Search results for: generalized anxiety disorder

Authors: Mansoor Aslamzai, Delaqa Del, Sayed Azam Sajid

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Introduction: Though moral disorders have a high burden, there is no separate topic regarding this problem in the International Classification of Diseases (ICD). Along with the modification of WHO ICD-11, spirituality can prevent the rapid progress of such derangement as well. Objective: This study evaluated the effects of bad moral characters on health, as well as carried out the role of spirituality in the improvement of immorality. Method: This narrative article review was accomplished in 2020-2021 and the articles were searched through the Web of Science, PubMed, BMC, and Google scholar. Results: Based on the current review, most experimental and observational studies revealed significant negative effects of unwell moral characters on the overall aspects of health and well-being. Nowadays, a lot of studies established the positive role of spirituality in the improvement of health and moral disorder. The studies concluded, facilities must be available within schools, universities, and communities for everyone to learn the knowledge of spirituality and improve their unwell moral character world. Conclusion: Considering the negative relationship between unwell moral characters and well-being, the current study proposes the addition of moral disorder as a separate topic in the WHO International Classification of Diseases. Based on this literature review, spirituality will improve moral disorder and establish excellent moral traits.

Keywords: bad moral characters, effect, health, spirituality and well-being

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Authors: Deepak Suresh Mohale, Anil V. Chandewar

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Anxiety is defined as an exaggerated feeling of apprehension, uncertainty and fear. Nerium indicum is a well-known ornamental and medicinal plant belonging to the family Apocynaceae. A wide spectrum of biological activities has been reported with various constituents isolated from different parts of the plant. This study was conducted to investigate antianxiety activity of flower extract. Flowers were collected and dried in shade and coarsely powdered. Powdered mixture was extracted with ethyl acetate by maceration process. Extract of flowers obtained was subsequently dried in oven at 40-50 °C. This extract is then tested for antianxiety activity at low and high dose using elevated plus maze and light & dark model. Rats shown increased open arm entries and time spent in open arm in elevated Plus maze with treatment low and high dose of extract of Nerium indicum flower as compared to their respective control groups. In Light & dark Model, light box entries and time spent in light box increased with treatment low and high dose of extract of Nerium indicum flower as compared to their respective control groups. From result it is concluded that ethyl acetate extract of flower of Nerium indicum possess antianxiety activity at low and high dose.

Keywords: antianxiety, anxiety, kaner, nerium indicum, social isolation

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Authors: Marios Loucas, Rafael Loucas, Oliver Muensterer

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Aim of the Study: Over the last two years, there has been a substantial rise of refugees entering Germany, of which approximately one-third are underage. Little is known about the general state of health such as nutrition, dental status and post-traumatic stress disorder among underage refugees. Our study assesses the general health status of underage refugees based on a large sample cohort. Methods: After ethics board approval, we used a structured questionnaire to collect demographic information and health-related elements in 3 large refugee accommodation centers, focusing on nutritional and dental status, as well as symptoms of posttraumatic stress disorder. Main results: A total of 461 minor refugees were included. The majority were boys (54.5%), average age was 8 years. Out of the 8 recorded countries of origin, most children came from Syria (33.6%), followed by Afghanistan (23.2%). Of the participants, 50.3% reported DSM-5 criteria of Posttraumatic stress disorder and presented mental health-related problems. The most frequently reported mental abnormalities were concentration disturbances (15.2%), sleep disorders (6.9%), unclear headaches (5.4%). The majority of the participants showed an unfavorable nutritional and dental status. According to the family, the majority of the children rarely eat healthy foods such as fruits, vegetables and fish. However, the majority of these children (over 90%) consume a large quantity of sugary foods and sweetened drinks such as soft drinks and confectionery at least daily. Caries was found in 63% of the minor children included in the study. A large proportion (47%) reported never brushing their teeth. According to the family, 78.3% of refugee children have never been evaluated by a dentist in Germany. The remainder visited a dentist mainly because of unbearable toothache. Conclusions: Minor refugees have specific psychological, nutritional and dental problems that must be considered in order to ensure appropriate medical care. Posttraumatic stress disorder is mainly caused by physical and emotional trauma suffered either during the flight or in the refugee camp in Germany. These data call for widespread screening of psychological, dental and nutritional problems in underage refugees. Dental care of this cohort is completely inadequate. Nutritional programs should focus on educating the families and providing the means to obtain healthy foods for these children.

Keywords: children, nutrition, posttraumatic stress disorder, refugee

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Authors: Han-Jeong Hwang, Jae-Hyun Jo, Fatemeh Alimardani

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An accurate diagnosis of psychiatric diseases is a challenging issue, in particular when distinct symptoms for different diseases are overlapped, such as delusions appeared in bipolar mood disorder (BMD) and schizophrenia (SCH). In the present study, we propose a useful way to discriminate BMD and SCH using electroencephalography (EEG). A total of thirty BMD and SCH patients (15 vs. 15) took part in our experiment. EEG signals were measured with nineteen electrodes attached on the scalp using the international 10-20 system, while they were exposed to a visual stimulus flickering at 16 Hz for 95 s. The flickering visual stimulus induces a certain brain signal, known as steady-state visual evoked potential (SSVEP), which is differently observed in patients with BMD and SCH, respectively, in terms of SSVEP amplitude because they process the same visual information in own unique way. For classifying BDM and SCH patients, machine learning technique was employed in which leave-one-out-cross validation was performed. The SSVEPs induced at the fundamental (16 Hz) and second harmonic (32 Hz) stimulation frequencies were extracted using fast Fourier transformation (FFT), and they were used as features. The most discriminative feature was selected using the Fisher score, and support vector machine (SVM) was used as a classifier. From the analysis, we could obtain a classification accuracy of 83.33 %, showing the feasibility of discriminating patients with BMD and SCH using EEG. We expect that our approach can be utilized for psychiatrists to more accurately diagnose the psychiatric disorders, BMD and SCH.

