Search results for: related interventions

Authors: Soultana Konstantinidou, Tiziana Schmidt, Elena Landi, Alessandro De Carli, Giovanni Maltinti, Darius Witt, Alicja Dziadosz, Agnieszka Lindstaedt, Michele Lai, Mauro Pistello, Valentina Cappello, Luciana Dente, Chiara Gabellini, Piotr Barski, Vittoria Raffa

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CRISPR/Cas9 technology has gained the interest of researchers in the field of biotechnology for genome editing. Since its discovery as a microbial adaptive immune defense, this system has been widely adopted and is acknowledged for having a variety of applications. However, critical barriers related to safety and delivery are persisting. Here, we propose a new concept of genome engineering, which is based on a nano-formulation of Cas9. The Cas9 enzyme was conjugated to a gold nanoparticle (AuNP-Cas9). The AuNP-Cas9 maintained its cleavage efficiency in vitro, to the same extent as the ribonucleoprotein, including non-conjugated Cas9 enzyme, and showed high gene editing efficiency in vivo in zebrafish embryos. Since CRISPR/Cas9 technology is extensively used in cancer research, melanoma was selected as a validation target. Cell studies were performed in A375 human melanoma cells. Particles per se had no impact on cell metabolism and proliferation. Intriguingly, the AuNP-Cas9 internalized spontaneously in cells and localized as a single particle in the cytoplasm and organelles. More importantly, the AuNP-Cas9 showed a high nuclear localization signal. The AuNP-Cas9, overcoming the delivery difficulties of Cas9, could be used in cellular biology and localization studies. Taking advantage of the plasmonic properties of gold nanoparticles, this technology could potentially be a bio-tool for combining gene editing and photothermal therapy in cancer cells. Further work will be focused on intracellular interactions of the nano-formulation and characterization of the optical properties.

Keywords: CRISPR/Cas9, gene editing, gold nanoparticles, nanotechnology

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Authors: Fleura Shkëmbi, Sevim Mustafa, Naim Fanaj

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Hypnosis, often known as cognitive therapy, is a sort of mind-body psychotherapy. A professional and certified hypnotist or hypnotherapist guides the patient into this extreme level of focus and relaxation during the session by utilizing verbal cues, repetition, and imagery. In recent years, hypnotherapy has gained popularity in the treatment of a variety of disorders, including anxiety and particular phobias. The term "phobia" is commonly used to define fear of a certain trigger. When faced with potentially hazardous situations, the brain naturally experiences dread. While a little dread here and there may keep us safe, phobias can drastically reduce our quality of life. In summary, persons who suffer from anxiety are considered to see particular environmental situations as dangerous, but those who do not suffer from anxiety do not. Hypnosis is essential in the treatment of anxiety disorders. Hypnosis can help patients minimize their anxiety symptoms. This broad concept has aided in the development of models and therapies for anxiety disorders such as generalized anxiety disorder, panic attacks, hypochondria, and obsessional disorders. Hypnosis techniques are supposed to be attentive and mental pictures, which is conceivable; this is why they're associated with improved working memory and visuospatial abilities. In this sense, the purpose of this study is to determine how effectively specific therapeutic methods perform in treating persons with anxiety and phobias. In addition to cognitive-behavioral therapy and other therapies, the approaches emphasized the use of therapeutic hypnosis. This study looks at the use of hypnosis and related psychotherapy procedures in the treatment of anxiety disorders. Following a discussion of the evolution of hypnosis as a therapeutic tool, neurobiological research is used to demonstrate the influence of hypnosis on the change of perception in the brain. The use of hypnosis in the treatment of phobias, stressful situations, and posttraumatic stress disorder is examined, as well as similarities between the hypnotic state and dissociative reactions to trauma. Through an extensive literature evaluation, this study will introduce hypnotherapy procedures that result in more successful anxiety and phobia treatment.

Keywords: anxiety, hypnosis, hypnotherapy, phobia, technique, state

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Authors: Andrea Corsale

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The historical and geographical regions of Banat and Crişana in Western Romania have long been characterized by a high degree of ethnic diversity. However, this traditionally complex cultural, linguistic, and religious mosaic has undergone a progressive simplification during the past century due to deportations, emigration, and assimilation, and both regions now have a large Romanian-speaking majority population. This contribution focuses on Jewish heritage in the two largest cities of these two regions, Timişoara (Banat) and Oradea (Crişana). The two cities shared some historical events but also went through different experiences, despite their relative geographic proximity. The Jewish community of Timişoara survived the Holocaust basically intact, an almost unique case in Central-Eastern Europe, but largely left the city after the war. Instead, the Jewish community of Oradea was almost completely deported and killed in Auschwitz, and a renewed post-war community gradually emigrated abroad in the following decades. The two Jewish communities are now very small in size but inherited a vast tangible and intangible heritage (synagogues, cemeteries, community buildings, characteristic architecture, memories, local traditions, and histories), partially restored and recovered in recent years. The author’s fieldwork shows that local Jewish stakeholders are aware of the potential of this heritage in terms of cultural and economic benefits, but significant weaknesses and concerns exist, as the small dimension of these communities, and their financial constraints, challenge their future role in the eventual promotion and management of this heritage, which is now basically in the hands of the non-Jewish public and private stakeholders. Projects, experiences, and views related to Jewish heritage conservation and promotion in these two contexts will be portrayed and analysed in order to contribute to a broader discussion on representations and narratives of minority heritage within cultural tourism development dynamics.

Keywords: Jewish heritage, ethnic minorities, heritage tourism, Romania

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Authors: Adamu Muhammed Tukur

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Pulp and paper industry is one of the fastest growing industries due to an increased demand in paper products. For it to satisfy this ever increasing demand, it adopts new technological innovations some of which are proved to affect our environment negatively. Global consumption of paper has increased by 400% in the last four decades and this suggests that more research is required to assess the impact of industrial effluents to our environment and public health. Paper products are generally biodegradable, however, the processes involved in its production which involve the use of mainly bleaching agents and other non-biodegradable substances pose serious problem to the environment. There are more than 250 chemicals released in paper mill waste and some are xenobiotics. Different methods such as physical and chemical methods can be adopted for the remediation of the effluents but are proved to be costly and not safe to the environment. On the other hand, biological method is shown to be less costly and environmentally friendly. Microorganisms and their enzymes have shown a promising future for bioremediation of effluents related to paper mill. Many studies prove that one of the major pollutants in the paper mill effluent is phenol especially its chlorinated derivatives. Pentachlorophenol is extremely hazardous to living cells and therefore need to be removed from the environment. Microorganisms including bacteria and fungi have the potential to degrade phenolic compounds e.g. Bacillus stearothermiphilus, Pseudomonas putida, Coricus versicolor, Sphingomonas chlorophenolica, Fusarium sp, Bacillus subtilis and P. aeroginosa. Enzymes used for the degradation include phenol hydrooxylase, polyphenoloxylase, laccase, peroxidase among others. Lignin is another important pollutant and is resistant to microbial degradation but it has been proved that certain bacteria and fungi like can degrade it. Among the fungi white-rot fungi like Fomes lividus and Trametes vesicolor are the most important bioremediators. This review focused on use of microorganism to reduce or eradicate pollutants released from the paper industry. It can serve as a review for further research to be conducted especially in the field of Biotechnology.

