Search results for: lysosomal storage disorder

Authors: B. McGovern, J. F. Luck, A. Gade, I. V. Lake, D. O’Connell, H. C. Cutcliffe, K. P. Shah, E. E. Ginalis, C. M. Lambert, N. Christian, J. R. Kait, A. W. Yu, C. P. Eckersley, C. R. Bass

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Mild traumatic brain injury (mTBI) in the form of post-concussive injuries and attention deficit / hyperactivity disorder (ADHD) share similar cognitive impairments, including impaired working memory and executive function. The memory-guided oculomotor task separates working memory and inhibitory components to provide further information on the nature of these deficits in each pathology. Eleven subjects with ADHD, fifteen control subjects, and ten subjects with recent concussive injury were matched on age, gender, and education (all high school-age males). Eye movements were recorded during memory-guided oculomotor tasks with varying delays using EyeLink 1000 (SR Research). The percentage of premature saccades and the latency of correct response are the analyzed measures for response inhibition and working memory, respectively. No significant differences were found in latencies between controls subjects and subjects with ADHD or post-concussive injuries, in accordance with previous studies. Subjects with ADHD and post-concussive injuries both demonstrated a trend of increased percentages of premature saccades compared to control subjects in the same oculomotor task. This trend reached statistical significance between the post-concussive and control groups (p < 0.05). These findings support the primary nature of the executive function deficits in response inhibition in ADHD and mTBI. The interpretation of results is limited by the small sample size and the exploratory nature of the study. Further investigation into oculomotor performance differences in mTBI and ADHD may help in differentiating these pathologies in consequent diagnoses and provide insight into the interaction of these deficits in mTBI.

Keywords: attention deficit / hyperactivity disorder (ADHD), concussion, diagnosis, oculomotor, pediatrics

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Authors: Eric Agyekum, Dominic Asitanga

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Ghana is widely considered asa beacon of democracy in sub-Saharan Africa. With a relatively free media, the country was ranked30thin the world and third in Africaon the 2021 Press Freedom Index. Despite the democratic gains, itis one of the most politically polarized nations in the world. Ghana’spolitical division is evident in the current hunglegislature, where each of the two dominant political parties has 137 members, with an independent member occupying the remaining one seat. Misinformation and fake newsthrive in systems with acuteideological and political differences(Imelda et al, 2021; Azzimonti&Fernandes, 2018; Spohr, 2017) and Ghana is no exception. The information disorder problem has been exacerbatedby the COVID-19 pandemic, with its attendant conspiracy theories and speculations, making it difficult for the media and fact-checking organizations to verifyall claims and flag false information. In Ghana, fact-checking agencies like Ghana Fact, Dubawa Ghana, and some mainstream news media organizations have been fact-checking political claims, COVID-19 conspiracy theories, and many others. However, it is not clear if the audience consumeand attach prominence to these fact-checked stories or even visit the websites of the fact-checking agencies to read the content. Nekmat (2020) opine that though the literature on fact-checking suggest that fact-checked stories can alter readers’ beliefs, very few studies have investigated the patronage and the potential of fact-checks to deter users from sharing false news with others, particularly on social media. In response to Nekmat, this study has been initiated to examine the perception and attitude of the audience in Ghana towards fact-checks. Anchored on the principles of the nudge theory, this study will investigate how fact-checked stories alters readers’ behavioural patterns. A survey will be conducted to collect data from sampled members of the Ghanaian society.

Keywords: fact-checking, information disorder, nudge theory, political polarization

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Authors: Liang-Jen Wang, Sung-Chou Li, Yuan-Ming Yeh, Sheng-Yu Lee, Ho-Chang Kuo, Chia-Yu Yang

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Background: Dysbiosis in the gut microbial community might be involved in the pathophysiology of attention deficit/hyperactivity disorder (ADHD). The fungal component of the gut microbiome, namely the mycobiota, is a hyperdiverse group of multicellular eukaryotes that can influence host intestinal permeability. This study therefore aimed to investigate the impact of fungal mycobiome dysbiosis and intestinal permeability on ADHD. Methods: Faecal samples were collected from 35 children with ADHD and from 35 healthy controls. Total DNA was extracted from the faecal samples, and the internal transcribed spacer (ITS) regions were sequenced using high-throughput next-generation sequencing (NGS). The fungal taxonomic classification was analysed using bioinformatics tools, and the differentially expressed fungal species between the ADHD and healthy control groups were identified. An in vitro permeability assay (Caco-2 cell layer) was used to evaluate the biological effects of fungal dysbiosis on intestinal epithelial barrier function. Results: The β-diversity (the species diversity between two communities), but not α-diversity (the species diversity within a community), reflected the differences in fungal community composition between ADHD and control groups. At the phylum level, the ADHD group displayed a significantly higher abundance of Ascomycota and significantly lower abundance of Basidiomycota than the healthy control group. At the genus level, the abundance of Candida (especially Candida albicans) was significantly increased in ADHD patients compared to the healthy controls. In addition, the in vitro cell assay revealed that C. albicans secretions significantly enhanced the permeability of Caco-2 cells. Conclusions: The current study is the first to explore altered gut mycobiome dysbiosis using the NGS platform in ADHD. The findings from this study indicated that dysbiosis of the fungal mycobiome and intestinal permeability might be associated with susceptibility to ADHD.

Keywords: ADHD, fungus, gut–brain axis, biomarker, child psychiatry

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Authors: Gadiri Sabiha

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Introduction: Current allergy diagnostic tools using Multiplex technology have made it possible to increase the efficiency of the search for specific IgE. This opportunity is provided by the newly developed “Alex Biochip”, consisting of a panel of 282 allergens in native and molecular form, a CCD inhibitor, and the potential for detecting cross-reactive allergens. We evaluated the performance of this technology in detecting cross-reactivity in previously explored patients. Material/Method: The sera of 39 patients presenting sensitization and polysensitization profiles were explored. The search for specific IgE is carried out by the Alex ® IgE Biochip, and the results are analyzed by nature and by molecular family of allergens using specific software. Results/Discussion: The analysis gave a particular profile of cross-reactivity allergens: 33% for the Ole e1 family, 31% for NPC2, 26% for storage proteins, 20% for Tropomyosin, 10% for LTPs, 10% for Arginine Kinase and 10% for Uteroglobin CCDs were absent in all patients. The “Ole e1” allergen is responsible for a pollen-pollen cross allergy. The storage proteins found and LTP are not species-specific, causing cross-pollen-food allergy. The nDer p2 of the NPC2 family is responsible for cross-reactivity between mite species. Conclusion: The cross-reactivities responsible for mixed syndromes at diagnosis in our patients were dominated by pollen-pollen and pollen-food syndromes. They allow the identification of severity factors linked to the prognosis and the best-adapted immunotherapy.