Keywords: bipolar mood disorder, electroencephalography, schizophrenia, machine learning

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Authors: Mathew Tran, Deepa Patel, Breann Prophete, Irandokht Khaki Najafabadi

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Status epilepticus is a neurological disorder requiring emergent control with medical therapy. Based on guideline recommendations for adults with status epilepticus, the first-line treatment is to start a benzodiazepine, as they are quick at seizure control. The second step is to initiate a non-benzodiazepine anti-epileptic drug to prevent refractory seizures. Studies show that the anti-epileptic drugs are approximately equivalent in status epilepticus control once a benzodiazepine has been given. This review provides a brief overview of the management of status epilepticus based on evidence from the literature and evidence-based guidelines.

Keywords: neurological disorder, seizure, status epilepticus, benzo diazepines, antiepileptic agents

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Authors: Claire P. Griffin

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The education provision for students with special educational needs, including students with Autism Spectrum Disorder (ASD), has undergone significant national and international changes in recent years. In particular, an increase in resource-based provision has occurred across educational settings in an effort to support inclusive practices. This paper seeks to explore the role of the Special Needs Assistant (SNA) in supporting children with ASD in Irish schools. This research stems from the second national evaluation of ‘Education Provision for Students with Autism Spectrum Disorder in Ireland’ (NCSE, 2016). This research was commissioned by the National Council for Special Education (NCSE) in Ireland and conducted by a team of researchers from Mary Immaculate College, Limerick from February to July 2014. This study involved a multiple case study research strategy across 24 educational sites, as selected through a stratified sampling process. Research strategies included semi-structured interviews, classroom observations, documentary review and child conversations. Data analysis was conducted electronically using Nvivo software, with use of an additional quantitative recording mechanism based on scaled weighting criteria for collected data. Based on such information, key findings from the NCSE national evaluation will be presented and critically reviewed, with particular reference to the role of the SNA in supporting pupils with ASD. Examples of positive practice inherent within the SNA role will be outlined and contrasted with discrete areas for development. Based on such findings, recommendations for the evolving role of the SNA will be presented, with the aim of informing both policy and best practice within the field.

Keywords: autism spectrum disorder, inclusive education , paraprofessional, special needs assistant

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Authors: Jonathan D. Moore, Mark G. Reith, David S. Long

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Serious games (SGs) have been shown to be an effective teaching tool in many contexts. Because of the success of SGs, several design frameworks have been created to expedite the process of making original serious games to teach specific learning objectives (LOs). Even with these frameworks, the time required to create a custom SG from conception to implementation can range from months to years. Furthermore, it is even more difficult to design a game framework that allows an instructor to create customized game variants supporting multiple LOs within the same field. This paper proposes a refactoring methodology to apply the theoretical principles from well-established design frameworks to a pre-existing serious game. The expected result is a generalized game that can be quickly customized to teach LOs not originally targeted by the game. This methodology begins by describing the general components in a game, then uses a combination of two SG design frameworks to extract the teaching elements present in the game. The identified teaching elements are then used as the theoretical basis to determine the range of LOs that can be taught by the game. This paper evaluates the proposed methodology by presenting a case study of refactoring the serious game Battlespace Next (BSN) to teach joint military capabilities. The range of LOs that can be taught by the generalized BSN are identified, and examples of creating custom LOs are given. Survey results from users of the generalized game are also provided. Lastly, the expected impact of this work is discussed and a road map for future work and evaluation is presented.

Keywords: serious games, learning objectives, game design, learning theory, game framework

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Authors: Verd Shomrom, Gilat Trabelsi

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The goal of the study was to examine the effects of Computerized Cognitive Training (CCT) with and without cognitive mediation on Executive Function (EF) (planning and self- regulation) and on psychological resiliency among adolescents with Attention Deficits Hyperactive Disorder (ADHD) with or without Learning Disabilities (LD). Adolescents diagnosed with Attention Deficit Disorder and / or Learning Disabilities have multidimensional impairments that result from neurological damage. This work explored the possibility of influencing cognitive aspects in the field of Executive Functions (specifically: patterns of planning and self-regulation) among adolescents with a diagnosis of Attention Deficit Disorder and / or Learning Disabilities who study for a 10-12 grades. 46 adolescents with ADHD and/or with LD were randomly applied to experimental and control groups. All the participants were tested (BRC- research version, Resiliency quaternaries) before and after the intervention: mediated/ non-mediated Computerized Cognitive Training (MINDRI). The results indicated significant effects of cognitive modification in the experimental group, between pre and post Phases, in comparison to control group, especially in self- regulation (BRC- research version, Resiliency quaternaries), and on process analysis of Computerized Cognitive Training (MINDRI). The main conclusion was that even short- term mediation synchronized with CCT could greatly enhance the performance of executive functions demands. Theoretical implications for the positive effects of MLE in combination with CCT indicate the ability for cognitive change. The practical implication is the awareness and understanding of efficient intervention processes to enhance EF, learning awareness, resiliency and self-esteem of adolescents in their academic and daily routine.

