Search results for: acceptance of psychological variables
Commenced in January 2007
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Edition: International
Paper Count: 6418

Search results for: acceptance of psychological variables

1558 Associations and Interactions of Delivery Mode and Antibiotic Exposure with Infant Cortisol Level: A Correlational Study

Authors: Samarpreet Singh, Gerald Giesbrecht

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Both c-section and antibiotic exposure are linked to gut microbiota imbalance in infants. Such disturbance is associated with the Hypothalamic-Pituitary-Adrenal (HPA) axis function. However, the literature only has contradicting evidence for the association between c-sections and the HPA axis. Therefore, this study aims to test if the mode of delivery and antibiotics exposure is associated with the HPA axis. Also, whether exposure to both interacts with the HPA-axis. It was hypothesized that associations and interactions would be observed. Secondary data analysis was used for this co-relational study. Data for the mode of delivery and antibiotics exposure variables were documented from hospital records or self-questionnaires. In addition, cortisol levels (Area under the curve with respect to increasing (AUCi) and Area under the curve with respect to ground (AUCg)) were based on saliva collected from three months old during the infant’s visit to the lab and after drawing blood. One-way and between-subject ANOVA analyses were run on data. No significant association between delivery mode and infant cortisol level was found, AUCi and AUCg, p > .05. Only the infant’s AUCg was found to be significantly higher if there were antibiotics exposure at delivery (p = .001) or their mothers were exposed during pregnancy (p < .05). Infants born by c-section and exposed to antibiotics at three months had higher AUCi than those born vaginally, p < .02. These results imply that antibiotic exposure before three months is associated with an infant’s stress response. The association might increase if antibiotic exposure occurs three months after a c-section birth. However, more robust and causal evidence in future studies is needed, given a variable group’s statistically weak sample size. Nevertheless, the results of this study still highlight the unintended consequences of antibiotic exposure during delivery and pregnancy.

Keywords: HPA-axis, antibiotics, c-section, gut-microbiota, development, stress

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1557 The Sub-Optimality of the Electricity Subsidy on Tube Wells in Balochistan (Pakistan): An Analysis Based on Socio-Cultural and Policy Distortions

Authors: Rameesha Javaid

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Agriculture is the backbone of the economy of the province of Balochistan which is known as the ‘fruit basket’ of Pakistan. Its climate zones comprising highlands and plateaus, dependent on rain water, are more suited for the production of deciduous fruit. The vagaries of weather and more so the persistent droughts prompted the government to announce flat rates of electricity bills per month irrespective of the size of the farm, quantum or water used and the category of crop group. That has, no doubt, resulted in increased cropping intensity, more production and employment but has enormously burdened the official exchequer which picks up the residual bills in certain percentages amongst the federal and provincial governments and the local electricity company. This study tests the desirability of continuing the subsidy in the present mode. Optimization of social welfare of farmers has been the focus of the study with emphasis on the contribution of positive externalities and distortions caused in terms of negative externalities. By using the optimization technique with due allowance for distortions, it has been established that the subsidy calls for limiting policy distortions as they cause sub-optimal utilization of the tube well subsidy and improved policy programming. The sensitivity analysis with changed rankings of contributing variables towards social welfare does not significantly change the result. Therefore it leads to the net findings and policy recommendations of significantly reducing the subsidy size, correcting and curtailing policy distortions and targeting the subsidy grant more towards small farmers to generate more welfare by saving a sizeable amount from the subsidy for investment in the wellbeing of the farmers in rural Balochistan.

Keywords: distortion, policy distortion, socio-cultural distortion, social welfare, subsidy

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1556 Obsession Unveiled: A Freud’s Psychoanalytical Analysis of Protagonist Fixations in Nabokov’s Lolita and Pamuk’s The Museum of Innocence

Authors: Kamilya Khamitova

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This study analyzes the overarching theme of obsession as portrayed through the two protagonists, Humbert Humbert and Kemal, in Vladimir Nabokov's Lolita and Orhan Pamuk's The Museum of Innocence through the lens of Freudian psychoanalytical theory of “transference.” Their obsessions are channeled into various forms of artistic expression following the loss of their beloved Lolita and Füsun. Employing psychoanalytical literary criticism, firmly grounded in the classical era of psychoanalysis, as pioneered by Sigmund Freud, this research explores the characters' psyches, revealing the concealed desires, conflicts, and symbolic manifestations within their relentless obsessions. The aim of this study is to unravel the psychological complexities of obsession, shedding light on the motivations and behaviors of Humbert and Kemal within the context of their respective narratives. Methodologically, this research employs close textual analysis of the novels, dissecting the protagonists' thoughts, actions, and artistic expressions. Through the lens of Freud's fundamental concept of “transference,” this analysis uncovers the protagonists' mechanisms of projecting their desires onto unattainable objects of desire—Lolita and Füsun. Humbert's pursuit of Lolita mirrors his unresolved emotional traumas and attempts to recapture the lost object of his childhood. In contrast, Kemal's fixation on Füsun is a desperate desire to fill an existential void, address a sense of inadequacy, and construct a semblance of immortality through the meticulous preservation of his memories with her. By adopting a psychoanalytic lens, this research provides a richer understanding of the characters, themes, and symbolism inherent in their artistic expressions of devotion.

Keywords: artistic expression, psychoanalysis of obsession, Sigmund Freud, transference

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1555 Foreign Direct Investment, International Trade and Environment in Bangladesh: An Empirical Study

Authors: Shilpi Tripathi

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After independence, Bangladesh had to learn to survive on its own without any economic crutches (aid). Foreign direct investment (FDI) became a crucial economic tool for the country to become economically independent. The government started removing restrictions to encourage foreign investment, economic growth, international trade, and the environment. FDI is considered as a way to bridge the saving-investment gap, reduce poverty, balance trade, create jobs for its vast labour force, increase foreign exchange earnings and acquire new modern technology and management skills in the country. At the same time, spillovers of foreign investments in Bangladesh, such as low wages (compared to laborers of developed countries), poor working conditions and unbridled exploitation of the domestic resources, environmental externalities, etc., cannot be ignored. The most important adverse implications of FDI inflows noticed are the environmental problems, which are further impacting the health and society of the country. This paper empirically studies the relationship between FDI, economic growth, international trade (exports and Imports), and the environment since 1996. The first part of the paper focuses on the background and trends of FDI, GDP, trade, and environment (CO₂). The second part focuses on the literature review on the relationship between all the variables. The last part of the paper examines the results of empirical analysis like co-integration and Granger causality. The findings of the paper reveal that a uni-directional relationship exists between FDI, CO₂, and international trade (exports and imports). The direction of the causality reveals that FDI inflow is one of the major contributors to high-volume international trade. At the same time, FDI and international trade both are contributing to carbon emissions in Bangladesh. The paper concludes with the policy recommendations that will ensure environmentally friendly trade, investment, and growth in Bangladesh for the future.

