Search results for: anxiety and covid-19

Authors: Eryati Darwin, Arina Widya Murni, Adnil Edwin Nurdin

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Background: Functional dyspepsia (FD) is a highly prevalent and heterogeneous disorder. Most patients with FD complain of symptoms related to the intake of meals. Psychological stress may promote peptic ulcer and had an effect on ulcers associated Hp, and may also trigger worsen symptoms in inflammatory disorders of the gastrointestinal. Cells in mucosal gastric stimulate the production of several cytokines, which might associated with Helicobacter pylori infection. The cascade of biological events leading to stress-induced FD remains poorly understood. Aim of Study: To determine the prion-flammatory cytokine IL-6, and Helicobacter pylori activity on mucosal gastric of FD and their association with psychological stress. Methods: The subjects of this study were dyspeptic patients who visited M. Djamil General Hospital and in two Community Health Centers in Padang. On the basis of the stress index scale to identify psychological stress by using Depression Anxiety and Stress Scale (DASS 42), subjects were divided into two groups of 20 each, stress groups and non-stress groups. All diagnoses were confirmed by review of cortisol and esophagogastroduodenoscopy reports. Gastric biopsy samples and peripheral blood were taken during diagnostic procedures. Immunohistochemistry methods were used to determine the expression of IL-6 and Hp in gastric mucosal. The data were statistically analyzed by univariate and bivariate analysis. All procedures of this study were approved by Research Ethics Committee of Medical Faculty Andalas University. Results: In this study, we enrolled 40 FD patients (26 woman and 14 men) in range between 35-56 years old. Cortisol level of blood FD patients as parameter of stress hormone which taken in the morning was significantly higher in stress group than non-stress group. The expression of IL-6 in gastric mucosa was significantly higher in stress group in compared to non-stress group (p<0,05). Helicobacter pylori activity in gastric mucosal in stress group were significantly higher than non-stress group. Conclusion: The present study showed that psychological stress can induce gastric mucosal inflammation and increase of Helicobacter pylori activity.

Keywords: functional dyspepsia, Helicobacter pylori, interleukin-6, psychological stress

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Authors: Elyce Cardonick, Shistri Dhar, Linsdey Seidman

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Background: When breast cancer is diagnosed during pregnancy, the prognosis is comparable to non-pregnant women matched for prognostic indicators when pregnant women receive treatment without delay. Chemotherapy, including taxanes, can be given during pregnancy with normal neonatal development in exposed fetuses. Methods: Cases of primary breast cancer were extracted from the Cancer and Pregnancy Registry and longitudinal study at Cooper Medical School, which collects cases of pregnant women diagnosed and treated for cancer into a single database. Obstetrical, oncology and pediatric records were reviewed, including annual neonatal developmental, behavioral and medical assessments. Results: 270 pregnant women were diagnosed with primary breast cancer at a mean gestational age of 14.7+9weeks. Mean maternal age at diagnosis 34.5+4.5 years. Receptor status is comparable to non-pregnant women of reproductive age. Forty-nine women were advised to terminate. Two hundred two women underwent surgery;244 women received chemotherapy in pregnancy after the first trimester; the majority of Doxorubucin/Cytoxan; 81 of the cases included a taxane. At a mean of 90 months, follow up obtained on 255 newborns.192/255 newborns are meeting developmental milestones. Respiratory illnesses, including asthma, and bronchiolitis, were reported in 64 newborns, the most common medical condition reported. Thirty-one children are undergoing treatment for GERD, 11 for urinary tract infections, and 7 are undergoing treatment for anemia. Twenty-six children with expressive or articulation language delays, 21/26 are mild. Eleven children with gross/ 7 with fine motor delays. Eight children are treated for ADHD, 4 for anxiety and 4 have social skill impairment. The majority of children with developmental, language or motor delays were born preterm. Conclusion: After chemotherapy exposure in utero for breast cancer, the majority of newborns are meeting developmental milestones and are medically healthy. The goal for treating pregnant women with breast cancer is to aim for delivery close to the term.

Keywords: breast cancer, pregnancy, chemotherapy, newborn

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Authors: Chueh Chang, Chia-jung Hsieh, Fu-yu Yu, Yu-Hwa Lin

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Background:The majority of women diagnosed with breast cancer undergo treatment involving surgery and radiotherapy or chemotherapy, or both. With these major advances in breast cancer management, many patients still have to deal with short or long-term side effects and psychological distress related to the disease and treatment, which have a substantial impact on their quality of life. The Laughing Qigong Program (LQP) is an interactive laughter program that combines the physical and physiological benefits of laughter with the mental benefits of Chinese qigong. Purpose: In order to improve the quality of life for breast cancer women in the community as well as echoing the WHO 2004 “Promoting Mental Health” for every one. This study focused on how to promote the positive mental health for women of breast cancer through the “laughter program” in Taiwan. During the presentation, how to practice Laughing Qigong will be demonstrated. Method: Using nonequivalent pretest-posttest design, ix-one breast cancer patients were volunteered to enroll in this study from the Taiwan Breast Cancer Alliance (TBCA). Thirty patients were assigned to the experimental group and the other 31 patients were assigned to the control group. The women who were assigned to the experimental group received laughter program one hour per session, once a week, totally 12 sessions. All subjects were tested before and after the intervention on the following: Self-Esteem scale (RSE), Face Scale (FS), Anxiety and pain experience were measured as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR),and heart rate variability (HRV) as physiological markers of the body’s response to stress. Results: After comparing the experimental and control groups, the results revealed that those breast cancer women with “laughing program” their sense of humor were improved, less uncomfortable on self report physical conditions, more positive attitudes toward stress management by using laughter, and had emotional improvement according to the face scale.

