Search results for: parents with mental ilnesses
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2764

Search results for: parents with mental ilnesses

184 The Effectiveness of Intervention Methods for Repetitive Behaviors in Preschool Children with Autism Spectrum Disorder: A Systematic Review

Authors: Akane Uda, Ami Tabata, Mi An, Misa Komaki, Ryotaro Ito, Mayumi Inoue, Takehiro Sasai, Yusuke Kusano, Toshihiro Kato

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Early intervention is recommended for children with autism spectrum disorder (ASD), and an increasing number of children have received support and intervention before school age in recent years. In this study, we systematically reviewed preschool interventions focused on repetitive behaviors observed in children with ASD, which are often observed at younger ages. Inclusion criteria were as follows : (1) Child of preschool status (age ≤ 7 years) with a diagnosis of ASD (including autism, Asperger's, and pervasive developmental disorder) or a parent (caregiver) with a preschool child with ASD, (2) Physician-confirmed diagnosis of ASD (autism, Asperger's, and pervasive developmental disorder), (3) Interventional studies for repetitive behaviors, (4) Original articles published within the past 10 years (2012 or later), (5) Written in English and Japanese. Exclusion criteria were as follows: (1) Systematic reviews or meta-analyses, (2) Conference reports or books. We carefully scrutinized databases to remove duplicate references and used a two-step screening process to select papers. The primary screening included close scrutiny of titles and abstracts to exclude articles that did not meet the eligibility criteria. During the secondary screening, we carefully read the complete text to assess eligibility, which was double-checked by six members at the laboratory. Disagreements were resolved through consensus-based discussion. Our search yielded 304 papers, of which nine were included in the study. The level of evidence was as follows: three randomized controlled trials (level 2), four pre-post studies (level 4b), and two case reports (level 5). Seven articles selected for this study described the effectiveness of interventions. Interventions for repetitive behaviors in preschool children with ASD were categorized as five interventions that directly involved the child and four educational programs for caregivers and parents. Studies that directly intervened with children used early intensive intervention based on applied behavior analysis (Early Start Denver Model, Early Intensive Behavioral Intervention, and the Picture Exchange Communication System) and individualized education based on sensory integration. Educational interventions for caregivers included two methods; (a) education regarding combined methods and practices of applied behavior analysis in addition to classification and coping methods for repetitive behaviors, and (b) education regarding evaluation methods and practices based on children’s developmental milestones in play. With regard to the neurophysiological basis of repetitive behaviors, environmental factors are implicated as possible contributors. We assumed that applied behavior analysis was shown to be effective in reducing repetitive behaviors because analysis focused on the interaction between the individual and the environment. Additionally, with regard to educational interventions for caregivers, the intervention was shown to promote behavioral change in children based on the caregivers' understanding of the classification of repetitive behaviors and the children’s developmental milestones in play and adjustment of the person-environment context led to a reduction in repetitive behaviors.

Keywords: autism spectrum disorder, early intervention, repetitive behaviors, systematic review

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183 Assessing the Spatial Distribution of Urban Parks Using Remote Sensing and Geographic Information Systems Techniques

Authors: Hira Jabbar, Tanzeel-Ur Rehman

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Urban parks and open spaces play a significant role in improving physical and mental health of the citizens, strengthen the societies and make the cities more attractive places to live and work. As the world’s cities continue to grow, continuing to value green space in cities is vital but is also a challenge, particularly in developing countries where there is pressure for space, resources, and development. Offering equal opportunity of accessibility to parks is one of the important issues of park distribution. The distribution of parks should allow all inhabitants to have close proximity to their residence. Remote sensing and Geographic information systems (GIS) can provide decision makers with enormous opportunities to improve the planning and management of Park facilities. This study exhibits the capability of GIS and RS techniques to provide baseline knowledge about the distribution of parks, level of accessibility and to help in identification of potential areas for such facilities. For this purpose Landsat OLI imagery for year 2016 was acquired from USGS Earth Explorer. Preprocessing models were applied using Erdas Imagine 2014v for the atmospheric correction and NDVI model was developed and applied to quantify the land use/land cover classes including built up, barren land, water, and vegetation. The parks amongst total public green spaces were selected based on their signature in remote sensing image and distribution. Percentages of total green and parks green were calculated for each town of Lahore City and results were then synchronized with the recommended standards. ANGSt model was applied to calculate the accessibility from parks. Service area analysis was performed using Network Analyst tool. Serviceability of these parks has been evaluated by employing statistical indices like service area, service population and park area per capita. Findings of the study may contribute in helping the town planners for understanding the distribution of parks, demands for new parks and potential areas which are deprived of parks. The purpose of present study is to provide necessary information to planners, policy makers and scientific researchers in the process of decision making for the management and improvement of urban parks.

Keywords: accessible natural green space standards (ANGSt), geographic information systems (GIS), remote sensing (RS), United States geological survey (USGS)

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182 Theta-Phase Gamma-Amplitude Coupling as a Neurophysiological Marker in Neuroleptic-Naive Schizophrenia

Authors: Jun Won Kim

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Objective: Theta-phase gamma-amplitude coupling (TGC) was used as a novel evidence-based tool to reflect the dysfunctional cortico-thalamic interaction in patients with schizophrenia. However, to our best knowledge, no studies have reported the diagnostic utility of the TGC in the resting-state electroencephalographic (EEG) of neuroleptic-naive patients with schizophrenia compared to healthy controls. Thus, the purpose of this EEG study was to understand the underlying mechanisms in patients with schizophrenia by comparing the TGC at rest between two groups and to evaluate the diagnostic utility of TGC. Method: The subjects included 90 patients with schizophrenia and 90 healthy controls. All patients were diagnosed with schizophrenia according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) by two independent psychiatrists using semi-structured clinical interviews. Because patients were either drug-naïve (first episode) or had not been taking psychoactive drugs for one month before the study, we could exclude the influence of medications. Five frequency bands were defined for spectral analyses: delta (1–4 Hz), theta (4–8 Hz), slow alpha (8–10 Hz), fast alpha (10–13.5 Hz), beta (13.5–30 Hz), and gamma (30-80 Hz). The spectral power of the EEG data was calculated with fast Fourier Transformation using the 'spectrogram.m' function of the signal processing toolbox in Matlab. An analysis of covariance (ANCOVA) was performed to compare the TGC results between the groups, which were adjusted using a Bonferroni correction (P < 0.05/19 = 0.0026). Receiver operator characteristic (ROC) analysis was conducted to examine the discriminating ability of the TGC data for schizophrenia diagnosis. Results: The patients with schizophrenia showed a significant increase in the resting-state TGC at all electrodes. The delta, theta, slow alpha, fast alpha, and beta powers showed low accuracies of 62.2%, 58.4%, 56.9%, 60.9%, and 59.0%, respectively, in discriminating the patients with schizophrenia from the healthy controls. The ROC analysis performed on the TGC data generated the most accurate result among the EEG measures, displaying an overall classification accuracy of 92.5%. Conclusion: As TGC includes phase, which contains information about neuronal interactions from the EEG recording, TGC is expected to be useful for understanding the mechanisms the dysfunctional cortico-thalamic interaction in patients with schizophrenia. The resting-state TGC value was increased in the patients with schizophrenia compared to that in the healthy controls and had a higher discriminating ability than the other parameters. These findings may be related to the compensatory hyper-arousal patterns of the dysfunctional default-mode network (DMN) in schizophrenia. Further research exploring the association between TGC and medical or psychiatric conditions that may confound EEG signals will help clarify the potential utility of TGC.

