Search results for: multiple nonpharmacological interventions

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

Abstract:

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: Keunhong Chae, Seokho Yoon

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Recently, the global navigation satellite system (GNSS) such as Galileo and GPS is employing more satellites to provide a higher degree of accuracy for the location service, thus calling for a more efficient signaling scheme among the satellites used in the overall GNSS network. In that the network throughput is improved, the spatial diversity can be one of the efficient signaling schemes; however, it requires multiple antenna that could cause a significant increase in the complexity of the GNSS. Thus, a diversity scheme called the cooperative signaling was proposed, where the virtual multiple-input multiple-output (MIMO) signaling is realized with using only a single antenna in the transmit satellite of interest and with modeling the neighboring satellites as relay nodes. The main drawback of the cooperative signaling is that the relay nodes receive the transmitted signal at different time instants, i.e., they operate in an asynchronous way, and thus, the overall performance of the GNSS network could degrade severely. To tackle the problem, several modified cooperative signaling schemes were proposed; however, all of them are difficult to implement due to a signal decoding at the relay nodes. Although the implementation at the relay nodes could be simpler to some degree by employing the time-reversal and conjugation operations instead of the signal decoding, it would be more efficient if we could implement the operations of the relay nodes at the source node having more resources than the relay nodes. So, in this paper, we propose a novel cooperative signaling scheme, where the data signals are combined in a unique way at the source node, thus obviating the need of the complex operations such as signal decoding, time-reversal and conjugation at the relay nodes. The numerical results confirm that the proposed scheme provides the same performance in the cooperative diversity and the bit error rate (BER) as the conventional scheme, while reducing the complexity at the relay nodes significantly. Acknowledgment: This work was supported by the National GNSS Research Center program of Defense Acquisition Program Administration and Agency for Defense Development.

Keywords: global navigation satellite network, cooperative signaling, data combining, nodes

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Authors: A. Harras, A. Tsuji, K. Terada

Abstract:

Tracking of moving people has gained a matter of great importance due to rapid technological advancements in the field of computer vision. The objective of this study is to design a motion based detection and tracking multiple walking pedestrians randomly in different directions. In our proposed method, Gaussian mixture model (GMM) is used to determine moving persons in image sequences. It reacts to changes that take place in the scene like different illumination; moving objects start and stop often, etc. Background noise in the scene is eliminated through applying morphological operations and the motions of tracked people which is determined by using the Kalman filter. The Kalman filter is applied to predict the tracked location in each frame and to determine the likelihood of each detection. We used a benchmark data set for the evaluation based on a side wall stationary camera. The actual scenes from the data set are taken on a street including up to eight people in front of the camera in different two scenes, the duration is 53 and 35 seconds, respectively. In the case of walking pedestrians in close proximity, the proposed method has achieved the detection ratio of 87%, and the tracking ratio is 77 % successfully. When they are deferred from each other, the detection ratio is increased to 90% and the tracking ratio is also increased to 79%.

Keywords: automatic detection, tracking, pedestrians, counting

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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: Hanady Hamdallah, H. Elyse Ireland, John H. H. Williams

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Conjugated linoleic acid (CLA) is a food supplement that is reported to have multiple beneficial health effects, including being anti-carcinogenic, anti-inflammatory and anti-obesity. Animal studies have shown a significant anti-obesity effect of CLA, but results in humans were inconsistent, where some of the studies found an anti-obesity effect while other studies failed to find any decline in obesity markers after CLA supplementation. This meta-analysis aimed to determine if oral CLA supplementation has been shown to reduce obesity related markers in women. Pub Med, Cochrane Library, and Google Scholar were used to identify the eligible trials using two main searching strategies: the first one was to search eligible trials using keywords 'Conjugated linoleic acid', 'CLA', 'Women', and the second strategy was to extract the eligible trials from previously published systematic reviews and meta-analyses. The eligible trials were placebo control trials where women supplemented with CLA mixture in the form of oral capsules for 6 months or less. Also, these trials provided information about body composition expressed as body weight (BW), body mass index (BMI), total body fat (TBF), percentage body fat (BF %), and/ or lean body mass (LBM). The quality of each included study was assessed using both JADAD scale and an adapted CONSERT checklist. Meta-analysis of 8 eligible trials showed that CLA supplementation was significantly associated with reduced BW (Mean ± SD, 1.2 ± 0.26 kg, p < 0.001), BMI (0.6 ± 0.13kg/m², p < 0.001) and TBF (0.76 ± 0.26 kg, p= 0.003) in women, when supplemented over 6-16 weeks. Subgroup meta-analysis demonstrated a significant reduction in BW (1.29 ± 0.31 kg, p < 0.001), BMI (0.60 ± 0.14 kg/m², p < 0.001) and TBF (0.82 ± 0.28 kg, p= 0.003) in the trials that had recruited overweight-obese women. The second subgroup meta-analysis, that considered the menopausal status of the participants, found that CLA was significantly associated with reduced BW (1.35 ± 0.37 kg, p < 0.001; 1.05 ± 0.36 kg, p= 0.003) and BMI (0.50 ± 0.17 kg/m², p= 0.003; 0.75 ± 0.2 kg/m², p < 0.001) in both pre and post-menopausal age women, respectively. A reduction in TBF (1.09 ± 0.37 kg, p= 0.003) was only significant in post-menopausal women. Interestingly, CLA supplementation was associated with a significant reduction in BW (1.05 ± 0.35 kg, p< 0.003), BMI (0.73 ± 0.2 kg/m², p < 0.001) and TBF (1.07 ± 0.36 kg, p= 0.003) in the trials without lifestyle monitoring or interventions. No significant effect of CLA on LBM was detected in this meta-analysis. This meta-analysis suggests a moderate anti-obesity effect of CLA on BW, BMI and TBF reduction in women, when supplemented over 6-16 weeks, particularly in overweight-obese women and post-menopausal women. However, this finding requires careful interpretation due to several issues in the designs of available CLA supplementation trials. More well-designed trials are required to confirm this meta-analysis results.

