Search results for: posttraumatic stress disorder
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4936

Search results for: posttraumatic stress disorder

3376 The Effect of Surface Roughness on the Fatigue Life of SCM440 Steel

Authors: C. Han, H. Kim, S. Park

Abstract:

The purpose of the present study is to analyze the effect of surface roughness on fatigue life of SCM440 steel. Two groups of specimens were made from SCM440 steel with and without surface polished after forging process and resulted in different values of surface roughness. The difference of the surface roughness between two groups was clearly distinguished even to the naked eye. Surface roughness of both groups of the specimens was quantitatively measured by a roughness measuring device, Talysurf series2 (Taylor-Hobson Co., USA). Average roughness (Ra) and maximum roughness depth (Rmax) values were obtained by scanning 45 mm with a speed of 0.25 mm/s. Fatigue tests were conducted using a three-point bending method with a cyclic sinusoidal profile of 5 Hz, stress ratio of R = 0.1 and reference life for fatigue limit of 1 × 106 cycles. Ra and Rmax without surface polished were 10.497 ± 1.721 μm and 87.936 ± 16.210 μm, respectively while those values with surface polished were much smaller (ongoing measurements). Fatigue lives of the surface-polished specimens achieved approximately 1 × 106 cycles under the maximum stress of 900 MPa, which was 10 times longer than those of the surface-untreated specimens with an average roughness of 10.082 μm. The results showed that an increase in surface roughness values led to a decrease in fatigue lives.

Keywords: surface roughness, fatigue test, fatigue life, SCM440 steel

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3375 Free Radical Scavenging Activity and Total Phenolic Assessment of Drug Repurposed Medicinal Plant Metabolites: Promising Tools against Post COVID-19 Syndromes and Non-Communicable Diseases in Botswana

Authors: D. Motlhanka, M. Mine, T. Bagaketse, T. Ngakane

Abstract:

There is a plethora of evidence from numerous sources that highlights the triumph of naturally derived medicinal plant metabolites with antioxidant capability for repurposed therapeutics. As post-COVID-19 syndromes and non-communicable diseases are on the rise, there is an urgent need to come up with new therapeutic strategies to address the problem. Non-communicable diseases and Post COVID-19 syndromes are classified as socio-economic diseases and are ranked high among threats to health security due to the economic burden they pose to any government budget commitment. Research has shown a strong link between accumulation of free radicals and oxidative stress critical for pathogenesis of non-communicable diseases and COVID-19 syndromes. Botswana has embarked on a robust programme derived from ethno-pharmacognosy and drug repurposing to address these threats to health security. In the current approach, a number of medicinally active plant-derived polyphenolics are repurposed and combined into new medicinal tools to target diabetes, Hypertension, Prostate Cancer and oxidative stress induced Post COVID 19 syndromes such as “brain fog”. All four formulants demonstrated Free Radical scavenging capacities above 95% at 200µg/ml using the diphenylpicryalhydrazyl free radical scavenging assay and the total phenolic contents between 6899-15000GAE(g/L) using the folin-ciocalteau assay respectively. These repurposed medicinal tools offer new hope and potential in the fight against emerging health threats driven by hyper-inflammation and free radical-induced oxidative stress.

Keywords: drug repurposed plant polyphenolics, free radical damage, non-communicable diseases, post COVID 19 syndromes

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3374 Tension-Free Vaginal Tape Secur (TVT Secur) versus Tension-Free Vaginal Tape-Obturator (TVT-O) from inside to outside in Surgical Management of Genuine Stress Urinary Incontinence

Authors: Ibrahim Mohamed Ibrahim Hassanin, Hany Hassan Mostafa, Mona Mohamed Shaban, Ahlam El Said Kamel

Abstract:

Background: New so-called minimally invasive devices have been developed to limit groin pain after sling placement for treatment of stress urinary incontinence (SUI) to minimize the risk of postoperative pain and organ perforation. A new generation of suburethral slings was described that avoided skin incision to pull out and tension the sling. Evaluation of this device through prospective short-term series has shown controversial results compared with other tension-free techniques. The aim of this study is to compare success rates and complications for tension-free vaginal tape secur (TVT secur) and trans-obturator sub urethral tape inside-out technique (TVT-O) for treatment of stress urinary incontinence (SUI). Materials and Methods: Fifty patients with genuine SUI were divided into two groups: group S (n=25) were operated upon using (TVT secur) and group O (n=25) were operated upon using trans-obturator suburethral tape inside-out technique (TVT-O). Success rate, quality of life and postoperative complications such as groin pain, urgency, urine retention and vaginal tape erosion were reported in both groups at one, three, and six months after surgery. Results: As regards objective cure rate at one, three, six months intervals; there was a significant difference between group S (56%, 64%, and 60%), and group O (80%, 88%, and 88%) respectively (P <0.05). As regards subjective cure rate at one, three, six months intervals; there was a significant difference between group S (44%, 44%, and 48%), and group O (76%, 80%, and 80%) respectively (P <0.05). Quality of life (QoL) parameters improved significantly in cured patients with no difference between both groups. As regards complications, group O had a higher frequency of complications than group S; groin pain (12% vs 12% p= 0.05), urgency (4% (1 case) vs 0%), urine retention (8% (2 cases) vs 0%), vaginal tape erosion (4% (1 case) vs 0%). No cases were complicated with wound infection. Conclusion: Compared to TVT secur, TVT-O showed higher subjective and objective cure rates after six months but higher rate of complications. Both techniques were comparable as regards improvement of quality of life after surgery.

