Search results for: narcissistic personality disorder
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1694

Search results for: narcissistic personality disorder

434 Factors That Affect the Mental Health Status of Syrian Refugee Girls in Post-Resettlement Context

Authors: Vivian Khamis

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Exposure to war and forced migration have been widely linked to child subsequent adaptation. What remains sparse is research spanning multiple risk and protective factors and examining their unique and relative implications to difficulties in mental health among refugee girls. This study investigated the mechanisms through which posttraumatic stress disorder (PTSD), emotion dysregulation , neuroticism, and behavioral and emotional disorders in Syrian refugee girls is impacted by exposure to war traumas, age, and other risk and protective factors such as coping styles, family relationships, and school environment. The sample consisted of 539 Syrian refugee girls who ranged in age from 7 to 18 years attending public schools in various governorates in Lebanon and Jordan. Two school counselors carried out the interviews with children at school. Results indicated that war trauma, older age, and a combination of negative copying style associated with conflict in the family could lead to an overall state of emotion dysregulation, neuroticism, behavioral and emotional disorders, and PTSD in refugee girls. On the other hand, lapse of time since resettlement in host country, positive copying style, cohesion, and expressiveness in the family would lead to more positive mental health status, including lower levels of emotion dysregulation, neuroticism, behavioral and emotional disorders, and PTSD . Enhanced understanding of the mechanistic role of risk and protective factors in contributing to difficulties in mental health in refugee girls may contribute to the development of effective interventions to target the psychological effects of the refugee experience.

Keywords: refugee girls, PTSD, emotion dysregulation, neuroticism, behavioral and emotional disorders

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433 Tractography Analysis and the Evolutionary Origin of Schizophrenia

Authors: Mouktafi Amine, Tahiri Asmaa

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A substantial number of traditional medical research has been put forward to managing and treating mental disorders. At the present time, to our best knowledge, it is believed that a fundamental understanding of the underlying causes of the majority of psychological disorders needs to be explored further to inform early diagnosis, managing symptoms and treatment. The emerging field of evolutionary psychology is a promising prospect to address the origin of mental disorders, potentially leading to more effective treatments. Schizophrenia as a topical mental disorder has been linked to the evolutionary adaptation of the human brain represented in the brain connectivity and asymmetry directly linked to humans' higher brain cognition in contrast to other primates being our direct living representation of the structure and connectivity of our earliest common African ancestors. As proposed in the evolutionary psychology scientific literature, the pathophysiology of schizophrenia is expressed and directly linked to altered connectivity between the Hippocampal Formation (HF) and Dorsolateral Prefrontal Cortex (DLPFC). This research paper presents the results of the use of tractography analysis using multiple open access Diffusion Weighted Imaging (DWI) datasets of healthy subjects, schizophrenia-affected subjects and primates to illustrate the relevance of the aforementioned brain regions' connectivity and the underlying evolutionary changes in the human brain. Deterministic fiber tracking and streamline analysis were used to generate connectivity matrices from the DWI datasets overlaid to compute distances and highlight disconnectivity patterns in conjunction with other fiber tracking metrics: Fractional Anisotropy (FA), Mean Diffusivity (MD) and Radial Diffusivity (RD).

Keywords: tractography, diffusion weighted imaging, schizophrenia, evolutionary psychology

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432 Mental Health of Female Runners - Results of a Pilot Study

Authors: Katalin Gocze, Gabriella Kiss, Zsuzsanna Gurdan, Krisztian Kvell, Attila Trabert

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Introduction: On a worldwide scale running has become an increasingly popular leisure time activity during the past decade. Since the participation rate of women has risen significantly the aim of our study was to analyze the mental status, sleeping habits and the prevalence of depression among female runners. Methods: Cross-sectional analysis included the use of validated and globally used surveys for the comprehensive evaluation of insomnia (AIS), depression (BDI), exercise dependence (EDS) and exercise addiction (EAI). Recreational and amateur female runners participating at half-marathon events in Hungary were asked to take part in our pilot study. Results: Participants mean age was 42.03±9.03 years. The prevalence of imsomnia was 18.87%. 60.34% has worries regarding their weight and 43.1% think that they have an actual weight problem. 77.6% stated that their body weight has an influence on their mood. 2.7% displayed borderline clinical depression, the prevalence of mild mood disorders was 10.81%. 17.2% had previously problems with disordered eating. Participants had a mean total EDS score of 46.94±15.55 and a mean total of 13.49±3.80 on EAI. Component scores were the highest for tolerance (a need for increased amounts of exercise to achieve the desired effect or a diminished effect occurs with continued use of the same amount of exercise). Conclusion: Even tough running can help improve mental health, tackle depression and overcome adversity, athletes are at risk of experiencing psychological difficulties which have an impact on their physical perfomance as well. Further research can help initiate targeted educational and screening programs to ensure that female athletes find a path to emotional well-being.

Keywords: depression, eating disorder, exercise addiction, exercise dependence, insomnia, running

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431 The Impact of Virtual Schooling Due to COVID-19 Restrictions on Children’s Mood and Behavior

Authors: Rahaf Alasiri, Tarek Alghamdi, Abdullah Zarkan

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Background: Due to measures such as school closure, social distancing, and virtual teaching during the pandemic, primary school children's psychological well-being is greatly affected. These measures have short and long-term consequences on the children's well-being and mental health. Identifying these consequences is important. Aim: This study aimed to evaluate mood and behavior changes in children who attended school virtually. Subjects and methods: This is a cross-sectional study conducted among children and their parents who visited the outpatient clinic. A self-administered questionnaire was given to the parents of children aged between 6 to 14 years. The questionnaire includes socio-demographic characteristics, Conor's modifies scale to assess the attention deficit hyperactivity disorder (ADHD) of children, and the parental stress scale (PSS) to assess the stress symptoms of the parents. Results: Of the 66 surveyed children, 60.6% were aged between 10 to 14 years old, with the female being dominant (77.3%). The most common medical condition was asthma (7.6%), and nearly two-thirds (63.6%) indicated good health conditions during the pandemic. There was a significant inverse correlation observed between ADHD score and PSS score (r=-0.387). No significant differences are in ADHD and PSS scores in relation to the socio-demographic characteristics of the children, including age, gender, and having an associated medical condition (p>0.05). Conclusion: During the pandemic, children who attended virtual classes did not seem to affect even with restrictions. Most children indicated good health conditions during the pandemic. However, it is surprising to know that in spite of children’s high spirits during the pandemic, their parents were seen to have an increased level of stress. Strategies to address parents’ psychological disorders during the pandemic are warranted.