Keywords: quantitative electroencephalography (QEEG), theta-phase gamma-amplitude coupling (TGC), schizophrenia, diagnostic utility

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181 Healthcare Professional’s Well-Being: Case Study of Two Care Units in a Big Hospital in Canada

Authors: Zakia Hammouni

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Healthcare professionals’ well-being is becoming a priority during this Covid-19 pandemic due to stress, fatigue, and workload. Well before this pandemic, contemporary hospitals are endowed with environmental attributes that contribute to achieving well-being within their environment with the emphasis on the patient. The patient-centered care approach has been followed by the patient-centered design approach. Studies that have focused on the physical environment in hospitals have dealt with the patient's recovery process and his well-being. Prior scientific literature has placed less emphasis on the healthcare professionals’ interactions within the physical environment and to guide hospital designers to make evidence-based design choices to meet the needs and expectations of hospital users by considering, in addition to patients, healthcare professionals. This paper examines these issues related to the daily stress of professionals who provide care in a hospital environment. In this exploratory study, the interest was to grasp the issues related to this environment and explores the current realities of newly built hospitals based on design approaches and what attributes of the physical setting support healthcare professional’s well-being. Within a constructivist approach, this study was conducted in two care units in a new hospital in a big city in Canada before the Covid-19 pandemic (august 2nd to November 2nd 2018). A spatial evaluation of these care units allowed us to understand the interaction of health professionals in their work environment, to understand the spatial behavior of these professionals, and the narratives from 44 interviews of various healthcare professionals. The mental images validated the salient components of the hospital environment as perceived by these healthcare professionals. Thematic analysis and triangulation of the data set were conducted. Among the key attributes promoting the healthcare professionals’ well-being as revealed by the healthcare professionals are the overall light-color atmosphere in the hospital and care unit, particularly in the corridors and public areas of the hospital, the maintenance and cleanliness. The presence of the art elements also brings well-being to the health professionals as well as panoramic views from the staff lounge and corridors of the care units or elevator lobbies. Despite the overall positive assessment of this environment, some attributes need to be improved to ensure the well-being of healthcare professionals and to provide them with a restructuring environment. These are the supply of natural light, softer colors, sufficient furniture, comfortable seating in the restroom, and views, which are important in allowing these healthcare professionals to recover from their work stress. Noise is another attribute that needs to be further improved in the hospital work environment, especially in the nursing workstations and consultant's room. In conclusion, this study highlights the importance of providing healthcare professionals with work and rest areas that allow them to resist the stress they face, particularly during periods of extreme stress and fatigue such as a Covid-19 pandemic.

Keywords: healthcare facilities, healthcare professionals, physical environment, well-being

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180 Bridging the Gap: Living Machine in Educational Nature Preserve Center

Authors: Zakeia Benmoussa

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Pressure on freshwater systems comes from removing too much water to grow crops; contamination from economic activities, land use practices, and human waste. The paper will be focusing on how water management can influence the design, implementation, and impacts of the ecological principles of biomimicry as sustainable methods in recycling wastewater. At Texas State, United States of America, in particular the lower area of the Trinity River refuge, there is a true example of the diversity to be found in that area, whether when exploring the lands or the waterways. However, as the Trinity River supplies water to the state’s residents, the lower part of the river at Liberty County presents several problem of wastewater discharge in the river. Therefore, conservation efforts are particularly important in the Trinity River basin. Clearly, alternative ways must be considered in order to conserve water to meet future demands. As a result, there should be another system provided rather than the conventional water treatment. Mimicking ecosystem's technologies out of context is not enough, but if we incorporate plants into building architecture, in addition to their beauty, they can filter waste, absorb excess water, and purify air. By providing an architectural proposal center, a living system can be explored through several methods that influence natural resources on the micro-scale in order to impact sustainability on the macro-scale. The center consists of an ecological program of Plant and Water Biomimicry study which becomes a living organism that purifies the river water in a natural way through architecture. Consequently, a rich beautiful nature could be used as an educational destination, observation and adventure, as well as providing unpolluted fresh water to the major cities of Texas. As a result, these facts raise a couple of questions: Why is conservation so rarely practiced by those who must extract a living from the land? Are we sufficiently enlightened to realize that we must now challenge that dogma? Do architects respond to the environment and reflect on it in the correct way through their public projects? The method adopted in this paper consists of general research into careful study of the system of the living machine, in how to integrate it at architectural level, and finally, the consolidation of the all the conclusions formed into design proposal. To summarise, this paper attempts to provide a sustainable alternative perspective in bridging physical and mental interaction with biodiversity to enhance nature by using architecture.

Keywords: Biodiversity, Design with Nature, Sustainable architecture, Waste water treatment.

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179 Through the Robot’s Eyes: A Comparison of Robot-Piloted, Virtual Reality, and Computer Based Exposure for Fear of Injections

Authors: Bonnie Clough, Tamara Ownsworth, Vladimir Estivill-Castro, Matt Stainer, Rene Hexel, Andrew Bulmer, Wendy Moyle, Allison Waters, David Neumann, Jayke Bennett

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The success of global vaccination programs is reliant on the uptake of vaccines to achieve herd immunity. Yet, many individuals do not obtain vaccines or venipuncture procedures when needed. Whilst health education may be effective for those individuals who are hesitant due to safety or efficacy concerns, for many of these individuals, the primary concern relates to blood or injection fear or phobia (BII). BII is highly prevalent and associated with a range of negative health impacts, both at individual and population levels. Exposure therapy is an efficacious treatment for specific phobias, including BII, but has high patient dropout and low implementation by therapists. Whilst virtual reality approaches exposure therapy may be more acceptable, they have similarly low rates of implementation by therapists and are often difficult to tailor to an individual client’s needs. It was proposed that a piloted robot may be able to adequately facilitate fear induction and be an acceptable approach to exposure therapy. The current study examined fear induction responses, acceptability, and feasibility of a piloted robot for BII exposure. A Nao humanoid robot was programmed to connect with a virtual reality head-mounted display, enabling live streaming and exploration of real environments from a distance. Thirty adult participants with BII fear were randomly assigned to robot-pilot or virtual reality exposure conditions in a laboratory-based fear exposure task. All participants also completed a computer-based two-dimensional exposure task, with an order of conditions counterbalanced across participants. Measures included fear (heart rate variability, galvanic skin response, stress indices, and subjective units of distress), engagement with a feared stimulus (eye gaze: time to first fixation and a total number of fixations), acceptability, and perceived treatment credibility. Preliminary results indicate that fear responses can be adequately induced via a robot-piloted platform. Further results will be discussed, as will implications for the treatment of BII phobia and other fears. It is anticipated that piloted robots may provide a useful platform for facilitating exposure therapy, being more acceptable than in-vivo exposure and more flexible than virtual reality exposure.

Keywords: anxiety, digital mental health, exposure therapy, phobia, robot, virtual reality

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178 An Ecological Grandeur: Environmental Ethics in Buddhist Perspective

Authors: Merina Islam

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There are many environmental problems. Various counter measures have been taken for environmental problems. Philosophy is an important contributor to environmental studies as it takes deep interest in meaning analysis of the concept environment and other related concepts. The Buddhist frame, which is virtue ethical, remains a better alternative to the traditional environmental outlook. Granting the unique role of man in immoral deliberations, the Buddhist approach, however, maintains a holistic concept of ecological harmony. Buddhist environmental ethics is more concerned about the complete moral community, the total ecosystem, than any particular species within the community. The moral reorientation proposed here has resemblance to the concept of 'deep ecology. Given the present day prominence of virtue ethics, we need to explore further into the Buddhist virtue theory, so that a better framework to treat the natural world would be ensured. Environment has turned out to be one of the most widely discussed issues in the recent times. Buddhist concepts such as Pratityasamutpadavada, Samvrit Satya, Paramartha Satya, Shunyata, Sanghatvada, Bodhisattva, Santanvada and others deal with interdependence in terms of both internal as well external ecology. The internal ecology aims at mental well-being whereas external ecology deals with physical well-being. The fundamental Buddhist concepts for dealing with environmental Problems are where the environment has the same value as humans as from the two Buddhist doctrines of the Non-duality of Life and its Environment and the Origination in Dependence; and the inevitability of overcoming environmental problems through the practice of the way of the Bodhisattva, because environmental problems are evil for people and nature. Buddhism establishes that there is a relationship among all the constituents of the world. There is nothing in the world which is independent from any other thing. Everything is dependent on others. The realization that everything in the universe is mutually interdependent also shows that the man cannot keep itself unaffected from ecology. This paper would like to focus how the Buddhist’s identification of nature and the Dhamma can contribute toward transforming our understanding, attitudes, and actions regarding the care of the earth. Environmental Ethics in Buddhism presents a logical and thorough examination of the metaphysical and ethical dimensions of early Buddhist literature. From the Buddhist viewpoint, humans are not in a category that is distinct and separate from other sentient beings, nor are they intrinsically superior. All sentient beings are considered to have the Buddha-nature, that is, the potential to become fully enlightened. Buddhists do not believe in treating of non-human sentient beings as objects for human consumption. The significance of Buddhist theory of interdependence can be understood from the fact that it shows that one’s happiness or suffering originates from ones realization or non-realization respectively of the dependent nature of everything. It is obvious, even without emphasis, which in the context of deep ecological crisis of today there is a need to infuse the consciousness of interdependence.

