Search results for: anxiety disorder
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2002

Search results for: anxiety disorder

652 Non-Medical Prescription and Other Drug Use in Relation to Mental Health and World Beliefs: A Study of College Students

Authors: Sarah P. Wuebbolt, Ashlee N. Sawyer-Mays

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Non-medical prescription and other drug (NMPOD) use has been a significant public health issue for the last few decades, with problematic use increasing among university students more recently. The current study focused on associations between NMPOD use and mental health, well-being, and world beliefs among young adults. Young adults (N=513) completed online questionnaires assessing stress, demographic characteristics, self-esteem, NMPOD use, coping mechanisms, and anxiety. A substantial portion of participants reported using cannabis (48.5%, n=249), while smaller portions of participants reported using stimulants (26.7%, n = 137), sedatives (17.2%, n=88), opioids (10.8%, n=55), and hallucinogens (14.4%, n=74). Five hierarchical logistic regressions were performed to determine the independent relationships between mental health, well-being, and world belief factors and NMPOD use for the five classes of substances. After controlling for demographic factors (age, gender, race/ethnicity, sexual orientation, and religious affiliation), depression was associated with increased non-medical stimulant, opioid, and cannabis use; coping self-efficacy was associated with increased hallucinogen use, and attendance of worship services was associated with decreased non-medical cannabis and hallucinogen use. Results suggest that depression was strongly associated with non-medical stimulant, opioid, and cannabis use, and attendance of worship services was protective against cannabis and hallucinogen use. To the best of our knowledge, this is one of the first studies to investigate the relationships between mental health, well-being, world beliefs, and NMPOD use among young adults. The present study illuminates future targets for intervention, such as increased access to mental health diagnosis and treatment and the exploration of the roles of religion and shared community in the prevention of drug use among young adults.

Keywords: cannabis, mental health, non-medical prescription and other drug use, world beliefs

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651 The Efficacy of Clobazam for Landau-Kleffner Syndrome

Authors: Nino Gogatishvili, Davit Kvernadze, Giorgi Japharidze

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Background and aims: Landau Kleffner syndrome (LKS) is a rare disorder with epileptic seizures and acquired aphasia. It usually starts in initially healthy children. The first symptoms are language regression and behavioral disturbances, and the sleep EEG reveals abnormal epileptiform activity. The aim was to discuss the efficacy of Clobazam for Landau Kleffner syndrome. Case report: We report a case of an 11-year-old boy with an uneventful pregnancy and delivery. He began to walk at 11 months and speak with simple phrases at the age of 2,5 years. At the age of 18 months, he had febrile convulsions; at the age of 5 years, the parents noticed language regression, stuttering, and serious behavioral dysfunction, including hyperactivity, temper outbursts. The epileptic seizure was not noticed. MRI was without any abnormality. Neuropsychological testing revealed verbal auditory agnosia. Sleep EEG showed abundant left fronto-temporal spikes, reaching over 85% during non-rapid eye movement sleep (non-REM sleep). Treatment was started with Clobazam. After ten weeks, EEG was improved. Stuttering and behavior also improved. Results: Since the start of Clobazam treatment, stuttering and behavior improved. Now, he is 11 years old, without antiseizure medication. Sleep EEG shows fronto-temporal spikes on the left side, over 10-49 % of non-REM sleep, bioccipital spikes, and slow-wave discharges and spike-waves. Conclusions: This case provides further support for the efficacy of Clobazam in patients with LKS.

Keywords: Landau-Kleffner syndrome, antiseizure medication, stuttering, aphasia

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650 Reentrant Spin-Glass State Formation in Polycrystalline Er₂NiSi₃

Authors: Santanu Pakhira, Chandan Mazumdar, R. Ranganathan, Maxim Avdeev

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Magnetically frustrated systems are of great interest and one of the most adorable topics for the researcher of condensed matter physics, due to their various interesting properties, viz. ground state degeneracy, finite entropy at zero temperature, lowering of ordering temperature, etc. Ternary intermetallics with the composition RE₂TX₃ (RE = rare-earth element, T= d electron transition metal and X= p electron element) crystallize in hexagonal AlB₂ type crystal structure (space group P6/mmm). In a hexagonal crystal structure with the antiferromagnetic interaction between the moments, the center moment is geometrically frustrated. Magnetic frustration along with disorder arrangements of non-magnetic ions are the building blocks for metastable spin-glass ground state formation for most of the compounds of this stoichiometry. The newly synthesized compound Er₂NiSi₃ compound forms in single phase in AlB₂ type structure with space group P6/mmm. The compound orders antiferromagnetically below 5.4 K and spin freezing of the frustrated magnetic moments occurs below 3 K for the compound. The compound shows magnetic relaxation behavior and magnetic memory effect below its freezing temperature. Neutron diffraction patterns for temperatures below the spin freezing temperature have been analyzed using FULLPROF software package. Diffuse magnetic scattering at low temperatures yields spin glass state formation for the compound.

Keywords: antiferromagnetism, magnetic frustration, spin-glass, neutron diffraction

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649 Mechanism of Melanin Inhibition of Morello Flavone- 7″- Sulphate and Sargaol extracts from Garcinia livingstonei (Clusiaceae): Homology Modelling, Molecular Docking, and Molecular Dynamics Simulations

Authors: Ncoza Dlova, Tivani Mashamba-Thompson

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Garcinia livingstonei (Clusiaceae) extracts, morelloflavone- 7″- sulphate and sargaol were shown to be effective against hyper-pigmentation through inhibition of tyrosinase enzyme, in vitro . The aim of this study is to elucidate the structural mechanism through which morelloflavone- 7″- sulphate and sargaol binds human tyrosinase. Implementing a homology model to construct a tyrosinase model using the crystal structure of a functional unit from Octopus hemocyanin (PDB: 1JS8) as a reference template enabled us to create a human tyrosinase model. Molecular dynamics and binding free energy calculations were optimized to enable molecular dynamics simulation of the copper dependent inhibitors. Results show the importance of the hydrogen bond formation morelloflavone- 7″- sulphate and sargaol between compound and active site residues. Both complexes demonstrated the metallic coordination between compound and arginine residue as well as copper ions within the active site. The comprehensive molecular insight gained from this study should be vital in understanding the binding mechanism morelloflavone- 7″- sulphate and sargaol. Moreover, these results will assist in the design of novel of metal ion dependent enzyme inhibitors as potential anti-hyper-pigmentation disorder therapies.

