Search results for: prevalence proportion
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2575

Search results for: prevalence proportion

265 Prenatal Paraben Exposure Impacts Infant Overweight Development and in vitro Adipogenesis

Authors: Beate Englich, Linda Schlittenbauer, Christiane Pfeifer, Isabel Kratochvil, Michael Borte, Gabriele I. Stangl, Martin von Bergen, Thorsten Reemtsma, Irina Lehmann, Kristin M. Junge

Abstract:

The worldwide production of endocrine disrupting compounds (EDC) has risen dramatically over the last decades, as so has the prevalence for obesity. Many EDCs are believed to contribute to this obesity epidemic, by enhancing adipogenesis or disrupting relevant metabolism. This effect is most tremendous in the early prenatal period when priming effects find a highly vulnerable time window. Therefore, we investigate the impact of parabens on childhood overweight development and adipogenesis in general. Parabens are ester of 4-hydroxy-benzoic acid and part of many cosmetic products or food packing. Therefore, ubiquitous exposure can be found in the westernized world, with exposure already starting during the sensitive prenatal period. We assessed maternal cosmetic product consumption, prenatal paraben exposure and infant BMI z-scores in the prospective German LINA cohort. In detail, maternal urinary concentrations (34 weeks of gestation) of methyl paraben (MeP), ethyl paraben (EtP), n-propyl paraben (PrP) and n-butyl paraben (BuP) were quantified using UPLC-MS/MS. Body weight and height of their children was assessed during annual clinical visits. Further, we investigated the direct influence of those parabens on adipogenesis in-vitro using a human mesenchymal stem cell (MSC) differentiation assay to mimic a prenatal exposure scenario. MSC were exposed to 0.1 – 50 µM paraben during the entire differentiation period. Differentiation outcome was monitored by impedance spectrometry, real-time PCR and triglyceride staining. We found that maternal cosmetic product consumption was highly correlated with urinary paraben concentrations at pregnancy. Further, prenatal paraben exposure was linked to higher BMI Z-scores in children. Our in-vitro analysis revealed that especially the long chained paraben BuP stimulates adipogenesis by increasing the expression of adipocyte specific genes (PPARγ, ADIPOQ, LPL, etc.) and triglyceride storage. Moreover, we found that adiponectin secretion is increased whereas leptin secretion is reduced under BuP exposure in-vitro. Further mechanistic analysis for receptor binding and activation of PPARγ and other key players in adipogenesis are currently in process. We conclude that maternal cosmetic product consumption is linked to prenatal paraben exposure of children and contributes to the development of infant overweight development by triggering key pathways of adipogenesis.

Keywords: adipogenesis, endocrine disruptors, paraben, prenatal exposure

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264 Association between Maternal Personality and Postnatal Mother-to-Infant Bonding

Authors: Tessa Sellis, Marike A. Wierda, Elke Tichelman, Mirjam T. Van Lohuizen, Marjolein Berger, François Schellevis, Claudi Bockting, Lilian Peters, Huib Burger

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Introduction: Most women develop a healthy bond with their children, however, adequate mother-to-infant bonding cannot be taken for granted. Mother-to-infant bonding refers to the feelings and emotions experienced by the mother towards her child. It is an ongoing process that starts during pregnancy and develops during the first year postpartum and likely throughout early childhood. The prevalence of inadequate bonding ranges from 7 to 11% in the first weeks postpartum. An impaired mother-to-infant bond can cause long-term complications for both mother and child. Very little research has been conducted on the direct relationship between the personality of the mother and mother-to-infant bonding. This study explores the associations between maternal personality and postnatal mother-to-infant bonding. The main hypothesis is that there is a relationship between neuroticism and mother-to-infant bonding. Methods: Data for this study were used from the Pregnancy Anxiety and Depression Study (2010-2014), which examined symptoms of and risk factors for anxiety or depression during pregnancy and the first year postpartum of 6220 pregnant women who received primary, secondary or tertiary care in the Netherlands. The study was expanded in 2015 to investigate postnatal mother-to-infant bonding. For the current research 3836 participants were included. During the first trimester of gestation, baseline characteristics, as well as personality, were measured through online questionnaires. Personality was measured by the NEO Five Factor Inventory (NEO-FFI), which covers the big five of personality (neuroticism, extraversion, openness, altruism and conscientiousness). Mother-to-infant bonding was measured postpartum by the Postpartum Bonding Questionnaire (PBQ). Univariate linear regression analysis was performed to estimate the associations. Results: 5% of the PBQ-respondents reported impaired bonding. A statistically significant association was found between neuroticism and mother-to-infant bonding (p < .001): mothers scoring higher on neuroticism, reported a lower score on mother-to-infant bonding. In addition, a positive correlation was found between the personality traits extraversion (b: -.081), openness (b: -.014), altruism (b: -.067), conscientiousness (b: -.060) and mother-to-infant bonding. Discussion: This study is one of the first to demonstrate a direct association between the personality of the mother and mother-to-infant bonding. A statistically significant relationship has been found between neuroticism and mother-to-infant bonding, however, the percentage of variance predictable by a personality dimension is very small. This study has examined one part of the multi-factorial topic of mother-to-infant bonding and offers more insight into the rarely investigated and complex matter of mother-to-infant bonding. For midwives, it is important recognize the risks for impaired bonding and subsequently improve policy for women at risk.

Keywords: mother-to-infant bonding, personality, postpartum, pregnancy

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263 Differentially Expressed Genes in Atopic Dermatitis: Bioinformatics Analysis Of Pooled Microarray Gene Expression Datasets In Gene Expression Omnibus

Authors: Danna Jia, Bin Li

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Background: Atopic dermatitis (AD) is a chronic and refractory inflammatory skin disease characterized by relapsing eczematous and pruritic skin lesions. The global prevalence of AD ranges from 1~ 20%, and its incidence rates are increasing. It affects individuals from infancy to adulthood, significantly impacting their daily lives and social activities. Despite its major health burden, the precise mechanisms underlying AD remain unknown. Understanding the genetic differences associated with AD is crucial for advancing diagnosis and targeted treatment development. This study aims to identify candidate genes of AD by using bioinformatics analysis. Methods: We conducted a comprehensive analysis of four pooled transcriptomic datasets (GSE16161, GSE32924, GSE130588, and GSE120721) obtained from the Gene Expression Omnibus (GEO) database. Differential gene expression analysis was performed using the R statistical language. The differentially expressed genes (DEGs) between AD patients and normal individuals were functionally analyzed using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. Furthermore, a protein-protein interaction (PPI) network was constructed to identify candidate genes. Results: Among the patient-level gene expression datasets, we identified 114 shared DEGs, consisting of 53 upregulated genes and 61 downregulated genes. Functional analysis using GO and KEGG revealed that the DEGs were mainly associated with the negative regulation of transcription from RNA polymerase II promoter, membrane-related functions, protein binding, and the Human papillomavirus infection pathway. Through the PPI network analysis, we identified eight core genes: CD44, STAT1, HMMR, AURKA, MKI67, and SMARCA4. Conclusion: This study elucidates key genes associated with AD, providing potential targets for diagnosis and treatment. The identified genes have the potential to contribute to the understanding and management of AD. The bioinformatics analysis conducted in this study offers new insights and directions for further research on AD. Future studies can focus on validating the functional roles of these genes and exploring their therapeutic potential in AD. While these findings will require further verification as achieved with experiments involving in vivo and in vitro models, these results provided some initial insights into dysfunctional inflammatory and immune responses associated with AD. Such information offers the potential to develop novel therapeutic targets for use in preventing and treating AD.

Keywords: atopic dermatitis, bioinformatics, biomarkers, genes

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262 The Negative Implications of Childhood Obesity and Malnutrition on Cognitive Development

Authors: Stephanie Remedios, Linda Veronica Rios

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Background. Pediatric obesity is a serious health problem linked to multiple physical diseases and ailments, including diabetes, heart disease, and joint issues. While research has shown pediatric obesity can bring about an array of physical illnesses, it is less known how such a condition can affect children’s cognitive development. With childhood overweight and obesity prevalence rates on the rise, it is essential to understand the scope of their cognitive consequences. The present review of the literature tested the hypothesis that poor physical health, such as childhood obesity or malnutrition, negatively impacts a child’s cognitive development. Methodology. A systematic review was conducted to determine the relationship between poor physical health and lower cognitive functioning in children ages 4-16. Electronic databases were searched for studies dating back to ten years. The following databases were used: Science Direct, FIU Libraries, and Google Scholar. Inclusion criteria consisted of peer-reviewed academic articles written in English from 2012 to 2022 that analyzed the relationship between childhood malnutrition and obesity on cognitive development. A total of 17,000 articles were obtained, of which 16,987 were excluded for not addressing the cognitive implications exclusively. Of the acquired articles, 13 were retained. Results. Research suggested a significant connection between diet and cognitive development. Both diet and physical activity are strongly correlated with higher cognitive functioning. Cognitive domains explored in this work included learning, memory, attention, inhibition, and impulsivity. IQ scores were also considered objective representations of overall cognitive performance. Studies showed physical activity benefits cognitive development, primarily for executive functioning and language development. Additionally, children suffering from pediatric obesity or malnutrition were found to score 3-10 points lower in IQ scores when compared to healthy, same-aged children. Conclusion. This review provides evidence that the presence of physical activity and overall physical health, including appropriate diet and nutritional intake, has beneficial effects on cognitive outcomes. The primary conclusion from this research is that childhood obesity and malnutrition show detrimental effects on cognitive development in children, primarily with learning outcomes. Assuming childhood obesity and malnutrition rates continue their current trade, it is essential to understand the complete physical and psychological implications of obesity and malnutrition in pediatric populations. Given the limitations encountered through our research, further studies are needed to evaluate the areas of cognition affected during childhood.

