Search results for: behavioral and emotional disorders
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3708

Search results for: behavioral and emotional disorders

318 Telogen Effluvium: A Modern Hair Loss Concern and the Interventional Strategies

Authors: Chettyparambil Lalchand Thejalakshmi, Sonal Sabu Edattukaran

Abstract:

Hair loss is one of the main issues that contemporary society is dealing with. It can be attributable to a wide range of factors, listing from one's genetic composition and the anxiety we experience on a daily basis. Telogen effluvium [TE] is a condition that causes temporary hair loss after a stressor that might shock the body and cause the hair follicles to temporarily rest, leading to hair loss. Most frequently, women are the ones who bring up these difficulties. Extreme illness or trauma, an emotional or important life event, rapid weight loss and crash dieting, a severe scalp skin problem, a new medication, or ceasing hormone therapy are examples of potential causes. Men frequently do not notice hair thinning with time, but women with long hair may be easily identified when shedding, which can occasionally result in bias because women tend to be more concerned with aesthetics and beauty standards of the society, and approach frequently with the concerns .The woman, who formerly possessed a full head of hair, is worried about the hair loss from her scalp . There are several cases of hair loss reported every day, and Telogen effluvium is said to be the most prevalent one of them all without any hereditary risk factors. While the patient has loss in hair volume, baldness is not the result of this problem . The exponentially growing Dermatology and Aesthetic medical division has discovered that this problem is the most common and also the easiest to cure since it is feasible for these people to regrow their hair, unlike those who have scarring alopecia, in which the follicle itself is damaged and non-viable. Telogen effluvium comes in two different forms: acute and chronic. Acute TE occurs in all the age groups with a hair loss of less than three months, while chronic TE is more common in those between the ages of 30 and 60 with a hair loss of more than six months . Both kinds are prevalent throughout all age groups, regardless of the predominance. It takes between three and six months for the lost hair to come back, although this condition is readily reversed by eliminating stresses. After shedding their hair, patients frequently describe having noticeable fringes on their forehead. The current medical treatments for this condition include topical corticosteroids, systemic corticosteroids, minoxidil and finasteride, CNDPA (caffeine, niacinamide, panthenol, dimethicone, and an acrylate polymer) .Individual terminal hair growth was increased by 10% as a result of the innovative intervention CNDPA. Botulinum Toxin A, Scalp Micro Needling, Platelet Rich Plasma Therapy [PRP], and sessions with Multivitamin Mesotherapy Injections are some recently enhanced techniques with partially or completely reversible hair loss. Also, it has been shown that supplements like Nutrafol and Biotin are producing effective outcomes. There is virtually little evidence to support the claim that applying sulfur-rich ingredients to the scalp, such as onion juice, can help TE patients' hair regenerate.

Keywords: dermatology, telogen effluvium, hair loss, modern hair loass treatments

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317 Kansei Engineering Applied to the Design of Rural Primary Education Classrooms: Design-Based Learning Case

Authors: Jimena Alarcon, Andrea Llorens, Gabriel Hernandez, Maritza Palma, Lucia Navarrete

Abstract:

The research has funding from the Government of Chile and is focused on defining the design of rural primary classroom that stimulates creativity. The relevance of the study consists of its capacity to define adequate educational spaces for the implementation of the design-based learning (DBL) methodology. This methodology promotes creativity and teamwork, generating a meaningful learning experience for students, based on the appreciation of their environment and the generation of projects that contribute positively to their communities; also, is an inquiry-based form of learning that is based on the integration of design thinking and the design process into the classroom. The main goal of the study is to define the design characteristics of rural primary school classrooms, associated with the implementation of the DBL methodology. Along with the change in learning strategies, it is necessary to change the educational spaces in which they develop. The hypothesis indicates that a change in the space and equipment of the classrooms based on the emotions of the students will motivate better learning results based on the implementation of a new methodology. In this case, the pedagogical dynamics require an important interaction between the participants, as well as an environment favorable to creativity. Methodologies from Kansei engineering are used to know the emotional variables associated with their definition. The study is done to 50 students between 6 and 10 years old (average age of seven years), 48% of men and 52% women. Virtual three-dimensional scale models and semantic differential tables are used. To define the semantic differential, self-applied surveys were carried out. Each survey consists of eight separate questions in two groups: question A to find desirable emotions; question B related to emotions. Both questions have a maximum of three alternatives to answer. Data were tabulated with IBM SPSS Statistics version 19. Terms referred to emotions are grouped into twenty concepts with a higher presence in surveys. To select the values obtained as part of the implementation of Semantic Differential, a number expected of 'chi-square test (x2)' frequency calculated for classroom space is considered lower limit. All terms over the N expected a cut point, are included to prepare tables for surveys to find a relation between emotion and space. Statistic contrast (Chi-Square) represents significance level ≥ 0, indicator that frequencies appeared are not random. Then, the most representative terms depend on the variable under study: a) definition of textures and color of vertical surfaces is associated with emotions such as tranquility, attention, concentration, creativity; and, b) distribution of the equipment of the rooms, with emotions associated with happiness, distraction, creativity, freedom. The main findings are linked to the generation of classrooms according to diverse DBL team dynamics. Kansei engineering is the appropriate methodology to know the emotions that students want to feel in the classroom space.

Keywords: creativity, design-based learning, education spaces, emotions

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316 Implementation of an Online-Platform at the University of Freiburg to Help Medical Students Cope with Stress

Authors: Zoltán Höhling, Sarah-Lu Oberschelp, Niklas Gilsdorf, Michael Wirsching, Andrea Kuhnert

Abstract:

A majority of medical students at the University of Freiburg reported stress-related psychosomatic symptoms which are often associated with their studies. International research supports these findings, as medical students worldwide seem to be at special risk for mental health problems. In some countries and institutions, psychologically based interventions that assist medical students in coping with their stressors have been implemented. It turned out that anonymity is an important aspect here. Many students fear a potential damage of reputation when being associated with mental health problems, which may be due to a high level of competitiveness in classes. Therefore, we launched an online-platform where medical students could anonymously seek help and exchange their experiences with fellow students and experts. Medical students of all semesters have access to it through the university’s learning management system (called “ILIAS”). The informative part of the platform consists of exemplary videos showing medical students (actors) who act out scenes that demonstrate the antecedents of stress-related psychosomatic disorders. These videos are linked to different expert comments, describing the exhibited symptoms in an understandable and normalizing way. The (inter-)active part of the platform consists of self-help tools (such as meditation exercises or general tips for stress-coping) and an anonymous interactive forum where students can describe their stress-related problems and seek guidance from experts and/or share their experiences with fellow students. Besides creating an immediate proposal to help affected students, we expect that competitiveness between students might be diminished and bondage improved through mutual support between them. In the initial phase after the platform’s launch, it was accessed by a considerable number of medical students. On a closer look it appeared that platform sections like general information on psychosomatic-symptoms and self-treatment tools were accessed far more often than the online-forum during the first months after the platform launch. Although initial acceptance of the platform was relatively high, students showed a rather passive way of using our platform. While user statistics showed a clear demand for information on stress-related psychosomatic symptoms and its possible remedies, active engagement in the interactive online-forum was rare. We are currently advertising the platform intensively and trying to point out the assured anonymity of the platform and its interactive forum. Our plans, to assure students their anonymity through the use of an e-learning facility and promote active engagement in the online forum, did not (yet) turn out as expected. The reasons behind this may be manifold and based on either e-learning related issues or issues related to students’ individual needs. Students might, for example, question the assured anonymity due to a lack of trust in the technological functioning university’s learning management system. However, one may also conclude that reluctance to discuss stress-related psychosomatic symptoms with peer medical students may not be solely based on anonymity concerns, but could be rooted in more complex issues such as general mistrust between students.

