Search results for: perinatal mood and anxiety disorders

Authors: Mary Katherine Hoth

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Despite racial and ethnic disparities in American psychiatry being well-documented, there remains an apathetic attitude among nurses and providers within the field to engage in active antiracism and provide equitable, recovery-oriented care. It is insufficient to be a “colorblind” nurse or provider and state that call care provided is identical for every patient. Maintaining an attitude of “colorblindness” perpetuates the racism prevalent throughout healthcare and leads to negative patient outcomes. The purpose of this literature review is to highlight the how the historical beginnings of psychiatry have evolved into the disparities seen in today’s practice, as well as to provide some insight on methods that providers and nurses can employ to actively participate in challenging these racial disparities. Background The application of psychiatric medicine to White people versus Black, Indigenous, and other People of Color has been distinctly different as a direct result of chattel slavery and the development of pseudoscience “diagnoses” in the 19th century. This weaponization of the mental health of Black people continues to this day. Population The populations discussed are Black, Indigenous, and other People of Color, with a primary focus on Black people’s experiences with their mental health and the field of psychiatry. Methods A literature review was conducted using CINAHL, EBSCO, MEDLINE, and PubMed databases with the following terms: psychiatry, mental health, racism, substance use, suicide, trauma-informed care, disparities and recovery-oriented care. Articles were further filtered based on meeting the criteria of peer-reviewed, full-text availability, written in English, and published between 2018 and 2023. Findings Black patients are more likely to be diagnosed with psychotic disorders and prescribed antipsychotic medications compared to White patients who were more often diagnosed with mood disorders and prescribed antidepressants. This same disparity is also seen in children and adolescents, where Black children are more likely to be diagnosed with behavior problems such as Oppositional Defiant Disorder (ODD) and White children with the same presentation are more likely to be diagnosed with Attention Hyperactivity Disorder. Medications advertisements for antipsychotics like Haldol as recent as 1974 portrayed a Black man, labeled as “agitated” and “aggressive”, a trope we still see today in police violence cases. The majority of nursing and medical school programs do not provide education on racism and how to actively combat it in practice, leaving many healthcare professionals acutely uneducated and unaware of their own biases and racism, as well as structural and institutional racism. Conclusions Racism will continue to grow wherever it is given time, space, and energy. Providers and nurses have an ethical obligation to educate themselves, actively deconstruct their personal racism and bias, and continuously engage in active antiracism by dismantling racism wherever it is encountered, be it structural, institutional, or scientific racism. Agents of change at the patient care level not only improve the outcomes of Black patients, but it will also lead the way in ensuring Black, Indigenous, and other People of Color are included in research of methods and medications in psychiatry in the future.

Keywords: disparities, psychiatry, racism, recovery-oriented care, trauma-informed care

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Authors: Małgorzata Osowiecka

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Negative emotions are rather seen as creativity inhibitor. On the other hand, it is worth noting that negative emotions may be good for our functioning. Negative emotions enhance cognitive resources and improve evaluative processes. Moreover maintaining a negative emotional state allow for cognitive reinterpretation of the emotional stimuli, what is good for our creativity, especially cognitive flexibility. Writing a diary or writing about difficult emotional experiences in general can be the way to not only improve psychical health, but also – enhance creative behaviors. Thanks to translating difficult emotions to the verbal level and giving them ‘a name’ or ‘a label’, we can get easier access to both emotional content of an experience and to the semantic content, without the need of speaking out loud. Expressive writing improves academic results and the efficiency of working memory. The classical method of writing about emotions consists in a long-term process of describing negative experiences. Present research demonstrate the efficiency of this process over a shorter period of time - one writing session, on school children sample. Participants performed writing task. Writing task had two different topics: emotions connected with their negative emotions (expressive writing) and content not connected with negative emotional state (writing about one’s typical day). Creativity was measured by Guilford’s Alternative Uses Task. Results have shown that writing about negative emotions results in the higher level of divergent thinking in all three parameters: fluency, flexibility and originality. After the writing task mood of expressive writing participants remained negative more than the mood of the controls. Taking an expressive action after a difficult emotional experience can support functioning, which can be observed in enhancement of divergent thinking. Writing about emotions connected with negative experience makes one more creative, than writing about something unrelated with difficult emotional moments. Research has shown that young people should not demonize negative emotions. Sometimes, properly applied, negative emotions can be the basis of creation. Preparation was supported by a The Young Scientist University grant titled ‘Dynamics of emotions in the creative process’ from The Polish Ministry of Science and Higher Education.

Keywords: creativity, divergent thinking, emotions, expressive writing

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Authors: Ilona Krone

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Maternal smoking during pregnancy increases the risk of perinatal/postnatal negative health outcomes; however, only 1 in 5 pregnant smokers quit smoking. That is a clinical and public health problem. Pregnant smokers have negative paternal support, and higher levels of perceived stress than non-smokers and quitters return to smoking in a stressful situation. A crisis like the COVID-19 outbreak causes significant uncertainty and stress. For pregnant women, additional stress may increase due to concerns for their fetus. Strategies targeting maternal stress and isolation may be particularly useful to prevent negative outcomes for women and their fetuses. Within the post-doctoral study, cooperating with leading specialists, an innovative program for pregnant smokers will be developed. Feasibility for reducing craving, distress intolerance, Covid 19 related stress, and fear in pregnant women in Latvia will be assessed.

Keywords: COVID 19, mindfulness, motivation, pregnancy, smoking cessation

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Authors: Mohd Fadzly Yahya, Matthew Teo Yong Chang

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Globally, the increasing life expectancy of human beings has brought more issues with non-communicable diseases, especially work-related musculoskeletal disorders (WMDs). WMSD also is one of the leading causes of health-related absence from work restricted work time in Malaysia. WMDs are cumulative disorders, resulting from repeated exposure to high or low-intensity loads over a long period. Evidence from a previous study showed that office workers in government and private sectors were showing high WRMDs prevalence in Malaysia. The objectives of this study were to determine the prevalence of MSDs among Malaysian office workers in Klang Valley and to identify the association between MSDs pain and working experience among office workers. This is a cross-sectional study focusing on officer workers in the Klang Valley area. The questionnaires consisted of the subject’s demographics, Nordic Musculoskeletal Questionnaire, and The Numeric Pain Rating Scale were distributed online via google forms to all consenting participants. The data were analyzed for descriptive analysis, parametric test, and student T-test using IBM SPSS Statistics Version 27. From a total of 244 participants, 95 (38.9%) were male and 149 (61.1%) were female. 57.8% of the total samples were government staff while private-sector workers were 42.2%. The highest MSDs prevalence was neck pain during the last 12 months which contributed to 69.3% (n=169) of total participants, which is male 38.5% (n=65) and female 61.5% (n=104). Our study revealed that female office workers have a higher prevalence of WMDs and there is a significant difference in elbow pain, wrist, and hands pain, and lower back pain across four different working experience groups. Office workers in this study were highly exposed to MSDs due to poor ergonomics implementation at the workplace. It is crucial to advocate preventative measures to employers such as workplace ergonomics and changes to work practices to reduce the incidence of MSDs cases in office settings.

