Search results for: bipolar II disorder

Authors: P. H. G. J. Pushpakumara, A. M. P. Adikari, S. U. B. Tennakoon, Ranil Abeysinghe, Andrew Dawson

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Introduction: Deliberate Self-harm (DSH) is a global public health problem. Since 1950, suicide rates in Sri Lanka are among the highest national rates in the world. It has become an increasingly common response to emotional distress in young adults. However, it remains unclear the reason for this occurrence. Objectives: The descriptive component of this study was conducted to identify of epidemiological pattern of DSH and suicide in Kurunegala District (KD). Assessment of association between DSH socio-cultural, economical and psychological factors were the objectives of the case control component. Methods: Prospective data collection of DSH and suicide was conducted at all (46) hospitals and all (28) police stations in the KD for thirty six months, from 1st January 2011, as the descriptive component. Case control component was conducted at T.H. Kurunegala (THK) for eighteen months duration, from 1st July 2011. Cases (n=439) were randomly selected from a block of 7 consecutively admitted consenting DSP patients using a computer program. Age, sex and residential divisional secretariat division one to one matched, individuals were randomly selected as controls from patients presented to Out Patient Department. Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders was used to diagnose psychiatric disorders. Validated tools were used to measure other constructs. Results: Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011- 2013 (Male:female ratio 5.7, 4.4 and 6.4). 60% of suicides were due to poisoning. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population in 2011- 2013. Highest age standardized male DSP incidence reported in 20-24 years (769.6/100,000) and female in 15-19 years (1304.0/100,000). Bing married (age >25 years), monthly family income less than Rs.30,000, not achieving G.C.E (O/L) qualifications, a school drop-out, not in a permanent position in occupation, being a manual and an own account worker, were significantly associated with DSP. Perceiving the quality of relationship as bad or very bad with parents, spouse/ girlfriend/ boyfriend and sibling as associated with 8, 40 and 10.5 times higher risk respectively. Feeling and experiences of neglect, other emotional abuses, feeling of insecurity with the family, in child hood, and having a contact history carried an excess risk for DSP. Cases were less likely to seek help. Further, they had significantly lower scores for life skills and life skills application ability. 25.6% DSH patients had DSM TR axis-I and/or TR axis-II disorder. The presence of psychiatric disorder carried 7.7 (95% CI 4.3 – 13.8) times higher risk for DSP. Conclusion: In general, pattern of DSH and suicide is, unique, different from developed, upper and middle income and lower and middle income countries. It is a learned way of expressing emotions in difficult situations of vulnerable people.

Keywords: deliberate self-harm, help-seeking, life-skills, mental- health, psychological, social, suicide

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Authors: Rana Zeina

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Cognitive and behavioral symptoms may, in fact, overlap and be related to the level of the general cognitive function. We measured the behavioral aspects of autism and its correlation to the cognitive ability in 30 children with ASD. We used a neuropsychological battery CANTAB eclipse to evaluate the ASD children's cognitive ability. Individuals with ASDs and challenging behaviors showed significant correlation between some cognitive abilities and motor behavior aspects. Based on these findings we can conclude that the motor behavioral problems in autism affect specific cognitive abilities in ASDs such as comprehension, learning, reversal, acquisition, attention set shifting, and speed of reaction to one stimulus. Future research should also focus on the relationship between motor stereotypes and other subtypes of repetitive behaviors, such as verbal stereotypes, and ritual and routine adherence and use different types of CANTAB tests.

Keywords: cognitive ability, CANTAB test, behaviour motor aspects, autism spectrum disorders

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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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Authors: Mohammad Javad Esmaeili

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Background: Coagulopathy is one of the complications with end stage renal disease with high prevalence in the world. Thromboelastogram is adynamic test for evaluation of coagulopathy and we have compared our patient's coagulation profiles with the results of TEG. Material and methods: In this study 50 patients with ESRD who were on regular hemodialysis for at least 6 months was selected with simple sampling and their coagulation profile was done with blood sampling and also TEG was done for every patient. Data were analyzed with SPSS and P<0.05 consider significant. Results: Protein s, Protein c and Antithrombin III deficiency was detected in 32%, 16% and 20% of patients and activated protein c resistance was abnormal in 2% of patients. In TEG, R time in 49% and K in 22/5% of patients was lower than normal and a-angle in 26% and maximum amplitude in 36% of patients was upper than normal (Hypercoagulable state). PS with R and ATIII with K have correlation. Conclusion: R time and K in TEG can be a suitable screening test in patients with suspicious to PS and ATIII deficiency.

Keywords: thromboelastography, chronic kidney disease, Coagulating disorder, hemodialysis

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Authors: Ayse Gul Bilen

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Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed antidepressants that are used clinically for the treatment of anxiety disorders, obsessive-compulsive disorder (OCD), panic disorders and eating disorders. The first SSRI, fluoxetine (sold under the brand names Prozac and Sarafem among others), had an adverse effect profile better than any other available antidepressant when it was introduced because of its selectivity for serotonin receptors. They have been considered almost free of side effects and have become widely prescribed, however questions about the safety and tolerability of SSRIs have emerged with their continued use. Most SSRI side effects are dose-related and can be attributed to serotonergic effects such as nausea. Continuous use might trigger adverse effects such as hyponatremia, tremor, nausea, weight gain, sleep disturbance and sexual dysfunction. Moderate toxicity can be safely observed in the hospital for 24 hours, and mild cases can be safely discharged (if asymptomatic) from the emergency department once cleared by Psychiatry in cases of intentional overdose and after 6 to 8 hours of observation. Although fluoxetine is relatively safe in terms of overdose, it might still be cardiotoxic and inhibit platelet secretion, aggregation, and plug formation. There have been reported clinical cases of seizures, cardiac conduction abnormalities, and even fatalities associated with fluoxetine ingestions. While the medical literature strongly suggests that most fluoxetine overdoses are benign, emergency physicians need to remain cognizant that intentional, high-dose fluoxetine ingestions may induce seizures and can even be fatal due to cardiac arrhythmia. Our case is a 35-year old female patient who was sent to ER with symptoms of confusion, amnesia and loss of orientation for time and location after being found wandering in the streets unconsciously by police forces that informed 112. Upon laboratory examination, no pathological symptom was found except sinus tachycardia in the EKG and high levels of aspartate transaminase (AST) and alanine transaminase (ALT). Diffusion MRI and computed tomography (CT) of the brain all looked normal. Upon physical and sexual examination, no signs of abuse or trauma were found. Test results for narcotics, stimulants and alcohol were negative as well. There was a presence of dysrhythmia which required admission to the intensive care unit (ICU). The patient gained back her conscience after 24 hours. It was discovered from her story afterward that she had been using fluoxetine due to post-traumatic stress disorder (PTSD) for 6 months and that she had attempted suicide after taking 3 boxes of fluoxetine due to the loss of a parent. She was then transferred to the psychiatric clinic. Our study aims to highlight the need to consider toxicologic drug use, in particular, the abuse of selective serotonin reuptake inhibitors (SSRIs), which have been widely prescribed due to presumed safety and tolerability, for diagnosis of patients applying to the emergency room (ER).

