Search results for: cognitive functions

Authors: Breanna Wright, Peter Bragge

Abstract:

Diagnostic error rates in healthcare are approximately 10% of cases. Diagnostic errors can cause patient harm due to inappropriate, inadequate or delayed treatment, and such errors contribute heavily to medical liability claims globally. Therefore, addressing diagnostic error is a high priority. In most cases, diagnostic errors are the result of faulty information synthesis rather than lack of knowledge. Specifically, the majority of diagnostic errors involve cognitive factors, and in particular, cognitive biases. Emergency Departments are an environment with heightened risk of diagnostic error due to time and resource pressures, a frequently chaotic environment, and patients arriving undifferentiated and with minimal context. This project aimed to develop a behavioural, evidence-informed intervention to reduce diagnostic error in Emergency Departments through co-design with emergency physicians, insurers, researchers, hospital managers, citizens and consumer representatives. The Forum Process was utilised to address this aim. This involves convening a small (4 – 6 member) expert panel to guide a focused literature and practice review; convening of a 10 – 12 person citizens panel to gather perspectives of laypeople, including those affected by misdiagnoses; and a 18 – 22 person structured stakeholder dialogue bringing together representatives of the aforementioned stakeholder groups. The process not only provides in-depth analysis of the problem and associated behaviours, but brings together expertise and insight to facilitate identification of a behaviour change intervention. Informed by the literature and practice review, the Citizens Panel focused on eliciting the values and concerns of those affected or potentially affected by diagnostic error. Citizens were comfortable with diagnostic uncertainty if doctors were honest with them. They also emphasised the importance of open communication between doctors and patients and their families. Citizens expect more consistent standards across the state and better access for both patients and their doctors to patient health information to avoid time-consuming re-taking of long patient histories and medication regimes when re-presenting at Emergency Departments and to reduce the risk of unintentional omissions. The structured Stakeholder Dialogue focused on identifying a feasible behavioural intervention to review diagnoses in Emergency Departments. This needed to consider the role of cognitive bias in medical decision-making; contextual factors (in Victoria, there is a legislated 4-hour maximum time between ED triage and discharge / hospital admission); resource availability; and the need to ensure the intervention could work in large metropolitan as well as small rural and regional ED settings across Victoria. The identified behavioural intervention will be piloted in approximately ten hospital EDs across Victoria, Australia. This presentation will detail the findings of all review and consultation activities, describe the behavioural intervention developed and present results of the pilot trial.

Keywords: behavioural intervention, cognitive bias, decision-making, diagnostic error

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Authors: Ali E. Abbas

Abstract:

This paper highlights some of the normative issues that might result by setting independent thresholds in risk analyses and particularly with safety regions. A second objective is to explain how such regions can be specified appropriately in a meaningful way. We start with a review of the importance of setting deterministic trade-offs among target requirements. We then show how to determine safety regions for risk analysis appropriately using utility functions.

Keywords: decision analysis, thresholds, risk, reliability

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Authors: Lisa Robins, Jill Newby, Kay Wilhelm, Therese Fletcher, Jessica Smith, Trevor Ma, Adam Finch, Lesley Campbell, Jerry Greenfield, Gavin Andrews

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Background:Depression treatment for people living with depression comorbid with diabetes is of critical importance for improving quality of life and diabetes self-management, however depression remains under-recognised and under-treated in this population. Cost—effective and accessible forms of depression treatment that can enhance the delivery of mental health services in routine diabetes care are needed. Provision of internet-delivered Cognitive Behaviour Therapy (iCBT) provides a promising way to deliver effective depression treatment to people with diabetes. Aims:To explore the outcomes of the clinician assisted iCBT program for people with comorbid Major Depressive Disorder (MDD) and diabetes compared to those who remain under usual care. The main hypotheses are that: (1) Participants in the treatment group would show a significant improvement on disorder specific measures (Patient Health Questionnaire; PHQ-9) relative to those in the control group; (2) Participants in the treatment group will show a decrease in diabetes-related distress relative to those in the control group. This study will also examine: (1) the effect of iCBT for MDD on disability (as measured by the SF-12 and SDS), general distress (as measured by the K10), (2) the feasibility of these treatments in terms of acceptability to diabetes patients and practicality for clinicians (as measured by the Credibility/Expectancy Questionnaire; CEQ). We hypothesise that associated disability, and general distress will reduce, and that patients with comorbid MDD and diabetes will rate the program as acceptable. Method:Recruit 100 people with MDD comorbid with diabetes (either Type 1 or Type 2), and randomly allocate to: iCBT (over 10 weeks) or treatment as usual (TAU) for 10 weeks, then iCBT. Measure pre- and post-intervention MDD severity, anxiety, diabetes-related distress, distress, disability, HbA1c, lifestyle, adherence, satisfaction with clinicians input and the treatment. Results:Preliminary results comparing MDD symptom levels, anxiety, diabetes-specific distress, distress, disability, HbA1c levels, and lifestyle factors from baseline to conclusion of treatment will be presented, as well as data on adherence to the lessons, homework downloads, satisfaction with the clinician's input and satisfaction with the mode of treatment generally.

Keywords: cognitive behaviour therapy, depression, diabetes, internet

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Authors: Albert Perez-Bellmunt, Eila Rivera, Aida Valls, Berta Estragues, Sara Ortiz, Roberto Seijas, Pedro Alvarez

Abstract:

INTRODUCTION: Physical and sports activity on a regular basis present numerous health benefits such as the prevention of cardiovascular and metabolic diseases. Also, there is a relation between sport and the psychological or the cognitive process of children and young people. The objective of the present study is to know if the sports practice has any positive influence on the university academic performance. MATERIALS AND METHODS: The level of the physical activity of 220 students of different degrees in health science was evaluated and compared with the academic results (grades). To assess the level of physical and sports activity, the Global Physical Activity Questionnaire (to calculate the sporting level in a general way) and the International Physical Activity Questionnaire (to estimate the physical activity carried out during the days leading up to the academic exams) were used. RESULTS: The students that realized an average level of sports activity the days before the exam obtained better grades than the rest of their classmate and the result was statistically significant. Controversially, if the sports level was analyzed in a general way, no relationship was observed between academic performance and the level of sport realized. CONCLUSION: A moderate physical activity, on the days leading up to an assessment, can be a positive factor for the university academic performance. Despite the fact that a regular sports activity improves many cognitive and physiological processes, the present study did not observe a direct relationship between sport/physical activity and academic performance.

