Search results for: fear of isolation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1350

Search results for: fear of isolation

1140 Role of Activated Partial Thromboplastin Time (APTT) to Assess the Need of Platelet Transfusion in Dengue

Authors: Kalyan Koganti

Abstract:

Background: In India, platelet transfusions are given to large no. of patients suffering from dengue due to the fear of bleeding especially when the platelet counts are low. Though many patients do not bleed when the platelet count falls to less than 20,000, certain patients bleed even if the platelet counts are more than 20,000 without any comorbid condition (like gastrointestinal ulcer) in the past. This fear has led to huge amounts of unnecessary platelet transfusions which cause significant economic burden to low and middle-income countries like India and also sometimes these transfusions end with transfusion-related adverse reactions. Objective: To identify the role of Activated Partial Thromboplastin Time (APTT) in comparison with thrombocytoenia as an indicator to assess the real need of platelet transfusions. Method: A prospective study was conducted at a hospital in South India which included 176 admitted cases of dengue confirmed by immunochromatography. APTT was performed in all these patients along with platelet count. Cut off values of > 60 seconds for APTT and < 20,000 for platelet count were considered to assess the bleeding manifestations. Results: Among the total 176 patients, 56 patients had bleeding manifestations like malena, hematuria, bleeding gums etc. APTT > 60 seconds had a sensitivity and specificity of 93% and 90% respectively in identifying bleeding manifestations where as platelet count of < 20,000 had a sensitivity and specificity of 64% and 73% respectively. Conclusion: Elevated APTT levels can be considered as an indicator to assess the need of platelet transfusion in dengue. As there is a significant variation among patients who bleed with respect to platelet count, APTT can be considered to avoid unnecessary transfusions.

Keywords: activated partial thromboplastin time, dengue, platelet transfusion, thrombocytopenia

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1139 Studying Perceived Stigma, Economic System Justification and Social Mobility Beliefs of Socially Vulnerable (Poor) People: The Case of Georgia

Authors: Nazi Pharsadanishvili, Anastasia Kitiashvili

Abstract:

The importance of studying the social-psychological features of people living in poverty is often emphasized in international research. Building a multidimensional economic framework for reducing poverty grounded in people’s experiences and values is the main goal of famous Poverty Research Centers (such as Oxford Poverty and Human Development Initiative, Abdul Latif Jameel Poverty Action Lab). The aims of the proposed research are to investigate the following characteristics of socially vulnerable people living in Georgia: 1) The features of the perceived stigma of poverty; 2) economic system justification and social justice beliefs; 3) Perceived social mobility and actual attempts at upward social mobility. Qualitative research was conducted to address the indicated research goals and descriptive research questions. Conducting in-depth interviews was considered to be the most appropriate method to capture the vivid feelings and experiences of people living in poverty. 17 respondents (registered in the unified database of socially vulnerable families) participated in in-depth interviews. According to the research results, socially vulnerable people living in Georgia perceive stigma targeted toward them. Two sub-dimensions were identified in perceived stigma: experienced stigma and internalized stigma. Experienced stigma reflects the instances of being discriminated and perceptions of negative treatment from other members of society. Internalized stigma covers negative personal emotions, the feelings of shame, the fear of future stigmatization, and self-isolation. The attitudes and justifications of the existing economic system affect people’s attempts to cope with poverty. Complex analysis of those results is important during the planning and implementing of social welfare reforms. Particularly, it is important to implement poverty stigma reduction mechanisms and help socially vulnerable people to see real perspectives on upward social mobility.

Keywords: coping with poverty, economic system justification, perceived stigma of poverty, upward social mobility

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1138 Isolation of Cytotoxic Compound from Tectona grandis Stem to Be Used as Thai Medicinal Preparation for Cancer Treatment

Authors: Onmanee Prajuabjinda, Pakakrong Thondeeying, Jipisute Chunthorng-Orn, Bhanuz Dechayont, Arunporn Itharat

Abstract:

A Thai medicinal preparation has been used for cancer treatment more than ten years ago in Khampramong Temple. Tectona grandis stem is one ingredient of this Thai medicinal remedy. The ethanolic extract of Tectona grandis stem showed the highest cytotoxic activities against human breast adenocarcinoma (MCF-7), but was less cytotoxic against large cell lung carcinoma (COR-L23) (IC50 = 3.92 and 7.78 µg/ml, respectively). It was isolated by bioassay-guided isolation method. Tectoquinone, a anthraquinone compound was isolated from this plant. This compound showed high specific cytotoxicity against human breast adenocarcinoma (MCF-7), but was less cytotoxic against large cell lung carcinoma (COR-L23)(IC50 =16.15 and 47.56 µg/ml or 72.67 and 214.00 µM, respectively). However, it showed less cytotoxic activity than the crude extract. In conclusion, tectoquinone as a main compound, is not the best cytotoxic compound from Tectona grandis, so there are more active cytotoxic compounds in this extract which should be isolated in the future. Moreover, tectoquinone displayed specific cytotoxicity against only human breast adenocarcinoma (MCF-7) which is a good criterion for cancer treatment.

Keywords: Tectona grandis, SRB assay, cytotoxicity, tectoquinone

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1137 Approach to Honey Volatiles' Profiling by Gas Chromatography and Mass Spectrometry

Authors: Igor Jerkovic

Abstract:

Biodiversity of flora provides many different nectar sources for the bees. Unifloral honeys possess distinctive flavours, mainly derived from their nectar sources (characteristic volatile organic components (VOCs)). Specific or nonspecific VOCs (chemical markers) could be used for unifloral honey characterisation as addition to the melissopalynologycal analysis. The main honey volatiles belong, in general, to three principal categories: terpenes, norisoprenoids, and benzene derivatives. Some of these substances have been described as characteristics of the floral source, and other compounds, like several alcohols, branched aldehydes, and furan derivatives, may be related to the microbial purity of honey processing and storage conditions. Selection of the extraction method for the honey volatiles profiling should consider that heating of the honey produce different artefacts and therefore conventional methods of VOCs isolation (such as hydrodistillation) cannot be applied for the honey. Two-way approach for the isolation of the honey VOCs was applied using headspace solid-phase microextraction (HS-SPME) and ultrasonic solvent extraction (USE). The extracts were analysed by gas chromatography and mass spectrometry (GC-MS). HS-SPME (with the fibers of different polarity such as polydimethylsiloxane/ divinylbenzene (PDMS/DVB) or divinylbenzene/carboxene/ polydimethylsiloxane (DVB/CAR/PDMS)) enabled isolation of high volatile headspace VOCs of the honey samples. Among them, some characteristic or specific compounds can be found such as 3,4-dihydro-3-oxoedulan (in Centaurea cyanus L. honey) or 1H-indole, methyl anthranilate, and cis-jasmone (in Citrus unshiu Marc. honey). USE with different solvents (mainly dichloromethane or the mixture pentane : diethyl ether 1 : 2 v/v) enabled isolation of less volatile and semi-volatile VOCs of the honey samples. Characteristic compounds from C. unshiu honey extracts were caffeine, 1H-indole, 1,3-dihydro-2H-indol-2-one, methyl anthranilate, and phenylacetonitrile. Sometimes, the selection of solvent sequence was useful for more complete profiling such as sequence I: pentane → diethyl ether or sequence II: pentane → pentane/diethyl ether (1:2, v/v) → dichloromethane). The extracts with diethyl ether contained hydroquinone and 4-hydroxybenzoic acid as the major compounds, while (E)-4-(r-1’,t-2’,c-4’-trihydroxy-2’,6’,6’-trimethylcyclo-hexyl)but-3-en-2-one predominated in dichloromethane extracts of Allium ursinum L. honey. With this two-way approach, it was possible to obtain a more detailed insight into the honey volatile and semi-volatile compounds and to minimize the risks of compound discrimination due to their partial extraction that is of significant importance for the complete honey profiling and identification of the chemical biomarkers that can complement the pollen analysis.