Keywords: stress urinary incontinence, trans-vaginal tape-obturator, TVT Secur, TVT-O

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3373 The Difference of Serum Tnf-α Levels between Patients Schizophrenic Male with Smoking and Healthy Control

Authors: Rona Hanani Simamora, Bahagia Loebis, M. Surya Husada

Abstract:

Background: The exact cause of schizophrenia is not known, although several etiology theories have been proposed for the disease, including immune dysfunction or autoimmune mechanisms. Cytokines including Tnf-α has an important role in the pathophysiology of schizophrenia and the effects of pharmacological treatment with antipsychotics. Nicotine is widespread effects on the brain, immune system and cytokine levels. Smoking among schizophrenic patients could play a role in the altered cytokine profiles of schizophrenia such as Tnf-α. Aims: To determine differences of serum Tnf-α levels between schizophrenic patients with smoking in male and healthy control. Methods: This study was a comparative analytic study, divided into two groups: 1) group of male schizophrenic patients with smoking (n1=30) with inclusion criteria were patients who have been diagnosed schizophrenic based PPDGJ-III, 20-60 years old, male, smoking, chronic schizophrenic patients in the stable phase and willing to participate this study. Exclusion criteria were having other mental disorders and comorbidity with other medical illnesses. 2) healthy control group (n2=30) with inclusion criteria were 20-60 years old, male, smoking, willing to participate this study. Exclusion criteria were having mental disorder, a family history of psychiatric disorders, the other medical illnesses, a history of alcohol and other substances abuse (except caffeine and nicotine). Serum Tnf-α were analyzed using the Quantikine HS Human Tnf –α Immunoassay. Results: Serum Tnf-α level measure in patient schizophrenia male with smoking and compared with the healthy control subjects. Tnf-α levels were significantly higher in patients schizophrenic male with smoking (25,79±27,96) to healthy control subjects (2,74±2,19), by using the Mann Whitney U test showed a statistically significant difference was observed for serum Tnf-α level (p < 0,001). Conclusions: Schizophrenia is a highly heterogeneous disorder, and this study shows an increase Tnf-α as pro-inflammation cytokines in schizophrenics. These results suggest an immune abnormalities may be involved in the etiology and pathophysiology of schizophrenia.

Keywords: male, schizophrenic, smoking, Tnf Alpha

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3372 Mechanical Characterization of Brain Tissue in Compression

Authors: Abbas Shafiee, Mohammad Taghi Ahmadian, Maryam Hoviattalab

Abstract:

The biomechanical behavior of brain tissue is needed for predicting the traumatic brain injury (TBI). Each year over 1.5 million people sustain a TBI in the USA. The appropriate coefficients for injury prediction can be evaluated using experimental data. In this study, an experimental setup on brain soft tissue was developed to perform unconfined compression tests at quasistatic strain rates ∈0.0004 s-1 and 0.008 s-1 and 0.4 stress relaxation test under unconfined uniaxial compression with ∈ 0.67 s-1 ramp rate. The fitted visco-hyperelastic parameters were utilized by using obtained stress-strain curves. The experimental data was validated using finite element analysis (FEA) and previous findings. Also, influence of friction coefficient on unconfined compression and relaxation test and effect of ramp rate in relaxation test is investigated. Results of the findings are implemented on the analysis of a human brain under high acceleration due to impact.

Keywords: brain soft tissue, visco-hyperelastic, finite element analysis (FEA), friction, quasistatic strain rate

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3371 Memory-Guided Oculomotor Task in High School Football Players with ADHD, Post-Concussive Injuries, and Controls

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

Abstract:

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

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

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3370 Study of the Influence of Hole Topology on Crack Propagation Rate

Authors: Hallan Moura Ladeira, Carla Tatiana Mota Anflor

Abstract:

The drilling process for bolted or riveted joints of components is very common in the naval, aeronautical, mechanical, and civil industries. In this context, the present work aims to study, through computer simulation, the influence of hole geometry (through, chamfered, and rounded) on crack propagation when submitted to static and dynamic loads. For the static crack evaluation, failure was considered when the stress intensity factor (FIT) exceeds the fracture toughness of the material (KIc). In the case of fatigue, the condition of the small crack tip plastification zone and the Paris Law were considered for determining region II of the dadN x ΔK curve. Initially, a parametric analysis of the hole geometry was performed to obtain a topology that would result in less discontinuity of the stress field and, consequently, less influence on static crack growth. The best performing topology was then used to study the fatigue crack growth rate considering the Paris Law. The numerical tests were performed on a 7075-T6 aluminum specimen resulting in dadN x ΔK curves in good agreement with the literature.