Keywords: Buddhism, deep ecology, environmental problems, Pratityasamutpadavada

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177 Cognitive Performance and Everyday Functionality in Healthy Greek Seniors

Authors: George Pavlidis, Ana Vivas

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The demographic change into an aging population has stimulated the examination of seniors’ mental health and ability to live independently. The corresponding literature depicts the relation between cognitive decline and everyday functionality with aging, focusing largely in individuals that are reaching or have bridged the threshold of various forms of neuropathology and disability. In this context, recent meta-analysis depicts a moderate relation between cognitive performance and everyday functionality in AD sufferers. However, there has not been an analogous effort for the examination of this relation in the healthy spectrum of aging (i.e, in samples that are not challenged from a neurodegenerative disease). There is a consensus that the assessment tools designed to detect neuropathology with those that assess cognitive performance in healthy adults are distinct, thus their universal use in cognitively challenged and in healthy adults is not always valid. The same accounts for the assessment of everyday functionality. In addition, it is argued that everyday functionality should be examined with cultural adjusted assessment tools, since many vital everyday tasks are heterotypical among distinct cultures. Therefore, this study was set out to examine the relation between cognitive performance and everyday functionality a) in the healthy spectrum of aging and b) by adjusting the everyday functionality tools EPT and OTDL-R in the Greek cultural context. In Greece, 107 cognitively healthy seniors ( Mage = 62.24) completed a battery of neuropsychological tests and everyday functionality tests. Both were carefully chosen to be sensitive in fluctuations of performance in the healthy spectrum of cognitive performance and everyday functionality. The everyday functionality assessment tools were modified to reflect the local cultural context (i.e., EPT-G and OTDL-G). The results depicted that performance in all everyday functionality measures decline with age (.197 < r > .509). Statistically significant correlations emerged between cognitive performance and everyday functionality assessments that range from r =0.202 to r=0.510. A series of independent regression analysis including the scores of cognitive assessments has yield statistical significant models that explained 20.9 < AR2 > 32.4 of the variance in everyday functionality scored indexes. All everyday functionality measures were independently predicted by the TMT B-A index, and indicator of executive function. Stepwise regression analyses depicted that TMT B-A and age were statistically significant independent predictors of EPT-G and OTDL-G. It was concluded that everyday functionality is declining with age and that cognitive performance and everyday functional may be related in the healthy spectrum of aging. Age seems not to be the sole contributing factor in everyday functionality decline, rather executive control as well. Moreover, it was concluded that the EPT-G and OTDL-G are valuable tools to assess everyday functionality in Greek seniors that are not cognitively challenged, especially for research purposes. Future research should examine the contributing factors of a better cognitive vitality especially in executive control, as vital for the maintenance of independent living capacity with aging.

Keywords: cognition, everyday functionality, aging, cognitive decline, healthy aging, Greece

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176 Female Subjectivity in William Faulkner's Light in August

Authors: Azza Zagouani

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Introduction: In the work of William Faulkner, characters often evade the boundaries and categories of patriarchal standards of order. Female characters like Lena Grove and Joanna Burden cross thresholds in attempts to gain liberation, while others fail to do so. They stand as non-conformists and refuse established patterns of feminine behavior, such as marriage and motherhood after. They refute submissiveness, domesticity and abstinence to reshape their own identities. The presence of independent and creative women represents new, unconventional images of female subjectivity. This paper will examine the structures of submission and oppression faced by Lena and Joanna, and will show how, in the end, they reshape themselves and their identities, and disrupt or even destroy patriarchal structures. Objectives: Participants will understand through the examples of Lena Grove and Joanna Burden that female subjectivities are constructions, and are constantly subject to change. Approaches: Two approaches will be used in the analysis of the subjectivity formation of Lena Grove and Joanna Burden. Following the arguments propounded by Judith Butler, We explore the ways in which Lena Grove maneuvers around the restrictions and the limitations imposed on her without any physical or psychological violence. She does this by properly performing the roles prescribed to her gendered body. Her repetitious performances of these roles are both the ones that are constructed to confine women and the vehicle for her travel. Her performance parodies the prescriptive roles and thereby reveals that they are cultural constructions. Second, We will explore the argument propounded by Kristeva that subjectivity is always in a state of development because we are always changing in context with changing circumstances. For example, in Light in August, Lena Grove changes the way she defines herself in light of the events of the novel. Also, Kristeva talks about stages of development: the semiotic stage and the symbolic stage. In Light in August, Joanna shows different levels of subjectivity as time passes. Early in the novel, Joanna is very connected to her upbringing. This suggests Kristeva’s concept of the semiotic, in which the daughter identifies closely to her parents. Kristeva relates the semiotic to a strong daughter/mother connection, but in the novel it is strong daughter/father/grandfather identification instead. Then as Joanna becomes sexually involved with Joe, she breaks off, and seems to go into an identity crisis. To me, this represents Kristeva’s move from the semiotic to the symbolic. When Joanna returns to a religious fanaticism, she is returning to a semiotic state. Detailed outline: At the outset of this paper, We will investigate the subjugation of women: social constraints, and the formation of the feminine identity in Light in August. Then, through the examples of Lena Grove’s attempt to cross the boundaries of community moralities and Joanna Burden’s refusal to submit to the standards of submissiveness, domesticity, and obstinance, We will reveal the tension between progressive conceptions of individual freedom and social constraints that limit this freedom. In the second part of the paper, We will underscore the rhetoric of femininity in Light in August: subjugation through naming. The implications of both female’s names offer a powerful contrast between the two different forms of subjectivity. Conclusion: Through Faulkner’s novel, We demonstrate that female subjectivity is an open-ended issue. The spiral shaping of its form maintains its characteristics as a process changing according to different circumstances.

Keywords: female subjectivity, Faulkner’s light August, gender, sexuality, diversity

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175 Depressive-Like Behavior in a Murine Model of Colorectal Cancer Associated with Altered Cytokine Levels in Stress-Related Brain Regions

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

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

Keywords: cytokines, brain, depression, colorectal cancer

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174 Iranian English as Foreign Language Teachers' Psychological Well-Being across Gender: During the Pandemic

Authors: Fatemeh Asadi Farsad, Sima Modirkhameneh

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The purpose of this study was to explore the pattern of Psychological Well-Being (PWB) of Iranian male and female EFL teachers during the pandemic. It was intended to see if such a drastic change in the context and mode of teaching affects teachers' PWB. Furthermore, the possible difference between the six elements of PWB of Iranian EFL male vs. female teachers during the pandemic was investigated. The other purpose was to find out the EFL teachers’ perceptions of any modifications, and factors leading to such modifications in their PWB during pandemic. For the purpose of this investigation, a total of 81 EFL teachers (59 female, 22 male) with an age range of 25 to 35 were conveniently sampled from different cities in Iran. Ryff’s PWB questionnaire was sent to participant teachers through online platforms to elicit data on their PWB. As for their perceptions on the possible modifications and the factors involved in PWB during pandemic, a set of semi-structured interviews were run among both sample groups. The findings revealed that male EFL teachers had the highest mean on personal growth, followed by purpose of life, and self-acceptance and the lowest mean on environmental mastery. With a slightly similar pattern, female EFL teachers had the highest mean on personal growth, followed by purpose in life, and positive relationship with others with the lowest mean on environmental mastery. However, no significant difference was observed between the male and female groups’ overall means on elements of PWB. Additionally, participants perceived that their anxiety level in online classes altered due to factors like (1) Computer literacy skills, (2) Lack of social communications and interactions with colleagues and students, (3) Online class management, (4) Overwhelming workloads, and (5) Time management. The study ends with further suggestions as regards effective online teaching preparation considering teachers PWB, especially at severe situations such as covid-19 pandemic. The findings offer to determine the reformations of educational policies concerning enhancing EFL teachers’ PWB through computer literacy courses and stress management courses. It is also suggested that to proactively support teachers’ mental health, it is necessary to provide them with advisors and psychologists if possible for free. Limitations: One limitation is the small number of participants (81), suggesting that future replications should include more participants for reliable findings. Another limitation is the gender imbalance, which future studies should address to yield better outcomes. Furthermore, Limited data gathering tools suggest using observations, diaries, and narratives for more insights in future studies. The study focused on one model of PWB, calling for further research on other models in the literature. Considering the wide effect of the COVID-19 pandemic, future studies should consider additional variables (e.g., teaching experience, age, income) to understand Iranian EFL teachers’ vulnerabilities and strengths better.

