Search results for: major depressive disorders
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8636

Search results for: major depressive disorders

8366 Investigating the Influence of L2 Motivational Self-System on Willingness to Communicate in English: A Study of Chinese Non-English Major Students in EFL Classrooms

Authors: Wanghongshu Zhou

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This study aims to explore the relationship between the L2MSS and WTC among Chinese non-English major students in order to provide pedagogical implications for English as a Foreign Language (EFL) classrooms in Chinese universities. By employing a mixed methods approach, we involved 103 Chinese non-English major students from a typical university in China, conducted questionnaire survey to measure their levels of L2WTC and L2MSS level, and then analyzed the correlation between the two above mentioned variables. Semi-structured interviews were conducted with eight participants to provide a deeper understanding and explanation of the questionnaire data. Findings show that 1) Chinese non-English major students’ ideal L2 self and L2 learning experience could positively predict their L2 WTC in EFL class; 2) Chinese non-English major students’ ought-to L2 self might have no significant impact on their L2 WTC in EFL class; and 3) self-confidence might be another main factor that will influence Chinese non-English major students’ L2 WTC in EFL class. These findings might shed light on the second language acquisition field and provide pedagogical recommendations for pre-service as well as in-service EFL teachers.

Keywords: L2 willingness to communicate, L2 motivation, self-confidence, Chinese non-English major students

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8365 In the Face of Brokenness: Finding Meaning and Purpose in a Shattered World

Authors: Le Khanh Huyen

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This dissertation focuses on the psychological study of children, particularly those who lack parental affection or face family pressures. It will analyze the severe consequences of insufficient parental love and familial pressure on children's psychology, including emotional and behavioral disorders, learning difficulties in academics and daily life, loss of faith, and low self-esteem. Additionally, this dissertation will propose solutions to support children in challenging circumstances, contributing to the protection of children's mental health.

Keywords: child psychology, lack of parental love, family pressure, emotional and behavioral disorders, learning difficulties, loss of faith, self-esteem, mental health

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8364 Combination of Work and Family Demands Correlated with the Severity of Wrist Musculoskeletal Disorders among Nurses

Authors: Hsien Hwa Kuo, Lin Wen Chun, Lin Wen Chun, Hsien Wen Kuo

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Objective: Nurses represent an important occupational group frequently affected by wrist musculoskeletal disorders (WMSDs) due to a heavy workload, working shifts, poor posture, giving shots, making beds, lifting patients, bending their waist and insufficient rest time every day. However, lack of research reported nurses whether workload in household correlated with the severity of WMSDs. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire including the demographic information, workplace condition and nine body parts of musculoskeletal disorders. Results: 17.9% and 23.9% of severity and symptoms in WMSDs among nurses with children were significant higher than among nurses without children (1​2.4% and 15.9%). Based on multiple logistic regression models adjusted for age, work duration, job title and body mass index (BMI), we found that heavy workload in hospital had higher odds ratio (OR) of the severity and symptoms of WMSD among nurses with children (OR= 8.67 and OR= 4.30, p<0.05) compared to nurses without children (OR= 1.94 and OR= 1.70). Conclusion: The severity and symptoms of WMSDs among nurses significantly correlated with workload in hospital among nurses with children. If women are at greater risk because of the combination of their work and family demands, synergistic effect of WMSDs was found among nurses. Comment: Women's domestic work, especially once they become mothers, they invest more time and energy caring for children, helping others, and doing housework. Thus domestic work, per se, may be a risk factor for wrist musculoskeletal problems, and, more importantly, it may constrain women's ability to protect themselves from the effects of their paid work. If nurses with more domestic work periodically make efforts to physical activity or modify inappropriate posture, their WMSDs symptoms will be alleviated.

Keywords: musculoskeletal disorders, nurse, NMQ, WMSDs

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8363 The Social Aspects of Mental Illness among Orthodox Christians of the Tigrinya Ethnic Group in Eritrea

Authors: Erimias Firre

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This study is situated within the religio-cultural milieu of Coptic Orthodox Christians of the Tigrinya ethnic group in Eritrea. With this ethnic group being conservative and traditionally bound, extended family structures dissected along various clans and expansive community networks are the distinguishing mark of its members. Notably, Coptic Tigrinya constitutes the largest percentage of all Christian denominations in Eritrea. As religious, cultural beliefs, rituals and teachings permeate in all aspects of social life, a distinct worldview and traditionalized health and illness conceptualization are common. Accordingly, this study argues that religio-culturally bound illness ideologies immensely determine the perception, help seeking behavior and healing preference of Coptic Tigrinya in Eritrea. The study bears significance in the sense that it bridges an important knowledge gap, given that it is ethno-linguistically (within the Tigrinya ethnic group), spatially (central region of Eritrea) and religiously (Coptic Christianity) specific. The conceptual framework guiding this research centered on the social determinants of mental health, and explores through the lens of critical theory how existing systems generate social vulnerability and structural inequality, providing a platform to reveal how the psychosocial model has the capacity to emancipate and empower those with mental disorders to live productive and meaningful lives. A case study approach was employed to explore the interrelationship between religio-cultural beliefs and practices and perception of common mental disorders of depression, anxiety, bipolar affective, schizophrenia and post-traumatic stress disorders and the impact of these perceptions on people with those mental disorders. Purposive sampling was used to recruit 41 participants representing seven diverse cohorts; people with common mental disorders, family caregivers, general community members, ex-fighters , priests, staff at St. Mary’s and Biet-Mekae Community Health Center; resulting in rich data for thematic analysis. Findings highlighted current religio-cultural perceptions, causes and treatment of mental disorders among Coptic Tigrinya result in widespread labelling, stigma and discrimination, both of those with mental disorders and their families. Traditional healing sources are almost exclusively tried, sometimes for many years, before families and sufferers seek formal medical assessment and treatment, resulting difficult to treat illness chronicity. Service gaps in the formal medical system result in the inability to meet the principles enshrined in the WHO Mental Health Action Plan 2013-2020 to which the Eritrean Government is a signatory. However, the study found that across all participant cohorts, there was a desire for change that will create a culture whereby those with mental disorders will have restored hope, connectedness, healing and self-determination.

