Search results for: attention deficit hyperactivity disorder (ADHD)
2487 The Effectiveness of Exercise Therapy on Decreasing Pain in Women with Temporomandibular Disorders and How Their Brains Respond: A Pilot Randomized Controlled Trial
Authors: Zenah Gheblawi, Susan Armijo-Olivo, Elisa B. Pelai, Vaishali Sharma, Musa Tashfeen, Angela Fung, Francisca Claveria
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Due to physiological differences between men and women, pain is experienced differently between the two sexes. Chronic pain disorders, notably temporomandibular disorders (TMDs), disproportionately affect women in diagnosis, and pain severity in opposition of their male counterparts. TMDs are a type of musculoskeletal disorder that target the masticatory muscles, temporalis muscle, and temporomandibular joints, causing considerable orofacial pain which can usually be referred to the neck and back. Therapeutic methods are scarce, and are not TMD-centered, with the latest research suggesting that subjects with chronic musculoskeletal pain disorders have abnormal alterations in the grey matter of their brains which can be remedied with exercise, and thus, decreasing the pain experienced. The aim of the study is to investigate the effects of exercise therapy in TMD female patients experiencing chronic jaw pain and to assess the consequential effects on brain activity. In a randomized controlled trial, the effectiveness of an exercise program to improve brain alterations and clinical outcomes in women with TMD pain will be tested. Women with chronic TMD pain will be randomized to either an intervention arm or a placebo control group. Women in the intervention arm will receive 8 weeks of progressive exercise of motor control training using visual feedback (MCTF) of the cervical muscles, twice per week. Women in the placebo arm will receive innocuous transcutaneous electrical nerve stimulation during 8 weeks as well. The primary outcomes will be changes in 1) pain, measured with the Visual Analogue Scale, 2) brain structure and networks, measured by fractional anisotropy (brain structure) and the blood-oxygen level dependent signal (brain networks). Outcomes will be measured at baseline, after 8 weeks of treatment, and 4 months after treatment ends and will determine effectiveness of MCTF in managing TMD, through improved clinical outcomes. Results will directly inform and guide clinicians in prescribing more effective interventions for women with TMD. This study is underway, and no results are available at this point. The results of this study will have substantial implications on the advancement in understanding the scope of plasticity the brain has in regards with pain, and how it can be used to improve the treatment and pain of women with TMD, and more generally, other musculoskeletal disorders.Keywords: exercise therapy, musculoskeletal disorders, physical therapy, rehabilitation, tempomandibular disorders
Procedia PDF Downloads 2922486 Taiwanese Families' Perspectives: Promoting Foundations of Self-Determination Skills for Young Children with Special Needs
Authors: Szu-Yin Chu
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Self-determination has been particularly influential in obtaining a better quality of life through successful transition processes for students with disabilities. The development of self-determination through learning has raised attention at an early age. This study used a survey questionnaire to construct the understanding of the self-determination in Taiwan, learn the perspectives about the environmental and situational contexts where the respondents expect children to display self-determination skills in different cultures. Specifically, the research questions are: (a) What are Taiwanese families’ general perspectives about the development of foundations of self-determination for young children with special needs? and (b) how does families’ demographic background (i.e., income level, educational background) and child characteristics (i.e., age, emotional or behavior problems) impact Taiwanese families’ perspectives on the foundations of self-determination across three critical components (i.e., choice-making and problem-solving, self-regulation, and engagement) for young children with special needs? Data from 125 participants were gathered and analyzed. The findings suggested that Taiwanese families showed very positive attitudes toward promoting a foundation of self-determination for young children with special needs. Families’ income level and child’s severity of emotional/behavioral problems were two variables that were found to impact families’ views on their child’s foundational self-determination skills. Implications for future research and practice in supporting families to promote foundations of self-determination for young children with special needs will be provided.Keywords: disabilities, self-determination, Taiwan, young children
Procedia PDF Downloads 3012485 Settings of Conditions Leading to Reproducible and Robust Biofilm Formation in vitro in Evaluation of Drug Activity against Staphylococcal Biofilms
Authors: Adela Diepoltova, Klara Konecna, Ondrej Jandourek, Petr Nachtigal
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A loss of control over antibiotic-resistant pathogens has become a global issue due to severe and often untreatable infections. This state is reflected in complicated treatment, health costs, and higher mortality. All these factors emphasize the urgent need for the discovery and development of new anti-infectives. One of the most common pathogens mentioned in the phenomenon of antibiotic resistance are bacteria of the genus Staphylococcus. These bacterial agents have developed several mechanisms against the effect of antibiotics. One of them is biofilm formation. In staphylococci, biofilms are associated with infections such as endocarditis, osteomyelitis, catheter-related bloodstream infections, etc. To author's best knowledge, no validated and standardized methodology evaluating candidate compound activity against staphylococcal biofilms exists. However, a variety of protocols for in vitro drug activity testing has been suggested, yet there are often fundamental differences. Based on our experience, a key methodological step that leads to credible results is to form a robust biofilm with appropriate attributes such as firm adherence to the substrate, a complex arrangement in layers, and the presence of extracellular polysaccharide matrix. At first, for the purpose of drug antibiofilm activity evaluation, the focus was put on various conditions (supplementation of cultivation media by human plasma/fetal bovine serum, shaking mode, the density of initial inoculum) that should lead to reproducible and robust in vitro staphylococcal biofilm formation in microtiter plate model. Three model staphylococcal reference strains were included in the study: Staphylococcus aureus (ATCC 29213), methicillin-resistant Staphylococcus aureus (ATCC 43300), and Staphylococcus epidermidis (ATCC 35983). The total biofilm biomass was quantified using the Christensen method with crystal violet, and results obtained from at least three independent experiments were statistically processed. Attention was also paid to the viability of the biofilm-forming staphylococcal cells and the presence of extracellular polysaccharide matrix. The conditions that led to robust biofilm biomass formation with attributes for biofilms mentioned above were then applied by introducing an alternative method analogous to the commercially available test system, the Calgary Biofilm Device. In this test system, biofilms are formed on pegs that are incorporated into the lid of the microtiter plate. This system provides several advantages (in situ detection and quantification of biofilm microbial cells that have retained their viability after drug exposure). Based on our preliminary studies, it was found that the attention to the peg surface and substrate on which the bacterial biofilms are formed should also be paid to. Therefore, further steps leading to the optimization were introduced. The surface of pegs was coated by human plasma, fetal bovine serum, and L-polylysine. Subsequently, the willingness of bacteria to adhere and form biofilm was monitored. In conclusion, suitable conditions were revealed, leading to the formation of reproducible, robust staphylococcal biofilms in vitro for the microtiter model and the system analogous to the Calgary biofilm device, as well. The robustness and typical slime texture could be detected visually. Likewise, an analysis by confocal laser scanning microscopy revealed a complex three-dimensional arrangement of biofilm forming organisms surrounded by an extracellular polysaccharide matrix.Keywords: anti-biofilm drug activity screening, in vitro biofilm formation, microtiter plate model, the Calgary biofilm device, staphylococcal infections, substrate modification, surface coating