Keywords: children's mood, COVID-19, ADHD, parental stress

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430 A Dual Debrief-Based Co-Autoethnography of a Humanitarian Delegation Member: Supporting Ukraine Refugee Mothers through Ambiguous Loss

Authors: Bilha Paryente, Rivi Frei Landau

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Autoethnography - a combination of autobiography and ethnography - focuses on the intersection of personal experiences and the culture in which they take place and is considered a viable method for exploring human experiences. The Russo-Ukrainian war has resulted in millions of forcibly displaced asylum-seeking refugees facing ambiguous loss. Whereas much is known about refugees' support needs, little is known about the needs and experiences of the humanitarian delegation members (HDM) who assist them. Through a debrief-based co-autoethnographic account of a female HDM who supported Ukrainian refugee mothers and children on the Polish borders, we explored the lived experiences involved in such a mission. Specifically, we conducted a transnational dyadic autoethnography debrief-based co-autoethnography which included both verbal and photo-based debriefing (8 two-hour sessions) alongside a reflexive (10-day) field diary analysis. Content analysis revealed cognitive dilemmas, emotional struggles, and practical adaptations occurring within the HDM's three identity-related domains: personal, professional (psychologist), and ethnic. The methodology presented and demonstrated in this paper enhances our theoretical understanding of the challenges faced by HDMs and may contribute to better future design of HDM training. Practically, the findings of the current study suggest the need for a three-stage accompaniment for HDMs relating to their personal, professional, and ethnic identities and considering their cognitive, emotional, and adaptive aspects. First, before leaving, HDMs should be briefed on personal and professional aspects of their experiences and ways of coping with them, as well as ethnic and religious affiliation issues. Second, while volunteering every evening their dilemmas, emotional struggles, and ways of adapting should be addressed for the three layers of identities. And finally, shortly after their return, there should be a final meeting to discuss all aspects of their identities and layers of personality. In this way, HDMs can become more effective in the important mission they fulfill. We hope that future HDMs and the bodies that send them on humanitarian missions of paramount importance will adopt these recommendations and generate proactive insights for members of future delegations.

Keywords: autoethnography, refugees, humanitarian delegation, ambiguous loss, Russo-Ukraine War, parenting

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429 Being Reticent for Healing – Singularity and Non-Verbalization in Indigenous Medical Practices in Sri Lanka

Authors: Ayami Umemura

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The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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428 The Benefit of a Universal Screening Program for Lipid Disorders in Two to Ten Years Old Lebanese Children

Authors: Nicolas Georges, Akiki Simon, Bassil Naim, Nawfal Georges, Abi Fares Georges

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Introduction: Dyslipidemia has been recognized as a risk factor for cardiovascular diseases. While the development of atherosclerotic lesions begins in childhood and progresses throughout life, data on the prevalence of dyslipidemic children in Lebanon is lacking. Objectives: This study was conducted to assess the benefit of a protocol for universal screening for lipid disorder in Lebanese children aged between two and ten years old. Materials and Methods: A total of four hundred children aged 2 to 10 years old (51.5% boys) were included in the study. The subjects were recruited from private pediatric clinics after parental consent. Fasting total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) levels were measured and non-HDL cholesterol was calculated. The values were categorized according to 2011 Expert on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Results: The overall prevalence of high TC ( ≥ 200 mg/dL), high non-HDL-C ( ≥ 145 mg/dL), high LDL ( ≥ 130 mg/dL), high TG ( ≥ 100 mg/dL) and low HDL ( < 40 mg/dL) was respectively 19.5%, 23%, 19%, 31.8% and 20%. The overall frequency of dyslipidemia was 51.7%. In a bivariate analysis, dyslipidemia in children was associated with a BMI ≥ 95ᵗʰ percentile and parents having TC > 240 mg/dL with a P value respectively of 0.006 and 0.0001. Furthermore, high TG was independently associated with a BMI ≥ 95ᵗʰ percentile (P=0.0001). Children with parents having TC > 240 mg/dL was significantly correlated with high TC, high non-HDL-C and high LDL (P=0.0001 for all variables). Finally, according to the Pediatric dyslipidemia screening guidelines from the 2011 Expert Panel, 62.3% of dyslipidemic children had at least 1 risk factor that qualified them for screening while 37.7% of them didn’t have any risk factor. Conclusions: It is preferable to review the latest pediatric dyslipidemia screening guidelines by performing a universal screening program since a third of our dyslipidemic Lebanese children have been missed.

Keywords: cardiovascular risk factors, dyslipidemia, Lebanese children, screening

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427 The Effect of Incorporating Animal Assisted Interventions with Trauma Focused Cognitive Behavioral Therapy

Authors: Kayla Renteria

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This study explored the role animal-assisted psychotherapy (AAP) can play in treating Post-Traumatic Stress Disorder (PTSD) when incorporated into Trauma-informed cognitive behavioral therapy (TF-CBT). A review of the literature was performed to show how incorporating AAP could benefit TF-CBT since this treatment model often presents difficulties, such as client motivation and avoidance of the exposure element of the intervention. In addition, the fluidity of treatment goals during complex trauma cases was explored, as this issue arose in the case study. This study follows the course of treatment of a 12-year-old female presenting with symptoms of PTSD. Treatment consisted of traditional components of the TF-CBT model, with the added elements of AAP to address typical treatment obstacles in TF-CBT. A registered therapy dog worked with the subject in all sessions throughout her treatment. The therapy dog was incorporated into components such as relaxation and coping techniques, narrative therapy techniques, and psychoeducation on the cognitive triangle. Throughout the study, the client’s situation and clinical needs required the therapist to switch goals to focus on current safety and stability. The therapy dog provided support and neurophysiological benefits to the client through AAP during this shift in treatment. The client was assessed quantitatively using the Child PTSD Symptom Scale Self Report for DSM-5 (CPSS-SR-5) before and after therapy and qualitatively through a feedback form given after treatment. The participant showed improvement in CPSS-SR-V scores, and she reported that the incorporation of the therapy animal improved her therapy. The results of this study show how the use of AAP provided the client a solid, consistent relationship with the therapy dog that supported her through processing various types of traumas. Implications of the results of treatment and for future research are discussed.

