Search results for: health risk factors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 21032

Search results for: health risk factors

13952 Investigating Factors Influencing Generation Z’s Pro-Environmental Behavior to Support the Energy Transition in Jakarta, Indonesia

Authors: Phimsupha Kokchang, Divine Ifransca Wijaya

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The energy transition is crucial for mitigating climate change and achieving sustainable development and resilience. As the energy transition advances, generation Z is entering the economic world and will soon be responsible for taking care of the environment. This study aims to investigate the factors influencing generation Z’s pro-environmental behavior to support the energy transition. The theory of planned behavior approach was combined with the pro-environmental behavior concept to examine generation Z’s support toward the energy transition through participating in activism, using energy from renewable sources, opting for energy-efficient utilities or vehicles, and influencing others. Data were collected through an online questionnaire of 400 respondents aged 18-26 living in Jakarta, Indonesia. Partial least square structural equation modeling (PLS-SEM) using SmartPLS 3.0 software was used to analyze the reliability and validity of the measurement model. The results show that attitude, subjective norms, and perceived behavior control positively correlate with generation Z’s pro-environmental behavior to support the energy transition. This finding could enhance understanding and provide insights to formulate effective strategies and policies to increase generation Z’s support towards the energy transition. This study contributes to the energy transition discussion as it is included in the Sustainable Development Goals, as well as pro-environmental behavior and theory of planned behavior literature.

Keywords: energy transition, pro-environmental behavior, theory of planned behavior, generation Z

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13951 The Use of Ultrasound as a Safe and Cost-Efficient Technique to Assess Visceral Fat in Children with Obesity

Authors: Bassma A. Abdel Haleem, Ehab K. Emam, George E. Yacoub, Ashraf M. Salem

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Background: Obesity is an increasingly common problem in childhood. Childhood obesity is considered the main risk factor for the development of metabolic syndrome (MetS) (diabetes type 2, dyslipidemia, and hypertension). Recent studies estimated that among children with obesity 30-60% will develop MetS. Visceral fat thickness is a valuable predictor of the development of MetS. Computed tomography and dual-energy X-ray absorptiometry are the main techniques to assess visceral fat. However, they carry the risk of radiation exposure and are expensive procedures. Consequently, they are seldom used in the assessment of visceral fat in children. Some studies explored the potential of ultrasound as a substitute to assess visceral fat in the elderly and found promising results. Given the vulnerability of children to radiation exposure, we sought to evaluate ultrasound as a safer and more cost-efficient alternative for measuring visceral fat in obese children. Additionally, we assessed the correlation between visceral fat and obesity indicators such as insulin resistance. Methods: A cross-sectional study was conducted on 46 children with obesity (aged 6–16 years). Their visceral fat was evaluated by ultrasound. Subcutaneous fat thickness (SFT), i.e., the measurement from the skin-fat interface to the linea alba, and visceral fat thickness (VFT), i.e., the thickness from the linea alba to the aorta, were measured and correlated with anthropometric measures, fasting lipid profile, homeostatic model assessment for insulin resistance (HOMA-IR) and liver enzymes (ALT). Results: VFT assessed via ultrasound was found to strongly correlate with the BMI, HOMA-IR with AUC for VFT as a predictor of insulin resistance of 0.858 and cut off point of >2.98. VFT also correlates positively with serum triglycerides and serum ALT. VFT correlates negatively with HDL. Conclusions: Ultrasound, a safe and cost-efficient technique, could be a useful tool for measuring the abdominal fat thickness in children with obesity. Ultrasound-measured VFT could be an appropriate prognostic factor for insulin resistance, hypertriglyceridemia, and elevated liver enzymes in obese children.

Keywords: metabolic syndrome, pediatric obesity, sonography, visceral fat

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13950 Functional Characterization of Transcriptional Regulator WhiB Proteins of Mycobacterium Tuberculosis

Authors: Sonam Kumari

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Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis, possesses a remarkable feature of entering into and emerging from a persistent state. The mechanism by which Mtb switches from the dormant state to the replicative form is still poorly characterized. Proteome studies have given us an insight into the role of certain proteins in giving stupendous virulence to Mtb, but numerous dotsremain unconnected and unaccounted. The WhiB family of proteins is one such protein that is associated with developmental processes in actinomycetes.Mtb has seven such proteins (WhiB1 to WhiB7).WhiB proteins are transcriptional regulators; their conserved C-terminal HTH motif is involved in DNA binding. They regulate various essential genes of Mtbby binding to their promoter DNA. Biophysical Analysis of the effect of DNA binding on WhiB proteins has not yet been appropriately characterized. Interaction with DNA induces conformational changes in the WhiB proteins, confirmed by steady-state fluorescence and circular dichroism spectroscopy. ITC has deduced thermodynamic parameters and the binding affinity of the interaction. Since these transcription factors are highly unstable in vitro, their stability and solubility were enhanced by the co-expression of molecular chaperones. The present study findings help determine the conditions under which the WhiB proteins interact with their interacting partner and the factors that influence their binding affinity. This is crucial in understanding their role in regulating gene expression in Mtbandin targeting WhiB proteins as a drug target to cure TB.

Keywords: tuberculosis, WhiB proteins, mycobacterium tuberculosis, nucleic acid binding

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13949 Comparison of Maternal and Perinatal Outcomes of Obstetric Population Diagnosed with Covid-19 in Reference to Influenza A/H1N1: A Systematic Review and Meta-Analysis

Authors: Maria Vargas Hernandez, Jose Rojas Suarez, Carmelo Dueñas Castell, Sandra Contreras, Camilo Bello, Diana Borre, Walter Anichiarico, Harold Vasquez, Eduard Perez, Jose Santacruz

