Search results for: psychological distress

Authors: Camille Plant, Katherine McGill, Pek Ang

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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.

Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry

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Authors: S. Alina Wang

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A Gibsonian approach is used to understand the existential dimensions of the human ecological niche. Then, this existential-Gibsonian framework is applied to rethinking Hacking’s historical analysis of multiple personality disorder. This research culminates in a generalized account of psychiatric illness from an enactivist lens. In conclusion, reflections on the implications of this account on approaches to psychiatric treatment are mentioned. J.J. Gibson’s theory of affordances centered on affordances of sensorimotor varieties, which guide basic behaviors relative to organisms’ vital needs and physiological capacities (1979). Later theorists, notably Neisser (1988) and Rietveld (2014), expanded on the theory of affordances to account for uniquely human activities relative to the emotional, intersubjective, cultural, and narrative aspects of the human ecological niche. This research shows that these affordances are structured by what Haugeland (1998) calls existential commitments, which draws on Heidegger’s notion of dasein (1927) and Merleau-Ponty’s account of existential freedom (1945). These commitments organize the existential affordances that fill an individual’s environment and guide their thoughts, emotions, and behaviors. This system of a priori existential commitments and a posteriori affordances is called existential enactivism. For humans, affordances do not only elicit motor responses and appear as objects with instrumental significance. Affordances also, and possibly primarily, determine so-called affective and cognitive activities and structure the wide range of kinds (e.g., instrumental, aesthetic, ethical) of significances of objects found in the world. Then existential enactivism is applied to understanding the psychiatric phenomenon of multiple personality disorder (precursor of the current diagnosis of dissociative identity disorder). A reinterpretation of Hacking’s (1998) insights into the history of this particular disorder and his generalizations on the constructed nature of most psychiatric illness is taken on. Enactivist approaches sensitive to existential phenomenology can provide a deeper understanding of these matters. Conceptualizing psychiatric illness as strictly a disorder in the head (whether parsed as a disorder of brain chemicals or meaning-making capacities encoded in psychological modules) is incomplete. Rather, psychiatric illness must also be understood as a disorder in the world, or in the interconnected networks of existential affordances that regulate one’s emotional, intersubjective, and narrative capacities. All of this suggests that an adequate account of psychiatric illness must involve (1) the affordances that are the sources of existential hindrance, (2) the existential commitments structuring these affordances, and (3) the conditions of these existential commitments. Approaches to treatment of psychiatric illness would be more effective by centering on the interruption of normalized behaviors corresponding to affordances targeted as sources of hindrance, the development of new existential commitments, and the practice of new behaviors that erect affordances relative to these reformed commitments.

Keywords: affordance, enaction, phenomenology, psychiatry, psychopathology

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Authors: Halima Sadia Qureshi, Urooj Sadiq, Noshi Eram Zaman

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The goal of this study was to see how cognitive behavior hypnotherapy affected nonsuicidal self-injury. DSM 5 invites the researchers to explore the newly added condition under the chapter of conditions under further study named Nonsuicidal self-injury disorder. To date, no empirical sound intervention has been proven effective for NSSI as given in DSM 5. Nonsuicidal self-injury is defined by DSM 5 as harming one's self physically, without suicidal intention. Around 7.6% of teenagers are expected to fulfill the NSSI disorder criteria. 3 Adolescents, particularly university students, account for around 87 percent of self-harm studies. Furthermore, one of the risks associated with NSSI is an increased chance of suicide attempts, and in most cases, the cycle repeats again. 6 The emotional and psychological components of the illness might lead to suicide, either intentionally or unintentionally. 7 According to a research done at a Pakistani military hospital, over 80% of participants had no intention of committing suicide. Furthermore, it has been determined that improvements in NSSI prevention and intervention are necessary as a stand-alone strategy. The quasi-experimental study took place in Islamabad and Rawalpindi, Pakistan, from May 2019 to April 2020 and included students aged 18 to 25 years old from several institutions and colleges in the twin cities. According to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, the individuals were assessed for >2 episodes without suicidal intent using the intentional self-harm questionnaire. The Clinician Administered Nonsuicidal Self-Injury Disorder Index (CANDI) was used to assess the individual for NSSI condition. Symptom checklist-90 (SCL-90) was used to screen the participants for differential diagnosis. Mclean Screening Instrument for Borderline Personality Disorder (MSI-BPD) was used to rule out the BPD cases. The selected participants, n=106 from the screening sample of 600, were selected. They were further screened to meet the inclusion and exclusion criteria, and the total of n=71 were split into two groups: intervention and control. The intervention group received cognitive behavior hypnotherapy for the next three months, whereas the control group received no treatment. After the period of three months, both the groups went through the post assessment, and after the three months’ period, follow-up assessment was conducted. The groups were evaluated, and SPSS 25 was used to analyse the data. The results showed that each of the two groups had 30 (50 percent) of the 60 participants. There were 41 males (68 percent) and 19 girls (32 percent) in all. The bulk of the participants were between the ages of 21 and 23. (48 percent). Self-harm events were reported by 48 (80 percent) of the pupils, and suicide ideation was found in 6 (ten percent). In terms of pre- and post-intervention values (d=4.90), post-intervention and follow-up assessment values (d=0.32), and pre-intervention and follow-up values (d=5.42), the study's effect size was good. The comparison of treatment and no-treatment groups revealed that treatment was more successful than no-treatment, F (1, 58) = 53.16, p.001. The results reveal that the treatment manual of CBH is effective for Nonsuicidal self-injury disorder.

Keywords: NSSI, nonsuicidal self injury disorder, self-harm, self-injury, Cognitive behaviour hypnotherapy, CBH

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Authors: Rasmita Mishra, Chander Shekher

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Background: Population ageing is an inevitable outcome of demographic transition. Due to increased life expectancy, the old age population in India and worldwide has increased, and it will continue to grow more alarmingly in the near future. There are redundant austerity that has been bestowed upon the widows, thus, the life of widows is never been easy in India. The loss of spouse along with other disadvantaged socioeconomic intermediaries like illiteracy and poverty often make the life of widows more difficult to live. Methodology: Ethical statement: The study used secondary data available in the public domain for its wider use in social research. Thus, there was no requirement of ethical consent in the present study. Data source: Building a Knowledge Base on Population Aging in India (BKPAI), 2011 dataset is used to fulfill the objectives of this study. It was carried out in seven states – Himachal Pradesh, Kerala, Maharashtra, Odisha, Punjab, Tamil Nadu, and West Bengal – having a higher percentage of the population in the age group 60 years and above compared to the national average. Statistical analysis: Descriptive and inferential statistics were used to understand the level of elderly widows and incidence of abuse against them in India and selected states. Bivariate and Trivariate analysis were carried out to check the pattern of abuse by selected covariates. Chi-Square test is used to verify the significance of the association. Further, Discriminant Analysis (DA) is carried out to understand which factor can separate out group of neglect and non-neglect elderly. Result: With the addition of 27 million from 2001 to 2011, the total elderly population in India is more than 100 million. Elderly females aged 60+ were more widows than their counterpart elderly males. This pattern was observed across selected states and at national level. At national level, more than one tenth (12 percent) of elderly experienced abuse in their lifetime. Incidence of abuse against elderly widows within family was considerably higher than the outside the family. This pattern was observed across the selected place and abuse in the study. In discriminant analysis, the significant difference between neglected and non-neglected elderly on each of the independent variables was examined using group mean and ANOVA. Discussion: The study is the first of its kind to assess the incidence of abuse against elderly widows using large-scale survey data. Another novelty of this study is that it has assessed for those states in India whereby the proportion of elderly is higher than the national average. Place and perpetrators involved in the abuse against elderly widows certainly envisaged the safeness in the present living arrangement of elderly widows. Conclusion: Due to the increasing life expectancy it is expected that the number of elderly will increase much faster than before. As biologically women live longer than men, there will be more women elderly than men. With respect to the living arrangement, after the demise of the spouse, elderly widows are more likely to live with their children who emerged as the main perpetrator of abuse.

Keywords: elderly abuse, emotional abuse physical abuse, material abuse, psychological abuse, quality of life

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Authors: Wai Yan Shih, Sau Man Wong, Wing Chung Chang, Wai Chi Chan

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Background: Late-life depression is associated with significant consequences. Although symptomatic reduction is achievable through pharmacological interventions, older adults are more vulnerable to the side effects than their younger counterparts. In addition, drugs do not address underlying cognitive dysfunctions such as rumination and reduced autobiographical memory specificity (AMS), both shown to be maladaptive coping styles that are associated with a poorer prognosis in depression. Considering how aging is accompanied by cognitive, psychological and physical changes, the interplay of these age-related factors may potentially aggravate and interfere with these depressive cognitive dysfunctions in late-life depression. Special care should, therefore, be drawn to ensure these cognitive dysfunctions are adequately addressed. Aim: This randomized controlled trial aims to examine the effect of mindfulness-based cognitive therapy (MBCT) on depressed older adults, and whether the potential benefits of MBCT are mediated by improvements in rumination and AMS. Method: Fifty-seven participants with an average age of 70 years old were recruited from multiple elderly centers and online mailing lists. Participants were assessed with: (1) Hamilton depression scale, (2) ruminative response scale, (3) autobiographical memory test, (4) mindful attention awareness scale, and (5) Montreal cognitive assessment. Eligible participants with mild to moderate depressive symptoms and normal cognitive functioning were randomly allocated to an 8-week MBCT group or active control group consisting of a low-intensity exercise program and health education. Post-intervention assessments were conducted after the 8-week program. Ethics approval was given by the Institutional Review Board of the University of Hong Kong/Hospital Authority. Results: Mixed-factorials ANOVAs demonstrated significant time x group interaction effects for depressive symptoms, AMS, and dispositional mindfulness. A marginally significant interaction effect was found for rumination. Simple effect analyses revealed a significant reduction in depressive symptoms for the both the MBCT group (mean difference = 7.1, p = .000), and control group (mean difference = 2.7, p = .023). However, only participants in the MBCT group demonstrated improvements in rumination, AMS, and dispositional mindfulness. Bootstrapping-based mediation analyses showed that the effect of MBCT in alleviating depressive symptoms was only mediated by the reduction in rumination. Conclusions: The findings support the use of MBCT as an effective intervention for depressed older adults, considering the improvements in depressive symptoms, rumination, AMS and dispositional mindfulness despite their age. Reduction in ruminative tendencies plays a major role in the cognitive mechanism of MBCT.

