Search results for: perinatal mood and anxiety disorders
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2287

Search results for: perinatal mood and anxiety disorders

2077 Death Anxiety and Life Expectancy among Older Adults in Iran

Authors: Vahid Rashedi, Banafsheh Ebrahimi, Mahtab Sharif Mohseni, Mohammadali Hosseini

Abstract:

Introduction: One of the metrics used to evaluate health status is life expectancy. This index alters as people age as a result of several events, illnesses, stress, and anxiety. One of the issues that might develop into a lethal phobia is death anxiety. This study looked at older persons in Tehran, Iran, to see if there was any correlation between life expectancy and fear of dying. Methods: Cluster random sampling was used to select 208 older persons (age 60) who had been sent to adult daycare facilities in Tehran for this correlational descriptive study. A demographic questionnaire, Temper's death anxiety scale, and Snyder's life expectancy scale were used to gather the data. Statistical Package for the Social Sciences softwear version 22 was used to conduct the data analysis. Results: The average age of the senior citizens was 66.60 (6.58) years. With a mean life expectancy of 24.94, it was discovered that the average death anxiety was 12.21. Additionally, Pearson's correlation coefficient demonstrated a bad correlation between fear of dying and life expectancy. Age, residential status, and death fear were the three primary predictors of a decline in life expectancy, according to multiple regression analysis. Conclusion: The findings suggest that there is a link between death fear and a lower life expectancy, which calls for the use of appropriate strategies to increase older individuals' life expectancies as well as the teaching of anxiety coping mechanisms.

Keywords: aged, frailty, death, anxiety, life

Procedia PDF Downloads 85
2076 Diagnosis and Treatment of Sleep Disorders

Authors: Andrew Anis Fakhrey Mosaad

Abstract:

Introduction: There are many different types of sleep disorders, each with serious implications for a person's health and a large financial burden on society. Method: This review offers a framework based on the International Classification of Sleep Disorders to aid in the diagnosis and treatment of sleep disorders. Differentiating between primary and secondary insomnia is covered, along with pharmacological and nonpharmacological therapy options. Common abnormalities of the circadian rhythm are mentioned along with their therapies, such as light therapy and chronotherapy. This article discusses the identification and management of periodic limb movement disorder and restless legs syndrome. The therapy of upper airway resistance syndrome and obstructive sleep apnea are the main topics of discussion. Conclusion: The range of narcolepsy symptoms and results, as well as diagnostic procedures and treatment, are discussed. The causes, outcomes, and treatments of many types of insomnias, such as sleep terrors, somnambulism, and rapid eye movement (REM) behavior sleep disorders, are discussed.

Keywords: diagnosis, treatment, sleep disorders, insomnia

Procedia PDF Downloads 62
2075 The Role of Psychological Resilience in Predicting Psychological Distress in Kuwaiti Adults during Corona Varies Pandemic

Authors: Al-Tammar M. Shahah

Abstract:

Background and Objective: A novel pneumonia caused by coronavirus disease 2019 (COVID-19), which is spreading domestically and internationally, has been identified by the Chinese city of Wuhan since the end of December 2019. Limited studies examined the psychological experience such as anxiety, depression, and stress during Corona pandemic. Moreover, to the best of author's knowledge, there is no study to date has examined the psychological resilience and mental health during Corona pandemic in Kuwait. Therefore, the present research investigates the role of psychological resilience in predicting psychological distress among Kuwaiti adults during Corona pandemic. Method: Kuwaiti citizens (N = 735) completed an online survey, which includes four scales the Hospital Anxiety and Depression Scale HADS (anxiety and depression), the Connor-Davidson Resilience Scale (CD-RISC-25), and the Perceived Stress Scale (PSS). A cross-sectional correlational design was used. Results: A high level of stress was observed, with 59% reported moderate to severe stress. In contrast, low levels of anxiety and depression were observed; with 70% reporting no anxiety symptoms and 74% report no depression symptoms. Psychological resilience was negatively correlated with anxiety, depression, and stress, consistent with previous studies. As expected, resilience was found to account for significant variance in anxiety and stress after controlling for quarantine variables and demographic variables. Conclusion: The findings suggest that increasing psychological resilience might help reduce psychological distress after confronting with stressful live events in Kuwaiti citizen.

Keywords: anxiety, corona, depression, psychological resilience, stress

Procedia PDF Downloads 123
2074 Systematic Literature Review of Therapeutic Use of Autonomous Sensory Meridian Response (ASMR) and Short-Term ASMR Auditory Training Trial

Authors: Christine H. Cubelo

Abstract:

This study consists of 2-parts: a systematic review of current publications on the therapeutic use of autonomous sensory meridian response (ASMR) and a within-subjects auditory training trial using ASMR videos. The main intent is to explore ASMR as potentially therapeutically beneficial for those with atypical sensory processing. Many hearing-related disorders and mood or anxiety symptoms overlap with symptoms of sensory processing issues. For this reason, inclusion and exclusion criteria of the systematic review were generated in an effort to produce optimal search outcomes and avoid overly confined criteria that would limit yielded results. Criteria for inclusion in the review for Part 1 are (1) adult participants diagnosed with hearing loss or atypical sensory processing, (2) inclusion of measures related to ASMR as a treatment method, and (3) published between 2000 and 2022. A total of 1,088 publications were found in the preliminary search, and a total of 13 articles met the inclusion criteria. A total of 14 participants completed the trial and post-trial questionnaire. Of all responses, 64.29% agreed that the duration of auditory training sessions was reasonable. In addition, 71.43% agreed that the training improved their perception of music. Lastly, 64.29% agreed that the training improved their perception of a primary talker when there are other talkers or background noises present.