Keywords: musculoskeletal disorders, pain, prevalence rate, office workers, risks

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Authors: Dulal Bhaumik, Fei Jie, Runa Bhaumik, Bikas Sinha

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Human brain is an amazingly complex network. Aberrant activities in this network can lead to various neurological disorders such as multiple sclerosis, Parkinson’s disease, Alzheimer’s disease and autism. fMRI has emerged as an important tool to delineate the neural networks affected by such diseases, particularly autism. In this paper, we propose mixed-effects models together with an appropriate procedure for controlling false discoveries to detect disrupted connectivities in whole brain studies. Results are illustrated with a large data set known as Autism Brain Imaging Data Exchange or ABIDE which includes 361 subjects from 8 medical centers. We believe that our findings have addressed adequately the small sample inference problem, and thus are more reliable for therapeutic target for intervention. In addition, our result can be used for early detection of subjects who are at high risk of developing neurological disorders.

Keywords: ABIDE, autism spectrum disorder, fMRI, mixed-effects model

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Authors: Tai-Young Park, Yangjin Park

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Introduction: This study analyzed a family therapy case involving a female client in her thirties with panic disorder (PD) in South Korea. We identified five stages of the psychological process in the development of PD and examined external situations, family dynamics, and psychological experiences at each stage. Method: The client, mother, sister, and husband participated in therapy. Researchers analyzed the transcripts, notes, and video recordings of the therapy sessions. A thematic analysis was used to examine the data and display our findings using a network. Results: The developmental process of PD was as follows: (1) formation of anxiety, (2) sheltered life, (3) crisis, (4) loss of safe haven, and (5) inner breakdown. Conclusion: The family dynamics that developed as a result of coping with external situations in each stage contributed to clients’ psychological experiences. These psychological experiences triggered anxiety, which led to the development of PD. Moreover, this study empirically suggests that family dynamics can be associated with a person’s internal experiences that could lead to PD. Our findings highlight the significance of functional family dynamics and coping patterns when facing difficult external situations or crises.

Keywords: developmental process, family therapy, panic disorder, psychological dynamics

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Authors: Amin Nakhostin-Ansari, Samaneh Akbarour, Khosro Sadeghniiat Haghighi, Zahra Banafsheh Alemohammad, Farnaz Etesam, Arezu Najafi, Mahnaz Khalafehnilsaz

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Introduction: The outbreak of coronavirus disease has considerably burdened the healthcare system in Iran. This study aimed to evaluate the characteristics of insomnia experienced by the general Iranian population during the COVID-19 pandemic. Method: A scale(FCV-19) was used for Fear of COVID-19, Insomnia Severity Index (ISI), Patient Health Questionnaire-2 (PHQ-2), and Generalized Anxiety Disorder Scale-2 (GAD-2) for detailed characterization of insomnia and its patterns Results: In total, 675 people with insomnia with the mean age of 40.28 years (SD=11.15) participated in this study. Prevalence of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) were 91.4%, 86.7%, and 77%, respectively. DIS, DMS, and EMA were more common in people with depression and anxiety. FCV-19 score was higher in those with more severe types of DIS, DMS, and EMA (P<0.001). FCV-19 was a risk factor for all patterns of insomnia (OR=1.19, 1.12, 1.02 for DIS, DMS, and EMA, respectively). Conclusion: fear of COVID-19 is a major factor to insomnia patterns. Investigation of COVID-19 fear in people with insomnia and the addition of attributed relieving or management strategies to conventional management of insomnia are reasonable approaches to improve the sleep condition of people in the pandemic.

Keywords: insomnia, difficulty maintaining sleep, COVID-19, Coronavirus

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Authors: Ellen McClure

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It is generally well-known that a number of inmates suffer from some form of substance or alcohol use disorder. This study identifies, analyses, classifies and codifies the most recent Canadian criminal judgments involving an accused diagnosed with an alcohol use disorder specifically. From this research, patterns in judicial discourse and sentencing norms can be established, and these findings can be juxtaposed with existing relevant academic literature, particular attention will be given to this discussion at the sentencing stage, and the subsequent incarceration of those with alcohol use disorders. This topic will be explored with an overarching emphasis on the effects that a lack of conversation regarding a possible correlation between alcohol consumption and crime may have. Although comparisons may be made in order to clarify or highlight certain issues, particular attention will be paid to jurisdictions within Canada. This paper explores the existing judicial discourse in sentencing regarding the relationship between alcohol and crime, and how this might explain the higher incarceration rates of those suffering from alcohol use disorders in Canada. The research questions are as follows: (1) What are the existing judicial discourses in sentencing around the relationship between alcohol and crime? (2) To what extent has the current discourse on alcohol addiction among judges and legal academics contributed to the incarceration of alcoholics?The major findings of this research indicate a strong correlation between a lack of judicial discussion regarding the accused’s alcohol use disorder and an increased tendency to consider an alcohol use disorder as an aggravating factor. Furthermore, it was found that an 82% of judges who discussed the alcohol use disorder meaningfully referred to the disorder as a mitigating factor. This can be compared with 6.7% of judges who referred to the alcohol use disorder as a mitigating factor in cases where the disorder was not meaningfully discussed.

Keywords: alcohol use disorder, addiction, criminal justice, judicial discourse

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Authors: B. O. Adegoke, B. O. Ola, D. T. Ademiluyi

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This paper examines the use of computer and its related health hazard among computer users in South-Western zone of Nigeria. Two hundred and eighteen (218) computer users constituted the population used to evaluate association between posture, extensive computer use and related health hazard. The instruments for the study are a questionnaire on demographics, lifestyle, body features and work ability index while mean rating, standard deviation and t test were used for data analysis. Identified health related hazard include damages to the eyesight, bad posture, arthritis, musculoskeletal disorders, headache, stress and so on. The results showed that factors such as work demand, posture, closeness to computer screen and excessive working hours on computers constitute health hazards in both old and young computer users of various gender. It is therefore recommended that total number of hours spent with computer should be monitored and controlled.

Keywords: computer-related health hazard, musculoskeletal disorders, computer usage, work ability index

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Authors: Taik Kim

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Mathematics anxiety has an important consequence for teacher practices that influence students’ attitudes and achievement. Elementary prospective teachers have the highest levels of mathematics anxiety in comparison with other college majors. In his teaching practice, the researcher developed a highly successful teaching model to reduce pre-service teachers’ higher math anxiety and simultaneously to improve their pedagogical math content knowledge. There were eighty one participants from 2015 to 2018 who took the Mathematics for Elementary Teachers I and II. As the analysis data indicated, elementary prospective teachers’ math anxiety was greatly reduced with improving their math pedagogical knowledge. U.S encounters a critical shortage of well qualified educators. To solve the issue, it is essential to engage students in a long-term commitmentto shape better teachers, who will, in turn, produce k-12 school students that are better-prepared for college students. It is imperative that new instructional strategies are implemented to improve student learning and address declining interest, poor preparedness, a lack of diverse representation, and low persistence of students in mathematics. Many four year college students take math courses from the math department in the College of Arts& Science and then take methodology courses from the College of Education. Before taking pedagogy, many students struggle in learning mathematics and lose their confidence. Since the content course focus on college level math, instead of pre service teachers’ teaching area, per se elementary math, they do not have a chance to improve their teaching skills on topics which eventually they teach. The research, a joint appointment of math and math education, has been involved in teaching content and pedagogy. As the result indicated, participants were able to math content at the same time how to teach. In conclusion, the new initiative to use several teaching strategies was able not only to increase elementary prospective teachers’ mathematical skills and knowledge but also to improve their attitude toward mathematics. We need an innovative teaching strategy which implements evidence-based tactics in redesigning a education and math to improve pre service teachers’math skills and which can improve students’ attitude toward math and students’ logical and reasoning skills. Implementation of these best practices in the local school district is particularly important because K-8 teachers are not generally familiar with lab-based instruction. At the same time, local school teachers will learn a new way how to teach math. This study can be a vital teacher education model expanding throughout the State and nationwide. In summary, this study yields invaluable information how to improve teacher education in the elementary level and, eventually, how to enhance K-8 students’ math achievement.