Keywords: childhood malnutrition, childhood obesity, cognitive development, cognitive functioning

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261 Effects of Cranberry Juice Enriched with n-3 PUFA Consumption in Adjunct with Non-Surgical Periodontal Therapy on Glycemic Control, Antioxidant Status and Periodontal indices in Type 2 Diabetes Patients with Periodontitis

Authors: A. Zare Javid, H. Babaee, E. Ashrafzadeh, H. Yousefimanesh, M. Zakerkish, K. Ahmadi Angali, M. Ravanbakhsh

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Introduction: Type 2 diabetes mellitus and periodontal disease hold a physiologically relationship. Periodontal disease, a common widespread chronic disease, is considered as an important complication in diabetes mellitus. The prevalence and severity of periodontal disease are increased among diabetic patients. A balanced nutrition may improve either diabetes or periodontal disease by controlling one of them. The aim of this study was to evaluate the effects of cranberry juice enriched with n-3 PUFA and their individual consumption on glycemic control and antioxidant status in diabetic patients with periodontal disease. Methods: In this randomized clinical trial 41 diabetic patients (35 – 65 y) with chronic adult periodontal disease were recruited from Endocrinology Clinic of Golestan Hospital in Ahvaz city, Iran. Subjects were randomly assigned to four groups as follow: one control group (n=12) and three intervention groups as receiving 1 g n-3 PUFA capsule (n=10), 400 ml cranberry juice (n=9), 400 ml cranberry juice enriched with 1g n-3 PUFA (n=10) for 8 weeks. Non-surgical periodontal therapy was provided for all patients during study. Fasting blood glucose, glycated hemoglobin, plasma and saliva TAOC and MDA, pocket depth and bleeding on probing were measured at baseline and post intervention. Results: There was a significant reduction in glycated hemoglobin observed in intervention groups of receiving n-3 PUFA and cranberry enriched with n-3 PUFA (11 %, P = 0.01 and 7 %, P = 0.01, respectively). The intervention group receiving n-3 PUFA had significantly lower glycated hemoglobin compared with control group. There was no significant difference found in FBS between and within groups. Furthermore, there was a significant increase in plasma TAOC only in cranberry enriched with n-3 PUFA group. Moreover, plasma MDA significantly decreased in intervention groups of receiving cranberry and cranberry enriched with n-3 PUFA. A significant increase was observed in TAOC of salvia in cranberry enriched with n-3 PUFA group compared to control group .The intervention group receiving cranberry enriched with n-3 PUFA had significantly lower MDA of salvia compared with control group. Pocket depth were significantly decreased in all groups, however, bleeding on probing didn’t significantly changed in patients post intervention. Conclusion: It is suggested that consumption of cranberry juice enriched with n-3 PUFA as a nutritional approach in adjunct with non-surgical periodontal therapy may help to improve glycosylated hemogolobin and TAOC in salvia and plasma in diabetic patients with periodontal disease.

Keywords: antioxidant, cranberry, oxidant status, periodontal disease, type 2 diabetes mellitus

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260 Evidence of Social Media Addiction and Problematic Internet Use Among High School and University Students in Cyprus

Authors: Costas Christodoulides

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Excessive use of social networking sites (SNS) and the Internet by high school pupils and university students, can cause consequences similar to those observed in substance or gambling related addictions, negatively influence individual well-being notwithstanding self-assessments that people make about their life and experiences. The present study examined, for the first time in Cyprus, the levels of problematic use of the Social Media and the Internet among Cypriot pupils and students aiming at contributing to the discussion about the need for a more conclusive policy framework in the island. The Bergen Social Media Addiction Scale (BSMAS) and the Generalized Problematic Internet Use Scale 2 (GPIUS-2) were adapted to a Cypriot version and along with a sociodemographic questionnaire were introduced to a sample of 1059 young persons in order to respectively assess the addiction risk for Social Media Use and the risk of Problematic Internet Use. The sample consisted of 59% females, aged 15 to 35 (M=18.9 years, SD=3.20), 465 of them were high school students and 594 university students. Of 1059 respondents from 4 high-schools and 5 Universities (HEI) in Cyprus, 8.3% of the sample had BSMAS scores suggestive of addiction. Approximately a quarter of the sample (24%), demonstrated GPIUS-2 scores suggestive of high risk for problematic internet use. It is notable that differences seem to exist across gender with the score of the female population (11.1%) reaching levels of addiction to social media more than twice the level of addiction of the male population (4.3%). Also, the female population of high school students seems to be at the most vulnerable position for problematic internet use (28%). The 26% of the sample often or very often used some SNSs to forget of personal problems. The results of this study show that half of those surveyed used the Internet to feel better when they were upset or to escape the isolation they felt. Among the sample population, the study reports that 60% of the pupils and female university students are in agreement with the relevant statements. Conclusively, this study suggests that SNSs addiction levels among pupils and students in Cyprus ought to be an important public health concern. The same if not more alarming is the identified by the study prevalence of problematic Internet use among the same population. These results confirm international trends reported by scholarly research while also suggest that particular categories such as high school pupils and young females may be more exposed to problem SNSs and Internet use. Preventive strategies need first to acknowledge the problem in order to then formulate an effective strategy for prevention and intervention. For relevant authorities it is of primary importance to “exploit” the fact that high schools and universities can be seen as small communities and units potentially available for forging alliances for healthy Social Media and Internet use.

Keywords: problematic internet use, social media addiction, social networking sites, well-being

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259 Assessment of the Impact of Social Compliance Certification on Abolition of Forced Labour and Discrimination in the Garment Manufacturing Units in Bengaluru: A Perspective of Women Sewing Operators

Authors: Jonalee Das Bajpai, Sandeep Shastri

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The Indian Textile and Garment Industry is one of the major contributors to the country’s economy. This industry is also one of the largest labour intensive industries after agriculture and livestock. This Indian garment industry caters to both the domestic and international market. Although this industry comes under the purview of Indian Labour Laws and other voluntary work place standards yet, this industry is often criticized for the undue exploitation of the workers. This paper explored the status of forced labour and discrimination at work place in the garment manufacturing units in Bengaluru. This study is conducted from the perspective of women sewing operators as majority of operators in Bengaluru are women. The research also explored to study the impact of social compliance certification in abolishing forced labour and discrimination at work place. Objectives of the Research: 1. To study the impact of 'Social Compliance Certification' on abolition of forced labour among the women workforce. 2. To study the impact of 'Social Compliance Certification' on abolition of discrimination at workplace among the women workforce. Sample Size and Data Collection Techniques: The main backbone of the data which is the primary data was collected through a structured questionnaire. The questionnaire attempted to explore the extent of prevalence of forced labour and discrimination against women workers from the perspective of women workers themselves. The sample size for the same was 600 (n) women sewing operators from the garment industry with minimum one year of work experience. Three hundred samples were selected from units with Social Compliance Certification like SA8000, WRAP, BSCI, ETI and so on. Other three hundred samples were selected from units without Social Compliance Certification. Out of these three hundred samples, one hundred and fifty samples were selected from units with Buyer’s Code of Conduct and another one hundred and fifty were from domestic units that do not come under the purview of any such certification. The responses of the survey were further authenticated through on sight visit and personal interactions. Comparative analysis of the workplace environment between units with Social Compliance certification, units with Buyer’s Code of Conduct and domestic units that do not come under the purview of any such voluntary workplace environment enabled to analyze the impact of Social Compliance certification on abolition of workplace environment and discrimination at workplace. Correlation analysis has been conducted to measure the relationship between impact of forced labour and discrimination at workplace on the level of job satisfaction. The result displayed that abolition of forced labour and abolition of discrimination at workplace have a higher level of job satisfaction among the women workers.