Keywords: foreign direct investment, GDP, international trade, CO₂, Granger causality, environment

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1554 The Perspective of Waria Transgenders in Singaraja on Their Reproduction Health

Authors: Made Kurnia Widiastuti Giri, Nyoman Kanca, Arie Swastini, Bambang Purwanto

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Aim: Waria transgenders are a phenomenon whose existence is undeniable. The sexual behaviours of waria transgenders belong to the groups of high-risk STDs infections, especially HIV/AIDS. The present study was aimed at finding out the general idea of the existence of waria transgenders in Singaraja, their sexual transactions, their sexual behaviours, and at exploring the factors affecting their sexual behaviours along with their participation in regular reproduction health control. Methods: The subjects of the present research were male-to-female transgenders living in the town of Singaraja. The research applied a qualitative approach. Data collection in this research was conducted through in-depth interview and observation. Results: The results of the study exposed 1) the existence of waria transgender community in Singaraja observed from their active participation in social events such as taking the roles of counsellors in the campaign of prevention and control of HIV/AIDS with the Local Commission of AIDS Control and other foundations; 2) the sexual services provided by waria transgenders which were performed in squeeze method, oral and anal sex which could be categorized as HIV/AIDS high-risk sexual behaviours, while the consistency in doing safe sex among the trangenders in Singaraja showed that most of the waria transgenders (80%) were aware of the urgency of using condoms during sexual intercourse; and 3) the low participation of the waria transgenders in Singaraja in regular reproduction health check up at the local Centre of Public Health Service was caused by their negative perception about being examined by female doctors. Conclucions: Waria in singaraja categorized as HIV/AIDS high-risk sexual behaviours but they do have consistency in doing safe sex by using condoms. They have a negative psychological perception about being examined by female doctors.

Keywords: waria transgenders, sexual behaviours, reproduction health, hiv/aids

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1553 ESG and Corporate Financial Performance: Empirical Evidence from Vietnam’s Listed Construction Companies

Authors: My Linh Hoang, Van Dung Hoang

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Environmental, Social, and Governance (ESG) factors have become a focus for companies globally, as businesses are now focusing on long-term sustainable goals rather than only operating for the goals of profit maximization. According to recent research, in several countries, companies have shown positive results in their financial performance by improving their ESG performance. The construction industry is one of the most crucial components of social and economic development; as a result, considerations for ESG factors are becoming more and more essential for companies in this sector. In Vietnam, the construction industry has been growing rapidly in recent years; however, it has yet to be discussed and studied extensively in Vietnam how ESG factors create impacts on corporate financial performance in general and construction corporations’ financial performance in particular. This research aims to examine the relationship between ESG factors and financial indicators in construction companies from 2011 to 2021 through panel data analysis of 75 listed construction companies in Vietnam and to provide insights into how these companies can better integrate ESG considerations into their operations to enhance their financial performance. The data was analyzed through 3 main methods: descriptive statistics, correlation coefficient analysis applied to all dependent, explanatory and control variables, and panel data analysis method. In panel data analysis, the study uses the fixed effects model (FEM) and random effects model (REM). The Hausman test will be used to select which model is suitable to be used. The findings indicate that maintaining a strong commitment to ESG principles can have a positive impact on financial performance. Finally, FGLS estimation will be performed when the problem of autocorrelation and variable variance appears in the model. This is significant for all parties involved, including investors, company managers, decision-makers, and industry regulators.

Keywords: ESG, financial performance, construction company, Vietnam

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1552 Extent to Which Various Academic Factors Cause Stress in Undergraduate Students at a University in Karachi and What Unhealthy Coping Strategies They Use

Authors: Sumara Khanzada

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This research investigated how much stress is induced by various study-related factors, in undergraduate students belonging to a renowned university in Karachi along with the unhealthy coping strategy the students use to manage the stress. The study related factors considered for the purpose of the study were curriculum and instruction based stress, teacher-student relationship, assessment system and different components related to academic work. A survey in which questionnaires were administered to hundred students was conducted. The data were analyzed quantitatively to determine the percentages of stress induced by the various factors. The study found that student-teacher relationship is the strongest factor that causes stress in the undergraduate students specifically when teachers do not deliver the lectures effectively and give assignments and presentations to students without clear guidelines and instructions. The second important factor that causes stress was the different components of academic life, such as, parental expectations and pressures to achieve one's goals. Assessment system was found to be the third key factor inducing stress and affecting students' cognitive and psychological functioning. The most commonly used unhealthy coping strategy for stress management was procrastination. In light of the findings, it is recommended that importance be given to teacher training to ensure that instruction is proper and healthy teacher student relationship exists. Effective support programs, workshops, seminars, and different awareness programs should be arranged for promoting awareness regarding mental health in educational institutions. Moreover, additional zero credit courses should be offered to teach students how to learn stress management and healthy coping skills. Sumara Khanzada Clinical Psychologist [email protected]

Keywords: Stress, coping stretigies, acadamic stress, relationship

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1551 Examining Postcolonial Corporate Power Structures through the Lens of Development Induced Projects in Africa

Authors: Omogboyega Abe

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This paper examines the relationships between socio-economic inequalities of power, race, wealth engendered by corporate structure, and domination in postcolonial Africa. The paper further considers how land as an epitome of property and power for the locals paved the way for capitalist accumulation and control in the hands of transnational corporations. European colonization of Africa was contingent on settler colonialism, where properties, including land, were re-modified as extractive resources for primitive accumulation. In developing Africa's extractive resources, transnational corporations (TNCs) usurped states' structures and domination over native land. The usurpation/corporate capture that exists to date has led to remonstrations and arguably a counter-productive approach to development projects. In some communities, the mention of extractive companies triggers resentment. The paradigm of state capture and state autonomy is simply inadequate to either describe or resolve the play of forces or actors responsible for severe corporate-induced human rights violations in emerging markets. Moreover, even if the deadly working conditions are conceived as some regulatory failure, it is tough to tell whose failure. The analysis in this paper is that the complexity and ambiguity evidenced by the multiple regimes and political and economic forces shaping production, consumption, and distribution of socio-economic variables are not exceptional in emerging markets. Instead, the varied experience in developing countries provides a window for seeing what we face in understanding and theorizing the structure and operation of the global economic and regulatory order in general.