Keywords: quality of education and improvement method, teacher education, innovative teaching and learning methodologies, math education

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Authors: Prajwal Paudel, Shreeprasad Adhikari, Shailendra Bir Karmacharya, Kalpana Upadhyaya

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Background: Human milk banks have been recommended by the World Health Organization (WHO) for newborn and child nourishment in the provision of optimum nutrition as an alternative to breastfeeding in circumstances when direct breastfeeding is inaccessible. The vulnerable group of babies, mainly preterm, low birth weight, and sick newborns, are at a greater risk of mortality and possibly benefit from the safe use of donated human milk through milk banks. In this study, we aimed to shed light on the process involved during the setting up of the nation’s first milk bank and its vitality in small and sick newborn nutrition and care. Methods: The study was conducted in Paropakar Maternity and Women’s Hospital, where the first human milk (HMB) was established. The establishment involved a stepwise process of need assessment meeting, formation of the HMB committee, learning visit to HMB in India, studying the strengths and weaknesses of promoting breastfeeding and HMB system integration, procurement, installation, and setting up the infrastructure, and developing technical competency, launching of the HMB. After the initiation of HMB services, information regarding the recruited donor mothers and the volume of milk pasteurized and consumed by the needy recipient babies were recorded. Descriptive statistics with frequencies and percentages were used to describe the utilization of HMB services. Results: During the study period, a total of 506113 ml of milk was collected, while 49930 ml of milk was pasteurized. Of the pasteurized milk, 381248 ml of milk was dispensed. The total volume of milk received was from a total of 883 after proper routine screening tests. Similarly, the total number of babies who received the donated human milk (DHM) was 912 with different neonatal conditions. Among the babies who received DHM, 527(57.7%) were born via CS, and 385 (42.21%) were delivered normally. In the birth weight category,9 (1%) of the babies were less than 1000 grams, 75 (8.2%) were less than 1500 grams, 405 (44.4%) were between 1500 to less than 2500 grams whereas, 423 (46.4%) of the babies who received DHM were normal weight babies. Among the sick newborns, perinatal asphyxia accounted for 166 (18.2%), preterm with other complications 372 (40.7%), preterm 23 (2.02%), respiratory distress 140 (15.35%), neonatal jaundice 150 (16.44%), sepsis 94 (10.30%), meconium aspiration syndrome 9(1%), seizure disorder 28 (3.07%), congenital anomalies 13 (1.42%) and others 33(3. 61%). The neonatal mortality rate dropped to 6.2/1000 live births from 7.5/1000 live births in the first year of establishment as compared to the previous year. Conclusion: The establishment of the first HMB in Nepal involved a comprehensive approach to integrate a new system with the existing newborn care in the provision of safe DHM. Premature babies with complication, babies born via CS, perinatal asphyxia and babies with sepsis consumed the greater proportion of DHM. Rigorous research is warranted to assess the impact of DHM in small and sick newborn who otherwise would be fed formula milk.

Keywords: human milk bank, sick-newborn, mortality, neonatal nutrition

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Authors: Muhammad Suhail Ibrahim, Muhammad Nadeem, Muhammad Sultan, Uzair Sajjad, Khalid Hamid, Tahir Mahmood Qureshi, Sadaf Javaria

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Metabolic disorders, including hypertension, diabetes, cardiovascular disease etc., are major threats to public health and economy. Management and prevention of alarmingly increasing disorders have attracted researchers to explore natural barriers against these disorders. The objective of this study was to explore oats as a potential source of dietary fiber. Extraction of dietary was optimized by response surface methodology, and five indigenous oat cultivars, including SGD2011, Avon, SGD81, PD2LV65, and S2000, were also characterized for techno-functional characteristics, mineral composition and phytochemical quantification. These cultivars varied significantly (p < 0.05) for oil holding capacity, water saturation, and water holding capacity, respectively. SGD81 showed the highest oil-holding capacity, water-holding capacity, and water saturation due to the highest fraction of dietary fiber. The highest values of total phenolic contents, total flavonoid contents, total flavonol contents, 2, 2-Diphenyl-1-picrylhydrazyl radical scavenging activity, and anthocyanin were shown by SGD81, and SGD2011, respectively. All cultivars varied significantly (P<0.05) with respect to phytochemical quantification. Oat cultivars SGD81 and SGD2011 showed the best phenolic acid profile and can be effectively used as a source of nutraceuticals. Beyond the nutritional properties of oats, these also contribute and emerged as potential sources of dietary fiber and have gained attention as nutraceutical cereal crops. This approach offers oats as a natural means of dietary fiber to protect humans from alarmingly increasing metabolic disorders, and its extraction by sonication has made it a sustainable and eco-friendly strategy.

Keywords: oat cultivars, dietary fibers, mineral profile, antioxidant activity, color properties

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Authors: Roshani Gusain, Deep Sinha, Karan Nayal, Anmol Kumar Mishra, Manav Singh

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In this research paper, we introduce "Mind Care Assistant - Companion App", which is a Flutter and Firebase-based mental health monitor. The app wants to improve and monitor the mental health of its users, it uses noninvasive ways to check for a change in their emotional state. By responding to questions, the app will provide individualized suggestions ᅳ tasks and mindfulness exercises ᅳ for users who are depressed or anxious. The app features a chat-bot that incorporates cognitive behavioural therapy (CBT) principles and combines natural language processing with machine learning to develop personalised responses. The feature of the app that makes it easy for us to choose between iOS and Android is cross-platform, which allows users from both mobile systems to experience almost no changes in their interfaces. With Firebase integration synchronized and real-time data storage, security is easily possible. The paper covers the architecture of the app, how it was developed and some important features. The primary research result presents the promise of a "Mind Care Assistant" in mental health care using new wait-for-health technology, proposing a full stack application to be able to manage depression/anxiety and overall Mental well-being very effectively.