Keywords: bioremediation, pulp and paper, pentachlorophenol, environment

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Ibrahim Darwish, Noora Abu Ain

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Referring to female relatives by male Jordanian speakers in public is governed by various linguistic and social constraints. Although Jordanian society is less conservative than it was a few decades ago, women are still considered the weaker link in society and men still believe that they need to protect them. Conservative Jordanians often avoid referring to their female relatives overtly, i.e., using their real names. Instead, they use covert names, such as pseudonyms, nicknames, pet names, etc. The reason behind such language use has to do with how Arab men, in general, see women as part of their honor. This study intends to investigate to what extent Jordanian males hide their female relatives’ names in public domains. The data was collected from spontaneous informal voice-recorded interviews carried out in the village of Saham in the far north of Jordan. Saham’s dialect is part of a larger Horani dialect used by speakers along a wide area that stretches from Salt in the south to the Syrian borders in the north of Jordan. The voice-recorded interviews were originally carried out as an audio record of some customs and traditions in the village of Saham in 2013. During most of these interviews, the researchers observed how the male participants indirectly referred to their female relatives. Instead of using real names, the male speakers used broad terms to refer to their female relatives, such al-Beit ‘the home,’ al-ciyaal ‘the kids’, um-x ‘the mother of x,’ etc. All tokens related to the issue in question were collected, analyzed and quantified about three age cohorts: young, middle-aged and old speakers. The results show that young speakers are more direct in referring to their female relatives than the other two age groups. This can point to a possible change in progress in the speech community of Saham. It is argued that due to contact with other urban speech communities, the young speakers in Saham do not feel the need to hide the real names of their female relatives as they consider them as equals. Indeed, the young generation is more open to the idea of women's rights and call for expanding Jordanian women’s roles in Jordanian society.

Keywords: gender differences, Horan, proper names, social constraints

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Authors: Pibool Waijittragum

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The purpose of this research is to analyze the marketing strategies of Thai Halal products which related to the way of life for Thai Muslims. The expected benefit is the marketing strategy for brand building process for Halal products in Thailand. 4 elements of marketing strategies which necessary for the brand identity creation is the research framework: Consists of Attributes, Benefits, Values and Personality. The research methodology was applied using qualitative and quantitative; 19 marketing experts with dynamic roles in Thai consumer products were interviewed. In addition, a field survey of 122 Thai Muslims selected from 175 Muslim communities in Bangkok was studied. Data analysis will be according to 5 categories of Thai Halal product: 1) Meat 2) Vegetable and Fruits 3) Instant foods and Garnishing ingredient 4) Beverages, desserts and snacks 5) Hygienic daily products; such as soap, shampoo and body lotion. The results will explain some suitable representation in the marketing strategies of Thai Halal products as are: 1) Benefit; the characteristics of the product with its benefit. Consumers will purchase this product with the reason of; it is beneficial nutrients product, there are no toxic or chemical residues. Fresh and clean materials 2) Attribute; the exterior images that attract to consumer. Consumers will purchase this product with the reason of; there is a standard proof mark, food and drug secure proof mark and Halal products mark. Packaging and its materials should be draw attention. Use an attractive graphic. Use outstanding images of product, material or ingredients. 3) Value; the value of products that affect to consumers perception; it is healthy products. Accumulate quality of life. It is a product of expertise, manufacturing of research result. Consumers are important. It’s sincere, honest and reliable to all. 4) Personality; reflection of consumers thought. The personality feedback to them after they were consumes this product; they are health care persons. They are the rational person, moral person, justice person and thoughtful person like a progressive thinking.

Keywords: marketing strategies, product identity, branding, Thai Halal products

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Authors: Lim Pey Huan

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Yi-Kuan-Tao has been developing in Malaysia for nearly 60 years. It was initially introduced from mainland China and later from Taiwan starting from the 1970s. Yi-Kuan-Tao was considered a 'new religion' for the local Chinese community in Malaysia in its early stages, as Chinese immigrants primarily practiced Taoism, Buddhism, Christianity, or Catholicism upon settling in the region. The overseas propagation and development of Yi-Kuan-Tao today primarily occur through Taiwanese temples, which began spreading abroad as early as 1949. Particularly since the 1970s, with the rapid economic growth of Taiwan, various branches of Taiwanese Yi-Kuan-Tao have gained economic strength to propagate abroad, further expanding the influence of Yi-Kuan-Tao overseas. Southeast Asia is the region out from Taiwan where the propagation and development of Yi-Kuan-Tao are fastest and most concentrated. With approximately over 6 million Chinese inhabitants, Malaysia's pursuit of traditional Chinese culture has led to a flourishing interest in Yi-Kuan-Tao, particularly its advocacy of the unity of Confucianism, Buddhism, and Taoism, with an emphasis on promoting Confucian thought. Moreover, Taiwan's rapid economic development since the 1970s has enabled Yi-Kuan-Tao to allocate significant human and financial resources for external propagation efforts. Additionally, Malaysia's government has adopted a relatively tolerant policy towards religion since that time, further fostering the flourishing development of Yi-Kuan-Tao in Malaysia. Furthermore, this thesis aims to strengthen the lineage and continuity of the Yi-Kuan-Tao tradition, particularly the branch of Fa Yi Chong De, through the perspective of Heavenly Mandate (天命). By examining the different origins and ethnic backgrounds, it investigates how the Malaysian Chinese community has experienced different changes through the cultural baptism of religion, thus delving into the religious influence of Yi-Kuan-Tao. Given that the Fa Yi Chong De Academy in Taiwan is currently in an active development and construction phase, academic works related to Yi-Kuan-Tao will lay a more solid academic foundation for the future establishment of the academy.