Keywords: mental health promotion, breast cancer, laughing Qigong, women

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Authors: Theresa Slump, Paula Neumeister, Katharina Feldker, Carina Y. Heitmann, Thomas Straube

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A characteristic feature of post-traumatic stress disorder (PTSD) is the automatic processing of disorder-specific stimuli that expresses itself in intrusive symptoms such as intense physical and psychological reactions to trauma-associated stimuli. That automatic processing plays an essential role in the development and maintenance of symptoms. The aim of our study was, therefore, to investigate the behavioral and neural correlates of automatic processing of trauma-related stimuli in PTSD. Although interpersonal traumatization is a form of traumatization that often occurs, it has not yet been sufficiently studied. That is why, in our study, we focused on patients suffering from interpersonal traumatization. While previous imaging studies on PTSD mainly used faces, words, or generally negative visual stimuli, our study presented complex trauma-related and neutral visual scenes. We examined 19 female subjects suffering from PTSD and examined 19 healthy women as a control group. All subjects did a geometric comparison task while lying in a functional-magnetic-resonance-imaging (fMRI) scanner. Trauma-related scenes and neutral visual scenes that were not relevant to the task were presented while the subjects were doing the task. Regarding the behavioral level, there were not any significant differences between the task performance of the two groups. Regarding the neural level, the PTSD patients showed significant hyperactivation of the hippocampus for task-irrelevant trauma-related stimuli versus neutral stimuli when compared with healthy control subjects. Connectivity analyses revealed altered connectivity between the hippocampus and other anxiety-related areas in PTSD patients, too. Overall, those findings suggest that fear-related areas are involved in PTSD patients' processing of trauma-related stimuli even if the stimuli that were used in the study were task-irrelevant.

Keywords: post-traumatic stress disorder, automatic processing, hippocampus, functional magnetic resonance imaging

Procedia PDF Downloads 176

Authors: Chaudhary Itisha, Shankar Manu

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Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: patient education, post-operative pain, postoperative outcomes, patient satisfaction

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Authors: Nyimas Annissa Mutiara Andini

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There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.

Keywords: application, children, D-Epi, epilepsy

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Authors: Clare Maxwell, Lorna Porcellato, Valerie Fleming, Kate Fleming

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A review of global online forums and social media reveals large numbers of mothers experiencing bottle refusal by their breastfed baby. It is difficult to determine precise numbers due to a lack of data, however, established virtual communities illustrate thousands of posts in relation to the issue. Mothers report various negative consequences of bottle refusal including delaying their return to work, time and financial outlay spent on methods to overcome it and experiencing stress, anxiety, and resentment of breastfeeding. A search of the literature revealed no studies being identified, and due to a lack of epidemiological data, a study investigating mother’s experiences of bottle refusal by their breastfed baby was undertaken. The aim of the study was to investigate UK mothers’ experiences of bottle refusal by their breastfed baby. Data were collected using an online questionnaire collecting quantitative and qualitative data. 841 UK mothers who had experienced or were experiencing bottle refusal by their breastfed baby completed the questionnaire. Data were analyzed using descriptive statistics and non-parametric testing. The results showed 61% (516/840) of mothers reported their breastfed baby was still refusing/had never accepted a bottle, with 39% (324/840) reporting their baby had eventually accepted. The most frequently reported reason to introduce a bottle was so partner/family could feed the baby 59% (499/839). 75% (634/841) of mothers intended their baby to feed on a bottle ‘occasionally’. Babies who accepted a bottle were more likely to be older at 1st attempt to introduce one than those babies who refused (Mdn = 12 weeks v 8 weeks, n = 286) (p = <0.001). Length of time taken to acceptance was 9 weeks (Mdn = 9, IQR = 18, R = 103.9, n = 306) with the older the baby was at 1st attempt to introduce a bottle being associated with a shorter length of time to acceptance (p = < 0.002). 60% (500/841) of mothers stated that none of the methods they used had worked. 26% (222/841) of mothers reported bottle refusal had had a negative impact upon their overall breastfeeding experience. 47% (303/604) reported they would have tried to introduce a bottle earlier to prevent refusal. This study provides a unique insight into the scenario of bottle refusal by breastfed babies. It highlights that bottle refusal by breastfed babies is a significant issue, which requires recognition from those communicating breastfeeding information to mothers.

Keywords: bottle feeding, bottle refusal, breastfeeding, infant feeding

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Authors: Njoroge Margaret W., Johnson Deborah

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Gender-specific risk factors for common mental disorders that disproportionately affect women include but are not limited to gender-based violence, socioeconomic disadvantage, sociocultural factors and unrelenting responsibility for the care of others. The overall objective of this study was to assess mental health conditions and their risk factors among women in Garissa County, Kenya. The study adopted both quantitative and qualitative research designs. The study participants were 100 adult women and 20 key informants from different sectors in the region. Data was collected using DSM-5 (PCL-5) and Kessler Psychological Distress, interviews schedule and focus group discussions. Analysis of quantitative data was done using univariate analysis, while qualitative data was analyzed using thematic analysis. The results revealed that about 60% of women presented with moderate to severe psychological distress (PD), while 53% presented with PTSD. Additionally, women who have undergone female genital mutilation had higher PTSD and PD scores. They also presented with low self-esteem, depressive symptoms, sex anxiety, avoidance of reminders and intrusive memories of the event, especially those who developed fistula. The risk factors for poor mental health outcomes include lack of awareness/knowledge of mental health, retrogressive cultural practices (child marriage and female genital mutilation), as well as beliefs about the causes of mental disorders. The study also established that people with mental illness are neglected, abused and stigmatized. Preferred treatment approaches include prayers and the use of witch doctors and traditional healers. The study recommends gendered and culturally responsive interventions geared towards increasing community awareness and knowledge on mental health, reducing stigma and improving mental-health-seeking behaviors for women and girls in the region. Supported by the Ministry of Health, the approach should be spearheaded by trained community lay counselors.

Keywords: women, mental health conditions, cultural beliefs/practices, stigma, poverty, psychological distress, PTSD

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Authors: M.J. Seddighi, Moradchelleh, M. Keyvan

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The ultimate goal in building a city is to provide pleasant, comfortable and nurturing environment as a context of public life. City environment establishes strong connection with people and their surrounding habitant, acting as relevance in social interactions between citizens itself. Urban environment and appropriate municipal facilities are the only way for proper communication between city and citizens and also citizens themselves.There is a need for complement elements between buildings and constructions to settling city life through which the move, comfort, reactions and anxiety will adjust and reflect the spirit to the city. In the surging development of society, urban’ spaces are encountered evolution, sometimes causing the symbols to fade and waste, and as a result, leading to destroy belongs among humans and their physical liquidate. Houses and living spaces exhibit materialistic reflection of life style. In the other words, way of life makes the symbolic essence of living spaces. In addition, it is of sociocultural factor of lifestyle, consisting the concepts and culture, morality, worldview, and national character. Culture is responsible for some crucial meaningful needs which can be wide because they depend on various causes such as perception and interpretation of believes, philosophy of life, interaction with neighbors and protection against climate and enemies. The bi-lateral relationship between human and nature is the main factor that needs to be properly addressed. It is because of the fact that the approach which is taken against landscape and nature has a pertinent influence on creation and shaping the structure of a house. The first response of human in tackling the environment is to build a “shelter” and place as dwelling. This has been a crucial factor in all time periods. In the proposed study, dwelling in Khorasgan’ Stream, as an area located in one of the important historical city of Iran, has been studied. Khorasgan’ Stream is the basic constituent elements of the present architectural form of Isfahan. The influence of Islamic spiritual culture and neighborhood with the historical elements on the dwelling of the selected location, subsequently on other regions of the town are presented.