Keywords: academic performance, academic results, global physical activity questionnaire, physical activity questionnaire, sport, sport practice

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Authors: Jin Hun Choi, So Hyun Ahn, Seong Keun Wang, Ik-Seung Chee, Jung Lan Kim, Sun Woo Lee

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Objectives: The purpose of the study is to investigate the effects of day hospital care in hospitalized schizophrenic patients in terms of treatment adherence and treatment outcomes. Methods: Among schizophrenic patients hospitalized between 2011 and 2012, 23 day hospital care patient and 40 control subjects were included in the study. All candidates underwent Beck Cognitive Insight Scale, Drug Attitude Inventory, World Health Organization Quality of Life Assessment and Psychological Well-Being Scale when their symptoms were stabilized during hospitalization, and after being discharged, 23 patients received day hospital care for two months and then changed to out-patient care while 40 patients received out-patient care immediately after discharge. At the point of two months of out-patient care, the treatment adherence of the two groups was evaluated; tracking observation was performed until February, 2013, and survival rates were compared between the two groups. Results: Treatment adherence was higher in the day hospital care group than in the control group. Kaplan-Meier survival analysis showed a higher survival rate for the day hospital care group compared to the control group. Levels of cognitive insight and quality of life were higher after day hospital care than before day hospital care in the day hospital care group. Conclusions: Through the study, it was confirmed that when hospitalized schizophrenic patients received continuous day hospital care after being discharged, they received further out-patient care more faithfully. The study is considered to aid in the understanding regarding schizophrenic patients’ treatment adherence issues and improvement of treatment outcomes.

Keywords: schizophrenia, day hospital care, adherence, outcomes

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Authors: Gursimran Jandu, Melissa Nelson, Mia Ingram, Hana Jalal

Abstract:

There is a significant overlap between autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD), with up to 90% of young people diagnosed with ASD having this co-morbidity. Distinguishing between the symptoms of the two leads to issues with accurate treatment, yet this is paramount in benefiting the young person. There are two distinct methods of treatment, psychological or pharmacological, with clinicians tending to choose one or the other, potentially due to the lack of research available. This report reviews the efficacy of psychological and pharmacological treatments for young people diagnosed with ASD and co-morbid OCD. A literature review was performed on papers from the last fifteen years including ‘ASD’, ‘OCD’ and individuals under the age of 18. Eleven papers were selected as relevant. The report looks at the comparison between more traditional methods, such as selective-serotonin-reuptake-inhibitors (SSRI) and Cognitive behaviour therapy (CBT), and newer therapies, such as modified or intensive ASD focused psychotherapies, and the use of other medication classes. On reviewing the data, it was identified that there was a distinct lack of information on this important topic. The most widely used treatment was medication such as Fluoxetine, an SSRI, which rarely showed improvement in symptoms or outcomes. This is in contrast to modified forms of CBT which often reduces symptoms or even results in OCD remission. With increased research into non-traditional management of these co-morbid conditions, it is clear there is scope that modified CBT may become the future treatment of choice for OCD in young people with ASD.

Keywords: autism spectrum disorder, intensive or adapted cognitive behavioural therapy, obsessive compulsive disorder, pharmacological management

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Authors: Edison Bicudo

Abstract:

Cell and gene therapies (CGTs) result from the intense manipulation of cells or the use of techniques such as gene editing. They have been increasingly used to tackle rare diseases or conditions of genetic origin, such as cancer. One might expect such a complex scientific field to be dominated by scientific findings and evidence-based explanations. However, people engaged in scientific argumentation also mobilize a range of cognitive operations of which they are not fully aware, in addition to drawing on widely available oral traditions. This paper analyses how experts discussing the potentialities and challenges of CGTs have recourse to a particular kind of prototypical myth. This sociology study, conducted at the University of Sussex (UK), involved interviews with scientists, regulators, and entrepreneurs involved in the development or governance of CGTs. It was observed that these professionals, when voicing their views, sometimes have recourse to narratives where CGTs appear as promising tools for alleviating or curing diseases. This is said to involve much personal, scientific, and financial sacrifice. In his study of traditional narratives, Hogan identified three prototypes: the romantic narrative, moved by the ideal of romantic union; the heroic narrative, moved by the desire for political power; and the sacrificial narrative, where the ideal is plenty, well-being, and health. It is argued here that discourses around CGTs often involve some narratives – or myths – that have a sacrificial nature. In this sense, the development of innovative therapies is depicted as a huge sacrificial endeavor involving biomedical scientists, biotech and pharma companies, and decision-makers. These sacrificial accounts draw on oral traditions and benefit from an emotional intensification that can be easily achieved in stories of serious diseases and physical suffering. Furthermore, these accounts draw on metaphorical understandings where diseases and vectors of diseases are considered enemies or invaders while therapies are framed as shields or protections. In this way, this paper aims to unravel the cognitive underpinnings of contemporary science – and, more specifically, biomedicine – revealing how myths, prototypes, and metaphors are highly operative even when complex reasoning is at stake. At the same time, this paper demonstrates how such hidden cognitive operations underpin the construction of powerful ideological discourses aimed at defending certain ways of developing, disseminating, and governing technologies and therapies.