Keywords: body composition, body mass index, body weight, conjugated linoleic acid

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Authors: B. Schofield, F. Gul, S. McClean, R. Hoskins, R. Terry, U. Rolfe, A. Gibson, S. Voss, J. Benger

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Aim: The aim of this study is to determine whether and how health promotion activities are undertaken by paramedics and emergency department nurses and investigate ways of overcoming potential barriers. Background: Paramedics and emergency department nurses are uniquely placed to reach millions of people and could use these contacts as positive opportunities to help people improve their health by identifying people with risk factors and provide information, brief interventions, and signposting to locally provided services. These interventions can be carried out when the opportunity arises, typically take no more than a few minutes, have a low financial cost and can be a highly efficient method of health promotion. Methodology: Three NHS Emergency Departments and four Ambulance Trusts in England were recruited to the study. A link to an online survey was distributed to paramedics and emergency department nurses at participating sites. Staff were invited to participate in virtual semi-structured interviews. Patients seen, treated, and discharged at the participating sites were invited to virtual semistructured interviews. Findings: A total of 331 survey responses were received, 21 virtual semi-structured staff interviews and 11 patient interviews were completed. Staff reported lack of time to prioritise, lack of knowledge, resources, and confidence as barriers. Receptiveness of patients guided their decision to undertake health promotion activities. They reported a desire to learn how to undertake health promotion conversations. Emergency department nurses felt more supported than paramedics by their organisations to undertake health promotion activities. Patients were not aware of health promotion activities and reported fear and lack of privacy as barriers. Conclusions: These results will guide the development of an intervention to support the provision of health promotion by staff in urgent and emergency care settings. The components of the intervention will be mapped to a framework which will consider the needs of staff working within these settings, patients they treat, and organisational issues and practices related to the implementation of such an intervention.

Keywords: emergency service, hospital, nursing, allied health personnel, emergency medical services, health promotion

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Authors: Mark Davies, Carolyn Wallace, Christina Lloydwin, Tom Powell

Abstract:

Background: Frailty is increasingly recognized as a public health problem within an aging population. It is often characterized as an accumulation of clinical symptoms with progressive decline. We contend that dehydration is potentially the missing link driving the cycle of frailty; it contributes to malnutrition and cognitive decline and is a risk factor for other conditions. Frailty may also impact on fluid intake in cognitively intact older adults, indicating the cyclical nature of dehydration contributing to increasing frailty. Aim: To examine the relationships between fluid, hydration, and frailty in older adults in order to determine what works, for whom, how, why, and in what circumstances. Methods: A Realist Synthesis was first undertaken with n=50 studies, leading to the development of a Refined Programme Theory (RPT) articulating what hydration interventions work, for whom, to what degree, in what contexts, and how & why. Within the subsequent evaluation, the RPT was further confirmed/refuted/refined following semi-structured interviews with n=8 participants (healthcare professionals and patients). The RAMESES Quality Standards were followed throughout the study. Results: The Refined Programme Theory (RPT) highlighted three factors that result in optimized hydration for frail older people, i.e., Developing an Understanding Around Hydration, Empowering Participation, and System Reconfiguration. Our RPT indicates that hydration interventions work by developing an understanding of the importance of hydration, mitigating physical & cognitive barriers, increasing the agency of the patient, using a prompting process to reinforce drinking behavior, and routinizing hydration as a dimension of overall care. Conclusion: The study indicates that a greater understanding of the importance of hydration is required for all parties. Patients also require physical and psychological support if they are to be active agents in meeting their hydration needs. At a wider ‘system’ level, organizations must work in an integrated manner introducing processes that enable continuing professional development (CPD), encourage ongoing holistic assessment, and routinize hydration support.

Keywords: frailty, dehydration, older adults, realist review, realist evaluation

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Authors: Jianhua Zhou, Yuwen Zhang

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A two-step multigrid approach is proposed to solve the inverse heat conduction problem in a 3-D object under laser irradiation. In the first step, the location of the laser center is estimated using a coarse and uniform grid system. In the second step, the front-surface temperature is recovered in good accuracy using a multiple grid system in which fine mesh is used at laser spot center to capture the drastic temperature rise in this region but coarse mesh is employed in the peripheral region to reduce the total number of sensors required. The effectiveness of the two-step approach and the multiple grid system are demonstrated by the illustrative inverse solutions. If the measurement data for the temperature and heat flux on the back surface do not contain random error, the proposed multigrid approach can yield more accurate inverse solutions. When the back-surface measurement data contain random noise, accurate inverse solutions cannot be obtained if both temperature and heat flux are measured on the back surface.