Keywords: colonial, emerging markets, business, human rights, corporation

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1550 Satellite-Based Drought Monitoring in Korea: Methodologies and Merits

Authors: Joo-Heon Lee, Seo-Yeon Park, Chanyang Sur, Ho-Won Jang

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Satellite-based remote sensing technique has been widely used in the area of drought and environmental monitoring to overcome the weakness of in-situ based monitoring. There are many advantages of remote sensing for drought watch in terms of data accessibility, monitoring resolution and types of available hydro-meteorological data including environmental areas. This study was focused on the applicability of drought monitoring based on satellite imageries by applying to the historical drought events, which had a huge impact on meteorological, agricultural, and hydrological drought. Satellite-based drought indices, the Standardized Precipitation Index (SPI) using Tropical Rainfall Measuring Mission (TRMM) and Global Precipitation Mission (GPM); Vegetation Health Index (VHI) using MODIS based Land Surface Temperature (LST), and Normalized Difference Vegetation Index (NDVI); and Scaled Drought Condition Index (SDCI) were evaluated to assess its capability to analyze the complex topography of the Korean peninsula. While the VHI was accurate when capturing moderate drought conditions in agricultural drought-damaged areas, the SDCI was relatively well monitored in hydrological drought-damaged areas. In addition, this study found correlations among various drought indices and applicability using Receiver Operating Characteristic (ROC) method, which will expand our understanding of the relationships between hydro-meteorological variables and drought events at global scale. The results of this research are expected to assist decision makers in taking timely and appropriate action in order to save millions of lives in drought-damaged areas.

Keywords: drought monitoring, moderate resolution imaging spectroradiometer (MODIS), remote sensing, receiver operating characteristic (ROC)

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1549 The Relationship between Fluctuation of Biological Signal: Finger Plethysmogram in Conversation and Anthropophobic Tendency

Authors: Haruo Okabayashi

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Human biological signals (pulse wave and brain wave, etc.) have a rhythm which shows fluctuations. This study investigates the relationship between fluctuations of biological signals which are shown by a finger plethysmogram (i.e., finger pulse wave) in conversation and anthropophobic tendency, and identifies whether the fluctuation could be an index of mental health. 32 college students participated in the experiment. The finger plethysmogram of each subject was measured in the following conversation situations: Fun memory talking/listening situation and regrettable memory talking/ listening situation for three minutes each. Lyspect 3.5 was used to collect the data of the finger plethysmogram. Since Lyspect calculates the Lyapunov spectrum, it is possible to obtain the largest Lyapunov exponent (LLE). LLE is an indicator of the fluctuation and shows the degree to which a measure is going away from close proximity to the track in a dynamical system. Before the finger plethysmogram experiment, each participant took the psychological test questionnaire “Anthropophobic Scale.” The scale measures the social phobia trend close to the consciousness of social phobia. It is revealed that there is a remarkable relationship between the fluctuation of the finger plethysmography and anthropophobic tendency scale in talking about a regrettable story in conversation: The participants (N=15) who have a low anthropophobic tendency show significantly more fluctuation of finger pulse waves than the participants (N=17) who have a high anthropophobic tendency (F (1, 31) =5.66, p<0.05). That is, the participants who have a low anthropophobic tendency make conversation flexibly using large fluctuation of biological signal; on the other hand, the participants who have a high anthropophobic tendency constrain a conversation because of small fluctuation. Therefore, fluctuation is not an error but an important drive to make better relationships with others and go towards the development of interaction. In considering mental health, the fluctuation of biological signals would be an important indicator.

Keywords: anthropophobic tendency, finger plethymogram, fluctuation of biological signal, LLE

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1548 The Politics of Disruption: Disrupting Polity to Influence Policy in Nigeria

Authors: Okechukwu B. C. Nwankwo

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The surge of social protests sweeping through the globe is a contemporary phenomenon. Yet the phenomenon in itself is not new. Thus, various scholars have over the years developed conceptual frameworks for evaluating it. Adopting and adapting some of these frameworks this paper begins from a purely theoretical perspective exploring the concept and content of social protest within the specific context of Nigeria. It proceeds to build a typology of the phenomenon in terms of form, actors, origin, character, organisation, goal, dynamics, outcome and a whole lot of other variables that are context relevant for evaluating it in an operationally useful manner. The centrality of the context in which protest evolves is demonstrated. Adopting Easton’s systems theory, the paper builds on the assumption that protests emerge whenever and wherever political institutions and structures prove unable or unwilling to transform inputs in form of basic demands into outputs in form of responsive policies. It argues that protests in Nigeria are simply the crystallisation of opposition in the streets. Protests are thus extra-institutional politics. This is usually the case, as elsewhere, where there is no functional institutionalised opposition. Noting that protest, disruptive or otherwise, is an influence strategy, it argues that every single protest is a new opportunity for reform, for reorganisation of state capacities, for modifying rights and obligation of citizens and government to each other. Each reform outcome is, however, only a temporal antecedent. Its extensity gives signal for the next similar protest event. Through providing evidence on how protests in Nigeria create opportunity for reform, for more accountable, more effective governance, the paper shows the positive impact of protests and its importance even in the consolidation effort for the nation’s nascent democracy. Data on protest events will be based on media reports, especially print media.

