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Authors: Bassma A. Abdelhaleem, Mamdouh A. Abdulrhman, Nagwa I. Mohamed

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Malnutrition in children is an increasing problem worldwide which may result in both short and long-term irreversible negative health outcomes. Severe Acute Malnutrition (SAM) affects more than 18 million children each year, mostly living in low-income settings. SAM contributes to 45% of all deaths in children less than five years of age. Honey is a natural sweetener, containing mainly monosaccharides (up to 80%), disaccharides (3–5%), water (17–20%), and a wide range of minor constituents such as vitamins, minerals, proteins, amino acids, enzymes, and phytochemicals, mainly phenolic acids, and flavonoids. Honey has been used in many cultures around the world due to its known nutritional and medicinal benefits including the treatment of hypercholesterolemia. Despite its use since ancient times yet little is known about its potential benefits for malnourished children. Honey has the potential to be an affordable solution for malnourished low-income children as it is nutrient-dense and calorie dense food, easily absorbed, highly palatable, enhances appetite, and boosts immunity. This study assessed the effect of clover honey supplementation on the anthropometric measurements and lipid profile of malnourished infants and children. A prospective interventional clinical trial was conducted between November 2019 to November 2020, on 40 malnourished infants and children divided into two groups: Group A (20 children; 11 males and 9 females) received honey in a dose of 1.75ml/kg/dose, twice weekly for 12 weeks and Group B (20 children; 6 males and 14 females) received placebo. Written informed consent was obtained for parents/guardians. Patients were recruited from the Pediatric Nutrition Clinic at Ain Shams University. Anthropometric measurements (weight, height, body mass index, head circumference, and mid-arm circumference) and fasting serum cholesterol levels were measured at baseline and after 3 months. The 3-month honey consumption had a statistically highly significant effect on increasing weight, height, and body mass index and lowering fasting serum cholesterol levels in primary malnourished infants and children. Weight, height, body mass index, and fasting serum cholesterol level before honey consumption were (9.49 ± 2.03, 81.45 ± 8.31, 14.24 ± 2.15, 178.00 ± 20.91) and after 3 months of honey consumption were (10.91 ± 2.11, 84.80 ± 8.23, 15.07 ± 2.05, 162.45 ± 19.73) respectively with P-value < 0.01. Our results showed a significant desirable effect of honey consumption on changes in nutritional status based on weight, height, and body mass index, and has a favourable effect on lowering fasting serum cholesterol levels. These results propose the use of honey as an affordable solution to improve malnutrition, particularly in low-income countries. However, further research needs to weigh benefits against potential harms including the risk of botulinum toxin that is historically associated with honey consumption in early childhood.

Keywords: clinical trial, dyslipidemia, honey, malnutrition

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Authors: Kyung-Ja Cho, Sun Jin Park

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This study examined what effective dimension affects facial attractiveness. Two orthogonal dimensions, sharp-soft and babyish-mature, were used to rate the levels of facial attractiveness in 20’s women. This research also investigated the sex difference on the effect of effective dimension of face on attractiveness. The test subjects composed of 15 males and 18 females. They looked 330 photos of women in 20s. Then they rated the levels of the effective dimensions of faces with sharp-soft and babyish-mature, and the attraction with charmless-charming. The respond forms were Likert scales, the answer was scored from 1 to 9. As a result of multiple regression analysis, the subject reported the milder and younger appearance as more attractive. Both male and female subjects showed the same evaluation. This result means that two effective dimensions have the effect on estimating attractiveness.

Keywords: affective dimension of faces, facial attractiveness, sharp-soft, babyish-mature

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Authors: Suzan Odabasi

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Suicide attempts and mental health problems among immigrants have been increasing and have become important public health concerns during the last century. Immigrants may face more difficulties in society because of social conflict, language barriers, inadequate social support, socioeconomic problems, and delay in accessing help. The limited number of research has shown that: first-generation migrants may be at higher risk of mental disorders and a higher prevalence of suicide attempts. The main aim of the proposed work is to identify to what degree each of these pressures is causing higher suicides currently observed. In addition, a comparison will be conducted between females and males and also rural and urban areas for which recent data are available. Specifically, this study investigates how accessing mental health services, the uninsured population rate, socioeconomic factors, and being an immigrant affect Turkish immigrants’ mental health and suicide attempts.

Keywords: access to healthcare, immigration, health economics, mental health economics

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Authors: Vilani Sachitra, Udari Bandara

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Self-efficacy beliefs provide the foundation for human motivation, well-being, and personal accomplishment. This study measured the levels of academic self-efficacy of undergraduates and also examined whether there any differences in academic self-efficacy with respect to gender and academic year. A structured questionnaire was employed to collect data from undergraduates who enrolled the Bachelor of Commerce degree programme at the University of Sri Jayewardenepura. The outcome of the study revealed that undergraduates lacked the confidence to ask and answer questions, seek help from lecturers, have a study plan and engage in academic discussion and note-taking. However, the findings also demonstrated that undergraduates were not hesitant about seeking help from friends, had confidence on meeting the deadlines and completing the degree within four years. Interestingly, females displayed higher academic self-efficacy than males. Specifically, the data were supported to conclude that there were significant differences in academic self-efficacy with respect to academic years.

Keywords: academic year, bachelor of commerce undergraduates, gender, self-efficacy

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Authors: Saba Harati, Nasrin Arian Parsa

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The current research was an attempt to investigate the effect of resilience on mental health and life satisfaction. In one Cross Sectional research, 287 (173 females and 114 males) students of Tehran University were participated their average age was 23.17 years old (SD=4.9). The instruments used for assessing the research variables included: Cutter and Davidson resilience scale (CD-RISC), the short form of the depression-anxiety-stress scale, and life satisfaction scale. The data analysis was done in the form of structural equation model. The results of Simultaneous Hierarchical Multiple Regression Analysis indicated that there was a significant mediating role of the negative emotions (depression, anxiety, and stress), in the relationship between the family resilience (p < 0.001) and satisfaction with life (p < 0.001). Resilience results in life satisfaction by reducing the emotional problems (or increasing the mental health level). The effect of the resilience variable on life satisfaction was indirect.

