Search results for: psychological changes

Authors: Nova Grail S. Luminang, Gwyneth B. Gortiza, Alvin E. Haboc, Marinol K. Hate, Rhean Mitchel N. Joven, Kara Kate D. Lammao, Rosemarie M. Lambayung, Elmo Carl D. Lardizabal, Zyra B. Linggayo, Rizza Mae G. Liwag, Ronalyn O. Songcuan

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Breast cancer survivorship represents a complex and continuous journey extending beyond the completion of treatment, involving coping with physical, emotional, and psychological aspects of life post-treatment. This study aimed to explore the lived experiences of breast cancer survivors after successful treatment in Tabuk City, focusing on their post-treatment experiences, coping mechanisms, and necessary lifestyle changes. Researchers have selected Tabuk City as their research locale. Utilizing Martin Heidegger’s descriptive phenomenological design, this qualitative research included six participants, allowing for data saturation. Purposive sampling was employed to select participants. Researchers used Colaizzi’s Phenomenological Method in analyzing the data in order to achieve a reliable understanding of the participants’ experiences. The findings revealed three main themes: going through post-treatment hurdles, building resilience, and transformative wellness adjustments. Breast cancer survivors faced significant challenges, including physical adversities, emotional turmoil, limited social life, memory lapses, decreased sexual intimacy, and economic constraints. To cope, survivors adjusted their thoughts and attitudes, accepted their situation, relied on religious beliefs, and joined the support group Kalinga Cancer Care Ministry INC. Additionally, they strived to return to a normal life and embraced gratitude. Survivors made essential changes to their daily routines, modifying their diets, exploring herbal remedies, and incorporating physical activities such as walking and household chores. These adjustments helped improve their overall well-being and prevent cancer recurrence. The researchers concluded that the journey of breast cancer survivors is marked by significant challenges and inspiring resilience. The impact of breast cancer treatment extends beyond physical recovery, encompassing profound emotional and social dimensions. Despite these difficulties, survivors demonstrate remarkable strength and adaptability, making positive lifestyle changes that offer a hopeful and inspiring narrative of recovery and perseverance.

Keywords: breast cancer, lived experiences, breast cancer survivor, post-treatment hurdles, emotional turmoil

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Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

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Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

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Authors: Wafeek Mohamed Ibrahim Mohamed

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In the era of globalization, the camera of the cinematographic film plays a very important role in terms of monitoring and documenting what it was and distinguished the built environment of architectural and Urbanism. Moving the audience to the out-going backward through the cinematographic film and its stereophonic screen by which the picture appears at its best and its coexistence reached now its third dimension. The camera has indicated to the city shape with its paths, (alley) lanes, buildings and its architectural style. We have seen the architectural styles in its cinematic scenes which remained a remembrance in its history, in spite of the fact that some of which has been disappearing as what happened to ‘Boulak Bridge’ in Cairo built by ‘Eiffel’ and it has been demolished, but it remains a remembrance we can see it in the films of ’Usta Hassan’and A Crime in the Quiet Neighborhood. The purpose of the fundamental research is an attempt to reach a critical view of the idea of criticism and theorizing for Architecture and Urbanism in the cinematographic film and their relationship and reflection on the ‘audience’ understanding of the public opinion related to our built environment of Architectural and Urbanism with its problems and hardness. It is like as a trial to study the Architecture and Urbanism of the built environment in the cinematographic film and hooking up (linking) a realistic view of the governing conceptual significance thereof. The aesthetic thought of our traditional environment, in a psychological and anthropological framework, derives from the cinematic concept of the Architecture and Urbanism of the place and the dynamics of the space. The architectural space considers the foundation stone of the cinematic story and the main background of the events therein, which integrate the audience into a romantic trip to the city through its symbolized image of the spaces, lanes [alley], etc. This will be done through two main branches: firstly, Reviewing during time pursuit of the Architecture and Urbanism in the cinematographic films the thirties ago in the Egyptian cinema [onset from the film ‘Bab El Hadid’ to the American University at a film of ‘Saidi at the American University’]. The research concludes the importance of the need to study the cinematic films which deal with our societies, their architectural and Urbanism concerns whether the traditional ones or the contemporary and their crisis (such as the housing crisis in the film of ‘Krakoun in the street’, etc) to study the built environment with its architectural dynamic spaces through a modernist view. In addition, using the cinema as an important Media for spreading the ideas, documenting and monitoring the current changes in the built environment through its various dramas and comedies, etc. The cinema is considered as a mirror of the society and its built environment over the epochs. It assured the unique case constituted by cinema with the audience (public opinion) through a sense of emptiness and forming the mental image related to the city and the built environment.

Keywords: architectural and urbanism, cinematographic architectural, film, space in the film, media

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Authors: Szymon Rutkowski, Tomasz Korbak

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We present a reinforcement-learning-based method of training neural machine translation models without parallel corpora. The standard encoder-decoder approach to machine translation suffers from two problems we aim to address. First, it needs parallel corpora, which are scarce, especially for low-resource languages. Second, it lacks psychological plausibility of learning procedure: learning a foreign language is about learning to communicate useful information, not merely learning to transduce from one language’s 'encoding' to another. We instead pose the problem of learning to translate as learning a policy in a communication game between two agents: the translator and the classifier. The classifier is trained beforehand on a natural language inference task (determining the entailment relation between a premise and a hypothesis) in the target language. The translator produces a sequence of actions that correspond to generating translations of both the hypothesis and premise, which are then passed to the classifier. The translator is rewarded for classifier’s performance on determining entailment between sentences translated by the translator to disciple’s native language. Translator’s performance thus reflects its ability to communicate useful information to the classifier. In effect, we train a machine translation model without the need for parallel corpora altogether. While similar reinforcement learning formulations for zero-shot translation were proposed before, there is a number of improvements we introduce. While prior research aimed at grounding the translation task in the physical world by evaluating agents on an image captioning task, we found that using a linguistic task is more sample-efficient. Natural language inference (also known as recognizing textual entailment) captures semantic properties of sentence pairs that are poorly correlated with semantic similarity, thus enforcing basic understanding of the role played by compositionality. It has been shown that models trained recognizing textual entailment produce high-quality general-purpose sentence embeddings transferrable to other tasks. We use stanford natural language inference (SNLI) dataset as well as its analogous datasets for French (XNLI) and Polish (CDSCorpus). Textual entailment corpora can be obtained relatively easily for any language, which makes our approach more extensible to low-resource languages than traditional approaches based on parallel corpora. We evaluated a number of reinforcement learning algorithms (including policy gradients and actor-critic) to solve the problem of translator’s policy optimization and found that our attempts yield some promising improvements over previous approaches to reinforcement-learning based zero-shot machine translation.

Keywords: agent-based language learning, low-resource translation, natural language inference, neural machine translation, reinforcement learning

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Authors: Shyamani Hettiarachchi, Gopi Kitnasamy

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Background: The potentially high level of physical need and dependency experienced by children with cerebral palsy could affect the quality of life (QOL) of the child, the caregiver and his/her family. Poor QOL in children with cerebral palsy is associated with the parent-child relationship, limited opportunities for social participation, limited access to healthcare services, psychological well-being and the child's physical functioning. Given that children experiencing disabilities have little access to remedial support with an inequitable service across districts in Sri Lanka, and given the impact of culture and societal stigma, there may be differing viewpoints across respondents. Objectives: The aim of this study was to evaluate the psychometric properties of the Tamil version of the Cerebral Palsy Quality of Life for Children (CPQOL-Child) Questionnaire. Design: An instrument development and validation study. Methods: Forward and backward translations of the CPQOL-Child were undertaken by a team comprised of a physiotherapist, speech and language therapist and two linguists for the primary caregiver form and the child self-report form. As part of a pilot phase, the Tamil version of the CPQOL was completed by 45 primary caregivers with children with cerebral palsy and 15 children with cerebral palsy (GMFCS level 3-4). In addition, the primary caregivers commented on the process of filling in the questionnaire. The psychometric properties of test-retest reliability, internal consistency and construct validity were undertaken. Results: The test-retest reliability and internal consistency were high. A significant association (p < 0.001) was found between limited motor skills and poor QOL. The Cronbach's alpha for the whole questionnaire was at 0.95.Similarities and divergences were found between the two groups of respondents. The child respondents identified limited motor skills as associated with physical well-being and autonomy. Akin to this, the primary caregivers associated the severity of motor function with limitations of physical well-being and autonomy. The trend observed was that QOL was not related to the level of impairment but connected to environmental factors by the child respondents. In addition to this, the main concern among primary caregivers about the child's future and on the child's lack of independence was not fully captured by the QOL questionnaire employed. Conclusions: Although the initial results of the CPQOL questionnaire show high test-retest reliability and internal consistency of the instrument, it does not fully reflect the socio-cultural realities and primary concerns of the caregivers. The current findings highlight the need to take child and caregiver perceptions of QOL into account in clinical practice and research. It strongly indicates the need for culture-specific measures of QOL.