Keywords: democracy, dialectics, social protest, reform

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1547 From Being to Becoming: Emancipation and Empowerment in the African Diaspora

Authors: R. Vidhya

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Diasporic writings present a comprehensive view of social, cultural and psychological dualities of immigrants. Isolation and the strong feelings of insecurity and inferiority due to constant marginalization coupled with a nostalgia for their motherland, its customs, culture, language, food and people which keep haunting the minds of immigrants are the major themes that are handled by diasporic writers. In the African diaspora, more than the men, it is the women who face the brunt and burden of the triple jeopardy – the racial, class and gender discrimination. Women writers from Africa have successfully sketched the plight of African women in the diaspora. Buchi Emecheta, a Nigerian woman writer deftly portrays the African Diaspora in her novels. She skillfully weaves her stories with her own experiences as an immigrant in the United Kingdom. She portrays the immigrant life and psychology through numerous themes like exile, geographical shift of locations, transactions of culture, political instability and the dilemma of moral and religious ideologies in her diasporic novels Second-class Citizen, Gwendolyn and Kehinde. The contemporary Nigerian woman writer Chimamanda Ngozi Adichie has also dexterously depicted the diasporic dilemma of her protagonist Ifemelu in Americannah, who initially has the experience of a despondent and a downcast in the United States of America. This paper aims to analyse the diasporic sentiments and sensibilities of the Nigerian Igbo women writers Buchi Emecheta and Chimamanda Ngozi Adichie whose women characters finally find emancipation and empowerment in the African Diaspora. This study is based on the Africana Womanist Literary theory propounded by Clenora Hudson-Weems.

Keywords: African Diaspora, Nigerian women writers, Buchi Emecheta, Chimamanda Ngozi Adichie, emancipation, empowerment

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1546 Effect of Thermal Radiation and Chemical Reaction on MHD Flow of Blood in Stretching Permeable Vessel

Authors: Binyam Teferi

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In this paper, a theoretical analysis of blood flow in the presence of thermal radiation and chemical reaction under the influence of time dependent magnetic field intensity has been studied. The unsteady non linear partial differential equations of blood flow considers time dependent stretching velocity, the energy equation also accounts time dependent temperature of vessel wall, and concentration equation includes time dependent blood concentration. The governing non linear partial differential equations of motion, energy, and concentration are converted into ordinary differential equations using similarity transformations solved numerically by applying ode45. MATLAB code is used to analyze theoretical facts. The effect of physical parameters viz., permeability parameter, unsteadiness parameter, Prandtl number, Hartmann number, thermal radiation parameter, chemical reaction parameter, and Schmidt number on flow variables viz., velocity of blood flow in the vessel, temperature and concentration of blood has been analyzed and discussed graphically. From the simulation study, the following important results are obtained: velocity of blood flow increases with both increment of permeability and unsteadiness parameter. Temperature of the blood increases in vessel wall as Prandtl number and Hartmann number increases. Concentration of the blood decreases as time dependent chemical reaction parameter and Schmidt number increases.

Keywords: stretching velocity, similarity transformations, time dependent magnetic field intensity, thermal radiation, chemical reaction

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1545 An Exploratory Sequential Design: A Mixed Methods Model for the Statistics Learning Assessment with a Bayesian Network Representation

Authors: Zhidong Zhang

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This study established a mixed method model in assessing statistics learning with Bayesian network models. There are three variants in exploratory sequential designs. There are three linked steps in one of the designs: qualitative data collection and analysis, quantitative measure, instrument, intervention, and quantitative data collection analysis. The study used a scoring model of analysis of variance (ANOVA) as a content domain. The research study is to examine students’ learning in both semantic and performance aspects at fine grain level. The ANOVA score model, y = α+ βx1 + γx1+ ε, as a cognitive task to collect data during the student learning process. When the learning processes were decomposed into multiple steps in both semantic and performance aspects, a hierarchical Bayesian network was established. This is a theory-driven process. The hierarchical structure was gained based on qualitative cognitive analysis. The data from students’ ANOVA score model learning was used to give evidence to the hierarchical Bayesian network model from the evidential variables. Finally, the assessment results of students’ ANOVA score model learning were reported. Briefly, this was a mixed method research design applied to statistics learning assessment. The mixed methods designs expanded more possibilities for researchers to establish advanced quantitative models initially with a theory-driven qualitative mode.

Keywords: exploratory sequential design, ANOVA score model, Bayesian network model, mixed methods research design, cognitive analysis

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1544 Unraveling the Complexity of Postpartum Distress: Examining the Influence of Alexithymia, Social Support, Partners' Support, and Birth Satisfaction on Postpartum Distress among Bulgarian Mothers

Authors: Stela Doncheva

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Postpartum distress, encompassing depressive symptoms, obsessions, and anxiety, remains a subject of significant scientific interest due to its prevalence among individuals giving birth. This critical and transformative period presents a multitude of factors that impact women's health. On the one hand, variables such as social support, satisfaction in romantic relationships, shared newborn care, and birth satisfaction directly affect the mental well-being of new mothers. On the other hand, the interplay of hormonal changes, personality characteristics, emotional difficulties, and the profound life adjustments experienced by mothers can profoundly influence their self-esteem and overall physical and emotional well-being. This paper extensively explores the factors of alexithymia, social support, partners' support, and birth satisfaction to gain deeper insights into their impact on postpartum distress. Utilizing a qualitative survey consisting of six self-reflective questionnaires, this study collects valuable data regarding the individual postpartum experiences of Bulgarian mothers. The primary objective is to enrich our understanding of the complex factors involved in the development of postpartum distress during this crucial period. The results shed light on the intricate nature of the problem and highlight the significant influence of bio-psycho-social elements. By contributing to the existing knowledge in the field, this research provides valuable implications for the development of interventions and support systems tailored to the unique needs of mothers in the postpartum period. Ultimately, this study aims to improve the overall well-being of new mothers and promote optimal maternal health during the postpartum journey.

Keywords: maternal mental health, postpartum distress, postpartum depression, postnatal mothers

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1543 Classification on Statistical Distributions of a Complex N-Body System

Authors: David C. Ni

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Contemporary models for N-body systems are based on temporal, two-body, and mass point representation of Newtonian mechanics. Other mainstream models include 2D and 3D Ising models based on local neighborhood the lattice structures. In Quantum mechanics, the theories of collective modes are for superconductivity and for the long-range quantum entanglement. However, these models are still mainly for the specific phenomena with a set of designated parameters. We are therefore motivated to develop a new construction directly from the complex-variable N-body systems based on the extended Blaschke functions (EBF), which represent a non-temporal and nonlinear extension of Lorentz transformation on the complex plane – the normalized momentum spaces. A point on the complex plane represents a normalized state of particle momentums observed from a reference frame in the theory of special relativity. There are only two key parameters, normalized momentum and nonlinearity for modelling. An algorithm similar to Jenkins-Traub method is adopted for solving EBF iteratively. Through iteration, the solution sets show a form of σ + i [-t, t], where σ and t are the real numbers, and the [-t, t] shows various distributions, such as 1-peak, 2-peak, and 3-peak etc. distributions and some of them are analog to the canonical distributions. The results of the numerical analysis demonstrate continuum-to-discreteness transitions, evolutional invariance of distributions, phase transitions with conjugate symmetry, etc., which manifest the construction as a potential candidate for the unification of statistics. We hereby classify the observed distributions on the finite convergent domains. Continuous and discrete distributions both exist and are predictable for given partitions in different regions of parameter-pair. We further compare these distributions with canonical distributions and address the impacts on the existing applications.