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In the last two decades, there have been outbreaks of emerging infectious diseases, with an impact on both the general population and the obstetric population. These infections, which affect the general population, pose a high risk for adverse maternal and perinatal outcomes, taking into account that physiological and immunological changes that occur during pregnancy can increase their risk or severity. Among these, the pandemics of viral infections, Influenza A/H1N1 and SARS-CoV-2/COVID-19, stand out. In 2009, Influenza A/H1N1 infection (H1N1 2009pdm) affected approximately 3,110 obstetric patients, with data reported from 29 countries, including 1,625 (52.3%) cases that were hospitalized, 378 (23.3%) admissions to ICU and 130 (8%) deaths; and since the end of 2019, the Severe Acute Respiratory Syndrome - 2 (SARS-CoV-2) has been identified, causing the COVID-19 pandemic, with global mortality that is around 2-4% for the general population, and higher mortality in patients requiring admission to the intensive care unit. Its impact on the obstetric population is still unknown. Objectives: To evaluate the impact on maternal and perinatal outcomes of COVID-19 infection in reference to influenza A/H1N1 infection in the obstetric population. Methodology: Systematic review of the literature and meta-analysis. Results: Mortality from maternal infection with influenza A/H1N1 appears to be higher (8%) than mortality due to maternal infection with COVID-19 (3%). The rates of ICU admission, hospitalization, the requirement for invasive mechanical ventilation, and fetal death also appear to be higher in the maternal population with A/H1N1 infection, in reference to the maternal population with COVID-19 infection. Within perinatal outcomes, the admission to the neonatal ICU appears to be higher in the infants born to mothers with COVID-19 infection (28% vs. 15% for COVID-19 and A/H1N1, respectively). Conclusion: A/H1N1 infection in the obstetric population seems to be associated with a higher proportion of adverse outcomes in relation to COVID-19 infection. The actual impact of maternal influenza A/H1N1 infection on perinatal outcomes is unknown. More COVID-19 studies are needed to understand the impact of maternal infection on perinatal outcomes in this population.

Keywords: A/H1N1, COVID-19, maternal outcomes, perinatal outcomes

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13948 Everyone Can Sing: A Feasibility Study of Class Choir as a Mental Health Promoting Intervention Among 0-3rd Grade Students in Denmark

Authors: Anne Tetens, Susan Andersen, Lars Ole Bonde, Pia Jeppesen, Katrine Rich Madsen

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Background: The World Health Organization (WHO) has emphasized the critical need for feasible and effective school-based mental health promotion interventions. High-quality music education in school has been suggested to promote well-being, inclusion, and positive relations, which are essential for children’s mental health. This study explores the potential of choir singing as a distinct approach to enhance children’s mental health within the school setting. ‘Everyone Can Sing’ is a class-based mental health promotion intervention for children in grades 0-3 (ages 5-10) in Danish primary school, which integrates choir singing into the students’ normal school schedule twice a week to promote mental health through the increase of school well-being, class coherence and social inclusion. The intervention uses trained choir leaders to lead the lessons in close collaboration with the class teacher, placing a distinct emphasis on well-being and the inclusive aspect of musical expression through body and voice. Aim: The aim of the study is to evaluate the feasibility of the Everyone Can Sing intervention with the specific objective to assess implementation and changes in mental health parameters, including school well-being, class coherence and social inclusion. Methodologies: The study is a feasibility study of a one-year intervention, which started in January 2024 and is being implemented in grades 0-3 (ages 5-10) across three different Danish primary schools. It is designed according to a mixed methods approach, including both quantitative and qualitative methods. Baseline questionnaires were obtained from students, parents and teachers, and follow-up is planned at 12 months. Participant observations of class choir and individual and group interviews with students, teachers, choir leaders, and school management are collected during the intervention period. The study uses the validated ‘Strengths and Difficulties Questionnaire’ for parent- and teacher-reports. The student questionnaire, which assesses school well-being, class coherence, social inclusion and indicators of mental health, was developed and validated for this study. Participant observations and interviews provide in-depth insights into the implementation process and participants’ experiences of the mental health-promoting potential of the intervention. Findings: The study included 41 classes across three schools (N=904) and questionnaire data from students (n=845, = 93%), teachers (n=890, = 98%), and parents (n=608, = 67%) at baseline. Follow-up data will be obtained in January 2025. While collection and analyses of data are still ongoing, preliminary implementation findings based on interviews and observations indicate high levels of engagement and acceptability. At 6 months into the intervention period, the study protocol is on track and suggests that the intervention is well-received. Further findings and analyses will be presented. The final results of the study will be used to decide whether the AKS intervention should proceed to a future, full-size effectiveness trial, return to refinement of the intervention or the evaluation design, or stop. Contributions: This study will provide valuable insights into new approaches to school-based mental health promotion initiatives. If feasible, the vision is to implement the intervention or elements of it in primary schools across all five Danish regions, potentially lowering the mental health burden.

Keywords: child mental health, early childhood, mental health promotion, mixed methods research, school-based intervention.

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13947 The Effects of Vitamin D Supplementation on Anthropometric Indicators of Adiposity and Fat Distribution in Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Simin Zarea Karizi, Somaye Fatahi, Amirhossein Hosseni

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Background: There are conflicting findings regarding the effect of vitamin D supplementation on obesity-related factors. This study aimed to investigate the effect of vitamin D supplementation on changes in anthropometric indicators of adiposity and fat distribution in children and adolescents. Methods: Original databases were searched using standard keywords to identify all controlled trials investigating the effects of vitamin D supplementation on obesity-related factors in children and adolescents. Pooled weighted mean difference and 95% confidence intervals were achieved by random-effects model analysis. Results: Fourteen treatment arms were included in this systematic review and meta-analysis. The quantitative meta-analysis revealed no significant effect of vitamin D supplement on BMI (-0.01 kg/m2; 95% CI: -0.09, 0.12; p= 0.74; I2=0.0%), BMI z score (0.02; 95% CI: -0.04, 0.07; p= 0.53; I2=0.0%) and fat mass (0.07%; 95% CI: -0.09 to 0.24; p= 0.38; I2=31.2%). However, the quantitative meta-analysis displayed a significant effect of vitamin D supplementation on WC compared with the control group (WMD=-1.17 cm, 95% CI: -2.05, -0.29, p=0.009; I2=32.0 %). It seems that this effect was greater in healthy children with duration>12 weeks, dose<=400 IU and baseline less than 50 nmol/l vitamin D than others. Conclusions: Our findings suggest that vitamin D supplementation may be a protective factor of abdominal obesity and should be evaluated on an individual basis in clinical practice.