Keywords: dwelling, neighborhood, historical, Islamic, architectural elements

Procedia PDF Downloads 385

Authors: Peder O. Laugen Heggdal, Oyvind Nordvik, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

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Background: Hearing loss (HL) affect people of all ages and stages in life. To author's best knowledge, if patients with an HL have reduced Generic Quality of life (QoL), has yet not been answered. Aim: The aim of the present study was to investigate the relationship between HL and generic and disease-specific Health Related Quality of Life (HRQoL) in adult patients (aged 18–78 years) with an HL, seeking Hearing Aid (HA). Material and Methods: 158 adult (aged 18-78 years) patients with HL, referred for HA fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals, were included. First-time users had been pre-examined by an Ear Nose and Throat specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2 and 4 kHz) was determined for each ear. The generic European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire general part and a shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) were answered. In addition, EORTC HRQoL answers from a general population and patients with former head and neck cancer served as comparison. Results: In general, no lowered HRQoL scores were determined among HL patients compared to the general population. Patients with unilateral HL to some extent showed lower HRQoL than those with bilateral HL (social function and fatigue). The APHAB scores correlated significantly with the EORTC HRQoL scores. By stepwise linear regression analysis, the APHAB scores were scored secondary to PTA (best ear), cognitive and physical function. Conclusion: HRQoL scores in HL patients, in general, seems to be at the population level, but the unilateral HL patients scored to some extent lower than the bilateral HI patients. APHAB and generic QoL scores levels are associated. Both HRQoL and APHAB scores are generated more complexly than anticipated.

Keywords: quality of life, hearing loss, hearing impairment, distress, depression, anxiety, hearing aid

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Authors: Ilana Margalith, Adaya Meirowitz, Sigalit Cohavi

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Violence against health professionals by patients and their families have recently become a disturbing phenomenon worldwide, exacting psychological as well as economic tolls. Health workplaces in Israel (e.g. hospitals and H.M.O clinics) provide workshops for their employees, supplying them with coping strategies. However, these workshops do not focus on nursing students, who are also subjected to this violence. Their learning environment is no longer as protective as it used to be. Furthermore, coping with violence was not part of the curriculum for Israeli nursing students. Thus, based on human aggression theories which depict the pivotal role of the professional's correct response in preventing the onset of an aggressive response or the escalation of violence, a workshop was developed for undergraduate nursing students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel. The workshop aimed at reducing students' anxiety vis a vis the aggressive patient or family in addition to strengthening their ability to cope with such situations. The students practiced interpersonal skills, especially relevant to early detection of potential violence, as well as ‘a correct response’ reaction to the violence, thus developing the necessary steps to be implemented when encountering violence in the workplace. In order to assess the efficiency of the workshop, the participants filled out a questionnaire comprising knowledge and self-efficacy scales. Moreover, the replies of the 23 participants in this workshop were compared with those of 24 students who attended a standard course on interpersonal communication. Students' self-efficacy and knowledge were measured in both groups before and after the course. A statistically significant interaction was found between group (workshop/standard course) and time (before/after) as to the influence on students' self-efficacy (p=0.004) and knowledge (p=0.007). Nursing students, who participated in this ‘coping with workplace violence’ workshop, gained knowledge, confidence and a sense of self-efficacy with regard to workplace violence. Early detection of signs of imminent violence amongst patients or families and the prevention of its escalation, as well as the ability to manage the threatening situation when occurring, are acquired skills. Encouraging nursing students to learn and practice these skills may enhance their ability to cope with these unfortunate occurrences.

Keywords: early detection of violence, nursing students, patient aggression, self-efficacy, workplace violence

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Authors: Farzad Shidfar, Najmeh Rostami, Ziaodin Mazhari, Fatemeh Hosseini Baharanchi

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Background and Aim: The rate of failure to maintain a reduced weight has been increased. By definition, people who regain about one-third to two-thirds of their lost weight after one year from the end of the dietary treatment and return all the lost weight after 5 years it is called weight regain. This study was performed to find the causes of weight regain and its relationship with biochemical and psychological factors. Materials and Methods: This cross-sectional study was performed by reviewing the files of people who followed the dietary treatment in 1397-1398.seventy-three persons was in the weight regain group, and seventy-three people were in the weight maintenance group. Psychological factors such as depression, anxiety, quality of life, physical activity, and dietary frequency were assessed through a questionnaire, and biochemical factors such as serum insulin and fasting blood sugar were measured. The mean basal energy in the weight regain group was significantly higher than the weight maintenance group (p = 0.004). There was no significant difference between the two groups in terms of food intake and inflammatory index of food. There was no significant difference between the two groups in terms of food intake and inflammatory index of food. Mean serum insulin concentration (p = 0.023), mean fasting blood sugar (p = 0.04) and insulin resistance (p = 0.013) in the weight regain group were higher than the weight maintenance group. The weight maintenance group showed higher insulin sensitivity than the weight regain group (p = 0.005). There was no significant difference between the two groups in terms of psychological indicators. Conclusion: The only body mass index after one year from the end of the treatment period, insulin sensitivity, serum insulin concentration, fasting blood sugar, insulin resistance, selenium intake, and basal energy expenditure Specific and significant with weight regain. However, the significance of insulin resistance, basal energy expenditure, and body mass index after one year from the end of the treatment period was higher than other variables in the weight regain group.