Keywords: blaschke, lorentz transformation, complex variables, continuous, discrete, canonical, classification

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1542 The Effects of Acupoint Catgut Embedding for Weight Control in Mice Model

Authors: Chanya Inprasit, Ching-Liang Hsieh, Yi-Wen Lin

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Obesity (OB) is a hazardous global health problem that has been increasing in prevalence, more severely in last decade. It is the mainly resultant from the imbalance between food consumption and energy expenditure, which is concordant with a modern lifestyle, implying an increase in calories with poorer quality of food intake accompanied by a decrease in physical activities. Obesity does not concern the appearance only but is also a major factor contributing to poor physiology, psychology, society and economic issues. Moreover, OB induces low-grade inflammation in the body through the regulatory effect it enacts on the adipocyte function. Various alternative treatments were investigated for body weight control, including Acupoint Catgut Embedding (ACE). ACE is the implantation of absorbable catgut sutures at specific acupoints, displaying durable and potent stimulation and thereby reducing the treatment frequency. Our study utilized a mouse model to exclude any psychological factors of OB and ACE treatment. High-fat diet and body weight were measured once a week before subjects in ACE and Sham group received the ACE treatment or placebo treatment. We hypothesized that ACE can control body weight through the interaction of the TRPV1 pathways, as TRPV1 accordingly responds to inflammatory factors. The results of body weight variation show a significant decrease in body weight in ACE group compared with the baseline of control and Sham group. Meanwhile, converse results were explored in TRPV1 knockout mice, where a significant maintenance of normal body weight throughout the experiment period was observed. There was no significant difference in food consumption of each group. These finding indicated that TRPV1 pathways and its associated pathways may be involved in the maintenance of body weight, which can be controlled by ACE treatment of genetic manipulation.

Keywords: acupoint catgut embedding, obesity, hypothalamus, TRPV1

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1541 Ratio Energy and Protein of Dietary Based on Rice Straw Ammoniated on Productivity of Male Simenthal Cattle

Authors: Mardiati Zain, Yetti Marlida, Elihasridas Elihasridas, Erpomen Erpomen, Andri Andri

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Background: Livestock productivity is greatly influenced by the energy and protein balance in diet. This study aimed to determine the energy and protein balance of male Simenthal cattle diet with protein and energy levels. The experimental design used was a randomized block design (RBD) 2x3x3 factorial design. There are two factors namely A level of energy diet that is 65% and 70% TDN. Factor B is a protein level of diet used were 10, 12 and 14% and each treatment is repeated three times. The weight of Simenthal cattle used ranged between 240 - 300 kg. Diet consisted of ammoniated rice straw and concentrated with ratio 40:60. Concentrate consisted of palm kernel cake, rice brain, cassava, mineral, and urea. The variables measured were digestibility of dry matter, organic matter and fiber, dry matter intake, daily gain, feed efficiency and blood characteristic. Results: There was no interaction between protein and energy level of diet on the nutrients intake (DM intake, OM intake, CP intake), weight gain and efficiency (P < 0.01). There was an interaction between protein and energy level of diet on digestibility (DM, OM, CP and allantoin urine (P > 0.01) Nutrients intake decreases with increasing levels of energy and protein diet, while nutrient digestibility, Avarage daily gain and feed efficiency increases with increasing levels of energy and protein diet. Conclusions: The result can be concluded that the best treatment was A2B1 which is energy level 70% TDN and protein 10%, where are dry matter intake 7.66 kg/d, daily gain 1.25 kg/d, feed efficiency 16.12%, and dry matter and organic matter digestibility 64.08 and 69.42% respectively.

Keywords: energy and protein ratio, simenthal cattle, rice straw ammoniated, digestibility

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1540 Linearization of Y-Force Equation of Rigid Body Equation of Motion and Behavior of Fighter Aircraft under Imbalance Weight on Wings during Combat

Authors: Jawad Zakir, Syed Irtiza Ali Shah, Rana Shaharyar, Sidra Mahmood

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Y-force equation comprises aerodynamic forces, drag and side force with side slip angle β and weight component along with the coupled roll (φ) and pitch angles (θ). This research deals with the linearization of Y-force equation using Small Disturbance theory assuming equilibrium flight conditions for different state variables of aircraft. By using assumptions of Small Disturbance theory in non-linear Y-force equation, finally reached at linearized lateral rigid body equation of motion; which says that in linearized Y-force equation, the lateral acceleration is dependent on the other different aerodynamic and propulsive forces like vertical tail, change in roll rate (Δp) from equilibrium, change in yaw rate (Δr) from equilibrium, change in lateral velocity due to side force, drag and side force components due to side slip, and the lateral equation from coupled rotating frame to decoupled rotating frame. This paper describes implementation of this lateral linearized equation for aircraft control systems. Another significant parameter considered on which y-force equation depends is ‘c’ which shows that any change bought in the weight of aircrafts wing will cause Δφ and cause lateral force i.e. Y_c. This simplification also leads to lateral static and dynamic stability. The linearization of equations is required because much of mathematics control system design for aircraft is based on linear equations. This technique is simple and eases the linearization of the rigid body equations of motion without using any high-speed computers.