Keywords: discrimination, garment industry, forced labour, social compliance certification

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258 Knowledge State of Medical Students in Morocco Regarding Metabolic Dysfunction Associated with Non-alcoholic Fatty Liver Disease (MASLD)

Authors: Elidrissi Laila, El Rhaoussi Fatima-Zahra, Haddad Fouad, Tahiri Mohamed, Hliwa Wafaa, Bellabah Ahmed, Badre Wafaa

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Introduction: Metabolic Dysfunction Associated with Non-Alcoholic Fatty Liver Disease (MASLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is the leading cause of chronic liver disease. The cardiometabolic risk factors associated with MASLD represent common health issues and significant public health challenges. Medical students, being active participants in the healthcare system and a young demographic, are particularly relevant for understanding this entity to prevent its occurrence on a personal and collective level. The objective of our study is to assess the level of knowledge among medical students regarding MASLD, its risk factors, and its long-term consequences. Materials and Methods: We conducted a descriptive cross-sectional study using an anonymous questionnaire distributed through social media over a period of 2 weeks. Medical students from various faculties in Morocco answered 22 questions about MASLD, its etiological factors, diagnosis, complications, and principles of treatment. All responses were analyzed using the Jamovi software. Results: A total of 124 students voluntarily provided complete responses. 59% of our participants were in their 3rd year, with a median age of 21 years. Among the respondents, 27% were overweight, obese, or diabetic. 83% correctly answered more than half of the questions, and 77% believed they knew about MASLD. However, 84% of students were unaware that MASLD is the leading cause of chronic liver disease, and 12% even considered it a rare condition. Regarding etiological factors, overweight and obesity were mentioned in 93% of responses, and type 2 diabetes in 84%. 62% of participants believed that type 1 diabetes could not be implicated in MASLD. For 83 students, MASLD was considered a diagnosis of exclusion, while 41 students believed that a biopsy was mandatory for diagnosis. 12% believed that MASLD did not lead to long-term complications, and 44% were unaware that MASLD could progress to hepatocellular carcinoma. Regarding treatment, 85% included weight loss, and 19% did not consider diabetes management as a therapeutic approach for MASLD. At the end of the questionnaire, 89% of the students expressed a desire to learn more about MASLD and were invited to access an informative sheet through a hyperlink. Conclusion: MASLD represents a significant public health concern due to the prevalence of its risk factors, notably the obesity pandemic, which is widespread among the young population. There is a need for awareness about the seriousness of this emerging and long-underestimated condition among young future physicians.

Keywords: MASLD, medical students, obesity, diabetes

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257 Need and Willingness to Use ‘Meditation on Twin Hearts’ for Management of Anxiety and Depression for the Transgender Community: A Pilot Study

Authors: Neha Joshi, Srikanth Jois, Hector J. Peughero, Poornima Jayakrishna, Moulya R., Purnima Madivanan, Kiran Kumar K. Salagame

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Transgenders are a marginalized section of the community, who are at high risk of mental health problems due to their stigmatization, abandonment by family, prejudice, discrimination by society at large, and the physical, emotional, and sexual abuse from both within and outside their community. Their mental healthcare needs remain largely unaddressed due to lack of access, discrimination by healthcare professions, and lack of resources, including time and money, to seek conventional medical and psychotherapeutic treatments. Meditation is increasingly receiving acceptance as a tool for managing stress and anxiety by the patients as well as mental healthcare professionals. “Meditation on Twin Hearts” is a no cost, self-administered intervention that a person can practice anywhere and at any time of the day. This pilot study evaluates the need for alternate traditional and ingenious interventions like “Meditation of Twin Hearts” to address the mental healthcare needs of the transgender community and acceptance of such an intervention by the community. Thirteen individuals identifying themselves as transgender were invited to participate in one (Hunsur Taluk) of the five scheduled free meditation camps in Mysore. After obtaining informed consent for participation in the study, their mental health status is captured using an anonymous survey using standard, validated, self-reported questionnaires Generalised Anxiety Disorders (GAD)-7 for anxiety, Patient Health Questionnaire (PHQ-9) for depression, and Suicidal Behavior Questionnaire-Revised for suicidality. Then, they were requested to attend a session on “Meditation on Twin Hearts.” After the session, their feedback on willingness to further explore the meditation technique for managing their mental healthcare need was assessed through another survey form. Out of the 13 participants, 92% scored for anxiety (4 mild, and 8 moderate anxiety). In the depression scale, 5 scored for mild and 5 for moderate depression, with a total of 77% (10/13) scoring positively on depression scale. Nearly 70% of participants (9/13), scored greater than the clinical cutoff for the need for clinical intervention. The proportion of individuals at risk for suicide was particularly high in this group, with 8/ 13 (61.5%) participants scoring the clinical cutoff score of ≥ 7. Surprisingly, none of the participants had ever consulted a mental healthcare professional. All the participants (13/13; 100%) responded in affirmative to the question, “Will you be willing to continue meditation for management of your anxiety?” Six out of 13 participants described their experience of meditation as “happy” and 3 described it as “peaceful”. None of the participants reported any negative beliefs or experience regarding the meditation. The study provides evidence for the urgent yet unmet mental healthcare need of the transgender community. The findings of the study also supports the rationale of conducting future systematic research to evaluate and explore ingenious and traditional practices, such as meditation, to meet the healthcare needs, especially in marginalized populations in a low income setting such as Lower and Middle Income countries. Based on these preliminary findings, the Principal Investigator (PI) is planning to cover 4 more areas of Mysore district.

Keywords: anxiety, depression, meditation on twin heart, suicidality, transgender

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256 Returning to Work: A Qualitative Exploratory Study of Head and Neck Cancer Survivor Disability and Experience

Authors: Abi Miller, Eleanor Wilson, Claire Diver

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Background: UK Head and Neck Cancer incidence and prevalence were rising related to better treatment outcomes and changed demographics. More people of working-age now survive Head and Neck Cancer. For individuals, work provides income, purpose, and social connection. For society, work increases economic productivity and reduces welfare spending. In the UK, a cancer diagnosis is classed as a disability and more disabled people leave the workplace than non-disabled people. Limited evidence exists on return-to-work after Head and Neck Cancer, with no UK qualitative studies. Head and Neck Cancer survivors appear to return to work less when compared to other cancer survivors. This study aimed to explore the effects of Head and Neck Cancer disability on survivors’ return-to-work experience. Methodologies: This was an exploratory qualitative study using a critical realist approach to carry out semi-structured one-off interviews with Head and Neck Cancer survivors who had returned to work. Interviews were informed by an interview guide and carried out remotely by Microsoft Teams or telephone. Interviews were transcribed verbatim, pseudonyms allocated, and transcripts anonymized. Data were interpreted using Reflexive Thematic Analysis. Findings: Thirteen Head and Neck Cancer survivors aged between 41 -63 years participated in interviews. Three major themes were derived from the data: changed identity and meaning of work after Head and Neck Cancer, challenging and supportive work experiences and impact of healthcare professionals on return-to-work. Participants described visible physical appearance changes, speech and eating challenges, mental health difficulties and psycho-social shifts following Head and Neck Cancer. These factors affected workplace re-integration, ability to carry out work duties, and work relationships. Most participants experienced challenging work experiences, including stigmatizing workplace interactions and poor communication from managers or colleagues, which further affected participant confidence and mental health. Many participants experienced job change or loss, related both to Head and Neck Cancer and living through a pandemic. A minority of participants experienced strategies like phased return, which supported workplace re-integration. All participants, bar one, wanted conversations with healthcare professionals about return-to-work but perceived these conversations as absent. Conclusion: All participants found returning to work after Head and Neck Cancer to be a challenging experience. This appears to be impacted by participant physical, psychological, and functional disability following Head and Neck Cancer, work interaction and work context.

Keywords: disability, experience, head and neck cancer, qualitative, return-to-work

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255 Posttraumatic Stress Disorder and Associated Factors among Patients with Prostate Cancer

Authors: Meral Huri, Sedef Şahin

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Post-traumatic stress disorder (PTSD) is characterized by psychiatric symptoms and triggered by a terrifying experience which may immediately effect cognitive, affective, behavioral and social skills of the individual. One of the most common noncutaneous cancer among men is prostate cancer. The incidence of psychological stress is quite common in men with prostate cancer. The aim of the study was to explore the PTSD frequency among prostate cancer and define the relationship between occupational participation, coping skills and level of perceived social support among patients with prostate cancer. Forty patients diagnosed with prostate cancer were included in the study. After dividing the patients into two groups ( study/ control) according to type of tumor, we recorded their characteristics and evaluations differences. We evaluated the demographic information form, Structured Clinical Interview for DSM-IV (SCID- I)- Clinical Version for PTSD, Multidimensional Scale of Perceived Social Support, Styles of Coping Inventory and Canadian Occupational Performance Measure (COPM) before and after 1 month from surgery. The mean age of the study group (n:18) was 65.85.6 years (range: 61-79 years). The mean age of the control group (n: 22) was a little bit higher than the study group with mean age 71.3±6.9 years (range: 60-85 years). There was no statistically significant difference between the groups for age and the other characteristics. According to the results of the study, statistically significant difference was found between the level of PTSD of study and the control group. 22% of study group showed PTSD while 13% of the control group showed PTSD (r: 0.02, p<0.001). The scores of study group and control group showed statistically significant difference in five sub-categories of Styles of Coping Inventory. Patients with prostate cancer showed decreased scores in optimistic, seeking social supports and self-confident approach, while increased scores in helpless and submissive sub-categories than the control group (p<0.001). The scores of Multidimensional Scale of Perceived Social Supports of study group and control group showed statistically significant difference. The total perceived social supports score of the study group was 71.34 ± 0.75 while it was 75.34 ± 0.64 for the control group. Total and the sub-category scores of study group were statistically significant lower than the control group. According to COPM, mean scores of occupational participation of study group for occupational performance were 4.32±2.24 and 7.01±1.52 for the control group, respectively). Mean Satisfaction scores were 3,22±2.31 and 7.45±1.74 for the study and control group, respectively. The patients with prostate cancer and benign prostate hyperplasia (BPH) did not show any statistically difference in activity performance (r:0.87) while patients with prostate cancer showed statistically lower scores than the patients with BPH in activity satisfaction (r:0.02, p<0.001).Psycho-social occupational therapy interventions might help to decrease the prevalence of PTSD by increasing associated factors such as the social support perception, using coping skills and activity participation of patients with prostate cancer.