Keywords: cerebral palsy, CPQOL, culture, quality of life

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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Introduction: An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavored to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learners. Aim: Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Methods: Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Results: Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. Discussion: After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Conclusion: Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: ethics, medical student, doubt, medical education, faith

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Authors: Anup Anand Deshmukh, Catherine Soladie, Renaud Seguier

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Emotion plays a key role in many applications like healthcare, to gather patients’ emotional behavior. Unlike typical ASR (Automated Speech Recognition) problems which focus on 'what was said', it is equally important to understand 'how it was said.' There are certain emotions which are given more importance due to their effectiveness in understanding human feelings. In this paper, we propose an approach that models human stress from audio signals. The research challenge in speech emotion detection is finding the appropriate set of acoustic features corresponding to an emotion. Another difficulty lies in defining the very meaning of emotion and being able to categorize it in a precise manner. Supervised Machine Learning models, including state of the art Deep Learning classification methods, rely on the availability of clean and labelled data. One of the problems in affective computation is the limited amount of annotated data. The existing labelled emotions datasets are highly subjective to the perception of the annotator. We address the first issue of feature selection by exploiting the use of traditional MFCC (Mel-Frequency Cepstral Coefficients) features in Convolutional Neural Network. Our proposed Emo-CNN (Emotion-CNN) architecture treats speech representations in a manner similar to how CNN’s treat images in a vision problem. Our experiments show that Emo-CNN consistently and significantly outperforms the popular existing methods over multiple datasets. It achieves 90.2% categorical accuracy on the Emo-DB dataset. We claim that Emo-CNN is robust to speaker variations and environmental distortions. The proposed approach achieves 85.5% speaker-dependant categorical accuracy for SAVEE (Surrey Audio-Visual Expressed Emotion) dataset, beating the existing CNN based approach by 10.2%. To tackle the second problem of subjectivity in stress labels, we use Lovheim’s cube, which is a 3-dimensional projection of emotions. Monoamine neurotransmitters are a type of chemical messengers in the brain that transmits signals on perceiving emotions. The cube aims at explaining the relationship between these neurotransmitters and the positions of emotions in 3D space. The learnt emotion representations from the Emo-CNN are mapped to the cube using three component PCA (Principal Component Analysis) which is then used to model human stress. This proposed approach not only circumvents the need for labelled stress data but also complies with the psychological theory of emotions given by Lovheim’s cube. We believe that this work is the first step towards creating a connection between Artificial Intelligence and the chemistry of human emotions.

Keywords: deep learning, brain chemistry, emotion perception, Lovheim's cube

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Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

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Authors: Sharon Jackson, Lynn Kelly

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This paper proposes a conceptual review of the interdisciplinary literature which has theorised the concept of ‘children’s voices’. The primary aim is to identify and consider the theoretical relevance of conceptual thought on ‘children’s voices’ for research and practice in child protection contexts. Attending to the ‘voice of the child’ has become a core principle of social work practice in contemporary child protection contexts. Discourses of voice permeate the legislative, policy and practice frameworks of child protection practices within the UK and internationally. Voice is positioned within a ‘child-centred’ moral imperative to ‘hear the voices’ of children and take their preferences and perspectives into account. This practice is now considered to be central to working in a child-centered way. The genesis of this call to voice is revealed through sociological analysis of twentieth-century child welfare reform as rooted inter alia in intersecting political, social and cultural discourses which have situated children and childhood as cites of state intervention as enshrined in the 1989 United Nations Convention on the Rights of the Child ratified by the UK government in 1991 and more specifically Article 12 of the convention. From a policy and practice perspective, the professional ‘capturing’ of children’s voices has come to saturate child protection practice. This has incited a stream of directives, resources, advisory publications and ‘how-to’ guides which attempt to articulate practice methods to ‘listen’, ‘hear’ and above all – ‘capture’ the ‘voice of the child’. The idiom ‘capturing the voice of the child’ is frequently invoked within the literature to express the requirements of the child-centered practice task to be accomplished. Despite the centrality of voice, and an obsession with ‘capturing’ voices, evidence from research, inspection processes, serious case reviews, child abuse and death inquires has consistently highlighted professional neglect of ‘the voice of the child’. Notable research studies have highlighted the relative absence of the child’s voice in social work assessment practices, a troubling lack of meaningful engagement with children and the need to more thoroughly examine communicative practices in child protection contexts. As a consequence, the project of capturing ‘the voice of the child’ has intensified, and there has been an increasing focus on developing methods and professional skills to attend to voice. This has been guided by a recognition that professionals often lack the skills and training to engage with children in age-appropriate ways. We argue however that the problem with ‘capturing’ and [re]representing ‘voice’ in child protection contexts is, more fundamentally, a failure to adequately theorise the concept of ‘voice’ in the ‘voice of the child’. For the most part, ‘The voice of the child’ incorporates psychological conceptions of child development. While these concepts are useful in the context of direct work with children, they fail to consider other strands of sociological thought, which position ‘the voice of the child’ within an agentic paradigm to emphasise the active agency of the child.

Keywords: child-centered, child protection, views of the child, voice of the child

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Authors: Emanuela Zilli, Suana Tikvina, Davide Bonaldo, Monica Varotto, Scilla Rizzardi, Barbara Ruzzante, Raffaele Napolitano, Stefano Bevilacqua, Antonella Ruffatto

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A healthy workplace increases productivity, creativity and decreases absenteeism and turnover. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work-related stress that are often unsustainable. The Hospital of Cittadella (in the province of Padua) has 400 beds and serves a territory of 300,000 inhabitants. The hospital itself counts 1.250 healthcare employees (healthcare professionals). This year, the Medical Board of Directors has requested additional staff; however, the economic situation of Italy can not sustain additional hires. At the same time, we have initiated projects that aim to increase well-being, decrease stress and encourage activities that promote self-care. One of the projects that the hospital has organized is the psychomotor practice. It is held by therapists and trainers who operate according to the traditional method. According to the literature, the psychomotor practice is specifically intended for the staff operating in the Intensive Care Unit, Emergency Department and Pneumology Ward. The project consisted of one session of 45 minutes a week for 3 months. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue, creating a more mindful and sustainable lifestyle. In addition, a Qigong course was held every two weeks for 5 months. It is an ancient Chinese practice designed to optimize the energy within the body, reducing stress levels and increasing general well-being. Finally, Tibetan singing crystal bowls sessions, held by a music therapist, consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Sound therapy uses the vibrations created from the crystal bowls to balance the vibrations within the body to promote relaxation. In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and, consequently, user satisfaction of the services provided.