Keywords: online teaching, psychological well-being, female and male EFL teachers, pandemic

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173 Enhancing VR Exposure Therapy for the Treatment of Phobias with the Use of Photorealistic VR Environments and Stimuli, and the Use of Tactile Feedback Suits and Responsive Systems

Authors: Vardan Melkonyan, Arman Azizyan, Astghik Boyajyan

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Virtual reality (VR) exposure therapy is a form of cognitive-behavioral therapy that uses immersive virtual environments to expose individuals to the feared stimuli or situations that trigger their phobia. VR exposure therapy has become an increasingly popular treatment for phobias, including fear of heights, public speaking, and flying, due to its ability to provide a controlled and safe environment for individuals to confront their fears while also allowing therapists to tailor the virtual exposure to the specific needs and goals of each individual. It is also a cost-effective and accessible treatment option, as it can be delivered remotely and does not require the use of drugs. Overall, VR exposure therapy has the potential to be a valuable tool for therapists in the treatment of phobias. But current methods may be improved by incorporating advanced technology such as photorealistic VR environments, tactile feedback suits, and responsive systems. The aim of this study was to identify the most effective approach for enhancing VR exposure therapy for the treatment of phobias. Photorealistic VR environments and stimuli can greatly enhance the effectiveness of VR exposure therapy for the treatment of phobias. By creating immersive, realistic virtual environments that closely mimic the real-life situations that trigger phobia responses, patients are able to more fully engage in the therapeutic process and confront their fears in a controlled and safe manner. This can help to reduce the severity of phobia symptoms and increase treatment outcomes. The use of tactile feedback suits and responsive systems can further enhance the VR exposure therapy experience by adding a physical element to the virtual environment. These suits, which can mimic the sensations of touch, pressure, and movement, allow patients to fully immerse themselves in the virtual world and feel as if they are physically present in the situation. This can help to increase the realism of the virtual environment and make it more effective in reducing phobia symptoms. Additionally, responsive systems can be used to trigger specific events or responses within the virtual environment based on the patient's actions, providing a more interactive and personalized treatment experience. A comprehensive literature review was conducted, including studies on VR exposure therapy for phobias and the use of advanced technology to enhance the therapy. Results indicate that incorporating these enhancements may significantly increase the effectiveness of VR exposure therapy for phobias. Further research is needed to fully understand the potential of these enhancements and to determine the optimal combination and implementation.

Keywords: virtual reality, mental health, phobias, fears, treatment, photorealistic, immersive, phobia

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172 Assessment of Physical Activity Patterns in Patients with Cardiopulmonary Diseases

Authors: Ledi Neçaj

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Objectives: The target of this paper is (1) to explain objectively physical activity model throughout three chronic cardiopulmonary conditions, and (2) to study the connection among physical activity dimensions with disease severity, self-reported physical and emotional functioning, and exercise performance. Material and Methods: This is a cross-sectional study of patients in their domestic environment. Patients with cardiopulmonary diseases were: chronic obstructive pulmonary disease (COPD), (n-63), coronary heart failure (n=60), and patients with implantable cardioverter defibrillator (n=60). Main results measures: Seven ambulatory physical activity dimensions (total steps, percentage time active, percentage time ambulating at low, medium, and hard intensity, maximum cadence for 30 non-stop minutes, and peak performance) have been measured with an accelerometer. Results: Subjects with COPD had the lowest amount of ambulatory physical activity compared with topics with coronary heart failure and cardiac dysrhythmias (all 7 interest dimensions, P<.05); total step counts have been: 5319 as opposed to 7464 as opposed to 9570, respectively. Six-minute walk distance becomes correlated (r=.44-.65, P<.01) with all physical activity dimensions inside the COPD pattern, the most powerful correlations being with total steps and peak performance. In topics with cardiac impairment, maximal oxygen intake had the most effective small to slight correlations with five of the physical activity dimensions (r=.22-.40, P<.05). In contrast, correlations among 6-minute walk test distance and physical activity have been higher (r=.48-.61, P<.01) albeit in a smaller pattern of most effective patients with coronary heart failure. For all three samples, self-reported physical and mental health functioning, age, frame mass index, airflow obstruction, and ejection fraction had both exceptionally small and no significant correlations with physical activity. Conclusions: Findings from this study present a profitable benchmark of physical activity patterns in individuals with cardiopulmonary diseases for comparison with future studies. All seven dimensions of ambulatory physical activity have disfavor between subjects with COPD, heart failure, and cardiac dysrhythmias. Depending on the research or clinical goal, the use of one dimension, such as total steps, may be sufficient. Although physical activity had high correlations with performance on a six-minute walk test relative to other variables, accelerometers-based physical activity monitoring provides unique, important information about real-world behavior in patients with cardiopulmonary not already captured with existing measures.

Keywords: ambulatory physical activity, walking, monitoring, COPD, heart failure, implantable defibrillator, exercise performance

Procedia PDF Downloads 63
171 Trajectories of Conduct Problems and Cumulative Risk from Early Childhood to Adolescence

Authors: Leslie M. Gutman

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Conduct problems (CP) represent a major dilemma, with wide-ranging and long-lasting individual and societal impacts. Children experience heterogeneous patterns of conduct problems; based on the age of onset, developmental course and related risk factors from around age 3. Early childhood represents a potential window for intervention efforts aimed at changing the trajectory of early starting conduct problems. Using the UK Millennium Cohort Study (n = 17,206 children), this study (a) identifies trajectories of conduct problems from ages 3 to 14 years and (b) assesses the cumulative and interactive effects of individual, family and socioeconomic risk factors from ages 9 months to 14 years. The same factors according to three domains were assessed, including child (i.e., low verbal ability, hyperactivity/inattention, peer problems, emotional problems), family (i.e., single families, parental poor physical and mental health, large family size) and socioeconomic (i.e., low family income, low parental education, unemployment, social housing). A cumulative risk score for the child, family, and socioeconomic domains at each age was calculated. It was then examined how the cumulative risk scores explain variation in the trajectories of conduct problems. Lastly, interactive effects among the different domains of cumulative risk were tested. Using group-based trajectory modeling, four distinct trajectories were found including a ‘low’ problem group and three groups showing childhood-onset conduct problems: ‘school-age onset’; ‘early-onset, desisting’; and ‘early-onset, persisting’. The ‘low’ group (57% of the sample) showed a low probability of conducts problems, close to zero, from 3 to 14 years. The ‘early-onset, desisting’ group (23% of the sample) demonstrated a moderate probability of CP in early childhood, with a decline from 3 to 5 years and a low probability thereafter. The ‘early-onset, persistent’ group (8%) followed a high probability of conduct problems, which declined from 11 years but was close to 70% at 14 years. In the ‘school-age onset’ group, 12% of the sample showed a moderate probability of conduct problems from 3 and 5 years, with a sharp increase by 7 years, increasing to 50% at 14 years. In terms of individual risk, all factors increased the likelihood of being in the childhood-onset groups compared to the ‘low’ group. For cumulative risk, the socioeconomic domain at 9 months and 3 years, the family domain at all ages except 14 years and child domain at all ages were found to differentiate childhood-onset groups from the ‘low’ group. Cumulative risk at 9 months and 3 years did not differentiate between the ‘school-onset’ group and ‘low’ group. Significant interactions were found between the domains for the ‘early-onset, desisting group’ suggesting that low levels of risk in one domain may buffer the effects of high risk in another domain. The implications of these findings for preventive interventions will be highlighted.

Keywords: conduct problems, cumulative risk, developmental trajectories, early childhood, adolescence

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170 How to Talk about It without Talking about It: Cognitive Processing Therapy Offers Trauma Symptom Relief without Violating Cultural Norms

Authors: Anne Giles

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Humans naturally wish they could forget traumatic experiences. To help prevent future harm, however, the human brain has evolved to retain data about experiences of threat, alarm, or violation. When given compassionate support and assistance with thinking helpfully and realistically about traumatic events, most people can adjust to experiencing hardships, albeit with residual sad, unfortunate memories. Persistent, recurrent, intrusive memories, difficulty sleeping, emotion dysregulation, and avoidance of reminders, however, may be symptoms of Post-traumatic Stress Disorder (PTSD). Brain scans show that PTSD affects brain functioning. We currently have no physical means of restoring the system of brain structures and functions involved with PTSD. Medications may ease some symptoms but not others. However, forms of "talk therapy" with cognitive components have been found by researchers to reduce, even resolve, a broad spectrum of trauma symptoms. Many cultures have taboos against talking about hardships. Individuals may present themselves to mental health care professionals with severe, disabling trauma symptoms but, because of cultural norms, be unable to speak about them. In China, for example, relationship expectations may include the belief, "Bad things happening in the family should stay in the family (jiāchǒu bùkě wàiyán 家丑不可外扬)." The concept of "family (jiā 家)" may include partnerships, close and extended families, communities, companies, and the nation itself. In contrast to many trauma therapies, Cognitive Processing Therapy (CPT) for Post-traumatic Stress Disorder asks its participants to focus not on "what" happened but on "why" they think the trauma(s) occurred. The question "why" activates and exercises cognitive functioning. Brain scans of individuals with PTSD reveal executive functioning portions of the brain inadequately active, with emotion centers overly active. CPT conceptualizes PTSD as a network of cognitive distortions that keep an individual "stuck" in this under-functioning and over-functioning dynamic. Through asking participants forms of the question "why," plus offering a protocol for examining answers and relinquishing unhelpful beliefs, CPT assists individuals in consciously reactivating the cognitive, executive functions of their brains, thus restoring normal functioning and reducing distressing trauma symptoms. The culturally sensitive components of CPT that allow people to "talk about it without talking about it" may offer the possibility for worldwide relief from symptoms of trauma.