Keywords: resilience, negative emotion, mental health, life satisfaction

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Authors: Vakhtang Nozadze, Luiza Arutinova, Khatuna Martskvishvili

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The social empowerment of most needed individuals is a challenging issue, especially for developing countries. The current study explores the effects of visual impairment on individuals’ satisfaction with different aspects of life (i.e. education, job, income, family) and coping strategies. Furthermore, the difference between groups according to health status is revealed. Other demographic variables (education, employment, and marital status) is also considered. The cross-sectional design and self-reported questionnaires were adopted. Seventy-two visually impaired males and females (age range 13-66) and seventy healthy individuals participated in the study. The results reveal the importance of health status on the accessibility of social amenities, individuals’ satisfaction with life, and a diversity of coping strategies, irrespective of the age. The research has an important implication for social integration research and policy.

Keywords: coping strategies, life satisfaction, social integration, visual impairment

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Authors: Hajar Mohafezatkar Abadi

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The family foundation is formed by marriage, and each couple, with their unique attitudes and personalities, takes a step into marriage. The more efficient and flexible these variables are, the more stable the marriage will be predicted. This group of couples sees their conflicts as an opportunity for growth, not as a threat to their shared life. Regarding family issue importance, a lot of research has been done around this topic which can be an effective step toward improving couples' life quality. The aim of the present study was to determine the role of personality and attitude on marital conflict. 306 couples (153 females, 153 males) were selected using multistage cluster sampling. The participants completed the personality Questionnaire (16PF, Cattell, 1975), marital conflict Questionnaire (MCQ-R, Sanaee Zaker, 1387), and dysfunctional attitude Questionnaire (DAS-26, Weissman & beck. 1987). The regression analysis results indicated that some personality traits and dysfunctional attitudes had a significant positive correlation with marital conflict.

Keywords: marital conflict, dysfunctional attitude, personality, personality questionnaire (16PF)

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Authors: Jingjing Yan, Gengen He, Anahid Basiri

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The design of an indoor navigation system for fire evacuation support requires not only physical feasibility but also a relatively thorough consideration of the human factors. This study has taken a survey to investigate the fire response performances (FRP) of the indoor occupants in age of 20s, virtually in an environment for their routine life, focusing on the aspects of indoor familiarity (spatial cognition), psychological stress and decision makings. For indoor familiarity, it is interested in three factors, i.e., the familiarity to exits and risky places as well as the satisfaction degree of the current indoor sign installation. According to the results, males have a higher average familiarity with the indoor exits while both genders have a relatively low level of risky place awareness. These two factors are positively correlated with the satisfaction degree of the current installation of the indoor signs, and this correlation is more evident for the exit familiarity. The integration of the height factor with the other two indoor familiarity factors can improve the degree of indoor sign satisfaction. For psychological stress, this study concentrates on the situated cognition of moving difficulty, nervousness, and speed reduction when using a bending posture during the fire evacuation to avoid smoke inhalation. The results have shown that both genders have a similar mid-level of hardness sensation. The females have a higher average level of nervousness, while males have a higher average level of speed reduction sensation. This study has assumed that the growing indoor spatial cognition can help ease the psychological hardness and nervousness. However, it only seems to be true after reaching a certain level. When integrating the effects from indoor familiarity and the other two psychological factors, the correlation to the sensation of speed change can be strengthened, based on a stronger positive correlation with the integrated factors. This study has also investigated the participants’ attitude to the navigation support during evacuation, and the majority of the participants have shown positive attitudes. For following the guidance under some extreme cases, i.e., changing to a longer path and to an alternative exit, the majority of the participants has shown the confidence of keeping trusting the guidance service. These decisions are affected by the combined influences from indoor familiarity, psychological stress, and attitude of using navigation service. For the decision time of the selected extreme cases, it costs more time in average for deciding to use a longer route than to use an alternative exit, and this situation is more evident for the female participants. This requires further considerations when designing a personalized smartphone-based navigation app. This study has also investigated the calming factors for people being trapped during evacuation. The top consideration is the distance to the nearest firefighters, and the following considerations are the current fire conditions in the surrounding environment and the locations of all firefighters. The ranking of the latter two considerations is very gender-dependent according to the results.

Keywords: fire response performances, indoor spatial cognition, situated cognition, survey analysis

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Authors: Johannes Van Der Sandt

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Worldwide, there are many boys choirs, but the Drakensberg Boys Choir is one of only a few of its kind: selected from a residential boys choir school using choral music as a significant vehicle for holistic education. With ongoing debates as to whether single-gender education is advantageous for boys, and research on the missing males in choirs problem, this presentation‘s purpose is to explore the perceived benefits and values for boys singing in the world-renowned Drakensberg Boys Choir, and to establish educational grounds for the existence of boys choirs. Semi-structured questionnaires were given to choristers, known as Drakies, to ascertain their perceptions of their choir membership. Their experiences are noted in terms of musical, social and behavioral skills gained. The main emerging themes in each category are discussed in order to lay claim to the assumption that boys choirs exist not only to entertain, and nor are their goals purely musical or pedagogical, but that they can be regarded as unique, cultural artifacts that aid boys‘ development into well-equipped and well-rounded young men.

Keywords: boys, choirs, choral, education, skills, values

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Authors: Prajakta Bhadgaonkar

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Forgiveness is taught since birth in Indian tradition. However, delivering a disabled child is a trauma for the parents. They keep on blaming themselves for the fault, which they are not responsible. Hence, due to lack of forgiving oneself the quality of life of both parent and child gets affected. In forgiveness, person tries to relieve oneself from the feeling of hatred towards oneself or other person. Forgiveness helps move ahead in the life. Hence, one can handle problem more efficiently resulting into better quality of life. In this study, the 30 parents of children with intellectual disability were contacted to find out quality of life. They were administered standardized measure of quality of life (QOL). The children were between 6 to 8 years of age. Out of these 30 parents, 12 parents (7 females and 5 males) were given forgiveness therapy for three months span. After every one month, the QOL scale was administered. At the end of three months, the significant difference was observed in quality of life of parents of children with intellectual disability. Genderwise there was no significant difference between male and female on quality of life.