Keywords: weight loss, vitamin D, anthropometry, children, adolescent

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13946 Differential Diagnosis of Malaria and Dengue Fever on the Basis of Clinical Findings and Laboratory Investigations

Authors: Aman Ullah Khan, Muhammad Younus, Aqil Ijaz, Muti-Ur-Rehman Khan, Sayyed Aun Muhammad, Asif Idrees, Sanan Raza, Amar Nasir

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Dengue fever and malaria are important vector-borne diseases of public health significance affecting millions of people around the globe. Dengue fever is caused by Dengue virus while malaria is caused by plasmodium protozoan. Generally, the consequences of Malaria are less severe compared to dengue fever. This study was designed to differentiate dengue fever and malaria on the basis of clinical and laboratory findings and to compare the changes in both diseases having different causative agents transmitted by the common vector. A total of 200 patients of dengue viral infection (120 males, 80 females) were included in this prospective descriptive study. The blood samples of the individuals were first screened for malaria by blood smear examination and then the negative samples were tested by anti-dengue IgM strip. The strip positive cases were further screened by IgM capture ELISA and their complete blood count including hemoglobin estimation (Hb), total and differential leukocyte counts (TLC and DLC), erythrocyte sedimentation rate (ESR) and platelet counts were performed. On the basis of the severity of signs and symptoms, dengue virus infected patients were subdivided into dengue fever (DF) and dengue hemorrhagic fever (DHF) comprising 70 and 100 confirmed patients, respectively. On the other hand, 30 patients were found infected with Malaria while overall 120 patients showed thrombocytopenia. The patients of DHF were found to have more leucopenia, raised hemoglobin level and thrombocytopenia < 50,000/µl compared to the patients belonging to DF and malaria. On the basis of the outcomes of the study, it was concluded that patients affected by DF were at a lower risk of undergoing haematological disturbance than suffering from DHF. While, the patients infected by Malaria were found to have no significant change in their blood components.

Keywords: dengue fever, blood, serum, malaria, ELISA

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13945 Enhancing Mental Health Services Through Strategic Planning: The East Tennessee State University Counseling Center’s 2024-2028 Plan

Authors: R. M. Kilonzo, S. Bedingfield, K. Smith, K. Hudgins Smith, K. Couper, R. Ratley, Z. Taylor, A. Engelman, M. Renne

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Introduction: The mental health needs of university students continue to evolve, necessitating a strategic approach to service delivery. The East Tennessee State University (ETSU) Counseling Center developed its inaugural Strategic Plan (2024-2028) to enhance student mental health services. The plan focuses on improving access, quality of care, and service visibility, aligning with the university’s mission to support academic success and student well-being. Aim: This strategic plan aims to establish a comprehensive framework for delivering high-quality, evidence-based mental health services to ETSU students, addressing current challenges, and anticipating future needs. Methods: The development of the strategic plan was a collaborative effort involving the Counseling Center’s leadership, staff, with technical support from Doctor of Public Health-community and behavioral health intern. Multiple workshops, online/offline reviews, and stakeholder consultations were held to ensure a robust and inclusive process. A SWOT analysis and stakeholder mapping were conducted to identify strengths, weaknesses, opportunities, and challenges. Key performance indicators (KPIs) were set to measure service utilization, satisfaction, and outcomes. Results: The plan resulted in four strategic priorities: service application, visibility/accessibility, safety and satisfaction, and training programs. Key objectives include expanding counseling services, improving service access through outreach, reducing stigma, and increasing peer support programs. The plan also focuses on continuous quality improvement through data-driven assessments and research initiatives. Immediate outcomes include expanded group therapy, enhanced staff training, and increased mental health literacy across campus. Conclusion and Recommendation: The strategic plan provides a roadmap for addressing the mental health needs of ETSU students, with a clear focus on accessibility, inclusivity, and evidence-based practices. Implementing the plan will strengthen the Counseling Center’s capacity to meet the diverse needs of the student population. To ensure sustainability, it is recommended that the center continuously assess student needs, foster partnerships with university and external stakeholders, and advocate for increased funding to expand services and staff capacity.

Keywords: strategic plan, university counseling center, mental health, students

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13944 Study on the Renewal Strategy of Mountain City Trail Based on Place Attachment Theory

Authors: Long Xumeng

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Place attachment focuses on the emotions and practices between people and their environment, and the influencing factors of place attachment vary depending on the nature of the place. As an important carrier of public slow-moving activities and urban culture, the feelings, cognition, and behaviors of the subjects involved in the use of mountain city trails have become the focus of research in this field. This paper will take Daijiaxiang Cliff Walkway in Yuzhong District, Chongqing City, as an example and analyze the evaluation results and correlation of each factor through questionnaire survey and field observation, using the three scales of Recreational Experience Scale, Satisfaction Scale, and Place Attachment Scale, as well as the intensity of activity, by using SPSS software. The study shows that there is a significant difference between the demographic variables of users' identity and age and the formation of place attachment; the degree of place attachment is significantly positively correlated with the emotion, industry, and service quality of recreational experience; and the recreational experience of the Mountain City Trail is significantly positively correlated with the overall satisfaction. By analyzing the influencing factors of recreational experience, satisfaction and place attachment, the corresponding conclusions and enhancement strategies were drawn to provide references for the renewal and construction of mountain city trails.

Keywords: mountain city trail, place attachment, recreational experience, satisfaction, urban renewal

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13943 Physical Education Curricula and Teaching Methodologies for Children with Disabilities: Scoping Review

Authors: Xavier Mc Creanor, Rowena Naidoo, Verusia Chetty

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The exclusion of children with disabilities from physical education presents notable health risks and hinders their overall development. Despite the acknowledged significance of inclusive education, there remains a limited understanding of effective teaching methodologies and curricula tailored to this demographic. In this scoping review, existing literature on physical education curricula and teaching methodologies for children with disabilities was systematically mapped. A comprehensive search across various electronic databases, including Google Scholar, EBSCOhost, the Cochrane Library, PubMed, and Science Direct, yielded 5,361 potential articles. Following the application of inclusion and exclusion criteria, 18 relevant studies were examined. The review highlighted persistent barriers to inclusion, such as inaccessible facilities and negative attitudes among educators. Noteworthy findings underscored the necessity for comprehensive training for physical education instructors and the adaptation of curricula to accommodate diverse learning needs better. The analysis identified significant themes, including the impact of legislative frameworks, educator preparedness, and cultural factors influencing participation. Structural changes and effective teaching strategies are imperative to cultivate inclusivity in physical education for children with disabilities. This review underscores the ongoing need for educators to develop professionally and adapt physical education curricula to enrich the educational experiences of children with disabilities.