Keywords: activity performance, occupational therapy, posttraumatic stress disorder, prostate cancer

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254 Dangerous Words: A Moral Economy of HIV/AIDS in Swaziland

Authors: Robin Root

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A fundamental premise of medical anthropology is that clinical phenomena are simultaneously cultural, political, and economic: none more so than the linked acronyms HIV/AIDS. For the medical researcher, HIV/AIDS signals an epidemiological pandemic and a pathophysiology. For persons diagnosed with an HIV-related condition, the acronym often conjures dread, too often marking and marginalizing the afflicted irretrievably. Critical medical anthropology is uniquely equipped to theorize the linkages that bind individual and social wellbeing to global structural and culture-specific phenomena. This paper reports findings from an anthropological study of HIV/AIDS in Swaziland, site of the highest HIV prevalence in the world. The project, initiated in 2005, has documented experiences of HIV/AIDS, religiosity, and treatment and care as well as drought and famine. Drawing on interviews with Swazi religious and traditional leaders about their experiences of leadership amidst worsening economic conditions, environmental degradation, and an ongoing global health crisis, the paper provides uncommon insights for global health practitioners whose singular paradigm for designing and delivering interventions is biomedically-based. In contrast, this paper details the role of local leaders in mediating extreme social suffering and resilience in ways that medical science cannot model but which radically impact how sickness is experienced and health services are delivered and accessed. Two concepts help to organize the paper’s argument. First, a ‘moral economy of language’ is central to showing up the implicit ‘technologies of knowledge’ that inhere in scientific and religious discourses of HIV/AIDS; people draw upon these discourses strategically to navigate highly vulnerable conditions. Second, Paulo Freire’s ethnographic focus on a culture’s 'dangerous words' opens up for examination how ‘sex’ is dangerous for religion and ‘god’ is dangerous for science. The paper interrogates hegemonic and ‘lived’ discourses, both biomedical and religious, and contributes to an important literature on the moral economies of health, a framework of explication and, importantly, action appropriate to a wide-range of contemporary global health phenomena. The paper concludes by asserting that it is imperative that global health planners reflect upon and ‘check’ their hegemonic policy platforms by, one, collaborating with local authoritative agents of ‘what sickness means and how it is best treated,’ and, two, taking account of the structural barriers to achieving good health.

Keywords: Africa, biomedicine, HIV/AIDS, qualitative research , religion

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253 Designing a Combined Outpatient and Day Treatment Eating Disorder Program for Adolescents and Transitional Aged Youth: A Naturalistic Case Study

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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Background and significance: Patients with eating disorders have traditionally been an underserviced population within the publicly-funded Canadian healthcare system. This situation was worsened by the COVID-19 pandemic and accompanying public health measures, such as “lockdowns” which led to increased isolation, changes in routine, and other disruptions. Illness severity and prevalence rose significantly with corresponding increases in patient suffering and poor outcomes. In Ontario, Canada, the provincial government responded by increasing funding for the treatment of eating disorders, including the launch of a new day program at an intermediate, regional health centre that already housed an outpatient treatment service. The funding was received in March 2022. The care team sought to optimize this opportunity by designing a program that would fit well within the resource-constrained context in Ontario. Methods: This case study will detail how the team consulted the literature and sought patient and family input to design a program that optimizes patient outcomes and supports for patients and families while they await treatment. Early steps include a review of the literature, expert consultation and patient and family focus groups. Interprofessional consensus was sought at each step with the team adopting a shared leadership and patient-centered approach. Methods will include interviews, observations and document reviews to detail a rich description of the process undertaken to design the program, including evaluation measures adopted. Interim findings pertaining to the early stages of the program-building process will be detailed as well as early lessons and ongoing evolution of the program and design process. Program implementation and outcome evaluation will continue throughout 2022 and early 2023 with further publication and presentation of study results expected in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to the design and implementation of eating disorder treatment services that combine outpatient and day treatment services in a resource-constrained context.

Keywords: eating disorders, day program, interprofessional, outpatient, adolescents, transitional aged youth

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252 The Emerging Role of Cannabis as an Anti-Nociceptive Agent in the Treatment of Chronic Back Pain

Authors: Josiah Damisa, Michelle Louise Richardson, Morenike Adewuyi

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Lower back pain is a significant cause of disability worldwide and associated with great implications in terms of the well-being of affected individuals and society as a whole due to its undeniable socio-economic impact. With its prevalence on the increase as a result of an aging global population, the need for novel forms of pain management is ever paramount. This review aims to provide further insight into current research regarding a role for the endocannabinoid signaling pathway as a target in the treatment of chronic pain, with particular emphasis on its potential use as part of the treatment of lower back pain. Potential advantages and limitations of cannabis-based medicines over other forms of analgesia currently licensed for medical use are discussed in addition to areas that require ongoing consideration and research. To evaluate the efficacy of cannabis-based medicines in chronic pain, studies pertaining to the role of medical cannabis in chronic disease were reviewed. Standard searches of PubMed, Google Scholar and Web of Science databases were undertaken with peer-reviewed journal articles reviewed based on the indication for pain management, cannabis treatment modality used and study outcomes. Multiple studies suggest an emerging role for cannabis-based medicines as therapeutic agents in the treatment of chronic back pain. A potential synergistic effect has also been purported if these medicines are co-administered with opiate analgesia due to the similarity of the opiate and endocannabinoid signaling pathways. However, whilst recent changes to legislation in the United Kingdom mean that cannabis is now licensed for medicinal use on NHS prescription for a number of chronic health conditions, concerns remain as to the efficacy and safety of cannabis-based medicines. Research is lacking into both their side effect profiles and the long-term effects of cannabis use. Legal and ethical considerations to the use of these products in standardized medical practice also persist due to the notoriety of cannabis as a drug of abuse. Despite this, cannabis is beginning to gain traction as an alternative or even complementary drug to opiates, with some preclinical studies showing opiate-sparing effects. Whilst there is a paucity of clinical trials in this field, there is scope for cannabinoids to be successful anti-nociceptive agents in managing chronic back pain. The ultimate aim would be to utilize cannabis-based medicines as alternative or complementary therapies, thereby reducing opiate over-reliance and providing hope to individuals who have exhausted all other forms of standard treatment.

Keywords: endocannabinoids, cannabis-based medicines, chronic pain, lower back pain

Procedia PDF Downloads 183
251 Depressive-Like Behavior in a Murine Model of Colorectal Cancer Associated with Altered Cytokine Levels in Stress-Related Brain Regions

Authors: D. O. Miranda, L. R. Azevedo, J. F. C. Cordeiro, A. H. Dos Santos, S. F. Lisboa, F. S. Guimarães, G. S. Bisson

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Background: The Colorectal cancer (CRC) is one of the most common cancers and the fourth leading cause of cancer death in the world. The prevalence of psychiatric-disorders among CRC patients, mainly depression, is high, resulting in impaired quality of life and side effects of primary treatment. High levels of proinflammatory cytokines at tumor microenvironment is a feature of CRC and the literature suggests that those mediators could contribute to the development of psychiatric disorders. Nevertheless, the ability of tumor-associated biological processes to affect the central nervous system (CNS) has only recently been explored in the context of symptoms of depression and is still not well understood. Therefore, the aim of the present study was to test the hypothesis that depressive-like behavior in an experimental model of CCR induced by N-methyl-N-nitro-N-nitrosoguanidine (MNNG) was correlated to proinflammatory profile in the periphery and in the brain. Methods: Colorectal carcinogenesis was induced in adult C57BL/6 mice (n=12) by administration of MNNG (5mg/kg, 0.1ml/intrarectal instillation) 2 times a week, for 2 week. Control group (n=12) received saline (0.1ml/intrarectal instillation). Eight weeks after beginning of MNNG administration animals were submitted to the forced swim test (FST) and the sucrose preference test for evaluation, respectively, of depressive- and anhedonia-like behaviors. After behavioral evaluation, the colon was collected and brain regions dissected (cortex-C, striatum-ST and hippocampus-HIP) for posterior evaluation of cytokine levels (IL-1β, IL-10, IL-17, and CX3CL1) by ELISA. Results: MNNG induced depressive-like behavior, represented by increased immobility time in the FST (Student t test, p < 0.05) and lower sucrose preference (Student t test, p < 0.05). Moreover, there were increased levels of IL-1β, IL-17 and CX3CL1 in the colonic tissue (Student t test, p < 0.05) and in the brain (IL-1 β in the ST and HIP, Student t test, p < 0.05; IL-17 and CX3CL1 in the C and HIP, p < 0.05). IL-10 levels, in contrast, were decreased in both the colon (p < 0.05) and the brain (C and HIP, p < 0.05). Conclusions: The results obtained in the present work support the notion that tumor growth induces neuroinflammation in stress-related brain regions and depressive-like behavior, which could be related to the high incidence of depression in colorectal carcinogenesis. This work have important clinical and research implications, taken into account that cytokine levels may be a marker promissory for the developing depression in CRC patients. New therapeutic strategies to assist in alleviating mental suffering in cancer patients might result from a better understanding of the role of cytokines in the pathophysiology of depression in these subjects.

