Search results for: struggles of dementia
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 302

Search results for: struggles of dementia

62 Mental Health Difficulties and Abnormal Feeding Regulation during a Crisis: A Mixed-Methods Approach

Authors: Leja Salciute

Abstract:

Mental health difficulties are one of the reasons for abnormal feeding behaviour. This is especially evident in a crisis situation. Abnormal feeding behaviour occurs when individuals use food as a method to provide relief for these negative emotions. The study aimed to discover an association between emotional regulation, mental health difficulties and disruption in feeding behaviours in the UK in times of crisis. A mixed-methods design was used. Abnormal feeding behaviour was measured using the Binge Eating Disorder Screener-7, SCOFF scale, Crisis impact scale, Difficulties in Emotion Regulation Scale and demographics. The sample comprised 342 participants with a history of excessive overeating. The participants (male= 198, female= 141 and other= 3) came from the general population and they were aged 16 and over. Participants ranged in age from 16 to 89. Findings from the survey concluded that difficulties with emotion regulation were found to be associated with abnormal feeding behaviours. Mental health difficulties correlated significantly with changes in individuals’ lives, such as work or routines. Individuals differed in their abnormal feeding behaviour in terms of their age, that is, younger individuals showed less struggle with their eating patterns while older individuals faced greater struggles with their abnormal feeding behaviour. Emotion regulation significantly influenced abnormal feeding behaviour. Results from qualitative data suggest four common themes that were identified: demonstration of gratitude, negative emotions, disruptions to social life, and financial loss. For example, participants developed and gained an awareness of being grateful for the simple things in life even when participants experienced hardships. The results also suggested that emotional eating acted like a sedative that allowed the participant to run away from their painful reality. Crisis situation negatively affected relationships among participants and induced negativity related to social interaction. Finally, the respondents highlighted that the presence of uncertainty made it hard to plan ahead and look forward to the future. Although respondents experienced negative emotions and financial losses, some of them still managed to allocate time for themselves and enjoy their time off during crisis. However, majority of respondents referred to their inability to control their external circumstances and turned to and relied upon food overconsumption instead. This had a negative effect on their mental health and presented disruptions in feeding behaviour. It was recommended for individuals in times of crisis to seek psychological support in the form of Cognitive Behavioural Therapy (CBT).

Keywords: binge eating, maladaptive eating behaviours, mental health, negative emotions in crisis

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61 A Call for Justice and a New Economic Paradigm: Analyzing Counterhegemonic Discourses for Indigenous Peoples' Rights and Environmental Protection in Philippine Alternative Media

Authors: B. F. Espiritu

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This paper examines the resistance of the Lumad people, the indigenous peoples in Mindanao, Southern Philippines, and of environmental and human rights activists to the Philippine government's neoliberal policies and their call for justice and a new economic paradigm that will uphold peoples' rights and environmental protection in two alternative media online sites. The study contributes to the body of knowledge on indigenous resistance to neoliberal globalization and the quest for a new economic paradigm that upholds social justice for the marginalized in society, empathy and compassion for those who depend on the land for their survival, and environmental sustainability. The study analyzes the discourses in selected news articles from Davao Today and Kalikasan (translated to English as 'Nature') People's Network for the Environment’s statements and advocacy articles for the Lumad and the environment from 2018 to February 2020. The study reveals that the alternative media news articles and the advocacy articles contain statements that expose the oppression and violation of human rights of the Lumad people, farmers, government environmental workers, and environmental activists as shown in their killings, illegal arrest and detention, displacement of the indigenous peoples, destruction of their schools by the military and paramilitary groups, and environmental plunder and destruction with the government's permit for the entry and operation of extractive and agribusiness industries in the Lumad ancestral lands. Anchored on Christian Fuch's theory of alternative media as critical media and Bert Cammaerts' theorization of alternative media as counterhegemonic media that are part of civil society and form a third voice between state media and commercial media, the study reveals the counterhegemonic discourses of the news and advocacy articles that oppose the dominant economic system of neoliberalism which oppresses the people who depend on the land for their survival. Furthermore, the news and advocacy articles seek to advance social struggles that transform society towards the realization of cooperative potentials or a new economic paradigm that upholds economic democracy, where the local people, including the indigenous people, are economically empowered their environment and protected towards the realization of self-sustaining communities. The study highlights the call for justice, empathy, and compassion for both the people and the environment and the need for a new economic paradigm wherein indigenous peoples and local communities are empowered towards becoming self-sustaining communities in a sustainable environment.

Keywords: alternative media, environmental sustainability, human rights, indigenous resistance

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60 Five Years Analysis and Mitigation Plans on Adjustment Orders Impacts on Projects in Kuwait's Oil and Gas Sector

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

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

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

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59 The Language of Science in Higher Education: Related Topics and Discussions

Authors: Gurjeet Singh, Harinder Singh

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In this paper, we present "The Language of Science in Higher Education: Related Questions and Discussions". Linguists have written and researched in depth the role of language in science. On this basis, it is clear that language is not just a medium or vehicle for communicating knowledge and ideas. Nor are there mere signs of language knowledge and conversion of ideas into code. In the process of reading and writing, everyone thinks deeply and struggles to understand concepts and make sense. Linguistics play an important role in achieving concepts. In the context of such linguistic diversity, there is no straightforward and simple answer to the question of which language should be the language of advanced science and technology. Many important topics related to this issue are as follows: Involvement in practical or Deep theoretical issues. Languages for the study of science and other subjects. Language issues of science to be considered separate from the development of science, capitalism, colonial history, the worldview of the common man. The democratization of science and technology education in India is possible only by providing maximum reading/resource material in regional languages. The scientific research should be increase to chances of understanding the subject. Multilingual instead or monolingual. As far as deepening the understanding of the subject is concerned, we can shed light on it based on two or three experiences. An attempt was made to make the famous sociological journal Economic and Political Weekly Hindi almost three decades ago. There were many obstacles in this work. The original articles written in Hindi were not found, and the papers and articles of the English Journal were translated into Hindi, and a journal called Sancha was taken out. Equally important is the democratization of knowledge and the deepening of understanding of the subject. However, the question is that if higher education in science is in Hindi or other languages, then it would be a problem to get job. In fact, since independence, English has been dominant in almost every field except literature. There are historical reasons for this, which cannot be reversed. As mentioned above, due to colonial rule, even before independence, English was established as a language of communication, the language of power/status, the language of higher education, the language of administration, and the language of scholarly discourse. After independence, attempts to make Hindi or Hindustani the national language in India were unsuccessful. Given this history and current reality, higher education should be multilingual or at least bilingual. Translation limits should also be increased for those who choose the material for translation. Writing in regional languages on science, making knowledge of various international languages available in Indian languages, etc., is equally important for all to have opportunities to learn English.

Keywords: language, linguistics, literature, culture, ethnography, punjabi, gurmukhi, higher education

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58 Role of Onion Extract for Neuro-Protection in Experimental Stroke Model

Authors: Richa Shri, Varinder Singh, Kundan Singh Bora, Abhishek Bhanot, Rahul Kumar, Amit Kumar, Ravinder Kaur

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The term ‘neuroprotection’ means preserving/salvaging function and structure of neurons. Neuroprotection is an adjunctive treatment option for neurodegenerative disorders. Oxidative stress is considered a major culprit in neurodegenerative disorders; hence, management strategies include use of antioxidants. Our search for a neuroprotective agent began with Allium cepa L. or onions, (family Amaryllidaceae) - a potent antioxidant. We have investigated the neuroprotective potential of onions in experimental models of ischemic stroke, diabetic neuropathy, neuropathic pain, and dementia. In pre and post-ischemic stroke model, the methanol extract of outer scales of onion bulbs (MEOS) prevented memory loss and motor in-coordination; reduced oxidative stress and cerebral infarct size. This also prevented and ameliorated diabetic neuropathy in mice. The MEOS was fractionated to yield a flavonoid rich fraction (FRF) that successfully reversed ischemia-reperfusion induced neuronal damage, thereby demonstrating that the flavonoids are responsible for the activity. The FRF effectively ameliorated chronic constriction induced neuropathic pain in rats. The FRF was subjected to bioactivity-guided fractionated. It was seen that FRF is more effective as compared to the isolated components probably due to synergism among the constituents (i.e., quercetin and quercetin glucosides) in the FRF. The outer scales of onion bulbs have great potential for prevention as well as for treatment of neuronal disorders. Red onions, with higher amounts of flavonoids as compared to the white onions, produced more significant neuroprotection. Thus, the standardized FRF from the waste material of a commonly used vegetable, especially the red variety, may be developed as a valuable neuroprotective agent.