Keywords: children with disabilities, special needs education, physical education, curriculum, teaching methodologies

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13942 Non-Invasive Evaluation of Patients After Percutaneous Coronary Revascularization. The Role of Cardiac Imaging

Authors: Abdou Elhendy

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Numerous study have shown the efficacy of the percutaneous intervention (PCI) and coronary stenting in improving left ventricular function and relieving exertional angina. Furthermore, PCI remains the main line of therapy in acute myocardial infarction. Improvement of procedural techniques and new devices have resulted in an increased number of PCI in those with difficult and extensive lesions, multivessel disease as well as total occlusion. Immediate and late outcome may be compromised by acute thrombosis or the development of fibro-intimal hyperplasia. In addition, progression of coronary artery disease proximal or distal to the stent as well as in non-stented arteries is not uncommon. As a result, complications can occur, such as acute myocardial infarction, worsened heart failure or recurrence of angina. In a stent, restenosis can occur without symptoms or with atypical complaints rendering the clinical diagnosis difficult. Routine invasive angiography is not appropriate as a follow up tool due to associated risk and cost and the limited functional assessment. Exercise and pharmacologic stress testing are increasingly used to evaluate the myocardial function, perfusion and adequacy of revascularization. Information obtained by these techniques provide important clues regarding presence and severity of compromise in myocardial blood flow. Stress echocardiography can be performed in conjunction with exercise or dobutamine infusion. The diagnostic accuracy has been moderate, but the results provide excellent prognostic stratification. Adding myocardial contrast agents can improve imaging quality and allows assessment of both function and perfusion. Stress radionuclide myocardial perfusion imaging is an alternative to evaluate these patients. The extent and severity of wall motion and perfusion abnormalities observed during exercise or pharmacologic stress are predictors of survival and risk of cardiac events. According to current guidelines, stress echocardiography and radionuclide imaging are considered to have appropriate indication among patients after PCI who have cardiac symptoms and those who underwent incomplete revascularization. Stress testing is not recommended in asymptomatic patients, particularly early after revascularization, Coronary CT angiography is increasingly used and provides high sensitive for the diagnosis of coronary artery stenosis. Average sensitivity and specificity for the diagnosis of in stent stenosis in pooled data are 79% and 81%, respectively. Limitations include blooming artifacts and low feasibility in patients with small stents or thick struts. Anatomical and functional cardiac imaging modalities are corner stone for the assessment of patients after PCI and provide salient diagnostic and prognostic information. Current imaging techniques cans serve as gate keeper for coronary angiography, thus limiting the risk of invasive procedures to those who are likely to benefit from subsequent revascularization. The determination of which modality to apply requires careful identification of merits and limitation of each technique as well as the unique characteristic of each individual patient.

Keywords: coronary artery disease, stress testing, cardiac imaging, restenosis

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13941 An Investigation of Cyber Financial Crimes After the Enactment of PECA: A Case Study of Pakistan’s Banking Sector During 2016 to 2022

Authors: Zain Khalid

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The paper outlines the trends of cyber financial crimes and frauds – approximating upto – in Pakistan after the enactment of The Prevention of Electronic Crimes Act in 2016. The paper elaborates on the newer methods that fraudsters have adopted after tighter preventive and counter measures were employed in Pakistan partly as a result of following the international finance related commitments, particularly the FATF regulations. The paper adopts case studies methods to highlight various aspects of the financial frauds and crimes committed and later investigated jointly by Pakistan’s one of the federal law enforcement agencies, the Federal Investigation Agency, and Mobilink Microfinance Bank , Pakistan’s premier microfinance bank. It additionally enriches the data through expert interviews – with crime investigators and the experts to carry out an in-depth analysis of the various factors involving the crime. This paper emphasizes the structural and situational factors that shape up the cyber financial crimes in Pakistan vis-à-vis digital illiteracy and lack of awareness among the users of financial services. This paper, thus, on the basis of findings and expert interviews, suggests policy reforms to reduce the instances of the financial crimes, especially in the remotest areas of the country.

Keywords: financial crimes, cyber crimes, digital literacy, terrorism financing, banking sector

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13940 Seamounts and Submarine Landslides: Study Case of Island Arcs Area in North of Sulawesi

Authors: Muhammad Arif Rahman, Gamma Abdul Jabbar, Enggar Handra Pangestu, Alfi Syahrin Qadri, Iryan Anugrah Putra, Rizqi Ramadhandi.

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Indonesia lies above three major tectonic plates, Indo-Australia plate, Eurasia plate, and Pacific plate. Interactions between those plates resulted in high tectonic and volcanic activities that corelates into high risk of geological hazards in adjacent areas, one of the areas is in North of Sulawesi’s Islands. This case raises a problem in terms of infrastructure in order to mitigate existing infrastructure and various future infrastructures plan. One of the infrastructures that is essentials to enhance telecommunication aspect is submarine fiber optic cable, that has risk to geological hazard. This cable is essential that act as backbone in telecommunication. Damaged fiber optic cables can pose serious problem that make existing signal to be loss and have negative impact to people’s social and economic factor with also decreasing various governmental services performance. Submarine cables are facing challenges in terms of geological hazards, for instance are seamounts activity. Previous studies show that until 2023, five seamounts are identified in North of Sulawesi. Seamounts itself can damage and trigger many activities that can risks submarine cables, one of the examples is submarine landslide. Main focuses of this study are to identify new possible seamounts and submarine landslide path in area North of Sulawesi Islands to help minimize risks pose by those hazards, either to existing or future plan submarine cables. Using bathymetry data, this study conduct slope analysis and use distinctive morphological features to interpret possible seamounts. Then we mapped out valleys in between seamounts and determine where sediments might flow in case of landslide, and to finally, know how it affect submarine cables in the area.