Keywords: holes, cracks, loading, fracture toughness

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3369 Development of a Finite Element Model of the Upper Cervical Spine to Evaluate the Atlantoaxial Fixation Techniques

Authors: Iman Zafarparandeh, Muzammil Mumtaz, Paniz Taherzadeh, Deniz Erbulut

Abstract:

The instability in the atlantoaxial joint may occur due to cervical surgery, congenital anomalies, and trauma. There are different types of fixation techniques proposed for restoring the stability and preventing harmful neurological deterioration. Application of the screw constructs has become a popular alternative to the older techniques for stabilizing the joint. The main difference between the various screw constructs is the type of the screw which can be lateral mass screw, pedicle screw, transarticular screw, and translaminar screw. The aim of this paper is to study the effect of three popular screw constructs fixation techniques on the biomechanics of the atlantoaxial joint using the finite element (FE) method. A three-dimensional FE model of the upper cervical spine including the skull, C1 and C2 vertebrae, and groups of the existing ligaments were developed. The accurate geometry of the model was obtained from the CT data of a 35-year old male. Three screw constructs were designed to compare; Magerl transarticular screw (TA-Screw), Goel-Harms lateral mass screw and pedicle screw (LM-Screw and Pedicle-Screw), and Wright lateral mass screw and translaminar screw (LM-Screw and TL-Screw). Pure moments were applied to the model in the three main planes; flexion (Flex), extension (Ext), axial rotation (AR) and lateral bending (LB). The range of motion (ROM) of C0-C1 and C1-C2 segments for the implanted FE models are compared to the intact FE model and the in vitro study of Panjabi (1988). The Magerl technique showed less effect on the ROM of C0-C1 than the other two techniques in sagittal plane. In lateral bending and axial rotation, the Goel-Harms and Wright techniques showed less effect on the ROM of C0-C1 than the Magerl technique. The Magerl technique has the highest fusion rate as 99% in all loading directions for the C1-C2 segment. The Wright technique has the lowest fusion rate in LB as 79%. The three techniques resulted in the same fusion rate in extension loading as 99%. The maximum stress for the Magerl technique is the lowest in all load direction compared to other two techniques. The maximum stress in all direction was 234 Mpa and occurred in flexion with the Wright technique. The maximum stress for the Goel-Harms and Wright techniques occurred in lateral mass screw. The ROM obtained from the FE results support this idea that the fusion rate of the Magerl is more than 99%. Moreover, the maximum stress occurred in each screw constructs proves the less failure possibility for the Magerl technique. Another advantage of the Magerl technique is the less number of components compared to other techniques using screw constructs. Despite the benefits of the Magerl technique, there are drawbacks to using this method such as reduction of the C1 and C2 before screw placement. Therefore, other fixation methods such as Goel-Harms and Wright techniques find the solution for the drawbacks of the Magerl technique by adding screws separately to C1 and C2. The FE model implanted with the Wright technique showed the highest maximum stress almost in all load direction.

Keywords: cervical spine, finite element model, atlantoaxial, fixation technique

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3368 Fact-checking and Political Polarization in an Emerging Democracy

Authors: Eric Agyekum, Dominic Asitanga

Abstract:

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

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

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3367 Gut Mycobiome Dysbiosis and Its Impact on Intestinal Permeability in Attention-Deficit/Hyperactivity Disorder

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

Abstract:

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

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

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3366 Non-Linear Velocity Fields in Turbulent Wave Boundary Layer

Authors: Shamsul Chowdhury

Abstract:

The objective of this paper is to present the detailed analysis of the turbulent wave boundary layer produced by progressive finite-amplitude waves theory. Most of the works have done for the mass transport in the turbulent boundary layer assuming the eddy viscosity is not time varying, where the sediment movement is induced by the mean velocity. Near the ocean bottom, the waves produce a thin turbulent boundary layer, where the flow is highly rotational, and shear stress associated with the fluid motion cannot be neglected. The magnitude and the predominant direction of the sediment transport near the bottom are known to be closely related to the flow in the wave induced boundary layer. The magnitude of water particle velocity at the Crest phase differs from the one of the Trough phases due to the non-linearity of the waves, which plays an important role to determine the sediment movement. The non-linearity of the waves become predominant in the surf zone area, where the sediment movement occurs vigorously. Therefore, in order to describe the flow near the bottom and relationship between the flow and the movement of the sediment, the analysis was done using the non-linear boundary layer equation and the finite amplitude wave theory was applied to represent the velocity fields in the turbulent wave boundary layer. At first, the calculation was done for turbulent wave boundary layer by two-dimensional model where throughout the calculation is non-linear. But Stokes second order wave profile is adopted at the upper boundary. The calculated profile was compared with the experimental data. Finally, the calculation is done based on various modes of the velocity and turbulent energy. The mean velocity is found to differ from condition of the relative depth and the roughness. It is also found that due to non-linearity, the absolute value for velocity and turbulent energy as well as Reynolds stress are asymmetric. The mean velocity of the laminar boundary layer is always positive but in the turbulent boundary layer plays a very complicated role.