Keywords: cell and gene therapies, myths, prototypes, metaphors

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Authors: Mariana Calderón, Rocío Murad, Natalia Acevedo, Laura León, Juliana Fonseca, Maria de los Angeles Balaguera Villa

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Recently, different countries and international organizations have put on their agenda the elimination of violence against people with disabilities. This research aims to evaluate the social dimensions of sexual violence against people with disabilities, particularly those with psychosocial and cognitive, in Colombia. Results reveal that 55% of people with disabilities that are survivors of sexual violence are younger than 29 years and 20,4 are people with cognitive and psychosocial disabilities. Colombian regions with better social positions presented more cases of sexual violence against people with disabilities. There were found access barriers for health, education and employment among this population, and there was also found poor data quality. Despite Colombia having an important normative framework aimed at preventing and attending to gender-based violence, it does not take into account people with disabilities specific needs. Additionally, it was found an insufficient implementation and appropriation of these norms, negative attitudes, and in general, a lack of service adaptation according to the needs, identities and circumstances of people with disabilities. Furthermore, among the factors that are exposing people with disabilities to sexual violence, it was found that family members tend to be the main aggressors, there are deep gaps in the sex education received by people with disabilities, imaginaries and perceptions about their sexuality are both hypersexualizing and presenting them as asexual. On the other hand, among protective factors, there were found body self-knowledge and conscience, acknowledgment of their sexuality and their sexual and reproductive rights and access to sex ed. Although during the last few years, there has occurred a positive change toward social inclusion of people with disabilities, specifically through their role in the political agenda and the recognition of their rights. More work is needed in order to guarantee their sexual and reproductive rights, particularly for persons with psychosocial and cognitive disabilities. This research results showed the importance of transforming persisting negative imaginaries about their sexuality and also enforcing and promoting their autonomy. In this sense, it is important to acknowledge gaps and barriers faced by them and create strategies to encourage their social inclusion through education, employment, and skill development. Nevertheless, it is necessary to keep contributing new evidence of the social determinants of health that are influencing the occurrence of sexual violence. This research understands sexual violence against people with disabilities in a multidimensional manner and offers the following recommendations: 1- To foment public sensitization and understanding of disabilities. 2- To increase parents, caregivers and officers’ commitment to the prevention and reduction of sexual violence. 3- To focus on the needs, identities and circumstances of people with disabilities.

Keywords: disabilities, sexual and reproductive rights, sexual violence, prevention

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Authors: Vineesh Amin, Ananya Agrawal

Abstract:

In a prolonged period of uncertainty and disruptions in the pre-said normal order, non-cognitive skills, especially entrepreneurial mindsets, have become a pillar that can reform the educational models to inform the economy. Dreamverse Learning Lab’s IVR-based storytelling program -Call-a-Kahaani- is an evolving experiment with an aim to kindle entrepreneurial mindsets in the remotest locations of India in an accessible and engaging manner. At the heart of this experiment is the belief that at every phase in our life’s story, we have a choice which brings us closer to achieving our true potential. This interactive program is thus designed using real-time storytelling principles to empower learners, ages 24 and below, to make choices and take decisions as they become more self-aware, practice grit, try new things through stories, guided activities, and interactions, simply over a phone call. This research paper highlights the framework behind an ongoing scalable, data-oriented, low-tech program to kindle entrepreneurial mindsets in media dark zones supported by iterative design and prototyping to reach 13700+ unique learners who made 59000+ calls for 183900+min listening duration to listen to content pieces of around 3 to 4 min, with the last monitored (March 2022) record of 34% serious listenership, within one and a half years of its inception. The paper provides an in-depth account of the technical development, content creation, learning, and assessment frameworks, as well as mobilization models which have been leveraged to build this end-to-end system.

Keywords: non-cognitive skills, entrepreneurial mindsets, speech interface, remote learning, storytelling

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Authors: Jansen Ang, Andrew Neo, Dawn Chia

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Border Security is unlike mainstream policing in that officers are essentially in static deployment, working round the clock every day and every hour of the year looking for illegitimate entry of persons and goods. In Singapore, Border Security officers perform multiple functions to ensure the nation’s safety and security. They are responsible for safeguarding the borders of Singapore to prevent threats from entering the country. Being the first line of defence in ensuring the nation’s border security officers are entrusted with the responsibility of screening travellers inbound and outbound of Singapore daily. They examined 99 million arrivals and departures at the various checkpoints in 2014, which is a considerable volume compared to most immigration agencies. The officers’ work scopes also include cargo clearance, protective and security functions of checkpoints. The officers work in very demanding environment which can range from the smog at the land checkpoints to the harshness of the ports at the sea checkpoints. In addition, all immigration checkpoints are located at the boundaries, posing commuting challenges for officers. At the land checkpoints, festive seasons and school breaks are peak periods as given the surge of inbound and outbound travellers at the various checkpoints. Such work provides unique challenges in comparison to other law enforcement duties. This paper assesses the current stressors faced by officers of a border security agency through the conduct of ground observations as well as a perceived stress survey as well as recommendations in combating stressors faced by border security officers. The findings from the field observations and surveys indicate organisational and operational stressors that are unique to border security and recommends interventions in managing these stressors. Understanding these stressors would better inform border security agencies on the interventions needed to enhance the resilience of border security officers.

Keywords: border security, Singapore, stress, operations

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Authors: Alice Carter, Lucy Dumbell, Lorna Cameron, Victoria Lewis

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The Olympic discipline of eventing is the triathlon of equestrian sport, consisting of dressage, cross-country and show jumping. Falls on the cross-country are common and can be serious even causing death to rider. Research identifies an increased risk of a fall with an increasing number of obstacles and for jumping efforts later in the course suggesting fatigue maybe a contributing factor. Advice based on anecdotal evidence suggests riders undertake strength and conditioning programs to improve their ‘core’, thus improving their ability to maintain and control their riding position. There is little empirical evidence to support this advice. Therefore, the aim of this study is to investigate truck muscle fatigue and cognitive function during a simulated jumping test. Eight adult riders participated in a riding test on a Racewood Event simulator for 10 minutes, over a continuous jumping programme. The SEMG activity of six trunk muscles were bilaterally measured at every minute, and normalised root mean squares (RMS) and median frequencies (MDF) were computed from the EMG power spectra. Visual analogue scales (VAS) measuring Fatigue and Pain levels and Cognitive Function ‘tapping’ tests were performed before and after the riding test. Average MDF values for all muscles differed significantly between each sampled minute (p = 0.017), however a consistent decrease from Minute 1 and Minute 9 was not found, suggesting the trunk muscles fatigued and then recovered as other muscle groups important in maintaining the riding position during dynamic movement compensated. Differences between the MDF and RMS of different muscles were highly significant (H=213.01, DF=5, p < 0.001), supporting previous anecdotal evidence that different trunk muscles carry out different roles of posture maintenance during riding. RMS values were not significantly different between the sampled minutes or between riders, suggesting the riding test produced a consistent and repeatable effect on the trunk muscles. MDF values differed significantly between riders (H=50.8, DF = 5, p < 0.001), suggesting individuals may experience localised muscular fatigue of the same test differently, and that other parameters of physical fitness should be investigated to provide conclusions. Lumbar muscles were shown to be important in maintaining the position, therefore physical training program should focus on these areas. No significant differences were found between pre- and post-riding test VAS Pain and Fatigue scores or cognitive function test scores, suggesting the riding test was not significantly fatiguing for participants. However, a near significant correlation was found between time of riding test and VAS Pain score (p = 0.06), suggesting somatic pain may be a limiting factor to performance. No other correlations were found between the factors of participant riding test time, VAS Pain and Fatigue, however a larger sample needs to be tested to improve statistical analysis. The findings suggest the simulator riding test was not sufficient to provoke fatigue in the riders, however foundations for future studies have been laid to enable methodologies in realistic eventing settings.