Keywords: attention deficits hyperactive disorder, computerized cognitive training, executive function, mediated learning experience, learning disabilities

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Authors: Mariam Anwaar, Kiran B. Ahmad

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Borderline Personality Disorder (BPD) is an invasive presence of affect instability, disturbance in self-concept and attachment in relationships. The profound indicator is the dichotomous approach of the world in which the ego categorizes individuals, especially their significant others, into secure or threatful beings, leaving little room for a complex combination of characteristics in one person. This defense mechanism of splitting their world has been described through the explanatory model of unconscious conflict theorized by Sigmund Freud’s Electra Complex in the Phallic Stage. The central role is of the father with whom the daughter experiences penis envy, thus identifying with the mother’s characteristics to receive the father’s attention. However, Margret Mahler, an object relation theorist, elucidates the central role of the mother and that the split occurs during the pre-Electra complex stage. Amid the 14 and 24 months of the infant, it acknowledges the world away from the mother as they have developed milestones such as crawling. In such novelty, the infant crawls away from the mother creating a sense of independence (individuation). On the other hand, being distant causes anxiety, making them return to their original object of security (separation). In BPD, the separation-individuation stage is disrupted, due to contradictory actions of the caregiver, which results in splitting the object into negative and positive aspects, repressing the former and adhering to the latter for survival. Thus, with time, the ego distorts the reality into dichotomous categories, using the splitting defenses, and the mental representation of the self is distorted due to the internalization of the negative objects. The explanatory model was recognized in the case study of Fizza, at 21-year-old Pakistani female, residing in Karachi. Her marital status is single with an occupation being a dental student. Fizza lives in a nuclear family but is surrounded by her extended family as they all are in close vicinity. She came with the complaints of depressive symptoms for two-years along with self-harm due to severe family conflicts. Through the intervention of Dialectical Behavior Therapy (DBT), the self-harming actions were reduced, however, this libidinal energy transformed into claustrophobic symptoms and, along with this, Fizza has always experienced vivid dreams. A retrospective method of Jungian dream-analysis was applied to locate the origins of the splitting in the unconscious. The result was the revelation of a sexual harassment trauma at the age of six-years which was displaced in the form of self-harm. In addition to this, the presence of a conflict at the separation-individuation stage was detected during the dream-analysis, and it was the underlying explanation of the claustrophobic symptoms. This qualitative case study implicates the use of a patient’s subjective experiences, such as dreams, to journey through the spiral of the unconscious in order to not only detect repressed memories but to use them in psychotherapy as a means of healing the patient.

Keywords: borderline personality disorder, dream-analysis, Electra complex, separation-individuation, splitting, unconscious

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Authors: Mohadeseh Shojaei Shahrokhabadi, Ding-Geng (Din) Chen

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Positive continuous outcomes with a substantial number of zero values and incomplete longitudinal follow-up are quite common in medical cost data. To jointly model semi-continuous longitudinal cost data and survival data and to provide marginalized covariate effect estimates, a marginalized two-part joint model (MTJM) has been developed for outcome variables with lognormal distributions. In this paper, we propose MTJM models for outcome variables from a generalized gamma (GG) family of distributions. The GG distribution constitutes a general family that includes approximately all of the most frequently used distributions like the Gamma, Exponential, Weibull, and Log Normal. In the proposed MTJM-GG model, the conditional mean from a conventional two-part model with a three-parameter GG distribution is parameterized to provide the marginal interpretation for regression coefficients. In addition, MTJM-gamma and MTJM-Weibull are developed as special cases of MTJM-GG. To illustrate the applicability of the MTJM-GG, we applied the model to a set of real electronic health record data recently collected in Iran, and we provided SAS code for application. The simulation results showed that when the outcome distribution is unknown or misspecified, which is usually the case in real data sets, the MTJM-GG consistently outperforms other models. The GG family of distribution facilitates estimating a model with improved fit over the MTJM-gamma, standard Weibull, or Log-Normal distributions.

Keywords: marginalized two-part model, zero-inflated, right-skewed, semi-continuous, generalized gamma

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Authors: Zachary Smith, Riette Bloomfield, Taylor Dukate, Joshua Halterman, Noah Phillips

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College students have stressful lives, classes, work, and home life; it all adds up to anxiety and stress. Most students can manage the stress, but some can’t and need help. Mental health issues are on the rise among college-age students, which could lead to other health issues, depression, or even suicidal thoughts. There needs to be an outlet for these students, and one suggestion is participating in sports or exercise/recreation activities. “Strong body, strong mind” is a concept that has been researched for many decades now. While that has been preached, depression and anxiety have still been at an all-time high in college students within the last five years. College students are expected to stay on top of their academic coursework, obtain and keep relationships, adjust to living independently, and economic strain. As p oor mental health becomes inherent, struggles academically, dropping out of school, becoming involved in immoral situations, or as far as committing suicide, can be seen shortly after. This research proposal examines the positive impact of sports on students' mental health in post-secondary education programs. The study aims to investigate how participation in college sports can alleviate stress, anxiety, and depression, improve mood and focus, and contribute to better academic performance. With the increasing prevalence of mental health issues among college students and the growing emphasis on mental health awareness, this research is significant for understanding and managing collegiate sports programs. Overall, sports help with mental and physical health for all ages.