Keywords: specific IgE, allergy, cross reactivity, molecular allergens

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Authors: T. Topór, A. Derkowski, P. Ziemiański

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Formation of organic matter (OM)-hosted nanopores upon thermal maturation are one of the key factor controlling methane storage potential in unconventional shale-gas reservoirs. In this study, the subcritical CO₂ and N₂ gas adsorption measurements combined with scanning electron microscopy and supercritical methane adsorption have been used to characterize pore system and methane storage potential in black shales from the Baltic Basin (Poland). The samples were collected from a virtually equivalent Llandovery strata across the basin and represent a complete digenetic sequence, from thermally immature to overmature. The results demonstrate that the thermal maturation is a dominant mechanism controlling the formation of OM micro- and mesopores in the Baltic Basin shales. The formation of micro- and mesopores occurs in the oil window (vitrinite reflectance; leavedVR; ~0.5-0.9%) as a result of oil expulsion from kerogenleft OM highly porous. The generated hydrocarbons then turn into solid bitumen causing pore blocking and substantial decrease in micro- and mesopore volume in late-mature shales (VR ~0.9-1.2%). Both micro- and mesopores are regenerated in a middle of the catagenesis range (VR 1.4-1.9%) due to secondary cracking of OM and gas formation. The micropore volume in investigated shales is almost exclusively controlled by the OM content. The contribution of clay minerals to micropore volume is insignificant and masked by a strong contribution from OM. Methane adsorption capacity in the Baltic Basin shales is predominantly controlled by microporous OM with pores < 1.5 nm. The mesopore volume (2-50 nm) and mesopore surface area have no effect on methane sorption behavior. The adsorbed methane density equivalent, calculated as absolute methane adsorption divided by micropore volume, reviled a decrease of the methane loading potential in micropores with increasing maturity. The highest methane loading potential in micropores is observed for OM before metagenesis (VR < 2%), where the adsorbed methane density equivalent is greater than the density of liquid methane. This implies that, in addition to physical adsorption, absorption of methane in OM may occur before metagenesis. After OM content reduction using NaOCl solution methane adoption capacity substantially decreases, suggesting significantly greater adsorption potential for OM microstructure than for the clay minerals matrix.

Keywords: maturation, methane sorption, organic matter, porosity, shales

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Authors: Mariam Anwaar, Kiran B. Ahmad

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Borderline Personality Disorder (BPD) is an invasive presence of affect instability, disturbance in self-concept and attachment in relationships. The profound indicator is the dichotomous approach of the world in which the ego categorizes individuals, especially their significant others, into secure or threatful beings, leaving little room for a complex combination of characteristics in one person. This defense mechanism of splitting their world has been described through the explanatory model of unconscious conflict theorized by Sigmund Freud’s Electra Complex in the Phallic Stage. The central role is of the father with whom the daughter experiences penis envy, thus identifying with the mother’s characteristics to receive the father’s attention. However, Margret Mahler, an object relation theorist, elucidates the central role of the mother and that the split occurs during the pre-Electra complex stage. Amid the 14 and 24 months of the infant, it acknowledges the world away from the mother as they have developed milestones such as crawling. In such novelty, the infant crawls away from the mother creating a sense of independence (individuation). On the other hand, being distant causes anxiety, making them return to their original object of security (separation). In BPD, the separation-individuation stage is disrupted, due to contradictory actions of the caregiver, which results in splitting the object into negative and positive aspects, repressing the former and adhering to the latter for survival. Thus, with time, the ego distorts the reality into dichotomous categories, using the splitting defenses, and the mental representation of the self is distorted due to the internalization of the negative objects. The explanatory model was recognized in the case study of Fizza, at 21-year-old Pakistani female, residing in Karachi. Her marital status is single with an occupation being a dental student. Fizza lives in a nuclear family but is surrounded by her extended family as they all are in close vicinity. She came with the complaints of depressive symptoms for two-years along with self-harm due to severe family conflicts. Through the intervention of Dialectical Behavior Therapy (DBT), the self-harming actions were reduced, however, this libidinal energy transformed into claustrophobic symptoms and, along with this, Fizza has always experienced vivid dreams. A retrospective method of Jungian dream-analysis was applied to locate the origins of the splitting in the unconscious. The result was the revelation of a sexual harassment trauma at the age of six-years which was displaced in the form of self-harm. In addition to this, the presence of a conflict at the separation-individuation stage was detected during the dream-analysis, and it was the underlying explanation of the claustrophobic symptoms. This qualitative case study implicates the use of a patient’s subjective experiences, such as dreams, to journey through the spiral of the unconscious in order to not only detect repressed memories but to use them in psychotherapy as a means of healing the patient.

Keywords: borderline personality disorder, dream-analysis, Electra complex, separation-individuation, splitting, unconscious

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Authors: Kingston Rajiah, Mari Kannan Maharajan, Si Jen Yeen, Sara Lew

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Parkinson’s disease (PD) is a progressive neurodegenerative disorder with evolving layers of complexity. Both motor and non-motor symptoms of PD may affect patients’ quality of life (QoL). Life expectancy for an individual with Parkinson’s disease depends on the level of care the individual has access to, can have a direct impact on length of life. Therefore, improvement of the QoL is a significant part of therapeutic plans. Patients with PD, especially those who are in advanced stages, are in great need of assistance, mostly from their family members or caregivers in terms of medical, emotional, and social support. The role of a caregiver becomes increasingly important with the progression of PD, the severity of motor impairment and increasing age of the patient. The nature and symptoms associated with PD can place significant stresses on the caregivers’ burden. As the prevalence of PD is estimated to more than double by 2030, it is important to recognize and alleviate the burden experienced by caregivers. This study focused on the impact of the clinical features on the QoL of PD patients, and of their caregivers. This study included PD patients along with their caregivers and was undertaken at the Malaysian Parkinson's Disease Association from June 2016 to November 2016. Clinical features of PD patients were assessed using the Movement Disorder Society revised Unified Parkinson Disease Rating Scale (MDS-UPDRS); the Hoehn and Yahr Staging of Parkinson's Disease were used to assess the severity and Parkinson's disease activities of daily living scale were used to assess the disability of Parkinson’s disease patients. QoL of PD patients was measured using the Parkinson's Disease Questionnaire-39 (PDQ-39). The revised version of the Zarit Burden Interview assessed caregiver burden. At least one of the clinical features affected PD patients’ QoL, and at least one of the QoL domains affected the caregivers’ burden. Clinical features ‘Saliva and Drooling’, and ‘Dyskinesia’ explained 29% of variance in QoL of PD patients. The QoL domains ‘stigma’, along with ‘emotional wellbeing’ explained 48.6% of variance in caregivers’ burden. Clinical features such as saliva, drooling and dyskinesia affected the QoL of PD patients. The PD patients’ QoL domains such as ‘stigma’ and ‘emotional well-being’ influenced their caregivers’ burden.