Keywords: abuse, amnesia, fluoxetine, intoxication, SSRI

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Authors: Khodijah Salimah

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Game Space Program is the program design and development game for therapy the autistic child who had problems with sensory processing and integration. This program is the basic for game space to expand treatment therapy in many areas to help autistic's ability to think through visual perception. This problem can be treated with sensory experience and integration with visual experience to learn how to think and how to learn with visual perception. This perception can be accommodated through an understanding of visual thinking received from sensory exist in game space as virtual healthcare facilities are adjusted based on the sensory needs of children with autism. This paper aims to analyze the potential of virtual visual thinking for treatment autism with the game space program.

Keywords: autism, game space program, sensory, virtual healthcare facilities, visual perception

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Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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The present study was aimed to find out the prevalence of DD's in Visakhapatnam, one of the north coastal districts of Andhra Pradesh, India during a span of five years. A cross-sectional investigation was held at District early intervention center (DEIC), Visakhapatnam from 2016 to 2020. To identify the pattern and trend of different DD's including seasonal variations, a retrospective analysis of the health center's inpatient database for the past 5 years was done. Male and female children aged 2 months-18 years are included in the study with the prior permission of the concerned medical officer. The screening tool developed by the Ministry of health and family welfare, India, was used for the study. Among 26,423 cases, children with birth defects are 962, 2229 with deficiencies, 7516 with diseases, and 15716 with disabilities were admitted during the study period. From birth defects, congenital deafness occurred in large numbers with 22.66%, and neural tube defect observed in a small number of cases with 0.83% during the period. From the side of deficiencies, severe acute malnutrition has mostly occurred (66.80 %) and a small number of children were affected with goiter (1.70%). Among the diseases, dental carriers (67.97%) are mostly found and these cases were at peak during the years 2016 and 2019. From disabilities, children with vision impairment (20.55%) have mostly approached the center. Over the past 5 years, the admission rate of down's syndrome and congenital deafness cases showed a rising trend up to 2019 and then declined. Hearing impairment, motor delay, and learning disorder showed a steep rise and gradual decline trend, whereas severe anemia, vitamin-D deficiency, otitis media, reactive airway disease, and attention deficit hyperactivity disorder showed a declining trend. However, congenital heart diseases, dental caries, and vision impairment admission rates showed a zigzag pattern over the past 5 years. This center had inadequate diagnostic facilities related to genetic disease management. For advanced confirmation, the cases are referred to a district government hospital or private diagnostic laboratories in the city for genetic tests. Information regarding the overall burden and pattern of admissions in the health center is obtained by the review of DEIC records. Through this study, it is observed that the incidence of birth defects, as well as genetic disease burden, is high in the Visakhapatnam district. Hence there is a need for strengthening of management services for these diseases in this region.

Keywords: child health screening, developmental delays, district early intervention center, genetic disease management, infrastructural facility, Visakhapatnam district

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Authors: Surajbhan Sevda

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Metal containing wastewater is generated in large quintiles due to rapid industrialization. Generally, the metal present in wastewater is not biodegradable and can be accumulated in living animals, humans and plant tissue, causing disorder and diseases. The conventional metal recovery methods include chemical, physical and biological methods, but these are chemical and energy intensive. The recent development in microbial fuel cell (MFC) technology provides a new approach for metal recovery; this technology offers a flexible platform for both reduction and oxidation reaction oriented process. The use of MFCs will be a new platform for more efficient and low energy approach for metal recovery from the wastewater. So far metal recover was extensively studied using chemical, physical and biological methods. The MFCs present a new and efficient approach for removing and recovering metals from different wastewater, suggesting the use of different electrode for metal recovery can be a new efficient and effective approach.

Keywords: metal recovery, microbial fuel cell, wastewater, bioelectricity

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Authors: M. Al Azri, M. Elzain, K. Bouziane, S. M. Chérif

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n-Type 6H-SiC(0001) substrates were implanted with three fluencies of Mn+ 5x1015 Mn/cm2 (Mn content: 0.7%), 1x1016 (~2 %), and 5x1016 cm–2 (7%) with implantation energy of 80 keV and substrate temperature of 365ºC. The samples were characterized using Rutherford Backscattering and Channeling Spectroscopy (RBS/C), High-Resolution X-Ray Diffraction technique (HRXRD), micro-Raman Spectroscopy (μRS), and Superconducting Quantum Interference Device (SQUID) techniques. The aim of our work is to investigate implantation induced defects with dose and to study any correlation between disorder-composition and magnetic properties. In addition, ab-initio calculations were used to investigate the structural and magnetic properties of Mn-doped 6H-SiC. Various configurations of Mn sites and vacancy types were considered. The calculations showed that a substitutional Mn atom at Si site possesses larger magnetic moment than Mn atom at C site. A model is introduced to explain the dependence of the magnetic structure on site occupation. The magnetic properties of ferromagnetically (FM) and antiferromagnetically (AFM) coupled pairs of Mn atoms with and without neighboring vacancies have also been explored.