Keywords: animal-assisted therapy, trauma-focused cognitive behavioral therapy, PTSD in children, trauma treatment

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426 Lessons Learnt from a Patient with Pseudohyperkalaemia Secondary to Polycythaemia Rubra Vera in a Neuro-ICU Patient Resulting in Dangerous Interventions: Lessons Learnt on Patient Safety Improvement

Authors: Dinoo Kirthinanda, Sujani Wijeratne

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Pseudohyperkalaemia is a common benign in vitro phenomenon caused by the release of potassium ions (K+) from cells during specimen processing. Analysis of haemolysed blood samples for predominantly intracellular electrolytes may lead to re-investigation and potentially harmful interventions. We report a case of a 52-year male with myeloproliferative disease manifested as Polycythaemia Rubra Vera, Hypertension and hypertensive nephropathy with stage 3 chronic kidney disease admitted to Neuro-intensive care unit (NICU) with an intra-cerebral haemorrhage secondary to hypertensive bleed. His initial blood investigations showed hyperkalemia with serum K+ 6.2 mmol/L yet the bedside arterial blood gas analysis yielded K+ of 4.6 mmol/L. The patient was however given hyperkalemia regime twice based on venous electrolyte analysis. The discrepancy between the bedside electrolyte analysis using arterial blood and venous blood prompted further evaluation. The 12 lead Electrocardiogram showed U waves and sinus bradycardia corresponding to the serum K+ of 2.8 mmol/L on arterial blood gas analysis. Immediate K+ replacement ensured the patient did not develop life-threatening cardiac complications. Pseudohyperkalaemia may pose diagnostic challenges in the absence of detectable haemolysis and should be suspected in susceptible patients with normal Electrocardiogram and Glomerular Filtration Rate to avoid potentially life-threatening interventions. When in doubt, rapid analysis of arterial blood gas may be useful for accurate quantification of potassium.

Keywords: patient safety, pseudohyperkalaemia, haemolysis, myeloproliferative disorder

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425 Temperamental Determinants of Eye-Hand Coordination Formation in the Special Aerial Gymnastics Instruments (SAGI)

Authors: Zdzisław Kobos, Robert Jędrys, Zbigniew Wochyński

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Motor activity and good health are sine qua non determinants of a proper practice of the profession, especially aviation. Therefore, candidates to the aviation are selected according their psychomotor ability by both specialist medical commissions. Moreover, they must past an examination of the physical fitness. During the studies in the air force academy, eye-hand coordination is formed in two stages. The future aircraft pilots besides all-purpose physical education must practice specialist training on SAGI. Training includes: looping, aerowheel, and gyroscope. Aim of the training on the above listed apparatuses is to form eye-hand coordination during the tasks in the air. Such coordination is necessary to perform various figures in the real flight. Therefore, during the education of the future pilots, determinants of the effective ways of this important parameter of the human body functioning are sought for. Several studies of the sport psychology indicate an important role of the temperament as a factor determining human behavior during the task performance and acquiring operating skills> Polish psychologist Jan Strelau refers to the basic, relatively constant personality features which manifest themselves in the formal characteristics of the human behavior. Temperament, being initially determined by the inborn physiological mechanisms, changes in the course of maturation and some environmental factors and concentrates on the energetic level and reaction characteristics in time. Objectives. This study aimed at seeking a relationship between temperamental features and eye-hand coordination formation during training on SAGI. Material and Methods: Group of 30 students of pilotage was examined in two situations. The first assessment of the eye-hand coordination level was carried out before the beginning of a 30-hour training on SAGI. The second assessment was carried out after training completion. Training lasted for 2 hours once a week. Temperament was evaluated with The Formal Characteristics of Behavior − Temperament Inventory (FCB-TI) developed by Bogdan Zawadzki and Jan Strelau. Eye-hand coordination was assessed with a computer version of the Warsaw System of Psychological Tests. Results: It was found that the training on SAGI increased the level of eye-hand coordination in the examined students. Conclusions: Higher level of the eye-hand coordination was obtained after completion of the training. Moreover, a relationship between eye-hand coordination level and selected temperamental features was statistically significant.

Keywords: temperament, eye-hand coordination, pilot, SAGI

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424 The Maps of Meaning (MoM) Consciousness Theory

Authors: Scott Andersen

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Perhaps simply and rather unadornedly, consciousness is having multiple goals for action and the continuously adjudication of such goals to implement action, referred to as the Maps of Meaning (MoM) Consciousness Theory. The MoM theory triangulates through three parallel corollaries, action (behavior), mechanism (morphology/pathophysiology), and goals (teleology). (1) An organism’s consciousness contains a fluid, nested goals. These goals are not intentionality, but intersectionality, embodiment meeting the world. i.e., Darwinian inclusive fitness or randomization, then survival of the fittest. These goals form via gradual descent under inclusive fitness, the goals being the abstraction of a ‘match’ between the evolutionary environment and organism. Human consciousness implements the brain efficiency hypothesis, genetics, epigenetics, and experience crystallize efficiencies, not necessitating best or objective but fitness, i.e., perceived efficiency based on one’s adaptive environment. These efficiencies are objectively arbitrary, but determine the operation and level of one’s consciousness, termed extreme thrownness. Since inclusive fitness drives efficiencies in physiologic mechanism, morphology and behavior (action) and originates one’s goals, embodiment is necessarily entangled to human consciousness as its the intersection of mechanism or action (both necessitating embodiment) occurring in the world that determines fitness. Perception is the operant process of consciousness and is the consciousness’ de facto goal adjudication process. Goal operationalization is fundamentally efficiency-based via one’s unique neuronal mapping as a byproduct of genetics, epigenetics, and experience. Perception involves information intake and information discrimination, equally underpinned by efficiencies of inclusive fitness via extreme thrownness. Perception isn’t a ‘frame rate,’ but Bayesian priors of efficiency based on one’s extreme thrownness. Consciousness and human consciousness is a modular (i.e., a scalar level of richness, which builds up like building blocks) and dimensionalized (i.e., cognitive abilities become possibilities as emergent phenomena at various modularities, like stratified factors in factor analysis). The meta dimensions of human consciousness seemingly include intelligence quotient, personality (five-factor model), richness of perception intake, and richness of perception discrimination, among other potentialities. Future consciousness research should utilize factor analysis to parse modularities and dimensions of human consciousness and animal models.