Keywords: mindfulness-based cognitive therapy, depression, older adults, rumination, autobiographical memory specificity

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Authors: Maria C. Almario, Pam Remer, Jeff Resse, Kathy Moran, Linda Theander Adam

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The identification of victims of human trafficking and consequential service provision is characterized by a significant disconnection between the estimated prevalence of this issue and the number of cases identified. This poses as tremendous problem for human rights advocates as it prevents data collection, information sharing, allocation of resources and opportunities for international dialogues. The current paper introduces the Inclusive Human Trafficking Checklist (IHTC) as a measurement methodology with theoretical underpinnings derived from dialectic theory. The presence of human trafficking in a person’s life is conceptualized as a dynamic and dialectic interaction between vulnerability and exploitation. The current papers explores the operationalization of exploitation and vulnerability, evaluates the metric qualities of the instrument, evaluates whether there are differences in assessment based on the participant’s profession, level of knowledge, and training, and assesses if users of the instrument perceive it as useful. A total of 201 participants were asked to rate three vignettes predetermined by experts to qualify as a either human trafficking case or not. The participants were placed in three conditions: business as usual, utilization of the IHTC with and without training. The results revealed a statistically significant level of agreement between the expert’s diagnostic and the application of the IHTC with an improvement of 40% on identification when compared with the business as usual condition While there was an improvement in identification in the group with training, the difference was found to have a small effect size. Participants who utilized the IHTC showed an increased ability to identify elements of identity-based vulnerabilities as well as elements of fraud, which according to the results, are distinctive variables in cases of human trafficking. In terms of the perceived utility, the results revealed higher mean scores for the groups utilizing the IHTC when compared to the business as usual condition. These findings suggest that the IHTC improves appropriate identification of cases and that it is perceived as a useful instrument. The application of the IHTC as a multidisciplinary instrumentation that can be utilized in legal and human services settings is discussed as a pivotal piece of helping victims restore their sense of dignity, and advocate for legal, physical and psychological reparations. It is noteworthy that this study was conducted with a sample in the United States and later re-tested in Colombia. The implications of the instrument for treatment conceptualization and intervention in human trafficking cases are discussed as opportunities for enhancement of victim well-being, restoration engagement and activism. With the idea that what is personal is also political, we believe that the careful observation and data collection in specific cases can inform new areas of human rights activism.

Keywords: exploitation, human trafficking, measurement, vulnerability, screening

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Authors: Simona Maria Ignat

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Bullying online has been an increasing studied topic during the last years. Different approaches, psychological, linguistic, or computational, have been applied. To our best knowledge, a definition and a set of characteristics of phenomenon agreed internationally as a common framework are still waiting for answers. Thus, the objectives of this paper are the identification of bullying utterances on Twitter and their algorithms. This research paper is focused on the identification of words or groups of words, categorized as “utterances”, with bullying effect, from Twitter platform, extracted on a set of legislative criteria. This set is the result of analysis followed by synthesis of law documents on bullying(online) from United States of America, European Union, and Ireland. The outcome is a linguistic corpus with approximatively 10,000 entries. The methods applied to the first objective have been the following. The discourse analysis has been applied in identification of keywords with bullying effect in texts from Google search engine, Images link. Transcription and anonymization have been applied on texts grouped in CL1 (Corpus linguistics 1). The keywords search method and the legislative criteria have been used for identifying bullying utterances from Twitter. The texts with at least 30 representations on Twitter have been grouped. They form the second corpus linguistics, Bullying utterances from Twitter (CL2). The entries have been identified by using the legislative criteria on the the BoW method principle. The BoW is a method of extracting words or group of words with same meaning in any context. The methods applied for reaching the second objective is the conversion of parts of speech to alphabetical and numerical symbols and writing the bullying utterances as algorithms. The converted form of parts of speech has been chosen on the criterion of relevance within bullying message. The inductive reasoning approach has been applied in sampling and identifying the algorithms. The results are groups with interchangeable elements. The outcomes convey two aspects of bullying: the form and the content or meaning. The form conveys the intentional intimidation against somebody, expressed at the level of texts by grammatical and lexical marks. This outcome has applicability in the forensic linguistics for establishing the intentionality of an action. Another outcome of form is a complex of graphemic variations essential in detecting harmful texts online. This research enriches the lexicon already known on the topic. The second aspect, the content, revealed the topics like threat, harassment, assault, or suicide. They are subcategories of a broader harmful content which is a constant concern for task forces and legislators at national and international levels. These topic – outcomes of the dataset are a valuable source of detection. The analysis of content revealed algorithms and lexicons which could be applied to other harmful contents. A third outcome of content are the conveyances of Stylistics, which is a rich source of discourse analysis of social media platforms. In conclusion, this corpus linguistics is structured on legislative criteria and could be used in various fields.

Keywords: corpus linguistics, cyberbullying, legislation, natural language processing, twitter

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Authors: Roberta Martino, Viviana Ventre

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Intertemporal choices are choices under conditions of uncertainty in which the consequences are distributed over time. The Discounted Utility Model is the essential reference for describing the individual in the context of intertemporal choice. The model is based on the idea that the individual selects the alternative with the highest utility, which is calculated by multiplying the cardinal utility of the outcome, as if the reception were instantaneous, by the discount function that determines a decrease in the utility value according to how the actual reception of the outcome is far away from the moment the choice is made. Initially, the discount function was assumed to have an exponential trend, whose decrease over time is constant, in line with a profile of a rational investor described by classical economics. Instead, empirical evidence called for the formulation of alternative, hyperbolic models that better represented the actual actions of the investor. Attitudes that do not comply with the principles of classical rationality are termed anomalous, i.e., difficult to rationalize and describe through normative models. The development of behavioral finance, which describes investor behavior through cognitive psychology, has shown that deviations from rationality are due to the limited rationality condition of human beings. What this means is that when a choice is made in a very difficult and information-rich environment, the brain does a compromise job between the cognitive effort required and the selection of an alternative. Moreover, the evaluation and selection phase of the alternative, the collection and processing of information, are dynamics conditioned by systematic distortions of the decision-making process that are the behavioral biases involving the individual's emotional and cognitive system. In this paper we present an original decomposition of the discount function to investigate the psychological principles of hyperbolic discounting. It is possible to decompose the curve into two components: the first component is responsible for the smaller decrease in the outcome as time increases and is related to the individual's impatience; the second component relates to the change in the direction of the tangent vector to the curve and indicates how much the individual perceives the indeterminacy of the future indicating his or her aversion to uncertainty. This decomposition allows interesting conclusions to be drawn with respect to the concept of impatience and the emotional drives involved in decision-making. The contribution that neuroscience can make to decision theory and inter-temporal choice theory is vast as it would allow the description of the decision-making process as the relationship between the individual's emotional and cognitive factors. Neurofinance is a discipline that uses a multidisciplinary approach to investigate how the brain influences decision-making. Indeed, considering that the decision-making process is linked to the activity of the prefrontal cortex and amygdala, neurofinance can help determine the extent to which abnormal attitudes respect the principles of rationality.

Keywords: impatience, intertemporal choice, neurofinance, rationality, uncertainty

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Authors: Soumi Banerjee

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In this research paper we will go deep into understanding Benedict Anderson’s definition of the nation as an imagined community and we will analyze why and how national identities were created through long and complex processes, and how there can exist strong emotional bonds between people within an imagined community, given the fact that these people have never known each other personally, but will still feel some form of imagined unity. Such identity construction on the part of an individual or within societies are always in some sense in a state of flux as imagined communities are ever changing, which provides us with the ontological foundation for reaching on this paper. This sort of identity crisis among individuals living in the Western world, who are in search for psychological comfort and security, illustrates a possible need for spatially dislocated, ontologically insecure and vulnerable individuals to have a secure identity. To create such an identity there has to be something to build upon, which could be achieved through what may be termed as ‘homesteading’. This could in short, and in my interpretation of Kinnvall and Nesbitt’s concept, be described as a search for security that involves a search for ‘home’, where home acts as a secure place, which one can build an identity around. The next half of the paper will then look into how populism and identity have played an increasingly important role in the political elections in the so-called western democracies of the world, using the U.S. as an example. Notions of ‘us and them’, the people and the elites will be looked into and analyzed through a social constructivist theoretical lens. Here we will analyze how such narratives about identity and the nation state affects people, their personality development and identity in different ways by studying the U.S. President Donald Trump’s speeches and analyze if and how he used different identity creating narratives for gaining political and popular support. The reason to choose narrative analysis as a method in this research paper is to use the narratives as a device to understand how the perceived notions of 'us and them' can initiate huge identity crisis with a community or a nation-state. This is a relevant subject as results and developments such as rising populist rightwing movements are being felt in a number of European states, with the so-called Brexit vote in the U.K. and the election of Donald Trump as president are two of the prime examples. This paper will then attempt to argue that these mechanisms are strengthened and gaining significance in situations when humans in an economic, social or ontologically vulnerable position, imagined or otherwise, in a general and broad meaning perceive themselves to be under pressure, and a sense of insecurity is rising. These insecurities and sense of being under threat have been on the rise in many of the Western states that are otherwise usually perceived to be some of the safest, democratically stable and prosperous states in the world, which makes it of interest to study what has changed, and help provide some part of the explanation as to how creating a ‘them’ in the discourse of national identity can cause massive security crisis.

