Search results for: females sexual dysfunction

Authors: Ghada Al-Kafaji, Mohamed Sabry

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Mitochondria are the site of cellular respiration and produce energy in the form of adenosine triphosphate (ATP) via oxidative phosphorylation. They are the major source of intracellular reactive oxygen species (ROS) and are also direct target to ROS attack. Oxidative stress and ROS-mediated disruptions of mitochondrial function are major components involved in the pathogenicity of diabetic complications. In this work, the changes in mitochondrial DNA (mtDNA) copy number, biogenesis, gene expression of mtDNA-encoded subunits of electron transport chain (ETC) complexes, and mitochondrial function in response to hyperglycemia-induced ROS and the effect of direct inhibition of ROS on mitochondria were investigated in an in vitro model of diabetic nephropathy using human renal mesangial cells. The cells were exposed to normoglycemic and hyperglycemic conditions in the presence and absence of Mn(III)tetrakis(4-benzoic acid) porphyrin chloride (MnTBAP) or catalase for 1, 4 and 7 days. ROS production was assessed by the confocal microscope and flow cytometry. mtDNA copy number and PGC-1a, NRF-1, and TFAM, as well as ND2, CYTB, COI, and ATPase 6 transcripts, were all analyzed by real-time PCR. PGC-1a, NRF-1, and TFAM, as well as ND2, CYTB, COI, and ATPase 6 proteins, were analyzed by Western blotting. Mitochondrial function was determined by assessing mitochondrial membrane potential and adenosine triphosphate (ATP) levels. Hyperglycemia-induced a significant increase in the production of mitochondrial superoxide and hydrogen peroxide at day 1 (P < 0.05), and this increase remained significantly elevated at days 4 and 7 (P < 0.05). The copy number of mtDNA and expression of PGC-1a, NRF-1, and TFAM as well as ND2, CYTB, CO1 and ATPase 6 increased after one day of hyperglycemia (P < 0.05), with a significant reduction in all those parameters at 4 and 7 days (P < 0.05). The mitochondrial membrane potential decreased progressively at 1 to 7 days of hyperglycemia with the parallel progressive reduction in ATP levels over time (P < 0.05). MnTBAP and catalase treatment of cells cultured under hyperglycemic conditions attenuated ROS production reversed renal mitochondrial oxidative stress and improved mtDNA, mitochondrial biogenesis, and function. These results show that hyperglycemia-induced ROS caused an early increase in mtDNA copy number, mitochondrial biogenesis and mtDNA-encoded gene expression of the ETC subunits in human mesangial cells as a compensatory response to the decline in mitochondrial function, which precede the mtDNA defect and mitochondrial dysfunction with a progressive oxidative response. Protection from ROS-mediated damage to renal mitochondria induced by hyperglycemia may be a novel therapeutic approach for the prevention/treatment of DN.

Keywords: diabetic nephropathy, hyperglycemia, reactive oxygen species, oxidative stress, mtDNA, mitochondrial dysfunction, manganese superoxide dismutase, catalase

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Authors: Babina Aryal

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Background: The diagnosis of pancreatitis is generally based on clinical and laboratory findings; however, Computed Tomography (CT) is an imaging technique of choice specially Contrast Enhanced Computed Tomography (CECT) shows morphological characteristic findings that allow for establishing the diagnosis of pancreatitis and determining the extent of disease severity which is done along with the administration of appropriate contrast medium. The purpose of this study was to compare Computed Tomography Dose Index (CTDI), Dose Length Product (DLP) and Effective Dose (ED) among male and female patients from Contrast Enhanced Computed Tomography (CECT) Pancreatitis Protocol. Methods: This retrospective study involved data collection based on clinical/laboratory/ultrasonography diagnosis of Pancreatitis and has undergone CECT Abdomen pancreatitis protocol. data collection involved detailed information about a patient's Age and Gender, Clinical history, Individual Computed Tomography Dose Index and Dose Length Product and effective dose. Results: We have retrospectively collected dose data from 150 among which 127 were males and 23 were females. The values obtained from the display of the CT screen were measured, calculated and compared to determine whether the CTDI, DLP and ED values were similar or not. CTDI for females was more as compared to males. The differences in CTDI values for females and males were 32.2087 and 37.1609 respectively. DLP values and Effective dose for both the genders did not show significant differences. Conclusion: This study concluded that there were no more significant changes in the DLP and ED values among both the genders however we noticed that female patients had more CTDI than males.