Keywords: health promotion, healthcare workers management, Weel being and organizational performance, Psychomotor practice

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Authors: M. Ghasemi, S.Fazelifar

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Abstract Aim: Over-weight is not desirable and has implications for health and in the case of athletes affects performance. Exercise is a strategy used to counteract overweight owing to create a negative energy balance by increasing energy expenditure and influencing appetite regulating hormones. Interestingly, recent studies have revealed inhibitory effects of exercise on the hunger associated with these hormones in healthy subjects Neuropeptide Y(NPY) is a 36 amino acid protein that is a powerful stimulant appetite. NPY is an important central orexigenic hormone predominantly produced by the hypothalamus, and recently found to be secreted in adipose tissue. This neurotransmitter is secreted in the brain and autonomic nervous system. On the other hand, research has shown that thyme in addition to various properties, also affects the appetite. The purpose of this study was to determine Effects of eight weeks endurance training and thyme consumption on neuropeptide Y in untrained men. Methodology: 36 Healthy untrained men (mean body weight 78.25±3.2 kg, height 176±6.8 cm, age 34.32±4.54 years and BMI 29.1±4.3 kg/m2) voluntarily participated in this study . Subjects were randomly divided into four groups: 1. control, 2. Endurance training, 3. Thyme 4. Endurance training + Thyme. Amount of 10cc Blood sampling were obtained pre-test and post-test (after 8 weeks). The taken blood samples were centrifuged at 1500 × g for 15 min then plasma was stored at -20 °C until analysis. Endurance training consisted three session per week with 60% -75% of reserve heart rate for eight weeks. Exclusion criteria were history of gastrointestinal, endocrine, cardiovascular or psychological disease, and consuming any supplementation, alcohol and tobacco products. Descriptive statistics including means, standard deviations, and ranges were calculated for all measures. K-S test to determine the normality of the data and analysis of variance for repeated measures was used to analyze the data. A significant difference in the p<0/05 accepted. Results: Results showed that aerobic training significantly reduced body weight, body mass index, percent body fat, but significant increase observed in maximal oxygen consumption level (p ≤ 0/05). The neuropeptide Y levels were significantly increased after exercise. Analysis of data determined that there was no significant difference between the four groups. Conclusion: Appetite control plays a critical role in the competition between energy consumption and energy expenditure. The results of this study showed that endurance training and thyme consumption can be cause improvement in physiological parameters such as increasing aerobic capacity, reduction of fat mass and improve body composition in untrained men.

Keywords: Endurance training, neuropeptide Y, thyme, untrained men

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Authors: Laith F. Gulli, Nicole M. Mallory

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We developed a novel measurement instrument to assess Knowledge of Educational Programs in Professional Psychotherapy Programs (KEP-PPP or KEP-Triple P) within the United States. The instrument was designed by a Panel of Experts (PoE) that consisted of Licensed Psychotherapists and Medical Care Providers. Licensure track psychotherapy programs are listed in the databases of the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE); American Psychological Association (APA); Council on Social Work Education (CSWE); and the Council for Accreditation of Counseling & Related Educational Programs (CACREP). A complete list of psychotherapy programs can be obtained from these professional databases, selecting search fields of (All Programs) in (All States). Each program has a Web link that electronically and directly connects to the institutional program, which can be researched using the KEP-Triple P. The 29-item KEP Triple P was designed to consist of six categorical fields; Institutional Type: Degree: Educational Delivery: Accreditation: Coursework Competency: and Special Program Considerations. The KEP-Triple P was designed to determine whether a specific course(s) is offered in licensure track psychotherapy programs. The KEP-Triple P is designed to be modified to assess any part or the entire curriculum of licensure graduate programs. We utilized the KEP-Triple P instrument to study whether a graduate course in Addictions was offered in Marriage and Family Therapy (MFT) programs. Marriage and Family Therapists are likely to commonly encounter patients with Addiction(s) due to the broad treatment scope providing psychotherapy services to individuals, couples and families of all age groups. Our study of 124 MFT programs which concluded at the end of 2016 found that we were able to assess 61 % of programs (N = 76) since 27 % (N = 34) of programs were inaccessible due to broken Web links. From the total of all MFT programs 11 % (N = 14) did not have a published curriculum on their Institutional Web site. From the sample study, we found that 66 % (N = 50) of curricula did not offer a course in Addiction Treatment and that 34 % (N =26) of curricula did require a mandatory course in Addiction Treatment. From our study sample, we determined that 15 % (N = 11) of MFT doctorate programs did not require an Addictions Treatment course and that 1 % (N = 1) did require such a course. We found that 99 % of our study sample offered a Campus based program and 1 % offered a hybrid program with both online and residential components. From the total sample studied, we determined that 84 % of programs would be able to obtain reaccreditation within a five-year period. We recommend that MFT programs initiate procedures to revise curricula to include a required course in Addiction Treatment prior to their next accreditation cycle, to improve the escalating addiction crisis in the United States. This disparity in MFT curricula raises serious ethical and legal consideration for national and Federal stakeholders as well as for patients seeking a competently trained psychotherapist.

Keywords: addiction, competency, curriculum, psychotherapy

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Authors: Diana Vieira Figueiredo, Rita Ramos Miguel, Maria do Céu Salvador, Luiza Nobre-Lima, Daniel RIjo, Paula Vagos

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Social Anxiety Disorder (SAD) is characterized by a marked and persistent fear of social and/or performance situations in which one may be exposed to the scrutiny of others.  SAD has its usual onset and is highly prevalent during adolescence; if left untreated, it often has a chronic and unremitting course. So, it seems important to understand the psychological processes that might predict the development of SAD. One of these processes may be self-compassion, which has been found to be associated with social anxiety in both adults and adolescents. Self-compassion involves three main components, each with a positive (compassionate behavior) and negative (uncompassionate behavior) pole – self-kindness versus self-judgment, common humanity versus isolation, and mindfulness versus over-identification. The negative indicators of self-compassion (self-judgement, isolation, and over-identification) were found to be more strongly linked to mental health problems than the positive indicators (self-kindness, common humanity, and mindfulness). Additionally, negative associations were found between the positive indicators of self-compassion (self-kindness, common humanity, mindfulness) and psychopathology. The current study aimed to investigate the role of self-kindness, self-judgment, common humanity, isolation, mindfulness, and over-identification in the likelihood of an adolescent presenting SAD by comparing groups of normative and socially anxious adolescents. The sample consisted of 32 adolescents (Mage = 15.88, SD = .833) of which 23 were girls. Adolescents were assessed through a clinical structured interview that led 17 to be assigned to the clinical group (presenting a primary diagnosis of SAD) and 15 to be assigned to the non-clinical group (presenting no clinical diagnosis). Variables under study were measured through the Self-Compassion Scale for adolescents (SCS-A), which assesses the six indicators of self-compassion presented above. Six separate models were tested, each with one of the subscales of the SCS-A as the independent variable and with the group (clinical versus non-clinical) as the dependent variable. The models considering isolation, over-identification, self-judgement, and self-kindness fitted the data and accurately predicted group belonging for between 75% to 84.4% of cases. Results indicated that the log of the odds of an adolescent presenting SAD was positively related to isolation, over-identification, and self-judgement and negatively associated with self-kindness. Findings provide support for the idea that decreased self-compassion may place adolescents at increased risk for experiencing clinical levels of social anxiety: on the one hand, adolescents with higher levels of isolation, over-identification, and self-judgement seem to be more prone to the development of psychopathological levels of social anxiety; on the other hand, self-kindness may play a protective role in the development of SAD in this developmental phase. So, if focusing on social feared consequences and perceiving to be different from others may be distinctive features of SAD, developing self-kindness may be the antidote to promote diminished levels of social anxiety and more.