Keywords: hyper-pigmentation disorders, dyschromia African skin, morelloflavone- 7″- sulphate, sagoal

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648 The Association of Smoking and Body Mass Index with Acne Vulgaris in Adolescents and Young Adults

Authors: Almutazballlah Qablan, Jihan M. Muhaidat, Bana Abu Rajab

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Background: Acne vulgaris is the most common skin condition that general practitioners and dermatologists encounter. It represents a chronic inflammatory disease affecting the pilosebaceous unit. Although acne vulgaris is not a life-threatening condition, it has a considerable psychological impact on the affected person. Acne patients have poor body image, low self-esteem, social isolation, and restricted activities. As part of the emotional impact, increased levels of anxiety, anger, depression, and frustration have also been observed in acne patients. (1) In this study, we want to assess the association between two modifiable risk factors; BMI and smoking, regarding acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Irbid, north Jordan in 2019/2020. A total number of 163 Acne cases were collected and interviewed by the author; on the other hand, there were 162 control cases. Anthropometric measures for Acne patients and control individuals were taken, and BMI was calculated. Both groups were asked about smoking habits. Data on subjects between 14 and 33 years of age were extracted. The characteristics of people who reported acne were compared with those with no acne using univariate and multivariate analysis. The Statistical Package for Social Sciences (SPSS) was relied on to analyze the collected data. The crosstabs methods (chi-square) and odd ratios were relied on to test the study hypothesis. Results: Cigarette smoking was highly associated with no-acne, with an odds ratio of 0.4 (95% CI: 0.2–0.9), P-value = 0.018. BMI and waterpipe smoking were not significantly associated with acne in the multivariate analysis. Conclusion: Cigarette smoking was found to be protective from Acne. No significant relation between BMI nor waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, BMI, smoking, case-control

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647 Applying the Information System to Enhance the Management of Perioperative Nursing

Authors: Ya-Yi Yen

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The operating room is a medical environment full of high-risk, high-complexity and high-cost. In addition to assuring patient safety, the operating room should effort on the efficient and safe medical quality for the surgical patients of high risk, elders, and children. If the nursing staffs of operation room carry on the pre-operative visiting prior to surgery, the patient's anxiety and complications are expected to be alleviated, and the hospitalization days may also be shortened. Purpose: Applying the information system to enhance pre-operative visiting, case tracking, and effectiveness recording Method: (I) Application the information system to screen cases by integrating the operation scheduling, and linking the severe surgery codes, for to shorten the time to track cases of operative visiting. Through the improvement, the time required decreased to 1.5 minutes per day from 20 minutes per day, and nursing staffs’ satisfaction with satisfaction for tracking and visiting procedure of case increased to 86% from 54%. (II)The electronic establishment of the operative visiting record enhanced the integrity of the operative visiting record. The integrity rate was rise to 92% from 66%, while nursing staffs’ satisfaction with the visiting record increased to 82% from 61.3%. Since information technology continues evolving, the application of information technology is helpful to the integration of nursing information, simplification of processes, and saving of man-hours. This article introduces the application of information systems to simplify the processes and improve the effectiveness of operation visiting and tracking, including the saving of time, improving the integrity rate of record, and improving the satisfaction of nursing staffs.

Keywords: effectiveness, information system, perioperative nursing, pre-operative visiting

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646 Neural Changes Associated with Successful Antidepressant Treatment in Adolescents with Major Depressive Disorder

Authors: Dung V. H. Pham, Kathryn Cullen

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Introduction: 40% of adolescents with major depression (MDD) are unresponsive to 1st line antidepressant treatment. The neural mechanism underlying treatment-responsive and treatment-resistant depression in adolescent are unclear. Amygdala is important for emotion processing and has been implicated in mood disorders. Past research has shown abnormal amygdala connectivity in adolescents with MDD. This research study changes in amygdala resting-state functional connectivity to find neural correlates of successful antidepressant treatment. Methods: Thirteen adolescents aged 12-19 underwent rfMRI before and after 8-week antidepressant treatment and completed BDI-II at each scan. A whole-brain approach, using anatomically defined amygdala ROIs (1) identified brain regions that are highly synchronous with the amygdala, (2) correlated neural changes with changes in overall depression and specific symptom clusters within depression. Results: Some neural correlates were common across domains: (1) decreased amygdala RSFC with the default mode network (posterior cingulate, precuneus) is associated with improvement in overall depression and many symptom clusters, (2) increased amygdala RSFC with fusiform gyrus is associated with symptom improvement across many symptom clusters. We also found unique neural changes associated with symptom improvement in each symptom cluster. Conclusion: This is the first preliminary study that looks at neural correlates of antidepressant treatment response to overall depression as well as different clusters of symptoms of depression. The finding suggests both overlapping and distinct neural mechanisms underlying improvement in each symptom clusters within depression. Some brain regions found are also implicated in MDD among adults in previous literature.

Keywords: depression, adolescents, fMRI, antidepressants

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645 Nutritive Value of Three-Stage Olive Cake (Olea europaea L.) for Growing Rabbit

Authors: Zahia Dorbane, Si Ammar Kadi, Dalila Boudouma, Thierry Gidenne

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In rabbits feeding, minimum fibre intake is essential to avoid digestive disorders. However, this concentration of fibre is not easy to obtain when formulating feeds, without reduction of nutritional value. Three stage olive cake, the residual material after oil extraction by centrifugation, including pulp and stones, can be used as a fibre source in rabbit diet. The incorporation of olive cake can allow a better balance between different fibre fractions and reduce health disorder. However, for practical use of any raw material, it is necessary to know its chemical and nutritive value. The aim of this study was to assess the nutritive value of three-stage olive cake (TSOC) for growing rabbits. Thus, 36 rabbits weaned at 35 days (702.8 ± 28.5) were divided into three groups of 12 receiving one of the following diets: control with 0% of TSOC, TSOC10 (10% of TSOC) and TSOC20 (20% TSOC). The rabbits were individually housed in digestibility cages and received ad libitum one of the three diets, fresh and clean water was provided ad libitum. After an adaptation period of 7d, feces were collected for 4d. Collected feces were frozen and stored for further analysis. The chemical composition of TSOC shows that it is a rich fiber raw material since it contains (%DM): 6% of CP; 7.4% of EE; 78.7% of NDF; 55.4% of ADF and 24.3% of ADL. The inclusion of TSOC at 20% of basal diet reduced the digestibility coefficient of organic matter, crude protein and NDF from 67.8 to 55.3%, 80.4 to 75.3% and from 31.5 to 18.4% (p < 0.001) respectively. The digestible energy and digestible protein content of the three-stage olive cake estimated by regression was 2.94 ± 0.52MJ DE/kg DM and 22.4 ± 6 g DP/kg DM respectively. In conclusion, based on the results of the present experiment, the three-stage olive cake can be used as a fibre source for rabbit.