Keywords: Coptic Tigrinya, mental disorders, psychosocial model social integration and recovery, traditional healing

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8362 Testicular Dose and Associated Risk from Common Pelvis Radiation Therapy in Iran

Authors: Ahmad Shanei, Milad Baradaran-Ghahfarokhi

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This study aimed to investigate testicular dose (TD) and the associated risk of heritable disease from common pelvis radiotherapy of male patients in Iran. In this work, the relation between TD and changes in beam energy, pelvis size, source to skin distance (SSD) and beam directions (anterior or posterior) were also evaluated. The values of TDs were measured on 67 randomly selected male patients during common pelvis radiotherapy using 1.17 and 1.33 MeV, Theratron Cobalt-60 unit at SSD of 80 cm and 9 MV, Neptun 10 PC and 18 MV, GE Saturne 20 at SSD of 100 cm at Seyed-Al Shohada Hospital, Isfahan, Iran. Results showed that the maximum TD was up to 12% of the tumor dose. Considering the risk factor for radiation-induced heritable disorders of 0.1% per Sv, an excess risk of hereditary disorders of 72 per 10000 births was conservatively calculated. There was a significant difference in the measured TD using different treatment machines and energies (P < 0.001). The TD at 100 cm SSD were much less than that for 80 cm SSD (P <0.001). The Pearson Correlation test showed that, as expected, there was a strong correlation between TD and patient’s pelvis size (r = 0.275, P <0.001). Using the student’s t-tests, it was found that, there was not a significant difference between TD and beam direction (P = 0.231). Iranian male patients undergoing pelvic radiotherapy have the potential of receiving a TD of more than 1 Gy which might result in temporary azoospermia. The risk for induction of hereditary disorders in future generations should be considered as low but not negligible in comparison with the correspondent nominal risk.

Keywords: pelvis radiotherapy, testicular dose, infertility, hereditary effects

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8361 Prevalence of Thyroid Disorders in Pregnancy in Northern Algeria

Authors: Samira Akdader-Oudahmane, Assia Kamel, Lynda Lakabi, Michael Bruce Zimmermann, Zohra Hamouli-Said, Djamila Meskine

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Background: Iodine is a trace element whose adequate intakes are essential during pregnancy to promote the correct growth and development of the fetus. Iodine deficiency is the cause of several disorders in foetal development, and thyroid disorders during pregnancy are associated with an increased risk of miscarriage or premature birth. The aim of this study was to assess the iodine status and thyroid function of pregnant women (PW) in northern Algeria. Methods: Healthy PW were recruited from an urban area (Algiers). Spot urine and venous blood samples were collected to assess iodine status (urinary iodine concentration, UIC) and serum thyroid hormones (TSH, FT4), and anti-thyroid peroxidase antibodies (TPO-Ab) concentrations. Results: The median UIC for the PW (n=172) in Algiers was 246,74µg/L, 244,68 µg/L, and 220,63µg/L, respectively, during the first, second, and third trimesters of pregnancy. Mean TSH and FT4 concentrations were within reference ranges in all groups of women. Among PW, 72.7%, 75.4%, and 75.5% in the first, second and third trimester were TPO-Ab+. Among PW, 14%, 10%, and 10% in the first, second and third trimester, respectively, with TPO -Ab+ had subclinical hypothyroidism. An analysis of the variations in the levels of the serum parameters (FT4, TSH and anti-TPO antibodies) was analyzed according to the UIC intervals admitted and show that these marker are predictive of thyroid function. Conclusion: In northern Algeria, median UICs indicate iodine sufficiency in PW. About 75% of PW are TPO-Ab+ and the prevalence of subclinical hypothyroidism is high.

Keywords: thyroid, pregnant woman, urinary iodine, subclinical hypothyroidism

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8360 Exploring Eating Disorders in Sport: Coaching Knowledge and the Effects of the Pandemic

Authors: Rebecca Quinlan

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Background: The pandemic has caused a surge in eating disorders (ED). The prevalence of ED is higher in athletes than in the general population. It would therefore be expected that there will be a rise in ED among athletic populations. Coaches regularly work with athletes and should be in a position to identify signs of ED in their athletes. However, there is limited awareness of ED among coaches. Given the effects of the pandemic, it is crucial that coaches have the skills and knowledge to identify ED. This research will explore the effects of the pandemic on athletes, current knowledge of ED among coaches, and possible solutions for building back better from the pandemic. Methods: Freedom of Information requests were conducted, and a systematic review of the literature was undertaken regarding ED in sports and following the pandemic. Results: The systematic review of the literature showed that there had been a rise in ED in athletes due to the pandemic. Freedom of Information results revealed that ED is not covered in level 1 coaching courses. This lack of education has resulted in many coaches stating they feel unable to identify ED. Discussion: The increased prevalence of ED in athletes, coupled with the negative effects of the pandemic, highlight the need for action. Recommendations are provided, which include Level 1 coaching courses to include compulsory ED education, including signs and symptoms, what to do if an athlete has an ED, and resources/contacts. It is anticipated that the findings will be used to improve coaching knowledge of ED and support offered to athletes, with the overarching aim of building back better and faster from the pandemic.

Keywords: eating disorders, sport, athletes, pandemic

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8359 Neurocognitive Deficits Explaining Psychosocial Function and Relapse in Depression Remission: A Systematic Review

Authors: Nandini Mohan, Elayne Ahern

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Neurocognitive deficits, as well as psychosocial dysfunction, are typically observed in major depressive disorder (MDD). These deficits persist even after a significant reduction of symptoms and remission from MDD. These deficits have also been linked to greater relapse rates. The link between neurocognitive deficits, relapse, and psychosocial functioning in MDD, on the other hand, has received little attention. This review aimed to conduct an in-depth review of the literature on the association between neurocognitive deficits, relapse, and psychosocial functioning in MDD remission. We used search terms related to MDD, MDD remission, psychosocial functioning, neurocognitive impairments, and relapse to conduct a systematic review of English-language literature in PubMed, PsycArticles, PsycINFO, Medline, and Web of Science to identify relevant studies in the area from which 15 studies were identified for inclusion following an examination against inclusion/ exclusion criteria. Executive functioning, psychomotor speed, and memory were closely related to the psychosocial deficits in the phase of MDD remission. Similarly, Executive function, divided attention, and inhibition were closely related to the relapse in the phase of MDD remission. The limitations of the present review include limited and contradicting evidence that led to fewer studies being included. The implications of this review include an understanding of the difference between clinical and full-functional recovery. This evidence can be the basis for incorporating treatment measures that focus on neurocognitive and psychosocial deficits along with the affective symptoms of MDD.