Keywords: e-tutoring, stress-coping, student support, online forum

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315 Functionalization of Sanitary Pads with Probiotic Paste

Authors: O. Sauperl, L. Fras Zemljic

Abstract:

The textile industry is gaining increasing importance in the field of medical materials. Therefore, presented research is focused on textile materials for external (out-of-body) use. Such materials could be various hygienic textile products (diapers, tampons, sanitary napkins, incontinence products, etc.), protective textiles and various hospital linens (surgical covers, masks, gowns, cloths, bed linens, etc.) wound pillows, bandages, orthopedic socks, etc. Function of tampons and sanitary napkins is not only to provide protection during the menstrual cycle, but their function can be also to take care of physiological or pathological vaginal discharge. In general, women's intimate areas are against infection protected by a low pH value of the vaginal flora. High pH inhibits the development of harmful microorganisms, as it is difficult to be reproduced in an acidic environment. The normal vaginal flora in healthy women is highly colonized by lactobacilli. The lactic acid produced by these organisms maintains the constant acidity of the vagina. If the balance of natural protection breaks, infections can occur. In the market, there exist probiotic tampons as a medical product supplying the vagina with beneficial probiotic lactobacilli. But, many users have concerns about the use of tampons due to the possible dry-out of the vagina as well as the possible toxic shock syndrome, which is the reason that they use mainly sanitary napkins during the menstrual cycle. Functionalization of sanitary napkins with probiotics is, therefore, interesting in regard to maintain a healthy vaginal flora and to offer to users added value of the sanitary napkins in the sense of health- and environmentally-friendly products. For this reason, the presented research is oriented in functionalization of the sanitary napkins with the probiotic paste in order to activate the lactic acid bacteria presented in the core of the functionalized sanitary napkin at the time of the contact with the menstrual fluid. In this way, lactobacilli could penetrate into vagina and by maintaining healthy vaginal flora to reduce the risk of vaginal disorders. In regard to the targeted research problem, the influence of probiotic paste applied onto cotton hygienic napkins on selected properties was studied. The aim of the research was to determine whether the sanitary napkins with the applied probiotic paste may assure suitable vaginal pH to maintain a healthy vaginal flora during the use of this product. Together with this, sorption properties of probiotic functionalized sanitary napkins were evaluated and compared to the untreated one. The research itself was carried out on the basis of tracking and controlling the input parameters, currently defined by Slovenian producer (Tosama d.o.o.) as the most important. Successful functionalization of sanitary pads with the probiotic paste was confirmed by ATR-FTIR spectroscopy. Results of the methods used within the presented research show that the absorption of the pads treated with probiotic paste deteriorates compared to non-treated ones. The coating shows a 6-month stability. Functionalization of sanitary pads with probiotic paste is believed to have a commercial potential for lowering the probability of infection during the menstrual cycle.

Keywords: functionalization, probiotic paste, sanitary pads, textile materials

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314 The Effect of Environmental Assessment Learning in Evacuation Centers on the COVID-19 Situation

Authors: Hiromi Kawasaki, Satoko Yamasaki, Mika Iwasa, Tomoko Iki, Akiko Takaki

Abstract:

In basic nursing, the conditions necessary for maintaining human health -temperature, humidity, illumination, distance from others, noise, moisture, meals, and excretion- were explained. Nursing students often think of these conditions in the context of a hospital room. In order to make students think of these conditions in terms of an environment necessary for maintaining health and preventing illness for residents, in the third year of community health nursing, students learned how to assess and improve the environment -particularly via the case of shelters in the event of a disaster. The importance of environmental management has increased in 2020 as a preventive measure against COVID-19 infection. We verified the effect of the lessons, which was decided to be conducted through distance learning. Sixty third-year nursing college students consented to participate in this study. Environmental standard knowledge for conducting environmental assessment was examined before and after class, and the percentage of correct answers was compared. The χ² test was used for the test, with a 5% significance level employed. Measures were evaluated via a report submitted by the students after class. Student descriptions were analyzed both qualitatively and descriptively with respect to expected health problems and suggestions for improvement. Students have already learned about the environment in terms of basic nursing in their second year. The correct answers for external environmental values concerning interpersonal distance, illumination, noise, and room temperature (p < 0.001) increased significantly after taking the class. Humidity was registered 83.3% before class and 93.3% after class (p = 0.077). Regarding the body, the percentage of students who answered correctly was 70% or more, both before and after the class. The students’ reports included overcrowding, high humidity/high temperature, and the number of toilets as health hazards. Health disorders to be prevented were heat stroke, infectious diseases, and economy class syndrome; improvement methods were recommended for hyperventilation, stretching, hydration, and waiting at home. After the public health nursing class, the students were able to not only propose environmental management of a hospital room but also had an understanding of the environment in terms of the lives of individuals, environmental assessment, and solutions to health problems. The response rate for basic items learned in the second year was already high before and after class, and interpersonal distance and ventilation were described by students. Students were able to use what they learned in basic nursing about the standards of the human mind and body. In the external environment, the memory of specific numerical values was ambiguous. The environment of the hospital room is controlled, and interest in numerical values may decrease. Nursing staff needs to maintain and improve human health as well as hospital rooms. With COVID-19, it was thought that students would continue to not only consider this point in reference to hospital rooms but also in regard to places where people gather. Even in distance learning, students were able to learn the important issues and lessons.

Keywords: environmental assessment, evacuation center, nursing education, nursing students

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313 Revisiting Hospital Ward Design Basics for Sustainable Family Integration

Authors: Ibrahim Abubakar Alkali, Abubakar Sarkile Kawuwa, Ibrahim Sani Khalil

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The concept of space and function forms the bedrock for spatial configuration in architectural design. Thus, the effectiveness and functionality of an architectural product depends their cordial relationship. This applies to all buildings especially to a hospital ward setting designed to accommodate various complex and diverse functions. Health care facilities design, especially an inpatient setting, is governed by many regulations and technical requirements. It is also affected by many less defined needs, particularly, response to culture and the need to provide for patient families’ presence and participation. The spatial configuration of the hospital ward setting in developing countries has no consideration for the patient’s families despite the significant role they play in promoting recovery. Attempts to integrate facilities for patients’ families have always been challenging, especially in developing countries like Nigeria, where accommodation for inpatients is predominantly in an open ward system. In addition, the situation is compounded by culture, which significantly dictates healthcare practices in Africa. Therefore, achieving such a hospital ward setting that is patient and family-centered requires careful assessment of family care actions and transaction spaces so as to arrive at an evidence based solution. Therefore, the aim of this study is to identify how hospital ward spaces can be reconfigured to provide for sustainable family integration. In achieving this aim, a qualitative approach using the principles of behavioral mapping was employed in male and female medical wards of the Federal Teaching Hospital (FTH) Gombe, Nigeria. The data obtained was analysed using classical and comparative content analysis. Patients’ families have been found to be a critical component of hospital ward design that cannot be undermined. Accordingly, bedsides, open yards, corridors and foyers have been identified as patient families’ transaction spaces that require design attention. Arriving at sustainable family integration can be achieved by revisiting the design requirements of the family transaction spaces based on the findings in order to avoid the rowdiness of the wards and uncoordinated sprawl.

Keywords: caregiving, design basics, family integration, hospital ward, sustainability

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312 Translation and Validation of the Thai Version of the Japanese Sleep Questionnaire for Preschoolers

Authors: Natcha Lueangapapong, Chariya Chuthapisith, Lunliya Thampratankul

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Background: There is a need to find an appropriate tool to help healthcare providers determine sleep problems in children for early diagnosis and management. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) is a parent-reported sleep questionnaire that has good psychometric properties and can be used in the context of Asian culture, which is likely suitable for Thai children. Objectives: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep disorders in preschoolers. Methods: After approval by the original developer, the cross-cultural adaptation process of JSQ-P was performed, including forward translation, reconciliation, backward translation, and final approval of the Thai version of JSQ-P (TH-JSQ-P) by the original creator. This study was conducted between March 2021 and February 2022. The TH-JSQ-P was completed by 2,613 guardians whose children were aged 2-6 years twice in 10-14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). Face validity, content validity, structural validity, construct validity (discriminant validity), criterion validity and predictive validity were assessed. The sensitivity and specificity of the TH-JSQ-P were also measured by using a total JSQ-P score cutoff point 84, recommended by the original JSQ-P and each subscale score among the clinical samples of obstructive sleep apnea syndrome. Results: Internal consistency reliability, evaluated by Cronbach’s α coefficient, showed acceptable reliability in all subscales of JSQ-P. It also had good test-retest reliability, as the intraclass correlation coefficient (ICC) for all items ranged between 0.42-0.84. The content validity was acceptable. For structural validity, our results indicated that the final factor solution for the Th-JSQ-P was comparable to the original JSQ-P. For construct validity, age group was one of the clinical parameters associated with some sleep problems. In detail, parasomnias, insomnia, daytime excessive sleepiness and sleep habits significantly decreased when the children got older; on the other hand, insufficient sleep was significantly increased with age. For criterion validity, all subscales showed a correlation with the Epworth Sleepiness Scale (r = -0.049-0.349). In predictive validity, the Epworth Sleepiness Scale was significantly a strong factor that correlated to sleep problems in all subscales of JSQ-P except in the subscale of sleep habit. The sensitivity and specificity of the total JSQ-P score were 0.72 and 0.66, respectively. Conclusion: The Thai version of JSQ-P has good internal consistency reliability and test-retest reliability. It passed 6 validity tests, and this can be used to evaluate sleep problems in preschool children in Thailand. Furthermore, it has satisfactory general psychometric properties and good reliability and validity. The data collected in examining the sensitivity of the Thai version revealed that the JSQ-P could detect differences in sleep problems among children with obstructive sleep apnea syndrome. This confirmed that the measure is sensitive and can be used to discriminate sleep problems among different children.

