Search results for: health risk assessments

Authors: Kristina Sutiene, Lina Dapkute

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The paper investigates the current demographic trends that exert the sustainability of pension systems in most EU regions. Several drivers usually compose the demographic challenge, coming from the structure and trends of population in the country. As the case of research, three main variables of demographic risk in Lithuania have been singled out and have been used in making up the analysis. Over the last two decades, the country has presented a peculiar demographic situation characterized by pessimistic fertility trends, negative net migration rate and rising life expectancy that make the significant changes in labor-age population. This study, therefore, sets out to assess the relative impact of these risk factors both individually and in aggregate, while assuming economic trends to evolve historically. The evidence is presented using data of pension funds that operate in Lithuania and are financed by defined-contribution plans. To achieve this goal, the discrete-time pension fund’s value model is developed that reflects main operational modalities: contribution income from current participants and new entrants, pension disbursement and administrative expenses; it also fluctuates based on returns from investment activity. Age-structured Leslie population dynamics model has been integrated into the main model to describe the dynamics of fertility, migration and mortality rates upon age. Validation has concluded that Leslie model adequately fits the current population trends in Lithuania. The elasticity of pension system is examined using Loimaranta efficiency as a measure for comparison of plausible long-term developments of demographic risks. With respect to the research question, it was found that demographic risks have different levels of influence on future value of aggregated pension funds: The fertility rates have the highest importance, while mortality rates give only a minor impact. Further studies regarding the role of trying out different economic scenarios in the integrated model would be worthwhile.

Keywords: asset liability modelling, Leslie model, pension funds, population dynamics

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Authors: Maria Sonto Maputle, Rhulani C. Shihundla, Rachel T. Lebese

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Background: Patients’ information must be complete and accurately documented in order to foster quality and continuity of care. The multidisciplinary health care members use patients’ documentation to communicate about health status, preventive health services, treatment, planning and delivery of care. The purpose of this study was to determine the practice of nursing documentation of patients’ information at selected Primary Health Care (PHC) facilities in Vhembe District, Limpopo Province, South Africa. Methods: The research approach adopted was qualitative while exploratory and descriptive design was used. The study was conducted at selected PHC facilities. Population included twelve professional nurses. Non-probability purposive sampling method was used to sample professional nurses who were willing to participate in the study. The criteria included participants’ whose daily work and activities, involved creating, keeping and updating nursing documentation of patients’ information. Qualitative data collection was through unstructured in-depth interviews until no new information emerged. Data were analysed through open–coding of, Tesch’s eight steps method. Results: Following data analysis, it was found that professional nurses’ had knowledge deficit related to insufficient training on updates and rendering multiple services daily had negative impact on accurate documentation of patients’ information. Conclusion: The study recommended standardization of registers, books and forms used at PHC facilities, and reorganization of PHC services into open day system.

Keywords: documentation, knowledge, patient care, patient’s information, training

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Authors: Rani Fernandez

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As global concerns regarding environmental degradation and climate change intensify, the imperative for sustainable living has never been more critical. This research delves into the role of eco-products in everyday life as a pivotal strategy for achieving sustainability. The study investigates the awareness, adoption, and impact of eco-friendly products on individual and community levels. The research employs a mixed-methods approach, combining surveys, interviews, and case studies to explore consumer perceptions, behaviours, and motivations surrounding the use of eco-products. Additionally, life cycle assessments are conducted to evaluate the environmental footprint of selected eco-products, shedding light on their tangible contributions to sustainability. The findings reveal the diverse range of eco-products available in the market, from biodegradable packaging to energy-efficient appliances, and the extent to which consumers integrate these products into their daily routines. Moreover, the research examines the challenges and opportunities associated with widespread adoption, considering factors such as cost, accessibility, and efficacy. In addition to individual consumption patterns, the study investigates the broader societal impact of eco-product integration. It explores the potential for eco-products to drive systemic change by influencing supply chains, corporate practices, and government policies. The research highlights successful case studies of communities or businesses that have effectively incorporated eco-products, providing valuable insights into scalable models for sustainability. Ultimately, this research contributes to the discourse on sustainable living by elucidating the pivotal role of eco-products in shaping environmentally conscious behaviours. By understanding the dynamics of eco-product adoption, policymakers, businesses, and individuals can collaboratively work towards a more sustainable future. The implications of this study extend beyond academia, informing practical strategies for fostering a global shift towards sustainable consumption and production.

Keywords: eco-friendly, sustainablity, environment, climate change

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Authors: Saad Mahmud Khan, Sarah El Hajj Chehadeh, Mehera Abdulrahman, Wael Osman, Habiba Al Safar

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Obesity is a non-communicable disease that is widely prevalent with approximately 600 million people classified as obese worldwide. Its etiology is multifactorial and involves a complex interplay between genes and the environment. Over the past few decades, obesity rates among the Emirati population have been increasing. The aim of this study was to investigate the association of candidate gene single nucleotide polymorphisms (SNPs), namely the fat mass and obesity associated (FTO) gene SNP rs9939609 and Vitamin D Receptor (VDR) gene SNP rs1544410, with obesity in the UAE population. Methods: This is a case-control study in which 414 individuals were enrolled during their routine visit to endocrinology clinics in Abu Dhabi, United Arab Emirates between the period of June 2012 and December 2013. Several biochemical tests and clinical assessments along with a lifestyle questionnaire for each participant were completed at the clinic. Genomic DNA was extracted from saliva samples of 201 obese, 114 overweight and 99 normal subjects. Genotyping for the variants was performed using TaqMan assay. Results: The mean Body Mass Index (BMI) ± SD for the obese, overweight, and normal subjects was 35.76 ± 4.54, 27.53 ± 1.45 and 22.69 ± 1.84 kg/m2, respectively. Increasing BMI values were associated with an increase in values for systolic blood pressure, diastolic blood pressure, HbA1c, and triglycerides. The SNP rs9939609 in the FTO gene was found to be significantly associated with the BMI (p=0.028), with the minor allele A having a clear additive effect on BMI values. No significant association was detected between BMI and rs1544410 of the VDR gene. Conclusions: Our study findings indicate that the minor allele A of the rs9939609 has a significant association with increasing BMI values. In addition, our findings support the fact that increasing BMI is associated with increasing risks of other comorbidities such as higher blood pressure, poorer glycemic control and higher triglycerides.