Keywords: depression, MDD, remission, relapse, neurocognitive functioning, psychosocial deficits

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8358 Evaluating the Latest Advances in Dry Powder Inhaler Technology

Authors: Leila Asadollahi

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Dry powder inhalers (DPIs) have come a long way since their creation, starting with the Spinhaler Fisons in 1967. For optimal performance, it is important to consider the interplay between formulation, device, and patient. DPIs have shown great potential in treating systemic disorders, as evidenced by their success in clinical practices. Ongoing clinical trials and market availability of DPI products for systemic disease treatment are also examined. Furthermore, the current COVID-19 pandemic has sparked increased interest in dry powder inhalation as a potential avenue for vaccines and antiviral drugs, prompting further exploration of its applications. To achieve optimal treatment outcomes for respiratory diseases, a thorough understanding of the various types of DPIs currently available is crucial. These include single-dose, multiple-unit dose, and multi-dose DPIs. This informative article delves into the administration of drugs via inhalation, examining its diverse routes of administration. Additionally, it illuminates the exciting advancements in inhalation delivery systems and investigates the latest therapeutic approaches for the treatment of respiratory ailments. Additionally, the article discusses the historical development of DPIs and the need for improved designs to enhance efficacy and patient adherence. The potential of DPIs in treating systemic diseases is also examined. Overall, this review provides valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders. The review aims to provide valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders.

Keywords: dry powder inhalers (DPIs), respiratory diseases, systemic disorders, pulmonary drug delivery

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8357 Social Appearance Concerns among College Students

Authors: Koninika Mukherjee, Dilwar Hussain

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Introduction: One of the most prevalent psychopathologies among the youth is social anxiety. The presence of comorbid disorders further complicates diagnosis and treatment. One of the most commonly co-occurring disorders, along with social anxiety, is related to eating behavior. Objective: Identifying the risk and protective factors and the mechanism through which the effect of these disorders might help in treatment and prevention. So, the stated objective of the present study is to investigate the role of fear of negative evaluation and social appearance anxiety in the relationship of parental bonding with social anxiety and comorbid disordered eating. Method: A cross-sectional study was conducted with 411 Indian undergraduates. Data collection was done with the help of self-report measures like the social interaction anxiety scale, parental bonding instrument, brief fear of negative evaluation, social appearance anxiety scale, and the eating attitudes test. SPSS Amos 22.0 version was used for path analyses. Results: Out of the different dimensions of parental bonding, only maternal care and the father’s granting of behavioural freedom proved significant in the development and maintenance of social anxiety and disordered eating behaviour and symptoms. Fear of negative evaluation and social appearance anxiety mediated the impact of the mother’s care on social anxiety and comorbid disordered eating. However, only fear of negative evaluation seemed to mediate the effect of paternal granting of behavioral freedom on social anxiety and comorbid issues. Implications: One of the vital contributions of this study is looking at perceived maternal and paternal bonding separately in the path model. Identifying parenting dimensions significantly related to social anxiety and comorbid disorders can aid in establishing consensus around operational definitions and in the formulation of comprehensive assessments. Future Directions: Future research can include both participant and parental perceptions of parental bonding.

Keywords: social anxiety, disordered eating, fear of negative evaluation, social appearance anxiety

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8356 Musculoskeletal Disorders among Employees of an Assembly Industrial Workshop: Biomechanical Constrain’s Semi-Quantitative Analysis

Authors: Lamia Bouzgarrou, Amira Omrane, Haithem Kalel, Salma Kammoun

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Background: During recent decades, mechanical and electrical industrial sector has greatly expanded with a significant employability potential. However, this sector faces the increasing prevalence of musculoskeletal disorders with heavy consequences associated with direct and indirect costs. Objective: The current intervention was motivated by large musculoskeletal upper limbs and back disorders frequency among the operators of an assembly workshop in a leader company specialized in sanitary equipment and water and gas connections. We aimed to identify biomechanical constraints among these operators through activity and biomechanical exposures semi-quantitative analysis based on video recordings and MUSKA-TMS software. Methods: We conducted, open observations and exploratory interviews at first, in order to overall understand work situation. Then, we analyzed operator’s activity through systematic observations and interviews. Finally, we conducted a semi-quantitative biomechanical constraints analysis with MUSKA-TMS software after representative activity period video recording. The assessment of biomechanical constrains was based on different criteria; biomechanical characteristics (work positions), aggravating factor (cold, vibration, stress, etc.) and exposure time (duration and frequency of solicitations, recovery phase); with a synthetic score of risk level variable from 1 to 4 (1: low risk of developing MSD and 4: high risk). Results: Semi-quantitative analysis objective many elementary operations with higher biomechanical constrains like high repetitiveness, insufficient recovery time and constraining angulation of shoulders, wrists and cervical spine. Among these risky elementary operations we sited the assembly of sleeve with the body, the assembly of axis, and the control on testing table of gas valves. Transformation of work situations were recommended, covering both the redevelopment of industrial areas and the integration of new tools and equipment of mechanical handling that reduces operator exposure to vibration. Conclusion: Musculoskeletal disorders are complex and costly disorders. Moreover, an approach centered on the observation of the work can promote the interdisciplinary dialogue and exchange between actors with the objective to maximize the performance of a company and improve the quality of life of operators.

Keywords: musculoskeletal disorders, biomechanical constrains, semi-quantitative analysis, ergonomics

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8355 The Adverse Effects of Air Pollution on Mental Health in Metropolitans

Authors: Farrin Nayebzadeh, Mohammadreza Eslami Amirabadi

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According to technological progress and urban development, the cities of the world are growing to become metropolitans, living in which can be enthusiastic, entertaining and accessibility to the facilities like education, economic factors, hygiene and welfare is high. On the other hand, there are some problems that have been ignored in planning for such high quality of life, most important of which, is human health. Two aspects of human health are physical health and mental health, that are closely associated. Human mental health depends on two important factors: Biological factor and environmental factor. Air pollution is one of the most important environmental risk factors that affects mental health. Psychological and toxic effects of air pollution can lead to psychiatric symptoms, including anxiety and changes in mood, cognition, and behavior, depression and also children's mental disorders like hyperactivity, aggression and agitation. Increased levels of some air pollutants are accompanied by an increase in psychiatric admissions and emergency calls and, in some studies, by changes in behavior and a reduction in psychological well-being. Numerous toxic pollutants interfere with the development and adult functioning of the nervous system. Psychosocial stress can cause symptoms similar to those of organic mental disorders. These factors can cause resonance of psychiatric disorders. So, in cities of developing countries, people challenge with mental health problems due to environmental factors especially air pollution that have not been forecasted in urban planning.