Keywords: mental health, sports, college students, recreation programs

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Authors: J. O. Alvarez, L. Y. Rivera

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Physical activity can reduce symptomatology in children with autism spectrum disorder (ASD). The sport of soccer has been widely applied as a therapeutic method for ASD children. However, empirical results from soccer programs are not widely known. This paper presents the case study of Golitos, the only dedicated soccer program for children on the island of Puerto Rico, and analyzes its results in the reduction of ASD social and emotional symptoms. The paper shows evidence that suggests that program approach, content, and community-based elements can make a notable difference in the effectiveness of using soccer or sports as therapeutic methods for children with ASD.

Keywords: autism, soccer, program, community

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Authors: Tatjana Stefanovic Stanojevic, Milica Tosic Radev, Aleksandra Bogdanovic

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Depression is considered to be a leading cause of death and disability in the female population, and that is the reason why understanding the dynamics of the onset of depressive symptomatology is important. A review of the literature indicates the relationship between depressive symptoms and insecure attachment patterns, but very few studies have examined the mechanism underlying this relation. The aim of the study was to examine the pathway from the preoccupied attachment pattern to depressive symptomatology, as well as to test the mediation effect of mentalization, social anxiety and rumination in this relationship using a serial mediation model. The research was carried out on a geographical cluster sample from the general population of Serbia included within the project ‘Indicators and models of family and work roles harmonization’ funded by the Ministry of Education, Science and Technological Development of the Republic of Serbia. This research was carried out on a subsample of 791 working-age female adults from 37 urban and rural locations distributed through 20 administrative districts of Serbia. The respondents filled in a battery of instruments, including Relationship Questionnaire - Clinical Version (RQ - CV), The Mentalization Scale (MentS), Scale of Social Anxiety (SA), Patient Ruminative Thought Style Questionnaire (RTSQ), Health Questionnaire (PHQ-9). The results confirm our assumption that the total indirect effect of the preoccupied attachment pattern to depressive symptoms is significant across all mediators separately. More importantly, this effect is still present in a model with a sequential mediator relationship, where social anxiety, rumination, and mentalization were perceived as serial mediators of a relationship between preoccupied attachment and depressive symptoms (estimated indirect effect=0.004, boot-strapped 95% CI=0.002 to 0.007). Our findings suggest that there is a significant specific indirect effect of the preoccupied attachment pattern to depressive symptoms, occurring through mentalization, social anxiety and rumination, indicating that preoccupied attachment cause decrease of a self related mentalization, which in turn causes increasing of social anxiety and rumination, concluding in depressive symptoms as a final consequence. The finding that the path from the preoccupied attachment pattern to depressive symptoms is typical in women is understandable from the perspective of both evolutionary and culturally conditioned gender differences. The practical implications of the study are reflected in the recommendations for the prevention and forehand psychotherapy response among preoccupied women with depressive symptomatology. Treatment of this specific group of depressed patients should be focused on strengthening mentalization, learning to accept and to understand herself better, reducing anxiety in situations where mistakes are visible to others, and replacing the rumination strategy with more constructive coping strategies.

Keywords: preoccupied attachment, depression, serial mediation model, mentalization, rumination

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Authors: M. M. Essa, S. Subash, M. Akbar, S. Al-Adawi, A. Al-Asmi, G. J. Guillemein

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Objective: Transgenic (tg) mice which contain an amyloid precursor protein (APP) gene mutation, develop extracellular amyloid beta (Aβ) deposition in the brain, and severe memory and behavioural deficits with age. These mice serve as an important animal model for testing the efficacy of novel drug candidates for the treatment and management of symptoms of Alzheimer's disease (AD). Several reports have suggested that oxidative stress is the underlying cause of Aβ neurotoxicity in AD. Pomegranates contain very high levels of antioxidants and several medicinal properties that may be useful for improving the quality of life in AD patients. In this study, we investigated the effect of dietary supplementation of Omani pomegranate extract on the memory, anxiety and learning skills along with inflammation in an AD mouse model containing the double Swedish APP mutation (APPsw/Tg2576). Methods: The experimental groups of APP-transgenic mice from the age of 4 months were fed custom-mix diets (pellets) containing 4% pomegranate. We assessed spatial memory and learning ability, psychomotor coordination, and anxiety-related behavior in Tg and wild-type mice at the age of 4-5 months and 18-19 months using the Morris water maze test, rota rod test, elevated plus maze test, and open field test. Further, inflammatory parameters also analysed. Results: APPsw/Tg2576 mice that were fed a standard chow diet without pomegranates showed significant memory deficits, increased anxiety-related behavior, and severe impairment in spatial learning ability, position discrimination learning ability and motor coordination along with increased inflammation compared to the wild type mice on the same diet, at the age of 18-19 months In contrast, APPsw/Tg2576 mice that were fed a diet containing 4% pomegranates showed a significant improvements in memory, learning, locomotor function, and anxiety with reduced inflammatory markers compared to APPsw/Tg2576 mice fed the standard chow diet. Conclusion: Our results suggest that dietary supplementation with pomegranates may slow the progression of cognitive and behavioural impairments in AD. The exact mechanism is still unclear and further extensive research needed.