Keywords: preschooler, questionnaire, validation, Thai version

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311 Fucoidan: A Potent Seaweed-Derived Polysaccharide with Immunomodulatory and Anti-inflammatory Properties

Authors: Tauseef Ahmad, Muhammad Ishaq, Mathew Eapen, Ahyoung Park, Sam Karpiniec, Vanni Caruso, Rajaraman Eri

Abstract:

Fucoidans are complex, fucose-rich sulfated polymers discovered in brown seaweeds. Fucoidans are popular around the world, particularly in the nutraceutical and pharmaceutical industries, due to their promising medicinal properties. Fucoidans have been shown to have a variety of biological activities, including anti-inflammatory effects. They are known to inhibit inflammatory processes through a variety of mechanisms, including enzyme inhibition and selectin blockade. Inflammation is a part of the complicated biological response of living systems to damaging stimuli, and it plays a role in the pathogenesis of a variety of disorders, including arthritis, inflammatory bowel disease, cancer, and allergies. In the current investigation, various fucoidan extracts from Undaria pinnatifida, Fucus vesiculosus, Macrocystis pyrifera, Ascophyllum nodosum, and Laminaria japonica were assessed for inhibition of pro-inflammatory cytokine production (TNF-α, IL-1β, and IL-6) in LPS induced human macrophage cell line (THP-1) and human peripheral blood mononuclear cells (PBMCs). Furthermore, we also sought to catalogue these extracts based on their anti-inflammatory effects in the current in-vitro cell model. Materials and Methods: To assess the cytotoxicity of fucoidan extracts, MTT (3-[4,5-dimethylthiazol-2-yl]-2,5, -diphenyltetrazolium bromide) cell viability assay was performed. Furthermore, a dose-response for fucoidan extracts was performed in LPS induced THP-1 cells and PBMCs after pre-treatment for 24 hours, and levels of TNF-α, IL-1β, and IL-6 cytokines were measured using Enzyme-Linked Immunosorbent Assay (ELISA). Results: The MTT cell viability assay demonstrated that fucoidan extracts exhibited no evidence of cytotoxicity in THP-1 cells or PBMCs after 48 hours of incubation. The results of the sandwich ELISA revealed that all fucoidan extracts suppressed cytokine production in LPS-stimulated PBMCs and human THP-1 cells in a dose-dependent manner. Notably, at lower concentrations, the lower molecular fucoidan (5-30 kDa) extract from Macrocystis pyrifera was a highly efficient inhibitor of pro-inflammatory cytokines. Fucoidan extracts from all species including Undaria pinnatifida, Fucus vesiculosus, Macrocystis pyrifera, Ascophyllum nodosum, and Laminaria japonica exhibited significant anti-inflammatory effects. These findings on several fucoidan extracts provide insight into strategies for improving their efficacy against inflammation-related diseases. Conclusion: In the current research, we have successfully catalogued several fucoidan extracts based on their efficiency in LPS-induced macrophages and PBMCs in downregulating the key pro-inflammatory cytokines (TNF-, IL-1 and IL-6), which are prospective targets in human inflammatory illnesses. Further research would provide more information on the mechanism of action, allowing it to be tested for therapeutic purposes as an anti-inflammatory medication.

Keywords: fucoidan, PBMCs, THP-1, TNF-α, IL-1β, IL-6, inflammation

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310 The Home as Memory Palace: Three Case Studies of Artistic Representations of the Relationship between Individual and Collective Memory and the Home

Authors: Laura M. F. Bertens

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The houses we inhabit are important containers of memory. As homes, they take on meaning for those who live inside, and memories of family life become intimately tied up with rooms, windows, and gardens. Each new family creates a new layer of meaning, resulting in a palimpsest of family memory. These houses function quite literally as memory palaces, as a walk through a childhood home will show; each room conjures up images of past events. Over time, these personal memories become woven together with the cultural memory of countries and generations. The importance of the home is a central theme in art, and several contemporary artists have a special interest in the relationship between memory and the home. This paper analyses three case studies in order to get a deeper understanding of the ways in which the home functions and feels like a memory palace, both on an individual and on a collective, cultural level. Close reading of the artworks is performed on the theoretical intersection between Art History and Cultural Memory Studies. The first case study concerns works from the exhibition Mnemosyne by the artist duo Anne and Patrick Poirier. These works combine interests in architecture, archaeology, and psychology. Models of cities and fantastical architectural designs resemble physical structures (such as the brain), architectural metaphors used in representing the concept of memory (such as the memory palace), and archaeological remains, essential to our shared cultural memories. Secondly, works by Do Ho Suh will help us understand the relationship between the home and memory on a far more personal level; outlines of rooms from his former homes, made of colourful, transparent fabric and combined into new structures, provide an insight into the way these spaces retain individual memories. The spaces have been emptied out, and only the husks remain. Although the remnants of walls, light switches, doors, electricity outlets, etc. are standard, mass-produced elements found in many homes and devoid of inherent meaning, together they remind us of the emotional significance attached to the muscle memory of spaces we once inhabited. The third case study concerns an exhibition in a house put up for sale on the Dutch real estate website Funda. The house was built in 1933 by a Jewish family fleeing from Germany, and the father and son were later deported and killed. The artists Anne van As and CA Wertheim have used the history and memories of the house as a starting point for an exhibition called (T)huis, a combination of the Dutch words for home and house. This case study illustrates the way houses become containers of memories; each new family ‘resets’ the meaning of a house, but traces of earlier memories remain. The exhibition allows us to explore the transition of individual memories into shared cultural memory, in this case of WWII. Taken together, the analyses provide a deeper understanding of different facets of the relationship between the home and memory, both individual and collective, and the ways in which art can represent these.

Keywords: Anne and Patrick Poirier, cultural memory, Do Ho Suh, home, memory palace

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309 How Childhood Trauma Changes the Recovery Models

Authors: John Michael Weber

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The following research results spanned six months and 175 people addicted to some form of substance, from alcohol to heroin. One question was asked, and the answers were amazing and consistent. The following work is the detailed results of this writer’s answer to his own question and the 175 that followed. A constant pattern took shape throughout the bio-psycho-social assessments, these addicts had “first memories,” the memories were vivid and took place between the ages of three to six years old, to a person those first memories were traumatic. This writer’s personal search into his childhood was not to find an excuse for the way he became, but to explain the reason for becoming an addict. To treat addiction, these memories that have caused Post Traumatic Stress Disorder (PTSD), must be recognized as the catalyst that sparked a predisposition. Cognitive Behavioral Therapy (CBT), integrated with treatment specifically focused on PTSD, gives the addict a better chance at recovery sans relapse. This paper seeks to give the findings of first memories of the addicts assessed and provide the best treatment plan for such an addict, considering, the childhood trauma in congruence with treatment of the Substance Use Disorder (SUD). The question posed was concerning what their first life memory wa It is the hope of this author to take the knowledge that trauma is one of the main catalysts for addiction, will allow therapists to provide better treatment and reduce relapse from abstinence from drugs and alcohol. This research led this author to believe that if treatment of childhood trauma is not a priority, the twelve steps of Alcoholics Anonymous, specifically steps 4 and 5, will not be thoroughly addressed and odds for relapse increase. With this knowledge, parents can be educated on childhood trauma and the effect it has on their children. Parents could be mindful of the fact that the things they perceive as traumatic, do not match what a child, in the developmental years, absorbs as traumatic. It is this author’s belief that what has become the status quo in treatment facilities has not been working for a long time. It is for that reason this author believes things need to change. Relapse has been woven into the fabric of standard operating procedure and that, in this authors view, is not necessary. Childhood Trauma is not being addressed early in recovery and that creates an environment of inevitable relapse. This paper will explore how to break away from the status -quo and rethink the current “evidencebased treatments.” To begin breaking away from status-quo, this ends the Abstract, with hopes an interest has been peaked to read on.

Keywords: childood, trauma, treatment, addiction, change

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308 Making Sense of C. G. Jung’s Red Book and Black Books: Masonic Rites and Trauma

Authors: Lynn Brunet

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In 2019 the author published a book-length study examining Jung’s Red Book. This study consisted of a close reading of each of the chapters in Liber Novus, focussing on the fantasies themselves and Jung’s accompanying paintings. It found that the plots, settings, characters and symbolism in each of these fantasies are not entirely original but remarkably similar to those found in some of the higher degrees of Continental Freemasonry. Jung was the grandson of his namesake, C.G. Jung (1794–1864), who was a Freemason and one-time Grand Master of the Swiss Masonic Lodge. The study found that the majority of Jung’s fantasies are very similar to those of the Ancient and Accepted Scottish Rite, practiced in Switzerland during the time of Jung’s childhood. It argues that the fantasies appear to be memories of a series of terrifying initiatory ordeals conducted using spurious versions of the Masonic rites. Spurious Freemasonry is a term that Masons use for the ‘irregular’ or illegitimate use of the rituals and are not sanctioned by the Order. Since the 1980s there have been multiple reports of ritual trauma amongst a wide variety of organizations, cults and religious groups that psychologists, counsellors, social workers, and forensic scientists have confirmed. The abusive use of Masonic rites features frequently in these reports. This initial study allows a reading of The Red Book that makes sense of the obscure references, bizarre scenarios and intense emotional trauma described by Jung throughout Liber Novus. It suggests that Jung appears to have undergone a cruel initiatory process as a child. The author is currently examining the extra material found in Jung’s Black Books and the results are confirming the original discoveries and demonstrating a number of aspects not covered in the first publication. These include the complex layering of ancient gods and belief systems in answer to Jung’s question, ‘In which underworld am I?’ It demonstrates that the majority of these ancient systems and their gods are discussed in a handbook for the Scottish Rite, Morals and Dogma by Albert Pike, but that the way they are presented by Philemon and his soul is intended to confuse him rather than clarify their purpose. This new study also examines Jung’s soul’s question ‘I am not a human being. What am I then?’ While further themes that emerge from the Black Books include his struggle with vanity and whether he should continue creating his ‘holy book’; and a comparison between Jung’s ‘mystery plays’ and examples from the Theatre of the Absurd. Overall, it demonstrates that Jung’s experience, while inexplicable in his own time, is now known to be the secret and abusive practice of initiation of the young found in a range of cults and religious groups in many first world countries. This paper will present a brief outline of the original study and then examine the themes that have emerged from the extra material found in the Black Books.