Keywords: bathymetry, geological hazard, mitigation, seamount, submarine cable, submarine landslide, volcanic activity

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13939 Mental Illness, Dargahs and Healing: A Qualitative Exploration in a North Indian City

Authors: Reetinder Kaur, R. K. Pathak

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Mental health is recognised as an important global health concern. World Health Organisation in 2004 estimated that neuropsychiatric illnesses in India account for 10.8 percent of the global burden. The prevalence of serious mental illnesses is estimated as 6.5 percent by National Commission of Macroeconomics and Health in 2005. India spends only 0.06 percent of its health budget on mental health. One of the major problems that exist in Indian mental health care is the treatment gap due to scarcity of manpower, inadequate infrastructure and deficiencies in policy initiatives. As a result, traditional healing is a popular resource for mentally ill individuals and their families. The various traditional healing resources include faith healers, healers at temples and Dargahs. Chandigarh is a Union Territory located in North India. It has surplus manpower and infrastructure available for mental health care. Inspite of availability of mental health care services, mentally ill individuals and their families seek help from traditional healers at various Dargahs within or outside Chandigarh. For the present study, the data was collected from four dargahs. A total of thirty patients medically diagnosed with various mental illnesses, their family members who accompanied them and healers were part of this study. The aim of the study was to: Understand the interactions between healer, patient and family members during the course of treatment, understand explanations of mental illnesses and analyse the healing practices in context of culture. The interviews were conducted using an interview guide for the three sets of informants: Healers, patients and family members. The interview guide for healer focussed on the healing process, healer’s understanding of patient’s explanatory models, healer’s knowledge about mental illnesses and types of these illnesses cured by the healer. The interview guide for patients and family members focussed on their understanding of the symptoms, explanations for illness and help-seeking behaviour. The patients were observed over the weeks (every Thursday, the day of pir and healing) during their visits to the healer. Detailed discussions were made with the healer regarding the healing process and benefits of healing. The data was analysed thematically and the themes: The role of sacred, holistic healing, healer’s understanding of patient’s explanatory models of mental illness, the patient’s, and family’s understanding of mental illnesses, healer’s knowledge about mental illnesses, types of mental illnesses cured by the healer, bad dreams and their interpretation emerged. From the analysis of data, it was found that the healers concentrate their interventions in the social arena, ‘curing’ distressed patients by bringing significant changes in their social environment. It is suggested that in order to make the mental health care services effective in India, the collaboration between healers and psychiatrist is essential. However, certain specifications need to be made to make this kind of collaboration successful and beneficial for the stakeholders.

Keywords: Dargah, mental illness, traditional healing, policy

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13938 Implementation of an Online-Platform at the University of Freiburg to Help Medical Students Cope with Stress

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

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

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

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13937 Socio-Economic Factors Influencing the Use of Coping Strategies among Conflict Actors (Farmers and Herders) in Giron Masa Village, Kebbi State, Nigeria

Authors: S. Umar, B. F. Umar

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This study was conducted at Giron Masa village, located 30 km from Yauri town. The study determines the socio-economic factors influencing the use of coping strategies among farmers and herders during post-conflict situation. Simple random sampling was employed to select one hundred respondents (50 farmers and 50 herders) from the study area. Logistic regression analysis (LR) was used to ascertain the socioeconomic variables that influenced the use of the coping strategies. The results of the study shows that age, income, family size and farming experience were individually significant and thus influenced the use of POCS by farmers. Annual income and production system influenced the use of POCS by herders. Age, farm size and farming experience were found to be individually significant in influencing the use of EOCS among farmers. Specifically, years of occupation experience among the herders increased the use of emotion oriented coping strategies among herders. The use of SSCS among farmers was influenced by educational level; farm size and farming experience, while the variables are not collectively significant in influencing the use of SSCS among the herders. The research recommends a need to adopt the strategy of community coping to cope with stress.

Keywords: farmers, herders, conflict, coping strategies

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13936 Estimation of Carbon Sequestration and Air Quality of Terrestrial Ecosystems Using Remote Sensing Techniques

Authors: Kanwal Javid, Shazia Pervaiz, Maria Mumtaz, Muhammad Ameer Nawaz Akram

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Forests and grasslands ecosystems play an important role in the global carbon cycle. Land management activities influence both ecosystems and enable them to absorb and sequester carbon dioxide (CO2). Similarly, in Pakistan, these terrestrial ecosystems are well known to mitigate carbon emissions and have a great source to supply a variety of services such as clean air and water, biodiversity, wood products, wildlife habitat, food, recreation and carbon sequestration. Carbon sequestration is the main agenda of developed and developing nations to reduce the impacts of global warming. But the amount of carbon storage within these ecosystems can be affected by many factors related to air quality such as land management, land-use change, deforestation, over grazing and natural calamities. Moreover, the long-term capacity of forests and grasslands to absorb and sequester CO2 depends on their health, productivity, resilience and ability to adapt to changing conditions. Thus, the main rationale of this study is to monitor the difference in carbon amount of forests and grasslands of Northern Pakistan using MODIS data sets and map results using Geographic Information System. Results of the study conclude that forests ecosystems are more effective in reducing the CO2 level and play a key role in improving the quality of air.

Keywords: carbon sequestration, grasslands, global warming, climate change.

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13935 Genetic-Environment Influences on the Cognitive Abilities of 6-to-8 Years Old Twins

Authors: Annu Panghal, Bimla Dhanda

Abstract:

This research paper aims to determine the genetic-environment influences on the cognitive abilities of twins. Using the 100 pairs of twins from two districts, namely: Bhiwani (N = 90) and Hisar (N = 110) of Haryana State, genetic and environmental influences were assessed in twin study design. The cognitive abilities of twins were measured using the Wechsler Intelligence Scale for Children (WISC-R). Home Observation for Measurement of the Environment (HOME) Inventory was taken to examine the home environment of twins. Heritability estimate was used to analyze the genes contributing to shape the cognitive abilities of twins. The heritability estimates for cognitive abilities of 6-7 years old twins in Hisar district were 74% and in Bhiwani District 76%. Further the heritability estimates were 64% in the twins of Hisar district and 60 in Bhiwani district % in the age group of 7-8 years. The remaining variations in the cognitive abilities of twins were due to environmental factors namely: provision for Active Stimulation, paternal involvement, safe physical environment. The findings provide robust evidence that the cognitive abilities were more influenced by genes than the environmental factors and also revealed that the influence of genetic was more in the age group 6-7 years than the age group 7-8 years. The conclusion of the heritability estimates indicates that the genetic influence was more in the age group of 6-7 years than the age group of 7-8 years. As the age increases the genetic influence decreases and environment influence increases. Mother education was strongly associated with the cognitive abilities of twins.