Procedia PDF Downloads 1562484 Environmental Modeling of Storm Water Channels
Authors: L. Grinis
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Turbulent flow in complex geometries receives considerable attention due to its importance in many engineering applications. It has been the subject of interest for many researchers. Some of these interests include the design of storm water channels. The design of these channels requires testing through physical models. The main practical limitation of physical models is the so called “scale effect”, that is, the fact that in many cases only primary physical mechanisms can be correctly represented, while secondary mechanisms are often distorted. These observations form the basis of our study, which centered on problems associated with the design of storm water channels near the Dead Sea, in Israel. To help reach a final design decision we used different physical models. Our research showed good coincidence with the results of laboratory tests and theoretical calculations, and allowed us to study different effects of fluid flow in an open channel. We determined that problems of this nature cannot be solved only by means of theoretical calculation and computer simulation. This study demonstrates the use of physical models to help resolve very complicated problems of fluid flow through baffles and similar structures. The study applies these models and observations to different construction and multiphase water flows, among them, those that include sand and stone particles, a significant attempt to bring to the testing laboratory a closer association with reality.Keywords: open channel, physical modeling, baffles, turbulent flow
Procedia PDF Downloads 2842483 The Ongoing Impact of Secondary Stressors on Businesses in Northern Ireland Affected by Flood Events
Authors: Jill Stephenson, Marie Vaganay, Robert Cameron, Caoimhe McGurk, Neil Hewitt
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Purpose: The key aim of the research was to identify the secondary stressors experienced by businesses affected by single or repeated flooding and to determine to what extent businesses were affected by these stressors, along with any resulting impact on health. Additionally, the research aimed to establish the likelihood of businesses being re-exposed to the secondary stressors through assessing awareness of flood risk, implementation of property protection measures and level of community resilience. Design/methodology/approach: The chosen research method involved the distribution of a questionnaire survey to businesses affected by either single or repeated flood events. The questionnaire included the Impact of Event Scale (a 15-item self-report measure which assesses subjective distress caused by traumatic events). Findings: 55 completed questionnaires were returned by flood impacted businesses. 89% of the businesses had sustained internal flooding while 11% had experienced external flooding. The results established that the key secondary stressors experienced by businesses, in order of priority, were: flood damage, fear of reoccurring flooding, prevention of access to the premise/closure, loss of income, repair works, length of closure and insurance issues. There was a lack of preparedness for potential future floods and consequent vulnerability to the emergence of secondary stressors among flood affected businesses, as flood resistance or flood resilience measures had only been implemented by 11% and 13% respectively. In relation to the psychological repercussions, the Impact of Event scores suggested that potential prevalence of post-traumatic stress disorder (PTSD) was noted among 8 out of 55 respondents (l5%). Originality/value: The results improve understanding of the enduring repercussions of flood events on businesses, indicating that not only residents may be susceptible to the detrimental health impacts of flood events and single flood events may be just as likely as reoccurring flooding to contribute to ongoing stress. Lack of financial resources is a possible explanation for the lack of implementation of property protection measures among businesses, despite 49% experiencing flooding on multiple occasions. Therefore it is recommended that policymakers should consider potential sources of financial support or grants towards flood defences for flood impacted businesses. Any form of assistance should be made available to businesses at the earliest opportunity as there was no significant association between the time of the last flood event and the likelihood of experiencing PTSD symptoms.Keywords: flood event, flood resilience, flood resistance, PTSD, secondary stressors
Procedia PDF Downloads 4302482 Review and Analyze on the Journal of Sport Science
Authors: Zhan Dong, Qiu Jianrong, Li Qinghui, Zhang Lei
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The quantity and quality of the papers published on sport science from 2001 to 2013 had been counted and analysed and compared with the papers published on the journal from 1990 to 2000. The result showed that: 1. In the sports medicine field, the proportion of basic/application was abnormal. Basic research was far more than the application research. The papers on researching of imitating altitude training was the main part. Gene research made great progress.The research on sport injury and medical supervision were lower and lower. Research on sports prescription had made much progress, especially in the patients of heart infarction. 2. In building up people’s health field, the research on the old people had been more and more compared with the 10 years before, but it was not enough. 3. In the field of sports psychology, the research on disable people had been more compared with the 10 years before. Solved the problem of the sportmen before the game. 4. In the field of sports biomechanics, it showed that methods had made great progress compared with the 10 years before. Sport biomechanics combined with sports medicine, helped the sportsmen in good condition in the game. 5. In the exercise training field, the experts pay more attention to the outstanding sportsmen, and the researches emphasized that biology knowledge is the main basic for them to the research.Keywords: sport medicine, sport injury, medical supervision
Procedia PDF Downloads 4992481 The Influence of Social Interaction of Flat Occupants to Infrastucture Management of Kutobedah Flat in Malang City
Authors: Nony Rahadiva
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The development of housing in urban areas can not be separated from the high rate of population growth from both natural population growth and population growth due to migration. The development is bounded by urban land area so that construction of flats become a development priority. Quality of residential flats are influenced by the patterns of behavior of its inhabitants. The frequency of contact between the occupants become one of the effects of good social relations, but harmful activity can degrade the environment, especially in flats. One of the social relationships that can be seen on the flats development is the residents in Kutobedah flat built in Malang city. Problems that occur in that place is unfavorable flat management due to social activities such as daily activities and also the neighboring activities of apartment dwellers who tend not to pay attention to the environment. Based on these problems we can do a study on social interaction in Kutobedah flat and its influence on the management of flat facilities and infrastructures. This research was carried out by submitting a questionnaire to the residents of the apartment based social activities , operations and maintenance of the flats. By using a weighted analysis, we can find that social interaction tenants is high, but the level of infrastructure and facilities management of the tenants is low so it is needed to counsel the residents how to use and maintain the infrastructure properly.Keywords: activities, flat, infrastructure management, social interaction