Keywords: wave boundary, mass transport, mean velocity, shear stress

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3365 Innovative Pump Design Using the Concept of Viscous Fluid Sinusoidal Excitation

Authors: Ahmed H. Elkholy

Abstract:

The concept of applying a prescribed oscillation to viscous fluids to aid or increase flow is used to produce a maintenance free pump. Application of this technique to fluids presents unique problems such as physical separation; control of heat and mass transfer in certain industrial applications; and improvement of some fluid process methods. The problem as stated is to obtain the velocity distribution, wall shear stress and energy expended when a pipe containing a stagnant viscous fluid is externally excited by a sinusoidal pulse, one end of the pipe being pinned. On the other hand, the effect of different parameters on the results are presented. Such parameters include fluid viscosity, frequency of oscillations and pipe geometry. It was found that the flow velocity through the pump is maximum at the pipe wall, and it decreases rapidly towards the pipe centerline. The frequency of oscillation should be above a certain value in order to obtain meaningful flow velocity. The amount of energy absorbed in the system is mainly due to pipe wall strain energy, while the fluid pressure and kinetic energies are comparatively small.

Keywords: sinusoidal excitation, pump, shear stress, flow

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3364 Possible Neuroprotective Mechanism of Remote Limb Ischemic Post Conditioning against Global Cerebral Ischemic Injury

Authors: Sruthi Ramagiri, Rajeev Taliyan

Abstract:

Background and purpose: Recent investigations on ischemia and reperfusion injury postulate that transient ischemia of remote organs after a prolonged ischemic insult confers neuroprotection. However, the molecular mechanisms of the remote limb ischemic post-conditioning (RIPOC) are yet to be elucidated. The current study was designed to investigate the protective mechanism of RIPOC against cerebral ischemic injury using global model of stroke. Materials and methods: Global ischemic reperfusion injury (IR) was achieved by 30 minutes ischemia of cerebral artery, followed by reperfusion for 24 hours. Induction of global ischemia was followed by 4 brief episodes (30 seconds each) of ischemia and reperfusion of femoral artery to accomplish RIPOC. 5-Hydroxy Decanoic acid (5-HD), a KATP channel blocker (20 mg/kg) was administered after induction of global ischemia and RIPOC intervention. Results: IR injury ensue significant behavioural deficits as manifested by rotarod performance and spontaneous locomotor activity when compared to sham control. Furthermore, IR injury significantly increased oxidonitrative stress and infarct volume as evidenced by biochemical parameters (MDA, GSH, Nitrite, SOD) and 2,3,5-triphenyltetrazolium chloride (TTC) staining respectively. Moreover, RIPOC intervention ameliorated the behavioural performance, attenuated the oxidative stress and infarct volume when compared to IR injury group. However, administration of 5-HD increased the oxidative stress and infarct size while deteriorating the behavioural parameters when compared to RIPOC group. Conclusions: In a nutshell, cerebral IR injury has significantly induced the neuronal damage, whereas RIPOC intervention decreased the neuronal injury. Moreover, 5-HD abolished the neuroprotection offered by RIPOC indicating the putative role of KATP channel opening in RIPOC against cerebral ischemic injury.

Keywords: RIPOC, cerebral injury, KATP channel, neuroprotection

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3363 Proposed Organizational Development Interventions in Managing Occupational Stressors for Business Schools in Batangas City

Authors: Marlon P. Perez

Abstract:

The study intended to determine the level of occupational stress that was experienced by faculty members of private and public business schools in Batangas City with the end in view of proposing organizational development interventions in managing occupational stressors. Stressors such as factors intrinsic to the job, role in the organization, relationships at work, career development and organizational structure and climate were used as determinants of occupational stress level. Descriptive method of research was used as its research design. There were only 64 full-time faculty members coming from private and public business schools in Batangas City – University of Batangas, Lyceum of the Philippines University-Batangas, Golden Gate Colleges, Batangas State University and Colegio ng Lungsod ng Batangas. Survey questionnaire was used as data gathering instrument. It was found out that all occupational stressors were assessed stressful when grouped according to its classification of tertiary schools while response of subject respondents differs on their assessment of occupational stressors. Age variable has become significantly related to respondents’ assessments on factors intrinsic to the job and career development; however, it was not significantly related to role in the organization, relationships at work and organizational structure and climate. On the other hand, gender, marital status, highest educational attainment, employment status, length of service, area of specialization and classification of tertiary school were revealed to be not significantly related to all occupational stressors. Various organizational development interventions have been proposed to manage the occupational stressors that are experienced by business faculty members in the institution.

Keywords: occupational stress, business school, organizational development, intervention, stressors, faculty members, assessment, manage

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3362 Experimental and Numerical Investigation of “Machining Induced Residual Stresses” during Orthogonal Machining of Alloy Steel AISI 4340

Authors: Theena Thayalan, K. N. Ramesh Babu

Abstract:

Machining induced residual stress (RS) is one of the most important surface integrity parameters that characterize the near surface layer of a mechanical component, which plays a crucial role in controlling the performance, especially its fatigue life. Since experimental determination of RS is expensive and time consuming, it would be of great benefit if they could be predicted. In such case, it would be possible to select the cutting parameters required to produce a favorable RS profile. In the present study, an effort has been made to develop a 'two dimensional finite element model (FEM)' to simulate orthogonal cutting process and to predict surface and sub-surface RS using the commercial FEA software DEFORM-2D. The developed finite element model has been validated through experimental investigation of RS. In the experimentation, the orthogonal cutting tests were carried out on AISI 4340 by varying the cutting speed (VC) and uncut chip thickness (f) at three levels and the surface & sub-surface RS has been measured using XRD and Electro polishing techniques. The comparison showed that the RS obtained using developed numerical model is in reasonable agreement with that of experimental data.