Keywords: autonomous sensory meridian response, auditory training, atypical sensory processing, hearing loss, hearing aids

Procedia PDF Downloads 55
2073 Intensity of Dyspnea and Anxiety in Seniors in the Terminal Phase of the Disease

Authors: Mariola Głowacka

Abstract:

Aim: The aim of this study was to present the assessment of dyspnea and anxiety in seniors staying in the hospice in the context of the nurse's tasks. Materials and methods: The presented research was carried out at the "Hospicjum Płockie" Association of St. Urszula Ledóchowska in Płock, in a stationary ward, for adults. The research group consisted of 100 people, women, and men. In the study described in this paper, the method of diagnostic survey, the method of estimation and analysis of patient records were used, and the research tools were the numerical scale of the NRS assessment, the modified Borg scale to assess dyspnea, the Trait Anxiety scale to test the intensity of anxiety and the sociodemographic assessment of the respondent. Results: Among the patients, the greatest number were people without dyspnoea (38 people) and with average levels of dyspnoea (26 people). People with lung cancer had a higher level of breathlessness than people with other cancers. Half of the patients included in the study felt anxiety at a low level. On average, men had a higher level of anxiety than women. Conclusion: 1) Patients staying in the hospice require comprehensive nursing care due to the underlying disease, comorbidities, and a wide range of medications taken, which aggravate the feeling of dyspnea and anxiety. 2) The study showed that in patients staying in the hospice, the level of dyspnea was of varying severity. The greatest number of people were without dyspnea (38) and patients with a low level of dyspnea (34). There were 12 people experiencing an average level of dyspnea and a high level of dyspnea 15. 3) The main factor influencing the severity of dyspnea in patients was the location of cancer. There was no significant relationship between the intensity of dyspnea and the age, gender of the patient, and time from diagnosis. 4) The study showed that in patients staying in the hospice, the level of anxiety was of varying severity. Most people experience a low level of anxiety (51). There were 16 people with a high level of anxiety, while there were 33 people experiencing anxiety at an average level. 5) The patient's gender was the main factor influencing the increase in anxiety intensity. Men had higher levels of anxiety than women. There was no significant correlation between the intensity of anxiety and the age of the respondents, as well as the type of cancer and time since diagnosis. 6) The intensity of dyspnea depended on the type of cancer the subjects had. People with lung cancer had a higher level of breathlessness than those with breast cancer and bowel cancer. It was not found that the anxiety increased depending on the type of cancer and comorbidities of the examined person.

Keywords: cancer, shortness of breath, anxiety, senior, hospice

Procedia PDF Downloads 94
2072 Effectiveness of Metacognitive Therapy in Metacognitive Beliefs, Anxiety and Social Phobia of Male High School Students

Authors: Saba Hasanvandi, Molok Khademi Ashkezari, Niloofar Esmaieli

Abstract:

The research purpose was to assess the effectiveness of metacognitive therapy in metacognitive beliefs, anxiety and social phobia of male students studying in the high schools of Dargaz City. The sample comprised 30 students who were randomly selected and assigned to the experimental and control groups. The kind of this study was experimental study with pre-ops and follow-up stages. Subjects filled out metacognitive beliefs, anxiety and social phobia questionnaires. The experimental group underwent 10 sessions of therapeutic metacognitive sessions. The group therapy was conducted for ten, weekly, 90-minute sessions. Mankova analysis was utilized to analyze the data. Results revealed that metacognitive group therapy decreased metacognitive beliefs (P=0.007), anxiety (P<0.001) and social phobia (P=<0.017) in the experimental group as compared to the control group. Furthermore, the effectiveness of group metacognitive therapy was stable and consistent after one month of time interval. The results of present study can be effective for mental health professional in reaching a better understanding of anxiety and social phobia.

Keywords: group metacognitive therapy, metacognitive beliefs, anxiety, social phobia, high school students

Procedia PDF Downloads 588
2071 The Effectiveness of Psychosocial Intervention in Reducing Career Anxiety among Nigerian University Students

Authors: Mkpoikanke Sunday Otu

Abstract:

Introduction: Career anxiety is a common issue among university students, particularly in developing countries like Nigeria. This anxiety can significantly impact students' academic performance, overall well-being, and future career prospects. Therefore, it is crucial to explore effective interventions that can alleviate career anxiety among university students. The primary aim of this study was to determine the effectiveness of a psychosocial intervention in reducing career anxiety among Nigerian university students. The study employed a group randomized trial research design to further analyze the impact on career anxiety. Methodology: A total of 306 university students from various universities in Akwa Ibom State, Nigeria, were recruited for this study. The participants were purposively selected to ensure diversity and represent a range of academic disciplines. A group randomized trial research design was employed, with participants randomly assigned to either the treatment group or the control group. The treatment group received a comprehensive psychosocial intervention, while the control group served as a comparison group. The Career Anxiety Questionnaire (CAQ) was used to assess career anxiety levels among the participants. The CAQ is a validated and reliable tool that assesses various aspects of career-related anxiety, including uncertainty, fear, and self-doubt. It was administered to the participants at baseline (before the intervention), immediately after the intervention, and at follow-up (after the intervention). Results: Data analysis was conducted using statistical techniques, including analysis of variance (ANOVA). The results demonstrated that the treatment group showed a significantly lower mean score of career anxiety compared to the control group (p-value<0.05). This finding suggests that the psychosocial intervention was effective in reducing the career anxiety levels of the participants at post-test and follow-up. Conclusion: The findings of this study provide compelling evidence that psychosocial interventions have a significant impact on the reduction of career anxiety among Nigerian university students. The treatment group demonstrated a significant reduction in career anxiety scores, indicating the effectiveness of this intervention. Additionally, this study highlights the importance of addressing the career anxiety challenges faced by university students. By implementing targeted interventions, educational institutions can play a vital role in supporting the overall well-being and success of their students, both academically and professionally.