Keywords: mental health, mobile application, flutter, firebase, Depression, Anxiety

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Authors: Jiangang Shen

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Olfactory dysfunction is a common symptom companied by anxiety- and depressive-like behaviors in depressive patients. Chronic stress triggers hormone responses and inhibits the proliferation and differentiation of neural stem cells (NSCs) in the hippocampus and subventricular zone (SVZ)-olfactory bulb (OB), contributing to depressive behaviors and olfactory dysfunction. However, the cellular signaling molecules to regulate chronic stress mediated olfactory dysfunction are largely unclear. Adaptor proteins containing the pleckstrin homology domain, phosphotyrosine binding domain, and leucine zipper motif (APPLs) are multifunctional adaptor proteins. Herein, we tested the hypothesis that APPL2 could inhibit hippocampal neurogenesis by affecting glucocorticoid receptor (GR) signaling, subsequently contributing to depressive and anxiety behaviors as well as olfactory dysfunctions. The major discoveries are included: (1) APPL2 Tg mice had enhanced GR phosphorylation under basic conditions but had no different plasma corticosterone (CORT) level and GR phosphorylation under stress stimulation. (2) APPL2 Tg mice had impaired hippocampal neurogenesis and revealed depressive and anxiety behaviors. (3) GR antagonist RU486 reversed the impaired hippocampal neurogenesis in the APPL2 Tg mice. (4) APPL2 Tg mice displayed higher GR activity and less capacity for neurogenesis at the olfactory system with lesser olfactory sensitivity than WT mice. (5) APPL2 negatively regulates olfactory functions by switching fate commitments of NSCs in adult olfactory bulbs via interaction with Notch1 signaling. Furthermore, baicalin, a natural medicinal compound, was found to be a promising agent targeting APPL2/GR signaling and promoting adult neurogenesis in APPL2 Tg mice and chronic corticosterone-induced depression mouse models. Behavioral tests revealed that baicalin had antidepressant and olfactory-improving effects. Taken together, APPL2 is a critical therapeutic target for antidepressant treatment.

Keywords: APPL2, hippocampal neurogenesis, depressive behaviors and olfactory dysfunction, stress

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Authors: Noelene Rose

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The DSM has been plagued with conceptual issues since its inception, not least discriminant validity and comorbidity issues. An attempt to remain a-theoretical in the divide between the psycho-dynamicists and the behaviourists contributed to much of this, in particular relating to the Personality Disorders. With the DSM-5, although the criterion have remained unchanged, major conceptual and structural directions have been flagged and proposed in section III. The biggest changes concern the Personality Disorders. While Narcissistic Personality Disorder (NPD) was initially tagged for removal, instead the addition of section III proposes a move away from a categorical approach to a more dimensional approach, with a measure of Global Function of Personality. This global measure is an assessment of impairment of self-other relations; a measure of trait narcissism. In the same way mainstream psychology has struggled in its diagnosis of narcissism, so too in its treatment. Kohut’s self psychology represents the most significant inroad in theory and treatment for the narcissistic disorders. Kohut had moved away from a categorical system, towards disorders of the self. According to this theory, disorders of the self are the result of childhood trauma (impaired attunement) resulting in a developmental arrest. Self-psychological, Psychodynamic treatment of narcissism, however, is expensive, in time and money and outside the awareness or access of most people. There is more than a suggestion that narcissism is on the increase, created in trauma and worsened by a fearful world climate. A dimensional model of narcissism, from mild to severe, requires cut off points for diagnosis. But where do we draw the line? Mainstream psychology is inclined to set it high when there is some degree of impairment in functioning in daily life. Transpersonal Psychology is inclined to set it low, with the concept that we all have some degree of narcissism and that it is the point and the path of our life journey to transcend our focus on our selves. Mainstream psychology stops its focus on trait narcissism with a healthy level of self esteem, but it is at this point that Transpersonal Psychology can complement the discussion. From a Transpersonal point of view, failure to begin the process of self-transcendence will also create emotional symptoms of meaning or purpose, often later in our lives, and is also conceived of as a developmental arrest. The maps for this transcendence are hidden in plain sight; in the chakras of kundalini yoga, in the sacraments of the Catholic Church, in the Kabbalah tree of life of Judaism, in Maslow’s hierarchy of needs, to name a few. This paper outlines some proposed research exploring the use of daily practices that can be incorporated into the therapy room; practices that utilise meditation, visualisation and imagination: that are informed by spiritual technology and guided by the psychodynamic theory of Self Psychology.

Keywords: narcissism, self-psychology, self-practice, self-transcendence

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Authors: Pellecchia M. T., Savarese G., Carpinelli L., Calabrese M.

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Introduction: Parkinson's disease (PD) is characterized by a progressive loss of autonomy which undoubtedly has a significant impact on the quality of life of caregivers, and parents are the main informal caregivers. Caring for a person with PD is associated with an increased risk of psychiatric morbidity and persistent anxiety-depressive distress. The aim of the study is to investigate the burden on caregivers of patients with PD, through the use of multidimensional scales and to identify their personological and environmental determinants. Methods: The study has been approved by the Ethic Committee of the University of Salerno and informed consent for participation to the study was obtained from patients and their caregivers. The study was conducted at the Neurology Department of the A.O.U. "San Giovanni di Dio and Ruggi D’Aragona" of Salerno between September 2020 and May 2021. Materials: The questionnaires used were: a) Caregiver Burden Inventory - CBI a questionnaire of 24 items that allow identifying five sub-categories of burden (objective, psychological, physical, social, emotional); b) Depression Anxiety Stress Scales Short Version - DASS-21 questionnaire consisting of 21 items and valid in examining three distinct but interrelated areas (depression, anxiety and stress); c) Family Strain Questionnaire Short Form - FSQ-SF is a questionnaire of 30 items grouped in areas of increasing psychological risk (OK, R, SR, U); d) Zarit Caregiver Burden Inventory - ZBI, consisting of 22 items based on the analysis of two main factors: personal stress and pressure related to his role; e) Life Satisfaction, a single item that aims to evaluate the degree of life satisfaction in a global way using a 0-100 Likert scale. Findings: N ° 29 caregivers (M age = 55.14, SD = 9.859; 69% F) participated in the study. 20.6% of the sample had severe and severe burden (CBI score = M = 26.31; SD = 22.43) and 13.8% of participants had moderate to severe burden (ZBI). The FSQ-SF highlighted a minority of caregivers who need psychological support, in some cases urgent (Area SR and Area U). The DASS-21 results show a prevalence of stress-related symptoms (M = 10.90, SD = 10.712) compared to anxiety (M = 7.52, SD = 10.752) and depression (M = 8, SD = 10.876). There are significant correlations between some specific variables and mean test scores: retired caregivers report higher ZBI scores (p = 0.423) and lower Life Satisfaction levels (p = -0.460) than working caregivers; years of schooling show a negative linear correlation with the ZBI score (p = -0.491). The T-Test indicates that caregivers of patients with cognitive impairment are at greater risk than those of patients without cognitive impairment. Conclusions: It knows the factors that affect the burden the most would allow for early recognition of risky situations and caregivers who would need adequate support.