Keywords: adolescents, social anxiety disorder, self-compassion, diagnosis odds-ration

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Authors: Hafsa Kamran, Asma Afreen, Zaheer Ahmed

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Internet addiction, an emerging mental health disorder from last two decades, is manifested by the inability in the controlled use of internet leading to academics, social, physiological and/or psychological difficulties. The present study aimed to assess the levels of internet addiction among university students in Lahore and to explore the effects of internet addiction on their dietary behavior and lifestyle. It was an analytical cross-sectional study. Data was collected from October to December 2016 from students of four universities selected through two-stage sampling method. The numbers of participants were 500 and 13 questionnaires were rejected due to incomplete information. Levels of Internet Addiction (IA) were calculated using Young Internet Addiction Test (YIAT). Data was also collected on students’ demographics, lifestyle factors and dietary behavior using self-reported questionnaire. Data was analyzed using SPSS (version 21). Chi-square test was applied to evaluate the relationship between variables. Results of the study revealed that 10% of the population had severe internet addiction while moderate Internet Addiction was present in 42%. High prevalence was found among males (11% vs. 8%), private sector university students (p = 0.008) and engineering students (p = 0.000). The lifestyle habits of internet addicts were significantly of poorer quality than normal users (p = 0.05). Internet addiction was found associated with lesser physically activity (p = 0.025), had shorter duration of physical activity (p = 0.016), had more disorganized sleep pattern (p = 0.023), had less duration of sleep (p = 0.019), reported being more tired and sleepy in class (p = 0.033) and spending more time on internet as compared to normal users. Severe and moderate internet addicts also found to be more overweight and obese than normal users (p = 0.000). The dietary behavior of internet addicts was significantly poorer than normal users. Internet addicts were found to skip breakfast more than a normal user (p = 0.039). Common reasons for meal skipping were lack of time and snacking between meals (p = 0.000). They also had increased meal size (p = 0.05) and habit of snacking while using the internet (p = 0.027). Fast food (p = 0.016) and fried items (p = 0.05) were most consumed snacks, while carbonated beverages (p = 0.019) were most consumed beverages among internet addicts. Internet Addicts were found to consume less than recommended daily servings of dairy (p = 0.008) and fruits (p = 0.000) and more servings of meat group (p = 0.025) than their no internet addict counterparts. In conclusion, in this study, it was demonstrated that internet addicts have unhealthy dietary behavior and inappropriate lifestyle habits. University students should be educated regarding the importance of balanced diet and healthy lifestyle, which are critical for effectual primary prevention of numerous chronic degenerative diseases. Furthermore, it is necessary to raise awareness concerning adverse effects of internet addiction among youth and their parents.

Keywords: dietary behavior, internet addiction, lifestyle, university students

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Authors: Ku Yu Yiu

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Writers have included the ugly in their works for centuries, but ugliness has often served merely as a contrast to bring out the beautiful, not having emerged as an independent aesthetic category until recent history. In the 1980s, China was going through a series of changes and transformations; the wounds and scars from the Cultural Revolution, a freer literary atmosphere then, and the introduction of Western thoughts into China gave rise to a trend of penning the ugly and the repulsive among writers. Such trend of utilizing 'Ugliness' as a theme of writing in Chinese literature is especially observed among Xianfeng writers (China’s pioneer writers or avant-garde writers). As a prominent Xianfeng writer, Su Tong (1963-) also incorporates ugliness into his novels: shoddy environment, degenerate and ruthless society, distorted and decadent humanity are part and parcel of his deliberate efforts of exploring and depicting the ugly aspects of the world. His full-length novel Rice, staging the appalling protagonist Five Dragons, is a prime example. In fact, all characters in Rice exhibit Ugliness but Five Dragons’s turning into a figure of ugly spite is the most thorough and complete, making Rice a masterpiece of Su Tong’s art in projecting the Ugliness embedded in society and human nature. Approaching Rice from the angle of the aesthetics of the Ugly and selecting Five Dragons as the subject of close reading and analysis, this paper offers insights into both Su Tong’s distinct style of foregrounding and unfolding Ugliness in his novel and the workings of such text when he deploys the Ugly as a center component of his writing. In addition to citing from the discussion of Rice by literary critics and the author himself, this paper also presents textual evidence and analyzes the imageries/motifs and calculated vocabulary/narration employed by Su Tong to illustrate how Five Dragons' extreme behaviors and psychological states are integral to the plot and ultimately to the manifestation of ugliness as the novel’s theme. This study reveals that although the psyche and doings of Five Dragons and other 'ugly' characters are, as the author once stated, imagined products of the writer Su Tong himself, Rice sheds light onto the ugly aspects of life in China in 1920s-30s. Three aspects of Ugliness are identified and discussed in the paper. Lastly, this paper also suggests some effects of Su Tong’s exploration of Ugliness in Rice, proposing that the portrayal of Ugliness per se is not the ends of Su Tong’s mastery of the aesthetics of the Ugly but rather a means to making his writing transcend from provoking spontaneous moral judgment in readers on the doings of Five Dragons to prompting readers to ponder on philosophical questions such as how humanity can still be possible when an individual confronts the dark sides of a self, a society, and his/her fate.

Keywords: aesthetics, Rice, Su Tong, Ugly

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Authors: Fabiola Xavier Leal, Lara Campanharo, Sueli Aparecida Rodrigues Lucas

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The phenomenon of judicialization in health policy brings with it a great deal of problematization, but in general, it means that some issues that were previously solved by traditional political bodies are being decided by the Judiciary bodies. It is, therefore, a controversial topic that has generated many reflections both in the academic and political fields, considering that not only a dispute of public funds is at stake, but also the debate on access to social rights provided for in the Brazilian Federal Constitution of 1988 and in the various public policies, such as healthcare. With regard to the phenomenon in the Mental Health Policy focusing on people who use drugs, the disputes that permeate this scenario are evident: moral, cultural, sanitary, economic, psychological aspects. There are also the individual and collective dimensions of suffering. And in this process, we all question: What is the role of the Brazilian State in this matter? In this context, another question that needs to be answered is the amount spent on this procedure in the state of Espírito Santo (ES), Brazil (in the last 04 years, around R$121,978,591.44 were paid only for compulsory hospitalization of individuals) in the field in question, which is the financing of the services of the Psychosocial Care Network (RAPS). Therefore, this article aims to problematize the phenomenon of judicialization in Mental Health Policy through the compulsory hospitalization of people who use drugs in Espírito Santo (ES). We proposed a study that sought to understand how this has been occurring and making an impact on the provision of RAPS services in the Espírito Santo scenario. Therefore, the general objective of this study is to analyze the expenses with compulsory hospitalizations for drug use carried out by the State Health Department (SESA) between 2014 and 2019, in which we will seek to identify its destination and the impact of these actions on public health policy. For the purposes of this article, we will present the preliminary data of this study, such as the amount spent by the state and the receiving institutions. For data collection, the following data sources were used: documents available publicly on the Transparency Portal (payments made per year, institutions that received, subjects hospitalized, period and the amount of the daily rates paid); as well as the processes generated by SESA through its own system - ONBASE. For qualitative analysis, content analysis was used; and for quantitative analysis, descriptive statistics was used. Thus, we seek to problematize the issue of judicialization for compulsory hospitalizations, considering the current situation in which this resource has been widely requested to legitimize the war on drugs. This scenario highlights the moral-legal discourse, pointing out strategies through the control of bodies and through faith as an alternative.