Keywords: eventing, fatigue, horse-rider, surface EMG, trunk muscles

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Authors: A. S. Issa, S. K. Q. AL-Omari

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In this paper, we investigate certain spaces of generalized functions for the Fourier and Fourier type integral transforms. We discuss convolution theorems and establish certain spaces of distributions for the considered integrals. The new Fourier type integral is well-defined, linear, one-to-one and continuous with respect to certain types of convergences. Many properties and an inverse problem are also discussed in some details.

Keywords: Boehmian, Fourier integral, Fourier type integral, generalized quotient

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Authors: Sergio Mauricio Pérez López, Luis Rodrigo Valencia Pérez, Juan Manuel Peña Aguilar, Adelina Morita Alexander

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The culture of continuous improvement in organizations is very important as it represents a source of competitive advantage. This article discusses the transfer of knowledge between companies which formed cross-functional teams and used a dynamic model for knowledge creation as a framework. In addition, the article discusses the structure of cognitive assets in companies and the concept of "stickiness" (which is defined as an obstacle to the transfer of knowledge). The purpose of this analysis is to show that an improvement in the attitude of individual members of an organization creates opportunities, and that an exchange of information and knowledge leads to generating continuous improvements in the company as a whole. This article also discusses the importance of creating the proper conditions for sharing tacit knowledge. By narrowing gaps between people, mutual trust can be created and thus contribute to an increase in sharing. The concept of adapting knowledge to new environments will be highlighted, as it is essential for companies to translate and modify information so that such information can fit the context of receiving organizations. Adaptation will ensure that the transfer process is carried out smoothly by preventing "stickiness". When developing the transfer process on cross-functional teams (as opposed to working groups), the team acquires the flexibility and responsiveness necessary to meet objectives. These types of cross-functional teams also generate synergy due to the array of different work backgrounds of their individuals. When synergy is established, a culture of continuous improvement is created.

Keywords: knowledge transfer, continuous improvement, teamwork, cognitive assets

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Authors: Thor Alexis Sazon, Alexander Guzman-Urbina, Yasuhiro Fukushima

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This study outlines the method of how to develop a surrogate life cycle model based on fuzzy logic using three fuzzy inference methods: (1) the conventional Fuzzy Inference System (FIS), (2) the hybrid system of Data Analytics and Fuzzy Inference (DAFIS), which uses data clustering for defining the membership functions, and (3) the Adaptive-Neuro Fuzzy Inference System (ANFIS), a combination of fuzzy inference and artificial neural network. These methods were demonstrated with a case study where the Global Warming Potential (GWP) and the Levelized Cost of Energy (LCOE) of solar photovoltaic (PV) were estimated using Solar Irradiation, Module Efficiency, and Performance Ratio as inputs. The effects of using different fuzzy inference types, either Sugeno- or Mamdani-type, and of changing the number of input membership functions to the error between the calibration data and the model-generated outputs were also illustrated. The solution spaces of the three methods were consequently examined with a sensitivity analysis. ANFIS exhibited the lowest error while DAFIS gave slightly lower errors compared to FIS. Increasing the number of input membership functions helped with error reduction in some cases but, at times, resulted in the opposite. Sugeno-type models gave errors that are slightly lower than those of the Mamdani-type. While ANFIS is superior in terms of error minimization, it could generate solutions that are questionable, i.e. the negative GWP values of the Solar PV system when the inputs were all at the upper end of their range. This shows that the applicability of the ANFIS models highly depends on the range of cases at which it was calibrated. FIS and DAFIS generated more intuitive trends in the sensitivity runs. DAFIS demonstrated an optimal design point wherein increasing the input values does not improve the GWP and LCOE anymore. In the absence of data that could be used for calibration, conventional FIS presents a knowledge-based model that could be used for prediction. In the PV case study, conventional FIS generated errors that are just slightly higher than those of DAFIS. The inherent complexity of a Life Cycle study often hinders its widespread use in the industry and policy-making sectors. While the methodology does not guarantee a more accurate result compared to those generated by the Life Cycle Methodology, it does provide a relatively simpler way of generating knowledge- and data-based estimates that could be used during the initial design of a system.

Keywords: solar photovoltaic, fuzzy logic, inference system, artificial neural networks

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Authors: Natalia V. Ursul

Abstract:

In linguistic studies, the question of nonsense is attracting increasing interest. Nonsense is usually defined as spoken or written words that have no meaning. However, this definition is likely to be outdated as any speech act is generated due to the speaker’s pragmatic reasons, thus it cannot be purely illogical or meaningless. In the current paper a new working definition of nonsense as a linguistic medium will be formulated; moreover, the pragmatic peculiarities of newly coined linguistic patterns and possible ways of their interpretation will be discussed.