Keywords: anxious-depressive axis, caregivers’ burden, Parkinson’ disease, psychological risks

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Authors: Sujeeva Sebastian Pereira

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Language Anxiety (LA) – a distinct psychological construct of self-perceptions and behaviors related to classroom language learning – is perceived as a significant variable highly correlated with Second Language Acquisition (SLA). However, the existing scholarship has inadequately explored the nuances of LA in relation to South Asia, especially in terms of Sri Lankan higher education contexts. Thus, the current study, situated within the broad areas of Psychology of SLA and Applied Linguistics, investigates the impact of competency-based LA and identity-based LA on learner achievement among undergraduates of Sri Lanka. Employing a case study approach to explore the impact of LA, 750 undergraduates of the University of Sri Jayewardenepura, Sri Lanka, thus covering 25% of the student population from all seven faculties of the university, were selected as participants using stratified proportionate sampling in terms of ethnicity, gender, and disciplines. The qualitative and quantitative research inquiry utilized for data collection include a questionnaire consisting a set of structured and unstructured questions, and semi-structured interviews as research instruments. Data analysis includes both descriptive and statistical measures. As per the quantitative measures of data analysis, the study employed Pearson Correlation Coefficient test, Chi-Square test, and Multiple Correspondence Analysis; it used LA as the dependent variable, and two types of independent variables were used: direct and indirect variables. Direct variables encompass the four main language skills- reading, writing, speaking and listening- and test anxiety. These variables were further explored through classroom activities on grammar, vocabulary and individual and group presentations. Indirect variables are identity, gender and cultural stereotypes, discipline, social background, income level, ethnicity, religion and parents’ education level. Learner achievement was measured through final scores the participants have obtained for Compulsory English- a common first-year course unit mandatory for all undergraduates. LA was measured using the FLCAS. In order to increase the validity and reliability of the study, data collected were triangulated through descriptive content analysis. Clearly evident through both the statistical analysis and the qualitative analysis of the results is the significant linear negative correlation between LA and learner achievement, and the significant negative correlation between LA and culturally-operated gender stereotypes which create identity disparities in learners. The study also found that both competency-based LA and identity-based LA are experienced primarily and inescapably due to the apprehensions regarding speaking in English. Most participants who reported high levels of LA were from an urban socio-economic background of lower income families. Findings exemplify the linguistic inequality prevalent in the socio-cultural milieu in Sri Lankan society. This inequality makes learning English a dire need, yet, very much an anxiety provoking process because of many sociolinguistic, cultural and ideological factors related to English as a Second Language (ESL) in Sri Lanka. The findings bring out the intricate interrelatedness of both the dependent variable (LA) and the independent variables stated above, emphasizing that the significant linear negative correlation between LA and learner achievement is connected to the affective, cognitive and sociolinguistic domains of SLA. Thus, the study highlights the promise in linguistic practices such as code-switching, crossing and accommodating hybrid identities as strategies in minimizing LA and maximizing the experience of ESL.

Keywords: language anxiety, identity-based anxiety, competence-based anxiety, TESL, Sri Lanka

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Authors: Xiao Yang, Ji Zhang, Yingli Song, Hui Huang, Jing Zhang, Yan Wang, Rongrong Han, Zhixuan Xiang, Lu Chen, Lingling Gao

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Aim and Objectives: To examine physical activity self-efficacy, identify its predictors, and further explore the mechanism of action among the predictors in mainland Chinese pregnant women with high risk for gestational diabetes mellitus (GDM). Background: Physical activity could protect pregnant women from developing GDM. Physical activity self-efficacy was the key predictor of physical activity. Design: A cross-sectional study was conducted from October 2021 to May 2022 in Zhengzhou, China. Methods: 252 eligible pregnant women completed the Pregnancy Physical Activity Self-efficacy Scale, the Social Support for Physical Activity Scale, the Knowledge on Physical Activity Questionnaire, the 7-item Generalized Anxiety Disorder scale, the Edinburgh Postnatal Depression Scale, and a socio-demographic data sheet. Multiple linear regression was applied to explore the predictors of physical activity self-efficacy. Structural equation modeling was used to explore the mechanism of action among the predictors. Results: Chinese pregnant women with a high risk for GDM reported a moderate level of physical activity self-efficacy. The best-fit regression analysis revealed four variables explained 17.5% of the variance in physical activity self-efficacy. Social support for physical activity was the strongest predictor, followed by knowledge of the physical activity, intention to do physical activity, and anxiety symptoms. The model analysis indicated that knowledge of physical activity could release anxiety and depressive symptoms and then increase physical activity self-efficacy. Conclusion: The present study revealed a moderate level of physical activity self-efficacy. Interventions targeting pregnant women with high risk for GDM need to include the predictors of physical activity self-efficacy. Relevance to clinical practice: To facilitate pregnant women with high risk for GDM to engage in physical activity, healthcare professionals may find assess physical activity self-efficacy and intervene as soon as possible on their first antenatal visit. Physical activity intervention programs focused on self-efficacy may be conducted in further research.

Keywords: physical activity, gestational diabetes, self-efficacy, predictors

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Authors: Sinead Morrison, Ann Swillen, Therese Van Amelsvoort, Samuel Chawner, Elfi Vergaelen, Michael Owen, Marianne Van Den Bree

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22q11.2 Deletion Syndrome (22q11.2DS) is caused by the deletion of approximately 60 genes on chromosome 22 and is associated with high rates of neurodevelopmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD). The presentation of these disorders in 22q11.2DS is reported to be comparable to idiopathic forms and therefore presents a valuable model for understanding mechanisms of neurodevelopmental disorders. Cognitive deficits are thought to be a core feature of neurodevelopmental disorders, and possibly manifest in behavioural and emotional problems. There have been mixed findings in 22q11.2DS on whether the presence of ADHD or ASD is associated with greater cognitive deficits. Furthermore, the influence of developmental stage has never been taken into account. The aim was therefore to examine whether the presence of ADHD or ASD was associated with cognitive deficits in childhood and/or adolescence in 22q11.2DS. We conducted the largest study to date of this kind in 22q11.2DS. The same battery of tasks measuring processing speed, attention and spatial working memory were completed by 135 participants with 22q11.2DS. Wechsler IQ tests were completed, yielding Full Scale (FSIQ), Verbal (VIQ) and Performance IQ (PIQ). Age-standardised difference scores were produced for each participant. Developmental stages were defined as children (6-10 years) and adolescents (10-18 years). ADHD diagnosis was ascertained from a semi-structured interview with a parent. ASD status was ascertained from a questionnaire completed by a parent. Interaction and main effects of cognitive performance of those with or without a diagnosis of ADHD or ASD in childhood or adolescence were conducted with 2x2 ANOVA. Significant interactions were followed up with t-tests of simple effects. Adolescents with ASD displayed greater deficits in all measures (processing speed, p = 0.022; sustained attention, p = 0.016; working memory, p = 0.006) than adolescents without ASD; there was no difference between children with and without ASD. There were no significant differences on IQ measures. Both children and adolescents with ADHD displayed greater deficits on sustained attention (p = 0.002) than those without ADHD. There were no significant differences on any other measures for ADHD. Magnitude of cognitive deficit in individuals with 22q11.2DS varied by cognitive domain, developmental stage and presence of neurodevelopmental disorder. Adolescents with 22q11.2DS and ASD showed greater deficits on all measures, which suggests there may be a sensitive period in childhood to acquire these domains, or reflect increasing social and academic demands in adolescence. The finding of poorer sustained attention in children and adolescents with ADHD supports previous research and suggests a specific deficit which can be separated from processing speed and working memory. This research provides unique insights into the association of ASD and ADHD with cognitive deficits in a group at high genomic risk of neurodevelopmental disorders.