Keywords: body weight maintenance, weight regain, insulin resistance, insulin sensitivity

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Authors: Moldir Makenova

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Alongside the implementation of trilingual education in schools, the Ministry of Education and Science of the Republic of Kazakhstan innovated the school curriculum in 2013 to include a Content and Language Integrated Learning (CLIL) approach. In this regard, some transition issues have arisen, such as unprepared teachers, a need for more awareness of the CLIL approach, and teaching resources. Some teachers view it as a challenge due to its combination of both content and language. This often creates anxiety among teachers who are knowledgeable about their subject areas in Kazakh or Russian but are deficient in delivering the subject’s content in English. Thus, with this new teaching approach, teachers encounter to choose the role of language and answer how language works in the CLIL classroom. This study aimed to explore how teachers experience the changing role of language in the curriculum and to find out what challenges teachers face related to CLIL implementation and how their language proficiency influences their teaching practices. A qualitative comparative case study was conducted in an X Lyceum and a mainstream school piloting CLIL. Data collection procedures were conducted via semi-structured interviews, classroom observations, and document analysis. Eight content teachers were chosen from these two schools as the target group of this study. Subject teachers, rather than language teachers, were chosen as the target group to grasp how the language-related issues in the new curriculum are interpreted by educators who do not necessarily identify themselves as language experts at the outset. The findings showed that mainstream teachers prioritize content over language because, as content teachers, the knowledge of content is more essential for them rather than the language. In contrast, most X Lyceum teachers balance language and content and additionally showed their preferences to support the ‘English language only' policy among 10-11 graders. Moreover, due to the low-level English proficiency, mainstream teachers did highlight the necessity of CLIL training and further collaboration with language teachers. This study will be beneficial for teachers and policy-makers to enable them to solve the issues mentioned above related to the implementation of CLIL. Larger-scale research conducted in the future would further inform its successful deployment country-wide.

Keywords: role of language, trilingual education, updated curriculum, teacher practices

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Authors: Lizel Bertie, Kim Johnston

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Parental emotion regulation plays a central role in the socialisation of emotion, especially when teaching young children to cope with negative emotions. Despite evidence which shows non-supportive parental responses to children’s expression of negative emotions has implications for the social and emotional development of the child, few studies have investigated risk factors which impact parental emotion socialisation processes. The current study aimed to explore the extent to which parental stress contributes to both difficulties in parental emotion regulation and non-supportive parental responses to children’s expression of negative emotions. In addition, the study examined whether parental use of expressive suppression as an emotion regulation strategy facilitates the influence of parental stress on non-supportive responses by testing the relations in a mediation model. A sample of 140 Australian adults, who identified as parents with children aged 5 to 10 years, completed an online questionnaire. The measures explored recent symptoms of depression, anxiety, and stress, the use of expressive suppression as an emotion regulation strategy, and hypothetical parental responses to scenarios related to children’s expression of negative emotions. A mediated regression indicated that parents who reported higher levels of stress also reported higher levels of expressive suppression as an emotion regulation strategy and increased use of non-supportive responses in relation to young children’s expression of negative emotions. These findings suggest that parents who experience heightened symptoms of stress are more likely to both suppress their emotions in parent-child interaction and engage in non-supportive responses. Furthermore, higher use of expressive suppression strongly predicted the use of non-supportive responses, despite the presence of parental stress. Contrary to expectation, no indirect effect of stress on non-supportive responses was observed via expressive suppression. The findings from the study suggest that parental stress may become a more salient manifestation of psychological distress in a sub-clinical population of parents while contributing to impaired parental responses. As such, the study offers support for targeting overarching factors such as difficulties in parental emotion regulation and stress management, not only as an intervention for parental psychological distress, but also the detection and prevention of maladaptive parenting practices.

Keywords: emotion regulation, emotion socialisation, expressive suppression, non-supportive responses, parental stress

Procedia PDF Downloads 139

Authors: Kyra Kannen, Sonja D. Roelen, Sebastian Schnieder, Jarek Krajewski, Steffen Holsteg, André Karger, Johanna Askeridis, Celina Slawik, Philip Mildner, Jens Piesk, Ruslan David, Holger Kürten, Benjamin Oster, Robert Malzan, Mike Ludemann

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Virtual Reality (VR) is increasingly recognized for its potential in transforming mental disorder treatment, offering advantages such as cost-effectiveness, time efficiency, accessibility, reduced stigma, and scalability. While the application of VR in the context of anxiety disorders has been extensively evaluated and demonstrated to be effective, the utilization of VR as a therapeutic treatment for depression remains under-investigated. Our goal is to pioneer immersive VR therapy modules for treating major depression, alongside a web-based system for home use. We develop a modular digital therapy platform grounded in psychodynamic therapy interventions which addresses stress reduction, exploration of social situations and relationship support, social skill training, avoidance behavior analysis, and psychoeducation. In addition, an automated depression monitoring system, based on acoustic voice analysis, is implemented in the form of a speech-based diary to track the affective state of the user and depression severity. The use of immersive VR facilitates patient immersion into complex and realistic interpersonal interactions with high emotional engagement, which may contribute to positive treatment acceptance and satisfaction. In a proof-of-concept study, 45 depressed patients were assigned to VR or web-platform modules, evaluating user experience, usability and additional metrics including depression severity, mindfulness, interpersonal problems, and treatment satisfaction. The findings provide valuable insights into the effectiveness and user-friendliness of VR and web modules for depression therapy and contribute to the refinement of more tailored digital interventions to improve mental health.

Keywords: virtual reality therapy, digital health, depression, psychotherapy

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Authors: Soumya Mishra, Elena Neiterman

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Aligned with the growing interest in the impact of the pandemic on academic experiences of university students, this study aimed to examine the challenges Canadian undergraduate students experienced during the university closures due to COVID-19. Using qualitative methodological approach, the study utilized semi-structured interviews conducted with 20 undergraduate students enrolled in an Ontario university to explore their thoughts and experience regarding online learning during the peak of the COVID-19 pandemic, from January 2021 to March 2021. The interviews yielded four major themes with the following associated subthemes: Personal Challenges Associated with Adapting to the Pandemic (Change in the Type of Stress Experienced, Unique Impact on Certain Groups of Students, Decreased Motivation, Crucial Role of Resilience), Social Challenges Associated with Adapting to the Pandemic (Increased Loneliness, Challenges Faced while Communicating, Perception of Group work, Role of Living Conditions), Challenges associated with Accessing University Resources (Crucial Role of Professors, Perception of Virtual Events, Importance of Physical Spaces). Overall, the analysis showed that the COVID-19 pandemic fostered resilience and psychological flexibility amongst all students. However, the mental health and social wellbeing of students deteriorated during the COVID-19 pandemic and they reported experiencing chronic stress, anxiety and loneliness. International students, first year and final year students experienced a unique set of challenges. It was hard for participants in our study to make strong new connections with their classmates and maintain existing friendships with their peers. The importance of professors in facilitating learning was amplified in the online environment due to the lack of in-person interaction with other students. Despite these challenges, most participants reported that they received high grades during online learning. The findings from this study could be helpful for organizations and individuals working towards fostering the wellbeing of undergraduate students. They can also help in making post-secondary institutions more resilient to future emergencies by creating contingency plans regarding online instructions and risk management techniques.