Keywords: FEM, machining, residual stress, XRF

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3361 Classifying Affective States in Virtual Reality Environments Using Physiological Signals

Authors: Apostolos Kalatzis, Ashish Teotia, Vishnunarayan Girishan Prabhu, Laura Stanley

Abstract:

Emotions are functional behaviors influenced by thoughts, stimuli, and other factors that induce neurophysiological changes in the human body. Understanding and classifying emotions are challenging as individuals have varying perceptions of their environments. Therefore, it is crucial that there are publicly available databases and virtual reality (VR) based environments that have been scientifically validated for assessing emotional classification. This study utilized two commercially available VR applications (Guided Meditation VR™ and Richie’s Plank Experience™) to induce acute stress and calm state among participants. Subjective and objective measures were collected to create a validated multimodal dataset and classification scheme for affective state classification. Participants’ subjective measures included the use of the Self-Assessment Manikin, emotional cards and 9 point Visual Analogue Scale for perceived stress, collected using a Virtual Reality Assessment Tool developed by our team. Participants’ objective measures included Electrocardiogram and Respiration data that were collected from 25 participants (15 M, 10 F, Mean = 22.28  4.92). The features extracted from these data included heart rate variability components and respiration rate, both of which were used to train two machine learning models. Subjective responses validated the efficacy of the VR applications in eliciting the two desired affective states; for classifying the affective states, a logistic regression (LR) and a support vector machine (SVM) with a linear kernel algorithm were developed. The LR outperformed the SVM and achieved 93.8%, 96.2%, 93.8% leave one subject out cross-validation accuracy, precision and recall, respectively. The VR assessment tool and data collected in this study are publicly available for other researchers.

Keywords: affective computing, biosignals, machine learning, stress database

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3360 Flow Control around Bluff Bodies by Attached Permeable Plates

Authors: Gokturk Memduh Ozkan, Huseyin Akilli

Abstract:

The aim of present study is to control the unsteady flow structure downstream of a circular cylinder by use of attached permeable plates. Particle image velocimetry (PIV) technique and dye visualization experiments were performed in deep water and the flow characteristics were evaluated by means of time-averaged streamlines, Reynolds Shear Stress and Turbulent Kinetic Energy concentrations. The permeable plate was made of a chrome-nickel screen having a porosity value of β=0.6 and it was attached on the cylinder surface along its midspan. Five different angles were given to the plate (θ=0°, 15°, 30°, 45°, 60°) with respect to the centerline of the cylinder in order to examine its effect on the flow control. It was shown that the permeable plate is effective on elongating the vortex formation length and reducing the fluctuations in the wake region. Compared to the plain cylinder, the reductions in the values of maximum Reynolds shear stress and Turbulent Kinetic Energy were evaluated as 72.5% and 66%, respectively for the plate angles of θ=45° and 60° which were also found to be suggested for applications concerning the vortex shedding and consequent Vortex-Induced Vibrations.

Keywords: bluff body, flow control, permeable plate, PIV, VIV, vortex shedding

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3359 Design, Modification and Structural Analysis of Bicycle Sprocket Using ANSYS

Authors: Roman Kalvin, Saba Arif, Anam Nadeem, Burhan Ali Ghumman, Juntakan Taweekun

Abstract:

Bicycles are important parts of the transportation industry. In the current world, use of sprocket is very high on bicycles these days. Sprocket and chains are important parts of the transmission of power in the bicycle. However, transmission of power is highly dependent on sprocket design. In conventional bicycles, sprockets are made up of mild steel which undergoes wear and tears with the passage of time due to high pressures applied on it. In the current research, a new sprocket is designed by changing its structure and material to carbon fiber from mild steel. The existing sprocket of a bicycle is compared with the new and modified sprocket design. However, new design has structural and material changes as well. According to the results, in carbon fiber, sprocket deformation is 0.091 mm while sprocket stress value is 371.13N/mm². Also, comparison based analysis is done by physical testing and software analysis. There is 8.1% variation in software and experimental results of steel. Additionally, the difference between both methods comes 8 to 9%. This improved design can be used in future for more durability and long run timings for bicycles.