Keywords: initial exploration, cultural shifts, Yi-Kuan-Tao, Malaysian Chinese community

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Authors: Pooja Kumari, Anandkumar Tengli

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Aurora kinase enzyme, a protein on overexpression, leads to metastasis and is extremely important for women’s health in terms of prevention or treatment. While creating a targeted technique, the aim of the work is to design purine molecules that inhibit in aurora kinase enzyme and helps to suppress breast cancer. Purine molecules attached to an amino acid in DNA block protein synthesis or halt the replication and metastasis caused by the aurora kinase enzyme. Various protein related to the overexpression of aurora protein was docked with purine molecule using Biovia Drug Discovery, the perpetual software. Various parameters like X-ray crystallographic structure, presence of ligand, Ramachandran plot, resolution, etc., were taken into consideration for selecting the target protein. A higher negative binding scored molecule has been taken for simulation studies. According to the available research and computational analyses, purine compounds may be powerful enough to demonstrate a greater affinity for the aurora target. Despite being clinically effective now, purines were originally meant to fight breast cancer by inhibiting the aurora kinase enzyme. In in-silico studies, it is observed that purine compounds have a moderate to high potency compared to other molecules, and our research into the literature revealed that purine molecules have a lower risk of side effects. The research involves the design, synthesis, and identification of active purine molecules against breast cancer. Purines are structurally similar to the normal metabolites of adenine and guanine; hence interfere/compete with protein synthesis and suppress the abnormal proliferation of cells/tissues. As a result, purine target metastasis cells and stop the growth of kinase; purine derivatives bind with DNA and aurora protein which may stop the growth of protein or inhibits replication and stop metastasis of overexpressed aurora kinase enzyme.

Keywords: aurora kinases, in silico studies, medicinal chemistry, combination therapies, chronic cancer, clinical translation

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Authors: Uchenna Cosmas Ugwu, Osmond Chukwuemeka Ene

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Globally, older adults are considered the most vulnerable groups to age-related diseases including diabetes mellitus, obesity, cardiovascular diseases, cancer and osteoporosis. With improved access to quality healthcare services, these complications can be prevented and the incidence rates reduced to the least occurrence. The aim of this study is to validate appropriate measures for improving quality healthcare services utilization among elderly persons in Nigeria and also to determine the significant association within demographic variables. A cross-sectional survey research design was adopted. Using a convenient sampling technique, a total of 400 experts (150 registered nurses and 250 public health professionals) with minimum of doctoral degree qualification were sampled and studied. A structured instrument titled “Expert-Based Healthcare Services Utilization Questionnaire (EBHSUQ) with .83 reliability index was used for data collection. All the statistical data analysis was completed using frequency counts, percentage scores and chi-square statistics. The results were significant at p≤0.05. It was found that quality healthcare services utilization by elderly persons in Nigeria would be improved if the services are: available (83%), affordable (82%), accessible (79%), suitable (77%), acceptable (77%), continuous (75%) and stress-free (75%). Statistically, significant association existed on quality healthcare services utilization with gender (p=.03<.05) and age (p=.01<.05) while none was observed on work experience (p=.23>.05), marital status (p=.11>.05) and employment category (p=.09>.05). To improve quality healthcare services utilization for elderly persons in Nigeria, the adoption of appropriate measures by Nigerian government and professionals in healthcare sectors are paramount. Therefore, there is need for collaborative efforts by the Nigerian government and healthcare professionals geared towards educating the general public through mass sensitization, awareness campaign, conferences, seminars and workshops for the importance of accessing healthcare services.

Keywords: elderly persons, healthcare services, cross-sectional survey research design, utilization.

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Authors: Eman Alatawi

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The world is currently experiencing an upsurge in the number of international migrants, which has reached 281 million worldwide; in particular, both the UK and Saudi Arabia have recently been faced with an unprecedented number of immigrants. As a result, the media in these two countries is constantly posting news about the issue, and newspapers, in particular, play a vital role in shaping the public’s view of immigration issues. Because the media is an influential tool in society, it has the ability to construct a specific image of migrants and influence public opinion concerning immigrant groups. However, most of the existing studies have addressed the plight of migrants in the UK, Europe, and the US, and few have considered the Middle East; specifically, there is a pressing need for studies that focus on the press in Saudi Arabia, which is one of the main countries that is experiencing immigration at a tremendous rate. This paper employs critical discourse analysis (CDA) to examine the depiction of migrants in the British and Saudi Arabian media in order to explore the involvement of three linguistic features in the media’s representation of migrant-related topics. These linguistic features are the names, metaphors, and collocations that the press in the UK and in Saudi Arabia uses to describe migrants; the impact of these depictions is also considered. This comparative study could create a better understanding of how the Saudi Arabian press presents the topic of migrants and immigration, which will assist in extending the understanding of migration discourses beyond an Anglo-centric viewpoint. The main finding of this study was that both British and Saudi Arabian newspapers tended to represent migrants’ issues by painting migrants in a negative light through the use of negative references or names, metaphors, and collocations; furthermore, the media’s negative stereotyping of migrants was found to be consistent, which could have an influence on the public’s opinion of these minority groups. Such observations show that the issue is not as simple as individuals, press systems, or political affiliations.

Keywords: representation, migrants, the UK press, Saudi Arabia press, cross-linguistic, discourse analysis

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Authors: Shih-Wen Hsiao, Yi-Cheng Tsao

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In the field of reverse engineering and creative industries, applying 3D scanning process to obtain geometric forms of the objects is a mature and common technique. For instance, organic objects such as faces and nonorganic objects such as products could be scanned to acquire the geometric information for further application. However, although the data resolution of 3D scanning device is increasing and there are more and more abundant complementary applications, the penetration rate of 3D scanning for the public is still limited by the relative high price of the devices. On the other hand, Kinect, released by Microsoft, is known for its powerful functions, considerably low price, and complete technology and database support. Therefore, related studies can be done with the applying of Kinect under acceptable cost and data precision. Due to the fact that Kinect utilizes optical mechanism to extracting depth information, limitations are found due to the reason of the straight path of the light. Thus, various angles are required sequentially to obtain the complete 3D information of the object when applying a single Kinect for 3D scanning. The integration process which combines the 3D data from different angles by certain algorithms is also required. This sequential scanning process costs much time and the complex integration process often encounter some technical problems. Therefore, this paper aimed to apply multiple Kinects simultaneously on the field of developing a rapid 3D mannequin scan platform and proposed suggestions on the number and angles of Kinects. In the content, a method of establishing the coordination based on the relation between mannequin and the specifications of Kinect is proposed, and a suggestion of angles and number of Kinects is also described. An experiment of applying multiple Kinect on the scanning of 3D mannequin is constructed by Microsoft API, and the results show that the time required for scanning and technical threshold can be reduced in the industries of fashion and garment design.