Keywords: children with intellectual disability, forgiveness, parents, quality of life

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Authors: Ali Kassem, Ehab Fawzy, Mahmoud Sef el-eslam, Fatma Salah- Eldeen, El zahraa Mohamed

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Introduction: The combination of interferon (INF) and ribavirin is the preferred treatment for chronic hepatitis C viral (HCV) infection. However, nonresponse to this therapy remains common and is associated with several factors such as HCV genotype and HCV viral load in addition to host factors such as sex, HLA type and cytokine polymorphisms. Aim of the work: The aim of this study was to determine predictors of response to (INF) therapy in chronic HCV infected patients treated with INF alpha and ribavirin combination therapy. Patients and Methods: The present study included 110 patients (62 males, 48 females) with chronic HCV infection. Their ages ranged from 20-59 years. Inclusion criteria were organized according to the protocol of the Egyptian National Committee for control of viral hepatitis. Patients included in this study were recruited to receive INF ribavirin combination therapy; 54 patients received pegylated NF α-2a (180 μg) and weight based ribavirin therapy (1000 mg if < 75 kg, 1200 mg if > 75 kg) for 48 weeks and 53 patients received pegylated INF α-2b (1.5 ug/kg/week) and weight based ribavirin therapy (800 mg if < 65 kg, 1000 mg if 65-75 kg and 1200 mg if > 75kg). One hundred and seven liver biopsies were included in the study and submitted to histopathological examination. Hematoxylin and eosin (H&E) stained sections were done to assess both the grade and the stage of chronic viral hepatitis, in addition to the degree of steatosis. Modified hepatic activity index (HAI) grading, modified Ishak staging and Metavir grading and staging systems were used. Laboratory follow up including: HCV PCR at the 12th week to assess the early virologic response (EVR) and at the 24th week were done. At the end of the course: HCV PCR was done at the end of the course and tested 6 months later to document end virologic response (ETR) and sustained virologic response (SVR) respectively. Results One hundred seven patients; 62 males (57.9 %) and 45 females (42.1%) completed the course and included in this study. The age of patients ranged from 20-59 years with a mean of 40.39±10.03 years. Six months after the end of treatment patients were categorized into two groups: Group (1): patients who achieved sustained virological response (SVR). Group (2): patients who didn't achieve sustained virological response (non SVR) including non-responders, breakthrough and relapsers. In our study, 58 (54.2%) patients showed SVR, 18 (16.8%) patients were non-responders, 15 (14%) patients showed break-through and 16 (15 %) patients were relapsers. Univariate binary regression analysis of the possible risk factors of non SVR showed that the significant factors were higher age, higher fasting insulin level, higher Metavir stage and higher grade of hepatic steatosis. Multivariate binary regression analysis showed that the only independent risk factor for non SVR was high fasting insulin level. Conclusion: Younger age, lower Metavir stage, lower steatosis grade and lower fasting insulin level are good predictors of SVR and could be used in predicting the treatment response of pegylated interferon/ribavirin therapy.

Keywords: chronic HCV infection, interferon ribavirin combination therapy, predictors to antiviral therapy, treatment response

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Authors: Pranav Saxena

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This study examines the influence of social media usage, gym activities (weightlifting vs. cardiovascular exercise), and gender on body image perceptions among urban emerging adults in India. The research aimed to assess how these factors interact to shape body esteem, a crucial aspect of psychological well-being in a society increasingly influenced by media portrayals of idealized bodies. A purposive sample of 317 participants aged 18–27 years (167 male, 150 female) was recruited through snowball sampling across diverse urban areas. Body esteem was measured using the Body-Esteem Scale for Adolescents and Adults (BESAA), which evaluates perceptions related to appearance, weight, and how individuals perceive others’ view their bodies. Data was collected via online surveys, and Mann-Whitney U tests were used to examine differences in body esteem scores based on the type of gym activity, gender, and social media usage. Results revealed that participants who engaged in cardiovascular activities had significantly higher body esteem compared to those who participated in weightlifting (p = 0.020). Gender differences were also notable, with females reporting higher body esteem than males (p = 0.01). These findings suggest that women may experience more positive body perceptions, possibly influenced by the broader body positivity movement. Contrary to expectations, social media usage was found to be significantly associated with the drive for thinness (p = 0.030) but not with overall body esteem scores (p = 0.329). This suggests that while social media may contribute to specific body dissatisfaction related to thinness, it does not appear to be a major factor influencing overall body esteem in this sample. These results underscore the significant role of physical activity and gender in shaping body image perceptions while challenging the view that social media is the primary driver of negative body image in emerging adults. The findings indicate that physical activity, particularly cardiovascular exercise, may have a protective effect on body esteem, whereas weightlifting could potentially contribute to body dissatisfaction, especially among males. The study also highlights the need for a nuanced understanding of social media's role in shaping body image, suggesting that its impact may be less pronounced than previously thought when compared to other social factors such as gender and physical activity. This study contributes to the growing body of literature on body image in emerging adults, particularly in the context of urban India, where media and fitness culture heavily influence perceptions of the ideal body. It calls for further research into the long-term effects of social media on body image, the role of specific fitness cultures, and how gender norms continue to shape body image concerns. The findings have important implications for designing mental health and fitness interventions that are tailored to address the unique challenges faced by young adults, especially those who may experience heightened dissatisfaction with their bodies due to societal pressures or media portrayals.

Keywords: body image, gender, gym activity, social media usage

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Authors: Sanjaya Humagain, Rajendra Koju

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Background: Rheumatic heart disease (RHD) is the most common cardiovascular disease in children and young adults. Though declined and almost non-existent in developed nations, RHD is still one of the leading cause for premature death and disability in developing countries. Prevalence of RHD is high in both rural as well as urban area of Nepal. Present study is designed to look at the pattern of valvular involvement and demographic features in RHD. Methods: 326 patients indicated for inj. Benzathine penicillin were selected and echocardiograph performed to see the pattern of vavular involvement. Data analysis was done using SPSS 17. Result: The most common type of lesion was mixed type with mitral valve involvement. MR was the most common isolated lesion. MS was more commonly seen in females whereas AS was more common in males. Secondary prophylaxis was more common than primary prophylaxis. Conclusion: RHD still being a major problem and a preventable disease so extensive screening program is required to identify them early and prevent the complication.