Keywords: sprocket, mild steel, drafting, stress, deformation

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3358 Effect of Fiber Types and Elevated Temperatures on the Bond Characteristic of Fiber Reinforced Concretes

Authors: Erdoğan Özbay, Hakan T. Türker, Müzeyyen Balçıkanlı, Mohamed Lachemi

Abstract:

In this paper, the effects of fiber types and elevated temperatures on compressive strength, modulus of rapture and the bond characteristics of fiber reinforced concretes (FRC) are presented. By using the three different types of fibers (steel fiber-SF, polypropylene-PPF and polyvinyl alcohol-PVA), FRC specimens were produced and exposed to elevated temperatures up to 800 ºC for 1.5 hours. In addition, a plain concrete (without fiber) was produced and used as a control. Test results obtained showed that the steel fiber reinforced concrete (SFRC) had the highest compressive strength, modulus of rapture and bond stress values at room temperatures, the residual bond, flexural and compressive strengths of both FRC and plain concrete dropped sharply after exposure to high temperatures. The results also indicated that the reduction of bond, flexural and compressive strengths with increasing the exposed temperature was relatively less for SFRC than for plain, and FRC with PPF and PVA.

Keywords: bond stress, compressive strength, elevated temperatures, fiber reinforced concrete, modulus of rapture

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3357 Rheological Study of Natural Sediments: Application in Filling of Estuaries

Authors: S. Serhal, Y. Melinge, D. Rangeard, F. Hage Chehadeh

Abstract:

Filling of estuaries is an international problem that can cause economic and environmental damage. This work aims the study of the rheological structuring mechanisms of natural sedimentary liquid-solid mixture in estuaries in order to better understand their filling. The estuary of the Rance river, located in Brittany, France is particularly targeted by the study. The aim is to provide answers on the rheological behavior of natural sediments by detecting structural factors influencing the rheological parameters. So we can better understand the fillings estuarine areas and especially consider sustainable solutions of ‘cleansing’ of these areas. The sediments were collected from the trap of Lyvet in Rance estuary. This trap was created by the association COEUR (Comité Opérationnel des Elus et Usagers de la Rance) in 1996 in order to facilitate the cleansing of the estuary. It creates a privileged area for the deposition of sediments and consequently makes the cleansing of the estuary easier. We began our work with a preliminary study to establish the trend of the rheological behavior of the suspensions and to specify the dormant phase which precedes the beginning of the biochemical reactivity of the suspensions. Then we highlight the visco-plastic character at younger age using the Kinexus rheometer, plate-plate geometry. This rheological behavior of suspensions is represented by the Bingham model using dynamic yield stress and viscosity which can be a function of volume fraction, granular extent, and chemical reactivity. The evolution of the viscosity as a function of the solid volume fraction is modeled by the Krieger-Dougherty model. On the other hand, the analysis of the dynamic yield stress showed a fairly functional link with the solid volume fraction.

Keywords: estuaries, rheological behavior, sediments, Kinexus rheometer, Bingham model, viscosity, yield stress

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3356 A Case of Borderline Personality Disorder: An Explanatory Study of Unconscious Conflicts through Dream-Analysis

Authors: Mariam Anwaar, Kiran B. Ahmad

Abstract:

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

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

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3355 Patients' Quality of Life and Caregivers' Burden of Parkinson's Disease

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

Abstract:

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

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

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3354 Adaptation Mechanisms of the Polyextremophile Natranaerobius Thermophilus to Saline-Alkaline-Hermal Environments

Authors: Qinghua Xing, Xinyi Tao, Haisheng Wang, Baisuo Zhao

Abstract:

The first true anaerobic, halophilic alkali thermophile, Natranaerobius thermophilus DSM 18059T, serves as a valuable model for studying cellular adaptations to saline, alkaline and thermal extremes. To uncover the adaptive strategies employed by N. thermophilus in coping with these challenges, we conducted a comprehensive iTRAQ-based quantitative proteomic analysis under different conditions of salinity (3.5 M vs. 2.5 M Na+), pH (pH 9.6 vs. pH 8.6), and temperature (52°C vs. 42°C). The increased intracellular accumulation of glycine betaine, through both synthesis and transport, plays a critical role in N. thermophilus' adaptation to these combined stresses. Under all three stress conditions, the up-regulation of Trk family proteins responsible for K+ transport is observed. Intracellular K+ concentration rises in response to salt and pH levels. Multiple types of Na+/H+ antiporter (NhaC family, Mrp family and CPA family) and a diverse range of FOF1-ATP synthase are identified as vital components for maintaining ionic balance under different stress conditions. Importantly, proteins involved in amino acid metabolism, carbohydrate metabolism, ABC transporters, signaling and chemotaxis, as well as biological macromolecule repair and protection, exhibited significant up-regulation in response to these extreme conditions. These metabolic pathways emerge as critical factors in N. thermophilus' adaptation mechanisms under extreme environmental stress. To validate the proteomic data, ddPCR analysis confirmed changes in mRNA expression, thereby corroborating the up-regulation and down-regulation patterns of 19 co-up-regulated and 36 key proteins under saline, alkaline and thermal stresses. This research enriches our understanding of the complex regulatory systems that enable polyextremophiles to survive in combined extreme conditions.