Keywords: 3D scan, depth sensor, fashion and garment design, mannequin, multiple Kinect sensor

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Authors: Elena Masi, Adolfo Morrone

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Migration has recently become a mainstream development sector and is currently at the forefront in institutional and civil society context. However, no consensus exists on how the link between migration and development operates, that is how development is related to migration and how migration can promote development. On one hand, Official Development Assistance is recognized to be one of the levers to development. On the other hand, the debate is focusing on what should be the scope of aid programs targeting migrants groups and in general the migration process. This paper provides a descriptive analysis on how development aid for migration was allocated in the recent past, focusing on the actions that were funded and implemented by the international donor community. In the absence of an internationally shared methodology for defining the boundaries of development aid on migration, the analysis based on lexical hypotheses on the title or on the short description of initiatives funded by several Organization for Economic Co-operation and Development (OECD) countries. Moreover, the research describes and quantifies aid flows for each country according to different criteria. The terms migrant and refugee are used to identify the projects in accordance with the most internationally agreed definitions and only actions in countries of transit or of origin are considered eligible, thus excluding the amount sustained for refugees in donor countries. The results show that the percentage of projects targeting migrants, in terms of amount, has followed a growing trend from 2009 to 2016 in several European countries, and is positively correlated with the flows of migrants. Distinguishing between programs targeting migrants and programs targeting refugees, some specific national features emerge more clearly. A focus is devoted to actions targeting the root causes of migration, showing an inter-sectoral approach in international aid allocation. The analysis gives some tentative solutions to the lack of consensus on language on migration and development aid, and emphasizes the need to internationally agree on a criterion for identifying programs targeting both migrants and refugees, to make action more transparent and in order to develop effective strategies at the global level.

Keywords: migration, official development assistance, ODA, refugees, time series

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Authors: P. V. Pramila , V. Mahesh

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Pulmonary Function Tests are important non-invasive diagnostic tests to assess respiratory impairments and provides quantifiable measures of lung function. Spirometry is the most frequently used measure of lung function and plays an essential role in the diagnosis and management of pulmonary diseases. However, the test requires considerable patient effort and cooperation, markedly related to the age of patients esulting in incomplete data sets. This paper presents, a nonlinear model built using Multivariate adaptive regression splines and Random forest regression model to predict the missing spirometric features. Random forest based feature selection is used to enhance both the generalization capability and the model interpretability. In the present study, flow-volume data are recorded for N= 198 subjects. The ranked order of feature importance index calculated by the random forests model shows that the spirometric features FVC, FEF 25, PEF,FEF 25-75, FEF50, and the demographic parameter height are the important descriptors. A comparison of performance assessment of both models prove that, the prediction ability of MARS with the `top two ranked features namely the FVC and FEF 25 is higher, yielding a model fit of R2= 0.96 and R2= 0.99 for normal and abnormal subjects. The Root Mean Square Error analysis of the RF model and the MARS model also shows that the latter is capable of predicting the missing values of FEV1 with a notably lower error value of 0.0191 (normal subjects) and 0.0106 (abnormal subjects). It is concluded that combining feature selection with a prediction model provides a minimum subset of predominant features to train the model, yielding better prediction performance. This analysis can assist clinicians with a intelligence support system in the medical diagnosis and improvement of clinical care.

Keywords: FEV, multivariate adaptive regression splines pulmonary function test, random forest

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Authors: Lokman Gozcu, Sule Deniz Gozcu

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This study aims to analyze the skills of speaking in the acquisition of Turkish as a foreign language. One of the most important things for the individual who learns a foreign language is to be successful in the oral communication (speaking) skills and to interact in an understandable way. Speech skill requires much more time and effort than other language skills. In this direction, it is necessary to make an analysis of these oral communication skills, which is important in Turkish language acquisition as a foreign language and to draw out a road map according to the result. The aim of this study is to determine the competence and attitudes of speaking competence according to the individuals who learn Turkish as a foreign language and to be considered as speaking skill elements; Grammar, emphasis, intonation, body language, speed, ranking, accuracy, fluency, pronunciation, etc. and the results and suggestions based on these determinations. A mixed method has been chosen for data collection and analysis. A Likert scale (for competence and attitude) was applied to 190 individuals who were interviewed face-to-face (for speech skills) with a semi-structured interview form about 22 participants randomly selected. In addition, the observation form related to the 22 participants interviewed were completed by the researcher during the interview, and after the completion of the collection of all the voice recordings, analyses of voice recordings with the speech skills evaluation scale was made. The results of the research revealed that the speech skills of the individuals who learned Turkish as a foreign language have various perspectives. According to the results, the most inadequate aspects of the participants' ability to speak in Turkish include vocabulary, using humorous elements while speaking Turkish, being able to include items such as idioms and proverbs while speaking Turkish, Turkish fluency respectively. In addition, the participants were found not to feel comfortable while speaking Turkish, to feel ridiculous and to be nervous while speaking in formal settings. There are conclusions and suggestions for the situations that arise after the have been analyses made.

Keywords: learning Turkish as a foreign language, proficiency criteria, phonetic (modalities), speaking skills

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Authors: Umar Rehman, Holly Roy, K. T. Tsang, D. S. Jeyaretna, W Singleton, B. Fisher, P. A. Glew, J. Greig, Peter C. Whitfield

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Introduction: A brain abscess is a life-threatening condition, carrying significant mortality. It requires rapid identification and treatment. Management involves a combination of antibiotics and surgery. The aim of the current study was to identify common bacteria responsible for cerebral abscesses as well as the long term functional and neurological outcomes of patients following treatment in a retrospective series at a single UK neurosurgical centre. Methodology: We analysed patients that had received a diagnosis of 'cerebral abscess' or 'subdural empyema' between June 2002 and June 2018. This was done in the form of a retrospective review. The search resulted in a total of 180 patients; with 37 patients being excluded (spinal abscess, below 18 or non-abscess related admissions). Data were collected from medical case notes including information about demographics, comorbidities, immunosuppression, presentation, size/location of lesions, pathogens, treatment, and outcomes. Results: In total, we analysed 143 patients between the ages of 18-90. Focal neurological deficit and headaches were seen in 84% and 68% of patients respectively. 108 positive brain cultures were seen; with the largest proportion, 59.2% being gram-positive cocci, with strep intermedius being the most common pathogen identified in 13.9% of patients. Of the patients with positive blood cultures (n=11), 72.7% showed the same organism both in the blood and on the brain cultures. Long term outcomes (n=72) revealed that 48% of patients seizure-free without requiring anti-epileptics, 51.3% of patients had full recovery of their neurological symptoms. There was a mortality rate of 13.9% in the series. Conclusion: In conclusion, the largest bacterial cause of abscess within our population was due to gram-positive cocci. The majority of the patient demonstrated full neurological recovery with close to half of patients not requiring anti-epileptics following discharge.

