Search results for: borderline personality disorder

Authors: Tamene Keneni, Tibebu Yohannes

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The prevalence of autism spectrum disorder (ASD) in general and autism in particular is on the rise globally, and the need for evidence-based intervention and care for children with autism has grown, too. However, evidence on autism is scanty in developing countries, including Ethiopia. With the aim to help fill the gap and paucity in research into the issue, the main purpose of this study is to explore, better understand, and document the experiences and perceptions of parents of children with autism. To this end, we used a qualitative survey to collect data from a convenient sample of parents raising a child with autism. The data collected were subjected to qualitative analysis that yielded several themes and subthemes, including late diagnosis, parents’ reactions to diagnosis, sources of information during and after diagnosis, differing reactions to having a child with autism from siblings, extended family members, and the larger community, attribution of autism to several causes by the community, lack of recognition and open discussion of autism and lack of appropriated public educational and health care services for children with autism and their parents. The themes and subthemes identified were discussed in light of existing literature, and implications for practice were drawn.

Keywords: ASD, autism, children with autism, raising children with autism

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Authors: Sandra Figueiredo

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To guarantee the well-being and the academic achievement it is crucial into the global society to develop techniques to assess language competence and control psychological aspects on the second language learning context. The current scenario of the war conflicts that are emerging mostly in Europe and Middle East have been resulting in forced immigration and refugees’ maladjustment. The inclusion is the priority for United Nations concerning the sustainability of societies. For inclusion, psychological screening tests and educational tools are urgent. Method: Approximately 100 refugees from Ukraine were assessed, in Portugal, under the administration of the PCL-5. This 20-item instrument evaluates the Post-Traumatic Disorder. Expected results: The statistical analysis will be performed with the International Database Analyzer and SPSS (v. 28). The results expected are the relationship between traumatic events caused by war and post-traumatic symptomatology (anxiety, hypervigilance, stress). Implications: The data will be discussed concerning the problems of belonging, the psychological constraints and educational attainment (language needs included) experienced by the individuals more recently arrived to the hosting societies. The refugees’ acculturation process and the emotional regulation will be addressed.

Keywords: refugees, immigration, educational needs, trauma, inclusion, second language.

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Authors: Maja Pandža, Sanjin Lovrić, Iva Čolak, Josipa Mandarić, Miro Klarić

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This study explores the role of symptoms related to mood disorders salience on different types of defense mechanisms (mature, neurotic, immature) predominance. Total of 177 both clinical and non-clinical participants in Mostar, Bosnia & Herzegovina, completed a battery of questionnaires associated with defense mechanisms and self-reported depression and anxiety symptoms. The sample was additionally divided into four groups, given the level of symptoms experienced: 1. minimal, 2. mild, 3. moderate, 4. severe depression/anxiety. Participants with minimal anxiety and depression symptoms use mature defense mechanisms more often than other three groups. Immature mechanisms are most commonly used by the group with severe depression/anxiety levels in comparison with other groups. These differences are discussed on the dynamic level of analysis to have a better understanding of the relationship between defense mechanisms' maturity and degree of mood disorders' symptom severity. Also, results given could serve as an implication for the psychotherapeutic treatment plans.

Keywords: anxiety/depression symptoms, clinical/non-clinical sample, defense mechanism maturity, dynamic approach

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Authors: Mary Katherine Hoth

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

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

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Authors: Liang Fang

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The development of the large suburban residential area is a product of the leap development during the rapid urbanization process in China. On the process of the large-scale development of large settlements in a short time, various problems arose in the suburban residential area, such as spatial layout being disorder, basic facilities construction lagging behind and being unreasonable, residential neighborhood space and street culture missing. Aimed at the contradictions mentioned above, exploring a way is imminent to construct appropriate residential area. We select a typical Liangzhu Culture Village in Hangzhou and put forward functional composite residential area of fine development strategy, along which business promotes and assists community autonomy and then a good community culture is constructed. All in all, the development and construction mode, contributing to an all-people and full-time participation, is beneficial to create a harmonious community of sustainable development, which gives good implication to a single enterprise development city real estate projects.

Keywords: community autonomy, development and construction mode, functional composite, suburban large residential area

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Authors: Tugba Metinyurt

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Microaggressions are small, everyday verbal and behavioral slights that communicate derogatory messages to individuals on the basis of their group membership. They are often unintentional and not intended to do harm, and yet research has shown that their cumulative effect can be quite detrimental. The current pilot study focuses on the role of bystanders disrupting gender microaggressions and potential barriers of challenging them in the academic workplace at University of Massachusetts Lowell (UML). The participants in this study included 9 male and 20 female from faculty of different disciplines at UML. A Barriers to Intervening Questionnaire asks respondents 1) to rate barriers to intervening in situations described in three short vignettes and 2) to identify more general factors that make it more or less likely that UML faculty will intervene in microaggressions as bystanders through response to an open-ended question. Responses to the questionnaire scales that ask about respondents’ own reactions to the vignettes indicated that faculty may hesitate to interrupt gender microaggressions to avoid being perceived as offensive, losing their relationship with their coworkers, and engaging possible arguments. Responses to the open-ended question, which asked more generally about perceived barriers, revealed a few additional barriers; lack of interpersonal and institutional support, repercussion to self, personal orientation/personality, and privilege. Interestingly, participants tended to describe the obstacles presented in the questionnaire as unlikely to prevent them from intervening, yet the same barriers were suggested to be issues for others on the open-ended questions. Limitations and future directions are discussed. The barriers identified in this research can inform efforts to create bystander trainings to interrupt microaggressions in the academic workplaces.

