Search results for: symptom distress
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 653

Search results for: symptom distress

563 The Effectiveness of Cognitive Behavioural Intervention in Alleviating Social Avoidance for Blind Students

Authors: Mohamed M. Elsherbiny

Abstract:

Social Avoidance is one of the most important problems that face a good number of disabled students. It results from the negative attitudes of non-disabled students, teachers and others. Some of the past research has shown that non-disabled individuals hold negative attitudes toward persons with disabilities. The present study aims to alleviate Social Avoidance by applying the Cognitive Behavioral Intervention. 24 Blind students aged 19–24 (university students) were randomly chosen we compared an experimental group (consisted of 12 students) who went through the intervention program, with a control group (12 students also) who did not go through such intervention. We used the Social Avoidance and Distress Scale (SADS) to assess social anxiety and distress behavior. The author used many techniques of cognitive behavioral intervention such as modeling, cognitive restructuring, extension, contingency contracts, self-monitoring, assertiveness training, role play, encouragement and others. Statistically, T-test was employed to test the research hypothesis. Result showed that there is a significance difference between the experimental group and the control group after the intervention and also at the follow up stages of the Social Avoidance and Distress Scale. Also for the experimental group, there is a significance difference before the intervention and the follow up stages for the scale. Results showed that, there is a decrease in social avoidance. Accordingly, cognitive behavioral intervention program was successful in decreasing social avoidance for blind students.

Keywords: social avoidance, cognitive behavioral intervention, blind disability, disability

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562 Cognitive Functioning and Cortisol Suppression in Major Depression in a Long-Term Perspective

Authors: Pia Berner Hansson, Robert Murison Anders Lund, Hammar Åsa

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Major Depressive Disorder (MDD) is often associated with high levels of stress and disturbances in the Hypothalamic Pituitary Adrenal (HPA) system, yielding high levels of cortisol, in addition to cognitive dysfunction. Previous studies in this patient group have shown a relationship between cortisol profile and cognitive functioning in the acute phase of MDD and that the patients had significantly less suppression after dexamethasone administration. However, few studies have investigated this relationship over time and in phases of symptom reduction. The aim of the present study was to examine the relationships between cortisol levels after the Dexamethasone Suppression Test (DST) and cognitive function in a long term perspective in MDD patients. Patients meeting the DSM-IV criteria for a MDD were included in the study and tested in symptom reduction. A control group was included. Cortisol was measured in saliva collected with Salivette sampling devices. Saliva samples were collected 4 times during a 24 hours period over two consecutive days: at awakening, after 45 minutes, after 7 hours and at 11 pm. Dexamethasone (1.0 mg) was given on Day 1 at 11 pm. The neuropsychological test battery consisted of standardized tests measuring memory and Executive Functioning (EF). Cortisol levels did not differ significantly between patients and controls on Day 1 or Day 2. Both groups showed significant suppression after Dexamethasone. There were no correlations between cortisol levels or suppression after Dexamethasone and cognitive measures. The results indicate that the HPA-axis functioning normalizes in phases of symptom reduction in MDD patients and that there no relation between cortisol profile and cognitive functioning in memory or EF.

Keywords: depression, MDD, cortisol, suppression, cognitive functioning

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561 The Relationship between Human Neutrophil Elastase Levels and Acute Respiratory Distress Syndrome in Patients with Thoracic Trauma

Authors: Wahyu Purnama Putra, Artono Isharanto

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Thoracic trauma is trauma that hits the thoracic wall or intrathoracic organs, either due to blunt trauma or sharp trauma. Thoracic trauma often causes impaired ventilation-perfusion due to damage to the lung parenchyma. This results in impaired tissue oxygenation, which is one of the causes of acute respiratory distress syndrome (ARDS). These changes are caused by the release of pro-inflammatory mediators, plasmatic proteins, and proteases into the alveolar space associated with ongoing edema, as well as oxidative products that ultimately result in severe inhibition of the surfactant system. This study aims to predict the incidence of acute respiratory distress syndrome (ARDS) through human neutrophil elastase levels. This study examines the relationship between plasma elastase levels as a predictor of the incidence of ARDS in thoracic trauma patients in Malang. This study is an observational cohort study. Data analysis uses the Pearson correlation test and ROC curve (receiver operating characteristic curve). It can be concluded that there is a significant (p= 0.000, r= -0.988) relationship between elastase levels and BGA-3. If the value of elastase levels is limited to 23.79 ± 3.95, the patient will experience mild ARDS. While if the value of elastase levels is limited to 57.68 ± 18.55, in the future, the patient will experience moderate ARDS. Meanwhile, if the elastase level is between 107.85 ± 5.04, the patient will likely experience severe ARDS. Neutrophil elastase levels correlate with the degree of severity of ARDS incidence.

Keywords: ARDS, human neutrophil elastase, severity, thoracic trauma

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560 Psychological Distress and Quality of Life in Inflammatory Bowel Disease Patients: The Role of Dispositional Mindfulness

Authors: Kelly E. Tow, Peter Caputi, Claudia Rogge, Thomas Lee, Simon R. Knowles

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Inflammatory Bowel Disease (IBD) is a serious chronic health condition, characterised by inflammation of the gastrointestinal tract. Individuals with active IBD experience severe abdominal symptoms, which can adversely impact their physical and mental health, as well as their quality of life (QoL). Given that stress may exacerbate IBD symptoms and is frequently highlighted as a contributing factor for the development of psychological difficulties and poorer QoL, it is vital to investigate stress-management strategies aimed at improving the lives of those with IBD. The present study extends on the limited research in IBD cohorts by exploring the role of dispositional mindfulness and its impact on psychological well-being and QoL. The study examined how disease activity and dispositional mindfulness were related to psychological distress and QoL in a cohort of IBD patients. The potential role of dispositional mindfulness as a moderator between stress and anxiety, depression and QoL in these individuals was also examined. Participants included 47 patients with a clinical diagnosis of IBD. Each patient completed a series of psychological questionnaires and was assessed by a gastroenterologist to determine their disease activity levels. Correlation analyses indicated that disease activity was not significantly related to psychological distress or QoL in the sample of IBD patients. However, dispositional mindfulness was inversely related to psychological distress and positively related to QoL. Furthermore, moderation analyses demonstrated a significant interaction between stress and dispositional mindfulness on anxiety. These findings demonstrate that increased levels of dispositional mindfulness may be beneficial for individuals with IBD. Specifically, the results indicate positive links between dispositional mindfulness, general psychological well-being and QoL, and suggest that dispositional mindfulness may attenuate the negative impacts of stress on levels of anxiety in IBD patients. While further research is required to validate and expand on these findings, the current study highlights the importance of addressing psychological factors in IBD and indicates support for the use of mindfulness-based interventions for patients with the disease.

