Search results for: nutrition counseling
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 912

Search results for: nutrition counseling

582 The Effects of the Parent Training Program for Obesity Reduction on Health Behaviors of School-Age Children

Authors: Muntanavadee Maytapattana

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The purposes of the study were to evaluate the effectiveness of the Parent Training Program for Obesity Reduction (PTPOR) on health behaviors of school-age children. An Ecological Systems Theory (EST) was approached the study and a randomized control trial was used in this study. Participants were school-age overweight or obese children and their parents. One hundred and one parent-child dyads were recruited and random assigned into the PTPOR (N=30), Educational Intervention or EI (N=32), and control group (N=39). The parents in the PTPOR group participated in five sessions including an educational session, a cooking session, aerobic exercise training, 2-time group discussion sessions, and 4-time telephoned counseling sessions. Repeated Measure ANCOVA was used to analyze data. The results presented that the outcomes of the PTPOR group were better than the EI and the control groups at 1st, 8th, and 32nd weeks after finishing the program such as child exercise behavior (F(2,97) = 3.98, p = .02) and child dietary behavior (F(2,97) = 9.42, p = .00). The results suggest that nurses and health care providers should utilize the PTPOR for child weight reduction and for the health promotion of a lifestyle among overweight and obese children.

Keywords: parent training program, obesity reduction, child health behaviors, school-age children

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581 Which Mechanisms are Involved by Legume-Rhizobia Symbiosis to Increase Its Phosphorus Use Efficiency under Low Phosphorus Level?

Authors: B. Makoudi, R. Ghanimi, A. Bargaz, M. Mouradi, M. Farissi, A. Kabbaj, J. J. Drevon, C. Ghoulam

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Legume species are able to establish a nitrogen fixing symbiosis with soil rhizobia that allows them, when it operates normally, to ensure their necessary nitrogen nutrition. This biological process needs high phosphorus (P) supply and consequently it is limited under low phosphorus availability. To overcome this constraint, legume-rhizobia symbiosis develops many mechanisms to increase P availability in the rhizosphere and also the efficiency of P fertilizers. The objectives of our research works are to understand the physiological and biochemical mechanisms implemented by legume-rhizobia symbiosis to increase its P use efficiency (PUE) in order to select legume genotypes-rhizobia strains combination more performing for BNF under P deficiency. Our studies were carried out on two grain legume species, common bean (Phaseolus vulgaris) and faba bean (Vicia faba) tested in farmers’ fields and in experimental station fewer than two soil phosphorus levels. Under field conditions, the P deficiency caused a significant decrease of Plant and nodule biomasses in all of the tested varieties with a difference between them. This P limitation increased the contents of available P in the rhizospheric soils that was positively correlated with the increase of phosphatases activities in the nodules and the rhizospheric soil. Some legume genotypes showed a significant increase of their P use efficiency under P deficiency. The P solubilization test showed that some rhizobia strains isolated from Haouz region presented an important capacity to grow on solid and liquid media with tricalcium phosphate as the only P source and their P solubilizing activity was confirmed by the assay of the released P in the liquid medium. Also, this P solubilizing activity was correlated with medium acidification and the excretion of acid phosphatases and phytases in the medium. Thus, we concluded that medium acidification and excretion of phosphatases in the rhizosphere are the prominent reactions for legume-rhizobia symbiosis to improve its P nutrition.

Keywords: legume, phosphorus deficiency, rhizobia, rhizospheric soil

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580 Exogenous Application of Silicon through the Rooting Medium Modulate Growth, Ion Uptake, and Antioxidant Activity of Barley (Hordeum vulgare L.) Under Salt Stress

Authors: Sibgha Noreen, Muhammad Salim Akhter, Seema Mahmood

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Salt stress is an abiotic stress that causes a heavy toll on growth and development and also reduces the productivity of arable and horticultural crops. Globally, a quarter of total arable land has fallen prey to this menace, and more is being encroached because of the usage of brackish water for irrigation purposes. Though barley is categorized as salt-tolerant crop, but cultivars show a wide genetic variability in response to it. In addressing salt stress, silicon nutrition would be a facile tool for enhancing salt tolerant to sustain crop production. A greenhouse study was conducted to evaluate the response of barley (Hordeum vulgare L.) cultivars to silicon nutrition under salt stress. The treatments included [(a) four barley cultivars (Jou-87, B-14002, B-14011, B-10008); (b) two salt levels (0, 200 mM, NaCl); and (c) two silicon levels (0, 200ppm, K2SiO3. nH2O), arranged in a factorial experiment in a completely randomized design with 16 treatments and repeated 4 times. Plants were harvested at 15 days after exposure to different experimental salinity and silicon foliar conditions. Results revealed that various physiological and biochemical attributes differed significantly (p<0.05) in response to different treatments and their interactive effects. Cultivar “B-10008” excelled in biological yield, chlorophyll constituents, antioxidant enzymes, and grain yield compared to other cultivars. The biological yield of shoot and root organs was reduced by 27.3 and 26.5 percent under salt stress, while it was increased by 14.5 and 18.5 percent by exogenous application of silicon over untreated check, respectively. The imposition of salt stress at 200 mM caused a reduction in total chlorophyll content, chl ‘a’ , ‘b’ and ratio a/b by 10.6,16.8,17.1 and 7.1, while spray of 200 ppm silicon improved the quantum of the constituents by 10.4,12.1,10.2,10.3 over untreated check, respectively. The quantum of free amino acids and protein content was enhanced in response to salt stress and the spray of silicon nutrients. The amounts of superoxide dismutase, catalases, peroxidases, hydrogen peroxide, and malondialdehyde contents rose to 18.1, 25.7, 28.1, 29.5, and 17.6 percent over non-saline conditions under salt stress. However, the values of these antioxidants were reduced in proportion to salt stress by 200 ppm silicon applied as rooting medium on barley crops. The salt stress caused a reduction in the number of tillers, number of grains per spike, and 100-grain weight to the amount of 29.4, 8.6, and 15.8 percent; however, these parameters were improved by 7.1, 10.3, and 9.6 percent by foliar spray of silicon over untreated crop, respectively. It is concluded that the barley cultivar “B-10008” showed greater tolerance and adaptability to saline conditions. The yield of barley crops could be potentiated by a foliar spray of 200 ppm silicon at the vegetative growth stage under salt stress.