Keywords: compulsory hospitalization, drugs, judicialization, mental health

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Authors: Rahul Rajak, Archana Kumari Roy

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Purpose: Development brings about structural change in the society. It is essential for socio-economic progress of the society, but it also causes pain to the people who are forced to displace from their motherland. Most of the people who are displaced due to development are poor and tribes. Development and displacement are interlinked with each other in the sense development sometimes leads to displacement of people. These studies mainly focus on socio-economic profile of villages and villagers likely to be affected by the Airport Project and they examine the issues of compensation and people’s level of satisfaction. Methodology: The study is based on Descriptive design; it is basically observational and correlation study. Primary data is used in this study. Considering the time and resource constrains, 100 people were interviewed covering socio-economic and demographic diversities from 6 out of 10 affected villages. Due to Navi Mumbai International Airport Project ten villages have to be displaced. Out of ten villages, this study is based on only six villages. These are Ulwe, Ganeshpuri, Targhar Komberbuje, Chincpada and Kopar. All six villages situated in Raigarh district under the Taluka Panvel in Maharashtra. Findings: It is revealed from the survey that there are three main castes of affected villages that are Agri, Koli, and Kradi. Entire village population of migrated person is very negligible. All three caste have main occupation are agricultural and fishing activities. People’s perception revealed that due to the establishment of the airport project, they may have more opportunities and scope of development rather than the adverse effect, but vigorously leave a motherland is psychological effect of the villagers. Research Limitation: This study is based on only six villages, the scenario of the entire ten affected villages is not explained by this research. Practical implication: The scenario of displacement and resettlement signifies more than a mere physical relocation. Compensation is not only hope for villagers, is it only give short time relief. There is a need to evolve institutions to protect and strengthen the right of Individuals. The development induced displacement exposed them to a new reality, the reality of their legality and illegality of stay on the land which belongs to the state. Originality: Mumbai has large population and high industrialized city have put land at the center of any policy implication. This paper demonstrates through the actual picture gathered from the field that how seriously the affected people suffered and are still suffering because of the land acquisition for the Navi Mumbai International Airport Project. The whole picture arise the question which is how long the government can deny the rights to farmers and agricultural laborers and remain unwilling to establish the balance between democracy and development.

Keywords: compensation, displacement, land acquisition, project affected person (PAPs), rehabilitation

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Authors: Mary Elizabeth Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Injuries due to interpersonal violence are a common reason for emergency department (ED) visits amongst the American pediatric population. Gun violence, in particular, is associated with high morbidity, mortality as well as financial costs. Patterns of pediatric ED usage may be an indicator of risk for future violence, but very little data on the topic exists. Objective: The aims of this study were to assess for frequencies of ED usage for previous interpersonal violence, mental/behavioral issues, sexual/reproductive issues and concerns for abuse in youths presenting to EDs due to physical assault injuries (PAIs) compared to firearm injuries (FIs). Methods: In this retrospective case-control study, ED charts of children ages 8-19 years who presented with injuries due to interpersonal violent encounters from 2014-2017 were reviewed. Data was collected regarding all previous ED visits for injuries due to interpersonal violence (including physical assaults and firearm injuries), mental/behavioral health visits (including depression, suicidal ideation, suicide attempt, homicidal ideation and violent behavior), sexual/reproductive health visits (including sexually transmitted infections and pregnancy related issues), and concerns for abuse (including physical abuse or domestic violence, neglect, sexual abuse, sexual assault, and intimate partner violence). Logistic regression was used to identify predictors of gun violence based on previous ED visits amongst physical assault injured versus firearm injured youths. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed, 251 (62%) of which were due to physical assault injuries (PAIs) and 156 (38%) due to firearm injuries (FIs). The majority of both PAI and FI patients had no previous history of ED visits for violence, mental/behavioral health, sexual/reproductive health or concern for abuse (60.8% PAI, 76.3% FI). 19.2% of PAI and 13.5% of FI youths had previous ED visits for physical assault injuries (OR 0.68, P=0.24, 95% CI 0.36 to 1.29). 1.6% of PAI and 3.2% of FI youths had a history of ED visits for previous firearm injuries (OR 3.6, P=0.34, 95% CI 0.04 to 2.95). 10% of PAI and 3.8% of FI youths had previous ED visits for mental/behavioral health issues (OR 0.91, P=0.80, 95% CI 0.43 to 1.93). 10% of PAI and 2.6% of FI youths had previous ED visits due to concerns for abuse (OR 0.76, P=0.55, 95% CI 0.31 to 1.86). Conclusions: There are no statistically significant differences between physical assault-injured and firearm-injured youths in terms of ED usage for previous violent injuries, mental/behavioral health visits, sexual/reproductive health visits or concerns for abuse. However, violently injured youths in this study have more than twice the number of previous ED usage for physical assaults and mental health visits than previous literature indicates. Data comparing ED usage of victims of interpersonal violence to nonviolent ED patients is needed, but this study supports the notion that EDs may be a useful place for identification of and enrollment in interventions for youths most at risk for future violence.

Keywords: child abuse, emergency department usage, pediatric gun violence, pediatric interpersonal violence, pediatric mental health, pediatric reproductive health

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Authors: Hossam N. Alhawatmeh, Areen I. Albustanji

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Hemodialysis negatively affects physical and psychological health. Pain, poor sleep quality, and low self-esteem are highly prevalent among patients with end-stage renal disease (ESRD) who receive hemodialysis, significantly increasing mortality and morbidity of those patients. Mind-body interventions (MBI), such as mindfulness meditation, have been recently gaining popularity that improved pain, sleep quality, and self-esteem in different populations. However, to our best knowledge, its effects on these health problems in patients receiving hemodialysis have not been studied in Jordan. Thus, the purpose of the study was to examine the effect of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESR receiving hemodialysis in Jordan. An experimental repeated-measures, randomized, parallel control design was conducted on (n =60) end-stage renal disease patients undergoing hemodialysis between March and June 2023 in the dialysis center at a public hospital in Jordan. Participants were randomly assigned to the experimental (n =30) and control groups (n =30) using a simple random assignment method. The experimental group practiced mindfulness meditation for 30 minutes three times per week for five weeks during their hemodialysis treatments. The control group's patients continued to receive hemodialysis treatment as usual for five weeks during hemodialysis sessions. The study variables for both groups were measured at baseline (Time 0), two weeks after intervention (Time 1), and at the end of intervention (Time 3). The numerical rating scale (NRS), the Rosenberg Self-Esteem Scale (RSES-M), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure pain, self-esteem, and sleep quality, respectively. SPSS version 25 was used to analyze the study data. The sample was described by frequency, mean, and standard deviation as an appropriate. The repeated measures analysis of variance (ANOVA) tests were run to test the study hypotheses. The results of repeated measures ANOVA (within-subject) revealed that mindfulness meditation significantly decrease pain by the end of the intervention in the experimental group. Additionally, mindfulness meditation improved sleep quality and self-esteem in the experimental group, and these improvements occurred significantly after two weeks of the intervention and at the end of the intervention. The results of repeated measures ANOVA (within and between-subject) revealed that the experimental group, compared to the control group, experienced lower levels of pain and higher levels of sleep quality and self-esteem over time. In conclusion, the results provided substantial evidence supporting the positive impacts of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESRD undergoing hemodialysis. These results highlight the potential of mindfulness meditation as an adjunctive therapy in the comprehensive care of this patient population. Incorporating mindfulness meditation into the treatment plan for patients receiving hemodialysis may contribute to improved well-being and overall quality of life.

Keywords: hemodialysis, pain, sleep quality, self-esteem, mindfulness

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Authors: Lynne McCormack, Andrew Digges

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Since 2013, the Australian government has enforced mandatory detention of anyone arriving in Australia without a valid visa, including those subsequently identified as a refugee or seeking asylum. While consistent with the increased use of immigration detention internationally, Australia’s use of offshore processing facilities both during and subsequent to refugee status determination processing has until recently remained a unique feature of Australia’s program of deterrence. The commonplace detention of refugees and asylum seekers following displacement is a significant and independent source of trauma and a contributory factor in adverse psychological outcomes. Officially, these individuals have no prospect of resettlement in Australia, are barred from applying for substantive visas, and are frequently and indefinitely detained in closed facilities such as immigration detention centres, or alternative places of detention, including hotels. It is also important to note that the limited access to Australia’s immigration detention population made available to researchers often means that data available for secondary analysis may be incomplete or delayed in its release. Further, studies into the lived experience of refugees and asylum seekers are typically cross-sectional and convenience sampled, employing a variety of designs and research methodologies that limit comparability and focused on the immediacy of the individual’s experience. Consequently, how former detainees make sense of their experience, redefine their future trajectory upon release, and recover a sense of authenticity and purpose, is unknown. As such, the present study sought the positive and negative subjective interpretations of 6 participants in Australia regarding their lived experiences as refugees and asylum seekers within Australia’s immigration detention system and its impact on their future sense of self. It made use of interpretative phenomenological analysis (IPA), a qualitative research methodology that is interested in how individuals make sense of, and ascribe meaning to, their unique lived experiences of phenomena. Underpinned by phenomenology, hermeneutics, and critical realism, this idiographic study aimed to explore both positive and negative subjective interpretations of former refugees and asylum seekers held in detention in Australia. It sought to understand how they make sense of their experiences, how detention has impacted their overall journey as displaced persons, and how they have moved forward in the aftermath of protracted detention in Australia. Examining the unique lived experiences of previously detained refugees and asylum seekers may inform the future development of theoretical models of posttraumatic growth among this vulnerable population, thereby informing the delivery of future mental health and resettlement services.