Keywords: body mass index, FTO gene, obesity, rs9939609, United Arab Emirates

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Authors: Preeti Tiwari, Jay Wood, Duncan Babbage

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Family planning plays a role in saving lives across the globe by preventing unwanted pregnancies. The purpose of this multidisciplinary research was to determine the impact of mHealth tools have on psychosocial determinants of behaviour for family planning. The present study examines a topic that is very relevant in times where human-technology interaction is at its peak. It is probably one of the first studies that have investigated the impact of mobile phone technology on the underlying mechanisms of behaviour change for family planning using primary data. To examine the association between exposure to mHealth tools and predictors of behaviour, data was collected from mHealth intervention areas in India. A post-intervention quasi-experimental study with a 2x2 factorial design was conducted among 831 men and women from the state of Bihar. The quantitative data analysis evaluated the extent of influence that predictors of behaviour (beliefs, social norms, perceived behaviour control, and outcome behaviour) have on a woman’s decisions about family planning. The results indicated an association between exposure to mHealth tools and improved communication about family planning among various family members after receiving health information from a health worker (H1). A relationship between exposure to mHealth tools and increased support women received from their husbands and extended family (mothers-in-law specifically) and peers (H2) was also found. A further result showed that knowledge about family planning was greater among users of family planning (H4). mHealth tools empower women to communicate with family members. This has important implications for developing mobile phone-based tools, as they can be used as a crucial communication channel that can be an effective method of increasing communication among family members about contraceptives. Thus, it can be implied that where women feel nervous talking about contraception, the successful application of mHealth tools can strengthen the interactivity of the health communication and could increase the likelihood of using contraception. However, while it may improve health communication that can inform health decisions, it may be insufficient on its own to cause behaviour change.

Keywords: contraceptive, e-health, psycho-social, women

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Authors: Mirian Graciella Dalla Porta, Humberto Jorge José, Danielle de Bem Luiz, Regina de F. P. M.Moreira

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Similar to most processing industries, fish processing produces large volumes of wastewater, which contains especially organic contaminants, salts and oils dispersed therein. Different processes have been used for the treatment of fishery wastewaters, but the most commonly used are chemical coagulation and flotation. These techniques are well known but sometimes the characteristics of the treated effluent do not comply with legal standards for discharge. Electrocoagulation (EC) is an electrochemical process that can be used to treat wastewaters in terms of both organic matter and nutrient removal. The process is based on the use of sacrificial electrodes such as aluminum, iron or zinc, that are oxidized to produce metal ions that can be used to coagulate and react with organic matter and nutrients in the wastewater. While EC processes are effective to treatment of several types of wastewaters, applications have been limited due to the high energy demands and high current densities. Generally, the for EC process can be performed without additional chemicals or pre-treatment, but the costs should be reduced for EC processes to become more applicable. In this work, we studied the treatment of a real wastewater from fishmeal industry by electrocoagulation process. Removal efficiencies for chemical oxygen demand (COD), total organic carbon (TOC) turbidity, phosphorous and nitrogen concentration were determined as a function of the operating conditions, such as pH, current density and operating time. The optimum operating conditions were determined to be operating time of 10 minutes, current density 100 A.m-2, and initial pH 4.0. COD, TOC, phosphorous concentration, and turbidity removal efficiencies at the optimum operating conditions were higher than 90% for aluminum electrode. Operating costs at the optimum conditions were calculated as US$ 0.37/m3 (US$ 0.038/kg COD) for Al electrode. These results demonstrate that the EC process is a promising technology to remove nutrients from fishery wastewaters, as the process has both a high efficiency of nutrient removal, and low energy requirements.

Keywords: electrocoagulation, fish, food industry, wastewater

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Authors: Ram Sharan Mehta, Naveen Kumar Pandey, Binod Kumar Deo

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Quality of Life (QOL) is an important component in the evaluation of the well-being of People Living with AIDS (PLWA). This study assessed the effectiveness of education intervention programme in improving the QOL of PLWA on ART attaining the ART-clinics at B. P. Koirala Institute of Health Sciences (BPKIHS), Nepal. A pre-experimental research design was used to conduct the study among the PLWA on ART at BPKIHS from June to August 2013 involving 60 PLWA on pre-test randomly. The mean age of the respondents was 36.70 ± 9.92, and majority of them (80%) were of age group of 25-50 years and Male (56.7%). After education intervention programme there is significant change in the QOL in all the four domains i.e. Physical (p=0.008), Psychological (p=0.019), Social (p=0.046) and Environmental (p=0.032) using student t-test at 0.05 level of significance. There is significant (p= 0.016) difference in the mean QOL scores of pre-test and post-test. High QOL scores in post-test after education intervention programme may reflective of the effectiveness of planned education interventions programme.

Keywords: telephone, AIDS, health service, Nepal

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Authors: Amlakie Nigussie Assefa, Jemal Mohammed Haile, Amanuel Gebru Woldearegay

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Childhood vaccination communication is an important strategy to promote child immunization. This study was conducted with the objective of examining mothers’/caregivers’ perceptions of the child vaccine communication practice in the Amhara Region of Ethiopia. The researchers employed a quantitative research design to achieve the objective. A pretested questionnaire was used to collect the required data. The quantitative method was used to analyze the data. To this end, the result of the one-sample t-test revealed that mothers/caregivers perceive that child vaccine communication is irrelevant, indicated by the average mean of 13.11<15 of the expected mean. The finding also indicated that interpersonal health communication principles were not applied, which is indicated by the average mean of 16.82<18 of the ideal mean. The independent sample t-test underscored that knowledge about vaccines has an impact on the perceived relevance of child vaccine communication (Yes: M=16.55 SD=6.323; No: M=9.24, SD=4.087) (F=97.150 p=0.000, p<0.05), and the implementation of interpersonal health communication principals (M=18.65, SD=5.517; No: (M=9.81, SD=4.491) (F=11.015, p=0.000, p<0.05). The analysis of variance showed that mothers /caregivers’ education level has an impact on the perceived relevance of child vaccine communication (F=3.844 p=0.004, p<0.05) and to the implementation of interpersonal health communication principles (F=6.334 p=0.000, p<0.05). Besides, the post-hoc test showed that the respondents’ in the “Other” education level category have a positive perception to the relevance of child vaccine communication ((M=4.2 p= 0.006, p<0.05) and to the implementation of interpersonal health communication principles (M=3.5 p=0.000, p<0.05). The correlation analysis shows that education level has a positive correlation with the perceived relevance of child vaccine communication (r =0.198, p=0.00, P<0.01) and with the perceived implementation of interpersonal health communication principles (r = 0.250, p = 0.000 p< 0.01). Furthermore, one-to-one, one-to-group, and door-to-door communication were the most preferred strategies used to communicate about child vaccines. What is more, health workers were the most trusted sources of child vaccine information. In conclusion, the study highlighted that mothers/caregivers did not have a positive view of the child vaccine communication. Hence, efforts have to be made to improve mothers’/caregivers' knowledge about child vaccines. Besides, the education level of mothers/caregivers should be taken into consideration during the implementation of child vaccine communication interventions.