Keywords: cognitive processing therapy (CPT), cultural norms, post-traumatic stress disorder (PTSD), trauma recovery

Procedia PDF Downloads 180
169 Floating Populations, Rooted Networks Tracing the Evolution of Russeifa City in Relation to Marka Refugee Camp

Authors: Dina Dahood Dabash

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Refugee camps are habitually defined as receptive sites, transient spaces of exile and nondescript depoliticized places of exception. However, such arguments form partial sides of reality, especially in countries that are geopolitically challenged and rely immensely on international aid. In Jordan, the dynamics brought with the floating population of refugees (Palestinian amongst others) have resulted in spatial after-effects that cannot be easily overlooked. For instance, Palestine refugee camps have turned by time into socioeconomic centers of gravity and cores of spatial evolution. Yet, such a position is not instantaneous. Amongst various reasons, it can be related, according to this paper, to a distinctive institutional climate that has been co-produced by the refugees, host community and the state. This paper aims to investigate the evolution of urban and spatial regulations in Jordan between 1948 and 1995, more specifically, state regulations, community regulations and refugee-self-regulation that all dynamically interacted that period. The paper aims to unpack the relations between refugee camps and their environs to further explore the agency of such floating populations in establishing rooted networks that extended the time and place boundaries. The paper’s argument stems from the fact that the spatial configuration of urban systems is not only an outcome of a historical evolutionary process but is also a result of interactions between the actors. The research operationalizes Marka camp in Jordan as a case study. Marka Camp is one of the six "emergency" camps erected in 1968 to shelter 15,000 Palestine refugees and displaced persons who left the West Bank and Gaza Strip. Nowadays, camp shelters more than 50,000 refugees in the same area of land. The camp is located in Russeifa, a city in Zarqa Governorate in Jordan. Together with Amman and Zarqa, Russeifa is part of a larger metropolitan area that acts as a home to more than half of Jordan’s businesses. The paper aspires to further understand the post-conflict strategies which were historically applied in Jordan and can be employed to handle more recent geopolitical challenges such as the Syrian refugee crisis. Methodological framework: The paper traces the evolution of the refugee-camp regulating norms in Jordan, parallel with the horizontal and vertical evolution of the Marka camp and its surroundings. Consequently, the main methods employed are historical and mental tracing, Interviews, in addition to using available Aerial and archival photos of the Marka camp and its surrounding.

Keywords: forced migration, Palestine refugee camps, spatial agency, urban regulations

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168 A Longitudinal Exploration into Computer-Mediated Communication Use (CMC) and Relationship Change between 2005-2018

Authors: Laurie Dempsey

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Relationships are considered to be beneficial for emotional wellbeing, happiness and physical health. However, they are also complicated: individuals engage in a multitude of complex and volatile relationships during their lifetime, where the change to or ending of these dynamics can be deeply disruptive. As the internet is further integrated into everyday life and relationships are increasingly mediated, Media Studies’ and Sociology’s research interests intersect and converge. This study longitudinally explores how relationship change over time corresponds with the developing UK technological landscape between 2005-2018. Since the early 2000s, the use of computer-mediated communication (CMC) in the UK has dramatically reshaped interaction. Its use has compelled individuals to renegotiate how they consider their relationships: some argue it has allowed for vast networks to be accumulated and strengthened; others contend that it has eradicated the core values and norms associated with communication, damaging relationships. This research collaborated with UK media regulator Ofcom, utilising the longitudinal dataset from their Adult Media Lives study to explore how relationships and CMC use developed over time. This is a unique qualitative dataset covering 2005-2018, where the same 18 participants partook in annual in-home filmed depth interviews. The interviews’ raw video footage was examined year-on-year to consider how the same people changed their reported behaviour and outlooks towards their relationships, and how this coincided with CMC featuring more prominently in their everyday lives. Each interview was transcribed, thematically analysed and coded using NVivo 11 software. This study allowed for a comprehensive exploration into these individuals’ changing relationships over time, as participants grew older, experienced marriages or divorces, conceived and raised children, or lost loved ones. It found that as technology developed between 2005-2018, everyday CMC use was increasingly normalised and incorporated into relationship maintenance. It played a crucial role in altering relationship dynamics, even factoring in the breakdown of several ties. Three key relationships were identified as being shaped by CMC use: parent-child; extended family; and friendships. Over the years there were substantial instances of relationship conflict: for parents renegotiating their dynamic with their child as they tried to both restrict and encourage their child’s technology use; for estranged family members ‘forced’ together in the online sphere; and for friendships compelled to publicly display their relationship on social media, for fear of social exclusion. However, it was also evident that CMC acted as a crucial lifeline for these participants, providing opportunities to strengthen and maintain their bonds via previously unachievable means, both over time and distance. A longitudinal study of this length and nature utilising the same participants does not currently exist, thus provides crucial insight into how and why relationship dynamics alter over time. This unique and topical piece of research draws together Sociology and Media Studies, illustrating how the UK’s changing technological landscape can reshape one of the most basic human compulsions. This collaboration with Ofcom allows for insight that can be utilised in both academia and policymaking alike, making this research relevant and impactful across a range of academic fields and industries.

Keywords: computer mediated communication, longitudinal research, personal relationships, qualitative data

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167 A Systematic Review Investigating the Use of EEG Measures in Neuromarketing

Authors: A. M. Byrne, E. Bonfiglio, C. Rigby, N. Edelstyn

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Introduction: Neuromarketing employs numerous methodologies when investigating products and advertisement effectiveness. Electroencephalography (EEG), a non-invasive measure of electrical activity from the brain, is commonly used in neuromarketing. EEG data can be considered using time-frequency (TF) analysis, where changes in the frequency of brainwaves are calculated to infer participant’s mental states, or event-related potential (ERP) analysis, where changes in amplitude are observed in direct response to a stimulus. This presentation discusses the findings of a systematic review of EEG measures in neuromarketing. A systematic review summarises evidence on a research question, using explicit measures to identify, select, and critically appraise relevant research papers. Thissystematic review identifies which EEG measures are the most robust predictor of customer preference and purchase intention. Methods: Search terms identified174 papers that used EEG in combination with marketing-related stimuli. Publications were excluded if they were written in a language other than English or were not published as journal articles (e.g., book chapters). The review investigated which TF effect (e.g., theta-band power) and ERP component (e.g., N400) most consistently reflected preference and purchase intention. Machine-learning prediction was also investigated, along with the use of EEG combined with physiological measures such as eye-tracking. Results: Frontal alpha asymmetry was the most reliable TF signal, where an increase in activity over the left side of the frontal lobe indexed a positive response to marketing stimuli, while an increase in activity over the right side indexed a negative response. The late positive potential, a positive amplitude increase around 600 ms after stimulus presentation, was the most reliable ERP component, reflecting the conscious emotional evaluation of marketing stimuli. However, each measure showed mixed results when related to preference and purchase behaviour. Predictive accuracy was greatly improved through machine-learning algorithms such as deep neural networks, especially when combined with eye-tracking or facial expression analyses. Discussion: This systematic review provides a novel catalogue of the most effective use of each EEG measure commonly used in neuromarketing. Exciting findings to emerge are the identification of the frontal alpha asymmetry and late positive potential as markers of preferential responses to marketing stimuli. Predictive accuracy using machine-learning algorithms achieved predictive accuracies as high as 97%, and future research should therefore focus on machine-learning prediction when using EEG measures in neuromarketing.

Keywords: EEG, ERP, neuromarketing, machine-learning, systematic review, time-frequency

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166 Four Museums for One (Hi) Story

Authors: Sheyla Moroni

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A number of scholars around the world have analyzed the great architectural and urban planning revolution proposed by Skopje 2014, but so far, there are no readings of the parallels between the museums in the Balkan area (including Greece) that share the same name as the museum at the center of that political and cultural revolution. In the former FYROM (now renamed North Macedonia), a museum called "Macedonian Struggle" was born during the reconstruction of the city of Skopje as the new "national" capital. This new museum was built under the "Skopje 2014" plan and cost about 560 million euros (1/3 of the country's GDP). It has been a "flagship" of the government of Nikola Gruevski, leader of the nationalist VMRO-DPMNE party. Until 2016 this museum was close to the motivations of the Macedonian nationalist movement (and later party) active (including terrorist actions) during the 19th and 20th centuries. The museum served to narrate a new "nation-building" after "state-building" had already taken place. But there are three other museums that tell the story of the "Macedonian struggle" by understanding "Macedonia" as a territory other than present-day North Macedonia. The first one is located in Thessaloniki and primarily commemorates the "Greek battle" against the Ottoman Empire. While the first uses a new dark building and many reconstructed rooms and shows the bloody history of the quest for "freedom" for the Macedonian language and people (different from Greeks, Albanians, and Bulgarians), the second is located in an old building in Thessaloniki and in its six rooms on the ground floor graphically illustrates the modern and contemporary history of Greek Macedonia. There are also third and fourth museums: in Kastoria (toward the Albanian border) and in Chromio (near the Greek-North Macedonian border). These two museums (Kastoria and Chromio) are smaller, but they mark two important borders for the (Greek) regions bordering Albania to the east and dividing it to the northwest not only from the Ottoman past but also from two communities felt to be "foreign" (Albanians and former Yugoslav Macedonians). All museums reconstruct a different "national edifice" and emphasize the themes of language and religion. The objective of the research is to understand, through four museums bearing the same name, what are the main "mental boundaries" (religious, linguistic, cultural) of the different states (reconstructed between the late 19th century and 1991). Both classical historiographic methodology (very different between Balkan and "Western" areas) and on-site observation and interactions with different sites are used in this research. An attempt is made to highlight four different political focuses with respect to nation-building and the Public History (and/or propaganda) approaches applied in the construction of these buildings and memorials tendency often that one "defines" oneself by differences from "others" (even if close).

