our feelings affect us. Understanding the patient’s emotional health leads to improved provider-patient relationships and health outcomes. For example, when a patient first hears his or her diagnosis from a provider, they might find it difficult to cope with their emotions. Struggling to cope with emotions interferes with the patient’s ability to read, understand, and act on health information and services. As a result, the patient becomes more frustrated and confused, creating barriers to accessing healthcare services. These barriers are challenging for both the patient and their healthcare providers. There are five basic emotions that are part of who we are and are always with us: fear, anger, sadness, joy, and compassion. Living with a chronic disease however can cause a patient to experience and express these emotions in new and unique ways. Within the provider-patient relationship, there needs to be an understanding that each patient experiences these five emotions and, experiences them at different times. In response to this need, the paper highlights a health promotion framework for patients with chronic disease. This framework emphasizes the emotional health of patients.

Keywords: Health promotion, emotional health, patients with chronic disease, patient-centered care.

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157 Pre-Clinical Studying of Antitumor Ramon Preparation: Chronic Toxicity

Authors: Raissa A. Muzychkina, Irina M. Korulkina, Dmitriy Yu. Korulkin

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In article the data of chronic toxicity for pre-clinical researches of Ramon preparation is described. Ramon effects to hormone system and gastrointestinal tract; local irritative effect, allergic, pyrogenic properties and reaction to the immune system were studied.

Keywords: Cancer, toxicity, antitumor activity, pre-clinical testing, anthraquinones, phytopreparation, Ramon.

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156 Artificial Intelligence Support for Interferon Treatment Decision in Chronic Hepatitis B

Authors: Alexandru George Floares

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Chronic hepatitis B can evolve to cirrhosis and liver cancer. Interferon is the only effective treatment, for carefully selected patients, but it is very expensive. Some of the selection criteria are based on liver biopsy, an invasive, costly and painful medical procedure. Therefore, developing efficient non-invasive selection systems, could be in the patients benefit and also save money. We investigated the possibility to create intelligent systems to assist the Interferon therapeutical decision, mainly by predicting with acceptable accuracy the results of the biopsy. We used a knowledge discovery in integrated medical data - imaging, clinical, and laboratory data. The resulted intelligent systems, tested on 500 patients with chronic hepatitis B, based on C5.0 decision trees and boosting, predict with 100% accuracy the results of the liver biopsy. Also, by integrating the other patients selection criteria, they offer a non-invasive support for the correct Interferon therapeutic decision. To our best knowledge, these decision systems outperformed all similar systems published in the literature, and offer a realistic opportunity to replace liver biopsy in this medical context.

Keywords: Interferon, chronic hepatitis B, intelligent virtualbiopsy.

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155 Chronic Consumer States Influencing Compulsive Consumption

Authors: K. Prakash Vel, Lif Miriam Hamouda

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Consumer behaviour analysis represents an important field of study in marketing. Particularly strategy development for marketing and communications will be more focused and effective when marketers have an understanding of the motivations, behaviour and psychology of consumers. While materialism has been found to be one of the important elements in consumer behaviour, compulsive consumption represents another aspect that has recently attracted more attention. This is because of the growing prevalence of dysfunctional buying that has raised concern in consumer societies. Present studies and analyses on origins and motivations of compulsive buying have mainly focused on either individual factors or groups of related factors and hence a need for a holistic view exists. This paper provides a comprehensive perspective on compulsive consumption and establishes relevant propositions keeping the family life cycle stages as a reference for the incidence of chronic consumer states and their influence on compulsive consumption.

Keywords: Chronic consumer states, compulsive consumption, family life cycle

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154 Efficacy of Biosimilar Pegylated Interferon Alpha 40 KD (Peg INF) in Chronic Hepatitis C Infection

Authors: Ghias ul Hassan, Bilal Nasir, Israr ul Haque, ShafiqAwan, Ghias Un NabiTayyab, S. Hassan Akhtar Bokhari, Khawar Saeed, Qazi Masroor