Keywords: Allium cepa, antioxidant activity, flavonoid rich fraction, neuroprotection

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57 Importance of Detecting Malingering Patients in Clinical Setting

Authors: Sakshi Chopra, Harsimarpreet Kaur, Ashima Nehra

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Objectives: Malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of secondary gains or motives, which may include financial compensation; avoiding work; getting lighter criminal sentences; or simply to attract attention or sympathy. Malingering is different from somatization disorder and factitious disorder. The prevalence of malingering is unknown and difficult to determine. In an estimated study in forensic population, it can reach up to 17% cases. But the accuracy of such estimates is questionable as successful malingerers are not detected and thus, not included. Methods: The case study of a 58 years old, right handed, graduate, pre-morbidly working in a national company with reported history of stroke leading to head injury; cerebral infarction/facial palsy and dementia. He was referred for disability certification so that his job position can be transferred to his son as he could not work anymore. A series of Neuropsychological tests were administered. Results: With a mental age of < 2.5 years; social adaptive functioning was overall < 20 showing profound Mental Retardation, less than 1 year social age in abilities of self-help, eating, dressing, locomotion, occupation, communication, self-direction, and socialization; severely impaired verbal and performance ability, 96% impairment in Activities of Daily Living, with an indication of very severe depression. With inconsistent and fluctuating medical findings and problem descriptions to different health professionals forming the board for his disability, it was concluded that this patient was malingering. Conclusions: Even though it can be easily defined, malingering can be very challenging to diagnosis. Cases of malingering impose a substantial economic burden on the health care system and false attribution of malingering imposes a substantial burden of suffering on a significant proportion of the patient population. Timely, tactful diagnosis and management can help ease this patient burden on the healthcare system. Malingering can be detected by only trained mental health professionals in the clinical setting.

Keywords: disability, India, malingering, neuropsychological assessment

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56 Multi-Scale Modelling of the Cerebral Lymphatic System and Its Failure

Authors: Alexandra K. Diem, Giles Richardson, Roxana O. Carare, Neil W. Bressloff

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Alzheimer's disease (AD) is the most common form of dementia and although it has been researched for over 100 years, there is still no cure or preventive medication. Its onset and progression is closely related to the accumulation of the neuronal metabolite Aβ. This raises the question of how metabolites and waste products are eliminated from the brain as the brain does not have a traditional lymphatic system. In recent years the rapid uptake of Aβ into cerebral artery walls and its clearance along those arteries towards the lymph nodes in the neck has been suggested and confirmed in mice studies, which has led to the hypothesis that interstitial fluid (ISF), in the basement membranes in the walls of cerebral arteries, provides the pathways for the lymphatic drainage of Aβ. This mechanism, however, requires a net reverse flow of ISF inside the blood vessel wall compared to the blood flow and the driving forces for such a mechanism remain unknown. While possible driving mechanisms have been studied using mathematical models in the past, a mechanism for net reverse flow has not been discovered yet. Here, we aim to address the question of the driving force of this reverse lymphatic drainage of Aβ (also called perivascular drainage) by using multi-scale numerical and analytical modelling. The numerical simulation software COMSOL Multiphysics 4.4 is used to develop a fluid-structure interaction model of a cerebral artery, which models blood flow and displacements in the artery wall due to blood pressure changes. An analytical model of a layer of basement membrane inside the wall governs the flow of ISF and, therefore, solute drainage based on the pressure changes and wall displacements obtained from the cerebral artery model. The findings suggest that an active role in facilitating a reverse flow is played by the components of the basement membrane and that stiffening of the artery wall during age is a major risk factor for the impairment of brain lymphatics. Additionally, our model supports the hypothesis of a close association between cerebrovascular diseases and the failure of perivascular drainage.

Keywords: Alzheimer's disease, artery wall mechanics, cerebral blood flow, cerebral lymphatics

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55 Combined Use of FMRI and Voxel-Based Morphometry in Assessment of Memory Impairment in Alzheimer's Disease Patients

Authors: A. V. Sokolov, S. V. Vorobyev, A. Yu. Efimtcev, V. Yu. Lobzin, I. A. Lupanov, O. A. Cherdakov, V. A. Fokin

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Alzheimer’s disease (AD) is the most common form of dementia. Different brain regions are involved to the pathological process of AD. The purpose of this study was to evaluate brain activation by visual memory task in patients with Alzheimer's disease and determine correlation between memory impairment and atrophy of memory specific brain regions of frontal and medial temporal lobes. To investigate the organization of memory and localize cortical areas activated by visual memory task we used functional magnetic resonance imaging and to evaluate brain atrophy of patients with Alzheimer's disease we used voxel-based morphometry. FMRI was performed on 1.5 T MR-scanner Siemens Magnetom Symphony with BOLD (Blood Oxygenation Level Dependent) technique, based on distinctions of magnetic properties of hemoglobin. For test stimuli we used series of 12 not related images for "Baseline" and 12 images with 6 presented before for "Active". Stimuli were presented 3 times with reduction of repeated images to 4 and 2. Patients with Alzheimer's disease showed less activation in hippocampal formation (HF) region and parahippocampal gyrus then healthy persons of control group (p<0.05). The study also showed reduced activation in posterior cingulate cortex (p<0.001). Voxel-based morphometry showed significant atrophy of grey matter in Alzheimer’s disease patients, especially of both temporal lobes (fusiform and parahippocampal gyri); frontal lobes (posterior cingulate and superior frontal gyri). The study showed correlation between memory impairment and atrophy of memory specific brain regions of frontal and medial temporal lobes. Thus, reduced activation in hippocampal formation and parahippocampal gyri, in posterior cingulate gyrus in patients with Alzheimer's disease correlates to significant atrophy of these regions, detected by voxel-based morphometry, and to deterioration of specific cognitive functions.

Keywords: Alzheimer’s disease, functional MRI, voxel-based morphometry

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54 The Incorporation of Themes Related to Islandness in Tourism Branding among Cold-Water, Warm-Water, and Temperate-Water Islands

Authors: Susan C. Graham

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Islands have a long established allure for travellers the world over. From earliest accounts of human history, travellers were drawn by the sense of islandness embodied by these destinations. The concept of islandness describes the essence of what makes islands unique relative to non-islands and extends beyond geographic interpretations by attempting to capture the specific sense of self-exhibited by islanders in relation to their connection to place. The themes most strongly associated with islandness include a) a strong connection to water as both the life blood and a physical barrier, b) a unique culture and robust arts community that is deeply linked to both the island and islanders, c) an appreciation of and for nature, d) a rich sense of history and tradition connected to the place, e) a sense of community and belonging that arose through shared triumphs and struggles, and f) a profound awareness of independence, separateness, and uniqueness derived from both physical and social experience. The island brand, like all brands, is a marketing tactic designed to succinctly express a specific value proposition in simplistic ways which might include a brand symbol, logo, slogan, or representation meant to distinguish one brand from another. If a value proposition is the identification of attributes that separate one brand from another by highlighting the brand’s uniqueness, then presumably island brands may, at least in part, emphasize islandness as part of the destination brand. Yet it may in naïve to expect all islands to brand themselves using similar themes when islands can differ so substantially in terms of population, geography, political climate, economy, culture, and history. Of particular interest is the increased focus on tourism among 'cold-water' islands. This paper will examine the incorporation of themes related to islandness in tourism branding among cold-water, warm-water, and temperate-water islands. The tourism logos of 83 islands were collected and assessed for the use of themes related to islandness, namely water, arts and culture, nature, history and tradition, community and belongingness, and independence, separateness, and uniqueness. The ratings for each theme related to islandness for each of the 83 island destinations were then analyzed to identify if differences exist between cold-water, warm-water, and temperate-water islands. A general consensus of what constitutes 'cold-water' destinations is lacking, therefore a water temperature of 15C was adopted using the guidelines from the National Center for Cold Water Safety. Among these 83 islands, the average high and average low water temperatures of 196 specific locations, including the capital, northern, and southern most points of each island, was recorded to determine if the location was a cold-water (average high and low below 15C), warm-water (average high and low above 15C), or temperate-water (average high above 15C and low below 15C) location.