Keywords: conduction, inverse problems, conjugated gradient method, laser

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Authors: Mohammad Rusdi Mohd Nasir, Ismail Hafiz Salleh

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Kota Bharu, as an Islamic City, represents a symbolic icon in the urban development of the Islamic state of Kelantan, Malaysia. This research seeks to provide a basis for new approaches to landscape planning that shows greater respect for the traditional vernacular landscape. In addition, this research also intends to distinguish the prospects for the future Kelantan Malay cultural landscape, building upon the multiple historical influences in the evolution of the cultural landscape using multiple methods including literature review, observation, document analysis and content analysis. The study of the Kelantan Malay cultural landscape is particularly important in view of its distinctive contribution to Malay heritage by identifying the elements, characteristics, history and their influences. As a result, this research recognizes the importance of incorporating the existing heritage alongside contemporary design as well as further research on the Kelantan Malay cultural landscape. Optimistically, there will be better landscape practices in the future to understand the past, the present and the future prospects of the vernacular tradition, in order to ensure that our architecture, landscape and urbanism practices express its values.

Keywords: Malay culture, Malay heritage, cultural landscape, Islamic concept

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Authors: Muhamad Hafiz Ismail, Ahmad H., Nelfianty M. R.

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The longitudinal study is conducted to identify predictive factors of soccer talent among male players aged 14 to 17 years. Convenience sampling involving elite respondents (n=20) and sub-elite respondents (n=20) male soccer players. Descriptive statistics were reported as frequencies and percentages. The inferential statistical analysis is used to report the status of reliability, independent samples t-test, paired samples t-test, and multiple regression analysis. Generally, there are differences in mean of height, muscular strength, muscular endurance, cardiovascular endurance, task orientation, cognitive anxiety, self-confidence, juggling skills, short pass skills, long pass skills, dribbling skills, and shooting skills for 20 elite players and sub-elite players. Accordingly, there was a significant difference between pre and post-test for thirteen variables of height, weight, fat percentage, muscle strength, muscle endurance, cardiovascular endurance, flexibility, BMI, task orientation, juggling skills, short pass skills, a long pass skills, and dribbling skills. Based on the first predictive factors (physical), second predictive factors (fitness), third predictive factors (psychological), and fourth predictive factors (skills in playing football) pledged to the soccer talent; four multiple regression models were produced. The first predictive factor (physical) contributed 53.5 percent, supported by height and percentage of fat in soccer talents. The second predictive factor (fitness) contributed 63.2 percent and the third predictive factors (psychology) contributed 66.4 percent of soccer talent. The fourth predictive factors (skills) contributed 59.0 percent of soccer talent. The four multiple regression models could be used as a guide for talent scouting for soccer players of the future.

Keywords: soccer talent identification, fitness and physical test, soccer skills test, psychological test

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Authors: Hassan Wajid

Abstract:

We will commend accommodating an environmentally friendly architectural proposal that is extremely common/usual but whose features will make it a sustainable space. In this experiment, the natural and artificial built space is being proposed in such a way that deals with Environmental, Ecological, and Economic Criteria under different climatic conditions. Moreover, the criteria against ecology-environment-economics reflect in the different modules which are being experimented with and analyzed by multiple research groups. The ecological, environmental, and economic services are provided used as units of production side by side, resulting in local job creation and saving resources, for instance, conservation of rainwater, soil formation or protection, less energy consumption to achieve Net Zero, and a stable climate as a whole. The synthesized results from the collected data suggest several aspects to consider when designing buildings for beginning the design process under the supervision of instructors/directors who are responsible for developing curricula and sustainable goals. Hence, the results of the research and the suggestions will benefit the sustainable design through multiple results, heat analysis of different small modules, and comparisons. As a result, it is depleted as the resources are either consumed or the pollution contaminates the resources.

Keywords: optimization, ecology, environment, sustainable solution

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Authors: Anitha Narasimhan, Aarthy Anandan, Madhan Karky, C. N. Subalalitha

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Games can be the excellent tools for teaching a language. There are few e-learning games in Indian languages like word scrabble, cross word, quiz games etc., which were developed mainly for educational purposes. This paper proposes a Tamil word game called, “Porul”, which focuses on education as well as on players’ thinking and decision-making skills. Porul is a multiple choice based quiz game, in which the players attempt to answer questions correctly from the given multiple options that are generated using a unique algorithm called the Option Selection algorithm which explores the semantics of the question in various dimensions namely, synonym, rhyme and Universal Networking Language semantic category. This kind of semantic exploration of the question not only increases the complexity of the game but also makes it more interesting. The paper also proposes a Scoring Algorithm which allots a score based on the popularity score of the question word. The proposed game has been tested using 20,000 Tamil words.

Keywords: Porul game, Tamil word game, option selection, flash card, scoring, algorithm

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Authors: Artem Kim, Clara Savary, Christele Dubourg, Wilfrid Carre, Houda Hamdi-Roze, Valerie Dupé, Sylvie Odent, Marie De Tayrac, Veronique David