Keywords: Canadian, COVID-19, university students, wellbeing

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Authors: Mili Dutta, Lokender Prashad

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Introduction: Population ageing is a phenomenon that can be observed around the globe. The health-related quality of life (HRQOL) is a measurement of health status of an individual, and it describes the effect of physical and mental health disorders on the well-being of a person. The present study is aimed to describe the influence of socio-economic characteristics of elderly on their health-related quality of life in India. Methods: EQ-5D instrument and population-based EQ-5D index score has been measured to access the HRQOL among elderly. Present study utilized the Study on Global Ageing and Adult Health (SAGE) data which was conducted in 2007 in India. Multiple Logistic Regression model and Multivariate Linear Regression model has been employed. Result: In the present study, it was found that the female are more likely to have problems in mobility (OR=1.41, 95% Cl: 1.14 to 1.74), self-care (OR=1.26, 95% Cl: 1.01 to 1.56) and pain or discomfort (OR=1.50, 95% Cl: 1.16 to 1.94). Elderly residing in rural area are more likely to have problems in pain/discomfort (OR=1.28, 95% Cl: 1.01 to 1.62). More older and non-working elderly are more likely whereas higher educated and highest wealth quintile elderly are less likely to have problems in all the dimensions of EQ-5D viz. mobility, self-care, usual activity, pain/discomfort and anxiety/depression. The present study has also shown that oldest old people, residing in rural area and currently not working elderly are more likely to report low EQ-5D index score whereas elderly with high education level and high wealth quintile are more likely to report high EQ-5D index score than their counterparts. Conclusion: The present study has found EQ-5D instrument as the valid measure for assessing the HRQOL of elderly in India. The study indicates socio-economic characteristics of elderly such as female, more older people, residing in rural area, non-educated, poor and currently non-working as the major risk groups of having poor HRQOL in India. Findings of the study will be helpful for the programmes and policy makers, researchers, academician and social workers who are working in the field of ageing.

Keywords: ageing, HRQOL, India, EQ-5D, SAGE, socio-economic characteristics

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Authors: Filiz Celik, Rachel Harrad, Rob Keasley, Paul Bennett

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The COVID-19 pandemic has posed a significant challenge to many, with some groups with particular vulnerability to adverse psychological impacts. These include those disadvantaged by mental ill health, either pre-existing or occurring during pregnancy or post-partum. Using a qualitative approach, the research aimed to identify the challenges posed by COVID-19 to women, their infants and families during the perinatal period and to suggest what further support can help alleviate the adverse mental health impact of COVID-19. 21 expectant and new mothers who were currently receiving support via a peri-natal mental health service participated in semi-structured interviews. In these interviews, participants explored the impact of changes in social circumstances and healthcare providers as a result of COVID-19 restrictions, with the resultant audio recordings transcribed and analyzed using Reflexive Thematic Analysis (RTA). Based on these accounts, it was concluded that women, their partners and potentially their infants experienced heightened peri-natal distress, and their experience at this time increased their risk for future mental health problems. Women described emerging as more vulnerable, owing to their role as primary caregivers during the perinatal period and also explained how social isolation and limited access to services meant protective buffers against mental health deterioration were reduced and the resources they needed in order to develop resilience were weakened. Although partners were invited to take part in the research, a sizeable volume of data could not be generated to fully assess the impact of the pandemic on a partner’s mental well-being. However, women expressed concerns about the paternal mental health of partners and husbands which invites us to be further vigilant to paternal mental health and associated experiences. Overall, these interviews serve to highlight and provide a voice to these women and their families who describe experiencing disadvantage at an already vulnerable time in their lives, as well as illustrating the need for services to prioritize the needs of this population when acute events strike, be those future pandemics or other disasters.

Keywords: patient experience, perinatal mental health, covid-19 pandemic, heightened anxiety, birth trauma, post-natal well-being

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Authors: M.J. Seddighi, A. Moradchelleh, M. Keyvan

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The ultimate goal in building a city is to provide pleasant, comfortable and nurturing environment as a context of public life. City environment establishes strong connection with people and their surrounding habitant, acting as relevance in social interactions between citizens itself. Urban environment and appropriate municipal facilities are the only way for proper communication between city and citizens and also citizens themselves. There is a need for complement elements between buildings and constructions to settling city life through which the move, comfort, reactions and anxiety will adjust and reflect the spirit to the city. In the surging development of society, urban’ spaces are encountered evolution, sometimes causing the symbols to fade and waste, and as a result, leading to destroy belongs among humans and their physical liquidate. Houses and living spaces exhibit materialistic reflection of life style. In other words, way of life makes the symbolic essence of living spaces. In addition, it is of sociocultural factor of lifestyle, consisting the concepts and culture, morality, worldview, and national character. Culture is responsible for some crucial meaningful needs which can be wide because they depend on various causes such as perception and interpretation of believes, philosophy of life, interaction with neighbors and protection against climate and enemies. The bilateral relationship between human and nature is the main factor that needs to be properly addressed. It is because of the fact that the approach which is taken against landscape and nature has a pertinent influence on creation and shaping the structure of a house. The first response of human in tackling the environment is to build a “shelter” and place as dwelling. This has been a crucial factor in all time periods. In the proposed study, dwelling in Khorasgan’ Stream, as an area located in one of the important historical city of Iran, has been studied. Khorasgan’ Stream is the basic constituent elements of the present architectural form of Isfahan. The influence of Islamic spiritual culture and neighborhood with the historical elements on the dwelling of the selected location, subsequently on other regions of the town are presented.