Keywords: academic workplace, bystander behavior, implicit bias, microaggressions

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Authors: Ika Wulansari, Yati Afiyanti, Indang Trihandini

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Sleeping disorder experienced by patients with breast cancer can affect the physical, mental, health, and well-being. This study examines the effect of progressive muscle relaxation training and sleep hygiene education to change sleep quality scores of the patient with breast cancer. The study design using quasi-experiment with pre-post test within the control group, involving 62 breast cancer patients using consecutive sampling method in Jakarta. Statistical test results with independent t-test showed a significant difference in score of sleep quality between in intervention group and the control group (6,66±3,815; 9,30±3,334, p-value = 0,005). Progressive muscle relaxation exercise and sleep hygiene education proven to be affective to change the patients sleeping quality, so that it can be an alternative therapeutic option to overcome sleeping disorders.

Keywords: sleeping disorders, breast cancer, progressive muscle relaxation, sleep hygiene education

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Authors: Liu Yuhong, Hussen Mansai, Mei Chunli

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Inflammatory discitis is a sterile inflammatary disease that typically presents with abnormalities in two adjacent vertebral bodies and the intervening disk. Diagnosis this disorder is usually difficult and ideal management remains controversial. In this report，we examine a case of inflammatory discitis in a 56 year old female in which treatment with adalimumab ameliorated symptoms. The 56-year-old female patient developed repeatedly inflammatory discitis in the past three years, presenting with severe back pain, an elevated C-reactive protein and erythrocyte sedimentation rate, radiological erosive changes in vertebral and intervertebral disk of the spine. Surgical treatment, antibiotics and non steroidal anti-inflammatory drugs(NSAIDs) were used, but the patient still suffered from recurrent onset of unbearable backache. Three years later from the patient’s first admission，adalimumab was prescribed due to the third occurrence of Anderson lesions, which she had been suffering from for years. Soon after the same day of adalimumab therapy, her symptoms had a dramatic improvement. On the following day she could stand and walk slowly, her CRP and ESR were decreased to nearly normal levels in 4 weeks. Human leukocyte antigen (HLA)-typing analysis revealed a positive result for HLA-B27, the patient’s inflammatory discitis was considered to be associated with spondyloarthropathy.

Keywords: adalimumab, inflammatory discitis, spondyloarthropathy, patient

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Authors: A. Iqbal Banauaji, Muchamad Sholikun

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Diabetes mellitus (DM) is a metabolism disorder that tends to increase its prevalence in the world, including in Indonesia. The development of DM type 2 can cause oxidative stress characterized by an imbalance between oxidants and antioxidants in the body Increased oxidative stress causes type 2 diabetes mellitus to require intake of exogenous antioxidants in large quantities to inhibit oxidative damage in the body. Bran can be defined as a functional food because it consists of 11.39% fiberand 28.7% antioxidants and the purple yam consists of anthocyanin which functions as an antioxidant. With abundant amount and low price, purple yam and bran can be used for analog rice as the effort to diversify functional food. The antioxidant’s activity of analog rice from purple yam and bran which is measured by using DPPH’s method is 12,963%. The rough fiber’s level on the analog rice from purple yam is 2.985%. The water amount of analog rice from purple yam and bran is 8.726%. Analog rice from purple yam and bran has the similar texture as the usual rice, tasted slightly sweet, light purple colored, and smelled like bran.

Keywords: antioxidant, analog rice, functional food, diabetes mellitus

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Authors: M. Skibinska, A. Rajewska-Rager, M. Dmitrzak-Weglarz, N. Lepczynska, P. Sibilski, P. Kapelski, J. Pawlak, J. Twarowska-Hauser