Keywords: 22q11.2 deletion syndrome, attention deficit hyperactivity disorder, autism spectrum disorder, cognitive development

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Authors: Pamela Ventola, Laurel Bales, Sara Florczyk

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Background: Fully remote or hybrid administration of clinical outcome measures in rare neurodevelopmental disorders trials is increasing due to the ongoing pandemic and recognition that remote assessments reduce the burden on families. Many assessments in rare neurodevelopmental disorders trials are complex; however, remote/hybrid trials readily allow for the use of centralized raters to administer and score the scales. The use of centralized raters has many benefits, including reducing site burden; however, a specific impact on data quality has not yet been determined. Purpose: The current study has two aims: a) evaluate differences in data quality between administration of a standardized clinical interview completed by centralized raters compared to those completed by site raters and b) evaluate improvement in accuracy of scoring standardized developmental assessments when scored centrally compared to when scored by site raters. Methods: For aim 1, the Vineland-3, a widely used measure of adaptive functioning, was administered by site raters (n= 52) participating in one of four rare disease trials. The measure was also administered as part of two additional trials that utilized central raters (n=7). Each rater completed a comprehensive training program on the assessment. Following completion of the training, each clinician completed a Vineland-3 with a mock caregiver. Administrations were recorded and reviewed by a neuropsychologist for administration and scoring accuracy. Raters were able to certify for the trials after demonstrating an accurate administration of the scale. For site raters, 25% of each rater’s in-study administrations were reviewed by a neuropsychologist for accuracy of administration and scoring. For central raters, the first two administrations and every 10th administration were reviewed. Aim 2 evaluated the added benefit of centralized scoring on the accuracy of scoring of the Bayley-3, a comprehensive developmental assessment widely used in rare neurodevelopmental disorders trials. Bayley-3 administrations across four rare disease trials were centrally scored. For all administrations, the site rater who administered the Bayley-3 scored the scale, and a centralized rater reviewed the video recordings of the administrations and also scored the scales to confirm accuracy. Results: For aim 1, site raters completed 138 Vineland-3 administrations. Of the138 administrations, 53 administrations were reviewed by a neuropsychologist. Four of the administrations had errors that compromised the validity of the assessment. The central raters completed 180 Vineland-3 administrations, 38 administrations were reviewed, and none had significant errors. For aim 2, 68 administrations of the Bayley-3 were reviewed and scored by both a site rater and a centralized rater. Of these administrations, 25 had errors in scoring that were corrected by the central rater. Conclusion: In rare neurodevelopmental disorders trials, sample sizes are often small, so data quality is critical. The use of central raters inherently decreases site burden, but it also decreases rater variance, as illustrated by the small team of central raters (n=7) needed to conduct all of the assessments (n=180) in these trials compared to the number of site raters (n=53) required for even fewer assessments (n=138). In addition, the use of central raters dramatically improves the quality of scoring the assessments.

Keywords: neurodevelopmental disorders, clinical trials, rare disease, central raters, remote trials, decentralized trials

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Authors: Jennie Long, Marjorie Bock

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Although the professional literature related to Autism Spectrum Disorder (ASD) has focused on successful interventions and strategies, there is a lack of documentation regarding which of these methods and supports are most foundational and essential for classroom use. Specifically, literature does not define the core foundational interventions and strategies that would be elemental for educators to use with students with an ASD diagnosis. From the increase in prevalence of autism spectrum disorders, to the challenge students with ASD pose in classrooms, to the requirement to implement evidence-based practice, rises an enormous challenge in the field of education. Foundational interventions should be in place the first day the student enters the classroom. The nine interventions are foundational in nature and because of the dramatic increase in prevalence there is currently a need for classroom programs to provide the foundation of basic educational skills as well as the specialty skills specific to the area of ASD utilizing the most current research. This article presents nine evidence-based intervention categories for implementation with students on the spectrum.

Keywords: autism spectrum disorder, classroom, evidence-based, foundational

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Authors: Anna Mucha, Ewa Wojtyna, Anita Pollak

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The environment in which an individual resides and observes may play a meaningful role in well-being and related constructs. Contact with nature may have a positive influence of natural environments on individuals, impacting mood and psychophysical sensations, such as pain relief. Conversely, urban settings, dominated by concrete elements, might lead to mood decline and heightened stress levels. Similarly, the situation may appear in the case of the perception of virtual environments. However, this is a topic that requires further exploration, especially in the context of relationships with pain. The aforementioned matters served as the basis for formulating and executing the outlined experimental research within the realm of environmental psychology, leveraging new technologies, notably virtual reality (VR), which is progressively gaining prominence in the domain of mental health. The primary objective was to investigate the impact of a simulated virtual environment, mirroring a natural setting abundant in greenery, on the perception of acute pain induced by thermal stimuli (high temperature) – encompassing intensity, unpleasantness, and pain tolerance. Comparative analyses were conducted between the virtual natural environment (intentionally constructed in the likeness of a therapeutic garden), virtual urban environment, and a control group devoid of virtual projections. Secondary objectives aimed to determine the mutual relationships among variables such as positive and negative emotions, preferences regarding virtual environments, sense of presence, and restorative experience in the context of the perception of presented virtual environments and induced thermal pain. The study encompassed 126 physically healthy Polish adults, distributing 42 individuals across each of the three comparative groups. Oculus Rift VR technology and the TSA-II neurosensory analyzer facilitated the experiment. Alongside demographic data, participants' subjective feelings concerning virtual reality and pain were evaluated using the Visual Analogue Scale (VAS), the original Restorative Experience in the Virtual World questionnaire (Doświadczenie Regeneracji w Wirtualnym Świecie), and an adapted Slater-Usoh-Steed (SUS) questionnaire. Results of statistical and psychometric analyses, such as Kruskal-Wallis tests, Wilcoxon tests, and contrast analyses, underscored the positive impact of the virtual natural environment on individual pain perception and mood. The virtual natural environment outperformed the virtual urban environment and the control group without virtual projection, particularly in subjective pain components like intensity and unpleasantness. Variables such as restorative experience, sense of presence and virtual environment preference also proved pivotal in pain perception and pain tolerance threshold alterations, contingent on specific conditions. This implies considerable application potential for virtual natural environments across diverse realms of psychology and related fields, among others as a supportive analgesic approach and a form of relaxation following psychotherapeutic sessions.