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Holoprosencephaly (HPE) is a rare congenital brain malformation resulting from the incomplete separation of the two cerebral hemispheres. It is characterized by a wide phenotypic spectrum and a high degree of locus heterogeneity. Genetic defects in 16 genes have already been implicated in HPE, but account for only 30% of cases, suggesting that a large part of genetic factors remains to be discovered. HPE has been recently redefined as a complex multigenic disorder, requiring the joint effect of multiple mutational events in genes belonging to one or several developmental pathways. The onset of HPE may result from accumulation of the effects of multiple rare variants in functionally-related genes, each conferring a moderate increase in the risk of HPE onset. In order to decipher the genetic basis of HPE, unconventional patterns of inheritance involving multiple genetic factors need to be considered. The primary objective of this study was to uncover possible disease causing combinations of multiple rare variants underlying HPE by performing trio-based Whole Exome Sequencing (WES) of familial cases where no molecular diagnosis could be established. 39 families were selected with no fully-penetrant causal mutation in known HPE gene, no chromosomic aberrations/copy number variants and without any implication of environmental factors. As the main challenge was to identify disease-related variants among a large number of nonpathogenic polymorphisms detected by WES classical scheme, a novel variant prioritization approach was established. It combined WES filtering with complementary gene-level approaches: transcriptome-driven (RNA-Seq data) and clinically-driven (public clinical data) strategies. Briefly, a filtering approach was performed to select variants compatible with disease segregation, population frequency and pathogenicity prediction to identify an exhaustive list of rare deleterious variants. The exome search space was then reduced by restricting the analysis to candidate genes identified by either transcriptome-driven strategy (genes sharing highly similar expression patterns with known HPE genes during cerebral development) or clinically-driven strategy (genes associated to phenotypes of interest overlapping with HPE). Deeper analyses of candidate variants were then performed on a family-by-family basis. These included the exploration of clinical information, expression studies, variant characteristics, recurrence of mutated genes and available biological knowledge. A novel bioinformatics pipeline was designed. Applied to the 39 families, this final integrated workflow identified an average of 11 candidate variants per family. Most of candidate variants were inherited from asymptomatic parents suggesting a multigenic inheritance pattern requiring the association of multiple mutational events. The manual analysis highlighted 5 new strong HPE candidate genes showing recurrences in distinct families. Functional validations of these genes are foreseen.

Keywords: complex genetic disorder, holoprosencephaly, multiple rare variants, whole exome sequencing

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Authors: Nils Haglund, Svenolof Dahlgren, Maria Rastam, Peik Gustafsson, Karin Kalien

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In Sweden, like in most developed countries, there is a substantial increase of children diagnosed with autism and other conditions within the autism spectrum (ASD). The rapid increase of ASD rates stresses the importance of developing care programs to provide support and comprehensive interventions for affected families. The current observational study was conducted in order to evaluate an ongoing Comprehensive Intensive Early Intervention (CIEI) program for children with autism in southern Sweden. The change in autism symptoms among children participating in CIEI (intervention group, n=67) was compared with children who received traditional habilitation services only (comparison group, n=27). Children of parents who accepted the offered CIEI-program, constituted the intervention group, whereas children, whose parents (for some reason) were not interested in the offered CIEI-program, constituted the comparison group. The CIEI-program was individualized to each child by experienced applied behavior analysis (ABA) specialists with different backgrounds as psychologists, speech pathologists or special education teachers, in cooperation with parents and preschool staff. Due to the individualization, the intervention could vary in intensity and techniques. The intensity was calculated to 15-25 hours each week at home and the preschool altogether. Each child was assigned one 'trainer', who was often employed as a preschool teacher but could have another educational background. An agreement between supervisor- parents and preschool staff was reached to confirm the intensity and content of the CIEI- program over an approximately two-year intervention period. Symptom changes were measured as evaluation-ADOS-2-scores, total- and severity-scores, minus the corresponding baseline-scores, divided by the time between baseline and evaluation. The difference between the study-groups regarding change of ADOS-2-scores was estimated using ANCOVA. In the current study, children in the CIEI-group improved their ADOS-2-total scores between baseline and evaluation (-0.8 scores per year; 95%CI: -1.2 to -0.4), whereas no such improvement was detected in the comparison group (+0.1 scores per year; 95%CI: -0.7 to +0.9). The change difference (change in the CIEI-group vs. change in the comparison group) was statistically significant, both crude and after adjusting for possible confounders (-1.1; 95%CI -1.9 to -0.4). Children in the CIEI-group also significantly improved their ADOS-calibrated severity scores, but not significantly differently so from the comparison group. The results from the current study indicate that the CIEI program significantly improves social and communicative skills among children with autism and that children with developmental delay could benefit to a similar degree as other children. The results support earlier studies reporting on the improvement of autism symptoms after early intensive interventions. The results from observational studies are difficult to interpret, but it is nevertheless of uttermost importance to evaluate costly autism intervention programs. Such results may be of immediate importance to healthcare organizations when allocating the already strained resources to different patient groups. Albeit the obvious limitation of the current naturalistic study, the results support previous positive studies and indicate that children with autism benefit from participating in early comprehensive, intensive programs and that investments in these programs may be highly justifiable.

Keywords: autism symptoms, ADOS-scores, evaluation, intervention program

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Authors: Derradji A., Ben El Mamoun M., Zakaria E., Charadi I. Anrur

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The issue of dilapidated buildings represents a significant opportunity for constructive and beneficial interventions in Morocco. Faced with challenges associated with aging constructions and rapid urbanization, the country is committed to developing innovative strategies aimed at revitalizing urban areas and enhancing the sustainability of infrastructure, thereby ensuring citizens' safety. Through targeted investments in the renovation and modernization of existing buildings, Morocco aims to stimulate job creation, boost the local economy, and improve the quality of life for residents. Additionally, the integration of sustainable construction standards and the strengthening of regulations will promote resilient and environmentally friendly urban development. In this proactive perspective, LABOTEST has been commissioned by the National Agency for Urban Renewal (ANRUR) to conduct an in-depth study. This study focuses on the technical expertise of 1800 buildings identified as dilapidated in the prefectures of Rabat and Skhirat-Témara following an initial clearance operation. The primary objective of this initiative is to conduct a comprehensive diagnosis of these buildings and define the necessary interventions to eliminate potential risks while ensuring appropriate treatment. The article presents the adopted intervention methodology, taking into account the social dimensions involved, as well as the results of the technical expertise. These results include the classification of buildings according to their degree of urgency and recommendations for appropriate conservatory measures. Additionally, different pathologies are identified and accompanied by specific treatment proposals for each type of building. Since this study, the adopted approach has been generalized to the entire territory of Morocco. LABOTEST has been solicited by other cities such as Casablanca, Chefchaouen, Ouazzane, Azilal, Bejaad, and Demnate. This extension of the initiative demonstrates Morocco's commitment to addressing urban challenges in a proactive and inclusive manner. These efforts also illustrate the endeavors undertaken to transform urban challenges into opportunities for sustainable development and socio-economic progress for the entire population.