Procedia PDF Downloads 4322480 Green Supply Chain Management: A Revolutionary and Robust Innovation in the Field of Efficient Environmental Development and Regulation
Authors: Jinesh Kumar Jain, Faishal Pathan
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The concept of sustainable development and effective environmental regulation has led to the emergence of a new field of study and practise that is the Green Supply Chain Management. GSCM has become a subject of great importance for both the developed and developing countries to achieve the desired and much-awaited goals of the firm within the environmental and sustainable framework. Its merits are comprised of good financial pay off and competitiveness to the firms in a long lasting and sustainable manner. The purpose of the paper is to briefly review the recent literature of the GSCM and also determines the new direction area of this emerging field. A detailed study has helped to enlighten the minute details and develop the research direction of the study. The GSCM has gained popularity with both academic and practitioners. The items for the study were developed based on the extent literature. Here we found that the state of adoption of GSCM practices by Indian Firms was still in its infancy, the awareness of environmental sustainability was quite low among consumers and the regulatory frameworks were also lacking in terms promoting environmental sustainability. The present paper is an attempt to emphasize much attention on the above-mentioned issues and present a conclusive summary to make its use widespread and for reaching.Keywords: environmental management, environmental performance, financial performance, green supply chain management
Procedia PDF Downloads 2152479 The Relationship between Self Concept Clarity and Need for Absolute Truth and Problem Solving and Symptoms of Stress in Homosexual Male
Authors: Gizem Akcan, Erdinc Ozturk
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When it is examined as historically, it has caught attention that homosexual people try to behave as heterosexual or come out to have a place in community. Homosexual people have identity confusion during identity development, they have high levels of need for absolute truth and their psychological well being is affected negatively because of high levels of need for absolute truth and they have problems about self concept clarity. People who have problems about self concept clarity have problems on problem solving and show lots of symptoms of stress. People who have clear self concept use healthier coping strategies to solve problems. The purpose of this study is to show whether need for absolute truth predicts problem solving and symptoms of stress via mediator effect of self concept clarity or not on homosexual men. The participants of this study were 200 homosexual men. The ages of participants were 20-50. In addition, Demographic Information Form, Self Concept Clarity Scale, Need for Absolute Truth Scale, Stres Self-Assessment Checklist and Problem Solving Inventory were applied to the participants. The assessment of the data was made with confirmatory factor analysis and structural equation modeling analysis. According to the results of this study, need for absolute truth predicts problem solving and symptoms of stress via mediator effect of self concept clarity on homosexual men.Keywords: need for absolute truth, self concept clarity, symptoms of stress, problem solving
Procedia PDF Downloads 2242478 A Systematic Review of Sensory Processing Patterns of Children with Autism Spectrum Disorders
Authors: Ala’a F. Jaber, Bara’ah A. Bsharat, Noor T. Ismael
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Background: Sensory processing is a fundamental skill needed for the successful performance of daily living activities. These skills are impaired as parts of the neurodevelopmental process issues among children with autism spectrum disorder (ASD). This systematic review aimed to summarize the evidence on the differences in sensory processing and motor characteristic between children with ASD and children with TD. Method: This systematic review followed the guidelines of the preferred reporting items for systematic reviews and meta-analysis. The search terms included sensory, motor, condition, and child-related terms or phrases. The electronic search utilized Academic Search Ultimate, CINAHL Plus with Full Text, ERIC, MEDLINE, MEDLINE Complete, Psychology, and Behavioral Sciences Collection, and SocINDEX with full-text databases. The hand search included looking for potential studies in the references of related studies. The inclusion criteria included studies published in English between years 2009-2020 that included children aged 3-18 years with a confirmed ASD diagnosis, according to the DSM-V criteria, included a control group of typical children, included outcome measures related to the sensory processing and/or motor functions, and studies available in full-text. The review of included studies followed the Oxford Centre for Evidence-Based Medicine guidelines, and the Guidelines for Critical Review Form of Quantitative Studies, and the guidelines for conducting systematic reviews by the American Occupational Therapy Association. Results: Eighty-eight full-text studies related to the differences between children with ASD and children with TD in terms of sensory processing and motor characteristics were reviewed, of which eighteen articles were included in the quantitative synthesis. The results reveal that children with ASD had more extreme sensory processing patterns than children with TD, like hyper-responsiveness and hypo-responsiveness to sensory stimuli. Also, children with ASD had limited gross and fine motor abilities and lower strength, endurance, balance, eye-hand coordination, movement velocity, cadence, dexterity with a higher rate of gait abnormalities than children with TD. Conclusion: This systematic review provided preliminary evidence suggesting that motor functioning should be addressed in the evaluation and intervention for children with ASD, and sensory processing should be supported among children with TD. More future research should investigate whether how the performance and engagement in daily life activities are affected by sensory processing and motor skills.Keywords: sensory processing, occupational therapy, children, motor skills
Procedia PDF Downloads 1282477 Route Planning for Optimization Approach PSO_GA Sharing System (Scooter Sharing-Public Transportation) with Hybrid Optimization Approach PSO_GA
Authors: Mohammad Ali Farrokhpour
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In the current decade and sustainable transportation systems, scooter sharing has attracted widespread attention as an environmentally-friendly means of public transportation which can help develop public transportation. The combination of scooters and subway in the area of sustainable transportation systems can provide a great many opportunities for developing access to public transportation. Of the challenges which have arisen and initiated discussions of interest about the implementation of a scooter-subway system to replace personal vehicles is the issue of routing in the aforementioned system. This has been chosen as the main subject of the present paper. Thus, the present paper provides an account for routing in this system. Because the issue of routing includes multiple factors such as time, costs, traffic, green spaces, etc., the above-mentioned problem is considered to be a multi-objective NP-hard optimization problem. For this purpose, the hybrid optimization approach of PSO-GA has been put forward in the present paper for the provided answers to be of higher accuracy and validity than those of normal optimization methods. The results obtained from modeling and problem solving for the case study in the MATLAB software are indicative of the efficiency and desirability of the model and the proposed approach for solving the modelKeywords: route planning, scooter sharing, public transportation, sharing system
