Search results for: musculoskeletal disorder work related
Commenced in January 2007
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Edition: International
Paper Count: 21784

Search results for: musculoskeletal disorder work related

21574 Psychosocial Experience of Parents of Children with Conduct Disorder in Thulamela, South Africa

Authors: Constance Singo, Choja Oduaran

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Child mental disorders are strongly associated with different forms of challenges, including behavioural problems. The burden of care for children with a mental disorder is high and put primary caregivers, parents in particular, at risk of poor mental wellbeing. Understanding the experience of parents of children with mental disorders is crucial to developing a relevant intervention to assist them to attain optimal mental wellbeing. The aim of this study was to explore the experiences of parents of children with conduct disorder by focussing on the psychological and social stress experience of the parents in raising and caring for their children with conduct disorder. A qualitative research approach, using in-depth interview was utilized in this study. Purposive and snowballing sampling techniques were used to select 9 parents of children with conduct disorder in Thulamela Municipality, Limpopo Province of South Africa. Participants comprising of 2 males and 7 females aged between 30 years and 49 years were interviewed individually at scheduled appointment in-home setting. Interviews were conducted in both English and Setswana language. Data collected in Setswana language were translated to English by 'expert in language translation'. Ethical approval was obtained from appropriate authority before data collection. Thematic analysis was conducted to analyse the collected data. The findings identified anger, fear, depressive symptoms, denial, and suicidal ideation as predominant psychological experiences of the parents. Furthermore, deteriorated interpersonal relationships with family and community members, financial stress, and stigma emerged as social problems being the experience of the parents. It was concluded that parents of children with conduct disorder are highly traumatized by the challenges of caring for their children. We recommend professional engagement in terms of counselling service to support the parents. There is also a need for massive enlightenment programmes for members of the community in order to support the parents of children with child mental disorders.

Keywords: conduct disorder, parents, psychosocial experiences, South Africa

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21573 D-Epi App: Mobile Application to Control Sodium Valproat Administration in Children with Idiopatic Epilepsy in Indonesia

Authors: Nyimas Annissa Mutiara Andini

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There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.

Keywords: application, children, D-Epi, epilepsy

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21572 Linguistic Analysis of Borderline Personality Disorder: Using Language to Predict Maladaptive Thoughts and Behaviours

Authors: Charlotte Entwistle, Ryan Boyd

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Recent developments in information retrieval techniques and natural language processing have allowed for greater exploration of psychological and social processes. Linguistic analysis methods for understanding behaviour have provided useful insights within the field of mental health. One area within mental health that has received little attention though, is borderline personality disorder (BPD). BPD is a common mental health disorder characterised by instability of interpersonal relationships, self-image and affect. It also manifests through maladaptive behaviours, such as impulsivity and self-harm. Examination of language patterns associated with BPD could allow for a greater understanding of the disorder and its links to maladaptive thoughts and behaviours. Language analysis methods could also be used in a predictive way, such as by identifying indicators of BPD or predicting maladaptive thoughts, emotions and behaviours. Additionally, associations that are uncovered between language and maladaptive thoughts and behaviours could then be applied at a more general level. This study explores linguistic characteristics of BPD, and their links to maladaptive thoughts and behaviours, through the analysis of social media data. Data were collected from a large corpus of posts from the publicly available social media platform Reddit, namely, from the ‘r/BPD’ subreddit whereby people identify as having BPD. Data were collected using the Python Reddit API Wrapper and included all users which had posted within the BPD subreddit. All posts were manually inspected to ensure that they were not posted by someone who clearly did not have BPD, such as people posting about a loved one with BPD. These users were then tracked across all other subreddits of which they had posted in and data from these subreddits were also collected. Additionally, data were collected from a random control group of Reddit users. Disorder-relevant behaviours, such as self-harming or aggression-related behaviours, outlined within Reddit posts were coded to by expert raters. All posts and comments were aggregated by user and split by subreddit. Language data were then analysed using the Linguistic Inquiry and Word Count (LIWC) 2015 software. LIWC is a text analysis program that identifies and categorises words based on linguistic and paralinguistic dimensions, psychological constructs and personal concern categories. Statistical analyses of linguistic features could then be conducted. Findings revealed distinct linguistic features associated with BPD, based on Reddit posts, which differentiated these users from a control group. Language patterns were also found to be associated with the occurrence of maladaptive thoughts and behaviours. Thus, this study demonstrates that there are indeed linguistic markers of BPD present on social media. It also implies that language could be predictive of maladaptive thoughts and behaviours associated with BPD. These findings are of importance as they suggest potential for clinical interventions to be provided based on the language of people with BPD to try to reduce the likelihood of maladaptive thoughts and behaviours occurring. For example, by social media tracking or engaging people with BPD in expressive writing therapy. Overall, this study has provided a greater understanding of the disorder and how it manifests through language and behaviour.