Keywords: Y-force linearization, small disturbance theory, side slip, aerodynamic force drag, lateral rigid body equation of motion

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1539 Biogenic Amines Production during RAS Cheese Ripening

Authors: Amr Amer

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Cheeses are among those high-protein-containing foodstuffs in which enzymatic and microbial activities cause the formation of biogenic amines from amino acids decarboxylation. The amount of biogenic amines in cheese may act as a useful indicator of the hygienic quality of the product. In other words, their presence in cheese is related to its spoilage and safety. Formation of biogenic amines during Ras cheese (Egyptian hard cheese) ripening was investigated for 4 months. Three batches of Ras cheese were manufactured using Egyptian traditional method. From each batch, Samples were collected at 1, 7, 15, 30, 60, 90 and 120 days after cheese manufacture. The concentrations of biogenic amines (Tyramine, Histamine, Cadaverine and Tryptamine) were analyzed by high performance liquid chromatography (HPLC). There was a significant increased (P<0.05) in Tyramine levels from 4.34± 0.07 mg|100g in the first day of storage till reached 88.77± 0.14 mg|100g at a 120-day of storage. Also, Histamine and Cadaverine levels had the same increased pattern of Tyramine reaching 64.94± 0.10 and 28.28± 0.08 mg|100g in a 120- day of storage, respectively. While, there was a fluctuation in the concentration of Tryptamine level during ripening period as it decreased from 3.24± 0.06 to 2.66± 0.11 mg|100g at 60-day of storage then reached 5.38±0.08 mg|100g in a 120- day of storage. Biogenic amines can be formed in cheese during production and storage: many variables, as pH, salt concentration, bacterial activity as well as moisture, storage temperature and ripening time, play a relevant role in their formation. Comparing the obtained results with the recommended standard by Food and Drug Administration "FDA" (2001), High levels of biogenic amines in various Ras cheeses consumed in Egypt exceeded the permissible value (10 mg%) which seemed to pose a threat to public health. In this study, presence of high concentrations of biogenic amines (Tyramine, Histamine, cadaverine and Tryptamine) in Egyptian Ras cheeses reflects the bad hygienic conditions under which they produced and stored. Accordingly, the levels of biogenic amines in different cheeses should be come in accordance with the safe permissible limit recommended by FDA to ensure human safety.

Keywords: Ras cheese, biogenic amines, tyramine, histamine, cadaverine

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1538 The Recording of Personal Data in the Spanish Criminal Justice System and Its Impact on the Right to Privacy

Authors: Deborah García-Magna

Abstract:

When a person goes through the criminal justice system, either as a suspect, arrested, prosecuted or convicted, certain personal data are recorded, and a wide range of persons and organizations may have access to it. The recording of data can have a great impact on the daily life of the person concerned during the period of time determined by the legislation. In addition, this registered information can refer to various aspects not strictly related directly to the alleged or actually committed infraction. In some areas, the Spanish legislation does not clearly determine the cancellation period of the registers nor what happens when they are cancelled since some of the files are not really erased and remain recorded, even if their consultation is no more allowed or it is stated that they should not be taken into account. Thus, access to the recorded data of arrested or convicted persons may reduce their possibilities of reintegration into society. In this research, some of the areas in which data recording has a special impact on the lives of affected persons are analyzed in a critical manner, taking into account Spanish legislation and jurisprudence, and the influence of the European Court of Human Rights, the Council of Europe and other supranational instruments. In particular, the analysis cover the scope of video-surveillance in public spaces, the police record, the recording of personal data for the purposes of police investigation (especially DNA and psychological profiles), the registry of administrative and minor offenses (especially as they are taken into account to impose aggravating circumstaces), criminal records (of adults, minors and legal entities), and the registration of special circumstances occurred during the execution of the sentence (files of inmates under special surveillance –FIES–, disciplinary sanctions, special therapies in prison, etc.).

Keywords: ECHR jurisprudence, formal and informal criminal control, privacy, disciplinary sanctions, social reintegration

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1537 Exoskeleton-Enhanced Manufacturing: A Study Exploring Psychological and Physical Effects on Assembly Operators' Wellbeing

Authors: Iveta Eimontaite, Sarah R. Fletcher, Michele Surico, Alfio Minissale, Fabio F. Abba

Abstract:

Industry 4.0 offers possibilities for increased production volumes and greater efficiency whilst at the same time presenting new opportunities and challenges for the human workforce. Exoskeletons have been used in healthcare and are now starting to be adopted in manufacturing. The potential benefits of reducing fatigue and physical strain are attractive prospects of the technology for industry; however, the novelty of exoskeletons and surrounding ethical issues raise concerns amongst the stakeholders. The current case study investigated the introduction of an upper body exoskeleton designed to support posture but not increase physical strength in a factory over three time points: before the exoskeleton was introduced, and one and two months post-introduction once operators had experienced working with it. The main focus was to evaluate changes in operators' workload, situation awareness, technology self-efficacy, and physical discomfort following the introduction of the exoskeleton. After using the exoskeleton over two months, operators reported a decrease in temporal demand and an increase in performance of the NASA TLX instrument. Furthermore, over the second month, operators' self-reported technology self-efficacy scores increased, but at the same time, their situation awareness decreased. Interestingly, operators' physical discomfort after using the exoskeleton for two months increased from not uncomfortable to quite uncomfortable in the shoulder, arm, and middle back regions. The results suggest that self-perceived task efficiency improved; however, increased discomfort and decreased situation awareness scores indicate that two months might not be long enough for the exoskeleton to be integrated into operators’ mental body schema. The paper will discuss further implications and suggestions for exoskeleton introduction to manufacturing environments.

Keywords: exoskeleton, manufacturing, mental workload, physical discomfort, situation awareness, technology self-efficacy

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1536 The Contribution of Hip Strategy in Dynamic Balance in Recurrent Ankle Sprain

Authors: Radwa Talaat Mohammed El-Shorbagy, Alaa El-Din Balbaa, Khaled Ayad, Waleed Red

Abstract:

Introduction: Ankle sprain is a common lower limb injury that is complicated by high recurrence rate. The cause of recurrence is not clear; however, changes in motor control have been postulated. Objective: To determine the contribution of proximal hip strategy to dynamic balance control in patients with recurrent ankle sprain. Methods: Fifteen subjects with recurrent ankle sprain (group A) and fifteen healthy control subjects (group B) participated in this study. Abductor-adductors as well as flexor-extensor hip musculatures control was abolished by fatigue using the Biodex Isokinetic system. Dynamic balance was measured before and after fatigue by the Biodex Balance system Results: Repeated measures MANOVA was used to compare between and within group differences. In group A fatiguing of hip muscles (flexors-extensors and abductors-adductors) increased overall stability index (OASI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) significantly (p=0.00) whereas; in group B fatiguing of hip flexors-extensors increased significantly OASI and APSI only (p= 0.017, 0.010; respectively) while fatiguing of hip abductors-adductors has no significant effect on these variables. Moreover, patients with ankle sprain had significantly lower dynamic balance after hip muscles fatigue compared to the control group. Specifically, after hip flexor-extensor fatigue, the OASI, APSI and MLSI were increased significantly than those of the control values (p=0.002, 0.011, and 0.003, respectively) whereas fatiguing of hip abductors-adductors increased significantly in OASI and APSI only (p=0.012, 0.026, respectively). Conclusion: To maintain dynamic balance, patients with recurrent ankle sprain seem to relay more on the hip strategy.