Keywords: consciousness, perception, prospection, embodiment

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423 Analysis of Gait Characteristics Using Dynamic Foot Scanner in Type 2 Diabetes Mellitus

Authors: C. G. Shashi Kumar, G. Arun Maiya, H. Manjunath Hande, K. V. Rajagopal

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Background: Diabetes mellitus (DM) is a metabolic disorder with involvement of neurovascular and muscular system. Studies have documented that the gait parameter is altered in type 2 diabetes mellitus with peripheral neuropathy. However, there is a dearth of literature regarding the gait characteristics in type 2 diabetes mellitus (T2DM) without peripheral neuropathy. Therefore, the present study is focused on identifying gait changes in early type 2 diabetes mellitus without peripheral neuropathy. Objective: To analyze the gait characteristics in Type 2 diabetes mellitus without peripheral neuropathy. Methods: After obtaining ethical clearance from Institutional Ethical Committee (IEC), 36 T2DM without peripheral neuropathy and 32 matched healthy subjects were recruited. Gait characteristics (step duration, gait cycle length, gait cycle duration, stride duration, step length, double stance duration) of all the subjects were analyzed using Windtrack dynamic foot scanner. Data were analyzed using Independent‘t’ test to find the difference between the groups (step duration, gait cycle length, gait cycle duration) and Mann-Whitney test was used to analyze the step length and double stance duration to find difference between the groups. Level of significance was kept at P<0.05. Results: Result analysis showed significant decrease in step duration, gait cycle length, gait cycle duration, step length, double stance duration in T2DM subjects as compared to healthy subjects. We also observed a mean increase in stride duration in T2DM subjects compared to healthy subjects.

Keywords: type 2 diabetes mellitus, dynamic foot scan, gait characteristics, medical and health sciences

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422 The Invisible Labour of Informal Care: Parentified Caregiving in David Chariandy's Soucouyant

Authors: Walter Rafael Ramos Villanueva

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The overwhelming majority of scholarship on David Chariandy’s novel Soucouyant focuses on how Adele’s dementia represents the preservation of “cultural memory” and the perniciousness of “historical trauma.” However, by metaphorizing Adele’s mental condition, these critics risk treating her dementia as mostly figurative, and they thus elide a more detailed discussion of the literal ramifications of her dementia diagnosis. To move beyond these readings, then, my paper will approach Adele’s disorder as a literal medical condition and explore how her caregiving needs affect not only her but also those around her. Soucouyant subverts traditional caregiving narratives by depicting the difficult and typically invisible labour of informal caregiving that is undertaken by the families and friends of those who are ill or otherwise disabled. Because Adele’s family is unable to access proper public healthcare resources within the community, the burden of care falls upon the protagonist and his brother, who become “parentified children.” Parentified children, according to Nancy D. Chase, are “parents to their parents, and fulfill this role at the expense of their own developmentally appropriate needs and pursuits.” The novel provides a depiction of informal caregiving that is multi-faceted and asks us to question why is it exactly that we place the burden of care on those who are not equipped to handle such pressures instead of putting the onus on the government and the public healthcare system to take care of its most vulnerable members. Ageing Studies scholar Larry Polvika notes that although policymakers often offer “pious expressions of appreciation” and acknowledge that informal caregiving is “the backbone of our long-term care system,” governmental support for these caregivers remains inadequate. It is my belief that, by showcasing the struggles of informal caregivers, Chariandy’s text combats this dangerous and empty political rhetoric.

Keywords: caregiving, dementia, literature, parentified children

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421 Profile of the Elderly Users of Alcohol and Other Drugs Attended at the Psychosocial Care Centers in the Federal District

Authors: J. S. P. Barbosa, L. C. Pereira, K. R. Garcia, P. C. P. Bouchardet, S. C. T. Vieira, A. O. Gomes, S. S. Funghetto, M. G. O. Kanikowski

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For this population, height seems to be a good predictor of strength and body composition. This increase in life expectancy of the Brazilian's population is associated with sociodemographic variables, but also to more access to health services in the prevention and better living conditions. With the growth of elderly population, a problem that has been a concern to health's professionals and public health at all is the use of psychoactive substances. The purpose of this study was to identify the sociodemographic profile of the elderly people who was attended at the Center of Psychosocial Care of alcohol and other drugs in the Federal District of Brazil. 408 medical records of people aged 60 years or over were evaluated, and it is possible to know that most of them were males (85.3%), with a mean age of 64 years (DP ± 4.16), 60 and 84 years and a mean age of 64 years (DP ± 4.42); 88.2% have some family ties, are married and have children, with relatives living in masonry housing. The educational level of drug users was considered low with more emphasis on those who had elementary education being the majority retired or unemployed. Regarding the street situation, there was no significance (p = 0.084), and the women (OR = 2.98) had few chances of street situations compared to men (OR = 0.89). As for substance consumption, the highest quantity of drug consumption bids in relation to the number of illicit. It did not present significant statistical value, and there is a greater probability of consumption/abuse of legal and/or illicit drugs for both sexes (OR = 0.96) for men and (OR = 1.32) for women. In relation to the use of multiple drugs, there was no significant difference between the sexes, (OR = 1.1) male sex and (OR = 0.74) female sex. Based on the results found in the present study, it was concluded that alcohol consumption is the main agent that causes vulnerability in the elderly and predisposes the latter to the consumption of other associated drugs.

Keywords: centers of attention psychosocial alcohol and drugs, elderly, mental disorder due to drug use, street situations

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420 Developing an Edutainment Game for Children with ADHD Based on SAwD and VCIA Model

Authors: Bruno Gontijo Batista

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This paper analyzes how the Socially Aware Design (SAwD) and the Value-oriented and Culturally Informed Approach (VCIA) design model can be used to develop an edutainment game for children with Attention Deficit Hyperactivity Disorder (ADHD). The SAwD approach seeks a design that considers new dimensions in human-computer interaction, such as culture, aesthetics, emotional and social aspects of the user's everyday experience. From this perspective, the game development was VCIA model-based, including the users in the design process through participatory methodologies, considering their behavioral patterns, culture, and values. This is because values, beliefs, and behavioral patterns influence how technology is understood and used and the way it impacts people's lives. This model can be applied at different stages of design, which goes from explaining the problem and organizing the requirements to the evaluation of the prototype and the final solution. Thus, this paper aims to understand how this model can be used in the development of an edutainment game for children with ADHD. In the area of education and learning, children with ADHD have difficulties both in behavior and in school performance, as they are easily distracted, which is reflected both in classes and on tests. Therefore, they must perform tasks that are exciting or interesting for them, once the pleasure center in the brain is activated, it reinforces the center of attention, leaving the child more relaxed and focused. In this context, serious games have been used as part of the treatment of ADHD in children aiming to improve focus and attention, stimulate concentration, as well as be a tool for improving learning in areas such as math and reading, combining education and entertainment (edutainment). Thereby, as a result of the research, it was developed, in a participatory way, applying the VCIA model, an edutainment game prototype, for a mobile platform, for children between 8 and 12 years old.