Keywords: mothers’/caregivers' perception, child vaccine communication, preferred communication strategies, trusted sources

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Authors: Antònio Inês, Davide Silva, Filipa Carvalho, Luís Filipe-Riberiro, Fernando M. Nunes, Luís Abrunhosa, Fernanda Cosme

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The presence of mycotoxins in foodstuff is a matter of concern for food safety. Mycotoxins are toxic secondary metabolites produced by certain molds, being ochratoxin A (OTA) one of the most relevant. Wines can also be contaminated with these toxicants. Several authors have demonstrated the presence of mycotoxins in wine, especially ochratoxin A. Its chemical structure is a dihydro-isocoumarin connected at the 7-carboxy group to a molecule of L-β-phenylalanine via an amide bond. As these toxicants can never be completely removed from the food chain, many countries have defined levels in food in order to attend health concerns. OTA contamination of wines might be a risk to consumer health, thus requiring treatments to achieve acceptable standards for human consumption. The maximum acceptable level of OTA in wines is 2.0 μg/kg according to the Commission regulation No. 1881/2006. Therefore, the aim of this work was to reduce OTA to safer levels using different fining agents, as well as their impact on white wine physicochemical characteristics. To evaluate their efficiency, 11 commercial fining agents (mineral, synthetic, animal and vegetable proteins) were used to get new approaches on OTA removal from white wine. Trials (including a control without addition of a fining agent) were performed in white wine artificially supplemented with OTA (10 µg/L). OTA analyses were performed after wine fining. Wine was centrifuged at 4000 rpm for 10 min and 1 mL of the supernatant was collected and added of an equal volume of acetonitrile/methanol/acetic acid (78:20:2 v/v/v). Also, the solid fractions obtained after fining, were centrifuged (4000 rpm, 15 min), the resulting supernatant discarded, and the pellet extracted with 1 mL of the above solution and 1 mL of H2O. OTA analysis was performed by HPLC with fluorescence detection. The most effective fining agent in removing OTA (80%) from white wine was a commercial formulation that contains gelatin, bentonite and activated carbon. Removals between 10-30% were obtained with potassium caseinate, yeast cell walls and pea protein. With bentonites, carboxymethylcellulose, polyvinylpolypyrrolidone and chitosan no considerable OTA removal was verified. Following, the effectiveness of seven commercial activated carbons was also evaluated and compared with the commercial formulation that contains gelatin, bentonite and activated carbon. The different activated carbons were applied at the concentration recommended by the manufacturer in order to evaluate their efficiency in reducing OTA levels. Trial and OTA analysis were performed as explained previously. The results showed that in white wine all activated carbons except one reduced 100% of OTA. The commercial formulation that contains gelatin, bentonite and activated carbon reduced only 73% of OTA concentration. These results may provide useful information for winemakers, namely for the selection of the most appropriate oenological product for OTA removal, reducing wine toxicity and simultaneously enhancing food safety and wine quality.

Keywords: wine, ota removal, food safety, fining

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Authors: Ansoné Human, Nantes Kirsten, Tanja Verster, Willem D. Schutte

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Every year the telecommunications industry suffers huge losses due to fraud. Mobile fraud, or generally, telecommunications fraud is the utilisation of telecommunication products or services to acquire money illegally from or failing to pay a telecommunication company. A South African telecommunication operator developed two internal fraud scorecards to mitigate future risks of application fraud events. The scorecards aim to predict the likelihood of an application being fraudulent and surprise fraudsters before they surprise the telecommunication operator by identifying fraud at the time of application. The scorecards are utilised in the vetting process to evaluate the applicant in terms of the fraud risk the applicant would present to the telecommunication operator. Telecommunication providers can utilise these scorecards to profile customers, as well as isolate fraudulent and/or high-risk applicants. We provide the complete methodology utilised in the development of the scorecards. Furthermore, a Determination and Discrimination (DD) ratio is provided in the methodology to select the most influential variables from a group of related variables. Throughout the development of these scorecards, the following was revealed regarding fraudulent cases and fraudster behaviour within the telecommunications industry: Fraudsters typically target high-value handsets. Furthermore, debit order dates scheduled for the end of the month have the highest fraud probability. The fraudsters target specific stores. Applicants who acquire an expensive package and receive a medium-income, as well as applicants who obtain an expensive package and receive a high income, have higher fraud percentages. If one month prior to application, the status of an account is already in arrears (two months or more), the applicant has a high probability of fraud. The applicants with the highest average spend on calls have a higher probability of fraud. If the amount collected changes from month to month, the likelihood of fraud is higher. Lastly, young and middle-aged applicants have an increased probability of being targeted by fraudsters than other ages.