Keywords: mandatory detention, refugee, asylum seeker, authenticity, Interpretative phenomenological analysis

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Authors: Rune Bjerke

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Psychologists incline to see creativity as a mental and psychological process. However, creativity is as well results of cultural and social interactions. Therefore, creativity is not a product of individuals in isolation, but of social systems. Creative people get ideas from the influence of others and the immediate cultural environment – a space of knowledge, situations, and practices. Therefore, in this study we apply the systems theory in practice to activate creativity processes in the production of our novel and screenplay writing. We, as storytellers actively seek to get into situations in our everyday lives, our systems, to generate ideas. Within our personal systems, we have the potential to induce situations to realise ideas to our texts, which may be accepted by our gate-keepers and can become socially validated. This is our method of writing – get into situations, get ideas to texts, and test them with family and friends in our social systems. Example of novel text as an outcome of our method is as follows: “Is it a matter of obviousness or had I read it somewhere, that the one who increases his knowledge increases his pain? And also, the other way around, with increased pain, knowledge increases, I thought. Perhaps such a chain of effects explains why the rebel August Strindberg wrote seven plays in ten months after the divorce with Siri von Essen. Shortly after, he tried painting. Neither the seven theatre plays were shown, nor the paintings were exhibited. I was standing in front of Munch's painting Women in Three Stages with chaotic mental images of myself crumpled in a church and a laughing x-girlfriend watching my suffering. My stomach was turning at unpredictable intervals and the subsequent vomiting almost suffocated me. Love grief at the worst. Was it this pain Strindberg felt? Despite the failure of his first plays, the pain must have triggered a form of creative energy that turned pain into ideas. Suffering, thoughts, feelings, words, text, and then, the reader experience. Maybe this negative force can be transformed into something positive, I asked myself. The question eased my pain. At that moment, I forgot the damp, humid air in the Munch Museum. Is it the similar type of Strindberg-pain that could explain the recurring, depressive themes in Munch's paintings? Illness, death, love and jealousy. As a beginning art student at the master's level, I had decided to find the answer. Was it the same with Munch's pain, as with Strindberg - a woman behind? There had to be women in the case of Munch - therefore, the painting “Women in Three Stages”? Who are they, what personality types are they – the women in red, black and white dresses from left to the right?” We, the writers, are using persons, situations and elements in our systems, in a systems theory perspective, to prompt creative ideas. A conceptual model is provided to advance creativity theory.

Keywords: creativity theory, systems theory, novel writing, screenplay writing, sources of creativity in social systems

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Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh

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Introduction: Early age of onset of baldness has marked psychological impact on personality. Combination therapies have better efficacy than monotherapy in androgenetic alopecia. Although medical, surgical treatment and cosmetic aids are available for treatment of pattern baldness, medical is first preferred the line of treatment. Although only 5% topical minoxidil is USFDA approved, 10% is available in India since 2007. Efficacy of tablet finasteride is well established in male pattern baldness. 5% topical minoxidil is effective and safe in female pattern baldness. There is a role of saw palmetto in regrowth of scalp hair. With this background research was undertaken to study efficacy and safety of topical minoxidil 10% + tab. Finesteride (1mg) + dermaroller in male pattern baldness and topical minoxidil 5% + cap. Saw palmetto (320 mg) + dermaroller in female pattern baldness. Methods and Materials: It was a randomized uncontrolled evaluator blind study consisting of total 21 patients, 15 of male pattern baldness and 6 of female pattern baldness within 20-35 yrs of age were enrolled. Male patients had Hamilton grade 2-4 MPB and females had Ludwig grade 2 FPB. Male patients were treated with Tab Finesteride 1mg once daily + 10% topical Minoxidil 1ml twice daily for 6 months. Female patients were treated with Cap. Saw palmetto 320 mg once daily + 5% topical Minoxidil twice daily for 6 months. In both male & female patients dermaroller therapy was used once in 10 days for 4 sittings followed by once in 15 days for next 5 months. Blood pressure and possible side effects were monitored in every follow up visits. Pre and post treatment photographs were taken. Assessment of hair growth was done at baseline and at the end of 6 months. Patients satisfactory grading scale and Physician assessment of hair growth scale were used to assessing the results. Trichoscan was done for assessment of hair-shaft diameter and density. Pre and post treatment photographs and Trichoscan hair growth analysis (by diameter and density) was done by physician (dermatologist) not directly involved in this study (evaluator blind). Result: This combination therapy showed moderate response in female pattern alopecia and good to excellent results in male pattern alopecia at the end of 6 months. During therapy none of the patients showed side effects like hypotension, headache and loss of libido, hirsuitism. Mild irritation due to crystal deposition was noted by 3 patients. Conclusion: Effective and early treatment using combination therapy with higher percent of Minoxidil for rapid hair growth is necessary in initial period since it will boost up the self-confidence in patients leading to better treatment compliance. Subsequent maintenance of hair growth can be done with lower concentration. No significant side effects with treatment are observed in both group of patients.

Keywords: androgenetic alopecia, dermaroller, finasteride, minoxidil, saw palmetto

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Authors: Zhuo Job Chen, Kevin Nute

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The work reported examines potential linkages between spatial and temporal prospects, and more specifically, between variations in the spatial depth and foreground obstruction of window views, and observers’ sense of connection to the future. It was found that external views from indoor spaces were strongly associated with a sense of the future, that partially obstructing such a view with foreground objects significantly reduced its association with the future, and replacing it with a pictorial representation of the same scene (with no real actual depth) removed most of its temporal association. A lesser change in the spatial depth of the view, however, had no apparent effect on association with the future. While the role of spatial depth has still to be confirmed, the results suggest that spatial prospects directly affect temporal ones. The word “prospect” typifies the overlapping of the spatial and temporal in most human languages. It originated in classical times as a purely spatial term, but in the 16th century took on the additional temporal implication of an imagined view ahead, of the future. The psychological notion of prospection, then, has its distant origins in a spatial analogue. While it is not yet proven that space directly structures our processing of time at a physiological level, it is generally agreed that it commonly does so conceptually. The mental representation of possible futures has been a central part of human survival as a species (Boyer, 2008; Suddendorf & Corballis, 2007). A sense of the future seems critical not only practically, but also psychologically. It has been suggested, for example, that lack of a positive image of the future may be an important contributing cause of depression (Beck, 1974; Seligman, 2016). Most people in the developed world now spend more than 90% of their lives indoors. So any direct link between external views and temporal prospects could have important implications for both human well-being and building design. We found that the ability to see what lies in front of us spatially was strongly associated with a sense of what lies ahead temporally. Partial obstruction of a view was found to significantly reduce that sense connection to the future. Replacing a view with a flat pictorial representation of the same scene removed almost all of its connection with the future, but changing the spatial depth of a real view appeared to have no significant effect. While foreground obstructions were found to reduce subjects’ sense of connection to the future, they increased their sense of refuge and security. Consistent with Prospect and Refuge theory, an ideal environment, then, would seem to be one in which we can “see without being seen” (Lorenz, 1952), specifically one that conceals us frontally from others, without restricting our own view. It is suggested that these optimal conditions might be translated architecturally as screens, the apertures of which are large enough for a building occupant to see through unobstructed from close by, but small enough to conceal them from the view of someone looking from a distance outside.

