Johnson Alex | Manipal Academy of Higher Education (original) (raw)

Papers by Johnson Alex

Background: To enhance psychological wellbeing of health care providers (HCP) who look after pati... more Background: To enhance psychological wellbeing of health care providers (HCP) who look after patients with COVID-19. This study is a psychological intervention in COVID19 pandemic to check at what extent can interventions based on mindfulness affect psychological resilience and anxiety of HCP. Methods: This is a randomized controlled trial study that was conducted from July to August 2020 at King Fahad Hospital and Qateef Central Hospital in Saudi Arabia. 147 COVID19 frontline HCP were randomized to a 2-week virtual intervention with brief mindfulness-based intervention (BMM) or to progressive muscle relaxation(PMR). Pre and post intervention assessment were done using the (state trait anxiety–20 Item Scale), the (Connor-Davidson Resilience Scale (CD-RISC-10), and WHO – 5 Well-Being Index. Results: The two groups had significant improvement results in the psychological wellbeing and reduction of the sate anxiety but not the trait anxiety nor the resiliency. Improved cases was higher...

Journal of Taibah University Medical Sciences

Journal of Indian Association for Child and Adolescent Mental Health, Oct 1, 2016

Background: Psychological stress during adolescence is a natural phenomenon. Issues related to ac... more Background: Psychological stress during adolescence is a natural phenomenon. Issues related to academics, parents, peers, social life, and personal doubts have always created some queries in these young minds. But most of the times, they get neglected by care givers. So the psychological stress tends to go unchecked among school students. There is not much work done in the area of stress levels and interventions among Indian adolescents. So our primary objective was to test the effectiveness of life skill training program in reducing stress among adolescents. Methods: Forty two adolescent boys participated in the study. Prevalence of stress was determined by administering a standardized stress questionnaire. The intervention program consisted of seven daily sessions of 50 minutes each conducted within school timings. Life skills, stress management modules from NIMHANS model were selected to address adolescent stressors. SPSS 15 was used for data entry and analysis. Pre, post and three month follow up assessments were conducted. Results: 66% of the adolescents reported to be stressed. The mean stress scores among adolescents who underwent the intervention program 310 reduced significantly from 133 to 116 after post one month and to 117 after post three month follow up (p<0.05). Conclusion: Results suggested that group based stress management programs if conducted regularly would be beneficial to reduce the stress levels. Positive feedback from students suggested that these activities were feasible and acceptable.

Middle East Current Psychiatry, 2021

BackgroundIn recent times, COVID-19 has been recognized as a public health emergency and thus far... more BackgroundIn recent times, COVID-19 has been recognized as a public health emergency and thus far, most papers published on it are focused only on the clinical characteristics of infected patients. This pandemic has also made phenomenal emotional impact among the young and the old. We aimed to find out the impact of the COVID-19 pandemic on the psychological well-being of medical students in a University at Riyadh.ResultsThere were 309 participants in the study. Out of them 44% did not have PTSD, 29% had score more than 37 which might contribute to immune suppression, in 18.4% PTSD was a clinical concern and 8.6% had probable PTSD. Female participants were the majority in the group and they also had higher chance of having consequences than the male counterparts (P< 0.001). Avoidance score between male and female gender was significantly different.ConclusionCOVID-19 pandemic has not just affected the physiological functioning of the affected individuals but also has had a probabl...

Indian Journal of Respiratory Care, 2021

Impact of COVID-19 on mental health has affected various dimensions of human life. Various emerge... more Impact of COVID-19 on mental health has affected various dimensions of human life. Various emergency government decisions and policies were developed during this period. Forced implementation of lockdown and quarantine during the pandemic made a significant impact on the general public and frontline health-care workers. The uncertainty due to COVID-19 caused major psychological problems such as anxiety, depression, stress, uncontrolled fear, and significant lifestyle changes. It has affected the world economy and also changed education and learning process.