Keywords: air pollution, environmental factors, mental health, psychiatric disorder

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8354 The Prevalence of Musculoskeletal Disorders and Their Associated Factors among Nurses in Jordan

Authors: Khader A. Almhdawi, Hassan Alrabbaie

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Background: Musculoskeletal disorders (MSDs) represent a significant challenge for registered nurses. To our best knowledge, there is no published study that investigated the prevalence of MSDs among nurses and their associated factors comprehensively in Jordan. This study aimed to find the prevalence of MSDs, their possible predictors among registered nurses in Jordanian hospitals. Methods: A cross-sectional design was used. Outcome measures included Nordic Musculoskeletal Questioner (NMQ), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), IPAQ, and sociodemographic data. Prevalence of musculoskeletal complaints was reported using descriptive analysis. Logistic regression analyses were conducted to identify predictors of MSDs. Results: 597 nurses from different hospitals in Jordan participated in this study. Reported MSDs prevalence was the highest at neck (61.1%), followed by upper back (47.2%), shoulder (46.7%), wrist and hands (27.3%), and elbow (13.9%). Significant predictors of MSDs among Jordanian nurses included: being a female, poor sleep quality, high physical activity levels, poor ergonomics, increased workload, and mental stress. Conclusion: This study showed a high prevalence of MSDs among Jordanian nurses and identified their significant predictors. Future studies are needed to investigate the progressive nature of MSDs and their effective treatment strategies.

Keywords: musculoskeletal disorders, nursing, ergonomic, occupational stress

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8353 Examining the Relationship between Concussion and Neurodegenerative Disorders: A Review on Amyotrophic Lateral Sclerosis and Alzheimer’s Disease

Authors: Edward Poluyi, Eghosa Morgan, Charles Poluyi, Chibuikem Ikwuegbuenyi, Grace Imaguezegie

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Background: Current epidemiological studies have examined the associations between moderate and severe traumatic brain injury (TBI) and their risks of developing neurodegenerative diseases. Concussion, also known as mild TBI (mTBI), is however quite distinct from moderate or severe TBIs. Only few studies in this burgeoning area have examined concussion—especially repetitive episodes—and neurodegenerative diseases. Thus, no definite relationship has been established between them. Objectives : This review will discuss the available literature linking concussion and amyotrophic lateral sclerosis (ALS) and Alzheimer’s disease (AD). Materials and Methods: Given the complexity of this subject, a realistic review methodology was selected which includes clarifying the scope and developing a theoretical framework, developing a search strategy, selection and appraisal, data extraction, and synthesis. A detailed literature matrix was set out in order to get relevant and recent findings on this topic. Results: Presently, there is no objective clinical test for the diagnosis of concussion because the features are less obvious on physical examination. Absence of an objective test in diagnosing concussion sometimes leads to skepticism when confirming the presence or absence of concussion. Intriguingly, several possible explanations have been proposed in the pathological mechanisms that lead to the development of some neurodegenerative disorders (such as ALS and AD) and concussion but the two major events are deposition of tau proteins (abnormal microtubule proteins) and neuroinflammation, which ranges from glutamate excitotoxicity pathways and inflammatory pathways (which leads to a rise in the metabolic demands of microglia cells and neurons), to mitochondrial function via the oxidative pathways.

Keywords: amyotrophic lateral sclerosis, Alzheimer's disease, mild traumatic brain injury, neurodegeneration

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8352 Speech and LanguageTherapists’ Advices for Multilingual Children with Developmental Language Disorders

Authors: Rudinë Fetahaj, Flaka Isufi, Kristina Hansson

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While evidence shows that in most European countries’ multilingualism is rising, unfortunately, the focus of Speech and Language Therapy (SLT) is still monolingualism. Furthermore, there is sparse information on how the needs of multilingual children with language disorders such as Developmental Language Disorder (DLD) are being met and which factors affect the intervention approach of SLTs when treating DLD. This study aims to examine the relationship and correlation between the number of languages SLTs speak, years of experience, and length of education with the advice they give to parents of multilingual children with DLD regarding which language to be spoken. This is a cross-sectional study where a survey was completed online by 2608 SLTs across Europe and data has been used from a 2017 COST-action project. IBM-SPSS-28 was used where descriptive analysis, correlation and Kruskal-Wallis test were performed.SLTs mainly advise the parents of multilingual children with DLD to speak their native language at home. Besides years of experience, language status and the level of education showed to have no association with the type of advice SLTs give. Results showed a non-significant moderate positive correlation between SLTs years of experience and their advice regarding the native language, whereas language status and length of education showed no correlation with the advice SLTs give to parents.

Keywords: quantitative study, developmental language disorders, multilingualism, speech and language therapy, children, European context

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8351 Pain Assessment in Patients at a Tertiary Hospital in the Central Region of Ghana

Authors: Douglas Arthur, Oluwayemisi Ekor, Ernest Obese, Andrew Kissi Agyei, Elvis Ofori Ameyaw

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bjective: Pain negatively impacts every aspect of health, and patients with pain disorders create enormous demands on healthcare systems globally, costing economies up to $635 billion annually. The study was therefore conducted at the Cape Coast Teaching Hospital (CCTH), the only Tertiary Hospital in the Central Region of Ghana and was designed to assess pain disorders in patients between 18 and 90 years attending Urology Clinic. Methods: The study employed a descriptive cross-sectional design, and 149 subjects (16-24, 25-34, 35-44, 45-54, 55-64, 65-90 years) were conveniently selected. The McGill Pain Questionnaire (MPQ), a multidimensional instrument that assesses several aspects of pain by the use of words (descriptors) that the patient chooses to express his/her pain, was used as the primary instrument for data collection. A patient profile form (PPF) was also designed to document the demographics and history of patients. Results: The prevalence of pain disorders was higher among females compared to males. The univariate and multivariate analysis showed that females were more likely to experience pain while being married correlated with a lower likelihood of pain. Again, the 45-54 age group exhibited the highest prevalence of pain disorders. Results from the MPQ showed that half of the patients experienced pain on a daily basis, 15.91% had experienced pain for 3-6 months and 37% experienced pain for more than one year. Pain intensity was described by 25% of the subjects as excruciating for their worst pain experience, followed by 21% for the distressing experience. The most frequently reported area of pain was the abdominal region (22.72%). The co-administration of NSAIDs and opioid compounds was provided for 17.46% of the patients with chronic pain. Conclusion: The treatment interventions improved the pain and associated symptoms such as nausea, improved daily activities and ability to sleep. However, attention and resources should be devoted to 45-54 age group.