Keywords: ADHD, edutainment, SAwD, VCIA

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419 An Alternative Credit Scoring System in China’s Consumer Lendingmarket: A System Based on Digital Footprint Data

Authors: Minjuan Sun

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Ever since the late 1990s, China has experienced explosive growth in consumer lending, especially in short-term consumer loans, among which, the growth rate of non-bank lending has surpassed bank lending due to the development in financial technology. On the other hand, China does not have a universal credit scoring and registration system that can guide lenders during the processes of credit evaluation and risk control, for example, an individual’s bank credit records are not available for online lenders to see and vice versa. Given this context, the purpose of this paper is three-fold. First, we explore if and how alternative digital footprint data can be utilized to assess borrower’s creditworthiness. Then, we perform a comparative analysis of machine learning methods for the canonical problem of credit default prediction. Finally, we analyze, from an institutional point of view, the necessity of establishing a viable and nationally universal credit registration and scoring system utilizing online digital footprints, so that more people in China can have better access to the consumption loan market. Two different types of digital footprint data are utilized to match with bank’s loan default records. Each separately captures distinct dimensions of a person’s characteristics, such as his shopping patterns and certain aspects of his personality or inferred demographics revealed by social media features like profile image and nickname. We find both datasets can generate either acceptable or excellent prediction results, and different types of data tend to complement each other to get better performances. Typically, the traditional types of data banks normally use like income, occupation, and credit history, update over longer cycles, hence they can’t reflect more immediate changes, like the financial status changes caused by the business crisis; whereas digital footprints can update daily, weekly, or monthly, thus capable of providing a more comprehensive profile of the borrower’s credit capabilities and risks. From the empirical and quantitative examination, we believe digital footprints can become an alternative information source for creditworthiness assessment, because of their near-universal data coverage, and because they can by and large resolve the "thin-file" issue, due to the fact that digital footprints come in much larger volume and higher frequency.

Keywords: credit score, digital footprint, Fintech, machine learning

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418 The Relations Between Hans Kelsen’s Concept of Law and the Theory of Democracy

Authors: Monika Zalewska

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Hans Kelsen was a versatile legal thinker whose achievements in the fields of legal theory, international law, and the theory of democracy are remarkable. All of the fields tackled by Kelsen are regarded as part of his “pure theory of law.” While the link between international law and Kelsen’s pure theory of law is apparent, the same cannot be said about the link between the theory of democracy and his pure theory of law. On the contrary, the general thinking concerning Kelsen’s thought is that it can be used to legitimize authoritarian regimes. The aim of this presentation is to address this concern by identifying the common ground between Kelsen’s pure theory of law and his theory of democracy and to show that they are compatible in a way that his pure theory of law and authoritarianism cannot be. The conceptual analysis of the purity of Kelsen’s theory and his goal of creating ideology-free legal science hints at how Kelsen’s pure theory of law and the theory of democracy are brought together. The presentation will first demonstrate that these two conceptions have common underlying values and meta-ethical convictions. Both are founded on relativism and a rational worldview, and the aim of both is peaceful co-existence. Second, it will be demonstrated that the separation of law and morality provides the maximum space for deliberation within democratic processes. The conclusion of this analysis is that striking similarities exist between Kelsen’s legal theory and his theory of democracy. These similarities are grounded in the Enlightenment tradition and its values, including rationality, a scientific worldview, tolerance, and equality. This observation supports the claim that, for Kelsen, legal positivism and the theory of democracy are not two separate theories but rather stem from the same set of values and from Kelsen’s relativistic worldview. Furthermore, three main issues determine Kelsen’s orientation toward a positivistic and democratic outlook. The first, which is associated with personality type, is the distinction between absolutism and relativism. The second, which is associated with the values that Kelsen favors in the social order, is peace. The third is legality, which creates the necessary condition for democracy to thrive and reveals that democracy is capable of fulfilling Kelsen’s ideal of law at its fullest. The first two categories exist in the background of Kelsen’s pure theory of law, while the latter is an inherent part of Kelsen’s concept of law. The analysis of the text concerning natural law doctrine and democracy indicates that behind the technical language of Kelsen’s pure theory of law is a strong concern with the trends that appeared after World War I. Despite his rigorous scientific mind, Kelsen was deeply humanistic. He tried to create a powerful intellectual weapon to provide strong arguments for peaceful coexistence and a rational outlook in Europe. The analysis provided by this presentation facilitates a broad theoretical, philosophical, and political understanding of Kelsen’s perspectives and, consequently, urges a strong endorsement of Kelsen’s approach to constitutional democracy.

Keywords: hans kelsen, democracy, legal positivism, pure theory of law

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417 Mental Disorders and Physical Illness in Geriatric Population

Authors: Vinay Kumar, M. Kishor, Sathyanarayana Rao Ts

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Background: Growth of elderly people in the general population in recent years is termed as ‘greying of the world’ where there is a shift from high mortality & fertility to low mortality and fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio-economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. Methods: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of JSS Medical College and Hospital, Mysore, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Keywords: Geriatric, mental disorders, physical illness, psychiatry

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416 Iodine Nutritional Knowledge of Food Handlers: A Capricorn and Waterberg District Study, Limpopo Province, South Africa

Authors: Solomon Ngoako Mabapa, Selekane Ananias Motadi, Nteseng Mailula, Hlekani Vanessa Mbhatsani, Lindelani Fhumudzani Mushaphi

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Background: South Africa has indeed made good progress towards IDD elimination, as far as implementation of salt iodization and coverage of iodized salt are concerned, the education and promotion aspects of the iodized salt intervention are seriously lacking. Objective: To determine the iodine nutritional knowledge of food handlers at primary schools under the National School Nutrition Programme in Capricorn and Waterberg district. Design: This study included 300 food handlers recruited from 95 primary schools in Capricorn district and 105 primary schools in Waterberg district, Limpopo Province, South Africa. Primary schools and study participants where conveniently selected. The data was collected by means of a structured questionnaire. Information obtained was on the socio-demographic characteristics of the participants, general knowledge on salt fortification and knowledge test. Results: The iodine knowledge for the food handlers in two districts was poor with the entire population’s iodine nutritional knowledge of 12% on the Lickert scale. The mean score on the Lickert scale for Capricorn and Waterberg districts was 17% and 8.6% respectively indicated poor iodine nutritional knowledge. Conclusion: The two districts had poor iodine nutritional knowledge. Giving nutrition education to the public on the importance of iodine and the consequences of iodine deficiency disorder (IDD) and continue advocacy on mass media on the iodine fortification as an intervention strategy to combat the escalating problem of micronutrient malnutrition control.