Paripex Indian Journal of Research, Jul 1, 2013

Nonverbal Learning Disability (NLD) is neuropsychological syndrome due to right-hemisphere malfun... more Nonverbal Learning Disability (NLD) is neuropsychological syndrome due to right-hemisphere malfunction and lack of mental coordination (Rourke, 1989). Approximately 10% of general population identified as NLD. Expression of NLD symptoms is deficits predominantly attributed to motor coordination, visuo-spatial & perceptual disturbance, and arithmetical difficulty. Etiology of NLD considered as dysfunction of white matter in the right hemisphere. Current classification systems are not supporting the diagnosis of NLD, however the impact of this syndrome plays significant role in children’s academic performance. Future direction of research on NLD need to be addressed with appropriate individualized intervention strategies.

International journal of adolescent medicine and health, Jan 10, 2015

Adolescence is a tumultuous period of hormonal and psychological transitions ranging from 10 to 1... more Adolescence is a tumultuous period of hormonal and psychological transitions ranging from 10 to 19 years (WHO). This growth phase is usually accompanied by stressors. Very few studies have reported the prevalence of stress levels among adolescent boys. Our aim was to assess the prevalence and determinants of stress and its tolerance levels among high school boys. A cross sectional study design was selected for this purpose. A standardized self reported questionnaire was administered to 1153 high school boys. A score of 130 and more was used to classify the participants as stressed. The prevalence of stress and its tolerance levels was found to be 55% and 33.7%, respectively. Also correlations suggest that parental education and occupational status play a significant role in adolescent stress. Together, these findings suggest necessitating an intervention to counter the same. The proportion of stressed adolescent boys (55.5%) reported to have poor stress tolerance (41%). Studies addr...

Paripex - Indian Journal Of Research, 2012

Learning disabilities (LDs) are heterogeneous group of disorders and children shows difficulty in... more Learning disabilities (LDs) are heterogeneous group of disorders and children shows difficulty in reading, writing, and arithmetic. The prevalence of LDs is 9-39% in Indian population. Assessments of LDs based on its components are key factor in designing appropriate individualized intervention. Various models of assessments consist of discrepancy criteria, Intra-individual difference, and Response to Intervention. Interventions of LDs are classified into counseling & psychoeducation, remedial methods (multisensory instruction, learning modality approach, direct instruction, strategies instruction, and cooperative learning) cognitive remediation (PREP & COGENT) and psychotherapy.

Indian Journal of Applied Research, 2011

Attention Deficit Hyperactivity Disorder (ADHD) is a developmental impairment of complex range of... more Attention Deficit Hyperactivity Disorder (ADHD) is a developmental impairment of complex range of executive functions among which cognitive emotion regulation and behavioral inhibition plays a significant role in regulating their behaviors. The ADHD children (N=20) selected as study group and age, education matched Normal group (N=20) were selected to the control group. Cognitive emotion regulation and Behavioral inhibition was measured. The ADHD group performed poorly than the control group on the tests of behavioral inhibition. No significant differences were found between the groups on cognitive emotion regulation. However, ADHD group scored high on less adaptive coping strategies such as increased rumination, catastrophisation, and other blame. The cognitive emotion regulation ability of the child facilitated by behavior inhibition and executive function abilities of the child, which regulate and moderate their coping strategies as adaptive or less adaptive. Introduction Children with Attention Deficit Hyperactivity Disorder (ADHD) have significant difficulty in controlling their impulses and regulating their activity, attention, and social interactions to a degree consistent with relevant age and culture norms. This leads to their being frequently in trouble with adults and unpopular with peers. They under achieve at school or do not achieve at the level expected for their intelligence and most have learning difficulties. ADHD children shows characteristics such as fails to give close attention to details or makes careless mistakes in schoolwork, or other activities, often has difficulty sustaining attention in tasks or play activities, often does not seem to listen when spoken directly, often does not follow through instructions and fails to finish school work, chores, or duties in the workplace, often has difficulty in organizing tasks that require sustained mental effort, often loses things necessary for tasks or activities (e.g. toys, school assignments, pencils, books or tools), is often easily distracted by extraneous stimuli, is often forgetful in daily activities (APA, 2000). The ADHD symptoms are present before the age 7 years in most of the clinical population. Hyperactive Impulsive (HI) type of ADHD considered as single dimension of behavior. ADHD children are unable to bridle their immediate reactions or to think before they act. Impulsivity in them may be cognitive or behavioral. Cognitive impulsivity refers to their hurried thinking, disorganization and the need for supervision. Behavioral impulsivity refers to their acting without considering the consequences of the actions (Reznick, 1989). ADHD is often associated with dysregulation of affect, in addition to the hallmark dysregulation of activity, speech and activities of daily living. They have poor sense of time and understanding what is appropriate and difficulty with appropriate social performance even when the skill is established (Sandberg, 1996). These features are secondary to the deficits in self-regulation (Barkely, 1989; Jaap, 2010). The selfregulation deficits are associated with behavior inhibition deficits in ADHD Behavioral inhibition is “the tendency to display an initial period of inhibition of speech, play, associated with retreat to a target of attachment, when the child encounters an unfamiliar/challenging environment” (Barkley & Ullman, 1975). Behavioral inhibition deficit is a neurological dysfunction (Barkely, 1997) and is linked to four executive functions that appear to depend on it for their effective organization such as emotional regulation, working memory, internalization of speech and reconstitution. The executive functions are higher order cognitive capacities that evident in activities like decision-making, planning and social conduct. Literature shows primarily in the prefrontal region, which has solid reciprocal connections with the other cortical sub cortical and cerebellar regions (Baumeister & Vohs, 2005). Emotion regulation is an ongoing process of responding to environmental situation with emotions that are both socially acceptable and context-appropriate for a given situation (Cole, Michel, & Teti, 1994). Cognitive emotion regulation involves generating, maintaining, decreasing or increasing either positive emotions or negative emotions. The cognitive emotional regulation plays a significant role in regulating appropriate behavior. It is major dimension influence the behavior of ADHD children regulating what they think (cognitive) versus what they do (behavioral). The nature and extent of influence of these dimensions on their behavior will be helpful in management of ADHD. The purpose of the study was to examine the nature of relationship between behavioral inhibition and cognitive emotion regulation in ADHD children. It was hypothesized that compared to non-ADHD peers, those with ADHD would not be able inhibit gtheir behavior or regulate their emotion properly as stated by Walcott and Landau…