Keywords: building, dilapidated, rehabilitation, Morocco

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Authors: Rawaa H. El-Bidweihy, Hisham M. Abdelsalam, Ihab A. El-Khodary

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In an era where machines run and shape our world, the need for a stable, non-ending source of energy emerges. In this study, the focus was on the solar energy in Egypt as a renewable source, the most important factors that could affect the solar energy’s market share throughout its life cycle production were analyzed and filtered, the relationships between them were derived before structuring a Bayesian network. Also, forecasted models were built for multiple factors to predict the states in Egypt by 2035, based on historical data and patterns, to be used as the nodes’ states in the network. 37 factors were found to might have an impact on the use of solar energy and then were deducted to 12 factors that were chosen to be the most effective to the solar energy’s life cycle in Egypt, based on surveying experts and data analysis, some of the factors were found to be recurring in multiple stages. The presented Bayesian network could be used later for scenario and decision analysis of using solar energy in Egypt, as a stable renewable source for generating any type of energy needed.

Keywords: ARIMA, auto correlation, Bayesian network, forecasting models, life cycle, partial correlation, renewable energy, SARIMA, solar energy

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Authors: Lihyo Sung

Abstract:

Background: Children and teens in Korea experience extreme levels of academic stress. To perform better on the college entrance exam and gain admission to Korea’s most prestigious universities, they devote a significant portion of their early lives to studying. Because of their excessive preparation for entrance exams, students have become accustomed to passive and involuntary engagement. Any student starting university, however, faces new challenges that require more active involvement and self-regulated practice. As a way to tackle this issue, the study focuses on investigating the mediating effects of positive psychological capital on the relationship between self-leadership and career maturity among Korean university students. Objectives and Hypotheses: The long term goal of this study is to offer insights that promote the use of positive psychological interventions in the development and adaptation of career maturity. The current objective is to assess the role of positive psychological capital as a mediator between self-leadership and career maturity among Korean university students. Based on previous research, the hypotheses are: (a) self-leadership will be positively associated with indices of career maturity, and (b) positive psychological capital will partially or fully mediate the relationship between self-leadership and career maturity. Sample Characteristics and Sample Size: Participants in the current study consisted of undergraduate students enrolled in various courses at 5 large universities in Korea. A total of 181 students participated in the study. Methodology: A quantitative research design was adopted to test the hypotheses proposed in the current study. By using a cross-sectional approach to research, a self-administered questionnaire was used to collect data on indices of positive psychological capital, self-leadership, and career maturity. The data were analyzed by means of Cronbach's alpha, Pierson correlation test, multiple regression, path analysis, and SPSS for Windows version 22.0 using descriptive statistics. Results: Findings showed that positive psychological capital fully mediated the relationship between self-leadership and career maturity. Self-leadership significantly impacted positive psychological capital and career maturity, respectively. Scientific Contribution: The results of the current study provided useful insights into the role of psychological strengths such as positive psychological capital in improving self-leadership and career maturity. Institutions can assist in increasing positive psychological capital through the creation of positive experiences for undergraduate students, such as opportunities for coaching and mentoring.

Keywords: career maturity, mediating role, positive psychological capital, self-leadership

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Authors: Brian Fleischli, Shani Robins

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In recent years, the implementation of wisdom skills, including emotional intelligence, mindfulness, empathy, compassion, gratitude, realism (Cognitive-Behavioral Therapy), and humility, within K-12 educational settings has demonstrated significant benefits in reducing stress, anxiety, anger, and conflict among students. This study summarizes the findings of research conducted over several years, showcasing the positive outcomes associated with teaching these skills to elementary and high school students. Additionally, this overview includes an updated synthesis of current literature concerning the application and effectiveness of training these skill sets in K-12 schools. The research outcomes highlight substantial improvements in student well-being and behavior. Demonstrated with treatment group students exhibiting notable reductions in anger, anxiety, depression, and disruptive behaviors compared to control groups. For instance, fourth-grade students showed enhanced empathy, responsibility, and attention, particularly benefiting those with lower initial scores on these measures. Specific interaction effects suggest that older students and males particularly benefit from these interventions, showcasing the nuanced impact of wisdom skill training across different demographics. Furthermore, this presentation emphasizes the critical role of Social and Emotional Learning (SEL) programs in addressing the multifaceted challenges faced by children and adolescents, including mental health issues, academic performance, and social behaviors. The integration of wisdom skills into school curricula not only fosters individual growth and emotional regulation but also enhances overall school climate and academic achievement. In conclusion, the findings contribute to the growing body of empirical evidence supporting the efficacy of teaching wisdom skills in educational settings. The success of these interventions underscores the potential for widespread implementation of evidence-based programs to promote emotional well-being and academic success among students nationwide.