Keywords: cytokines, brain, depression, colorectal cancer

Procedia PDF Downloads 250
250 Toy Engagement Patterns in Infants with a Familial History of Autism Spectrum Disorder

Authors: Vanessa Do, Lauren Smith, Leslie Carver

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It is widely known that individuals with autism spectrum disorder (ASD) may exhibit sensitivity to stimuli. Even at a young age, they tend to display stimuli-related discomfort in their behavior during play. Play serves a crucial role in a child’s early years as it helps support healthy brain development, socio-emotional skills, and adaptation to their environment There is research dedicated to studying infant preferences for toys, especially in regard to: gender preferences, the advantages of promoting play, and the caregiver’s role in their child’s play routines. However, there is a disproportionate amount of literature examining how play patterns may differ in children with sensory sensitivity, such as children diagnosed with ASD. Prior literature has studied and found supporting evidence that individuals with ASD have deficits in social communication and have increased presence of repetitive behaviors and/or restricted interests, which also display in early childhood play patterns. This study aims to examine potential differences in toy preference between infants with (FH+) and without (FH-) a familial history of ASD ages 6. 9, and 12 months old. More specifically, this study will address the question, “do FH+ infants tend to play more with toys that require less social engagement compared to FH- infants?” Infants and their caregivers were recruited and asked to engage in a free-play session in their homes that lasted approximately 5 minutes. The sessions were recorded and later coded offline for engagement behaviors categorized by toy; each toy that the infants interacted with was coded as belonging to one of 6 categories: sensory (designed to stimulate one or more senses such as light-up toys or musical toys) , construction (e.g., building blocks, rubber suction cups), vehicles (e.g., toy cars), instructional (require steps to accomplish a goal such as flip phones or books), imaginative (e.g., dolls, stuffed animals), and miscellaneous (toys that do not fit into these categories). Toy engagement was defined as the infant looking and touching the toy (ILT) or looking at the toy while their caregiver was holding it (IL-CT). Results reported include/will include the proportion of time the infant was actively engaged with the toy out of the total usable video time per subject — distractions observed during the session were excluded from analysis. Data collection is still ongoing; however, the prediction is that FH+ infants will have higher engagement with sensory and construction toys as they require the least amount of social effort. Furthermore, FH+ infants will have the least engagement with the imaginative toys as prior literature has supported the claim that individuals with ASD have a decreased likelihood to engage in play that requires pretend play and other social skills. Looking at what toys are more or less engaging to FH+ infants is important as it provides significant contributions to their healthy cognitive, social, and emotional development. As play is one of the first ways for a child to understand the complexities of the larger world, the findings of this study may help guide further research into encouraging play with toys that are more engaging and sensory-sensitive for children with ASD.

Keywords: autism engagement, children’s play, early development, free-play, infants, toy

Procedia PDF Downloads 199
249 The Effectiveness of a Six-Week Yoga Intervention on Body Awareness, Warnings of Relapse, and Emotion Regulation among Incarcerated Females

Authors: James D. Beauchemin

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Introduction: The incarceration of people with mental illness and substance use disorders is a major public health issue with social, clinical, and economic implications. Yoga participation has been associated with numerous psychological benefits; however, there is a paucity of research examining impacts of yoga with incarcerated populations. The purpose of this study was to evaluate effectiveness of a six-week yoga intervention on several mental health-related variables, including emotion regulation, body awareness, and warnings of substance relapse among incarcerated females. Methods: This study utilized a pre-post, three-arm design, with participants assigned to intervention, therapeutic community, or general population groups. A between-group analysis of covariance (ANCOVA) was conducted across groups to assess intervention effectiveness using the Difficulties in Emotion Regulation Scale (DERS), Scale of Body Connection (SBC), and Warnings of Relapse (AWARE) Questionnaire. Results: ANCOVA results for warnings of relapse (AWARE) revealed significant between-group differences F(2, 80) = 7.15, p = .001; np2 = .152), with significant pairwise comparisons between the intervention group and both the therapeutic community (p = .001) and the general population (p = .005) groups. Similarly, significant differences were found for emotional regulation (DERS) F(2, 83) = 10.521, p = .000; np2 = .278). Pairwise comparisons indicated a significant difference between the intervention and general population (p = .01). Finally, significant differences between the intervention and control groups were found for body awareness (SBC) F(2, 84) = 3.69, p = .029; np2 = .081). Between-group differences were clarified via pairwise comparisons, indicating significant differences between the intervention group and both the therapeutic community (p = .028) and general population groups (p = .020). Implications: Study results suggest that yoga may be an effective addition to integrative mental health and substance use treatment for incarcerated women and contributes to increasing evidence that holistic interventions may be an important component for treatment with this population. Specifically, given the prevalence of mental health and substance use disorders, findings revealed that changes in body awareness and emotion regulation might be particularly beneficial for incarcerated populations with substance use challenges as a result of yoga participation. From a systemic perspective, this proactive approach may have long-term implications for both physical and psychological well-being for the incarcerated population as a whole, thereby decreasing the need for traditional treatment. By integrating a more holistic, salutogenic model that emphasizes prevention, interventions like yoga may work to improve the wellness of this population while providing an alternative or complementary treatment option for those with current symptoms.

Keywords: wellness, solution-focused coaching, college students, prevention

Procedia PDF Downloads 99
248 Sacidava and Its Role of Military Outpost in the Moesian Sector of the Danube Limes: Animal Food Resources and Landscape Reconstruction

Authors: Margareta Simina Stanc, Aurel Mototolea, Tiberiu Potarniche

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Sacidava archeological site is located in Dobrudja region, Romania, on a hill on the right bank of the Danube - the Musait point, located at about 5 km north-east from Dunareni village. The place-name documents the fact that, prior to the Roman conquest, in the area, there was a Getic settlement. The location of the Sacidava was made possible by corroborating the data provided by the ancient sources with the epigraphic documents (the milial pillar during the time of Emperor Decius). The tegular findings attest that an infantry unit, cohors I Cilicum milliaria equitata, as well as detachments from Legio V Macedonica and Legio XI Claudia, were confined to Sacidava. During the period of the Dominion, the garrison of the fortification is the host of a cavalry unit: cuneus equitum scutariorum. In the immediate vicinity to the Roman fortress, to the east, were identified two other fortifications: a Getic settlement (4th-1st century B.C.) and an Early Medieval settlement (9th-10th century A.C.). The archaeological material recovered during the research is represented by ceramic forms such as amphoras, jugs, pots, cups, plates, to which are added oil lamps, some of them typologically new at the time of discovery. Local ceramic shapes were also founded, worked by hand or by wheel, considered un-Romanized or in the course of Romanization. During the time of the Principality, Sacidava it represented an important military outpost serving mainly the city of Tropaeum Traiani, controlling also the supply and transport on the Danube limes in the Moesic sector. This role will determine the development of the fortress and the appearance of extramuros civil structures, thus becoming an important landmark during the 5th-6th centuries A.C., becoming a representation of power of the Roman empire in an area of continuous conflict. During recent archaeological researches, faunal remains were recovered, and their analysis allowed to estimate the animal resources and subsistence practices (animal husbandry, hunting, fishing) in the settlement. The methodology was specific to archaeozoology, mainly consisting of anatomical, taxonomical, and taphonomical identifications, recording, and quantification of the data. The remains of domestic mammals have the highest proportion indicating the importance of animal husbandry; the predominant species are Bos taurus, Ovis aries/Capra hircus, and Sus domesticus. Fishing and hunting were of secondary importance in the subsistence economy of the community. Wild boar and the red deer were the most frequently hunted species. Just a few fish bones were recovered. Thus, the ancient city of Sacidava is proving to be an important element of cultural heritage of the south-eastern part of Romania, for whose conservation and enhancement efforts must be made, especially by landscape reconstruction.