Keywords: digestibility, nutritive value, olive cake, rabbit

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644 Students’ Perceptions of Well-Being and School-Based Well-Being Programs and Interventions

Authors: Amanda Madden

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The purpose of this research was to identify students understanding of well-being and perceptions of the effective components of school-based well-being programs they have participated in during their time in secondary school. With one in four adolescents suffering from some form of mental health disorder, which has the potential to directly impact their academic ability, schools have moved towards a more holistic approach to education, resulting in the growth of school-based well-being programs. There is limited research on the effectiveness of school-based well-being programs, with fewer studies examining students’ perspectives on their well-being. A mixed-method design was utilized, framed by a social constructivist methodology. Quantitative data was collected through a researcher-developed self-report survey, and qualitative data were collected through one-on-one interviews and a semi-structured focus group undertaken with Year 12 students from three independent co-educational schools in Western Australia. Preliminary findings indicate that participants have experienced a minimal impact, either positively or negatively, on their well-being from school-based well-being programs. The data detailed that adolescents consider happiness, positive attitude, good physical health, balance, emotional fulfillment and confidence components of well-being. The findings also highlighted sports, positive family relationships, positive friendships, and pets positively enhanced well-being. This research suggests that researchers and educational leaders should consider students’ understanding of well-being in the development of school-based well-being assessments and interventions. Students are the recipients of school-based well-being programs and are best placed to inform what they will and will not respond to in the determination of appropriate well-being content.

Keywords: wellbeing, school based wellbeing, adolescents, wellbeing interventions

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643 The Conceptual Exploration of Comfort Zone by Using Content Analysis

Authors: Lilla Szabó Hangya, Szilvia Jambori

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The comfort zone is less studied area in the field of psychology. One of the most important definitions is that comfort zone is a psychological state in which things feel familiar to a person with low level of anxiety and stress. But the validity of comfort zone does not confirm till now. The aim of our pilot research is to test which psychological factors could determine how young adults behave during their decision process to stay in one’s comfort zone or to leave it. Every person has a number of comfort zones, so we are not able to measure it directly, only those personality traits which predict if someone leaves his comfort zone easier or harder. In our study at first we wanted to clarify the meaning of comfort zone. 110 young adults (male: 37, female: 73; ages from 18 to 70, average age: 26,6) took part in the study. Beside their demographic datas we asked them what does the comfort zone mean for them. The results showed that the meaning of the comfort zone can be grouped in five dimensions: comfort (49,6 %), leaving it-change (8,1%), ambivalent feelings (10,6%), related to other people (10,6%), pursuit of self-realization (16,8%). Our results demonstrated age related characteristics. For young people at the age of 19 the comfort zone is related to other people, because during adolescents peer relationships become more important. Subjects at the age 20-30 answered that the comfort zone means comfort and stability for them. Their life becomes stable for a while, they are studying or working. But at the age of 25, when they finish university, most of them answered comfort zone means a changing process for them. On the other hand for subjects at the age of 27 the means of the comfort zone is pursuit of self-realization. After that period at the age of 31 when they have families and stable job the stability will also dominant. We saw that the comfort zone has much more meaning besides a pleasant psychological trait. Further we would like to determine which psychological factors relate to comfort zone, and what kind of personality traits could predict leaving or staying in one’s comfort zone. We want to observe the relationship between comfort zone and subjective well-being, life satisfaction self-efficacy or self-esteem.

Keywords: comfort zone, development, personality trait, young adults

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642 A New Source on Ottoman Self-Narratives: Kulakzade Mahmud Pasha’s Dream Diary

Authors: Semra Çörekçi̇

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In this study, a new source on Ottoman Self-narratives, Kulakzâde Mahmud Paşa’s Düşname (Dreambook), will be introduced to illustrate how dreams can provide a ground for historical analysis. The manuscript looks like a private notebook of an Ottoman official, Mahmud Pasha, who lived and operated in Rumelia in the early eighteenth century. It provides insight into the ordinary and daily concerns of a bureaucrat who had the knowledge and tools to record them in writing. On the one side of the notebook, Mahmud Pasha recorded his travels and appointments in 1730-1731. He wrote places that he reached and stayed every day. On the reverse side, the same author kept a record of his dreams and named that part of his notebook, Düşname. He recorded his dreams on a daily basis in writing and therefore they were well-preserved in a dream diary. This study aims at drawing the social, cultural and psychic life of an early modern Ottoman bureaucrat. It will uncover the ways and means whereby he interpreted his environment, as well as how he made meaning of his dreams considering the social milieu and historical context within which he lived. The first part will focus on 'official dreams' uncovering how his official life and ambitions coincide with his spiritual life. Related to this, connection between anxiety and dream narratives will be evaluated as dreams in which the mundane concerns of securing a post occupied the most central place in the construction of his narrative. A further point will be made by questioning Mahmud Pasha’s possible Sufi connections and his familiarity with the tradition of dream interpretation. Also, considering Mahmud Pasha’s inclusion of other’s dreams in his Düşnâme, the issue of dream-telling will be questioned in order to reveal how dreams were interconnected and how they created a space for social gathering.

Keywords: Ottoman self-narratives, dreams, diary, Ottoman cultural history

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641 A Hybrid Normalized Gradient Correlation Based Thermal Image Registration for Morphoea

Authors: L. I. Izhar, T. Stathaki, K. Howell

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Analyzing and interpreting of thermograms have been increasingly employed in the diagnosis and monitoring of diseases thanks to its non-invasive, non-harmful nature and low cost. In this paper, a novel system is proposed to improve diagnosis and monitoring of morphoea skin disorder based on integration with the published lines of Blaschko. In the proposed system, image registration based on global and local registration methods are found inevitable. This paper presents a modified normalized gradient cross-correlation (NGC) method to reduce large geometrical differences between two multimodal images that are represented by smooth gray edge maps is proposed for the global registration approach. This method is improved further by incorporating an iterative-based normalized cross-correlation coefficient (NCC) method. It is found that by replacing the final registration part of the NGC method where translational differences are solved in the spatial Fourier domain with the NCC method performed in the spatial domain, the performance and robustness of the NGC method can be greatly improved. It is shown in this paper that the hybrid NGC method not only outperforms phase correlation (PC) method but also improved misregistration due to translation, suffered by the modified NGC method alone for thermograms with ill-defined jawline. This also demonstrates that by using the gradients of the gray edge maps and a hybrid technique, the performance of the PC based image registration method can be greatly improved.