Keywords: identity crisis, migration, ontological security(in), nation-states

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Authors: Selin Küçük

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Pre-industrial architecture is integration of natural and subsequent properties by intelligence and experience. Since various settlements relatively industrialized or non-industrialized at any time, ‘pre-industrial’ term does not refer to a definite time. Natural properties, which are existent conditions and materials in natural local environment, are climate, geomorphology and local materials. Subsequent properties, which are all anthropological comparatives, are culture of societies, requirements of people and construction techniques that people use. Yet, after industrialization, technology took technique’s place, cultural effects are manipulated, requirements are changed and local/natural properties are almost disappeared in architecture. Technology is universal, global and expands simply; conversely technique is time and experience dependent and should has a considerable cultural background. This research is about construction techniques according to natural properties of a region and classification of these techniques. Understanding local architecture is only possible by searching its background which is hard to reach. There are always changes in positive and negative in architectural techniques through the time. Archaeological layers of a region sometimes give more accurate information about transformation of architecture. However, natural properties of any region are the most helpful elements to perceive construction techniques. Many international sources from different cultures are interested in local architecture by mentioning natural properties separately. Unfortunately, there is no literature deals with this subject as far as systematically in the correct way. This research aims to improve a clear perspective of local architecture existence by categorizing archetypes according to natural properties. The ultimate goal of this research is generating a clear classification of local architecture independent from subsequent (anthropological) properties over the world such like a handbook. Since local architecture is the most sustainable architecture with refer to its economic, ecologic and sociological properties, there should be an excessive information about construction techniques to be learned from. Constructing the same buildings in all over the world is one of the main criticism of modern architectural system. While this critics going on, the same buildings without identity increase incrementally. In post-industrial term, technology widely took technique’s place, yet cultural effects are manipulated, requirements are changed and natural local properties are almost disappeared in architecture. These study does not offer architects to use local techniques, but it indicates the progress of pre-industrial architectural evolution which is healthier, cheaper and natural. Immigration from rural areas to developing/developed cities should be prohibited, thus culture and construction techniques can be preserved. Since big cities have psychological, sensational and sociological impact on people, rural settlers can be convinced to not to immigrate by providing new buildings designed according to natural properties and maintaining their settlements. Improving rural conditions would remove the economical and sociological gulf between cities and rural. What result desired to arrived in, is if there is no deformation (adaptation process of another traditional buildings because of immigration) or assimilation in a climatic region, there should be very similar solutions in the same climatic regions of the world even if there is no relationship (trade, communication etc.) among them.

Keywords: climate zones, geomorphology, local architecture, local materials

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Authors: Milena Trojanowska

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Disability is a phenomenon for which meanings and definitions have evolved over the decades. This became the trigger to start a project to answer the question of what disability constitutes in the course of an incurable chronic disease. The chosen research group are people living with multiple sclerosis.The contextual phase of the research was participant observation at the Polish Multiple Sclerosis Society, the largest NGO in Poland supporting people living with MS and their relatives. The research techniques used in the project are (in order of implementation): group interviews with people living with MS and their relatives, narrative interviews, asynchronous technique, participant observation during events organised for people living with MS and their relatives.The researcher is currently conducting follow-up interviews, as inaccuracies in the respondents' narratives were identified during the data analysis. Interviews and supplementary research techniques were used over the four years of the research, and the researcher also benefited from experience gained from 12 years of working with NGOs (diaries, notes). The research was carried out in Poland with the participation of people living in this country only.The research has been based on grounded theory methodology in a constructivist perspectivedeveloped by Kathy Charmaz. The goal was to follow the idea that research must be reliable, original, and useful. The aim was to construct an interpretive theory that assumes temporality and the processualityof social life. TheAtlas.ti software was used to collect research material and analyse it. It is a program from the CAQDAS(Computer-Assisted Qualitative Data Analysis Software) group.Several key factors influencing the construction of a disability identity by people living with multiple sclerosis was identified:-course of interaction with significant relatives,- the expectation of identification with disability (expressed by close relatives),- economic profitability (pension, allowances),- institutional advantages (e.g. parking card),- independence and autonomy (not equated with physical condition, but access to adapted infrastructure and resources to support daily functioning),- the way a person with MS construes the meaning of disability,- physical and mental state,- medical diagnosis of illness.In addition, it has been shown that making an assumption about the experience of disability in the course of MS is a form of cognitive reductionism leading to further phenomenon such as: the expectation of the person with MS to construct a social identity as a person with a disability (e.g. giving up work), the occurrence of institutional inequalities. It can also be a determinant of the choice of a life strategy that limits social and individual functioning, even if this necessity is not influenced by the person's physical or psychological condition.The results of the research are important for the development of knowledge about the phenomenon of disability. It indicates the contextuality and complexity of the disability phenomenon, which in the light of the research is a set of different phenomenon of heterogeneous nature and multifaceted causality. This knowledge can also be useful for institutions and organisations in the non-governmental sector supporting people with disabilities and people living with multiple sclerosis.

Keywords: disability, multiple sclerosis, grounded theory, poland

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Authors: Liliana Gomez Cardona, Mary McComber, Kristyn Brown, Arlene Laliberté, Outi Linnaranta

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The history of colonialism and more contemporary political issues have resulted in the exposure of Kanien'kehá:ka: non (Kanien'kehá:ka of Kahnawake) to challenging and even traumatic experiences. Colonization, religious missions, residential schools as well as economic and political marginalization are the factors that have challenged the wellbeing and mental health of these populations. In psychiatry, screening for mental illness is often done using questionnaires with which the patient is expected to respond to how often he/she has certain symptoms. However, the Indigenous view of mental wellbeing may not fit well with this approach. Moreover, biomedical treatments do not always meet the needs of Indigenous people because they do not understand the culture and traditional healing methods that persist in many communities. Assess whether the questionnaires used to measure symptoms, commonly used in psychiatry are appropriate and culturally safe for the Mohawk in Quebec. Identify the most appropriate tool to assess and promote wellbeing and follow the process necessary to improve its cultural sensitivity and safety for the Mohawk population. Qualitative, collaborative, and participatory action research project which respects First Nations protocols and the principles of ownership, control, access, and possession (OCAP). Data collection based on five focus groups with stakeholders working with these populations and members of Indigenous communities. Thematic analysis of the data collected and emerging through an advisory group that led a revision of the content, use, and cultural and conceptual relevance of the instruments. The questionnaires measuring psychiatric symptoms face significant limitations in the local indigenous context. We present the factors that make these tools not relevant among Mohawks. Although the scale called Growth and Empowerment Measure (GEM) was originally developed among Indigenous in Australia, the Mohawk in Quebec found that this tool comprehends critical aspects of their mental health and wellbeing more respectfully and accurately than questionnaires focused on measuring symptoms. We document the process of cultural adaptation of this tool which was supported by community members to create a culturally safe tool that helps in growth and empowerment. The cultural adaptation of the GEM provides valuable information about the factors affecting wellbeing and contributes to mental health promotion. This process improves mental health services by giving health care providers useful information about the Mohawk population and their clients. We believe that integrating this tool in interventions can help create a bridge to improve communication between the Indigenous cultural perspective of the patient and the biomedical view of health care providers. Further work is needed to confirm the clinical utility of this tool in psychological and psychiatric intervention along with social and community services.