Keywords: ab-initio calculations, diluted magnetic semiconductors, magnetic properties, silicon carbide

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Authors: Swati Arun

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The present paper argues that Balance of Power (BOP) needs to conjugate with certain contingencies like geography. It is evident that sea powers (‘insular’ for better clarity) are not balanced (if at all) in the same way as land powers. Its apparent that artificial insularity that the US has achieved reduces the chances of balancing (constant) and helps it maintain preponderance (variable). But how precise is this approach in assessing the dynamics between China’s rise and reaction of other powers and US. The ‘evolved’ theory can be validated by putting China and US in the equation. Systemic Relation between the nations was explained through the Balance of Power theory much before the systems theory was propounded. The BOP is the crux of functionality of ‘power relation’ dynamics which has played its role in the most astounding ways leading to situations of war and peace. Whimsical; but true that, the BOP has remained a complicated and indefinable concepts since Hans. Morganthau to Kenneth Waltz. A challenge of the BOP, however remains; “ that it has too many meanings”. In the recent times it has become evident that the myriad of expectations generated by BOP has not met the practicality of the current world politics. It is for this reason; the BoP has been replaced by Preponderance Theory (PT) to explain prevailing power situation. PT does provide an empirical reasoning for the success of this theory but fails in a abstract logical reasoning required for making a theory universal. Unipolarity clarifies the current system as one where balance of power has become redundant. It seems to reach beyond the contours of BoP, where a superpower does what it must to remain one. The centrality of this arguments pivots around - an exception, every time BOP fails to operate, preponderance of power emerges. PT does not sit well with the primary logic of a theory because it works on an exception. The evolution of such a pattern and system where BOP fails and preponderance emerges is absent. The puzzle here is- if BOP really has become redundant or it needs polishing. The international power structure changed from multipolar to bipolar to unipolar. BOP was looked at to provide inevitable logic behind such changes and answer the dilemma we see today- why US is unchecked, unbalanced? But why was Britain unchecked in 19th century and why China was unbalanced in 13th century? It is the insularity of the state that makes BOP reproduce “imbalance of power”, going a level up from off-shore balancer. This luxury of a state to maintain imbalance in the region of competition or threat is the causal relation between BOP’s and geography. America has applied imbalancing- meaning disequilibrium (in its favor) to maintain the regional balance so that over time the weaker does not get stronger and pose a competition. It could do that due to the significant parity present between the US and the rest.

Keywords: balance of power, china, preponderance of power, US

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Authors: Line Massé, Claire Baudry, Claudia Verret, Marie-France Nadeau, Anne Brault-Labbé

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Little research has been conducted on educational services adapted for twice exceptional students. Within an action research, a cluster grouping was set up in an elementary school in Quebec, bringing together gifted or doubly exceptional (2E) students (n = 11) and students not identified as gifted (n = 8) within a multilevel class (3ᵣ𝒹 and 4ₜₕ years). 2E students had either attention deficit hyperactivity disorder (n = 8, including 3 with specific learning disability) or autism spectrum disorder (n = 2). Differentiated instructions strategies were implemented, including the possibility of progressing at their own pace of learning, independent study or research projects, flexible accommodation, tutoring with older students and the development of socio-emotional learning. A specialized educator also supported the teacher in the class for behavioural and socio-affective aspects. Objectives: The study aimed to assess the impacts of the grouping on all students, their academic motivation, and their socio-emotional adaptation. Method: A mixed method was used, combining a qualitative approach with a quantitative approach. Semi-directed interviews were conducted with students (N = 18, 4 girls and 14 boys aged 8 to 9) and one of their parents (N = 18) at the end of the school year. Parents and students completed two questionnaires at the beginning and end of the school year: the Behavior Assessment System for Children-3, children or parents versions (BASC-3, Reynolds and Kampus, 2015) and the Academic Motivation in Education (Vallerand et al., 1993). Parents also completed the Multidimensional Student Life Satisfaction Scale (Huebner, 1994, adapted by Fenouillet et al., 2014) comprising three domains (school, friendships, and motivation). Mixed thematic analyzes were carried out on the data from the interviews using the N'Vivo software. Related-samples Wilcoxon rank-sums tests were conducted for the data from the questionnaires. Results: Different themes emerge from the students' comments, including a positive impact on school motivation or attitude toward school, improved school results, reduction of their behavioural difficulties and improvement of their social relations. These remarks were more frequent among 2E students. Most 2E students also noted an improvement in their academic performance. Most parents reported improvements in attitudes toward school and reductions in disruptive behaviours in the classroom. Some parents also observed changes in behaviours at home or in the socio-emotional well-being of their children, here again, particularly parents of 2E children. Analysis of questionnaires revealed significant differences at the end of the school year, more specifically pertaining to extrinsic motivation identified, problems of conduct, attention, emotional self-control, executive functioning, negative emotions, functional deficiencies, and satisfaction regarding friendships. These results indicate that this approach could benefit not only gifted and doubly exceptional students but also students not identified as gifted.

Keywords: Cluster grouping, elementary school, giftedness, mixed methods, twice exceptional students