Keywords: honey chemical biomarkers, honey volatile compounds profiling, headspace solid-phase microextraction (HS-SPME), ultrasonic solvent extraction (USE)

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1136 Cognitive Behaviour Drama: Playful Method to Address Fears in Children on the Higher-End of the Autism Spectrum

Authors: H.Karnezi, K. Tierney

Abstract:

Childhood fears that persist over time and interfere with the children’s normal functioning may have detrimental effects on their social and emotional development. Cognitive behavior therapy is considered highly effective in treating fears and anxieties. However, given that many childhood fears are based on fantasy, the applicability of CBT may be hindered by cognitive immaturity. Furthermore, a lack of motivation to engage in therapy is another commonly encountered obstacle. The purpose of this study was to introduce and evaluate a more developmentally appropriate intervention model, specifically designed to provide phobic children with the motivation to overcome their fears. To this end, principles and techniques from cognitive and behavior therapies are incorporated into the ‘Drama in Education’ model. The Cognitive Behaviour Drama (CBD) method involves using the phobic children’s creativity to involve them in the therapeutic process. The children are invited to engage in exciting fictional scenarios tailored around their strengths and special interests. Once their commitment to the drama is established, a problem that they will feel motivated to solve is introduced. To resolve it, the children will have to overcome a number of obstacles culminating in an in vivo confrontation with the fear stimulus. The study examined the application of the CBD model in three single cases. Results in all three cases shown complete elimination of all fear-related symptoms. Preliminary results justify further evaluation of the Cognitive Behaviour Drama model. It is time and cost-effective, ensuring the clients' immediate engagement in the therapeutic process.

Keywords: phobias, autism, intervention, drama

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1135 Physicochemical and Functional Characteristics of Hemp Protein Isolate

Authors: El-Sohaimy Sobhy A., Androsova Natalia, Toshev Abuvali Djabarovec

Abstract:

The conditions of the isolation of proteins from the hemp seeds were optimized in the current work. Moreover, the physicochemical and functional properties of hemp protein isolate were evaluated for its potential application in food manufacturing. The elastin protein is the most predominant protein in the protein profile with a molecular weight of 58.1 KDa, besides albumin, with a molecular weight of 31.5 KDa. The FTIR spectrum detected the absorption peaks of the amide I in 1750 and 1600 cm⁻¹, which pointed to C=O stretching while N-H was stretching at 1650-1580 cm⁻¹. The peak at 3250 was related to N-H stretching of primary aliphatic amine (3400-3300 cm⁻¹), and the N-H stretching for secondary (II) amine appeared at 3350-3310 cm⁻¹. Hemp protein isolate (HPI) was showed high content of arginine (15.52 g/100 g), phenylalanine+tyrosine (9.63 g/100 g), methionine + cysteine (5.49 g/100 g), leucine + isoleucine (5.21 g/100 g) and valine (4.53 g/100 g). It contains a moderate level of threonine (3.29 g/100 g) and lysine (2.50 g/100 g), with the limiting amino acid being a tryptophan (0.22 g/100 g HPI). HPI showed high water-holding capacity (4.5 ± 2.95 ml/g protein) and oil holding capacity (2.33 ± 1.88 ml/g) values. The foaming capacity of HPI was increased with increasing the pH values to reach the maximum value at pH 11 (67.23±3.20 %). The highest emulsion ability index of HPI was noted at pH 9 (91.3±2.57 m2/g) with low stability (19.15±2.03).

Keywords: Cannabis sativa ssp., protein isolate, isolation conditions, amino acid composition, chemical properties, functional properties

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1134 Phenotypical and Molecular Characterization of Burkholderia mallei from Horses with Glanders: Preliminary Data

Authors: A. F. C. Nassar, D. K. Tessler, L. Okuda, C. Del Fava, D. P. Chiebao, A. H. C. N. Romaldini, A. P. Alvim, M. J. Sanchez-Vazquez, M. S. Rosa, J. C. Pompei, R. Harakava, M. C. S. Araujo, G. H. F. Marques, E. M. Pituco

Abstract:

Glanders is a zoonotic disease of Equidae caused by the bacterium Burkholderia mallei presented in acute or chronic clinical forms with inflammatory nodules in the respiratory tract, lymphangitis and caseous lymph nodes. There is not a treatment with veterinary drugs to this life-threatening disease; thus, its occurrence must be notified to official animal health services and any infected animal must be eliminated. This study aims to detect B. mallei from horses euthanized in outbreaks of glanders in Brazil, providing a better understanding of the bacterial characteristics and determine a proper protocol for isolation. The work was carried out with the collaboration of the Ministry of Agriculture and the Sao Paulo State Animal Health Department, while its procedures were approved by the Committee of Ethics in Animal Experimentation from the Instituto Biologico (CETEA n°156/2017). To the present time, 16 horses from farms with outbreaks of glanders detected by complement fixation test (CFT) serology method were analyzed. During the necropsy, samples of possibly affected organs (lymph nodes, lungs, heart, liver, spleen, kidneys and trachea) were collected for bacterial isolation, molecular tests and pathology. Isolation was performed using two enriched mediums, a potato infusion agar with 5% sheep blood, 4% glycerol and antibiotics (penicilin100U/ mL), and another with the same ingredients except the antibiotic. A PCR protocol was modified for this study using primers design to identify a region of the Flip gen of B. mallei. Thru isolation, 12.5% (2/16) animals were confirmed positive using only the enriched medium with antibiotic and confirmed by PCR: from mediastinal and submandibular lymph nodes and lungs in one animal and from mediastinal lymph node in the other. The detection of the bacterium using PCR showed positivity of 100% (16/16) horses from 144 samples of organs. Pathology macroscopic lesions observed were catarrhal nasal discharge, fetlock ulcers, emaciation, lymphangitis in limbs, suppurative lymphangitis, lymph node enlargement, star shaped liver, and spleen scars, adherence of the renal capsule, pulmonary hemorrhage, and miliary nodules. Microscopic lesions were suppurative bronchopneumonia with microabscesses and Langhans giant cells in lungs; lymph nodes with abscesses and intense lymphoid reaction; hemosiderosis and abscesses in spleen. Positive samples on PCR will be sequenced later and analyzed comparing with previous records in the literature. A throughout description of the recent acute cases of glanders occurring in Brazil and characterization of the bacterium related will contribute to advances in the knowledge of the pathogenicity, clinical symptoms, and epidemiology of this zoonotic disease. Acknowledgment: This project is sponsored by FAPESP.