Keywords: computed tomography, contrast enhanced computed tomography, computed tomography dose index, dose length product, effective dose

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Authors: Bridget J. Kenny, Elizabeth Hoban, Jo Williams

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Adolescent pregnancy presents a significant public health challenge for Cambodia. Despite declines in the overall fertility rate, the adolescent fertility rate is increasing. Adolescent pregnancy is particularly problematic in the Northeast provinces of Ratanak Kiri and Mondul Kiri where 34 percent of girls aged between 15 and 19 have begun childbearing; this is almost three times Cambodia’s national average of 12 percent. Language, cultural and geographic barriers have restricted qualitative exploration of the sexual and reproductive health (SRH) challenges that face indigenous adolescents in Northeast Cambodia. The current study sought to address this gap by exploring the SRH practices of adolescent mothers from indigenous populations in Ratanak Kiri Province. Twenty-two adolescent mothers, aged between 15 and 19, were recruited from seven indigenous villages in Ratanak Kiri Province and asked to participate in a combined body mapping exercise and semi-structured interview. Participants were given a large piece of paper (59.4 x 84.1 cm) with the outline of a female body and asked to draw the female reproductive organs onto the ‘body map’. Participants were encouraged to explain what they had drawn with the purpose of evoking conversation about their reproductive bodies. Adolescent mothers were then invited to participate in a semi-structured interview to further expand on topics of SRH. The qualitative approach offered an excellent avenue to explore the unique SRH challenges that face indigenous adolescents in rural Cambodia. In particular, the use of visual data collection methods reduced the language and cultural barriers that have previously restricted or prevented qualitative exploration of this population group. Thematic analysis yielded six major themes: (1) understanding of the female reproductive body, (2) contraceptive knowledge, (3) contraceptive use, (4) barriers to contraceptive use, (5) sexual practices, (6) contact with healthcare facilities. Participants could name several modern contraceptive methods and knew where they could access family planning services. However, adolescent mothers explained that they gained this knowledge during antenatal care visits and consequently participants had limited SRH knowledge, including contraceptive awareness, at the time of sexual initiation. Fear of the perceived side effects of modern contraception, including infertility, provided an additional barrier to contraceptive use for indigenous adolescents. Participants did not cite cost or geographic isolation as barriers to accessing SRH services. Child marriage and early sexual initiation were also identified as important factors contributing to the high prevalence of adolescent pregnancy in this population group. The findings support the Ministry of Education, Youth and Sports' (MoEYS) recent introduction of SRH education into the primary and secondary school curriculum but suggest indigenous girls in rural Cambodia require additional sources of SRH information. Results indicate adolescent girls’ first point of contact with healthcare facilities occurs after they become pregnant. Promotion of an effective continuum of care by increasing access to healthcare services during the pre-pregnancy period is suggested as a means of providing adolescents girls with an additional avenue to acquire SRH information.