Keywords: carers, quality of life, clinical features, Malaysia

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Authors: Kuhorfah Emmanuel Mawuli

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Generally, for firms to enhance their operational efficiency of logistics, it is imperative to assess the logistics function. The cost of logistics conventionally represents a key consideration in the pricing decisions of firms, which suggests that cost efficiency in logistics can go a long way to improve margins. Warehousing, which is a key part of logistics operations, has the prospect of influencing operational efficiency in logistics management as well as customer value, but this potential has often not been recognized. It has been found that there is a paucity of research that evaluates the efficiency of warehouses. Indeed, limited research has been conducted to examine potential barriers to effective warehousing management. Due to this paucity of research, there is limited knowledge on how to address the obstacles associated with warehousing management. In order for warehousing management to become profitable, there is the need to integrate, balance, and manage the economic inputs and outputs of the entire warehouse operations, something that many firms tend to ignore. Management of warehousing is not solely related to storage functions. Instead, effective warehousing management requires such practices as maximum possible mechanization and automation of operations, optimal use of space and capacity of storage facilities, organization through "continuous flow" of goods, a planned system of storage operations, and safety of goods. For example, there is an important need for space utilization of the warehouse surface as it is a good way to evaluate the storing operation and pick items per hour. In the setting of Mantrac Ghana, not much knowledge regarding the management of the warehouses exists. The researcher has personally observed many gaps in the management of the warehouse facilities in the case organization Mantrac Ghana. It is important, therefore, to assess the warehouse facility management of the case company with the objective of identifying weaknesses for improvement. The study employs an in-depth qualitative research approach using interviews as a mode of data collection. Respondents in the study mainly comprised warehouse facility managers in the studied company. A total of 10 participants were selected for the study using a purposive sampling strategy. Results emanating from the study demonstrate limited warehousing effectiveness in the case company. Findings further reveal that the major barriers to effective warehousing facility management comprise poor layout, poor picking optimization, labour costs, and inaccurate orders; policy implications of the study findings are finally outlined.

Keywords: assessing, warehousing, facility, management

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Authors: Zeeshan Ahmed, Ajinkya Sarode, Pratik Basarkar, Atul Bhargav, Debjyoti Banerjee

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The use of CO₂ in oil recovery and in CO₂ capture and storage is gaining traction in recent years. These applications involve heat transfer between CO₂ and the base fluid, and hence, there arises a need to improve the thermal conductivity of CO₂ to increase the process efficiency and reduce cost. One way to improve the thermal conductivity is through nanoparticle addition in the base fluid. The nanofluid model in this study consisted of copper (Cu) nanoparticles in varying concentrations with CO₂ as a base fluid. No experimental data are available on thermal conductivity of CO₂ based nanofluid. Molecular dynamics (MD) simulations are an increasingly adopted tool to perform preliminary assessments of nanoparticle (NP) fluid interactions. In this study, the effect of the formation of a nanolayer (or molecular layering) at the gas-solid interface on thermal conductivity is investigated using equilibrium MD simulations by varying NP diameter and keeping the volume fraction (1.413%) of nanofluid constant to check the diameter effect of NP on the nanolayer and thermal conductivity. A dense semi-solid fluid layer was seen to be formed at the NP-gas interface, and the thickness increases with increase in particle diameter, which also moves with the NP Brownian motion. Density distribution has been done to see the effect of nanolayer, and its thickness around the NP. These findings are extremely beneficial, especially to industries employed in oil recovery as increased thermal conductivity of CO₂ will lead to enhanced oil recovery and thermal energy storage.

Keywords: copper-CO2 nanofluid, molecular dynamics simulation, molecular interfacial layer, thermal conductivity

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Authors: M. D. Antoine

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Despite the widespread use of complementary and alternative medicine (CAM) for autistic children, little is known about the communication flow between the different parties involved in autism care (e.g., parents/caregivers, conventional providers, alternative practitioners). This study aimed to describe how communication occurs through the first year following an autism spectrum disorder (ASD) diagnosis to identify challenges and potential barriers to communication within the healthcare system in Ottawa, Canada. From an ecological perspective, we collected qualitative data through 12 semi-structured interviews with six parents/caregivers, three conventional providers (e.g., family doctor, neurodevelopmental pediatrician, psychologist), and three alternative practitioners (e.g., naturopath, occupational therapist, speech and language pathologist) operating in Ottawa. We interpreted the data using thematic analysis. Findings revealed communication challenges between the parents/caregivers and conventional providers while they experience better communication flow with fewer challenges in alternative care settings. However, parents/caregivers are the only links between the health professionals of both streams. From the five contexts examined: organizational, interpersonal, media, cultural, and political-legal, we found four themes (provider knowledge, care integration, flexible care, and time constraints) underlining specific barriers to communication flow between the parties involved in the care of autistic children. The increasing interest in alternative medicine is forcing changes in the healthcare system. Communications occur outside the norms making openings for better communication and information-sharing increasingly essential. Within the identified themes in the current study, the necessity for better communication between all parties involved in the care of autistic children is evident. More ASD and CAM-related training for providers would support effective parent/caregiver-provider communication. The findings of the current study contribute to a better understanding of the role of communication in the care management of autism, which has implications for effective autism care.

Keywords: alternative medicine, autism care management, autism spectrum disorder, conventional medicine, parent-provider communication

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Authors: Jolanta Jonak

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Emotional wellbeing is crucial for healthy development of children, youth, and adolescence. Lack of healthy emotional development and functioning can lead to many challenges in academic, social, and physical domains. Unfortunately, mental health problems are steadily increasing over the past several years and significantly intensified during and after the Covid 19 pandemic. Some experts warn that globally, we are entering a mental health crisis pandemic. Prior to the Covid 19 pandemic in 2020, a considerable number of youth aged 6-17 experienced a mental health disorder each year, with half of all mental health conditions beginning by age 14. The most common mental health disorders in children are Attention-Deficit/Hyperactivity Disorder (ADHD), behavior problems, anxiety, and depression. In U.S. schools, youth with these diagnoses tend to be classified under the umbrella of Emotional Disability. Several concerning trends have been emerging about the mental health of U.S. high school students. These trends have been steadily increasing for the past decade, particularly having increasing numbers of high school students who experienced persistent feelings of sadness or hopelessness, seriously considered attempting suicide, made a suicide plan, and attempted suicide. The number of students who felt persistently sad or hopeless increased across every racial and ethnic group. Parents, educators, and mental health providers are key stakeholders that are responsible for actively and effectively supporting struggling youth. A commonly faced challenge is that mental wellbeing is not supported as effectively as it should be. When effective prevention is paired with enhanced treatment developed on a multidisciplinary approach, mental health and emotional wellbeing in young people can be positively enhanced. Major health organizations including the Center for Disease Control and the National Institutes of Health encourage health professionals and other stakeholders to focus on addressing emotional wellbeing and mental health of young people.