Keywords: anxiety, depression, dispositional mindfulness, inflammatory bowel disease, quality of life, stress

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559 Prevalence, Associated Factors, and Help-Seeking Behavior of Psychological Distress among International Students at the National University of Malaysia

Authors: Khadiga Kahwa, Aniza Ismail

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Depression, anxiety, and stress are associated with decreased role functioning, productivity, and quality of life. International students are more prone to psychological distress as they face many stressors while studying abroad. The objectives of the study were to determine the prevalence and associated factors of depression, anxiety, and stress among international students, their help-seeking behavior, and their awareness of the available on-campus mental support services. A cross-sectional study with a purposive sampling method was performed on 280 international students at Universiti Kebangsaan Malaysia (UKM) between the age of 18 and 35 years. The Depression Anxiety Stress Scale-21 (DASS-21) questionnaire was used anonymously to assess the mental health of students. Socio-demographic, help-seeking behavior, and awareness data were obtained. Independent sample t-test, one-way ANOVA test, and multiple linear regression were used to explore associated factors. The overall prevalence of depression, anxiety, and stress among international students were 58.9%, 71.8%, and 53.9%, respectively. Age was significantly associated with depression and anxiety. Ethnicity showed a significant association with depression and stress. No other factors were found to be significantly associated with psychological distress. Only 9.6% of the international students had sought help from on-campus mental support services. Students who were aware of the presence of such services were only 21.4% of the participants. In conclusion, this study addressed the gap in the literature on the mental health of international students and provided data that could be used in intervention programs to improve the mental health of the increasing number of international students in Malaysia.

Keywords: anxiety, depression, stress, help-seeking behavior, students

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558 Successful Cesarean Delivery with Veno-Venous Extracorporeal Membrane Oxygenation Support in a Pregnant Woman with Severe Acute Respiratory Distress Syndrome and Heart Failure Complicated by a Rare Condition of Pre-B Cell Acute Lymphoblastic Leukemia in P

Authors: Kristel Dame Bañez Sumagaysay, Marie Victoria Cruz-javier

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The current subject is a case of a 21 year-old woman at 29 1/7 weeks of gestation with Pre-B cell Acute Lymphoblastic Leukemia who was admitted to the coronary care unit (CCU) of the St. Luke’s Medical Center-Global City for Severe Acute Respiratory Distress Syndrome (ARDS) secondary to hospital-acquired pneumonia secondary to pneumocystis jiroveci; central line-associated bloodstream infection (E. aerogenes). She presented with chronic hypoxemia caused by Pulmonary edema, probably secondary to heart failure secondary to cardiomyopathy chemotherapy-induced. Due to worsening feto-maternal status, extracorporeal membrane oxygenation (ECMO) for respiratory support was instituted, and an elective cesarean section was done due to multiple maternal factors and deteriorating health status under total intravenous anesthesia assisted by veno-venous extracorporeal membrane oxygenation. She delivered a live preterm newborn male, APGAR Score: 1, 0, 0, birth weight 985 grams, birth length: 40.5cm, small for gestational age.

Keywords: extracorporeal membrane oxygenation, pre-b cell acute lymphoblastic leukemia, severe acute respiratory distress syndrome, ethical dilemmas

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557 Emotion Regulation Mediates the Relationship between Affective Disposition and Depression

Authors: Valentina Colonnello, Paolo Maria Russo

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Studies indicate a link between individual differences in affective disposition and depression, as well as between emotion dysregulation and depression. However, the specific role of emotion dysregulation domains in mediating the relationship between affective disposition and depression remains largely unexplored. In three cross-sectional quantitative studies (total n = 1350), we explored the extent to which specific emotion regulation difficulties mediate the relationship between personal distress disposition (Study 1), separation distress as a primary emotional trait (Study 2), and an insecure, anxious attachment style (Study 3) and depression. Across all studies, we found that the relationship between affective disposition and depression was mediated by difficulties in accessing adaptive emotion regulation strategies. These findings underscore the potential for modifiable abilities that could be targeted through preventive interventions.

Keywords: emotions, mental health, individual traits, personality

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556 The Role of Psychological Resilience in Predicting Psychological Distress in Kuwaiti Adults during Corona Varies Pandemic

Authors: Al-Tammar M. Shahah

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

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

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555 Breast Cancer as a Response to Distress in Women with or without a History of Precancerous Breast Disease

Authors: Viacheslav Sushko, Viktor Sushko

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Pre-cancerous breast diseases are pathological changes that precede the appearance of adenocarcinoma. The most common benign breast disease is mastopathy. We examined the life and disease history of 114 women aged 58-69 who were diagnosed with adenocarcinoma of the breast at different stages of development. They filled out the Reeder Scale to determine the level of stress. The results of the study revealed that 62 of them had mastopathy at the age of 30-45 years old. These women refused surgical treatment for mastopathy. Five to six years before their diagnosis of adenocarcinoma of the mammary gland, 84 women had experienced severe stress (death of a beloved close relative, torture accompanied by rape, prolonged stay in extreme conditions (under bombardment and bombardment). In the assessment of data from completed Reeder scales, 114 women had a high level of mental stress, with a score from 1-1.72. The 84 women who suffered from severe stress showed overeating or a significant decrease in food intake, insomnia, apathy, increased irritability and restlessness, loss of interest in sexual relationships, forgetfulness, difficulty in performing routine work, prolonged uncontrollable headaches, unexplained fatigue, heart pain, reduced capacity for work. In conclusion, it is important to provide psychotherapy for breast cancer patients as the diagnosis, and the different stages of treatment are very stressful. It is also advisable to see a psychiatrist at an early stage and prevent distress and treat precancerous breast disease.