Keywords: Alzheimer's disease, pomegranates, oman, cognitive decline, memory loss, anxiety, inflammation

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Authors: Shima Hashemi, Firoozeh Ghazanfari

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Introduction: Eating disorder is a psychiatric disorder that is increasingly growing. This study aimed to determine the relationship between eating disorders (anorexia and bulimia nervosa) with some of the demographic factors among Lorestan University of Medical Sciences students. Materials and Methods: This study is a cross-sectional and descriptive study that was done at Lorestan University of Medical Sciences in 2019. Four hundred fifty students were studied by stratified and cluster sampling methods. For gathering data, we use the standard questionnaire Eating Attitudes Test EAT (26). Data were analyzed using statistical software SPSS. Results: According to the results, 144 (32%) males and 305 (67.8%) females were studied. 88.7% were single, and 8.9% were married. In the anorexia nervosa group, the results showed that there was a significant meaning between demographic information, and the number of family members, marital status, BMI, level of education, family income, father and mother education, as well as in the bulimia nervosa group, there was no significant meaning with any demographic information (p>0.05). Conclusion: Anorexia and bulimia nervosa are two known types of eating disorders, and some demographic factors can be effective in causing or aggravating these disorders.

Keywords: eating disorder, anorexia nervosa, bulimia nervosa, students

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Authors: Stephanie Newman

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Niemann-Pick Type C disease is a rare, usually fatal lysosomal storage disorder. Although clinically characterized by progressive neurodegeneration, there is also evidence of altered innate immune responses such as neuroinflammation that promote disease progression. We have initiated an investigation into whether phagocytosis, an important innate immune activity and the process by which particles are ingested is defective in NPC. Using an in vitro assay, we have shown that NPC macrophages have a deficiency in the phagocytosis of different particles. We plan to investigate the mechanistic basis for impaired phagocytosis, the contribution that this deficiency makes to disease pathology, and whether therapies that have shown in vivo benefit are able to restore phagocytic activity.

Keywords: Niemann Pick Disease C, phagocytosis, innate immunity, lysosomal storage disorder

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Authors: P. Srisuruk, P. Narot

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The purpose of this research were 1) to develop the curriculum and instructional approach that are suitable for children with autism, attention deficit hyperactivity disorder and learning disability as well as to arrange the instructional approach that can be integrated into inclusive classroom 2) to increase the competency of the children in these group. The research processes were to a) study related documents, b) arrange workshops to clarify fundamental issues in developing core curriculum among the researchers and experts in curriculum development, c) arrange workshops to develop the curriculum, submit it to the experts for criticism and editing, d) implement the instructional approach to examine its effectiveness, e) select the schools to participate in the project and arrange training programs for teachers in the selected school, f) implement the instruction approach in the selected schools in different regions. The research results were 1) the core curriculum to enhance the competency of children with autism, attention deficit hyperactivity disorder and learning disability , and to be used as a guideline for teachers, and these group of children in order to arrange classrooms for students with special needs to study with normal students, 2) teaching and learning methods arranged for students with autism, attention deficit, hyperactivity disorder and learning disability to study with normal students can be used as a framework for writing plans to help students with parallel problems by developing teaching materials as part of the instructional approach. However, the details of how to help the students in each skill or content differ according to the demand of development as well as the problems of individual students or group of students. Furthermore; it was found that most of target teacher could implement the instructional approach based on the guideline model developed by the research team. School in each region does not have much difference in their implementation. The good point of the developed instructional model is that teacher can construct a parallel lesson plan. So teacher did not fell that they have to do extra work it was also shown that students in regular classroom enjoyed studying with the developed instructional model as well.

Keywords: instructional approach, autism, attention deficit hyperactivity disorder, learning disability

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Authors: Tarul Garg, P. N. Agrawal

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We propose to define the q-analogue of the α-Bernstein Kantorovich operators and then introduce the q-bivariate generalization of these operators to study the approximation of functions of two variables. We obtain the rate of convergence of these bivariate operators by means of the total modulus of continuity, partial modulus of continuity and the Peetre’s K-functional for continuous functions. Further, in order to study the approximation of functions of two variables in a space bigger than the space of continuous functions, i.e. Bögel space; the GBS (Generalized Boolean Sum) of the q-bivariate operators is considered and degree of approximation is discussed for the Bögel continuous and Bögel differentiable functions with the aid of the Lipschitz class and the mixed modulus of smoothness.

Keywords: Bögel continuous, Bögel differentiable, generalized Boolean sum, K-functional, mixed modulus of smoothness

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Authors: Maria Klitgaard Christensen, Carmen Lim, Sukanta Saha, Danielle Cannon, Finley Prentis, Oleguer Plana-Ripoll, Natalie Momen, Kim Moesgaard Iburg, John J. McGrath