Keywords: social emotional wellbeing, disability, learning, prevention

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Authors: Adira Nofeadri Ryofi, Alvin Andrianus, Anna Khairunnisa, Anugrah Cahyo Widodo, Arbhyando Tri Putrananda, Arsy Imanda N. Raswati, Gita Rahmaningsih, Ina Agustina

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The consumption level of fresh bananas from 2005 until 2010, increased from 8.2 to 10 kg/capita/year. The commercial scale of banana generally harvested when it still green to make the banana avoid physical damage, chemical, and disease after harvest and ripe fruit. That first metabolism activity can be used as a synthesis reaction. Ripening fruit was influenced by ethylene hormone that synthesized in fruit which is experiencing ripe and including hormone in the ripening fruit process in klimaterik phase. This ethylene hormone is affected by the respiration level that would speed up the restructuring of carbohydrates inside the fruit, so the weighting of fruit will be decreased. Compared to other klimaterik fruit, banana is a fruit that has a medium ethylene production rate and the rate of respiration is low. The salicylic acid can regulate the result number of the growth process or the development of fruits and plants. Salicylic acid serves to hinder biosynthesis ethylene and delay senses. The research aims to understand the influence of salicylic acid concentration that derived from the waste of avocado skin in inhibition process to ethylene production that the maturation can be controlled, so it can keep the quality of banana for storage. It is also to increase the potential value of the waste of avocado skin that were still used in industrial cosmetics.

Keywords: ethylene hormone, extract avocado skin, inhibitor, salicylic acid

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Authors: Jubaida Gulshan Ara, Zebun Nasreen Ahmed

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Urban flood and drought has been a major problem of Dhaka city, particularly in recent years. Continuous increase of the city built up area, and limiting rainwater infiltration zone, are thought to be the main causes of the problem. Proper rainwater management, even at the individual plot level, might bring significant improvement in this regard. As residential use pattern occupies a significant portion of the city surface, the scope of rainwater harvesting (RWH) in residential buildings can be investigated. This paper reports on a research which explored the scope of rainwater harvesting in residential plots, with multifamily apartment buildings, in Dhaka city. The research investigated the basics of RWH, contextual information, i.e., hydro-geological, meteorological data of Dhaka city and the rules and legislations for residential building construction. The study also explored contemporary rainwater harvesting practices in the local and international contexts. On the basis of theoretical understanding, 21 sample case-studies, in different phases of construction, were selected from seven different categories of plot sizes, in different residential areas of Dhaka city. Primary data from the 21 case-study buildings were collected from a physical survey, from design drawings, accompanied by a questionnaire survey. All necessary secondary data were gathered from published and other relevant sources. Collected primary and secondary data were used to calculate and analyze the RWH needs for each case study, based on the theoretical understanding. The main findings have been compiled and compared, to observe residential development trends with regards to building rainwater harvesting system. The study has found that, in ‘Multifamily Apartment Building’ of Dhaka city, storage, and recharge structure size for rainwater harvesting, increases along with occupants’ number, and with the increasing size of the plot. Hence, demand vs. supply ratio remains almost the same for different sizes of plots, and consequently, the size of the storage structure increases significantly, in large-scale plots. It has been found that rainwater can meet only 12%-30% of the total restricted water demand of these residential buildings of Dhaka city. Therefore, artificial groundwater recharge might be the more suitable option for RWH, than storage. The study came up with this conclusion that, in multifamily residential apartments of Dhaka city, artificial groundwater recharge might be the more suitable option for RWH, than storing the rainwater on site.

Keywords: Dhaka city, rainwater harvesting, residential plots, urban flood

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Authors: Remya Radhakrishnan, Hema Perinbanathan, Anukriti Rath, Reshmi Ramachandran, Rohith Thazhathuvetil Sasindrababu, Maria Karizhenskaia

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Childhood adversities have lasting effects on health and well-being. This abstract explores the connection between adverse childhood experiences (ACEs) and health consequences, including substance abuse and obesity. Understanding the impact of childhood trauma and emphasizing the importance of culturally sensitive treatments and focused interventions help to mitigate these effects. Research consistently shows a strong link between ACEs and poor health outcomes. Our team conducted a comprehensive literature review of depression and anxiety in Canadian children and youth, exploring diverse treatment methods, including medical, psychotherapy, and alternative therapies like art and music therapy. We searched Medline, Google Scholar, and St. Lawrence College Library. Only original research papers, published between 2012 and 2023, peer-reviewed, and reporting on childhood adversities on health and its treatment methods in children and youth in Canada were considered. We focused on their significance in treating depression and anxiety. According to the study's findings, the prevalence of adverse childhood experiences (ACEs) is still a significant concern. In Canada, 40% of people report having had multiple ACEs, and 78% report having had at least one ACE, highlighting the persistence of childhood adversity and indicating that the issue is unlikely to fade off in the near future. Likewise, findings revealed that individuals who experienced abuse, neglect, or violence during childhood are likelier to engage in harmful behaviors like polydrug use, suicidal ideation, and victimization and suffer from mental health problems such as depression and post-traumatic stress disorder (PTSD).

Keywords: adverse childhood experiences (ACEs), obesity, post-traumatic stress disorder (PTSD), resilience, substance abuse, trauma-informed care

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Authors: Sajad Haghanifar, Seyed-Farshid Kashani Bozorg

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Nano-crystalline Mg2Ni-based powder was produced by mechanical alloying technique using binary and ternary powder mixtures with stoichiometric compositions of Mg2Ni, Mg1.9C0.1Ni and Mg2C0.1Ni0.9. The structures and morphologies of the milled products were studied by XRD, SEM and HRTEM. Their electrochemical hydrogen storage characteristics were investigated in 6 M KOH solution. X-Ray diffraction, scanning and transmission electron microscopy of the milled products showed the formation of Mg2Ni-based nano-crystallites after 5, 15 and 30 h of milling using the initial powder mixtures of Mg1.9C0.1Ni, Mg2Ni and Mg2C0.1Ni0.9, respectively. It was found that partial substitution of C for Mg has beneficial effect on the formation kinetic of nano-crystalline Mg2Ni. Contrary to this, partial substitution of C for Ni was resulted in retardation of formation kinetic of nano-crystalline Mg2Ni. In addition, the negative electrode made from Mg1.9C0.1Ni ternary milled product after 30 hour of milling exhibited the highest initial discharge capacity and longest discharge life. Thus, partial substitution of C for Mg is beneficial to electrode properties of the Mg2Ni-based crystallites. The relation between the discharge capacity and cycling number of mechanically alloyed products was proposed on the basis of the fact that the degradation of discharge capacity was mainly caused by the oxidation of magnesium and nickel. The experimental data fitted the deduced equation well.