Keywords: application fraud scorecard, predictive modeling, regression, telecommunications

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Authors: Kalayanee Senasu

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Research on happiness has been growing in recent decades. In the early stages, scholars were primarily concerned with establishing the validity of happiness measures and with exploring socio-economic correlates of happiness. More recent studies have focused on outcomes of happiness as well as the identification of happiness policies. This research investigates the happiness levels and influences of quality of life in terms of mental health satisfaction, family satisfaction, community satisfaction, and work satisfaction as determinants of happiness in Thailand during 2009-2014. The data collected by the National Statistic Office of Thailand in the project of Socio-economic Survey inclusion of Mental Health Survey in 2009, 2010, and 2012; and in the project of Labor Force Survey inclusion of Mental Health Survey in August 2014 were employed. There was a total of 59,430, 64,720, 54,736, and 9,997 respondents who were at least 15 years old in the survey during 2009-2014. Statistical analyses include both descriptive and inferential statistics. All research hypotheses were tested by means of hierarchical regression analysis. The analysis results reveal that happiness means during the studied period are quite at high levels (in the range of 7.42 to 7.60 from the scale 0-10). And the results indicate that all model variables (i.e., mental health satisfaction, family satisfaction, community satisfaction, and work satisfaction), have positive effects on happiness in Thailand. Additionally, the mental health satisfaction plays the most important role in predicting happiness. Further, our results indicate significant positive relationship between education, and income/expense and happiness, while other socio-economic variables reveal variety relationships during the studied period. Our results not only validate research findings in other countries but also verify the importance of quality of life (in terms of mental health satisfaction, family satisfaction, community satisfaction, and work satisfaction) as important factors of happiness for public policy makers. One conclusion stands firm in our study: happiness can be advanced in many ways. At the society level, greater happiness for people can be achieved by policies that aim to promote good health, an engaged family relationship, a high community as well as work qualities. A contented population is advantaged in many ways over one that is not. Government or policy makers should understand and realize that happiness is a valuable and tangible aspect of the population for which they are responsible. Therefore, they should include happiness issues in their political agenda.

Keywords: community satisfaction, family satisfaction, mental health satisfaction, work satisfaction, happiness, Thailand

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Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

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Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

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Authors: Ibrahim Alreshidi, Aseel Albrekeit, Ruaa Alharthi

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Background: As a result of the spread of COVID-19 at the beginning of 2020, many governments, including Saudi Arabia, have suspended operations in many agencies. Most dermatologists have restricted their practice, including cosmetic procedures, to ensure social distancing. On the 7th of May 2020, Saudi authorities reduced the restriction of COVID-19 virus preventative measures, allowing clinics to start accepting patients following the ministry of health protocols. Objectives: Evaluation of the public's perception and willingness to undergo cosmetic procedures during COVID-19 outbreaks in Saudi Arabia. Materials and methods: A descriptive, cross-sectional, questionnaire-based study was carried out among the individuals who lack typical symptoms of COVID-19 infection in Saudi Arabia. A self-designed web-based questionnaire was developed; content face validity and a pilot study were done. The questionnaire was distributed electronically from the 8th of May until the 31st of May 2020. Results: A total of 656 individuals who lack typical symptoms of COVID-19 infection were included in this analysis. Only 10.5% of participants expressed their will to do cosmetic procedures during the COVID-19 pandemic. More than 90% of the participants believed that the COVID-19 pandemic was either somewhat serious (52.9%) or very serious (38.7%). The willingness to do cosmetic procedures during the COVID-19 pandemic remained unaltered when the price was discounted (p<0.001) and when infection control measures were ensured (p<0.001). Conclusion: The COVID-19 pandemic had a negative impact on the practice of cosmetic dermatology. Fear of transferring the infection to a beloved home member is the main reason to avoid these procedures. Generating well-structured safety guidelines to decrease the risk of this unusual virus transmission in dermatology practice and creating financial incentives may help increase the public willingness to do these cosmetic procedures during this pandemic.

Keywords: COVID-19 pandemic, cosmetic procedures, questionnaire, dermatology

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Authors: Mustafa Gok, Sair Kahraman, Mustafa Fener

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In rock engineering applications, determining uniaxial compressive strength (UCS), Brazilian tensile strength (BTS), and basic index properties such as density, porosity, and water absorption is crucial for the design of both underground and surface structures. However, obtaining reliable samples for direct testing, especially from rocks that weather quickly and have low strength, is often challenging. In such cases, indirect methods provide a practical alternative to estimate the physical and mechanical properties of these rocks. In this study, tuff samples collected from the Cappadocia region (Nevşehir) in Turkey were subjected to indirect testing methods. Over 100 tests were conducted, using needle penetrometer index (NPI), point load strength index (PLI), and disc shear index (BPI) to estimate the uniaxial compressive strength (UCS), Brazilian tensile strength (BTS), density, and water absorption index of the tuffs. The relationships between the results of these indirect tests and the target physical properties were evaluated using simple and multiple regression analyses. The findings of this research reveal strong correlations between the indirect methods and the mechanical properties of the tuffs. Both uniaxial compressive strength and Brazilian tensile strength could be accurately predicted using NPI, PLI, and BPI values. The regression models developed in this study allow for rapid, cost-effective assessments of tuff strength in cases where direct testing is impractical. These results are particularly valuable for geological engineering applications, where time and resource constraints exist. This study highlights the significance of using indirect methods as reliable predictors of the mechanical behavior of weak rocks like tuffs. Further research is recommended to explore the application of these methods to other rock types with similar characteristics. Further research is required to compare the results with those of established direct test methods.

Keywords: brazilian tensile strength, disc shear strength, indirect methods, tuffs, uniaxial compressive strength

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Authors: Isabella Lobo Sasaoka, Felipe Q. da Luz, Zubeyir Salis, Phillipa Hay, Tamiris Gaeta, Paula Costa Teixeira, Táki Cordás, Amanda Sainsbury

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Background: A significant number of people with obesity that seek weight loss treatments experience binge eating episodes. Nonetheless, it is unknown whether binge eating episodes can hinder weight loss outcomes. Objective: To compare weight change in people with or without binge eating submitted to bariatric surgery, pharmacotherapy, nutritional orientation, and/or psychological therapies. Method: We conducted a systematic review with meta-analyses by searching studies in PubMed, American Psychological Association (APA), and Embase. Results: Thirty-four studies were included in our systematic review, and 17 studies were included in the meta-analyses. Overall, we found no significant difference in weight loss between people with or without binge eating submitted to any type of weight loss treatment. Additionally, we found no statistically significant differences in body weight between people with or without binge eating at short and long follow-up assessments following any type of weight loss treatment. We also examined changes in body weight in people with or without binge eating in three additional meta-analyses categorized by the type of weight loss treatment (i.e., behavioural and/or nutritional interventions; bariatric surgery; pharmacotherapy isolated or combined with behavior interventions) and found no difference in weight loss. Eleven out of the 17 studies that were assessed qualitatively (i.e., not included in meta-analyses) did not show differences in weight loss in people with or without binge eating submitted to any type of weight loss treatment. Conclusion: This systematic review with meta-analyses showed no difference in weight loss in people with or without binge eating submitted to a variety of weight loss treatments. Nonetheless, specialized therapies can be required to address eating disorder psychopathology and recurrent binge eating in people with obesity that seek weight loss.