Keywords: branding, cold-water, islands, tourism

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53 Activation-TV® to Reduce Elderly Loneliness and Insecurity

Authors: Hannele Laaksonen, Seija Nyqvist, Kari Nurmes

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Objectives: In the year 2011 the City of Vaasa started to develop know-how in the technology and the introduction of services for aging people in cooperation with the Polytechnic Novia University of Applied Sciences and VAMK, University of Applied Sciences. The project´s targets included: to help elderly people to maintain their ability to function, to provide them social and physical activities, to prevent their social exclusion, to decrease their feelings of loneliness and insecurity and to develop their technical know-how. Methods: The project was built based on open source code, tailor-made service system and user interface for the elderly living at home and their families, based on the users´ expectations and experiences of services. Activation-TV®-project vas carried out 1.4.2011-31.3.2014. A pilot group of eight elderly persons, who were living at home, were selected to the project. All necessary technical means as well as guidance and teaching equipment were provided to the pilot group. The students of University of Applied Sciences (VAMK, Novia) and employees of Center of Ageing were made all programs to the Activation-TV®. The project group were interviewed after and before intervention. The data were evaluated both qualitatively and quantitatively. Results: The built service includes a video library, a group room for interactive programs and a personal room for bilateral meetings and direct shipment. The program is bilingual and produced in both national languages. The Activation TV® reduced elderly peoples´ (n=8) feelings of emptiness, added mental well-being and quality of life with social contacts. Relatives felt, that they were able to get in to older peoples´ everyday life with Activation TV®. Discussion: The built application was tailored to the model that has not been developed elsewhere in Finland. This model can be copied from one server to another and thus transferred to other municipalities but the program requires its own personnel system management and maintenance as well as program production cooperation between the different actors. This service can be used for the elderly who are living at home without dementia.

Keywords: mental well-being, quality of life, elderly people, Finland

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52 Development of Positron Emission Tomography (PET) Tracers for the in-Vivo Imaging of α-Synuclein Aggregates in α-Synucleinopathies

Authors: Bright Chukwunwike Uzuegbunam, Wojciech Paslawski, Hans Agren, Christer Halldin, Wolfgang Weber, Markus Luster, Thomas Arzberger, Behrooz Hooshyar Yousefi

Abstract:

There is a need to develop a PET tracer that will enable to diagnosis and track the progression of Alpha-synucleinopathies (Parkinson’s disease [PD], dementia with Lewy bodies [DLB], multiple system atrophy [MSA]) in living subjects over time. Alpha-synuclein aggregates (a-syn), which are present in all the stages of disease progression, for instance, in PD, are a suitable target for in vivo PET imaging. For this reason, we have developed some promising a-syn tracers based on a disarylbisthiazole (DABTA) scaffold. The precursors are synthesized via a modified Hantzsch thiazole synthesis. The precursors were then radiolabeled via one- or two-step radiofluorination methods. The ligands were initially screened using a combination of molecular dynamics and quantum/molecular mechanics approaches in order to calculate the binding affinity to a-syn (in silico binding experiments). Experimental in vitro binding assays were also performed. The ligands were further screened in other experiments such as log D, in vitro plasma protein binding & plasma stability, biodistribution & brain metabolite analyses in healthy mice. Radiochemical yields were up to 30% - 72% in some cases. Molecular docking revealed possible binding sites in a-syn and also the free energy of binding to those sites (-28.9 - -66.9 kcal/mol), which correlated to the high binding affinity of the DABTAs to a-syn (Ki as low as 0.5 nM) and selectivity (> 100-fold) over Aβ and tau, which usually co-exist with a-synin some pathologies. The log D values range from 2.88 - 2.34, which correlated with free-protein fraction of 0.28% - 0.5%. Biodistribution experiments revealed that the tracers are taken up (5.6 %ID/g - 7.3 %ID/g) in the brain at 5 min (post-injection) p.i., and cleared out (values as low as 0.39 %ID/g were obtained at 120 min p.i. Analyses of the mice brain 20 min p.i. Revealed almost no radiometabolites in the brain in most cases. It can be concluded that in silico study presents a new venue for the rational development of radioligands with suitable features. The results obtained so far are promising and encourage us to further validate the DABTAs in autoradiography, immunohistochemistry, and in vivo imaging in non-human primates and humans.

Keywords: alpha-synuclein aggregates, alpha-synucleinopathies, PET imaging, tracer development

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51 The Association Between CYP2C19 Gene Distribution and Medical Cannabis Treatment

Authors: Vichayada Laohapiboolkul

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Introduction: As the legal use of cannabis is being widely accepted throughout the world, medical cannabis has been explored in order to become an alternative cure for patients. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are natural cannabinoids found in the Cannabis plant which is proved to have positive treatment for various diseases and symptoms such as chronic pain, neuropathic pain, spasticity resulting from multiple sclerosis, reduce cancer-associated pain, autism spectrum disorders (ASD), dementia, cannabis and opioid dependence, psychoses/schizophrenia, general social anxiety, posttraumatic stress disorder, anorexia nervosa, attention-deficit hyperactivity disorder, and Tourette's disorder. Regardless of all the medical benefits, THC, if not metabolized, can lead to mild up to severe adverse drug reactions (ADR). The enzyme CYP2C19 was found to be one of the metabolizers of THC. However, the suballele CYP2C19*2 manifests as a poor metabolizer which could lead to higher levels of THC than usual, possibly leading to various ADRs. Objective: The aim of this study was to investigate the distribution of CYP2C19, specifically CYP2C19*2, genes in Thai patients treated with medical cannabis along with adverse drug reactions. Materials and Methods: Clinical data and EDTA whole blood for DNA extraction and genotyping were collected from patients for this study. CYP2C19*2 (681G>A, rs4244285) genotyping was conducted using the Real-time PCR (ABI, Foster City, CA, USA). Results: There were 42 medical cannabis-induced ADRs cases and 18 medical cannabis tolerance controls who were included in this study. A total of 60 patients were observed where 38 (63.3%) patients were female and 22 (36.7%) were male, with a range of age approximately 19 - 87 years. The most apparent ADRs for medical cannabis treatment were dry mouth/dry throat (76.7%), followed by tachycardia (70%), nausea (30%) and a few arrhythmias (10%). In the total of 27 cases, we found a frequency of 18 CYP2C19*1/*1 alleles (normal metabolizers, 66.7%), 8 CYP2C19*1/*2 alleles (intermediate metabolizers, 29.6%) and 1 CYP2C19*2/*2 alleles (poor metabolizers, 3.7%). Meanwhile, 63.6% of CYP2C19*1/*1, 36.3% and 0% of CYP2C19*1/*2 and *2/*2 in the tolerance controls group, respectively. Conclusions: This is the first study to confirm the distribution of CYP2C19*2 allele and the prevalence of poor metabolizer genes in Thai patients who received medical cannabis for treatment. Thus, CYP2C19 allele might serve as a pharmacogenetics marker for screening before initiating treatment.

Keywords: medical cannabis, adverse drug reactions, CYP2C19, tetrahydrocannabinol, poor metabolizer

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50 Confessors in Im Sun-dŭk’s Short Stories: Interiority of Korean Women under the End of Japanese Colonial Rule

Authors: Min Koo Choi

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The paper will examine Im Sun-dŭk’s two short stories, 'Iryoil' (Sunday, 1937) and 'Nazuoya' (A Godmother, 1942), which illuminate the subjects of Korean intellectuals going through the later period of a harsh and oppressive Japanese colonial rule. When Japan went to war against China in 1937, Korea, a colony of Japan since 1910, became an outpost for Japanese expansionism into China, and the Korean people were mobilized into the war effort. Nationalist movements and radical ideas that posed a threat and opposition to Japanese colonial rule in Korea and its colonial expansionism were ruthlessly suppressed, and Koreans were forcibly assimilated into becoming Japanese citizens without political rights. Racial discrimination between Koreans and Japanese was prevalent. Im Sun-dŭk, who participated in the Socialist movement in the 1930s, had his debut as a literary writer and a critic in the late 1930s, when Korean literary society was reincorporated in order to collaborate with the Japanese war effort through writing and public speech. Sun-duk's writing illuminates the unique internal landscape of a female subject who strives to live on while preserving her commitment and dignity under the circumstances that force Korean intellectuals either to collaborate with or acquiesce to Japanese colonial rule. 'Iryoil' (Sunday, 1937) foregrounds an educated intellectual, Hyeyŏng, who supplies her fiancé in prison for political involvement in resistance against Japan. On Sundays, she turns down her friends’ suggestion for enjoying holidays outside, due to her indebtedness to her fiancé. Her fiancé's imprisonment indicates the social conscience that still remains, and she seeks to share the commitment and suffering with her fiancé. The short story 'Nazuoya' (A Godmother, 1942), written in Japanese due to the suppression of Korean language publications at the time, also problematizes Japanese policy that forces Koreans to change their names into Japanese. Through the narrator I, who struggles to find a meaningful name for her cousin brother’s baby, she highlights how meaningful one’s name is for one’s life and identity. What makes her two stories unique is that her writing draws other people’s confessions into its own narrative through fragmentary forms, such as part of letter or reflection. The voices of others are intersected with the main character in 'Iryoil' (Sunday, 1937) and a narrator in 'Nazuoya' (A Godmother, 1942). In many ways, the narrator and main character provide the confessional voices who display the characters' gloomy interiorities. Even though these confessional voices do not share the commitment and values, both the main character and I in the stories reveal a more open set of viewpoints to them. In this way, they seek to form bonds and encouragement and acquire a more resilient sensibility that embraces those who strive to survive and endure in the gloomy days of the later period of Japanese colonial rule.

