Journal of Intellectual Disability - Diagnosis and Treatment

100-106

Authors: Gholam Reza Shamsaei, Shahram Rafie, Zeinab Rahimi

Background and Objective: Although current evidence has demonstrated the efficacy and immunity of Alteplase, further studies are needed to evaluate its functioning in the therapeutic system. This study aims to assess the effect and immunity of tissue plasminogen activator (tPA) in the treatment of acute ischemic stroke (AIS).Methods: This study was conducted as a retrospectiveobservational study on patients with AIS referred to Ahvaz Golestan Hospital in 2017-2018. By using the hospital database, demographic information, the cause of lack of thrombolytic therapy, the onset of symptoms and admission were extracted. The National Institutes of Health Stroke Scale (NIHSS) at the time of referral, 24 hours after treatment, and at the time of discharge, the modified Rankin Scale (mRS) scores at discharge time and 3 months after discharge, complications and mortality at the time of admission and 3 months after discharge were recorded.Results: The mean of the event to needle (hrs) was significantly lower in the tPA group (P <0.0001), and delay in visiting time and loss of golden time were of the main reasons for not receiving tPA in the control group. The mean difference and the decrease in NIHSS score 24 hours after admission and discharge in the tPA group was significantly higher (P <0.0001). At the time of discharge, the mean score of mRS in the two groups was not significantly different. Three months after treatment, the mean score of mRS in the tPA group was significantly lower than that in the control group (P <0.05). The percentage of patients with bleeding complications was higher in the tPA group (7.27%) than that in the control group (4.89%). The percentage of deaths during the hospital stay in the tPA group (3.64%) was higher than that in the control group (1.63%).Conclusion: Patients with AIS under intravenous thrombolytic therapy with tPA showed improvement in functional measurements and neurological outcomes compared with the control group. Lack of significant difference in the rate of complications and mortality between the two groups indicated the safety and high efficacy of thrombolytic therapy in patients with AIS.

112-116

Authors: Gholamreza Shamsaei, Shahram Rafie, Fatemeh Pourshams

Background and Objective: Attempts have been made to confirm the diagnosis of stroke at the earliest stage and to prevent the development of neurological deficits. Tissue plasminogen activator (tPA) plays a logical role in the treatment of acute stroke by converting plasminogen to plasmin, and recent studies have shown that the drug can be injected up to four and a half hours after the onset of symptoms. The present study aimed to evaluate the effect of an in-hospital intervention to reduce door to needle (DTN) time in acute stroke patients.Methods: This epidemiological case-control study was performed on patients with acute ischemic stroke from September to March 2016 (n= 25) (group A) who were treated with tPA according to stroke guidelines. Their basic specifications, DTN and Door to Computed Tomography scan (DTC) time were recorded. Then, from April to August 2017, an intra-hospital recipe for tPA injection was provided by investigating the obstacles and causes of intra-hospital delays. Subsequently, stroke patients receiving tPA from September to March 2017 (n= 23) (group B) were examined, and their DTN and DTC were compared with patients in the first group.Results: The mean DTN and DTC in group A were 67.27±28.83 and 30.40±10.59 minutes, and in group B, were 45±25.98 and 22.17±8.50, minutes, respectively, which made a significant difference between the two groups (P=0.005, P=0.006, respectively). The percentage of patients with DTN less than 60 minutes increased from 52% in group A to95.6% in group B. The percentage of patients with DTC less than 25 minutes decreased from 32% to 69.56% (P<0.001). The percentage of patients with symptomatic cerebral haemorrhage increased from 12% to 8.7% (P<0.001). The percentage of patients with independent ambulatory (mRS: 0-2) at three months after discharge increased from 48% to 56.5% (P=0.003). The mortality rate also decreased from 24% to 13.4% (P<0.001).Conclusion: By resolving the causes of intra-hospital delays and using a proper team program, the mean DTN and DTC of patients receiving tPA were reduced. This decrease in DTN time was accompanied by reduced complications in the form of reduced symptomatic cerebral haemorrhage and mortality and improved prognosis.

124-132

Authors: Olga Emishyants, Andrii Trofimov, Antonina Hrys, Mariia Pavliuk, Olena Shopsha, Angelina Tereshchuk, Svetlana Polishchuk

The article considers the concept of the social maturity of adolescents in the context of the development of creative abilities. The relationships of social maturity with socialization, social creativity and innovative thinking of adolescents are researched. It is found that girls are more likely to move from the previous to the next level of social maturity. It is found that with age, the ability to social creativity develops. There is a connection between the level of social creativity and the levels of social autonomy, social morality and social activity of adolescents

142-147

Authors: Zaryana Olexyuk, Aiman Konkabayeva, Gulnaziya Alshynbekova, Gulmira Tykezhanova, Sholpan Nugumanova, Manara Mukasheva