Keywords: Mg2Ni, hydrogen absorbing materials, electrochemical properties, nano-crystalline, amorphous, mechanical alloying, carbon

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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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Authors: Mohamed Youssry, Dominique Guyomard, Bernard Lestriez

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In order to enhance the energy and power densities of electrodes for energy storage systems, the formulation and processing of electrode slurries proved to be a critical issue in determining the electrode performance. In this study, we introduce novel approach to formulate carbon black slurries based on microemulsion and lyotropic liquid crystalline phases (namely, lamellar phase) composed of non-ionic surfactant (Triton X100), decanol and water. Simultaneous measurements of electrical properties of slurries under shear flow (rheology) have been conducted to elucidate the microstructure evolution with the surfactant concentration and decanol/water ratio at rest, as well as, the structural transition under steady-shear which has been confirmed by rheo-microscopy. Interestingly, the carbon black slurries at low decanol/water ratio are weak-gel (flowable) with higher electrical conductivity than those at higher ratio which behave strong-gel viscoelastic response. In addition, the slurries show recoverable electrical behaviour under shear flow in tandem with the viscosity trend. It is likely that oil-in-water microemulsion enhances slurries’ stability without affecting on the percolating network of carbon black. On the other hand, the oil-in-water analogous and bilayer structure of lamellar phase cause the slurries less conductive as a consequence of losing the network percolation. These findings are encouraging to formulate microemulsion-based electrodes for energy storage system (lithium-ion batteries).

Keywords: electrode slurries, microemulsion, microstructure transition, rheo-electrical properties

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Authors: Jason Clarke, Michaela Porubanova, Angela Mazzoli, Gulsah Kut

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What accounts for our perception that time inexorably passes in one direction, from the past to the future, the so-called arrow of time, given that the laws of physics permit motion in one temporal direction to also happen in the reverse temporal direction? Modern physics says that the reason for time’s unidirectional physical arrow is the relationship between time and entropy, the degree of disorder in the universe, which is evolving from low entropy (high order; thermal disequilibrium) toward high entropy (high disorder; thermal equilibrium), the second law of thermodynamics. Accordingly, our perception of the direction of time, from past to future, is believed to emanate as a result of the natural evolution of entropy from low to high, with low entropy defining our notion of ‘before’ and high entropy defining our notion of ‘after’. Here we explored this proposed relationship between entropy and the perception of time’s arrow. We predicted that if the brain has some mechanism for detecting entropy, whose output feeds into processes involved in constructing our perception of the direction of time, presentation of violations to the expectation that low entropy defines ‘before’ and high entropy defines ‘after’ would alert this mechanism, leading to measurable behavioral effects, namely a disruption in duration perception. To test this hypothesis, participants were shown briefly-presented (1000 ms or 500 ms) computer-generated visual dynamic events: novel 3D shapes that were seen either to evolve from whole figures into parts (low to high entropy condition) or were seen in the reverse direction: parts that coalesced into whole figures (high to low entropy condition). On each trial, participants were instructed to reproduce the duration of their visual experience of the stimulus by pressing and releasing the space bar. To ensure that attention was being deployed to the stimuli, a secondary task was to report the direction of the visual event (forward or reverse motion). Participants completed 60 trials. As predicted, we found that duration reproduction was significantly longer for the high to low entropy condition compared to the low to high entropy condition (p=.03). This preliminary data suggests the presence of a neural mechanism that detects entropy, which is used by other processes to construct our perception of the direction of time or time’s arrow.

Keywords: time perception, entropy, temporal illusions, duration perception

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Authors: Siphesihle Hlongwane

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Background: Globally, alcohol consumption, smoking, and the use of illicit drugs kill more than 11.8 million people each year. In sub-Saharan Africa, substance abuse is responsible for more than 6.4% of all deaths recorded and about 4.7% of all Disability Adjusted Life Years (DALYs), with numbers still expected to grow if no drastic measures are taken to curb and address drug use. In a setting where substance use is rife, understanding contextual factors that influence an individual’s perceived eligibility to seek rehabilitation is paramount. Using the candidacy framework, we unpack how situational factors influence an individual’s perceived eligibility for healthcare uptake in adolescents and youth with substance use disorder (SUD). Methods: The candidacy framework is concerned with how people consider their eligibility for accessing a health service. The study collected and analyzed primary qualitative data to answer the research question. Data were collected between January and July 2022 on participants aged between 18 and 35 for drug users and 18 to 60 for family members. Participants include 20 previous and current drug users and 20 family members that experience the effects of addiction. A pre-drafted semi-structured interview guide was administered to a conveniently sampled population supplemented with a referral sampling method. Data were thematically analyzed using the NVivo 12pro software to manage the data. Findings: Our findings show that people with substance use disorders are aware of their drug use habits and acknowledge their candidacy for health services. Candidacy for health services is also acknowledged by those around them, such as family members and peers, and as such, information on the navigation of health services for drug users is shared by those who have attended health services, those affected by drug use, and this includes health service research by family members to identify accessible health services. While participants reported willingness to quit drug use if assistance is provided, the permeability of health care services is hindered by both individual determinations to quit drug use from long-time use and the availability of health services for drug users, such as rehabilitation centers. Our findings also show that drug users are conscious and can articulate their ailments; however, the hunt for the next dose of drugs and long waiting cues for health service acquisition overshadows their claim to health services. Participants reported a mixture of treatments prescribed, with some more gruesome than others prescribed, thus serving as both a facilitator and barrier for health service uptake. Despite some unorthodox forms of treatments prescribed in health care, the majority of those who enter treatment complete the process of treatment, although some are met with setbacks and sometimes relapse after treatment has finished. Conclusion: Drug users are able to ascertain their candidacy for health services; however, individual and environmental characteristics relating to drug use hinder the use of health services. Drug use interventions need to entice health service uptake as a way to improve candidacy for health use.