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Introduction: Pegylated Interferon and Ribavirin combination is standard of care in the management of chronic HCV infected patients. Efficacy of the therapy is judged by the ability to achieve biochemical and virological response as judged by RVR, EVR, ETR and SVR.Objective: To evaluate the efficacy of newly marketed biosimilar Pegylated Interferon Alpha 40KD (Peg INF) in chronic HCV patients. Materials and methods: This was observational, prospective multicentre study to evaluate the ability of biosimilar pegylated interferon alfa 2a (40KD) along with Ribavirin (weight based) to achieve SVR. The enrolled patients were separated into Naïve (A), Relapsers (B) and Non Responders(C) based on the previous history of interferon exposure and its response. The RGT was followed on ALT and RVR, EVR, ETR and SVR.Results:As per protocol analysis estimated SVR for three groups is 86.6% for naïve, 89.4% for relapsers and 52.4% for non-responders to standard interferon. Conclusion: It is concluded that Bio-similar pegylated interferon alfa-2a (40kD) along with Ribavirin has good anti-viral efficacy in Naïve, Relapsers and Non-responders to standard IFN of chronic HCV infected patients requiring treatment.

Keywords: SVR (Sustained virological response), NR (Nonresponders), Pegylated Interferon.

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153 The Impact of Web Based Education on Cancer Patients’ Clinical Outcomes

Authors: F. Arıkan, Z. Karakus

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Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

Keywords: Cancer Patients, E-Learning, Nursing, Web Based Education.

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152 Investigation of Possible Behavioural and Molecular Effects of Mobile Phone Exposure on Rats

Authors: Ç. Gökçek-Saraç, Ş. Özen, N. Derin

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The N-methyl-D-aspartate (NMDA)-dependent pathway is the major intracellular signaling pathway implemented in both short- and long-term memory formation in the hippocampus which is the most studied brain structure because of its well documented role in learning and memory. However, little is known about the effects of RF-EMR exposure on NMDA receptor signaling pathway including activation of protein kinases, notably Ca2+/calmodulin-dependent protein kinase II alpha (CaMKIIα). The aim of the present study was to investigate the effects of acute and chronic 900 MHz RF-EMR exposure on both passive avoidance behaviour and hippocampal levels of CaMKIIα and its phosphorylated form (pCaMKIIα). Rats were divided into the following groups: Sham rats, and rats exposed to 900 MHz RF-EMR for 2 h/day for 1 week (acute group) or 10 weeks (chronic group), respectively. Passive avoidance task was used as a behavioural method. The hippocampal levels of selected kinases were measured using Western Blotting technique. The results of passive avoidance task showed that both acute and chronic exposure to 900 MHz RF-EMR can impair passive avoidance behaviour with minor effects on chronic group of rats. The analysis of western blot data of selected protein kinases demonstrated that hippocampal levels of CaMKIIα and pCaMKIIα were significantly higher in chronic group of rats as compared to acute groups. Taken together, these findings demonstrated that different duration times (1 week vs 10 weeks) of 900 MHz RF-EMR exposure have different effects on both passive avoidance behaviour of rats and hippocampal levels of selected protein kinases.

Keywords: Hippocampus, protein kinase, rat, RF-EMR.

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151 Inflammatory Markers in the Blood and Chronic Periodontitis

Authors: Saimir Heta, Ilma Robo, Nevila Alliu, Tea Meta

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Background: Plasma levels of inflammatory markers are the expression of the infectious wastes of existing periodontitis, as well as of existing inflammation everywhere in the body. Materials and Methods: The study consists of the clinical part of the measurement of inflammatory markers of 23 patients diagnosed with chronic periodontitis and the recording of parental periodontal parameters of patient periodontal status: hemorrhage index and probe values, before and 7-10 days after non-surgical periodontal treatment. Results: The level of fibrinogen drops according to the categorization of disease progression, active and passive, with the biggest % (18%-30%) at the fluctuation 10-20 mg/d. Fluctuations in fibrinogen level according to the age of patients in the range 0-10 mg/dL under 40 years and over 40 years was 13%-26%, in the range 10-20 mg/dL was 26%-22%, in the 20-40 mg/dL was 9%-4%. Conclusions: Non-surgical periodontal treatment significantly reduces the level of non-inflammatory markers in the blood. Oral health significantly reduces the potential source for periodontal bacteria, with the potential of promoting thromboembolism, through interaction between thrombocytes.

Keywords: Chronic periodontitis, atherosclerosis, risk factor, inflammatory markers.

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150 Impact of Hepatitis C Virus Chronic Infection on Quality of Life in Egypt

Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Walaa A. Fouad, Thanaa M. Rabah, Amira Mohsen, Fatma A. Shaaban, Iman I. Salama

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The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL), its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know how to cope with having a family member with hepatitis C and more importantly to know what should you say and what shouldn’t you say as a positive hopeful attitude is essential for combating HCV chronic infection.