Keywords: psychosocial intervention, career anxiety, psychoeducation, university students

Procedia PDF Downloads 58
2070 Application of the Tripartite Model to the Link between Non-Suicidal Self-Injury and Suicidal Risk

Authors: Ashley Wei-Ting Wang, Wen-Yau Hsu

Abstract:

Objectives: The current study applies and expands the Tripartite Model to elaborate the link between non-suicidal self-injury (NSSI) and suicidal behavior. We propose a structural model of NSSI and suicidal risk, in which negative affect (NA) predicts both anxiety and depression, positive affect (PA) predicts depression only, anxiety is linked to NSSI, and depression is linked to suicidal risk. Method: Four hundreds and eighty seven undergraduates participated. Data were collected by administering self-report questionnaires. We performed hierarchical regression and structural equation modeling to test the proposed structural model. Results: The results largely support the proposed structural model, with one exception: anxiety was strongly associated with NSSI and to a lesser extent with suicidal risk. Conclusions: We conclude that the co-occurrence of NSSI and suicidal risk is due to NA and anxiety, and suicidal risk can be differentiated by depression. Further theoretical and practical implications are discussed.

Keywords: non-suicidal self-injury, suicidal risk, anxiety, depression, the tripartite model, hierarchical relationship

Procedia PDF Downloads 470
2069 Effects of a Brisk-Walking Program on Anxiety, Depression and Self-Concept in Adolescents: A Time-Series Design

Authors: Ming Yi Hsu, Hui Jung Chao

Abstract:

The anxiety and depression adolescents in Taiwan experience can cause suicide attempts and result in unfortunate deaths. An effective method for relieving anxiety and depression is brisk walking; a moderate and low intensity aerobic exercise, which uses large muscle groups rhythmically. The research purpose was to investigate the effects of a 12-week, school-based, brisk-walking program in decreasing anxiety and depression, and in improving self-concept among high school students living in central Taiwan. A quasi-experiment using the time series design (T1 T2 X T3 T4) was conducted. The Beck Youth Inventories 2 (BYI-II) Chinese version was given four times: the first time T1 was in the 4th week prior to intervention, T2 was in the intervention week, T3 was in the 6th week after the start of the intervention period and T4 was in the 12th week post intervention. The baseline phase of the time series constituted T1 and T2. The intervention phase constituted T2, T3, and T4. The amounts of brisk walking were recorded by self-report The Generalized Estimating Equation (GEE) was used to examine the effects of brisk walking on anxiety, depression, and self-concept. The independent t-test was used to compare mean scores on three dependent variables between brisk walking over and less than 90-minutes per week. Findings revealed that levels of anxiety and self-concept had nonsignificant change during the baseline phase, while the level of depression increased significantly. In contrast, the study demonstrated significant decreases in anxiety and depression as well as increases in positive self-concept (p=.001, p<.001, p=.017) during the intervention phase. Furthermore, a subgroup analysis was completed on participants who demonstrated elevated anxiety (23.4%), and depression (29.7%), and below average self-concept (18.6%) at baseline (T2). The subgroup of anxious, depressed, or low self-concept participants who received the brisk-walking intervention demonstrated significant decreases in anxiety and depression, and significant increases in self-concept scores. Participants who engaged in brisk walking over 90 minutes per week reported decreased mean scores on anxiety (t=-2.395, p=.035) and depression (t=-2.142, p=.036) in contrast with those who engaged in brisk-walking time less than 90 minutes per week. Regarding the effects on participants whose anxiety, scores were within the normal range at baseline, there was demonstrated significant decrease in the level of anxiety when they increased their time on brisk walking before each term examination. Overall, the brisk-walking program was effective and feasible to promote adolescents’ mental health by decreasing anxiety and depression as well as elevating self-concept. It also helped adolescents from anxiety before term examinations.

Keywords: adolescents, anxiety, depression, self-concept

Procedia PDF Downloads 198
2068 Mother-Child Attachment and Anxiety Symptoms in Middle Childhood: Differences in Levels of Attachment Security

Authors: Simran Sharda

Abstract:

There is increasing evidence that leads psychologists today to believe that the attachment formed between a mother and child plays a much more profound role in later-life outcomes than previously expected. Particularly, the fact that a link may exist between maternal attachment and the development in addition to the severity of social anxiety in middle childhood seems to be gaining ground. This research will examine and address a myriad of major issues related to the impact of mother-child attachment: behaviors of children with different levels of secure attachment, various aspects of anxiety in relation to attachment security as well as other styles of mother-child attachments, especially avoidant attachment and over-attachment. This analysis serves to compile previous literature on the subject and touch light upon a logical extension of the research. Moreover, researchers have identified links between attachment and the externalization of problem behaviors: these behaviors may later manifest as social anxiety as well as increased severity and likelihood of PTSD diagnosis (an anxiety disorder). Furthermore, secure attachment has been linked to increased health benefits, cognitive skills, emotive socialization, and developmental psychopathology.

Keywords: child development, anxiety, cognition, developmental psychopathology, mother-child relationships, maternal, cognitive development

Procedia PDF Downloads 159
2067 Mathematics Anxiety among Secondary Level Students in Nepal: Classroom Environment Perspective

Authors: Krishna Chandra Paudel

Abstract:

This paper explores the association between the perceived classroom environment and mathematics learning and test anxiety among secondary level students in Nepal. Categorizing the students in three dominant variables- gender, ethnicity and previous schooling, and selecting sample students with respect to higher mathematics anxiety from five heterogeneous classes, the research explores disparities in student's mathematics cognition and reveals nexus between classroom environment and mathematics learning and test anxiety. This research incorporates social learning theory and social development theory as interpretive tool for analyzing themes through qualitative data. Focussing on the interviews with highly mathematics learning anxious students, the study sheds light on how mathematics anxiety among the targeted students is interlinked with multiple factors. The research basically exposes the students’ lack of mathematical passion, their association with other students and participation in classroom learning, asymmetrical content and their lack of preparedness for the tests as caustic factors behind such anxieties. The study further reveals that students’ lack of foundational knowledge and complexity of mathematical content have jointly contributed to mathematics anxiety. Admitting learning as a reciprocal experience, the study points out that the students’ gender, ethnicity and disparities in previous schooling in the context of Nepal has very insignificant impact on students’ mathematics anxiety. It finally recommends that the students who get trapped into the vicious cycle of mathematics anxiety require positive and supportive classroom environment along with inspiring comments/compliments and symmetrical course contents.