Keywords: salt stress, silicon nutrition, chlorophyll constituents, antioxidant enzymes, barley crop

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579 Application of ATP7B Gene Mutation Analysis in Prenatal Diagnosis of Wilson’s Disease

Authors: Huong M. T. Nguyen, Hoa A. P. Nguyen, Chi V. Phan, Mai P. T. Nguyen, Ngoc D. Ngo, Van T. Ta, Hai T. Le

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Wilson’s disease is an autosomal recessive disorder of copper metabolism, which is caused by mutation in copper- transporting P-type ATPase (ATP7B). The mechanism of this disease is a failure of hepatic excretion of copper to the bile, and it leads to copper deposits in the liver and other organs. Most clinical symptoms of Wilson’s disease can present as liver disease and/or neurologic disease. Objective: The goal of the study is prenatal diagnosis for pregnant women at high risk of Wilson’s disease in Northern Vietnam. Material and method: Three probands with clinically diagnosed liver disease were detected in the mutations of 21 exons and exon-intron boundaries of the ATP7B gene by direct Sanger-sequencing. Prenatal diagnoses were performed by amniotic fluid sampling from pregnant women in the 16th-18th weeks of pregnancy after the genotypes of parents with the probands were identified. Result: A total of three different mutations of the probands, including of S105*, P1052L, P1273G, were detected. Among three fetuses which underwent prenatal genetic testing, one fetus was homozygote; two fetuses were carriers. Conclusion: Genetic testing provided a useful method for prenatal diagnosis, and is a basis for genetic counseling.

Keywords: ATP7B gene, genetic testing, prenatal diagnosis, pedigree, Wilson disease

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578 An Evaluation of the Efficacy of School-Based Suicide Prevention Programs

Authors: S. Wietrzychowski

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The following review has identified specific programs, as well as the elements of these programs, that have been shown to be most effective in preventing suicide in schools. Suicide is an issue that affects many students each year. Although this is a prominent issue, there are few prevention programs used within schools. The primary objective of most prevention programs is to reduce risk factors such as depression and hopelessness, and increase protective factors like support systems and help-seeking behaviors. Most programs include a gatekeeper training model, education component, peer support group, and/or counseling/treatment. Research shows that some of these programs, like the Signs of Suicide and Youth Aware of Mental Health Programme, are effective in reducing suicide behaviors and increasing protective factors. These programs have been implemented in many countries across the world and have shown promising results. Since schools can provide easy access to adolescents, implement education programs, and train staff members and students how to identify and to report suicide behaviors, school-based programs seem to be the best way to prevent suicide among adolescents. Early intervention may be an effective way to prevent suicide. Although, since early intervention is not always an option, school-based programs in high schools have also been shown to decrease suicide attempts by up to 50%. As a result of this presentation, participants will be able to 1.) list at least 2 evidence-based suicide prevention programs, 2.) identify at least 3 factors which protect against suicide, and 3.) describe at least 3 risk factors for suicide.

Keywords: school, suicide, prevention, programs

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577 A Nutritional Wellness Program for Overweight Health Care Providers in Hospital Setting: A Randomized Controlled Trial Pilot Study

Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

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Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: weight management, weight control, health care providers, hospital

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576 An Ethnographic Study on How Namibian Sex Workers Experience Their Violation of Rights

Authors: Tessa Verhallen, Mama Africa

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By co-constructing personal narratives of sex workers in Namibia this paper represents how sex workers experience their violation of rights in Namibia. It is written from an emic (as an advisor for a sex worker-led organization named Rights not Rescue Trust) and an etic (as an ethnographer) point of view, in collaboration with the staff of the organization Rights not Rescue Trust. This organization represents circa 3000 members. The paper describes the current deplorable situation of sex workers in Namibia, encompassing the stigma and discrimination they face, their struggle to have their work decriminalized and their urge to advocate for human rights and the end of violations. Based on a triangular research design (ethnography, narratives, literature study, human rights’ training and counseling sessions) the authors show that sex workers, particularly LGBTI sex workers, are extremely vulnerable to emotional, physical, and sexual violence in Namibia. The main perpetrators of violence turn out to be not only clients and intimate partners but also law enforcement officers and health care workers who are supposed to protect and support sex workers. The sex workers’ narratives voice their disgraceful circumstances regarding how their rights are violated. It also highlights their importance to fight for their rights and access to health care, legal services and education in order to improve the sexual reproductive health of sex workers.

Keywords: HIV/aids, LGBTI, methodological innovative, sex work

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575 Women and Food Security: Evidence from Bangladesh Demographic Health Survey 2011

Authors: Abdullah Al. Morshed, Mohammad Nahid Mia

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Introduction: Food security refers to the availability of food and a person’s access to it. It is a complex sustainable development issue, which is closely related to under-nutrition. Food security, in turn, can widely affect the living standard, and is rooted in poverty and leads to poor health, low productivity, low income, food shortage, and hunger. The study's aim was to identify the most vulnerable women who are in insecure positions. Method: 17,842 married women were selected for analysis from the Bangladesh Demographic and Health Survey 2011. Food security defined as dichotomous variables of skipped meals and eaten less food at least once in the last year. The outcome variables were cross-tabulated with women's socio-demographic characteristics and chi2 test was applied to see the significance. Logistic regression models were applied to identify the most vulnerable groups in terms of food security. Result: Only 18.5% of women said that they ever had to skip meals in the last year. 45.7% women from low socioeconomic status had skip meal for at least once whereas only 3.6% were from women with highest socioeconomic status. Women meal skipping was ranged from 1.4% to 34.2% by their educational status. 22% of women were eaten less food during the last year. The rate was higher among the poorest (51.6%), illiterate (39.9%) and household have no electricity connection (38.1) in compared with richest (4.4%), higher educated (2.0%), and household has electricity connection (14.0%). The logistic regression analysis indicated that household socioeconomic status, and women education show strong gradients to skip meals. Poorest have had higher odds (20.9) than richest and illiterate women had 7.7 higher odds than higher educated. In terms of religion, Christianity was 2.3 times more likely to skip their meals than Islam. On the other hand, a similar trend was observed in our other outcome variable eat less food. Conclusion: In this study we able to identify women with lower economics status and women with no education were mostly suffered group from starvation.