Brazilian Journal of Physical Therapy, 2018

Objective: To explore the personal and environmental contextual factors that influence use of aff... more Objective: To explore the personal and environmental contextual factors that influence use of affected arm for function among stroke survivors. Methods: We conducted a qualitative phenomenological study using an interpretivist paradigm among 23 stroke survivors in their late sub-acute and chronic stages and their relatives living in the rural regions of India using maximum variation sampling. Semi-structured interviews were conducted to identify personal and environmental contextual factors relevant to arm use. Their current level of arm use, motor and functional ability were evaluated using Motor Activity Log, AbilHand and Lawton Instrumental Activities of Daily Living scales and the scores were categorized in order to describe and compare the participant's characteristics before analyzing each interview. Differences among the contextual factors of participants with high and low levels of functional arm use and exercise using paretic limb were analyzed using qualitative content analysis. Results: Study participants followed active exercises or passive interventions to improve their arm. Their immediate social environment influenced these decisions. Lack of awareness on how to self-engage or scale down their physical environment to match their abilities demoted active functional task performance. Ability to perceive small gains in arm function helped them sustain their efforts.

Indian Journal of Applied Research, 2011

The utilization of environmentally friendly and eco-safe wastewater treatment plan is nowadays wi... more The utilization of environmentally friendly and eco-safe wastewater treatment plan is nowadays widespread. This study aimed to assess the potentiality of hybrid constructed wetlands for treating of landfill leachate, river polluted water, domestic, industrial, hospital, runoff and agricultural wastewaters in lab-scale, pilot-scale and full-scale with various configurations. The results revealed that the hybrid constructed wetlands are effective to remove organic matter (BOD 5 , COD) and suspended solid, while in terms of nutrient removal such as N and P components, the removal efficiencies were depending to system properties and operational condition. Additionally it is very useful system to remove the heavy metals and pharmaceuticals pollutants from different wastewaters. Combination of constructed wetlands enhances pollutants removal efficiency as hybrid constructed wetlands could cover the limitation of each single constructed wetlands. It could be concluded that the hybrid constructed wetlands ensure a more stable removal rate of pollutants from various wastewaters in comparison with other wastewaters treatment plans. Keywords hybrid constructed wetlands; wastewater treatment; macrophytes; organic and inorganic pollutants.