Keywords: archaeozoology, landscape reconstruction, limes, military outpost

Procedia PDF Downloads 297
247 Designing a Waitlist Intervention for Adult Patients Awaiting Outpatient Treatment for Eating Disorders: Preliminary Findings from a Pilot Test

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

Procedia PDF Downloads 79
246 Need for a Tailor Made HIV Prevention Services to the Migrants Community: Evidence from Implementing Migrant Service Delivery System (MSDS) among Migrant Workers, National AIDS Control Program, and India

Authors: Debasish Chowdhury, Sunil Mekale, Sarvanamurthy Sakthivel, Sukhvinder Kaur, Rambabu Khambampati, Ashok Agarwal

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Introduction: The migrant intervention in India was initiated during the National AIDS Control Program (NACP) Phase-2 (2002-2007). HIV Sentinel surveillance Studies (HSS) conducted in 2012-13 indicated higher HIV prevalence among migrants (0.99%) compared to general populations (0.35%). Migrants continue to bear a heightened risk of HIV infection which results from the condition and structure of the migration process. USAID PHFI-PIPPSE project in collaboration with the National AIDS Control Organization (NACO) developed a unique system called Migrant Service Delivery System (MSDS) to capture migrants profile with respect to their risk profile and to provide tailor made services to them. Description: MSDS is a web-based system, designed and implemented to increase service uptake among migrants through evidence based planning. 110 destination migrants Targeted Intervention (TI) from 11 states were selected for study with varied target populations in terms of occupations; to understand occupation related risk behaviors among the migrants. Occupation wise registration data of high risk vulnerable migrants were analyzed through MSDS for the period April 2014–June 2016. Analysis was made on specific indicators among these occupational groups to understand the risk behavior and their vulnerability to HIV and STIs. Findings: Out of total HIV positive migrant’s workers (N= 847) enrolled in MSDS HIV rate is found to be highest among Auto-Rickshaw (18.66%) followed by Daily wage laborers (14.46%), Loom workers (10.73%), Industrial workers (10.04%) and Construction worker 7.93%. With 45.14% positivity, industrial workers are found to be most vulnerable to Sexually Transmitted Infections (STIs) (N=10057) among all occupational categories followed by loom workers (16.28%), Skilled worker (Furniture, Jeweler)-7.14%, daily wage laborers (5.45%). Conclusion: MSDS is an effective tool to assess migrants’ risk and their vulnerability to HIV for designing evidence informed program. This system calls for a replication across all destination TIs by NACO for differential strategies for different occupation groups to ensure better yield through scientific planning of intervention among high risk and high vulnerable migrants.

Keywords: migrants, migrant service delivery system, risk, vulnerability

Procedia PDF Downloads 250
245 The Invisible Planner: Unearthing the Informal Dynamics Shaping Mixed-Use and Compact Development in Ghanaian Cities

Authors: Muwaffaq Usman Adam, Isaac Quaye, Jim Anbazu, Yetimoni Kpeebi, Michael Osei-Assibey

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Urban informality, characterized by spontaneous and self-organized practices, plays a significant but often overlooked role in shaping the development of cities, particularly in the context of mixed-use and compact urban environments. This paper aims to explore the invisible planning processes inherent in informal practices and their influence on the urban form of Ghanaian cities. By examining the dynamic interplay between informality and formal planning, the study will discuss the ways in which informal actors shape and plan for mixed-use and compact development. Drawing on the synthesis of relevant secondary data, the research will begin by defining urban informality and identifying the factors that contribute to its prevalence in Ghanaian cities. It will delve into the concept of mixed-use and compact development, highlighting its benefits and importance in urban areas. Drawing on case studies, the paper will uncover the hidden planning processes that occur within informal settlements, showcasing their impact on the physical layout, land use, and spatial arrangements of Ghanaian cities. The study will also uncover the challenges and opportunities associated with informal planning. It examines the constraints faced by informal planners (actors) while also exploring the potential benefits and opportunities that emerge when informality is integrated into formal planning frameworks. By understanding the invisible planner, the research will offer valuable insights into how informal practices can contribute to sustainable and inclusive urban development. Based on the findings, the paper will present policy implications and recommendations. It highlights the need to bridge the policy gaps and calls for the recognition of informal planning practices within formal systems. Strategies are proposed to integrate informality into planning frameworks, fostering collaboration between formal and informal actors to achieve compact and mixed-use development in Ghanaian cities. This research underscores the importance of recognizing and leveraging the invisible planner in Ghanaian cities. By embracing informal planning practices, cities can achieve more sustainable, inclusive, and vibrant urban environments that meet the diverse needs of their residents. This research will also contribute to a deeper understanding of the complex dynamics between informality and planning, advocating for inclusive and collaborative approaches that harness the strengths of both formal and informal actors. The findings will likewise contribute to advancing our understanding of informality's role as an invisible yet influential planner, shedding light on its spatial planning implications on Ghanaian cities.

Keywords: informality, mixed-uses, compact development, land use, ghana

Procedia PDF Downloads 89
244 Five Years Analysis and Mitigation Plans on Adjustment Orders Impacts on Projects in Kuwait's Oil and Gas Sector

Authors: Rawan K. Al-Duaij, Salem A. Al-Salem

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Projects, the unique and temporary process of achieving a set of requirements have always been challenging; Planning the schedule and budget, managing the resources and risks are mostly driven by a similar past experience or the technical consultations of experts in the matter. With that complexity of Projects in Scope, Time, and execution environment, Adjustment Orders are tools to reflect changes to the original project parameters after Contract signature. Adjustment Orders are the official/legal amendments to the terms and conditions of a live Contract. Reasons for issuing Adjustment Orders arise from changes in Contract scope, technical requirement and specification resulting in scope addition, deletion, or alteration. It can be as well a combination of most of these parameters resulting in an increase or decrease in time and/or cost. Most business leaders (handling projects in the interest of the owner) refrain from using Adjustment Orders considering their main objectives of staying within budget and on schedule. Success in managing the changes results in uninterrupted execution and agreed project costs as well as schedule. Nevertheless, this is not always practically achievable. In this paper, a detailed study through utilizing Industrial Engineering & Systems Management tools such as Six Sigma, Data Analysis, and Quality Control were implemented on the organization’s five years records of the issued Adjustment Orders in order to investigate their prevalence, and time and cost impact. The analysis outcome revealed and helped to identify and categorize the predominant causations with the highest impacts, which were considered most in recommending the corrective measures to reach the objective of minimizing the Adjustment Orders impacts. Data analysis demonstrated no specific trend in the AO frequency in past five years; however, time impact is more than the cost impact. Although Adjustment Orders might never be avoidable; this analysis offers’ some insight to the procedural gaps, and where it is highly impacting the organization. Possible solutions are concluded such as improving project handling team’s coordination and communication, utilizing a blanket service contract, and modifying the projects gate system procedures to minimize the possibility of having similar struggles in future. Projects in the Oil and Gas sector are always evolving and demand a certain amount of flexibility to sustain the goals of the field. As it will be demonstrated, the uncertainty of project parameters, in adequate project definition, operational constraints and stringent procedures are main factors resulting in the need for Adjustment Orders and accordingly the recommendation will be to address that challenge.

Keywords: adjustment orders, data analysis, oil and gas sector, systems management

Procedia PDF Downloads 139
243 Tribological Behaviour of the Degradation Process of Additive Manufactured Stainless Steel 316L

Authors: Yunhan Zhang, Xiaopeng Li, Zhongxiao Peng

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Additive manufacturing (AM) possesses several key characteristics, including high design freedom, energy-efficient manufacturing process, reduced material waste, high resolution of finished products, and excellent performance of finished products. These advantages have garnered widespread attention and fueled rapid development in recent decades. AM has significantly broadened the spectrum of available materials in the manufacturing industry and is gradually replacing some traditionally manufactured parts. Similar to components produced via traditional methods, products manufactured through AM are susceptible to degradation caused by wear during their service life. Given the prevalence of 316L stainless steel (SS) parts and the limited research on the tribological behavior of 316L SS samples or products fabricated using AM technology, this study aims to investigate the degradation process and wear mechanisms of 316L SS disks fabricated using AM technology. The wear mechanisms and tribological performance of these AM-manufactured samples are compared with commercial 316L SS samples made using conventional methods. Additionally, methods to enhance the tribological performance of additive-manufactured SS samples are explored. Four disk samples with a diameter of 75 mm and a thickness of 10 mm are prepared. Two of them (Group A) are prepared from a purchased SS bar using a milling method. The other two disks (Group B), with the same dimensions, are made of Gas Atomized 316L Stainless Steel (size range: 15-45 µm) purchased from Carpenter Additive and produced using Laser Powder Bed Fusion (LPBF). Pin-on-disk tests are conducted on these disks, which have similar surface roughness and hardness levels. Multiple tests are carried out under various operating conditions, including varying loads and/or speeds, and the friction coefficients are measured during these tests. In addition, the evolution of the surface degradation processes is monitored by creating moulds of the wear tracks and quantitatively analyzing the surface morphologies of the mould images. This analysis involves quantifying the depth and width of the wear tracks and analyzing the wear debris generated during the wear processes. The wear mechanisms and wear performance of these two groups of SS samples are compared. The effects of load and speed on the friction coefficient and wear rate are investigated. The ultimate goal is to gain a better understanding of the surface degradation of additive-manufactured SS samples. This knowledge is crucial for enhancing their anti-wear performance and extending their service life.