Keywords: bacteria, cerebral abscess, long term outcome, neurological deficit

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Authors: Hilal Keklicek, Baris Cetin, Yeliz Salci, Ayla Fil, Umut Altinkaynak, Kadriye Armutlu

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Objectives and Goals: Spasticity is a common symptom characterized with a velocity dependent increase in tonic stretch reflexes (muscle tone) in patient with multiple sclerosis (MS). Hypertonic muscles affect the normal plantigrade contact by disturbing accommodation of foot to the ground while walking. It is important to know the differences between healthy and neurologic foot features for management of spasticity related deformities and/or determination of rehabilitation purposes and contents. This study was planned with the aim of investigating the dynamic plantar pressure distribution in individuals with MS and determining the differences between healthy individuals (HI). Methods: Fifty-five individuals with MS (108 foot with spasticity according to Modified Ashworth Scale) and 20 HI (40 foot) were the participants of the study. The dynamic pedobarograph was utilized for evaluation of dynamic loading parameters. Participants were informed to walk at their self-selected speed for seven times to eliminate learning effect. The parameters were divided into 2 categories including; maximum loading pressure (N/cm2) and time of maximum pressure (ms) were collected from heal medial, heal lateral, mid foot, heads of first, second, third, fourth and fifth metatarsal bones. Results: There were differences between the groups in maximum loading pressure of heal medial (p < .001), heal lateral (p < .001), midfoot (p=.041) and 5th metatarsal areas (p=.036). Also, there were differences between the groups the time of maximum pressure of all metatarsal areas, midfoot, heal medial and heal lateral (p < .001) in favor of HI. Conclusions: The study provided basic data about foot pressure distribution in individuals with MS. Results of the study primarily showed that spasticity of lower extremity muscle disrupted the posteromedial foot loading. Secondarily, according to the study result, spasticity lead to inappropriate timing during load transfer from hind foot to forefoot.

Keywords: multiple sclerosis, plantar pressure distribution, gait, norm values

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Authors: John Ahluwalia

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As an affluent first-world nation, Canada took swift and comprehensive action during the outbreak of the SARS-CoV-2 (COVID-19) pandemic compared to other countries in the same socio-economic cohort. The United States has stumbled to overcome obstacles most developed nations have faced, which has led to significantly more per capita cases and deaths. The initial outbreaks of COVID-19 occurred in the US and Canada within days of each other and posed similar potentially catastrophic threats to public health, the economy, and governmental stability. On a macro level, events that take place in the US have a direct impact on Canada. For example, both countries tend to enter and exit economic recessions at approximately the same time, they are each other’s largest trading partners, and their currencies are inexorably linked. Why is it that Canada has not shared the same fate as the US (and many other nations) that have realized much worse outcomes relative to the COVID-19 pandemic? Variables intrinsic to Canada’s national infrastructure have been instrumental in the country’s efforts to flatten the curve of COVID-19 cases and deaths. Canada’s coordinated multi-level governmental effort has allowed it to create and enforce policies related to COVID-19 at both the national and provincial levels. Canada’s policy of universal healthcare is another variable. Health care and public health measures are enforced on a provincial level, and it is within each province’s jurisdiction to dictate standards for public safety based on scientific evidence. Rather than introducing confusion and the possibility of competition for resources such as PPE and vaccines, Canada’s multi-level chain of government authority has provided consistent policies supporting national public health and local delivery of medical care. This paper will demonstrate that the coordinated efforts on provincial and federal levels have been the linchpin in Canada’s relative success in containing the deadly spread of the COVID-19 virus.

Keywords: COVID-19, Canada, GIS, temporal analysis, ESRI

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Authors: Konstantinos Tolidis

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The mountains are amongst the most fragile environments in the world. The world’s mountain areas cover 24% of the Earth’s land surface and are home to 12% of the global population. A further 14% of the global population is estimated to live in the vicinity of their surrounding areas. As urbanization continues to increase in the world, the mountains are also key centers for recreation and tourism; their attraction is often heightened by their remarkably high levels of biodiversity. Due to the fact that the features in mountain areas vary spatially (development degree, human geography, socio-economic reality, relations of dependency and interaction with other areas-regions), the spatial planning on these areas consists of a crucial process for preserving the natural, cultural and human environment and consists of one of the major processes of an integrated spatial policy. This research has been focused on the spatial decision problem of land use allocation optimization which is an ordinary planning problem on the mountain areas. It is a matter of fact that such decisions must be made not only on what to do, how much to do, but also on where to do, adding a whole extra class of decision variables to the problem when combined with the consideration of spatial optimization. The utility of optimization as a normative tool for spatial problem is widely recognized. However, it is very difficult for planners to quantify the weights of the objectives especially when these are related to mountain areas. Furthermore, the land use allocation optimization problems at mountain areas must be addressed not only by taking into account the general development objectives but also the spatial objectives (e.g. compactness, compatibility and accessibility, etc). Therefore, the main research’s objective was to approach the land use allocation problem by utilizing a hybrid meta-heuristic optimization technique tailored to the mountain areas’ spatial characteristics. The results indicates that the proposed methodological approach is very promising and useful for both generating land use alternatives for further consideration in land use allocation decision-making and supporting spatial management plans at mountain areas.