Keywords: breast cancer, distress, mastopathy, severe stress

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554 Selected Childhood Experiences, Current Psychological Status and Its Associates among Imprisoned Women in Welikada Prison, Colombo Sri Lanka

Authors: Jayathilake Wijethunga B. G. Mudiyanselage, Jeewantha Ranawaka, Nirosha Lansakara

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Introduction: Women imprisonment is rising in the world. Imprisoned women have more psychological problems and more adverse childhood experiences than the general population. Female prisoners who had psychological problems had more adverse childhood experiences than the prisoners who did not have psychological problems. Most of the imprisoned women are mothers. Mothers are the principal carer for the children. The psychological status of imprisoned female is worth seeking along with its associates since this is a group of women who need others assistance to make their life adjusted. Any intervention that could uplift their psychological wellbeing would make their life better if they are to be released out of the prison. Since there are no studies done in Sri Lanka to study the imprisoned women psychological wellbeing and their childhood experiences, it is important to study on this to find the magnitude of the problem in Sri Lanka. Methodology: A descriptive cross-sectional study was done at the Welikada Prison, Colombo, among the imprisoned women. 273 imprisoned women were selected using simple random sampling technique. Using interviewer administered questionnaire 270 women were interviewed. Three women did not consent for the study. Frequencies of the selected socio demographic characteristics and selected childhood experiences calculated. GHQ 30 questionnaire was used to assess the psychological distress. Odds ratio was used to calculate the associations between the psychological distress and the selected socio demographic characteristics, selected childhood experiences. Results: Response rate was 98.9%. Mean age of the imprisoned women were 41.28years (SD ±11.86yrs) and Most of women were within the age group of 35-49 years (38.1%). Of them 68.5% were currently married and majority had at least one child. (86.3%). House hold member’s smoking (58.5%) and alcohol (40.4%) use was the commonest adverse childhood experience experienced by the imprisoned women. Nearly one fourth (22.6%) of the imprisoned women had attempted suicide during their life and more than half (55.7%) of them had attempted before the age of 18 years. Similarly of the 258 women who had been sexually active during their life, half (50.0%) of the women had exposed to sexual activities during first eighteen years of life and mean age at first sexual exposure was 19.2 (SD±4.86) years. Nearly three forth (73.7%) of imprisoned women were psychologically distressed in the study sample. Being a women of aged less than 25 years((OR=4.51, 95% CI=1.035-19.64)),previous history of suicidal attempts(OR=2.10,95%CI =1.00-4.41), not having enough foods to eat( OR=2.97, 1.009-8.75) and absence of someone to tell worries (OR=0.355, 95% CI =0.113-0.945) during childhood were significantly associate with psychological distress. Conclusion: Nearly three forth of the imprisoned women were psychologically distressed and younger age, history of suicidal attempts, the absence of someone to tell their worries and not having enough food to eat during childhood were risk factors for psychological distress. Recommendation: Need to strengthen the rehabilitation and mental health services to the imprisoned women.

Keywords: adverse childhood experiences, imprisoned women, psychological distress, prisoners

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553 A Method for Clinical Concept Extraction from Medical Text

Authors: Moshe Wasserblat, Jonathan Mamou, Oren Pereg

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Natural Language Processing (NLP) has made a major leap in the last few years, in practical integration into medical solutions; for example, extracting clinical concepts from medical texts such as medical condition, medication, treatment, and symptoms. However, training and deploying those models in real environments still demands a large amount of annotated data and NLP/Machine Learning (ML) expertise, which makes this process costly and time-consuming. We present a practical and efficient method for clinical concept extraction that does not require costly labeled data nor ML expertise. The method includes three steps: Step 1- the user injects a large in-domain text corpus (e.g., PubMed). Then, the system builds a contextual model containing vector representations of concepts in the corpus, in an unsupervised manner (e.g., Phrase2Vec). Step 2- the user provides a seed set of terms representing a specific medical concept (e.g., for the concept of the symptoms, the user may provide: ‘dry mouth,’ ‘itchy skin,’ and ‘blurred vision’). Then, the system matches the seed set against the contextual model and extracts the most semantically similar terms (e.g., additional symptoms). The result is a complete set of terms related to the medical concept. Step 3 –in production, there is a need to extract medical concepts from the unseen medical text. The system extracts key-phrases from the new text, then matches them against the complete set of terms from step 2, and the most semantically similar will be annotated with the same medical concept category. As an example, the seed symptom concepts would result in the following annotation: “The patient complaints on fatigue [symptom], dry skin [symptom], and Weight loss [symptom], which can be an early sign for Diabetes.” Our evaluations show promising results for extracting concepts from medical corpora. The method allows medical analysts to easily and efficiently build taxonomies (in step 2) representing their domain-specific concepts, and automatically annotate a large number of texts (in step 3) for classification/summarization of medical reports.

Keywords: clinical concepts, concept expansion, medical records annotation, medical records summarization

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552 The Association between Health-Related Quality of Life and Physical Activity in Different Domains with Other Factors in Croatian Male Police Officers

Authors: Goran Sporiš, Dinko Vuleta, Stefan Lovro

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The purpose of the present study was to determine the associations between health-related quality of life (HRQOL) and physical activity (PA) in different domains. In this cross-sectional study, participants were 169 Croatian police officers (mean age 35.14±8.95 yrs, mean height 180.93±7.53 cm, mean weight 88.39±14.05 kg, mean body-mass index 26.90±3.39 kg/m2). The dependent variables were two general domains extracted from the HRQOL questionnaire: (1) physical component scale (PCS) and (2) mental component scale (MCS). The independent variables were job-related, transport, domestic and leisure-time PA, along with other factors: age, body-mass index, smoking status, psychological distress, socioeconomic status and time spent in sedentary behaviour. The associations between dependent and independent variables were analyzed by using multiple regression analysis. Significance was set up at p < 0.05. PCS was positively associated with leisure-time PA (β 0.28, p < 0.001) and socioeconomic status (SES) (β 0.16, p=0.005), but inversely associated with job-related PA (β -0.15, p=0.012), domestic-time PA (β -0.14, p=0.014), age (β -0.12, p=0.050), psychological distress (β -0.43, p<0.001) and sedentary behaviour (β -0.15, p=0.009). MCS was positively associated with leisure-time PA (β 0.19, p=0.013) and SES (β 0.20, p=0.002), while inversely associated with age (β -0.23, p=0.001), psychological distress (β -0.27, p<0.001) and sedentary behaviour (β -0.22, p=0.001). Our results added new information about the associations between domain-specific PA and both physical and mental component scale in police officers. Future studies should deal with the same associations in other stressful occupations.