Keywords: C. G. Jung, the red book, the black books, masonic themes, trauma and dissociation, initiation rites, secret societies

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307 Ultrastructural Characterization of Lipid Droplets of Rat Hepatocytes after Whole Body 60-Cobalt Gamma Radiation

Authors: Ivna Mororó, Lise P. Labéjof, Stephanie Ribeiro, Kely Almeida

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Lipid droplets (LDs) are normally presented in greater or lesser number in the cytoplasm of almost all eukaryotic and some prokaryotic cells. They are independent organelles composed of a lipid ester core and a surface phospholipid monolayer. As a lipid storage form, they provide an available source of energy for the cell. Recently it was demonstrated that they play an important role in other many cellular processes. Among the many unresolved questions about them, it is not even known how LDs is formed, how lipids are recruited to LDs and how they interact with the other organelles. Excess fat in the organism is pathological and often associated with the development of some genetic, hormonal or behavioral diseases. The formation and accumulation of lipid droplets in the cytoplasm can be increased by exogenous physical or chemical agents. It is well known that ionizing radiation affects lipid metabolism resulting in increased lipogenesis in cells, but the details of this process are unknown. To better understand the mode of formation of LDs in liver cells, we investigate their ultrastructural morphology after irradiation. For that, Wistar rats were exposed to whole body gamma radiation from 60-cobalt at various single doses. Samples of the livers were processed for analysis under a conventional transmission electron microscope. We found that when compared to controls, morphological changes in liver cells were evident at the higher doses of radiation used. It was detected a great number of lipid droplets of different sizes and homogeneous content and some of them merged each other. In some cells, it was observed diffused LDs, not limited by a monolayer of phospholipids. This finding suggests that the phospholipid monolayer of the LDs was disrupted by ionizing radiation exposure that promotes lipid peroxydation of endo membranes. Thus the absence of the phospholipid monolayer may prevent the realization of some cellular activities as follow: - lipid exocytosis which requires the merging of LDs membrane with the plasma membrane; - the interaction of LDs with other membrane-bound organelles such as the endoplasmic reticulum (ER), the golgi and mitochondria and; - lipolysis of lipid esters contained in the LDs which requires the presence of enzymes located in membrane-bound organelles as ER. All these impediments can contribute to lipid accumulation in the cytoplasm and the development of diseases such as liver steatosis, cirrhosis and cancer.

Keywords: radiobiology, hepatocytes, lipid metabolism, transmission electron microscopy

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306 Maternal Adverse Childhood Experiences and Preschool Children’s Behavioural Problems: Mediation via Adult Attachment and Moderation by Maternal Mental Health, Social Support, and Child Sex

Authors: Stefan Kurbatfinski, Aliyah Dosani, Andrew F. Hayes, Deborah Dewey, Nicole Letourneau

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Background: Maternal adverse childhood experiences (ACEs) have been associated with internalizing and externalizing behavioral problems in preschool children. However, little is known about the influence of maternal adult attachment patterns on this association. Further, potential moderation by maternal mental health, maternal social support, or child sex is poorly understood. Therefore, this study examined associations between 1) maternal ACEs and preschool children’s behavioural problems, with mediation through maternal attachment patterns and moderation by maternal mental health, maternal social support, and child sex; and 2) maternal attachment patterns and children’s behavioural problems, with mediation through maternal mental health and social support and moderation by child sex. Methods: This secondary analysis used data (n=625) from a high socioeconomic, longitudinally prospective cohort (Alberta Pregnancy Outcomes and Nutrition). Child behaviour (BASC-2) and maternal adult attachment (ECR-Q) were measured at five years of child age, maternal ACEs (ACEs Questionnaire) at around 12 months, and maternal mental health (CESD and SCL-90-R) and social support (SSQ) across various prenatal and postnatal time points. All moderation and mediation analyses occurred through RStudio using PROCESS, interpreting significant interactions through Johnson-Neyman plots. Findings: Maternal ACEs interacted with maternal anxiety symptoms to predict both behavioural problems (pexternalizing=0.007; pinternalizing=0.0159). An indirect pathway via dismissive attachment was moderated by maternal social support ([0.0058, 0.0596]). Attachment patterns predicted all behavioural problems (p<0.05) and interacted with maternal anxiety symptoms to predict internalizing behaviours among male children ([0.0321, 0.1307]; [0.0321, 0.1291]). Interpretation: Maternal attachment patterns may predict children’s behavioural problems more than ACEs. Social support interventions may not always be beneficial for highly dismissively attached mothers. Implications for policy and child health include mandatory sex and gender education for teachers; assessing attachment patterns prior to recommending social support as an intervention; and anxiety-focused interventions for mothers in higher socioeconomic populations.

Keywords: maternal adverse childhood experiences, internalizing behaviours, externalizing behaviours, mediators and moderators, attachment patterns, child health

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305 Soft Power Contestation in South Asia: Analyzing Bollywood and Chinese Cinema as Strategic Tools in the India-China Rivalry and Their Impact on Cultural Diplomacy and Regional Identity

Authors: Julia Mathew

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This paper explores the use of Bollywood and Chinese movies as soft power instruments within the larger context of India-China contention in South Asia. As India and China compete for influence in South Asia, they have increasingly relied on cultural diplomacy, using cinema to change perceptions, promote goodwill, and build cultural linkages. Bollywood, with its long-standing popularity and cultural resonance, has been a powerful instrument for projecting Indian ideals and identity throughout South Asia. In contrast, China has made concerted attempts in recent years to promote its own films, showing Chinese culture and values in a positive manner to offset Bollywood’s effect. This study examines the ways in which Chinese and Bollywood films influence public opinion and appeal to South Asian audiences while also supporting their respective countries’ soft power goals. To learn about this, we take a mixed-methods approach that incorporates content analysis of popular Bollywood and Chinese films released in South Asia, focussing on issues such as cultural identity, nationalism, and social values. In addition, we use sentiment analysis and surveys to map how these two cinematic traditions are received in various South Asian countries. This study takes into account government activities and cultural policies that promote each country’s cinema industry as a diplomatic instrument. The present study uses case studies from Nepal, Sri Lanka, Bangladesh, and Bhutan to demonstrate the subtle ways in which Bollywood and Chinese movies influence regional attitudes. For example, in Nepal and Bangladesh, Bollywood’s deep cultural ties have historically given India an advantage, but China’s growing economic relations and media presence have presented Chinese cinema as an alternative cultural influence. In contrast, Sri Lanka exemplifies a complicated relationship in which Bollywood’s cultural attraction is strong, but Chinese state-backed media diplomacy is making inroads, altering the cultural landscape. Due to limited cultural interchange and Bhutan’s historical alignment with India, Chinese cinema has a small presence in the country. The findings highlight cinema’s significance as a soft power tool in India and China’s regional ambitions. Bollywood’s emotional resonance and cultural familiarity have long bolstered India’s prominence, but Chinese cinema’s expansion reflects China’s desire to shift cultural narratives in its favour. This paper closes by presenting insights into the broader implications of cultural diplomacy within the India-China competition, arguing that as India and China continue to compete for influence in South Asia, film will play an increasingly crucial role in defining the soft power environment.

Keywords: soft power, China, India, Bollywood, Chinese cinema

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304 Deciphering Orangutan Drawing Behavior Using Artificial Intelligence

Authors: Benjamin Beltzung, Marie Pelé, Julien P. Renoult, Cédric Sueur

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To this day, it is not known if drawing is specifically human behavior or if this behavior finds its origins in ancestor species. An interesting window to enlighten this question is to analyze the drawing behavior in genetically close to human species, such as non-human primate species. A good candidate for this approach is the orangutan, who shares 97% of our genes and exhibits multiple human-like behaviors. Focusing on figurative aspects may not be suitable for orangutans’ drawings, which may appear as scribbles but may have meaning. A manual feature selection would lead to an anthropocentric bias, as the features selected by humans may not match with those relevant for orangutans. In the present study, we used deep learning to analyze the drawings of a female orangutan named Molly († in 2011), who has produced 1,299 drawings in her last five years as part of a behavioral enrichment program at the Tama Zoo in Japan. We investigate multiple ways to decipher Molly’s drawings. First, we demonstrate the existence of differences between seasons by training a deep learning model to classify Molly’s drawings according to the seasons. Then, to understand and interpret these seasonal differences, we analyze how the information spreads within the network, from shallow to deep layers, where early layers encode simple local features and deep layers encode more complex and global information. More precisely, we investigate the impact of feature complexity on classification accuracy through features extraction fed to a Support Vector Machine. Last, we leverage style transfer to dissociate features associated with drawing style from those describing the representational content and analyze the relative importance of these two types of features in explaining seasonal variation. Content features were relevant for the classification, showing the presence of meaning in these non-figurative drawings and the ability of deep learning to decipher these differences. The style of the drawings was also relevant, as style features encoded enough information to have a classification better than random. The accuracy of style features was higher for deeper layers, demonstrating and highlighting the variation of style between seasons in Molly’s drawings. Through this study, we demonstrate how deep learning can help at finding meanings in non-figurative drawings and interpret these differences.