Keywords: acute rheumatic fever, RHD, MS, MR, AS, AR, Inj benzathine penicillin

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Authors: Juanita Wallace, Mark Jackson, Bethany Jurs

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Introduction: Exergames, VR games used as a form of exercise, are being used to reduce sedentary lifestyles in a vast number of populations. However, there is a distinct lack of research comparing the physiological response during VR exergaming to that of traditional exercises. The purpose of this study was to create a foundationary investigation establishing changes in physiological responses resulting from VR exergaming in a college aged population. Methods: In this IRB approved study, college aged students were recruited to play a virtual reality exergame (Beat Saber) on the Oculus Quest 2 (Facebook, 2021) in either a control group (CG) or training group (TG). Both groups consisted of subjects who were not habitual users of virtual reality. The CG played VR one time per week for three weeks and the TG played 150 min/week three weeks. Each group played the same nine Beat Saber songs, in a randomized order, during 30 minute sessions. Song difficulty was increased during play based on song performance. Subjects completed a pre- and posttests at which the following was collected: • Beat Saber Game Metrics: song level played, song score, number of beats completed per song and accuracy (beats completed/total beats) • Physiological Data: heart rate (max and avg.), active calories • Demographics Results: A total of 20 subjects completed the study; nine in the CG (3 males, 6 females) and 11 (5 males, 6 females) in the TG. • Beat Saber Song Metrics: The TG improved performance from a normal/hard difficulty to hard/expert. The CG stayed at the normal/hard difficulty. At the pretest there was no difference in game accuracy between groups. However, at the posttest the CG had a higher accuracy. • Physiological Data (Table 1): Average heart rates were similar between the TG and CG at both the pre- and posttest. However, the TG expended more total calories. Discussion: Due to the lack of peer reviewed literature on c exergaming using Beat Saber, the results of this study cannot be directly compared. However, the results of this study can be compared with the previously established trends for traditional exercise. In traditional exercise, an increase in training volume equates to increased efficiency at the activity. The TG should naturally increase in difficulty at a faster rate than the CG because they played 150 hours per week. Heart rate and caloric responses also increase during traditional exercise as load increases (i.e. speed or resistance). The TG reported an increase in total calories due to a higher difficulty of play. The song accuracy decreases in the TG can be explained by the increased difficulty of play. Conclusion: VR exergaming is comparable to traditional exercise for loads within the 50-70% of maximum heart rate. The ability to use VR for health could motivate individuals who do not engage in traditional exercise. In addition, individuals in health professions can and should promote VR exergaming as a viable way to increase physical activity and improve health in their clients/patients.

Keywords: virtual reality, exergaming, health, heart rate, wellness

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Authors: Rezaei Hachesu Peyman, Oliyaee Azadeh, Salahzadeh Zahra, Alizadeh Somayyeh, Safaei Naser

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Coronary Artery Disease (CAD) is one major cause of disability in adults and one main cause of death in developed. In this study, data mining techniques including Decision Trees, Artificial neural networks (ANNs), and Support Vector Machine (SVM) analyze CAD data. Data of 4948 patients who had suffered from heart diseases were included in the analysis. CAD is the target variable, and 24 inputs or predictor variables are used for the classification. The performance of these techniques is compared in terms of sensitivity, specificity, and accuracy. The most significant factor influencing CAD is chest pain. Elderly males (age > 53) have a high probability to be diagnosed with CAD. SVM algorithm is the most useful way for evaluation and prediction of CAD patients as compared to non-CAD ones. Application of data mining techniques in analyzing coronary artery diseases is a good method for investigating the existing relationships between variables.

Keywords: classification, coronary artery disease, data-mining, knowledge discovery, extract

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Authors: Mariia A. Parfenenko, Ilya S. Dantsev, Sergei V. Bochenkov, Natalia V. Vinogradova, Olga S. Groznova, Victoria Yu. Voinova

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Introduction: Autism is the most common neurodevelopmental disorder. Autism is characterized by difficulties in social interaction and adherence to stereotypic behavioral patterns and frequently co-occurs with epilepsy, intellectual disabilities, connective tissue disorders, and other conditions. CHD8 codes for chromodomain-helicase-DNA-binding protein 8 - a chromatin remodeler that regulates cellular proliferation and neurodevelopment in embryogenesis. CHD8 is one of the genes most frequently involved in autism. Patients and methods: 2 unrelated male patients, P3 and P12, aged 3 and 12 years old, underwent whole genome sequencing, which determined that they both had different likely pathogenic variants, both previously undescribed in literature. Sanger sequencing later determined that P12 inherited the variant from his affected mother. Results: P3 and P12 presented with autism, a developmental delay, ataxia, sleep disorders, overgrowth, and macrocephaly, as well as other clinical features typically present in patients with causative variants in CHD8. The mother of P12 also has autistic traits, as well as ataxia, hypotonia, sleep disorders, and other symptoms. However, P3 and P12 also have different cardiac abnormalities. P3 had signs of a repolarization disorder: a flattened T wave in the III and aVF derivations and a negative T wave in the V1-V2 derivations. He also had structural valve anomalies with associated regurgitation, local contractility impairment of the left ventricular, and diastolic dysfunction of the right ventricle. Meanwhile, P12 had Wolff-Parkinson-White syndrome and underwent radiofrequency ablation at the age of 2 years. At the time of observation, P12 had mild sinus arrhythmia and an incomplete right bundle branch block, as well as arterial hypertension. Discussion: Cardiac abnormalities were not previously reported in patients with causative variants in CHD8. The underlying mechanism for the formation of those abnormalities is currently unknown. However, the two hypotheses are either a disordered interaction with CHD7 – another chromodomain remodeler known to be directly involved in the cardiophenotype of CHARGE syndrome – a rare condition characterized by coloboma, heart defects and growth abnormalities, or the disrupted functioning of CHD8 as an A-Kinase Anchoring Protein, which are known to modulate cardiac function. Conclusion: We observed 2 unrelated autistic males with likely pathogenic variants in CHD8 that presented with typical symptoms of CHD8-related neurodevelopmental disorder, as well as cardiac abnormalities. Cardiac abnormalities have, until now, been considered uncharacteristic for patients with causative variants in CHD8. Further accumulation of data, including experimental evidence of the involvement of CHD8 in heart formation, will elucidate the mechanism underlying the cardiophenotype of those patients. Acknowledgements: Molecular genetic testing of the patients was made possible by the Charity Fund for medical and social genetic aid projects «Life Genome.»