Keywords: genetics, heritability, twins, environment, cognitive abilities

Procedia PDF Downloads 140
13934 Determinants of Successful Accounting Information System Outsourcing for the Egyptian Small and Medium Enterprises: An Empirical Study

Authors: Maram Elkady

Abstract:

Purpose: The purpose behind this study is to determine the impact of some factors on achieving successful accounting information systems (AIS) outsourcing in Egypt, taking into account two factors: the selection of an effective accounting service provider and the quality relationships between the client firm and the accounting service provider. The researcher measured outsourcing success through the perceived benefits, including (strategic, technological, and economic benefits). Design/Methodology/Approach: A survey was carried out by means of questionnaires answered by 152 small and medium Egyptian firms outsourcing their accounting activities. The researcher targeted the personnel in the client firms who were in direct contact with the accounting outsourcer. The hypotheses were tested through multiple regression analysis using SPSS 24 and AMOS 22. Findings: Building a quality relationship with the provider is found to have more impact than the effective selection of the AIS provider on the success of the AIS outsourcing process. Originality/Value: The researcher found that some proxies of each success determinant can be more influential than others based on type of benefits perceived from AIS outsourcing (strategic, technological, and economic).

Keywords: accounting information system, AIS, outsourcing, successful outsourcing, AIS service provider selection, relationship with the accounting service provider

Procedia PDF Downloads 162
13933 Mental Health Literacy in Ghana: Consequences of Religiosity, Education, and Stigmatization

Authors: Peter Adu

Abstract:

Although research on the concept of Mental Health Literacy (MHL) is growing internationally, to the authors’ best of knowledge, the beliefs and knowledge of Ghanaians on specific mental disorders have not yet been explored. This vignette study was conducted to explore the relationships between religiosity, education, stigmatization, and MHL among Ghanaians using a sample of laypeople (N = 409). The adapted questionnaire presented two vignettes (depression and schizophrenia) about a hypothetical person. The results revealed that more participants were able to recognize depression (47.4%) than schizophrenia (15.9%). Religiosity was not significantly associated with recognition of mental disorders (MHL) but was positively related with both social and personal stigma for depression and negatively associated with personal and perceived stigma for schizophrenia. Moreover, education was found to relate positively with MHL and negatively with perceived stigma. Finally, perceived stigma was positively associated with MHL, whereas personal stigma for schizophrenia related negatively to MHL. In conclusion, education but not religiosity predicted identification accuracy, but both predictors were associated with various forms of stigma. Findings from this study have implications for MHL and anti-stigma campaigns in Ghana and other developing countries in the region.

Keywords: depression, education, mental health literacy, religiosity, schizophrenia

Procedia PDF Downloads 159
13932 Integrated Waste-to-Energy Approach: An Overview

Authors: Tsietsi J. Pilusa, Tumisang G. Seodigeng

Abstract:

This study evaluates the benefits of advanced waste management practices in unlocking waste-to-energy opportunities within the solid waste industry. The key drivers of sustainable waste management practices, specifically with respect to packaging waste-to-energy technology options are discussed. The success of a waste-to-energy system depends significantly on the appropriateness of available technologies, including those that are well established as well as those that are less so. There are hard and soft interventions to be considered when packaging an integrated waste treatment solution. Technology compatibility with variation in feedstock (waste) quality and quantities remains a key factor. These factors influence the technology reliability in terms of production efficiencies and product consistency, which in turn, drives the supply and demand network. Waste treatment technologies rely on the waste material as feedstock; the feedstock varies in quality and quantities depending on several factors; hence, the technology fails, as a result. It is critical to design an advanced waste treatment technology in an integrated approach to minimize the possibility of technology failure due to unpredictable feedstock quality, quantities, conversion efficiencies, and inconsistent product yield or quality. An integrated waste-to-energy approach offers a secure system design that considers sustainable waste management practices.

Keywords: emerging markets, evaluation tool, interventions, waste treatment technologies

Procedia PDF Downloads 274
13931 Analysis of the Production Time in a Pharmaceutical Company

Authors: Hanen Khanchel, Karim Ben Kahla

Abstract:

Pharmaceutical companies are facing competition. Indeed, the price differences between competing products can be such that it becomes difficult to compensate them by differences in value added. The conditions of competition are no longer homogeneous for the players involved. The price of a product is a given that puts a company and its customer face to face. However, price fixing obliges the company to consider internal factors relating to production costs and external factors such as customer attitudes, the existence of regulations and the structure of the market on which the firm evolved. In setting the selling price, the company must first take into account internal factors relating to its costs: costs of production fall into two categories, fixed costs and variable costs that depend on the quantities produced. The company cannot consider selling below what it costs the product. It, therefore, calculates the unit cost of production to which it adds the unit cost of distribution, enabling it to know the unit cost of production of the product. The company adds its margin and thus determines its selling price. The margin is used to remunerate the capital providers and to finance the activity of the company and its investments. Production costs are related to the quantities produced: large-scale production generally reduces the unit cost of production, which is an asset for companies with mass production markets. This shows that small and medium-sized companies with limited market segments need to make greater efforts to ensure their profit margins. As a result, and faced with high and low market prices for raw materials and increasing staff costs, the company must seek to optimize its production time in order to reduce loads and eliminate waste. Then, the customer pays only value added. Thus, and based on this principle we decided to create a project that deals with the problem of waste in our company, and having as objectives the reduction of production costs and improvement of performance indicators. This paper presents the implementation of the Value Stream Mapping (VSM) project in a pharmaceutical company. It is structured as follows: 1) determination of the family of products, 2) drawing of the current state, 3) drawing of the future state, 4) action plan and implementation.

Keywords: VSM, waste, production time, kaizen, cartography, improvement

Procedia PDF Downloads 152
13930 Research of the Factors Affecting the Administrative Capacity of Enterprises in the Logistic Sector of Bulgaria

Authors: R. Kenova, K. Anguelov, R. Nikolova

Abstract:

The human factor plays a major role in boosting the competitive capacity of logistic enterprises. This is of particular importance when it comes to logistic companies. On the one hand they should be strictly compliant with legislation; on the other hand, they should be competitive in terms of pricing and of delivery timelines. Moreover, their policies should allow them to be as flexible as possible. All these circumstances are reason for very serious challenges for the qualification, motivation and experience of the human resources, working in logistic companies or in logistic departments of trade and industrial enterprises. The geographic place of Bulgaria puts it in position of a country with some specific competitive advantages in the goods transport from Europe to Asia and back. Along with it, there is a number of logistic companies, that operate in this sphere in Bulgaria. In the current paper, the authors aim to establish the condition of the administrative capacity and human resources in the logistic companies and logistic departments of trade and industrial companies in Bulgaria in order to propose some guidelines for improving of their effectiveness. Due to independent empirical research, conducted in Bulgarian logistic, trade and industrial enterprises, the authors investigate both the impact degree and the interdependence of various factors that characterize the administrative capacity. The study is conducted with a prepared questionnaire, in format of direct interview with the respondents. The volume of the poll is 50 respondents, representatives of: general managers of industrial or trade enterprises; logistic managers of industrial or trade enterprises; general managers of forwarding companies – either with own or with hired transport; experts from Bulgarian association of logistics; logistic lobbyist and scientists of the relevant area. The data are gathered for 3 months, then arranged by a specialized software program and analyzed by preset criteria. Based on the results of this methodological toolbox, it can be claimed that there is a correlation between the individual criteria. Also, a commitment between the administrative capacity and other factors that determine the competitiveness of the studied companies is established. In this paper, the authors present results of the empirical research that concerns the number and the workload in the logistic departments of the enterprises. Also, what is commented is the experience, related to logistic processes management and human resources competence. Moreover, the overload level of the logistic specialists is analyzed as one of the main threats for making mistakes and losing clients. The paper stands behind the thesis that there is indispensability of forming an effective and efficient administrative capacity, based on the number, qualification, experience and motivation of the staff in the logistic companies. The paper ends with recommendations about the qualification and experience of the specialists in logistic departments; providing effective and efficient administrative capacity in the logistic departments; interdependence of the human factor and the other factors that influence the enterprise competitiveness.

Keywords: administrative capacity, human resources, logistic competitiveness, staff qualification

Procedia PDF Downloads 153
13929 Modeling the Philippine Stock Exchange Index Closing Value Using Artificial Neural Network

Authors: Frankie Burgos, Emely Munar, Conrado Basa

Abstract:

This paper aimed at developing an artificial neural network (ANN) model specifically for the Philippine Stock Exchange index closing value. The inputs to the ANN are US Dollar and Philippine Peso(USD-PHP) exchange rate, GDP growth of the country, quarterly inflation rate, 10-year bond yield, credit rating of the country, previous open, high, low, close values and volume of trade of the Philippine Stock Exchange Index (PSEi), gold price of the previous day, National Association of Securities Dealers Automated Quotations (NASDAQ), Standard and Poor’s 500 (S & P 500) and the iShares MSCI Philippines ETF (EPHE) previous closing value. The target is composed of the closing value of the PSEi during the 627 trading days from November 3, 2011, to May 30, 2014. MATLAB’s Neural Network toolbox was employed to create, train and simulate the network using multi-layer feed forward neural network with back-propagation algorithm. The results satisfactorily show that the neural network developed has the ability to model the PSEi, which is affected by both internal and external economic factors. It was found out that the inputs used are the main factors that influence the movement of the PSEi closing value.

Keywords: artificial neural networks, artificial intelligence, philippine stocks exchange index, stocks trading

Procedia PDF Downloads 298
13928 The Impact of Water Reservoirs on Biodiversity and Food Security and the Creation of Adaptation Mechanisms

Authors: Inom S. Normatov, Abulqosim Muminov, Parviz I. Normatov

Abstract:

Problems of food security and the preservation of reserved zones in the region of Central Asia under the conditions of the climate change induced by the placement and construction of large reservoirs are considered. The criteria for the optimum placement and construction of reservoirs that entail the minimum impact on the environment are established. The need for the accounting of climatic parameters is shown by the calculation of the water quantity required for the irrigation of agricultural lands.

Keywords: adaptation, biodiversity, food security, water reservoir, risk

Procedia PDF Downloads 256
13927 Selecting Special Education as a Career: A Qualitative Study of Motivating Factors for Special Education Teachers

Authors: Jennifer Duffy, Liz Fleming

Abstract:

Teacher shortage in special education is an American educational problem. Due to the implementation of The No Child Left Behind Act (2001) and The Individuals with Disabilities Education Improvement Act (2004), there has been an increase in the number of students requiring special education services. Consequently, there has been an influx to hire more special education teachers. However, the historic challenge of hiring certified special education teachers has been intensified with this the profession’s increasing demand of positions to fill. Efforts to improve recruitment and entry into the field must be informed by an understanding of the factors that initially inspire special education teachers to choose this career pathway. Hence, an understanding of reasons why teachers select special education as a profession is needed. The purpose of this study was to explore personal, academic, and professional motivations that lead to the selection of special education as a career choice. Using the grounded theory approach, this research investigation examined the factors that were most instrumental in influencing applicants to select special education as a career choice. Over one hundred de-identified graduate school applications to Bay Path University’s Graduate Special Education Programs from 2014- 2017 were qualitatively analyzed. Grounded coding was used to discover themes that emerged in applicants’ admissions essays explaining why he/she was pursuing a career in special education. The central themes that were most influential in applicants’ selection of special education as a career trajectory were (a) personal/familial connections to disability, (b) meaningful paraprofessional experiences working with disabled children, (c) aptitudes for teaching, and (d) finding personal rewards and professional fulfillment by advocating for vulnerable children. Implications from these findings include educating family members of children with disabilities about possible career tracks in special education, designing programs for paraprofessionals to become certified teachers, exposing prospective teacher candidates to the field of special education, and recruiting professionals from the human services field who seek to improve the quality of life and educational opportunities for children with special needs.

Keywords: career choice, professional pathways to teaching children with disabilities, special education, teacher recruitment

Procedia PDF Downloads 297
13926 Structural Challenges of Social Integration of Immigrants in Iran: Investigating the Status of Providing Citizenship and Social Services

Authors: Iman Shabanzadeh

Abstract:

In terms of its geopolitical position, Iran has been one of the main centers of migration movements in the world in recent decades. However, the policy makers' lack of preparation in completing the cycle of social integration of these immigrants, especially the second and third generation, has caused these people to always be prone to leave the country and immigrate to developed and industrialized countries. In this research, the issue of integration of immigrants in Iran from the perspective of four indicators, "Identity Documents", "Access to Banking Services", "Access to Health and Treatment Services" and "Obtaining a Driver's License" will be analyzed. The research method is descriptive-analytical. To collect information, library and document sources in the field of laws and regulations related to immigrants' rights in Iran, semi-structured interviews with experts have been used. The investigations of this study show that none of the residence documents of immigrants in Iran guarantee the full enjoyment of basic citizenship rights for them. In fact, the function of many of these identity documents, such as the census card, educational support card, etc., is only to prevent crossing the border, and none of them guarantee the basic rights of citizenship. Therefore, for many immigrants, the difference between legality and illegality is only in the risk of crossing the border, and this has led to the spread of the habit of illegal presence for them. Despite this, it seems that there is no clear and coherent policy framework around the issue of foreign immigrants in the country. This policy incoherence can be clearly seen in the diversity and plurality of identity and legal documents of the citizens present in the country and the policy maker's lack of planning to integrate and organize the identity of this huge group. Examining the differences and socioeconomic inequalities between immigrants and the native Iranian population shows that immigrants have been poorly integrated into the structures of Iranian society from an economic and social point of view.