Keywords: historical architectural elements, dwelling' neighborhood, Khorasgan’ Stream of Isfahan, architecture

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Authors: Suantak Demkhosei Vaiphei

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Mental illness is still considered as an illness not to be treated, resulting India becoming the most depressed country in the world. At present, 150 million Indians are suffering from mental illness and desperately in need of immediate care assessment for their mental health condition. However, only 0.06 per cent of India’s health budget is devoted to mental health treatment, in which the available data suggests that the state of spending the sanctioned budget in this regard is abysmal. Lack of awareness, ignorance, social stigma, and discriminations becomes the underlying factors for worsening the individual mental health conditions. Unfortunately, India becomes the most depressed country in the world, which is hugely affected by anxiety, schizophrenia, and bipolar disorder followed by China and USA as per the latest World Health Organization report. The National Care of Medical Health stated that at least 6.5 per cent of the Indian populations are under serious mental disorder both in the rural and the urban areas’Mental health is the integral part of health and can be affected by a range of psychosocial-economic factors that need comprehensive strategically approach for promotion, prevention, treatment, and recovery. In a low- and middle-income country like India, the advance progress in mental health service is visible consistently slow and minimal. Some of the major barriers can be seen in the existing public health priorities and its influence on funding; challenges to delivery of basic mental health care in the primary care settings; the minimal numbers of well-trained professionals in the area of mental health care; and lack of mental health perspective in public-health leadership. The existing barriers according to WHO (2007) are; lack of funding for mental health services is the core barrier in implementing quality mental health services, including inadequate coordinated and consensus based national mental health advocacy and plans, the absence of mental health in major donor priorities, marketing of expensive pharmaceuticals by industry, cost-effectiveness information on mental health services that is unknown to senior decision-makers and social stigma among others. Moreover, lack of strong mental health advocacy in countries to increase resources for mental health services and the role of social stigma and the view that mental health is a private responsibility are also the two barriers to mental health.

Keywords: mental health, depression, stigma, barriers

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Authors: Yan Lu, Song Hong, Janakiraman Udaiyappan, Aarti Nagayach, Quoc-Viet A. Duong, Masao Morita, Shun Saito, Yuichi Kobayashi, Yuhai, Zhao, Hongying Peng, Nicholas B. Pham, Walter J Lukiw, Christopher A. Vuong, Nicolas G. Bazan

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Aims: Neurodegeneration and behavior dysfunction occurs in patients with Alzheimer's Disease (AD), and as the disease progresses many patients develop cognitive impairment. 5XFAD mouse model of AD is widely used to study AD pathogenesis and treatment. This study aimed to investigate the effect of maresin like 1 (MaR-L1) treatment in AD pathology using 5XFAD mice. Methods: We tested 12-month-old male 5XFAD mice and wild type control mice treated with MaR-L1 in a battery of behavioral tasks. We performed open field test, beam walking test, clasping test, inverted grid test, acetone test, marble burring test, elevated plus maze test, cross maze test and novel object recognition test. We also studied neuronal loss, amyloid β burden, and inflammation in the brains of 5XFAD mice using immunohistology and Western blotting. Results: MaR-L1 treatment to the 5XFAD mice showed improved cognitive function of 5XFAD mice. MaR-L1 showed decreased anxiety behavior in open field test and marble burring test, increased muscular strength in the beam walking test, clasping test and inverted grid test. Cognitive function was improved in MaR-L1 treated 5XFAD mice in the novel object recognition test. MaR-L1 prevented neuronal loss and aberrant inflammation. Conclusion: Our finding suggests that behavioral abnormalities were normalized by the administration of MaR-L1 and the neuroprotective role of MaR-L1 in the AD. It also indicates that MaR-L1 treatment is able to prevent and or ameliorate neuronal loss and aberrant inflammation. Further experiments to validate the results are warranted using other AD models in the future.

Keywords: Alzheimer's disease, motor and cognitive behavior, 5XFAD mice, Maresin Like 1, microglial cell, astrocyte, neurodegeneration, inflammation, resolution of inflammation

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Authors: Fonteyne Lot

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SIMON (Study capacities and Interest Monitor is a freely accessible online self-assessment tool that allows secondary education pupils to evaluate their interests and capacities in order to choose a post-secondary major that maximally suits their potential. The tool consists of two broad domains that correspond with two general questions pupils ask: 'What study fields interest me?' and 'Am I capable to succeed in this field of study?'. The first question is addressed by a RIASEC-type interest inventory that links personal interests to post-secondary majors. Pupils are provided with a personal profile and an overview of majors with their degree of congruence. The output is dynamic: respondents can manipulate their score and they can compare their results to the profile of all fields of study. That way they are stimulated to explore the broad range of majors. To answer whether pupils are capable of succeeding in a preferred major, a battery of tests is provided. This battery comprises a range of factors that are predictive of academic success. Traditional predictors such as (educational) background and cognitive variables (mathematical and verbal skills) are included. Moreover, non-cognitive predictors of academic success (such as 'motivation', 'test anxiety', 'academic self-efficacy' and 'study skills') are assessed. These non-cognitive factors are generally not included in admission decisions although research shows they are incrementally predictive of success and are less discriminating. These tests inform pupils on potential causes of success and failure. More important, pupils receive their personal chances of success per major. These differential probabilities are validated through the underlying research on academic success of students. For example, the research has shown that we can identify 22 % of the failing students in psychology and educational sciences. In this group, our prediction is 95% accurate. SIMON leads more students to a suitable major which in turn alleviates student success and retention. Apart from these benefits, the instrument grants insight into risk factors of academic failure. It also supports and fosters the development of evidence-based remedial interventions and therefore gives way to a more efficient use of means.

Keywords: academic success, online self-assessment, student retention, vocational choice

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Authors: Puran Prasad Adhikari

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Considering the fact that when we are able to communicate science and economics effectively to broader nonprofessional audiences, it promotes a great understanding of its wider relevance to society and encourages more informed and confident decision-making at all levels, from the government to communities to individuals. The study has been conducted. This study is aimed to examine the understanding of the general public of economics and the basic sciences functioning in our surroundings in our day-to-day life. Data was gathered through historical documents related to science communication and through interviews with the public. The statistical result shows that there is a great lack of knowledge in the general public about the basic sciences and how economics impacts their life daily. The difficulties faced by the public include the view that these things can only be understood by professionals and it is beyond their capacity to grasp these concepts, the use of technical words and jargon by the professionals, and the lack of the medium to understand even if they want to learn it. The result further indicates that the lack of this basic knowledge also leads to bad decision-making, which causes frustration and anxiety. The result shows the great correlation between the confidence level of a person and the knowledge of basic science and economics. The factor behind this was the right decision-making capacity of the individual, which boosts the happy hormones of the individual. So indirectly, we found the correlation between mental health and the understanding of science and economics. The public wants to have a basic understanding and concepts of these topics, but they complain that there is no effective medium through which they can gain the understanding; the medium which is available is full of jargon and technical terms directed to professional and highly educated which they consider is beyond their reach. So, communicating the basic concepts to the general public is of great importance in the 21st century for the overall progress of society. The professional one can make this possible by considering the level of public understanding and making the communication and the programs comprehensible to the layman. Various means can be used to make this successful and effective, e.g., cartoon guide books, Q&A with the layman, animations use, and daily life examples. This study’s implication will help educators of high-level institutions and policymakers improve general public [layman] access to comprehensible knowledge.