Keywords: Blaschko’s lines, image registration, morphoea, thermal imaging

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640 Unfolding the Affective Atmospheres during the COVID-19 Pandemic Crisis: The Constitution and Performance of Affective Governance in Taiwan

Authors: Sang-Ju Yu

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This paper examines the changing essences and effects of ‘affective atmosphere’ during the COVID-19 pandemic crisis, which have been facilitated and shaped the ‘affective governance’ in Taiwan. Due to long-term uncertainty and unpredictability, the COVID-19 pandemic not only caused unprecedented global crisis but triggered the public’s negative emotional responses. This paper unravels how the shortage of Personal Protective Equipment and the proliferating fake news heightened people’s fear and anxiety and how specific affective atmospheres can be provoked and manipulated to harness emotional appeals of citizens strategically in Taiwan. Through the in-depth interviews with diverse stakeholders involved, it unfolds the dynamics and strategies of affective governance, wherein public emotions and concerns are now given significant consideration in both policy measures and the affective expression of leadership, spatial arrangement, service delivery, and the interaction with citizens. Addressing psychosocial and emotional needs has become the core of crisis response mechanisms suited to dynamic affective atmospheres and pandemic situation. This paper also demonstrates that epidemic prevention and control is not merely the production of neutral or rational policy-making processes, as it is dominated by multiple emotions resulted from unexpected and salient events at different moments. It provides explicit insight into how different prevention scenarios operated effectively through political and affective mobilisation to strengthen emotional bonding and collective identity which energises collective action. Basically, successful affective governance calls for both negative and positive emotions, for both scientific and political decision-making, for both community and bureaucracy, and both quality and efficiency of private–public collaboration.

Keywords: affective atmospheres, affective governance, COVID-19 pandemic, private-public collaboration

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639 Unraveling the Complexity of Postpartum Distress: Examining the Influence of Alexithymia, Social Support, Partners' Support, and Birth Satisfaction on Postpartum Distress among Bulgarian Mothers

Authors: Stela Doncheva

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Postpartum distress, encompassing depressive symptoms, obsessions, and anxiety, remains a subject of significant scientific interest due to its prevalence among individuals giving birth. This critical and transformative period presents a multitude of factors that impact women's health. On the one hand, variables such as social support, satisfaction in romantic relationships, shared newborn care, and birth satisfaction directly affect the mental well-being of new mothers. On the other hand, the interplay of hormonal changes, personality characteristics, emotional difficulties, and the profound life adjustments experienced by mothers can profoundly influence their self-esteem and overall physical and emotional well-being. This paper extensively explores the factors of alexithymia, social support, partners' support, and birth satisfaction to gain deeper insights into their impact on postpartum distress. Utilizing a qualitative survey consisting of six self-reflective questionnaires, this study collects valuable data regarding the individual postpartum experiences of Bulgarian mothers. The primary objective is to enrich our understanding of the complex factors involved in the development of postpartum distress during this crucial period. The results shed light on the intricate nature of the problem and highlight the significant influence of bio-psycho-social elements. By contributing to the existing knowledge in the field, this research provides valuable implications for the development of interventions and support systems tailored to the unique needs of mothers in the postpartum period. Ultimately, this study aims to improve the overall well-being of new mothers and promote optimal maternal health during the postpartum journey.

Keywords: maternal mental health, postpartum distress, postpartum depression, postnatal mothers

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638 CYP2D6*4 Allele Frequency and Extrapyramidal Side Effects during Haloperidol Therapy Among Russians and Tatars: A Pilot Study

Authors: Irina S. Burashnikova, Dmitriy A. Sychev, Ruslan Y. Kazakov

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Сytochrome P450 CYP2D6 activity affects antipsychotic therapy safety. CYP2D6*4 polymorphism frequency varies among different ethnic groups. We studied CYP2D6*4 polymorphism frequency in Tatar and Russian schizophrenic patients and association of CYP2D6*4 polymorphism and extrapyramidal disorders (EPD) frequency in schizophrenic patients on haloperidol monotherapy in daily doses up to 20 mg. Results: Heterozygous CYP2D6*4 allele carrier frequency among Tatars was lower (23.8% vs 32.4% in Russians), but the differences did not reach statistical significance. CYP2D6*4 allele frequency among Tatars was also lower (11.9% vs 24.3% in Russians), but the difference was not quite significant (p=0.0592). Average daily haloperidol dose in the group without EPD was significantly higher than in the group with EPD (11.35±4.6 vs 13.87±3.3 mg, p=0.0252), but average daily haloperidol dose/weight ratios in the compared groups had no significant differences. Statistically significant association between EPD development and heterozygous CYP2D6*1/*4 genotype and CYP2D6*4 allele carrier frequency was revealed among all schizophrenic patients and among those of Tatar nationality. Further well designed pharmacogenetic studies in different Russian regions are needed to improve psychotropic therapy safety and to establish evidence-based indications for pharmacogenetic testing in clinical practice.

Keywords: antipsychotic, CYP2D6 polymorphism, ethnic differences of CYP2D6*4 allele frequency, extrapyramidal side effects/disorder, schizophrenia, pharmacogenetics, Russians, Tatars

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637 The Ameliorative Effects of the Histamine H3 Receptor Antagonist/Inverse Agonist DL77 on MK801-Induced Memory Deficits in Rats

Authors: B. Sadek, N. Khan, Shreesh K. Ojha, Adel Sadeq, D. Lazewska, K. Kiec-Kononowicz