Keywords: cultural adaptation, cultural safety, empowerment, Mohawks, mental health, Quebec

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Authors: Li Shuping, Shu Huaping, Yi Chaofan, Tao Jiang

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Equestrian practice is often considered having a unique effect on improving symptoms in children with autism. This study evaluated and measured the changes in daily behavior, morphological, physical function, and fitness indexes of two group children with autism by means of 12 weeks of equestrian and basketball exercises. 19 clinically diagnosed children with moderate/mild autism were randomly divided into equestrian group (9 children, age=10.11±1.90y) and basketball group (10 children, age=10.70±2.16y). Both the equestrian and basketball groups practiced twice a week for 45 to 60 minutes each time. Three scales, the Autism Behavior Checklist (ABC), the Childhood Autism Rating Scale (CARS) and the Clancy Autism Behavior Scale (CABS) were used to assess their human behavior and psychology. Four morphological, seven physical function and fitness indicators were measured to evaluate the effects of the two exercises on the children’s body. The evaluations were taken by every four weeks ( pre-exercise, the 4th week, the 8th week and 12th week (post exercise). The result showed that the total scores of ABC, CARS and CABS, the dimension scores of ABC on the somatic motor, language and life self-care obtained after exercise were significantly lower than those obtained before 12 week exercises in both groups. The ABC feeling dimension scores of equestrian group and ABC communication dimension score of basketball group were significantly lower,and The upper arm circumference, sitting forward flexion, 40 second sit-up, 15s lateral jump, vital capacity, and single foot standing of both groups were significantly higher than that of before exercise.. The BMI of equestrian group was significantly reduced. The handgrip strength of basketball group was significantly increased. In conclusion, both types of exercises could improve daily behavior, morphological, physical function, and fitness indexes of the children with autism. However, the behavioral psychological scores, body morphology and function indicators and time points were different in the middle and back of the two interventions.But the indicators and the timing of the improvement were different. To the group of equestrian, the improvement of the flexibility occurred at week 4, the improvement of the sensory perception, control and use their own body, and promote the development of core strength endurance, coordination and cardiopulmonary function occurred at week 8，and the improvement of core strength endurance, coordination and cardiopulmonary function occurred at week 12. To the group of basketball, the improvement of the hand strength, balance, flexibility and cardiopulmonary function occurred at week 4, the improvement of the self-care ability and language expression ability, and core strength endurance and coordination occurred at week 8, the improvement of the control and use of their own body and social interaction ability occurred at week 12. In comparison of the exercise effects, the equestrian exercise improved the physical control and application ability appeared earlier than that of basketball group. Basketball exercise improved the language expression ability, self-care ability, balance ability and cardiopulmonary function of autistic children appeared earlier than that of equestrian group.

Keywords: intervention, children with autism, equestrain, basketball

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Authors: Caterina Grandi, Lukas Lochner, Marco Padovan, Mirco Rizzi, Paola Sperinde, Fabio Vittadello, Luisa Cavada

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Background: In recent years, the use of Complementary Alternative Medicine (CAM) has achieved worldwide popularity. With the increased public interest in CAMs, attention to it within Health Care Schools and Colleges has also improved. Studies generally assess the knowledge and attitudes regarding CAMs in medical and nursing students. The current study focused on the knowledge, attitudes and practice of CAM in healthcare students. Aim: To assess the knowledge and attitudes regarding complementary and alternative medicine (CAM) in healthcare students in South Tyrol, a region in Northern Italy. Methodology: This cross-sectional study was carried out among 361 students. Self-administered questionnaire was adapted and modified by the researchers from several questionnaires. The instrument consisted of three sections: 1) demographical characteristics (gender, place of residence and year of study); 2) general attitudes towards CAM, evaluated through 11 items using a Likert scale (agree, partly agree, partly disagree, disagree); 3) knowledge and use about any particular CAM practices (acupuncture, aromatherapy, creative therapies, diet/nutritional therapies, phytotherapy/herbal therapies, compresses, massage therapy, Ayurvedic therapy, Tibetan medicine, naturopathy, homeopathy, pet therapy, reflexology, therapeutic touch, chiropractic/osteopathy). Results: The sample consisted of 63 males and 297 females, 58% living in villages. 151 students (42%) were in the first year, 99 (27%) in the second and 106 (30%) in the third. Both men and women agreed with statements about the utility and benefits of CAMs. Women were significantly more likely than men to agree that the CAM practices should be included in the curriculum (p < 0.004), that the health professionals should be able to advice their patients about commonly used CAM methods (p < 0.002) and that the clinical care should integrate CAM practices (p < 0.04). Students in the second year showed the highest mean score for the statement 'CAM includes ideas and methods from which conventional medicine could benefit' (p = 0.049), highlighting a positive attitude, while students in the third year achieved the lowest mean score for the negative statement 'The results of CAM are in most cases due to a placebo effect'. Regarding this statement, participants living in villages disagreed significantly than students living in the city (p < 0.001). Females appeared to be significantly more familiar with homeopathy (p < 0.002), aromatherapy (p < 0.033), creative therapies (p < 0.001) and herbal therapies (p<0.002) than males. Moreover, women were likely to use CAM more frequently than men, particularly to solve psychological problems (p < 0.004). In addition, women perceived the benefit significantly more positive than men (p < 0.001). Students in the second year revealed to use the CAM mostly to improve the quality of life (p < 0.023), while students in the third year used CAMs particularly for chronic diseases (p < 0.001). Conclusions: Results from this study suggested that female students show more positive attitudes on CAM than male students. Moreover, the prevalence of CAM use and its perceived benefits differ between males and females, so that women are more willing to use CAM practices.

Keywords: attitude, CAM, complementary and alternative medicine, healthcare students, knowledge

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Authors: Tamir Michal

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The subject of Bedouin dispersion has accompanied the State of Israel from the day of its establishment. From a legal point of view, this subject has offered a launchpad for creative judicial decisions. Thus, for example, the first court decision in Israel to recognize affirmative action (Avitan), dealt with a petition submitted by a Jew appealing the refusal of the State to recognize the Petitioner’s entitlement to the long-term lease of a plot designated for Bedouins. The Supreme Court dismissed the petition, holding that there existed a public interest in assisting Bedouin to establish permanent urban settlements, an interest which justifies giving them preference by selling them plots at subsidized prices. In another case (The Forum for Coexistence in the Negev) the Supreme Court extended equitable relief for the purpose of constructing a bridge, even though the construction infringed the Law, in order to allow the children of dispersed Bedouin to reach school. Against this background, the recent verdict, delivered during the Protective Edge military campaign, which dismissed a petition aimed at forcing the State to spread out Protective Structures in Bedouin villages in the Negev against the risk of being hit from missiles launched from Gaza (Abu Afash) is disappointing. Even if, in arguendo, no selective discrimination was involved in the State’s decision not to provide such protection, the decision, and its affirmation by the Court, is problematic when examined through the prism of the Theory of Recognition. The article analyses the issue by tools of theory of Recognition, according to which people develop their identities through mutual relations of recognition in different fields. In the social context, the path to recognition is cognitive respect, which is provided by means of legal rights. By seeing other participants in Society as bearers of rights and obligations, the individual develops an understanding of his legal condition as reflected in the attitude to others. Consequently, even if the Court’s decision may be justified on strict legal grounds, the fact that Jewish settlements were protected during the military operation, whereas Bedouin villages were not, is a setback in the struggle to make the Bedouin citizens with equal rights in Israeli society. As the Court held, ‘Beyond their protective function, the Migunit [Protective Structures] may make a moral and psychological contribution that should not be undervalued’. This contribution is one that the Bedouin did not receive in the Abu Afash verdict. The basic thesis is that the Court’s verdict analyzed above clearly demonstrates that the reliance on classical liberal instruments (e.g., equality) cannot secure full appreciation of all aspects of Bedouin life, and hence it can in fact prejudice them. Therefore, elements of the recognition theory should be added, in order to find the channel for cognitive dignity, thereby advancing the Bedouins’ ability to perceive themselves as equal human beings in the Israeli society.

Keywords: bedouin dispersion, cognitive respect, recognition theory, sustainable development

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Authors: Colin Schmidt, Adrien Lecossier, Pascal Crubleau, Simon Richir

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Introduction:The widespread availability of artificial intelligence, exemplified by Generative Pre-trained Transformers (GPT) relying on large language models (LLM), has caused a seismic shift in the realm of knowledge. Everyone now has the capacity to swiftly learn how these models can either serve them well or not. Today, conversational AI like ChatGPT is grounded in neural transformer models, a significant advance in natural language processing facilitated by the emergence of renowned LLMs constructed using neural transformer architecture. Inventiveness of an LLM : OpenAI's GPT-3 stands as a premier LLM, capable of handling a broad spectrum of natural language processing tasks without requiring fine-tuning, reliably producing text that reads as if authored by humans. However, even with an understanding of how LLMs respond to questions asked, there may be lurking behind OpenAI’s seemingly endless responses an inventive model yet to be uncovered. There may be some unforeseen reasoning emerging from the interconnection of neural networks here. Just as a Soviet researcher in the 1940s questioned the existence of Common factors in inventions, enabling an Under standing of how and according to what principles humans create them, it is equally legitimate today to explore whether solutions provided by LLMs to complex problems also share common denominators. Theory of Inventive Problem Solving (TRIZ) : We will revisit some fundamentals of TRIZ and how Genrich ALTSHULLER was inspired by the idea that inventions and innovations are essential means to solve societal problems. It's crucial to note that traditional problem-solving methods often fall short in discovering innovative solutions. The design team is frequently hampered by psychological barriers stemming from confinement within a highly specialized knowledge domain that is difficult to question. We presume ChatGPT Utilizes TRIZ 40. Hence, the objective of this research is to decipher the inventive model of LLMs, particularly that of ChatGPT, through a comparative study. This will enhance the efficiency of sustainable innovation processes and shed light on how the construction of a solution to a complex problem was devised. Description of the Experimental Protocol : To confirm or reject our main hypothesis that is to determine whether ChatGPT uses TRIZ, we will follow a stringent protocol that we will detail, drawing on insights from a panel of two TRIZ experts. Conclusion and Future Directions : In this endeavor, we sought to comprehend how an LLM like GPT addresses complex challenges. Our goal was to analyze the inventive model of responses provided by an LLM, specifically ChatGPT, by comparing it to an existing standard model: TRIZ 40. Of course, problem solving is our main focus in our endeavours.