Keywords: behaviour analysis, borderline personality disorder, natural language processing, social media data

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21571 The Analysis of the Stress Phenomenon among the Academic Teachers

Authors: Monika Szpringer, Mariola Wojciechowska, Robert Dutkiewicz, Grażyna Nowak-Starz, Marzena Olędzka

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The main aim of this article is to determine the phenomenon of stress among academic teachers as well as to identify the extent to which the teachers experience work-related psychological risks. It is also important to support academic teachers trade unions in scope of stress-oriented activities, including psychological dangers in the assessment of risk in the workplace (college). The authors used a method of a diagnostic survey with a polling as a technique and authors’ questionnaire as a tool. The survey was conducted between September and December of 2013 and it comprised 1890 academic teachers from five voivodeships. The study reveals that 84.0% of the respondents found the work of an academic teacher to be borne with a considerable stress. The percentage values of the most frequent causes of stress are as follows: frequent changes of both organisational and didactic matters as well as overwhelming bureaucracy (77.8 %), time pressure regarding professional development and related risk of losing job (68.2 %), difficult working conditions (45.4%), conflicts and rivalry between teachers (44.1%), excessive amount of duties as well as increasing requirements and demanding attitude of students (33.7%). Work-related stress affects or significantly affects the private life of 69 % and 66.4 % of the respondents respectively. The majority of the people surveyed deals with stress by undertaking various activities, with 40% pointing at using various substances, mostly cigarettes and alcohol (p > 0,05) Physical ailments were experienced by 81% of the respondents, in 9% they were rare and 8 % of the respondents had never experienced such disorders. The entire group of the surveyed people (100 %) claimed that they have no possibility of contacting a psychologist at their workplace (p > 0.05), and they stated that the need of contacting specialists does exist.

Keywords: stress, academic teachers, psychological risks, work-related

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21570 Managing Psychogenic Non-Epileptic Seizure Disorder: The Benefits of Collaboration between Psychiatry and Neurology

Authors: Donald Kushon, Jyoti Pillai

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Psychogenic Non-epileptic Seizure Disorder (PNES) is a challenging clinical problem for the neurologist. This study explores the benefits of on-site collaboration between psychiatry and neurology in the management of PNES. A 3 month period at a university hospital seizure clinic is described detailing specific management approaches taken as a result of this collaboration. This study describes four areas of interest: (1. After the video EEG results confirm the diagnosis of PNES, the presentation of the diagnosis of PNES to the patient. (2. The identification of co-morbid psychiatric illness (3. Treatment with specific psychotherapeutic interventions (including Cognitive Behavioral Therapy) and psychopharmacologic interventions (primarily SSRIs) and (4. Preliminary treatment outcomes.

Keywords: cognitive behavioral therapy (CBT), psychogenic non-epileptic seizure disorder (PNES), selective serotonin reuptake inhibitors (SSRIs), video electroencephalogram (VEEG)

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21569 Institutional Capacity of Health Care Institutes for Diagnosis and Management of Common Genetic Diseases-a Study from a North Coastal District of Andhra Pradesh, India

Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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21568 A Convolution Neural Network Approach to Predict Pes-Planus Using Plantar Pressure Mapping Images

Authors: Adel Khorramrouz, Monireh Ahmadi Bani, Ehsan Norouzi, Morvarid Lalenoor

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Background: Plantar pressure distribution measurement has been used for a long time to assess foot disorders. Plantar pressure is an important component affecting the foot and ankle function and Changes in plantar pressure distribution could indicate various foot and ankle disorders. Morphologic and mechanical properties of the foot may be important factors affecting the plantar pressure distribution. Accurate and early measurement may help to reduce the prevalence of pes planus. With recent developments in technology, new techniques such as machine learning have been used to assist clinicians in predicting patients with foot disorders. Significance of the study: This study proposes a neural network learning-based flat foot classification methodology using static foot pressure distribution. Methodologies: Data were collected from 895 patients who were referred to a foot clinic due to foot disorders. Patients with pes planus were labeled by an experienced physician based on clinical examination. Then all subjects (with and without pes planus) were evaluated for static plantar pressures distribution. Patients who were diagnosed with the flat foot in both feet were included in the study. In the next step, the leg length was normalized and the network was trained for plantar pressure mapping images. Findings: From a total of 895 image data, 581 were labeled as pes planus. A computational neural network (CNN) ran to evaluate the performance of the proposed model. The prediction accuracy of the basic CNN-based model was performed and the prediction model was derived through the proposed methodology. In the basic CNN model, the training accuracy was 79.14%, and the test accuracy was 72.09%. Conclusion: This model can be easily and simply used by patients with pes planus and doctors to predict the classification of pes planus and prescreen for possible musculoskeletal disorders related to this condition. However, more models need to be considered and compared for higher accuracy.

Keywords: foot disorder, machine learning, neural network, pes planus

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21567 Contribution of Crime Scene and Autopsy Investigation to the Solving of the Case in the Case of Death as a Result of Self-Harm

Authors: Murat Mert, Yusuf Ozer, Fatih Kolay

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Behaviour of giving harm to the body in literature has been named as “self-injury”, “self-mutilation” ve “self-harm”. “Self-injury”, or “self-mutilation” is generally used for the same meaning and mentioned as an action which is committed to the body itself directly. As is seen that alcohol and drug users have injured their bodies because of deprivation, whereas behaviour of self-injury in some societies is accepted as religious and cultural, it has nevertheless been diagnosed in people who have a borderline personality disorder, histrionic personality disorder, psychotic personality disorder and mood disorder. There has not been any direct self-murder tendency in people having self-harmed. However, death cases can be seen together with loss of consciousness depending on loss of blood by exceeding the limit in the course of injury action. 34- year old – male person who was alcohol addicted, having had a psycological treatment beforehand, had mutilated his small intestine together with fatty tissue by cutting his body with a razor-blade at the thought of insects strolling around the body (delirium tremens) due to deprivation attack and had died in the result of various cuts. In this study, crime scene investigation and death mechanism of the person having had self-harmed in a result of abstinence syndrome will be explained. Relevant criteria which differentiate this case from homicide will be examined.