Keywords: Hepatitis C virus chronic infection, physical health component and mental health component of QoL, total quality of life.

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149 The Effects of Mirror Therapy on Clinical Improvement in Hemiplegic Lower Extremity Rehabilitation in Subjects with Chronic Stroke

Authors: Hassan M. Abo Salem, Xiaolin Huang

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Background: The effectiveness of mirror therapy (MT) has been investigated in acute hemiplegia. The present study examines whether MT, given during chronic stroke, was more effective in promoting motor recovery of the lower extremity and walking speed than standard rehabilitation alone. Methods: The study enrolled 30 patients with chronic stroke. Fifteen patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received mirror therapy for 4 weeks, 5 days a week. Main measures: Passive ankle joint dorsiflexion range of motion, gait speed, Brunnstrom stages of motor recovery, plantar flexor muscle tone by Modified Ashworth Scale. Results: No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation, mirror therapy improved Ankle ROM, Brunnstrom stages and waking speed (p < 0.05). However, there were no significant differences between two groups on MAS (P > 0.05).Conclusion: Mirror therapy combined with a conventional stroke rehabilitation program enhances lowerextremity motor recovery and walking speed in chronic stroke patients.

Keywords: Mirror therapy, stroke, MAS, walking speed.

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148 Relationship between Criminal Behavior and Mental Illness in Teenagers

Authors: A. Chirita, L. Alexandru, D. Marcoci, C. Ene-Draghici

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Minor law breaking seems more and more to be a part of adolescence behavior. An important risk factor which seems to influence delinquency appears to be the socio-economic one. According to Romanian statistics, during the first six months of 2012, 1,378 minors have committed various crimes, the most common being theft, sexual offenses and violent assaults. Drug-related offenses did not reach the gravity of those from high income countries of the European Union, but have a continuous upward during the last years. The aim of our research was to examine whether delinquency in adolescence is correlated to mental disorders or socio-economic and familial factors. Forensic psychiatric expertise was performed to 79 adolescents who committed offenses between 01 January 2012 and 31 December 2012. Teenagers, with ages between 12 and 17, were examined by day hospitalization in the University Clinic of Psychiatry Craiova.

Keywords: Adolescents, criminal behavior, mental illness.

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147 Family Carers' Experiences in Striving for Medical Care and Finding Their Solutions for Family Members with Mental Illnesses

Authors: Yu-Yu Wang, Shih-Hua Hsieh, Ru-Shian Hsieh

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Wishes and choices being respected, and the right to be supported rather than coerced, have been internationally recognized as the human rights of persons with mental illness. In Taiwan, ‘coerced hospitalization’ has become difficult since the revision of the mental health legislation in 2007. Despite trend towards human rights, the real problem families face when their family members are in mental health crisis is the lack of alternative services. This study aims to explore: 1) When is hospitalization seen as the only solution by family members? 2) What are the barriers for arranging hospitalization, and how are they managed? 3) What have family carers learned, in their experiences of caring for their family members with mental illness? To answer these questions, qualitative approach was adopted, and focus group interviews were taken to collect data. This study includes 24 family carers. The main findings of this research include: First, hospital is the last resort for carers in helplessness. Family carers tend to do everything they could to provide care at home for their family members with mental illness. Carers seek hospitalization only when a patient’s behavior is too violent, weird, and/or abnormal, and beyond their ability to manage. Hospitalization, nevertheless, is never an easy choice. Obstacles emanate from the attitudes of the medical doctors, the restricted areas of ambulance service, and insufficient information from the carers’ part. On the other hand, with some professionals’ proactive assistance, access to medical care while in crisis becomes possible. Some family carers obtained help from the medical doctor, nurse, therapist and social workers. Some experienced good help from policemen, taxi drivers, and security guards at the hospital. The difficulty in accessing medical care prompts carers to work harder on assisting their family members with mental illness to stay in stable states. Carers found different ways of helping the ‘person’ to get along with the ‘illness’ and have better quality of life. Taking back ‘the right to control’ in utilizing medication, from passiveness to negotiating with medical doctors and seeking alternative therapies, are seen in many carers’ efforts. Besides, trying to maintain regular activities in daily life and play normal family roles are also experienced as important. Furthermore, talking with the patient as a person is also important. The authors conclude that in order to protect the human rights of persons with mental illness, it is crucial to make the medical care system more flexible and to make the services more humane: sufficient information should be provided and communicated, and efforts should be made to maintain the person’s social roles and to support the family.