Keywords: food security, hunger, under-nutrition, women

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574 Providing Healthy Food in Primary and Secondary Schools of Saudi Arabia to Significantly Reduce Obesity and Improve Health by Using the Star Rating System for a Healthier Diet

Authors: Emran M. Badghish

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Overweight and obesity have now become an epidemic around the globe, both in high-, as well as low-income regions. It is important to use preventive measures that are cost-effective. Schools are the essence of building societies and engaging them in healthy nutrition will offer a way to reach individuals at an early stage in life, with many positive and significant impacts. Aim: Provide healthy food in schools of children aged 5 to 18 years old. Methods: Distributing healthy food to a school and implementation of a star rating system for healthier foods, with five stars for the healthiest option to a half a star for the unhealthiest. The stars system was developed in Australia and should motivate children to consume the healthier nutritional options. Each canteen should be allowed a minimum of 3.5 stars rating for the food provided. Outcome Measurement: Body-mass-index as an indicator of overweight and obesity should be checked at the beginning of the study annually for five years for all children. Another side measurement is the performance by checking the grades and a questionnaire on eating habits at the start of the study and yearly. Expected Outcome: A lower health-risk behaviour and assistance to children in reaching their potentials as they will adapt to eating healthier. Nutrition during childhood has the potential to prevent obesity, type 2 diabetes, dental diseases, hypertension and, in later life, cardiovascular disease, osteoporosis and a variety of cancers. In Australia NSW starting from 2016 is expecting a 5% reduction of childhood overweight and obesity by 2025. As for Saudi-Arabia, it is expected to have an, even more, reduction by 2023 as a lot of our children are canteen-dependent. Conclusion: Introducing healthy food in schools is a preventative method that would have significant influence on the reduction of the prevalence of obesity in Saudi-Arabia and improves its general health.

Keywords: food, healthy, children, obesity, schools

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573 Assessing the Impact of Pharmacist-Led Medication Therapy Management on Treatment Adherence and Clinical Outcomes in Cancer Patients: A Prospective Intervention Study

Authors: Omer Ibrahim Abdallh Omer

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Cancer patients often face complex medication regimens, leading to challenges in treatment adherence and clinical outcomes. Pharmacist-led medication therapy management (MTM) has emerged as a potential solution to optimize medication use and improve patient outcomes in oncology settings. In this prospective intervention study, we aimed to evaluate the impact of pharmacist-led MTM on treatment adherence and clinical outcomes among cancer patients. Participants were randomized to receive either pharmacist-led MTM or standard care, with assessments conducted at baseline and follow-up visits. Pharmacist interventions included medication reconciliation, adherence counseling, and personalized care plans. Our findings reveal that pharmacist-led MTM significantly improved medication adherence rates and clinical outcomes compared to standard care. Patients receiving pharmacist interventions reported higher satisfaction levels and perceived value in pharmacist involvement in their cancer care. These results underscore the critical role of pharmacists in optimizing medication therapy and enhancing patient-centered care in oncology settings. Integration of pharmacist-led MTM into routine cancer care pathways holds promise for improving treatment outcomes and quality of life for cancer patients.

Keywords: cancer, medications adherence, medication therapy management, pharmacist

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572 Simple Assessments to Demystify Complementary Feeding: Leveraging a Successful Literacy Initiative Assessment Approach in Gujarat, India

Authors: Smriti Pahwa, Karishma Vats, Aditi Macwan, Jija Dutt, Sumukhi Vaid

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Age approporiate complementary feeding has been stressed upon for sound young child nutrition and appropriate growth. National Infant and Young Child Feeding guidelines, policies and programs indicate cognizance of the issue taken by the country’s government, policy makers and technical experts. However, it is important that ordinary people, the caregivers of young children too understand the importance of appropriate feeding. For this, an interface might be required where ordinary people could participate in assessing the gaps in IYCF as a first step to take subsequent action. In this context an attempt was made to extrapolate a citizen led learning level survey that has been involving around 25000 ordinary citizens to reach out to 600,000 children annually for over a decade in India. Based on this philosophy of involving ordinary people in simple assessments to produce understandable actionable evidence, a rapid diet assessment tool was developed and collected from caregivers of 90 < 3year children from two urban clusters in Ahmedabad and Baroda, Gujarat. Target sample for pilot was selected after cluster census. Around half the mothers reported that they had not yet introduced water or other fluids to their < 6 month babies. However, about a third were already feeding them food other than mother’s milk. Although complementary feeding was initiated in almost all (95%) children more than 6 months old, frequency was suboptimal in 60%; in 80% cases no measure was taken to either improve energy or nutrient density; only 33% were fed protective foods; Green Leafy Vegetables consumption was negligible (1.4%). Anganwadi food was not consumed. By engaging ordinary people to generate evidence and understand the gaps, such assessments have the potential to be used to generate useful evidence for action at scale as well as locally.