Keywords: layman, comprehensible, decision making, frustration, confidence

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Authors: Rui Zhang

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Translation has been elevated to one of the key notions in contemporary cultural discourse for a wide range of fields. It focuses not only on communication or transmission of meaning between different languages, but also on ways in which the very act of translation can be understood as a metaphor for cultural process. In recent years, the notion of translation is employed by some contemporary Chinese artists in a conceptual way, whose works contribute to constructing/deconstructing global/local cultural discourse and their own cultural identities. This study examines two artworks by contemporary Chinese artist Gu Wenda from a translational perspective, namely Forest of Stone Steles - Retranslation & Rewriting of Tang Poetry and United Nations - China Monument: Temple of Heaven, aiming to broaden the scope of Translation Studies to investigate visual culture and enrich methodological approach to contemporary Chinese art. Focusing on the relationship between translation, visuality and materiality in these two works, this study explores the nature of translation as part of the production of cultural discourse in the age of globalization as well as a way of establishing cultural identity. Gu Wenda, one of the most prestigious artists in contemporary China, is considered a pioneer in ‘85 Art Movement of China, and thereafter he went abroad for his artistic pursuits. His transnational experience enriches his cultural identity and the underlying discourse constructed/deconstructed in many of his works. In the two works already mentioned, the concept of translation is deployed by Gu Wenda on both linguistic level and metaphorical level for artistic expression. These two works produce discourses in which the artist’s perception of cultural identity in a transnational context is articulated by the tension between source text and target text. Based on the conceptual framework of cultural identity proposed by Stuart Hall, analyses of Gu Wenda’s cultural identity revealed through translation in these two works are centred on two axes, i.e., the axis of similarity and continuity with Chinese intellectual culture and the axis of difference and rupture with it, and the dialogic relationship between these two vectors. It argues that besides serving as a means of constructing visuality in the two works, translation metaphorizes Gu Wenda’s journey from overcoming his cultural identity anxiety to re-establishing a transcultural identity embedded in the underlying discourse.

Keywords: contemporary Chinese art, cultural identity, transculturality, translation

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Authors: Anjana Aggarwal, Sheilja Walia

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Prevalence of obesity and overweight is increasing due to sedentary lifestyles and busy schedules of people that spend less time on physical exercise. To reduce weight, people are finding easier and more convenient ways. The easiest solution is the use of dietary supplements and fat burners. These are products that decrease body weight by increasing the basal metabolic rate. Various reports have been published on the consumption of fat burners leading to heart palpitations, seizures, anxiety, depression, psychosis, bradycardia, insomnia, muscle contractions, hepatotoxicity, and even liver failure. Case reports and series are reporting that the ingredients present in the fat burners caused acute liver failure (ALF) and hepatic toxicity in many cases. Another contributing factor is the absence of regulations from the Food and Drug Administration on these products, leading to increased consumption and a higher risk of liver diseases among the population. This systematic review aims to attain a better understanding of the dietary supplements used globally to reduce weight and document the case reports/series of acute liver failure caused by the consumption of fat burners. Electronic databases like PubMed, Cochrane, Google Scholar, etc., will be systematically searched for relevant articles. Various websites of dietary products and brands that sell such supplements, Journals of Hepatology, National and international projects launched for ALF, and their reports, along with the review of grey literature, will also be done to get a better understanding of the topic. After discussing with the co-author, the selection and screening of the articles will be performed by the author. The studies will be selected based on the predefined inclusion and exclusion criteria. The case reports and case series that will be included in the final list of the studies will be assessed for methodological quality using the CARE guidelines. The results from this study will provide insights and a better understanding of fat burners. Since the supplements are easily available in the market without any restrictions on their sale, people are unaware of their adverse effects. The consumption of these supplements causes acute liver failure. Thus, this review will provide a platform for future larger studies to be conducted.

Keywords: acute liver failure, dietary supplements, fat burners, weight loss supplements

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Authors: Tonya P. Bowers

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Background: The community/patient-focused quality improvement (QI) project has resolved a clinical problem using a quantitative design evaluating behavior change practices in a convenience sample from a multi-cultural congregation in a faith-based setting. AD is a legal document that speaks for the patient when they are unable to speak for themselves. The AD provides detailed information regarding critical medical decisions on behalf of the patient if they’re unable to make decisions themselves. The goal of an AD is to improve EOL care renderings that align with the patient’s desires. The AD diminishes anxiety and stress associated with making difficult EOL care decisions for patients and their families. Method: The project has two intervention strategies: pre-intervention and post-intervention formative surveys and a final summative survey. Most of the data collection takes place during implementation. The Let’s Talk About It Program utilized an online meeting platform for presentation. Participants were asked to complete informed consent and surveys via an online portal. Education included slide presentation, Advance Directive demonstration, video clips, discussions and 1:1 assistance with AD completion with a project manager. Results: Considering the overwhelming likelihood responses where 87.5% identified they “definitely would” hold an End-Of-Life conversation with their healthcare provider or family, and 81.25% indicated their likelihood that they “definitely would” complete an advance directive. In addition, the final summative post-intervention survey (n-14) also demonstrated an overwhelming 93% positive response. Which undoubtedly demonstrates favorable outcomes for the project. Conclusion: the Let’s Talk About It Program demonstrated effectiveness in improving participants' attitudes and acceptance towards Advance Directives and expanding End-of-Life care discussions. Emphasis on program sustainment within the church is imperative in fostering continued awareness and improved health outcomes for the local community with low health literacy.

Keywords: advance directive, end of life, advance care planning, palliative care, low health literacy, faith-based

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Authors: Helena Baffoe

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Context: In the United States, there have been significant advancements in programs aimed at improving the lives of individuals with mental health disorders and substance abuse problems. However, public attitudes and beliefs regarding these issues have not improved correspondingly. This study aims to explore the perceptions and beliefs surrounding mental health disorders and substance abuse in the context of data analytics in the field of social work. Research Aim: The aim of this research is to provide empirical evidence on the beliefs and perceptions regarding mental health disorders and substance abuse. Specifically, the study seeks to answer the question of whether being diagnosed with a mental disorder implies a diagnosis of substance abuse. Additionally, the research aims to analyze the specific roles that social workers can play in addressing individuals with mental disorders. Methodology: This research adopts a data-driven methodology, acquiring comprehensive data from the Substance Abuse and Mental Health Services Administration (SAMHSA). A noteworthy causal connection between mental disorders and substance abuse exists, a relationship that current literature tends to overlook critically. To address this gap, we applied logistic regression with an Instrumental Variable approach, effectively mitigating potential endogeneity issues in the analysis in order to ensure robust and unbiased results. This methodology allows for a rigorous examination of the relationship between mental disorders and substance abuse. Empirical Findings: The analysis of the data reveals that depressive, anxiety, and trauma/stressor mental disorders are the most common in the United States. However, the study does not find statistically significant evidence to support the notion that being diagnosed with these mental disorders necessarily implies a diagnosis of substance abuse. This suggests that there is a misconception among the public regarding the relationship between mental health disorders and substance abuse. Theoretical Importance: The research contributes to the existing body of literature by providing empirical evidence to challenge prevailing beliefs and perceptions regarding mental health disorders and substance abuse. By using a novel methodological approach and analyzing new US data, the study sheds light on the cultural and social factors that influence these attitudes.