In the last decades of the 21st century, the problem of a significant increase in the number of children with disorders in mental and somatic development has become particularly acute. Often there are neurotic conditions caused by the influence of various psycho-traumatic factors: the growth of scientific and technological progress and related changes in all areas of human life activity. In this regard, shifts occurred in the structure of the incidence among the population towards an increase in the proportion of diseases associated with nervous and psychic overstrain. One of the most vulnerable age groups is children of preschool and primary school age. Untimely diagnosed neurotic disorders in children, as a rule, turn into protracted forms of neurotic conditions and subsequently become chronic. This, of course, affects the adaptation of the individual in society and the further quality of life. This study, aimed at assessing autonomic regulation in preschool children with different psychological status, allowed to reveal the activity of the sympathetic and parasympathetic link of the autonomic nervous system (ANS) by the method of cardiointervalography according to R.M. Baevskii. We examined 127 children aged 4-5.5 years old. The average statistical indicators characterizing the regulation of heart rate (HR, HF, LF, VLF, LF/HF, TP, SI) in preschool children in various groups (neurosis, pre-neurosis, anxiety, and normal) were determined. The study revealed changes in the regulation of heart rhythm in children with neurotic disorders, which indicates an increase in the influence of the sympathetic circuit of autonomic regulation and a decrease in parasympathetic influences. Overstrain of vegetative centres in children with neurosis and pre-neurotic conditions is determined by high psychoemotional stresses.

159-166

Authors: Marianna Tkalych, Iryna Snyadanko, Natalya Guba, Yuliia Zhelezniakova

Objective: The study aimed to explore the work-life balance concept, assessing the level and the peculiarities of work-life balance.Background: The paper covers the psychological reconstruction of the concept of "the work-life balance" in terms of its implicit understanding and differentiated diagnosis.Method: The main research methods are: theoretical – the study of literature on the research problem; empirical – a study on the methodology for assessing psychological well-being, as well as methods of descriptive and analytical statistics.Results: It has been designed an inventory based on 16 statements divided into the work-life balance components by means of the factor analysis. Satisfaction with work and family roles have been found to have additive effects on happiness, life satisfaction, and perceived quality of life. The basic strategies in social and psychological programs in organisations have been analysed as focus strategies, "resource/refusal" strategies, adaptive strategies. Adaptive strategies are the ones helping to adapt to problems arising at work or/and at home.Conclusion: Empirical findings suggest that involvement in multiple roles can improve psychological and mental health by buffering negative effects such as reduced. The use of individual adaptive strategies with the resource increase strategy perfectly contributes to the work-life balance achievement.

174-180

Authors: Shahram Rafie, Davood Kashipazha, Navid Sabahi

Background and Objective: Given that a small percentage of people with ischemic stroke are treated with recombinant tissue plasminogen activator (rtPA) in Iran, it is necessary to use appropriate educational methods that, in addition to raising the awareness of patients about stroke, lead them to refer health centres early. The purpose of this study was to evaluate the effect of new methods of training warning signs of acute stroke on thrombolytic therapy.Method: This was a community-based empirical intervention study in Ahvaz, Iran, in 2018. Initially, educational content was provided, including warning signs of a stroke, its risk factors, and the need for prompt referral to a well-equipped treatment centre for thrombolytic therapy. This content was used to prepare brochures, pamphlets, posters, and training sessions for health care personnel. Before starting, immediately, and three months after the training course, a questionnaire was used to assess staff knowledge of stroke symptoms and the need for rapid patient referral for FAST-based thrombolytic therapy. Also, the timely referral of patients with suspected stroke to hospital, as well as their thrombolytic therapy during the six months after the intervention and the similar six months in the previous year were compared.Results: The level of knowledge was significantly increased at the end of training (P<0.0001). Although this average was reduced three months after completion of training, the difference was not significant (P = 0.42). Based on the results, the number of stroke patients referred to hospital in golden time (less than 4.5 hours) from the beginning of training to 6 months after the end of the course (n = 54) was increased compared to the same period last year (n=38). The number of thrombolytic patients from the beginning of the training course to 6 months after the course (n=38) increased compared to the same period of the previous year (n=21).Conclusion: Based on the results, the implementation of educational programs was reported to be effective in raising public awareness of stroke symptoms and the need for prompt hospital referral for appropriate and timely treatment.

188-195

Authors: Aiste Diržyte, Aleksandras Patapas

Objective: This study aimed at identifying the relationship between socioeconomic status and psychological well being in the Lithuanian population.Background: Socioeconomic status implies that not all individuals have equal opportunities to achieve their goals, because not everyone has equal access to education, health, even business support services, and the psychological well-being of some may be significantly reduced solely by lack of material resources.Method: The main method of research in the article is an interview method at the respondent's home. Also, various assessment tools were used in the Lithuanian population survey. In this survey, the authors applied the following scales: Flourishing Scale; The Satisfaction with Life Scale; The Cantril Self-Anchoring Striving Scale and The Positive and Negative Emotional Experience Scale.Results: The results of the study showed statistically significant differences in psychological well-being (psychological flourishing, life satisfaction, happiness, positive and negative emotional experiences) between different income quintile groups, with average psychological well-being constructs in the lowest income quintile being about twice lower than in the highest income quintile. The study showed that the mean ranks of the happiness score in the most deprived group were almost seven times lower than in the middle class.Conclusion: The research has established that strong and lasting negative emotional experiences are related to diminished well-being and can cause direct and indirect public damages. Authors indicate that additional research is needed.