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Introduction: Neurotrophic factors have been implicated in neuropsychiatric disorders. Brain-Derived Neurotrophic Factor (BDNF) influences neuron differentiation in development as well as synaptic plasticity and neuron survival in adulthood. BDNF is widely studied in mood disorders and has been proposed as a biomarker for depression. BDNF is synthesized as precursor protein – proBDNF. Both forms are biologically active and exert opposite effects on neurons. Aim: The aim of the study was to examine the serum levels of BDNF and proBDNF in unipolar and bipolar young patients below 24 years old during hypo/manic, depressive episodes and in remission compared to healthy control group. Methods: In a prospective 2 years follow-up study, we investigated alterations in levels of BDNF and proBDNF in 79 patients (23 males, mean age 19.08, SD 3.3 and 56 females, mean age 18.39, SD 3.28) diagnosed with mood disorders: unipolar and bipolar disorder compared with 35 healthy control subjects (7 males, mean age 20.43, SD 4.23 and 28 females, mean age 21.25, SD 2.11). Clinical characteristics including mood, comorbidity, family history, and treatment, were evaluated during control visits and clinical symptoms were rated using the Hamilton Depression Rating Scale and Young Mania Rating Scale. Serum BDNF and proBDNF concentrations were determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Serum BDNF and proBDNF levels were analysed with covariates: sex, age, age > 18 and < 18 years old, family history of affective disorders, drug-free vs. medicated status. Normality of the data was tested using Shapiro-Wilk test. Levene’s test was used to calculate homogeneity of variance. Non-parametric Tests: Mann-Whitney U test, Kruskal-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient were applied in analyses The statistical significance level was set at p < 0.05. Results: BDNF and proBDNF serum levels did not differ between patients at baseline and controls as well as comparing patients in acute episode of depression/hypo/mania at baseline and euthymia (at month 3 or 6). Comparing BDNF and proBDNF levels between patients in euthymia and control group no differences have been found. Increased BDNF level in women compared to men at baseline (p=0.01) have been observed. BDNF level at baseline was negatively correlated with depression and mania occurence at 24 month (p=0.04). BDNF level at 12 month was negatively correlated with depression and mania occurence at 12 month (p=0.01). Correlation of BDNF level with sex have been detected (p=0.01). proBDNF levels at month 3, 6 and 12 negatively correlated with disease status (p=0.02, p=0.008, p=0.009, respectively). No other correlations of BDNF and proBDNF levels with clinical and demographical variables have been detected. Discussion: Our results did not show any differences in BDNF and proBDNF levels between depression, mania, euthymia, and controls. Imbalance in BDNF/proBDNF signalling may be involved in pathogenesis of mood disorders. Further studies on larger groups are recommended. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: bipolar disorder, Brain-Derived Neurotrophic Factor (BDNF), proBDNF, unipolar depression

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Authors: Sehur Sibel Ozkaynak, Zakir Koc, Ebru Barcın

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Essential tremor (ET) is one of the most common movement disorders and has long been considered a monosymptomatic disorder. While ET has traditionally been categorized as a pure motor disease, cross-sectional and longitudinal studies of cognition in ET have been demonstrated that these patients may have cognitive dysfunction. We investigated the neuro physiological aspects of cognition in ET, using event-related potentials (ERPs).Twenty patients with ET and 20 age-education and sex matched healthy controls underwent a neuro physiological evaluation. P300 components and Contingent Negative Variation (CNV) were recorded. The latencies and amplitudes of the P300 and CNV were evaluated. P200-N200 amplitude was significantly smaller in the ET group, while no differences emerged between patients and controls in P300 latencies. CNV amplitude was significantly smaller at Cz electrode site in the ET group. No differences were observed between in the two groups in CNV latencies. As a result, P300 and CNV parameters did not show significant differences between in the two groups, does not mean that there aren't mild cognitive changes in ET patients. In this regard, there is a need to further studies using electro physiological tests related to cognitive changes in ET patients.

Keywords: cognition, essential tremor, event related potentials

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Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

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Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

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Authors: Yishu Gong, Liangliang Yang, Jianyu Zhang, Zhengyu Chen, Sihong He, Xusheng Zhang, Wei Zhang

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Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that affects millions of people worldwide and is characterized by cognitive decline and behavioral changes. People living with Alzheimer’s disease often find it hard to complete routine tasks. However, there are limited objective assessments that aim to quantify the difficulty of certain tasks for AD patients compared to non-AD people. In this study, we propose to use speech emotion recognition (SER), especially the frustration level, as a potential biomarker for quantifying the difficulty patients experience when describing a picture. We build an SER model using data from the IEMOCAP dataset and apply the model to the DementiaBank data to detect the AD/non-AD group difference and perform longitudinal analysis to track the AD disease progression. Our results show that the frustration level detected from the SER model can possibly be used as a cost-effective tool for objective tracking of AD progression in addition to the Mini-Mental State Examination (MMSE) score.