Keywords: obesity, binge eating, weight loss, systematic review, meta-analysis

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Authors: Mary Ann L. Halliday, Zoengpari Gohain

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The stigma associated with HIV-AIDS negatively affect mental health and ability to effectively manage the disease. While the number of People living with HIV/AIDS (PLHIV) has been increasing day by day in Mizoram (a small north-eastern state in India), research on HIV/AIDS stigma has so far been limited. Despite the potential significance of Internalized HIV Stigma (IHS) in the lives of PLHIV, there has been very limited research in this area. It was therefore, felt necessary to explore the internalized HIV stigma, mental health, coping and perceived social support of PLHIV in Aizawl District, Mizoram. The present study was designed with the objectives to determine the degree of IHS, to study the relationship between the socio-demographic characteristics and level of IHS, to highlight the mental health status, coping strategies and perceived social support of PLHIV and to elucidate the relationship between these psychosocial variables. In order to achieve the objectives of the study, six hypotheses were formulated and statistical analyses conducted accordingly. The sample consisted of 300 PLWHA from Aizawl District, 150 males and 150 females, of the age group 20 to 70 years. Two- way classification of “Gender” (male and female) and three-way classification of “Level of IHS” (High IHS, Moderate IHS, Low IHS) on the dependent variables was employed, to elucidate the relationship between Internalized HIV Stigma, mental health, coping and perceived social support of PLHIV. The overall analysis revealed moderate level of IHS (67.3%) among PLHIV in Aizawl District, with a small proportion of subjects reporting high level of IHS. IHS was found to be significantly different on the basis of disclosure status, with the disclosure status of PLHIV accounting for 9% variability in IHS.  Results also revealed more or less good mental health among the participants, which was assessed by minimal depression (50.3%) and minimal anxiety (45%), with females with high IHS scoring significantly higher in both depression and anxiety (p<.01). Examination of the coping strategies of PLHIV found that the most frequently used coping styles were Acceptance (91%), Religion (84.3%), Planning (74.7%), Active Coping (66%) and Emotional Support (52.7%). High perception of perceived social support (48%) was found in the present study. Correlation analysis revealed significant positive relationships between IHS and depression as well as anxiety (p<.01), thus revealing that IHS negatively affects the mental health of PLHIV. Results however revealed that this effect may be lessened by the use of various coping strategies by PLHIV as well as their perception of social support.

Keywords: Aizawl, anxiety, depression, internalized HIV stigma, HIV/AIDS, mental health, mizoram, perceived social support

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Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah

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Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.

Keywords: attraction, retention, medical doctors, deprived regions, Ghana

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Authors: R. S. Fisca, Y. R. Elox, L. Umi, U. Z. Luttfia, Kun Harismah

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Petai (Parkia speciosa) is a plant indigenous to Southeast Asia. It is consumed either raw or cooked. It has been used in folk medicine to treat diabetes, hypertension, and kidney problems. It contains minerals and vitamins. Petai contains a lot of chemical compounds that are beneficial for health, including antioxidants, Vitamin B6 0,9mg, energy 142 g. cal, 10.4 g protein. 2 g fat, 22 g carbohydrates, 95 mg calcium, phosphorus 115 mg, 1 mg iron, 200 IU of vitamin A, vitamin B1 0.17 mg, 36 mg of vitamin C that can resolve various health problems. These chips are the result of innovation from petai packaged in such a way becomes a tasty snack chips and can be enjoyed by many people to relax and also nutritious for health. In the manufacture of petai chips require several steps of them start by boiling, flating, drying and the last frying. In introducing the products widely we sell petai chips with several methods. Some of these methods include direct sales, delivery order, online/social media, and open some booth at a few places and the car free day in Solo every sunday. Opportunity in selling petai chips is very wide because there is no competitors with similar business. With the innovation of petai chips become healthy snacks can be introduced to the public and can even be exported out of the country as one of the extraordinary snacks from Indonesia.

Keywords: antioxidants, chips, healty, petai

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Authors: Jamila Mohammed Makarfi, Yontem Sonmez

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Developing countries like Nigeria have recently been affected by conflicts characterized by violence, high levels of risk and insecurity, resulting in loss of lives, livelihoods, displacement of communities, degradation of health, educational and social infrastructure as well as economic underdevelopment. The Nigerian government’s response to most of these conflicts has mainly been reactionary in the form of military deployments, as against precautionary to prevent or address the root causes of the conflicts. Several studies have shown that at various points of a conflict, conflict regions can benefit from the resources and expertise available outside the government, mainly from the private sector through mechanisms such as corporate social responsibility (CSR) by businesses. The main aim of this study is to examine the role of businesses in peacebuilding in Northern Nigeria through CSR in the last decade. The expected contributions from this will answer research questions, such as the key business motivations to engage in peacebuilding, as well as the degree of influence exerted from various stakeholder groups on the business decision to engage. The methodology of the study adopts a multiple case study of over 120 businesses of various sizes, ranging from small, medium and large-scale. A mixed method enabled the collection of quantitative and qualitative primary data to augment the secondary data. The results indicated that the most important business motivations to engage in peacebuilding were the negative effects of the conflict on economic stability, as well as stakeholder-driven motives. On the other hand, out of the 12 identified stakeholders, micro-, small- and medium-scale enterprises (MSMEs) considered the chief executive officer’s interest to be the most important factor, while large companies rated the government and community pressure as the highest. Overall, the foreign stakeholders scored low on the influence chart for all business types.