Keywords: equines, bacterial isolation, zoonosis, PCR, pathology

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1133 Disabilities in Railways: Proposed Changes to the Design of Railway Compartments for the Inclusion of Differently Abled Persons

Authors: Bathmajaa Muralisankar

Abstract:

As much as railway station infrastructure designs and ticket-booking norms have been changed to facilitate use by differently abled persons, the railway train compartments themselves have not been made user-friendly for differently abled persons. Owing to safety concerns, dependency on others for their travel, and fear of isolation, differently abled people do not prefer travelling by train. Rather than including a dedicated compartment open only to the differently abled, including the latter with others in the normal compartment (with the proposed modifications discussed here) will make them feel secure and make for an enhanced travel experience for them. This approach also represents the most practical way to include a particular category of people in the mainstream society. Lowering the height of the compartment doors and providing a wider entrance with a ramp will provide easy entry for those using wheelchairs. As well, removing the first two alternate rows and the first two side seats will not only widen the passage and increase seating space but also improve wheelchair turning radius. This will help them travel without having to depend on others. Seating arrangements may be done to accommodate their family members near them instead of isolating the differently abled in a separate compartment. According to present ticket-booking regulations of the Indian Railways, three to four disabled persons may travel without their family or one to two along with their family, and the numbers may be added or reduced. To help visually challenged and hearing-impaired persons, in addition to the provision of special instruments, railings, and textured footpaths and flooring, the seat numbers above the seats may be set in metal or plastic as an outward projection so the visually impaired can touch and feel the numbers. Braille boards may be included at the entrance to the compartment along with seat numbers in the aforementioned projected manner. These seat numbers may be designed as buttons, which when pressed results in an announcement of the seat number in the applicable local language as well as English. Emergency buttons, rather than emergency chains, within the easy reach of disabled passengers will also help them.

Keywords: dependency, differently abled, inclusion, mainstream society

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1132 Evaluation of High Damping Rubber Considering Initial History through Dynamic Loading Test and Program Analysis

Authors: Kyeong Hoon Park, Taiji Mazuda

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High damping rubber (HDR) bearings are dissipating devices mainly used in seismic isolation systems and have a great damping performance. Although many studies have been conducted on the dynamic model of HDR bearings, few models can reflect phenomena such as dependency of experienced shear strain on initial history. In order to develop a model that can represent the dependency of experienced shear strain of HDR by Mullins effect, dynamic loading test was conducted using HDR specimen. The reaction of HDR was measured by applying a horizontal vibration using a hybrid actuator under a constant vertical load. Dynamic program analysis was also performed after dynamic loading test. The dynamic model applied in program analysis is a bilinear type double-target model. This model is modified from typical bilinear model. This model can express the nonlinear characteristics related to the initial history of HDR bearings. Based on the dynamic loading test and program analysis results, equivalent stiffness and equivalent damping ratio were calculated to evaluate the mechanical properties of HDR and the feasibility of the bilinear type double-target model was examined.

Keywords: base-isolation, bilinear model, high damping rubber, loading test

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1131 Speeding up Nonlinear Time History Analysis of Base-Isolated Structures Using a Nonlinear Exponential Model

Authors: Nicolò Vaiana, Giorgio Serino

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The nonlinear time history analysis of seismically base-isolated structures can require a significant computational effort when the behavior of each seismic isolator is predicted by adopting the widely used differential equation Bouc-Wen model. In this paper, a nonlinear exponential model, able to simulate the response of seismic isolation bearings within a relatively large displacements range, is described and adopted in order to reduce the numerical computations and speed up the nonlinear dynamic analysis. Compared to the Bouc-Wen model, the proposed one does not require the numerical solution of a nonlinear differential equation for each time step of the analysis. The seismic response of a 3d base-isolated structure with a lead rubber bearing system subjected to harmonic earthquake excitation is simulated by modeling each isolator using the proposed analytical model. The comparison of the numerical results and computational time with those obtained by modeling the lead rubber bearings using the Bouc-Wen model demonstrates the good accuracy of the proposed model and its capability to reduce significantly the computational effort of the analysis.

Keywords: base isolation, computational efficiency, nonlinear exponential model, nonlinear time history analysis

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1130 Molecular Characterization and Phylogenetic Analysis of Influenza a(H3N2) Virus Circulating during the 2010-2011 in Riyadh, Saudi Arabia

Authors: Ghazanfar Ali, Fahad N Almajhdi

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This study provides data on the viral diagnosis and molecular epidemiology of influenza A(H3N2) virus isolated in Riyadh, Saudi Arabia. Nasopharyngeal aspirates from 80 clinically infected patients in the peak of the 2010-2011 winter seasons were processed for viral diagnosis by RT-PCR. Sequencing of entire HA and NA genes of representative isolates and molecular epidemiological analysis were performed. A total of 06 patients were positive for influenza A, B and respiratory syncytial viruses by RT-PCR assays; out of these only one sample was positive for influenza A(H3N2) by RT-PCR. Phylogenetic analysis of the HA and NA gene sequences showed identities higher than 99-98.8 % in both genes. They were also similar to reference isolates in HA sequences (99 % identity) and in NA sequences (99 % identity). Amino acid sequences predicted for the HA gene were highly identical to reference strains. The NA amino acid substitutions identified did not include the oseltamivir-resistant H275Y substitution. Conclusion: Viral isolation and RT-PCR together were useful for diagnosis of the influenza A (H3N2) virus. Variations in HA and NA sequences are similar to those identified in worldwide reference isolates and no drug resistance was found.