Keywords: Im Sun-dŭk, Japanese colonial rule, Korean literature, socialist movement

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49 AI-based Digital Healthcare Application to Assess and Reduce Fall Risks in Residents of Nursing Homes in Germany

Authors: Knol Hester, Müller Swantje, Danchenko Natalya

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Objective: Falls in older people cause an autonomy loss and result in an economic burden. LCare is an AI-based application to manage fall risks. The study's aim was to assess the effect of LCare use on patient outcomes in nursing homes in Germany. Methods: LCare identifies and monitors fall risks through a 3D-gait analysis and a digital questionnaire, resulting in tailored recommendations on fall prevention. A study was conducted with AOK Baden-Württemberg (01.09.2019- 31.05.2021) in 16 care facilities. Assessments at baseline and follow-up included: a fall risk score; falls (baseline: fall history in the past 12 months; follow-up: a fall record since the last analysis); fall-related injuries and hospitalizations; gait speed; fear of falling; psychological stress; nurses experience on app use. Results: 94 seniors were aged 65-99 years at the initial analysis (average 84±7 years); 566 mobility analyses were carried out in total. On average, the fall risk was reduced by 17.8 % as compared to the baseline (p<0.05). The risk of falling decreased across all subgroups, including a trend in dementia patients (p=0.06), constituting 43% of analyzed patients, and patients with walking aids (p<0.05), constituting 76% of analyzed patients. There was a trend (p<0.1) towards fewer falls and fall-related injuries and hospitalizations (baseline: 23 seniors who fell, 13 injury consequences, 9 hospitalizations; follow-up: 14 seniors who fell, 2 injury consequences, 0 hospitalizations). There was a 16% improvement in gait speed (p<0.05). Residents reported less fear of falling and psychological stress by 38% in both outcomes (p<0.05). 81% of nurses found LCare effective. Conclusions: In the presented study, the use of LCare app was associated with a reduction of fall risk among nursing home residents, improvement of health-related outcomes, and a trend toward reduction in injuries and hospitalizations. LCare may help to improve senior resident care and save healthcare costs.

Keywords: falls, digital healthcare, falls prevention, nursing homes, seniors, AI, digital assessment

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48 Inappropriate Prescribing Defined by START and STOPP Criteria and Its Association with Adverse Drug Events among Older Hospitalized Patients

Authors: Mohd Taufiq bin Azmy, Yahaya Hassan, Shubashini Gnanasan, Loganathan Fahrni

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Inappropriate prescribing in older patients has been associated with resource utilization and adverse drug events (ADE) such as hospitalization, morbidity and mortality. Globally, there is a lack of published data on ADE induced by inappropriate prescribing. Our study is specific to an older population and is aimed at identifying risk factors for ADE and to develop a model that will link ADE to inappropriate prescribing. The design of the study was prospective whereby computerized medical records of 302 hospitalized elderly aged 65 years and above in 3 public hospitals in Malaysia (Hospital Serdang, Hospital Selayang and Hospital Sungai Buloh) were studied over a 7 month period from September 2013 until March 2014. Potentially inappropriate medications and potential prescribing omissions were determined using the published and validated START-STOPP criteria. Patients who had at least one inappropriate medication were included in Phase II of the study where ADE were identified by local expert consensus panel based on the published and validated Naranjo ADR probability scale. The panel also assessed whether ADE were causal or contributory to current hospitalization. The association between inappropriate prescribing and ADE (hospitalization, mortality and adverse drug reactions) was determined by identifying whether or not the former was causal or contributory to the latter. Rate of ADE avoidability was also determined. Our findings revealed that the prevalence of potential inappropriate prescribing was 58.6%. A total of ADEs were detected in 31 of 105 patients (29.5%) when STOPP criteria were used to identify potentially inappropriate medication; All of the 31 ADE (100%) were considered causal or contributory to admission. Of the 31 ADEs, 28 (90.3%) were considered avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when a potentially inappropriate medication was prescribed (odds ratio, 11.18; 95% confidence interval [CI], 5.014 - 24.93; p < .001). The medications identified by STOPP criteria, are significantly associated with avoidable ADE in older people that cause or contribute to urgent hospitalization but contributed less towards morbidity and mortality. Findings of the study underscore the importance of preventing inappropriate prescribing.

Keywords: adverse drug events, appropriate prescribing, health services research

Procedia PDF Downloads 395
47 Prediction of Alzheimer's Disease Based on Blood Biomarkers and Machine Learning Algorithms

Authors: Man-Yun Liu, Emily Chia-Yu Su

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Alzheimer's disease (AD) is the public health crisis of the 21st century. AD is a degenerative brain disease and the most common cause of dementia, a costly disease on the healthcare system. Unfortunately, the cause of AD is poorly understood, furthermore; the treatments of AD so far can only alleviate symptoms rather cure or stop the progress of the disease. Currently, there are several ways to diagnose AD; medical imaging can be used to distinguish between AD, other dementias, and early onset AD, and cerebrospinal fluid (CSF). Compared with other diagnostic tools, blood (plasma) test has advantages as an approach to population-based disease screening because it is simpler, less invasive also cost effective. In our study, we used blood biomarkers dataset of The Alzheimer’s disease Neuroimaging Initiative (ADNI) which was funded by National Institutes of Health (NIH) to do data analysis and develop a prediction model. We used independent analysis of datasets to identify plasma protein biomarkers predicting early onset AD. Firstly, to compare the basic demographic statistics between the cohorts, we used SAS Enterprise Guide to do data preprocessing and statistical analysis. Secondly, we used logistic regression, neural network, decision tree to validate biomarkers by SAS Enterprise Miner. This study generated data from ADNI, contained 146 blood biomarkers from 566 participants. Participants include cognitive normal (healthy), mild cognitive impairment (MCI), and patient suffered Alzheimer’s disease (AD). Participants’ samples were separated into two groups, healthy and MCI, healthy and AD, respectively. We used the two groups to compare important biomarkers of AD and MCI. In preprocessing, we used a t-test to filter 41/47 features between the two groups (healthy and AD, healthy and MCI) before using machine learning algorithms. Then we have built model with 4 machine learning methods, the best AUC of two groups separately are 0.991/0.709. We want to stress the importance that the simple, less invasive, common blood (plasma) test may also early diagnose AD. As our opinion, the result will provide evidence that blood-based biomarkers might be an alternative diagnostics tool before further examination with CSF and medical imaging. A comprehensive study on the differences in blood-based biomarkers between AD patients and healthy subjects is warranted. Early detection of AD progression will allow physicians the opportunity for early intervention and treatment.