Procedia PDF Downloads 842476 Second Order Optimality Conditions in Nonsmooth Analysis on Riemannian Manifolds
Authors: Seyedehsomayeh Hosseini
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Much attention has been paid over centuries to understanding and solving the problem of minimization of functions. Compared to linear programming and nonlinear unconstrained optimization problems, nonlinear constrained optimization problems are much more difficult. Since the procedure of finding an optimizer is a search based on the local information of the constraints and the objective function, it is very important to develop techniques using geometric properties of the constraints and the objective function. In fact, differential geometry provides a powerful tool to characterize and analyze these geometric properties. Thus, there is clearly a link between the techniques of optimization on manifolds and standard constrained optimization approaches. Furthermore, there are manifolds that are not defined as constrained sets in R^n an important example is the Grassmann manifolds. Hence, to solve optimization problems on these spaces, intrinsic methods are used. In a nondifferentiable problem, the gradient information of the objective function generally cannot be used to determine the direction in which the function is decreasing. Therefore, techniques of nonsmooth analysis are needed to deal with such a problem. As a manifold, in general, does not have a linear structure, the usual techniques, which are often used in nonsmooth analysis on linear spaces, cannot be applied and new techniques need to be developed. This paper presents necessary and sufficient conditions for a strict local minimum of extended real-valued, nonsmooth functions defined on Riemannian manifolds.Keywords: Riemannian manifolds, nonsmooth optimization, lower semicontinuous functions, subdifferential
Procedia PDF Downloads 3612475 Probability-Based Damage Detection of Structures Using Kriging Surrogates and Enhanced Ideal Gas Molecular Movement Algorithm
Authors: M. R. Ghasemi, R. Ghiasi, H. Varaee
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Surrogate model has received increasing attention for use in detecting damage of structures based on vibration modal parameters. However, uncertainties existing in the measured vibration data may lead to false or unreliable output result from such model. In this study, an efficient approach based on Monte Carlo simulation is proposed to take into account the effect of uncertainties in developing a surrogate model. The probability of damage existence (PDE) is calculated based on the probability density function of the existence of undamaged and damaged states. The kriging technique allows one to genuinely quantify the surrogate error, therefore it is chosen as metamodeling technique. Enhanced version of ideal gas molecular movement (EIGMM) algorithm is used as main algorithm for model updating. The developed approach is applied to detect simulated damage in numerical models of 72-bar space truss and 120-bar dome truss. The simulation results show the proposed method can perform well in probability-based damage detection of structures with less computational effort compared to direct finite element model.Keywords: probability-based damage detection (PBDD), Kriging, surrogate modeling, uncertainty quantification, artificial intelligence, enhanced ideal gas molecular movement (EIGMM)
Procedia PDF Downloads 2402474 The Role of Rapid Maxillary Expansion in Managing Obstructive Sleep Apnea in Children: A Literature Review
Authors: Suleman Maliha, Suleman Sidra
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Obstructive sleep apnea (OSA) is a sleep disorder that can result in behavioral and psychomotor impairments in children. The classical treatment modalities for OSA have been continuous positive airway pressure and adenotonsillectomy. However, orthodontic intervention through rapid maxillary expansion (RME) has also been commonly used to manage skeletal transverse maxillary discrepancies. Aim and objectives: The aim of this study is to determine the efficacy of rapid maxillary expansion in paediatric patients with obstructive sleep apnea by assessing pre and post-treatment mean apnea-hypopnea index (AHI) and oxygen saturations. Methodology: Literature was identified through a rigorous search of the Embase, Pubmed, and CINAHL databases. Articles published from 2012 onwards were selected. The inclusion criteria consisted of patients aged 18 years and under with no systemic disease, adenotonsillar surgery, or hypertrophy who are undergoing RME with AHI measurements before and after treatment. In total, six suitable papers were identified. Results: Three studies assessed patients pre and post-RME at 12 months. The first study consisted of 15 patients with an average age of 7.5 years. Following treatment, they found that RME resulted in both higher oxygen saturations (+ 5.3%) and improved AHI (- 4.2 events). The second study assessed 11 patients aged 5–8 years and also noted improvements, with mean AHI reduction from 6.1 to 2.4 and oxygen saturations increasing from 93.1% to 96.8%. The third study reviewed 14 patients aged 6–9 years and similarly found an AHI reduction from 5.7 to 4.4 and an oxygen saturation increase from 89.8% to 95.5%. All modifications noted in these studies were statistically significant. A long-term study reviewed 23 patients aged 6–12 years post-RME treatment on an annual basis for 12 years. They found that the mean AHI reduced from 12.2 to 0.4, with improved oxygen saturations from 78.9% to 95.1%. Another study assessed 19 patients aged 9-12 years at two months into RME and four months post-treatment. Improvements were also noted at both stages, with an overall reduction of the mean AHI from 16.3 to 0.8 and an overall increase in oxygen saturations from 77.9% to 95.4%. The final study assessed 26 children aged 7-11 years on completion of individual treatment and found an AHI reduction from 6.9 to 5.3. However, the oxygen saturation remained stagnant at 96.0%, but this was not clinically significant. Conclusion: Overall, the current evidence suggests that RME is a promising treatment option for paediatric patients with OSA. It can provide efficient and conservative treatment; however, early diagnosis is crucial. As there are various factors that could be contributing to OSA, it is important that each case is treated on its individual merits. Going forward, there is a need for more randomized control trials with larger cohorts being studied. Research into the long-term effects of RME and potential relapse amongst cases would also be useful.Keywords: orthodontics, sleep apnea, maxillary expansion, review
Procedia PDF Downloads 822473 Narcissism and Kohut's Self-Psychology: Self Practices in Service of Self-Transcendence
Authors: Noelene Rose
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The DSM has been plagued with conceptual issues since its inception, not least discriminant validity and comorbidity issues. An attempt to remain a-theoretical in the divide between the psycho-dynamicists and the behaviourists contributed to much of this, in particular relating to the Personality Disorders. With the DSM-5, although the criterion have remained unchanged, major conceptual and structural directions have been flagged and proposed in section III. The biggest changes concern the Personality Disorders. While Narcissistic Personality Disorder (NPD) was initially tagged for removal, instead the addition of section III proposes a move away from a categorical approach to a more dimensional approach, with a measure of Global Function of Personality. This global measure is an assessment of impairment of self-other relations; a measure of trait narcissism. In the same way mainstream psychology has struggled in its diagnosis of narcissism, so too in its treatment. Kohut’s self psychology represents the most significant inroad in theory and treatment for the narcissistic disorders. Kohut had moved away from a categorical system, towards disorders of the self. According to this theory, disorders of the self are the result of childhood