Keywords: anxiety, asymmetry, cognition, habitus, pedagogy, preparedness

Procedia PDF Downloads 135
2066 The Effect of Environmental Enrichment on Anxiety and Stress Hormone in Maternally Separated Male Rats

Authors: Özge Selin Çevik, Leyla Şahin, Gülhan Örekeci Temel

Abstract:

The early postnatal period is critical for the development of cognitive and emotional functions. Maternal separation is a detrimental postnatal influence, whereas environmental enrichment is a therapeutic and protective agent. It is unclear if long-term environmental enrichment can compensate for the effects of maternal separation stress on anxiety behavior. This study was designed to examine how environmental enrichment affects anxiety levels and corticosterone levels in maternally separated rats. There are six main groups in this study: control (C), maternal separation+standard cage (MS), maternal separation+enriched environment (MSE), enriched environment (E), the maternal separation that decapitated at postnatal (PN) 21 (MS21), and standard cage that decapitated at PN21 (STD21). The maternal separation procedure consisted of PN for 21 days (between 09:00 a.m and 12:00 a.m). Enriched (E, MSE) or standard cage environment rats (MS, C) spent PN (22-55) days in either enriched cages or standard cages. Anxiety and locomotor activity were examined with the open field and elevated plus-maze test. Blood corticosterone level was evaluated by the enzyme-linked immunosorbent assay (ELISA) method. Results showed that maternal separation (MS) increased locomotor activity and anxiety. An enriched environment (E) did not change the locomotor activity. MSE group’s anxiety and locomotor activity did not change. Corticosterone levels increased in the maternal separation group that decapitated at the PN 21 days. Maternal separation increases anxiety. Environmental enrichment alone was insufficient to cause alterations in the anxiety level. In addition, environmental enrichment did not ameliorate the anxiety level in maternally separated rats. However, environmental enrichment decreased the locomotor activity in the maternally separated rats.

Keywords: maternal separation, environment enrichment, stress, hippocampus, anxiety, memory, rat

Procedia PDF Downloads 91
2065 Trait Anxiety, Cognitive Flexibility, Self-Efficacy and Emotion Regulation: A Moderation Model

Authors: Amina Ottozbeer, Nazanin Derakhshan

Abstract:

Emotion regulation, a transdiagnostic process, is often impaired in individuals with high trait anxiety due to compromised executive functioning and attentional control. Recent research underscores the importance of studying individual differences and contextual factors in understanding the adaptability of emotion regulation processes, particularly in those with high trait anxiety. Prior studies have emphasized the role of self-efficacy in promoting positive cognitive flexibility outcomes and mitigating executive function impairments in highly anxious individuals. Accordingly, the objective of this study was to examine the moderating influence of attentional control, cognitive flexibility, and self-efficacy on the relationship between trait anxiety and emotion regulation. Using a correlational design, an online study was conducted with a sample of 82 participants (mean age: 22 years). Self-report questionnaires measured individual difference variables. The Classic Stroop Task assessed attentional control as an objective measure of cognitive flexibility . The findings revealed three significant interactions. Firstly, high cognitive flexibility and self-efficacy were linked to reduced expressive suppression in individuals with low trait anxiety. Secondly, elevations in cognitive flexibility and self-efficacy were associated with increased suppression in those with high trait anxiety. Thirdly, high trait anxiety was associated with reduced attentional control. The results suggest that typically adaptive processes can yield different outcomes in highly anxious populations, highlighting the need to explore additional variables that could alter the impact of cognitive flexibility and self-efficacy on emotion regulation in individuals with high anxiety. These findings have significant clinical implications, emphasizing the need to consider individual differences in emotion regulation and trait anxiety to inform more effective psychological treatments.

Keywords: attentional control, trait anxiety, emotional dysregulation, transdiagnostic, individual differences

Procedia PDF Downloads 26
2064 Investigating the Relationship Between Alexithymia and Mobile Phone Addiction Along with the Mediating Role of Anxiety, Stress and Depression: A Path Analysis Study and Structural Model Testing

Authors: Pouriya Darabiyan, Hadis Nazari, Kourosh Zarea, Saeed Ghanbari, Zeinab Raiesifar, Morteza Khafaie, Hanna Tuvesson

Abstract:

Introduction Since the beginning of mobile phone addiction, alexithymia, depression, anxiety and stress have been stated as risk factors for Internet addiction, so this study was conducted with the aim of investigating the relationship between Alexithymia and Mobile phone addiction along with the mediating role of anxiety, stress and depression. Materials and methods In this descriptive-analytical and cross-sectional study in 2022, 412 students School of Nursing & Midwifery of Ahvaz Jundishapur University of Medical Sciences were included in the study using available sampling method. Data collection tools were: Demographic Information Questionnaire, Toronto Alexithymia Scale (TAS-20), Depression, Anxiety, Stress Scale (DASS-21) and Mobile Phone Addiction Index (MPAI). Frequency, Pearson correlation coefficient test and linear regression were used to describe and analyze the data. Also, structural equation models and path analysis method were used to investigate the direct and indirect effects as well as the total effect of each dimension of Alexithymia on Mobile phone addiction with the mediating role of stress, depression and anxiety. Statistical analysis was done by SPSS version 22 and Amos version 16 software. Results Alexithymia was a predictive factor for mobile phone addiction. Also, Alexithymia had a positive and significant effect on depression, anxiety and stress. Depression, anxiety and stress had a positive and significant effect on mobile phone addiction. Depression, anxiety and stress variables played the role of a relative mediating variable between Alexithymia and mobile phone addiction. Alexithymia through depression, anxiety and stress also has an indirect effect on Internet addiction. Conclusion Alexithymia is a predictive factor for mobile phone addiction; And the variables of depression, anxiety and stress play the role of a relative mediating variable between Alexithymia and mobile phone addiction.