Keywords: cognition, deep learning, drawing behavior, interpretability

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303 Factors Associated with Hand Functional Disability in People with Rheumatoid Arthritis: A Systematic Review and Best-Evidence Synthesis

Authors: Hisham Arab Alkabeya, A. M. Hughes, J. Adams

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Background: People with Rheumatoid Arthritis (RA) continue to experience problems with hand function despite new drug advances and targeted medical treatment. Consequently, it is important to identify the factors that influence the impact of RA disease on hand function. This systematic review identified observational studies that reported factors that influenced the impact of RA on hand function. Methods: MEDLINE, EMBASE, CINAL, AMED, PsychINFO, and Web of Science database were searched from January 1990 up to March 2017. Full-text articles published in English that described factors related to hand functional disability in people with RA were selected following predetermined inclusion and exclusion criteria. Pertinent data were thoroughly extracted and documented using a pre-designed data extraction form by the lead author, and cross-checked by the review team for completion and accuracy. Factors related to hand function were classified under the domains of the International Classification of Functioning, Disability, and Health (ICF) framework and health-related factors. Three reviewers independently assessed the methodological quality of the included articles using the quality of cross-sectional studies (AXIS) tool. Factors related to hand function that was investigated in two or more studies were explored using a best-evidence synthesis. Results: Twenty articles form 19 studies met the inclusion criteria from 1,271 citations; all presented cross-sectional data (five high quality and 15 low quality studies), resulting in at best limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicates that there was a range of body structure and function factors that were related with hand functional disability. However, key factors were hand strength, disease activity, and pain intensity. Low functional status (physical, emotional and social) level was found to be related with limited hand function. For personal factors, there is limited evidence that gender is not related with hand function; whereas, conflicting evidence was found regarding the relationship between age and hand function. In the domain of environmental factors, there was limited evidence that work activity was not related with hand function. Regarding health-related factors, there was limited evidence that the level of the rheumatoid factor (RF) was not related to hand function. Finally, conflicting evidence was found regarding the relationship between hand function and disease duration and general health status. Conclusion: Studies focused on body structure and function factors, highlighting a lack of investigation into personal and environmental factors when considering the impact of RA on hand function. The level of evidence which exists was limited, but identified that modifiable factors such as grip or pinch strength, disease activity and pain are the most influential factors on hand function in people with RA. The review findings suggest that important personal and environmental factors that impact on hand function in people with RA are not yet considered or reported in clinical research. Well-designed longitudinal, preferably cohort, studies are now needed to better understand the causality between personal and environmental factors and hand functional disability in people with RA.

Keywords: factors, hand function, rheumatoid arthritis, systematic review

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302 Risk and Protective Factors for the Health of Primary Care-Givers of Children with Autism Spectrum Disorders or Intellectual Disability: A Narrative Review and Discussion

Authors: Jenny Fairthorne, Yuka Mori, Helen Leonard

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Background: Primary care-givers of children with autism spectrum disorder (ASD) or intellectual disability (ID) have poorer health and quality of life (QoL) than primary care-givers (hereafter referred to as just care-givers) of typically developing children. We aimed to review original research which described factors impacting the health of care-givers of children with ASD or ID and to discuss how these factors might influence care-giver health. Methods: We searched Web of Knowledge, Medline, Scopus and Google Scholar using selections of words from each of three groups. The first comprised terms associated with ASD and ID and included autism, pervasive development disorder, intellectual disability, mental retardation, disability, disabled, Down and Asperger. The second included terms related to health such as depression, physical, mental, psychiatric, psychological and well-being. The third was terms related to care-givers such as mother, parent and care-giver. We included an original paper in our review if it was published between 1st January 1990 and 31st December, 2016, described original research in a peer-reviewed journal and was written in English. Additional criteria were that the research used a study population of 15 persons or more; described a risk or protective factor for the health of care-givers of a child with ASD, ID or a sub-type (such as ASD with ID or Down syndrome). Using previous research, we developed a simple and objective five-level tool to assess the strength of evidence provided by the reviewed papers. Results: We retained 33 papers. Factors impacting primary care-giver health included child behaviour, level of support, socio-economic status (SES) and diagnostic issues. Challenging child behaviour, the most commonly identified risk factor for poorer care-giver health and QoL was reported in ten of the studies. A higher level of support was associated with improved care-giver health and QoL. For example, substantial evidence indicated that family support reduced care-giver burden in families with a child with ASD and that family and neighbourhood support was associated with improved care-giver mental health. Higher socio-economic status (SES) was a protective factor for care-giver health and particularly maternal health. Diagnostic uncertainty and an unclear prognosis are factors which can cause the greatest concern to care-givers of children with ASD and those for whom a cause of their child’s ID has not been identified. We explain how each of these factors might impact caregiver health and how they might act differentially in care-givers of children with different types of ASD or ID (such as Down syndrome and ASD without ID). Conclusion: Care-givers of children with ASD may be more likely to experience many risk factors and less likely to experience the protective factors we identified for poorer mental health. Interventions to reduce risk factors and increase protective factors could pave the way for improved care-giver health. For example, workshops to train care-givers to better manage challenging child behaviours and earlier diagnosis of ASD (and particularly ASD without ID) would seem likely to improve care-giver well-being. Similarly, helping to expand support networks might reduce care-giver burden and stress leading to improved health.

Keywords: autism, caregivers, health, intellectual disability, mothers, review

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301 Association between Obstetric Factors with Affected Areas of Health-Related Quality of Life of Pregnant Women

Authors: Cinthia G. P. Calou, Franz J. Antezana, Ana I. O. Nicolau, Eveliny S. Martins, Paula R. A. L. Soares, Glauberto S. Quirino, Dayanne R. Oliveira, Priscila S. Aquino, Régia C. M. B. Castro, Ana K. B. Pinheiro

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Introduction: As an integral part of the health-disease process, gestation is a period in which the social insertion of women can influence, in a positive or negative way, the course of the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices in the quest to make them more effective and real for the promotion of a more humanized care. This study explores the associations between the obstetric factors with affected areas of health-related quality of life of pregnant women with habitual risk. Methods: This is a cross-sectional, quantitative study conducted in three public facilities and a private service that provides prenatal care in the city of Fortaleza, Ceara, Brazil. The sample consisted of 261 pregnant women who underwent low-risk prenatal care and were interviewed from September to November 2014. The collection instruments were a questionnaire containing socio-demographic and obstetric variables, in addition to the Brazilian version of the Mother scale Generated Index (MGI) characterized by being a specific and objective instrument, consisting of a single sheet and subdivided into three stages. It allows identifying the areas of life of the pregnant woman that are most affected, which could go unnoticed by the pre-formulated measurement instruments. The obstetric data, as well as the data concerning the application of the MGI scale, were compiled and analyzed through the statistical program Statistical Package for the Social Sciences (SPSS), version 20.0. After the compilation, a descriptive analysis was carried out. Then, associations were made between some variables. The tests applied were the Pearson Chi-Square and the Fisher's exact test. The odds ratio was also calculated. These associations were considered statistically significant when the p (probability) value was less than or equal to a level of 5% (α = 0.05) in the tests performed. Results: The variables that negatively reflected the quality of life of the pregnant women and presented a significant association with the polaciuria were: gestational age (p = 0.022) and parity (p = 0.048). Episodes of nausea and vomiting also showed significant with gestational age correlation (p = 0.0001). Evaluating the crossing of stress, we observed a significant association with parity (p = 0.0001). In turn, emotional lability revealed dependence on the variable type of delivery (p = 0.009). Conclusion: The health professionals involved in the assistance to the pregnant woman can understand how the process of gestation is experienced, considering all its peculiar transformations; to meet their individual needs, stimulating their autonomy and their power of choice, envisaging the achievement of a better quality of life related to health in the perspective of health promotion.