Keywords: nationalisms, museum, nation building, public history

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165 Rehabilitation Team after Brain Damages as Complex System Integrating Consciousness

Authors: Olga Maksakova

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A work with unconscious patients after acute brain damages besides special knowledge and practical skills of all the participants requires a very specific organization. A lot of said about team approach in neurorehabilitation, usually as for outpatient mode. Rehabilitologists deal with fixed patient problems or deficits (motion, speech, cognitive or emotional disorder). Team-building means superficial paradigm of management psychology. Linear mode of teamwork fits casual relationships there. Cases with deep altered states of consciousness (vegetative states, coma, and confusion) require non-linear mode of teamwork: recovery of consciousness might not be the goal due to phenomenon uncertainty. Rehabilitation team as Semi-open Complex System includes the patient as a part. Patient's response pattern becomes formed not only with brain deficits but questions-stimuli, context, and inquiring person. Teamwork is sourcing of phenomenology knowledge of patient's processes as Third-person approach is replaced with Second- and after First-person approaches. Here is a chance for real-time change. Patient’s contacts with his own body and outward things create a basement for restoration of consciousness. The most important condition is systematic feedbacks to any minimal movement or vegetative signal of the patient. Up to now, recovery work with the most severe contingent is carried out in the mode of passive physical interventions, while an effective rehabilitation team should include specially trained psychologists and psychotherapists. It is they who are able to create a network of feedbacks with the patient and inter-professional ones building up the team. Characteristics of ‘Team-Patient’ system (TPS) are energy, entropy, and complexity. Impairment of consciousness as the absence of linear contact appears together with a loss of essential functions (low energy), vegetative-visceral fits (excessive energy and low order), motor agitation (excessive energy and excessive order), etc. Techniques of teamwork are different in these cases for resulting optimization of the system condition. Directed regulation of the system complexity is one of the recovery tools. Different signs of awareness appear as a result of system self-organization. Joint meetings are an important part of teamwork. Regular or event-related discussions form the language of inter-professional communication, as well as the patient's shared mental model. Analysis of complex communication process in TPS may be useful for creation of the general theory of consciousness.

Keywords: rehabilitation team, urgent rehabilitation, severe brain damage, consciousness disorders, complex system theory

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164 Methylphenidate Use by Canadian Children and Adolescents and the Associated Adverse Reactions

Authors: Ming-Dong Wang, Abigail F. Ruby, Michelle E. Ross

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Methylphenidate is a first-line treatment drug for attention deficit hyperactivity disorder (ADHD), a common mental health disorder in children and adolescents. Over the last several decades, the rate of children and adolescents using ADHD medication has been increasing in many countries. A recent study found that the prevalence of ADHD medication use among children aged 3-18 years increased in 13 different world regions between 2001 and 2015, where the absolute increase ranged from 0.02 to 0.26% per year. The goal of this study was to examine the use of methylphenidate in Canadian children and its associated adverse reactions. Methylphenidate use information among young Canadians aged 0-14 years was extracted from IQVIA data on prescriptions dispensed by pharmacies between April 2014 and June 2020. The adverse reaction information associated with methylphenidate use was extracted from the Canada Vigilance database for the same time period. Methylphenidate use trends were analyzed based on sex, age group (0-4 years, 5-9 years, and 10-14 years), and geographical location (province). The common classes of adverse reactions associated with methylphenidate use were sorted, and the relative risks associated with methylphenidate use as compared with two second-line amphetamine medications for ADHD were estimated. This study revealed that among Canadians aged 0-14 years, every 100 people used about 25 prescriptions (or 23,000 mg) of methylphenidate per year during the study period, and the use increased with time. Boys used almost three times more methylphenidate than girls. The amount of drug used was inversely associated with age: Canadians aged 10-14 years used nearly three times as many drugs compared to those aged 5-9 years. Seasonal methylphenidate use patterns were apparent among young Canadians, but the seasonal trends differed among the three age groups. Methylphenidate use varied from region to region, and the highest methylphenidate use was observed in Quebec, where the use of methylphenidate was at least double that of any other province. During the study period, Health Canada received 304 adverse reaction reports associated with the use of methylphenidate for Canadians aged 0-14 years. The number of adverse reaction reports received for boys was 3.5 times higher than that for girls. The three most common adverse reaction classes were psychiatric disorders, nervous system disorders and injury, poisoning procedural complications. The number one commonly reported adverse reaction for boys was aggression (11.2%), while for girls, it was a tremor (9.6%). The safety profile in terms of adverse reaction classes associated with methylphenidate use was similar to that of the selected control products. Methylphenidate is a commonly used pharmaceutical product in young Canadians, particularly in the province of Quebec. Boys used approximately three times more of this product as compared to girls. Future investigation is needed to determine what factors are associated with the observed geographic variations in Canada.

Keywords: adverse reaction risk, methylphenidate, prescription trend, use variation

Procedia PDF Downloads 134
163 Using Technology to Deliver and Scale Early Childhood Development Services in Resource Constrained Environments: Case Studies from South Africa

Authors: Sonja Giese, Tess N. Peacock

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South African based Innovation Edge is experimenting with technology to drive positive behavior change, enable data-driven decision making, and scale quality early years services. This paper uses five case studies to illustrate how technology can be used in resource-constrained environments to first, encourage parenting practices that build early language development (using a stage-based mobile messaging pilot, ChildConnect), secondly, to improve the quality of ECD programs (using a mobile application, CareUp), thirdly, how to affordably scale services for the early detection of visual and hearing impairments (using a mobile tool, HearX), fourthly, how to build a transparent and accountable system for the registration and funding of ECD (using a blockchain enabled platform, Amply), and finally enable rapid data collection and feedback to facilitate quality enhancement of programs at scale (the Early Learning Outcomes Measure). ChildConnect and CareUp were both developed using a design based iterative research approach. The usage and uptake of ChildConnect and CareUp was evaluated with qualitative and quantitative methods. Actual child outcomes were not measured in the initial pilots. Although parents who used and engaged on either platform felt more supported and informed, parent engagement and usage remains a challenge. This is contrast to ECD practitioners whose usage and knowledge with CareUp showed both sustained engagement and knowledge improvement. HearX is an easy-to-use tool to identify hearing loss and visual impairment. The tool was tested with 10000 children in an informal settlement. The feasibility of cost-effectively decentralising screening services was demonstrated. Practical and financial barriers remain with respect to parental consent and for successful referrals. Amply uses mobile and blockchain technology to increase impact and accountability of public services. In the pilot project, Amply is being used to replace an existing paper-based system to register children for a government-funded pre-school subsidy in South Africa. Early Learning Outcomes Measure defines what it means for a child to be developmentally ‘on track’ at aged 50-69 months. ELOM administration is enabled via a tablet which allows for easy and accurate data collection, transfer, analysis, and feedback. ELOM is being used extensively to drive quality enhancement of ECD programs across multiple modalities. The nature of ECD services in South Africa is that they are in large part provided by disconnected private individuals or Non-Governmental Organizations (in contrast to basic education which is publicly provided by the government). It is a disparate sector which means that scaling successful interventions is that much harder. All five interventions show the potential of technology to support and enhance a range of ECD services, but pathways to scale are still being tested.