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Introduction: About a third of the world’s population will develop a mental disorder over their lifetime. Having a mental disorder is a huge burden in health loss and cost for the individual, but also for society because of treatment cost, production loss and caregivers’ cost. The objective of this study is to synthesize the international published literature on the economic burden of mental disorders. Methods: Systematic literature searches were conducted in the databases PubMed, Embase, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to 1980 until May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses, (2) diagnosis of at least one mental disorder, (3) samples based on the general population, and (4) outcome in monetary units. 13,640 publications were screened by their title/abstract and 439 articles were full-text screened by at least two independent reviewers. 112 articles were included from the systematic searches and 31 articles from snowball searching, giving a total of 143 included articles. Results: Information about diagnosis, diagnostic criteria, sample size, age, sex, data sources, study perspective, study period, costing approach, cost categories, discount rate and production loss method and cost unit was extracted. The vast majority of the included studies were from Western countries and only a few from Africa and South America. The disorder group most often investigated was mood disorders, followed by schizophrenia and neurotic disorders. The disorder group least examined was intellectual disabilities, followed by eating disorders. The preliminary results show a substantial variety in the used perspective, methodology, costs components and outcomes in the included studies. An online tool is under development enabling the reader to explore the published information on costs by type of mental disorder, subgroups, country, methodology, and study quality. Discussion: This is the first systematic review synthesizing the economic cost of mental disorders worldwide. The paper will provide an important and comprehensive overview over the economic burden of mental disorders, and the output from this review will inform policymaking.

Keywords: cost-of-illness, health economics, mental disorders, systematic review

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Authors: Sonia Pajaron, Flaviano Sentina, Ranulfo Etulle

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Learning a second language calls for a total commitment from the learner whose response is necessary to successfully send and receive linguistic messages. It is relevant to virtually every aspect of human behaviour which is even more challenging when the components on -affective domains- are involved in second language learning. This study investigated the association between the identified affective attributes and second language performance of the one hundred seventeen (117) randomly selected third year maritime students. A descriptive-correlational method was utilized to generate data on their affective attributes while composition writing (2 series) and IELTS-based interview was done for speaking test. Additionally, to establish the respondents’ English language profile, data on their high school grades (GPA), entrance exam results in English subject (written) as well as in the interview was extracted as baseline information. Data were subjected to various statistical treatment (average means, percentages and pearson-r moment coefficient correlation) and found out that, Nautical Science and Marine Engineering students were found to have average high school grade, entrance test results, both written and in the interview turned out to be very satisfactory at 50% passing percentage. Varied results were manifested in their affective attributes towards learning the second language. On attitude, nautical science students had true positive attitude while marine engineering had only a moderate positive one. Secondly, the former were positively motivated to learn English while the latter were just moderately motivated. As regards anxiety, both groups embodied a moderate level of anxiety in the English language. Finally, data showed that nautical science students exuded real confidence while the marine engineering group had only moderate confidence with the second language. Respondents’ English academic achievement (GWA) was significantly correlated with confidence and speaking with anxiety towards the second language among the students from the nautical science group with moderate positive and low negative degree of correlation, respectively. On the other hand, the marine engineering students’ speaking test result was significantly correlated with anxiety and self-confidence with a moderate negative and low positive degree of correlation, respectively while writing was significantly correlated with motivation bearing a low positive degree of correlation.

Keywords: affective attributes, second language, second language performance, anxiety, attitude, self-confidence and motivation

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Authors: Luo Lan, Huang Jingjing, Li Huafang

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Hypoactive sexual desire disorder (HSDD) was common in China, and Chinese women's sexual health-seeking behaviors were found to be mainly impeded by their psychological barriers. However, underlying mechanisms for such unhealthy sexual health attitudes and symptoms of HSDD were unknown. Many studies suggested the correlation between women's psychological barriers, HSDD and attachment style but had limitations, so this study further explored their relationship. Chinese women of childbearing age were recruited from May 2020 to December 2022 in Shanghai, China. The Revised Adult Attachment Scale (RAAS), the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO), a sexual health attitude questionnaire, and a psychiatric interview were administered. The analytic sample contained 279 women, of which 107 women were HSDD patients. Women with a fearful attachment style were found to be more likely to be unwilling to communicate sexual health (aOR 2.55, 95%CI 1.05-6.28) and feel ashamed of sexual health-related disorders (aOR 2.66, 95%CI 1.14-6.13). They are also linked with a higher risk of HSDD (aOR 3.25, 95%CI 1.35-8.12). Therefore, fearful attachment style should be given enough attention in the whole process of the diagnosis and treatment of HSDD and should be one of the focuses that guide sexual education.

Keywords: attachment style, hypoactive sexual desire disorder, attitude to health, sexual desire, sexual distress

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Authors: Masaki Yamaguchi, Daimei Sasayama, Shinsuke Washizuka

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The goal of this study was to examine the possibility of salivary cytokines for the screening of attention deficit hyperactivity disorder (ADHD) in children. We carried out a case-control study, including 19 children with ADHD and 17 healthy children (controls). A multiplex bead array immunoassay was used to conduct a multi-analysis of 27 different salivary cytokines. Six salivary cytokines (interleukin (IL)-1β, IL-8, IL12p70, granulocyte colony-stimulating factor (G-CSF), interferon gamma (IFN-γ), and vascular endothelial growth factor (VEGF)) were significantly associated with the presence of ADHD (p < 0.05). An informative salivary cytokine panel was developed using VEGF by logistic regression analysis (odds ratio: 0.251). Receiver operating characteristic analysis revealed that assessment of a panel using VEGF showed “good” capability for discriminating between ADHD patients and controls (area under the curve: 0.778). ADHD has been hypothesized to be associated with reduced cerebral blood flow in the frontal cortex, due to reduced VEGF levels. Our study highlights the possibility of utilizing differential salivary cytokine levels for point-of-care testing (POCT) of biomarkers in children with ADHD.