Keywords: Family carers, coercive treatment, independent living, mental health crisis, persons with mental illness.

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146 Sociocultural Context of Pain Management in Oncology and Palliative Nursing Care

Authors: Andrea Zielke-Nadkarni

Abstract:

Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: Pain management, migrants, sociocultural context, palliative care.

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145 Age, Body Composition, Body Mass Index and Chronic Venous Diseases in Postmenopausal Women

Authors: Grygorii Kostromin, Vladyslav Povoroznyuk

Abstract:

Chronic venous diseases (CVD) are one of the common, though controversial problems in medicine. It is generally accepted that this pathology predominantly occurs in women. The issue of excessive weight as a risk factor for CVD is still considered debatable. To the author's best knowledge, today in Ukraine, there are barely any studies that describe the relationship between CVD and obesity. Our study aims to determine the association between age, body composition, obesity and CVD in postmenopausal women. The study was conducted in D. F. Chebotarev Institute of Gerontology, National Academy of Medical Sciences of Ukraine. We have examined 96 postmenopausal women aged 46-85 years (mean age – 66.19 ± 0.96 years), who were divided into two groups depending on the presence of CVD. The women were examined by vascular surgeons. For the diagnosis of CVD, we used clinical, anatomic and pathophysiologic classifications. We also performed clinical, ultrasound and densitometry examinations. We found that the CVD frequency in postmenopausal women increased with age (from 72% in those aged 45-59 years to 84% in those aged 75-89 years). A significant correlation between the total fat mass and age was determined in postmenopausal women with CVD. We also observed a significant correlation between the lower extremities’ fat mass and age in both examined groups. A significant correlation between body mass index and age was determined only in postmenopausal women without CVD.

Keywords: Chronic venous disease, risk factors, age, obesity, postmenopausal women.

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144 Evaluation of the Hepatitis C Virus and Classical and Modern Immunoassays Used Nowadays to Diagnose It in Tirana

Authors: Stela Papa, Klementina Puto, Migena Pllaha

Abstract:

HCV is a hepatotropic RNA virus, transmitted primarily via the blood route, which causes progressive disease such as chronic hepatitis, liver cirrhosis, or hepatocellular carcinoma. HCV nowadays is a global healthcare problem. A variety of immunoassays including old and new technologies are being applied to detect HCV in our country. These methods include Immunochromatography assays (ICA), Fluorescence immunoassay (FIA), Enzyme linked fluorescent assay (ELFA), and Enzyme linked immunosorbent assay (ELISA) to detect HCV antibodies in blood serum, which lately is being slowly replaced by more sensitive methods such as rapid automated analyzer chemiluminescence immunoassay (CLIA). The aim of this study is to estimate HCV infection in carriers and chronic acute patients and to evaluate the use of new diagnostic methods. This study was realized from September 2016 to May 2018. During this study period, 2913 patients were analyzed for the presence of HCV by taking samples from their blood serum. The immunoassays performed were ICA, FIA, ELFA, ELISA, and CLIA assays. Concluding, 82% of patients taken in this study, resulted infected with HCV. Diagnostic methods in clinical laboratories are crucial in the early stages of infection, in the management of chronic hepatitis and in the treatment of patients during their disease.

Keywords: CLIA, ELISA, hepatitis C virus, immunoassay.

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143 Successful Management of a Boy with Mild Persistent Asthma (A Longitudinal Case)

Authors: Lubis A., Setiawati L., Setyoningrum A. R., Suryawan A., Irwanto

Abstract:

Asthma is a condition that causing chronic health problems in children. In addition to basic therapy against disease, we must try to reduce the impact of chronic health problems and also optimize their medical aspect of growth and development. A boy with mild asthma attack frequent episode did not showed any improvement with medical treatment and his asthma control test was 11. From radiologic examination he got hyperaerated lung and billateral sinusitis maxillaris; skin test results were house dust, food and pet allergy; an overweight body; bad school grades; psychological and environmental problem. We followed and evaluated this boy in 6 months, treated holistically. Even we could not do much on environmental but no more psychological and school problems, his on a good bodyweight and his asthma control test was 22. A case of a child with mild asthma attack frequent episode was reported. Asthma clinical course show no significant improvement when other predisposing factor is not well-controlled and a child’s growth and development may be affected. Improving condition of the patient can be created with the help of loving and caring way of nurturing from the parents and supportive peer group. Therefore, continuous and consistent monitoring is required because prognosis of asthma is generally good when regularly and properly controlled.