Keywords: autism spectrum disorders, chromodomain-helicase-DNA-binding protein 8, neurodevelopmental disorder, cardio phenotype

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Authors: Anne Nattembo

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Cervical cancer remains a major public health problem in developing countries, especially in Africa. Effective cervical cancer prevention communication requires identification of behaviors, attitudes and increasing awareness of a given population; thus this study focused on investigating awareness, attitudes, and behavior among female university students towards cervical cancer messages. The study objectives sought to investigate the communication behavior of young adults towards cervical cancer, to understand female students recognition of cervical cancer as a problem, to identify the frames related to cervical cancer and their impact towards audience communication and participation behaviors, to identify the factors that influence behavioral intentions and level of involvement towards cervical cancer services and to make recommendations on how to improve cervical cancer communication towards female university students. The researcher obtained data using semi-structured interviews and focus group discussions targeting 90 respondents. The semi-structured in-depth interviews were carried out through one-on-one discussions basis using a set of prepared questions among 53 respondents. All interviews were audio-tape recorded. Each interview was directly typed into Microsoft Word. 4 focus group discussions were conducted with a total of 37 respondents; 2 female only groups with 10 respondents in one and 9 respondents in another, 1 mixed with 12 participants 5 of whom were male, and 1 male only group with 6 participants. The key findings show that the participants preferred to receive and access cervical cancer information from doctors although they were mainly receiving information from the radio. In regards to the type of public the respondents represent, majority of the respondents were non-publics in the sense that they did not have knowledge about cervical cancer, had low levels of involvement and had high constraint recognition their cervical cancer knowledge levels. The researcher identified the most salient audience frames among female university students towards cervical cancer and these included; death, loss, and fear. These frames did not necessarily make cervical cancer an issue of concern among the female university students but rather an issue they distanced themselves from as they did not perceive it as a risk. The study also identified the constraints respondents face in responding to cervical cancer campaign calls-to-action which included; stigma, lack of knowledge and access to services as well as lack of recommendation from doctors. In regards to sex differences, females had more knowledge about cervical cancer than the males. In conclusion the study highlights the importance of interpersonal communication in risk or health communication with a focus on health providers proactively sharing cervical cancer prevention information with their patients. Health provider’s involvement in cervical cancer is very important in influencing behavior and compliance of cervical cancer calls-to-action. The study also provides recommendations for designing effective cervical cancer campaigns that will positively impact on the audience such as packaging cervical cancer messages that also target the males as a way of increasing their involvement and more campaigns to increase awareness of cervical cancer as well as designing positive framed messages to counter the negative audience frames towards cervical cancer.

Keywords: cervical cancer communication, health communication, university students, risk communication

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Authors: Rashed Shah, Jeanne Koepsell, Dixmer Rivera, Eric Swedberg, David Marsh

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Success of primary health care goals of health promotion and disease prevention may well be determined by community based health workers’ overall job satisfaction. It is also important to understand the ways community health workers perceive their jobs and the importance they give to the various factors influencing their job satisfaction, which is critical before making a decision for task-shifting and for expanding their scope of work. Although brigadistas are unpaid volunteers, they are formally recognized and receive support and supervision from the Ministry of Health in Nicaragua. Brigadistas are responsible for classifying and diagnosing illnesses, administering treatment, counseling mothers and care givers within the community, encouraging referral in case of serious illness and making follow-up visits at home. Some brigadistas provide more technically advanced services, including treatment for pneumonia, diarrhea, malaria and tuberculosis and/or distribution of contraceptives. Expanding brigadistas’ duties could threaten their heretofore ‘job satisfaction’. This study primarily aims to report on job satisfaction of brigadistas in Nicaragua before expanding the scope of their work by adding more responsibilities. The study was guided by the following research questions: 1) What aspects of their job made the brigadistas satisfied or dissatisfied? 2) What is the job satisfaction level of brigadistas in Nicaragua? This cross-sectional study was conducted during March – July 2014, to assess brigadistas’ job satisfaction, prior to deciding on inclusion of care for sick newborns and young infants (<2 months of age) to brigadistas’ existing service package of community case management for children of 2-59 months of age. Following stratified random sampling strategy, 15 brigadistas were randomly selected from each of the following four strata: [(1) females under 25 years of age, (2) females over 30 years of age, (3) males under 25 years of age, and (4) males over 30 years of age. Out of 45 completed in-person interview with eligible and available brigadistas, 20 (44.4%) were with female and 25 (55.6%) were with male respondents; the mean age (±sd) was found as 32.0 (±3.2) years. About 53% (24/45) brigadista mentioned “Training” as the most helpful for performing their job. Another 31% (14/45) mentioned that “feeling of doing good, supporting community, women and children” was helpful to perform their job well. When asked about difficulty, about 35.5% (16/45) brigadistas mentioned about “Lack of time” due to their responsibilities in family, farm, other work places, study and such time constraint made their job performance difficult. Measured on a 0-5 scale, estimated average job satisfaction was 4.2. Current trends in task-shifting and integrated program delivery require community health workers (like the brigadistas) to deliver several essential services, including maternal, newborn and child health, and family planning, and thereby increasing their responsibilities. Given the reported level of job satisfaction among brigadistas (4.2 out of 5), and the mentioned difficulty in performing their current job (as ‘Lack of Time’) in this study results, the policy makers and program managers in MOH should be cautious enough before making a decision to expand current scope of work for brigadistas in Nicaragua.

Keywords: Brigadisata, job satisfaction, Nicaragua, task-shifting

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Authors: Avantika Verma

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In industrialized nations, corneal lacerations are one of the most common reason for hospitalization. This study was designed to study visual and clinical outcome in patients presenting with full thickness corneal lacerations in Indian population and to ascertain the impact of various preoperative and operative factors influencing prognosis after repair of corneal lacerations. Males in third decade with injuries at work with metallic objects were common. Lens damage, hyphema, vitreous hemorrhage, retinal detachment and endophthalmitis were seen. All the patients underwent primary repair within first 24 hours of presentation. At 3 months, 74.3% had a good visual outcome. About 5.7% of patients had no perception of light.In conclusion, various demographic and preoperative factors like age, time of presentation, vision at presentation, length of corneal wound, involvement of visual axis, associated ocular features like hyphaema, lenticular changes, vitreous haemorrhage and retinal detachment are significant prognostic indicators for final visual outcome.