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Authors: Suhrita Saha

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Barbie is a fashion doll manufactured by the American toy company Mattel Inc and it made debut at the American International Toy Fair in New York in 9 March 1959. From being a fashion doll to a symbol of fetishistic commodification, Barbie has come a long way. A Barbie doll is sold every three seconds across the world, which makes the billion dollar brand the world’s most popular doll for the girls. The 11.5 inch moulded plastic doll has a height of 5 feet 9 inches at 1/6 scale. Her vital statistics have been estimated at 36 inches (chest), 18 inches (waist) and 33 inches (hips). Her weight is permanently set at 110 pounds which would be 35 pounds underweight. Ruth Handler, the creator of Barbie wanted a doll that represented adulthood and allowed children to imagine themselves as teenagers or adults. While Barbie might have been intended to be independent, imaginative and innovative, the physical uniqueness does not confine the doll to the status of a play thing. It is a cultural icon but with far reaching critical implications. The doll is a commodity bearing more social value than practical use value. The way Barbie is produced represents industrialization and commodification of the process of symbolic production. And this symbolic production and consumption is a standardized planned one that produce stereotypical ‘pseudo-individuality’ and suppresses cultural alternatives. Children are being subject to and also arise as subjects in this consumer context. A very gendered, physiologically dissected sexually charged symbolism is imposed upon children (both male and female), childhood, their social worlds, identity, and relationship formation. Barbie is also very popular among Indian children. While the doll is essentially an imaginative representation of the West, it is internalized by the Indian sensibilities. Through observation and questionnaire-based interview within a sample population of adolescent children (primarily female, a few male) and parents (primarily mothers) in Kolkata, an Indian metropolis, the paper puts forth findings of sociological relevance. 1. Barbie creates, recreates, and accentuates already existing divides between the binaries like male- female, fat- thin, sexy- nonsexy, beauty- brain and more. 2. The Indian girl child in her associative process with Barbie wants to be like her and commodifies her own self. The male child also readily accepts this standardized commodification. Definition of beauty is thus based on prejudice and stereotype. 3. Not being able to become Barbie creates health issues both psychological and physiological varying from anorexia to obesity as well as personality disorder. 4. From being a plaything Barbie becomes the game maker. Barbie along with many other forms of simulation further creates a consumer culture and market for all kind of fitness related hyper enchantment and subsequent disillusionment. The construct becomes the reality and the real gets lost in the play world. The paper would thus argue that Barbie from being an innocuous doll transports itself into becoming social construct with long term and irreversible adverse impact.

Keywords: barbie, commodification, personality disorder, sterotype

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Authors: Emna Abid, Linda Chebbi, Yosra Mabrouk, Amel Labidi, Lamia Mansour

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Werner syndrome (WS) is a rare genetic disorder inherited in an autosomal recessive pattern characterized by accelerated aging. While extensive research has been conducted on its systemic manifestations, the specific dental implications of WS remain poorly understood. The medical history and the oral health status of two patients diagnosed with WS were detailed. Our findings revealed a high prevalence of dental problems in both patients, including periodontitis, xerostomia, and temporomandibular joint disorders. This article aims to investigate the dental challenges faced by individuals with WS as well as the prosthetic options envisaged through two clinical cases contributing to a deeper understanding of the dental implications of WS and to choose the appropriate prosthetic solution in this population. Future research should focus on larger scale studies and clinical trials to validate these proposed strategies.

Keywords: adult progeria, clinical symptoms, oral manifestations, dental care, prosthetic management

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Authors: Makkhan Lal Meena, R. C. Bairwa, G. S. Dangayach, Rahul Jain

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The current study looked at the frequency of chronic illness conditions, accidents, health complaints, and ergonomic issues among 100 conventional and 100 greenhouse farmers. Data related to the health symptoms and ergonomic problems were collected through questionnaires by conducting direct interviews of farmers. According to the findings, symptoms of heat exposure (skin rashes, headache, dizziness, and lack of appetite) were substantially higher among conventional farmers than greenhouse farmers. The greenhouse farmers reported much more pain, numbness, or weakness in wrists/hands, fingers, upper back, hips, and ankles/feet than conventional farmers. The findings of the study suggest that suitable ergonomic knowledge and awareness campaign programs concentrating on safety at work, particularly low back pain, should be implemented in workplaces to allow for earlier detection of symptoms among the greenhouse farmers.

Keywords: accident, conventional farmer, ergonomics, health symptoms, greenhouse farmers, pesticide

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Authors: Aline Woine, Moïra Mikolajczak, Virginie Dardier, Isabelle Roskam

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Background information: Becoming a parent is said to be the happiest event one can ever experience in one’s life. This popular (and almost absolute) truth–which no reasonable and decent human being would ever dare question on pain of being singled out as a bad parent–contrasts with the nuances that reality offers. Indeed, while many parents do thrive in their parenting role, some others falter and become progressively overwhelmed by their parenting role, ineluctably caught in a spiral of exhaustion. Parental burnout (henceforth PB) sets in when parental demands (stressors) exceed parental resources. While it is now generally acknowledged that PB affects the parent’s behavior in terms of neglect and violence toward their offspring, little is known about the impact that the syndrome might have on the children’s internalized (anxious and depressive symptoms, somatic complaints, etc.) and/or externalized (irritability, violence, aggressiveness, conduct disorder, oppositional disorder, etc.) behaviors. Furthermore, at the time of writing, to our best knowledge, no research has yet tested the reverse effect, namely, that of the child's internalized and/or externalized behaviors on the onset and/or maintenance of parental burnout symptoms. Goals and hypotheses: The present pioneering research proposes to fill an important gap in the existing literature related to PB by investigating the bidirectional effect between PB and the child’s internalized and/or externalized behaviors. Relying on a cross-lagged longitudinal study with three waves of data collection (4 months apart), our study tests a transactional model with bidirectional and recursive relations between observed variables and at the three waves, as well as autoregressive paths and cross-sectional correlations. Methods: As we write this, wave-two data are being collected via Qualtrics, and we expect a final sample of about 600 participants composed of French-speaking (snowball sample) and English-speaking (Prolific sample) parents. Structural equation modeling is employed using Stata version 17. In order to retain as much statistical power as possible, we use all available data and therefore apply the maximum likelihood with a missing value (mlmv) as the method of estimation to compute the parameter estimates. To limit (in so far is possible) the shared method variance bias in the evaluation of the child’s behavior, the study relies on a multi-informant evaluation approach. Expected results: We expect our three-wave longitudinal study to show that PB symptoms (measured at T1) raise the occurrence/intensity of the child’s externalized and/or internalized behaviors (measured at T2 and T3). We further expect the child’s occurrence/intensity of externalized and/or internalized behaviors (measured at T1) to augment the risk for PB (measured at T2 and T3). Conclusion: Should our hypotheses be confirmed, our results will make an important contribution to the understanding of both PB and children’s behavioral issues, thereby opening interesting theoretical and clinical avenues.