Keywords: Asthma, chronic health problems, growth and development.

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142 Physical Exercise Intervention on Hypertension Patients

Authors: Ling-Lih Shen, Feng-Chuan Pan

Abstract:

Chronic diseases prevailed along with economic growth as well as life style changed in recent years in Taiwan. According to the governmental statistics, hypertension related disease is the tenth of death causes with 1,816 died directly from hypertension in 2010. There were more death causes amongst the top ten had been proofed that having strong association with the hypertension, such as heart diseases, cardiovascular diseases, and diabetes. Hypertension or High blood pressure is one of the major indicators for chronic diseases, and was generally perceived as the major causes of mortality. The literature generally suggested that regular physical exercise was helpful to prevent the occurrence or to ease the progress of a hypertension. This paper reported the process and outcomes in detailed of an improvement project of physical exercise intervention specific for hypertension patients. Physical information were measured before and after the project to obtain information such as weight, waistline, cholesterol (HD & LD), blood examination, as well as self-perceived health status. The intervention project involved a six-week exercise program, of which contained three times a week, 30 minutes of tutored physical exercise intervention. The project had achieved several gains in changing the subjects- behavior in terms of many important biophysical indexes. Around 20% of the participants had significantly improved their cholesterols, BMI, and changed unhealthy behaviors. Results from the project were encouraging, and would be good reference for other samples.

Keywords: Intervention, biological information, hypertension patients, behavioral changes, chronic disease

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141 Development of Online Islamic Medication Expert System (OIMES)

Authors: Hanita Daud, Noorhana Yahya, Low Tan Jung, Azizuddin Abd Aziz, Rabibah Ahmad Samawe

Abstract:

This paper presents an overview of the design and implementation of an online rule-based Expert Systems for Islamic medication. T his Online Islamic Medication Expert System (OIMES) focuses on physical illnesses only. Knowledge base of this Expert System contains exhaustively the types of illness together with their related cures or treatments/therapies, obtained exclusively from the Quran and Hadith. Extensive research and study are conducted to ensure that the Expert System is able to provide the most suitable treatment with reference to the relevant verses cited in Quran or Hadith. These verses come together with their related 'actions' (bodily actions/gestures or some acts) to be performed by the patient to treat a particular illness/sickness. These verses and the instructions for the 'actions' are to be displayed unambiguously on the computer screen. The online platform provides the advantage for patient getting treatment practically anytime and anywhere as long as the computer and Internet facility exist. Patient does not need to make appointment to see an expert for a therapy.

Keywords: Expert System, Quran and Hadith, Islamic Medication, Rule-Based.

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140 A Descriptive Study on Psychiatric Morbidity among Nurses Working in Selected Hospitals of Udupi and Mangalore Districts Karnataka, India

Authors: Tessy Treesa Jose, Sripathy M. Bhat

Abstract:

Nursing is recognized as a stressful occupation and has indicated a probable high prevalence of distress. It is a helping profession requiring a high degree of commitment and involvement. If stress is intense, continuous and repeated, it becomes a negative phenomenon or "distress," which can lead to physical illness and psychological disorders. The frequency of common psychosomatic symptoms including sleeping problems, tension headache, chronic fatigue, palpitation etc. may be an indicator of nurses’ work-related stress level. Objectives of the study were to determine psychiatric morbidity among nurses and to find its association with selected variables. The study population consisted of 1040 registered nurses working in selected medical college hospitals and government hospitals of Udupi and Mangalore districts. Descriptive survey design was used to conduct the study. Subjects were selected by using purposive sampling. Data were gathered by administering background proforma and General Health questionnaire. Severe distress was experienced by 0.9% of nurses and 5.6% had some evidence of distress. Subjects who did not have any distress were 93.5%. No significant association between psychiatric morbidity in nurses and demographic variables was observed. With regard to work variables significant association is observed between psychiatric morbidity and total years of experience (z=10.67, p=0.03) and experience in current area of work (z=9.43, p=0.02).

Keywords: Psychiatric morbidity, nurse, selected hospitals, working.

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