Keywords: corneal laceration, corneal wound repair, injury, visual outcome

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Authors: Hsin-Yi Lien

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The study explored the role of metacognition in foreign language anxiety on a sample of 411 Taiwanese students of English as a Foreign Language. The reading strategy inventory was employed to evaluate the tertiary learners’ level of metacognitive awareness and a semi-structured background questionnaire was also used to examine the learners’ perceptions of their English proficiency and satisfaction of their current English learning. In addition, gender and academic level differences in employment of reading strategies were investigated. The results showed the frequency of reading strategy use increase slightly along with academic years and males and females actually employ different reading strategies. The EFL tertiary learners in the present study utilized cognitive strategies more frequently than metacognitive strategies or support strategies. Male students use metacognitive strategy more often while female students use cognitive and support strategy more frequently.

Keywords: cognitive strategy, gender differences, metacognitive strategy, support strategy

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Authors: Lata Rathi, N. R. Mrinal

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Dental Disfigurement is a major problem for a person who is suffering from Malocclusion. Malocclusion, is a technical name given to crowded, irregular or protruded teeth. In the present investigation the Anxiety and Stress are studied with reference to Dental Disfigurement among Adolescents. The 8 SQ Questionnaire (Cattell,1976)was administered to 50 Male(age range 12-20 years) and 50 Female(age range 12-20 years) patients to investigate anxiety and stress with an equal number of normal’s having no dental disfigurement of teeth. Both the groups, experimental and control were matched on age and sex. It was found that experimental group, i. e. orthodontic patients (M=14.34,s= 4.99) have significantly greater anxiety than their normal counterparts (M=11.8,s= 4.20) F=15.04,p=<.01. The sex differences were not observed. However, with reference to stress it was observed that it was significantly greater in orthodontic patients (M=15.11,s= 4.93 )as compared to normal’s (M=12.83, s=4.87). The gender differences on stress were also observed. The females showed greater stress (M=15.06) as compared to males (M=12.88),F=11.55,p.<1. Overall Malocclusion was found to have significant effect on anxiety and stress.

Keywords: anxiety, malocclusion, orthodontic patients, stress

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Authors: Maria Ines Azambuja

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Graphic displays of Age-Period-Cohort (APC) mortality trends generally uses data aggregated within 5 or 10-year intervals. Technology allows one to increase the amount of processed data. Displaying occurrences by 1-year intervals is a logic first step in the direction of attaining higher quality landscapes of variations in temporal occurrences. Method: 1) Comparison of UK mortality trends plotted by 10-, 5- and 1-year intervals; 2) Comparison of UK and US mortality trends (period X age and cohort X age) displayed by 1-year intervals. Source: Mortality data (period, 1x1, males, 1933-1912) uploaded from the Human Mortality Database to Excel files, where Period X Age and Cohort X Age graphics were produced. The choice of transforming age-specific trends from calendar to birth-cohort years (cohort = period – age) (instead of using cohort 1x1 data available at the HMD resource) was taken to facilitate the comparison of age-specific trends when looking across calendar-years and birth-cohorts. Yearly live births, males, 1933 to 1912 (UK) were uploaded from the HFD. Influenza references are from the literature. Results: 1) The use of 1-year intervals unveiled previously unsuspected period, cohort and interacting period x cohort effects upon all-causes mortality. 2) The UK and US figures showed variations associated with particular calendar years (1936, 1940, 1951, 1957-68, 72) and, most surprisingly, with particular birth-cohorts (1889-90 in the US, and 1900, 1918-19, 1940-41 and 1946-47, in both countries. Also, the figures showed ups and downs in age-specific trends initiated at particular birth-cohorts (1900, 1918-19 and 1947-48) or a particular calendar-year (1968, 1972, 1977-78 in the US), variations at times restricted to just a range of ages (cohort x period interacting effects). Importantly, most of the identified “scars” (period and cohort) correlates with the record of occurrences of Influenza A epidemics since the late 19th Century. Conclusions: The use of 1-year intervals to describe APC mortality trends both increases the amount of information available, thus enhancing the opportunities for patterns’ recognition, and increases our capability of interpreting those patterns by describing trends across smaller intervals of time (period or birth-cohort). The US and the UK mortality landscapes share many but not all 'scars' and distortions suggested here to be associated with influenza epidemics. Different size-effects of wars are evident, both in mortality and in fertility. But it would also be realistic to suppose that the preponderant influenza A viruses circulating in UK and US at the beginning of the 20th Century might be different and the difference to have intergenerational long-term consequences. Compared with the live births trend (UK data), birth-cohort scars clearly depend on birth-cohort sizes relatives to neighbor ones, which, if causally associated with influenza, would result from influenza-related fetal outcomes/selection. Fetal selection could introduce continuing modifications on population patterns of immune-inflammatory phenotypes that might give rise to 'epidemic constitutions' favoring the occurrence of particular diseases. Comparative analysis of mortality landscapes may help us to straight our record of past circulation of Influenza viruses and document associations between influenza recycling and fertility changes.

Keywords: age-period-cohort trends, epidemic constitution, fertility, influenza, mortality

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Authors: Aleksandra Rajewska-Rager, Maria Skibinska, Monika Dmitrzak-Weglarz, Natalia Lepczynska, Pawel Kapelski, Joanna Pawlak, Joanna Hauser

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Introduction: Inflammation and cytokines have emerged as a promising target in mood disorders research; however there are still very limited numbers of study regarding inflammatory alterations among adolescents and young adults with mood disorders. The Macrophage Migration Inhibitory Factor (MIF) and Stem Cell Factor (SCF) are the pleiotropic cytokines which may play an important role in mood disorders pathophysiology. The aim of this study was to investigate levels of these factors in serum of adolescent and young adults with mood disorders compared to healthy controls. Subjects: We involved 79 patients aged 12-24 years in 2-year follow-up study with a primary diagnosis of mood disorders: bipolar disorder (BP) and unipolar disorder with BP spectrum. Study group includes 23 males (mean age 19.08, SD 3.3) and 56 females (18.39, SD 3.28). Control group consisted 35 persons: 7 males (20.43, SD 4.23) and 28 females (21.25, SD 2.11). Clinical diagnoses according to DSM-IV-TR criteria were assessed using Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) and Structured Clinical Interview for the Diagnostic and Statistical Manual (SCID) in young adults respectively. Clinical assessment includes evaluation of clinical factors and symptoms severity (rated using the Hamilton Depression Rating Scale and Young Mania Rating Scale). Clinical and biological evaluations were made at control visits respectively at baseline (week 0), euthymia (at month 3 or 6) and after 12 and 24 months. Methods: Serum protein concentration was determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Human MIF and SCF DuoSet ELISA kits were used. In the analyses non-parametric tests were used: Mann-Whitney U test, Kruskal-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation. We defined statistical significance as p < 0.05. Results: Comparing MIF and SCF levels between acute episode of depression/hypo/mania at baseline and euthymia (at month 3 or 6) we did not find any statistical differences. At baseline patients with age above 18 years old had decreased MIF level compared to patients younger than 18 years. MIF level at baseline positively correlated with age (p=0.004). Positive correlations of SCF level at month 3 and 6 with depression or mania occurrence at month 24 (p=0.03 and p=0.04, respectively) was detected. Strong correlations between MIF and SCF levels at baseline (p=0.0005) and month 3 (p=0.03) were observed. Discussion: Our results did not show any differences in MIF and SCF levels between acute episode of depression/hypo/mania and euthymia in young patients. Further studies on larger groups are recommended. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: cytokines, MIF, mood disorders, SCF