Keywords: environmental psychology, nature, acute pain, emotions, vitrual reality, virtual environments

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Authors: Agata Chudzicka-Czupała, Nadiya Hapon, Liudmyla Karamushka, Marta żywiołek-Szeja

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Objectives: The study is about the determinants of coping with stress connected with volunteer activity for Russo-Ukrainian war 2022 refugees. We examined the mental health reactions, chosen psychological traits, and motivational functions of volunteers working in Poland and Ukraine in relation to their coping with stress styles. The study was financed with funds from the Foundation for Polish Science in the framework of the FOR UKRAINE Programme. Material and Method: The study was conducted in 2022. The study was a quantitative, questionnaire-based survey. Data was collected through an online survey. The volunteers were asked to assess their propensity to use different styles of coping with stress connected with their activity for Russo-Ukrainian war refugees using The Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE) questionnaire. Depression, anxiety, and stress were measured using the Depression, Anxiety, and Stress (DASS)-21 item scale. Chosen psychological traits, psychological capital and hardiness, were assessed by The Psychological Capital Questionnaire and The Norwegian Revised Scale of Hardiness (DRS-15R). Then The Volunteer Function Inventory (VFI) was used. The significance of differences between the variable means of the samples was tested by the Student's t-test. We used multivariate linear regression to identify factors associated with coping with stress styles separately for each national sample. Results: The sample consisted of 720 volunteers helping war refugees (in Poland, 435 people, and 285 in Ukraine). The results of the regression analysis indicate variables that are significant predictors of the propensity to use particular styles of coping with stress (problem-focused style, emotion-focused style and avoidant coping). These include levels of depression and stress, individual psychological characteristics and motivational functions, different for Polish and Ukrainians. Ukrainian volunteers are significantly more likely to use all three coping with stress styles than Polish ones. The results also prove significant differences in the severity of anxiety, stress and depression, the selected psychological traits and motivational functions studied, which led volunteers to participate in activities for war refugees. Conclusions: The results show that depression and stress severity, as well as psychological capital and hardiness, and motivational factors are connected with coping with stress behavior. The results indicate the need for increased attention to the well-being of volunteers acting under stressful conditions. They also prove the necessity of guiding the selection of people for specific types of volu

Keywords: anxiety, coping with stress styles, depression, hardiness, mental health, motivational functions, psychological capital, resilience, stress, war, volunteer, civil society

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Authors: Muzamil Mahmood, Afshan Naseem, Muhammad Zeeshan Mirza, Yasir Ahmad, Masood Raza

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The purpose of this research is to analyze how aviation maintenance workers’ characteristics and work demand affect their development of work-related musculoskeletal disorders (WMSDs). Guided by literature on task characteristics, work demand, and WMSDs, data is collected from 128 aviation maintenance workers of private and public airlines. Data is then analyzed through descriptive and inferential statistics. It is found that task characteristics have a significant positive effect on WMSDs and an increase in tasks performed by aviation maintenance workers leads to increase in WMSDs. Work demand did not have a significant effect on WMSDs. The task characteristics of aviation maintenance workers moderates the relationship between their work demand and WMSDs. This reveals that task characteristics of aviation maintenance workers enhance the effect of work demand on WMSDs. The task characteristics of aviation maintenance workers are challenging and unpredictable. Subsequently, WMSDs are prevalent among aviation maintenance workers. The work demand of aviation maintenance workers does not influence their development of WMSDs. Pakistan Civil Aviation Authority should minimize the intensity of tasks assigned to aviation maintenance workers by introducing work dynamisms such as task sharing, job rotation, and probably teleworking to enhance flexibility. Human Resource and Recruitment Department need to consider the ability and fitness levels of potential aviation maintenance workers during recruitment. In addition, regular physical activities and ergonomic policies should be put in place by the management of the Pakistan Civil Aviation Authority to reduce the incidences of WMSDs.

Keywords: work related musculoskeletal disorders, ergonomics, occupational health and safety, human factors

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Authors: Unal Demirtas, Mehmet Ergin Dipcin, Mehmet Cetin

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Background: Applied to student candidates prior to entering the air force academy, under the name of Cadet selection flights and executed as 7-8 sorties under the surveillance of flight instructors, this training is mainly towards appraising students’ characteristics of flying ability. All pilot cadets are gone through physical examination before cadet selection flight in a military hospital. Some cadets may show motion sickness symptoms during this flights. The most common symptoms: Nausea, vomiting, vertigo, headache, anxiety, paresthaesia, asthenia, muscle contraction and excitement. These cadets are examined by flight surgeon, after this flight surgeon and psychologist have an motivational interviewing with these cadets. Method: In this study, we have applied a survey that we question the severity of the symptom to the candidates that have motion sickness after the first sortie. We have questioned the candidate who had a motivational interviewing by the psychologist after the treatment of the flight surgeon that whether the candidate relived the complaints that he has at the previous sortie after the second sortie and whether there is decrease or increase in the severity of the complaints compared to the previous flight. Findings: 15 candidates have applied for the flight surgeon with at least one of the motion sickness symptoms. 11 of the 15 candidates showing motion sickness symptoms after the first flight expressed that their complaints are decreased after the motivational interviewing and 4 of the candidates stated that there are no changes in their complaints. The frequently expressed complaints are nausea, vertigo, headache, exhaustion and vomiting respectively. 7 out of 15 candidates expressed that they have same kind of complains in bus, ship etc. Conclusion: It is observed in our study that only conducting motivational interviewing with the candidates without any organic disorders without giving any drugs has a positive effect on the candidates in terms of motion sickness.

Keywords: aeromedicine, candidate, motion sickness, motivational interviewing, pilot

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Authors: Lucie Mrackova, Helena Kisvetrova

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Spirituality is an integral part of human life. In a secular environment, spiritual needs are often overlooked, especially in acute nursing care. Spiritual needs assessment for patients (SNAP), which also exists in the Czech version (SNAP-CZ), can be used for objective evaluation. The aim of this study was to measure the psychometric properties of SNAP-CZ and to find correlations between SNAP-CZ and sociodemographic and clinical variables. A cross-sectional study with tools assessing spiritual needs (SNAP-CZ), anxiety (Beck Anxiety Inventory; BAI), depression (Beck Depression Inventory; BDI), pain (Visual Analogue Scale; VAS), self-sufficiency (Barthel Index; BI); cognitive function (Montreal Cognitive Test; MoCa) and selected socio-demographic data was performed. The psychometric properties of SNAP-CZ were tested using factor analysis, reliability and validity tests, and correlations between the questionnaire and sociodemographic data and clinical variables. Internal consistency was established with Cronbach’s alfa for the overall score, respective domains, and individual items. Reliability was assessed by test-retest by Interclass correlation coefficient (ICC). Data for correlation analysis were processed according to Pearson's correlation coefficient. The study included 172 trauma patients (the mean age = 40.6 ± 12.1 years) who experienced polytrauma or severe monotrauma. There were a total of 106 (61.6%) male subjects, 140 (81.4%) respondents identified themselves as non-believers. The full-scale Cronbach's alpha was 0.907. The test-retest showed the reliability of the individual domains in the range of 0.924 to 0.960 ICC. Factor analysis resulted in a three-factor solution (psychosocial needs (alfa = 0.788), spiritual needs (alfa = 0.886) and religious needs (alfa = 0.841)). Correlation analysis using Pearson's correlation coefficient showed that the domain of psychosocial needs significantly correlated only with gender (r = 0.178, p = 0.020). Males had a statistically significant lower average value in this domain (mean = 12.5) compared to females (mean = 13.8). The domain of spiritual needs significantly correlated with gender (r = 0.199, p = 0.009), social status (r = 0.156, p = 0.043), faith (r = -0.250, p = 0.001), anxiety (r = 0.194, p = 0.011) and depression (r = 0.155, p = 0.044). The domain of religious needs significantly correlated with age (r = 0,208, p = 0,007), education (r = -0,161, p = 0,035), faith (r = -0,575, p < 0,0001) and depression (r = 0,179, p = 0,019). Overall, the whole SNAP scale significantly correlated with gender (r = 0.219, p = 0.004), social status (r = 0.175, p = 0.023), faith (r = -0.334, p <0.0001), anxiety (r = 0.177, p = 0.022) and depression (r = 0.173, p = 0.025). The results of this study corroborate the reliability of the SNAP-CZ and support its future use in the nursing care of trauma patients in a secular society. Acknowledgment: The study was supported by grant nr. IGA_FZV_2020_003.