Keywords: pain, opioids, distressing, excruciating

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8350 Predicting Suicidal Behavior by an Accurate Monitoring of RNA Editing Biomarkers in Blood Samples

Authors: Berengere Vire, Nicolas Salvetat, Yoann Lannay, Guillaume Marcellin, Siem Van Der Laan, Franck Molina, Dinah Weissmann

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Predicting suicidal behaviors is one of the most complex challenges of daily psychiatric practices. Today, suicide risk prediction using biological tools is not validated and is only based on subjective clinical reports of the at-risk individual. Therefore, there is a great need to identify biomarkers that would allow early identification of individuals at risk of suicide. Alterations of adenosine-to-inosine (A-to-I) RNA editing of neurotransmitter receptors and other proteins have been shown to be involved in etiology of different psychiatric disorders and linked to suicidal behavior. RNA editing is a co- or post-transcriptional process leading to a site-specific alteration in RNA sequences. It plays an important role in the epi transcriptomic regulation of RNA metabolism. On postmortem human brain tissue (prefrontal cortex) of depressed suicide victims, Alcediag found specific alterations of RNA editing activity on the mRNA coding for the serotonin 2C receptor (5-HT2cR). Additionally, an increase in expression levels of ADARs, the RNA editing enzymes, and modifications of RNA editing profiles of prime targets, such as phosphodiesterase 8A (PDE8A) mRNA, have also been observed. Interestingly, the PDE8A gene is located on chromosome 15q25.3, a genomic region that has recurrently been associated with the early-onset major depressive disorder (MDD). In the current study, we examined whether modifications in RNA editing profile of prime targets allow identifying disease-relevant blood biomarkers and evaluating suicide risk in patients. To address this question, we performed a clinical study to identify an RNA editing signature in blood of depressed patients with and without the history of suicide attempts. Patient’s samples were drawn in PAXgene tubes and analyzed on Alcediag’s proprietary RNA editing platform using next generation sequencing technology. In addition, gene expression analysis by quantitative PCR was performed. We generated a multivariate algorithm comprising various selected biomarkers to detect patients with a high risk to attempt suicide. We evaluated the diagnostic performance using the relative proportion of PDE8A mRNA editing at different sites and/or isoforms as well as the expression of PDE8A and the ADARs. The significance of these biomarkers for suicidality was evaluated using the area under the receiver-operating characteristic curve (AUC). The generated algorithm comprising the biomarkers was found to have strong diagnostic performances with high specificity and sensitivity. In conclusion, we developed tools to measure disease-specific biomarkers in blood samples of patients for identifying individuals at the greatest risk for future suicide attempts. This technology not only fosters patient management but is also suitable to predict the risk of drug-induced psychiatric side effects such as iatrogenic increase of suicidal ideas/behaviors.

Keywords: blood biomarker, next-generation-sequencing, RNA editing, suicide

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8349 Narrative Family Therapy and the Treatment of Perinatal Mood and Anxiety Disorders

Authors: Jamie E. Banker

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For many families, pregnancy and the postpartum time are filled with both anticipation and change. For some pregnant or postpartum women, this time is marked by the onset of a mood or anxiety disorder. Experiencing a mood or anxiety disorders during this time of life differs from depression or anxiety at other times of life. Not only because of the physical changes occurring in the mother’s body but also the mental and physical preparation necessary to redefine family roles, responsibilities, and develop new identities in the life transition. The presence of a mood or anxiety disorder can influence the way in which a mother defines herself and can complicate her understanding of her abilities and competencies as a mother. The complexity of experiencing a mood or anxiety disorder in the midst of these changes necessitates specific treatment interventions to match both the symptomatology and psychological adjustments. This study explores the use of narrative family therapy techniques when treating a mother who is experiencing postpartum depression. Externalization is a common technique used in narrative family therapy and can help client’s separate their identity from the problems they are experiencing. This is crucial to a new mom who is in the middle of defining her identity during her transition to parenthood. The goal of this study is to examine how the use of externalization techniques help postpartum women separate their mood and anxiety symptoms from their identity as a mother. An exploratory case study design was conducted in a single setting, private practice therapy office, and explored how a narrative family therapy approach can be used to treat perinatal mood and anxiety disorders. The therapy sessions were audio recorded and transcribed. Constructivism and narrative theory are used as theoretical frameworks and data from the therapy sessions, and a follow-up survey was triangulated and analyzed. During the course of the treatment, the participant reports using the new externalizing labels for her symptoms. Within one month of treatment, the participant reports that she could stop herself from thinking the harmful thoughts faster, and within three months, the harmful thoughts went away. The main themes in this study were building courage and less self-blame. This case highlights the role narrative family therapy can play in the treatment of perinatal mood and anxiety disorders and the importance of separating a women’s mood from her identity as a mother. This conceptual framework was beneficial to the postpartum mother when treating perinatal mood and anxiety disorder symptoms.

Keywords: externalizing techniques, narrative family therapy, perinatal mood and anxiety disorders, postpartum depression

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8348 Intervening between Family Functioning and Depressive Symptoms: Effect of Deprivation of Liberty, Self-Efficacy and Differentiation of Self

Authors: Jasna Hrncic

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Poor family relations predict depression, but also to other mental health issues. Mediating effect of self-efficacy and differentiation of self and moderating effect of decreased accessibility and/or success of other adaptive and defensive mechanisms for overcoming social disadvantages could explain depression as a specific outcome of dysfunctional family relations. The present study analyzes the mediation effect of self-efficacy and differentiation of self from poor family functioning to depressive symptoms and the moderation effect of deprivation of liberty on the listed mediation effect. Deprivation of liberty has, as a general consequence, a decreased accessibility and/or success of many adaptive and defensive mechanisms. It is hypothesized that: 1) self-efficacy and differentiation of self will mediate between family functioning and depressiveness in the total sample, and 2) deprivation of liberty will moderate the stated relations. Cross-sectional study was conducted among 323 male juveniles in Serbia divided in three groups: 98 adolescents deprived of their liberty due to antisocial behavior (incarcerated antisocial group - IAG), 121 adolescents with antisocial behavior in their natural setting (antisocial control group - CAG) and 105 adolescents in general population (general control group - CGG). The CAG was included along with GCG to control the possible influence that comorbidity of antisocial behavior and depressiveness could have on results. Instruments for family relations assessment were: for a whole family of origin the emotional exchange scale and individuation scale from GRADIR by Knezevic, and for a relationship with mother PCS-YSR and CRPBI by barber, and intimacy, rejection, sacrifice, punishment, demands, control and internal control by Opacic and Kos. Differentiation of self (DOS) is measured by emotional self scale (Opacic), self-efficacy (SE) by general incompetence scale by Bezinovic, and depression by BDI (Back), CES-D (Radloff) and D6R (Momirovic). Two-path structural equation modeling based on most commonly reported fit indices, showed that the mediation model had unfavorable fit to our data for total sample [(χ2 (1, N = 324) = 13.73); RMSEA= .20 (90% CI= [.12, .30]); CFI= .98; NFI= .97; AIC=31.73]. Path model provided an adequate fit to the data only for AIG - and not to the data from ACG and GCG. SE and DOS mediated the relationship between PFF and depressiveness. Test of the indirect effects revealed that 23.85% of PFF influences on depressiveness is mediated by these two mediators (the quotient of mediated effect = .24). Test of specific indirect effects showed that SE mediates 22.17%, while DOS mediates 1.67% of PFF influence on depressiveness. Lack of expected mediation effect could be explained by missing other potential mediators (i.e., relationship with that father, social skills, self-esteem) and lower variability of both predictor and criterion variable due to their low levels on the whole sample and on control subsamples. Results suggested that inaccessibility and/or successfulness of other adaptive and defensive mechanisms for overcoming social disadvantages has a strong impact on the mediation effect of self/efficacy and differentiation of self from poor family functioning to depressive symptoms. Further researches could include other potential mediators and a sample of clinically depressed people.