Keywords: citizen led, grass root engagement, IYCF (Infant and Young Child Feeding), rapid diet assessment, under nutrition

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571 A Longitudinal Study of Psychological Capital, Parent-Child Relationships, and Subjective Well-Beings in Economically Disadvantaged Adolescents

Authors: Chang Li-Yu

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Purposes: The present research focuses on exploring the latent growth model of psychological capital in disadvantaged adolescents and assessing its relationship with subjective well-being. Methods: Longitudinal study design was utilized and the data was from Taiwan Database of Children and Youth in Poverty (TDCYP), using the student questionnaires from 2009, 2011, and 2013. Data analysis was conducted using both univariate and multivariate latent growth curve models. Results: This study finds that: (1) The initial state and growth rate of individual factors such as parent-child relationships, psychological capital, and subjective wellbeing in economically disadvantaged adolescents have a predictive impact; (2) There are positive interactive effects in the development among factors like parentchild relationships, psychological capital, and subjective well-being in economically disadvantaged adolescents; and (3) The initial state and growth rate of parent-child relationships and psychological capital in economically disadvantaged adolescents positively affect the initial state and growth rate of their subjective well-being. Recommendations: Based on these findings, this study concretely discusses the significance of psychological capital and family cohesion for the mental health of economically disadvantaged youth and offers suggestions for counseling, psychological therapy, and future research.

Keywords: economically disadvantaged adolescents, psychological capital, parent-child relationships, subjective well-beings

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570 The Mediating Effect of Taxpayers’ Compliance on Internal Business Process-Tax Revenue Relationship: A Case Study at the Directorate General of Taxation in Indonesia

Authors: Efrizal, Ferdiansyah, Noorlailie Soewarno, Bambang Tjahjadi

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Tax revenue plays an important role in the State Budget of the Government of Indonesia (GOI). The GOI keeps raising tax revenue portion of the Budget from year to year. The low tax ratio of 11 percent in Indonesia shows a big opportunity to collect taxes in the future. The Directorate General of Taxation (DGT) is the institution mandated by the Law to collect tax revenue. This is a case study using quantitative and qualitative approaches. This study introduces contingent factors of taxpayers’ compliance as the mediating variable and internal business process as the independent variable. This study aims to empirically test the contingency theory, especially the mediating effect of taxpayers’ compliance on internal business process-tax revenue relationship. Internal business processes of the DGT include servicing, counseling, expanding, supervising, inspecting, and enforcing. The secondary data of 31 regional offices representing 293 tax offices in Indonesia was collected and analyzed using Partial Least Square. The result showed the following: (1) internal business process affected tax revenue; (2) taxpayers’ compliance did not mediate internal business processes - tax revenue relationship, and (3) taxpayers’ compliance affected tax revenue. In-depth interviews revealed that the DGT needs to make more innovations in business processes in the future.

Keywords: innovations, internal business process, taxpayers’ compliance, tax revenue

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569 In Working, Career Is Not Everything: A Case Study of Family Friendly Policies on Bank Company

Authors: Trias Setiawati, Rizkika Awalia

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The study title is “In Working, Career is not everything: A Case Study of Family Friendly Policies (FFP) on Bank Company.” This study aims to describe the application of FFP in the banking, especially Bank Rakyat Indonesia or BRI (Indonesian People Bank) in Katamso Branch Office in Yogyakarta Katamso Branch Office in Yogyakarta (KBOY) as a support company to create a work-life balance, as well as the achievement of career and family harmony is seen from the work-family conflict faced by the employees. The importance of the application of FFP in an organization is basically to build competitive advantage of a company. This study used qualitative research methods with a case study approach in BRI in KBOY. Data collection techniques used non-participant observation and in-depth structured interviews with three employees. The results showed that FFP is in general adoption and not optimal yet. Optimal FFP policy is not yet implemented; it just in the in-formal policies such as the lack of flexible-time, the lack of daycare, the lack of counseling for employees of personal nature, despite it was the availability of lactation rooms for feeding. The employees found difficulties in balancing between achieving careers at work and reaching family harmony. Not pursued a career does not mean that they do not want to reach a better position, but they do not want to ignore the family harmony because of the hours of work overload.

Keywords: career, family friendly policies, work-family balance, work-family conflict

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568 Exploring the Food Environments and Their Influence on Food Choices of Working Adults

Authors: Deepa Shokeen, Bani Tamber Aeri

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Food environments are believed to play a significant role in the obesity epidemic and robust research methods are required to establish which factors or aspects of the food environment are relevant to food choice and to adiposity. The relationship between the food environment and obesity is complex. While there is little research linking food access with obesity as an outcome measure in any age group, with the help of this article we will try to understand the relationship between what we eat and the environmental context in which these food choices are made. Methods: A literature search of studies published between January 2000 and December 2013 was undertaken on computerized medical, social science, health, nutrition and education databases including Google, PubMed etc. Reports of organisations such as World Health Organisation (WHO), Centre for Chronic Disease Control (CCDC) were studied to project the data. Results: Studies show that food environments play a significant role in the obesity epidemic and robust research methods are required to establish which factors or aspects of the food environment are relevant to food choice and to adiposity. Evidence indicates that the food environment may help explain the obesity and cardio-metabolic risk factors among young adults. Conclusion: Cardiovascular disease is the ever growing chronic disease, the incidence of which will increase markedly in the coming decades. Therefore, it is the need of the hour to assess the prevalence of various risk factors that contribute to the incidence of cardiovascular diseases especially in the work environment. Research is required to establish how different environments affect different individuals as individuals interact with the environment on a number of levels. We need to ascertain the impact of selected food and nutrition environments (Information, organization, community, consumer) on food choice and dietary intake of the working adults as it is important to learn how these food environments influence the eating perceptions and health behaviour of the adults.