Keywords: self-injury, autopsy, abstinence syndrome, CSI

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21566 Amyloid Angiopathy and Golf: Two Opposite but Close Worlds

Authors: Andrea Bertocchi, Alessio Barnaba Di Fonzo, Davide Talarico, Simone Rivaroli, Jeff Konin

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The patient is a 89 years old male (180cm/85kg) retired notary former golfer with no past medical history. He describes a progressive ideomotor slowdown for 14 months. The disorder is characterized by short-term memory deficits and, for some months, also by unstable walking with a broad base with skidding and risk of falling at directional changes and urinary urgency. There were also episodes of aggression towards his wife and staff. At the time, the patient takes no prescribed medications. He has difficulty eating, dressing, and some problems with personal hygiene. In the initial visit, the patient was alert, cooperating, and performed simple tasks; however, he has a hearing impairment, slowed spontaneous speech, and amnestic deficit to the short story. Ideomotor apraxia is not present. He scored 20 points in the MMSE. From a motor function, he has deficits using Medical Research Council (MRC) 3-/5 in bilateral lower limbs and requires maximum assistance from sit to stand with existing premature fatigue. He’s unable to walk for about 1 month. Tremors and hypertonia are absent. BERG was unable to be administered, and BARTHEL was obtained 45/100. An Amyloid Angiopathy is suspected and then confirmed at the neurological examination. Therehabilitation objectives were the recovery of mobility and reinforcement of the UE/LE, especially legs, for recovery of standing and walking. The cognitive aspect was also an essential factor for the patient's recovery. The literature doesn’t demonstrate any particular studies regarding motor and cognitive rehabilitation on this pathology. Failing to manage his attention on exercise and tending to be disinterested and falling asleep constantly, we used golf-specific gestures to stimulate his mind to work and get results because the patient has memory recall of golf related movement. We worked for 4 months with a frequency of 3 sessions per week. Every session lasted for 45 minutes. After 4 months of work, the patient walked independently with the use of a stick for about 120 meters without stopping. MRC 4/5 AI bilaterally andpostural steps performed independently with supervision. BERG 36/56. BARTHEL 65/100. 6 Minutes Walking Test (6MWT), at the beginning, it wasn’t measurable, now, he performs 151,5m with Numeric Rating Scale 4 at the beginning and 7 at the end. Cognitively, he no longer has episodes of aggression, although the short-term memory and concentration deficit remains. Amyloid Angiopathy is a mix of motor and cognitive disorder. It is worth the thought that cerebral amyloid angiopathy manifests with functional deficits due to strokes and bleedings and, as such, has an important rehabilitation indication, as classical stroke is not associated with amyloidosis. Exploring the motor patterns learned at a young age and remained in the implicit and explicit memory of the patient allowed us to set up effective work and to obtain significant results in the short-middle term. Surely many studies will still be done regarding this pathology and its rehabilitation, but the importance of the cognitive sphere applied to the motor sphere could represent an important starting point.

Keywords: amyloid angiopathy, cognitive rehabilitation, golf, motor disorder

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21565 Effect of Early Therapeutic Intervention for the Children with Autism Spectrum Disorders: A Quasi Experimental Design

Authors: Sultana Razia

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The purpose of this study was to investigate the effect of early therapeutic intervention on children with an autism spectrum disorder. Participants were 140 children with autism spectrum disorder from Autism Corner in a selected rehabilitation center of Bangladesh. This study included children who are at aged of 18-month to 36-month and who were taking occupational therapy and speech and language therapy from the autism center. They were primarily screened using M-CHAT; however, children with other physical disabilities or medical conditions were excluded. 3-months interventions of 6 sessions per week are a minimum of 45-minutes long per session, one to one interaction followed by parent-led structured home-based therapy were provided. The results indicated that early intensive therapeutic intervention improves understanding, social skills and sensory skills. It can be concluded that therapeutic early intervention has a positive effect on diminishing symptoms of Autism Spectrum Disorder.

Keywords: autism, m-chat, reciprocal social behavior, CRP

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21564 Evaluation of P300 and CNV Changes in Patients with Essential Tremor

Authors: Sehur Sibel Ozkaynak, Zakir Koc, Ebru Barcın

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Essential tremor (ET) is one of the most common movement disorders and has long been considered a monosymptomatic disorder. While ET has traditionally been categorized as a pure motor disease, cross-sectional and longitudinal studies of cognition in ET have been demonstrated that these patients may have cognitive dysfunction. We investigated the neuro physiological aspects of cognition in ET, using event-related potentials (ERPs).Twenty patients with ET and 20 age-education and sex matched healthy controls underwent a neuro physiological evaluation. P300 components and Contingent Negative Variation (CNV) were recorded. The latencies and amplitudes of the P300 and CNV were evaluated. P200-N200 amplitude was significantly smaller in the ET group, while no differences emerged between patients and controls in P300 latencies. CNV amplitude was significantly smaller at Cz electrode site in the ET group. No differences were observed between in the two groups in CNV latencies. As a result, P300 and CNV parameters did not show significant differences between in the two groups, does not mean that there aren't mild cognitive changes in ET patients. In this regard, there is a need to further studies using electro physiological tests related to cognitive changes in ET patients.