Keywords: conflict, corporate social responsibility, peacebuilding, stakeholder

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Authors: Azadeh Mottaghi, Zeynab Shakeri

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Background: Eating disorders (ED) are group of psychological disorders that significantly impair physical health and psychosocial function. EDconsists wide range of morbidity such as loss of eating control, binge eating disorder(BED), night eating syndrome (NES), and bulimia nervosa. Eating behavior is a wide range term that includes food choices, eating patterns, eating problems. In this study, current knowledge will be discussed aboutcomparison of eating disorders and eating behaviors in morbid obese women with and without type 2 diabetes. Methods: 231 womenwith morbid obesity were included in the study.Loss of eating control, Binge eating disorder and Bulimia nervosa, Night eating syndrome, and eating behaviors and psychosocial factorswere assessed. SPSS version 20 was used for statistical analysis. A p-value of <0.05 was considered significant. Results: There was a significant difference between women with and without diabetes in case of binge eating disorder (76.3% vs. 47.3%, p=0.001). Women with the least Interpersonal support evaluation list (ISEL) scores had a higher risk of eating disorders, and it is more common among diabetics (29.31% vs. 30.45%, p= 0.050). There was no significant difference between depression level and BDI score among women with or without diabetes. Although 38.5% (n=56) of women with diabetes and 50% (n=71) of women without diabetes had minimal depression. The logistic regression model has shown that women without diabetes had lower odds of exhibiting BED (OR=0.28, 95% CI 0.142-0.552).Women with and without diabetes with high school degree (OR=5.54, 95% CI 2.46-9.45, P= 0.0001 & OR=6.52, 95% CI 3.15-10.56, respectively) and moderate depression level (OR=2.03, 95% CI 0.98-3.95 & OR=3.12, 95% CI 2.12-4.56, P= 0.0001) had higher odds of BED. Conclusion: The result of the present study shows that the odds of BED was lower in non-diabetic women with morbid obesity. Women with morbid obesity who had high school degree and moderate depression level had more odds for BED.

Keywords: eating disorders binge eating disorder, night eating syndrome, bulimia nervosa, morbid obesity

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Authors: N. Liu, N. Tuah, D. Ying

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This research aims to identify and test whether serious games can help children learn and pick up healthy eating habits. The practical component takes the form of digitalizing an already existing educational board game called “All you can eat” (AYCE), designed with the nutritious subject matter in mind. This time with the added features of online playability, which will widen its availability and accessibility to reach more players compared to the physical iteration. The game will be deployed alongside the conducting of theoretical research, which also involves teachers leading children to play said digital version. The research methodology utilizes two experiments, such as handing out surveys to gather feedback from both the partners and students. The research was carried out in several countries, namely Brunei, Malaysia, and Taiwan. The results are to be used for validating the concept of “serious games,” particularly when tied to the health aspect of the players, which in this case were children. As for the research outcomes, they can be applied to a variety of serious games that are related to health topics more broadly and not simply limited to healthy eating habits alone, adopting a balanced combination of practical and theoretical considerations. The study will also help other researchers in the correlated fields of serious game development and pediatrics to better comprehend the needs of children. On the theoretical side, these findings can enable further technological advancements to be made possible, a case in point being more serious games, to provide the appropriate social support precisely on the matter of health-related issues. Not just individuals but rather communities could benefit from improved health and well-being as a result of the project, which, when done right, will potentially improve their quality of life and have fun while doing it. AYCE will be demonstrated to support a wide range of health issues as a result of this research case.

Keywords: culture heritage, digital games, digitalization, traditional religious culture

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Authors: Oljana Hoxhaj

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The integration process of Albania into the European family carries many difficulties. In this context, the Albanian legislator is inclined to implement in the domestic legal framework models which have been successful in other countries. Our paper aims to present an analytical and comparative approach to the health system in Albania and France, mainly focusing on citizen’s access to these services. Different standards and cultures between states, in the context of an approximate model, will be the first challenge of our paper. Over the last few years, the Albanian government has undertaken concrete reforms in this sector, aiming to transform the vision on which the previous health system was structured. In this perspective, the state fulfills not only an obligation to its citizens, but also consolidates progressive steps toward alignment with European Union standards. The necessity to undertake a genuine reform in this area has come as an exigency of society, which has permanently identified problems within this sector, considering it ineffective, out of standards, and corrupt. The inclusion of health services on the Albanian government agenda reflects its will in the function of good governance, transparency, and broadening access to the provision of quality health services in the public and private sectors. The success of any initiative in the health system consists of giving priority to patient needs. Another objective that should be in the state's consideration is to create the premise to provide a comprehensive process on whose foundations partnership and broader co-operation with beneficiary entities are established in any decision-making that is directly related to their interests. Some other important and widespread impacts on the effective realization of citizens' access to the healthcare system coincide with the construction of appropriate infrastructure, increasing the professionalism and qualification of medical staff, and the allocation of a higher budget. France has one of the most effective healthcare models in Europe. That is why we have chosen to analyze this country, aiming to highlight the advantages of this system, as well as the commitment of the French state to drafting effective health policies. In the framework of the process of harmonization of the Albanian legislation with that of the European Union, through our work, we aim to identify the space to implement the whole of these legislative innovations in the Albanian legislation.

Keywords: effective service, harmonization level, innovation, reform

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Authors: Warsi A. Ibrahim, Qureshi A. Ambrina, Younus M. Anjum