Keywords: wisdom skills, CBT, cognitive behavioral training, mindfulness, empathy, anxiety

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Authors: Bingjie Wang, Qianqian Qang, Nan Lu, Xiubing Liang, Baolong Shen

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Novel composites of HfNbTaTiZrV refractory high-entropy alloy (RHEA) reinforced with 0-5 vol.% Al₂O₃ particles have been synthesized by vacuum arc melting. The microstructure evolution, compressive mechanical properties at room and elevated temperatures, as well as strengthening mechanism of the composites, are analyzed. The HfNbTaTiZrV RHEA reinforced with 4 vol.% Al₂O₃ displays excellent phase stability at elevated temperatures. A superior compressive yield strength of 2700 MPa at room temperature, 1392 MPa at 800 °C, and 693 MPa at 1000 °C has been obtained for this composite. The improved yield strength results from multiple strengthening mechanisms caused by Al₂O₃ addition, including interstitial strengthening, grain boundary strengthening, and dispersion strengthening. Besides, the effects of interstitial strengthening increase with the temperature and is the main strengthening mechanism at elevated temperatures. These findings not only promote the development of oxide-reinforced RHEAs for challenging engineering applications but also provide guidelines for the design of light refractory materials with multiple strengthening mechanisms.

Keywords: Al₂O₃-reinforcement, HfNbTaTiZrV, refractory high-entropy alloy, interstitial strengthening

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Authors: Metrek Almetrek, Naser Alqahtani, Eisa Ghazwani, Mona Asiri, Mohammed Alqahtani, Magboolah Balobaid

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Background: Advocacy of potential for community coalitions to positively address social determinants of health and quality of life, little is known about the views of stakeholders involved in such efforts. This study sought to assess the provinces leaders’ perspectives about social determinants related to the Health Neighborhood Initiative (HNI), a new county effort to support community coalitions. Method and Subjects: We used a descriptive, qualitative study using personal interviews in 2022. We conducted it in the community coalition's “main cities committees” set across service planning areas that serve vulnerable groups located in the seven registered healthy cities to WHO (Abha, Tareeb, Muhayel, Balqarn, Alharajah, Alamwah, and Bisha). We conducted key informant interviews with 76 governmental, profit, non-profit, and community leaders to understand their perspectives about the HNI. As part of a larger project, this study focused on leaders’ views about social determinants of health related to the HNI. All interviews were audio-recorded and transcribed. An inductive approach to coding was used, with text segments grouped by social determinant categories. Results: Provinces leaders described multiple social determinants of health and quality of life that were relevant to the HNI community coalitions: housing and safety, community violence, economic stability, city services coordination and employment and education. Leaders discussed how social determinants were interconnected with each other and the need for efforts to address multiple social determinants simultaneously to effectively improve health and quality of life. Conclusions: Community coalitions have an opportunity to address multiple social determinants of health and quality of life to meet the social needs of vulnerable groups. Future research should examine how community coalitions, like those in the HNI, can actively engage with community members to identify needs and then deliver evidence-based care.

Keywords: social determinants, health and quality of life, vulnerable groups, qualitative research

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Authors: Michael Stewart

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Mutation testing is a type of software testing proposed in the 1970s where program statements are deliberately changed to introduce simple errors so that test cases can be validated to determine if they can detect the errors. Test cases are executed against the mutant code to determine if one fails, detects the error and ensures the program is correct. One major issue with this type of testing was it became intensive computationally to generate and test all possible mutations for complex programs. This paper used reinforcement learning and parallel processing within the context of mutation testing for the selection of mutation operators and test cases that reduced the computational cost of testing and improved test suite effectiveness. Experiments were conducted using sample programs to determine how well the reinforcement learning-based algorithm performed with one live mutation, multiple live mutations and no live mutations. The experiments, measured by mutation score, were used to update the algorithm and improved accuracy for predictions. The performance was then evaluated on multiple processor computers. With reinforcement learning, the mutation operators utilized were reduced by 50 – 100%.

Keywords: automated-testing, machine learning, mutation testing, parallel processing, reinforcement learning, software engineering, software testing

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Authors: Debabrata Biswas

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The current trend in the development of antibiotic resistance by multiple bacterial pathogens has resulted in a troubling loss of effective antibiotic options for human. The emergence of multi-drug-resistant pathogens has necessitated higher dosages and combinations of multiple antibiotics, further exacerbating the problem of antibiotic resistance. Zoonotic bacterial pathogens, such as Salmonella, Campylobacter, Shiga toxin-producing Escherichia coli (such as enterohaemorrhagic E. coli or EHEC), and Listeria are the most common and predominant foodborne enteric infectious agents. It was observed that these pathogens gained/developed their ability to survive in the presence of antibiotics either in farm animal gut or farm environment and researchers believe that therapeutic and sub-therapeutic antibiotic use in farm animal production might play an important role in it. The mechanism of action of antimicrobial components used in farm animal production in genomic interplay in the gut and farm environment, has not been fully characterized. Even the risk of promoting the exchange of mobile genetic elements between microbes specifically pathogens needs to be evaluated in depth, to ensure sustainable farm animal production, safety of our food and to mitigate/limit the enteric infection with multiple antibiotic resistant bacterial pathogens. Due to the consumer’s demand and considering the current emerging situation, many countries are in process to withdraw antibiotic use in farm animal production. Before withdrawing use of the sub-therapeutic antibiotic or restricting the use of therapeutic antibiotics in farm animal production, it is essential to find alternative natural antimicrobials for promoting the growth of farm animal and/or treating animal diseases. Further, it is also necessary to consider whether that compound(s) has the potential to trigger the acquisition or loss of genetic materials in zoonotic and any other bacterial pathogens. Development of alternative therapeutic and sub-therapeutic antimicrobials for farm animal production and food processing and preservation and their effective implementation for sustainable strategies for farm animal production as well as the possible risk for horizontal gene transfer in major enteric pathogens will be focus in the study.