Keywords: cognition, essential tremor, event related potentials

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21563 Narrative Identity Predicts Borderline Personality Disorder Features in Inpatient Adolescents up to Six Months after Admission

Authors: Majse Lind, Carla Sharp, Salome Vanwoerden

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Narrative identity is the dynamic and evolving story individuals create about their personal pasts, presents, and presumed futures. This storied sense of self develops in adolescence and is crucial for fostering a sense of self-unity and purpose in life. A growing body of work has shown that several characteristics of narrative identity are disturbed in adults suffering from borderline personality disorder (BPD). Very little research, however, has explored the stories told by adolescents with BPD features. Investigating narrative identity early in the lifespan and in relation to personality pathology is crucial; BPD is a developmental disorder with early signs appearing already in adolescence. In the current study, we examine narrative identity (focusing on themes of agency and communion) coded from self-defining memories derived from the child attachment interview in 174 inpatient adolescents (M = 15.12, SD = 1.52) at the time of admission. The adolescents’ social cognition was further assessed on the basis of their reactions to movie scenes (i.e., the MASC movie task). They also completed a trauma checklist and self-reported BPD features at three different time points (i.e., at admission, at discharge, and 6 months after admission). Preliminary results show that adolescents who told stories containing themes of agency and communion evinced better social cognition, and lower emotional abuse on the trauma checklist. In addition, adolescents who disclosed stories containing lower levels of agency and communion demonstrated more BPD symptoms at all three time points, even when controlling for the occurrence of traumatic life events. Surprisingly, social cognitive abilities were not significantly associated with BPD features. These preliminary results underscore the importance of narrative identity as an indicator, and potential cause, of incipient personality pathology. Thus, focusing on diminished themes of narrative-based agency and communion in early adolescence could be crucial in preventing the development of personality pathology over time.

Keywords: borderline personality disorder, inpatient adolescents, narrative identity, follow-ups

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21562 Understanding the Manifestation of Psychosocial Difficulties in Children with Developmental Language Disorder, with a Focus on Anxiety and Social Frustration

Authors: Annabel Burnley, Michelle St. Clair, Charlotte Dack, Yvonne Wren

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Children with Developmental Language Disorder (DLD) are well documented to experience social and emotional difficulties. Despite this, there is little consensus as to how these difficulties manifest, without which the ability to develop prevention initiatives is limited. An online survey was completed by 107 parents of either child with DLD (‘DLD sample’; n=57), or typically developing children (‘typical sample’; n=50), all aged 6-12 years old. Psychosocial symptom measures were used, alongside 11 psychosocial statements generated from previous qualitative work. Qualitative interviews were then held to understand the manifestation of key difficulties in more depth (n=4). The DLD sample scored significantly higher on all psychosocial statements than the typical sample. Experiencing anxiety (80.7%), requiring routine and sameness (75.4%) and struggling to regulate their emotions (75.4%) were the most common difficulties for a majority of children with DLD. For this DLD sample, family communication and coping styles were found not to contribute to the manifestation of these difficulties. Two separate mediation models were run to understand the role of other psychosocial difficulties in the manifestation of (1) anxiety and (2) social frustration. ‘Intolerance of uncertainty was found to strongly mediate the relationship between DLD diagnosis and symptoms of anxiety. Emotion regulation was found to moderately mediate the relationship between DLD diagnosis and social frustration. Parents appear to cope well with their children’s complex psychosocial needs, but further external intervention is needed. Intervention focussing on intolerance of uncertainty and emotion dysregulation may help the management of anxiety and social frustration. Further research is needed to understand the children’s routined behaviors.

Keywords: psychosocial difficulties, developmental language disorder, specific language impairment, parent, anxiety

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21561 Pattern of ICU Admission due to Drug Problems

Authors: Kamel Abd Elaziz Mohamed

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Introduction: Drug related problems (DRPs) are of major concern, affecting patients of both sex. They impose considerable economic burden on the society and the health-care systems. Aim of the work: The aim of this work was to identify and categorize drug-related problems in adult intensive care unit. Patients and methods: The study was a prospective, observational study as eighty six patients were included. They were consecutively admitted to ICU through the emergency room or transferred from the general ward due to DRPs. Parameters included in the study as length of stay in ICU, need for cardiovascular support or mechanical ventilation, dialysis, as well as APACHE II score were recorded. Results: Drug related problems represent 3.6% of the total ICU admission. The median (range) of APACHE II score for 86 patients included in the study was 17 (10-23), and length of ICU stay was 2.4 (1.5-4.2) days. In 45 patients (52%), DRP was drug over dose (group 1), while other DRP was present in the other 41 patients (48%, group 11). Patients in group 1 were older (39 years versus 32 years in group 11), with significant impaired renal function. The need of inotropic drugs and mechanical ventilation as well as the length of stay (LOS) in ICU was significantly higher in group 1. There were no significant difference in GCS between both groups, however APACHE II score was significantly higher in group 1. Only four patients (4.6%) were admitted by suicidal attempt as well as three patients (3.4%) due to trauma drug-related admissions, all were in (group 1). Nineteen percent of the patients had drug related problem due to hypoglycaemic medication followed by tranquilizer (15%). Adverse drug effect followed by failure to receive medication were the most causes of drug problem in (group11).The total mortality rate was 4.6%, all of them were eventually non preventable. Conclusion: The critically ill patients admitted due to drug related problems represented a small proportion (3.6%) of admissions to the ICU. Hypoglycaemic medication was one of the most common causes of admission by drug related problems.

Keywords: drug related problems, ICU, cost, safety

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21560 Virtual Reality Exposure Therapy for Post-Traumatic Stress Disorder: A Literature Review

Authors: Daniel Azizyan, Marina Vardanyan, Astghik Dallakyan

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The objective of this literature review is to bring valuable and much-needed insight into Virtual Reality Exposure Therapy (VRET) for the treatment of Post-Traumatic Stress Disorder (PTSD) among military personnel. As the issues regarding war veterans who suffer from PTSD become more and more widespread, the task of finding possible solutions that would provide alternative approaches to existing methods being used today becomes more relevant than ever. By analyzing the previous applications of VRET, this literature review covers the state of the research done currently on the topic, reviews the known information while identifying the main problems, and aims to use missed opportunities and find potential solutions. It provides the answers to the most relevant questions concerning VRET and leads to important conclusions in the hope of making the technology more practical, widespread, and effective.