205-210

Authors: Raugash K. Nurmaganbetova, Aychurek T. Kaldybayeva, Nurjan K. Sartbekova, Ayzat K. Umirbekova, Elvir M. Akhmetshin

Objective: The study aims to explore the readiness of future teachers for the implementation of education in the inclusive environment.Background: Inclusive education, which is intensively included in the practice of the modern school, raises many complex issues and new challenges. The teachers need specialised training in the field of correctional pedagogy to provide professional assistance and training for children with the oppositional defiant disorder.Method: The main method of research in the article is the study of literature on the research problem and a questionnaire survey method which was participated by 247 teachers of comprehensive schools of Karaganda Region.Results: During the analysis of the results of the survey, it was noted that many teachers were not ready for full and optimal communication with children with disabilities in development. The authors identified the conditions for the formation of professional and personal readiness of the teacher to work with children with disabilities.Conclusion: The transition to inclusive education requires the participation of all specialists of the education system and the availability of fundamental theoretical developments. The main problems of teachers who will have to work in the environment of inclusion are related to their theoretical training and practical skills of teaching this contingent of children.

219-224

Authors: Myron Y. Varii

Objective: The article researches the essence and bases of functioning and development of the consciousness (conscious level of the human psyche) in the context of the psychic and energetic conception of the psyche and psychic.Background: There are thousands of writings about consciousness. However, operational and functional processes of conscious perception of the world and self, understanding of various connections in this world, determining of attitude to it and self and forming responsibilities for results of interaction are described unclearly almost in all psychological conceptions.Method: To disclose the human consciousness, the following methods were used: analysis, synthesis, comparison, abstraction, generalisation and grouping of existing knowledge about a human, functioning of the human psyche.Results: It has been proved that the conscious is the plurality of different psychic, about which human is aware.We hav e found out that the personal unconsciouscontains phenomena that are in the subconscious, not in the unconscious because "came" from consciousness.Conclusion: This plurality is the basis of forming psy-programs of different degree of complication and perfection to transform the world as external psyche through activity, behaviour, their comparison with previous experience, isolation of "Self" from the environment to analyse it and consciousness from different perspectives.

233-243

Authors: Mahmoud-Reza Panahi-Bazaz, Mostafa Feghhi, Mohammad Malek Ahmadi, Aram Mohamad Jafary, Mohammad Sadegh Mirdehghan

A cataract is an ocular complication of diabetes mellitus, and the risk of developing diabetic macular oedema (DME) increases in cataract surgery. This randomized, single-blind clinical trial study was conducted on 45 eyes (39 patients) with stable diabetic retinopathy with cataract to compare the efficacy of three therapeutic procedures in the prevention of DME after phacoemulsification through intraocular lens implantation. After cataract surgery by phacoemulsification, the patients were randomly assigned into three groups. The group A received 1.25 mg of intravitreal bevacizumab, and group B received a sub-tenon injection of 40 mg triamcinolone at the end of the surgery. The group C received topical diclofenac drops every 8h for four weeks after the surgery. Results showed there was no significant difference in the demographics and clinical features, central macular thickness, and systemic condition of the three groups at the beginning of the study. There was a significant difference between the preoperative and postoperative periods (i.e., three months after surgery) in the three groups regarding mean macular thickness; however, the difference among the three groups was not significant in the post-operative periods. The DME after cataract surgery occurred in 4 eyes (26.67%) in the diclofenac group and three eyes (20.00%) in the intravitreal bevacizumab andthree eyes (20.00%) in sub-tenon triamcinolone groups. According to results, the administration of these three therapeutic procedures can be beneficial in the prevention of DME in patients with cataract and diabetic retinopathy

254-261

Authors: Owoade Philip Adeleke, James Abua Ewa, James Eburikuri Olayi, Samuel Orim Orim

This study investigated the impact of intellectual disability (ID) on the family economy in Calabar, Cross River State, Nigeria. The cost of parenting a child with ID in Nigeria is overwhelming as there is no state provision for the care of this group, consequently imposing burden onthe parents. Parents of persons with ID in Calabar South Local Government Area, Cross River State, Nigeria, constituted the study population. The study sample includes 150 parents of persons with ID. Intellectual Disability and Family Economy Assessment Scale (r = 0.877) was used for datacollection. Data were analysed using frequency count and percentage. The study revealed that ID significantly affects the family economy and education of siblings and persons with ID in Calabar, Cross River State, Nigeria. The impact of ID on the family economy in the study area is generally negative. Nigerian government should put in place the necessarysocial facility that will help reduce the impact of the disability on the families.