Keywords: health-related quality of life, obstetric nursing, pregnant women, prenatal care

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300 The Academic Importance of the Arts in Fostering Belonging

Authors: Ana Handel, Jamal Ellerbe, Sarah Kanzaki, Natalie White, Nathan Ousey, Sean Gallagher

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A sense of belonging is the ability for individuals to feel they are a necessary part of whatever organization or community they find themselves in. In an academic setting, a sense of belonging is key to a student’s success. The collected research points to this sense of belonging in academic settings as a significant contributor of students’ levels of engagement and trust. When universities leverage the arts, students are provided with more opportunities to engage and feel confident in their surroundings. This allows for greater potential to develop within academic and social settings. The arts also call for the promotion of diversity, equity, and inclusion by showcasing works of artists from all different backgrounds, thus allowing students to gain cultural knowledge and be able to embrace differences. Equity, diversity, and inclusion are all emotional facets of belonging. Equity relates to the concept of making the conscious choice to recognize opportunities to incorporate inclusive and diverse ideals into different thought processes and collaboration. Inclusion involves providing equal access to opportunities and resources for people of all ‘ingroups. In an inclusive culture, individuals are able to maximize their potential with the confidence they have gained through an accepting environment. A variety of members in academic communities have noted it may be beneficial to make certain events surrounding the arts to be built into course requirements in order to ensure students are expanding their horizons and exposing themselves to the arts. These academics also recommend incorporating the arts into extracurricular activities, such as Greek life, in order to appeal to large groups of students. Once students have an understanding of the rich knowledge cultivated through exploring the arts, they will feel more comfortable in their surroundings and thus more confident to become involved in other areas of their university. A number of universities, including West Chester and Carnegie Mellon, have instituted programs aiming to provide students with the necessary tools and resources to feel comfortable in their educational settings. Different programs include references to hotlines for discrimination and office for diversity, equity, and inclusion. Staff members have also been provided with means of combating biases and increasing feelings of belongingness in order to properly support and communicate with students. These tools have successfully allowed universities to foster inviting environments for students of all backgrounds to feel belong as well as strengthening the community’s diversity, equity, and inclusion. Through demonstrating concepts of diversity, equity, and inclusion by introducing the arts into learning spaces, students can find a sense of belonging within their academic environments. It is essential to understand these topics and how they work together to achieve a common goal. The efforts of universities have made much progress in shedding light on different cultures and ideas to show students their full potential and opportunities. Once students feel more comfortable within their organizations, engagement will increase substantially.

Keywords: arts, belonging, engagement, inclusion

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299 The Psycho-Linguistic Aspect of Translation Gaps in Teaching English for Specific Purposes

Authors: Elizaveta Startseva, Elena Notina, Irina Bykova, Valentina Ulyumdzhieva, Natallia Zhabo

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With the various existing models of intercultural communication that contain a vast number of stages for foreign language acquisition, there is a need for conscious perception of the foreign culture. Such a process is associated with the emergence of linguistic conflict with the consistent students’ desire to solve the problem of the language differences, along with cultural discrepancies. The aim of this study is to present the modern ways and methods of removing psycholinguistic conflict through skills development in professional translation and intercultural communication. The study was conducted in groups of 1-4-year students of Medical Institute and Agro-Technological Institute RUDN university. In the course of training, students got knowledge in such disciplines as basic grammar and vocabulary of the English language, phonetics, lexicology, introduction to linguistics, theory of translation, annotating and referencing media texts and texts in specialty. The students learned to present their research work, participated in the University and exit conferences with their reports and presentations. Common strategies of removing linguistic and cultural conflict can be attributed to the development of such abilities of a language personality as a commitment to communication and cooperation, the formation of cultural awareness and empathy of other cultures of the individual, realistic self-esteem, emotional stability, tolerance, etc. The process of mastering a foreign language and culture of the target language leads to a reduplication of linguistic identity, which leads to successive formation of the so-called 'secondary linguistic personality.' In our study, we tried to approach the problem comprehensively, focusing on the translation gaps for technical and non-technical language still missing such a typology which could classify all of the lacunas on the same principle. When obtaining the background knowledge, students learn to overcome the difficulties posed by the national-specific and linguistic differences of cultures in contact, i.e., to eliminate the gaps (to fill in and compensate). Compensation gaps is a means of fixing it, the initial phase of elimination, followed in some cases and some not is filling semantic voids (plenus). The concept of plenus occurs in most cases of translation gaps, for example in the transcription and transliteration of (intercultural and exoticism), the replication (reproduction of the morphemic structure of words or idioms. In all the above cases the task of the translator is to ensure an identical response of the receptors of the original and translated texts, since any statement is created with the goal of obtaining communicative effect, and hence pragmatic potential is the most important part of its contents. The practical value of our work lies in improving the methodology of teaching English for specific purposes on the basis of psycholinguistic concept of the secondary language personality.

Keywords: lacuna, language barrier, plenus, secondary language personality

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298 Research on Spatial Pattern and Spatial Structure of Human Settlement from the View of Spatial Anthropology – A Case Study of the Settlement in Sizhai Village, City of Zhuji, Zhejiang Province, China

Authors: Ni Zhenyu

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A human settlement is defined as the social activities, social relationships and lifestyles generated within a certain territory, which is also relatively independent territorial living space and domain composed of common people. Along with the advancement of technology and the development of society, the idea, presented in traditional research, that human settlements are deemed as substantial organic integrity with strong autonomy, are more often challenged nowadays. Spatial form of human settlements is one of the most outstanding external expressions with its subjectivity and autonomy, nevertheless, the projections of social, economic activities on certain territories are even more significant. What exactly is the relationship between human beings and the spatial form of the settlements where they live in? a question worth thinking over has been raised, that if a new view, a spatial anthropological one , can be constructed to review and respond to spatial form of human settlements based on research theories and methods of cultural anthropology within the profession of architecture. This article interprets how the typical spatial form of human settlements in the basin area of Bac Giang Province is formed under the collective impacts of local social order, land use condition, topographic features, and social contracts. A particular case of the settlement in Sizhai Village, City of Zhuji, Zhejiang Province is chosen to study for research purpose. Spatial form of human settlements are interpreted as a modeled integrity affected corporately by dominant economy, social patterns, key symbol marks and core values, etc.. Spatial form of human settlements, being a structured existence, is a materialized, behavioral, and social space; it can be considered as a place where human beings realize their behaviors and a path on which the continuity of their behaviors are kept, also for social practice a territory where currant social structure and social relationships are maintained, strengthened and rebuilt. This article aims to break the boundary of understanding that spatial form of human settlements is pure physical space, furthermore, endeavors to highlight the autonomy status of human beings, focusing on their relationships with certain territories, their interpersonal relationships, man-earth relationships and the state of existence of human beings, elaborating the deeper connotation behind spatial form of human settlements.

Keywords: spatial anthropology, human settlement, spatial pattern, spatial structure

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297 Developing Creative and Critically Reflective Digital Learning Communities

Authors: W. S. Barber, S. L. King

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This paper is a qualitative case study analysis of the development of a fully online learning community of graduate students through arts-based community building activities. With increasing numbers and types of online learning spaces, it is incumbent upon educators to continue to push the edge of what best practices look like in digital learning environments. In digital learning spaces, instructors can no longer be seen as purveyors of content knowledge to be examined at the end of a set course by a final test or exam. The rapid and fluid dissemination of information via Web 3.0 demands that we reshape our approach to teaching and learning, from one that is content-focused to one that is process-driven. Rather than having instructors as formal leaders, today’s digital learning environments require us to share expertise, as it is the collective experiences and knowledge of all students together with the instructors that help to create a very different kind of learning community. This paper focuses on innovations pursued in a 36 hour 12 week graduate course in higher education entitled “Critical and Reflective Practice”. The authors chronicle their journey to developing a fully online learning community (FOLC) by emphasizing the elements of social, cognitive, emotional and digital spaces that form a moving interplay through the community. In this way, students embrace anywhere anytime learning and often take the learning, as well as the relationships they build and skills they acquire, beyond the digital class into real world situations. We argue that in order to increase student online engagement, pedagogical approaches need to stem from two primary elements, both creativity and critical reflection, that are essential pillars upon which instructors can co-design learning environments with students. The theoretical framework for the paper is based on the interaction and interdependence of Creativity, Intuition, Critical Reflection, Social Constructivism and FOLCs. By leveraging students’ embedded familiarity with a wide variety of technologies, this case study of a graduate level course on critical reflection in education, examines how relationships, quality of work produced, and student engagement can improve by using creative and imaginative pedagogical strategies. The authors examine their professional pedagogical strategies through the lens that the teacher acts as facilitator, guide and co-designer. In a world where students can easily search for and organize information as self-directed processes, creativity and connection can at times be lost in the digitized course environment. The paper concludes by posing further questions as to how institutions of higher education may be challenged to restructure their credit granting courses into more flexible modules, and how students need to be considered an important part of assessment and evaluation strategies. By introducing creativity and critical reflection as central features of the digital learning spaces, notions of best practices in digital teaching and learning emerge.