Keywords: multiobjective land use allocation, mountain areas, spatial planning, spatial decision making, meta-heuristic methods

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Authors: Jennifer Isabelle Rios Rendón, Ursula Sanchez, Dana Lee Baker

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Disability Policy in México has witnessed numerous changed throughout the years. Physical disabilities are more often recognized in Mexican culture. However, with an emerging focus on neurological disabilities or differences in individuals’ new policies are needed to serve better and understand the needs of these populations. The need to understand and communicate with local leaders is imperative, as the lens used to analyze autism has historically been from a Western school of thought. We are looking to comprehend the disability policy subsystem in México - specifically how autism is perceived, the language used to describe it, and how it ties to the cultural stigma of disabilities that exist in México. Therefore, to understand this, we seek to interview multiple policy leaders on their experience in autism and disability policy. The goal is to conduct qualitative research through interviews with local autism and disability leaders in México. This methodology aims to answer the questions of what language commonly and culturally is utilized in disability policy, the context of how autism is perceived in México, and in general, the lived experience of the disability policy leaders that take part in this effort in México. Local activists and policy leaders were initially found through an online search then collected using snowball sampling. The interviews were conducted through a series of pre-formulated questions that the policy leader answered via email or a phone conversation with the researchers. Acknowledging the importance of language and accessibility, the need for the content to be in both English and Spanish as well as auditory and visual is essential to take steps in the inclusion of a Neurodiverse group of leaders. This work is a demonstration of the framework of the investigation which hopes to create a more complete understanding of the policy and political culture around autism in México. Results of the project include new insight into the developing relationship between the President Andrés Manuel López Obrador’s administration, disability activists, and neurodiverse communities. The project contributes to denormalizing the legacy of white supremacy in autism related, historically rooted in the assumption that autism occurs predominantly in white communities.

Keywords: autism, disability leaders, disability policy, México, Neurodiversity

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Authors: Pınar Karakaya, Meral Mert, Yildiz Okuturlar, Didem Acarer, Asuman Gedikbasi, Filiz Islim, Teslime Ayaz, Ozlem Soyluk, Ozlem Harmankaya, Abdulbaki Kumbasar

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Objective: To evaluate the relation of mean platelet volume (MPV) levels with serum paraoxonase-1 activity and brachial artery diameter and intima media thickness in diabetic patients with respect to obesity and diabetic complications. Methods: A total of 201 diabetic patients grouped with respect to obesity [obese (n=89) and non-obese (n=112) and diabetic complications [with (n=50) or without (n=150) microvascular complications and with (n=91) or without (n=108) macrovascular complications] groups were included. Data on demographic and lifestyle characteristics of patients, anthropometric measurements, diabetes related microvascular and macrovascular complications, serum levels for MPV, bBrachial artery diameter and intima media thickness (IMT) and serum paraoxonase and arylesterase activities were recorded. Correlation of MPV values to paraoxonase and arylesterase activities as well as to brachial artery diameter and IMT was evaluated in study groups. Results: Mean(SD) paraoxonase and arylesterase values were 119.8(37.5) U/L and 149.0(39.9) U/L, respectively in the overall population with no significant difference with respect to obesity and macrovascular diabetic complications, whereas significantly lower values for paraoxonase (107.5(30.7) vs. 123.9(38.8) U/L, p=0.007) and arylesterase (132.1(30.2) vs. 154.7(41.2) U/L, p=0.001) were noted in patients with than without diabetic microvascular complications. Mean(SD) MPV values were 9.10 (0.87) fL in the overall population with no significant difference with respect to obesity and diabetic complications. No significant correlation of MPV values to paraoxonase, arylesterase activities, to brachial artery diameter and IMT was noted in the overall study population as well as in study groups. Conclusion: In conclusion, our findings revealed a significant decrease I PON-1 activity in diabetic patients with microvascular rather than macrovascular complications, whereas regardless of obesity and diabetic complications, no increase in thrombogenic activity and no relation of thrombogenic activity with PON-1 activity and brachial artery diameter and IMK.

Keywords: atherosclerosis, diabetes mellitus, microvascular complications, macrovascular complications, obesity, paraoxonase

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Authors: Nancy Retzlaff, Sarah J. Berkemer, Trudie Strauss

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In the last couple of decades, the advent of digitalization of any kind of data was probably one of the major advances in all fields of study. This paves the way for also analysing these data even though they might come from disciplines where there was no initial computational necessity to do so. Especially in linguistics, one can find a rather manual tradition. Still when considering studies that involve the history of language families it is hard to overlook the striking similarities to bioinformatics (phylogenetic) approaches. Alignments of words are such a fairly well studied example of an application of bioinformatics methods to historical linguistics. In this paper we will not only consider alignments of strings, i.e., words in this case, but also alignments of syntax trees of selected Indo-European languages. Based on initial, crude alignments, a sophisticated scoring model is trained on both letters and syntactic features. The aim is to gain a better understanding on which features in two languages are related, i.e., most likely to have the same root. Initially, all words in two languages are pre-aligned with a basic scoring model that primarily selects consonants and adjusts them before fitting in the vowels. Mixture models are subsequently used to filter ‘good’ alignments depending on the alignment length and the number of inserted gaps. Using these selected word alignments it is possible to perform tree alignments of the given syntax trees and consequently find sentences that correspond rather well to each other across languages. The syntax alignments are then filtered for meaningful scores—’good’ scores contain evolutionary information and are therefore used to train the sophisticated scoring model. Further iterations of alignments and training steps are performed until the scoring model saturates, i.e., barely changes anymore. A better evaluation of the trained scoring model and its function in containing evolutionary meaningful information will be given. An assessment of sentence alignment compared to possible phrase structure will also be provided. The method described here may have its flaws because of limited prior information. This, however, may offer a good starting point to study languages where only little prior knowledge is available and a detailed, unbiased study is needed.

Keywords: alignments, bioinformatics, comparative linguistics, historical linguistics, statistical methods

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Authors: Mustafa Metin Donma

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Obesity increases the risk of elevated blood pressure, which is a metabolic syndrome (MetS) component. Waist circumference (WC) is accepted as an indispensable parameter for the evaluation of these health problems. The close relationship of height with blood pressure values revealed the necessity of including height in tense indices. The association of tense indices with WC has also become an increasingly important topic. The purpose of this study was to develop a tense index that could contribute to differential diagnosis of MetS more than the indices previously introduced. One hundred and ninety-four children, aged 06-11 years, were considered to constitute four groups. The study was performed on normal weight (Group 1), overweight+obese (Group 2), morbid obese [without (Group 3) and with (Group 4) MetS findings] children. Children were included in the groups according to the recommendations of World Health Organization based on age- and gender dependent body mass index percentiles. For MetS group, MetS components well-established before were considered. Anthropometric measurements, as well as blood pressure values were taken. Tense indices were computed. The formula for the first tense index was (SP+DP)/2. The second index was Advanced Donma Tense Index (ADTI). The formula for this index was [(SP+DP)/2] * Height. Statistical calculations were performed. 0.05 was accepted as the p value indicating statistical significance. There were no statistically significant differences between the groups for pulse pressure, systolic-to-diastolic pressure ratio and tense index. Increasing values were observed from Group 1 to Group 4 in terms of mean arterial blood pressure and advanced Donma tense index (ADTI), which was highly correlated with WC in all groups except Group 1. Both tense index and ADTI exhibited significant correlations with WC in Group 3. However, in Group 4, ADTI, which includes height parameter in the equation, was unique in establishing a strong correlation with WC. In conclusion, ADTI was suggested as a tense index while investigating children with MetS.