Keywords: military PTSD, post-traumatic stress disorder, prolonged exposure, virtual reality exposure therapy, VRE

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21559 A Small-Scale Survey on Risk Factors of Musculoskeletal Disorders in Workers of Logistics Companies in Cyprus and on the Early Adoption of Industrial Exoskeletons as Mitigation Measure

Authors: Kyriacos Clerides, Panagiotis Herodotou, Constantina Polycarpou, Evagoras Xydas

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Background: Musculoskeletal disorders (MSDs) in the workplace is a very common problem in Europe which are caused by multiple risk factors. In recent years, wearable devices and exoskeletons for the workplace have been trying to address the various risk factors that are associated with strenuous tasks in the workplace. The logistics sector is a huge sector that includes warehousing, storage, and transportation. However, the task associated with logistics is not well-studied in terms of MSDs risk. This study was aimed at looking into the MSDs affecting workers of logistics companies. It compares the prevalence of MSDs among workers and evaluates multiple risk factors that contribute to the development of MSDs. Moreover, this study seeks to obtain user feedback on the adoption of exoskeletons in such a work environment. Materials and Methods: The study was conducted among workers in logistics companies in Nicosia, Cyprus, from July to September 2022. A set of standardized questionnaires was used for collecting different types of data. Results: A high proportion of logistics professionals reported MSDs in one or more other body regions, the lower back being the most commonly affected area. Working in the same position for long periods, working in awkward postures, and handling an excessive load, were found to be the most commonly reported job risk factor that contributed to the development of MSDs, in this study. A significant number of participants consider the back region as the most to be benefited from a wearable exoskeleton device. Half of the participants would like to have at least a 50% reduction in their daily effort. The most important characteristics for the adoption of exoskeleton devices were found to be how comfortable the device is and its weight. Conclusion: Lower back and posture were the highest risk factors among all logistics professionals assessed in this study. A larger scale study using quantitative analytical tools may give a more accurate estimate of MSDs, which would pave the way for making more precise recommendations to eliminate the risk factors and thereby prevent MSDs. A follow-up study using exoskeletons in the workplace should be done to assess whether they assist in MSD prevention.

Keywords: musculoskeletal disorders, occupational health, safety, occupational risk, logistic companies, workers, Cyprus, industrial exoskeletons, wearable devices

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21558 Linking Work-Family Enrichment and Innovative Workplace Behavior: The Mediating Role of Positive Emotions

Authors: Nidhi Bansal, Upasna Agarwal

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Innovation is a key driver for economic growth and well-being of developed as well as emerging economies like India. Very few studies examined the relationship between IWB and work-family enrichment. Therefore, the present study examines the relationship between work-family enrichment (WFE) and innovative workplace behavior (IWB) and whether it is mediated by positive emotions. Social exchange theory and broaden and build theory explain the proposed relationships. Data were collected from 250 full time dual working parents in different Indian organizations through a survey questionnaire. Snowball technique was used for approaching respondents. Mediation analysis was assessed through PROCESS macro (Hayes, 2012) in SPSS. With correlational analysis, it was explored that all three variables were significantly and positively related. Analysis suggests that work-family enrichment is significantly related to innovative workplace behavior and this relationship is partially mediated by positive emotions. A cross-sectional design, use of self-reported questions and data collected only from dual working parents are few limitations of the study. This is one of the few studies to examine the innovative workplace behavior in response to work-family enrichment and first attempt to examine the mediation effect of emotions between these two variables.

Keywords: dual working parents, emotions, innovative workplace behavior, work-family enrichment

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21557 The Social Construction of Diagnosis: An Exploratory Study on Gender Dysphoria and Its Implications on Personal Narratives

Authors: Jessica Neri, Elena Faccio

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In Europe, except for Denmark and Malta, the legal gender change and the stages of the possible process of gender transition are bound to the diagnosis of a gender identity disorder. The requirement of the evaluation of a mental disorder might have many implications on trans people’s self-representations, interpersonal relations in different social contexts and the therapeutic relations with clinicians during the transition. Psychopathological language may contribute to define the individual’s reality from normative presuppositions with value implications related to the dominant cultural principles. In an effort to mark the boundaries between sanity and pathology, it concurs to the definition of the management procedures of the constructed diversities and deviances, legitimizing the operational practices of particular professional figures. The aim of this research concerns the analysis of the diagnostic category of gender dysphoria contained in the last edition of the Diagnostic and Statistical Manual of Mental Disorders. In particular, this study focuses on the relationship between the implicit and explicit assumptions related to the expressions of gender non-conformity, that sustain the language and the criteria characterizing the Manual, and the possible implications on people’s narratives of transition. In order to achieve this objective two main research methods were used: historical reconstruction of the diagnostic category in the different versions of the Manual and content analysis of that category in the present version. From the historical analysis, in the medical and psychiatric field gender non-conformity has been predominantly explicated by naturalistic perspectives, naming it ‘transsexualism’ and collocating it in the category of gender identity disorder. Currently, pathological judged experiences are represented by gender dysphoria, described in the DSM-5 as the distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender, specifying that there must be ‘evidence’ of this. Implicit theories about gender binary, parallelism between gender identity, sex and sexuality and the understanding of the mental health and the subject’s agency as subordinated to the expert knowledge, can be found in the process of designation of the category. A lack of awareness of the historical, social and political aspects connected to the cultural and normative dimensions at the basis of these implicit theories, can be noticed and data given by culture and data given by supposed -biological or psychological- nature, are often confused. This reductionist interpretation of gender and its presumed diversities legitimize the clinician to assume the role of searching and orienting, in a correctional perspective, the biographical elements that correspond to him specific expectations, with no space for other possibilities and identity configurations for people in transition. This research may contribute to the current critical debate about the epistemological foundation of the psychodiagnosis, emphasizing the pragmatic effects on the individuals and on the psychological practice in its wider social context. This work also permits to underline the risks due to the lack of awareness of the processes of social construction of the diagnostic system and its essential role of defence of the values that hold up the symbolic universe of reference.