Keywords: cytokine, saliva, attention deficit hyperactivity disorder, child

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Authors: M. R. Bhuiyan, S. M. M. Hossain, M. Z. Islam

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Autism Spectrum Disorder (ASD) is the fastest growing serious developmental disorder characterized by social deficits, communicative difficulties, and repetitive behaviors. ASD is an emerging public health issue globally which is associated with huge financial burden to the family, community and the nation. The aim of this study was to assess the financial burden of family for the children with Autism spectrum Disorder. This cross-sectional study was carried out from July 2015 to June 2016 among 154 children with ASD to assess the financial burden of family. Data were collected by face-to-face interview with semi-structured questionnaire following systematic random sampling technique. Majority (73.4%) children were male and mean (±SD) age was 6.66 ± 2.97 years. Most (88.8%) of the children were from urban areas with average monthly family income Tk. 41785.71±23936.45. Average monthly direct cost of the children was Tk.17656.49 ± 9984.35, while indirect cost was Tk. 13462.90 ± 9713.54 and total treatment cost was Tk. 23076.62 ± 15341.09. Special education cost (Tk. 4871.00), cost of therapy (Tk. 4124.07) and travel cost (Tk. 3988.31) were the major types of direct cost, while loss of income (Tk.14570.18) was the chief indirect cost incurred by the families. The study found that majority (59.8%) of the children attended special schools were incurred Tk.20001-78700 as total treatment cost, which were statistically significant (p<0.001). Again, families with higher monthly family income incurred higher treatment cost (r=0.526, p<0.05). Difference between mean direct and indirect cost was found significant (t=4.190, df=61, p<0.001). According to the analysis of variance, mean difference of father’s educational status among direct cost (F=10.337, p<0.001) and total treatment cost (F=7.841, p<0.001), which were statistically significant. The study revealed that maximum children with ASD were under five years, three-fourth were male. According to monthly family income, maximum family were in middle class. The study recommends cost effective interventions and financial safety-net measures to reduce the financial burden of families for the children with ASD.

Keywords: autism spectrum disorder, financial burden, direct cost, indirect cost, special education

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Authors: Horesh Reinman Netta

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Early research on child sexual abuse (CSA) attempted to assess its possible effects. Researchers found that victims of CSA are prone to a host of emotional disorders, including post-traumatic stress disorder, depression, dissociative disorders, anxiety disorders and suicidality later in life. The study examined the development of symptoms over a two-year period at base line and after six months. Factors including the age at the onset of abuse, the gender of the abused child and academic achievements were also examined. Other variables examined include the complex association among self-disclosure, self-esteem, the child’s attachment and coping styles, and psychological adjustment. The abused child’s domestic environment has been found to have a relevant impact on the psychological outcomes of CSA. The study examined inter-parental conflicts, cohesion in the child’s home, parental attachment styles and psychopathology. To the best of our knowledge, no investigation of this nature has yet been performed. Hence, the study makes a major contribution to research in this field. In addition, a combined examination of abuse characteristics, child characteristics, domestic environment and therapeutic history will facilitate enhanced understanding of the interactions among CSA, mediating factors and psychological outcomes.

Keywords: sexual abuse, follow up, victimization, children

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Authors: Saeed Dehnavi, Ismail Asadallahi, Fatemeh Rahmatian, Elahe Rahimian

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Purpose: Due to an increasing prevalence of over eating disorders, this paper aims to investigate the effectiveness of short-term group cognitive-behavioral therapy on reducing binge eating behavior and depression symptoms among females suffered from binge eating disorder (BED) in Qazvin, Iran. Methodology: This is aquasi-experimental study (pre-post testing plan with control group). Using a convenience sampling technique, binge eating scale (BES) and clinical interviews, 30 persons were selected among all clients who had referred to weight loss centers in Qazvin, these persons were randomly placed into two control and experimental groups. The experimental group participated in a seven-session plan on short-term cognitive-behavioral group therapy. Results: The results showed that the short term group cognitive-behavioral therapy results in a significant reduction in binge eating signs and depressive symptoms within the experimental group, compared to the control. Conclusion: Regarding the results, it is known that short-term group cognitive-behavioral therapy is effective in reducing overeating symptoms. Hence, it can be used as an economical and effective treatment method for individuals suffering from BED.

Keywords: cognitive-behavioral group therapy, binge eating disorder, depression

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Authors: Caroline Kim

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The designation autism spectrum disorder (ASD) groups complex disorders in the development of the brain. Autism is defined essentially as a condition in which an individual lacks a theory of mind. The theory of mind, in this sense, explains the ability of an individual to attribute feelings, emotions, or thoughts to another person. An autistic patient is characteristically unable to determine what an interlocutor is feeling, or to understand the beliefs of others. However, it is possible that autism cannot plausibly characterized as the lack of theory of mind in an individual. Genes, the bran, and its interplay with environmental factors may also cause autism. A mutation in a gene may be hereditary, or instigated by diseases such as mumps. Though an autistic patient may experience abnormalities in the cerebellum and the cortical regions, these are in fact only possible theories as to a biochemical explanation behind the disability. The prevailing theory identifying autism with lacking the theory of mind is supported by behavioral observation, but this form of observation is itself determined by socially constructed standards, limiting the possibility for empirical verification. The theory of mind infers that the beliefs and emotions of people are causally based on their behavior. This paper demonstrates the fallacy of this inference, critiquing its basis in socially constructed values, and arguing instead for a biochemical approach free from the conceptual apparatus of language and social expectation.