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Introduction: Oral lesions related to commercially available Smokeless Tobacco (ST), such as, Pan, Gutka, Mahwa, Naswar is considered a serious challenge for dental health care providers in Pakistan. Majority of labored Pakistani population consume ST, where public transporters and drivers are no exception. It was necessary to identify individuals of this particular population group and screen their oral health and early signs of pre-cancerous lesions so that appropriate preventive measures could be taken to reduce the burden on health providers. Aim of Study: To estimate Prevalence of ST consumption and perception of use, and to evaluate Oral Health status among public drivers of Karachi. Material & methods: A cross-sectional study survey was conducted over duration of 2 months, through convenient sampling. Sample size (n=615) of public drivers (age > 18 years) all over Karachi was gathered. A structured proforma was used to record socio-demographics, addiction profile, perception of use and oral health status (oral lesions, oral sub-mucosal fibrosis and dental caries) of study participants. Data was entered and analyzed using SPSS version 16.0 using descriptive statistics only. Results: Prevalence of ST consumption among the study participants was figured to 92.5%. Out of these almost 70% suffered from one or the other form of oral lesion(s). Four major types of ST consumption were observed out of which 60 % of oral lesion were related to Gutka chewers showing early signs of oral cancer. In addition, occurrence of Oral sub-mucosal fibrosis (OSF) was found to be significantly high around 54.8%. Overall dental caries status was also high, showing on an average 5 teeth of an individual were decayed, missing or filled deviating from WHO normal criteria (mean < 3). It was thus proven from the study that public drivers relied on oral tobacco consumption because it helps them ‘Improve consciousness’ (p-value: < 0.01; using chi-square test). Multivariate analysis showed that there were higher prevalence of smokeless tobacco among highway drivers versus local drivers (A.O.R: 2.82 [0.83-9.61], p-value: < 0.01) Conclusion: Smokeless tobacco (ST) consumption has a direct effect on oral health. However, the type of ST, the duration of consumption are factors which are directly related to the severity. Moreover, Gutka may be considered as having most lethal effects on oral health which may lead to oral cancer and affect individual’s quality of life. Specific preventive programs must be undertaken to reduce the consumption of Gutka among public transporters and drivers.

Keywords: smokeless tobacco, oral lesions, drivers, public transporters

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Authors: Syed Asif Ali Naqvi, Muhammad Azeem Tufail

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Inadequate sanitation causes direct costs of treating illnesses and loss of income through reduced productivity. This study estimated the economic cost of health (ECH) due to poor sanitation and factors determining the lack of access to latrine for the rural, backward hamlets and slums of district Faisalabad, Pakistan. Cross sectional data were collected and analyzed for the study. As the population under study was homogenous in nature, it is why a simple random sampling technique was used for the collection of data. Data of 440 households from 4 tehsils were gathered. The ordinary least square (OLS) model was used for health cost analysis, and the Probit regression model was employed for determining the factors responsible for inaccess to toilets. The results of the study showed that condition of toilets, situation of sewerage system, access to adequate sanitation, Cholera, diarrhea and dysentery, Water and Sanitation Agency (WASA) maintenance, source of medical treatment can plausibly have a significant connection with the dependent variable. Outcomes of the second model showed that the variables of education, family system, age, and type of dwelling have positive and significant sway with the dependent variable. Variable of age depicted an insignificant association with access to toilets. Variable of monetary expenses would negatively influence the dependent variable. Findings revealed the fact, health risks are often exacerbated by inadequate sanitation, and ultimately, the cost on health also surges. Public and community toilets for youths and social campaigning are suggested for public policy.

Keywords: sanitation, toilet, economic cost of health, water, Punjab

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Authors: Devanshu Gupta, Kailash Chandra, Priyanka Das, Joyjit Ghosh

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Beetles, in the insect order Coleoptera are the most species-rich group on this planet today. They represent about 40% of the total insect diversity of the world. With a considerable range of landform types including significant mountain ranges, deserts, fertile irrigational plains, and hilly forested areas, India is one of the mega-diverse countries and includes more than 0.1 million faunal species. Despite having rich biodiversity, the efforts to catalogue the beetle diversity of the extant species/taxa reported from India have been less. Therefore, in this paper, the information on the beetle fauna of India is provided based on the data available with the museum collections of Zoological Survey of India and taxa extracted from zoological records and published literature. The species were listed with their valid names, synonyms, type localities, type depositories, and their distribution in states and biogeographic zones of India. The catalogue also incorporates the bibliography on Indian Coleoptera. The exhaustive species inventory, prepared by us include distributional records from Himalaya, Trans Himalaya, Desert, Semi-Arid, Western Ghats, Deccan Peninsula, Gangetic Plains, Northeast, Islands, and Coastal areas of the country. Our study concludes that many of the species are still known from their type localities only, so there is need to revisit and resurvey those collection localities for the taxonomic evaluation of those species. There are species which exhibit single locality records, and taxa-specific biodiversity assessments are required to be undertaken to understand the distributional range of such species. The primary challenge is taxonomic identifications of the species which were described before independence, and the type materials are present in overseas museums. For such species, taxonomic revisions of the different group of beetles are required to solve the problems of identification and classification.

Keywords: checklist, taxonomy, museum collections, biogeographic zones

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Authors: Heba Ahmed Abdelaziz, Doaa Tawfik Mohamed Ibrahim

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Background: COVID-19 pandemic is the major health problem facing the world recently, causing variable effects on mental health and eating behavior. Aim of the study: Identifying changes in eating patterns and other health behaviors in relation to the anxiety caused by the COVID-19 pandemic lockdown in adult females in Alexandria, Egypt. Method: 344 adult females (20+ years old), were included in online self-administered questionnaire. Results: Severe anxiety symptoms was among 34.6% of the studied females especially; those aged 25-40 years, married, non-working or student females, females who had change in their work routine (half or full time from home). Homemade pastries and bakery product then beverages followed by fresh fruits and vegetables were frequently consumed by the studied females than before lockdown while fast foods were decreased during lockdown. Overweight and obesity were high among most of the participants with different grades of anxiety symptoms. Females with moderate and severe anxiety symptoms reported increase in appetite and body weight with irregular sleeping during lockdown. Conclusion: the current study concluded that stressful situations like lockdown due to COVID-19 pandemic is associated with anxiety (severe, moderate, mild then minimal, respectively) along with changes in eating habits, physical activity, sleeping pattern and smoking.

Keywords: COVID-19, lockdown, females, anxiety, eating, stress, lifestyle

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Authors: Sumaiyya Ali, Humaira Jamshed

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Selfie culture has become increasingly prevalent in recent years, with young adults being one of the most active demographics when it comes to taking and sharing selfies. While some argue that selfies can be a harmless way to express oneself, connect with others, and boost self-esteem, others have raised concerns about the potential negative effects of selfie culture on mental health. This study investigated the complex relationship between selfie culture, social media use, self-image, and mental well-being among young adults. A cross-sectional survey was conducted with over 75 participants aged 18–30. The results of the study showed that there is a positive relationship between selfie culture and social media use and that both of these factors are associated with lower self-esteem, higher self-consciousness, and increased appearance anxiety among young adults. Additionally, the study found that selfie culture was associated with increased narcissistic traits among young adults. The findings of this study suggest that selfie culture may have some negative effects on the mental health of young adults. However, it is important to note that the study was cross-sectional, which means that it cannot establish causality. Future research is needed to further investigate the relationship between selfie culture and mental health. In addition to the findings of the study, it is also important to consider the motivation behind selfie-taking. The study identified four main motivations for taking selfies: to communicate with others, to promote oneself, to express oneself, and to seek attention. It is likely that the negative effects of selfie culture are more pronounced for individuals who take selfies for narcissistic or attention-seeking reasons. Overall, the findings of this study suggest that selfie culture is a complex phenomenon with both positive and negative potential effects on the mental health of young adults. It is important to be aware of the potential risks associated with selfie culture, and to use it in a healthy and balanced way.