Keywords: artificial intelligence, Triz, ChatGPT, inventiveness, problem-solving

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Authors: Junaid Hamid Bhat

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Background: Musculoskeletal disorders are one of the main causes of occupational illness. Mechanisms and the factors like repetitive work, physical effort and posture, endangering the risk of musculoskeletal disorders would now appear to have been properly identified. Teacher’s exposure to work-related musculoskeletal disorders appears to be insufficiently described in the literature. Little research has investigated the prevalence and risk factors of musculoskeletal disorders in teaching profession. Very few studies are available in this regard and there are no studies evident in India. Purpose: To determine the prevalence of musculoskeletal disorders and to identify and measure the association of such risk factors responsible for developing musculoskeletal disorders among school teachers. Methodology: An observational cross sectional study was carried out. 500 school teachers from primary, middle, high and secondary schools were selected, based on eligibility criteria. A signed consent was obtained and a self-administered, validated questionnaire was used. Descriptive statistics was used to compute the statistical mean and standard deviation, frequency and percentage to estimate the prevalence of musculoskeletal disorders among school teachers. The data analysis was done by using SPSS version 16.0. Results: Results indicated higher pain prevalence (99.6%) among school teachers during the past 12 months. Neck pain (66.1%), low back pain (61.8%) and knee pain (32.0%) were the most prevalent musculoskeletal complaints of the subjects. Prevalence of shoulder pain was also found to be high among school teachers (25.9%). 52.0% subjects reported pain as disabling in nature, causing sleep disturbance (44.8%) and pain was found to be associated with work (87.5%). A significant association was found between musculoskeletal disorders and sick leaves/absenteeism. Conclusion: Work-related musculoskeletal disorders particularly neck pain, low back pain, and knee pain, is highly prevalent and risk factors are responsible for the development of same in school teachers. There is little awareness of musculoskeletal disorders among school teachers, due to work load and prolonged/static postures. Further research should concentrate on specific risk factors like repetitive movements, psychological stress, and ergonomic factors and should be carried out all over the country and the school teachers should be studied carefully over a period of time. Also, an ergonomic investigation is needed to decrease the work-related musculoskeletal disorder problems. Implication: Recall bias and self-reporting can be considered as limitations. Also, cause and effect inferences cannot be ascertained. Based on these results, it is important to disseminate general recommendations for prevention of work-related musculoskeletal disorders with regards to the suitability of furniture, equipment and work tools, environmental conditions, work organization and rest time to school teachers. School teachers in the early stage of their careers should try to adapt the ergonomically favorable position whilst performing their work for a safe and healthy life later. Employers should be educated on practical aspects of prevention to reduce musculoskeletal disorders, since changes in workplace and work organization and physical/recreational activities are required.

Keywords: work related musculoskeletal disorders, school teachers, risk factors funding, medical and health sciences

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Authors: Zia Ul Haq, Saleem Muhammad, Naeem Ullah, Abbas Shah, Abdullah Shah

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Pakistan being the developing country is facing double burden of communicable and non-communicable disease. The aspect of secondary prevention of ischemic heart disease in developing countries is the dire need for public health specialists, clinicians and policy makers. There is some evidence that psychotherapeutic measures, including psychotherapy, recreation, exercise and stress management training have positive impact on secondary prevention of cardiovascular diseases but there are some contradictory findings as well. Cardiac rehabilitation program (CRP) has not yet fully implemented in Pakistan. Psychological, physical and specific health-related quality of life (HRQoL) outcomes needs assessment with respect to its practicality, effectiveness, and success. Objectives: To determine the effect of cardiac rehabilitation program (CRP) on the health-related quality of life (HRQoL) measures of post MI patients compared to the usual care. Hypothesis: Post MI patients who receive the interventions (CRP) will have better HRQoL as compared to those who receive the usual cares. Methods: The randomized control trial was conducted at a Cardiac Rehabilitation Unit of Lady Reading Hospital (LRH), Peshawar. LRH is the biggest hospital of the Province Khyber Pakhtunkhwa (KP). A total 206 participants who had recent first myocardial infarction were inducted in the study. Participants were randomly allocated into two group i.e. usual care group (UCG) and cardiac rehabilitation group (CRG) by permuted-block randomization (PBR) method. CRP was conducted in CRG in two phases. Three HRQoL outcomes i.e. general health questionnaire (GHQ), self-rated health (SRH) and MacNew quality of life after myocardial infarction (MacNew QLMI) were assessed at baseline and follow-up visits among both groups. Data were entered and analyzed by appropriate statistical test in STATA version 12. Results: A total of 195 participants were assessed at the follow-up period due to lost-to-follow-up. The mean age of the participants was 53.66 + 8.3 years. Males were dominant in both groups i.e. 150 (76.92%). Regarding educational status, majority of the participants were illiterate in both groups i.e. 128 (65.64%). Surprisingly, there were 139 (71.28%) who were non-smoker on the whole. The comorbid status was positive in 120 (61.54%) among all the patients. The SRH at follow-up among UCG and CRG was 4.06 (95% CI: 3.93, 4.19) and 2.36 (95% CI: 2.2, 2.52) respectively (p<0.001). GHQ at the follow-up of UCG and CRG was 20.91 (95% CI: 18.83, 21.97) and 7.43 (95% CI: 6.59, 8.27) respectively (p<0.001). The MacNew QLMI at follow-up of UCG and CRG was 3.82 (95% CI: 3.7, 3.94) and 5.62 (95% CI: 5.5, 5.74) respectively (p<0.001). All the HRQoL measures showed strongly significant improvement in the CRG at follow-up period. Conclusion: HRQOL improved in post MI patients after comprehensive CRP. Education of the patients and their supervision is needed when they are involved in their rehabilitation activities. It is concluded that establishing CRP in cardiac units, recruiting post-discharged MI patients and offering them CRP does not impose high costs and can result in significant improvement in HRQoL measures. Trial registration no: ACTRN12617000832370

Keywords: cardiovascular diseases, cardiac rehabilitation, health-related quality of life, HRQoL, myocardial infarction, quality of life, QoL, rehabilitation, randomized control trial

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Authors: Pavlina Capkova, Josef Srovnal, Vera Becvarova, Marie Trkova, Zuzana Capkova, Andrea Stefekova, Vaclava Curtisova, Alena Santava, Sarka Vejvalkova, Katerina Adamova, Radek Vodicka

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ASDs are heterogeneous and complex developmental diseases with a significant genetic background. Recurrent CNVs are known to be a frequent cause of ASD. These CNVs can have, however, a variable expressivity which results in a spectrum of phenotypes from asymptomatic to ID/DD/ASD. ASD is associated with ID in ~75% individuals. Various platforms are used to detect pathogenic mutations in the genome of these patients. The performed study is focused on a determination of the frequency of pathogenic mutations in a group of ASD patients and a group of ID/DD patients using various strategies along with a comparison of their detection rate. The possible role of the origin of these mutations in aetiology of ASD was assessed. The study included 35 individuals with ASD and 68 individuals with ID/DD (64 males and 39 females in total), who underwent rigorous genetic, neurological and psychological examinations. Screening for pathogenic mutations involved karyotyping, screening for FMR1 mutations and for metabolic disorders, a targeted MLPA test with probe mixes Telomeres 3 and 5, Microdeletion 1 and 2, Autism 1, MRX and a chromosomal microarray analysis (CMA) (Illumina or Affymetrix). Chromosomal aberrations were revealed in 7 (1 in the ASD group) individuals by karyotyping. FMR1 mutations were discovered in 3 (1 in the ASD group) individuals. The detection rate of pathogenic mutations in ASD patients with a normal karyotype was 15.15% by MLPA and CMA. The frequencies of the pathogenic mutations were 25.0% by MLPA and 35.0% by CMA in ID/DD patients with a normal karyotype. CNVs inherited from asymptomatic parents were more abundant than de novo changes in ASD patients (11.43% vs. 5.71%) in contrast to the ID/DD group where de novo mutations prevailed over inherited ones (26.47% vs. 16.18%). ASD patients shared more frequently their mutations with their fathers than patients from ID/DD group (8.57% vs. 1.47%). Maternally inherited mutations predominated in the ID/DD group in comparison with the ASD group (14.7% vs. 2.86 %). CNVs of an unknown significance were found in 10 patients by CMA and in 3 patients by MLPA. Although the detection rate is the highest when using CMA, recurrent CNVs can be easily detected by MLPA. CMA proved to be more efficient in the ID/DD group where a larger spectrum of rare pathogenic CNVs was revealed. This study determined that maternally inherited highly penetrant mutations and de novo mutations more often resulted in ID/DD without ASD in patients. The paternally inherited mutations could be, however, a source of the greater variability in the genome of the ASD patients and contribute to the polygenic character of the inheritance of ASD. As the number of the subjects in the group is limited, a larger cohort is needed to confirm this conclusion. Inherited CNVs have a role in aetiology of ASD possibly in combination with additional genetic factors - the mutations elsewhere in the genome. The identification of these interactions constitutes a challenge for the future. Supported by MH CZ – DRO (FNOl, 00098892), IGA UP LF_2016_010, TACR TE02000058 and NPU LO1304.