Keywords: exhaustion, structural equation modeling, cross-lagged longitudinal study, violence and neglect, child-parent relationship

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Authors: Neelam Singha

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The present work intends to analyze the system dynamics of Hashimoto’s thyroiditis with the assistance of fractional calculus. Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disorder in which the immune system attacks the thyroid gland, which gradually results in interrupting the normal thyroid operation. Consequently, the feedback control of the system gets disrupted due to thyroid follicle cell lysis. And, the patient perceives life-threatening clinical conditions like goiter, hyperactivity, euthyroidism, hyperthyroidism, etc. In this work, we aim to obtain the approximate solution to the posed fractional-order problem describing Hashimoto’s thyroiditis. We employ the Adomian decomposition method to solve the system of fractional-order differential equations, and the solutions obtained shall be useful to provide information about the effect of medical care. The numerical technique is executed in an organized manner to furnish the associated details of the progression of the disease and to visualize it graphically with suitable plots.

Keywords: adomian decomposition method, fractional derivatives, Hashimoto's thyroiditis, mathematical modeling

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Authors: Vanessa Do, Lauren Smith, Leslie Carver

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It is widely known that individuals with autism spectrum disorder (ASD) may exhibit sensitivity to stimuli. Even at a young age, they tend to display stimuli-related discomfort in their behavior during play. Play serves a crucial role in a child’s early years as it helps support healthy brain development, socio-emotional skills, and adaptation to their environment There is research dedicated to studying infant preferences for toys, especially in regard to: gender preferences, the advantages of promoting play, and the caregiver’s role in their child’s play routines. However, there is a disproportionate amount of literature examining how play patterns may differ in children with sensory sensitivity, such as children diagnosed with ASD. Prior literature has studied and found supporting evidence that individuals with ASD have deficits in social communication and have increased presence of repetitive behaviors and/or restricted interests, which also display in early childhood play patterns. This study aims to examine potential differences in toy preference between infants with (FH+) and without (FH-) a familial history of ASD ages 6. 9, and 12 months old. More specifically, this study will address the question, “do FH+ infants tend to play more with toys that require less social engagement compared to FH- infants?” Infants and their caregivers were recruited and asked to engage in a free-play session in their homes that lasted approximately 5 minutes. The sessions were recorded and later coded offline for engagement behaviors categorized by toy; each toy that the infants interacted with was coded as belonging to one of 6 categories: sensory (designed to stimulate one or more senses such as light-up toys or musical toys) , construction (e.g., building blocks, rubber suction cups), vehicles (e.g., toy cars), instructional (require steps to accomplish a goal such as flip phones or books), imaginative (e.g., dolls, stuffed animals), and miscellaneous (toys that do not fit into these categories). Toy engagement was defined as the infant looking and touching the toy (ILT) or looking at the toy while their caregiver was holding it (IL-CT). Results reported include/will include the proportion of time the infant was actively engaged with the toy out of the total usable video time per subject — distractions observed during the session were excluded from analysis. Data collection is still ongoing; however, the prediction is that FH+ infants will have higher engagement with sensory and construction toys as they require the least amount of social effort. Furthermore, FH+ infants will have the least engagement with the imaginative toys as prior literature has supported the claim that individuals with ASD have a decreased likelihood to engage in play that requires pretend play and other social skills. Looking at what toys are more or less engaging to FH+ infants is important as it provides significant contributions to their healthy cognitive, social, and emotional development. As play is one of the first ways for a child to understand the complexities of the larger world, the findings of this study may help guide further research into encouraging play with toys that are more engaging and sensory-sensitive for children with ASD.

Keywords: autism engagement, children’s play, early development, free-play, infants, toy

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Authors: Isao Tomita

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Electrical conduction in a quasi-one-dimensional polycrystalline metallic ring with a long electron phase coherence length realized at low temperature is investigated. In this situation, the wave nature of electrons is important in the ring, where the electrical current I can be induced by a vector potential that arises from a static magnetic field applied perpendicularly to the ring’s area. It is shown that if the average grain size of the polycrystalline ring becomes large (or comparable to the Fermi wavelength), the electrical current I increases to ~I0, where I0 is a current in a disorder-free ring. The cause of this increasing effect is examined, and this takes place if the electron localization length in the polycrystalline potential increases with increasing grain size, which gives rise to coherent connection of tails of a localized electron wave function in the ring and thus provides highly coherent electrical conduction.

Keywords: electrical conduction, electron phase coherence, polycrystalline metal, magnetic field

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Authors: K. Menad, A. Feddag, M. A. Hassnaoui

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We are living in a time and in a world heavily polluted. In the list of the great dangers awaiting the man can be placed on top of the list pollution by heavy metals: lead, mercury, cadmium, etc. Fatigue, Depression, Thyroid disorder, Alzheimer's, Parkinson's, Cancer, are some of the health problems caused by heavy metal pollution. The environmental protection has long since become a major political and economic issue. Among the priorities, include safeguarding water resources. All countries of the world are concerned either because they lack water or because they pollute it. There are several ways to remove these heavy metals; ion exchange by zeolites is one of these ways, which our work is based on. Zeolites were among the main clean up materials by either adsorption, ion exchange and catalysis. Lead and cadmium, heavy metals, is one of the main dangers fulminate the flora and fauna of our small planet, so many resources are deployed to remedy them. The elimination of lead and cadmium by ion exchange has been extensively studied. However, exchange capacity of more and larger formed a major challenge for researchers and industry.