Keywords: alexithymia, mobile phone, depression, anxiety, stress

Procedia PDF Downloads 99
2063 Application of Container Technique to High-Risk Children: Its Effect on Their Levels of Stress, Anxiety and Depression

Authors: Nguyen Thi Loan, Phan Ngoc Thanh Tra

Abstract:

Container is one of the techniques used in Eye Movement Desensitization and Reprocessing (EDMR) Therapy. This paper presents the positive results of applying Container technique to “high risk children”. The sample for this research is composed of 60 “high risk children” whose ages range from 11 to 18 years old, housed in Ho Chi Minh City Youth Center. They have been under the program of the Worldwide Orphans Foundation since August 2015 for various reasons such as, loss of parents, anti-social behaviors, homelessness, child labor among others. These “high risk children” are under high levels of stress, anxiety and depression. The subjects were divided into two groups: the control and the experimental with 30 members each. The experimental group was applied Container Technique and the instruments used to measure their levels of stress, anxiety, and depression are DASS-42 and ASEBA. Results show that after applying the Container Technique to the experimental group, there are significant differences between the two groups’ levels of stress, anxiety and depression. The experimental group’s levels of stress, anxiety and depression decreased significantly. The results serve as a basis for the researchers to make an appeal to psychologists to apply Container Technique in doing psychological treatment in a suitable context.

Keywords: anxiety, depression, container technique, EMDR

Procedia PDF Downloads 297
2062 The Effect of Inhalation of Ylang-ylang Aroma on the Levels of Anxiety of Parents with Hospitalized Toddlers Diagnosed with Pneumonia

Authors: Crisostomo Hart A., Cruz Anna Cecilia R., Cruz Bianca Isabelle A., Cruz John Edward Ligzurc M., Cruz Mikaela Denise P.

Abstract:

Aim/purpose: The researchers aimed to determine the effect of Ylang-ylang aroma in decreasing the anxiety levels of parents with hospitalized toddlers diagnosed with pneumonia. Method: Quantitative Quasi-experimental one-group pre-test post-test design was utilized in the study. The study includes a pretest, an intervention, and a posttest on the same experimental group. Participants are parents aged 20 – 35 years old with a hospitalized toddler who is diagnosed with pneumonia. Anxiety levels were measured before the intervention using the State Trait Anxiety Inventory by Spielberger. Those who scored 41-120 proceeded to receive the intervention. The intervention was a 3-day course of aromatherapy where the participants inhaled the Ylang-ylang flower at a distance of 10 – 15 cm away from the face for 10 minutes. The post-test using the same instrument measured the levels of anxiety after the 3-day aromatherapy. Paired T-test of SPSS 21.0 was used to analyze the pre-test and post-test scores. Results: Study yielded a p value of 0.047 which shows significant difference between the levels of anxiety before and after the intervention. Conclusions: Based on the data analysis, the researchers concluded that inhalation of Ylang-ylang aroma is effective in reducing the anxiety level of the parents of hospitalized toddlers diagnosed with Pneumonia.

Keywords: Ylang-ylang, Pneumonia, Toddlers, Aromatherapy

Procedia PDF Downloads 414
2061 Impact of Using Peer Instruction and PhET Simulations on the Motivation and Physics Anxiety

Authors: Jaypee Limueco

Abstract:

This research focused on the impact of Peer Instruction and PhET Simulations on the level of motivation and Physics anxiety of Grade 9 students. Two groups of students were used in the study. The experimental group involved 65 registered students while the control group has 64 registered students. To determine the level of motivation of students in learning physics, the Physics Motivation Questionnaire was administered. On the other hand, to determine the level of Physics anxiety of the students in each group, Physics Anxiety Rating Scale was used. Peer Instruction supplemented with PhET simulations was implemented in the experimental group while the traditional lecture method was used in the control group. Both instruments were again administered after the implementation of the two different teaching approaches. “Wilcoxon Signed Rank test” was used to test the significant difference between pretest and posttest of each group. “Mann Whitney U” was used to test if significant differences exist between each group before and after instruction. Results showed that there is no significant difference between the level of motivation and anxiety of the experimental and control group before the implementation at p<0.05 significance level. It implies that the students have the same level of motivation and physics anxiety before instruction. However, the results of both tests have significant differences between the groups after instruction. It is also found that there is a significant positive change in the responses of the students in the experimental group while no change was evident on the control. The result of the analysis of the Mann Whitney U shows that the change in the attributes of the students is caused by the treatment. Therefore, it is concluded that Peer Instruction and PhET simulation helped in alleviating motivation of students and minimizing their anxiety towards Physics.

Keywords: anxiety, motivation, peer instruction, PhET simulations

Procedia PDF Downloads 356
2060 Computer Anxiety and the Use of Computerized System by University Librarians in Delta State University Library, Nigeria

Authors: L. Arumuru

Abstract:

The paper investigates computer anxiety and the use of computerized library system by university librarians in Delta State University library, Abraka, Nigeria. Some of the root causes of computer anxiety among university librarians such as lack of exposure to computers at early age, inadequate computer skills, inadequate computer training, fear at the sight of a computer, lack of understanding of how computers work, etc. were pin-pointed in the study. Also, the different services rendered in the university libraries with the aid of computers such as reference services, circulation services, acquisition services, cataloguing and classification services, etc. were identified. The study employed the descriptive survey research design through the expo-facto method, with a population of 56 librarians, while the simple percentage and frequency counts were used to analyze the data generated from the administered copies of the questionnaire. Based on the aforementioned root causes of computer anxiety and the resultant effect on computerized library system, recommendations were proffered in the study.