Keywords: immigrants, social integration, citizen services, structural inequality

Procedia PDF Downloads 45
13925 Vulnerability Assessment of Healthcare Interdependent Critical Infrastructure Coloured Petri Net Model

Authors: N. Nivedita, S. Durbha

Abstract:

Critical Infrastructure (CI) consists of services and technological networks such as healthcare, transport, water supply, electricity supply, information technology etc. These systems are necessary for the well-being and to maintain effective functioning of society. Critical Infrastructures can be represented as nodes in a network where they are connected through a set of links depicting the logical relationship among them; these nodes are interdependent on each other and interact with each at other at various levels, such that the state of each infrastructure influences or is correlated to the state of another. Disruption in the service of one infrastructure nodes of the network during a disaster would lead to cascading and escalating disruptions across other infrastructures nodes in the network. The operation of Healthcare Infrastructure is one such Critical Infrastructure that depends upon a complex interdependent network of other Critical Infrastructure, and during disasters it is very vital for the Healthcare Infrastructure to be protected, accessible and prepared for a mass casualty. To reduce the consequences of a disaster on the Critical Infrastructure and to ensure a resilient Critical Health Infrastructure network, knowledge, understanding, modeling, and analyzing the inter-dependencies between the infrastructures is required. The paper would present inter-dependencies related to Healthcare Critical Infrastructure based on Hierarchical Coloured Petri Nets modeling approach, given a flood scenario as the disaster which would disrupt the infrastructure nodes. The model properties are being analyzed for the various state changes which occur when there is a disruption or damage to any of the Critical Infrastructure. The failure probabilities for the failure risk of interconnected systems are calculated by deriving a reachability graph, which is later mapped to a Markov chain. By analytically solving and analyzing the Markov chain, the overall vulnerability of the Healthcare CI HCPN model is demonstrated. The entire model would be integrated with Geographic information-based decision support system to visualize the dynamic behavior of the interdependency of the Healthcare and related CI network in a geographically based environment.

Keywords: critical infrastructure interdependency, hierarchical coloured petrinet, healthcare critical infrastructure, Petri Nets, Markov chain

Procedia PDF Downloads 530
13924 Investigation of the Impact of Family Status and Blood Group on Individuals’ Addiction

Authors: Masoud Abbasalipour

Abstract:

In this study, the impact of family status on individuals, involving factors such as parents' literacy level, family size, individuals' blood group, and susceptibility to addiction, was investigated. Statistical tests were employed to scrutinize the relationships among these specified factors. The statistical population of the study consisted of 338 samples divided into two groups: individuals with addiction and those without addiction in the city of Amol. The addicted group was selected from individuals visiting the substance abuse treatment center in Amol, and the non-addicted group was randomly selected from individuals in urban and rural areas. The Chi-square test was used to examine the presence or absence of relationships among the variables, and Kramer's V test was employed to determine the strength of the relationship between them. Excel software facilitated the initial entry of data, and SPSS software was utilized for the desired statistical tests. The research results indicated a significant relationship between the variable of parents' education level and individuals' addiction. The analysis showed that the education level of their parents was significantly lower compared to non-addicted individuals. However, the variables of the number of family members and blood group did not significantly impact individuals' susceptibility to addiction.

Keywords: addiction, blood group, parents' literacy level, family status

Procedia PDF Downloads 70
13923 Internet-Delivered Cognitive Behaviour Therapy for Depression Comorbid with Diabetes: Preliminary Findings

Authors: Lisa Robins, Jill Newby, Kay Wilhelm, Therese Fletcher, Jessica Smith, Trevor Ma, Adam Finch, Lesley Campbell, Jerry Greenfield, Gavin Andrews

Abstract:

Background:Depression treatment for people living with depression comorbid with diabetes is of critical importance for improving quality of life and diabetes self-management, however depression remains under-recognised and under-treated in this population. Cost—effective and accessible forms of depression treatment that can enhance the delivery of mental health services in routine diabetes care are needed. Provision of internet-delivered Cognitive Behaviour Therapy (iCBT) provides a promising way to deliver effective depression treatment to people with diabetes. Aims:To explore the outcomes of the clinician assisted iCBT program for people with comorbid Major Depressive Disorder (MDD) and diabetes compared to those who remain under usual care. The main hypotheses are that: (1) Participants in the treatment group would show a significant improvement on disorder specific measures (Patient Health Questionnaire; PHQ-9) relative to those in the control group; (2) Participants in the treatment group will show a decrease in diabetes-related distress relative to those in the control group. This study will also examine: (1) the effect of iCBT for MDD on disability (as measured by the SF-12 and SDS), general distress (as measured by the K10), (2) the feasibility of these treatments in terms of acceptability to diabetes patients and practicality for clinicians (as measured by the Credibility/Expectancy Questionnaire; CEQ). We hypothesise that associated disability, and general distress will reduce, and that patients with comorbid MDD and diabetes will rate the program as acceptable. Method:Recruit 100 people with MDD comorbid with diabetes (either Type 1 or Type 2), and randomly allocate to: iCBT (over 10 weeks) or treatment as usual (TAU) for 10 weeks, then iCBT. Measure pre- and post-intervention MDD severity, anxiety, diabetes-related distress, distress, disability, HbA1c, lifestyle, adherence, satisfaction with clinicians input and the treatment. Results:Preliminary results comparing MDD symptom levels, anxiety, diabetes-specific distress, distress, disability, HbA1c levels, and lifestyle factors from baseline to conclusion of treatment will be presented, as well as data on adherence to the lessons, homework downloads, satisfaction with the clinician's input and satisfaction with the mode of treatment generally.

Keywords: cognitive behaviour therapy, depression, diabetes, internet

Procedia PDF Downloads 491