Keywords: antisocial behavior, mediating effect, moderating effect, natural setting, incarceration

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8347 Differential Effect of Technique Majors on Isokinetic Strength in Youth Judoka Athletes

Authors: Chungyu Chen, Yi-Cheng Chen, Po-Hsian Hsu, Hsin-Ying Chen, Yen-Po Hsiao

Abstract:

The purpose of this study was to assess the muscular strength performance of upper and lower extremity in isokinetic system for the youth judo players, and also to compare the strength difference between major techniques. Sixteen male and 20 female judo players (age: 16.7 ± 1.6 years old, training age: 4.5 ± 0.8 years) were served as the volunteers for this study. There were 21 players major hand techniques and 15 players major foot techniques. The Biodex S4 Pro was used to assess the strength performance of extensor and flexor of concentric action under the load condition of 30 degree/sec, 60 degree/sec, and 120 degree/sec for elbow joints and knee joints. The strength parameters were included the maximal torque, the normalized maximal torque, the average power, and the average maximal torque. A t test for independent groups was used to evaluate whether hand major and foot major differ significantly with an alpha level of .05. The result showed the maximal torque of left knee extensor in foot major players (243.5 ± 36.3 Nm) was higher significantly than hand major (210.7 ± 21.0 Nm) under the load of 30 degree/sec (p < .05). There were no differences in upper extremity strength between the hand and foot techniques major in three loads (ps < .05). It indicated that the judo player is required to develop the upper extremity strength overall to secure the execution of major techniques.

Keywords: knee, elbow, power, judo

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8346 The Macrophage Migration Inhibitory Factor and Stem Cell Factor Levels in Serum of Adolescent and Young Adults with Mood Disorders: A Two Year Follow-Up Study

Authors: Aleksandra Rajewska-Rager, Maria Skibinska, Monika Dmitrzak-Weglarz, Natalia Lepczynska, Pawel Kapelski, Joanna Pawlak, Joanna Hauser

Abstract:

Introduction: Inflammation and cytokines have emerged as a promising target in mood disorders research; however there are still very limited numbers of study regarding inflammatory alterations among adolescents and young adults with mood disorders. The Macrophage Migration Inhibitory Factor (MIF) and Stem Cell Factor (SCF) are the pleiotropic cytokines which may play an important role in mood disorders pathophysiology. The aim of this study was to investigate levels of these factors in serum of adolescent and young adults with mood disorders compared to healthy controls. Subjects: We involved 79 patients aged 12-24 years in 2-year follow-up study with a primary diagnosis of mood disorders: bipolar disorder (BP) and unipolar disorder with BP spectrum. Study group includes 23 males (mean age 19.08, SD 3.3) and 56 females (18.39, SD 3.28). Control group consisted 35 persons: 7 males (20.43, SD 4.23) and 28 females (21.25, SD 2.11). Clinical diagnoses according to DSM-IV-TR criteria were assessed using Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) and Structured Clinical Interview for the Diagnostic and Statistical Manual (SCID) in young adults respectively. Clinical assessment includes evaluation of clinical factors and symptoms severity (rated using the Hamilton Depression Rating Scale and Young Mania Rating Scale). Clinical and biological evaluations were made at control visits respectively at baseline (week 0), euthymia (at month 3 or 6) and after 12 and 24 months. Methods: Serum protein concentration was determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Human MIF and SCF DuoSet ELISA kits were used. In the analyses non-parametric tests were used: Mann-Whitney U test, Kruskal-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation. We defined statistical significance as p < 0.05. Results: Comparing MIF and SCF levels between acute episode of depression/hypo/mania at baseline and euthymia (at month 3 or 6) we did not find any statistical differences. At baseline patients with age above 18 years old had decreased MIF level compared to patients younger than 18 years. MIF level at baseline positively correlated with age (p=0.004). Positive correlations of SCF level at month 3 and 6 with depression or mania occurrence at month 24 (p=0.03 and p=0.04, respectively) was detected. Strong correlations between MIF and SCF levels at baseline (p=0.0005) and month 3 (p=0.03) were observed. Discussion: Our results did not show any differences in MIF and SCF levels between acute episode of depression/hypo/mania and euthymia in young patients. Further studies on larger groups are recommended. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: cytokines, MIF, mood disorders, SCF

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8345 Stress Perception, Social Supports and Family Function among Military Inpatients with Adjustment Disorders in Taiwan

Authors: Huey-Fang Sun, Wei-Kai Weng, Mei-Kuang Chao, Hui-Shan Hsu, Tsai-Yin Shih

Abstract:

Psycho-social stress is important for mental illness and the presence of emotional and behavioral symptoms to an identifiable event is the central feature of adjustment disorders. However, whether patients with adjustment disorders have been raised in family with poor family functions and social supports and have higher stress perception than their peer group when they both experienced a similar stressful environment remains unknown. The specific aims of the study are to investigate the correlation among the family function, social supports and the level of stress perception and to test the hypothesis that military patients with adjustment disorders would have lower family function, lower social supports and higher stress perception than their healthy colleagues recruited in the same cohort for military services given their common exposure to similar stressful environments. Methods: The study was conducted in four hospitals of northern part of Taiwan from July 1, 2015 to June 30, 2017 and a matched case-control study design was used. The inclusion criteria for potential patient participants were psychiatric inpatients that serviced in military during the study period and met the diagnosis of adjustment disorders. Patients who had been admitted to psychiatric ward before or had illiteracy problem were excluded. A healthy military control sample matched by the same military service unit, gender, and recruited cohort was invited to participate the study as well. Totally 74 participants (37 patients and 37 controls) completed the consent forms and filled out the research questionnaires. Questionnaires used in the study included Perceived Stress Scale (PSS) as a measure of stress perception; Family APGAR as a measure of family function, and Multidimensional Scale of Perceived Social Support (MSPSS) as a measure of social supports. Pearson correlation analysis and t-test were applied for statistical analysis. Results: The analysis results showed that PSS level significantly negatively correlated with three social support subscales (family subscale, r= -.37, P < .05; friend subscale, r= -.38, P < .05; significant other subscale, r= -.39, P < .05). A negative correlation between PSS level and Family APGAR only reached a borderline significant level (P= .06). The t-test results for PSS scores, Family APGAR levels, and three subscale scores of MSPSS between patient and control participants were all significantly different (P < .001, P < .05, P < .05, P < .05, P < .05, respectively) and the patient participants had higher stress perception scores, lower social supports and lower family function scores than the healthy control participants. Conclusions: Our study suggested that family function and social supports were negatively correlated with patients’ subjective stress perception. Military patients with adjustment disorders tended to have higher stress perception and lower family function and social supports than those military peers who remained healthy and still provided services in their military units.