Keywords: adolescent pregnancy, contraceptive use, family planning, sexual and reproductive health

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Authors: Dina Maria Smit

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Worldwide, it seems as if women are adequately represented in government and parliament but are almost absent from governing boards of private enterprises. The reasons for this seem to be embedded in perceptions of inadequacy, remnants of patriarchy, glass ceilings and even female choice. Direct or indirect discrimination against females have been found to be one of the reasons that female employees are found in traditionally “softer” roles, whilst the old “Boy’s Club” is still operational to keep women out of senior managerial positions, especially in the private sector. The cultural construct of Indian society, focusing on male preference, patriarchy, divorce laws and low educational levels of females as opposed to men, is indicative of a society wherein high gender inequality still exists. The position in South Africa is similar in that substantive gender equality has not been reached despite a progressive constitution and anti-discrimination laws. There is a strong push to propel women to senior positions in South Africa, but these efforts have not yet translated into females taking up senior positions in private companies. In South Africa, females still earn less than their male counterparts whilst performing doing the same jobs, are overrepresented in parliament, but do not captain the ships in the private sector. The lack of female parity in employment leads to a lack of autonomy and authority in both South Africa and India. The divide between formal and informal work, unpaid work, mainly being done by women, need to be investigated to ensure substantive gender parity. The findings will show that females are still not equal to men in employment, especially in senior private positions; mainly due to the remnants of patriarchy and glass ceilings that still need to be shattered. This article aims to set out the reasons why gender disparity still exists in India and South Africa, seen through a legal lense. Both countries are signatories to the CEDAW Convention and have constitutions that advocate for the right of equality. Although equal rights have been implemented in both countries, equality may not be well implemented. This investigation is comparative in nature and aims to contribute to the growing body of evidence on how to ensure gender parity in all occupational levels and categories. The study is in quantitative in nature. If substantive gender equality, as opposed to formative gender equality, is a key motivator to ensure gender equality, an investigation into the reasons for this disparity is warranted before suggestions can be tendered to effect lasting change. The aim of this comparative study is not to plug the legal system of one country into the other, but to take into account of the autonomy of choice, set against cultural differences and similarities in an effort to shatter the glass ceilings for women who aspire to climb the corporate ladders.

Keywords: gender inequality, glass ceilings, patriarchy, female disparity

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Authors: Jawaria Zafaror, Najma Iqbal Malik

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The present study has been undertaken to explore the relationship among mild cognitive impairment, loneliness and depression among a convenient sample of old people (N = 100) living in old age homes (n = 50) and family home residence (n = 50). Mild Cognitive Impairment Questionnaire, Depression Subscale of Depression Anxiety Stress Scale and UCLA Loneliness Scales were used. Results revealed that Mild cognitive impairment had a significant positive relationship with depression and loneliness among old people both living in old age homes and family home residences. Results also showed that loneliness was the significant positive predictor of depression. However, t-test analysis revealed that old females had higher depression as compared to old males, but old males suffered a significantly high level of cognitive distortions and loneliness as compared to old females. Mediation analysis suggests that loneliness was the partial mediator between mild cognitive impairment and loneliness among old people. Limitations, suggestions and implications were also discussed.

Keywords: loneliness, mild cognitive impairment, depression, old age

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Authors: Wern Lin Yeo, Choo Kim Tan, Sook Ling Lew

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Mathematics anxiety refers to the feeling of anxious when one having difficulties in solving mathematical problem. Mathematics anxiety is the most common type of anxiety among other types of anxiety which occurs among the students. However, level of anxiety among males and females are different. There were few past study were conducted to determine the relationship of anxiety and gender but there were still did not have an exact results. Hence, the purpose of this study is to determine the relationship of anxiety level between male and female undergraduates at a private university in Malaysia. Convenient sampling method used in this study in which the students were selected based on the grouping assigned by the faculty. There were 214 undergraduates who registered the probability courses had participated in this study. Mathematics Anxiety Rating Scale (MARS) was the instrument used in study which used to determine students’ anxiety level towards probability. Reliability and validity of instrument was done before the major study was conducted. In the major study, students were given briefing about the study conducted. Participation of this study were voluntary. Students were given consent form to determine whether they agree to participate in the study. Duration of two weeks were given for students to complete the given online questionnaire. The data collected will be analyzed using Statistical Package for the Social Sciences (SPSS) to determine the level of anxiety. There were three anxiety level, i.e., low, average and high. Students’ anxiety level were determined based on their scores obtained compared with the mean and standard deviation. If the scores obtained were below mean and standard deviation, the anxiety level was low. If the scores were at below and above the mean and between one standard deviation, the anxiety level was average. If the scores were above the mean and greater than one standard deviation, the anxiety level was high. Results showed that both of the gender were having average anxiety level. Males having high frequency of three anxiety level which were low, average and high anxiety level as compared to females. Hence, the mean values obtained for males (M = 3.62) was higher than females (M = 3.42). In order to be significant of anxiety level among the gender, the p-value should be less than .05. The p-value obtained in this study was .117. However, this value was greater than .05. Thus, there was no significant difference of anxiety level among the gender. In other words, there was no relationship of anxiety level with the gender.