Keywords: assessment, behavior change, communication, data, disabilities, mobile, scale, technology, quality

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162 Application of the Pattern Method to Form the Stable Neural Structures in the Learning Process as a Way of Solving Modern Problems in Education

Authors: Liudmyla Vesper

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The problems of modern education are large-scale and diverse. The aspirations of parents, teachers, and experts converge - everyone interested in growing up a generation of whole, well-educated persons. Both the family and society are expected in the future generation to be self-sufficient, desirable in the labor market, and capable of lifelong learning. Today's children have a powerful potential that is difficult to realize in the conditions of traditional school approaches. Focusing on STEM education in practice often ends with the simple use of computers and gadgets during class. "Science", "technology", "engineering" and "mathematics" are difficult to combine within school and university curricula, which have not changed much during the last 10 years. Solving the problems of modern education largely depends on teachers - innovators, teachers - practitioners who develop and implement effective educational methods and programs. Teachers who propose innovative pedagogical practices that allow students to master large-scale knowledge and apply it to the practical plane. Effective education considers the creation of stable neural structures during the learning process, which allow to preserve and increase knowledge throughout life. The author proposed a method of integrated lessons – cases based on the maths patterns for forming a holistic perception of the world. This method and program are scientifically substantiated and have more than 15 years of practical application experience in school and student classrooms. The first results of the practical application of the author's methodology and curriculum were announced at the International Conference "Teaching and Learning Strategies to Promote Elementary School Success", 2006, April 22-23, Yerevan, Armenia, IREX-administered 2004-2006 Multiple Component Education Project. This program is based on the concept of interdisciplinary connections and its implementation in the process of continuous learning. This allows students to save and increase knowledge throughout life according to a single pattern. The pattern principle stores information on different subjects according to one scheme (pattern), using long-term memory. This is how neural structures are created. The author also admits that a similar method can be successfully applied to the training of artificial intelligence neural networks. However, this assumption requires further research and verification. The educational method and program proposed by the author meet the modern requirements for education, which involves mastering various areas of knowledge, starting from an early age. This approach makes it possible to involve the child's cognitive potential as much as possible and direct it to the preservation and development of individual talents. According to the methodology, at the early stages of learning students understand the connection between school subjects (so-called "sciences" and "humanities") and in real life, apply the knowledge gained in practice. This approach allows students to realize their natural creative abilities and talents, which makes it easier to navigate professional choices and find their place in life.

Keywords: science education, maths education, AI, neuroplasticity, innovative education problem, creativity development, modern education problem

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161 Learning Language through Story: Development of Storytelling Website Project for Amazighe Language Learning

Authors: Siham Boulaknadel

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Every culture has its share of a rich history of storytelling in oral, visual, and textual form. The Amazigh language, as many languages, has its own which has entertained and informed across centuries and cultures, and its instructional potential continues to serve teachers. According to many researchers, listening to stories draws attention to the sounds of language and helps children develop sensitivity to the way language works. Stories including repetitive phrases, unique words, and enticing description encourage students to join in actively to repeat, chant, sing, or even retell the story. This kind of practice is important to language learners’ oral language development, which is believed to correlate completely with student’s academic success. Today, with the advent of multimedia, digital storytelling for instance can be a practical and powerful learning tool. It has the potential in transforming traditional learning into a world of unlimited imaginary environment. This paper reports on a research project on development of multimedia Storytelling Website using traditional Amazigh oral narratives called “tell me a story”. It is a didactic tool created for the learning of good moral values in an interactive multimedia environment combining on-screen text, graphics and audio in an enticing environment and enabling the positive values of stories to be projected. This Website developed in this study is based on various pedagogical approaches and learning theories deemed suitable for children age 8 to 9 year-old. The design and development of Website was based on a well-researched conceptual framework enabling users to: (1) re-play and share the stories in schools or at home, and (2) access the Website anytime and anywhere. Furthermore, the system stores the students work and activities over the system, allowing parents or teachers to monitor students’ works, and provide online feedback. The Website contains following main feature modules: Storytelling incorporates a variety of media such as audio, text and graphics in presenting the stories. It introduces the children to various kinds of traditional Amazigh oral narratives. The focus of this module is to project the positive values and images of stories using digital storytelling technique. Besides development good moral sense in children using projected positive images and moral values, it also allows children to practice their comprehending and listening skills. Reading module is developed based on multimedia material approach which offers the potential for addressing the challenges of reading instruction. This module is able to stimulate children and develop reading practice indirectly due to the tutoring strategies of scaffolding, self-explanation and hyperlinks offered in this module. Word Enhancement assists the children in understanding the story and appreciating the good moral values more efficiently. The difficult words or vocabularies are attached to present the explanation, which makes the children understand the vocabulary better. In conclusion, we believe that the interactive multimedia storytelling reveals an interesting and exciting tool for learning Amazigh. We plan to address some learning issues, in particularly the uses of activities to test and evaluate the children on their overall understanding of story and words presented in the learning modules.

Keywords: Amazigh language, e-learning, storytelling, language teaching

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160 The Socio-Emotional Vulnerability of Professional Rugby Union Athletes

Authors: Hannah Kuhar

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This paper delves into the attitudes of professional and semi-professional rugby union athletes in regard to socio-emotional vulnerability, or the willingness to express the full spectrum of human emotion in a social context. Like all humans, athletes of all sports regularly experience feelings of shame, powerlessness, and loneliness, and often feel unable to express such feelings due to factors including lack of situational support, absence of adequate expressive language and lack of resource. To this author’s knowledge, however, no previous research has considered the particular demographic of professional rugby union athletes, despite the sport’s immense popularity and economic contribution to global communities. Hence, this paper aims to extend previous research by exploring the experiences of professional rugby union athletes and their unwillingness and inability to express socio-emotional vulnerability. By having a better understanding of vulnerability in rugby and sports, this paper is able to contribute to the growing field of mental health and wellbeing research, particularly towards the emerging themes of resilience and belonging. Based on qualitative fieldwork conducted over a period of seven months across France and Australia, via the mechanisms of semi-structured interview and observation, this work uses the field theory framework of Pierre Bourdieu to construct an analysis of multidisciplinary thought. Approaching issues of gender, sexuality, physicality, education, and family, this paper shows that socio-emotional vulnerability is experienced by all players regardless of their background, in a variety of ways. Common themes and responses are drawn to show the universality of rugby’s pitfalls, which have previously been limited to specific demographics in isolation of their broader contexts. With the author themselves a semi-professional athlete, the provision of unique ‘insider’ access facilitates a deeper and more comprehensive understanding of first-hand athlete experiences, often unexplored within the context of the academic arena. The primary contention of this paper is to argue that by celebrating socio-emotional vulnerability, there becomes an opportunity to improve on-field team outcomes. Ultimately, players play better when they feel supported by their teammates, and this logic extends to the outcome of the team when socio-emotional team initiatives are widely embraced. The creation of such a culture requires deliberate and purposeful efforts, where player ownership and buy-in are high. Further study in this field may assist teams to better understand the elements which contribute to strong team culture and to strong results on the pitch.

Keywords: rugby, vulnerability, athletes, France, Bourdieu

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159 Interdisciplinary Evaluations of Children with Autism Spectrum Disorder in a Telehealth Arena

Authors: Janice Keener, Christine Houlihan

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Over the last several years, there has been an increase in children identified as having Autism Spectrum Disorder (ASD). Specialists across several disciplines: mental health and medical professionals have been tasked with ensuring accurate and timely evaluations for children with suspected ASD. Due to the nature of the ASD symptom presentation, an interdisciplinary assessment and treatment approach best addresses the needs of the whole child. During the unprecedented COVID-19 Pandemic, clinicians were faced with how to continue with interdisciplinary assessments in a telehealth arena. Instruments that were previously used to assess ASD in-person were no longer appropriate measures to use due to the safety restrictions. For example, The Autism Diagnostic Observation Schedule requires examiners and children to be in very close proximity of each other and if masks or face shields are worn, they render the evaluation invalid. Similar issues arose with the various cognitive measures that are used to assess children such as the Weschler Tests of Intelligence and the Differential Ability Scale. Thus the need arose to identify measures that are able to be safely and accurately administered using safety guidelines. The incidence of ASD continues to rise over time. Currently, the Center for Disease Control estimates that 1 in 59 children meet the criteria for a diagnosis of ASD. The reasons for this increase are likely multifold, including changes in diagnostic criteria, public awareness of the condition, and other environmental and genetic factors. The rise in the incidence of ASD has led to a greater need for diagnostic and treatment services across the United States. The uncertainty of the diagnostic process can lead to an increased level of stress for families of children with suspected ASD. Along with this increase, there is a need for diagnostic clarity to avoid both under and over-identification of this condition. Interdisciplinary assessment is ideal for children with suspected ASD, as it allows for an assessment of the whole child over the course of time and across multiple settings. Clinicians such as Psychologists and Developmental Pediatricians play important roles in the initial evaluation of autism spectrum disorder. An ASD assessment may consist of several types of measures such as standardized checklists, structured interviews, and direct assessments such as the ADOS-2 are just a few examples. With the advent of telehealth clinicians were asked to continue to provide meaningful interdisciplinary assessments via an electronic platform and, in a sense, going to the family home and evaluating the clinical symptom presentation remotely and confidently making an accurate diagnosis. This poster presentation will review the benefits, limitations, and interpretation of these various instruments. The role of other medical professionals will also be addressed, including medical providers, speech pathology, and occupational therapy.