Keywords: food environment, prevalence, cardiovascular disease, India, worksite, risk factors

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567 Phenotypic and Genotypic Diagnosis of Gaucher Disease in Algeria

Authors: S. Hallal, Z. Chami, A. Hadji-Lehtihet, S. Sokhal-Boudella, A. Berhoune, L. Yargui

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Gaucher disease is the most common lysosomal storage in our population, it is due to a deficiency of β –glucosidase acid. The enzyme deficiency causes a pathological accumulation of undegraded substrate in lysosomes. This metabolic overload is responsible for a multisystemic disease with hepatosplenomegaly, anemia, thrombocytopenia, and bone involvement. Neurological involvement is rare. The laboratory diagnosis of Gaucher disease consists of phenotypic diagnosis by determining the enzymatic activity of β - glucosidase by fluorimetric method, a study by genotypic diagnosis in the GBA gene, limiting the search recurrent mutations (N370S, L444P, 84 GG); PCR followed by an enzymatic digestion. Abnormal profiles were verified by sequencing. Monitoring of treated patients is provided by the determination of chitotriosidase. Our experience spaning a period of 6 years (2007-2014) has enabled us to diagnose 78 patients out of a total of 328 requests from the various departments of pediatrics, internal medicine, neurology. Genotypic diagnosis focused on the entire family of 9 children treated at pediatric CHU Mustapha, which help define the clinical form; or 5 of them had type III disease, carrying the L444P mutation in the homozygous state. Three others were composite (N370/L444P) (N370S/other unintended mutation in our study), and only in one family no recurrent mutation has been found. This molecular study permits screening of heterozygous essential for genetic counseling.

Keywords: Gaucher disease, mutations, N370S, L444P

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566 The Effectiveness of the Counselling Module in Counseling Interventions for Low Performance Employees

Authors: Hazaila Hassan

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This research aims and discusses about the effectiveness of the Psynnova i-Behaviour Modification Technique (iBMT) module towards the change in behaviour of low-performing employees. The purpose of the study is to examine the effectiveness of the Psynnova Module on changing behaviour through five factors among low-performing employees in the public sector. The five main factors/constructs were cognitive enhancement and rationality, emotional stability, attitude alignment and adjustment, social skills development and psycho-spirituality enhancement. In this research, 5 main constructs will be using to indicate behaviour changing performance of the employees after attending The Psynnova Program that using this Psynnova IBMT Module. The respondents are among those who have low scores in terms of annual performance through annual performance value reports and have gone through various stages before being required to attend Psynnova Program. Besides that, the research plan was also to critically examine and understand the change in behaviour among the low-performing employees through the five dimensions in the Psynnova Module. A total of 50 respondent will purposively sampled to be the respondents of this research. This study will use the Experimental Method to One Group Purposively Pre and Post Test using the Time Series Design. Experimental SPSS software version 22.0 will be used to analyse this data. Hopefully this research can see the changing of their behaviour in five factors as an indicator to the respondent after attending the Psynnova Programme. Findings from this study are also used to propose to assisting psychologist to see the changes that occurred to the respondents with the best framework of behaviour changing for them.

Keywords: five dimension of behaviour changing, among adult, low performance, modul effectiveness

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565 Role of Social Workers in Juvenile Justice Board as a Child Protection Mechanism for Children in Conflict with Law

Authors: Ida D. Souza, Lena Ashok

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Every child has a fundamental right to be protected and it is only a safe, supported child who can effectively cope with difficult circumstances and lead a happy childhood. The vulnerability of children has increased due to emerging lifestyles, raising cost of living, higher expectations from adults, parental and care-giver stress /burn-out and a general raise in demand for services for children. A major area of concern is the rise of juvenile crimes in the overall crimes committed in the country. The UNCRC 1989 and JJ Act 2000 enables the structures to handle the juvenile children in care and concern in its real terms. One of the mechanisms to protect the children is the JJB a justice system. The aim is to hold a child culpable (guilty) for offence they committed, not through punishment, but counseling the child to understand their actions and persuade them away from such deviated activities in the future. The JJB consists of two social workers and a judicial magistrate and one of whom should be a woman. This study aims at understanding the role of social workers in best practices in deciding the best course of action for the rehabilitation of the child. Two case studies were carried out through in-depth interviews with the social worker member of the JJB of two Udupi and Mangalore districts. The best practices reported in which children are being allowed to express themselves in a child friendly environment and in the best interest of the child. The study highlighted team work to be very effective in understanding the child in their reformation.

Keywords: child protection, best practices, juvenile justice, reformation teamwork

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564 Label Survey in Romania: A Study on How Consumers Use Food Labeling

Authors: Gabriela Iordachescu, Mariana Cretu Stuparu, Mirela Praisler, Camelia Busila, Doina Voinescu, Camelia Vizireanu

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The aim of the study was to evaluate the consumers’ degree of confidence in food labeling, how they use and understand the label and respectively food labeling elements. The label is a bridge between producers, suppliers, and consumers. It has to offer enough information in terms of public health and food safety, statement of ingredients, nutritional information, warnings and advisory statements, producing date and shelf-life, instructions for storage and preparation (if required). The survey was conducted on 500 consumers group in Romania, aged 15+, males and females, from urban and rural areas and with different graduation levels. The questionnaire was distributed face to face and online. It had single or multiple choices questions and label images for the efficiency and best understanding of the question. The law 1169/2011 applied to food products from 13 of December 2016 improved and adapted the requirements for labeling in a clear manner. The questions were divided on following topics: interest and general trust in labeling, use and understanding of label elements, understanding of the ingredient list and safety information, nutrition information, advisory statements, serving sizes, best before/use by meanings, intelligent labeling, and demographic data. Three choice selection exercises were also included. In this case, the consumers had to choose between two similar products and evaluate which label element is most important in product choice. The data were analysed using MINITAB 17 and PCA analysis. Most of the respondents trust the food label, taking into account some elements especially when they buy the first time the product. They usually check the sugar content and type of sugar, saturated fat and use the mandatory label elements and nutrition information panel. Also, the consumers pay attention to advisory statements, especially if one of the items is relevant to them or the family. Intelligent labeling is a challenging option. In addition, the paper underlines that the consumer is more careful and selective with the food consumption and the label is the main helper for these.