Keywords: selfie, social media, psychology, mental health

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Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand

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Introduction: Limited facility situations require allocating the most available resources for most casualties. Accordingly, Traumatic Brain Injury (TBI) is the one that may need to transport the patient as soon as possible. In a mass casualty event, deciding when the facilities are restricted is hard. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: In a multicenter cross-sectional study conducted on 144 patients with TBI admitted to trauma emergency centers. All the patients with isolated TBI who were mentally and physically healthy before the trauma entered the study. The patient’s information was evaluated, including demographic characteristics, duration of hospital stays, mechanical ventilation on admission laboratory measurements, and on-admission vital signs. We recorded the patients’ TBI-related symptoms and brain computed tomography (CT) scan findings. Results: GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30), and within three months (7.58 ± 1.21) evaluations (P < 0.001). On discharge, GOSE was positively correlated with Glasgow Coma Scale (GCS) (r = 0.729, P < 0.001) and motor GCS (r = 0.812, P < 0.001), and inversely with age (r = −0.261, P = 0.002), hospitalization period (r = −0.678, P < 0.001), pulse rate (r = −0.256, P = 0.002) and white blood cell (WBC). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) were significantly associated with GOSE at discharge in multivariable analysis. Conclusion: Our study showed some predictive factors that could help to decide which casualty should transport earlier to a trauma center. According to the current study findings, GCS, pulse rate, WBC, and among imaging signs and trauma-related symptoms, ICH, IVH, SAH, SDH, and EDH are significant independent predictors of GOSE at discharge in TBI patients.

Keywords: field, Glasgow outcome score, prediction, traumatic brain injury.

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Authors: Stefan Kurbatfinski, Aliyah Dosani, Andrew F. Hayes, Deborah Dewey, Nicole Letourneau

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Background: Maternal adverse childhood experiences (ACEs) have been associated with internalizing and externalizing behavioral problems in preschool children. However, little is known about the influence of maternal adult attachment patterns on this association. Further, potential moderation by maternal mental health, maternal social support, or child sex is poorly understood. Therefore, this study examined associations between 1) maternal ACEs and preschool children’s behavioural problems, with mediation through maternal attachment patterns and moderation by maternal mental health, maternal social support, and child sex; and 2) maternal attachment patterns and children’s behavioural problems, with mediation through maternal mental health and social support and moderation by child sex. Methods: This secondary analysis used data (n=625) from a high socioeconomic, longitudinally prospective cohort (Alberta Pregnancy Outcomes and Nutrition). Child behaviour (BASC-2) and maternal adult attachment (ECR-Q) were measured at five years of child age, maternal ACEs (ACEs Questionnaire) at around 12 months, and maternal mental health (CESD and SCL-90-R) and social support (SSQ) across various prenatal and postnatal time points. All moderation and mediation analyses occurred through RStudio using PROCESS, interpreting significant interactions through Johnson-Neyman plots. Findings: Maternal ACEs interacted with maternal anxiety symptoms to predict both behavioural problems (pexternalizing=0.007; pinternalizing=0.0159). An indirect pathway via dismissive attachment was moderated by maternal social support ([0.0058, 0.0596]). Attachment patterns predicted all behavioural problems (p<0.05) and interacted with maternal anxiety symptoms to predict internalizing behaviours among male children ([0.0321, 0.1307]; [0.0321, 0.1291]). Interpretation: Maternal attachment patterns may predict children’s behavioural problems more than ACEs. Social support interventions may not always be beneficial for highly dismissively attached mothers. Implications for policy and child health include mandatory sex and gender education for teachers; assessing attachment patterns prior to recommending social support as an intervention; and anxiety-focused interventions for mothers in higher socioeconomic populations.

Keywords: maternal adverse childhood experiences, internalizing behaviours, externalizing behaviours, mediators and moderators, attachment patterns, child health

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Authors: Md Y. Reja, Samuel D. Brody, Wesley E. Highfield, Galen D. Newman

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Historically, wetlands in the United States have been lost due to agriculture, anthropogenic activities, and rapid urbanization along the coast. Such losses of wetlands have resulted in high flooding risk for coastal communities over the period of time. In addition, alteration of wetlands via the Section 404 Clean Water Act permits can increase the flooding risk to future hurricane events, as the cumulative impact of this program is poorly understood and under-accounted. Further, recovery after hurricane events is acting as an encouragement for new development and reconstruction activities by converting wetlands under the wetland alteration permitting program. This study investigates the degree to which hurricane recovery activities in coastal communities are undermining the ability of these places to absorb the impacts of future storm events. Specifically, this work explores how and to what extent wetlands are being affected by the federal permitting program post-Hurricane Ike in 2008. Wetland alteration patterns are examined across three counties (Harris, Galveston, and Chambers County) along the Texas Gulf Coast over a 10-year time period, from 2004-2013 (five years before and after Hurricane Ike) by conducting descriptive spatial analyses. Results indicate that after Hurricane Ike, the number of permits substantially increased in Harris and Chambers County. The vast majority of individual and nationwide type permits were issued within the 100-year floodplain, storm surge zones, and areas damaged by Ike flooding, suggesting that recovery after the hurricane is compromising the ecological resiliency on which coastal communities depend. The authors expect that the findings of this study can increase awareness to policy makers and hazard mitigation planners regarding how to manage wetlands during a long-term recovery process to maintain their natural functions for future flood mitigation.

Keywords: ecological resiliency, Hurricane Ike, recovery, Section 404 Permitting, wetland alteration

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