Keywords: blood pressure, child, height, metabolic syndrome, waist circumference

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Authors: Rujuta Matapurkar, Shivganesh Bhargava

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This paper discusses work-family enrichment and its relationship with certain antecedents and outcomes while considering effect of mindfulness and organizational pride as moderators. The work-family enrichment has been the topic of interest for researchers as well as practitioners for decades now. It focusses on the positive side of work family interaction rather that the scarcity or balance principle. Research shows that work family enrichment is linked to multiple work place outcomes like job satisfaction, organization citizenship behavior and turnover intention. Enrichment is also linked to life outcomes like life satisfaction, wellbeing. Thus not only the individuals but the organizations too want to engage in the activities resulting in the positive spillover between work and non-work domains. One of the recent focus areas in organization behavior literature has been Mindfulness. Mindfulness is defined as a trait or state in which the mind focuses on the present. It is the conscious attention and awareness of the present thought. The research in the area of mindfulness at work suggests that the same is related to work family balance and job satisfaction. This paper discusses the possibility of mindfulness having effect on the relationship between antecedents of enrichment and enrichment. On the outcome side job embeddedness and job ambivalence are the newest additions to the retention literature. Job ambivalence talks about having strong positive as well as negative feelings about the job. Job ambivalence is the work outcome which is linked to turnover intention. This paper talks about the relationship between enrichment and job ambivalence. Another measure for work place outcomes which is discussed in recent research is job embeddedness. This term talks about the advantages of continuing with the job rather than quitting it. It is described as like a net or a web in which an individual can become stuck and is focused on why people stay rather than on how they leave. The research has have found that establishing or increasing job embeddedness is likely to increase retention, attendance, citizenship and job performance. This paper studies the relationship between enrichment and embeddedness. Lastly this paper studies whether organizational pride has an an effect on the relationship between enrichment and its outcomes. This paper concludes with the direction for future research.

Keywords: work-family enrichment, mindfulness, job ambivalence, job embeddedness, organizational pride

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Authors: Simone Belli, Sergio Minniti, Valeria Santoro

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ICTs and technology transfer can benefit and move a country forward in economic and social development. However, ICT and access to the Internet have been inequitably distributed in most developing countries. In terms of science production and dissemination, this divide articulates itself also through the inequitable distribution of access to scientific knowledge and networks, which results in the exclusion of developing countries from the center of science. Developing countries are on the fringe of Science and Technology (S&T) production due not only to low investment in research but also to the difficulties to access international scholarly literature. In this respect, Open access (OA) initiatives and knowledge infrastructure represent key elements for both producing significant changes in scholarly communication and reducing the problems of developing countries. The spreading of the OA movement in the region, exemplified by the growth of regional and national initiatives, such as the creation of OA institutional repositories (e.g. SciELO and Redalyc) and the establishing of supportive governmental policies, provides evidence of the significant role that OA is playing in reducing the scientific gap between Latin American countries and improving their participation in the so-called ‘global knowledge commons’. In this paper, we map OA publications in Latin America and observe how Latin American countries are moving forward and becoming a leading force in widening access to knowledge. Our analysis, developed as part of the H2020 EULAC Focus research project, is based on mixed methods and consists mainly of a bibliometric analysis of OA publications indexed in the most important scientific databases (Web of Science and Scopus) and OA regional repositories, as well as the qualitative analysis of documents related to the main OA initiatives in Latin America. Through our analysis, we aim at reflecting critically on what policies, international standards, and best practices might be adapted to incorporate OA worldwide and improve the infrastructure of the global knowledge commons.

Keywords: open access, LAC countries, scientific publications, bibliometric analysis

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Authors: Marijana Ivanov, Roman Šubić

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The single rulebook together with the Single Supervisory Mechanism and the Single Resolution Mechanism - as two main pillars of the banking union, represent important steps towards completing the Economic and Monetary Union. It should provide a consistent application of common rules and administrative standards for supervision, recovery and resolution of banks – with the final aim that a former practice of the bail-out is replaced with the bail-in system through which bank failures will be resolved by their own funds, i.e. with minimal costs for taxpayers and real economy. It has to reduce the financial fragmentation recorded in the years of crisis as the result of divergent behaviors in risk premium, lending activities, and interest rates between the core and the periphery. In addition, it should strengthen the effectiveness of monetary transmission channels, in particular the credit channels and overflows of liquidity on the single interbank money market. However, contrary to all the positive expectations related to the future functioning of the banking union, low and unbalanced economic growth rates remain a challenge for the maintenance of financial stability in the euro area, and this problem cannot be resolved just by a single supervision. In many countries bank assets exceed their GDP by several times, and large banks are still a matter of concern because of their systemic importance for individual countries and the euro zone as a whole. The creation of the SSM and the SRM should increase transparency of the banking system in the euro area and restore confidence that have been disturbed during the depression. It would provide a new opportunity to strengthen economic and financial systems in the peripheral countries. On the other hand, there is a potential threat that future focus of the ECB, resolution mechanism and other relevant institutions will be extremely oriented to the large and significant banks (whereby one half of them operate in the core and most important euro area countries), while it is questionable to what extent the common resolution funds will be used for rescue of less important institutions.