Keywords: consumers, food safety information, labeling, labeling nutritional information

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563 Adequate Nutritional Support and Monitoring in Post-Traumatic High Output Duodenal Fistula

Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

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Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

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562 Economic Value Added of Green Marketing for Urban Commerical Center

Authors: Kuo-Wei Hsu, Yen-Ting, Wu

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Recently, green marketing issues have emerged as the developing direction for local governments and social enterprises. At the same time, many social enterprises have considered how to effectively create a low-carbon and sustainable environment. Local government has a role to play in promoting low-carbon life styles and creating a green sustainable environment within this green marketing trend. Therefore, urban commercial centers have implemented relevant plans such as: Green Store, Green Action Shops, Green Restaurants and Green Hotels. The purpose of these plans to select the commercial center organizations have potential energy saving demonstration and environmental greenification. These organizations are willing to provide assistance counseling and become a green demonstration district, thereby promoting the major shopping district to take the initiative to enhance its green competitiveness. Finally, they create a new landscape for the commercial center. Studies on green marketing in commercial centers are seen as less attractive and only a few studies for commercial centers have focused on green marketing strategies. There is no empirical evidence for how commercial center managers evaluate a commercial center green marketing strategy. This research investigated the major commercial centers in Taichung City and found green marketing helps to enhance the connection between the urban commercial center value and society value, shape corporate image with social responsibility and create brand value, and therefore impact the increase of economic value.

Keywords: economic value added, green marketing, sustainable environment, urban commercial center.

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561 Social Justice-Focused Mental Health Practice: An Integrative Model for Clinical Social Work

Authors: Hye-Kyung Kang

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Social justice is a central principle of the social work profession and education. However, scholars have long questioned the profession’s commitment to putting social justice values into practice. Clinical social work has been particularly criticized for its lack of attention to social justice and for failing to address the concerns of the oppressed. One prominent criticism of clinical social work is that it often relies on individual intervention and fails to take on system-level changes or advocacy. This concern evokes the historical macro-micro tension of the social work profession where micro (e.g., mental health counseling) and macro (e.g., policy advocacy) practices are conceptualized as separate domains, creating a false binary for social workers. One contributor to this false binary seems to be that most clinical practice models do not prepare social work students and practitioners to make a clear link between clinical practice and social justice. This paper presents a model of clinical social work practice that clearly recognizes the essential and necessary connection between social justice, advocacy, and clinical practice throughout the clinical process: engagement, assessment, intervention, and evaluation. Contemporary relational theories, critical social work frameworks, and anti-oppressive practice approaches are integrated to build a clinical social work practice model that addresses the urgent need for mental health practice that not only helps and heals the person but also challenges societal oppressions and aims to change them. The application of the model is presented through case vignettes.

Keywords: social justice, clinical social work, clinical social work model, integrative model

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560 Knowledge of Risk Factors and Health Implications of Fast Food Consumption among Undergraduate in Nigerian Polytechnic

Authors: Adebusoye Michael, Anthony Gloria, Fasan Temitope, Jacob Anayo

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Background: The culture of fast food consumption has gradually become a common lifestyle in Nigeria especially among young people in urban areas, in spite of the associated adverse health consequences. The adolescent pattern of fast foods consumption and their perception of this practice, as a risk factor for Non-Communicable Diseases (NCDs), have not been fully explored. This study was designed to assess fast food consumption pattern and the perception of it as a risk factor for NCDs among undergraduates of Federal Polytechnic, Bauchi. Methodology: The study was descriptive cross-sectional in design. One hundred and eighty-five students were recruited using systematic random sampling method from the two halls of residence. A structured questionnaire was used to assess the consumption pattern of fast foods. Data collected from the questionnaires were analysed using statistical package for the social sciences (SPSS) version 16. Simple descriptive statistics, such as frequency counts and percentages were used to interpret the data. Results: The age range of respondents was 18-34 years, 58.4% were males, 93.5% singles and 51.4% of their parents were employed. The majority (100%) were aware of fast foods and (75%) agreed to its implications as NCD. Fast foods consumption distribution included meat pie (4.9%), beef roll/ sausage (2.7%), egg roll (13.5%), doughnut (16.2%), noodles(18%) and carbonated drinks (3.8%). 30.3% consumed thrice in a week and 71% attached workload to high consumption of fast food. Conclusion: It was revealed that a higher social pressure from peers, time constraints, class pressure and school programme had the strong influence on high percentages of higher institutions’ students consume fast foods and therefore nutrition educational campaigns for campus food outlets or vendors and behavioural change communication on healthy nutrition and lifestyles among young people are hereby advocated.

Keywords: fast food consumption, Nigerian polytechnic, risk factors, undergraduate

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559 Food Consumption Pattern and Other Associated Factors of Overweight/Obesity and the Prevalence of Dysglyceamia/Diabetes among Employees Attached to the Ministry of Economic Development