Keywords: autistic spectrum disorders, copy number variant, chromosomal microarray, intellectual disability, karyotyping, MLPA, multiplex ligation-dependent probe amplification

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Authors: Liu Jia’nan

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The default accounts hold the view that there exists a kind of scalar implicature which can be processed without context and own a psychological privilege over other scalar implicatures which depend on context. In contrast, the Relevance Theorist regards context as a must because all the scalar implicatures have to meet the need of relevance in discourse. However, in Katsos, the experimental results showed: Although quantitatively the adults rejected under-informative utterance with lexical scales (context-independent) and the ad hoc scales (context-dependent) at almost the same rate, adults still regarded the violation of utterance with lexical scales much more severe than with ad hoc scales. Neither default account nor Relevance Theory can fully explain this result. Thus, there are two questionable points to this result: (1) Is it possible that the strange discrepancy is due to other factors instead of the generation of scalar implicature? (2) Are the ad hoc scales truly formed under the possible influence from mental context? Do the participants generate scalar implicatures with ad hoc scales instead of just comparing semantic difference among target objects in the under- informative utterance? In my Experiment 1, the question (1) will be answered by repetition of Experiment 1 by Katsos. Test materials will be showed by PowerPoint in the form of pictures, and each procedure will be done under the guidance of a tester in a quiet room. Our Experiment 2 is intended to answer question (2). The test material of picture will be transformed into the literal words in DMDX and the target sentence will be showed word-by-word to participants in the soundproof room in our lab. Reading time of target parts, i.e. words containing scalar implicatures, will be recorded. We presume that in the group with lexical scale, standardized pragmatically mental context would help generate scalar implicature once the scalar word occurs, which will make the participants hope the upcoming words to be informative. Thus if the new input after scalar word is under-informative, more time will be cost for the extra semantic processing. However, in the group with ad hoc scale, scalar implicature may hardly be generated without the support from fixed mental context of scale. Thus, whether the new input is informative or not does not matter at all, and the reading time of target parts will be the same in informative and under-informative utterances. People’s mind may be a dynamic system, in which lots of factors would co-occur. If Katsos’ experimental result is reliable, will it shed light on the interplay of default accounts and context factors in scalar implicature processing? We might be able to assume, based on our experiments, that one single dominant processing paradigm may not be plausible. Furthermore, in the processing of scalar implicature, the semantic interpretation and the pragmatic interpretation may be made in a dynamic interplay in the mind. As to the lexical scale, the pragmatic reading may prevail over the semantic reading because of its greater exposure in daily language use, which may also lead the possible default or standardized paradigm override the role of context. However, those objects in ad hoc scale are not usually treated as scalar membership in mental context, and thus lexical-semantic association of the objects may prevent their pragmatic reading from generating scalar implicature. Only when the sufficient contextual factors are highlighted, can the pragmatic reading get privilege and generate scalar implicature.

Keywords: scalar implicature, ad hoc scale, dynamic interplay, default account, Mandarin Chinese processing

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Authors: Tiffany Riggleman, Andrea Schultheis, Kalyn Jannace, Jerika Taylor, Michelle Nordstrom, Paul F. Pasquina

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Introduction: Posttraumatic Stress (PTS) and Posttraumatic Stress Disorder (PTSD) remain significant problems for military and veteran communities. Symptoms of PTSD often include poor sleep, intrusive thoughts, difficulty concentrating, and trouble with emotional regulation. Unfortunately, despite its high prevalence, service members diagnosed with PTSD often do not seek help, usually because of the perceived stigma surrounding behavioral health care. To help address these challenges, non-pharmacological, therapeutic approaches are being developed to help improve care and enhance compliance. The Service Dog Training Program (SDTP), which involves teaching patients how to train puppies to become mobility service dogs, has been successfully implemented into PTS/PTSD care programs with anecdotal reports of improved outcomes. This study was designed to assess the biopsychosocial effects of SDTP from military beneficiaries with PTS symptoms. Methods: Individuals between the ages of 18 and 65 with PTS symptom were recruited to participate in this prospective study. Each subject completes 4 weeks of baseline testing, followed by 6 weeks of active service dog training (twice per week for one hour sessions) with a professional service dog trainer. Outcome measures included the Posttraumatic Stress Checklist for the DSM-5 (PCL-5), Generalized Anxiety Disorder questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), social support/interaction, anthropometrics, blood/serum biomarkers, and qualitative interviews. Preliminary analysis of 17 participants examined mean scores on the GAD-7, PCL-5, and PHQ-9, pre- and post-SDTP, and changes were assessed using Wilcoxon Signed-Rank tests. Results: Post-SDTP, there was a statistically significant mean decrease in PCL-5 scores of 13.5 on an 80-point scale (p=0.03) and a significant mean decrease of 2.2 in PHQ-9 scores on a 27 point scale (p=0.04), suggestive of decreased PTSD and depression symptoms. While there was a decrease in mean GAD-7 scores post-SDTP, the difference was not significant (p=0.20). Recurring themes among results from the qualitative interviews include decreased pain, forgetting about stressors, improved sense of calm, increased confidence, improved communication, and establishing a connection with the service dog. Conclusion: Preliminary results of the first 17 participants in this study suggest that individuals who received SDTP had a statistically significant decrease in PTS symptom, as measured by the PCL-5 and PHQ-9. This ongoing study seeks to enroll a total of 156 military beneficiaries with PTS symptoms. Future analyses will include additional psychological outcomes, pain scores, blood/serum biomarkers, and other measures of the social aspects of PTSD, such as relationship satisfaction and sleep hygiene.

Keywords: post-concussive syndrome, posttraumatic stress, service dog, service dog training program, traumatic brain injury

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Authors: Elisavet Kechagia

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Due to the interplay of different genetic and environmental risk factors and its heterogeneous nature, the concept of attention deficit hyperactivity disorder (ADHD) has shaped controversy and conflicts, which have been, in turn, reflected in the controversial arguments about its treatment. Taking into account recent well evidence-based researches suggesting that ADHD is a condition, in which biopsychosocial factors are all weaved together, the current paper explores the multiple risk-factors that are likely to influence ADHD, with a particular focus on adolescents with ADHD who might experience comorbid social, emotional and behavioural disorders (SEBD). In the first section of this paper, the primary objective was to investigate the conflicting ideas regarding the definition, diagnosis and treatment of ADHD at an international level as well as to critically examine and identify the limitations of the two most prevailing sets of diagnostic criteria that inform current diagnosis, the American Psychiatric Association’s (APA) diagnostic scheme, DSM-V, and the World Health Organisation’s (WHO) classification of diseases, ICD-10. Taking into consideration the findings of current longitudinal studies on ADHD association with high rates of comorbid conditions and social dysfunction, in the second section the author moves towards an investigation of the transitional points −physical, psychological and social ones− that students with ADHD might experience during early adolescence, as informed by neuroscience and developmental contextualism theory. The third section is an exploration of the different perspectives of ADHD as reflected in individuals’ with ADHD self-reports and the KENT project’s findings on school staff’s attitudes and practices. In the last section, given the high rates of SEBDs in adolescents with ADHD, it is examined how cognitive behavioural therapy (CBT), coupled with other interventions, could be effective in ameliorating anti-social behaviours and/or other emotional and behavioral difficulties of students with ADHD. The findings of a range of randomised control studies indicate that CBT might have positive outcomes in adolescents with multiple behavioural problems, hence it is suggested to be considered both in schools and other community settings. Finally, taking into account the heterogeneous nature of ADHD, the different biopsychosocial and environmental risk factors that take place during adolescence and the discourse and practices concerning ADHD and SEBD, it is suggested how it might be possible to make sense of and meaningful improvements to the education of adolescents with ADHD within a multi-modal and multi-disciplinary whole-school approach that addresses the multiple problems that not only students with ADHD but also their peers might experience. Further research that would be based on more large-scale controls and would investigate the effectiveness of various interventions, as well as the profiles of those students who have benefited from particular approaches and those who have not, will generate further evidence concerning the psychoeducation of adolescents with ADHD allowing for generalised conclusions to be drawn.

Keywords: adolescence, attention deficit hyperctivity disorder, cognitive behavioural theory, comorbid social emotional behavioural disorders, treatment

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Authors: Naod Mekonnen Anega

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The very objective of this paper was to empirically identify technology tailored determinants to the adoption and adoption intensity (extent of use) of agricultural water management technologies in Meda Welabu Woreda, Oromia regional state, Ethiopia. Meda Welabu Woreda which is one of the administrative Woredas of the Oromia regional state was selected purposively as this Woreda is one of the Woredas in the region where small scale irrigation practices and the use of agricultural water management technologies can be found among smallholders. Using the existence water management practices (use of water management technologies) and land use pattern as a criterion Genale Mekchira Kebele is selected to undergo the study. A total of 200 smallholders were selected from the Kebele using the technique developed by Krejeie and Morgan. The study employed the Logit and Tobit models to estimate and identify the economic, social, geographical, household, institutional, psychological, technological factors that determine adoption and adoption intensity of water management technologies. The study revealed that while 55 of the sampled households are adopters of agricultural water management technology the rest 140 were non adopters of the technologies. Among the adopters included in the sample 97% are using river diversion technology (traditional) with traditional canal while the rest 7% percent are using pond with treadle pump technology. The Logit estimation reveled that while adoption of river diversion is positively and significantly affected by membership to local institutions, active labor force, income, access to credit and land ownership, adoption of treadle pump technology is positively and significantly affected by family size, education level, access to credit, extension contact, income, access to market, and slope. The Logit estimation also revealed that whereas, group action requirement, distance to farm, and size of active labor force negative and significantly influenced adoption of river diversion, age and perception has negatively and significantly influenced adoption decision of treadle pump technology. On the other hand, the Tobit estimation reveled that while adoption intensity (extent of use) of agricultural water management is positively and significantly affected by education, credit, and extension contact, access to credit, access to market and income. This study revealed that technology tailored study on adoption of Agricultural water management technologies (AWMTs) should be considered to indentify and scale up best agricultural water management practices. In fact, in countries like Ethiopia, where there is difference in social, economic, cultural, environmental and agro ecological conditions even within the same Kebele technology tailored study that fit the condition of each Kebele would help to identify and scale up best practices in agricultural water management.