Keywords: Alzheimer's disease, blood-based biomarkers, diagnostics, early detection, machine learning

Procedia PDF Downloads 316
46 The Theotokos of the Messina Missal as a Byzantine Icon in Norman Sicily: A Study on Patronage and Devotion

Authors: Jesus Rodriguez Viejo

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The aim of this paper is to study cross-cultural interactions between the West and Byzantium, in the fields of art and religion, by analyzing the decoration of one luxury manuscript. The Spanish National Library is home to one of the most extraordinary examples of illuminated manuscript production of Norman Sicily – the Messina Missal. Dating from the late twelfth century, this liturgical book was the result of the intense activity of artistic patronage of an Englishman, Richard Palmer. Appointed bishop of the Sicilian city in the second half of the century, Palmer set a painting workshop attached to his cathedral. The illuminated manuscripts produced there combine a clear Byzantine iconographic language with a myriad of elements imported from France, such as a large number of decorated initials. The most remarkable depiction contained in the Missal is that of the Theotokos (fol. 80r). Its appearance immediately recalls portative Byzantine icons of the Mother of God in South Italy and Byzantium and implies the intervention of an artist familiar with icon painting. The richness of this image is a clear proof of the prestige that Byzantine art enjoyed in the island after the Norman takeover. The production of the school of Messina under Richard Palmer could be considered a counterpart in the field of manuscript illumination of the court art of the Sicilian kings in Palermo and the impressive commissions for the cathedrals of Monreale and Cefalù. However, the ethnic composition of Palmer’s workshop has never been analyzed and therefore, we intend to shed light on the permanent presence of Greek-speaking artists in Norman Messina. The east of the island was the last stronghold of the Greeks and soon after the Norman conquest, the previous exchanges between the cities of this territory and Byzantium restarted again, mainly by way of trade. Palmer was not a Norman statesman, but a churchman and his love for religion and culture prevailed over the wars and struggles for power of the Sicilian kingdom in the central Mediterranean. On the other hand, the representation of the Theotokos can prove that Eastern devotional approaches to images were still common in the east of the island more than a century after the collapse of Byzantine rule. Local Norman lords repeatedly founded churches devoted to Greek saints and medieval Greek-speaking authors were widely copied in Sicilian scriptoria. The Madrid Missal and its Theotokos are doubtless the product of Western initiative but in a land culturally dominated by Byzantium. Westerners, such as Palmer and his circle, could have been immersed in this Hellenophile culture and therefore, naturally predisposed to perform prayers and rituals, in both public and private contexts, linked to ideas and practices of Greek origin, such as the concept of icon.

Keywords: history of art, byzantine art, manuscripts, norman sicily, messina, patronage, devotion, iconography

Procedia PDF Downloads 340
45 Wrestling with Religion: A Theodramatic Exploration of Morality in Popular Culture

Authors: Nicholas Fieseler

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The nature of religion implicit in popular culture is relevant both in and out of the university. The traditional rules-based conception of religion and the ethical systems that emerge from them do not necessarily convey the behavior of daily life as it exists apart from spaces deemed sacred. This paper proposes to examine the religion implicit in the popular culture phenomenon of professional wrestling and how that affects the understanding of popular religion. Pro wrestling, while frequently dismissed, offers a unique manner through which to re-examine religion in popular culture. A global phenomenon, pro wrestling occupies a distinct space in numerous countries and presents a legitimate reflection of human behavior cross-culturally on a scale few other phenomena can equal. Given its global viewership of millions, it should be recognized as a significant means of interpreting the human attraction to violence and its association with religion in general. Hans Urs von Balthasar’s theory of Theodrama will be used to interrogate the inchoate religion within pro wrestling. While Balthasar developed theodrama within the confines of Christian theology; theodrama contains remarkable versatility in its potential utility. Since theodrama re-envisions reality as drama, the actions of every human actor on the stage contributes to the play’s development, and all action contains some transcendent value. It is in this sense that even the “low brow” activity of pro wrestling may be understood in religious terms. Moreover, a pro wrestling storyline acts as a play within a play: the struggles in a pro wrestling match reflect the human attitudes toward life as it exists in the sacred and profane realms. The indistinct lines separating traditionally good (face) from traditionally bad (heel)wrestlers mirror the moral ambiguity in which many people interpret life. This blurred distinction between good and bad, and large segments of an audience’s embrace of the heel wrestlers, reveal ethical constraints that guide the everyday values of pro wrestling spectators, a moral ambivalence that is often overlooked by traditional religious systems, and which has hitherto been neglected in the academic literature on pro wrestling. The significance of interpreting the religion implicit in pro wrestling through a the dramatic lens extends beyond pro wrestling specifically and can examine the religion implicit in popular culture in general. The use of theodrama mitigates the rigid separation often ascribed to areas deemed sacred/ profane, ortranscendent / immanent, enabling a re-evaluation of religion and ethical systems as practiced in popular culture. The use of theodrama will be expressed by utilizing the pro wrestling match as a literary text that reflects the society from which it emerges. This analysis will also reveal the complex nature of religion in popular culture and provides new directions for the academic study of religion. This project consciously bridges the academic and popular realms. The goal of the research is not to add only to the academic literature on implicit religion in popular culture but to publish it in a form which speaks to those outside the standard academic audiences for such work.

Keywords: ethics, popular religion, professional wrestling, theodrama

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44 Law, Resistance, and Development in Georgia: A Case of Namakhvani HPP

Authors: Konstantine Eristavi

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The paper will contribute to the discussion on the pitfalls, limits, and possibilities of legal and rights discourse in opposing large infrastructural projects in the context of neoliberal globalisation. To this end, the paper will analyse the struggle against the Namakhvani HPP project in Georgia. The latter has been hailed by the government as one of the largest energy projects in the history of the country, with an enormous potential impact on energy security, energy independence, economic growth, and development. This takes place against the backdrop of decades of market-led -or neoliberal- model of development in Georgia, characterised by structural adjustments, deregulation, privatisation, and Laissez-Fair approach to foreign investment. In this context, the Georgian state vies with other low and middle-income countries for foreign capital by offering to potential investors, on the one hand, exemptions from social and environmental regulations and, on the other hand, huge legal concessions and safeguards, thereby participating in what is often called a “race to the bottom.” The Namakhvani project is a good example of this. At every stage, the project has been marred with violations of laws and regulations concerning transparency, participation, social and environmental regulations, and so on. Moreover, the leaked contract between the state and the developer reveals the contractual safeguards which effectively insulate the investment throughout the duration of the contract from the changes in the national law that might adversely affect investors’ rights and returns. These clauses, aimed at preserving investors' economic position, place the contract above national law in many respects and even conflict with fundamental constitutional rights. In response to the perceived deficiencies of the project, one of the largest and most diverse social movements in the history of post-soviet Georgia has been assembled, consisting of the local population, conservative and leftist groups, human rights and environmental NGOs, etc. Crucially, the resistance movement is actively using legal tools. In order to analyse both the limitations and possibilities of legal discourse, the paper will distinguish between internal and immanent critiques. Law as internal critique, in the context of the struggles around the Namakhvani project, while potentially fruitful in hindering the project, risks neglecting and reproducing those factors -e.g., the particular model of development- that made such contractual concessions and safeguards and concomitant rights violations possible in the first place. On the other hand, the use of rights and law as part of immanent critique articulates a certain incapacity on the part of the addressee government to uphold existing laws and rights due to structural factors, hence, pointing to a need for a fundamental change. This 'ruptural' form of legal discourse that the movement employs makes it possible to go beyond the discussion around the breaches of law and enables a critical deliberation on the development model within which these violations and extraordinary contractual safeguards become necessary. It will be argued that it is this form of immanent critique that expresses the emancipatory potential of legal discourse.

Keywords: law, resistance, development, rights

Procedia PDF Downloads 75
43 Employing Remotely Sensed Soil and Vegetation Indices and Predicting ‎by Long ‎Short-Term Memory to Irrigation Scheduling Analysis

Authors: Elham Koohikerade, Silvio Jose Gumiere

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In this research, irrigation is highlighted as crucial for improving both the yield and quality of ‎potatoes due to their high sensitivity to soil moisture changes. The study presents a hybrid Long ‎Short-Term Memory (LSTM) model aimed at optimizing irrigation scheduling in potato fields in ‎Quebec City, Canada. This model integrates model-based and satellite-derived datasets to simulate ‎soil moisture content, addressing the limitations of field data. Developed under the guidance of the ‎Food and Agriculture Organization (FAO), the simulation approach compensates for the lack of direct ‎soil sensor data, enhancing the LSTM model's predictions. The model was calibrated using indices ‎like Surface Soil Moisture (SSM), Normalized Vegetation Difference Index (NDVI), Enhanced ‎Vegetation Index (EVI), and Normalized Multi-band Drought Index (NMDI) to effectively forecast ‎soil moisture reductions. Understanding soil moisture and plant development is crucial for assessing ‎drought conditions and determining irrigation needs. This study validated the spectral characteristics ‎of vegetation and soil using ECMWF Reanalysis v5 (ERA5) and Moderate Resolution Imaging ‎Spectrometer (MODIS) data from 2019 to 2023, collected from agricultural areas in Dolbeau and ‎Peribonka, Quebec. Parameters such as surface volumetric soil moisture (0-7 cm), NDVI, EVI, and ‎NMDI were extracted from these images. A regional four-year dataset of soil and vegetation moisture ‎was developed using a machine learning approach combining model-based and satellite-based ‎datasets. The LSTM model predicts soil moisture dynamics hourly across different locations and ‎times, with its accuracy verified through cross-validation and comparison with existing soil moisture ‎datasets. The model effectively captures temporal dynamics, making it valuable for applications ‎requiring soil moisture monitoring over time, such as anomaly detection and memory analysis. By ‎identifying typical peak soil moisture values and observing distribution shapes, irrigation can be ‎scheduled to maintain soil moisture within Volumetric Soil Moisture (VSM) values of 0.25 to 0.30 ‎m²/m², avoiding under and over-watering. The strong correlations between parcels suggest that a ‎uniform irrigation strategy might be effective across multiple parcels, with adjustments based on ‎specific parcel characteristics and historical data trends. The application of the LSTM model to ‎predict soil moisture and vegetation indices yielded mixed results. While the model effectively ‎captures the central tendency and temporal dynamics of soil moisture, it struggles with accurately ‎predicting EVI, NDVI, and NMDI.‎