Brazilian Journal of Physical Therapy

To explore the personal and environmental contextual factors that influence use of affected arm f... more To explore the personal and environmental contextual factors that influence use of affected arm for function among stroke survivors. We conducted a qualitative phenomenological study using an interpretivist paradigm among 23 stroke survivors in their late sub-acute and chronic stages and their relatives living in the rural regions of India using maximum variation sampling. Semi-structured interviews were conducted to identify personal and environmental contextual factors relevant to arm use. Their current level of arm use, motor and functional ability were evaluated using Motor Activity Log, AbilHand and Lawton Instrumental Activities of Daily Living scales and the scores were categorized in order to describe and compare the participant's characteristics before analyzing each interview. Differences among the contextual factors of participants with high and low levels of functional arm use and exercise using paretic limb were analyzed using qualitative content analysis. Study par...

International Tinnitus Journal, 2013

The present study investigated the relationship between the perceived tinnitus severity, depressi... more The present study investigated the relationship between the perceived tinnitus severity, depressive and anxiety symptoms in individuals with tinnitus. An attempt was also made to see if any relationship exists between the perceived tinnitus severity and the age, gender or hearing status of the sufferer. Materials and Methods: Fifty individuals (31 males, 19 females) with tinnitus (age range 19 to 60 years) were enrolled in the study. After the routine pure tone audiometry, each participant completed the Tinnitus Handicap Inventory, the State-Trait Anxiety Inventory and the Inventory of Depressive Symptomatology-Self Report-30. Results: A significant correlation (r = 0.585, p < 0.01) was found between the perceived tinnitus severity, as indicated by the Tinnitus Handicap Inventory scores and depressive symptoms. Tinnitus Handicap Inventory scores also correlated significantly with both state and trait anxiety levels (r = 0.602, p<0.01; r = 0.426, p < 0.01 respectively). Furthermore, age, gender and hearing status did not significantly influence the perceived severity of tinnitus. Conclusion: The results support the view that there is a strong relation between tinnitus and anxiety-depressive symptoms. Further, perceived severity of tinnitus is not influenced by age, gender and hearing status of the individual.

Indian Journal of Applied Research, 2011

Background: To enhance psychological wellbeing of health care providers (HCP) who look after pati... more Background: To enhance psychological wellbeing of health care providers (HCP) who look after patients with COVID-19. This study is a psychological intervention in COVID19 pandemic to check at what extent can interventions based on mindfulness affect psychological resilience and anxiety of HCP. Methods: This is a randomized controlled trial study that was conducted from July to August 2020 at King Fahad Hospital and Qateef Central Hospital in Saudi Arabia. 147 COVID19 frontline HCP were randomized to a 2-week virtual intervention with brief mindfulness-based intervention (BMM) or to progressive muscle relaxation(PMR). Pre and post intervention assessment were done using the (state trait anxiety–20 Item Scale), the (Connor-Davidson Resilience Scale (CD-RISC-10), and WHO – 5 Well-Being Index. Results: The two groups had significant improvement results in the psychological wellbeing and reduction of the sate anxiety but not the trait anxiety nor the resiliency. Improved cases was higher...

Journal of Taibah University Medical Sciences

Journal of Indian Association for Child and Adolescent Mental Health, Oct 1, 2016

Background: Psychological stress during adolescence is a natural phenomenon. Issues related to ac... more Background: Psychological stress during adolescence is a natural phenomenon. Issues related to academics, parents, peers, social life, and personal doubts have always created some queries in these young minds. But most of the times, they get neglected by care givers. So the psychological stress tends to go unchecked among school students. There is not much work done in the area of stress levels and interventions among Indian adolescents. So our primary objective was to test the effectiveness of life skill training program in reducing stress among adolescents. Methods: Forty two adolescent boys participated in the study. Prevalence of stress was determined by administering a standardized stress questionnaire. The intervention program consisted of seven daily sessions of 50 minutes each conducted within school timings. Life skills, stress management modules from NIMHANS model were selected to address adolescent stressors. SPSS 15 was used for data entry and analysis. Pre, post and three month follow up assessments were conducted. Results: 66% of the adolescents reported to be stressed. The mean stress scores among adolescents who underwent the intervention program 310 reduced significantly from 133 to 116 after post one month and to 117 after post three month follow up (p<0.05). Conclusion: Results suggested that group based stress management programs if conducted regularly would be beneficial to reduce the stress levels. Positive feedback from students suggested that these activities were feasible and acceptable.