Keywords: influenza A (H3N2), genetic characterization, viral isolation, RT-PCR, Saudi Arabia

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1129 Numerical Model of Low Cost Rubber Isolators for Masonry Housing in High Seismic Regions

Authors: Ahmad B. Habieb, Gabriele Milani, Tavio Tavio, Federico Milani

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Housings in developing countries have often inadequate seismic protection, particularly for masonry. People choose this type of structure since the cost and application are relatively cheap. Seismic protection of masonry remains an interesting issue among researchers. In this study, we develop a low-cost seismic isolation system for masonry using fiber reinforced elastomeric isolators. The elastomer proposed consists of few layers of rubber pads and fiber lamina, making it lower in cost comparing to the conventional isolators. We present a finite element (FE) analysis to predict the behavior of the low cost rubber isolators undergoing moderate deformations. The FE model of the elastomer involves a hyperelastic material property for the rubber pad. We adopt a Yeoh hyperelasticity model and estimate its coefficients through the available experimental data. Having the shear behavior of the elastomers, we apply that isolation system onto small masonry housing. To attach the isolators on the building, we model the shear behavior of the isolation system by means of a damped nonlinear spring model. By this attempt, the FE analysis becomes computationally inexpensive. Several ground motion data are applied to observe its sensitivity. Roof acceleration and tensile damage of walls become the parameters to evaluate the performance of the isolators. In this study, a concrete damage plasticity model is used to model masonry in the nonlinear range. This tool is available in the standard package of Abaqus FE software. Finally, the results show that the low-cost isolators proposed are capable of reducing roof acceleration and damage level of masonry housing. Through this study, we are also capable of monitoring the shear deformation of isolators during seismic motion. It is useful to determine whether the isolator is applicable. According to the results, the deformations of isolators on the benchmark one story building are relatively small.

Keywords: masonry, low cost elastomeric isolator, finite element analysis, hyperelasticity, damped non-linear spring, concrete damage plasticity

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1128 Comparison of the Isolation Rates and Characteristics of Salmonella Isolated from Antibiotic-Free and Conventional Chicken Meat Samples

Authors: Jin-Hyeong Park, Hong-Seok Kim, Jin-Hyeok Yim, Young-Ji Kim, Dong-Hyeon Kim, Jung-Whan Chon, Kun-Ho Seo

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Salmonella contamination in chicken samples can cause major health problems in humans. However, not only the effects of antibiotic treatment during growth but also the impacts of poultry slaughter line on the prevalence of Salmonella in final chicken meat sold to consumers are unknown. In this study, we compared the isolation rates and antimicrobial resistance of Salmonella between antibiotic-free, conventional, conventional Korean native retail chicken meat samples and clonal divergence of Salmonella isolates by multilocus sequence typing. In addition, the distribution of extended-spectrum β-lactamase (ESBL) genes in ESBL-producing Salmonella isolates was analyzed. A total of 72 retail chicken meat samples (n = 24 antibiotic-free broiler [AFB] chickens, n = 24 conventional broiler [CB] chickens, and n = 24 conventional Korean native [CK] chickens) were collected from local retail markets in Seoul, South Korea. The isolation rates of Salmonella were 66.6% in AFB chickens, 45.8% in CB chickens, and 25% in CK chickens. By analyzing the minimum inhibitory concentrations of β -lactam antibiotics with the disc-diffusion test, we found that 81.2% of Salmonella isolates from AFB chickens, 63.6% of isolates from CB chickens, and 50% of isolates from CK chickens were ESBL producers; all ESBL-positive isolates had the CTX-M-15 genotype. Interestingly, all ESBL-producing Salmonella were revealed as ST16 by multilocus sequence typing. In addition, all CTX-M-15-positive isolates had the genetic platform of blaCTX-M gene (IS26-ISEcp1-blaCTX-M-15-IS903), to the best of our knowledge, this is the first report in Salmonella around the world. The Salmonella ST33 strain (S. Hadar) isolated in this study has never been reported in South Korea. In conclusion, our findings showed that antibiotic-free retail chicken meat products were also largely contaminated with ESBL-producing Salmonella and that their ESBL genes and genetic platforms were the same as those isolated from conventional retail chicken meat products.

Keywords: antibiotic-free poultry, conventional poultry, multilocus sequence typing, extended-spectrum β-lactamase, antimicrobial resistance

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1127 Electrochemical Impedance Spectroscopy Based Label-Free Detection of TSG101 by Electric Field Lysis of Immobilized Exosomes from Human Serum

Authors: Nusrat Praween, Krishna Thej Pammi Guru, Palash Kumar Basu

Abstract:

Designing non-invasive biosensors for cancer diagnosis is essential for developing an affordable and specific tool to measure cancer-related exosome biomarkers. Exosomes, released by healthy as well as cancer cells, contain valuable information about the biomarkers of various diseases, including cancer. Despite the availability of various isolation techniques, ultracentrifugation is the standard technique that is being employed. Post isolation, exosomes are traditionally exposed to detergents for extracting their proteins, which can often lead to protein degradation. Further to this, it is very essential to develop a sensing platform for the quantification of clinically relevant proteins in a wider range to ensure practicality. In this study, exosomes were immobilized on the Au Screen Printed Electrode (SPE) using EDC/NHS chemistry to facilitate binding. After immobilizing the exosomes on the screen-printed electrode (SPE), we investigated the impact of the electric field by applying various voltages to induce exosome lysis and release their contents. The lysed solution was used for sensing TSG101, a crucial biomarker associated with various cancers, using both faradaic and non-faradaic electrochemical impedance spectroscopy (EIS) methods. The results of non-faradaic and faradaic EIS were comparable and showed good consistency, indicating that non-faradaic sensing can be a reliable alternative. Hence, the non-faradaic sensing technique was used for label-free quantification of the TSG101 biomarker. The results were validated using ELISA. Our electrochemical immunosensor demonstrated a consistent response of TSG101 from 125 pg/mL to 8000 pg/mL, with a detection limit of 0.125 pg/mL at room temperature. Additionally, since non-faradic sensing is label-free, the ease of usage and cost of the final sensor developed can be reduced. The proposed immunosensor is capable of detecting the TSG101 protein at low levels in healthy serum with good sensitivity and specificity, making it a promising platform for biomarker detection.

Keywords: biosensor, exosomes isolation on SPE, electric field lysis of exosome, EIS sensing of TSG101

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1126 MARTI and MRSD: Newly Developed Isolation-Damping Devices with Adaptive Hardening for Seismic Protection of Structures

Authors: Murast Dicleli, Ali SalemMilani

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In this paper, a summary of analytical and experimental studies into the behavior of a new hysteretic damper, designed for seismic protection of structures is presented. The Multi-directional Torsional Hysteretic Damper (MRSD) is a patented invention in which a symmetrical arrangement of identical cylindrical steel cores is so configured as to yield in torsion while the structure experiences planar movements due to earthquake shakings. The new device has certain desirable properties. Notably, it is characterized by a variable and controllable-via-design post-elastic stiffness. The mentioned property is a result of MRSD’s kinematic configuration which produces this geometric hardening, rather than being a secondary large-displacement effect. Additionally, the new system is capable of reaching high force and displacement capacities, shows high levels of damping, and very stable cyclic response. The device has gone through many stages of design refinement, multiple prototype verification tests and development of design guide-lines and computer codes to facilitate its implementation in practice. Practicality of the new device, as offspring of an academic sphere, is assured through extensive collaboration with industry in its final design stages, prototyping and verification test programs.