Keywords: food safety, natural antimicrobial, sustainable farming, antibiotic resistance

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Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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Authors: Ting Gao, Mingyue He

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Reconfigurable intelligent surfaces (RISs) are expected to be an important part of next-generation wireless communication networks due to their potential to reduce the hardware cost and energy consumption of millimeter Wave (mmWave) massive multiple-input multiple-output (MIMO) technology. However, owing to the lack of signal processing abilities of the RIS, the perfect channel state information (CSI) in RIS-assisted communication systems is difficult to acquire. In this paper, the uplink channel estimation for mmWave systems with a hybrid active/passive RIS architecture is studied. Specifically, a deep learning-based estimation scheme is proposed to estimate the channel between the RIS and the user. In particular, the sparse structure of the mmWave channel is exploited to formulate the channel estimation as a sparse reconstruction problem. To this end, the proposed approach is derived to obtain the distribution of non-zero entries in a sparse channel. After that, the channel is reconstructed by utilizing the least-squares (LS) algorithm and compressed sensing (CS) theory. The simulation results demonstrate that the proposed channel estimation scheme is superior to existing solutions even in low signal-to-noise ratio (SNR) environments.

Keywords: channel estimation, reconfigurable intelligent surface, wireless communication, deep learning

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Authors: Ameni Mejri, Moufida Hajjaj, Salem Hasnaoui, Ridha Bouallegue

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The technology advances have most lately made the millimeter wave (mmWave) communication possible. Due to the huge amount of spectrum that is available in MmWave frequency bands, this promising candidate is considered as a key technology for the deployment of 5G cellular networks. In order to enhance system capacity and achieve spectral efficiency, very large antenna arrays are employed at mmWave systems by exploiting array gain. However, it has been shown that conventional beamforming strategies are not suitable for mmWave hardware implementation. Therefore, new features are required for mmWave cellular applications. Unlike traditional multiple-input-multiple-output (MIMO) systems for which only digital precoders are essential to accomplish precoding, MIMO technology seems to be different at mmWave because of digital precoding limitations. Moreover, precoding implements a greater number of radio frequency (RF) chains supporting more signal mixers and analog-to-digital converters. As RF chain cost and power consumption is increasing, we need to resort to another alternative. Although the hybrid precoding architecture has been regarded as the best solution based on a combination between a baseband precoder and an RF precoder, we still do not get the optimal design of hybrid precoders. According to the mapping strategies from RF chains to the different antenna elements, there are two main categories of hybrid precoding architecture. Given as a hybrid precoding sub-array architecture, the partially-connected structure reduces hardware complexity by using a less number of phase shifters, whereas it sacrifices some beamforming gain. In this paper, we treat the hybrid precoder design in mmWave MIMO systems as a problem of matrix factorization. Thus, we adopt the alternating minimization principle in order to solve the design problem. Further, we present our proposed algorithm for the partially-connected structure, which is based on the iterative hard thresholding method. Through simulation results, we show that our hybrid precoding algorithm provides significant performance gains over existing algorithms. We also show that the proposed approach reduces significantly the computational complexity. Furthermore, valuable design insights are provided when we use the proposed algorithm to make simulation comparisons between the hybrid precoding partially-connected structure and the fully-connected structure.

Keywords: alternating minimization, hybrid precoding, iterative hard thresholding, low-complexity, millimeter wave communication, partially-connected structure

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Authors: Sean Goltz, Michael Mayo

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The purpose of this research is to use Global-Regulation.com database of the world laws, focusing on tax treaties between countries, in order to create an AI-driven tax simulator that will run an AI agent through potential tax scenarios across countries. The AI agent goal is to identify the scenario that will result in minimum tax liability based on tax treaties between countries. The results will be visualized by a three dimensional matrix. This will be an online web application. Multinational corporations are running their business through multiple countries. These countries, in turn, have a tax treaty with many other countries to regulate the payment of taxes on income that is transferred between these countries. As a result, planning the best tax scenario across multiple countries and numerous tax treaties is almost impossible. This research propose to use Global-Regulation.com database of word laws in English (machine translated by Google and Microsoft API’s) in order to create a simulator that will include the information in the tax treaties. Once ready, an AI agent will be sent through the simulator to identify the scenario that will result in minimum tax liability. Identifying the best tax scenario across countries may save multinational corporations, like Google, billions of dollars annually. Given the nature of the raw data and the domain of taxes (i.e., numbers), this is a promising ground to employ artificial intelligence towards a practical and beneficial purpose.