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Authors: Rami Al Jafar, Paul Elliott, Konstantinos K. Tsilidis, Abbas Dehghan

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Although Ramadan fasting is a ritual that is practiced every year by millions of Muslims, studies on Ramadan fasting are still scarce. To the best of our knowledge, none of the previous studies comprehensively explored the effect on the metabolic profile. In London Ramadan Fasting Study, blood samples were collected from 81 participants before and 10-14 days after Ramadan. Blood samples were analysed using nuclear magnetic resonance (NMR) spectroscopy which covers 249 metabolites. Mixed-effects models were used to analyse collected data and assess the effect of Ramadan fasting on the metabolic profile. Our observational study involved 85 individuals with a mean age of 45.2 years, and 53.1% of them were males. After Ramadan, forty metabolites were affected significantly by Ramadan fasting. Most of these metabolites were metabolites ratios (24), and the rest were three Glycolysis, three ketone bodies, nine Lipoprotein subclasses and one inflammation marker. This study suggests that Ramadan fasting is significantly associated with changes in the metabolic profile. However, the changes are assumed to be temporary, and the long-term effect of these changes is unknown.

Keywords: metabolic profile, Ramadan fasting, metabolites, intermittent fasting

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Authors: Annis Lai Chu Fung

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This study is to fill up a research gap on examining the differences in normative beliefs (namely acceptance of weaknesses, acceptance of provoked aggression, and acceptance of unprovoked aggression) among different subtypes of aggressors and non-aggressors (reactive aggressors, proactive aggressors, reactive-proactive aggressors, and non-aggressors,). 2,236 students (1,372 males and 864 females), aged from 11 to 18, completed a self-reported questionnaire. Results revealed that (a) schoolchildren with reactive-proactive aggression have the highest acceptance of provoked aggression, the highest acceptance of unprovoked aggression, and the lowest acceptance of weakness; (b) schoolchildren with proactive aggression have higher acceptance of unprovoked aggression and lower acceptance of weakness than reactive aggressors; and (c) schoolchildren without aggression have the lowest acceptance of provoked aggression, the lowest acceptance of unprovoked aggression, and the highest acceptance of weakness.

Keywords: normative belief, schoolchildren, reactive, proactive, aggression

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Authors: Tomaz Oliveira, Rui Medeiros, André Lacerda

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Introduction: Cleft lip and/or palate are the most frequent forms of congenital craniofacial anomalies, affecting mainly the middle third of the face and manifesting by functional and aesthetic changes. Bilateral cleft lip represents a reconstructive surgical challenge, not only for the labial component but also for the associated nasal deformation. Recently, the paradigm of the approach to this pathology has changed, placing the focus on muscle reconstruction and anatomical repositioning of the nasal cartilages in order to obtain the best aesthetic and functional results. The aim of this study is to carry out a systematic review of the surgical approach to bilateral cleft lip, retrospectively analyzing the case series of Plastic Surgery Service at Hospital Santa Maria (Lisbon, Portugal) regarding this pathology, the global assessment of the characteristics of the operated patients and the study of the different surgical approaches and their complications in the last 20 years. Methods: The present work demonstrates a retrospective and descriptive study of patients who underwent at least one reconstructive surgery for cleft lip and/or palate, in the CPRE service of the HSM, in the period between January 1 of 1997 and December 31 of 2017, in which the data relating to 361 individuals were analyzed who, after applying the exclusion criteria, constituted a sample of 212 participants. The variables analyzed were the year of the first surgery, gender, age, type of orofacial cleft, surgical approach, and its complications. Results: There was a higher overall prevalence in males, with cleft lip and cleft palate occurring in greater proportion in males, with the cleft palate being more common in females. The most frequently recorded malformation was cleft lip and palate, which is complete in most cases. Regarding laterality, alterations with a unilateral labial component were the most commonly observed, with the left lip being described as the most affected. It was found that the vast majority of patients underwent primary intervention up to 12 months of age. The surgical techniques used in the approach to this pathology showed an important chronological variation over the years. Discussion: Cleft lip and/or palate is a medical condition associated with high aesthetic and functional morbidity, which requires early treatment in order to optimize the long-term outcome. The existence of a nasolabial component and its respective surgical correction plays a central role in the treatment of this pathology. The high rates of post-surgical complications and unconvincing aesthetic results have motivated an evolution of the surgical technique, increasingly evident in recent years, allowing today to achieve satisfactory aesthetic results, even in bilateral cleft lip with high deformation complexity. The introduction of techniques that favor nasolabial reconstruction based on anatomical principles has been producing increasingly convincing results. The analyzed sample shows that most of the results obtained in this study are, in general, compatible with the results published in the literature. Conclusion: This work showed that the existence of small variations in the surgical technique can bring significant improvements in the functional and aesthetic results in the treatment of bilateral cleft lip.