Keywords: autism spectrum disorder, sociology of psychology, social construction, the theory of mind

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Authors: Haolin Li, Eric Bair, Jane Monaco, Quefeng Li

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The temporomandibular disorder (TMD) is a series of musculoskeletal disorders ranging from jaw pain to chronic debilitating pain, and the risk factors for the onset and maintenance of TMD are still unclear. Prior researches have shown that the potential risk factors for chronic TMD are related to psychosocial factors, autonomic functions, and pain sensitivity. Using data from the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study’s baseline case-control study, we examine whether the risk factors identified by prior researches are still statistically significant after taking all of the risk measures into account in one single model, and we also compare the relative influences of the risk factors in three different perspectives (psychosocial factors, autonomic functions, and pain sensitivity) on the chronic TMD. The statistical analysis is conducted by using ridge logistic regression and bootstrapping, in which the performance of the algorithms has been assessed using extensive simulation studies. The results support most of the findings of prior researches that there are many psychosocial and pain sensitivity measures that have significant associations with chronic TMD. However, it is surprising that most of the risk factors of autonomic functions have not presented significant associations with chronic TMD, as described by a prior research.

Keywords: autonomic function, OPPERA study, pain sensitivity, psychosocial measures, temporomandibular disorder

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Authors: Alireza Monzavi Chaleshtari, Maryam Aliakbari

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Objective: The aim of this study was to investigate the prediction of child attachment style based on a positive and safe combination parenting method mediated by maternal attachment styles in children with attention deficit hyperactivity disorder. Method: The design of the present study was descriptive of correlation and structural equations and applied in terms of purpose. The population of this study includes all children with attention deficit hyperactivity disorder living in Chaharmahal and Bakhtiari province and their mothers. The sample size of the above study includes 165children with attention deficit hyperactivity disorder in Chaharmahal and Bakhtiari province with their mothers, who were selected by purposive sampling method based on the inclusion criteria. The obtained data were analyzed in two sections of descriptive and inferential statistics. In the descriptive statistics section, statistical indices of mean, standard deviation, frequency distribution table and graph were used. In the inferential section, according to the nature of the hypotheses and objectives of the research, the data were analyzed using Pearson correlation coefficient tests, Bootstrap test and structural equation model. findings:The results of structural equation modeling showed that the research models fit and showed a positive and safe combination parenting style mediated by the mother attachment style has an indirect effect on the child attachment style. Also, a positive and safe combined parenting style has a direct relationship with child attachment style, and She has a mother attachment style. Conclusion:The results and findings of the present study show that there is a significant relationship between positive and safe combination parenting methods and attachment styles of children with attention deficit hyperactivity disorder with maternal attachment style mediation. Therefore, it can be expected that parents using a positive and safe combination232 parenting method can effectively lead to secure attachment in children with attention deficit hyperactivity disorder.

Keywords: child attachment style, positive and safe parenting, maternal attachment style, ADHD

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Authors: Wenqiu Cao

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Suicide prevention is a global problem that needs to be taken seriously. Investigating the mechanisms of suicide in major depressive disorder (MDD) separately through neuroimaging technology is essential for effective suicide prevention. And it’s particularly urgent in geriatric depressive patients since older adults are more likely to use rapidly deadly means, and suicidal behavior is more lethal for older adults. The current study reviews five studies related to suicide in geriatric MDD that uses neuroimaging methodology in order to analyze the relevant neurobiological mechanisms. The majority of the studies found significant white matter and grey matter reduction or lesion widespread in multiple brain regions, including the frontal and parietal regions, the midbrain, the external capsule, and the cerebellum. Regarding the cognitive impairment in geriatric MDD, the reward signals were found weakened in the paralimbic cortex. The functional magnetic resonance imaging (fMRI) studies also found hemodynamic changes in the right dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC), and right frontopolar cortex (FPC) regions in late-life MDD patients with suicidal ideation. Future studies should consider the age of depression onset, more accurate measurements of suicide, larger sample size, and longitudinal design.

Keywords: brain imaging, geriatric major depressive disorder, suicidality, suicide

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Authors: Sandra D. Prewitt

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Introduction—The purpose of the extant study was to explore the relationship between religiosity and suicidal ideation. Through this exploration, further knowledge was sought relevant to gaining a better understanding regarding the higher suicide rate continuing to be experienced by young adults. Endeavoring to discover why the suicide rate continues to increase for the subject population, depression and anxiety emerged as major contributory risk factors. Although religiosity has been shown to be related to the reduced risk of suicidal behavior, the curative value of religion relevant to suicide prevention and treatment has not been sufficiently recognized. Considering the enormity of the current suicide problem, pursuits relevant to discovering effective tools enabling impactful prevention and treatment strategies remain essential to reducing suicide deaths. Methodology—The subject study was conducted utilizing a systematic literature review (SLR) which required the researcher to perform searches of appropriate databases, toward the goal of acquiring advanced knowledge based upon existing studies relevant to the subject matter under consideration. Major Findings—Depression and anxiety have been identified as two potential pathways leading to increased suicidal behavior. On the contrary, religiosity emerged as an important protective factor associated with less depression and therefore, fewer instances of suicidal thoughts. The protective nature of religion has been shown to extend to young adults without regard to the presence of identified potential suicidal behavior pathways.

Keywords: anxiety, depression, religion, suicide

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