Keywords: diagnosis, gender dysphoria, narratives, social constructionism

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21556 How Social Support, Interaction with Clients and Work-Family Conflict Contribute to Mental Well-Being for Employees in the Human Service System

Authors: Uwe C. Fischer

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Mental health and well-being for employees working in the human service system are getting more and more important given the increasing rate of absenteeism at work. Besides individual capacities, social and community factors seem to be important in the working setting. Starting from a demand resource framework including the classical demand control aspects, social support systems, specific demands and resources of the client work, and work-family conflict were considered in the present study. We state hypothetically, that these factors have a meaningful association with the mental quality of life of employees working in the field of social, educational and health sectors. 1140 employees, working in human service organizations (education, youth care, nursing etc.) were asked for strains and resources at work (selected scales from Salutogenetic Subjective Work Assessment SALSA and own new scales for client work), work-family conflict, and mental quality of life from the German Short Form Health Survey. Considering the complex influences of the variables, we conducted a multiple hierarchical regression analysis. One third of the whole variance of the mental quality of life can be declared by the different variables of the model. When the variables concerning social influences were included in the hierarchical regression, the influence of work related control resource decreased. Excessive workload, work-family conflict, social support by supervisors, co-workers and other persons outside work, as well as strains and resources associated with client work had significant regression coefficients. Conclusions: Social support systems are crucial in the social, educational and health related service sector, regarding the influence on mental well-being. Especially the work-family conflict focuses on the importance of the work-life balance. Also the specific strains and resources of the client work, measured with new constructed scales, showed great impact on mental health. Therefore occupational health promotion should focus more on the social factors within and outside the working place.

Keywords: client interaction, human service system, mental health, social support, work-family conflict

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21555 Gut Microbiota in Patients with Opioid Use Disorder: A 12-week Follow up Study

Authors: Sheng-Yu Lee

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Aim: Opioid use disorder is often characterized by repetitive drug-seeking and drug-taking behaviors with severe public health consequences. Animal model showed that opioid-induced perturbations in the gut microbiota causally relate to neuroinflammation, deficits in reward responding, and opioid tolerance, possibly due to changes in gut microbiota. Therefore, we propose that the dysbiosis of gut microbiota can be associated with pathogenesis of opioid dependence. In this current study, we explored the differences in gut microbiota between patients and normal controls and in patients before and after initiation of methadone treatment program for 12 weeks. Methods: Patients with opioid use disorder between 20 and 65 years were recruited from the methadone maintenance outpatient clinic in 2 medical centers in the Southern Taiwan. Healthy controls without any family history of major psychiatric disorders (schizophrenia, bipolar disorder and major depressive disorder) were recruited from the community. After initial screening, 15 patients with opioid use disorder joined the study for initial evaluation (Week 0), 12 of them completed the 12-week follow-up while receiving methadone treatment and ceased heroin use (Week 12). Fecal samples were collected from the patients at baseline and the end of 12th week. A one-time fecal sample was collected from the healthy controls. The microbiota of fecal samples were investigated using 16S rRNA V3V4 amplicon sequencing, followed by bioinformatics and statistical analyses. Results: We found no significant differences in species diversity in opioid dependent patients between Week 0 and Week 12, nor compared between patients at both points and controls. For beta diversity, using principal component analysis, we found no significant differences between patients at Week 0 and Week 12, however, both patient groups showed significant differences compared to control (P=0.011). Furthermore, the linear discriminant analysis effect size (LEfSe) analysis was used to identify differentially enriched bacteria between opioid use patients and healthy controls. Compared to controls, the relative abundance of Lactobacillaceae Lactobacillus (L. Lactobacillus), Megasphaera Megasphaerahexanoica (M. Megasphaerahexanoica) and Caecibacter Caecibactermassiliensis (C Caecibactermassiliensis) were increased in patients at Week 0, while Coriobacteriales Atopobiaceae (C. Atopobiaceae), Acidaminococcus Acidaminococcusintestini (A. Acidaminococcusintestini) and Tractidigestivibacter Tractidigestivibacterscatoligenes (T. Tractidigestivibacterscatoligenes) were increased in patients at Week 12. Conclusion: In conclusion, we suggest that the gut microbiome community maybe linked to opioid use disorder, such differences may not be altered even after 12-week of cessation of opioid use.

Keywords: opioid use disorder, gut microbiota, methadone treatment, follow up study

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21554 A Contactless Capacitive Biosensor for Muscle Activity Measurement

Authors: Charn Loong Ng, Mamun Bin Ibne Reaz

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As elderly population grows globally, the percentage of people diagnosed with musculoskeletal disorder (MSD) increase proportionally. Electromyography (EMG) is an important biosignal that contributes to MSD’s clinical diagnose and recovery process. Conventional conductive electrode has many disadvantages in the continuous EMG measurement application. This research has design a new surface EMG biosensor based on the parallel-plate capacitive coupling principle. The biosensor is developed by using a double-sided PCB with having one side of the PCB use to construct high input impedance circuitry while the other side of the copper (CU) plate function as biosignal sensing metal plate. The metal plate is insulated using kapton tape for contactless application. The result implicates that capacitive biosensor is capable to constantly capture EMG signal without having galvanic contact to human skin surface. However, there are noticeable noise couple into the measured signal. Post signal processing is needed in order to present a clean and significant EMG signal. A complete design of single ended, non-contact, high input impedance, front end EMG biosensor is presented in this paper.