Keywords: polyextremophiles, natranaerobius thermophilus, saline- alkaline- thermal stresses, combined extremes

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3353 Numerical Investigation of Poling Vector Angle on Adaptive Sandwich Plate Deflection

Authors: Alireza Pouladkhan, Mohammad Yavari Foroushani, Ali Mortazavi

Abstract:

This paper presents a finite element model for a sandwich plate containing a piezoelectric core. A sandwich plate with a piezoelectric core is constructed using the shear mode of piezoelectric materials. The orientation of poling vector has a significant effect on deflection and stress induced in the piezo-actuated adaptive sandwich plate. In the present study, the influence of this factor for a clamped-clamped-free-free and simple-simple-free-free square sandwich plate is investigated using Finite Element Method. The study uses ABAQUS (v.6.7) software to derive the finite element model of the sandwich plate. By using this model, the study gives the influences of the poling vector angle on the response of the smart structure and determines the maximum transverse displacement and maximum stress induced.

Keywords: finite element method, sandwich plate, poling vector, piezoelectric materials, smart structure, electric enthalpy

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3352 Changes in Religious Belief after Flood Disasters

Authors: Sapora Sipon, Mohd Fo’ad Sakdan, Che Su Mustaffa, Najib Ahmad Marzuki, Mohamad Sukeri Khalid, Mohd Taib Ariffin, Husni Mohd Radzi, Salhah Abdullah

Abstract:

Flood disasters occur throughout the world including Malaysia. The major flood disaster that hit Malaysia in the 2014-2015 episodes proved the psychosocial and mental health consequences such as vivid images of destruction, upheaval, death and loss of lives. Flood, flood survivors reported that flood has changed one looks at their religious belief. The main objective of this paper is to investigate the changes in religious belief after the 2014-2015 Malaysia flood disaster. The total population of 1300 respondents who experienced the 2014-2015 Malaysia flood were surveyed a month after the disaster. The questionnaires were used to measure religiosity and stress. The results provide compelling evidence that religion played an important role in the lives of Malaysia flood disasters’ survivor where more than half of the respondents (>75%) experiencing the strengthening of their religious belief. It was also reported the victims’ strengthening of their religious belief proved to be a powerful factor in reducing stress in the aftermath of the flood.

Keywords: religious belief, flood disaster, humanity, society

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3351 One-Dimensional Numerical Simulation of the Nonlinear Instability Behavior of an Electrified Viscoelastic Liquid Jet

Authors: Fang Li, Xie-Yuan Yin, Xie-Zhen Yin

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Instability and breakup of electrified viscoelastic liquid jets are involved in various applications such as inkjet printing, fuel atomization, the pharmaceutical industry, electrospraying, and electrospinning. Studying on the instability of electrified viscoelastic liquid jets is of theoretical and practical significance. We built a one-dimensional electrified viscoelastic model to study the nonlinear instability behavior of a perfecting conducting, slightly viscoelastic liquid jet under a radial electric field. The model is solved numerically by using an implicit finite difference scheme together with a boundary element method. It is found that under a radial electric field a viscoelastic liquid jet still evolves into a beads-on-string structure with a thin filament connecting two adjacent droplets as in the absence of an electric field. A radial electric field exhibits limited influence on the decay of the filament thickness in the nonlinear evolution process of a viscoelastic jet, in contrast to its great enhancing effect on the linear instability of the jet. On the other hand, a radial electric field can induce axial non-uniformity of the first normal stress difference within the filament. Particularly, the magnitude of the first normal stress difference near the midpoint of the filament can be greatly decreased by a radial electric field. Decreasing the extensional stress by a radial electric field may found applications in spraying, spinning, liquid bridges and others. In addition, the effect of a radial electric field on the formation of satellite droplets is investigated on the parametric plane of the dimensionless wave number and the electrical Bond number. It is found that satellite droplets may be formed for a larger axial wave number at a larger radial electric field. The present study helps us gain insight into the nonlinear instability characteristics of electrified viscoelastic liquid jets.

Keywords: non linear instability, one-dimensional models, radial electric fields, viscoelastic liquid jets

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3350 Four-Way Coupled CFD-Dem Simulation of Concrete Pipe Flow Using a Non-Newtonian Rheological Model: Investigating the Simulation of Lubrication Layer Formation and Plug Flow Zones

Authors: Tooran Tavangar, Masoud Hosseinpoor, Jeffrey S. Marshall, Ammar Yahia, Kamal Henri Khayat

Abstract:

In this study, a four-way coupled CFD-DEM methodology was used to simulate the behavior of concrete pipe flow. Fresh concrete, characterized as a biphasic suspension, features aggregates comprising the solid-suspended phase with diverse particle-size distributions (PSD) within a non-Newtonian cement paste/mortar matrix forming the liquid phase. The fluid phase was simulated using CFD, while the aggregates were modeled using DEM. Interaction forces between the fluid and solid particles were considered through CFD-DEM computations. To capture the viscoelastic characteristics of the suspending fluid, a bi-viscous approach was adopted, incorporating a critical shear rate proportional to the yield stress of the mortar. In total, three diphasic suspensions were simulated, each featuring distinct particle size distributions and a concentration of 10% for five subclasses of spherical particles ranging from 1 to 17 mm in a suspending fluid. The adopted bi-viscous approach successfully simulated both un-sheared (plug flow) and sheared zones. Furthermore, shear-induced particle migration (SIPM) was assessed by examining coefficients of variation in particle concentration across the pipe. These SIPM values were then compared with results obtained using CFD-DEM under the Newtonian assumption. The study highlighted the crucial role of yield stress in the mortar phase, revealing that lower yield stress values can lead to increased flow rates and higher SIPM across the pipe.