Keywords: seismic, isolation, damper, adaptive stiffness

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1125 Relational Effect of Parent Interest, Basic School Attended, Gender, and Scare of Basic School Mathematics Teacher on Student Interest in Mathematics

Authors: Yarhands Dissou Arthur, Samuel Asiedu Addo, Jonathan Annan

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Interest in subject specific is very essential in the quest to ensure effective teaching and learning. In building interest in subject specific areas requires certain factors and strategies well-spelled out.The factors such as the gender of the student, the type of basic school attended, the parent interest as well as the scare of the basic school mathematics teacher is very important to consider. The relational effect and the contribution these above mentioned variables on student have not been fully investigated and this paper address the effect of these factors on the student interest. In the attainment of this goal, the current paper addresses the effect of parent interest, the type of basic school attended, the scare by basic school mathematics teacher and its effect on student’s interest in mathematics. A cross sectional data collected from two hundred and sixty post-secondary school student were analyzed using descriptive and inferential statistical methods by aid of SPSS version 16. The study found that parent interest and value for mathematics significantly influenced students interest and joy in solving mathematical problems. Moreover, we also observed that the fear imposed by basic school mathematics teachers was found to significantly influence students’ interest. The study further found that the type of basic school attended and gender are factors that do not influence students’ interest in mathematics. In addition to concluding that a student’s interest is influenced by both parent interest and the fear of basic school mathematics teacher, the study also showed that the type of basic school attended and gender does not affect the students’ interest in mathematics.

Keywords: gender, mathematics interest, teacher interest, teacher interest, student interest

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1124 Effects of Cassia tora Seeds Extract on Type 2 Diabetes Induced Mice

Authors: Min-Ju Jo, Min-Young Um, Moonsung Choi, Sooim Shin

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Type 2 diabetes (T2D) is characterized by insulin resistance, the inability of β-cell and the dysfunction of mitochondria. To characterize effects of Cassia tora extract on mitochondrial dysfunction related T2D, the reduced glutathione level, amount of mitochondrial complexes and activities of mitochondrial complexes were measured. Three groups of mice were modeled; a control group was fed a normal diet, a diabetic group was fed a diabetic diet high in fat and carbohydrates, and a third group was fed a diabetic diet + 70% ethanol extracted Cassia tora seeds for 12 weeks. The amount of mitochondria was determined by Bradford assay after isolation of mitochondria in liver from each group. During isolation of mitochondria, cytosolic fractions of the tissue were collected to measure the reduced glutathione level. Interestingly, high level of the reduced glutathione was observed in Cassia tora treated group and decreased activities of mitochondrial complexes in Cassia tora treated group compared to the diabetic diet group. It indicates that Cassia tora has the potential to increase the reduced form of glutathione functioned as an important antioxidant in cells, and to reduce mitochondrial metabolic compensatory mechanism.

Keywords: antioxidant, Cassia tora, diabetes, electron transport chain, glutathione, mitochondria, spectrophotometry

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1123 Acoustic and Thermal Isolation Performance Comparison between Recycled and Ceramic Roof Tiles Using Digital Holographic Interferometry

Authors: A. Araceli Sánchez, I. Manuel H. De la Torre, S. Fernando Mendoza, R. Cesar Tavera, R. Manuel de J. Briones

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Recycling, as part of any sustainable environment, is continuously evolving and impacting on new materials in manufacturing. One example of this is the recycled solid waste of Tetra Pak ™ packaging, which is a highly pollutant waste as it is not biodegradable since it is manufactured with different materials. The Tetra Pak ™ container consists of thermally joined layers of paper, aluminum and polyethylene. Once disposed, this packaging is recycled by completely separating the paperboard from the rest of the materials. The aluminum and the polyethylene remain together and are used to create the poly-aluminum, which is widely used to manufacture roof tiles. These recycled tiles have different thermal and acoustic properties compared with traditional manufactured ceramic and cement tiles. In this work, we compare a group of tiles using nondestructive optical testing to measure the superficial micro deformations of the tiles under well controlled experiments. The results of the acoustic and thermal tests show remarkable differences between the recycled tile and the traditional ones. These results help to determine which tile could be better suited to the specific environmental conditions in countries where extreme climates, ranging from tropical, desert-like, to very cold are experienced throughout the year.

Keywords: acoustic, digital holographic interferometry, isolation, recycled, roof tiles, sustainable, thermal

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1122 The Impact of COVID-19 Health Measures on Adults with Multiple Chemical Sensitivity

Authors: Riina I. Bray, Yifan Wang, Nikolas Argiropoulos, Stephanie Robins, John Molot, Kelly Tragash, Lynn M. Marshall, Margaret E. Sears, Marie-Andrée Pigeon, Michel Gaudet, Pierre Auger, Emily Bélanger, Rohini Peris

Abstract:

Multiple chemical sensitivity (MCS) is a chronic medical condition characterized by intolerances to chemical substances. Since the arrival of the COVID-19 pandemic and associated health measures, people experiencing MCS (PEMCS) are at a heightened risk of environmental exposures associated with cleaners, disinfectants, and sanitizers. Little attention has been paid to the well-being of PEMCS in the context of the COVID-19 pandemic. Objective: This study assesses the lived experiences of Canadian adults with MCS in relation to their living environment, access to healthcare, and levels of perceived social support before and during the pandemic. Methods: A total of 119 PEMCS completed an online questionnaire. McNemar Chi-Squared and Wilcoxon Signed Rank tests were used to evaluate if there were statistically significant changes in participants’ perception of their living environment, access to healthcare, and levels of social support before and after March 11, 2020. Results: Both positive and negative outcomes were noted. Participants reported an increase in exposure to disinfectants/sanitizers that entered their living environment (p<.001). There was a reported decrease in access to a family doctor during the pandemic (p<0.001). Although PEMCS experienced increased social isolation (p<0.001), they also reported an increase in understanding from family (p<0.029) and a decrease in stigma for wearing personal protective equipment (p<0.001). Conclusion: PEMCS reported experiencing: increased exposure to disinfectants or sanitizers, a loss of social support, and barriers in accessing healthcare during the pandemic. However, COVID-19 provided an opportunity to normalize the living conditions of PEMCS, such as wearing masks and social isolation. These findings can guide decision-makers on the importance of implementing nontoxic alternatives for cleaning and disinfection, as well as improving accommodation measures for PEMCS.