Keywords: foreground obstructions, prospection, spatial depth, window views

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Authors: Murray David Schane

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Though years of clinical encounters with patients with autism spectrum disorders and those with a schizoid personality the many defining diagnostic features shared between these conditions have been explored and current neurobiological differences have been reviewed; and, critical and different treatment strategies for each have been devised. The paper compares and contrasts the apparent similarities between autism spectrum disorders and the schizoid personality are found in these DSM descriptive categories: restricted range of social-emotional reciprocity; poor non-verbal communicative behavior in social interactions; difficulty developing and maintaining relationships; detachment from social relationships; lack of the desire for or enjoyment of close relationships; and preference for solitary activities. In this paper autism, fundamentally a communicative disorder, is revealed to present clinically as a pervasive aversive response to efforts to engage with or be engaged by others. Autists with the Asperger presentation typically have language but have difficulty understanding humor, irony, sarcasm, metaphoric speech, and even narratives about social relationships. They also tend to seek sameness, possibly to avoid problems of social interpretation. Repetitive behaviors engage many autists as a screen against ambient noise, social activity, and challenging interactions. Also in this paper, the schizoid personality is revealed as a pattern of social avoidance, self-sufficiency and apparent indifference to others as a complex psychological defense against a deep, long-abiding fear of appropriation and perverse manipulation. Neither genetic nor MRI studies have yet located the explanatory data that identifies the cause or the neurobiology of autism. Similarly, studies of the schizoid have yet to group that condition with those found in schizophrenia. Through presentations of clinical examples, the treatment of autists of the Asperger type is revealed to address the autist’s extreme social aversion which also precludes the experience of empathy. Autists will be revealed as forming social attachments but without the capacity to interact with mutual concern. Empathy will be shown be teachable and, as social avoidance relents, understanding of the meaning and signs of empathic needs that autists can recognize and acknowledge. Treatment of schizoids will be shown to revolve around joining empathically with the schizoid’s apprehensions about interpersonal, interactive proximity. Models of both autism and schizoid personality traits have yet to be replicated in animals, thereby eliminating the role of translational research in providing the kind of clues to behavioral patterns that can be related to genetic, epigenetic and neurobiological measures. But as these clinical examples will attest, treatment strategies have significant impact.

Keywords: autism spectrum, schizoid personality traits, neurobiological implications, critical diagnostic distinctions

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Authors: Jane E. Hill

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Quality of life is an important component for many. With that in mind, everyone will experience some type of loss within his or her lifetime. A person can experience loss due to break up, separation, divorce, estrangement, or death. An individual may experience loss of a job, loss of capacity, or loss caused by human or natural-caused disasters. An individual’s response to such a loss is unique to them, and not everyone will seek services to assist them with their grief due to loss. Counseling can promote positive outcomes for clients that are grieving by addressing the client’s personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as poor health, psychological distress, or an increased risk of depression. Education and training in grief counseling can improve counselors’ problem recognition and skills in treatment planning. The purpose of this study was to examine whether the Council for Accreditation of Counseling and Related Educational Programs (CACREP) master’s degree counseling students view themselves as having been adequately trained in grief theories and skills. Many people deal with grief issues that prevent them from having joy or purpose in their lives and that leaves them unable to engage in positive opportunities or relationships. This study examined CACREP-accredited master’s counseling students’ self-reported competency, training, and education in providing grief counseling. The implications for positive social change arising from the research may be to incorporate and promote education and training in grief theories and skills in a majority of counseling programs and to provide motivation to incorporate professional standards for grief training and practice in the mental health counseling field. The theoretical foundation used was modern grief theory based on John Bowlby’s work on Attachment Theory. The overall research question was how competent do master’s-level counselors view themselves regarding the education or training they received in grief theories or counseling skills in their CACREP-accredited studies. The author used a non-experimental, one shot survey comparative quantitative research design. Cicchetti’s Grief Counseling Competency Scale (GCCS) was administered to CACREP master’s-level counseling students enrolled in their practicum or internship experience, which resulted in 153 participants. Using a MANCOVA, there was significance found for relationships between coursework taken and (a) perceived assessment skills (p = .029), (b) perceived treatment skills (p = .025), and (c) perceived conceptual skills and knowledge (p = .003). Results of this study provided insight for CACREP master’s-level counseling programs to explore and discuss curriculum coursework inclusion of education and training in grief theories and skills.

Keywords: counselor education and training, grief education and training, grief and loss, quality of life

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Authors: Lisa Rudolfsson

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Socio-cognitive factors, such as social support and attribution of blame, influence the victim’s psychological adjustment after the abuse. Furthermore, the response from the person that the victim first confides to effect adjustment following the abuse. In Sweden, although police are investigating most of the reported cases of rape, very few rape-cases leads to trial and sentence. For many women who have been raped, contact with the police officer when reporting the crime will, therefore, be the most notable experience of how representatives for the Swedish society regard and handle what has happened. Hence, it seems urgent to gather information about these initial meetings. This study is part of a three-year research project, titled 'Female rape victims: Quality of initial police and medical care contact', funded by the Swedish Crime Victim and Support Authority. The focus of this study was on police officers in Sweden: their thoughts and experiences of meeting with raped women. Forthcoming are interviews with raped women about their experiences of meeting with police. Sixteen police officers participated in three focus groups and one interview. The participants consisted of five men and eleven women. Focus groups and interview were audio recorded and transcribed verbatim. The material was analyzed using thematic analysis. Participants described how violence against women was not a priority in Swedish society or within the Police Authority. They talked about rape cases as a Sisyphean work-task that put high demands on them, while they also lacked training and support. They expressed a wish to offer the woman some kind of restoration, and they talked about their work as potentially making a difference for the woman – even if she did not get juridical justice. However, participants also described that they did not feel validated in their hard work. They talked about working rape cases as causing them a great deal of frustration - directed towards the Police Authority, the juridical system, colleagues, and sometimes towards the woman. Participants also described how meeting with raped women was a work that affected them in a personal manner. Listening to stories about sexual violence made the participants sad, and they described it as a struggle to understand. They described wondering how the woman’s life turned out and how they sometimes questioned if they had done enough. Some of the conclusions concern the lack of prerequisites needed for police officers to be able to offer a good-enough treatment of raped women, as well as the lack of tools needed for police officers to care for themselves. In lack of training, validation, and support, the knowledge of how to offer a good- enough treatment of raped women becomes a task learned by doing. Attempts to offer, if not legal justice, then at least some kind of restoration becomes a personal task, dependent on individual police officers. It seems urgent that we address the risk of police officers’ frustration building up to be detrimental for both the crime victim and the officer her/himself.