Keywords: adjustment disorders, family function, social support, stress perception

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8344 The Efficacy of Psychological Interventions for Psychosis: A Systematic Review and Network Meta-Analysis

Authors: Radu Soflau, Lia-Ecaterina Oltean

Abstract:

Background: Increasing evidence supports the efficacy of psychological interventions for psychosis. However, it is unclear which one of these interventions is most likely to address negative psychotic symptoms and related outcomes. We aimed to determine the relative efficacy of psychological and psychosocial interventions for negative symptoms, overall psychotic symptoms, and related outcomes. Methods: To attain this goal, we conducted a systematic review and network meta-analysis. We searched for potentially eligible trials in PubMed, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases up until February 08, 2022. We included randomized controlled trials that investigated the efficacy of psychological for adults with psychosis. We excluded interventions for prodromal or “at risk” individuals, as well as patients with serious co-morbid medical or psychiatric conditions (others than depressive and/or anxiety disorders). Two researchers conducted study selection and performed data extraction independently. Analyses were run using STATA network and mvmeta packages, applying a random effect model under a frequentist framework in order to compute standardized mean differences or risk ratio. Findings: We identified 47844 records and screened 29466 records for eligibility. The majority of eligible interventions were delivered in addition to pharmacological treatment. Treatment as usual (TAU) was the most frequent common comparator. Theoretically driven psychological interventions generally outperformed TAU at post-test and follow-up, displaying small and small-to-medium effect sizes. A similar pattern of results emerged in sensitivity analyses focused on studies that employed an inclusion criterion for relevant negative symptom severity. Conclusion: While the efficacy of some psychological interventions is promising, there is a need for more high-quality studies, as well as more trials directly comparing psychological treatments for negative psychotic symptoms.

Keywords: psychosis, network meta-analysis, psychological interventions, efficacy, negative symptoms

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8343 Role of Environmental Risk Factors in Autism Spectrum Disorder

Authors: Dost Muhammad Halepoto, Laila AL-Ayadhi

Abstract:

Neurodevelopmental disorders such as autism can cause lifelong disability. Genetic and environmental factors are believed to contribute to the development of autism spectrum disorder (ASD), but relatively few studies have considered potential environmental risks. Several industrial chemicals and other environmental exposures are recognized causes of neurodevelopmental disorders and subclinical brain dysfunction. The toxic effects of such chemicals in the developing human brain are not known. This review highlights the role of environmental risk factors including drugs, toxic chemicals, heavy metals, pesticides, vaccines, and other suspected neurotoxicants including persistent organic pollutants for ASD. It also provides information about the environmental toxins to yield new insights into factors that affect autism risk as well as an opportunity to investigate the relation between autism and environmental exposure.

Keywords: Autism Spectrum Disorder, ASD, environmental factors, neurodevelopmental disorder

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8342 Green Synthesis of Nano Liposomes Containing Berberine Chlorideagainst Leishmania major

Authors: Ali Fattahi Bafghi, Abolghasem Siyadatpanah, Farzaneh Mirzaei, Fahimeh Pournasir, Roghayeh Norouzi, Maria De Lourdes Pereira

Abstract:

Leishmaniasis caused by Leishmania major is one of the main infectious diseases that affect populations in developing countries around the world. We assessed the effectiveness of berberine chloride nano-liposome (BcNLs) against L. major promastigotes in vitro. Nano-liposomal berberine chloride was prepared using the thin-film hydration method and characterized based on encapsulation efficiency, size, and zeta potential. Anti-Leishmania effect of different concentrations (0.05-60 µg/ml) of BcNLs as studied in L. major [MRHO/IR/75/ER] at 24, 48, and 72 h using the hemocytometer technique. Berberine chloride was successfully loaded into nano-liposomes with an encapsulation efficiency of 85.54%. The surface charge of nanoparticles is neutral, and the morphology of nano-liposomal berberine chloride is spherical without any agglomeration. Cell viability assay was performed on the HFF cell line to show the biocompatibility of liposome nanoparticles. IC50 of BcNPs at 24, 48, and 72 h against L. major were found to be 7.6, 5.96, and 3.19 µg/ml, respectively. BcNLs showed a significant anti-Leishmania effect and induced a better and more tangible effect on the survival of L. major promastigotes and could be suitable candidates for further investigation. The results showed that the BcNLs agent is effective against L. major promastigotes and may be a promising alternative to current treatments.

Keywords: Leishmania major, berberine chloride, nano-liposomes, cutaneous leishmaniasis

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8341 Analysys of Some Solutions to Protect the Tombolo of Giens

Authors: Yves Lacroix, Van Van Than, Didier Léandri, Pierre Liardet

Abstract:

The western Tombolo of the Giens peninsula in southern France, known as Almanarre beach, is subject to coastal erosion. We are trying to use computer simulation in order to propose solutions to stop this erosion. Our aim was first to determine the main factors for this erosion and successfully apply a coupled hydro-sedimentological numerical model based on observations and measurements that have been performed on the site for decades. We have gathered all available information and data about waves, winds, currents, tides, bathymetry, coastal line, and sediments concerning the site. These have been divided into two sets: one devoted to calibrating a numerical model using Mike 21 software, the other to serve as a reference in order to numerically compare the present situation to what it could be if we implemented different types of underwater constructions. This paper presents the first part of the study: selecting and melting different sources into a coherent data basis, identifying the main erosion factors, and calibrating the coupled software model against the selected reference period. Our results bring calibration of the numerical model with good fitting coefficients. They also show that the winter South-Western storm events conjugated to depressive weather conditions constitute a major factor of erosion, mainly due to wave impact in the northern part of the Almanarre beach. Together, current and wind impact is shown negligible.