Authors: G. S. Sumanasekara, A. Balasuriya

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Introduction: In Sri Lanka studies reveal higher trend in prevalence of diabetes. The office employees have sedentary life style and their eating patterns changed due to nutritional transition. Further overall, urban and rural pre diabetes is also increasing. Objectives - Study the general food pattern of office employees and its relation to overweight/obesity and prevalence of diabetes among them. Method: The data was collected from office employees between 30-60 years (n-400).Data analyzed using SPSS 16 version.The Study design was a descriptive cross sectional study. The study setting was Ministry of Economic Development. Anthropometric measurements and blood glucose assessed by trained nurses. Dietary pattern was studied through a food frequency questionairre thereby calculated daily nutrient intakes. Results: Mean age of office employees were 38.98 SD (7.033) CI=95%) and 245 females (61.2%) 155 males (38.8 %) ,Nationality includes Sinhala (67.5%), Tamil(20%), and Muslims (12.5%).Owerweight(7,1.8%), obese male(36,9%), obese female(66,16%)/ diabetes/obese(18,4.5%) out of 127(31.8%) who were above the normal BMI whereas 273(68.2) were within the normal. Mean BMI was 24.1593.Mean Blood sugar level was 104.646,SD(16.018).12% consume tobacco products,17.8 consumed alcohol.15.8% had nutrition training. Two main dietary patterns identified who were vegetarians and non vegetarians .Mean energy intake 1727.1, (SD 4.97), Mean protein consumption(11.33, SD 1.811), Mean fat consumption(24.07, SD 4.131),Mean CHO consumption (64.56, SD 4.54), Mean Fibre (30.05, SD 17.9), Mean cholesterol(16.85, SD 17.22), Energy intake was higher in non vegetarians and larger propotion of energy derived from proteins , and fat. Their carbohydrate and cholesterol intake was also higher. Tamils were mostly vegetarians. Mainly BMI were within normal range(18.5-23.5) whereas Muslims who had higher energy intakes showed BMI above the normal. Conclusion: Two distinct dietary patterns identified. Different ethnic groups consume different diets with different nutrient composition. Dietary pattern has a relation to overweight. Overweight related to high blood glucose levels but some overweight subjects do not show any relation.

Keywords: obesity, overweight, diabetes, dietary pattern, nutrition, BMI, non communicable disease

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558 Isolating Refugees in Mountains: The Case of the Austrian Border Regime

Authors: Deike Janssen

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In the scenery of the Tyrolean mountains, at an altitude of 1300 meters, stands a building. Residents and activists call it a prison. However, it is not a prison -according to authorities, it is a 'Return Counseling Facility' where migrants and refugees should be "motivated" to return "voluntary" to their countries of origin. This paper argues that the geographical location of the camp functions as a site of exclusion, isolation, and coercion where no one can decide “voluntary” to return, but where people are brought to despair to leave Austria. Through a qualitative case study, this paper documents the heavy impact of offshore detention on the mental, physical and social state of the residents and a variety of human rights problems in the centre. Different developments at the Return Counselling Facility and the law that back up the centre uncover a worrying dynamic that deliberately accepts human rights problems in order to enforce borders, a policy that disregards humanitarian, legal, and ethical stands in order to deport people at all hazards. It, therefore, can be seen as a creative and ultimate exercise of state power, which uses isolated locations to control migration. While the analysis revises the micro and macro implications of the facility and, therefore, the legal and political facets, it also sheds light on the role of the civil society, which tries to increase through constant and collective efforts the human rights efforts of the government.

Keywords: deportation, human rights, migration, refugee detention, voluntary return

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557 Geriatric Nutrition: An Important Marker for Oral Health Related Quality of Life of Complete Denture Patients

Authors: Rajlakshmi Banerjee, Sujoy Banerjee

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The prevalence of malnutrition, as the most common cause of morbidity and mortality increases with old age, especially in developing countries like India, because of many factors out of which dentate status is one. It affects diet, nutritional status and general health due to reduced chewing ability and poor food choices. Aim and Objective: This study aimed to evaluate the effect of nutritional status, dietary intake on the Oral Health-related Quality of life (OHRQoL) of elderly edentulous complete denture wearing patients and to know whether they are at a higher risk of malnutrition. The objective was to assess the need to include dietary and nutritional counselling during Prosthodontic rehabilitation of elderly edentulous patients. Materials and method: A cross-sectional study was conducted among 200 elderly denture wearing patients above 60 yrs of age from Nagpur, Maharashtra. The majority of study subjects (60%) were between the age group 60 and 75 years. Mini-Nutritional Assessment (MNA) Questionnaire was used to assess nutritional status and General Oral Health Assessment Index (GOHAI) questionnaire was used to determine the Oral health related Quality of life of these patients.Descriptive statistics was used to analyze data using SPSS version 21. Results: Among the assessed subjects, nearly 80% of them had total scores of GOHAI between 12 and 57 which require ‘needed dental care.’ As per MNA, 10.5% had adequate nutrition, 70 % were at risk of malnutrition, and remaining 19.5 % of subjects were malnourished. There was a significant correlation between GOHAI and MNA scores. A strong association was found between mean GOHAI and MNA scores and thereby nutritional status and OHRQOL.Conclusion: The use of conventional dentures increases the risk of malnutrition in the elderly due to inability to eat and chew food properly and therefore severely affecting the quality of life. Dietary analysis and counselling should be strictly incorporated into geriatric treatment planning during Prosthetic rehabilitation.

Keywords: general oral health assessment index, General Oral Health Assessment Index (GOHAI), nutritional assessment, mini-nutritional assessment, Mini-Nutritional Assessment (MNA), quality of life

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556 Beyond Information Failure and Misleading Beliefs in Conditional Cash Transfer Programs: A Qualitative Account of Structural Barriers Explaining Why the Poor Do Not Invest in Human Capital in Northern Mexico

Authors: Francisco Fernandez de Castro

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The Conditional Cash Transfer (CCT) model gives monetary transfers to beneficiary families on the condition that they take specific education and health actions. According to the economic rationale of CCTs the poor need incentives to invest in their human capital because they are trapped by a lack of information and misleading beliefs. If left to their own decision, the poor will not be able to choose what is in their best interests. The basic assumption of the CCT model is that the poor need incentives to take care of their own education and health-nutrition. Due to the incentives (income cash transfers and conditionalities), beneficiary families are supposed to attend doctor visits and health talks. Children would stay in the school. These incentivized behaviors would produce outcomes such as better health and higher level of education, which in turn will reduce poverty. Based on a grounded theory approach to conduct a two-year period of qualitative data collection in northern Mexico, this study shows that this explanation is incomplete. In addition to the information failure and inadequate beliefs, there are structural barriers in everyday life of households that make health-nutrition and education investments difficult. In-depth interviews and observation work showed that the program takes for granted local conditions in which beneficiary families should fulfill their co-responsibilities. Data challenged the program’s assumptions and unveiled local obstacles not contemplated in the program’s design. These findings have policy and research implications for the CCT agenda. They bring elements for late programming due to the gap between the CCT strategy as envisioned by policy designers, and the program that beneficiary families experience on the ground. As for research consequences, these findings suggest new avenues for scholarly work regarding the causal mechanisms and social processes explaining CCT outcomes.