trauma (impaired attunement) resulting in a developmental arrest. Self-psychological, Psychodynamic treatment of narcissism, however, is expensive, in time and money and outside the awareness or access of most people. There is more than a suggestion that narcissism is on the increase, created in trauma and worsened by a fearful world climate. A dimensional model of narcissism, from mild to severe, requires cut off points for diagnosis. But where do we draw the line? Mainstream psychology is inclined to set it high when there is some degree of impairment in functioning in daily life. Transpersonal Psychology is inclined to set it low, with the concept that we all have some degree of narcissism and that it is the point and the path of our life journey to transcend our focus on our selves. Mainstream psychology stops its focus on trait narcissism with a healthy level of self esteem, but it is at this point that Transpersonal Psychology can complement the discussion. From a Transpersonal point of view, failure to begin the process of self-transcendence will also create emotional symptoms of meaning or purpose, often later in our lives, and is also conceived of as a developmental arrest. The maps for this transcendence are hidden in plain sight; in the chakras of kundalini yoga, in the sacraments of the Catholic Church, in the Kabbalah tree of life of Judaism, in Maslow’s hierarchy of needs, to name a few. This paper outlines some proposed research exploring the use of daily practices that can be incorporated into the therapy room; practices that utilise meditation, visualisation and imagination: that are informed by spiritual technology and guided by the psychodynamic theory of Self Psychology.Keywords: narcissism, self-psychology, self-practice, self-transcendence
Procedia PDF Downloads 2602472 Preparation of Hyperbranched Polymers for Application in Light Emitting Diodes
Authors: Amal Aljohani, Ahmed Iraqi
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Emitting materials with thermally activated delayed fluorescence (TADF) properties as the third generation of organic light-emitting diodes (OLEDs) have received much attention as a modern class of highly efficient emitters because such properties enable the harvesting of both singlet and triplet excitons in EL applications without the doping with complexes of scarce noble metals such as platinum and iridium. Improved molecular design of TADF molecules and applied materials exhibiting internal electroluminescence (EL) with quantum efficiencies of nearly 100% has been achieved being. A2B3 hyperbranched polymers based on new derivatives containing silane core units serving as host materials for thermally activated delayed fluorescence (TADF) guest molecules have been designed and synthesized through several steps, including the synthesis of tetrakis(4-bromophenyl)silane, bis(4-(9H-carbazol-9-yl)phenyl)bis(4-bromophenyl)silane,bis(4-(9H-carbazol-9 yl)phenyl)bis(4-methoxyphenyl)silane and bis(4-(9H-carbazol-9-yl)phenyl)bis(4hydroxyphenyl)silane. This monomer has been used successfully used along with 1,1,1-tri-(p-tosyloxymethyl)-propane to prepare A2B3 hyperbranched polymers via step-growth polymerization. The characterization and the properties of these new host polymers will be presented and discussed in this contribution.Keywords: carbazole, organic light emitting diodes, thermally activated delayed fluorescence, donor-acceptor, host and guest interaction
Procedia PDF Downloads 1542471 Controlled Conductivity of Poly (3,4-Ethylenedioxythiophene): Poly (4-Styrene Sulfonate) Composites with Polyester
Authors: Kazui Sasakii, Seira Mormune-Moriya, Hiroaki Tanahashi, Shigeji Kongaya
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Poly (3.4-ethylenedioxythiophene) doped with poly (4-styrene sulfonate) (PEDOT: PSS) attracted a great deal of attention because of its unique characteristics of flexibility, optical properties, heat resistance and colloidal dispersion in water. It is well known that when high boiling solvents such as ethylene glycol or dimethyl sulfoxide are added as a secondary dopant to the micellar structure, PEDOT microcrystallizes and becomes highly conductive. In previous study bis(4-hydroxyphenyl) sulfone (BPS) was used as a secondary dopant for PEDOT:PSS and the enhancement of the conductivity was revealed. However, ductility is one of the serious issues which limited the application of PEDOT:PSS/BPS. So far, the composition with polymer binders has been conducted, however, polymer binders decrease the conductivity of the materials. In this study, PEDOT: PSS composites with polyester (PEs) were prepared by a simple aqueous process using PEs emulsion. The structural studies revealed that PEDOT:PSS and PEs were homogeneously distributed in the composites. It was found that the properties of PEDOT:PSS were remarkably enhanced by the incorporation of PEs. According to the tensile test, the ductility of PEDOT:PSS was remarkably improved. Interestingly, the conductivity of PEDOT:PSS/PEs composites was higher than that of neat PEDOT:PSS. For example, the conductivity increased by 8% at PEs content of 25 wt%. Since PEDOT:PSS were homogeneously dispersed on the surface of PEs particles, it was assumed that the conductive pathway was constructed by PEs particles in the nanocomposites. Therefore, a significant increase in conductivity was achieved.Keywords: polymer composites, conductivity, PEDOT:PSS, polyester
Procedia PDF Downloads 1152470 A Dimensional Approach to Family Involvement in Forensic Mental Health Settings - Prevention of the Systemic Replication of Abuse, Need for Accepted Falsehoods and Family Guilt and Shame
Authors: Katie E. Jennings
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The interactions between family dynamics and environmental factors with mental health vulnerability in individuals are well known and are a theme for on-going research and debate. The impact upon mental health issues and forensic issues on family dynamics, experience, and emotional wellbeing cannot be over-Emphasised. For forensic patients with diagnosed mental disorders, these relationships and environments may have also been functionally linked to the development and maintenance of those disorders; with significant adverse childhood experiences being a common feature of many Patient’s histories. Mental health hospitals remove the patient from their home environments and provide treatment outside of these relationships and often outside of the home area. There is, therefore, a major focus on Services ensuring that patients are able to build and maintain relationships with family and friends, requiring services to involve families in Patients' care and treatment wherever possible. There are standards set by Government and clinical bodies that require absolute demonstration of the inclusion of family and friends in all aspects of the care and treatment of forensic patients. For some patients and family members, this push to take on a “role” in care can be unhelpful, extremely stressful, and has constant implications for the potential delicate reparation of relationships. Based on work undertaken for over 20 years in forensic mental health settings, this paper explores the positive psychology approach to a dimensional model to family inclusion in mental health care that learns from family court work and allows for the maintenance of relationships to be at both proximal and Distil levels; to prevent the replication of abuse, decrease the need for falsehoods and assist the recovery of all. The model is based on allowing families to choose to not be involved or be involved in different ways if this is seen to be more helpful. It also allows patients to choose the level of potential involvement that they would find helpful, and for this to be reviewed at a timeframe agreed by all parties, rather than when the next survey is due or the patient has a significant care meeting. This paper is significant as there is a lack of research to support services to use a positive psychology approach to work in this area, the assumption that being asked to be involved must be positive for all seems naïve at best for this patient group. Work relating to the psychology of family can significantly contribute to the development of knowledge in this area. The development of a dimensional model will support choice within families and assist in the development of more honest and open relationships.Keywords: family dynamics, forensic, mental disorder, positive psychology