Keywords: Autism Spectrum Disorder Assessments, Interdisciplinary Evaluations , Tele-Assessment with Autism Spectrum Disorder, Diagnosis of Autism Spectrum Disorder

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158 A Meta-Analysis of School-Based Suicide Prevention for Adolescents and Meta-Regressions of Contextual and Intervention Factors

Authors: E. H. Walsh, J. McMahon, M. P. Herring

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Post-primary school-based suicide prevention (PSSP) is a valuable avenue to reduce suicidal behaviours in adolescents. The aims of this meta-analysis and meta-regression were 1) to quantify the effect of PSSP interventions on adolescent suicide ideation (SI) and suicide attempts (SA), and 2) to explore how intervention effects may vary based on important contextual and intervention factors. This study provides further support to the benefits of PSSP by demonstrating lower suicide outcomes in over 30,000 adolescents following PSSP and mental health interventions and tentatively suggests that intervention effectiveness may potentially vary based on intervention factors. The protocol for this study is registered on PROSPERO (ID=CRD42020168883). Population, intervention, comparison, outcomes, and study design (PICOs) defined eligible studies as cluster randomised studies (n=12) containing PSSP and measuring suicide outcomes. Aggregate electronic database EBSCO host, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched. Cochrane bias tools for cluster randomised studies demonstrated that half of the studies were rated as low risk of bias. The Egger’s Regression Test adapted for multi-level modelling indicated that publication bias was not an issue (all ps > .05). Crude and corresponding adjusted pooled log odds ratios (OR) were computed using the Metafor package in R, yielding 12 SA and 19 SI effects. Multi-level random-effects models accounting for dependencies of effects from the same study revealed that in crude models, compared to controls, interventions were significantly associated with 13% (OR=0.87, 95% confidence interval (CI), [0.78,0.96], Q18 =15.41, p=0.63) and 34% (OR=0.66, 95%CI [0.47,0.91], Q10=16.31, p=0.13) lower odds of SI and SA, respectively. Adjusted models showed similar odds reductions of 15% (OR=0.85, 95%CI[0.75,0.95], Q18=10.04, p=0.93) and 28% (OR=0.72, 95%CI[0.59,0.87], Q10=10.46, p=0.49) for SI and SA, respectively. Within-cluster heterogeneity ranged from no heterogeneity to low heterogeneity for SA across crude and adjusted models (0-9%). No heterogeneity was identified for SI across crude and adjusted models (0%). Pre-specified univariate moderator analyses were not significant for SA (all ps < 0.05). Variations in average pooled SA odds reductions across categories of various intervention characteristics were observed (all ps < 0.05), which preliminarily suggests that the effectiveness of interventions may potentially vary across intervention factors. These findings have practical implications for researchers, clinicians, educators, and decision-makers. Further investigation of important logical, theoretical, and empirical moderators on PSSP intervention effectiveness is recommended to establish how and when PSSP interventions best reduce adolescent suicidal behaviour.

Keywords: adolescents, contextual factors, post-primary school-based suicide prevention, suicide ideation, suicide attempts

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157 Familial Exome Sequencing to Decipher the Complex Genetic Basis of Holoprosencephaly

Authors: Artem Kim, Clara Savary, Christele Dubourg, Wilfrid Carre, Houda Hamdi-Roze, Valerie Dupé, Sylvie Odent, Marie De Tayrac, Veronique David

Abstract:

Holoprosencephaly (HPE) is a rare congenital brain malformation resulting from the incomplete separation of the two cerebral hemispheres. It is characterized by a wide phenotypic spectrum and a high degree of locus heterogeneity. Genetic defects in 16 genes have already been implicated in HPE, but account for only 30% of cases, suggesting that a large part of genetic factors remains to be discovered. HPE has been recently redefined as a complex multigenic disorder, requiring the joint effect of multiple mutational events in genes belonging to one or several developmental pathways. The onset of HPE may result from accumulation of the effects of multiple rare variants in functionally-related genes, each conferring a moderate increase in the risk of HPE onset. In order to decipher the genetic basis of HPE, unconventional patterns of inheritance involving multiple genetic factors need to be considered. The primary objective of this study was to uncover possible disease causing combinations of multiple rare variants underlying HPE by performing trio-based Whole Exome Sequencing (WES) of familial cases where no molecular diagnosis could be established. 39 families were selected with no fully-penetrant causal mutation in known HPE gene, no chromosomic aberrations/copy number variants and without any implication of environmental factors. As the main challenge was to identify disease-related variants among a large number of nonpathogenic polymorphisms detected by WES classical scheme, a novel variant prioritization approach was established. It combined WES filtering with complementary gene-level approaches: transcriptome-driven (RNA-Seq data) and clinically-driven (public clinical data) strategies. Briefly, a filtering approach was performed to select variants compatible with disease segregation, population frequency and pathogenicity prediction to identify an exhaustive list of rare deleterious variants. The exome search space was then reduced by restricting the analysis to candidate genes identified by either transcriptome-driven strategy (genes sharing highly similar expression patterns with known HPE genes during cerebral development) or clinically-driven strategy (genes associated to phenotypes of interest overlapping with HPE). Deeper analyses of candidate variants were then performed on a family-by-family basis. These included the exploration of clinical information, expression studies, variant characteristics, recurrence of mutated genes and available biological knowledge. A novel bioinformatics pipeline was designed. Applied to the 39 families, this final integrated workflow identified an average of 11 candidate variants per family. Most of candidate variants were inherited from asymptomatic parents suggesting a multigenic inheritance pattern requiring the association of multiple mutational events. The manual analysis highlighted 5 new strong HPE candidate genes showing recurrences in distinct families. Functional validations of these genes are foreseen.

Keywords: complex genetic disorder, holoprosencephaly, multiple rare variants, whole exome sequencing

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156 Spatial Deictics in Face-to-Face Communication: Findings in Baltic Languages

Authors: Gintare Judzentyte

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The present research is aimed to discuss semantics and pragmatics of spatial deictics (deictic adverbs of place and demonstrative pronouns) in the Baltic languages: in spoken Lithuanian and in spoken Latvian. The following objectives have been identified to achieve the aim: 1) to determine the usage of adverbs of place in spoken Lithuanian and Latvian and to verify their meanings in face-to-face communication; 2) to determine the usage of demonstrative pronouns in spoken Lithuanian and Latvian and to verify their meanings in face-to-face communication; 3) to compare the systems between the two spoken languages and to identify the main tendencies. As meanings of demonstratives (adverbs of place and demonstrative pronouns) are context-bound, it is necessary to verify their usage in spontaneous interaction. Besides, deictic gestures play a very important role in face-to-face communication. Therefore, an experimental method is necessary to collect the data. Video material representing spoken Lithuanian and spoken Latvian was recorded by means of the method of a qualitative interview (a semi-structured interview: an empirical research is all about asking right questions). The collected material was transcribed and evaluated taking into account several approaches: 1) physical distance (location of the referent, visual accessibility of the referent); 2) deictic gestures (the combination of language and gesture is especially characteristic of the exophoric use); 3) representation of mental spaces in physical space (a speaker sometimes wishes to mark something that is psychically close as psychologically distant and vice versa). The research of the collected data revealed that in face-to-face communication the participants choose deictic adverbs of place instead of demonstrative pronouns to locate/identify entities in situations where the demonstrative pronouns would be expected in spoken Lithuanian and in spoken Latvian. The analysis showed that visual accessibility of the referent is very important in face-to-face communication, but the main criterion while localizing objects and entities is the need for contrast: lith. čia ‘here’, šis ‘this’, latv. šeit ‘here’, šis ‘this’ usually identify distant entities and are used instead of distal demonstratives (lith. ten ‘there’, tas ‘that’, latv. tur ‘there’, tas ‘that’), because the referred objects/subjects contrast to further entities. Furthermore, the interlocutors in examples from a spontaneously situated interaction usually extend their space and can refer to a ‘distal’ object/subject with a ‘proximal’ demonstrative based on the psychological choice. As the research of the spoken Baltic languages confirmed, the choice of spatial deictics in face-to-face communication is strongly effected by a complex of criteria. Although there are some main tendencies, the exact meaning of spatial deictics in the spoken Baltic languages is revealed and is relevant only in a certain context.

Keywords: Baltic languages, face-to-face communication, pragmatics, semantics, spatial deictics

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155 Comparison of Effect of Group Counseling with Cognitive Therapy Approach and Interactive Lectures on Anxiety during Pregnancy in Primiparas: A Clinical Trial

Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

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Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

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