Keywords: anxiety level, gender, mathematics anxiety, probability and statistics

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Authors: Nigar Sultanova

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Facial morphology is a constant topic of concern for clinicians. When anthropometric methods were introduced into clinical practice to quantify changes in the craniofacial framework, features distinguishing various ethnic group were discovered. Normative data of facial measurements are indispensable to precise determination of the degree of deviations from normal. Establish the reference range of facial proportions in Azerbaijan population by anthropometric measurements of craniofacial complex. The study group consisted of 350 healthy young subjects, 175 males and 175 females, 18 to 25 years of age, from 7 different regions of Azerbaijan. The anthropometric examination was performed according to L.Farkas's method with our modification. In order to determine the morphologic characteristics of seven regions of the craniofacial complex 42 anthropometric measurements were selected. The anthropometric examination. Included the usage of 33 anthropometric landmarks. The 80 indices of the facial proportions, suggested by Farkas and Munro, were calculated: head -10, face - 23, nose - 23, lips - 9, orbits - 11, ears - 4. The date base of the North American white population was used as a reference group. Anthropometric measurements of facial proportions in Azerbaijan population revealed a significant difference between mеn and womеn, according to sexual dimorphism. In comparison with North American whites, considerable differences of facial proportions were observed in the head, face, orbits, labio-oral, nose and ear region. However, in women of the Azerbaijani population, 29 out of 80 proportion indices were similar to the proportions of NAW women. In the men of the Azerbaijani population, 27 out of 80 proportion indices did not reveal a statistically significant difference from the proportions of NAW men. Estimation of the reference range of facial proportions in Azerbaijan population migth be helpful to formulate surgical plan in treatment of congenital or post-traumatic facial deformities successfully.

Keywords: facial morphology, anthropometry, indices of proportion, measurement

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Authors: Gizem Akcan, Erdinc Ozturk

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The purpose of the study was to determine some psychosocial variables that predict dissociation in university students. These psychosocial variables were perceived childhood trauma, alexithymia, and gender. 150 (75 males, 75 females) university students (bachelor, master and postgraduate) were enrolled in this study. They were chosen from universities in Istanbul at the education year of 2016-2017. Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire (CTQ) and Toronto Alexithymia Scale were used to assess related variables. Demographic Information Form was given to students in order to have their demographic information. Frequency Distribution, Linear Regression Analysis, and t-test analysis were used for statistical analysis. Childhood trauma and alexithymia were found to have predictive value on dissociation among university students. However, physical abuse, physical neglect and emotional neglect sub dimensions of childhood trauma and externally-oriented thinking sub dimension of alexithymia did not have predictive value on dissociation. Moreover, there was no significant difference between males and females in terms of dissociation scores of participants.