Keywords: taxation, law, multinational, corporation

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Authors: Bonnie R. Brammall, Rhonda M. Garad, Helena J. Teede, Cheryce L. Harrison

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Introduction: Reproductive aged women are at high-risk for accelerated weight gain and obesity development, with pregnancy recognised as a critical contributory life phase. Healthy lifestyle interventions during the preconception and antenatal period improve maternal and infant health outcomes. Yet, interventions from preconception through to postpartum and translation and implementation into real-world healthcare settings remain limited. OptimalMe is a randomised, hybrid implementation effectiveness study of evidence-based healthy lifestyle intervention. Here, we report engagement, acceptability of the intervention during preconception, and self-reported behaviour change outcomes as a result of the preconception phase of the intervention. Methods: Reproductive aged women who upgraded their private health insurance to include pregnancy and birth cover, signalling a pregnancy intention, were invited to participate. Women received access to an online portal with preconception health and lifestyle modules, goal-setting and behaviour change tools, monthly SMS messages, and two coaching sessions (randomised to video or phone) prior to pregnancy. Results: Overall n=527 expressed interest in participating. Of these, n=33 did not meet inclusion criteria, n=8 were not contactable for eligibility screening, and n=177 failed to engage after the screening, leaving n=309 who were enrolled in OptimalMe and randomised to intervention delivery method. Engagement with coaching sessions dropped by 25% for session two, with no difference between intervention groups. Women had a mean (SD) age of 31.7 (4.3) years and, at baseline, a self-reported mean BMI of 25.7 (6.1) kg/m², with 55.8% (n=172) of a healthy BMI. Behaviour was sub-optimal with infrequent self-weighing (38.1%), alcohol consumption prevalent (57.1%), sub-optimal pre-pregnancy supplementation (61.5%), and incomplete medical screening. Post-intervention 73.2% of women reported engagement with a GP for preconception care and improved lifestyle behaviour (85.5%), since starting OptimalMe. Direct pre-and-post comparison of individual participant data showed that of 322 points of potential change (up-to-date cervical screening, elimination of high-risk behaviours [alcohol, drugs, smoking], uptake of preconception supplements and improved weighing habits) 158 (49.1%) points of change were achieved. Health coaching sessions were found to improve accountability and confidence, yet further personalisation and support were desired. Engagement with video and phone sessions was comparable, having similar impacts on behaviour change, and both methods were well accepted and increased women's accountability. Conclusion: A low-intensity digital health and lifestyle program with embedded health coaching can improve the uptake of preconception care and lead to self-reported behaviour change. This is the first program of its kind to reach an otherwise healthy population of women planning a pregnancy. Women who were otherwise healthy showed divergence from preconception health and lifestyle objectives and benefited from the intervention. OptimalMe shows promising results for population-based behaviour change interventions that can improve preconception lifestyle habits and increase engagement with clinical health care for pregnancy preparation.

Keywords: preconception, pregnancy, preventative health, weight gain prevention, self-management, behaviour change, digital health, telehealth, intervention, women's health

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Authors: Mridula Korde

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The terahertz band is the main pillar of 6G wireless communication system. It is difficult to meet the high data rate of 1Tbps by millimeter frequency support systems. The terahertz band suffers huge propagation loss limiting wireless distance. Terahertz band imposes ultra massive multiple input multiple output antenna (UM-MIMO) systems which produce high array gain with narrow beamforming. The conventional methods for MIMO beamforming are Analog and Digital beamforming. The fully digital beamforming methods utilize dedicated structure of DAC/ADC and RF chains. These structures increase hardware complexity and are power hungry. The analog beamforming structures utilize ADC/DAC with phase shifters with less hardware complexity but support less data rates. As a result, a hybrid beamforming method can be adapted for UM-MIMO systems. This paper will investigate challenges in hybrid beamforming architecture which will address the low spatial degrees of freedom (SDoF) limitation in Terahertz (THz) Communication. The flexible hardware connections are proposed, in order to switch the system in an adaptive manner so as to minimize the power requirements.

Keywords: 6G, terahertz communication, beamforming, challenges

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Authors: Aneena Suresh, C. S. Sidharth

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Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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Authors: Luísa Pedro, José Pais-Ribeiro, João Páscoa Pinheiro

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Multiple Sclerosis (MS) is a chronic disease of the central nervous system that affects more often young adults in the prime of his career and personal development, with no cure and unknown causes. The most common signs and symptoms are fatigue, muscle weakness, changes in sensation, ataxia, changes in balance, gait difficulties, memory difficulties, cognitive impairment and difficulties in problem solving. MS is a relatively common neurological disorder in which various impairments and disabilities impact strongly on function and daily life activities. The aim of this study is to examine the implications of the program of self-regulation in the perception of illness and mental health (psychological well-being domain) in MS patients. MS is a relatively common neurological disorder in which various impairments and disabilities impact strongly on function and daily life activities. The aim of this study is to examine the implications of the program of self-regulation in the perception of illness and mental health (psychological well-being domain) in MS patients. After this, a set of exercises was implemented to be used in daily life activities, according to studies developed with MS patients. We asked the subjects the question “Please classify the severity of your disease?” and used the domain of psychological well-being, the Mental Health Inventory (MHI-38) at the beginning (time A) and end (time B) of the program of self-regulation. We used the Statistical Package for the Social Sciences (SPSS) version 20. A non-parametric statistical hypothesis test (Wilcoxon test) was used for the variable analysis. The intervention followed the recommendations of the Helsinki Declaration. The age range of the subjects was between 20 and 58 years with a mean age of 44 years. 58.3 % were women, 37.5 % were currently married, 67% were retired and the mean level of education was 12.5 years. In the correlation between the severity of the disease perception and psychological well before the self-regulation program, an obtained result (r = 0.26, p <0.05), then the self-regulation program, was (r = 0.37, p <0.01), from a low to moderate correlation. We conclude that the program of self-regulation for physical activity in patients with MS can improve the relationship between the perception of disease severity and psychological well-being.

Keywords: psychological well-being, multiple sclerosis, self-regulation, physical activity

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