Keywords: covid-19, multiple chemical sensitivity, MCS, quality of life, social isolation, physical environment, healthcare

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1121 Deployment of Armed Soldiers in European Cities as a Source of Insecurity among Czech Population

Authors: Blanka Havlickova

Abstract:

In the last ten years, there are growing numbers of troops with machine guns serving on streets of European cities. We can see them around government buildings, major transport hubs, synagogues, galleries and main tourist landmarks. As the main purpose of armed soldier’s presence in European cities authorities declare the prevention of terrorist attacks and psychological support for tourists and domestic population. The main objective of the following study is to find out whether the deployment of armed soldiers in European cities has a calming and reassuring effect on Czech citizens (if the presence at armed soldiers make the Czech population feel more secure) or rather becomes a stress factor (the presence of soldiers standing guard in full military fatigues recalls serious criminality and terrorist attacks which are reflected in the fears and insecurity of Czech population). The initial hypothesis of this study is connected with the priming theory, the idea that when we are exposed to an image (armed soldier), it makes us unconsciously focus on a topic connected with this image (terrorism). This paper is based on a quantitative public survey, which was carried out in the form of electronic questioning among the citizens of the Czech Republic. Respondents answered 14 questions about two European cities – London and Paris. Besides general questions investigating the respondents' awareness of these cities, some of the questions focused on the fear that the respondents had when picturing themselves leaving next Monday for the given city (London or Paris). The questions asking about respondent´s travel fears and concerns were accompanied by different photos. When answering the question about fear some respondents have been presented with a photo of Westminster Palace and the Eiffel with ordinary citizens while other respondents have been presented with a picture of the Westminster Palace, the and Eiffel's tower not only with ordinary citizens, but also with one soldier holding a machine gun. The main goal of this paper is to analyse and compare data about concerns for these two groups of respondents (presented with different pictures) and find out if and how an armed soldier with a machine gun in front of the Westminster Palace or the Eiffel Tower affects the public's concerns about visiting the site. In other words, the aim of this paper is to confirm or rebut the hypothesis that the look at a soldier with a machine gun in front of the Eiffel Tower or the Westminster Palace automatically triggers the association with a terrorist attack leading to an increase in fear and insecurity among Czech population.

Keywords: terrorism, security measures, priming, risk perception

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1120 Preparation and Evaluation of Herbal Extracts for Washing of Vegetables and Fruits

Authors: Pareshkumar Umedbhai Patel

Abstract:

Variety of microbes were isolated from surface of fruit and vegetables to get idea about normal flora of their surface. The process of isolation of microbes involved use of sterilized cotton swabs to wipe the surface of the samples. For isolation of Bacteria, yeast and fungi microbiological media used were nutrient agar medium, GYE agar medium and MRBA agar medium respectively. The microscopical and macroscopical characteristics of all the isolates were studied. Different plants with known antimicrobial activity were selected for obtaining samples for extraction e.g. Ficus (Ficus religosa) stem, Amla (Phyllanthus emblica) fruit, Tulsi (Ocimum tenuiflorum) leaves and Lemon grass (Cymbopogon citratus) oil. Antimicrobial activity of these samples was tested initially against known bacteria followed by study against microbes isolated from surface of vegetables and fruits. During the studies carried out throughout the work, lemongrass oil and Amla extract were found superior. Lemongrass oil and Amla extract respectively inhibited growth of 65% and 42% microbes isolated from fruit and vegetable surfaces. Rest two studied plant extracts showed only 11% of inhibition against the studied isolates. The results of isolate inhibition show the antibacterial effect of lemongrass oil better than the rest of the studied plant extracts.

Keywords: herbal extracts, vegetables, fruits, antimicrobial activity

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1119 Design and Implementation of a 94 GHz CMOS Double-Balanced Up-Conversion Mixer for 94 GHz Imaging Radar Sensors

Authors: Yo-Sheng Lin, Run-Chi Liu, Chien-Chu Ji, Chih-Chung Chen, Chien-Chin Wang

Abstract:

A W-band double-balanced mixer for direct up-conversion using standard 90 nm CMOS technology is reported. The mixer comprises an enhanced double-balanced Gilbert cell with PMOS negative resistance compensation for conversion gain (CG) enhancement and current injection for power consumption reduction and linearity improvement, a Marchand balun for converting the single LO input signal to differential signal, another Marchand balun for converting the differential RF output signal to single signal, and an output buffer amplifier for loading effect suppression, power consumption reduction and CG enhancement. The mixer consumes low power of 6.9 mW and achieves LO-port input reflection coefficient of -17.8~ -38.7 dB and RF-port input reflection coefficient of -16.8~ -27.9 dB for frequencies of 90~100 GHz. The mixer achieves maximum CG of 3.6 dB at 95 GHz, and CG of 2.1±1.5 dB for frequencies of 91.9~99.4 GHz. That is, the corresponding 3 dB CG bandwidth is 7.5 GHz. In addition, the mixer achieves LO-RF isolation of 36.8 dB at 94 GHz. To the authors’ knowledge, the CG, LO-RF isolation and power dissipation results are the best data ever reported for a 94 GHz CMOS/BiCMOS up-conversion mixer.

Keywords: CMOS, W-band, up-conversion mixer, conversion gain, negative resistance compensation, output buffer amplifier

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1118 An Ontological Approach to Existentialist Theatre and Theatre of the Absurd in the Works of Jean-Paul Sartre and Samuel Beckett

Authors: Gülten Silindir Keretli

Abstract:

The aim of this study is to analyse the works of playwrights within the framework of existential philosophy. It is to observe the ontological existence in the plays of No Exit and Endgame. Literary works will be discussed separately in each section of this study. The despair of post-war generation of Europe problematized the ‘human condition’ in every field of literature which is the very product of social upheaval. With this concern in his mind, Sartre’s creative works portrayed man as a lonely being, burdened with terrifying freedom to choose and create his own meaning in an apparently meaningless world. The traces of the existential thought are to be found throughout the history of philosophy and literature. On the other hand, the theatre of the absurd is a form of drama showing the absurdity of the human condition and it is heavily influenced by the existential philosophy. Beckett is the most influential playwright of the theatre of the absurd. The themes and thoughts in his plays share many tenets of the existential philosophy. The existential philosophy posits the meaninglessness of existence and it regards man as being thrown into the universe and into desolate isolation. To overcome loneliness and isolation, the human ego needs recognition from the other people. Sartre calls this need of recognition as the need for ‘the Look’ (Le regard) from the Other. In this paper, existentialist philosophy and existentialist angst will be elaborated and then the works of existentialist theatre and theatre of absurd will be discussed within the framework of existential philosophy.