Keywords: Alzheimer’s disease, speech emotion recognition, longitudinal biomarker, machine learning

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Authors: M. Trousselard, D. Steiler, C. Drogou, P. van-Beers, G. Lamour, S. N. Crosnier, O. Bouilland, P. Dubost, M. Chennaoui, D. Léger

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According to published data, undersea navigation for long periods (nuclear-powered ballistic missile submarine, SSBN) constitutes an extreme environment in which crews are subjected to multiple stresses, including the absence of natural light, illuminance below 1,000 lux, and watch schedules that do not respect natural chronobiological rhythms, for a period of 60-80 days. These stresses seem clearly detrimental to the submariners’ sleep, with consequences for their affective (seasonal affective disorder-like) and cognitive functioning. In the long term, there are abundant publications regarding the consequences of sleep disruption for the occurrence of organic cardiovascular, metabolic, immunological or malignant diseases. It seems essential to propose countermeasures for the duration of the patrol in order to reduce the negative physiological effects on the sleep and mood of submariners. Light therapy, the preferred treatment for dysfunctions of the internal biological clock and the resulting seasonal depression, cannot be used without data to assist knowledge of submariners’ chronobiology (melatonin secretion curve) during patrols, given the unusual characteristics of their working environment. These data are not available in the literature. The aim of this project was to assess, in the course of two studies, the benefits of two environmental techniques for managing chronobiological stress: techniques for optimizing potential (TOP; study 1)3, an existing programme to help in the psychophysiological regulation of stress and sleep in the armed forces, and dawn and dusk simulators (DDS, study 2). For each experiment, psychological, physiological (sleep) or biological (melatonin secretion) data were collected on D20 and D50 of patrol. In the first experiment, we studied sleep and depressive distress in 19 submariners in an operational setting on board an SSBM during a first patrol, and assessed the impact of TOP on the quality of sleep and depressive distress in these same submariners over the course of a second patrol. The submariners were trained in TOP between the two patrols for a 2-month period, at a rate of 1 h of training per week, and assigned daily informal exercises. Results show moderate disruptions in sleep pattern and duration associated with the intensity of depressive distress. The use of TOP during the following patrol improved sleep and depressive mood only in submariners who regularly practiced the techniques. In light of these limited benefits, we assessed, in a second experiment, the benefits of DDS on chronobiology (daily secretion of melatonin) and depressive distress. Ninety submariners were randomly allocated to two groups, group 1 using DDS daily, and group 2 constituting the control group. Although the placebo effect was not controlled, results showed a beneficial effect on chronobiology and depressive mood for submariners with a morning chronotype. Conclusions: These findings demonstrate the difficulty of practicing the tools of psychophysiological management in real life. They raise the question of the subjects’ autonomy with respect to using aids that involve regular practice. It seems important to study autonomy in future studies, as a cognitive resource resulting from the interaction between internal positive resources and “coping” resources, to gain a better understanding of compliance problems.

Keywords: chronobiology, light therapy, seasonal affective disorder, sleep, stress, stress management, submarine

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Authors: Mária Hudáková, Vladimír Míka, Katarína Hollá

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Making decisions is the core of management and a result of conscious activities which is under way in a particular environment and concrete conditions. The managers decide about the goals, procedures and about the methods how to respond to the changes and to the problems which developed. Their decisions affect the effectiveness, quality, economy and the overall successfulness in every organisation. In spite of this fact, they do not pay sufficient attention to the individual steps of the decision-making process. They emphasise more how to cope with the individual methods and techniques of making decisions and forget about the way how to cope with analysing the problem or assessing the individual solution variants. In many cases, the underestimating of the analytical phase can lead to an incorrect assessment of the problem and this can then negatively influence its further solution. Based on our analysis of the theoretical solutions by individual authors who are dealing with this area and the realised research in Slovakia and also abroad we can recognise an insufficient interest of the managers to assess the risks in the decision-making process. The goal of this paper is to assess the risks in the managers´ decision-making process relating to the conditions of the environment, to the subject’s activity (the manager’s personality), to the insufficient assessment of individual variants for solving the problems but also to situations when the arisen problem is not solved. The benefit of this paper is the effort to increase the need of the managers to deal with the risks during the decision-making process. It is important for every manager to assess the risks in his/her decision-making process and to make efforts to take such decisions which reflect the basic conditions, states and development of the environment in the best way and especially for the managers´ decisions to contribute to achieving the determined goals of the organisation as effectively as possible.

Keywords: risk, decision-making, manager, process, analysis, source of risk

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Authors: Uma Kanth, Amy Cook

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Conceptual Metaphor Theory (CMT) proposes that metaphor is fundamental to human thought. CMT utilizes embodied cognition, in that emotions are conceptualized as effects on the body because of a coupling of one’s bodily experiences and one’s somatosensory system. Time perception is a function of embodied cognition and conceptual metaphor in that one’s experience of time is inextricably dependent on one’s perception of the world around them. A hallmark of depressive disorders is the distortion in one’s perception of time, such as neurological dysfunction and psychomotor retardation, and yet, to the author’s best knowledge, previous studies have not before linked CMT, embodied cognition, and depressive disorders. Therefore, the focus of this paper is the investigation of how the applications of CMT and embodied cognition (especially regarding time perception) have promise in improving current techniques to treat depressive disorders. This paper aimed to extend, through a thorough review of literature, the theoretical basis required to further research into CMT and embodied cognition’s application in treating time distortion related symptoms of depressive disorders. Future research could include the development of brain training technologies that capitalize on the principles of CMT, with the aim of promoting cognitive remediation and cognitive activation to mitigate symptoms of depressive disorder.