Keywords: substance use disorder, rehabilitation, drug use, relapse, South Africa, candidacy framework

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Authors: Rafael Martins Manzano Silva, Jean-Francois Tremong

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Electrification of railway lines allows to increase speed, power, capacity and energetic efficiency of rolling stocks. However, this process of electrification is complex and costly. An electrification project is not just about design of catenary. It also includes installation of structures around electrification, as substation installation, electrical isolation, signalling, telecommunication and civil engineering structures. France has more than 30,000 km of railways, whose only 53% are electrified. The others 47% of railways use diesel locomotive and represent only 10% of the circulation (tons.km). For this reason, a new type of electrification, less expensive than the usual, is requested to enable the modernization of these railways. One solution could be the use of hybrids trains. This technology opens up new opportunities for less expensive infrastructure development such as the partial electrification of railway lines. In a partially electrified railway, the power supply of theses hybrid trains could be made either by the catenary or by the on-board energy storage system (ESS). Thus, the on-board ESS would feed the energetic needs of the train along the non-electrified zones while in electrified zones, the catenary would feed the train and recharge the on-board ESS. This paper’s objective deals with the technical and economic potential identification of partial electrification of railway lines. This study provides different scenarios of electrification by replacing the most expensive places to electrify using on-board ESS. The target is to reduce the cost of new electrification projects, i.e. reduce the cost of electrification infrastructures while not increasing the cost of rolling stocks. In this study, scenarios are constructed in function of the electrification’s cost of each structure. The electrification’s cost varies considerably because of the installation of catenary support in tunnels, bridges and viaducts is much more expensive than in others zones of the railway. These scenarios will be used to describe the power supply system and to choose between the catenary and the on-board energy storage depending on the position of the train on the railway. To identify the influence of each partial electrification scenario in the sizing of the on-board ESS, a model of the railway line and of the rolling stock is developed for a real case. This real case concerns a railway line located in the south of France. The energy consumption and the power demanded at each point of the line for each power supply (catenary or on-board ESS) are provided at the end of the simulation. Finally, the cost of a partial electrification is obtained by adding the civil engineering costs of the zones to be electrified plus the cost of the on-board ESS. The study of the technical and economic potential ends with the identification of the most economically interesting scenario of electrification.

Keywords: electrification, hybrid, railway, storage

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Authors: N. N. Mosola, S. J. Molete, L. S. Masoebe, M. Letsae

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Hand gesture recognition is a technique used to locate, detect, and recognize a hand gesture. Detection and recognition are concepts of Artificial Intelligence (AI). AI concepts are applicable in Human Computer Interaction (HCI), Expert systems (ES), etc. Hand gesture recognition can be used in sign language interpretation. Sign language is a visual communication tool. This tool is used mostly by deaf societies and those with speech disorder. Communication barriers exist when societies with speech disorder interact with others. This research aims to build a hand recognition system for Lesotho’s Sesotho and English language interpretation. The system will help to bridge the communication problems encountered by the mentioned societies. The system has various processing modules. The modules consist of a hand detection engine, image processing engine, feature extraction, and sign recognition. Detection is a process of identifying an object. The proposed system uses Canny pruning Haar and Haarcascade detection algorithms. Canny pruning implements the Canny edge detection. This is an optimal image processing algorithm. It is used to detect edges of an object. The system employs a skin detection algorithm. The skin detection performs background subtraction, computes the convex hull, and the centroid to assist in the detection process. Recognition is a process of gesture classification. Template matching classifies each hand gesture in real-time. The system was tested using various experiments. The results obtained show that time, distance, and light are factors that affect the rate of detection and ultimately recognition. Detection rate is directly proportional to the distance of the hand from the camera. Different lighting conditions were considered. The more the light intensity, the faster the detection rate. Based on the results obtained from this research, the applied methodologies are efficient and provide a plausible solution towards a light-weight, inexpensive system which can be used for sign language interpretation.

Keywords: canny pruning, hand recognition, machine learning, skin tracking

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Authors: Joel Rookwood

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Sports mega events have become increasingly significant in sporting, political and economic terms, with analysis often focusing on issues including resource expenditure, development, legacy and sustainability. Transnational tournaments can inspire interest from a variety of demographics, and the operational management of such events can involve contributions from a range of personnel. In addition to television audiences events also attract attending spectators, and in football contexts the temporary migration of fans from potentially rival nations and teams can present event organising committees and security personnel with various challenges in relation to crowd management. The behaviour, interaction and control of supporters has previously led to incidents of disorder and hooliganism, with damage to property as well as injuries and deaths proving significant consequences. The Heysel tragedy at the 1985 European Cup final in Brussels is a notable example, where 39 fans died following crowd disorder and mismanagement. Football disasters and disorder, particularly in the context of international competition, have inspired responses from police, law makers, event organisers, clubs and associations, including stadium improvements, legislative developments and crowd management practice to improve the effectiveness of spectator safety. The growth and internationalisation of fandom and developments in event management and tourism have seen various responses to the evolving challenges associated with hosting large numbers of visiting spectators at mega events. In football contexts ‘fan parks’ are a notable example. Since the first widespread introduction in European football competitions at the 2006 World Cup finals in Germany, these facilities have become a staple element of such mega events. This qualitative, longitudinal, multi-continent research draws on extensive semi-structured interview and observation data. As a frame of reference, this work considers football events staged before and after the development of fan parks. Research was undertaken at four World Cup finals (Japan 2002, Germany 2006, South Africa 2010 and Brazil 2014), four European Championships (Portugal 2004, Switzerland/Austria 2008, Poland/Ukraine 2012 and France 2016), four other confederation tournaments (Ghana 2008, Qatar 2011, USA 2011 and Chile 2015), and four European club finals (Istanbul 2005, Athens 2007, Rome 2009 and Basle 2016). This work found that these parks are typically temporarily erected, specifically located zones where supporters congregate together irrespective of allegiances to watch matches on large screens, and partake in other forms of organised on-site entertainment. Such facilities can also allow organisers to control the behaviour, confine the movement and monitor the alcohol consumption of supporters. This represents a notable shift in policy from previous football tournaments, when the widely assumed causal link between alcohol and hooliganism which frequently shaped legislative and police responses to disorder, also dissuaded some authorities from permitting fans to consume alcohol in and around stadia. It also reflects changing attitudes towards modern football fans. The work also found that in certain contexts supporters have increasingly engaged with such provision which impacts fan behaviour, but that this is relative to factors including location, facilities, management and security.

Keywords: event, facility, fan, management, park

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Authors: Faozia A. S. Abuhtana, Yahia S. Abujnah, Said O. Gnann

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Ultra High Temperature (UHT) processed milk is widely distributed and preferred in numerous countries all over the world due its relatively high quality and long shelf life. Because of the notable high consumption rate of UHT in Libya in addition to negligible studies related to such product on the local level, this study was designed to assess the shelf life of locally produced as well as imported reconstituted sterilized whole milk samples marketed in Tripoli, Libya . Four locally produced vs. three imported brands were used in this study. All samples were stored at room temperature (25± 2C ) for 8 month long period, and subjected to physical, chemical, microbiological and sensory tests. These tests included : measurement of pH, specific gravity, percent acidity, and determination of fat, protein and melamine content. Microbiological tests included total aerobic count, total psychotropic bacteria, total spore forming bacteria and total coliform counts. Results indicated no detection of microbial growth of any type during the study period, in addition to no detection of melamine in all samples. On the other hand, a gradual decline in pH accompanied with gradual increase in % acidity of both locally produced and imported samples was observed. Such changes in both pH and % acidity reached their lowest and highest values respectively during the 24th week of storage. For instance pH values were (6.40, 6.55, 6.55, 6.15) and (6.30, 6.50, 6.20) for local and imported brands respectively. On the other hand, % acidity reached (0.185, 0181, 0170, 0183) and (0180, 0.180, 0.171) at the 24th week for local and imported brands respectively. Similar pattern of decline was also observed in specific gravity, fat and protein content in some local and imported samples especially at later stages of the study. In both cases, some of the recorded pH values, % acidity, sp. gravity and fat content were in violation of the accepted limits set by Libyan standard no. 356 for sterilized milk. Such changes in pH, % acidity and other UHT sterilized milk constituents during storage were coincided with a gradual decrease in the degree of acceptance of the stored milk samples of both types as shown by sensory scores recorded by the panelists. In either case degree of acceptance was significantly low at late stages of storage and most milk samples became relatively unacceptable after the 18th and 20th week for both untrained and trained panelists respectively.