Keywords: irrigation scheduling, LSTM neural network, remotely sensed indices, soil and vegetation ‎monitoring

Procedia PDF Downloads 36
42 Impact of Sufism on Indian Cinema: A New Cultural Construct for Mediating Conflict

Authors: Ravi Chaturvedi, Ghanshyam Beniwal

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Without going much into the detail of long history of Sufism in the world and the etymological definition of the word ‘Sufi’, it will be sufficient to underline that the concept of Sufism was to focus the mystic power on the spiritual dimension of Islam with a view-shielding the believers from the outwardly and unrealistic dogma of the faith. Sufis adopted rather a liberal view in propagating the religious order of Islam suitable to the cultural and social environment of the land. It is, in fact, a mission of higher religious order of any faith, which disdains strife and conflict in any form. The joy of self-realization being the essence of religion is experienced after a long spiritual practice. India had Sufi and Bhakti (devotion) traditions in Islam and Hinduism, respectively. Both Sufism and Bhakti traditions were based on respect for different religions. The poorer and lower caste Hindus and Muslims were greatly influenced by these traditions. Unlike Ulemas and Brahmans, the Sufi and Bhakti saints were highly tolerant and open to the truth in other faiths. They never adopted sectarian attitudes and were never involved in power struggles. They kept away from power structures. Sufism is integrated with the Indian cinema since its initial days. In the earliest Bollywood movies, Sufism was represented in the form of qawwali which made its way from dargahs (shrines). Mixing it with pop influences, Hindi movies began using Sufi music in a big way only in the current decade. However, of late, songs with Sufi influences have become de rigueur in almost every film being released these days, irrespective of the genre, whether it is a romantic Gangster or a cerebral Corporate. 'Sufi is in the DNA of the Indian sub-continent', according to several contemporary filmmakers, critics, and spectators.The inherent theatricality motivates the performer of the 'Sufi' rituals for a dramatic behavior. The theatrical force of these stages of Sufi practice is so powerful that even the spectator cannot resist himself from being moved. In a multi-cultural country like India, the mediating streams have acquired a multi-layered importance in recent history. The second half of Indian post-colonial era has witnessed a regular chain of some conflicting religio-political waves arising from various sectarian camps in the country, which have compelled the counter forces to activate for keeping the spirit of composite cultural ethos alive. The study has revealed that the Sufi practice methodology is also being adapted for inclusion of spirituality in life at par to Yoga practice. This paper, a part of research study, is an attempt to establish that the Sufism in Indian cinema is one such mediating voice which is very active and alive throughout the length and width of the country continuously bridging the gap between various religious and social factions, and have a significant role to play in future as well.

Keywords: Indian cinema, mediating voice, Sufi, yoga practice

Procedia PDF Downloads 486
41 Lived Experiences and Perspectives of Adult Survivors of Incest-Related Childhood Sexual Abuse

Authors: Varsha Puri, Sharon Hudson, Ian Kim

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Background: Incest-related childhood sexual abuse (IRCSA) is challenging to study due to the shame and secrecy experienced by its survivors. Ramifications of IRCSA worsen when it is unidentified, and interventions are not made. IRCSA perspectives are essential for future prevention and intervention strategies. However, there is limited understanding of this population’s experiences, perspectives, and long-term struggles. To date, research for IRCSA has utilized data from treatment programs and qualitative research with cohorts of 10-20 people, much of the data is from 10-40 years prior. Methods. In June 2018, an anonymous online survey was posted to multiple social media sites (e.g., Facebook IRCSA groups) and sexual abuse resource sites. Survey responses were collected for a year. The survey collected non-identifying demographics, IRCSA experiences, and outcomes data. Results: We obtained 1310 completed surveys. Demographics of all ages, racial backgrounds, financial backgrounds, and genders were obtained; the majority identified as white (81%) and female (76%). Childhood sexual abuse (CSA) started before the age of 6 in 49% and was endured for more than one year in 84% of respondents, and 39% reported ten or more years of abuse. CSA by multiple perpetrators occurred in 58%, while 8% had ten or more perpetrators. CSA by perpetrators under 21 years old was reported by 46%. Female perpetrators were reported by 28% of respondents. Fathers were the highest reported sexual abusers at 60%, and mothers were reported at 17%. Only 16% reported that at least one of their perpetrators was prosecuted for sexual abuse of a minor. Respondents confirmed that 54% of the time, they informed an adult of the abuse; only 2% agreed that “an intervention was made by the family that protected me.” A majority reported that IRCSA has negatively impacted their intimate/sexual relationships (96%) and mental health (96%). A majority reported negative impacts on biological family relationships (88%), physical health (73%), finances (59%), educational achievement (57%), and employment (56%). When asked about suffering from addiction, 85% of respondents answered yes. Prevention strategies selected most by respondents include early school education around CSA prevention (67%), removing the statute of limitations for reporting CSA (69%), and improved laws protecting IRCSA survivors (63%). Conclusion: The data document that IRCSA can be pervasive, and the dearth of intervention and support for survivors have major lasting impacts. Survivors have a unique and valuable perspective on what interventions are needed to prevent IRCSA and support survivors; their voice has long been unheard in crafting prevention and intervention policies and services. These results thus provide an important call to action from these critical stakeholders. Pediatricians should recognize that perpetrators can be pediatric patients, women, and parents. Pediatricians can advocate for more early CSA prevention education and policy changes that remove the statute of limitations for reporting CSA.

Keywords: incest, childhood sexual abuse, incest-related childhood sexual abuse, incest survivor

Procedia PDF Downloads 87
40 Decentralized Peak-Shaving Strategies for Integrated Domestic Batteries

Authors: Corentin Jankowiak, Aggelos Zacharopoulos, Caterina Brandoni

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In a context of increasing stress put on the electricity network by the decarbonization of many sectors, energy storage is likely to be the key mitigating element, by acting as a buffer between production and demand. In particular, the highest potential for storage is when connected closer to the loads. Yet, low voltage storage struggles to penetrate the market at a large scale due to the novelty and complexity of the solution, and the competitive advantage of fossil fuel-based technologies regarding regulations. Strong and reliable numerical simulations are required to show the benefits of storage located near loads and promote its development. The present study was restrained from excluding aggregated control of storage: it is assumed that the storage units operate independently to one another without exchanging information – as is currently mostly the case. A computationally light battery model is presented in detail and validated by direct comparison with a domestic battery operating in real conditions. This model is then used to develop Peak-Shaving (PS) control strategies as it is the decentralized service from which beneficial impacts are most likely to emerge. The aggregation of flatter, peak- shaved consumption profiles is likely to lead to flatter and arbitraged profile at higher voltage layers. Furthermore, voltage fluctuations can be expected to decrease if spikes of individual consumption are reduced. The crucial part to achieve PS lies in the charging pattern: peaks depend on the switching on and off of appliances in the dwelling by the occupants and are therefore impossible to predict accurately. A performant PS strategy must, therefore, include a smart charge recovery algorithm that can ensure enough energy is present in the battery in case it is needed without generating new peaks by charging the unit. Three categories of PS algorithms are introduced in detail. First, using a constant threshold or power rate for charge recovery, followed by algorithms using the State Of Charge (SOC) as a decision variable. Finally, using a load forecast – of which the impact of the accuracy is discussed – to generate PS. A performance metrics was defined in order to quantitatively evaluate their operating regarding peak reduction, total energy consumption, and self-consumption of domestic photovoltaic generation. The algorithms were tested on load profiles with a 1-minute granularity over a 1-year period, and their performance was assessed regarding these metrics. The results show that constant charging threshold or power are far from optimal: a certain value is not likely to fit the variability of a residential profile. As could be expected, forecast-based algorithms show the highest performance. However, these depend on the accuracy of the forecast. On the other hand, SOC based algorithms also present satisfying performance, making them a strong alternative when the reliable forecast is not available.