Keywords: online, pedagogy, learning, communities

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296 Diasporic Literature

Authors: Shamsher Singh

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The Diaspora Literature involves a concept of native land, from where the displacement occurs and a record of harsh journeys undertaken on account of economic compulsions. Basically, Diaspora is a splintered community living in eviction. The scattering (initially) signifies the location of a fluid human autonomous space involving a complex set of negotiations and exchange between the nostalgia and desire for the native land and the making of a new home, adapting to the relationships between the minority and majority, being spokes persons for minority rights and their people back native place and significantly transacting the Contact Zone - a space changed with the possibility of multiple challenges. They write in the background of the sublime qualities of their homeland and, at the same time, try to fit themselves into the traditions and cultural values of other strange communities or land. It also serves as an interconnection of the various cultures involved, and it is used to understand the customs of different cultures and countries; it is also a source of inspiration globally. Although diasporic literature originated back in the 20th century, it spread to other countries like Britain, Canada, America, Denmark, Netherland, Australia, Kenya, Sweden, Kuwait and different parts of Europe. Meaning of Diaspora is the combination of two words which means the movement of people away from their own country or motherland. From a historical point of view, the ‘Diaspora’ is often associated with Jewish bigotry. At the moment, the Diaspora is used for the dispersal of social or cultural groups. This group will be living in two different streams of cultures at the same time. One who left behind his culture and the other has to adapt himself to new cultural situations. The diasporic mind hangs between his birth land and place of work at the same time. A person’s mental state, living in dual existence, gives birth to Dysphoria sensation. Litterateurs had different experiences in this type of sensation e.g., social, universal, political, economic and experiences from the strange land. The struggle of these experiences is seen in diasporic literature. When a person moves to different land or country to fulfill his dreams, the discrimination of language, work and other difficulties with strangers make his relationship more emotional and deeper into his past. These past memories and relations create more difficulties in settling in a foreign land. He lives there physically, but his mental state is in his past constantly, and he ends up his life in those background memories. A person living in Diaspora is actually a dual visionary man. Although this double vision expands his global consciousness, due to this vision, he gains judgemental qualities to understand others. At the same time, he weighs his respect for his native land and the situations of foreign land he experiences, and he finds it difficult to survive in those conditions. It can be said that diaspora literature indicates a person or social organization who lives dual life inquisition structure which becomes the cause of diasporic literature.

Keywords: homeland sickness, language problem, quest for identity, materialistic desire

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295 Effects of Covid-19 pandemic in Japan on Japanese People’s and Expatriates’ Lifestyles

Authors: Noriyuki Suyama

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This paper looked into consumer behavioral changes by analyzing the data collected by ASMARKS Co., one of a research companies in Japan. The purpose of the paper is to understand the two differences of before vs. after COVID-19 pandemic and Japanese living in Japan. Subsequently, examining the analysis results helped obtain useful insights into new business models for business parties in Japan as a microlevel perspective. The paper also tried to explore future conditions of globalization by taking into consideration nation’s political and economic changes as a macro-level perspective. The COVID-19 has been continuing its spread across the world with more than 60 million confirmed cases in 190 countries. This pandemic with restricted scopes of behavior mandates have disrupted the consumer habits of their lifestyles. Consumers have tendency to learn new ways when they have trouble in taking routine action. For example, the government forces people to refrain from going out, they try to telecommute at home. If the situation come back to normal, people still change their lifestyles to fit in the best. Some of data show typical effects of COVID-19; forceful exposure to digitalized work-life styles; more flexible time at home; importance of trustful and useful information gathering between what's good and bad;etc. in comparison with before vs. after COVID-19 pandemic. In addition, Japanese have less changed their lifestyles than Expatriates living in Japan. For example, while 94% of the expatriates have decreased their outgo because of self-quarantine, only 55% of the Japanese have done. There are more differences in both comparisons in the analysis results. The economic downtrend resulting from COVID-19 is supposed to be at least as devastating if not more so than that of the financial crisis. With unemployment levels in the US taking two weeks to reach what took 6 months in the 2008 crisis, there is no doubt of a global recession some predict could reach 10% or above of GDP. As a result, globalization in the global supply chain of goods and services will end up with negative impact. A lot of governmental financial and economic policies are supposed to focus on their own profits and interests, exclusing other countries interests as is the case with the Recovery Act just after the global financial crisis from 2007 to 2008. Both micro- and macro-levels analysis successfully reveal important connotations and managerial implications of business in Japan for Japanese consumers as well as after COVID-19 global business.

Keywords: COVID-19, lifestyle in Japan, expatriates, consumer behavior

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294 Assessment of Sleeping Patterns of Saudis with Type 2 Diabetes Mellitus in Ramadan and Non-Ramadan Periods Using a Wearable Device and a Questionnaire

Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

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Background: Quantity and quality of sleep have been reported to be significant risk factors for obesity and development of metabolic disorders such as type 2 diabetes mellitus (T2DM). The relationship between diabetes and sleep quantity was reported to be U-shaped, which means increased or decreased sleeping hours can increase the risk of diabetes. The plasma glucagon levels were found to continuously decrease during night-time sleep in healthy individuals, independently of blood glucose and insulin levels. The disturbance of the circadian rhythm is also important and has been linked with an increased the chance of diabetes incidence. There is a lack of research on sleep patterns on Saudis with T2DM and how this is affected by Ramadan fasting. Aim: To assess the sleeping patterns of Saudis with T2DM (before, during, and after Ramadan), using two different techniques and relate this to their HbA1c levels. Method: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Their sleeping patterns were assessed by a self-administered questionnaire (before, during, and after Ramadan). The assessment included the daily total sleeping hours (DTSH), and total night-time sleeping hours (TNTSH) of the participants. In addition, sleeping patterns of 36 patients, randomly selected from the 82 participants, were further tracked during and after Ramadan by using Fitbit Flex 2™ accelerometer. Blood samples were collected in each period for measuring HbA1c. Results: Questionnaire analysis revealed that the sleeping patterns significantly changed between the periods, with shorter hours during Ramadan (P < 0.001 for DTSH, and P < 0.001 for TNTSH). These findings were confirmed by the Fitbit data, which also indicated significant shorter sleeping hours for the DTSH, and the TNTSH during Ramadan (P < 0.001 and P < 0.001, respectively). Although there were no significant correlations between the questionnaire and Fitbit data, the TNTSH were shorter among the participants in all periods by both techniques. The mean HbA1c significantly varied between periods, with lowest level during Ramadan. Although the statistical tests did not show significant variances in the mean HbA1c between the groups of participants regarding their hours of sleeping, the lowest mean HbA1c was observed in the group of participants who slept for 6-8 hours and had longer night-time sleeping hours. Conclusion: A short sleep duration, and absence of night-time sleep were significantly observed among the majority of the study population during Ramadan, which could suppress the full benefits of Ramadan fasting for diabetic patients. This study showed that there is a good agreement between the findings of the questionnaire and the Fitbit device for evaluating sleeping patterns in a Saudi population. A larger study is needed in the future to investigate the impact of Ramadan fasting on sleep quality and quantity and its relationship with health and disease.

Keywords: Diabetes, Fasting, Fitbit, HbA1c, IPAQ, Ramadan, Sleep

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293 Food Design as a University-Industry Collaboration Project: An Experience Design on Controlling Chocolate Consumption and Long-Term Eating Behavior

Authors: Büşra Durmaz, Füsun Curaoğlu

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While technology-oriented developments in the modern world change our perceptions of time and speed, they also force our food consumption patterns, such as getting pleasure from what we eat and eating slowly. The habit of eating quickly and hastily causes not only the feeling of not understanding the taste of the food eaten but also the inability to postpone the feeling of satiety and, therefore, many health problems. In this context, especially in the last ten years, in the field of industrial design, food manufacturers for healthy living and consumption have been collaborating with industrial designers on food design. The consumers of the new century, who are in an uncontrolled time intensity, receive support from small snacks as a source of happiness and pleasure in the little time intervals they can spare. At this point, especially chocolate has been a source of happiness for its consumers as a source of both happiness and pleasure for hundreds of years. However, when the portions have eaten cannot be controlled, a pleasure food such as chocolate can cause both health problems and many emotional problems, especially the feeling of guilt. Fast food, which is called food that is prepared and consumed quickly, has been increasing rapidly around the world in recent years. This study covers the process and results of a chocolate design based on the user experience of a university-industry cooperation project carried out within the scope of Eskişehir Technical University graduation projects. The aim of the project is a creative product design that will enable the user to experience chocolate consumption with a healthy eating approach. For this, while concepts such as pleasure, satiety, and taste are discussed; A survey with 151 people and semi-structured face-to-face interviews with 7 people during the experience design process within the scope of the user-oriented design approach, mainly literature review, within the scope of main topics such as mouth anatomy, tongue structure, taste, the functions of the eating action in the brain, hormones and chocolate, video A case study based on the research paradigm of Qualitative Research was structured within the scope of different research processes such as analysis and project diaries. As a result of the research, it has been reached that the melting in the mouth is the preferred experience of the users in order to spread the experience of eating chocolate for a long time based on pleasure while eating chocolate with healthy portions. In this context, researches about the production of sketches, mock-ups and prototypes of the product are included in the study. As a result, a product packaging design has been made that supports the active role of the senses such as sight, smell and hearing, where consumption begins, in order to consume chocolate by melting and to actively secrete the most important stimulus salivary glands in order to provide a healthy and long-term pleasure-based consumption.