Keywords: UHT milk, shelf life, quality, gravity, bacteria

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Authors: Dragos Dragomir-Stanciu, Leon Marsh

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Background As a response to the gaps identified in recent research in the provision of residential care to address co-occurring health needs, including mental health problems and complexities Gamble Aware has facilitated the possibility to provide a new service which would extend the NGTS provision of residential rehabilitation for gambling disorder with complex and co-morbid presentation. Gordon Moody, together with Adferiad have been successful in securing the tender for this service and this presentation aims to introduce FOLD, the resulting model of treatment developed for the delivery of the service. Setting As a partnership, we have come together to coproduce a model which allows us to share our clinical and industry knowledge and build on our reputations as trusted treatment providers. The presentation will outline our expertise share in development of a unified approach to recovery-oriented models of care, clinical governance, risk assessment and management and aftercare and continuous recovery. We will also introduce our innovative specialist referral portal which will offer referring partners the ability to include the service user in planning their own recovery journey. Outcomes Our collaboration has resulted in the development of the FOLD model which includes three agile and flexible treatment packages aimed at offering the most enhanced and comprehensive treatment in UK, to date, for those most affected by gambling harm. The paper will offer insight into each treatment package and all recovery model stages involved, as well as into the partnership work with NGST providers, local mental health and social care providers and lived experience organisation that will enable us to offer support to more 100 people a year who would otherwise get “lost in the system”. Conclusion FOLD offers a great opportunity to develop, implement and evaluate a new, much needed, whole-person and whole-system approach to counter gambling related harms.

Keywords: gambling treatment, partnership working, integrated care pathways, NGTS, complex needs

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Authors: Lan Luo, Jingjing Huang, Huafang Li

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Introduction: Distressing low sexual desire is common in China, while the lack of reliable and valid instruments to evaluate symptoms of hypoactive sexual desire disorder (HSDD) impedes related research and clinical services. Aim: This study aimed to validate the reliability and validity of the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) in Chinese female HSDD patients. Methods: We administered FSFI and FSDS-DAO in a convenient sample of Chinese adult women. Participants were diagnosed by a psychiatrist according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). Results: We had a valid analysis sample of 279 Chinese women, of which 107 were HSDD patients. The Cronbach's α of FSFI and FSDS-DAO were 0.947 and 0.956, respectively, and the intraclass correlation coefficients of which were 0.86 and 0.89, respectively (the interval was 13-15 days). The correlation coefficient between the Revised Adult Attachment Scale (RAAS) and FSFI (or FSDS-DAO) did not exceed 0.4; the area under the receiver operating characteristic (ROC) curve was 0. 83 when combined FSFI-d (the desire domain of FSFI) and FSDS-DAO to diagnose HSDD, which was significantly different from that of using these scales individually. FSFI-d of less than 2.7 (1.2-6) and FSDS-DAO of no less than 15 (0-60) (Sensitivity 65%, Specificity 83%), or FSFI-d of no more than 3.0 (1.2-6) and FSDS-DAO of no less than 14 (0-60) (Sensitivity 74%, Specificity 77%) can be used as cutoff scores in clinical research or outpatient screening. Clinical implications: FSFI (including FSFI-d) and FSDS-DAO are suitable for the screening and evaluation of Chinese female HSDD patients of childbearing age. Strengths and limitations: Strengths include a thorough validation of FSFI and FSDS-DAO and the exploration of the cutoff score combing FSFI-d and FSDS-DAO. Limitations include a small convenience sample and the requirement of being sexually active for HSDD patients. Conclusion: FSFI (including FSFI-d) and FSDS-DAO have good internal consistency, test-retest reliability, construct validity, and criterion validity in Chinese female HSDD patients of childbearing age.

Keywords: sexual desire, sexual distress, hypoactive sexual desire disorder, scale

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Authors: Parth Mehta, Vedasri Bai Khavala, Prabhu Rajagopal, Tiju Thomas

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There is an increasing need for alternative clean fuels, and hydrogen (H₂) has long been considered a promising solution with a high calorific value (142MJ/kg). However, the storage of H₂ and expensive processes for its generation have hindered its usage. Sodium borohydride (NaBH₄) can potentially be used as an economically viable means of H₂ storage. Thus far, there have been attempts to optimize the life of NaBH₄ (half-life) in aqueous media by stabilizing it with sodium hydroxide (NaOH) for various pH values. Other reports have shown that H₂ yield and reaction kinetics remained constant for all ratios of H₂O to NaBH₄ > 30:1, without any acidic catalysts. Here we highlight the importance of pH and H₂O: NaBH₄ ratio (80:1, 40:1, 20:1 and 10:1 by weight), for NaBH₄ stabilization (half-life reaction time at room temperature) and corrosion minimization of H₂ reactor components. It is interesting to observe that at any particular pH>10 (e.g., pH = 10, 11 and 12), the H₂O: NaBH₄ ratio does not have the expected linear dependence with stability. On the contrary, high stability was observed at the ratio of 10:1 H₂O: NaBH₄ across all pH>10. When the H₂O: NaBH₄ ratio is increased from 10:1 to 20:1 and beyond (till 80:1), constant stability (% degradation) is observed with respect to time. For practical usage (consumption within 6 hours of making NaBH₄ solution), 15% degradation at pH 11 and NaBH₄: H₂O ratio of 10:1 is recommended. Increasing this ratio demands higher NaOH concentration at the same pH, thus requiring a higher concentration or volume of acid (e.g., HCl) for H₂ generation. The reactions are done with tap water to render the results useful from an industrial standpoint. The observed stability regimes are rationalized based on complexes associated with NaBH₄ when solvated in water, which depend sensitively on both pH and NaBH₄: H₂O ratio.