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The involvement of Histamine H3 receptors (H3Rs) in memory and the potential role of H3R antagonists in pharmacological control of neurodegenerative disorders, e.g., Alzheimer disease (AD) is well established. Therefore, the memory-enhancing effects of the H3R antagonist DL77 on MK801-induced cognitive deficits were evaluated in passive avoidance paradigm (PAP) and novel object recognition (NOR) tasks in adult male rats, applying donepezil (DOZ) as a reference drug. Animals pretreated with acute systemic administration of DL77 (2.5, 5, and 10 mg/kg, i.p.) were significantly ameliorated in regard to MK801-induced memory deficits in PAP. The ameliorative effect of most effective dose of DL77 (5 mg/kg, i.p.) was abrogated when animals were pretreated with a co-injection with the H3R agonist R-(α)-methylhistamine (RAMH, 10 mg/kg, i.p.). Moreover, and in the NOR paradigm, DL77 (5 mg/kg, i.p.) reversed MK801-induced deficits long-term memory (LTM), and the DL77-provided procognitive effect was comparable to that of reference drug DOZ, and was reversed when animals were co-injected with RAMH (10 mg/kg, i.p.). However, DL77(5 mg/kg, i.p.) failed to alter short-term memory (STM) impairment in NOR test. Furthermore, DL77 (5 mg/kg) failed to induce any alterations of anxiety and locomotor behaviors of animals naive to elevated-plus maze (EPM), indicating that the ameliorative effects observed in PAP or NOR tests were not associated to alterations in emotions or in natural locomotion of tested animals. These results reveal the potential contribution of H3Rs in modulating CNS neurotransmission systems associated with neurodegenerative disorders, e.g., AD.

Keywords: histamine H3 receptor, antagonist, learning and memory, Alzheimer's disease, neurodegeneration, passive avoidance paradigm, novel object recognition, behavioral research

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636 Role of Selenium and Vitamin E in Occupational Exposure to Heavy Metals (Mercury, Lead and Cadmium): Impact of Working in Lamp Factory

Authors: Tarek Elnimr, Rabab El-kelany

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Heavy metals are environmental contaminants that may pose long-term health risks. Unfortunately, the consequent implementation of preventive measures was generally delayed, causing important negative effects to the exposed populations. The objective of this study was to determine whether co-consumption of nutritional supplements as selenium and vitamin E would treat the hazardous effects of exposure to mercury, lead and cadmium. 108 workers (60 males and 48 females) were the subject of this study, their ages ranged from 19-63 years, (M = 29.5±10.12). They were working in lamp factory for an average of 0.5-40 years (M= 5.3±8.8). Twenty control subjects matched for age and gender were used for comparison. All workers were subjected to neuropsychiatric evaluation. General Health Questionnaire (GHQ-28) revealed that 44.4% were complaining of anxiety, 52.7% of depression, 41.6% of social dysfunction and 22.2% of somatic symptoms. Cognitive tests revealed that long-term memory was not affected significantly when compared with controls, while short term memory and perceptual ability were affected significantly. Blood metal levels were measured by Inductively Coupled Plasma – optical emission spectrometry(ICP-OES), and revealed that the mean blood mercury, lead and cadmium concentrations before treatment were 1.6 mg/l, 0.39 mg/l and 1.7 µg/l, while they decreased significantly after treatment to 1.2 mg/l, 0.29 mg/l and 1.3 µg/l respectively. Anti-oxidative enzymes (paraoxonase and catalase) and lipid peroxidation product (malondialdehyde) were measured before and after treatment with selenium and vitamin E, and showed significant improvement. It could be concluded that co-consumption of selenium and vitamin E produces significant decrease in mercury, lead and cadmium levels in blood.

Keywords: mercury, lead, cadmium, neuropsychiatric impairment, selenium, vitamin E

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635 Characterization of the Intestinal Microbiota: A Signature in Fecal Samples from Patients with Irritable Bowel Syndrome

Authors: Mina Hojat Ansari, Kamran Bagheri Lankarani, Mohammad Reza Fattahi, Ali Reza Safarpour

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Irritable bowel syndrome (IBS) is a common bowel disorder which is usually diagnosed through the abdominal pain, fecal irregularities and bloating. Alteration in the intestinal microbial composition is implicating to inflammatory and functional bowel disorders which is recently also noted as an IBS feature. Owing to the potential importance of microbiota implication in both efficiencies of the treatment and prevention of the diseases, we examined the association between the intestinal microbiota and different bowel patterns in a cohort of subjects with IBS and healthy controls. Fresh fecal samples were collected from a total of 50 subjects, 30 of whom met the Rome IV criteria for IBS and 20 Healthy control. Total DNA was extracted and library preparation was conducted following the standard protocol for small whole genome sequencing. The pooled libraries sequenced on an Illumina Nextseq platform with a 2 × 150 paired-end read length and obtained sequences were analyzed using several bioinformatics programs. The majority of sequences obtained in the current study assigned to bacteria. However, our finding highlighted the significant microbial taxa variation among the studied groups. The result, therefore, suggests a significant association of the microbiota with symptoms and bowel characteristics in patients with IBS. These alterations in fecal microbiota could be exploited as a biomarker for IBS or its subtypes and suggest the modification of the microbiota might be integrated into prevention and treatment strategies for IBS.

Keywords: irritable bowel syndrome, intestinal microbiota, small whole genome sequencing, fecal samples, Illumina

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634 Assessing Undergraduate Students' Awareness and Utilization of University Mental Health Services and Programs for Depression: A Case Study

Authors: Calvin Odhiambo

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Depression among young adults is a common health problem and a growing public health concern. Of the young adult population, college students are particularly vulnerable to depression as they find themselves grappling with the stress and anxiety of college life while at the same navigating the demands of separation and independence from familial ties. To deal with the resultant mental health challenges affecting this population, most colleges offer counseling services to their student population. What is not known, however, is the extent to which students are aware of or even utilize such mental health services. Our study set out to assess the level of student awareness and utilization of counseling services and programs at a southeastern public university in the United States. Data were collected through self-administered questionnaires given to a convenience sample of 508 undergraduate students voluntarily recruited from 38 classes representing five colleges. Data analysis was done using the Statistical Package of Social Sciences (SPSS) version 25. Results showed that even though a majority of students were aware of the mental health services offered by the university, an overwhelming majority of these students did not utilize any of these services or participate in any mental health programs offered by the university. Significant gender and racial differences were observed. Reasons for the lack of awareness and utilization of mental health services are explored. Recommendations are made on how to increase student awareness and utilization of mental health services, and the implications of the findings are discussed. The findings of this study help to fill an academic lacuna on this issue and provides an important basis for developing policies to help mitigate the growing problem of depression and attendant mental health problems among undergraduate students.