Keywords: health, fitness, police force, relations

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551 Running Head: Psychological Inflexibility and Distress

Authors: Steven M. Sanders, April T. Berry, David W. Hollingsworth

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Previous research has shown that veterans have higher rates of mental health concerns compared to non-veteran populations. A potential risk factor for the development of mental health concerns (i.e., depression & anxiety), particularly in Black veterans, is psychological inflexibility. Psychological inflexibility, a component of Acceptance & Commitment Therapy (ACT), is a process by which behavior is expressed in ways that attempt to control emotional and psychological reactions to uncomfortable stimuli and situations rather than by direct contingencies or personal values. The present study explored the relationship between psychological inflexibility, symptoms of depression, and symptoms of anxiety in a sample of 131 Black veterans. Results demonstrated that Black veterans who endorsed psychological inflexibility also endorsed higher levels of both depression and anxiety symptomology. These findings indicate the deleterious consequences of experiencing psychological inflexibility, which could be treated through ACT.

Keywords: psychological flexibility, veteran, black, psychological distress

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550 Posttraumatic Distress, Hope and Growth in Survivors of Commercial Sexual Exploitation and Sex Trafficking in Nepal

Authors: Rebekah Volgin, Jane Shakespeare-Finch, Ian Shochet

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Commercial sexual exploitation (CSE) and sex trafficking affect between 5000-7000 girls and women in Nepal each year and can have devastating physical and psychological consequences. Much research has documented these effects, however, there is no published longitudinal research that focuses on whether healing and growth outcomes are possible for survivors of CSE and sex trafficking. The narratives of 27 girls and women (13-22 years) were taken at two-time points during participation in a six-week group psychoeducation and art therapy program which was delivered across three NGO’s in Kathmandu, Nepal. These narratives form part of a larger ethnographic project. Thematic analysis of the data was undertaken. Themes emerging from time point 1 were: psychological distress in the form of anxiety and grief over loss of family, psychosomatic symptoms, empathy and compassion, and posttraumatic growth (PTG) in the form of new possibilities, relating to others and personal strength. Posttraumatic growth refers to positive changes in the aftermath of trauma. The themes emerging from time point 2, were: empathy and compassion and PTG (cognitive restructuring, new possibilities, relating to others and personal strength). Alongside the distress that these participants experienced, they also experienced positive outcomes such as empathy and compassion and psychological growth. Future research would advance knowledge by further examining the process of PTG in this population, if the changes observed were lasting, and if so, ways in which PTG can be facilitated or promoted.

Keywords: commercial sexual exploitation, human trafficking, posttraumatic growth, sexual trauma

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549 Predicting Personality and Psychological Distress Using Natural Language Processing

Authors: Jihee Jang, Seowon Yoon, Gaeun Son, Minjung Kang, Joon Yeon Choeh, Kee-Hong Choi

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Background: Self-report multiple choice questionnaires have been widely utilized to quantitatively measure one’s personality and psychological constructs. Despite several strengths (e.g., brevity and utility), self-report multiple-choice questionnaires have considerable limitations in nature. With the rise of machine learning (ML) and Natural language processing (NLP), researchers in the field of psychology are widely adopting NLP to assess psychological constructs to predict human behaviors. However, there is a lack of connections between the work being performed in computer science and that psychology due to small data sets and unvalidated modeling practices. Aims: The current article introduces the study method and procedure of phase II, which includes the interview questions for the five-factor model (FFM) of personality developed in phase I. This study aims to develop the interview (semi-structured) and open-ended questions for the FFM-based personality assessments, specifically designed with experts in the field of clinical and personality psychology (phase 1), and to collect the personality-related text data using the interview questions and self-report measures on personality and psychological distress (phase 2). The purpose of the study includes examining the relationship between natural language data obtained from the interview questions, measuring the FFM personality constructs, and psychological distress to demonstrate the validity of the natural language-based personality prediction. Methods: The phase I (pilot) study was conducted on fifty-nine native Korean adults to acquire the personality-related text data from the interview (semi-structured) and open-ended questions based on the FFM of personality. The interview questions were revised and finalized with the feedback from the external expert committee, consisting of personality and clinical psychologists. Based on the established interview questions, a total of 425 Korean adults were recruited using a convenience sampling method via an online survey. The text data collected from interviews were analyzed using natural language processing. The results of the online survey, including demographic data, depression, anxiety, and personality inventories, were analyzed together in the model to predict individuals’ FFM of personality and the level of psychological distress (phase 2).

Keywords: personality prediction, psychological distress prediction, natural language processing, machine learning, the five-factor model of personality

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548 Understanding Psychological Distress and Protection Issues among Children Associated with Armed Groups

Authors: Grace Onubedo

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The primary objective of this research study is to contribute to and deepen the understanding of the realities and conditions for which children recruited by violent extremist organisations in Nigeria live, as well as ascertain the state of their mental health following their reunification with either family or protection workers. The research is intended to contribute to a more focused child protection programming agenda for children associated with armed forces and groups in Nigeria and the wider conflict setting. The extent to which violence has affected the psychological well-being and mental health of children abducted and exposed to activities of Violent Extremist groups remains a largely empirical question. This research attempts to answer the following research questions with the aim of providing further evidences for informed programming: I. What are the demographic characteristics of children associated with armed groups? II. What is the state of their mental health? III. What is the relationship between their background and their mental health?

Keywords: counterterrorism, psychosocial support, psychological distress, children, armed groups

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547 Identifying Factors Linking Childhood Neglect to Opiate Use

Authors: Usha Barahmand, Ali Khazaee, Goudarz Sadeghi Hashjin

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The purpose of this study is to assess the relative mediating effects of impulsivity and internalizing problems in the relationship between childhood neglect and motives for opiate use. Seventy-two adolescent opiate users were recruited for the study. Participants completed assessments of childhood abuse history, distress, impulsiveness and motives for substance use as well as a socio-demographic information sheet. Findings from bootstrap mediator analyses indicated that distress, but not impulsiveness, mediated the relationship between childhood emotional abuse and expansion and enhancement motives for substance use. The current study provides preliminary evidence that internalizing problems may function as a mechanism linking prior childhood experiences of emotional neglect to subsequent motives for substance use. Clinical implications of these findings suggest that targeting emotion dysregulation problems may be an effective adjunct in the treatment of adolescents with a history of childhood maltreatment that are at risk for substance use.