Keywords: decentralised control, domestic integrated batteries, electricity network performance, peak-shaving algorithm

Procedia PDF Downloads 109
39 Monitoring Memories by Using Brain Imaging

Authors: Deniz Erçelen, Özlem Selcuk Bozkurt

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The course of daily human life calls for the need for memories and remembering the time and place for certain events. Recalling memories takes up a substantial amount of time for an individual. Unfortunately, scientists lack the proper technology to fully understand and observe different brain regions that interact to form or retrieve memories. The hippocampus, a complex brain structure located in the temporal lobe, plays a crucial role in memory. The hippocampus forms memories as well as allows the brain to retrieve them by ensuring that neurons fire together. This process is called “neural synchronization.” Sadly, the hippocampus is known to deteriorate often with age. Proteins and hormones, which repair and protect cells in the brain, typically decline as the age of an individual increase. With the deterioration of the hippocampus, an individual becomes more prone to memory loss. Many memory loss starts off as mild but may evolve into serious medical conditions such as dementia and Alzheimer’s disease. In their quest to fully comprehend how memories work, scientists have created many different kinds of technology that are used to examine the brain and neural pathways. For instance, Magnetic Resonance Imaging - or MRI- is used to collect detailed images of an individual's brain anatomy. In order to monitor and analyze brain functions, a different version of this machine called Functional Magnetic Resonance Imaging - or fMRI- is used. The fMRI is a neuroimaging procedure that is conducted when the target brain regions are active. It measures brain activity by detecting changes in blood flow associated with neural activity. Neurons need more oxygen when they are active. The fMRI measures the change in magnetization between blood which is oxygen-rich and oxygen-poor. This way, there is a detectable difference across brain regions, and scientists can monitor them. Electroencephalography - or EEG - is also a significant way to monitor the human brain. The EEG is more versatile and cost-efficient than an fMRI. An EEG measures electrical activity which has been generated by the numerous cortical layers of the brain. EEG allows scientists to be able to record brain processes that occur after external stimuli. EEGs have a very high temporal resolution. This quality makes it possible to measure synchronized neural activity and almost precisely track the contents of short-term memory. Science has come a long way in monitoring memories using these kinds of devices, which have resulted in the inspections of neurons and neural pathways becoming more intense and detailed.

Keywords: brain, EEG, fMRI, hippocampus, memories, neural pathways, neurons

Procedia PDF Downloads 76
38 An EEG-Based Scale for Comatose Patients' Vigilance State

Authors: Bechir Hbibi, Lamine Mili

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Understanding the condition of comatose patients can be difficult, but it is crucial to their optimal treatment. Consequently, numerous scoring systems have been developed around the world to categorize patient states based on physiological assessments. Although validated and widely adopted by medical communities, these scores still present numerous limitations and obstacles. Even with the addition of additional tests and extensions, these scoring systems have not been able to overcome certain limitations, and it appears unlikely that they will be able to do so in the future. On the other hand, physiological tests are not the only way to extract ideas about comatose patients. EEG signal analysis has helped extensively to understand the human brain and human consciousness and has been used by researchers in the classification of different levels of disease. The use of EEG in the ICU has become an urgent matter in several cases and has been recommended by medical organizations. In this field, the EEG is used to investigate epilepsy, dementia, brain injuries, and many other neurological disorders. It has recently also been used to detect pain activity in some regions of the brain, for the detection of stress levels, and to evaluate sleep quality. In our recent findings, our aim was to use multifractal analysis, a very successful method of handling multifractal signals and feature extraction, to establish a state of awareness scale for comatose patients based on their electrical brain activity. The results show that this score could be instantaneous and could overcome many limitations with which the physiological scales stock. On the contrary, multifractal analysis stands out as a highly effective tool for characterizing non-stationary and self-similar signals. It demonstrates strong performance in extracting the properties of fractal and multifractal data, including signals and images. As such, we leverage this method, along with other features derived from EEG signal recordings from comatose patients, to develop a scale. This scale aims to accurately depict the vigilance state of patients in intensive care units and to address many of the limitations inherent in physiological scales such as the Glasgow Coma Scale (GCS) and the FOUR score. The results of applying version V0 of this approach to 30 patients with known GCS showed that the EEG-based score similarly describes the states of vigilance but distinguishes between the states of 8 sedated patients where the GCS could not be applied. Therefore, our approach could show promising results with patients with disabilities, injected with painkillers, and other categories where physiological scores could not be applied.

Keywords: coma, vigilance state, EEG, multifractal analysis, feature extraction

Procedia PDF Downloads 55
37 The Environmental Conflict over the Trans Mountain Pipeline Expansion in Burnaby, British Columbia, Canada

Authors: Emiliano Castillo

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The aim of this research is to analyze the origins, the development and possible outcomes of the environmental conflict between grassroots organizations, indigenous communities, Kinder Morgan Corporation, and the Canadian government over the Trans Mountain pipeline expansion in Burnaby, British Columbia, Canada. Building on the political ecology and the environmental justice theoretical framework, this research examines the impacts and risks of tar sands extraction, production, and transportation on climate change, public health, the environment, and indigenous people´s rights over their lands. This study is relevant to the environmental justice and political ecology literature because it discusses the unequal distribution of environmental costs and economic benefits of tar sands development; and focuses on the competing interests, needs, values, and claims of the actors involved in the conflict. Furthermore, it will shed light on the context, conditions, and processes that lead to the organization and mobilization of a grassroots movement- comprised of indigenous communities, citizens, scientists, and non-governmental organizations- that draw significant media attention by opposing the Trans Mountain pipeline expansion. Similarly, the research will explain the differences and dynamics within the grassroots movement. This research seeks to address the global context of the conflict by studying the links between the decline of conventional oil production, the rise of unconventional fossil fuels (e.g. tar sands), climate change, and the struggles of low-income, ethnic, and racial minorities over the territorial expansion of extractive industries. Data will be collected from legislative documents, policy and technical reports, scientific journals, newspapers articles, participant observation, and semi-structured interviews with representatives and members of the grassroots organizations, indigenous communities, and Burnaby citizens that oppose the Trans Mountain pipeline. These interviews will focus on their perceptions of the risks of the Trans Mountain pipeline expansion; the roots of the anti-tar sands movement; the differences and dynamics within the movement; and the strategies to defend the livelihoods of local communities and the environment against tar sands development. This research will contribute to the understanding of the underlying causes of the environmental conflict between the Canadian government, Kinder Morgan, and grassroots organizations over tar sands extraction, production, and transportation in Burnaby, British Columbia, Canada. Moreover, this work will elucidate the transformations of society-nature relationships brought by tar sands development. Research findings will provide scientific information about how the resistance movement in British Columbia can challenge the dominant narrative on tar sands, exert greater influence in environmental politics, and efficiently defend Indigenous people´s rights to lands. Furthermore, this research will shed light into how grassroots movements can contribute towards the building of more inclusive and sustainable societies.

Keywords: environmental conflict, environmental justice, extractive industry, indigenous communities, political ecology, tar sands

Procedia PDF Downloads 274
36 Symmetric Corticobasal Degeneration: Case Report

Authors: Sultan Çağırıcı, Arsida Bajrami, Beyza Aslan, Hacı Ali Erdoğan, Nejla Sözer Topçular, Dilek Bozkurt, Vildan Yayla

Abstract:

Objective: Corticobasal syndrome (CBS) is phenotypically characterized by asymmetric rigidity, apraxia, alien-limb phenomenon, cortical sensory loss, dystonia and myoclonus. The underlying pathologies consists of corticobasal degeneration (CBD), progressive supra nuclear palsy, Alzheimer's, Creutzfeldt-Jakob and frontotemporal degeneration. CBD is a degenerative disease with clinical symptoms related to the prominent involvement of cerebral cortex and basal ganglia. CBD is a pathological diagnosis and antemortem clinical diagnosis may change many times. In this paper, we described the clinical features and discussed a cases diagnosed with symmetric CBS because of its rarity. Case: Seventy-five-year-old woman presented with a three years history of difficulty in speaking and reading. Involuntary hand jerks and slowness of movement also had began in the last six months. In the neurological examination the patient was alert but not fully oriented. The speech was non-fluent, word finding difficulties were present. Bilateral limited upgaze, bradimimia, bilateral positive cogwheel' rigidity but prominent in the right side, postural tremor and negative myoclonus during action on the left side were detected. Receptive language was normal but expressive language and repetition were impaired. Acalculia, alexia, agraphia and apraxia were also present. CSF findings were unremarkable except for elevated protein level (75 mg/dL). MRI revealed bilateral symmetric cortical atrophy prominent in the frontoparietal region. PET showed hypometabolism in the left caudate nucleus. Conclusion: The increase of data related to neurodegenerative disorders associated with dementia, movement disorders and other findings results in an expanded range of diagnosis and transitions between clinical diagnosis. When considered the age of onset, clinical symptoms, imaging findings and prognosis of this patient, clinical diagnosis was CBS and pathologic diagnosis as probable CBD. Imaging of CBD usually consist of typical asymmetry between hemispheres. Still few cases with clinical appearance of CBD may show symmetrical cortical cerebral atrophy. It is presented this case who was diagnosed with CBD although we found symmetrical cortical cerebral atrophy in MRI.