Keywords: composite, ion excahnge, zeolite LTA, zeolite x

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Authors: Charlotte K. Lee, Henrique R. N. Aguiar, Ralph Smith, James Baldock, Sam Botchey

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Background: Femoral neck stress fractures (FNSF) are uncommon, making up 1 to 7.2% of stress fractures in healthy subjects. FNSFs are prevalent in young women, military recruits, endurance athletes, and individuals with energy deficiency syndrome or female athlete triad. Presentation is often non-specific and is often misdiagnosed following the initial examination. There is limited research addressing the return–to–activity time after FNSF. Previous studies have demonstrated prognostic time predictions based on various imaging techniques. Here, (1) OxSport clinic FNSF practice standards are retrospectively reviewed, (2) FNSF cohort demographics are examined, (3) Regression models were used to predict return–to–activity prognosis and consequently determine bone stress risk factors. Methods: Patients with a diagnosis of FNSF attending Oxsport clinic between 01/06/2020 and 01/01/2020 were selected from the Rheumatology Assessment Database Innovation in Oxford (RhADiOn) and OxSport Stress Fracture Database (n = 14). (1) Clinical practice was audited against five criteria based on local and National Institute for Health Care Excellence guidance, with a 100% standard. (2) Demographics of the FNSF cohort were examined with Student’s T-Test. (3) Lastly, linear regression and Random Forest regression models were used on this patient cohort to predict return–to–activity time. Consequently, an analysis of feature importance was conducted after fitting each model. Results: OxSport clinical practice met standard (100%) in 3/5 criteria. The criteria not met were patient waiting times and documentation of all bone stress risk factors. Importantly, analysis of patient demographics showed that of the population with complete bone stress risk factor assessments, 53% were positive for modifiable bone stress risk factors. Lastly, linear regression analysis was utilized to identify demographic factors that predicted return–to–activity time [R2 = 79.172%; average error 0.226]. This analysis identified four key variables that predicted return-to-activity time: vitamin D level, total hip DEXA T value, femoral neck DEXA T value, and history of an eating disorder/disordered eating. Furthermore, random forest regression models were employed for this task [R2 = 97.805%; average error 0.024]. Analysis of the importance of each feature again identified a set of 4 variables, 3 of which matched with the linear regression analysis (vitamin D level, total hip DEXA T value, and femoral neck DEXA T value) and the fourth: age. Conclusion: OxSport clinical practice could be improved by more comprehensively evaluating bone stress risk factors. The importance of this evaluation is demonstrated by the population found positive for these risk factors. Using this cohort, potential bone stress risk factors that significantly impacted return-to-activity prognosis were predicted using regression models.

Keywords: eating disorder, bone stress risk factor, femoral neck stress fracture, vitamin D

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Authors: Sarah Elshahat, Tina Moffat

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Suboptimal mental health is a considerable global public health challenge that leads to considerable inequalities worldwide. Newcomers are at elevated risk for developing mental health issues as a result of social exclusion, stigmatization, racism, unequal employment opportunities, and discrimination. The problem can be especially serious amongst Arabic-speaking immigrants and refugees (ASIR) whose mental wellness may have already been affected by exposure to political violence, persecution, hunger or war in their countries of origin. A scoping review was conducted to investigate pre- and post-migration mental health determinants amongst ASIR in North America (the U.S. and Canada), who are a rapidly growing population in both regions. Pertinent peer-reviewed papers and grey literature were located through a systematic search of five electronic databases (Medline, Embase, PsycINFO, Anthropology Plus, and Sociology Database). A stakeholder consultation was implemented to validate the analyzed findings of the included 44 studies. About 80% of the studies were carried out in the US, underscoring a lack of Canadian ASIR-mental health research. A gap in qualitative, mixed-method, and longitudinal research was detected, where approximately two-thirds of the studies adopted a cross-sectional method. Pre-migration determinants of mental health were related to the political unrest, violence and armed conflict in the Arab world, increasing post-traumatic stress disorder and psychological distress levels among ASIR. English language illiteracy and generational variations in acculturation patterns were major post-migration mental health triggering factors. Exposure to domestic violence, stigmatization, poverty, racialization, and harassment were significant post-migration mental health determinants that stem from social inequalities, triggering depression, and distress amongst ASIR. Family conflicts linked to child-rearing and gendered norms were considered as both pre- and post-migration mental health triggering factors. Most post-migration mental health protective factors were socio-culturally related and included the maintenance of positive ethnic identity, faith, family support, and community cohesion. Individual resilience, articulated as self-esteem and hope, was a significant negative predictor of depression and psychological distress among ASIR. Community-engaged, mixed-methods, and longitudinal studies are required to address the current gap in mental health research among ASIR in North America. A more thorough determination of potential mental health triggers and protective factors would help inform the development of mental wellness and resilience-promoting programs that are culturally sensitive to ASIR. On the policy level, the Health in All Policies framework of the World Health Organization can be potentially useful for addressing social and health inequalities among ASIR, reducing mental health challenges.

Keywords: depression, post-traumatic stress disorder, psychological distress, resilience

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Authors: Xiao-Dong Wang, Wei-Mon Yan

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The flow field design in the bipolar plates affects the performance of the proton exchange membrane (PEM) fuel cell. This work adopted a combined optimization procedure, including a simplified conjugate-gradient method and a completely three-dimensional, two-phase, non-isothermal fuel cell model, to look for optimal flow field design for a single serpentine fuel cell of size 9×9 mm with five channels. For the direct solution, the two-fluid method was adopted to incorporate the heat effects using energy equations for entire cells. The model assumes that the system is steady; the inlet reactants are ideal gases; the flow is laminar; and the porous layers such as the diffusion layer, catalyst layer and PEM are isotropic. The model includes continuity, momentum and species equations for gaseous species, liquid water transport equations in the channels, gas diffusion layers, and catalyst layers, water transport equation in the membrane, electron and proton transport equations. The Bulter-Volumer equation was used to describe electrochemical reactions in the catalyst layers. The cell output power density Pcell is maximized subjected to an optimal set of channel heights, H1-H5, and channel widths, W2-W5. The basic case with all channel heights and widths set at 1 mm yields a Pcell=7260 Wm-2. The optimal design displays a tapered characteristic for channels 1, 3 and 4, and a diverging characteristic in height for channels 2 and 5, producing a Pcell=8894 Wm-2, about 22.5% increment. The reduced channel heights of channels 2-4 significantly increase the sub-rib convection and widths for effectively removing liquid water and oxygen transport in gas diffusion layer. The final diverging channel minimizes the leakage of fuel to outlet via sub-rib convection from channel 4 to channel 5. Near-optimal design without huge loss in cell performance but is easily manufactured is tested. The use of a straight, final channel of 0.1 mm height has led to 7.37% power loss, while the design with all channel widths to be 1 mm with optimal channel heights obtained above yields only 1.68% loss of current density. The presence of a final, diverging channel has greater impact on cell performance than the fine adjustment of channel width at the simulation conditions set herein studied.