Keywords: ankle sprain, hip muscles fatigue, dynamic balance

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1535 Awareness on Risk Factors of Cardiovascular Disease among Patients with Diabetes Mellitus Attending Diabetic Clinic of B. P. Koirala Institute of Health Sciences

Authors: Ram Sharan Mehta, Dina Khanal, Pushpa Parajuli, Gayanand Mandal, Bijaya Bartuala

Abstract:

Background: Cardiovascular disease (CVD) is the leading cause of death worldwide. Adequate awareness of risk factors of CVD is the first step towards effective preventive strategies to combat the CVD burden in diabetes patients.This study aims to assess the awareness on risk factors of CVD among patients with diabetes mellitus attending diabetic clinic of BPKIHS and to find the association between awareness with their selected socio demographic variables. Methods and Material: A descriptive cross sectional study was conducted among 112 patients with diabetes in diabetic clinic of BPKIHS. Convenient sampling technique was used for data collection over duration of one month using interview schedule by HDFQ II tool. Data were analyzed by using descriptive and inferential statistics. (Chi square). Results: The mean age of respondents was 55.4±12.13 years. That mean HDFQ score was 14.31± 5.08. Only 33% of the respondents had adequate level of awareness whereas majority of the respondents (67%) had inadequate level of awareness. Majority of the respondent (83.9%) were aware about smoking, (78.6%) physical activity, (75%) increasing age, (75.9%) high blood pressure, (71.4%) overweight respectively. Whereas most of the respondents were not aware of high cholesterol, fatty diet, preventive strategies and association of diabetes with CVD. Awareness was statistically significant with (p=0.043) educational status, (p=0.025) monthly income, (p=0.05) residence, (p=0.006) CVD information received and (p=0.022) co morbid condition as a heart disease. Conclusion: The findings of this study concluded most of the respondents had an inadequate level of awareness on risk factors of CVD. So Effective education and appropriate preventive strategies of CVD are indeed important to reduce CVD burden in diabetes patients.

Keywords: cardiovascular disease, awareness, diabetes patients, risk

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1534 Relationship between Pain, Social Support and Socio-Economic Indicators in Individuals with Spinal Cord Injury

Authors: Zahra Khazaeipour, Ehsan Ahmadipour, Vafa Rahimi-Movaghar, Fereshteh Ahmadipour

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Research Objectives: Chronic pain is one of the common problems associated with spinal cord injuries (SCI), which causes many complications. Therefore, this study intended to evaluate the relationship between pain and demographic, injury characteristics, socio-economic and social support in individuals with spinal cord Injury in Iran. Design: Descriptive cross-sectional study. Setting: Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran, between 2012 and 2013. Participants: The participants were 140 individuals with SCI, 101 (72%) men and 39 (28%) women, with mean age of 29.4 ±7.9 years. Main Outcome Measure: The Persian version of the Brief Pain Inventory (BPI) was used to measure the pain, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Results: About 50.7% complained about having pain, which 79.3% had bilateral pain. The most common locations of pain were lower limbs and back. The most quality of pain was described as aching (41.4%), and tingling (32.9%). Patients with a medium level of education had the least pain compared to high and low level of education. SCI individuals with good economic situation reported higher frequency of having pain. There was no significant relationship between pain and social support. There was positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P < 0.001). Conclusion: These findings revealed the importance of socioeconomic factors such as economic situation and educational level in understanding chronic pain in people with SCI and provide further support for the bio-psychosocial model. Hence, multidisciplinary evaluations and treatment strategies are advocated, including biomedical, psychological, and psycho-social interventions.

Keywords: pain, social support, socio-economic indicators, spinal cord injury

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1533 Integrated HIV Prevention and Sexual and Reproductive Health Services Among Adolescent Girls and Young Women in Rwanda: Knowledge, Attitudes, and Practices Survey.

Authors: Nsenga Bakinahe

Abstract:

Background: Adolescent girls and young women (AGYW) globally and, particularly in Rwanda, face significant challenges related to HIV prevention and sexual and reproductive health (SRH). Rwanda has a young population, with 65.3% below 30 years of age, demonstrating a need for SRH promotion and HIV prevention for this population. We aimed to determine the knowledge, attitudes, and practices (KAP) of integrated HIV prevention and SRH services among AGYW in Rwanda. Methodology: We conducted a cross-sectional survey among 384 AGYW aged 15-24 years who had ever been pregnant and currently reside in Nyagatare district, Eastern Rwanda from January to April 2023. A questionnaire was developed to collect data, participants were randomly selected and data were collected by one-on-one interviews and were analyzed using SPSS V21. The statistical relationship between variables was significant at P-Value of 0.05 and 95% confidence interval. Results: The majority (97.9%) of respondents demonstrated a good level of knowledge, (52.2%) of the respondents had positive attitudes towards integrated HIV prevention and SRH services. Looking at the practice of integrated HIV prevention and SRH services use, 51.4% of respondents have a low level of practice. The practice of integrated HIV prevention and SRH services was significantly associated with school drop-out and family status (P>0.05). Conclusion: The findings from these studies collectively emphasize the need for comprehensive education, targeted interventions, and community-based support to achieve better health outcomes regarding HIV prevention and overall sexual and reproductive health among adolescent girls and young women. Empowering adolescent girls and young women with accurate information and comprehensive support will enable them to make informed decisions, protect their health effectively, and contribute to reducing the burden of HIV and improving sexual and reproductive health outcomes.