Keywords: computer anxiety, computerized library system, library services, university librarians

Procedia PDF Downloads 387
2059 Nurses' Experiences of Using Bergamot Essential Oil (Aromatherapy) on Patients with Dementia Suffering from Depression: A Pilot Study

Authors: Berit Johannessen

Abstract:

Introduction: Depression and dementia are the two most common psychiatric disorders of older people. The use of antidepressants does not always have the desired effect and serious side effects are common. Aroma therapists claim that the essential oil of Bergamot has an antidepressant effect. Aromatherapy is defined as holistic or complementary medicine and is rarely used in the Norwegian public health service, but in recent years, there has been an increasing interest in, and use of complementary and alternative therapies (CAM) in the Norwegian population, and aromatherapy is one of the most widely used. Focus for this study: How do nurses experience the use of Bergamot essential oil for patients suffering from dementia and depression? Method: Action research study including 12 patients and 8 nurses. The patients were strategically selected by the nurses and were given Bergamot in a fan diffuser every day for 12 weeks. The patients' mood and behavior patterns were reported daily and the nurse`s experiences were reported weekly. Individual interviews with the nurses were conducted at the end of the project. Results: The nurses reported that bergamot had positive impact on patients mood and wellbeing, and was considered as an effective method for six patients, four had uncertain effect and two had no effect. They also reported less use of medication and that the fan diffusers were easy and pleasant to administer. They found the use of natural remedies as Bergamot inspiring and wanted to learn more about aromatherapy and its use in nursing. Some were disturbed by the smell and some had to deal with critical and negative colleagues. Conclusion: Nurses experienced aromatherapy using bergamot oil in fan diffusers as a simple and useful procedure for patients suffering from dementia and depression. The effects were varying. Further research is needed.

Keywords: aromatherapy, bergamot, dementia, depression

Procedia PDF Downloads 254
2058 The Role of Cognitive Control and Social Camouflage Associated with Social Anxiety Autism Spectrum Conditions

Authors: Siqing Guan, Fumiyo Oshima, Eiji Shimizu, Nozomi Tomita, Toru Takahashi, Hiroaki Kumano

Abstract:

Risk factors for social anxiety in autism spectrum conditions involve executive attention, emotion regulation, and thought regulation as processes of cognitive dysregulation. Social camouflaging behaviors as strategies used to mask and/or compensate for autism characteristics during social interactions in autism spectrum conditions have also been emphasized. However, the role of cognitive dysregulation and social camouflaging related to social anxiety in autism spectrum conditions has not been clarified. Whether these factors are specific to social anxiety in autism spectrum conditions or common to social anxiety independent of autism spectrum conditions needs to be clarified. Here, we explored risk factors specific to social anxiety in autism spectrum conditions and general risk factors for social anxiety independent of autism spectrum conditions. From the Japanese participants in early adulthood (age=18~39) of the online survey in Japan, those who exceeded the Japanese version Autism-Spectrum Quotient cutoff (33 points or more )were divided into the autism spectrum conditions group (ASC; N=255, mean age=32.08, SD age=5.16)and those who did not exceed the cutoff were divided into the non-autism spectrum conditions group (Non-ASC; N=255, mean age=31.70, SD age=5.09). Using the Japanese versions of the Social Phobia Scale, the Social Interaction Anxiety Scale, and the Short Fear of Negative Evaluation Scale, a composite score for social anxiety was calculated using a method of principal. We also measured emotional control difficulties using the Difficulties in Emotion Regulation Scale, executive attention using the Effortful Control Scale for Adults, rumination using the Rumination-Reflection Questionnaire, and worry using the Penn State Worry Questionnaire. This study was passed through the review of the Ethics Committee. No conflicts of interest. Multiple regression analysis with forced entry method was used to predict social anxiety in the ASC and non-ASC groups separately, based on executive attention, emotion dysregulation, worry, rumination, and social camouflage. In the ASC group, emotion dysregulation (β=.277, p<.001), worry (β=.162, p<.05), assimilation (β=.308, p<.001) and masking (β=.275, p<.001) were significant predictors of social anxiety (F (7,247) = 45.791, p <.001, R2=.565). In the non-ASC groups,emotion dysregulation (β=.171, p<.05), worry (β=.344,p <.001), assimilation (β=.366,p <.001) and executive attention (β=-.132,p <.05) were significant predictors of social anxiety (F (7,207) =47.333, p <.001, R2=.615).The findings suggest that masking was shown to be a risk factor for social anxiety specific to autism spectrum conditions, while emotion dysregulation, worry, and assimilation were shown to be common risk factors for social anxiety, regardless of autism spectrum conditions. In addition, executive attention is a risk factor for social anxiety without autism spectrum conditions.

Keywords: autism spectrum, cognitive control, social anxiety, social camouflaging

Procedia PDF Downloads 208
2057 The Association between Masculinity and Anxiety in Canadian Men

Authors: Nikk Leavitt, Peter Kellett, Cheryl Currie, Richard Larouche

Abstract:

Background: Masculinity has been associated with poor mental health outcomes in adult men and is colloquially referred to as toxic. Masculinity is traditionally measured using the Male Role Norms Inventory, which examines behaviors that may be common in men but that are themselves associated with poor mental health regardless of gender (e.g., aggressiveness). The purpose of this study was to examine if masculinity is associated with generalized anxiety among men using this inventory vs. a man’s personal definition of it. Method: An online survey collected data from 1,200 men aged 18-65 across Canada in July 2022. Masculinity was measured using: 1) the Male Role Norms Inventory Short Form and 2) by asking men to self-define what being masculine means. Men were then asked to rate the extent they perceived themselves to be masculine on a scale of 1 to 10 based on their definition of the construct. Generalized anxiety disorder was measured using the GAD-7. Multiple linear regression was used to examine associations between each masculinity score and anxiety score, adjusting for confounders. Results: The masculinity score measured using the inventory was positively associated with increased anxiety scores among men (β = 0.02, p < 0.01). Masculinity subscales most strongly correlated with higher anxiety were restrictive emotionality (β = 0.29, p < 0.01) and dominance (β = 0.30, p < 0.01). When traditional masculinity was replaced by a man’s self-rated masculinity score in the model, the reverse association was found, with increasing masculinity resulting in a significantly reduced anxiety score (β = -0.13, p = 0.04). Discussion: These findings highlight the need to revisit the ways in which masculinity is defined and operationalized in research to better understand its impacts on men’s mental health. The findings also highlight the importance of allowing participants to self-define gender-based constructs, given they are fluid and socially constructed.