Keywords: optimization, flow field design, simplified conjugate-gradient method, serpentine flow field, sub-rib convection

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Authors: Sandy Elsayed, Aya Mohamed, Noha Nassar

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Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social deficits and repetitive behavior. Multiple studies suggest that oxidative stress and neuroinflammation are key factors in the etiology of ASD and often associated with worsening of ASD-related behaviors. Nuclear factor erythroid 2-related factor 2 (NRF-2) is a transcription factor that promotes expression of antioxidant response element genes in oxidative stress. In ASD subjects, decreased expression of NRF-2 in frontal cortex shifted the redox homeostasis towards oxidative stress, and resulted in inflammation evidenced by elevation of nuclear factor kappa B (NF-κB) transcriptional activity. Dimethyl fumarate (DMF) is a NRF-2 activator that is used in the treatment of psoriasis and multiple sclerosis. It participates in the transcriptional control of inflammatory factors via inhibition of NF-κB and its downstream targets. This study aimed to investigate the role of DMF in alleviating the cognitive impairments and behavior deficits associated with ASD through mitigation of oxidative stress and inflammation in prenatal valproic acid (VPA) rat model of autism. Methods: Pregnant female Wistar rats received a single intraperitoneal injection of VPA (600 mg/kg) to induce autistic-like-behavioral and neurobiological alterations in their offspring. Chronic oral gavage of DMF (150mg/kg/day) started from postnatal day (PND) 24 till PND62 (39 days). Prenatal VPA exposure elicited autistic behaviors including decreased social interaction and stereotyped behavior. Social interaction was evaluated using three-chamber sociability test and calculation of sociability index (SI), while stereotyped repetitive behavior and anxiety associated with ASD were assessed using marble burying test (MBT). Biochemical analyses were done on prefrontal cortex homogenates including NRF-2, and NF-κB expression. Moreover, inducible nitric oxide synthase (iNOS) gene expression and tumor necrosis factor (TNF-) protein expression were evaluated as markers of inflammation. Results: Prenatal VPA elicited decreased social interaction shown by decreased SI compared to control group (p < 0.001) and DMF enhanced SI (p < 0.05). In MBT, prenatal injection of VPA manifested stereotyped behavior and enhanced number of buried marbles compared to control (p < 0.05) and DMF reduced the anxiety-related behavior in rats exhibiting ASD-like behaviors (p < 0.05). In prefrontal cortex, NRF-2 expression was downregulated in prenatal VPA model (p < 0.0001) and DMF reversed this effect (p < 0.0001). The inflammatory transcription factor NF-κB was elevated in prenatal VPA model (p < 0.0001) and reduced (p < 0.0001) upon NRF-2 activation by DMF. Prenatal VPA expressed higher levels of proinflammatory cytokine TNF- compared to control group (p < 0.0001) and DMF reduced it (p < 0.0001). Finally, the gene expression of iNOS was downregulated upon NRF-2 activation by DMF (p < 0.01). Conclusion: This study proposes that DMF is a potential agent that can be used to ameliorate autistic-like-changes through NRF-2 activation along with NF-κB downregulation and therefore, it is a promising novel therapy for ASD.

Keywords: autism spectrum disorders, dimethyl fumarate, neuroinflammation, NRF-2

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Authors: Neelamshobha Nirala, R. Periyasamy, Awanish Kumar

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Diabetes is a metabolic disorder and with the increase of global prevalence of diabetes, cardiovascular diseases and mortality related to diabetes has also increased. Diabetes causes the increase of arterial stiffness by elusive hormonal and metabolic abnormalities. We used photoplethysmograph (PPG), a simple non-invasive method to study the change in arterial stiffness due to diabetes. Toe PPG signals were taken from 29 diabetic subjects with mean age of (65±8.4) years and 21 non-diabetic subjects of mean age of (49±14) years. Mean duration of diabetes is 12±8 years for diabetic group. Rise-time (RT) and area under rise time (AUR) were calculated from the PPG signal of each subject and Welch’s t-test is used to find the significant difference between two groups. We obtained a significant difference of (p-value) 0.0005 and 0.03 for RT and AUR respectively between diabetic and non-diabetic subjects. Average value of RT and AUR is 0.298±0.003 msec and 14.4±4.2 arbitrary units respectively for diabetic subject compared to 0.277±0.0005 msec and 13.66±2.3 a.u respectively for non-diabetic subjects. In conclusion, this study support that arterial stiffness is increased in diabetes and can be detected early using PPG.

Keywords: area under rise-time, AUR, arterial stiffness, diabetes, photoplethysmograph, PPG, rise-time (RT)

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Authors: Eki Devung, Eka Tyastutik, Indha Annisa, Digdaya Anoraga, Jamaluddin Arsyad

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Plant medicine is a whole species of plants are known to have medicinal properties. Bogor Agricultural University has high biodiversity, one of which flora potential as a drug. This study was conducted from 19 September to 10 October 2016 at Bogor Agricultural University using literature study and field observation. There are 85 species of medicinal plants which include a medicinal plant cultivation and wild plants. Family herbs most commonly found in Cikabayan that while the Euphorbiaceae, family which is found in the Tropical Medicinal Plant Conservation Laboratory is the family of Achantaceae. Species of medicinal plants is dominated by herbs and shrubs. Part herbs most widely used are the leaves. The diversity of diseases that can be treated with medicine plants include digestive system diseases and metabolic disorder.