Keywords: water management technology, adoption, adoption intensity, smallholders, technology tailored approach

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Authors: Hafid Smaili, Wilfred Rouwhorst, Paul Frost

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The trend of recent accident and incident cases worldwide show that the state-of-the-art automation and operations, for current and future demanding operational environments, does not provide the desired level of operational safety under crew peak workload conditions, specifically in complex situations such as loss-of-control in-flight (LOC-I). Today, the short term focus is on preparing crews to recognise and handle LOC-I situations through upset recovery training. This paper describes the cockpit integration aspects and piloted assessment of both a manually assisted and automatic upset detection and recovery system that has been developed and demonstrated within the European Advanced Cockpit for Reduction Of StreSs and workload (ACROSS) programme. The proposed system is a function that continuously monitors and intervenes when the aircraft enters an upset and provides either manually pilot-assisted guidance or takes over full control of the aircraft to recover from an upset. In order to mitigate the highly physical and psychological impact during aircraft upset events, the system provides new cockpit functionalities to support the pilot in recovering from any upset both manually assisted and automatically. A piloted simulator assessment was made in Oct-Nov 2015 using ten pilots in a representative civil large transport fly-by-wire aircraft in terms of the preference of the tested upset detection and recovery system configurations to reduce pilot workload, increase situational awareness and safe interaction with the manually assisted or automated modes. The piloted simulator evaluation of the upset detection and recovery system showed that the functionalities of the system are able to support pilots during an upset. The experiment showed that pilots are willing to rely on the guidance provided by the system during an upset. Thereby, it is important for pilots to see and understand what the aircraft is doing and trying to do especially in automatic modes. Comparing the manually assisted and the automatic recovery modes, the pilot’s opinion was that an automatic recovery reduces the workload so that they could perform a proper screening of the primary flight display. The results further show that the manually assisted recoveries, with recovery guidance cues on the cockpit primary flight display, reduced workload for severe upsets compared to today’s situation. The level of situation awareness was improved for automatic upset recoveries where the pilot could monitor what the system was trying to accomplish compared to automatic recovery modes without any guidance. An improvement in situation awareness was also noticeable with the manually assisted upset recovery functionalities as compared to the current non-assisted recovery procedures. This study shows that automatic upset detection and recovery functionalities are likely to positively impact the operational safety by means of reduced workload, improved situation awareness and crew stress reduction. It is thus believed that future developments for upset recovery guidance and loss-of-control prevention should focus on automatic recovery solutions.

Keywords: aircraft accidents, automatic flight control, loss-of-control, upset recovery

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Authors: Hsin-Hung Lin, Janet Chang, Te-Yi Chang, You-Sheng Huang

Abstract:

The natural and men-made disasters have become huge challenges for tourism destinations as well as emphasizing the fragility of the industry. Hot springs, among all destinations, are prone to disasters due to their dependence on natural resources and locations. After the COVID-19 outbreak, hot spring destinations have experienced not only the loss of businesses but also the psychological trauma. However, evidence has also shown that the impacts may not necessarily reduce the resilience for people but may be converted into posttraumatic growth. In Taiwan, a large proportion of hot springs are located in rural or indigenous areas. As a result, hot spring resources are associated with community cohesion for local residents. Yet prior research on hot spring destinations has mainly focused on visitors, whereas residents have been overlooked. More specifically, the relationship between hot springs resources and resident resilience in the face of the COVID-19 impacts remains unclear. To fulfill this knowledge gap, this paper aims to explore the COVID-19 impacts on residents’ hot spring experiences as well as individual and community resilience from the perspective of posttraumatic growth. A total of 315 residents of 13 hot spring destinations that are most popular in Taiwan were recruited. Online questionnaires were distributed over travel forums and social networks after the COVID-19. This paper subsequently used Partial Least Squares Structural Equation Modeling for data analysis as the technique offers significant advantages in addressing nonnormal data and small sample sizes. A preliminary test was conducted, and the results showed acceptable internal consistency and no serious common method variance. The path analysis demonstrated that the COVID-19 impacts strengthened residents’ perceptions of hot spring resources and experiences, implying that the pandemic had propelled the residents to visit hot springs for the healing benefits. In addition, the COVID-19 impacts significantly enhanced residents’ individual and community resilience, which indicates that the residents at hot springs are more resilient thanks to their awareness of external risks. Thirdly, residents’ individual resilience was positively associated with hot spring experiences, while community resilience was not affected by hot spring experiences. Such findings may suggest that hot spring experiences are more related to individual-level experiences and, consequently, have insignificant influence on community resilience. Finally, individual resilience was proved to be the most relevant factor that help foster community resilience. To conclude, the authorities may consider exploiting the hot spring resources so as to increase individual resilience for local residents. Such implications can be used as a reference for other post-disaster tourist destinations as well. As for future research, longitudinal studies with qualitative methods are suggested to better understand how the hot spring experiences have changed individuals and communities over the long term. It should be noted that the main subjects of this paper were focused on the hot spring communities in Taiwan. Therefore, the results cannot be generalized for all types of tourism destinations. That is, more diverse tourism destinations may be investigated to provide a broader perspective of post-disaster recovery.

Keywords: community resilience, hot spring destinations, individual resilience, posttraumatic growth

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Authors: Songdi Li, Louise Spry, Tony Woodall

Abstract:

Nowadays, Corporate Social responsibility (CSR) is becoming a buzz word, and more and more academics are putting efforts on CSR studies. It is believed that CSR could influence Corporate Reputation (CR), and they hold a favourable view that CSR leads to a positive CR. To be specific, the CSR related activities in the reputational context have been regarded as ways that associate to excellent financial performance, value creation, etc. Also, it is argued that CSR and CR are two sides of one coin; hence, to some extent, doing CSR is equal to establishing a good reputation. Still, there is no consensus of the CSR-CR relationship in the literature; thus, a systematic literature review is highly in need. This research conducts a systematic literature review with both bibliometric and content analysis. Data are selected from English language sources, and academic journal articles only, then, keyword combinations are applied to identify relevant sources. Data from Scopus and WoS are gathered for bibliometric analysis. Scopus search results were saved in RIS and CSV formats, and Web of Science (WoS) data were saved in TXT format and CSV formats in order to process data in the Bibexcel software for further analysis which later will be visualised by the software VOSviewer. Also, content analysis was applied to analyse the data clusters and the key articles. In terms of the topic of CSR-CR, this literature review with bibliometric analysis has made four achievements. First, this paper has developed a systematic study which quantitatively depicts the knowledge structure of CSR and CR by identifying terms closely related to CSR-CR (such as ‘corporate governance’) and clustering subtopics emerged in co-citation analysis. Second, content analysis is performed to acquire insight on the findings of bibliometric analysis in the discussion section. And it highlights some insightful implications for the future research agenda, for example, a psychological link between CSR-CR is identified from the result; also, emerging economies and qualitative research methods are new elements emerged in the CSR-CR big picture. Third, a multidisciplinary perspective presents through the whole bibliometric analysis mapping and co-word and co-citation analysis; hence, this work builds a structure of interdisciplinary perspective which potentially leads to an integrated conceptual framework in the future. Finally, Scopus and WoS are compared and contrasted in this paper; as a result, Scopus which has more depth and comprehensive data is suggested as a tool for future bibliometric analysis studies. Overall, this paper has fulfilled its initial purposes and contributed to the literature. To the author’s best knowledge, this paper conducted the first literature review of CSR-CR researches that applied both bibliometric analysis and content analysis; therefore, this paper achieves its methodological originality. And this dual approach brings advantages of carrying out a comprehensive and semantic exploration in the area of CSR-CR in a scientific and realistic method. Admittedly, its work might exist subjective bias in terms of search terms selection and paper selection; hence triangulation could reduce the subjective bias to some degree.