Middle East Current Psychiatry, 2021

BackgroundIn recent times, COVID-19 has been recognized as a public health emergency and thus far... more BackgroundIn recent times, COVID-19 has been recognized as a public health emergency and thus far, most papers published on it are focused only on the clinical characteristics of infected patients. This pandemic has also made phenomenal emotional impact among the young and the old. We aimed to find out the impact of the COVID-19 pandemic on the psychological well-being of medical students in a University at Riyadh.ResultsThere were 309 participants in the study. Out of them 44% did not have PTSD, 29% had score more than 37 which might contribute to immune suppression, in 18.4% PTSD was a clinical concern and 8.6% had probable PTSD. Female participants were the majority in the group and they also had higher chance of having consequences than the male counterparts (P< 0.001). Avoidance score between male and female gender was significantly different.ConclusionCOVID-19 pandemic has not just affected the physiological functioning of the affected individuals but also has had a probabl...

Indian Journal of Respiratory Care, 2021

Impact of COVID-19 on mental health has affected various dimensions of human life. Various emerge... more Impact of COVID-19 on mental health has affected various dimensions of human life. Various emergency government decisions and policies were developed during this period. Forced implementation of lockdown and quarantine during the pandemic made a significant impact on the general public and frontline health-care workers. The uncertainty due to COVID-19 caused major psychological problems such as anxiety, depression, stress, uncontrolled fear, and significant lifestyle changes. It has affected the world economy and also changed education and learning process.

Paripex Indian Journal of Research, Jul 1, 2013

Nonverbal Learning Disability (NLD) is neuropsychological syndrome due to right-hemisphere malfun... more Nonverbal Learning Disability (NLD) is neuropsychological syndrome due to right-hemisphere malfunction and lack of mental coordination (Rourke, 1989). Approximately 10% of general population identified as NLD. Expression of NLD symptoms is deficits predominantly attributed to motor coordination, visuo-spatial & perceptual disturbance, and arithmetical difficulty. Etiology of NLD considered as dysfunction of white matter in the right hemisphere. Current classification systems are not supporting the diagnosis of NLD, however the impact of this syndrome plays significant role in children’s academic performance. Future direction of research on NLD need to be addressed with appropriate individualized intervention strategies.

International journal of adolescent medicine and health, Jan 10, 2015

Adolescence is a tumultuous period of hormonal and psychological transitions ranging from 10 to 1... more Adolescence is a tumultuous period of hormonal and psychological transitions ranging from 10 to 19 years (WHO). This growth phase is usually accompanied by stressors. Very few studies have reported the prevalence of stress levels among adolescent boys. Our aim was to assess the prevalence and determinants of stress and its tolerance levels among high school boys. A cross sectional study design was selected for this purpose. A standardized self reported questionnaire was administered to 1153 high school boys. A score of 130 and more was used to classify the participants as stressed. The prevalence of stress and its tolerance levels was found to be 55% and 33.7%, respectively. Also correlations suggest that parental education and occupational status play a significant role in adolescent stress. Together, these findings suggest necessitating an intervention to counter the same. The proportion of stressed adolescent boys (55.5%) reported to have poor stress tolerance (41%). Studies addr...

Paripex - Indian Journal Of Research, 2012

Learning disabilities (LDs) are heterogeneous group of disorders and children shows difficulty in... more Learning disabilities (LDs) are heterogeneous group of disorders and children shows difficulty in reading, writing, and arithmetic. The prevalence of LDs is 9-39% in Indian population. Assessments of LDs based on its components are key factor in designing appropriate individualized intervention. Various models of assessments consist of discrepancy criteria, Intra-individual difference, and Response to Intervention. Interventions of LDs are classified into counseling & psychoeducation, remedial methods (multisensory instruction, learning modality approach, direct instruction, strategies instruction, and cooperative learning) cognitive remediation (PREP & COGENT) and psychotherapy.