Keywords: Almanarre beach, coastal erosion, hydro-sedimentological, numerical model

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8340 Mental Health Stigma: Barriers to Treatment and Participation in Mental Health Care among University Students in Kenya

Authors: Scholastic Nangila Adeli, Francisca Mbutitia Ngithi

Abstract:

Stigma is commonly associated with mental health patients and may act as a barrier to individuals who may seek or engage in treatment services. Stigmatization among university students is common whether they know someone with a mental health problem, or have a good knowledge and experience of mental health issues. The objective of this study was to establish the various barriers that prevent university students who have mental health challenges from seeking treatment and care. The study was a descriptive in nature where 320 respondents helped to establish the barriers to treatment or participation in mental health care among university students. A questionnaire was used to help establish the barriers and attitude towards mental illness among the respondents. Results from this study revealed that mental illnesses are common among university students and they are manifested in different forms like; anxiety and panic attacks, mood and eating disorders, Impulse control leading to gambling, alcohol and drug addictions, anger and depression leading to loneliness. Mental stigma (both social and self) was the major barrier with 62% of the respondents stating that social stigma was worse than self-stigma. This is because of the social discrimination towards the victim of mental challenges. On issues of attitude, 71% of the respondents said that they can never admit that they have a mental issue and would rather secretly seek clinical or psychological help for fear of being discriminated or excluded by peers. This view is informed by the societal belief that people with mental health challenges were dangerous (associating them with criminal behavior) and hard to socialize with or help. From the findings of this study, it is concluded that mental health problems are real among university students in Kenya and it is important for the university environment to minimize or eradicate stigma within the social circles. Stigma can be minimized or eradicated by creating awareness among university students and fostering social inclusion so that the students who have mental health challenges can experience a sense of belonging and acceptance hence build their self-esteem.

Keywords: disorders, impulse control, mental health problems, stigma

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8339 Major Incident Tier System in the Emergency Department: An Approach

Authors: Catherine Bernard, Paul Ransom

Abstract:

Recent events have prompted emergency planners to re-evaluate their emergency response to major incidents and mass casualties. At the Royal Sussex County Hospital, we have adopted a tiered system comprised of three levels, anticipating an increasing P1, P2 or P3 load. This will aid planning in the golden period between Major Incident ‘Standby,’ and ‘Declared’. Each tier offers step-by-step instructions on appropriate patient movement within and out of the department, as well as suggestions for overflow areas and additional staffing levels. This system can be adapted to individual hospitals and provides concise instructions to be followed in a potentially overwhelming situation.

Keywords: disaster planning, emergency preparedness, major incident planning, mass casualty event

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8338 Analysis of a Coupled Hydro-Sedimentological Numerical Model for the Western Tombolo of Giens

Authors: Yves Lacroix, Van Van Than, Didier Léandri, Pierre Liardet

Abstract:

The western Tombolo of the Giens peninsula in southern France, known as Almanarre beach, is subject to coastal erosion. We are trying to use computer simulation in order to propose solutions to stop this erosion. Our aim was first to determine the main factors for this erosion and successfully apply a coupled hydro-sedimentological numerical model based on observations and measurements that have been performed on the site for decades. We have gathered all available information and data about waves, winds, currents, tides, bathymetry, coastal line, and sediments concerning the site. These have been divided into two sets: one devoted to calibrating a numerical model using Mike 21 software, the other to serve as a reference in order to numerically compare the present situation to what it could be if we implemented different types of underwater constructions. This paper presents the first part of the study: selecting and melting different sources into a coherent data basis, identifying the main erosion factors, and calibrating the coupled software model against the selected reference period. Our results bring calibration of the numerical model with good fitting coefficients. They also show that the winter South-Western storm events conjugated to depressive weather conditions constitute a major factor of erosion, mainly due to wave impact in the northern part of the Almanarre beach. Together, current and wind impact is shown negligible.

Keywords: Almanarre beach, coastal erosion, hydro-sedimentological, numerical model

Procedia PDF Downloads 374
8337 Immune Disregulation in Inflammatory Skin Diseases with Comorbid Metabolic Disorders

Authors: Roman Khanferyan, Levon Gevorkyan, Ivan Radysh

Abstract:

Skin barrier dysfunction induces multiple inflammatory skin diseases. Epidemiological studies clearly support the link between most dermatological pathologies, immune disorders and metabolic disorders. Among them most common are psoriasis (PS) and Atopic dermatitis (AD). Psoriasis is a chronic immune-mediated inflammatory skin disease that affects 1.5 to 3.0% of the world's population. Comorbid metabolic disorders play an important role in the progression of PS and AD, as well. It is well known that PS, AD and overweight/obesity are associated with common pathophysiological mechanisms of mild chronic inflammation. The goal of the study was to study the immune disturbances in patients with PS, AD and comorbid metabolic disorders. To study the prevalence of comorbidity of PS and AD (data from 1406 patient’s histories of diseases) were analyzed. The severity of the disease is assessed using the PASI index (Psoriasis Area and Severity Index). 59 patients with psoriasis of different localizations of lesions and severity, as well as with different body mass index (BMI), were examined. The determination of the concentration of pro-inflammatory cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNFa) and chemokines (RANTES, IP-10, MCP-1 and Eotaxin) in sera and supernatants of 48h-cultivated peripheral blood mononuclear cell (PBMC) of psoriasis patients and healthy volunteers (36 adults) have been carried out by multiplex assay (Luminex Corporation, USA). It has been demonstrated that 42% of PS patients had comorbidity with different types of atopies. The most common was bronchial asthma and allergic rhinitis. At the same time, the prevalence of AD in PS patients was determined in 8.7% of patients. It has been shown that serum levels of all studied cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNF) in most of the studied patients were higher in PS patients than in those with AD and healthy controls (p<0.05). An in vitro synthesis of the IL-6 and IFNγ by PBMC demonstrated similar results to those determined in blood sera. There was a high correlation between BMI, immune mediators and the concentrations of adipokines and chemokines (p<0.05). The concentrations of Leptin and Resistin in obese psoriatic patients were greater by 28.6% and 17%, respectively, compared to non-obese psoriatic patients. In obese patients with psoriasis the serum levels of adiponectin were decreased up to 1.3-fold. The mean serum RANTES, IP-10, MCP-1, EOTAXIN levels in obese psoriatic patients were decreased by up to 13.1%, 21.9%, 40.4% and 28.2%, respectively. Similar results have been demonstrated in AD patients with comorbid overweight and obesity. Thus, the study demonstrated the important role of cytokines and chemokines dysregulation in inflammatory skin diseases, especially in patients with comorbid obesity and overweight. Metabolic disorders promote the severity of PS and AD, highly increase immune dysregulation, and synthesis of adipokines, which correlates with the production of proinflammatory immune mediators in comorbid obesity and overweight.

Keywords: psoriasis, atopic dermatitis, pro-inflammatory cytokines, chemokines, comorbid obesity

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