Keywords: masculinity, generalized anxiety disorder, race, intersectionality

Procedia PDF Downloads 71
2056 Science Anxiety Levels in Emirati Pre-Service Teachers

Authors: Martina Dickson, Hanadi Kadbey, Melissa Mcminn

Abstract:

Research has shown that anxiety and trepidation towards learning about science is prevalent among elementary school teachers in Western countries. It has also been shown repeatedly that pre-service and in-service teachers who show signs of anxiety towards science are; a) less likely to teach it at all, where they have some autonomy over this, b) less likely to teach it effectively c) ultimately that their students have lower attainment scores in science. It is therefore critically important to gauge pre-service teachers’ science anxiety levels early on whilst there are still possibilities to overturn some of the reasons behind these fears and avert these serious issues occurring later on. This study takes place in the capital of the United Arab Emirates (U.A.E.) in the context of training local elementary school teachers. In the U.A.E., where Emirati teachers are already in the vast minority and attrition rates are high, it is important to offer as much support to pre-service teachers as possible. If pre-service teachers are graduating with high levels of science anxiety unabated, according to the research there is a very real concern that as generalist primary school teachers, their science teaching will be far from optimal. The aims of this research study were to ascertain the science anxiety levels of pre-service elementary teachers and to identify particular areas of their science anxiety, if appropriate. We surveyed 200 Emirati pre-service teachers and found that levels of science anxiety were directly related to their perceptions of performance in science exams, laboratory experiments and inquiry approaches to science learning. Whilst some studies have shown that science anxiety can decrease as students gain confidence in science knowledge by studying courses, we did not see this effect in our study. This is based upon a theoretical framework which holds that in some cases, science anxiety is related to lack of exposure to, or insecurity with science content itself which in some cases is alleviated by the students’ covering of material and greater confidence in the subject. Exploring this variable allowed us to explore whether students educated in schools influenced by the educational reform in Abu Dhabi have differing science anxiety levels from those who were educated prior to the reforms. We discuss the possible implications of these findings to the future teaching of science in Abu Dhabi public schools.

Keywords: pre-service teachers, science anxiety, United Arab Emirates, educational reform

Procedia PDF Downloads 333
2055 The Psychological Impact of War Trauma on Refugees

Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis

Abstract:

The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.

Keywords: psychiatric disorders, refugees, war survivors, war trauma

Procedia PDF Downloads 200
2054 Development and Validation of the Dimensional Social Anxiety Scale: Assessment for the Offensive Type of Social Anxiety

Authors: Ryotaro Ishikawa

Abstract:

Social Anxiety Disorder (SAD) is marked by the persistent fear of social or performance situations in which embarrassment may occur. In contrast, SA in Japan and in China is understood differently. Taijin Kyofusho (TKS) is a culture-bound subtype of SAD which has been the focus of recent research. TKS refers to a unique form of SAD found in Japanese and East Asian cultures characterized by a fear of offending others, in contrast to prototypical SAD in which the source of fear is typically concerned about one’s own embarrassment, humiliation, or rejection by others. Criteria for TKS partially overlap with but are distinct from SAD; a primary factor distinguishing TKS from SAD appears to be individualistic versus interdependent or collectivistic self-construals. The aim of this study was to develop a scale to assess the typical SAD and offensive type of SAD (TKS). This study aimed to test the internal consistency and validity of the scale (Dimensional Social Anxiety Scale: DSAS) using university students sample. For this, 148 university students were enrolled (male=90, female=58, age=19.77, Standard Deviation=1.04). As a result of confirmatory factor analysis, three-factor models of DSAS were verified (χ2(74) =128.36). These three factors were named ‘general’, ‘perfomance’, and ‘offensive’. DSAS were significantly correlated with the Liebowitz Social Anxiety Scale (r = .538, p < .001). Good internal consistencies were indicated on the three subscales (α = .76 to 89). In conclusion, this study indicated DSAS has adequate internal consistency and validity for assessing of multi-type of SADs.

Keywords: social anxiety, cognitive theory, assessment, anxiety disorder

Procedia PDF Downloads 114
2053 Post COVID-19 Pandemic Determinants of Depression and Anxiety Among the Moroccan Population

Authors: Kaoutar Chbihi, Aziza Menouni, Imane Berni, Tarik Abchouch, Samir El Jaafari

Abstract:

The unpredictability and ambiguity of a pandemic, combined with the economic impact, sedentary lifestyle, and increased living cost, have the potential to seriously raise the risk of mental health issues among the population. Therefore, this study had the aim to assess the magnitude of mental health outcomes and risk factors among the general population in Morocco in times of the Covid-19 pandemic. This study consisted of a cross-sectional design and was survey-based and region-stratified by collecting demographic data and mental health measurements from 523 participants. The degree of depression, anxiety, and insomnia symptoms were assessed by using the 9-item Patient Health Questionnaire and the 7-items Generalized Anxiety Disorder. The survey was completed by 523 individuals. Results showed that 67.9% were women, and 58.6% were aged 18-30 years. 49% of participants reported depression issues, while 39.8% experienced anxiety. Being a married woman with children was associated with severe symptoms of depression and anxiety. Finally, our findings reported a significant mental health burden among the general population of Morocco, which needs to be tackled by specific co-created interventions and adapted strategies in order to prevent impacts on public health.