Keywords: consciousness, existentialism, the notion of the absurd, the other

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1117 Learners’ Violent Behaviour and Drug Abuse as Major Causes of Tobephobia in Schools

Authors: Prakash Singh

Abstract:

Many schools throughout the world are facing constant pressure to cope with the violence and drug abuse of learners who show little or no respect for acceptable and desirable social norms. These delinquent learners tend to harbour feelings of being beyond reproach because they strongly believe that it is well within their rights to engage in violent and destructive behaviour. Knives, guns, and other weapons appear to be more readily used by them on the school premises than before. It is known that learners smoke, drink alcohol, and use drugs during school hours, hence, their ability to concentrate, work, and learn, is affected. They become violent and display disruptive behaviour in their classrooms as well as on the school premises, and this atrocious behaviour makes it possible for drug dealers and gangsters to gain access onto the school premises. The primary purpose of this exploratory quantitative study was therefore to establish how tobephobia (TBP), caused by school violence and drug abuse, affects teaching and learning in schools. The findings of this study affirmed that poor discipline resulted in producing poor quality education. Most of the teachers in this study agreed that educating learners who consumed alcohol and other drugs on the school premises resulted in them suffering from TBP. These learners are frequently abusive and disrespectful, and resort to violence to seek attention. As a result, teachers feel extremely demotivated and suffer from high levels of anxiety and stress. The word TBP will surely be regarded as a blessing by many teachers throughout the world because finally, there is a word that will make people sit up and listen to their problems that cause real fear and anxiety in schools.

Keywords: aims and objectives of quality education, debilitating effects of tobephobia, fear of failure associated with education, learners' violent behaviour and drug abuse

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1116 Isolation, Characterization and Application of Bacteriophages on the Biocontrol of Listeria monocytogenes in Soft Cheese

Authors: Vinicius Buccelli Ribeiro, Maria Teresa Destro, Mariza Landgraf

Abstract:

Bacteriophages are one of the most abundant replicating entities on Earth and can be found everywhere in which their hosts live and there are reports regarding isolation from different niches such as soil and foods. Since studies are moving forward with regard to biotechnology area, different research projects are being performed focusing on the phage technology and its use by the food industry. This study aimed to evaluate a cocktail (LP501) of phages isolated in Brazil for its lytic potential against Listeria monocytogenes. Three bacteriophages (LP05, LP12 and LP20) were isolated from soil samples and all of them showed 100% lysis against a panel of 10 L. monocytogenes strains representing different serotypes of this pathogen. A mix of L. monocytogenes 1/2a and 4b were inoculated in soft cheeses (approximately 105 cfu/cm2) with the phage cocktail added thereafter (1 x 109 PFU/cm2). Samples were analyzed immediately and then stored at 10°C for ten days. At 30 min post-infection, the cocktail reduced L. monocytogenes counts approximately 1.5 logs, compared to controls without bacteriophage. The treatment produced a statistically significant decrease in the counts of viable cells (p < 0.05) and in all assays performed we observed a decrease of up to 4 logs of L. monocytogenes. This study will make available to the international community behavioral and molecular data regarding bacteriophages present in soil samples in Brazil. Furthermore, there is the possibility to apply this new cocktail of phages in different food products to combat L. monocytogenes.

Keywords: bacteriophages, biocontrol, listeria monocytogenes, soft cheese

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1115 The Relationship between Incidental Emotions, Risk Perceptions and Type of Army Service

Authors: Sharon Garyn-Tal, Shoshana Shahrabani

Abstract:

Military service in general, and in combat units in particular, can be physically and psychologically stressful. Therefore, type of service may have significant implications for soldiers during and after their military service including emotions, judgments and risk perceptions. Previous studies have focused on risk propensity and risky behavior among soldiers, however there is still lack of knowledge on the impact of type of army service on risk perceptions. The current study examines the effect of type of army service (combat versus non-combat service) and negative incidental emotions on risk perceptions. In 2014 a survey was conducted among 153 combat and non-combat Israeli soldiers. The survey was distributed in train stations and central bus stations in various places in Israel among soldiers waiting for the train/bus. Participants answered questions related to the levels of incidental negative emotions they felt, to their risk perceptions (chances to be hurt by terror attack, by violent crime and by car accident), and personal details including type of army service. The data in this research is unique because military service in Israel is compulsory, so that the Israeli population serving in the army is wide and diversified. The results indicate that currently serving combat participants were more pessimistic in their risk perceptions (for all type of risks) compared to the currently serving non-combat participants. Since combat participants probably experienced severe and distressing situations during their service, they became more pessimistic regarding their probabilities of being hurt in different situations in life. This result supports the availability heuristic theory and the findings of previous studies indicating that those who directly experience distressing events tend to overestimate danger. The findings also indicate that soldiers who feel higher levels of incidental fear and anger have pessimistic risk perceptions. In addition, respondents who experienced combat army service also have pessimistic risk perceptions if they feel higher levels of fear. In addition, the findings suggest that higher levels of the incidental emotions of fear and anger are related to more pessimistic risk perceptions. These results can be explained by the compulsory army service in Israel that constitutes a focused threat to soldiers' safety during their period of service. Thus, in this stressful environment, negative incidental emotions even during routine times correlate with higher risk perceptions. In conclusion, the current study results suggest that combat army service shapes risk perceptions and the way young people control their negative incidental emotions in everyday life. Recognizing the factors affecting risk perceptions among soldiers is important for better understanding the impact of army service on young people.

Keywords: army service, combat soldiers, incidental emotions, risk perceptions

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1114 Significance of Life Values in Relationship: A Detailed Analysis of Teenage Population

Authors: Preeti Nakhat

Abstract:

Background: Values are essential part of one's life. They are inculcated since the early years of life and shape the personality of the individual. They play a tremendous role in decision making. Teenagers are seen perplexed about the values of their life. The challenge faced by majority of the teenage population in choosing between a positive and negative value is high. The values they adopt remain throughout their life and in every decision, hence it is a crucial topic of research. Research Methodology: This research aimed at finding out the value conflict of teenagers in relations. Hypothesis of the study are: H₀- There is no significant association between the life values and value conflict of higher secondary students; H₁– There is a significant association between the life values and value conflict of higher secondary students. For the same, the standardized tool, value conflict scale by R. L. Bhardwaj has been used. The tool consists 24 questions of different life situations with multiple choice options. Findings: There is 96% variation in value conflict due to evasion vs. fortitude, dependence vs. self-reliance, selfishness vs. probity, hate vs. love, fear vs. assertion and pragmatism vs. idealism life values. There is a positive association between all the life values and value conflict of higher secondary school students. Percentages of association are: 0.17% between value conflict and evasion vs. fortitude value, 0.16% between value conflict and dependence vs. self-reliance value, 0.17% between value conflict and selfishness vs. probity value, 0.16% between value conflict and hate vs. love value, 0.17% between value conflict and fear vs. assertion, 0.17% between value conflict and pragmatism vs. idealism value. Discussions: The dilemma faced by the students regarding value conflict is high. Bewilderment of being honest or lying, of loving or hating family and friends, being pragmatic or idealistic in life decision, being selfish or selfless is seen among the students. It is the challenge for the future. Teaching of values with a practical aspect should be added in the school curriculum.