Keywords: chocolate, eating habit, pleasure, saturation, sense of taste

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292 Turkish College Students’ Attitudes toward Homophobia; Relations with, Right-Wing Authoritarianism, Social Dominance Orientation and Just World Beliefs

Authors: Melek Göregenli, Işık Gürşimşek

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There has been a great deal of research in the past few decades examining attitudes toward homosexuals.Theoretic research has demonstrated that antihomosexual attitudes are expressed in cognitive, affective, behavioral and cultural components. Homophobia is generally defined as hostility towards or fear of LGBTI people, but can also refer to social and cultural ideologies which stigmatize homosexuality. Negative feelings or attitudes towards non-heterosexual behavior, identity, relationships and community can lead to homophobic behavior and is the root of the discrimination experienced by many lesbian, gay, bisexual and transgender (LGBTI) people. Since the increase in number of hate crimes during the last decade, there has been a sense of urgency to respond to the problem of hate violence in Turkey. The LGBTI Rights Association KAOS-GL indicated that the most of lesbian, gay, bisexual, travesty and transsexuals reported some form of victimization in their lifetimes based on their sexual orientation in Turkey. This study explored the relations between homophobia, right-wing authoritarianism, social dominance orientation and just world belief attitudes towards LGBTI individuals in a sample of 393 Turkish college students from Ege University in Izmir, Turkey. Data were collected with a questionnaire including the Homosexism Scale, the Right-Wing Authoritarianism Scale, Social Dominance Orientation Scale and Just World Belief Scale. Participants completed a questionnaire containing the attitude measures and other several questions related with the socio-demographic variables. Consistent with the previous finding males were more homophobic than females. Contrary to this finding the main effects of other demographic variables (age, income, place of birth, class) were not statistically significant except the department of participants. These findings imply that efforts to garner wide-ranging support for policies designed to change negative attitudes to LGBT people and to enhance the given awareness on homophobia. The results of the study were discussed in cross-cultural and social psychological perspective considering cultural and social values of Turkey and current political circumstances of the country.

Keywords: homophobia, just world belief, right-wing authoritarianism, social dominance orientation, Turkey

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291 Sexual Behaviour and Psychological Well-Being of a Group of African Adolescent Males in Alice, Eastern Cape

Authors: Jabulani Gilford Kheswa, Thembelihle Lobi

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From a cultural perspective, expression of hegemonic masculinity in South Africa continues to escalate among adolescent males who grow up in communities lacking in role models and recreational facilities. However, when the schools are constructive, and peer influence is positive, adolescent male can potentially express character strengths and lead a meaningful life. Drawing from Bronfenbrenner’s Ecological Model and Keyes and Ryff’s six dimensions of psychological well-being and mental health, such youth may exemplify positive self-esteem, problem- focused coping strategies, condom self-efficacy, good leadership skills, enhanced motivation and a positive emotional state, which buffer against risky sexual behaviors. This paper was aimed at investigating the relationships between adolescent males’ sexual behavior and psychological well-being. This study employed a quantitative research to collect data from 54 Xhosa-speaking adolescent males from one school high school in Fort Beaufort, Eastern Cape, South Africa. These learners were from grade nine, ten and eleven with their ages ranging from 14 to 20. Prior the research commenced, the school principal and caregivers of the learners who participated in the study, gave their informed consent. Self- administered closed-ended questionnaire with Section A (that is, biographical information) and Section B with each question rated on the 5–point Likert scale was used. The advantages of questionnaires include a high response rate as they require less time and offer anonymity because participants’ names are not identified. The SPSS version 18 was used for statistical data analysis. The mean age was 16.83 with a standard deviation of 1.611. 44.4% of the participants were from grade 9, 33.3% from grade 10 and 22.2% from grade 11. The Chronbach alpha of 0.79 was yielded, with respect to self- esteem of adolescent males. In this study, 76.9% reported to attend church services whilst 23% indicated not to attend church services. A further 96.2% of adolescent males indicated to have good relations with guardians while only 3.8% had poorer relations. A large proportion of adolescent males (72.9%) indicated to high-quality friendship as opposed to 27.1% who reported being receiving negative guidance from peers. Other findings revealed that 81.1% of the participants’ parents do not drink alcohol, and they cope at school as 79.6% reported protective factors as attributable towards non-engagement to risky sexual practices. As a result, 81.4% of participants reported not to participate in criminal activities although 85% of the participants indicated that in their school there are drugs. It could be speculated from this study that adolescent males whose caregivers are authoritative, find purpose in life and are most likely to be socially and academically competent. This paper leads to further research interest into mental health, coping strategies and sexual decision-making skills of the youth in South Africa.

Keywords: church, mental health, school, sexual behaviour

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290 A Concept Study to Assist Non-Profit Organizations to Better Target Developing Countries

Authors: Malek Makki

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The main purpose of this research study is to assist non-profit organizations (NPOs) to better segment a group of least developing countries and to optimally target the most needier areas, so that the provided aids make positive and lasting differences. We applied international marketing and strategy approaches to segment a sub-group of candidates among a group of 151 countries identified by the UN-G77 list, and furthermore, we point out the areas of priorities. We use reliable and well known criteria on the basis of economics, geography, demography and behavioral. These criteria can be objectively estimated and updated so that a follow-up can be performed to measure the outcomes of any program. We selected 12 socio-economic criteria that complement each other: GDP per capita, GDP growth, industry value added, export per capita, fragile state index, corruption perceived index, environment protection index, ease of doing business index, global competitiveness index, Internet use, public spending on education, and employment rate. A weight was attributed to each variable to highlight the relative importance of each criterion within the country. Care was taken to collect the most recent available data from trusted well-known international organizations (IMF, WB, WEF, and WTO). Construct of equivalence was carried out to compare the same variables across countries. The combination of all these weighted estimated criteria provides us with a global index that represents the level of development per country. An absolute index that combines wars and risks was introduced to exclude or include a country on the basis of conflicts and a collapsing state. The final step applied to the included countries consists of a benchmarking method to select the segment of countries and the percentile of each criterion. The results of this study allowed us to exclude 16 countries for risks and security. We also excluded four countries because they lack reliable and complete data. The other countries were classified per percentile thru their global index, and we identified the needier and the areas where aids are highly required to help any NPO to prioritize the area of implementation. This new concept is based on defined, actionable, accessible and accurate variables by which NPO can implement their program and it can be extended to profit companies to perform their corporate social responsibility acts.

Keywords: developing countries, international marketing, non-profit organization, segmentation

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289 Interplay of Physical Activity, Hypoglycemia, and Psychological Factors: A Longitudinal Analysis in Diabetic Youth

Authors: Georges Jabbour

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Background and aims: This two-year follow-up study explores the long-term sustainability of physical activity (PA) levels in young people with type 1 diabetes, focusing on the relationship between PA, hypoglycemia, and behavioral scores. The literature highlights the importance of PA and its health benefits, as well as the barriers to engaging in PA practices. Studies have shown that individuals with high levels of vigorous physical activity have higher fear of hypoglycemia (FOH) scores and more hypoglycemia episodes. Considering that hypoglycemia episodes are a major barrier to physical activity, and many studies reported a negative association between PA and high FOH scores, it cannot be guaranteed that those experiencing hypoglycemia over a long period will remain active. Building on that, the present work assesses whether high PA levels, despite elevated hypoglycemia risk, can be maintained over time. The study tracks PA levels at one and two years, correlating them with hypoglycemia instances and Fear of Hypoglycemia (FOH) scores. Materials and methods: A self-administered questionnaire was completed by 61 youth with T1D, and their PA was assessed. Hypoglycemia episodes, fear of hypoglycemia scores and HbA1C levels were collected. All assessments were realized at baseline (visit 0: V0), one year (V1) and two years later (V2). For the purpose of the present work, we explore the relationships between PA levels, hypoglycemia episodes, and FOH scores at each time point. We used multiple linear regression to model the mean outcomes for each exposure of interest. Results: Findings indicate no changes in total moderate to vigorous PA (MVPA) and VPA levels among visits, and HbA1c (%) was negatively correlated with the total amount of VPA per day in minutes (β= -0.44; p=0.01, β= -0.37; p=0.04, and β= -0.66; p=0.01 for V0, V1, and V2, respectively). Our linear regression model reported a significant negative correlation between VPA and FOH across the visits (β=-0.59, p=0.01; β= -0.44, p=0.01; and β= -0.34, p=0.03 for V0, V1, and V2, respectively), and HbA1c (%) was influenced by both the number of hypoglycemic episodes and FOH score at V2 (β=0.48; p=0.02 and β=0.38; p=0.03, respectively). Conclusion: The sustainability of PA levels and HbA1c (%) in young individuals with type 1 diabetes is influenced by various factors, including fear of hypoglycemia. Understanding these complex interactions is essential for developing effective interventions to promote sustained PA levels in this population. Our results underline the necessity of a multi-strategic approach to promoting active lifestyles among diabetic youths. This approach should synergize PA enhancement with vigilant glucose monitoring and effective FOH management.

Keywords: physical activity, hypoglycemia, fear of hypoglycemia, youth

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