Keywords: integrated HIV prevention, sexual and reproductive health services, among adolescentes girls, and young women

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1532 The Effectiveness of Sleep Behavioral Interventions during the Third Trimester of Pregnancy on Sleep Quality and Postpartum Depression in a Randomized Clinical Controlled Trial

Authors: Somaye Ghafarpour, Kamran Yazdanbakhsh, Mohamad Reza Zarbakhsh, Simin Hosseinian, Samira Ghafarpour

Abstract:

Unsatisfactory sleep quality is one of the most common complications of pregnancy, which can predispose mothers to postpartum depression, requiring implementing effective psychological interventions to prevent and modify behaviors accentuating sleep problems. This study was a randomized clinical controlled trial with a pre-test/post-test design aiming to investigate the effectiveness of sleep behavioral interventions during the third trimester of pregnancy on sleep quality and postpartum depression. A total of 50 pregnant mothers in the 26-30 weeks of pregnancy suffering from sleep problems (based on the score obtained from the Pittsburgh Sleep Questionnaire) were randomized into two groups (control and intervention, n= 25 per group). The data were collected using interviews, the Pittsburgh Sleep Quality Index (PSQI), and the Edinburgh Postnatal Depression Scale (EPDS) were used. The participants in the intervention group received eight 60-minute sessions of combinational training for behavioral therapy techniques. At the end of the intervention and four weeks after delivery, sleep quality and postpartum depression were evaluated. Considering that the Kolmogorov Smirnov test confirmed the normal distribution of the data, the independent t-test and analysis of covariance were used to analyze the data, showing that the behavioral interventions were effective on the overall sleep quality after delivery (p=0.001); however, no statistically significant effects were observed on postpartum depression, the sub-scales of sleep disorders, and daily functioning (p>0.05). Considering the potential effectiveness of behavioral interventions in improving sleep quality and alleviating insomnia symptoms, it is recommended to implement such measures as an effective intervention to prevent or treat these problems during prenatal and postnatal periods.

Keywords: behavioral interventions, sleep quality, postpartum depression, pregnancy, delivery

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1531 Invisible to Invaluable - How Social Media is Helping Tackle Stigma and Discrimination Against Informal Waste Pickers of Bengaluru

Authors: Varinder Kaur Gambhir, Neema Gupta, Sonal Tickoo Chaudhuri

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Bengaluru, a rapidly growing metropolis in India, with a population of 12.5 million citizens, generates 5,757 metric tonnes of solid waste per day. Despite their invaluable contribution to waste management, society and the economy, waste pickers face significant stigma, suspicion and contempt and are left with a sense of shame about their work. In this context, BBC Media Action was funded by the H&M Foundation to develop a 3-year multi-phase social media campaign to shift perceptions of waste picking and informal waste pickers amongst the Bengaluru population. Research has been used to inform project strategy and adaptation, at all stages. Formative research to inform campaign strategy used mixed methods– 14 focused group discussions followed by 406 online surveys – to explore people’s knowledge of, and attitudes towards waste pickers, and identify potential barriers and motivators to changing perceptions. Use of qualitative techniques like metaphor maps (using bank of pictures rather than direct questions to understand mindsets) helped establish the invisibility of informal waste pickers, and the quantitative research enabled audience segmentation based on attitudes towards informal waste pickers. To pretest the campaign idea, eight I-GDs (individual interaction followed by group discussions) were conducted to allow interviewees to first freely express their feelings individually, before discussing in a group. Robert Plucthik’s ‘wheel of emotions’ was used to understand audience’s emotional response to the content. A robust monitoring and evaluation is being conducted (baseline and first phase of monitoring already completed) using a rotating longitudinal panel of 1,800 social media users (exposed and unexposed to the campaign), recruited face to face and representative of the social media universe of Bengaluru city. In addition, qualitative in-depth interviews are being conducted after each phase to better understand change drivers. The research methodology and ethical protocols for impact evaluation have been independently reviewed by an Institutional Review Board. Formative research revealed that while waste on the streets is visible and is of concern to the public, informal waste pickers are virtually ‘invisible’, for most people in Bengaluru Pretesting research revealed that the creative outputs evoked emotions like acceptance and gratitude towards waste-pickers, suggesting that the content had the potential to encourage attitudinal change. After the first phase of campaign, social media analytics show that #Invaluables content reached at least 2.6 million unique people (21% of the Bengaluru population) through Facebook and Instagram. Further, impact monitoring results show significant improvements in spontaneous awareness of different segments of informal waste pickers ( such as sorters at scrap shops or dry waste collection centres -from 10% at baseline to 16% amongst exposed and no change amongst unexposed), recognition that informal waste pickers help the environment (71% at baseline to 77% among exposed and no change among unexposed) and greater discussion about informal waste pickers among those exposed (60%) as against not exposed (49%). Using the insights from this research, the planned social media intervention is designed to increase the visibility of and appreciation for the work of waste pickers in Bengaluru, supporting a more inclusive society.

Keywords: awareness, discussion, discrimination, informal waste pickers, invisibility, social media campaign, waste management

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1530 Gaming Mouse Redesign Based on Evaluation of Pragmatic and Hedonic Aspects of User Experience

Authors: Thedy Yogasara, Fredy Agus

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In designing a product, it is currently crucial to focus not only on the product’s usability based on performance measures, but also on user experience (UX) that includes pragmatic and hedonic aspects of product use. These aspects play a significant role in fulfillment of user needs, both functionally and psychologically. Pragmatic quality refers to as product’s perceived ability to support the fulfillment of behavioral goals. It is closely linked to functionality and usability of the product. In contrast, hedonic quality is product’s perceived ability to support the fulfillment of psychological needs. Hedonic quality relates to the pleasure of ownership and use of the product, including stimulation for personal development and communication of user’s identity to others through the product. This study evaluates the pragmatic and hedonic aspects of gaming mice G600 and Razer Krait using AttrakDiff tool to create an improved design that is able to generate positive UX. AttrakDiff is a method that measures pragmatic and hedonic scores of a product with a scale between -3 to +3 through four attributes (i.e. Pragmatic Quality, Hedonic Quality-Identification, Hedonic Quality-Stimulation, and Attractiveness), represented by 28 pairs of opposite words. Based on data gathered from 15 participants, it is identified that gaming mouse G600 needs to be redesigned because of its low grades (pragmatic score: -0.838, hedonic score: 1, attractiveness score: 0.771). The redesign process focuses on the attributes with poor scores and takes into account improvement suggestions collected from interview with the participants. The redesigned mouse G600 is evaluated using the previous method. The result shows higher scores in pragmatic quality (1.929), hedonic quality (1.703), and attractiveness (1.667), indicating that the redesigned mouse is more capable of creating pleasurable experience of product use.

Keywords: AttrakDiff, hedonic aspect, pragmatic aspect, product design, user experience

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1529 Association of Maternal Age, Ethnicity and BMI with Gestational Diabetes Prevalence in Multi-Racial Singapore

Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

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Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

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