Procedia PDF Downloads 1482469 Photocatalytic Degradation of Toxic Phenols Using Zinc Oxide Doped Prussian Blue Nanocomposite
Authors: Rachna, Uma Shanker
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Aromatic phenols, being priority pollutants, are found in various industrial effluents and seeking the attention of environmentalists worldwide, owing to their life-threatening effects. In the present study, the coupling of zinc oxide with Prussian blue was achieved involving co-precipitation synthesis process using Azadirachta indica plant extract. The fabricated nanocatalyst was employed for the sunlight mediated photodegradation of various phenols (Phenol, 3-Aminophenol, and 2,4-Dinitrophenol). Doping of zinc oxide with Prussian blue caused an increase in the surface area to value 80.109 m²g⁻¹ and also enhanced the semiconducting tendency of the nanocomposite with band gap energy 1.101 eV. The experiment was performed at different parameters of phenols concentration, catalyst amount, pH, time, and exposure of sunlight. The obtained results showed a lower elimination of 2,4-DNP (93%) than 3-AP (97%) and phenol (95%) owing to their molecular weight and basicity differences. In comparison to the starting material (zinc oxide and Prussian blue), nanocomposite was more capable in degrading the phenols and lowered the t1/2 value of phenol (4.405 h), 3-AP (4.04 h) and 2,4-DNP (4.68 h) to a greater extent. Effect of different foreign anions was also studied to check nanocomposite’s liability under natural conditions. The extent of charge recombination being the most limiting factor in the photodegradation of pollutants was determined through the photoluminescence. Sunlight active ZnO@FeHCF nanocomposite was proven to exhibit good catalytic ability up to 10 cycles.Keywords: nanocomposite, phenols, photodegradation, sunlight, water
Procedia PDF Downloads 1262468 Making ‘Space’ For Work-integrated Learning In Singapore: Recognising The Next Wave Of Talents Through Skillsfuture Movement
Authors: Catherine Chua, Kashif Raza
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Work-integrated learning (WIL) has been heightened in the last few years across countries. With a specific attention on working adults, the key objective is to integrate work experiences with academic studies so that they will be given more opportunities to advance, gather relevant skills and credentials to enable them to contribute more positively to the labour market. In Singapore, developing talent through WIL aims to develop specialist and enduring skills for the industries. Collaborating with the institutes of higher education in Singapore, the Integrated Work Study Programs (IWSP) seek to harmonize classroom learning with practical work experiences so that adult students can develop skills and knowledge that are needed in the existing and future workplaces. Local higher education institutions will also work closely with industry partners, and design courses that support these students to deepen their skills. Using Critical Discourse Analysis, this paper examines the Singapore government policies in WIL and argues that despite the various supports and interventions provided by the government, it is equally important to create a ‘space’ in the society whereby there is a greater recognition for WIL as a valuable education approach, i.e., “continuous meritocracy”. This is especially so in Singapore where academic excellence and conventional front-loaded approach to education are valued.Keywords: work-integrated learning, adult learners, continuous meritocracy, skillsfuture singapore
Procedia PDF Downloads 662467 Direct In-Situ Ring Opening Polymerization of E-caprolactone to Produce Biodegradable PCL/Montmorillonite Nanocomposites
Authors: Amine Harrane, Mahmoud Belalia
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During the last decade, polymer layered silicate nanocomposites have received increasing attention from scientists and industrial researchers because they generally exhibit greatly improved mechanical, thermal, barrier and flame-retardant properties at low clay content in comparison with unfilled polymers or more conventional micro composites. Poly(ε-caprolactone) (PCL)-layered silicate nanocomposites have the advantage of adding biocompatibility and biodegradability to the traditional properties of nanocomposites. They can be prepared by in situ ring-opening polymerization of ε-caprolactone using a conventional initiator to induce polymerization in the presence of an organophilic clay, such as organomodified montmorillonite. Messersmith and Giannelis used montmorillonite exchanged with protonated 12-amino dodecanoic acid and Cr3+ exchanged fluorohectorite, a synthetic mica type of silicate. Sn-based catalysts such as tin (II) octoate and dibutyltin (IV) dimethoxide have been reported to efficiently promote the polymerization of ε-caprolactone in the presence of organomodified clays. In this work, we have used an alternative method to prepare PCL/montmorillonite nanocomposites. The cationic polymerization of ε-caprolactone was initiated directly by Maghnite-TOA, organomodified montmorillonite clay, to produce nanocomposites (Scheme 1). Resulted from nanocomposites were characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), force atomic microscopy (AFM) and thermogravimetry.Keywords: polycaprolactone, polycaprolactone/clay nanocomposites, biodegradables nanocomposites, Maghnite, Insitu polymeriation
Procedia PDF Downloads 782466 Evaluation of Critical Success Factors in Public-Private Partnership Projects Based on Structural Equation Model
Authors: Medya Fathi
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Today, success in the construction industry is not merely about project completion in a timely manner within an established budget and meeting required quality considerations. Management practices and partnerships need to be emphasized as well. In this regard, critical success factors (CSFs) cover necessary considerations for a successful project beyond the traditional success definition, which vary depending on project outcomes, delivery methods, project types, and partnering processes. Despite the extensive research on CSFs, there is a paucity of studies that examine CSFs for public-private partnership (PPP); the delivery method, which has gained increasing attention from researchers and practitioners over the last decade with a slow but growing adoption in the transportation infrastructure, particularly, highway industry. To fill this knowledge gap, data are collected through questionnaire surveys among private and public parties involved in PPP transportation projects in the United States. Then, the collected data are analyzed to explore the causality relationships between CSFs and PPP project success using structural equation model and provide a list of factors with the greatest influence. This study advocates adopting a critical success factor approach to enhance PPP success in the U.S. transportation industry and identify elements essential for public and private organizations to achieve this success.Keywords: project success, critical success factors, public-private partnership, transportation
Procedia PDF Downloads 972465 Energy Conservation Strategies of Buildings in Hot, Arid Region: Al-Khobar, Saudi Arabia
Authors: M. H. Shwehdi, S. Raja Mohammad
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Recently energy savings have become more pronounced as a result of the world financial crises as well the unstable oil prices. Certainly all entities needs to adapt Energy Conservation and Management Strategies due to high monthly consumption of their spread locations and advancements of its telecom systems. These system improvements necessitate the establishment of more exchange centers as well provide energy savings. This paper investigates the impact of HVAC System Characteristics, Operational Strategies, the impact of Envelope Thermal Characteristics, and energy conservation measures. These are classified under three types of measures i.e. Zero-Investment; Low-Investment and High-Investment Energy Conservation Measures. The study shows that the Energy Conservation Measures (ECMs) pertaining to the HVAC system characteristics and operation represent the highest potential for energy reduction, attention should be given to window thermal and solar radiation characteristics when large window areas are used. The type of glazing system needs to be carefully considered in the early design phase of future buildings. Paper will present the thermal optimization of different size centers in the two hot-dry and hot-humid Saudi Arabian city of Al Khobar, East province.Keywords: energy conservation, optimization, thermal design, intermittent operation, exchange centers, hot-humid climate, Saudi Arabia