Keywords: food handlers, nutritional knowledge, iodine, National School Nutrition Programme

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415 Facial Behavior Modifications Following the Diffusion of the Use of Protective Masks Due to COVID-19

Authors: Andreas Aceranti, Simonetta Vernocchi, Marco Colorato, Daniel Zaccariello

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Our study explores the usefulness of implementing facial expression recognition capabilities and using the Facial Action Coding System (FACS) in contexts where the other person is wearing a mask. In the communication process, the subjects use a plurality of distinct and autonomous reporting systems. Among them, the system of mimicking facial movements is worthy of attention. Basic emotion theorists have identified the existence of specific and universal patterns of facial expressions related to seven basic emotions -anger, disgust, contempt, fear, sadness, surprise, and happiness- that would distinguish one emotion from another. However, due to the COVID-19 pandemic, we have come up against the problem of having the lower half of the face covered and, therefore, not investigable due to the masks. Facial-emotional behavior is a good starting point for understanding: (1) the affective state (such as emotions), (2) cognitive activity (perplexity, concentration, boredom), (3) temperament and personality traits (hostility, sociability, shyness), (4) psychopathology (such as diagnostic information relevant to depression, mania, schizophrenia, and less severe disorders), (5) psychopathological processes that occur during social interactions patient and analyst. There are numerous methods to measure facial movements resulting from the action of muscles, see for example, the measurement of visible facial actions using coding systems (non-intrusive systems that require the presence of an observer who encodes and categorizes behaviors) and the measurement of electrical "discharges" of contracting muscles (facial electromyography; EMG). However, the measuring system invented by Ekman and Friesen (2002) - "Facial Action Coding System - FACS" is the most comprehensive, complete, and versatile. Our study, carried out on about 1,500 subjects over three years of work, allowed us to highlight how the movements of the hands and upper part of the face change depending on whether the subject wears a mask or not. We have been able to identify specific alterations to the subjects’ hand movement patterns and their upper face expressions while wearing masks compared to when not wearing them. We believe that finding correlations between how body language changes when our facial expressions are impaired can provide a better understanding of the link between the face and body non-verbal language.

Keywords: facial action coding system, COVID-19, masks, facial analysis

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414 Use of Smartwatches for the Emotional Self-Regulation of Individuals with Autism Spectrum Disorder (ASD)

Authors: Juan C. Torrado, Javier Gomez, Guadalupe Montero, German Montoro, M. Dolores Villalba

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One of the most challenging aspects of the executive dysfunction of people with Autism Spectrum Disorders is the behavior control. This is related to a deficit in their ability to regulate, recognize and manage their own emotions. Some researchers have developed applications for tablets and smartphones to practice strategies of relaxation and emotion recognition. However, they cannot be applied to the very moment of temper outbursts, anger episodes or anxiety, since they require to carry the device, start the application and be helped by caretakers. Also, some of these systems are developed for either obsolete technologies (old versions of tablet devices, PDAs, outdated operative systems of smartphones) or specific devices (self-developed or proprietary ones) that create differentiation between the users and the rest of the individuals in their context. For this project we selected smartwatches. Focusing on emergent technologies ensures a wide lifespan of the developed products, because the derived products are intended to be available in the same moment the very technology gets popularized, not later. We also focused our research in commercial versions of smartwatches, since this way differentiation is easily avoided, so the users’ abandonment rate lowers. We have developed a smartwatch system along with a smartphone authoring tool to display self-regulation strategies. These micro-prompting strategies are conformed of pictograms, animations and temporizers, and they are designed by means of the authoring tool: When both devices synchronize their data, the smartwatch holds the self-regulation strategies, which are triggered when the smartwatch sensors detect a remarkable rise of heart rate and movement. The system is being currently tested in an educational center of people with ASD of Madrid, Spain.

Keywords: assistive technologies, emotion regulation, human-computer interaction, smartwatches

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413 Effect of a GABA/5-HTP Mixture on Behavioral Changes and Biomodulation in an Invertebrate Model

Authors: Kyungae Jo, Eun Young Kim, Byungsoo Shin, Kwang Soon Shin, Hyung Joo Suh

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Gamma-aminobutyric acid (GABA) and 5-hydroxytryptophan (5-HTP) are amino acids of digested nutrients or food ingredients and these can possibly be utilized as non-pharmacologic treatment for sleep disorder. We previously investigated the GABA/5-HTP mixture is the principal concept of sleep-promoting and activity-repressing management in nervous system of D. melanogaster. Two experiments in this study were designed to evaluate sleep-promoting effect of GABA/5-HTP mixture, to clarify the possible ratio of sleep-promoting action in the Drosophila invertebrate model system. Behavioral assays were applied to investigate distance traveled, velocity, movement, mobility, turn angle, angular velocity and meander of two amino acids and GABA/5-HTP mixture with caffeine treated flies. In addition, differentially expressed gene (DEG) analyses from next generation sequencing (NGS) were applied to investigate the signaling pathway and functional interaction network of GABA/5-HTP mixture administration. GABA/5-HTP mixture resulted in significant differences between groups related to behavior (p < 0.01) and significantly induced locomotor activity in the awake model (p < 0.05). As a result of the sequencing, the molecular function of various genes has relationship with motor activity and biological regulation. These results showed that GABA/5-HTP mixture administration significantly involved the inhibition of motor behavior. In this regard, we successfully demonstrated that using a GABA/5-HTP mixture modulates locomotor activity to a greater extent than single administration of each amino acid, and that this modulation occurs via the neuronal system, neurotransmitter release cycle and transmission across chemical synapses.

Keywords: sleep, γ-aminobutyric acid, 5-hydroxytryptophan, Drosophila melanogaster

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412 An Educational Application of Online Games for Learning Difficulties

Authors: Maria Margoudi, Zacharoula Smyraniou

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The current paper presents the results of a conducted case study, which was part of the author’s master thesis. During the past few years the number of children diagnosed with Learning Difficulties has drastically augmented and especially the cases of ADHD (Attention Deficit Hyperactivity Disorder). One of the core characteristics of ADHD is a deficit in working memory functions. The review of the literature indicates a plethora of educational software that aim at training and enhancing the working memory. Nevertheless, in the current paper, the possibility of using for the same purpose free, online games will be explored. Another issue of interest is the potential effect of the working memory training to the core symptoms of ADHD. In order to explore the abovementioned research questions, three digital tests are employed, all of which are developed on the E-slate platform by the author, in order to check the level of ADHD’s symptoms and to be used as diagnostic tools, both in the beginning and in the end of the case study. The tools used during the main intervention of the research are free online games for the training of working memory. The research and the data analysis focus on the following axes: a) the presence and the possible change in two of the core symptoms of ADHD, attention and impulsivity and b) a possible change in the general cognitive abilities of the individual. The case study was conducted with the participation of a thirteen year-old, female student, diagnosed with ADHD, during after-school hours. The results of the study indicate positive changes both in the levels of attention and impulsivity. Therefore we conclude that the training of working memory through the use of free, online games has a positive impact on the characteristics of ADHD. Finally, concerning the second research question, the change in general cognitive abilities, no significant changes were noted.