Keywords: nonsense, nonse verse, pragmatics, speech act

Procedia PDF Downloads 522

Authors: Melissa Nelson, Simran Jandu, Hana Jalal, Mia Ingram, Chrysi Stefanidou

Abstract:

There is a significant overlap between autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD), with up to 90% of young people diagnosed with ASD having this co-morbidity. Distinguishing between the symptoms of the two leads to issues with accurate treatment, yet this is paramount in benefitting the young person. There are two distinct methods of treatment, psychological or pharmacological, with clinicians tending to choose one or the other, potentially due to the lack of research available. This report reviews the efficacy of psychological and pharmacological treatments for young people diagnosed with ASD and co-morbid OCD. A literature review was performed on papers from the last fifteen years, including “ASD,” “OCD,” and individuals under the age of 18. Eleven papers were selected as relevant. The report looks at the comparison between more traditional methods, such as selective serotonin reuptake inhibitors (SSRI) and cognitive behavior therapy (CBT), and newer therapies, such as modified or intensive ASD-focused psychotherapies and the use of other medication classes. On reviewing the data, it was identified that there was a distinct lack of information on this important topic. The most widely used treatment was medication such as Fluoxetine, an SSRI, which rarely showed an improvement in symptoms or outcomes. This is in contrast to modified forms of CBT, which often reduces symptoms or even results in OCD remission. With increased research into the non-traditional management of these co-morbid conditions, it is clear there is scope that modified CBT may become the future treatment of choice for OCD in young people with ASD.

Keywords: autism spectrum disorder, intensive or adapted cognitive behavioral therapy, obsessive compulsive disorder, pharmacological management

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Authors: Andras Dezső, Peter Baumli, George Kaptay

Abstract:

The phosphorous is the important components in the steels, because it makes the changing of the mechanical properties and possibly modifying the structure. The phosphorous can be create the Fe3P compounds, what is segregated in the ferrite grain boundary in the intervals of the nano-, or microscale. This intermetallic compound is decreasing the mechanical properties, for example it makes the blue brittleness which means that the brittle created by the segregated particles at 200 ... 300°C. This work describes the phosphide solubility by the other components effect. We make calculations for the Ni, Mo, Cu, S, V, C, Si, Mn, and the Cr elements by the Thermo-Calc software. We predict the effects by approximate functions. The binary Fe-P system has a solubility line, which has a determinating equation. The result is below: lnwo = -3,439 – 1.903/T where the w0 means the weight percent of the maximum soluted concentration of the phosphorous, and the T is the temperature in Kelvin. The equation show that the P more soluble element when the temperature increasing. The nickel, molybdenum, vanadium, silicon, manganese, and the chromium make dependence to the maximum soluted concentration. These functions are more dependent by the elements concentration, which are lower when we put these elements in our steels. The copper, sulphur and carbon do not make effect to the phosphorous solubility. We predict that all of cases the maximum solubility concentration increases when the temperature more and more high. Between 473K and 673 K, in the phase diagram, these systems contain mostly two or three phase eutectoid, and the singe phase, ferritic intervals. In the eutectoid areas the ferrite, the iron-phosphide, and the metal (III)-phospide are in the equilibrium. In these modelling we predicted that which elements are good for avoid the phosphide segregation or not. These datas are important when we make or choose the steels, where the phosphide segregation stopping our possibilities.

Keywords: phosphorous, steel, segregation, thermo-calc software

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Authors: Robinson, E. L., Freeman, E. E.

Abstract:

Over the last few decades, the social movement of involved fatherhood has stimulated a research focus on fathers, leading to an increase in the body of evidence into the paternal contributions to child development. Past research has suggested that rough-and-tumble play, which involves wrestling, chasing and tumbling, is the preferred play type of western fathers. This type of play remains underutilized and underrepresented in child developmental research as it’s perceived to be dangerous or too aggressive. The limited research available has shown a relationship between high quality rough-and-tumble play interactions, lower childhood aggression and improved child emotional regulation. The aim of this study was to examine father-child rough-and-tumble play and assess the impact on cognitive development in children aged 4-7 years. Father-child dyads completed a 10-minute rough-and-tumble play interaction, which consisted of 2 games, at the University of Newcastle. Children then completed the Wechsler Preschool & Primary Scale of Intelligence - Fourth Edition Australian and New Zealand Standardized Edition (WPPSI-IV A&NZ). Fathers reported on their involvement in various caregiving activities and on their child’s development. Analyses revealed that fathers-child play quality was positively related to working memory outcomes in children. Furthermore, the amount of rough-and-tumble play father and child did together on a regular basis was also related to working memory outcomes. While father-child play interactions remain an understudied area of research, this study outlines the importance of examining the paternal play role in children’s cognitive development.

Keywords: children, development, father, executive function

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Authors: Priyanka Bharti

Abstract:

Decades ago designs were based on common sense and tradition, but after an enhancement in visualization technology and research, we are now able to comprehend the cognitive ability involved in the decoding of the visual information. However, many fields in visuals need intense research to deliver an efficient explanation for the events. Visuals are an information representation mode through images, symbols and graphics. It plays an impactful role in decision making by facilitating quick recognition, comprehension, and analysis of a situation. They enhance problem-solving capabilities by enabling the processing of more data without overloading the decision maker. As research proves that, visuals offer an improved learning environment by a factor of 400 compared to textual information. Visual information engages learners at a cognitive level and triggers the imagination, which enables the user to process the information faster (visuals are processed 60,000 times faster in the brain than text). Appropriate information, visualization, and its presentation are known to aid and intensify the decision-making process for the users. However, most literature discusses the role of visual aids in comprehension and decision making during normal conditions alone. Unlike emergencies, in a normal situation (e.g. our day to day life) users are neither exposed to stringent time constraints nor face the anxiety of survival and have sufficient time to evaluate various alternatives before making any decision. An emergency is an unexpected probably fatal real-life situation which may inflict serious ramifications on both human life and material possessions unless corrective measures are taken instantly. The situation demands the exposed user to negotiate in a dynamic and unstable scenario in the absence or lack of any preparation, but still, take swift and appropriate decisions to save life/lives or possessions. But the resulting stress and anxiety restricts cue sampling, decreases vigilance, reduces the capacity of working memory, causes premature closure in evaluating alternative options, and results in task shedding. Limited time, uncertainty, high stakes and vague goals negatively affect cognitive abilities to take appropriate decisions. More so, theory of natural decision making by experts has been understood with far more depth than that of an ordinary user. Therefore, in this study, the author aims to understand the role of visual aids in supporting rapid comprehension to take appropriate decisions during an emergency situation.

Keywords: cognition, visual, decision making, graphics, recognition

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Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda

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Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.