Keywords: childhood neglect, impulsiveness, internalizing problems, substance use motives

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546 The Effect of Group Interpersonal Psychotherapy on Eating Disorder Symptom and Fear of Negative Evaluation of Lorestan University Female Students

Authors: S. Gholamrezaei, M. Mehrabizade Honarmand, Y. Zargar

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Introduction: This research was designed to assess the effect of group Interpersonal Psychotherapy on eating disorder symptom and fear of negative evaluation of Lorestan University female students. Materials and Methods: In this experimental study, 641 female students were randomly selected from various faculties of Lorestan University. Eating disorders symptoms and fear of negative evaluation were assessed by the Eating Attitudes Test (EAT-26), and Fear of Negative Evaluation Scale, Leary (FNES-B). Data were analyzed by SPSS software (multivariate analyze tests were used). Results: Interpersonal Psychotherapy can improve the eating disorder symptoms and reduce the fear of negative evaluation in girl students of group control in compare with control group. Conclusion: Interpersonal psychotherapy can be effective for eating disorder symptoms, and fear of negative evaluation among female students. Thus, it is suggested that this kind of psychotherapy was used for other psychological disease.

Keywords: interpersonal psychotherapy, eating disorder, fear of negative evaluation, students

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545 Health Literacy and Knowledge Related to Tuberculosis among Outpatients at a Referral Hospital in Lima, Peru

Authors: Rosalina Penaloza, Joanna Navarro, Pauline Jolly, Anna Junkins, Carlos Seas, Larissa Otero

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Background: Tuberculosis (TB) case detection in Peru relies on passive case finding. This strategy relies on the assumption that the community is aware that a persistent cough is a possible symptom of TB and that formal health care needs to be sought. Despite its importance, health knowledge specific to TB is underexplored in Peru. This study aimed to assess health literacy and level of TB knowledge among outpatients attending a referral hospital in Lima, Peru. The goal was to ascertain knowledge gaps in key areas relating to TB, to identify and prioritize subgroups for intervention, and to provide insight for policy and community interventions considering health literacy. Methods: An observational cross-sectional study was conducted using a survey to measure sociodemographic factors, tuberculosis knowledge, and health literacy. Bivariate and Multivariate logistic regression was performed to study the associations between variables and to account for potential confounders. The study was conducted at Hospital Cayetano Heredia in Lima, Peru from June – August 2017. Results: 272 participants were included in the analysis. 57.7% knew someone who had had TB before, 9% had had TB in the past. Two weeks a cough was correctly identified as a symptom that could be TB by 69.1%. High TB knowledge was found among 149 (54.8%) participants. High health literacy was found among 193 (71.0%) participants. Health literacy and TB knowledge were not significantly associated (OR 0.9 (95%CI 0.5-1.5)). After controlling for sex, age, district, education, health insurance, frequency of hospital visits and previous TB diagnosis: High TB knowledge was associated with knowing someone with TB (aOR 2.7 (95%CI 1.6-4.7)) and being a public transport driver, (aOR 0.2 (95%CI 0.05-0.9)). Not being poor was the single factor associated with high health literacy (aOR 3.8 (95%CI 1.6-8.9)). Conclusions: TB knowledge was fair, though 30% did not know the most important symptom of TB. Tailoring educational strategies to risk groups may enhance passive case detection especially amongst transport workers in Lima, Peru.

Keywords: health literacy, Peru, tuberculosis, tuberculosis knowledge

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544 Relative Importance of Contact Constructs to Acute Respiratory Illness in General Population in Hong Kong

Authors: Kin On Kwok, Vivian Wei, Benjamin Cowling, Steven Riley, Jonathan Read

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Background: The role of social contact behavior measured in different contact constructs in the transmission of respiratory pathogens with acute respiratory illness (ARI) remains unclear. We, therefore, aim to depict the individual pattern of ARI in the community and investigate the association between different contact dimensions and ARI in Hong Kong. Methods: Between June 2013 and September 2013, 620 subjects participated in the last two waves of recruitment of the population based longitudinal phone social contact survey. Some of the subjects in this study are from the same household. They are also provided with the symptom diaries to self-report any acute respiratory illness related symptoms between the two days of phone recruitment. Data from 491 individuals who were not infected on the day of phone recruitment and returned the symptom diaries after the last phone recruitment were used for analysis. Results: After adjusting different follow-up periods among individuals, the overall incidence rate of ARI was 1.77 per 100 person-weeks. Over 75% ARI episodes involve running nose, cough, sore throat, which are followed by headache (55%), malagia (35%) and fever (18%). Using a generalized estimating equation framework accounting for the cluster effect of subjects living in the same household, we showed that both daily number of locations visited with contacts and the number of contacts, explained the ARI incidence rate better than only one single contact construct. Conclusion: Our result suggests that it is the intertwining property of contact quantity (number of contacts) and contact intensity (ratio of subject-to-contact) that governs the infection risk by a collective set of respiratory pathogens. Our results provide empirical evidence that multiple contact constructs should be incorporated in the mathematical transmission models to feature a more realistic dynamics of respiratory disease.

Keywords: acute respiratory illness, longitudinal study, social contact, symptom diaries

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543 Patterns of Change in Specific Behaviors of Autism Symptoms for Boys and for Girls Across Childhood

Authors: Einat Waizbard, Emilio Ferrer, Meghan Miller, Brianna Heath, Derek S. Andrews, Sally J. Rogers, Christine Wu Nordahl, Marjorie Solomon, David G. Amaral

Abstract:

Background: Autism symptoms are comprised of social-communication deficits and restricted/repetitive behaviors (RRB). The severity of these symptoms can change during childhood, with differences between boys and girls. From the literature, it was found that young autistic girls show a stronger tendency to decrease and a weaker tendency to increase their overall autism symptom severity levels compared to young autistic boys. It is not clear, however, which symptoms are driving these sex differences across childhood. In the current study, we evaluated the trajectories of independent autism symptoms across childhood and compared the patterns of change in such symptoms between boys and girls. Method: The study included 183 children diagnosed with autism (55 girls) evaluated three times across childhood, at ages 3, 6 and 11. We analyzed 22 independent items from the Autism Diagnostic Observation Scheudule-2 (ADOS-2), the gold-standard assessment tool for autism symptoms, each item representing a specific autism symptom. First, we used latent growth curve models to estimate the trajectories for the 22 ADOS-2 items for each child in the study. Second, we extracted the factor scores representing the individual slopes for each ADOS-2 item (i.e., slope representing that child’s change in that specific item). Third, we used factor analysis to identify common patterns of change among the ADOS-2 items, separately for boys and girls, i.e., which autism symptoms tend to change together and which change independently across childhood. Results: The best-emerging patterns for both boys and girls identified four common factors: three factors representative of changes in social-communication symptoms and one factor describing changes in RRB. Boys and girls showed the same pattern of change in RRB, with four items (e.g., speech abnormalities) changing together across childhood and three items (e.g., mannerisms) changing independently of other items. For social-communication deficits in boys, three factors were identified: the first factor included six items representing initiating and engaging in social-communication (e.g., quality of social overtures, conversation), the second factor included five items describing responsive social-communication (e.g., response to name) and the third factor included three items related to different aspects of social-communication (e.g., level of language). Girls’ social-communications deficits also loaded onto three factors: the first factor included five items (e.g., unusual eye contact), the second factor included six items (e.g., quality of social response), and the third factor included four items (e.g., showing). Some items showed similar patterns of change for both sexes (e.g., responsive joint attention), while other items showed differences (e.g., shared enjoyment). Conclusions: Girls and boys had different patterns of change in autism symptom severity across childhood. For RRB, both sexes showed similar patterns. For social-communication symptoms, however, there were both similarities and differences between boys and girls in the way symptoms changed over time. The strongest patterns of change were identified for initiating and engaging in social communication for boys and responsive social communication for girls.

Keywords: autism spectrum disorder, autism symptom severity, symptom trajectories, sex differences

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542 Effects of Group Cognitive Restructuring and Rational Emotive Behavioral Therapy on Psychological Distress of Awaiting-Trial Inmates in Correctional Centers in North-West, Nigeria

Authors: Muhammad Shafi’U Adamu

Abstract:

This study examined the effects of two groups of Cognitive Behavioral Therapies (CBT) which, includes Cognitive Restructuring (CB) and Rational Emotive Behavioral Therapy (REBT), on the Psychological Distress of awaiting-trial Inmates in Correctional Centers in North-West Nigeria. The study had four specific objectives, four research questions, and four null hypotheses. The study used a quasi-experimental design that involved pre-test and post-test. The population comprised of all 7,962 awaiting-trial inmates in correctional centers in North-west Nigeria. 131 awaiting trial inmates from three intact Correctional Centers were randomly selected using the census technique. The respondents were sampled and randomly put into 3 groups (CR, REBT and Control). Kessler Psychological Distress Scale (K10) was adapted for data collection in the study. The instrument was validated by experts and subjected to a pilot study using Cronbach's Alpha with a reliability coefficient of 0.772. Each group received treatment for 8 consecutive weeks (60 minutes/week). Data collected from the field were subjected to descriptive statistics of mean, standard deviation and mean difference to answer the research questions. Inferential statistics of ANOVA and independent sample t-test were used to test the null hypotheses at P≤ 0.05 level of significance. Results in the study revealed that there was no significant difference among the pre-treatment mean scores of experimental and control groups. Statistical evidence also showed a significant difference among the mean scores of the three groups, and thus, results of the Post Hoc multiple-comparison test indicated the posttreatment reduction of psychological distress in the awaiting-trial inmates. Documented output also showed a significant difference between the post-treatment psychologically distressed mean scores of male and female awaiting-trial inmates, but there was no difference in those exposed to REBT. The research recommends that a standardized structured CBT counseling technique treatment should be designed for correctional centers across Nigeria, and CBT counseling techniques could be used in the treatment of PD in both correctional and clinical settings.

Keywords: awaiting-trial inmates, cognitive restructuring, correctional centers, rational emotive behavioral therapy

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541 Psychological Wellbeing of Caregivers: Findings from a Large Cohort of Thai Adults

Authors: Vasoontara Yiengprugsawan, Sam-ang Seubsman

Abstract:

As Thais live longer, caregivers will become even more important to social and healthcare systems. Commonly reported in many low and middle‐income countries in Asia, formal social welfare services to support caregivers are lacking and informal family support will be required for all levels of care. In 2005, 87,151 open‐university adults were recruited to the Thai Cohort Study, with the majority aged between 25 and 39 years, and residing nationwide. At the 4‐year follow up in 2009 (n=60569) and the 8‐year follow‐up in 2013 (n=42785), prospective cohort participants were asked if they provide care for chronically ill, disabled, or frail family members. Among Thai cohort members reporting between 2009 and 2013, approximately 56% were not caregivers in either year, 24.5% reported providing care in 2009 only, 8.6% in 2013 only, and 10.6% reported providing care at both time points. Caregivers in the cohort reported providing financial support, help with shopping, emotional support, and assist with daily activities. Kessler 6 psychological distress scale, measured in both 2009 and 2013, was used as the primary outcome of a relationship between caregiving status and mental health. Using multivariate logistic regression, our 4‐year longitudinal findings revealed that cohort members who reported providing care at both time points were 1.4 to 1.6 times more likely to report high psychological distress than non‐caregivers, after accounting for potential covariates. With increasing needs for informal care provided by family members, the future health and social welfare system will need to provide adequate support to caregivers (e.g., respite care, clinical support and information for the family, and awareness of mental health among caregivers).

Keywords: family caregivers, psychological distress, prospective cohort, longitudinal study, Thailand

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540 Factor Structure of the Korean Version of Multidimensional Experiential Avoidance Questionnaire (MEAQ)

Authors: Juyeon Lee, Sungeun You

Abstract:

Experiential avoidance is one’s tendency to avoid painful internal experience, unwanted adverse thoughts, emotions, and physical sensations. The Multidimensional Experiential Avoidance Questionnaire (MEAQ) is a measure of experiential avoidance, and the original scale consisted of 62 items with six subfactors including behavioral avoidance, distress aversion, procrastination, distraction/suppression, repression/denial, and distress endurance. The purpose of this study was to examine the factor structure of the MEAQ in a Korean sample. Three hundred community adults and university students aged 18 to 35 participated in an online survey assessing experiential avoidance (MEAQ and Acceptance and Action Questionnaire-II; AAQ-II), depression (Patient Health Questionnaire-9; PHQ-9), anxiety (Generalized Anxiety Disoder-7; GAD-7), negative affect (Positive and Negative Affect Scale; PANAS), neuroticism (Big Five Inventory; BFI), and quality of life (Satisfaction with Life Scale; SWLS). Factor analysis with principal axis with direct oblimin rotation was conducted to examine subfactors of the MEAQ. Results indicated that the six-factor structure of the original scale was adequate. Eight items out of 62 items were removed due to insufficient factor loading. These items included 3 items of behavior avoidance (e.g., “When I am hurting, I would do anything to feel better”), 2 items of repression/denial (e.g., “I work hard to keep out upsetting feelings”), and 3 items of distress aversion (e.g., “I prefer to stick to what I am comfortable with, rather than try new activities”). The MEAQ was positively associated with the AAQ-II (r = .47, p < .001), PHQ-9 (r = .37, p < .001), GAD-7 (r = .34, p < .001), PANAS (r = .35, p < .001), and neuroticism (r = .24, p < .001), and negatively correlated with the SWLS (r = -.38, p < .001). Internal consistency was good for the MEAQ total (Cronbach’s α = .90) as well as all six subfactors (Cronbach’s α = .83 to .87). The findings of the study support the multidimensional feature of experiential avoidance and validity of the MEAQ in a sample of Korean adults.

Keywords: avoidance, experiential avoidance, factor structure, MEAQ

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539 The Development of the Psychosomatic Nursing Model from an Evidence-Based Action Research on Proactive Mental Health Care for Medical Inpatients

Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee

Abstract:

In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.

Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing

Procedia PDF Downloads 88
538 Effects of Group Cognitive Restructuring and Rational Emotive Behavioral Therapy on Psychological Distress of Awaiting-Trial Inmates in Correctional Centers in North- West, Nigeria

Authors: Muhammad Shafi'u Adamu

Abstract:

This study examined the effects of two Group Cognitive Behavioural Therapies (Cognitive Restructuring and Rational Emotive Behavioural Therapy) on Psychological Distress of awaiting-trial Inmates in Correctional Centres in North-West, Nigeria. The study had four specific objectives, four research questions, and four null hypotheses. The study used a quasi-experimental design that involved pre-test and post-test. The population comprised of all 7,962 awaiting-trial inmates in correctional centres in North-west, Nigeria. 131 awaiting trial inmates from three intact Correctional Centres were randomly selected using the census technique. The respondents were sampled and randomly put into 3 groups (CR, REBT and Control). Kessler Psychological Distress Scale (K10) was adapted for data collection in the study. The instrument was validated by experts and subjected to pilot study using Cronbach's Alpha with reliability co-efficient of 0.772. Each group received treatment for 8 consecutive weeks (60 minutes/week). Data collected from the field were subjected to descriptive statistics of mean, standard deviation and mean difference to answer the research questions. Inferential statistics of ANOVA and independent sample t-test were used to test the null hypotheses at P≤ 0.05 level of significance. Results in the study revealed that there was no significant difference among the pre-treatment mean scores of experimental and control groups. Statistical evidence also showed a significant difference among the mean sores of the three groups, and thus, results of the Post Hoc multiple-comparison test indicating the posttreatment reduction of psychological distress on the awaiting-trial inmates. Documented output also showed a significant difference between the post-treatment psychologically distressed mean scores of male and female awaiting-trial inmates, but there was no difference on those exposed to REBT. The research recommends that a standardized structured CBT counselling technique treatment should be designed for correctional centres across Nigeria, and CBT counselling techniques could be used in the treatment of PD in both correctional and clinical settings.

Keywords: awaiting-trial inmates, cognitive restructuring, correctional centres, group cognitive behavioural therapies, rational emotive behavioural therapy

Procedia PDF Downloads 45
537 Identifying Physical and Psycho-Social Issues Facing Breast Cancer Survivors after Definitive Treatment for Early Breast Cancer: A Nurse-Led Clinic Model

Authors: A. Dean, M. Pitcher, L. Storer, K. Shanahan, I. Rio, B. Mann

Abstract:

Purpose: Breast cancer survivors are at risk of specific physical and psycho-social issues, such as arm swelling, fatigue, and depression. Firstly, we investigate symptoms reported by Australia breast cancer survivors upon completion of definitive treatment. Secondly, we evaluate the appropriateness and effectiveness of a multi-centre pilot program nurse-led clinic to identify these issues and make timely referrals to available services. Methods: Patients post-definitive treatment (excluding ongoing hormonal therapy) for early breast cancer or ductal carcinoma in situ were invited to participate. An hour long appointment with a breast care nurse (BCN) was scheduled. In preparation, patients completed validated quality-of-life surveys (FACT-B, Menopause Rating Scale, Distress Thermometer). During the appointment, issues identified in the surveys were addressed and referrals to appropriate services arranged. Results: 183 of 274 (67%) eligible patients attended a nurse-led clinic. Mean age 56.8 years (range 29-87 years), 181/183 women, 105/183 post-menopausal. 96 (55%) participants reported significant level of distress; 31 (18%) participants reported extreme distress or depression. Distress stemmed from a lack of energy (56/175); poor quality of sleep (50/176); inability to work or participate in household activities (35/172) and problems with sex life (28/89). 166 referrals were offered; 94% of patients accepted the referrals. 65% responded to a follow-up survey: the majority of women either strongly agreed or agreed that the BCN was overwhelmingly supportive, helpful in making referrals, and compassionate towards them. 39% reported making lifestyle changes as a result of the BCN. Conclusion: Breast cancer survivors experience a unique set of challenges, including low mood, difficulty sleeping, problems with sex life and fear of disease recurrence. The nurse-led clinic model is an appropriate and effective method to ensure physical and psycho-social issues are identified and managed in a timely manner. This model empowers breast cancer survivors with information about their diagnosis and available services.