Keywords: ADHD, attention, impulsivity, online games

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411 Single Item Presenteeism Question Reliability and Validity of Persian Version in Low Back Pain Patients

Authors: Mohammadreza Khanmohammadi, Noureddin Nakhostin Ansari, Soofia Naghdi

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Purpose: Our study aimed to validate single item presenteeism question (SIPQ) into the Persian language for patients with low back pain. Background information: low back pain is a common health problem, and it is one of the most prevalent disorder in working people. There are the different subjective way to evaluate the effect of back pain on work productivity that one of them is by implementing single item presenteeism question. This question has not been validated into the Persian language. Method: Patients were asked to answer SIPQ and pain from 0 to 10 according to numerical rating scale (NRS). The functional rating index was administrated to evaluate construct validity. For test-retest reliability, almost 50 patients re-completed the Persian SIPQ. The construct validity of SIPQ was assessed by analyzing Spearman rank correlation between this question and the Persian version of Functional rating index questionnaire. To analyze test-retest reliability, we assessed intraclass correlation coefficient (agreement) (ICC agreement) (two-way random effects model, single measure). Results: The SIPQ score of two groups of patients (84 males, 16 females, mean age ±SD: 33.85±11.16 years, range: 19-67 years) and healthy subjects (48 male, 2 female ones, mean age ±SD: 24.24 ±8.07 years) was statistically significant. (Mann-Whitney U =198.00, P<.001). The Spearman correlation of data showed that there is a significant correlation between Persian SIPQ score and Persian FRI band (r= .559, P<.001). The ICC was .62. So, the analysis indicated good, test-retest reliability. Conclusion: This study showed that Persian version of SIPQ is reliable and valid when applied to back pain patients.

Keywords: cross cultural adaptation, economic burden, low back pain, Persian language, translation

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410 Pistachio Supplementation Ameliorates the Motor and Cognitive Deficits in Rotenone-Induced Rat Model of Parkinson’s Disease

Authors: Saida Haider, Syeda Madiha

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Parkinson’s disease (PD) is a common neurological disorder characterized by motor deficits and loss of dopaminergic neurons. Oxidative stress is said to play a pivotal role in the pathophysiology of the disease. In the present study, PD was induced by injection of rotenone (1.5 mg/kg/day, s.c.) for eight days. Pistachio (800 mg/kg/day, p.o.) was given for two weeks. At the end of treatment brains were dissected out and striatum was isolated for biochemical and neurochemical analysis. Morris water maze (MWM) test and novel object recognition (NOR) task was used to test the memory function while motor behavior was determined by open field test (OFT), Kondziela inverted screen test (KIST), pole test (PT), beam walking test (BWT), inclined plane test (IPT) and footprint (FP) test. Several dietary components have been evaluated as potential therapeutic compounds in many neurodegenerative diseases. Increasing evidence shows that nuts have protective effects against various diseases by improving the oxidative status and reducing lipid peroxidation. Pistachio is the only nut that contains anthocyanin, a potent antioxidant having neuroprotective properties. Results showed that pistachio supplementation significantly restored the rotenone-induced motor deficits and improved the memory performance. Moreover, rats treated with pistachio also exhibited enhanced oxidative status and increased dopamine (DA) and 5-hydroxytryptamine (5-HT) concentration in striatum. In conclusion, to our best knowledge, we have for the first time shown that pistachio nut possesses neuroprotective effects against rotenone-induced motor and cognitive deficits. These beneficial effects of pistachio may be attributed to its high content of natural antioxidant and phenolic compounds. Hence, consumption of pistachio regularly as part of a daily diet can be beneficial in the prevention and treatment of PD.

Keywords: rotenone, pistachio, oxidative stress, Parkinson’s disease

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409 Considerations in Pregnancy Followed by Obesity Surgery

Authors: Maryam Nazari, Atefeh Ghanbari, Saghar Noorinia

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Obesity, as an abnormal or excessive accumulation of fat, is caused by genetic, behavioral and environmental factors. Recently, obesity surgeries, such as bariatric surgery, as the last measure to control obesity, have attracted experts and society, especially women, attention, so knowing the possible complications of this major surgery and their control in reproductive age is of particular importance due to its effects on pregnancy outcomes. Bariatric surgery reduces the risk of diabetes and high blood pressure associated with pregnancy, premature birth, macrosomia, stillbirth and dumping syndrome. Although in the first months after surgery, nausea and vomiting caused by changes in intra-abdominal pressure are associated with an increased risk of malabsorption of micronutrients such as folic acid, iron, vitamin B1, D, calcium, selenium and phosphorus and finally, fetal growth disorder. Moreover, serum levels of micronutrients such as vitamin D, calcium, and iron in mothers who used to have bariatric surgery and their babies have been shown to be lower than in mothers without a history of bariatric surgery. Moreover, vitamin A deficiency is shown to be more widespread in pregnancies after bariatric surgery, which leads to visual problems in newborns and premature delivery. However, complications such as the duration of hospitalization of newborns in the NICU, disease rate in the first 28 days of life and congenital anomalies are not significantly different in babies born to mothers undergoing bariatric surgery compared to the control group. In spite of the vast advantages following obesity surgeries, due to the catabolic conditions and severe weight loss followed by such major intervention and the probability of nutrients malnutrition in a pregnant woman and her baby, after having surgery, at least 12 to 18 months should be considered to get pregnant as a recovery period. In addition, taking essential supplements before and at least 6 months after this approach is recommended.