Keywords: dilemma, conflict, school, values

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1113 Genotyping of Salmonella enterica Collected from Poultry Farms Located in Riyadh, KSA by Multiplex-PCR

Authors: Moussa I. Mohamed, Turki, K. A. Al-Faraj, Abdullah A. Al-Arfaj, Ashgan M. Hessain

Abstract:

The objective of the present study is to detect the incidences of Salmonella enterica from different poultry farms located in Egypt on molecular basis. During the summer of 2012, a total of 1800 cloacal swabs were collected from poultry farms located I Cairo, Egypt to be subjected for isolation of Salmonella enteric. Moreover, a total of 300 samples of poultry and poultry products were collected from different retail establishment markets in Cairo, Egypt including, 150 local whole frozen chickens, 50 imported whole frozen chickens, 100 local chicken cut samples. The highest rate of isolation 8% was obtained from imported frozen chickens and local chicken cuts, followed by local frozen chickens 6.66% and finally rectal swabs from apparently health chickens 6.4 %. Salmonella Typhimurium and Salmonella Enteritidis were most frequent among the total Salmonella isolates. Multiplex-PCR for the rapid detection of Salmonella Typhimurium and Salmonella Enteritidis from field samples especially after pre-enrichment on Rappaport-Vassiliadis (RV) selective broth (PCR-RV), revealed the same positive samples. Therefore PCR-RV technique is rabid, time saving and applicable to detect Salmonella serovars directly from chicken samples. Moreover, detecting Salmonella Typhimurium and Salmonella Enteritidis by this assay was carried out within 2 days opposed to 5–6 d by the bacteriological and serological methods.

Keywords: Salmonella enterica, Salmonella typhimurium, Salmonella enteritidis enrichment, multiplex-PCR

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1112 Investigation into the Homoepitaxy of AlGaN/GaN Heterostructure via Molecular Beam Epitaxy

Authors: Jiajia Yao, Guanlin Wu, Fang Liu, Junshuai Xue, Yue Hao

Abstract:

As the production process of self-standing GaN substrates evolves, the commercialization of low dislocation density, large-scale, semi-insulating self-standing GaN substrates is gradually becoming a reality. This advancement has given rise to increased interest in GaN materials' homoepitaxial technology. However, at the homoepitaxial interface, there are considerable concentrations of impurity elements, including C, Si, and O, which generate parasitic leakage channels at the re-growth junction. This phenomenon results in leaked HEMTs that prove difficult to switch off, rendering them effectively non-functional. The emergence of leakage channels can also degrade the high-frequency properties and lower the power devices' breakdown voltage. In this study, the uniform epitaxy of AlGaN/GaN heterojunction with high electron mobility was accomplished through the surface treatment of the GaN substrates prior to growth and the design of the AlN isolation layer structure. By employing a procedure combining gallium atom in-situ cleaning and plasma nitridation, the C and O impurity concentrations at the homoepitaxial interface were diminished to the scale of 10¹⁷ cm-³. Additionally, the 1.5 nm nitrogen-rich AlN isolation layer successfully prevented the diffusion of Si impurities into the GaN channel layer. The result was an AlGaN/GaN heterojunction with an electron mobility of 1552 cm²/Vs and an electron density of 1.1 × 10¹³ cm-² at room temperature, obtained on a Fe-doped semi-insulating GaN substrate.

Keywords: MBE, AlGaN/GaN, homogenerous epitaxy, HEMT

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1111 Illness-Related PTSD Among Type 1 Diabetes Patients

Authors: Omer Zvi Shaked, Amir Tirosh

Abstract:

Type 1 Diabetes (T1DM) is an incurable chronic illness with no known preventive measures. Excess to insulin therapy can lead to hypoglycemia with neuro-glycogenic symptoms such as shakiness, nausea, sweating, irritability, fatigue, excessive thirst or hunger, weakness, seizure, and coma. Severe Hypoglycemia (SH) is also considered a most aversive event since it may put patients at risk for injury and death, which matches the criteria of a traumatic event. SH has a ranging prevalence of 20%, which makes it a primary medical Issue. One of the results of SH is an intense emotional fear reaction resembling the form of post-traumatic stress symptoms (PTS), causing many patients to avoid insulin therapy and social activities in order to avoid the possibility of hypoglycemia. As a result, they are at risk for irreversible health deterioration and medical complications. Fear of Hypoglycemia (FOH) is, therefore, a major disturbance for T1DM patients. FOH differs from prevalent post-traumatic stress reactions to other forms of traumatic events since the threat to life continuously exists in the patient's body. That is, it is highly probable that orthodox interventions may not be sufficient for helping patients after SH to regain healthy social function and proper medical treatment. Accordingly, the current presentation will demonstrate the results of a study conducted among T1DM patients after SH. The study was designed in two stages. First, a preliminary qualitative phenomenological study among ten patients after SH was conducted. Analysis revealed that after SH, patients confuse between stress symptoms and Hypoglycemia symptoms, divide life before and after the event, report a constant sense of fear, a loss of freedom, a significant decrease in social functioning, a catastrophic thinking pattern, a dichotomous split between the self and the body, and internalization of illness identity, a loss of internal locus of control, a damaged self-representation, and severe loneliness for never being understood by others. The second stage was a two steps study of intervention among five patients after SH. The first part of the intervention included three months of therapeutic 3rd wave CBT therapy. The contents of the therapeutic process were: acceptance of fear and tolerance to stress; cognitive de-fusion combined with emotional self-regulation; the adoption of an active position relying on personal values; and self-compassion. Then, the intervention included a one-week practical real-time 24/7 support by trained medical personnel, alongside a gradual exposure to increased insulin therapy in a protected environment. The results of the intervention are a decrease in stress symptoms, increased social functioning, increased well-being, and decreased avoidance of medical treatment. The presentation will discuss the unique emotional state of T1DM patients after SH. Then, the presentation will discuss the effectiveness of the intervention for patients with chronic conditions after a traumatic event. The presentation will make evident the unique situation of illness-related PTSD. The presentation will also demonstrate the requirement for multi-professional collaboration between social work and medical care for populations with chronic medical conditions. Limitations of the study and recommendations for further research will be discussed.

Keywords: type 1 diabetes, chronic illness, post-traumatic stress, illness-related PTSD

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