Keywords: childhood trauma, dissociation, alexithymia, gender

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Authors: Kajori Banerjee, Laxmi Kant Dwivedi

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“Health transition” is defined to be “a process through which high levels of mortality, morbidity and disability are reduced to low levels by influencing cultural, social and behavioural factors”. Life expectancy in India has been on the rise and parallel the burden of disease and disability has also risen noticeably. Borrowing data from Indian Census (2001, 2011), this study identifies the gender-wise burden of disability by calculating disability free life expectancy (DFLE) and life lived with disability (LWD). Sullivan’s method of calculating DFLE using proportion of disabled is used for this purpose. The change in person years lived with disability in the decade 2001-11 is further decomposed using Arriaga’s method into mortality and disability effects (ME and DE) to check the magnitude and direction of contribution of mortality and disability. Nationally, along with DFLE, LWD has amplified too. Despite having the highest life expectancy and DFLE, LWD in Kerala, was highest for both sexes in 2001. But in 2011, the LWD was highest among the males of Orissa and females of Rajasthan. For the overall population, DE is positive for the prime working age groups of 20-40years indicating that there has been an increase in the disability proportion holding mortality constant for 2001-2011. Females exhibit higher positive DE implying greater loss of healthy years due to disability than males. The findings call for an immediate attention to the causes of rising disability burden among the working population, especially females, as this might heavily effect the availability of quality labour force and its relative economic output in the Indian labour market. This also hints at the degrading quality of the elongated life and needs to be given the required attention to enhance the quality of life lead in the Nation.

Keywords: disability-free life expectancy, disability effect, life expectancy, mortality effect

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Authors: S. J. Taylor, S. Chowdhury, T. A. Pychyl

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Attention Deficit Hyperactivity Disorder (ADHD) and procrastination are often discussed in relation to problems with self-regulation and executive functioning (EF). The small body of extant research that has explored the relations between these variables has many limitations particularly in terms of the samples used and the measurement of procrastination. In this study, we recruited a sample of undergraduate students with a confirmed clinical diagnosis of ADHD (n = 48, 66.7% females) as well as a sample of student volunteers without ADHD (n = 68, 75.8% females) to investigate the relations between ADHD subtypes, EF, procrastination and other forms of delay. We used the newly developed Multidimensional Measure of Academic Procrastination and Delay Questionnaire. As hypothesized, the results revealed that individuals with ADHD displayed significantly more irrational delay, general procrastination and academic procrastination compared to individuals without ADHD. This study contributed to the research literature indicating that individuals with ADHD struggle with procrastination as a result of symptoms of ADHD and EF deficits. Theses results provide support for adopting a new language when describing procrastination problems among individuals with ADHD, and they have implications for the nature of academic accommodations and interventions for individuals with ADHD.

Keywords: ADHD, delay, executive functioning, procrastination, self-regulation

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Authors: Telma Fontao de Castro, Kylee Miller, Maria Xavier Araújo, Isabel Brandao, Sandra Torres

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Objective: There is a dearth of research investigating the long-term emotional functioning of individuals recovered from anorexia nervosa (AN). This 15-year longitudinal study aimed to examine whether difficulties in cognitive processing of emotions persisted after long-term AN recovery and its link to anxiety and depression. Method: Twenty-four females, who were tested longitudinally during their acute and recovered AN phases, and 24 healthy control (HC) women, were screened for anxiety, depression, alexithymia, and emotion regulation difficulties (ER; only assessed in recovery phase). Results: Anxiety, depression, and alexithymia levels decreased significantly with AN recovery. However, scores on anxiety and difficulty in identifying feelings (alexithymia factor) remained high when compared to the HC group. Scores on emotion regulation difficulties were also lower in HC group. The abovementioned differences between AN recovered group and HC group in difficulties in identifying and accepting feelings and lack of emotional clarity were no longer present when the effect of anxiety and depression was controlled. Conclusions: Findings suggest that emotional dysfunction tends to decrease in AN recovered phase. However, using an HC group as a reference, we conclude that several emotional difficulties are still increased after long-term AN recovery, in particular, limited access to emotion regulation strategies, and difficulty controlling impulses and engaging in goal-directed behavior, thus suggesting to be a trait vulnerability. In turn, competencies related to emotional clarity and acceptance of emotional responses seem to be state-dependent phenomena linked to anxiety and depression. In sum, managing emotions remains a challenge for individuals recovered from AN. Under this circumstance, maladaptive eating behavior can serve as an affect regulatory function, increasing the risk of relapse. Emotional education and stabilization of depressive and anxious symptomatology after recovery emerge as an important avenue to protect from long-term AN relapse.