Keywords: cleft lip, palate lip, congenital abnormalities, cranofacial malformations

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Authors: Sarah A. Harris, Fleur L. McIntyre, Paola T. Chivers, Benjamin G. Piggott, Fiona H. Farringdon

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Australian Rules Football (ARF) is an invasion based, contact field sport with over one million participants. The contact nature of the game increases exposure to all injuries, including head trauma. Evidence suggests that both concussion and sub-concussive traumas such as head knocks may damage the brain, in particular the prefrontal cortex. The prefrontal cortex may not reach full maturity until a person is in their early twenties with males taking longer to mature than females. Repeated trauma to the pre-frontal cortex during maturation may lead to negative social, cognitive and emotional effects. It is also during this period that males exhibit high levels of risk taking behaviours. Risk propensity and the incidence of injury is an unexplored area of research. Little research has considered if the level of player’s (especially younger players) risk propensity in everyday life places them at an increased risk of injury. Hence the current study, investigated if a relationship exists between risk propensity and self-reported injuries including diagnosed concussion and head knocks, among male ARF players aged 18 to 31 years. Method: The study was conducted over 22 weeks with one West Australian Football League (WAFL) club during the 2015 competition. Pre-season risk propensity was measured using the 7-item self-report Risk Propensity Scale. Possible scores ranged from 9 to 63, with higher scores indicating higher risk propensity. Players reported their self-perceived injuries (concussion, head knocks, upper body and lower body injuries) fortnightly using the WAFL Injury Report Survey (WIRS). A unique ID code was used to ensure player anonymity, which also enabled linkage of survey responses and injury data tracking over the season. A General Linear Model (GLM) was used to analyse whether there was a relationship between risk propensity score and total number of injuries for each injury type. Results: Seventy one players (N=71) with an age range of 18.40 to 30.48 years and a mean age of 21.92 years (±2.96 years) participated in the study. Player’s mean risk propensity score was 32.73, SD ±8.38. Four hundred and ninety five (495) injuries were reported. The most frequently reported injury was head knocks representing 39.19% of total reported injuries. The GLM identified a significant relationship between risk propensity and head knocks (F=4.17, p=.046). No other injury types were significantly related to risk propensity. Discussion: A positive relationship between risk propensity and head trauma in contact sports (specifically WAFL) was discovered. Assessing player’s risk propensity therefore, may identify those more at risk of head injuries. Potentially leading to greater monitoring and education of these players throughout the season, regarding self-identification of head knocks and symptoms that may indicate trauma to the brain. This is important because many players involved in WAFL are in their late teens or early 20’s hence, may be at greater risk of negative outcomes if they experience repeated head trauma. Continued education and research into the risks associated with head injuries has the potential to improve player well-being.

Keywords: football, head injuries, injury identification, risk

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Authors: Ignacio Luis Ramirez, Brittney Holcomb

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This study examines attitudes toward sexual assault based on religious affiliation, religiosity, religious beliefs, attitude about sexual assault education, alcohol, and drug use. This study found respondents who identified themselves as Catholics had more negative attitudes toward sexual assault and were more likely to support victim-blaming statements than Baptists or Protestants. Respondents who indicated a greater problem with alcohol had more negative attitudes toward sexual assault and were more likely to support victim-blaming statements. In reference to gender, males had more negative attitudes toward sexual assault and were more likely to support victim-blaming statements than females. The respondent’s religiosity and religious beliefs did not affect their attitudes toward sexual assault. Additionally, attitudes about sexual assault education and drug use did not affect attitudes toward sexual assault.

Keywords: sexual assault, religion, education, alcohol, drugs

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Authors: Nunna Venkata Prasad, Maryam Amoke Folarin, Muhammad Ali Shaukat Sham

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A quantitative investigation was conducted to explore the communication apprehension among undergraduate students of Abu Dhabi University. Communication apprehension (CA) is an individual’s level of fear or anxiety associated with either real or anticipated communication with another person or persons. All individuals experience some level of communication apprehension. A total of 100 participants selected through a stratified sampling method, which includes 50 males and 50 females participated in the study. The research was conducted by distributing the personal report of communication apprehension questionnaire, randomly amongst these students. Results were affirmative with previous researches conducted. Demographics, age, or college year did not make any significant differences amongst the undergraduate students. More students were found to have high CA with public speaking rather than other scenarios. And lesser students were found to have high CA level with one-on-one conversations although a significant number of them still tested to have high CA with interpersonal communications.

Keywords: communication apprehension, interpersonal communication, oral communication, public speaking

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Authors: Cynthia Sau Chun Yip, Richard Fielding

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High meat and especially red meat intakes are significantly and positively associated with a multiple burden of diseases and also high greenhouse gas (GHG) emissions. This study investigated population meat intake patterns in Hong Kong. It quantified the burden of disease and GHG emission outcomes by modeling to adjust Hong Kong population meat intakes to recommended healthy levels. It compared age- and sex-specific population meat, fruit and vegetable intakes obtained from a population survey among adults aged 20 years and over in Hong Kong in 2005-2007, against intake recommendations suggested in the Modelling System to Inform the Revision of the Australian Guide to Healthy Eating (AGHE-2011-MS) technical document. This study found that meat and meat alternatives, especially red meat intakes among Hong Kong males aged 20+ years and over are significantly higher than recommended. Red meat intakes among females aged 50-69 years and other meat and alternatives intakes among aged 20-59 years are also higher than recommended. Taking the 2005-07 age- and sex-specific population meat intake as baselines, three counterfactual scenarios of adjusting Hong Kong adult population meat intakes to AGHE-2011-MS and Pre-2011 AGHE recommendations by the year 2030 were established. Consequent energy intake gaps were substituted with additional legume, fruit and vegetable intakes. To quantify the consequent GHG emission outcomes associated with Hong Kong meat intakes, Cradle-to-ready-to-eat lifecycle assessment emission outcome modelling was used. Comparative risk assessment of burden of disease model was used to quantify the health outcomes. This study found adjusting meat intakes to recommended levels could reduce Hong Kong GHG emission by 17%-44% when compared against baseline meat intake emissions, and prevent 2,519 to 7,012 premature deaths in males and 53 to 1,342 in females, as well as multiple burden of diseases when compared to the baseline meat intake scenario. Comparing lump sum meat intake reduction and outcome measures across the entire population, and using emission factors, and relative risks from individual studies in previous co-benefit studies, this study used age- and sex-specific input and output measures, emission factors and relative risks obtained from high quality meta-analysis and meta-review respectively, and has taken government dietary recommendations into account. Hence evaluations in this study are of better quality and more reflective of real life practices. Further to previous co-benefit studies, this study pinpointed age- and sex-specific population and meat-type-specific intervention points and leverages. When compared with similar studies in Australia, this study also showed that intervention points and leverages among populations in different geographic and cultural background could be different, and that globalization also globalizes meat consumption emission effects. More regional and cultural specific evaluations are recommended to promote more sustainable meat consumption and enhance global food security.

Keywords: burden of diseases, greenhouse gas emissions, Hong Kong diet, sustainable meat consumption

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