Keywords: conditional cash transfers, incentives, poverty, structural barriers

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555 The Effectiveness of Spouses' Communication Skills Training on Reducing Emotional Harassment and Adjusting Marital Expectations: Married Iranian Women

Authors: Seyed Ali Kimiaei, Reza Pishghadam, Fatemeh Hajizadeh, Marjan Entezari

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The aim of this study was to investigate the effectiveness of the Minnesota Spouses Communication Skills Program on reducing emotional harassment and adjusting the marital expectations of married women. The research method was quasi-experimental with pretest-posttest design with waiting list group and follow-up period. The statistical population of the study consisted of married women referring to counseling and psychology centers in Mashhad, from which 30 people were selected as a sample by examining the entry criteria and questionnaire scores, and randomly divided into two experimental groups (15 people) and the waiting list group (15 people) were replaced. The experimental group was given 8 sessions of communication skills program of spouses. The emotional harassment and marital expectations questionnaire was used to collect data. The results showed a significant difference between the experimental group and the waiting list group, so that the communication skills training of the spouses reduced emotional harassment and adjusted marital expectations, and these effects continued in the follow-up period. Therefore, we can conclude that teaching the husband's communication skills program in the Minnesota method reduces emotional harassment and modifies women's marital expectations.

Keywords: spouses communication skills program, emotional harassment, marital expectations, women

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554 A Shift in Approach from Cereal Based Diet to Dietary Diversity in India: A Case Study of Aligarh District

Authors: Abha Gupta, Deepak K. Mishra

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Food security issue in India has surrounded over availability and accessibility of cereal which is regarded as the only food group to check hunger and improve nutrition. Significance of fruits, vegetables, meat and other food products have totally been neglected given the fact that they provide essential nutrients to the body. There is a need to shift the emphasis from cereal-based approach to a more diverse diet so that aim of achieving food security may change from just reducing hunger to an overall health. This paper attempts to analyse how far dietary diversity level has been achieved across different socio-economic groups in India. For this purpose, present paper sets objectives to determine (a) percentage share of different food groups to total food expenditure and consumption by background characteristics (b) source of and preference for all food items and, (c) diversity of diet across socio-economic groups. A cross sectional survey covering 304 households selected through proportional stratified random sampling was conducted in six villages of Aligarh district of Uttar Pradesh, India. Information on amount of food consumed, source of consumption and expenditure on food (74 food items grouped into 10 major food groups) was collected with a recall period of seven days. Per capita per day food consumption/expenditure was calculated through dividing consumption/expenditure by household size and number seven. Food variety score was estimated by giving 0 values to those food groups/items which had not been eaten and 1 to those which had been taken by households in last seven days. Addition of all food group/item score gave result of food variety score. Diversity of diet was computed using Herfindahl-Hirschman index. Findings of the paper show that cereal, milk, roots and tuber food groups contribute a major share in total consumption/expenditure. Consumption of these food groups vary across socio-economic groups whereas fruit, vegetables, meat and other food consumption remain low and same. Estimation of dietary diversity show higher concentration of diet due to higher consumption of cereals, milk, root and tuber products and dietary diversity slightly varies across background groups. Muslims, Scheduled caste, small farmers, lower income class, food insecure, below poverty line and labour families show higher concentration of diet as compared to their counterpart groups. These groups also evince lower mean intake of number of food item in a week due to poor economic constraints and resultant lower accessibility to number of expensive food items. Results advocate to make a shift from cereal based diet to dietary diversity which not only includes cereal and milk products but also nutrition rich food items such as fruits, vegetables, meat and other products. Integrating a dietary diversity approach in food security programmes of the country would help to achieve nutrition security as hidden hunger is widespread among the Indian population.

Keywords: dietary diversity, food Security, India, socio-economic groups

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553 Attitudes of Health Personnel towards Patients as Expressed by Literate Adults in Ilorin Metropolis, Kwara State: Implications for Counseling

Authors: Yahaya Lasiele Alabi, Odebode Aminat Adeola

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Attitudes of health personnel usually influence the speed of recovery. It is essential that professional counsellors investigate the attitude of health personnel toward patients. In view of this, this study examined attitudes of health personnel towards patients as expressed by literate adults in Ilorin metropolis, Kwara State. The study also examined the influence of gender, age, and educational qualification on the respondents’ views. A self designed instrument tittled ‘Attitude of Health Personnel towards Patients Questionnaire (AHPPQ)’ was used to collect data from six hundred respondents, who were selected through a two-stage sampling procedure. Four research questions were constructed while three null hypotheses were formulated and tested using t-test and ANOVA at 0.05 alpha level. The findings of the study showed that literate adults in Ilorin metropolis expressed that health personnel have negative attitude towards patients. It was also found out that there was no significant difference in the attitude of health personnel towards Patients as expressed by literate adults in Ilorin metropolis on the basis of gender, age, and educational qualification. Based on the findings of this study, recommendations were made that Government should formulate policies and laws that will promote disposition of positive attitudes toward patients by health personnel. Health Counsellors should be employed and involved in organisation of seminars and workshops from time to time in order to encourage health personnel to interract positively with patients.

Keywords: attitude, health personnel, patients, Kwara State

Procedia PDF Downloads 533