Keywords: depression, conceptual metaphor theory, embodied cognition, time

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Authors: I-Han Hsiao, Chun-Ping Huang, Ching-Liang Hsieh, Yi-Wen Lin

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Epilepsy is chronic brain disorder that results in the sporadic occurrence of spontaneous seizures in the temporal lobe, cerebral cortex, and hippocampus. Clinical antiepileptic medicines are often ineffective or little benefits in the small amount of patients and usually initiate severe side effects. This inflammation contributes to enhanced neuronal excitability and the onset of epilepsy. Auricular electric-stimulation (AES) can increase parasympathetic activity and stimulate the solitary tract nucleus to induce the cholinergic anti-inflammatory pathway. Furthermore, it may be a therapeutic strategy for the treatment of epilepsy. In the present study, we want to investigate the effects of AES on inflammatory mediators in kainic acid (KA)-induced epileptic seizure rats. Experimental KA injection increased expression of TLR-2 pathway associated inflammatory mediators, were further reduced by either 2Hz or 15 Hz AES in the prefrontal cortex, hippocampus, and somatosensory cortex. We suggest that AES can successfully control the epileptic seizure by down-regulation of inflammation signaling pathway.

Keywords: auricular electric-stimulation, epileptic seizures, anti-inflammation

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Authors: Charn Loong Ng, Mamun Bin Ibne Reaz

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As elderly population grows globally, the percentage of people diagnosed with musculoskeletal disorder (MSD) increase proportionally. Electromyography (EMG) is an important biosignal that contributes to MSD’s clinical diagnose and recovery process. Conventional conductive electrode has many disadvantages in the continuous EMG measurement application. This research has design a new surface EMG biosensor based on the parallel-plate capacitive coupling principle. The biosensor is developed by using a double-sided PCB with having one side of the PCB use to construct high input impedance circuitry while the other side of the copper (CU) plate function as biosignal sensing metal plate. The metal plate is insulated using kapton tape for contactless application. The result implicates that capacitive biosensor is capable to constantly capture EMG signal without having galvanic contact to human skin surface. However, there are noticeable noise couple into the measured signal. Post signal processing is needed in order to present a clean and significant EMG signal. A complete design of single ended, non-contact, high input impedance, front end EMG biosensor is presented in this paper.

Keywords: contactless, capacitive, biosensor, electromyography

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Authors: Yaa Asuaba Duopah, Lisa Moran, Khalifa Elmusharaf, Dervla Kelly

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Background: Research has identified a strong link between stress and drug use behaviours. Also, it has been established that the prolonged use of crack cocaine stimulates emotional, cognitive, neurological, and social changes. This paper examines the psychosocial stressors associated with crack cocaine use. Methodology: The study is qualitative and adopts a critical realist approach. Data was collected through 26 face-to-face, in-depth, semi-structured interviews with people who use crack cocaine. Study participants were recruited through two addiction services using purposive. Participants consisted of 15 males and 11 females between the ages of 24-57 years. Data were analysed using thematic analysis. Results: Cravings, financial hardship, family breakdown, and emotional stimulation were revealed as psychosocial stressors associated with crack cocaine use. Conclusion: Addressing the psychosocial stressors identified in this paper through targeted interventions and supportive policies is crucial for improving the well-being of persons who use crack cocaine. Collaboration between addiction, mental health, and support services is recommended to develop and deliver these interventions.

Keywords: psychological stress, substance misuse disorder, mental health, coping

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Authors: Meltem Ramoglu, Ertugrul Safran, Hikmet Ucgun, Busra Kepenek Varol, Hulya Nilgun Gurses

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Down’s syndrome (DS) is a human genetic disorder caused by the presence of all or part of an extra chromosome 21. Many patients with DS have musculoskeletal problems that affect weak muscle tone (hypotonia) and ligament laxity. This leads to excessive joint hypermobility and decreased position sense (proprioception). Lack of proprioception may cause balance problems. The aim of our study was to investigate how does joint hypermobility affect balance in patients with DS. Our study conducted with 13 DS patients age between 18 to 40 years. Demographic data were recorded. Beighton Hypermobility Score (BHS) was used to evaluate joint hypermobility. Balance score of participants was evaluated with Berg Balance Scale (BBS). Mean age of our participants was 29,8±3,57 year. Average score of body mass index and BHS were; 33,23 ±3,78 kg/m2 and 7,61±1,04, respectively. Out of a maximum possible score of 56 on the Berg Balance Scale, scores of participants with DS ranged from 36–51, with a mean of 43±4,45. Significant correlation was found between BHS and BBS (r: -,966, p=0.00). All of our participants have 6/9 or higher grade from BHS. As a conclusion of our study; joint hypermobility may affect balance score in patients with DS. The results suggest that people with DS have worse balance scores which affected by hypermobility. Further studies need larger population for more reliable results.