Keywords: depression, counseling services, undergraduate college students, utilization of mental health services, perceptions and awareness

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633 Prenatal Lead Exposure and Postpartum Depression: An Exploratory Study of Women in Mexico

Authors: Nia McRae, Robert Wright, Ghalib Bello

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Introduction: Postpartum depression is a prevalent mood disorder that is detrimental to the mental and physical health of mothers and their newborns. Lead (Pb) is a toxic metal that is associated with hormonal imbalance and mental impairments. The hormone changes that accompany pregnancy and childbirth may be exacerbated by Pb and increase new mothers’ susceptibility to postpartum depression. To the best of the author’s knowledge, this is the only study that investigates the association between prenatal Pb exposure and postpartum depression. Identifying risk factors can contribute to improved prevention and treatment strategies for postpartum depression. Methods: Data was derived from the Programming Research in Obesity, Growth, Environment and Social Stress (PROGRESS) study which is an ongoing longitudinal birth cohort. Postpartum depression was identified by a score of 13 or above on the 10-Item Edinburg Postnatal Depression Scale (EPDS) 6-months and 12-months postpartum. Pb was measured in the blood (BPb) in the second and third trimester and in the tibia and patella 1-month postpartum. Quantile regression models were used to assess the relationship between BPb and postpartum depression. Results: BPb in the second trimester was negatively associated with the 80th percentile of depression 6-months postpartum (β: -0.26; 95% CI: -0.51, -0.01). No significant association was found between BPb in the third trimester and depression 6-months postpartum. BPb in the third trimester exhibited an inverse relationship with the 60th percentile (β: -0.23; 95% CI: -0.41, -0.06), 70th percentile (β: -0.31; 95% CI: -0.52, -0.10), and 90th percentile of depression 12-months postpartum (β: -0.36; 95% CI: -0.69, -0.03). There was no significant association between BPb in the second trimester and depression 12-months postpartum. Bone Pb concentrations were not significantly associated with postpartum depression. Conclusion: The negative association between BPb and postpartum depression may support research which demonstrates lead is a nontherapeutic stimulant. Further research is needed to verify these results and identify effect modifiers.

Keywords: depression, lead, postpartum, prenatal

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632 Pattern and Clinical Profile of Children and Adolescent Visiting Psychiatry Out Patient Department of Tertiary Health Center Amidst COVID Pandemic- a Cross Sectional Study

Authors: Poornima Khadanga, Gaurav Pawar, Madhavi Rairikar

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Background: The COVID 19 pandemic, with its unparalleled mental health repercussions, has impacted people globally and has catalyzed a Mental Health pandemic among the youth. The detrimental effects on mental health needs to be pondered at the earliest. Aims: To study the behavioral problems among children and adolescents visiting Psychiatry Outpatient Department Tertiary Health Care during COVID pandemic and its correlation with socio-demographic profiles. Methods: A cross sectional study was conducted by interviewing 120 participants between 4 to 17 years of age and their parents, visiting Psychiatry OPD. Behavioral problems were assessed using the Strength and Difficulties Questionnaire and diagnosed by DSM-5. Statistical analysis was done by SPSS-21. Results: Male participants showed significant association with conduct (t=2.36, p=0.02) and hyperactive problems (t=5.07, p<0.05). Increase in screen time showed a positive correlation with conduct problems (r=0.22. p=0.02). Attention Deficit Hyperkinetic Disorder (18.3%) was the most commonly diagnosed psychiatric illness. Total difficulty score was significantly associated with difficult temperament (F=68.69, p<0.05). Conclusion: The study brings to light the pattern of behavioral problems that emerged during recent times of uncertainties among the young ones, including those with special needs. The increase in disruptive behaviors with increase screen time needs to be addressed at the earliest.

Keywords: behavioral problems, pandemic, screen time, temperament

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631 Exploration of FOMO, or the 'Fear of Missing out' and the Use of Mindfulness and Values-Based Interventions for Alleviating Its Effects and Bolstering Well-Being

Authors: Chasity O'Connell

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The use of social media and networking sites play a significant role in the lives of adolescents and adults. While research supports that social support and connectedness in general is beneficial; the nature of communication and interaction through social media and its subsequent benefits and impacts could be arguably different. As such, this research aims to explore a specific facet of social media interaction called fear of missing out, or 'FOMO' and investigate its relationship within the context of life stressors, social media usage, anxiety and depressive-symptoms, mindfulness, and psychological well-being. FOMO is the 'uneasy and sometimes all-consuming feeling that you’re missing out—that your peers are doing, in the know about, or in possession of more or something better than you'. Research suggests that FOMO can influence an individual’s level of engagement with friends and social media consumption, drive decisions on participating in various online or offline activities, and ultimately impact mental health. This study hopes to explore the potentially mitigating influence of mindfulness and values-based interventions in reducing the discomfort and distress that can accompany FOMO and increase the sense of psychological well-being in allowing for a more thoughtful and deliberate engagement in life. This study will include an intervention component wherein participants (comprised of university students and adults in the community) will partake in a six-week, group-based intervention focusing on learning practical mindfulness skills and values-exploration exercises (along with a waitlist control group). In doing so, researchers hope to understand if interventions centered on increasing one’s awareness of the present moment and one’s internal values impact decision-making and well-being with regard to social interaction and relationships.

Keywords: FOMO, mindfulness, values, stress, psychological well-being, intervention, distress

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630 Haemoglobin Variants and Their Frequency Distribution in Human Population of Niger State, Nigeria

Authors: Akeem Akinboro, Bala Alhaj Kegun

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Haemoglobinopathy is a genetic disorder that has the potentiality to cause death of individuals in whom both the alpha (α) and beta (β) globin chains of the haemoglobin molecule are defective due to mutations in their genes. The haemoglobin genotype variants among some residents of Niger state, Nigeria, were determined using the secondary data available at Bida, Minna and Kotangora general hospitals of the state. A total of 1,639 data, representing 434, 655 and 550, collected from the outside patients who visited the medical laboratory units of the three general hospitals, respectively, over five years period (2015-2020) were analyzed into gene frequency, sex and age to determine their haemoglobin genotypes status. More males (51.6 – 58.7%) than females (41.3 – 48.4%) visited the three hospitals during the period covered and most of the patients were between 11 - 20 years old. The frequency of HbA allele in the human population was 0.72, 0.65, 0.68 for Bida, Minna and Kotangora, respectively, while it was 0.25, 0.29 and 0.28 for HbS allele. The HbC allele was prevalent at 0.03, 0.06 and 0.05 among the human population in Bida, Minna and Kotangora cities of Niger state. In overall, the prevalence of HbA, HbS and HbC alleles in Niger state of Nigeria was 0.68, 0.28 and 0.05. Minna being the capital city of Niger state and the most populous among the three cities in the state seems to have influx of more people who are carriers of abnormal haemoglobin genotypes which has resulted to higher frequency of HbS and HbC than those of the other two cities in this study. These results show that the pattern of haemoglobin genotypes frequency of Kontagora could be a prediction for the whole of Niger state. It is therefore necessary and important to take screening of blood for haemoglobin genotype serious among intending couples to prevent and reduce the possibility of having increase in the number of people with abnormal haemoglobin genotypes in the state.