Procedia PDF Downloads 4522464 Extraction and Antibacterial Studies of Oil from Three Mango Kernel Obtained from Makurdi, Nigeria
Authors: K. Asemave, D. O. Abakpa, T. T. Ligom
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The ability of bacteria to develop resistance to many antibiotics cannot be undermined, given the multifaceted health challenges in the present times. For this reason, a lot of attention is on botanicals and their products in search of new antibacterial agents. On the other hand, mango kernel oils (MKO) can be heavily valorized by taking advantage of the myriads bioactive phytochemicals it contains. Herein, we validated the use of MKO as bioactive agent against bacteria. The MKOs for the study were extracted by soxhlet means with ethanol and hexane for 4 h from 3 different mango kernels, namely; 'local' (sample A), 'julie' (sample B), and 'john' (sample C). Prior to the extraction, ground fine particles of the kernels were obtained from the seed kernels dried in oven at 100 °C for 8 h. Hexane gave higher yield of the oils than ethanol. It was also qualitatively confirmed that the mango kernel oils contain some phytochemicals such as phenol, quinone, saponin, and terpenoid. The results of the antibacterial activities of the MKO against both gram positive (Staphylococcus aureus) and gram negative (Pseudomonas aeruginosa) at different concentrations showed that the oils extracted with ethanol gave better antibacterial properties than those of the hexane. More so, the bioactivities were best with the local mango kernel oil. Indeed this work has completely validated the previous claim that MKOs are effective antibacterial agents. Thus, these oils (especially the ethanol-derived ones) can be used as bacteriostatic and antibacterial agents in say food, cosmetics, and allied industries.Keywords: bacteria, mango, kernel, oil, phytochemicals
Procedia PDF Downloads 1532463 Extracting Therapeutic Grade Essential Oils from the Lamiaceae Plant Family in the United Arab Emirates (UAE): Highlights on Great Possibilities and Sever Difficulties
Authors: Suzan M. Shahin, Mohammed A. Salem
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Essential oils are expensive phytochemicals produced and extracted from specific species belonging to particular families in the plant kingdom. In the United Arab Emirates country (UAE), which is located in the arid region of the world, nine species, from the Lamiaceae family, having the capability to produce therapeutic grade essential oils. These species include; Mentha spicata, Ocimum forskolei, Salvia macrosiphon, Salvia aegyptiaca, Salvia macilenta, Salvia spinosa, Teucrium polium, Teucrium stocksianum, and Zataria multiflora. Although, such potential species are indigenous to the UAE, however, there are almost no studies available to investigate the chemical composition and the quality of the extracted essential oils under the UAE climatological conditions. Therefore, great attention has to be given to such valuable natural resources, through conducting highly supported research projects, tailored to the UAE conditions, and investigating different extraction techniques, including the application of the latest available technologies, such as superficial fluid CO2. This is crucially needed; in order to accomplish the greatest possibilities in the medicinal field, specifically in the discovery of new therapeutic chemotypes, as well as, to achieve the sustainability of this natural resource in the country.Keywords: essential oils, extraction techniques, Lamiaceae, traditional medicine, United Arab Emirates (UAE)
Procedia PDF Downloads 4592462 Effect of Fast and Slow Tempo Music on Muscle Endurance Time
Authors: Rohit Kamal, Devaki Perumal Rajaram, Rajam Krishna, Sai Kumar Pindagiri, Silas Danielraj
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Introduction: According to WHO, Global health observatory at least 2.8 million people die each year because of obesity and overweight. This is mainly because of the adverse metabolic effects of obesity and overweight on blood pressure, lipid profile especially cholesterol and insulin resistance. To achieve optimum health WHO has set the BMI in the range of 18.5 to 24.9 kg/m2. Due to modernization of life style, physical exercise in the form of work is no longer a possibility and hence an effective way to burn out calories to achieve the optimum BMI is the need of the hour. Studies have shown that exercising for more than 60 minutes /day helps to maintain the weight and to reduce the weight exercise should be done for 90 minutes a day. Moderate exercise for about 30 min is essential for burning up of calories. People with low endurance fail to perform even the low intensity exercise for minimal time. Hence, it is necessary to find out some effective method to increase the endurance time. Methodology: This study was approved by the Institutional Ethical committee of our college. After getting written informed consent, 25 apparently healthy males between the age group 18-20 years were selected. Subjects are with muscular disorder, subjects who are Hypertensive, Diabetes, Smokers, Alcoholics, taking drugs affecting the muscle strength. To determine the endurance time: Maximum voluntary contraction (MVC) was measured by asking the participants to squeeze the hand grip dynamometer as hard as possible and hold it for 3 seconds. This procedure was repeated thrice and the average of the three reading was taken as the maximum voluntary contraction. The participant was then asked to squeeze the dynamometer and hold it at 70% of the maximum voluntary contraction while hearing fast tempo music which was played for about ten minutes then the participant was asked to relax for ten minutes and was made to hold the hand grip dynamometer at 70% of the maximum voluntary contraction while hearing slow tempo music. To avoid the bias of getting habituated to the procedure the order of hearing for the fast and slow tempo music was changed. The time for which they can hold it at 70% of MVC was determined by using a stop watch and that was taken as the endurance time. Results: The mean value of the endurance time during fast and slow tempo music was compared in all the subjects. The mean MVC was 34.92 N. The mean endurance time was 21.8 (16.3) seconds with slow tempo music which was more then with fast tempo music with which the mean endurance time was 20.6 (11.7) seconds. The preference was more for slow tempo music then for fast tempo music. Conclusion: Music when played during exercise by some unknown mechanism helps to increase the endurance time by alleviating the symptoms of lactic acid accumulation.Keywords: endurance time, fast tempo music, maximum voluntary contraction, slow tempo music
Procedia PDF Downloads 3022461 Insecticidal Effects of Plant Extract-Based Formulations on the Cotton Bollworm, Helicoverpa armigera (Hübner) (Lepidoptera: Noctuidae)
Authors: Reza Sadeghi, Maryam Nazarahari