Keywords: adults, balance, Down's syndrome, joint hypermobility

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Authors: Rabindranath Bag, Surjeet Singh

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Materials in which the electrons are strongly correlated provide some of the most challenging and exciting problems in condensed matter physics today. After the discovery of high critical temperature superconductivity in layered or two-dimensional copper oxides, many physicists got attention in cuprates and it led to an upsurge of interest in the synthesis and physical properties of copper-oxide based material. The quest to understand superconducting mechanism in high-temperature cuprates, drew physicist’s attention to somewhat simpler compounds consisting of spin-chains or one-dimensional lattice of coupled spins. Low-dimensional quantum magnets are of huge contemporary interest in basic sciences as well emerging technologies such as quantum computing and quantum information theory, and heat management in microelectronic devices. Spin ladder is an example of quasi one-dimensional quantum magnets which provides a bridge between one and two dimensional materials. One of the examples of quasi one-dimensional spin-ladder compounds is Sr14Cu24O41, which exhibits a lot of interesting and exciting physical phenomena in low dimensional systems. Very recently, the ladder compound Sr14Cu24O41 was shown to exhibit long-distance quantum entanglement crucial to quantum information theory. Also, it is well known that hole-compensation in this material results in very high (metal-like) anisotropic thermal conductivity at room temperature. These observations suggest that Sr14Cu24O41 is a potential multifunctional material which invites further detailed investigations. To investigate these properties one must needs a large and high quality of single crystal. But these systems are showing incongruently melting behavior, which brings many difficulties to grow a large and quality of single crystals. Hence, we are using TSFZ (Travelling Solvent Floating Zone) method to grow the high quality of single crystals of the low dimensional magnets. Apart from this, it has unique crystal structure (alternating stacks of plane containing edge-sharing CuO2 chains, and the plane containing two-leg Cu2O3 ladder with intermediate Sr layers along the b- axis), which is also incommensurate in nature. It exhibits abundant physical phenomenon such as spin dimerization, crystallization of charge holes and charge density wave. The maximum focus of research so far involved in introducing defects on A-site (Sr). However, apart from the A-site (Sr) doping, there are only few studies in which the B-site (Cu) doping of polycrystalline Sr14Cu24O41 have been discussed and the reason behind this is the possibility of two doping sites for Cu (CuO2 chain and Cu2O3 ladder). Therefore, in our present work, the crystals (pristine and Cu-site doped) were grown by using TSFZ method by tuning the growth parameters. The Laue diffraction images, optical polarized microscopy and Scanning Electron Microscopy (SEM) images confirm the quality of the grown crystals. Here, we report the single crystal growth, magnetic and transport properties of Sr14Cu24O41 and its lightly doped variants (magnetic and non-magnetic) containing less than 1% of Co, Ni, Al and Zn impurities. Since, any real system will have some amount of weak disorder, our studies on these ladder compounds with controlled dilute disorder would be significant in the present context.

Keywords: low-dimensional quantum magnets, single crystal, spin-ladder, TSFZ technique

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Authors: Ngawang Tsering

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Traditional Tibetan medicine is primarily focused on promoting health and keeping away diseases from its unique in prescribing specific diet and lifestyle. The prevalence of chronic diseases has been rising day by day and kills a number of people due to the lack of proper nutritional design in modern times. According to traditional Tibetan medicine, chronic diseases such as diabetes, cancer, cardiovascular diseases, respiratory diseases, and arthritis are heavily associated with an unwholesome diet and inappropriate lifestyles. Diet and lifestyles are the two main conditions of diseases and healthy life. The prevalence of chronic diseases is one of the challenges, with massive economic impact and expensive health issues. Though chronic diseases are challenges, it has a solution in the preventive measurements by using proper nutrition design based on traditional Tibetan medicine. Until today, it is hard to evaluate whether traditional Tibetan medicine nutrition strategy could play a major role in preventive measurement as of the lack of current research evidence. However, compared with modern nutrition, it has an exclusive valuable concept, such as a holistic way and diet or nutrition recommendation based on different aspects. Traditional Tibetan medicine is one of the oldest ancient existing medical systems known as Sowa Rigpa (Science of Healing) highlights different aspects of dietetics and nutrition, namely geographical, seasonal, age, personality, emotional, food combination, the process of individual metabolism, potency, and amount of food. This article offers a critical perspective on the preventive measurement against chronic diseases through nutrition design using traditional Tibetan medicine and also needs attention for a deeper understanding of traditional Tibetan medicine in the modern world.