Keywords: benefits, biodiversity, Bogor Agricultural University, medicinal plants

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Authors: Tareq L. Mukattash, Karem H. Alzoubi, Ejlal Abu El-Rub, Anan S. Jarab, Sayyer I. Al-Azzam, Maher Khdour, Mohammed Shara, Yazid N. Alhamarneh

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Background: It has been estimated that up to 50% of any patient population is at least partially non-adherent to their prescribed treatment. Identifying barriers to adherence is required to develop effective interventions for psychiatric patients. Objective: To explore the prevalence and factors of non-adherence among psychiatric patients present at four psychiatric clinics. Method: A cross-sectional questionnaire-based study. A sample of psychiatric patients attending outpatient psychiatric clinics was enrolled between March and April 2011. Results: A total of 243 psychiatric patients took part in this study with the majority of patients (92.5%) being prescribed more than one psychiatric disorder. The majority (64.2%) of the patients was classified as non-adherent according to the Morisky adherence questionnaire and forgetfulness was the most prevalent reason for that. Conclusions: Non-adherence is a common and important issue among psychiatric patients. Polypharmacy, safety concerns and lack of insight towards the prescribed treatment were reported as the main reasons of non-adherence.

Keywords: medication adherence, psychiatric disorders, clinical pharmacy, polypharmacy

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Authors: Charu Kriti

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The year 2020 will be remembered in history as the year when everything changed suddenly. As the world is engrossed in fighting a pandemic, individual life has taken a hit. The sudden imposition of lockdown, the perpetual fear of testing positive for the COVID virus, and rescheduling one’s entire life around this one global phenomenon have created unprecedented stress among all cadres. This paper aims to highlight the level of stress that students face during the shift of the classroom from the physical setup to the virtual one. The paper takes into account the day-to-day hassles that a student faces during online classes. The paper also attempts to analyse these from the other perspective of the students’ lives and the difficulties faced by them on all fronts. This is an empirical research paper that takes into account responses from a total of 4,241 students. The responses have been collected via the online survey, which is being assessed and inferred for the purposes of this paper. The final results show the extent of stress that online classes have induced upon the students.

Keywords: anxiety, COVID, stress, anxiety disorder

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Authors: Fuming Yang, Telma Sousa Almeida, Xinyu Li, Yunxi Deng, Heying Zhang, Michael E. Lamb

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Twenty-seven children aged 6-15 years with autism spectrum disorder (ASD) and 32 typically developing children were questioned about their participation in a set of activities after a two-week delay and again after a two-month delay, using a best-practice interview protocol. This paper assessed the narrative coherence of children’s reports based on key story grammar elements and temporal features included in their accounts of the event. Results indicated that, over time, both children with ASD and typically developing (TD) children decreased their narrative coherence. Children with ASD were no different from TD peers with regards to story length and syntactic complexity. However, they showed significantly less coherence than TD children. They were less likely to use the gist of the story to organize their narrative coherence. Interviewer prompts influenced children’s narrative coherence. The findings indicated that children with ASD could provide meaningful and reliable testimony about an event they personally experienced, but the narrative coherence of their reports deteriorates over time and is affected by interviewer prompts.

Keywords: autism spectrum disorders, delay, eyewitness testimony, narrative coherence

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Authors: Sabri Serkan Gulluoglu

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The study is aimed at examining the effects of internet marketing with IPTV on human beings. Internet marketing with IPTV is emerging as an integral part of business strategies in today’s technologically advanced world and the business activities all over the world are influences with the emergence of this modern marketing tool. As the population of the Internet and on-line users’ increases, new research issues have arisen concerning the demographics and psychographics of the on-line user and the opportunities for a product or service. In recent years, we have seen a tendency of various services converging to the ubiquitous Internet Protocol based networks. Besides traditional Internet applications such as web browsing, email, file transferring, and so forth, new applications have been developed to replace old communication networks. IPTV is one of the solutions. In the future, we expect a single network, the IP network, to provide services that have been carried by different networks today. For finding some important effects of a video based technology market web site on internet, we determine to apply a questionnaire on university students. Recently some researches shows that in Turkey the age of people 20 to 24 use internet when they buy some electronic devices such as cell phones, computers, etc. In questionnaire there are ten categorized questions to evaluate the effects of IPTV when shopping. There were selected 30 students who are filling the question form after watching an IPTV channel video for 10 minutes. This sample IPTV channel is “buy.com”, it look like an e-commerce site with an integrated IPTV channel on. The questionnaire for the survey is constructed by using the Likert scale that is a bipolar scaling method used to measure either positive or negative response to a statement (Likert, R) it is a common system that is used is the surveys. By following the Likert Scale “the respondents are asked to indicate their degree of agreement with the statement or any kind of subjective or objective evaluation of the statement. Traditionally a five-point scale is used under this methodology”. For this study also the five point scale system is used and the respondents were asked to express their opinions about the given statement by picking the answer from the given 5 options: “Strongly disagree, Disagree, Neither agree Nor disagree, Agree and Strongly agree”. These points were also rates from 1-5 (Strongly disagree, Disagree, Neither disagree Nor agree, Agree, Strongly agree). On the basis of the data gathered from the questionnaire some results are drawn in order to get the figures and graphical representation of the study results that can demonstrate the outcomes of the research clearly.

Keywords: IPTV, internet marketing, online, e-commerce, video based technology

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Authors: Nirav P. Vaghela

Abstract:

Work-related musculoskeletal symptoms (WMS) are a major health issue in many occupations all over the world. Past research on hospital workers have mainly been focused on nurses [8] and very few studies have examined musculoskeletal symptoms among doctors in various specialties. The work of surgeons can involve high levels of mental concentration and very precise movements that can be categorized as mild-to-moderate physical demands. Design: Forty-three surgeons were enrolled in this study. To investigate musculoskeletal disorder among the surgeons we had used Standardised Nordic Questionnaire, Quick Exposure Check (QEC) and Workstyle Short Form. Result: In the current study, total 43 surgeons participants out of 30 males and 13 females. Their mean age was 42.07 ± 12.35, and the mean working years of the group were 15.14years ±9.017. On the average, they worked a total of about 8.58 h (±1.967) per day. The prevalence of work related musculoskeletal symptoms among the surgeons indicating 83.70% surgeons had atleast one joint affected while 16.30% had no symptoms at all. Conclusion: The present survey study has shown high prevalence rates of neck, back and shoulder musculoskeletal symptoms in surgeons.

Keywords: repetitive stress injury, pain, occupational hazards, disability, abneetism, physical health, quality of life

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