Keywords: degradation process, additive manufacturing, stainless steel, surface features

Procedia PDF Downloads 51
242 The Influence of a Radio Intervention on Farmers’ Practices in Climate Change Mitigation and Adaptation in Kilifi, Kenya

Authors: Fiona Mwaniki

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Climate change is considered a serious threat to sustainable development globally and as one of the greatest ecological, economic and social challenges of our time. The global demand for food is projected to increase by 60% by 2050. Small holder farmers who are vulnerable to the adverse effects of climate change are expected to contribute to this projected demand. Effective climate change education and communication is therefore required for smallholder and subsistence farmers’ in order to build communities that are more climate change aware, prepared and resilient. In Kenya radio is the most important and dominant mass communication tool for agricultural extension. This study investigated the potential role of radio in influencing farmers’ understanding and use of climate change information. The broad aims of this study were three-fold. Firstly, to identify Kenyan farmers’ perceptions and responses to the impacts of climate change. Secondly, to develop radio programs that communicate climate change information to Kenyan farmers and thirdly, to evaluate the impact of information disseminated through radio on farmers’ understanding and responses to climate change mitigation and adaptation. This study was conducted within the farming community of Kilifi County, located along the Kenyan coast. Education and communication about climate change was undertaken using radio to make available information understandable to different social and cultural groups. A mixed methods pre-and post-intervention design that provided the opportunity for triangulating results from both quantitative and qualitative data was used. Quantitative and qualitative data was collected simultaneously, where quantitative data was collected through semi structured surveys with 421 farmers’ and qualitative data was derived from 11 focus group interviews, six interviews with key informants and nine climate change experts. The climate change knowledge gaps identified in the initial quantitative and qualitative data were used in developing radio programs. Final quantitative and qualitative data collection and analysis enabled an assessment of the impact of climate change messages aired through radio on the farming community in Kilifi County. Results of this study indicate that 32% of the farmers’ listened to the radio programs and 26% implemented technologies aired on the programs that would help them adapt to climate change. The most adopted technologies were planting drought tolerant crops including indigenous crop varieties, planting trees, water harvesting and use of manure. The proportion of farmers who indicated they knew “a fair amount” about climate change increased significantly (Z= -5.1977, p < 0.001) from 33% (at the pre intervention phase of this study) to 64% (post intervention). However, 68% of the farmers felt they needed “a lot more” information on agriculture interventions (43%), access to financial resources (21%) and the effects of climate change (15%). The challenges farmers’ faced when adopting the interventions included lack of access to financial resources (18%), high cost of adaptation measures (17%), and poor access to water (10%). This study concludes that radio effectively complements other agricultural extension methods and has the potential to engage farmers’ on climate change issues and motivate them to take action.

Keywords: climate change, climate change intervention, farmers, radio

Procedia PDF Downloads 323
241 Caregivers Burden: Risk and Related Psychological Factors in Caregivers of Patients with Parkinson’s Disease

Authors: Pellecchia M. T., Savarese G., Carpinelli L., Calabrese M.

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Introduction: Parkinson's disease (PD) is characterized by a progressive loss of autonomy which undoubtedly has a significant impact on the quality of life of caregivers, and parents are the main informal caregivers. Caring for a person with PD is associated with an increased risk of psychiatric morbidity and persistent anxiety-depressive distress. The aim of the study is to investigate the burden on caregivers of patients with PD, through the use of multidimensional scales and to identify their personological and environmental determinants. Methods: The study has been approved by the Ethic Committee of the University of Salerno and informed consent for participation to the study was obtained from patients and their caregivers. The study was conducted at the Neurology Department of the A.O.U. "San Giovanni di Dio and Ruggi D’Aragona" of Salerno between September 2020 and May 2021. Materials: The questionnaires used were: a) Caregiver Burden Inventory - CBI a questionnaire of 24 items that allow identifying five sub-categories of burden (objective, psychological, physical, social, emotional); b) Depression Anxiety Stress Scales Short Version - DASS-21 questionnaire consisting of 21 items and valid in examining three distinct but interrelated areas (depression, anxiety and stress); c) Family Strain Questionnaire Short Form - FSQ-SF is a questionnaire of 30 items grouped in areas of increasing psychological risk (OK, R, SR, U); d) Zarit Caregiver Burden Inventory - ZBI, consisting of 22 items based on the analysis of two main factors: personal stress and pressure related to his role; e) Life Satisfaction, a single item that aims to evaluate the degree of life satisfaction in a global way using a 0-100 Likert scale. Findings: N ° 29 caregivers (M age = 55.14, SD = 9.859; 69% F) participated in the study. 20.6% of the sample had severe and severe burden (CBI score = M = 26.31; SD = 22.43) and 13.8% of participants had moderate to severe burden (ZBI). The FSQ-SF highlighted a minority of caregivers who need psychological support, in some cases urgent (Area SR and Area U). The DASS-21 results show a prevalence of stress-related symptoms (M = 10.90, SD = 10.712) compared to anxiety (M = 7.52, SD = 10.752) and depression (M = 8, SD = 10.876). There are significant correlations between some specific variables and mean test scores: retired caregivers report higher ZBI scores (p = 0.423) and lower Life Satisfaction levels (p = -0.460) than working caregivers; years of schooling show a negative linear correlation with the ZBI score (p = -0.491). The T-Test indicates that caregivers of patients with cognitive impairment are at greater risk than those of patients without cognitive impairment. Conclusions: It knows the factors that affect the burden the most would allow for early recognition of risky situations and caregivers who would need adequate support.

Keywords: anxious-depressive axis, caregivers’ burden, Parkinson’ disease, psychological risks

Procedia PDF Downloads 196
240 Environmental Management Accounting Practices and Policies within the Higher Education Sector: An Exploratory Study of the University of KwaZulu Natal

Authors: Kiran Baldavoo, Mishelle Doorasamy

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Universities have a role to play in the preservation of the environment, and the study attempted to evaluate the environmental management accounting (EMA) processes at UKZN. UKZN, a South African university, generates the same direct and indirect environmental impacts as the higher education sector worldwide. This is significant within the context of the South African environment which is constantly plagued by having to effectively manage the already scarce resources of water and energy, evident through the imposition of water and energy restrictions over the recent years. The study’s aim is to increase awareness of having a structured approach to environmental management in order to achieve the strategic environmental goals of the university. The research studied the experiences of key managers within UKZN, with the purpose of exploring the potential factors which influence the decision to adopt and apply EMA within the higher education sector. The study comprised two objectives, namely understanding the current state of accounting practices for managing major environmental costs and identifying factors influencing EMA adoption within the university. The study adopted a case study approach, comprising semi-structured interviews of key personnel involved in Management Accounting, Environmental Management, and Academic Schools within the university. Content analysis was performed on the transcribed interview data. A Theoretical Framework derived from literature was adopted to guide data collection and focus the study. Contingency and Institutional theory was the resultant basis of the derived framework. The findings of the first objective revealed that there was a distinct lack of EMA utilization within the university. There was no distinct policy on EMA, resulting in minimal environmental cost information being brought to the attention of senior management. The university embraced the principles of environmental sustainability; however, efforts to improve internal environmental accountability primarily from an accounting perspective was absent. The findings of the second objective revealed that five key barriers contributed to the lack of EMA utilization within the university. The barriers being attitudinal, informational, institutional, technological, and lack of incentives (financial). The results and findings of this study supported the use and application of EMA within the higher education sector. Participants concurred that EMA was underutilized and if implemented, would realize significant benefits for both the university and environment. Environmental management accounting is being widely acknowledged as a key management tool that can facilitate improved financial and environmental performance via the concept of enhanced environmental accountability. Historically research has been concentrated primarily on the manufacturing industry, due to it generating the greatest proportion of environmental impacts. Service industries are also an integral component of environmental management as they contribute significant environmental impacts, both direct and indirect. Educational institutions such as universities form part of the service sector and directly impact on the environment through the consumption of paper, energy, and water and solid waste generated, with the associated demands.

Keywords: environmental management accounting, environmental impacts, higher education, Southern Africa

Procedia PDF Downloads 101
239 Interferon-Induced Transmembrane Protein-3 rs12252-CC Associated with the Progress of Hepatocellular Carcinoma by Up-Regulating the Expression of Interferon-Induced Transmembrane Protein 3

Authors: Yuli Hou, Jianping Sun, Mengdan Gao, Hui Liu, Ling Qin, Ang Li, Dongfu Li, Yonghong Zhang, Yan Zhao

Abstract:

Background and Aims: Interferon-induced transmembrane protein 3 (IFITM3) is a component of ISG (Interferon-Stimulated Gene) family. IFITM3 has been recognized as a key signal molecule regulating cell growth in some tumors. However, the function of IFITM3 rs12252-CC genotype in the hepatocellular carcinoma (HCC) remains unknown to author’s best knowledge. A cohort study was employed to clarify the relationship between IFITM3 rs12252-CC genotype and HCC progression, and cellular experiments were used to investigate the correlation of function of IFITM3 and the progress of HCC. Methods: 336 candidates were enrolled in study, including 156 with HBV related HCC and 180 with chronic Hepatitis B infections or liver cirrhosis. Polymerase chain reaction (PCR) was employed to determine the gene polymorphism of IFITM3. The functions of IFITM3 were detected in PLC/PRF/5 cell with different treated:LV-IFITM3 transfected with lentivirus to knockdown the expression of IFITM3 and LV-NC transfected with empty lentivirus as negative control. The IFITM3 expression, proliferation and migration were detected by Quantitative reverse transcription polymerase chain reaction (qRT-PCR), QuantiGene Plex 2.0 assay, western blotting, immunohistochemistry, Cell Counting Kit(CCK)-8 and wound healing respectively. Six samples (three infected with empty lentiviral as control; three infected with LV-IFITM3 vector lentiviral as experimental group ) of PLC/PRF/5 were sequenced at BGI (Beijing Genomics Institute, Shenzhen,China) using RNA-seq technology to identify the IFITM3-related signaling pathways and chose PI3K/AKT pathway as related signaling to verify. Results: The patients with HCC had a significantly higher proportion of IFITM3 rs12252-CC compared with the patients with chronic HBV infection or liver cirrhosis. The distribution of CC genotype in HCC patients with low differentiation was significantly higher than that in those with high differentiation. Patients with CC genotype found with bigger tumor size, higher percentage of vascular thrombosis, higher distribution of low differentiation and higher 5-year relapse rate than those with CT/TT genotypes. The expression of IFITM3 was higher in HCC tissues than adjacent normal tissues, and the level of IFITM3 was higher in HCC tissues with low differentiation and metastatic than high/medium differentiation and without metastatic. Higher RNA level of IFITM3 was found in CC genotype than TT genotype. In PLC/PRF/5 cell with knockdown, the ability of cell proliferation and migration was inhibited. Analysis RNA sequencing and verification of RT-PCR found out the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/AKT/mTOR) pathway was associated with knockdown IFITM3.With the inhibition of IFITM3, the expression of PI3K/AKT/mTOR signaling pathway was blocked and the expression of vimentin was decreased. Conclusions: IFITM3 rs12252-CC with the higher expression plays a vital role in the progress of HCC by regulating HCC cell proliferation and migration. These effects are associated with PI3K/AKT/mTOR signaling pathway.