Keywords: traditional Tibetan medicine, nutrition, chronic diseases, preventive measurement, holistic approach, integrative

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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: Aline Giardin, Maria Rosa Chitolina, Maria Catarina Zanini

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In this paper, we analyze the conceptions of high school students about mental health issues, and discuss the creation of mental basic health programs in schools. We base our findings in a quantitative survey carried out by us with 156 high school students of CTISM (Colégio Técnico Industrial de Santa Maria) school, located in Santa Maria city, Brazil. We have found that: (a) 28 students relate the subject ‘mental health’ with psychiatric hospitals and lunatic asylums; (b) 28 students have relatives affected by mental diseases; (c) 76 students believe that mental patients, if treated, can live a healthy life; (d) depression, schizophrenia and bipolar disorder are the most cited diseases; (e) 84 students have contact with mental patients, but know nothing about the disease; (f) 123 students have never been instructed about mental diseases while in the school; and (g) 135 students think that a mental health program would be important in the school. We argue that these numbers reflect a vision of mental health that can be related to the reductionist education still present in schools and to the lack of integration between health professionals, sciences teachers, and students. Furthermore, this vision can also be related to a stigmatization process, which interferes with the interactions and with the representations regarding mental disorders and mental patients in society.

Keywords: mental health, schools, mental illness, conception

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Authors: Dimitrios J. Dimitriou, Maria F. Sartzetaki, Simoni K. Lintzerakou

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Air transport links markets and individuals, promoting social and economic development. The review of management direction towards social responsibility and especially for the enhancement of passengers with autism is the key objective of this paper. According to a top-down approach, the key dimensions that affect the basic principles and directions of airport enterprises management towards social responsibility for the case of passengers with autism are presented. Conventional wisdom is to present actions undertaken in improving accessibility for special population groups and highlight the social dimension in the management of transport hubs. The target is to focus on transport hubs serving special groups of passengers such as passengers with autism and highlight good practices and motivate transport infrastructure management authorities and decision makers to promote the social footprint of transport. The highlights and key findings are essential for managers and decision makers to support actions and plans towards management of airport enterprises towards social responsibility, focusing on the case of passengers traveling with Autism Spectrum Disorder (ASD).

Keywords: social responsibility, special groups, airport enterprises, AUTISM

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Authors: Elham Vojoudi, Marzieh Mehrafza, Ahmad Hosseini, Azadeh Raofi, Maryam Najafi

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Premature ovarian failure (POF) has become one of the main causes of infertility in women of childbearing age and the incidence of this disorder is increasing year by year. In these patients, poor ovarian response (POR) to gonadotropins reflects a diminished ovarian reserve (DOR) that gives place to few follicles despite aggressive stimulation. Up to now, egg donation is the only way to resolve infertility problems in POF patients. Therefore, some novel aspects such as activating (Akt signaling pathway) and inhibiting (Hippo-signaling) elements have been identified as IVA procedure that promotes primordial follicle activation. In this study, we used the newly developed technique (combination of in vitro activation of dormant follicles (IVA) and stem cell therapy) to promote ovarian follicle growth much more efficiently than the natural, in vivo process for women with POF. Transplantation of Warton Jelly-MSCs to the ovaries of POF patients rescued overall ovarian function. Participants (10 patients) were followed up monthly for a period of six months by hormonal (AMH, FSH, LH and E2), clinical (resuming menstruation), and US (folliculometry) outcomes after a laparoscopic operation. In summary, IVA/WJ-MSC transplantation may provide an effective treatment for POF.

Keywords: POF, in vitro activation, stem cell therapy, infertility

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Authors: Müberra Yüksel, Ömer Faruk Görçün

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The purpose of the present study is to investigate the role of strategic human resource management (SHRM) in constructing "employer branding" in logistics. Prior research does not focus on internal stakeholders, that is, employees. Despite the fact that logistic sector has become customer-oriented, the focus is solely on service quality as the unique aspect of logistic companies for competitive advantage. With an increasing interest lately in internal marketing of the employer brand, the emphasis is on the value that human capital brings to the firm which cannot be imitated. `Employer branding` has been the application of branding and relationship marketing principles for competitive advantage in SHRM. Employer branding is an organizing framework for human resource managers since it represents an organization’s efforts to promote, both within and outside, a coherent view of what makes the firm different and desirable as an employer, i.e., the distinct “employer brand personality” and "employee value propositions" (EVP) offered. The presumption of employer branding enhanced by internal marketing is to make customer-conscious employees to handle services better by being aligned with business mission and goals. Starting from internal customers and analyzing the gaps of EVP by using analytical hierarchy process methodology (AHP) and inquiring whether these brand values are communicated and conceived well may be the initial steps in our proposal for employer branding in logistics sector. This empirical study aims to fill this research gap within the context of an emergent market- Turkey, which is located at a hub of transportation and logistics.