Keywords: contactless, capacitive, biosensor, electromyography

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21553 The Socio Demographic Correlates of Post-Traumatic Stress Disorder among Youth Undergoing Domestic Violence in Kenya

Authors: Muchiri Josephine, Qdero Agnes

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The current study was conducted during the coronavirus pandemic (COVID-19) period, soon after the lifting of the lockdown measures and schools had just re-opened. It investigated the sociodemographic correlates of Post-Traumatic Stress Disorder (PTSD) among adolescents (13-18 years) who had undergone domestic violence (DV) in Kajiado County, Kenya. The adolescents were administered a sociodemographic questionnaire to ascertain the forms of domestic violence experienced, and those who met the criteria were assessed for the presence of PTSD using the Harvard Trauma Questionnaire (HTQ). Overall, 93(90.3%) had experienced domestic violence, and 57(61.3%) had PTSD; where the severity and prevalence of PTSD increased with increased age, and it also increased significantly among those in higher academic levels, indicating that PTSD prevalence was chronic and additionally influenced by increased academic pressure. Social connections seemed to mitigate PTSD prevalence, whereas, regarding the family background, those living with guardians seemed to have more severe PTSD.

Keywords: age, education level, gender, post-traumatic stress disorder

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21552 Relationship between Joint Hypermobility and Balance in Patients with Down’s Syndrome

Authors: Meltem Ramoglu, Ertugrul Safran, Hikmet Ucgun, Busra Kepenek Varol, Hulya Nilgun Gurses

Abstract:

Down’s syndrome (DS) is a human genetic disorder caused by the presence of all or part of an extra chromosome 21. Many patients with DS have musculoskeletal problems that affect weak muscle tone (hypotonia) and ligament laxity. This leads to excessive joint hypermobility and decreased position sense (proprioception). Lack of proprioception may cause balance problems. The aim of our study was to investigate how does joint hypermobility affect balance in patients with DS. Our study conducted with 13 DS patients age between 18 to 40 years. Demographic data were recorded. Beighton Hypermobility Score (BHS) was used to evaluate joint hypermobility. Balance score of participants was evaluated with Berg Balance Scale (BBS). Mean age of our participants was 29,8±3,57 year. Average score of body mass index and BHS were; 33,23 ±3,78 kg/m2 and 7,61±1,04, respectively. Out of a maximum possible score of 56 on the Berg Balance Scale, scores of participants with DS ranged from 36–51, with a mean of 43±4,45. Significant correlation was found between BHS and BBS (r: -,966, p=0.00). All of our participants have 6/9 or higher grade from BHS. As a conclusion of our study; joint hypermobility may affect balance score in patients with DS. The results suggest that people with DS have worse balance scores which affected by hypermobility. Further studies need larger population for more reliable results.

Keywords: adults, balance, Down's syndrome, joint hypermobility

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21551 Quality of Life of Mothers of Adolescents with Attention-Deficit/Hyperactivity Disorder Based on Lazarus-Folkman's Coping

Authors: Simin Hosseinian, Roghieh Nooripour

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Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a major neuropsychiatric disorder diagnosis in children, adolescents. This study was aimed to investigate the quality of life of mothers of adolescents with ADHD based on Lazarus-Folkman's coping. Method: Due to this purpose, 120 mothers were selected with convenience sampling method that referred to counseling centers with their adolescents with ADHD for treatment of their adolescents and then they completed Iranian Quality of Life Questionnaire and The Ways of Coping Questionnaire (WCQ). Data were analyzed by the Pearson correlation and stepwise regression methods with SPSS-19. Results: The result showed that there was a positive significant relationship between quality of life and self-controlling and also a negative relationship between quality of life and accepting responsibility (p < 0.05). Conclusion: According to these findings, we can suggest suitable intervention for mothers who have adolescents with ADHD and enhance their quality of life.

Keywords: ADHD, mother, adolescent, quality of life, Lazarus-Folkman

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21550 Ratings of Hand Activity and Force Levels in Identical Hand-Intensive Work Tasks in Women and Men

Authors: Gunilla Dahlgren, Per Liv, Fredrik Öhberg, Lisbeth Slunga Järvholm, Mikael Forsman, Börje Rehn

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Background: Accuracy of risk assessment tools in hand-repetitive work is important. This can support precision in the risk management process and for a sustainable working life for women and men equally. Musculoskeletal disorders, MSDs, from the hand, wrist, and forearm, are common in the working population. Women report a higher prevalence of MSDs in these regions. Objective: The objective of this study was to compare if women and men who performed the identical hand-intensive work task were rated equally using the Hand Activity Threshold Limit Value® (HA-TLV) when self-rated and observer-rated. Method: Fifty-six workers from eight companies participated, with various intensities in hand-repetitive work tasks. In total, 18 unique identical hand-intensive work tasks were executed in 28 pairs of a woman and a man. Hand activity and force levels were assessed. Each worker executed the work task for 15 minutes, which was also video recorded. Data was collected on workers who self-rated directly after the execution of the work task. Also, experienced observers performed ratings from videos of the same work tasks. For comparing means between women and men, paired samples t-tests were used. Results: The main results showed that there was no difference in self-ratings of hand activity level and force by women and men who executed the same work task. Further, there was no difference between observer ratings of hand activity level. However, the observer force ratings of women and men differed significantly (p=0.01). Conclusion: Hand activity and force levels are rated equally in women and men when self-rated, also by observers for hand activity. However, it is an observandum that observer force rating is rated higher for women and lower for men. This indicates the need of comparing force ratings with technical measures.