Keywords: focus groups, police, raped women, restoration

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Authors: E. Tugba Topcu

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The emergency services are usually the first places to encounter forensic cases. Hence, it is important to consider forensics from the perspective of the emergency services staff and the physiological and psychological consequences that may arise as a result of behaviour by itself or another person. Accurate and detailed documentation of the situation in which the patient first arrives at the emergency service and preservation of the forensic findings is pivotal for the subsequent forensic investigation. The first step in determining whether or not a forensic case exists is to perform a medical examination of the patient. For each individual suspected to be part of a forensic case, police officers should be informed at the same time as the medical examination is being conducted. Violent events are increasing every year and with an increase in the number of forensic cases, emergency service workers have increasing responsibility and consequently play a key role in protecting, collecting and arranging the forensic evidence. In addition, because the emergency service workers involved in forensic events typically have information about the accused and/or victim, as well as evidence related to the events and the cause of injuries, police officers often require their testimony. However, both nurses and other health care personnel do not typically have adequate expertise in forensic medicine. Emergency nurses should take an active role for determining that whether any patient admitted to the emergency services is a clinical forensic patient the emergency service with injury and requiring possible punishment and knowing of their roles and responsibilities in this area provides legal protection as well as the protection of the judicial affair. Particularly, in emergency services, where rapid patient turnover and high workload exists, patient registration and case reporting may not exist. In such instances, the witnesses, typically the nurses, are often consulted for information. Knowledge of forensic medical matters plays a vital role in achieving justice. According to the Criminal Procedure Law, Article 75, Paragraph 3, ‘an internal body examination or the taking of blood or other biological samples from the body can be performed only by a doctor or other health professional member’. In favour of this item, the clinic nurse and doctor are mainly responsible for evaluating forensic cases in emergency departments, performing the examination, collecting evidence, and storing and reporting data. The courts place considerable importance on determining whether a suspect is the victim or accused and, thus, in terms of illuminating events, it is crucial that any evidence is gathered carefully and appropriately. All the evidence related to the forensic case including the forensic report should be handed over to the police officers. In instances where forensic evidence cannot be collected and the only way to obtain the evidence is the hospital environment, health care personnel in emergency services need to have knowledge about the diagnosis of forensic evidence, the collection of evidence, hiding evidence and provision of the evidence delivery chain.

Keywords: emergency department, emergency nursing, forensic cases, forensic nursing

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Authors: Dieudonne Uwizeye, Reuben Muhayiteto

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Teenage pregnancy is a challenging problem for sustainable development due to restrictions it poses to socioeconomic opportunities for young mothers, their children and families. Being unable to take appropriate economic and social responsibilities, teen mothers get trapped into poverty and become economic burden to their family and country. Besides, teenage pregnancy is also a health problem because children born to very young mothers are vulnerable with greater risk of illnesses and deaths, and teenage mothers are more likely to be exposed to greater risk of maternal mortality and to other health and psychological problems. In Kigali city, in Rwanda, teenage pregnancy rate is currently high and its increase in recent years is worrisome. However, only individual factors influencing the teenage pregnancy tend to be the basis of interventions. It is important to understand the important socioeconomic factors at the household level that are associated with teenage pregnancy to help government, parents, and other stakeholders to appropriately address the problem with sustainable measures. This study analyzed secondary data from the Fifth Rwanda Demographic and Health Survey (RDHS-V 2014-2015) conducted by the National Institute of Statistics of Rwanda (NISR). The aim was to examine household socio-economic factors that are associated with incidence of teenage pregnancies in Kigali city. In addition to descriptive analysis, Pearson’s Chi Square and Binary Logistic Regression were used in the analysis. Findings indicate that marital status and age of household head, number of members in a household, number of rooms used for sleeping, educational level of the household head and household's wealth are significantly associated with teenage pregnancy in Rwanda ( p< 0.05). It was found that teenagers living with parents, those having parents with higher education and those from richer families are less likely to become pregnant. Age of household head was pinpointed as factor to teenage pregnancy, with teenage-headed households being more vulnerable. The findings also revealed that household composition correlates with the probability of teenage pregnancy (p < 0.05) with teenagers from households with less number of members being more vulnerable. Regarding the size of the house, the study suggested that the more rooms available in households, the less incidences of teenage pregnancy are likely to be observed (p < 0.05). However, teenage pregnancy was not significantly associated with physical violence among parents (p = 0.65) and sex of household heads (p = 0.52), except in teen-headed households of which female are predominantly heads. The study concludes that teenage pregnancy remains a serious social, economic and health problem in Rwanda. The study informs government officials, parents and other stakeholders to take interventions and preventive measures through community sex education, policies and strategies to foster effective parental guidance, care and control of young girls through meeting their necessary social and financial needs within households.

Keywords: household socio-economic factors, Rwanda, Rwanda demographic and health survey, teenage pregnancy

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Authors: Klaus Froehlich-Gildhoff, Ullrich Boettinger, Katharina Rauh, Angela Schickler

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The Prevention Network Ortenaukreis, PNO, funded by the German Ministry of Education and Research, aims to promote physical and mental health as well as the social inclusion of 3 to 10 years old children and their families in the Ortenau district. Within a period of four years starting 11/2014 a community network will be established. One regional and five local prevention representatives are building networks with stakeholders of the prevention and health promotion field bridging the health care, educational and youth welfare system in a multidisciplinary approach. The regional prevention representative implements regularly convening prevention and health conferences. On a local level, the 5 local prevention representatives implement round tables in each area as a platform for networking. In the setting approach, educational institutions are playing a vital role when gaining access to children and their families. Thus the project will offer 18 month long organizational development processes with specially trained coaches to 25 kindergarten and 25 primary schools. The process is based on a curriculum of prevention and health promotion which is adapted to the specific needs of the institutions. Also to ensure that the entire region is reached demand oriented advanced education courses are implemented at participating day care centers, kindergartens and schools. Evaluation method: The project is accompanied by an extensive research design to evaluate the outcomes of different project components such as interview data from community prevention agents, interviews and network analysis with families at risk on their support structures, data on community network development and monitoring, as well as data from kindergarten and primary schools. The latter features a waiting-list control group evaluation in kindergarten and primary schools with a mixed methods design using questionnaires and interviews with pedagogues, teachers, parents, and children. Results: By the time of the conference pre and post test data from the kindergarten samples (treatment and control group) will be presented, as well as data from the first project phase, such as qualitative interviews with the prevention coordinators as well as mixed methods data from the community needs assessment. In supporting this project, the Federal Ministry aims to gain insight into efficient components of community prevention and health promotion networks as it is implemented and evaluated. The district will serve as a model region, so that successful components can be transferred to other regions throughout Germany. Accordingly, the transferability to other regions is of high interest in this project.

Keywords: childhood research, health promotion, physical health, prevention network, psychological well-being, social inclusion

Procedia PDF Downloads 222

Authors: Gianluca Castelnuovo, Gian Mauro Manzoni, Giada Pietrabissa, Stefania Corti, Emanuele Giusti, Roberto Cattivelli, Enrico Molinari, Susan Simpson

Abstract:

Obesity is currently an important public health problem of epidemic proportions (globesity). Moreover Binge Eating Disorder (BED) is typically connected with obesity, even if not occurring exclusively in conjunction with overweight conditions. Typically obesity with BED requires a longer term treatment in comparison with simple obesity. Rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation, due to the growing costs of a limited inpatient approach. Internet-based technologies can improve long-term obesity rehabilitation within a collaborative approach. The new m health (m-health, mobile health) paradigm, defined as clinical practices supported by up to date mobile communication devices, could increase compliance- engagement and contribute to a significant cost reduction in BED and obesity rehabilitation. Five psychological components need to be considered for successful m Health-based obesity rehabilitation in order to facilitate weight-loss.1) Self-monitoring. Portable body monitors, pedometers and smartphones are mobile and, therefore, can be easily used, resulting in continuous self-monitoring. 2) Counselor feedback and communication. A functional approach is to provide online weight-loss interventions with brief weekly or monthly counselor or psychologist visits. 3) Social support. A group treatment format is typically preferred for behavioral weight-loss interventions. 4) Structured program. Technology-based weight-loss programs incorporate principles of behavior therapy and change with structured weekly protocolos including nutrition, exercise, stimulus control, self-regulation strategies, goal-setting. 5) Individually tailored program. Interventions specifically designed around individual’s goals typically record higher rates of adherence and weight loss. Opportunities and limitations of m health approach in clinical psychology for obesity and BED are discussed, taking into account future research directions in this promising area.

Keywords: obesity, rehabilitation, out-patient, new technologies, tele medicine, tele care, m health, clinical psychology, psychotherapy, chronic care management

Procedia PDF Downloads 473