Keywords: banking union, financial integration, single supervision mechanism (SSM)

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Authors: April Love Palad, Charita B. Lasala

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Mastery on English language is one of the important goals of all English language teachers. This goal can be seen based from the students’ actual performance using the target language which is English. Learning the English language includes hard work where efforts need to be exerted and this can be attained gradually over a long period of time. It is extremely important for all English language teachers to know the effects of incorporating games in teaching. Whether this strategy can have positive or negative effects in students learning, teachers should always consider what is best for their learners. Games may help and provide confidents language learners. These games help teachers to create context in which the language is suitable and significant. Focusing in accuracy and fluency is the heart of this study and this will be obtain in either teaching English using the traditional method or teaching English using language games. It is very important for all English teachers to know which strategy is effective in teaching English to be able to cope with students’ underachievement in this subject. This study made use of the comparative-experimental method. It made use of the pre-post test design with the aim to explore the effectiveness of the language games as strategy used in language teaching for high school students. There were two groups of students being observed, the controlled and the experimental, employing the two strategies in teaching English –traditional and with the use of language games. The scores obtained by two samples were compared to know the effectiveness of the two strategies in teaching English. In this study, it found out that language games help improve students’ fluency and accuracy in the use of target language and this is very evident in the results obtained in the pre-test and post –test result as well the mean gain scores by the two groups of students. In addition, this study also gives us a clear view on the positive effects on the use of language games in teaching which also supported by the related studies based from this research. The findings of the study served as the bases for the creation of the proposed learning plan that integrated language games that teachers may use in their own teaching. This study further concluded that language games are effective in developing students’ fluency in using the English language. This justifies that games help encourage students to learn and be entertained at the same time. Aside from that, games also promote developing language competency. This study will be very useful to teachers who are in doubt in the use of this strategy in their teaching.

Keywords: language games, experimental, comparative, strategy, language teaching, methodology

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Authors: Olga Giovani

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In this research, Bronfenbrenner's theory will be used to investigate the individual, microsystemic, and exosystemic factors that may affect adolescents' academic achievement as well as their expectations in Greece. First, the topic of academic achievement in an adolescent developmental context will be set as the target of the proposed study while focusing on the aspects of community influences on adolescents. More specifically, the effect of available resources and the perceived sense of safety and support will be further investigated. Then the issue of family factors will be analyzed, as they are subjectively perceived by the adolescents, focusing on the perceived parental style, parental monitor, and involvement as a mesosystemic factor. In turn, the school will also be discussed with emphasis on the perceived school climate and support as well as the academic aspects of student achievement. Finally, the adolescent's individual perspective will be taken into consideration in developmental terms, examining their perceptions regarding their community/neighborhood, their family, their school, as well as their sense of self-concept and self-esteem as these are expressed through their academic performance and prosocial behavior. The aim of the proposed research is to study these associations through the prism of the systemic perspective, the relationship between aspects of educational achievement and socioeconomic background, with an emphasis on the role of the community, which has not been adequately researched in the Greek context. Community will be defined by the available community resources (recreational activities, public library, local orchestras, free entrance museums, etc.), adolescents' own perception of social support, safety, and support inside that community. These perceptions need to be investigated since they may serve as possible predictors of a child's current cognitive, developmental, and psycho-social outcomes, such as their perceived self-concept and self-esteem, as well as on their future expectations related to the entrance to university and job expectations.

Keywords: bioecological model, developmental psychology, ecosystemic approach, student achievement, microsystemic factors, mesosystemic factors, individual perceptions

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Authors: Maria Luz Macasinag

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This study aims to determine and to examine critically successful family-owned higher educational institutions towards identifying the attributes and practices that may likely have led to their success. This research is confined to private, non-sectarian, family-owned higher institutions of learning that have been operating for more than fifty years, had only one founder and had at least two transitions in terms of generation. The criteria for selecting family-owned universities to be part of the cases under investigation include institutions (1) with increasing enrollment over the past five years, with level III accreditation status, (3) with good performance in the Board examinations in most of its programs and (4) with high employability of graduates. The study uses the multiple case study method. A model based on the cross-case analysis of the attributes and practices of all the case studies of successful family- owned higher institutions of learning is the output. The paper provides insights to current and future school owners and administrators in the management of their institutions for competitiveness, sustainability and advancement. This research encourages the evaluation of how the ideas that may lead to the success of schools owned by families in developing a sense of community, a reciprocal relationship among colleagues, the students and other stakeholders will result to the attainment of the vision and mission of the school. The study is beneficial to entrepreneurs and to business students whose know-how may provide insights that would be helpful in guiding prospective school owners. The commission on higher education and the Department of Education stand to benefit from this academic paper for the guidance that they provide to family-owned educational institutions. Banks and other financial institutions may find valuable ideas from this academic paper for the purpose of providing financial assistance to colleges and universities that are family-owned. Researchers in the field of educational management and administration may be able to extract from this study related topics for future research.

Keywords: administration practices, attributes, family-owned schools, success factors

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Authors: Sarah Potter, Michele Laliberte

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As eating disorders are associated with high levels of chronicity, impairment, and distress, it is paramount to evaluate factors that may improve treatment outcomes in this group. Individuals with eating disorders exhibit elevated levels of perfectionism and emotion dysregulation, as well as reduced self-compassion. These variables are related to eating disorder outcomes, including shape/weight concerns and psychosocial impairment. Thus, these factors may be tenable targets for treatment within eating disorder populations. However, the relative contributions of perfectionism, emotion dysregulation, and self-compassion to the severity of shape/weight concerns and psychosocial impairment remain largely unexplored. In the current study, mediation analyses were conducted to clarify how perfectionism, emotion dysregulation, and self-compassion are linked to shape/weight concerns and psychosocial impairment. The sample was comprised of 85 patients from an outpatient eating disorder clinic. The patients completed self-report measures of perfectionism, self-compassion, emotion dysregulation, eating disorder symptoms, and psychosocial impairment. Specifically, emotion dysregulation was assessed as a mediator in the relationships between (1) perfectionism and shape/weight concerns, (2) self-compassion and shape/weight concerns, (3) perfectionism and psychosocial impairment, and (4) self-compassion and psychosocial impairment. It was postulated that emotion dysregulation would significantly mediate relationships in the former two models. An a priori hypothesis was not constructed in reference to the latter models, as these analyses were preliminary and exploratory in nature. The PROCESS macro for SPSS was utilized to perform these analyses. Emotion dysregulation fully mediated the relationships between perfectionism and eating disorder outcomes. In the link between self-compassion and psychosocial impairment, emotion dysregulation partially mediated this relationship. Finally, emotion dysregulation did not significantly mediate the relationship between self-compassion and shape/weight concerns. The results suggest that emotion dysregulation and self-compassion may be suitable targets to decrease the severity of psychosocial impairment and shape/weight concerns in individuals with eating disorders. Further research is required to determine the stability of these models over time, between diagnostic groups, and in nonclinical samples.

Keywords: eating disorders, emotion dysregulation, perfectionism, self-compassion

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