Keywords: hydrogen, sodium borohydride, stability optimization, H₂O:NaBH₄ ratio

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Authors: Amadou Fall Dia, Maurras Ulbricht Togbe, Aliou Boly, Zakia Kazi Aoul, Elisabeth Metais

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Existing RDF (Resource Description Framework) Stream Processing (RSP) systems allow continuous processing of RDF data issued from different application domains such as weather station measuring phenomena, geolocation, IoT applications, drinking water distribution management, and so on. However, processing window phase often expires before finishing the entire session and RSP systems immediately delete data streams after each processed window. Such mechanism does not allow optimized exploitation of the RDF data streams as the most relevant and pertinent information of the data is often not used in a due time and almost impossible to be exploited for further analyzes. It should be better to keep the most informative part of data within streams while minimizing the memory storage space. In this work, we propose an RDF graph summarization system based on an explicit and implicit expressed needs through three main approaches: (1) an approach for user queries (SPARQL) in order to extract their needs and group them into a more global query, (2) an extension of the closeness centrality measure issued from Social Network Analysis (SNA) to determine the most informative parts of the graph and (3) an RDF graph summarization technique combining extracted user query needs and the extended centrality measure. Experiments and evaluations show efficient results in terms of memory space storage and the most expected approximate query results on summarized graphs compared to the source ones.

Keywords: centrality measures, RDF graphs summary, RDF graphs stream, SPARQL query

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Authors: Sakshi Chopra, Harsimarpreet Kaur, Ashima Nehra

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Objectives: Malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of secondary gains or motives, which may include financial compensation; avoiding work; getting lighter criminal sentences; or simply to attract attention or sympathy. Malingering is different from somatization disorder and factitious disorder. The prevalence of malingering is unknown and difficult to determine. In an estimated study in forensic population, it can reach up to 17% cases. But the accuracy of such estimates is questionable as successful malingerers are not detected and thus, not included. Methods: The case study of a 58 years old, right handed, graduate, pre-morbidly working in a national company with reported history of stroke leading to head injury; cerebral infarction/facial palsy and dementia. He was referred for disability certification so that his job position can be transferred to his son as he could not work anymore. A series of Neuropsychological tests were administered. Results: With a mental age of < 2.5 years; social adaptive functioning was overall < 20 showing profound Mental Retardation, less than 1 year social age in abilities of self-help, eating, dressing, locomotion, occupation, communication, self-direction, and socialization; severely impaired verbal and performance ability, 96% impairment in Activities of Daily Living, with an indication of very severe depression. With inconsistent and fluctuating medical findings and problem descriptions to different health professionals forming the board for his disability, it was concluded that this patient was malingering. Conclusions: Even though it can be easily defined, malingering can be very challenging to diagnosis. Cases of malingering impose a substantial economic burden on the health care system and false attribution of malingering imposes a substantial burden of suffering on a significant proportion of the patient population. Timely, tactful diagnosis and management can help ease this patient burden on the healthcare system. Malingering can be detected by only trained mental health professionals in the clinical setting.

Keywords: disability, India, malingering, neuropsychological assessment

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Authors: Jessica Neri, Elena Faccio

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In Europe, except for Denmark and Malta, the legal gender change and the stages of the possible process of gender transition are bound to the diagnosis of a gender identity disorder. The requirement of the evaluation of a mental disorder might have many implications on trans people’s self-representations, interpersonal relations in different social contexts and the therapeutic relations with clinicians during the transition. Psychopathological language may contribute to define the individual’s reality from normative presuppositions with value implications related to the dominant cultural principles. In an effort to mark the boundaries between sanity and pathology, it concurs to the definition of the management procedures of the constructed diversities and deviances, legitimizing the operational practices of particular professional figures. The aim of this research concerns the analysis of the diagnostic category of gender dysphoria contained in the last edition of the Diagnostic and Statistical Manual of Mental Disorders. In particular, this study focuses on the relationship between the implicit and explicit assumptions related to the expressions of gender non-conformity, that sustain the language and the criteria characterizing the Manual, and the possible implications on people’s narratives of transition. In order to achieve this objective two main research methods were used: historical reconstruction of the diagnostic category in the different versions of the Manual and content analysis of that category in the present version. From the historical analysis, in the medical and psychiatric field gender non-conformity has been predominantly explicated by naturalistic perspectives, naming it ‘transsexualism’ and collocating it in the category of gender identity disorder. Currently, pathological judged experiences are represented by gender dysphoria, described in the DSM-5 as the distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender, specifying that there must be ‘evidence’ of this. Implicit theories about gender binary, parallelism between gender identity, sex and sexuality and the understanding of the mental health and the subject’s agency as subordinated to the expert knowledge, can be found in the process of designation of the category. A lack of awareness of the historical, social and political aspects connected to the cultural and normative dimensions at the basis of these implicit theories, can be noticed and data given by culture and data given by supposed -biological or psychological- nature, are often confused. This reductionist interpretation of gender and its presumed diversities legitimize the clinician to assume the role of searching and orienting, in a correctional perspective, the biographical elements that correspond to him specific expectations, with no space for other possibilities and identity configurations for people in transition. This research may contribute to the current critical debate about the epistemological foundation of the psychodiagnosis, emphasizing the pragmatic effects on the individuals and on the psychological practice in its wider social context. This work also permits to underline the risks due to the lack of awareness of the processes of social construction of the diagnostic system and its essential role of defence of the values that hold up the symbolic universe of reference.

Keywords: diagnosis, gender dysphoria, narratives, social constructionism

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Authors: Helen Coronel, Will Brewer, Peggy Bergeron, Clarissa Hall, Victoria Casson

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Simulation-based training provides the nurse practitioner (NP) student with a safe and controlled environment in which they can practice a real-life scenario. This type of learning fosters critical thinking skills essential to practice. The expectation of this study was that students would have an increase in their competency and confidence after performing the simulation. Approximately 8.4% of Americans suffer from depression. The state of Alabama is ranked 47th out of 50 for access to mental health care. As a result of this significant shortage of mental health providers, primary care providers are frequently put in the position of screening for and treating mental health conditions, such as depression. Family nurse practitioners are often utilized as primary care providers, making their ability to assess, diagnose and treat these disorders a necessary skill. The expected outcome of this simulation is an increase in confidence, competency and the empowerment of the nurse practitioner student’s ability to assess, diagnose and treat a common mood disorder they may encounter in practice. The Kirkpatrick Module was applied for this study. A non-experimental design using descriptive statistical analysis was utilized. The simulation was based on a common psychiatric mood disorder frequently observed in primary care and mental health clinics. Students were asked to watch a voiceover power point presentation prior to their on-campus simulation. The presentation included training on the assessment, diagnosis, and treatment of a patient with depression. Prior to the simulation, the students completed a pre-test, then participated in the simulation, and completed a post-test when done. Apple iPads were utilized to access a simulated health record. Major findings of the study support an increase in students’ competency and confidence when assessing, diagnosing, and treating an adult patient with depression.

Keywords: advanced practice, nurse practitioner, simulation, primary care, depression

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