Keywords: early breast cancer, survivorship, breast care nursing, oncology nursing and cancer care

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536 Navigating Creditors' Interests in the Context of Business Rescue

Authors: Hermanus J. Moolman

Abstract:

The COVID-19 pandemic had a severe impact on the society and companies in South Africa. This raises questions about the position of creditors of companies facing financial distress and the actions that directors should take to cater to the interests of creditors. The extent to which directors owe their duties and consideration to creditors has been the subject of debate. The directors of a solvent company owe their duties to the company in favour of its shareholders. When the company becomes insolvent, creditors are the beneficiaries of the directors’ duties. However, the intermittent phase between solvency and insolvency, otherwise referred to as the realm of insolvency, is not accounted for. The purpose of this paper is to determine whether South African company law appropriately addresses the duties that directors owe to creditors and the extent of consideration given to creditors’ interests when the company is in the realm of insolvency and has started business rescue proceedings. A comparative study on South Africa, the United States of America, the United Kingdom and international instruments was employed to achieve the purpose statement. In the United States of America and the United Kingdom, the focus shifts from shareholders to the best interests of creditors when business recue proceedings commence. Such an approach is not aligned with the purpose of the Companies Act of 2008 that calls for a balance of interests of all persons affected by a company’s financial distress and will not be suitable for the South African context. Business rescue in South Africa is relatively new when compared to the practices of the United States of America and the United Kingdom, and the entrepreneurial landscape in South Africa is still evolving. The interests of creditors are not the only interests at risk when a company is financially distressed. It is recommended that an enlightened creditor value approach is adopted for South Africa, where the interests of creditors, albeit paramount, are balanced with those of other stakeholders. This approach optimises a gradual shift in the duties of directors from shareholders to creditors, without disregarding the interests of shareholders.

Keywords: business rescue, shareholders, creditors, financial distress, balance of interests, alternative remedies, company law

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535 Examining Gender Bias in the Sport Concussion Assessment Tool 3 (SCAT3): A Differential Item Functioning Analysis in NCAA Sports

Authors: Rachel M. Edelstein, John D. Van Horn, Karen M. Schmidt, Sydney N. Cushing

Abstract:

As a consequence of sports-related concussions, female athletes have been documented as reporting more symptoms than their male counterparts, in addition to incurring longer periods of recovery. However, the role of sex and its potential influence on symptom reporting and recovery outcomes in concussion management has not been completely explored. The present aims to investigate the relationship between female concussion symptom severity and the presence of assessment bias. The Sport Concussion Assessment Tool 3 (SCAT3), collected by the NCAA and DoD CARE Consortium, was quantified at five different time points post-concussion. N= 1,258 NCAA athletes, n= 473 female (soccer, rugby, lacrosse, ice hockey) and n=785 male athletes (football, rugby, lacrosse, ice hockey). A polytomous Item Response Theory (IRT) Graded Response Model (GRM) was used to assess the relationship between sex and symptom reporting. Differential Item Functioning (DIF) and Differential Group Functioning (DGF) were used to examine potential group-level bias. Interactions for DIF were utilized to explore the impact of sex on symptom reporting among NCAA male and female athletes throughout and after their concussion recovery. DIF was significantly detected after B-H corrections displayed in limited items; however, one symptom, “Pressure in Head” (-0.29, p=0.04 vs -0.20, p =0.04), was statistically significant at both < 6 hours and 24-48 hours. Thus, implies that at < 6 hours, males were 29% less likely to indicate “Pressure in the Head” compared to female athletes and 20% less likely at 24-48 hours. Overall, the DGF suggested significant group differences, suggesting that male athletes might be at a higher risk for returning to play prematurely (logits = -0.38, p < 0.001). However, after analyzing the SCAT 3, a clinically relevant trend was discovered. Twelve out of the twenty-two symptoms suggest higher difficulty in female athletes within three or more of the five-time points. These symptoms include Balance Problems, Blurry Vision, Confusion, Dizziness, Don’t Feel Right, Feel in Fog, Feel Slow Down, Low Energy, Neck Pain, Sensitivity to Light, Sensitivity to Noise, Trouble Falling Asleep. Despite a lack of statistical significance, this tendency is contrary to current literature stating that males may be unclear on symptoms, but females may be more honest in reporting symptoms. Further research, which includes possible modifying socioecological factors, is needed to determine whether females may consistently experience more symptoms and require longer recovery times or if, parsimoniously, males tend to present their symptoms and readiness for play differently than females. Such research will help to improve the validity of current assumptions concerning male as compared to female head injuries and optimize individualized treatments for sports-related head injuries.

Keywords: female athlete, sports-related concussion, item response theory, concussion assessment

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534 Budgetary Performance Model for Managing Pavement Maintenance

Authors: Vivek Hokam, Vishrut Landge

Abstract:

An ideal maintenance program for an industrial road network is one that would maintain all sections at a sufficiently high level of functional and structural conditions. However, due to various constraints such as budget, manpower and equipment, it is not possible to carry out maintenance on all the needy industrial road sections within a given planning period. A rational and systematic priority scheme needs to be employed to select and schedule industrial road sections for maintenance. Priority analysis is a multi-criteria process that determines the best ranking list of sections for maintenance based on several factors. In priority setting, difficult decisions are required to be made for selection of sections for maintenance. It is more important to repair a section with poor functional conditions which includes uncomfortable ride etc. or poor structural conditions i.e. sections those are in danger of becoming structurally unsound. It would seem therefore that any rational priority setting approach must consider the relative importance of functional and structural condition of the section. The maintenance priority index and pavement performance models tend to focus mainly on the pavement condition, traffic criteria etc. There is a need to develop the model which is suitably used with respect to limited budget provisions for maintenance of pavement. Linear programming is one of the most popular and widely used quantitative techniques. A linear programming model provides an efficient method for determining an optimal decision chosen from a large number of possible decisions. The optimum decision is one that meets a specified objective of management, subject to various constraints and restrictions. The objective is mainly minimization of maintenance cost of roads in industrial area. In order to determine the objective function for analysis of distress model it is necessary to fix the realistic data into a formulation. Each type of repair is to be quantified in a number of stretches by considering 1000 m as one stretch. A stretch considered under study is having 3750 m length. The quantity has to be put into an objective function for maximizing the number of repairs in a stretch related to quantity. The distress observed in this stretch are potholes, surface cracks, rutting and ravelling. The distress data is measured manually by observing each distress level on a stretch of 1000 m. The maintenance and rehabilitation measured that are followed currently are based on subjective judgments. Hence, there is a need to adopt a scientific approach in order to effectively use the limited resources. It is also necessary to determine the pavement performance and deterioration prediction relationship with more accurate and economic benefits of road networks with respect to vehicle operating cost. The infrastructure of road network should have best results expected from available funds. In this paper objective function for distress model is determined by linear programming and deterioration model considering overloading is discussed.

Keywords: budget, maintenance, deterioration, priority

Procedia PDF Downloads 173