Keywords: acute nursing care, assessment of spiritual needs, patient, psychometric validation, spirituality

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Authors: Alireza Javadzadeh

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Background: The purpose of this prospective, randomized study was to compare the safety and efficacy of oral versus i.v. midazolam in providing sedation for pediatric upper gastrointestinal (GI) endoscopy. Methods: Sixty-one children (age < 16 years) scheduled for upper GI endoscopy were studied. Patients were randomly assigned to receive oral or i.v. midazolam. Measurements were made and compared for vital signs, level of sedation, pre- and post-procedure comfort, anxiety during endoscopy, ease of separation from parents, ease and duration of procedure, and recovery time. Results: Patients were aged 1–16 years (mean 7.5 ± 3.42 years); 30 patients received oral medication, and 31 received i.v. medication. There were no statistically significant differences in age or gender between groups. There were no significant differences in level of sedation, ease of separation from parents, ease of ability to monitor the patient during the procedure, heart rate, systolic arterial pressure, or respiratory rate. Oxygen saturation was significantly lower in the i.v. group than the oral group 10 and 30 min after removal of the endoscope, and recovery time was longer in the oral than the i.v. group. Conclusions: Oral administration of midazolam is a safe and effective method of sedation that significantly reduces anxiety and improves overall tolerance for children undergoing esophagogastroduodenoscopy.

Keywords: children, endoscopy, midazolam, oral, sedation

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Authors: Asmaa Tahiri, Mouktafi Amine

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A substantial number of traditional medical research has been put forward to managing and treating mental disorders. At the present time, to our best knowledge, it is believed that fundamental understanding of the underlying causes of the majority psychological disorders needs to be explored further to inform early diagnosis, managing symptoms and treatment. The emerging field of evolutionary psychology is a promising prospect to address the origin of mental disorders, potentially leading to more effective treatments. Schizophrenia as a topical mental disorder has been linked to the evolutionary adaptation of the human brain represented in the brain connectivity and asymmetry directly linked to humans higher brain cognition in contrast to other primates being our direct living representation of the structure and connectivity of our earliest common African ancestors. As proposed in the evolutionary psychology scientific literature the pathophysiology of schizophrenia is expressed and directly linked to altered connectivity between the Hippocampal Formation (HF) and Dorsolateral Prefrontal Cortex (DLPFC). This research paper presents the results of the use of tractography analysis using multiple open access Diffusion Weighted Imaging (DWI) datasets of healthy subjects, schizophrenia-affected subjects and primates to illustrate the relevance of the aforementioned brain regions connectivity and the underlying evolutionary changes in the human brain. Deterministic fiber tracking and streamline analysis were used to generate connectivity matrices from the DWI datasets overlaid to compute distances and highlight disconnectivity patterns in conjunction with other fiber tracking metrics; Fractional Anisotropy (FA), Mean Diffusivity (MD) and Radial Diffusivity (RD).

Keywords: tractography, evolutionary psychology, schizophrenia, brain connectivity

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Authors: Patricia Wahl, Dirk Bruland, Albert Lenz

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Children of mentally ill parents are a large high risk group for mental disorders which is hardly reached by preventive programs. The children inherit a heightened risk to develop a mental disorder themselves during their lifetime, but they and their parents are often rejecting to seek help. To elicit the factors determining this prevention dilemma, an explorative qualitative interview study is conducted in 25 families with mentally ill parents and yet unaffected children. Inclusion criteria are the children’s age (7 to 14 years old) and that these children live together with the affected parent. With regard to the concept of Mental Health Literacy the following research questions are leading the Qualitative Content Analysis: What are the needs of families with mentally ill parents? How can their help-seeking behaviour be described? What are their subjective illness theories? And which influences do gender, ethnicity and socio-economic status have on needs, help-seeking and illness theories? Mental Health Literacy relates to the knowledge and attitudes towards mental disorders influencing the recognition, management or prevention of these disorders. The concept seems to be an interesting starting point for our analysis with the aim to understand antecedences and processes in the families more deeply. Results of an extensive literature review serve as deductive framework for our analysis, first findings from the interviews will be available up to the time of the conference and can be presented. They hopefully will give inside in the families’ living environment and help to adapt/develop interventions and in the long term reduce health inequalities. The project at hand is part of the Health Literacy in Childhood and Adolescence (HLCA) Research Consortium financed by the German Federal Ministry of Education and Research (BMBF).

Keywords: children of mentally ill parents, help-seeking behaviour, mental health literacy, prevention dilemma

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Authors: Junaid Mahmood Alam, Sana Anwar, Sarah Sughra Asghar

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Chronic hepatitis or Hepatitis C viral (HCV) infection has been identified as one of the factors that could elicit autoimmune disease resulting in the development of auto-antibodies. Furthermore, HCV is implicated in contravening of forbearance to antigens, therefore, inciting auto-reactivity. In this regard, several near and past studies noted the prevalence of thyroid dysfunction and production of anti-thyroid antibodies (ATAb) such as anti-thyroid peroxidase (AntiTPO) and anti-thyroglobulin (AntiTG) in patients with HCV. Likewise, one of the etiologies of augmentation of thyroid disease is basically interferon therapy for HCV infections, for which a number of autoimmune diseases have been noted including Grave’s disease, Hishimoto thyroiditis. A prospectively case-control study was therefore carried out at department of clinical biochemistry lab services and chemical pathology in collaboration with department of clinical microbiology, at Liaquat National Hospital and Medical College, Karachi Pakistan for the period January 2015 to December 2017. Two control groups were inducted for comparison purpose, control group 1 = without HCV infection and with thyroid disorders (n = 20), control group 2 = with HCV infection and without thyroid disorders (n = 20), whereas HCV infected were n = 40 where more than half were noted to be positive for either of HCV IgG and Ag. In HCV group, patients with existing sub-clinical hypothyroidism and clinical hyperthyroidism were less than 5%. Analysis showed the presence of AntiTG in 12 HCV patients (30%), AntiTPO in 15 (37.5%) and both AntiTG and antiTPO in 10 patients (25%). Only 3 patients were found with the history of anti-thyroid auto-antibodies (7.5%) and one with parents and relatives with auto-immune disorders (2.5%). Patients that remained untreated were 12 (30%), under treatment 18 (45%) and with complete-course of treatment 10 (25%). As per review of the literature, meta-analysis of evident data and cross-sectional studies of selective cohorts (as studied in presented research), thyroid connection is designated as one of the most recurrent endocrine ailment associated with chronic HCV infection. Moreover, it also represents an extrahepatic disease in the continuum of HCV syndrome. In conclusion, HCV patients were more likely to encompass thyroid disorders especially related to development of either of ATAb or both antiTG and AntiTPO.

Keywords: Hepatitis C viral (HCV) infection, anti-thyroid antibodies, anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies

Procedia PDF Downloads 157