Keywords: corporate social responsibility, corporate reputation, bibliometric analysis, software program

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Authors: Sanjay Ranade

Abstract:

Traditional film theory assumes the cinema audience in a darkened room where cinema is projected on to a white screen, and the audience suspends their sense of reality. Shifts in audiences due to changes in cultural tastes or trends have been studied for decades. In the past two decades, however, the audience, especially the youth, has shifted to digital media for the consumption of cinema. As a result, not only are audiences watching cinema on different devices, they are also consuming cinema in places and ways never imagined before. Public transport often crowded to the brim with a lot of ambient content, and a variety of workplaces have become sites for cinema viewing. Cinema is watched piecemeal and at different times of the day. Audiences use devices such as mobile phones and tablets to watch cinema. The cinema viewing experience is getting redesigned by the user. The emerging design allows the spectator to not only consume images and narratives but also produce, reproduce, and manipulate existing images and narratives, thereby participating in the process and influencing it. Spectatorship studies stress on the importance of subjectivity when dealing with the structure of the film text and the cultural and psychological implications in the engagement between the spectator and the film text. Indian cinema has been booming and contributing to global movie production significantly. In 2005 film production was 1000 films a year and doubled to 2000 by 2016. Digital technology helped push this growth in 2012. Film studies in India have had a decided Euro-American bias. The studies have chiefly analysed the content for ideological leanings or myth or as reflections of society, societal changes, or articulation of identity or presented retrospectives of directors, actors, music directors, etc. The one factor relegated to the background has been the spectator. If they have been addressed, they are treated as a collective of class or gender. India has a performative tradition going back several centuries. How Indians receive cinema is an important aspect to study with respect to film studies. This exploratory and descriptive study looked at 162 young media students studying cinema at the undergraduate and postgraduate levels. The students, speaking as many as 20 languages amongst them, were drawn from across the country’s media schools. The study looked at nine film societies registered with the Federation of Film Societies of India. A structured questionnaire was made and distributed online through media teachers for the students. The film societies were approached through the regional office of the FFSI in Mumbai. Lastly, group discussions were held in Mumbai with students and teachers of media. A group consisted of between five and twelve student participants, along with one or two teachers. All the respondents looked at themselves as spectators and shared their experiences of spectators of cinema, providing a very rich insight into Indian conditions of viewing cinema and challenges for cinema ahead.

Keywords: audience, digital, film studies, reception, reception spectatorship

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Authors: Hsin-Hung Lin, Janet Chang, Te-Yi Chang, You-Sheng Huang

Abstract:

The natural and men-made disasters have become huge challenges for tourism destinations as well as emphasizing the fragility of the industry. Hot springs, among all destinations, are prone to disasters due to their dependence on natural resources and locations. After the COVID-19 outbreak, hot spring destinations have experienced not only the loss of businesses but also the psychological trauma. However, evidence has also shown that the impacts may not necessarily reduce the resilience for people but may be converted into posttraumatic growth. In Taiwan, a large proportion of hot springs are located in rural or indigenous areas. As a result, hot spring resources are associated with community cohesion for local residents. Yet prior research on hot spring destinations has mainly focused on visitors, whereas residents have been overlooked. More specifically, the relationship between hot springs resources and resident resilience in the face of the COVID-19 impacts remains unclear. To fulfill this knowledge gap, this paper aims to explore the COVID-19 impacts on residents’ hot spring experiences as well as individual and community resilience from the perspective of posttraumatic growth. A total of 315 residents of 13 hot spring destinations that are most popular in Taiwan were recruited. Online questionnaires were distributed over travel forums and social networks after the COVID-19. This paper subsequently used Partial Least Squares Structural Equation Modeling for data analysis as the technique offers significant advantages in addressing nonnormal data and small sample sizes. A preliminary test was conducted, and the results showed acceptable internal consistency and no serious common method variance. The path analysis demonstrated that the COVID-19 impacts strengthened residents’ perceptions of hot spring resources and experiences, implying that the pandemic had propelled the residents to visit hot springs for the healing benefits. In addition, the COVID-19 impacts significantly enhanced residents’ individual and community resilience, which indicates that the residents at hot springs are more resilient thanks to their awareness of external risks. Thirdly, residents’ individual resilience was positively associated with hot spring experiences, while community resilience was not affected by hot spring experiences. Such findings may suggest that hot spring experiences are more related to individual-level experiences and, consequently, have insignificant influence on community resilience. Finally, individual resilience was proved to be the most relevant factor that help foster community resilience. To conclude, the authorities may consider exploiting the hot spring resources so as to increase individual resilience for local residents. Such implications can be used as a reference for other post-disaster tourist destinations as well.As for future research, longitudinal studies with qualitative methods are suggested to better understand how the hot spring experiences have changed individuals and communities over the long term. It should be noted that the main subjects of this paper were focused on the hot spring communities in Taiwan. Therefore, the results cannot be generalized for all types of tourism destinations. That is, more diverse tourism destinations may be investigated to provide a broader perspective of post-disaster recovery.

Keywords: community resilience, hot spring destinations, individual resilience, posttraumatic growth (PTG)

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Authors: Jenny Fairthorne, Yuka Mori, Helen Leonard

Abstract:

Background: Primary care-givers of children with autism spectrum disorder (ASD) or intellectual disability (ID) have poorer health and quality of life (QoL) than primary care-givers (hereafter referred to as just care-givers) of typically developing children. We aimed to review original research which described factors impacting the health of care-givers of children with ASD or ID and to discuss how these factors might influence care-giver health. Methods: We searched Web of Knowledge, Medline, Scopus and Google Scholar using selections of words from each of three groups. The first comprised terms associated with ASD and ID and included autism, pervasive development disorder, intellectual disability, mental retardation, disability, disabled, Down and Asperger. The second included terms related to health such as depression, physical, mental, psychiatric, psychological and well-being. The third was terms related to care-givers such as mother, parent and care-giver. We included an original paper in our review if it was published between 1st January 1990 and 31st December, 2016, described original research in a peer-reviewed journal and was written in English. Additional criteria were that the research used a study population of 15 persons or more; described a risk or protective factor for the health of care-givers of a child with ASD, ID or a sub-type (such as ASD with ID or Down syndrome). Using previous research, we developed a simple and objective five-level tool to assess the strength of evidence provided by the reviewed papers. Results: We retained 33 papers. Factors impacting primary care-giver health included child behaviour, level of support, socio-economic status (SES) and diagnostic issues. Challenging child behaviour, the most commonly identified risk factor for poorer care-giver health and QoL was reported in ten of the studies. A higher level of support was associated with improved care-giver health and QoL. For example, substantial evidence indicated that family support reduced care-giver burden in families with a child with ASD and that family and neighbourhood support was associated with improved care-giver mental health. Higher socio-economic status (SES) was a protective factor for care-giver health and particularly maternal health. Diagnostic uncertainty and an unclear prognosis are factors which can cause the greatest concern to care-givers of children with ASD and those for whom a cause of their child’s ID has not been identified. We explain how each of these factors might impact caregiver health and how they might act differentially in care-givers of children with different types of ASD or ID (such as Down syndrome and ASD without ID). Conclusion: Care-givers of children with ASD may be more likely to experience many risk factors and less likely to experience the protective factors we identified for poorer mental health. Interventions to reduce risk factors and increase protective factors could pave the way for improved care-giver health. For example, workshops to train care-givers to better manage challenging child behaviours and earlier diagnosis of ASD (and particularly ASD without ID) would seem likely to improve care-giver well-being. Similarly, helping to expand support networks might reduce care-giver burden and stress leading to improved health.

Keywords: autism, caregivers, health, intellectual disability, mothers, review

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Authors: Luci V. Hyett

Abstract:

The criminal law of England and Wales currently deems that a person cannot consent to the infliction of injury upon their own body, where the level of harm is considered to be Actual or Grevious. This renders the defence of consent of the victim as being unavailable to those persons carrying out an Alternative Body Modification procedure. However, the criminalization of consensual injury is more appropriately deemed as being categorized as an offense against public morality and not one against the person, which renders the State’s involvement in the autonomous choices of a consenting adult, when determining what can be done to one’s own body, an arbitrary one. Furthermore, to recognise in law that a person is capable of giving a valid consent to socially acceptable cosmetic interventions that largely consist of procedures designed to aesthetically please men and, not those of people who want to modify their bodies for other reasons means that patriarchal attitudes are continuing to underpin public repulsion and inhibit social acceptance of such practices. Theoretical analysis will begin with a juridical examination of R v M(B) [2019] QB 1 where the High Court determined that Alternative Body Modification was not a special category exempting a person so performing from liability for Grevious Bodily Harm using the defence of consent. It will draw from its reasoning which considered that ‘the removal of body parts were medical procedures being carried out for no medical reason by someone not qualified to carry them out’ which will form the basis of this enquiry. It will consider the philosophical work of Georgio Agamben when analysing whether the biopolitical climate in the UK, which places the optimization of the perfect, healthy body at the centre of political concern can explain why those persons who wish to engage in Alternative Body Modification are treated as the ‘Exception’ to that which is normal using the ‘no medical reason’ canon to justify criminalisation, rather than legitimising the industry through regulation. It will consider, through a feminist lens, the current conflict in law between traditional cosmetic interventions which alter one’s physical appearance for socially accepted aesthetic purposes such as those to the breast, lip and buttock and, modifications described as more outlandish such as earlobe stretching, tooth filing and transdermal implants to create horns and spikes under the skin. It will assert that ethical principles relating to the psychological impact of body modification described as ‘alternative’ is used as a means to exclude person’s seeking such a procedure from receiving safe and competent treatment via a registered cosmetic surgeon which leads to these increasingly popular surgery’s being performed in Tattoo parlours throughout the UK as an extension to other socially acceptable forms of self-modification such as piercings. It will contend that only by ‘inclusive exclusion’ will those ‘othered’ through ostracisation be welcomed into the fold of normality and this can only be achieved through recognition of alternative body modification as a legitimate cosmetic intervention, subject to the same regulatory framework as existing practice. This would assist in refocusing the political landscape by erring on the side of liberty rather than that of biology.

Keywords: biopolitics, body modification, consent, criminal law

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