Keywords: gender, equity, sex differences, repetitive strain injury, cumulative trauma disorders, upper extremity, exposure assessment, workload, health risk assessment, observation, psychophysics

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21549 Ecological Systems Theory, the SCERTS Model, and the Autism Spectrum, Node and Nexus

Authors: C. Surmei

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Autism Spectrum Disorder (ASD) is a complex developmental disorder that can affect an individual’s (but is not limited to) cognitive development, emotional development, language acquisition and the capability to relate to others. Ecological Systems Theory is a sociocultural theory that focuses on environmental systems with which an individual interacts. The SCERTS Model is an educational approach and multidisciplinary framework that addresses the challenges confronted by individuals on the autism spectrum and other developmental disabilities. To aid the understanding of ASD and educational philosophies for families, educators, and the global community alike, a Comparative Analysis was undertaken to examine key variables (the child, society, education, nurture/care, relationships, communication). The results indicated that the Ecological Systems Theory and the SCERTS Model were comparable in focus, motivation, and application, attaining to a viable and notable relationship between both theories. This paper unpacks two child development philosophies and their relationship to each other.

Keywords: autism spectrum disorder, ecological systems theory, education, SCERTS model

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21548 An Empirical Assessment of the Effect of War Exposure on the Attitudes towards Violence

Authors: Anastasiia Kuptsevych, Robert J. Johnson, Olena Antonaccio, Ekaterina V. Botchkovar

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Ukraine has recently experienced one of the bloodiest conflicts taking place on the European continent. Many active duty personnel and civilians have died, and millions of people have been displaced. This situation can lead to disorder in the country characterized by acceptance of violence and crime. There is a gap in the literature addressing the issues related to attitudes towards violence resulting from war, as well as focusing on the world’s more vulnerable civilian populations – those that live in lower and middle-income countries, such as Ukraine. Using a random sample of 1200 adults from two major Ukrainian cities, this study explores the relationship between different types of war exposure (direct and vicarious) and attitudes to violence. Multivariate models reveal that multiple types of war exposure (e.g., being injured, being a witness of death, watching war events on TV) are significantly associated with the attitudes to political and interpersonal violence. In addition, the KHB decomposition procedure showed that experiencing certain mental illnesses serve as important mediating mechanisms between war exposure and attitudes towards violence. Finally, in order to prevent society from disorder and high levels of violence, future studies need to pay more attention to exploring how vital and traumatic life events can lead a population to find violent acts acceptable.

Keywords: attitudes, Ukraine, violence, war

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21547 Efficacy of Isometric Neck Exercises and Stretching with Ergonomics for Neck Pain in Computer Professionals

Authors: Esther Liyanage, Indrajith Liyanage, Masih Khan

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Neck pain has become a common epidemiological problem. One of the reasons for this is a sedentary way of life, connected with using a personal computer during all daily activities. Work place and work duration has not been properly adapted to the personal physical conditions of these employees. During 1990’s the importance of workstation design and work methods, or ergonomics on health was brought to the forefront of public attention. Ergonomics is the application of scientific information concerning humans to the design of objects. Ergonomic intervention results in improvement of working posture and a decrease in prevalence of musculoskeletal symptoms. Stretching and resistance exercises to the neck are easy to do, when performed 1-2 times daily reduce discomfort and ease neck stiffness. This study is aimed at finding if ergonomics with exercises to the neck prove beneficial to reduce neck pain in Computer Professionals. The outcomes measures used were: Oswestry neck disability index and VAS score for pain. 100 subjects satisfying the inclusion criteria were included in the study. Results: Ergonomic intervention along with isometric neck exercises and stretching proved to reduce neck pain and disability among computer professionals.

Keywords: ergonomics, neck pain, neck exercises, physiotherapy for neck pain

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21546 A Qualitative Study of the Effect of Sibling and Parental Relationships on Coping Mechanisms in Families of Children with Autism Spectrum Disorder

Authors: Smriti Gour, Neelam Pandey

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The objective of this study was to describe and analyse the mutual relationship between the coping mechanisms used by the families of a child with Autism Spectrum Disorder (ASD) and family dynamics and the effect sibling interactions have on the dynamics and coping mechanisms in an urban setup. In-depth interviews were conducted for 25 families, with 4 members each in the Delhi NCR area in India. The families who were interviewed had a younger child who had received a diagnosis of ASD between the ages of 5-12. The in-depth questionnaires contained open-ended questions and the interviews were conducted separately for the mother, father and the typically developing sibling. The key findings of the study suggested that lack of communication was a common factor in most families (n=19) leading to other difficulties like stress and relationship dysfunction. It also fostered a fallacious perception of the relationship dynamics in the family in most of the interviewed families and changed depending on the family member being interviewed. In families where the typically developing elder sibling had a good relationship with the autistic child, the family dynamics were found to be more stable, and the overall family well-being was better maintained. The coping mechanisms employed by the families were also more positive and tended to work better if the typically developing sibling maintained a positive and interactive relationship with the parents and the autistic child. The type of coping mechanisms had a major impact on the relationship between the parents and in dictating the dynamics of the family of the child with ASD. Spirituality, professional help, family support and household help emerged to be the most effective coping mechanisms for the families, with spirituality emerging to be the most positive and effective coping mechanism in the families interviewed.

Keywords: autism spectrum disorder, coping mechanism, family dynamics, parental relationships, siblings

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21545 Disability Management and Occupational Health Enhancement Program in Hong Kong Hospital Settings

Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

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Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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