Indian Journal of Applied Research, 2011

Attention Deficit Hyperactivity Disorder (ADHD) is a developmental impairment of complex range of... more Attention Deficit Hyperactivity Disorder (ADHD) is a developmental impairment of complex range of executive functions among which cognitive emotion regulation and behavioral inhibition plays a significant role in regulating their behaviors. The ADHD children (N=20) selected as study group and age, education matched Normal group (N=20) were selected to the control group. Cognitive emotion regulation and Behavioral inhibition was measured. The ADHD group performed poorly than the control group on the tests of behavioral inhibition. No significant differences were found between the groups on cognitive emotion regulation. However, ADHD group scored high on less adaptive coping strategies such as increased rumination, catastrophisation, and other blame. The cognitive emotion regulation ability of the child facilitated by behavior inhibition and executive function abilities of the child, which regulate and moderate their coping strategies as adaptive or less adaptive. Introduction Children with Attention Deficit Hyperactivity Disorder (ADHD) have significant difficulty in controlling their impulses and regulating their activity, attention, and social interactions to a degree consistent with relevant age and culture norms. This leads to their being frequently in trouble with adults and unpopular with peers. They under achieve at school or do not achieve at the level expected for their intelligence and most have learning difficulties. ADHD children shows characteristics such as fails to give close attention to details or makes careless mistakes in schoolwork, or other activities, often has difficulty sustaining attention in tasks or play activities, often does not seem to listen when spoken directly, often does not follow through instructions and fails to finish school work, chores, or duties in the workplace, often has difficulty in organizing tasks that require sustained mental effort, often loses things necessary for tasks or activities (e.g. toys, school assignments, pencils, books or tools), is often easily distracted by extraneous stimuli, is often forgetful in daily activities (APA, 2000). The ADHD symptoms are present before the age 7 years in most of the clinical population. Hyperactive Impulsive (HI) type of ADHD considered as single dimension of behavior. ADHD children are unable to bridle their immediate reactions or to think before they act. Impulsivity in them may be cognitive or behavioral. Cognitive impulsivity refers to their hurried thinking, disorganization and the need for supervision. Behavioral impulsivity refers to their acting without considering the consequences of the actions (Reznick, 1989). ADHD is often associated with dysregulation of affect, in addition to the hallmark dysregulation of activity, speech and activities of daily living. They have poor sense of time and understanding what is appropriate and difficulty with appropriate social performance even when the skill is established (Sandberg, 1996). These features are secondary to the deficits in self-regulation (Barkely, 1989; Jaap, 2010). The selfregulation deficits are associated with behavior inhibition deficits in ADHD Behavioral inhibition is “the tendency to display an initial period of inhibition of speech, play, associated with retreat to a target of attachment, when the child encounters an unfamiliar/challenging environment” (Barkley & Ullman, 1975). Behavioral inhibition deficit is a neurological dysfunction (Barkely, 1997) and is linked to four executive functions that appear to depend on it for their effective organization such as emotional regulation, working memory, internalization of speech and reconstitution. The executive functions are higher order cognitive capacities that evident in activities like decision-making, planning and social conduct. Literature shows primarily in the prefrontal region, which has solid reciprocal connections with the other cortical sub cortical and cerebellar regions (Baumeister & Vohs, 2005). Emotion regulation is an ongoing process of responding to environmental situation with emotions that are both socially acceptable and context-appropriate for a given situation (Cole, Michel, & Teti, 1994). Cognitive emotion regulation involves generating, maintaining, decreasing or increasing either positive emotions or negative emotions. The cognitive emotional regulation plays a significant role in regulating appropriate behavior. It is major dimension influence the behavior of ADHD children regulating what they think (cognitive) versus what they do (behavioral). The nature and extent of influence of these dimensions on their behavior will be helpful in management of ADHD. The purpose of the study was to examine the nature of relationship between behavioral inhibition and cognitive emotion regulation in ADHD children. It was hypothesized that compared to non-ADHD peers, those with ADHD would not be able inhibit gtheir behavior or regulate their emotion properly as stated by Walcott and Landau…