Keywords: bariatric surgery, pregnancy, malnutrition, vitamin and mineral deficiency

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408 The Safety Profile of Vilazodone: A Study on Post-Marketing Surveillance

Authors: Humraaz Kaja, Kofi Mensah, Frasia Oosthuizen

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Background and Aim: Vilazodone was approved in 2011 as an antidepressant to treat the major depressive disorder. As a relatively new drug, it is not clear if all adverse effects have been identified. The aim of this study was to review the adverse effects reported to the WHO Programme for International Drug Monitoring (PIDM) in order to add to the knowledge about the safety profile and adverse effects caused by vilazodone. Method: Data on adverse effects reported for vilazodone was obtained from the database VigiAccess managed by PIDM. Data was extracted from VigiAccess using Excel® and analyzed using descriptive statistics. The data collected was compared to the patient information leaflet (PIL) of Viibryd® and the FDA documents to determine adverse drug reactions reported post-marketing. Results: A total of 9708 adverse events had been recorded on VigiAccess, of which 6054 were not recorded on the PIL and the FDA approval document. Most of the reports were received from the Americas and were for adult women aged 45-64 years (24%, n=1059). The highest number of adverse events reported were for psychiatric events (19%; n=1889), followed by gastro-intestinal effects (18%; n=1839). Specific psychiatric disorders recorded included anxiety (316), depression (208), hallucination (168) and agitation (142). The systematic review confirmed several psychiatric adverse effects associated with the use of vilazodone. The findings of this study suggested that these common psychiatric adverse effects associated with the use of vilazodone were not known during the time of FDA approval of the drug and is not currently recorded in the patient information leaflet (PIL). Conclusions: In summary, this study found several adverse drug reactions not recorded in documents emanating from clinical trials pre-marketing. This highlights the importance of continued post-marketing surveillance of a drug, as well as the need for further studies on the psychiatric adverse events associated with vilazodone in order to improve the safety profile.

Keywords: adverse drug reactions, pharmacovigilance, post-marketing surveillance, vilazodone

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407 Intracranial Hypertension without CVST in Apla Syndrome: An Unique Association

Authors: Camelia Porey, Binaya Kumar Jaiswal

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BACKGROUND: Antiphospholipid antibody (APLA) syndrome is an autoimmune disorder predisposing to thrombotic complications affecting CNS either by arterial vasooclusion or venous thrombosis. Cerebral venous sinus thrombosis (CVST) secondarily causes raised intracranial pressure (ICP). However, intracranial hypertension without evidence of CVST is a rare entity. Here we present two cases of elevated ICP with absence of identifiable CVST. CASE SUMMARY: Case 1, 28-year female had a 2 months history of holocranial headache followed by bilateral painless vision loss reaching lack of light perception over 20 days. CSF opening pressure was elevated. Fundoscopy showed bilateral grade 4 papilledema. MRI revealed a partially empty sella with bilateral optic nerve tortuosity. Idiopathic intracranial hypertension (IIH) was diagnosed. With acetazolamide, there was complete resolution of the clinical and radiological abnormalities. 5 months later she presented with acute onset right-sided hemiparesis. MRI was suggestive of acute left MCA infarct.MR venogram was normal. APLA came positive with high titres of Anticardiolipin and Beta 2 glycoprotein both IgG and IgM. Case 2, 23-year female, presented with headache and diplopia of 2 months duration. CSF pressure was elevated and Grade 3 papilledema was seen. MRI showed bilateral optic nerve hyperintensities with nerve head protrusion with normal MRV. APLA profile showed elevated beta 2 glycoprotein IgG and IgA. CONCLUSION: This is an important non thrombotic complication of APLA syndrome and requires further large-scale study for insight into the pathogenesis and early recognition to avoid future complications.

Keywords: APLA syndrome, idiopathic intracranial hypertension, MR venogram, papilledema

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406 Type 2 Diabetes Mellitus Among a St. Lucian Population: What We Know about Lifestyle Modification

Authors: Bradley Fevrier

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Background: Type 2 diabetes mellitus, a non-communicable metabolic disorder, is a fast-growing problem for health, as it presents numerous complications and death worldwide. St. Lucia, much like most other emerging nation in the Caribbean, struggles with the management of type 2 diabetes mellitus (T2DM) among its populace. Good knowledge, attitude, and practices [KAP] of T2DM are essential in the prevention and management of this disease.Lifestyle adaptation, including increased knowledge, positive attitude, and efficient practice towards lifestyle modifications, can avert the advancement of difficulties associated with diabetes. Methods: An institutional-based cross-sectional study was conducted during the period June 15, 2022, to July15 2022. Data were collected by using the self-administered questionnaire designed to collect the required information from participants, and the data wasanalyzed using the statistical package for social science (SPSS) version 26. Knowledge, attitude, and practice of lifestyle modification among participants were determined using descriptive statistics. Results: A total of 402 participants completed the study, fully yielding an 84% response rate. Overall, the assessed levels of KAP relating to the life-threatening complications of T2DM were moderate. Results further indicated that women outnumbered men 68.4% to 31.6%, respectively. Significant positive correlation (r= 0.244, p<0.001) and (r=.203, p<0.001) were found between the knowledge level as well as the attitude level of study respondents. Conclusion: The overall study findings regarding the level of knowledge and attitude concerning lifestyle modifications among study participants were interpreted as generally high. However, the practice of healthy lifestyle modification habits was poor. The current findings suggest a need for structured educational campaigns prioritizing the importance of lifestyle modifications (weight loss, smoking cessation, physical exercise) to the general population.

Keywords: Diabetes, knowledge, lifestyle, survey

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405 Numerical Investigation of Entropy Signatures in Fluid Turbulence: Poisson Equation for Pressure Transformation from Navier-Stokes Equation

Authors: Samuel Ahamefula Mba

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Fluid turbulence is a complex and nonlinear phenomenon that occurs in various natural and industrial processes. Understanding turbulence remains a challenging task due to its intricate nature. One approach to gain insights into turbulence is through the study of entropy, which quantifies the disorder or randomness of a system. This research presents a numerical investigation of entropy signatures in fluid turbulence. The work is to develop a numerical framework to describe and analyse fluid turbulence in terms of entropy. This decomposes the turbulent flow field into different scales, ranging from large energy-containing eddies to small dissipative structures, thus establishing a correlation between entropy and other turbulence statistics. This entropy-based framework provides a powerful tool for understanding the underlying mechanisms driving turbulence and its impact on various phenomena. This work necessitates the derivation of the Poisson equation for pressure transformation of Navier-Stokes equation and using Chebyshev-Finite Difference techniques to effectively resolve it. To carry out the mathematical analysis, consider bounded domains with smooth solutions and non-periodic boundary conditions. To address this, a hybrid computational approach combining direct numerical simulation (DNS) and Large Eddy Simulation with Wall Models (LES-WM) is utilized to perform extensive simulations of turbulent flows. The potential impact ranges from industrial process optimization and improved prediction of weather patterns.

Keywords: turbulence, Navier-Stokes equation, Poisson pressure equation, numerical investigation, Chebyshev-finite difference, hybrid computational approach, large Eddy simulation with wall models, direct numerical simulation

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