Keywords: symmetric cortical atrophy, corticobasal degeneration, corticobasal syndrome

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35 Approaches to Inducing Obsessional Stress in Obsessive-Compulsive Disorder (OCD): An Empirical Study with Patients Undergoing Transcranial Magnetic Stimulation (TMS) Therapy

Authors: Lucia Liu, Matthew Koziol

Abstract:

Obsessive-compulsive disorder (OCD), a long-lasting anxiety disorder involving recurrent, intrusive thoughts, affects over 2 million adults in the United States. Transcranial magnetic stimulation (TMS) stands out as a noninvasive, cutting-edge therapy that has been shown to reduce symptoms in patients with treatment-resistant OCD. The Food and Drug Administration (FDA) approved protocol pairs TMS sessions with individualized symptom provocation, aiming to improve the susceptibility of brain circuits to stimulation. However, limited standardization or guidance exists on how to conduct symptom provocation and which methods are most effective. This study aims to compare the effect of internal versus external techniques to induce obsessional stress in a clinical setting during TMS therapy. Two symptom provocation methods, (i) Asking patients thought-provoking questions about their obsessions (internal) and (ii) Requesting patients to perform obsession-related tasks (external), were employed in a crossover design with repeated measurement. Thirty-six treatments of NeuroStar TMS were administered to each of two patients over 8 weeks in an outpatient clinic. Patient One received 18 sessions of internal provocation followed by 18 sessions of external provocation, while Patient Two received 18 sessions of external provocation followed by 18 sessions of internal provocation. The primary outcome was the level of self-reported obsessional stress on a visual analog scale from 1 to 10. The secondary outcome was self-reported OCD severity, collected biweekly in a four-level Likert-scale (1 to 4) of bad, fair, good and excellent. Outcomes were compared and tested between provocation arms through repeated measures ANOVA, accounting for intra-patient correlations. Ages were 42 for Patient One (male, White) and 57 for Patient Two (male, White). Both patients had similar moderate symptoms at baseline, as determined through the Yale-Brown Obsessive Compulsive Scale (YBOCS). When comparing obsessional stress induced across the two arms of internal and external provocation methods, the mean (SD) was 6.03 (1.18) for internal and 4.01 (1.28) for external strategies (P=0.0019); ranges were 3 to 8 for internal and 2 to 8 for external strategies. Internal provocation yielded 5 (31.25%) bad, 6 (33.33%) fair, 3 (18.75%) good, and 2 (12.5%) excellent responses for OCD status, while external provocation yielded 5 (31.25%) bad, 9 (56.25%) fair, 1 (6.25%) good, and 1 (6.25%) excellent responses (P=0.58). Internal symptom provocation tactics had a significantly stronger impact on inducing obsessional stress and led to better OCD status (non-significant). This could be attributed to the fact that answering questions may prompt patients to reflect more on their lived experiences and struggles with OCD. In the future, clinical trials with larger sample sizes are warranted to validate this finding. Results support the increased integration of internal methods into structured provocation protocols, potentially reducing the time required for provocation and achieving greater treatment response to TMS.

Keywords: obsessive-compulsive disorder, transcranial magnetic stimulation, mental health, symptom provocation

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34 Play, Practice and Perform: The Pathway to Becoming and Belonging as an Engineer

Authors: Rick Evans

Abstract:

Despite over 40 years of research into why women choose not to enroll or leave undergraduate engineering programs, along with the subsequent and serious efforts to attract more women, women receiving bachelor's degrees in engineering in the US have remained disappointingly low. We know that even despite their struggles to become more welcoming and inclusive, engineering programs remain gendered, raced and classed. However, our research team has found that women who participate and indeed thrive in undergraduate engineering project teams do so in numbers that far exceed their participation in undergraduate programs. We believe part of the answer lies in the ways that project teams facilitate experiential learning, specifically providing opportunities for members to play, practice and perform. We employ a multi-case study method and assume a feminist, activist and interpretive perspective. We seek to generate concrete and context-dependent knowledge in order to explore potentially new variables and hypotheses. Our focus is to learn from those select women who are thriving. For this oral or e-poster presentation, we will focus on the results of the second of our semi-structured interviews – the learning journey interview. During this interview, we ask participants to tell us the story/ies of their participation in project teams. Our results suggest these women find joy in their experience of developing and applying engineering expertise. They experience this joy and develop their expertise in the highly patterned progression of play, practice and performance. Play is a purposeful activity in which someone enters an imaginary world, a world not yet real to them. However, this imaginary world is still very much connected to the real world, in this case, a particular kind of engineering, in that the ways of engaging are already established, codified and rule-governed. As such, these women are novices motivated to join a community of actors. Practice, better understood as practices, a count noun, is an embodied, materially interconnected collection of actions organized around the shared understandings of that community of actors. Those shared understandings reveal a social order – a particular field of engineering. No longer novices, these women begin to develop and display their emergent identities as engineers. Perform is activity meant either to demonstrate competence and/or to enable, even teach play and practice to others. As performers, these women participants become models for others. They direct play and practice, contextualizing both within a field of engineering and the specific aims of the project team community. By playing, practicing and performing engineering, women claim their identities as engineers and, equally important, have those identities acknowledged by team members. If we hope to transform our gendered, raced, classed institutions, we need to learn more about women who thrive within those institutions. We need to learn more about their processes of becoming and belonging as engineers. Our research presentation begins with a description of project teams and our multi-case study method. We then offer detailed descriptions of play, practice, and performance using the voices of women in project teams.

Keywords: engineering education, gender, identity, project teams

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33 Covid-19 Lockdown Experience of Elderly Female as Reflected in Their Artwork

Authors: Liat Shamri-Zeevi, Neta Ram-Vlasov

Abstract:

Today the world as a whole is attempting to cope with the COVID-19, which has affected all facets of personal and social life from country-wide confinement to maintaining social distance and taking protective measures to maintain hygiene. One of the populations faced with the most severe restrictions is seniors. Various studies have shown that creativity plays a crucial role in dealing with crisis events. Painting - regardless of media - allows for emotional and cognitive processing of these situations, and enables the expression of experiences in a tangible creative way that conveys and endows meaning to the artwork. The current study was conducted in Israel immediately after a 6-week lockdown. It was designed to specifically examine the impact of the COVID-19 pandemic on the quality of life of elderly women as reflected in their artworks. The sample was composed of 21 Israeli women aged 60-90, in good mental health (without diagnosed dementia or Alzheimer's), all of whom were Hebrew-speaking, and retired with an extended family, who indicated that they painted and had engaged in artwork on an ongoing basis throughout the lockdown (from March 12 to May 30, 2020). The participants' artworks were collected, and a semi-structured in-depth interview was conducted that lasted one to two hours. The participants were asked about their feelings during the pandemic and the artworks they produced during this time, and completed a questionnaire on well-being and mental health. The initial analysis of the interviews and artworks revealed themes related to the specific role of each piece of artwork. The first theme included notions that the artwork was an activity and a framework for doing, which supported positive emotions, and provided a sense of vitality during the closure. Most of the participants painted images of nature and growth which were ascribed concrete and symbolic meaning. The second theme was that the artwork enabled the processing of difficult and /or conflicting emotions related to the situation, including anxiety about death and loneliness that were symbolically expressed in the artworks, such as images of the Corona virus and the respiratory machines. The third theme suggested that the time and space prompted by the lockdown gave the participants time for a gathering together of the self, and freed up time for creative activities. Many participants stated that they painted more and more frequently during the Corona lockdown. At the conference, additional themes and findings will be presented.

Keywords: Corona virus, artwork, quality of life of elderly

Procedia PDF Downloads 136