Keywords: anxiety, COVID-19, depression, mental health, Morocco, pandemic

Procedia PDF Downloads 79
2052 Anxiety and Change in Eating Habits and Health Behaviors among Adult Women during COVID-19 Pandemic Lockdown in Alexandria, Egypt

Authors: Heba Ahmed Abdelaziz, Doaa Tawfik Mohamed Ibrahim

Abstract:

Background: COVID-19 pandemic is the major health problem facing the world recently, causing variable effects on mental health and eating behavior. Aim of the study: Identifying changes in eating patterns and other health behaviors in relation to the anxiety caused by the COVID-19 pandemic lockdown in adult females in Alexandria, Egypt. Method: 344 adult females (20+ years old), were included in online self-administered questionnaire. Results: Severe anxiety symptoms was among 34.6% of the studied females especially; those aged 25-40 years, married, non-working or student females, females who had change in their work routine (half or full time from home). Homemade pastries and bakery product then beverages followed by fresh fruits and vegetables were frequently consumed by the studied females than before lockdown while fast foods were decreased during lockdown. Overweight and obesity were high among most of the participants with different grades of anxiety symptoms. Females with moderate and severe anxiety symptoms reported increase in appetite and body weight with irregular sleeping during lockdown. Conclusion: the current study concluded that stressful situations like lockdown due to COVID-19 pandemic is associated with anxiety (severe, moderate, mild then minimal, respectively) along with changes in eating habits, physical activity, sleeping pattern and smoking.

Keywords: COVID-19, lockdown, females, anxiety, eating, stress, lifestyle

Procedia PDF Downloads 189
2051 Informational Support, Anxiety and Satisfaction with Care among Family Caregivers of Patients Admitted in Critical Care Units of B.P. Koirala Institute of Health Sciences, Nepal

Authors: Rosy Chaudhary, Pushpa Parajuli

Abstract:

Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

Procedia PDF Downloads 352
2050 Quality of Life of Women with Breast Cancer and Its Correlation with Depression and Anxiety

Authors: Maria Malliarou, Efrossini Lyraraki, Pavlos Sarafis, Theodosios Paralikas, Styliani Kotrotsiou, Evangelia Kotrotsiou, Mairy Gouva

Abstract:

Women with breast cancer have to adapt to physical malformations, side effects of chemotherapy, emotional insecurity, and changes in social roles. Inability to recognize the co-morbidity of psychiatric conditions can have an aggravating effect on patient compliance in therapeutic interventions, resulting in treatment delays and an impact on overall survival. The purpose of this study was to identify the quality of life of breast cancer patients undergoing external radiation therapy and to correlate it with depression and anxiety. Patients were asked to respond to an anonymous questionnaire with general demographic and clinical questions, followed by the EORTCQLQ-C30 questionnaire for assessing the quality of life of patients with breast cancer. Hospital Anxiety and Depression Scale (HADS) as well as the Depression, Anxiety and Stress Scale (DASS-21) was also administered. The statistical analysis of the data was done in IBM SPSS. Results indicated that the incidence of anxiety and depression in breast cancer patients is high both in HADS (37.5 % with mild to moderate depression and 62.5 % with significant to severe depression) and DASS - 21 (39.2 % mild to moderate depression and 60.8 % significant to severe) scales. The correlation of anxiety and depression with life quality was negative for HADS (r = -, 810, p = .000) as well as for DASS-21 (r = -, 682, p = .000). The psychological impact of breast cancer on patients is important. Its correlation with the quality of life may lead to better tolerance to treatment and better effectiveness of the therapeutic approach.

Keywords: anxiety, breast cancer, depression, quality of life

Procedia PDF Downloads 267
2049 Pregnant Women and Mothers in Prison, Mother and Baby Units and Mental Health

Authors: Rachel Dolan

Abstract:

Background: Over two thirds of women in prison in England are mothers, and estimates suggest between 100 and 200 women per year give birth during imprisonment. There are currently six mother and baby units (MBUs) in prisons in England which admit women and babies up to the age of 18 months. Although there are only 65 places available, and despite positive impacts, they are rarely full. Mental illness may influence the number of admissions, as may interpretation of admission criteria. They are the only current alternative to separation for imprisoned mothers and their babies. Aims: To identify the factors that affect the decision to apply for/be offered a place in a prison MBU; to measure the impact of a placement upon maternal mental health and wellbeing; To measure the Initial outcomes for mother and child. Methods: A mixed methods approach - 100 pregnant women in English prisons are currently being recruited from prisons in England. Quantitative measures will establish the prevalence of mental disorder, personality disorder, substance misuse and quality of life. Qualitative interviews will document the experiences of pregnancy and motherhood in prison. Results: Preliminary quantitative findings suggest the most prevalent mental disorders are anxiety and depression and approximately half the participants meet the criteria for one or more personality disorders. The majority of participants to date have been offered a place in a prison MBU, and those in a prison with an MBU prior to applying are more likely to be admitted. Those with a previous history of childcare issues, who are known to social services are less likely to be offered a place. Qualitative findings suggest that many women are often hungry and uncomfortable during pregnancy, many have feelings of guilt about having a child in prison and that feelings of anxiety and worry are exacerbated by lack of information.

Keywords: mothers, prison, mother and baby units, mental health

Procedia PDF Downloads 286
2048 Data Disorders in Healthcare Organizations: Symptoms, Diagnoses, and Treatments

Authors: Zakieh Piri, Shahla Damanabi, Peyman Rezaii Hachesoo

Abstract:

Introduction: Healthcare organizations like other organizations suffer from a number of disorders such as Business Sponsor Disorder, Business Acceptance Disorder, Cultural/Political Disorder, Data Disorder, etc. As quality in healthcare care mostly depends on the quality of data, we aimed to identify data disorders and its symptoms in two teaching hospitals. Methods: Using a self-constructed questionnaire, we asked 20 questions in related to quality and usability of patient data stored in patient records. Research population consisted of 150 managers, physicians, nurses, medical record staff who were working at the time of study. We also asked their views about the symptoms and treatments for any data disorders they mentioned in the questionnaire. Using qualitative methods we analyzed the answers. Results: After classifying the answers, we found six main data disorders: incomplete data, missed data, late data, blurred data, manipulated data, illegible data. The majority of participants believed in their important roles in treatment of data disorders while others believed in health system problems. Discussion: As clinicians have important roles in producing of data, they can easily identify symptoms and disorders of patient data. Health information managers can also play important roles in early detection of data disorders by proactively monitoring and periodic check-ups of data.

Keywords: data disorders, quality, healthcare, treatment

Procedia PDF Downloads 433