Keywords: haemoglobin, genotype, niger state, gene frequency, general hospitals

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629 Playing Safely: An Exploration of Irish Parental Attitudes Towards Risky Play and Its Impact on Play Opportunities for Children

Authors: Fiona Armstrong, David Gaul, Michael Barrett, Lorraine D'Arcy

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Playing is an instinctive and universal human behavior, is a child’s way of learning and an outlet for their innate need of activity. Risky play can be defined as any play that is thrilling or exciting involving the risk of injury. The benefits of risky play have been acknowledged as helping children to explore and conquer fears, develop confidence, reduce anxiety, and develop risk-management skills. Studies indicate that children learn sound judgment by assessing and confronting risks in relation to their own capabilities through exposure to carefully managed play experiences. Risky play has been associated with danger and increased risk of injury, with families focusing on risk aversion and protecting children from the risks inherent in the modern world. Despite children needing cultural, social, emotional, physical, and geographical space to play, the opportunity for children to play is diminishing. Aim: This study explores play behaviors and risky play in an Irish context by investigating parental attitudes to risky play. Methodology: This is a mixed methods study involving the State of Play survey and semi-structured interviews exploring parental attitudes to risky play. Data will be quantitatively analyzed using descriptive and inferential statistics using IBM SPSS and qualitatively analyzed via thematic analysis using NVivo. Conclusion: The information gathered could advise stakeholders regarding the creation and provision of developmentally appropriate, challenging, stimulating, adaptable, accessible, and safe as necessary outdoor play areas. This research can inform parents, planners, architects, and authorities involved in creating environments for play and contribute to policy development.

Keywords: child development, parental attitudes, play opportunities, risky play

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628 Narrative Review Evaluating Systematic Reviews Assessing the Effect of Probiotic Interventions on Depressive Symptoms

Authors: Ibrahim Nadeem, Mohammed Rahman, Yasser Ad-Dab’Bagh, Mahmood Akhtar

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Depression is one of the most prevalent mental illnesses and is often associated with various other medical disorders. In this review, we aim to evaluate existing systematic reviews that investigate the use of probiotics as a treatment for depressive symptoms. Five online databases were searched for relevant studies up to December 2017. Systematic reviews that included randomized controlled trials assessing the efficacy of probiotics in the treatment of depressive symptoms were included. Seven systematic reviews met the inclusion criteria. Three of these reviews conducted meta-analyses, out of which, two found probiotics to significantly improve depressive symptoms in the sample population. Two meta-analyses conducted subgroup analysis based on health status, and both found probiotics to significantly decrease depressive symptoms in patients with major depressive disorder, but only one review found it to significantly decrease in healthy patients. Another subgroup analysis was conducted based on age, and found probiotics to produce significant effects on subjects under the age of 60, but close to no effect on patients over the age of 65. Out of the four reviews that conducted qualitative analysis, three reviews concluded that probiotics have the potential to be used as a treatment. Due to the differences in clinical trials, a definitive effect of probiotics on depressive symptoms cannot be concluded. Nonetheless, probiotics seem to produce a significant therapeutic effect for subjects with pre-existing depressive symptoms. Further studies are warranted for definitive conclusions.

Keywords: depression, gut-brain axis, gut microbiota, probiotic, psychobiotic

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627 Evaluation of the Benefit of Anti-Endomysial IgA and Anti-Tissue Transglutaminase IgA Antibodies for the Diagnosis of Coeliac Disease in a University Hospital, 2010-2016

Authors: Recep Keşli, Onur Türkyılmaz, Hayriye Tokay, Kasım Demir

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Objective: Coeliac disease (CD) is a primary small intestine disorder caused by high sensitivity to gluten which is present in the crops, characterized by inflammation in the small intestine mucosa. The goal of this study was to determine and to compare the sensitivity and specificity values of anti-endomysial IgA (EMA IgA) (IFA) and anti-tissue transglutaminase IgA (anti-tTG IgA) (ELISA) antibodies in the diagnosis of patients suspected with the CD. Methods: One thousand two hundred seventy three patients, who have applied to gastroenterology and pediatric disease polyclinics of Afyon Kocatepe University ANS Research and Practice Hospital were included into the study between 23.09.2010 and 30.05.2016. Sera samples were investigated by immunofluorescence method for EMA positiveness (Euroimmun, Luebeck, Germany). In order to determine quantitative value of Anti-tTG IgA (EIA) (Orgentec Mainz, Germany) fully automated ELISA device (Alisei, Seac, Firenze, Italy) were used. Results: Out of 1273 patients, 160 were diagnosed with coeliac disease according to ESPGHAN 2012 diagnosis criteria. Out of 160 CD patients, 120 were female, 40 were male. The EMA specificity and sensitivity were calculated as 98% and 80% respectively. Specificity and sensitivity of Anti-tTG IgA were determined as 99% and 96% respectively. Conclusion: The specificity of EMA for CD was excellent because all EMA-positive patients (n = 144) were diagnosed with CD. The presence of human anti-tTG IgA was found as a reliable marker for diagnosis and follow-up the CD. Diagnosis of CD should be established on both the clinical and serologic profiles together.