Keywords: mental health disorder, substance abuse, empirical evidence, logistic regression with IV

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Authors: Debarshi Bhattacharya

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In 2015, historic Land Boundary Agreement (LBA) executed between India and Bangladesh finally settled almost seven decades long overdue critical enclave problems of the two neighbouring countries. Enclaves within India and Bangladesh were the awful outcome of the partition of India in 1947. As a dire consequence, the populace within these enclaves enormously suffered from getting basic rights and opportunities and governmental support services till long 67 years after India’s independence and partition. As per LBA, 2015, 51 Bangladeshi (BD) enclaves inside Indian territory and 111 Indian enclaves inside Bangladesh territory were actually transferred to each other. But, by virtue of LBA, 1974 executed earlier between the two countries, one BD enclave situated inside India, namely Dohogram-Angarpota (D-A) twin enclave, had not yet been exchanged by means of LBA, 2015 and it still remains as an integral part, may not be contiguous, of Bangladesh completely surrounded by Indian territory. A study was undertaken through an extensive field survey to assess the impact of the existence of D-A BD enclave inside Indian territory from India’s perspective. Field survey was conducted for the purpose in the form of an interview, group discussion, questionnaire survey, personal interaction etc. to gather information from the Indian people residing adjacent to D-A enclave and Tin Bigha Corridor (TBC), people of D-A enclave, officials of Border Security Forces of India and Bangladesh, public representatives, representatives of political organizations etc. The issue of the existence of D-A BD enclave inside Indian territory seriously brought apprehension of future problems to the people of Kuchlibari Region of Mekhligunj Block, India, on its contiguity with Indian mainland due to 24-hour open access for the BD people through TBC. The anxiety of the local Indian people regarding threats to the national security of India as well as to the law and order issues of the locality due to the open border of D-A BD enclave in the region. On the other hand, it was observed that 24 hours opening of TBC brought significant positive changes to the people of D-A BD enclave in terms of their socio-economic condition and security status.

Keywords: enclave, exchange of enclaves, land boundary agreement, Dohogram-Angarpota (D-A) Bangladeshi (BD) enclave, Tin Bigha Corridor

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Authors: Kirstin Griffin

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During a period of increased anxiety and stress, communication became the essential tool to help the public stay informed and feel prepared during the Covid-19 pandemic. However, certain groups of patients were not feeling as reassured. The news and media blasted the message that patients with diabetes were “high-risk" in regards to contracting the Covid-19 infection. Routine clinics were being cancelled, GP practices were closing their doors, and patients with type 1 diabetes were understandably scared. The influx of calls to diabetes specialists nurses from concerned patients highlighted the need for better and more specialised information. An Application specifically for patients with type 1 diabetes was created to deliver this information, and it proved to be the essential communication tool that was desperately needed. The Application for patients with type 1 diabetes aimed to deliver specialist information to patients in regards to their diagnosis, management, and ongoing follow-up commitments. The Application gives practical advice on multiple areas of diabetes management, including sick-day rules and diabetic emergencies, as well as up-to-date information on technology, including setting up Libre devices and downloading glucose meters to facilitate attending virtual clinics. Delivery of this information in an easy-to-understand and comprehensive way is intended to improve patient engagement with diabetes services and ultimately empower patients in the control of their own disease. The application also offers a messaging service to allow the diabetes team to send out alerts to patient groups on specific issues, such as changes to clinics, or respond to recent news updates regarding Covid-19. The App was launched in NHS Fife in June 2020 and has amassed 800 active users so far. There is growing engagement with the App since its launch, with over 1000 user interactions in the last month alone. Feedback shows that 100% of users like the App and have found it useful in the management of their diabetes. The App has proven to be an essential tool in communication with one of the most vulnerable groups during the Covid-19 pandemic, and its ongoing development will continue to increase patient engagement and improve glycaemic control for patients with type 1 diabetes. The future of chronic disease management should involve digital solutions such as apps to further empower patients in their healthcare.

Keywords: diabetes, endocrinology, digital healthcare, medical apps

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Authors: Catherine Wheatley, Emma L. Davies, Helen Dawes

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The health benefits of exercise are widely recognised, but numerous interventions have failed to halt a sharp decline in physical activity during early adolescence. Many such projects are underpinned by the Theory of Planned Behaviour, yet this model of rational decision-making leaves variance in behavior unexplained. This study investigated whether the Prototype Willingness Model, which proposes a second, reactive decision-making path to account for spontaneous responses to the social environment, has potential to improve understanding of adolescent exercise behaviour in school by exploring constructs in the model with young people. PE teachers in 4 Oxfordshire schools each nominated 6 pupils who were active in school, and 6 who were inactive, to participate in the study. Of these, 45 (22 male) aged 12-13 took part in 8 focus group discussions. These were transcribed and subjected to deductive thematic analysis to search for themes relating to the prototype willingness model. Participants appeared to make rational decisions about commuting to school or attending sports clubs, but spontaneous choices to be inactive during both break and PE. These reactive decisions seemed influenced by a social context described as more ‘judgmental’ than primary school, characterised by anxiety about physical competence, negative peer evaluation and inactive playground norms. Participants described their images of typical active and inactive adolescents: active images included negative social characteristics including ‘show-off’. There was little concern about the long-term risks of inactivity, although participants seemed to recognise that physical activity is healthy. The Prototype Willingness Model might more fully explain young adolescents’ physical activity in school than rational behavioural models, indicating potential for physical activity interventions that target social anxieties in response to the changing playground environment. Images of active types could be more complex than earlier research has suggested, and their negative characteristics might influence willingness to be active.

Keywords: adolescence, physical activity, prototype willingness model, school

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