Keywords: Strategic Human Resource Management (SHRM), employer branding, Employee Value Propositions (EVP), Analytical Hierarchy Process (AHP), logistics

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Authors: Elena Even-Simkin

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequently diagnosed disorders in children, but in many cases, the diagnosis is not provided until adulthood. Diagnosing adults with ADHD faces different obstacles due to numerous factors, such as educational or under-resourced familial environment, high intelligence compensating for stress-inducing difficulties, and additional comorbidities. Undiagnosed children and adolescents with ADHD may become undiagnosed adults with ADHD, who miss out on the early treatment and may experience significant social and pragmatic difficulties, leading to functional problems that subsequently affect their lifestyle, education, and occupational functioning. The proposed study presents a cost-effective and unique consideration of the pragmatic aspect among adults with ADHD. It provides a systematic and standardized evaluation of the pragmatic level in adults with ADHD, based on a comprehensive approach introduced by Arcara & Bambini (2016) for the assessment of pragmatic abilities in neuro-typical individuals. This assessment tool can promote the inclusion of pragmatic skills in the cognitive profile in the diagnostic practice of ADHD, and, thus, the proposed instrument can help not only identify the pragmatic difficulties in the ADHD population but also advance effective intervention programs that specifically focus on pragmatic skills in the targeted population.

Keywords: ADHD, adults, assessment, pragmatics

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Authors: Neerja Gupta

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Objective-Reconstruction of large cavities of the breast without contralateral symmetrisation Background- Reconstruction of breast includes a wide spectrum of procedures from displacement to regional and distant flaps. The pedicled Perforator flaps cover a wide spectrum of reconstruction surgery for all quadrants of the breast, especially in patients with comorbidities. These axial flaps singly or adjunct are based on a near constant perforator vessel, a ratio of 2:1 at its entry in a flap is good to maintain vascularity. The perforators of lateral chest wall viz LICAP, LTAP have overlapping perfurosomes without clear demarcation. LTAP is localized in the narrow zone between the lateral breast fold and anterior axillary line,2.5-3.8cm from the fold. MICAP are localized at 1-2 cm from sternum. Being 1-2mm in diameter, a Single perforator is good to maintain the flap. LICAP has a dominant perforator in 6th-11th spaces, while LTAP has higher placed dominant perforators in 4th and 5th spaces. Methodology-Six consecutive patients who underwent reconstruction of the breast with pedicled perforator flaps were retrospectively analysed. Selections of the flap was done based on the size and locations of the tumour, anticipated volume loss, willingness to undergo contralateral symmetrisation, cosmetic expectations, and finances available.3 patients underwent vertical LTAP, the distal limit of the flap being the inframammary crease. 3 patients underwent MICAP, oriented along the axis of rib, the distal limit being the anterior axillary line. Preoperative identification was done using a unidirectional hand held doppler. The flap was raised caudal to cranial, the pivot point of rotation being the vessel entry into the skin. The donor area is determined by the skin pinch. Flap harvest time was 20-25 minutes. Intra operative vascularity was assessed with dermal bleed. The patient immediate pre, post-operative and follow up pics were compared independently by two breast surgeons. Patients were given a breast Q questionnaire (licensed) for scoring. Results-The median age of six patients was 46. Each patient had a hospital stay of 24 hours. None of the patients was willing for contralateral symmetrisation. The specimen dimensions were from 8x6.8x4 cm to 19x16x9 cm. The breast volume reconstructed range was 30 percent to 45 percent. All wide excision had free margins on frozen. The mean flap dimensions were 12x5x4.5 cm. One LTAP underwent marginal necrosis and delayed wound healing due to seroma. Three patients were phyllodes, of which one was borderline, and 2 were benign on final histopathology. All other 3 patients were invasive ductal cancer and have completed their radiation. The median follow up is 7 months the satisfaction scores at median follow of 7 months are 90 for physical wellbeing and 85 for surgical results. Surgeons scored fair to good in Harvard score. Conclusion- Pedicled perforator flaps are a valuable option for 3/8th volume of breast defects. LTAP is preferred for tumours at the Central, upper, and outer quadrants of the breast and MICAP for the inner and lower quadrant. The vascularity of the flap is dependent on the angiosomalterritories; adequate venous and cavity drainage.

Keywords: breast, oncoplasty, pedicled, perforator

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Authors: William Albeiro Alvarez, Gloria Patricia Jaramillo, Ivan Reinaldo Sarmiento

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Understanding the behavior of individuals and the different human factors that influence the choice when faced with a complex system such as transportation is one of the most complicated aspects of measuring in the components that constitute the modeling of route choice due to that various behaviors and driving mode directly or indirectly affect the choice. During the last two decades, with the development of information and communications technologies, new data collection techniques have emerged such as GPS, geolocation with mobile phones, apps for choosing the route between origin and destination, individual service transport applications among others, where an interest has been generated to improve discrete choice models when considering the incorporation of these developments as well as psychological factors that affect decision making. This paper implements a discrete choice model that proposes and estimates a hybrid model that integrates route choice models and latent variables based on the observation on the route of a sample of public taxi drivers from the city of Medellín, Colombia in relation to its behavior, personality, socioeconomic characteristics, and driving mode. The set of choice options includes the routes generated by the individual service transport applications versus the driver's choice. The hybrid model consists of measurement equations that relate latent variables with measurement indicators and utilities with choice indicators along with structural equations that link the observable characteristics of drivers with latent variables and explanatory variables with utilities.

Keywords: behavior choice model, human factors, hybrid model, real time data

Procedia PDF Downloads 155