Keywords: anti-endomysial antibody, anti-tTG IgA, coeliac disease, immunofluorescence assay (IFA)

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626 Prevalence and Pattern of Drug Usage among Youth in Ogbomoso, Nigeria

Authors: Samson F. Agberotimi, Rachel B. Asagba, Choja Oduaran

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Disturbing rate of use of different substances such as cannabis, alcohol, as well as pharmaceutical drugs among Nigerian youth in recent times has been affirmed in the literature. There is, however, a paucity of literature addressing the pattern of usage of such drugs, especially for clinical relevance and intervention planning. The present study investigated the prevalence and pattern of drug usage among youth in Ogbomoso, Nigeria. A cross-sectional survey involving 92 purposively selected participants comprising of 82 males and 10 females aged between 15 and 24 years was conducted. A measure of drug involvement and demographic characteristics was administered to the participants. Descriptive analysis was done using the SPSS v.21. Cannabis (79.4%), alcohol (77.2%), codeine (70.7%), tobacco (65.2%) and tramadol (47.8%) are the five most frequently used substances. However, the majority of the users of tobacco (68.3%) and alcohol (62.0%) are casual users indicating a mild level of use of the substances among the participants. On the other hand, 49.2% of the codeine users, 27.3% of the tramadol users, and 21.9% of the cannabis users reported harmful/intensive levels of use. Furthermore, the results revealed individuals at the pathological level of use as 28.8% for cannabis, 25.0% for tramadol, and 21.6% for codeine, and thus require clinical/therapeutic intervention. In conclusion, cannabis remains the most frequently used substance among youths. However, there appears to be a shift from the use of conventional psychoactive substances to pharmaceutical/prescription drugs such as codeine and tramadol. The findings of this study raised the need for both preventive and therapeutic interventions addressing the problem of substance use disorder among youth in contemporary society.

Keywords: Ogbomoso, pattern of drug use, prevalence of drug use, youth

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625 The Moderating Effect of Pathological Narcissism in the Relationship between Victim Justice Sensitivity and Anger Rumination

Authors: Isil Coklar-Okutkan, Miray Akyunus

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Victim sensitivity is a form of justice sensitivity that reflects the tendency to perceive injustice to one’s disadvantage. Victim sensitivity is considered as a dysfunctional trait that predicts anger, aggression, uncooperative behavior, depression and anxiety. Indeed, exploring the mechanism of association between victim sensitivity and anger is clinically important since it can lead to externalizing and internalizing problems. This study aims to investigate the moderating role of pathological narcissism in the relationship between victim sensitivity and anger rumination. Through testing different models where subtypes of narcissism and anger rumination components are included independently, the specific mechanism of different ruminative processes in anger is investigated. The sample consisted of 311 undergraduate students from Turkey, 107 of whom were males, and 204 were females. Participants completed Justice Sensitivity Inventory-Victim Subscale, Pathological Narcissism Inventory and Anger Rumination Scale. In the proposed double moderation model, vulnerable and grandiose narcissism was the moderators in the relationship between victim justice sensitivity and anger rumination. Four separate models were tested where one of the four components of anger rumination (angry afterthoughts, thoughts of revenge, angry memories, understanding of causes) were the dependent variable in each model. Results revealed that two of the moderation models are significant. Firstly, grandiose narcissism is the only moderator in the relationship between victim sensitivity and thoughts of revenge. Secondly, vulnerable narcissism is the only moderator in the relationship between victim sensitivity and understanding causes. Accordingly, grandiose narcissism is positively associated with the thoughts of revenge, and vulnerable narcissism is positively associated with understanding causes, only when the level of victim sensitivity is high. To summarize, increased victim sensitivity leads to ruminative thoughts of revenge in individuals with grandiose narcissism, whereas it leads to rumination on causes of the incident in individuals with vulnerable narcissism. The clinical implications of the findings are discussed.

Keywords: anger rumination, victim sensitivity, grandiose narcissism, vulnerable narcissism

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624 Cognitive Functioning and Cortisol Suppression in Major Depression in a Long-Term Perspective

Authors: Pia Berner Hansson, Robert Murison Anders Lund, Hammar Åsa

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Major Depressive Disorder (MDD) is often associated with high levels of stress and disturbances in the Hypothalamic Pituitary Adrenal (HPA) system, yielding high levels of cortisol, in addition to cognitive dysfunction. Previous studies in this patient group have shown a relationship between cortisol profile and cognitive functioning in the acute phase of MDD and that the patients had significantly less suppression after dexamethasone administration. However, few studies have investigated this relationship over time and in phases of symptom reduction. The aim of the present study was to examine the relationships between cortisol levels after the Dexamethasone Suppression Test (DST) and cognitive function in a long term perspective in MDD patients. Patients meeting the DSM-IV criteria for a MDD were included in the study and tested in symptom reduction. A control group was included. Cortisol was measured in saliva collected with Salivette sampling devices. Saliva samples were collected 4 times during a 24 hours period over two consecutive days: at awakening, after 45 minutes, after 7 hours and at 11 pm. Dexamethasone (1.0 mg) was given on Day 1 at 11 pm. The neuropsychological test battery consisted of standardized tests measuring memory and Executive Functioning (EF). Cortisol levels did not differ significantly between patients and controls on Day 1 or Day 2. Both groups showed significant suppression after Dexamethasone. There were no correlations between cortisol levels or suppression after Dexamethasone and cognitive measures. The results indicate that the HPA-axis functioning normalizes in phases of symptom reduction in MDD patients and that there no relation between cortisol profile and cognitive functioning in memory or EF.

Keywords: depression, MDD, cortisol, suppression, cognitive functioning

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623 A Spatial Autocorrelation Analysis of Women’s Mental Health and Walkability Index in Mashhad City, Iran, and Recommendations to Improve It

Authors: Mohammad Rahim Rahnama, Lia Shaddel

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Today, along with the development of urbanism, its negative consequences on the health of citizens are emerging. Mental disorders are common in the big cities, while mental health enables individuals to become active citizens. Meanwhile, women have a larger share of mental problems. Depression and anxiety disorders have a higher prevalence rate among women and these disorders affect the health of future generations, too. Therefore, improving women’s mental health through the potentials offered by urban spaces are of paramount importance. The present study aims to first, evaluate the spatial autocorrelation of women’s mental health and walkable spaces and then present solutions, based on the findings, to improve the walkability index. To determine the spatial distribution of women’s mental health in Mashhad, Moran's I was used and 1000 questionnaire were handed out in various sub-districts of Mashhad. Moran's I was calculated to be 0.18 which indicates a cluster distribution pattern. The walkability index was calculated using the four variables pertaining to the length of walkable routes, mixed land use, retail floor area ratio, and household density. To determine spatial autocorrelation of mental health and the walkability index, bivariate Moran’s I was calculated. Moran's I was determined to be 0.37 which shows a direct spatial relationship between variables; 4 clusters in 9 sub-districts of Mashhad were created. In High-Low cluster, there was a negative spatial relationship and hence, to identify factors affecting walkability in urban spaces semi-structures interviews were conducted with 21 women in this cluster. The findings revealed that security is the major factor influencing women’s walking behavior in this cluster. In accordance with the findings, some suggestions are offered to improve the presence of women in this sub-district.

Keywords: Mashhad, spatial autocorrelation, women’s mental health, walkability index

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