Keywords: delirium, risk factors, outcome, intervention

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Authors: Shao-Ying Wang, Shin-I Shih, Chi-Cheng Wu

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Background: By following to the maturity theory about age, the manifestation of depression in different age groups under occupational stressors still remains unclear. Therefore, the aim of this study was to examine the depression within four main symptoms clusters: cognition, affect, physical complaints and interpersonal difficulty among the different age groups. Additionally, this study also used the stress appraisal theory, through the examination of challenge and hindrance appraisals, the effects of cognitive factors were expected to give therapeutic indication for the future treatment of depression under abusive leadership. Methods (Participants and Procedure): The data were collected in two waves from employees of local companies in Taiwan. The participants (58 males and 167 females) were native Chinese speakers, ranging in age from 20 to 59 years (M= 36.51). Up to 80% educational level of participants were above senior high. The married population was approximately at 43%. Measures; 1. Abusive Leadership: To measure abusive leadership, we used 15-item scale of abusive supervision which anchored on a 7-point Likert-type scale. (α= .96) 2. Depression: We used Taiwanese Depression Scale to measure the 4 clusters (cognition, affect, physical complaints and interpersonal difficulty) of symptoms. Participants responded for depression anchored on a 7-point Likert-type scale (α= .96). 3. Stress Appraisal Scale: To measure challenge and hindrance types of appraisal, participants responded to 33-item measure anchored on a 7-point Likert-type scale. (Challenge appraisal; α= .90; hindrance appraisal α= .87). Results: The results of correlation showed that there was a significant and negative correlation between abusive leadership and age (r = - .21, p < .01). Abusive leadership was positive correlated significantly with hindrance appraisal (r = .52, p < .01) and depression (r = .20, p < .01). The results also showed that hindrance appraisal was correlated to depression positively (r = .36, p < .01). A one-way ANOVA was conducted to compare the effect of lower/middle/order age groups on each cluster of depressive symptoms. The results showed that the effect of age groups on cognition was significant F (2, 157) =3.66, P < .05. Older age group (M=13.43 SD=6.84) reported less cognitive symptoms of depression than the middle (M=16.77 SD=7.49) and lower age (M=16.91 SD=6.97) groups. Besides, the effect of age groups on affect was also significant F (2,157)= 4.09 P < .05. Older age group (M=18.68 SD=8.98) reported less affective symptoms of depression than the middle (M=22.01 SD=7.96) and lower age (M=23.56 SD=7.67) groups. Moreover, the main effect of hindrance appraisal was found F (2, 157) =3.81, P < .05. Older age group (M=9.44 SD=2.89) reported fewer score on hindrance appraisals than the middle (M=11.06 SD=4.02) and lower age (M=9.62 SD=3.17) groups. To conclude, the severity of depression symptoms varies across different age groups. Maturity seems to be the protective factor to depression, accompanying with lower hindrance appraisals.

Keywords: abusive leadership, affective commitment, depression symptoms, psychological well-being

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Authors: Stefana Francisca Lupu, Jasmin Chantah, Mara Krone, Ingo Roden, Stephan Bongard, Gunter Kreutz

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Long-term music interventions could enhance both musical and nonmusical skills. The present study was designed to explore cognitive, socio-emotional, and musical development in a longitudinal setting. Third-graders (N = 184: 87 male, 97 female; mean age = 8.61 years; 115 native German and 69 migrant children) were randomly assigned to two intervention groups (music and maths) and a control group over a period of one school-year. At baseline, children in these groups were similar in basic cognitive skills, with a trend of advantage in the control group. Dependent measures included the culture fair intelligence test CFT 20-R; the questionnaire of emotional and social school experience for grade 3 and 4 (FEESS 3-4), the test of resources in childhood and adolescence (FRKJ 8-16), the test of language proficiency for German native and non-native primary school children (SFD 3), the reading comprehension test (ELFE 1-6), the German math test (DEMAT 3+) and the intermediate measures of music audiation (IMMA). Data were collected two times at the beginning (T1) and at the end of the school year (T2). A third measurement (T3) followed after a six months retention period. Data from baseline and post-intervention measurements are currently being analyzed. Preliminary results of all three measurements will be presented at the conference.

Keywords: musical training, primary-school German and migrant children, socio-emotional skills, transfer

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Authors: Slava Kalyuga

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There are two opposing major points of view on the optimal degree of initial instructional guidance that is usually discussed in the literature by the advocates of the corresponding learning approaches. Using unguided or minimally guided problem-solving tasks prior to explicit instruction has been suggested by productive failure and several other instructional theories, whereas an alternative approach - using fully guided worked examples followed by problem solving - has been demonstrated as the most effective strategy within the framework of cognitive load theory. An integrated approach discussed in this paper could combine the above frameworks within a broader theoretical perspective which would allow bringing together their best features and advantages in the design of learning tasks for STEM education. This paper represents a systematic review of the available empirical studies comparing the above alternative sequences of instructional methods to explore effects of several possible moderating factors. The paper concludes that different approaches and instructional sequences should coexist within complex learning environments. Selecting optimal sequences depends on such factors as specific goals of learner activities, types of knowledge to learn, levels of element interactivity (task complexity), and levels of learner prior knowledge. This paper offers an outline of a theoretical framework for the design of complex learning tasks in STEM education that would integrate explicit instruction and inquiry (exploratory, discovery) learning approaches in ways that depend on a set of defined specific factors.