Brazilian Journal of Physical Therapy, 2018

Objective: To explore the personal and environmental contextual factors that influence use of aff... more Objective: To explore the personal and environmental contextual factors that influence use of affected arm for function among stroke survivors. Methods: We conducted a qualitative phenomenological study using an interpretivist paradigm among 23 stroke survivors in their late sub-acute and chronic stages and their relatives living in the rural regions of India using maximum variation sampling. Semi-structured interviews were conducted to identify personal and environmental contextual factors relevant to arm use. Their current level of arm use, motor and functional ability were evaluated using Motor Activity Log, AbilHand and Lawton Instrumental Activities of Daily Living scales and the scores were categorized in order to describe and compare the participant's characteristics before analyzing each interview. Differences among the contextual factors of participants with high and low levels of functional arm use and exercise using paretic limb were analyzed using qualitative content analysis. Results: Study participants followed active exercises or passive interventions to improve their arm. Their immediate social environment influenced these decisions. Lack of awareness on how to self-engage or scale down their physical environment to match their abilities demoted active functional task performance. Ability to perceive small gains in arm function helped them sustain their efforts.

Indian Journal of Applied Research, 2011

The utilization of environmentally friendly and eco-safe wastewater treatment plan is nowadays wi... more The utilization of environmentally friendly and eco-safe wastewater treatment plan is nowadays widespread. This study aimed to assess the potentiality of hybrid constructed wetlands for treating of landfill leachate, river polluted water, domestic, industrial, hospital, runoff and agricultural wastewaters in lab-scale, pilot-scale and full-scale with various configurations. The results revealed that the hybrid constructed wetlands are effective to remove organic matter (BOD 5 , COD) and suspended solid, while in terms of nutrient removal such as N and P components, the removal efficiencies were depending to system properties and operational condition. Additionally it is very useful system to remove the heavy metals and pharmaceuticals pollutants from different wastewaters. Combination of constructed wetlands enhances pollutants removal efficiency as hybrid constructed wetlands could cover the limitation of each single constructed wetlands. It could be concluded that the hybrid constructed wetlands ensure a more stable removal rate of pollutants from various wastewaters in comparison with other wastewaters treatment plans. Keywords hybrid constructed wetlands; wastewater treatment; macrophytes; organic and inorganic pollutants.

Brazilian Journal of Physical Therapy

To explore the personal and environmental contextual factors that influence use of affected arm f... more To explore the personal and environmental contextual factors that influence use of affected arm for function among stroke survivors. We conducted a qualitative phenomenological study using an interpretivist paradigm among 23 stroke survivors in their late sub-acute and chronic stages and their relatives living in the rural regions of India using maximum variation sampling. Semi-structured interviews were conducted to identify personal and environmental contextual factors relevant to arm use. Their current level of arm use, motor and functional ability were evaluated using Motor Activity Log, AbilHand and Lawton Instrumental Activities of Daily Living scales and the scores were categorized in order to describe and compare the participant's characteristics before analyzing each interview. Differences among the contextual factors of participants with high and low levels of functional arm use and exercise using paretic limb were analyzed using qualitative content analysis. Study par...

International Tinnitus Journal, 2013

The present study investigated the relationship between the perceived tinnitus severity, depressi... more The present study investigated the relationship between the perceived tinnitus severity, depressive and anxiety symptoms in individuals with tinnitus. An attempt was also made to see if any relationship exists between the perceived tinnitus severity and the age, gender or hearing status of the sufferer. Materials and Methods: Fifty individuals (31 males, 19 females) with tinnitus (age range 19 to 60 years) were enrolled in the study. After the routine pure tone audiometry, each participant completed the Tinnitus Handicap Inventory, the State-Trait Anxiety Inventory and the Inventory of Depressive Symptomatology-Self Report-30. Results: A significant correlation (r = 0.585, p < 0.01) was found between the perceived tinnitus severity, as indicated by the Tinnitus Handicap Inventory scores and depressive symptoms. Tinnitus Handicap Inventory scores also correlated significantly with both state and trait anxiety levels (r = 0.602, p<0.01; r = 0.426, p < 0.01 respectively). Furthermore, age, gender and hearing status did not significantly influence the perceived severity of tinnitus. Conclusion: The results support the view that there is a strong relation between tinnitus and anxiety-depressive symptoms. Further, perceived severity of tinnitus is not influenced by age, gender and hearing status of the individual.

Indian Journal of Applied Research, 2011