Keywords: IFITM3, interferon-induced transmembrane protein 3, HCC, hepatocellular carcinoma, PI3K/ AKT/mTOR, phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin

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238 Epidemiology, Clinical, Immune, and Molecular Profiles of Microsporidiosis and Cryptosporidiosis among HIV/AIDS patients

Authors: Roger WUMBA

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The objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV) symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients. In this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women) with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl–Neelsen stainings, real-time polymerase chain reaction (PCR), immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR) and 95% confidence intervals were used to quantify the risk. Of the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and helminths, respectively. We found five genotypes of E. bieneusi: two older, NIA1 and D, and three new, KIN1, KIN2, and KIN3. Only 0.4% and 1.6% had Cryptosporidium parvum and Cryptosporidium hominis, respectively. Of the patients, 36.4%, 34.3%, 31%, and 39% had asthenia, diarrhea, a CD4 count of ,100 cells/mm³, and no antiretroviral therapy (ART), respectively. The majority of those with opportunistic intestinal parasites and C. hominis, and all with C. parvum and new E. bieneusi genotypes, had diarrhea, low CD4+ counts of ,100 cells/mm³, and no ART. There was a significant association between Entamoeba coli, Kaposi sarcoma, herpes zoster, chronic diarrhea, and asthenia, and the presence of 28 cases with opportunistic intestinal parasites. Rural areas, public toilets, and exposure to farm pigs were the univariate risk factors present in the 28 cases with opportunistic intestinal parasites. In logistic regression analysis, a CD4 count of ,100 cells/mm³ (OR = 4.60; 95% CI 1.70–12.20; P = 0.002), no ART (OR = 5.00; 95% CI 1.90–13.20; P , 0.001), and exposure to surface water (OR = 2.90; 95% CI 1.01–8.40; P = 0.048) were identified as the significant and independent determinants for the presence of opportunistic intestinal parasites. E. bieneusi and Cryptosporidium are becoming more prevalent in Kinshasa, Congo. Based on the findings, we recommend epidemiology surveillance and prevention by means of hygiene, the emphasis of sensitive PCR methods, and treating opportunistic intestinal parasites that may be acquired through fecal–oral transmission, surface water, normal immunity, rural area-based person–person and animal–human nfection, and transmission of HIV. Therapy, including ART and treatment with fumagillin, is needed.

Keywords: diarrhea, enterocytozoon bieneusi, cryptosporidium hominis, cryptosporidium parvum, risk factors, africans

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237 Mental Health Monitoring System as an Effort for Prevention and Handling of Psychological Problems in Students

Authors: Arif Tri Setyanto, Aditya Nanda Priyatama, Nugraha Arif Karyanta, Fadjri Kirana A., Afia Fitriani, Rini Setyowati, Moh.Abdul Hakim

Abstract:

The Basic Health Research Report by the Ministry of Health (2018) shows an increase in the prevalence of mental health disorders in the adolescent and early adult age ranges. Supporting this finding, data on the psychological examination of the student health service unit at one State University recorded 115 cases of moderate and severe health problems in the period 2016 - 2019. More specifically, the highest number of cases was experienced by clients in the age range of 21-23 years or equivalent, with the mid-semester stage towards the end. Based on the distribution of cases experienced and the disorder becomes a psychological problem experienced by students. A total of 29% or the equivalent of 33 students experienced anxiety disorders, 25% or 29 students experienced problems ranging from mild to severe, as well as other classifications of disorders experienced, including adjustment disorders, family problems, academics, mood disorders, self-concept disorders, personality disorders, cognitive disorders, and others such as trauma and sexual disorders. Various mental health disorders have a significant impact on the academic life of students, such as low GPA, exceeding the limit in college, dropping out, disruption of social life on campus, to suicide. Based on literature reviews and best practices from universities in various countries, one of the effective ways to prevent and treat student mental health disorders is to implement a mental health monitoring system in universities. This study uses a participatory action research approach, with a sample of 423 from a total population of 32,112 students. The scale used in this study is the Beck Depression Inventory (BDI) to measure depression and the Taylor Minnesota Anxiety Scale (TMAS) to measure anxiety levels. This study aims to (1) develop a digital-based health monitoring system for students' mental health situations in the mental health category. , dangers, or those who have mental disorders, especially indications of symptoms of depression and anxiety disorders, and (2) implementing a mental health monitoring system in universities at the beginning and end of each semester. The results of the analysis show that from 423 respondents, the main problems faced by all coursework, such as thesis and academic assignments. Based on the scoring and categorization of the Beck Depression Inventory (BDI), 191 students experienced symptoms of depression. A total of 24.35%, or 103 students experienced mild depression, 14.42% (61 students) had moderate depression, and 6.38% (27 students) experienced severe or extreme depression. Furthermore, as many as 80.38% (340 students) experienced anxiety in the high category. This article will review this review of the student mental health service system on campus.

Keywords: monitoring system, mental health, psychological problems, students

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236 A Preliminary in vitro Investigation of the Acetylcholinesterase and α-Amylase Inhibition Potential of Pomegranate Peel Extracts

Authors: Zoi Konsoula

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The increasing prevalence of Alzheimer’s disease (AD) and diabetes mellitus (DM) constitutes them major global health problems. Recently, the inhibition of key enzyme activity is considered a potential treatment of both diseases. Specifically, inhibition of acetylcholinesterase (AChE), the key enzyme involved in the breakdown of the neurotransmitter acetylcholine, is a promising approach for the treatment of AD, while inhibition of α-amylase retards the hydrolysis of carbohydrates and, thus, reduces hyperglycemia. Unfortunately, commercially available AChE and α-amylase inhibitors are reported to possess side effects. Consequently, there is a need to develop safe and effective treatments for both diseases. In the present study, pomegranate peel (PP) was extracted using various solvents of increasing polarity, while two extraction methods were employed, the conventional maceration and the ultrasound assisted extraction (UAE). The concentration of bioactive phytoconstituents, such as total phenolics (TPC) and total flavonoids (TFC) in the prepared extracts was evaluated by the Folin-Ciocalteu and the aluminum-flavonoid complex method, respectively. Furthermore, the anti-neurodegenerative and anti-hyperglycemic activity of all extracts was determined using AChE and α-amylase inhibitory activity assays, respectively. The inhibitory activity of the extracts against AChE and α-amylase was characterized by estimating their IC₅₀ value using a dose-response curve, while galanthamine and acarbose were used as positive controls, respectively. Finally, the kinetics of AChE and α-amylase in the presence of the most inhibitory potent extracts was determined by the Lineweaver-Burk plot. The methanolic extract prepared using the UAE contained the highest amount of phytoconstituents, followed by the respective ethanolic extract. All extracts inhibited acetylcholinesterase in a dose-dependent manner, while the increased anticholinesterase activity of the methanolic (IC₅₀ = 32 μg/mL) and ethanolic (IC₅₀ = 42 μg/mL) extract was positively correlated with their TPC content. Furthermore, the activity of the aforementioned extracts was comparable to galanthamine. Similar results were obtained in the case of α-amylase, however, all extracts showed lower inhibitory effect on the carbohydrate hydrolyzing enzyme than on AChE, since the IC₅₀ value ranged from 84 to 100 μg/mL. Also, the α-amylase inhibitory effect of the extracts was lower than acarbose. Finally, the methanolic and ethanolic extracts prepared by UAE inhibited both enzymes in a mixed (competitive/noncompetitive) manner since the Kₘ value of both enzymes increased in the presence of extracts, while the Vmax value decreased. The results of the present study indicate that PP may be a useful source of active compounds for the management of AD and DM. Moreover, taking into consideration that PP is an agro-industrial waste product, its valorization could not only result in economic efficiency but also reduce the environmental pollution.

Keywords: acetylcholinesterase, Alzheimer’s disease, α-amylase, diabetes mellitus, pomegranate

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