Keywords: cognitive load, explicit instruction, exploratory learning, worked examples

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Authors: N. Schneider, M. Bruchhage, M. Hartweg, G. Mutungi, J. O Regan, S. Deoni

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Observational neuroimaging studies suggest differences between breast-fed and formula-fed infants in developmental myelination, a key brain process for learning and cognitive development. However, the possible effects of a nutrient formulation on myelin development in healthy term infants in an intervention study have not been investigated. Objective was, therefore, to investigate the efficacy of a nutrient formulation with higher levels of myelin-relevant nutrients as compared to a control formulation with lower levels of the same nutrients on brain myelination and cognitive development in the first 6 months of life. The study is an ongoing randomized, controlled, double-blind, two-center, parallel-group clinical trial with a nonrandomized, non-blinded arm of exclusively breastfed infants. The current findings result from a staged statistical analysis at 6 months; the recruitment and intervention period has been completed for all participants. Follow-up visits at 12, 18 and 24 months are still ongoing. N= 81 enrolled full term, neurotypical infants of both sexes were randomized into either the investigational (N= 42) or the control group (N= 39), and N= 108 children in the breast-fed arm served as a natural reference group. The effect of a blend of docosahexaenoic acid, arachidonic acid, iron, vitamin B12, folic acid as well as sphingomyelin from a uniquely proceed whey protein concentrate enriched in alpha-lactalbumin and phospholipids in an infant nutrition product matrix was investigated. The main outcomes for the staged statistical analyses at 6 months included brain myelination measures derived from MRI. Additional outcomes were brain volume, cognitive development and safety. The full analyses set at 6 months comprised N= 66 infants. Higher levels of myelin-relevant nutrients compared to lower levels resulted in significant differences in myelin structure, volume, and rate of myelination as early as 3 and 6 months of life. The cross-sectional change of means between groups for whole-brain myelin volume was 8.4% for investigational versus control formulation (3.5% versus the breastfeeding reference) group at 3 months and increased to 36.4% for investigational versus control formulation (14.1% versus breastfeeding reference) at 6 months. No statistically significant differences were detected for early cognition scores. Safety findings were largely similar across groups. This is the first pediatric nutritional neuroimaging study demonstrating the efficacy of a myelin nutrient blend on developmental myelination in well-nourished term infants. Myelination is a critical process in learning and development. The effects were demonstrated across the brain, particularly in temporal and parietal regions, known to be functionally involved in sensory, motor and language skills. These first results add to the field of nutritional neuroscience by demonstrating early life nutrition benefits for brain architecture which may be foundational for later cognitive and behavioral outcomes. ClinicalTrials.gov Identifier: NCT03111927 (Infant Nutrition and Brain Development - Full-Text View - ClinicalTrials.gov).

Keywords: brain development, infant nutrition, MRI, myelination

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Authors: Muhammad Adamu Kwankwaso

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Early childhood is a critical period of rapid physical, cognitive and psycho-social development of a child. The quality of care and Education which a child receives at this crucial age will determine to a great extent the level of his/her physical and cognitive development in the future. In Nigeria, Early Childhood Care and Education (ECCE) is a fundamental aspect or form of Education for children between the age of 3-6. It was started after independence as pre-primary Education or early child development as contained in the 1977 National Policy on Education. The trends towards ECCE in Nigeria and the northwestern part of the country in particular keep up changing as in the case of other part of the world. The current trends are now towards expansions, inclusiveness, redefinition, early literacy, increased government participation and the unprecedented societal response and awareness towards the Education of the younger children. While all hands are on deck to ensure successful implementation of the ECCE programme, it is unfortunate that, ECCE is facing some challenges. This paper therefore, examines the trends in Early Childhood Care and Education and the major challenges in the north west of Nigeria. Some of the major challenges include, inadequate trained ECCE teachers, lack of unified curriculum, teacher pupil’s ratio, and the medium of instructions and inadequate infrastructural and teaching facilities respectively. To improve the situation the paper offered the following recommendations; establishment of more ECCE classes, enforcement for the use of mothers’ tongue or the languages of the immediate community as a medium of instructions, and adequate provision of infrastructural facilities and the unified curriculum across the northwestern States of Nigeria.

Keywords: early childhood care, education, trends, challenges

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Authors: Sidika McNeil

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Borderline personality disorder (BPD) is a personality disorder that has been found to have strong origins in childhood trauma. One of the key symptoms of BPD is an association with irregular moods swings, as well as suicidal ideation (SI). Owing to the typically severe trauma patients experience during childhood, it is hard for them to control their emotions and thus makes it hard to emotionally regulate. It is then very common for those suffering from BPD to turn to unhealthy coping mechanisms, such as substance use, unhealthy relationships, and more, often unsuccessfully creating experiences that facilitate safety which leads to further negative experiences. With the high suicide rating among children, adolescents, and teens, and an ever-increasing number of children being diagnosed with BPD, it is very important that more research is done to find further treatments for patients who are currently suffering. Methods: Utilizing data found in prior studies, this paper will analyze the literature to focus on a comprehensive treatment plan for those with DBT. It is currently suggested that with the use of dialectical behavioral therapy (DBT), a therapy that focuses on changing negative thinking patterns and pushes for more positive ones is helpful for treatment for those with BPD. Though this therapy is not a cure to BPD, it does help mitigate the risk; this essay will explore other options that can further the treatment process, such as cognitive analytical therapy (CAT), which focuses on delving into the past to find the root causes of an issue to create coping strategies and harm reduction, a type of therapy used to aid patients in lowering the use of substances without complete cessation. Results: The research provides enough evidence to link between the treatment of BPD with the utilization of CAT.

Keywords: borderline personality disorder, cognitive analytical therapy, dialectical behavioral therapy, harm reduction, suicidal ideation

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Authors: M. M. Wickramasinghe