Keywords: computational fluid dynamics, concrete pumping, coupled CFD-DEM, discrete element method, plug flow, shear-induced particle migration.

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3349 A Numerical Method to Evaluate the Elastoplastic Material Properties of Fiber Reinforced Composite

Authors: M. Palizvan, M. H. Sadr, M. T. Abadi

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The representative volume element (RVE) plays a central role in the mechanics of random heterogeneous materials with a view to predicting their effective properties. In this paper, a computational homogenization methodology, developed to determine effective linear elastic properties of composite materials, is extended to predict the effective nonlinear elastoplastic response of long fiber reinforced composite. Finite element simulations of volumes of different sizes and fiber volume fractures are performed for calculation of the overall response RVE. The dependencies of the overall stress-strain curves on the number of fibers inside the RVE are studied in the 2D cases. Volume averaged stress-strain responses are generated from RVEs and compared with the finite element calculations available in the literature at moderate and high fiber volume fractions. For these materials, the existence of an RVE is demonstrated for the sizes of RVE corresponding to 10–100 times the diameter of the fibers. In addition, the response of small size RVE is found anisotropic, whereas the average of all large ones leads to recover the isotropic material properties.

Keywords: homogenization, periodic boundary condition, elastoplastic properties, RVE

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3348 A Case Report on the Course and Outcome of a Patient Diagnosed with Trichotillomania and Major Depressive Disorder

Authors: Ziara Carmelli G. Tan, Irene Carmelle S. Tan

Abstract:

Background: Trichotillomania (TTM) and Major Depressive Disorder (MDD) are two psychiatric conditions that frequently co-occur, presenting a significant challenge for treatment due to their complex interplay. TTM involves repetitive hair-pulling, leading to noticeable hair loss and distress, while MDD is characterized by persistent low mood and loss of interest or pleasure, leading to dysfunctionality. This case report examines the intricate relationship between TTM and MDD in a young adult female, emphasizing the need for a comprehensive, multifaceted therapeutic approach to address both disorders effectively. Case Presentation: The patient is a 21-year-old female college student and youth church leader who presented with chronic hair-pulling and depressive symptoms. Her premorbid personality was marked by low self-esteem and a strong need for external validation. Despite her academic and social responsibilities and achievements, she struggled with managing her emotional distress, which was exacerbated by her family dynamics and her role within her church community. Her hair-pulling and mood symptoms were particularly triggered by self-esteem threats and feelings of inadequacy. She was diagnosed with Trichotillomania, Scalp and Major Depressive Disorder. Intervention/Management: The patient’s treatment plan was comprehensive, incorporating both pharmacological and non-pharmacological interventions. Initial pharmacologic management was Fluoxetine 20mg/day up, titrated to 40mg/day with no improvement; hence, shifted to Escitalopram 20mg/day and started with N-acetylcysteine 600mg/day with noted significant improvement in symptoms. Psychotherapeutic strategies played a crucial role in her treatment. These included supportive-expressive psychodynamic psychotherapy, which helped her explore and understand underlying emotional conflicts. Cognitive-behavioral techniques were employed to modify her maladaptive thoughts and behaviors. Grief processing was integrated to help her cope with significant losses. Family therapy was done to address conflicts and collaborate with the treatment process. Psychoeducation was provided to enhance her understanding of her condition and to empower her in her treatment journey. A suicide safety plan was developed to ensure her safety during critical periods. An interprofessional approach, which involved coordination with the Dermatology service for co-management, was also a key component of her treatment. Outcome: Over the course of 15 therapy sessions, the patient demonstrated significant improvement in both her depressive symptoms and hair-pulling behavior. Her active engagement in therapy, combined with pharmacological support, facilitated better emotional regulation and a more cohesive sense of self. Her adherence to the treatment plan, along with the collaborative efforts of the interprofessional team, contributed to her positive outcomes. Discussion: This case underscores the significance of addressing both TTM and its comorbid conditions to achieve effective treatment outcomes. The intricate interplay between TTM and MDD in the patient’s case highlights the importance of a comprehensive treatment plan that includes both pharmacological and psychotherapeutic approaches. Supportive-expressive psychodynamic psychotherapy, Cognitive-behavioral techniques, and Family therapy were particularly beneficial in addressing the complex emotional and behavioral aspects of her condition. The involvement of an interprofessional team, including dermatology co-management, was crucial in providing holistic care. Future practice should consider the benefits of such a multidisciplinary approach to managing complex cases like this, ensuring that both the psychological and physiological aspects of the disorders are adequately addressed.

Keywords: cognitive-behavioral therapy, interprofessional approach, major depressive disorder, psychodynamic psychotherapy, trichotillomania

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3347 Communication Barriers and Challenges for Accessing Autism Care: Conventional Versus Alternative Medicine

Authors: M. D. Antoine

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

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

Procedia PDF Downloads 169