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Considering the effectiveness of botanical pesticides in pest management, these compounds have garnered attention as a sustainable approach to reducing pest-induced damage in agriculture while preserving the environment. Botanical pesticides enable farmers to cultivate higher-quality crops by minimizing the use of chemical pesticides. In this study, plant extracts obtained using n-hexane as a solvent from two botanical sources, thyme and eucalyptus, were evaluated under laboratory conditions for their effectiveness in controlling the cotton bollworm (Helicoverpa armigera). The mortality rate of bollworm larvae was assessed across various concentrations of the hexane-based formulations. The results revealed that the hexane-based formulations of thyme and eucalyptus extracts significantly reduced the population of bollworm larvae after 24 hours of exposure. Thyme extract, in particular, demonstrated high effectiveness as a botanical pesticide, suggesting its potential as an efficient alternative to chemical pesticides in pest management. These findings underscore that botanical pesticides can mitigate the environmental consequences of chemical pesticides and provide innovative solutions for sustainable agriculture by leveraging the active compounds present in plant extracts.Keywords: cotton bollworm, thyme, eucalyptus, extract formulation, , toxicity
Procedia PDF Downloads 112460 Value Analysis Dashboard in Supply Chain Management, Real Case Study from Iran
Authors: Seyedehfatemeh Golrizgashti, Seyedali Dalil
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The goal of this paper is proposing a supply chain value dashboard in home appliance manufacturing firms to create more value for all stakeholders via balanced scorecard approach. Balanced scorecard is an effective approach that managers have used to evaluate supply chain performance in many fields but there is a lack of enough attention to all supply chain stakeholders, improving value creation and, defining correlation between value indicators and performance measuring quantitatively. In this research the key stakeholders in home appliance supply chain, value indicators with respect to create more value for stakeholders and the most important metrics to evaluate supply chain value performance based on balanced scorecard approach have been selected via literature review. The most important indicators based on expert’s judgment acquired by in survey focused on creating more value for. Structural equation modelling has been used to disclose relations between value indicators and balanced scorecard metrics. The important result of this research is identifying effective value dashboard to create more value for all stakeholders in the supply chain via balanced scorecard approach and based on an empirical study covering ten home appliance manufacturing firms in Iran. Home appliance manufacturing firms can increase their stakeholder's satisfaction by using this value dashboard.Keywords: supply chain management, balanced scorecard, value, structural modeling, stakeholders
Procedia PDF Downloads 3512459 Relationship between Pushing Behavior and Subcortical White Matter Lesion in the Acute Phase after Stroke
Authors: Yuji Fujino, Kazu Amimoto, Kazuhiro Fukata, Masahide Inoue, Hidetoshi Takahashi, Shigeru Makita
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Aim: Pusher behavior (PB) is a disorder in which stroke patients shift their body weight toward the affected side of the body (the hemiparetic side) and push away from the non-hemiparetic side. These patients often use further pushing to resist any attempts to correct their position to upright. It is known that the subcortical white matter lesion (SWML) usually correlates of gait or balance function in stroke patients. However, it is unclear whether the SWML influences PB. The purpose of this study was to investigate if the damage of SWML affects the severity of PB on acute stroke patients. Methods: Fourteen PB patients without thalamic or cortical lesions (mean age 73.4 years, 17.5 days from onset) participated in this study. Evaluation of PB was performed according to the Scale for Contraversive Pushing (SCP) for sitting and/or standing. We used modified criteria wherein the SCP subscale scores in each section of the scale were >0. As a clinical measurement, patients were evaluated by the Stroke Impairment Assessment Set (SIAS). For the depiction of SWML, we used T2-weighted fluid-attenuated inversion-recovery imaging. The degree of damage on SWML was assessed using the Fazekas scale. Patients were divided into two groups in the presence of SWML (SWML+ group; Fazekas scale grade 1-3, SWML- group; Fazekas scale grade 0). The independent t-test was used to compare the SCP and SIAS. This retrospective study was approved by the Ethics Committee. Results: In SWML+ group, the SCP was 3.7±1.0 points (mean±SD), the SIAS was 28.0 points (median). In SWML- group, the SCP was 2.0±0.2 points, and the SIAS was 31.5 points. The SCP was significantly higher in SWML+ group than in SWML- group (p<0.05). The SIAS was not significant in both groups (p>0.05). Discussion: It has been considered that the posterior thalamus is the neural structures that process the afferent sensory signals mediating graviceptive information about upright body orientation in humans. Therefore, many studies reported that PB was typically associated with unilateral lesions of the posterior thalamus. However, the result indicates that these extra-thalamic brain areas also contribute to the network controlling upright body posture. Therefore, SMWL might induce dysfunction through malperfusion in distant thalamic or other structurally intact neural structures. This study had a small sample size. Therefore, future studies should be performed with a large number of PB patients. Conclusion: The present study suggests that SWML can be definitely associated with PB. The patients with SWML may be severely incapacitating.Keywords: pushing behavior, subcortical white matter lesion, acute phase, stroke
Procedia PDF Downloads 2452458 The Efficacy of Lithium vs. Valporate on Bipolar Patients and Their Sexual Side Effect: A Meta-Analysis of 4159 Patients
Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Obada Ahmad Al Jayyousi, Ihdaa Mahmoud Bani Khalaf, Eman E. Alshial
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Background: Bipolar disorder, formerly known as manic depression, is a mental health status that leads to extreme mood swings that include emotional lows (depression) and highs (mania or hypomania). This systematic review and meta-analysis aimed to assess the safety and efficacy of lithium versus valproate among bipolar patients. Methods: A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until June 2022. Studies comparing lithium versus valproate among bipolar patients were selected for the analysis, and all relevant outcomes were pooled in the meta-analysis using Review Manager Software. Results: 11 Randomized Clinical Trials were included in this meta-analysis with a total of 4159 patients. Our meta showed that lithium was superior to valproate in terms of Young Mania Rating Scale (YMRS) (MD = 0.00 with 95% CI, (-0.55 – 0.55; I2 = 0%), P = 1.00). The results of the Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored the valproate treated group (MD = 1.41 with 95% CI, (-0.15 – 2.67; I2 = 0%), P = 0.03). Concerning the results of the Montgomery-Asberg Depression Rating Scale (MADRS), the results showed that the lithium was superior to valproate (MD = 0.03 with 95% CI, (-0.80 to 0.87; I2 = 40%), P = 0.94). In terms of the sexual side effect, we found that the valproate was superior to lithium (RR 1.19 with 95% CI, (0.74 to 1.91; I2 = 0%), P = 0.47). The lithium-treated group was superior in comparison to valproate treated group in terms of Abnormal Involuntary Movement Scale (AIMS) (MD = -0.03 with 95% CI (-0.38 to 0.32; I2 = 0%), P = 0.87). The lithium was more favorable in terms of Simpson-Agnes scale (MD = -0.40 with 95% CI, (-0.86 to 0.06; I2 = 0%), P = 0.09). The results of the Barnes akathisia scale showed that the overall effect of the valproate was more favorable in comparison to lithium (MD = 0.05 with 95% CI, (-0.12 to 0.22; I2 = 0%), P = 0.57). Conclusion: Our study revealed that on the scales of efficacy Lithium treated group surpassed Valproate treated group in terms of Young Mania Rating Scale (YMRS), Abnormal Involuntary Movement Scale (AIMS) and Simpson-Agnes scale, but valproate surpassed it in Barnes Akathisia scale. Furthermore, on the scales of depression Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored Valproate treated group, but Lithium surpassed valproate in terms of Montgomery-Asberg Depression Rating Scale (MADRS). Valproate surpassed Lithium in terms of sexual side effects.Keywords: bipolar, mania, bipolar-depression, sexual dysfunction, sexual side effects, treatment
Procedia PDF Downloads 156