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Cholesterol and triglycerides are lipids, mainly essential to maintain the cellular structure of the human body. Cholesterol is also important for hormone production, vitamin D production, proper digestion functions, and strengthening the immune system. Excess fats in the blood circulation, known as hyperlipidemia, become harmful leading to arterial clogging and causing atherosclerosis. Aim of this research is to develop a treatment protocol to efficiently break down and maintain circulatory lipids by improving blood circulation without strenuous physical exercises while immersed in a tub of water. To achieve the target of strong exercise effect, this method involves generating powerful ozone bubbles to spin, collide, and burst in the water. Powerful emission of air into water is capable of transferring locked energy of the water molecules and releasing energy. This method involves water and air-based impact generated by pumping ozone at the speed of 46 lts/sec with a concentration of 0.03-0.05 ppt according to safety standards of The Federal Institute for Drugs and Medical Devices, BfArM, Germany. The direct impact of ozone bubbles on the muscular system and skin becomes the main target and is capable of increasing the heart rate while immersed in water. A total time duration of 20 minutes is adequate to exert a strong exercise effect, improve blood circulation, and stimulate the nervous and endocrine systems. Unstable ozone breakdown into oxygen release onto the surface of the water giving additional benefits and supplying high-quality air rich in oxygen required to maintain efficient metabolic functions. The breathing technique was introduced to improve the efficiency of lung functions and benefit the air exchange mechanism. The temperature of the water is maintained at 39c to 40c to support arterial dilation and enzyme functions and efficiently improve blood circulation to the vital organs. The buoyancy of water and natural hydrostatic pressure release the tension of the body weight and relax the mind and body. Sufficient hydration (3lts of water per day) is an essential requirement to transport nutrients and remove waste byproducts to process through the liver, kidney, and skin. Proper nutritional intake is an added advantage to optimize the efficiency of this method which aids in a fast recovery process. Within 20-30 days of daily treatment, triglycerides, low-density lipoproteins (LDL), and total cholesterol reduction were observed in patients with abnormal levels of lipid profile. Borderline patients were cleared within 10–15 days of treatment. This is a highly efficient system that provides many benefits and is able to achieve a successful reduction of triglycerides, LDL, and total cholesterol within a short period of time. Supported by proper hydration and nutritional balance, this system of natural treatment maintains healthy levels of lipids in the blood and avoids the risk of cerebral stroke, high blood pressure, and heart attacks.

Keywords: atherosclerosis, cholesterol, hydrotherapy, hyperlipidemia, lipid management, ozone therapy, triglycerides

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Authors: H. Naseh, M. Mirshams, M. Mirdamadian, H. R. Fazeley

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This paper presents an extension of fuzzy-genetic algorithm multi-objective optimization methodology that could effectively be used to find the overall satisfaction of objective functions (selecting the design variables) in the early stages of design process. The coupling of objective functions due to design variables in an engineering design process will result in difficulties in design optimization problems. In many cases, decision making on design variables conflicts with more than one discipline in system design. In space launch system conceptual design, decision making on some design variable (e.g. oxidizer to fuel mass flow rate O/F) in early stages of the design process is related to objective of liquid propellant engine (specific impulse) and Tanks (structure weight). Then, the primary application of this methodology is the design of a liquid propellant engine with the maximum specific impulse and cylindrical stiffened tank with the minimum weight. To this end, the design problem is established the fuzzy rule set based on designer's expert knowledge with a holistic approach. The independent design variables in this model are oxidizer to fuel mass flow rate, thickness of stringers, thickness of rings, shell thickness. To handle the mentioned problems, a fuzzy-genetic algorithm multi-objective optimization methodology is developed based on Pareto optimal set. Consequently, this methodology is modeled with the one stage of space launch system to illustrate accuracy and efficiency of proposed methodology.

Keywords: cylindrical stiffened tanks, multi-objective, genetic algorithm, fuzzy approach

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Authors: Ningning Liu, Gaoding Jia, Yinshan Wang, Haimei Li, Xinian Zuo, Yufeng Wang, Lu Liu, Qiujin Qian

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Background: There has been speculation that a high IQ may not necessarily provide protection against attention deficit hyperactivity disorder (ADHD), and there may be a U-shaped correlation between IQ and ADHD symptoms. However, this speculation has not been validated in the ADHD population in any study so far. Method: We conducted a study with 5,138 children who have been professionally diagnosed with ADHD and have a wide range of IQ levels. General Linear Models were used to determine the optimal model between IQ and ADHD core symptoms with sex and age as covariates. The ADHD symptoms we looked at included the total scores (TO), inattention (IA) and hyperactivity/impulsivity (HI). Wechsler Intelligence scale were used to assess IQ [Full-Scale IQ (FSIQ), Verbal IQ (VIQ), and Performance IQ (PIQ)]. Furthermore, we examined the correlation between IQ and the execution function [Behavior Rating Inventory of Executive Function (BRIEF)], as well as between IQ and brain surface area, to determine if the associations between IQ and ADHD symptoms are reflected in executive functions and brain structure. Results: Consistent with previous research, the results indicated that FSIQ and VIQ both showed a linear negative correlation with the TO and IA scores of ADHD. However, PIQ showed an inverted U-shaped relationship with the TO and HI scores of ADHD, with 103 as the peak point. These findings were also partially reflected in the relationship between IQ and executive functions, as well as IQ and brain surface area. Conclusion: To sum up, the relationship between IQ and ADHD symptoms is not straightforward. Our study confirms long-standing academic hypotheses and finds that PIQ exhibits an inverted U-shaped relationship with ADHD symptoms. This study enhances our understanding of symptoms and behaviors of ADHD with varying IQ characteristics and provides some evidence for targeted clinical intervention.

Keywords: ADHD, IQ, execution function, brain imaging

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Authors: Doufoungognon Carine Kone

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Heavy metals present in large quantities in ecosystems can alter biological and cellular functions and disrupt trophic functions. However, their toxicity can change according to thermal conditions, as toxicity depends on their bioavailability and thermal optimum of organisms. Organisms can develop different tolerance strategies to maintain themselves in a stressful environment, but these strategies are often studied in a single-stressor context. This study evaluates the responses of the ciliate Tetrahymena thermophila to copper, high temperature, and their interaction. Six genotypes were exposed to a gradient of copper concentrations ranging from 0 to 350mg/L in synthetic media at three temperatures: 15°C, 23°C, and 31°C. Cell density, cell shape and size (and their variance), swimming speed and trajectory, and copper uptake rate were measured. Depending on the genotype, swimming speed, trajectory, and cell size were highly affected by stress gradients. One gets bigger, while two genotypes get smaller and the other remain unchanged. Some genotypes swam less rapidly, while others speed up as copper and temperature increased. Concerning copper uptake, the two genotypes accumulating the best and the worst, whatever the copper concentration or temperature, were also those that had the highest densities. Finally, very few temperature x copper interactions were observed on phenotypic parameters. The diversity of phenotypic responses revealed in this study reflects the existence of divergent strategies adopted by Tetrahymena thermophila to resist to copper and thermal stress, which suggests an important role of intraspecific variability in biodiversity response to environmental stress. One general and the surprising pattern was a global absence of interactive effects between copper and high temperature exposure on the observed phenotypic responses.

Keywords: ciliate, copper, intraspecific variability, phenotype, temperature, tolerance, multiple stressors

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