Keywords: alexithymia, anorexia nervosa, emotion recognition, emotion regulation

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Authors: A. K. M. Rezaul Karim, Abu Yusuf Mahmud, S. H. Mahmud

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The study aimed to investigate whether the affect (experience of feeling or emotion) of ethnic minority people can be predicted by gender and marital status. Toward this end, positive affect and negative affect of 103 adult indigenous persons were measured. Analysis of data in multiple regressions demonstrated that both gender and marital status are significantly associated with positive affect (Gender: β=.318, p < .001; Marital status: β=.201, p < .05), but not with negative affect. Results indicated that the indigenous males have 0.32 standard deviations increased positive affect as compared to the indigenous females and that married individuals have 0.20 standard deviations increased positive affect as compared to their unmarried counterparts. These findings advance our understanding that gender and marital status inequalities in the experience of emotion are not specific to the mainstream society; rather it is a generalized picture of all societies. In general, men possess more positive affect than females; married persons possess more positive affect than the unmarried persons.

Keywords: positive affect, negative affect, ethnic minority, gender, marital status

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Authors: Jessica Leigh Doyle

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In recent years there has been increasing academic and policy interest in domestic violence (DV) and in the implications of DV for the physical and psychological well-being of those who experience it. Yet, despite this interest, very few detailed empirical explorations of these issues have been conducted to date. Of the detailed empirical work that does exist, most studies have focused narrowly on physical violence and the impact of physical violence on rates of depression, post-traumatic stress disorder (PTSD) and substance use. This has often been to the exclusion of wider experiences of DV in relation to psychological, sexual and financial abuse, and of broader victim self-perceptions of psychological well-being that include self-esteem, social participation and quality of life as core components. This paper contributes towards filling this gap by examining these issues on the basis of comprehensive empirical evidence from the Northern Ireland context. Using qualitative methods, the paper presents the findings from 63 semi-structured interviews with women victims of DV from across Northern Ireland. The findings discuss the varied types of violence (physical, psychological, sexual, and financial) that women experience, how these experiences shape their broad physical and psychological well-being and capacity to live active and fulfilling lives and the processes of recovery from IPV. The implications of these findings for research and policy are then discussed.

Keywords: domestic violence, gender equality, intimate partner violence, violence against women, well-being

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Authors: Marthese Azzopardi, Liberato Camilleri

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This research was performed to investigate the study habits and level of difficulty perceived by post-secondary students in Biology at Advanced-level topics after completing their first year of study. At the end of a two-year ‘sixth form’ course, Maltese students sit for the Matriculation and Secondary Education Certificate (MATSEC) Advanced-level biology exam as a requirement to pursue science-related studies at the University of Malta. The sample was composed of 23 students (16 taking Chemistry and seven taking some ‘Other’ subject at the Advanced Level). The cohort comprised seven males and 16 females. A questionnaire constructed by the authors, was answered anonymously during the last lecture at the end of the first year of study, in May 2016. The Chi square test revealed that gender plays no effect on the various study habits (c² (6) = 5.873, p = 0.438). ‘Reading both notes and textbooks’ was the most common method adopted by males (71.4%), whereas ‘Writing notes on each topic’ was that mostly used by females (81.3%). The Mann-Whitney U test showed no significant difference in the study habits of students and the mean assessment mark obtained at the end of the first year course (p = 0.231). Statistical difference was found with the One-ANOVA test when comparing the mean assessment mark obtained at the end of the first year course when students are clustered by their Secondary Education Certificate (SEC) grade (p < 0.001). Those obtaining a SEC grade of 2 and 3 got the highest mean assessment of 68.33% and 66.9%, respectively [SEC grading is 1-7, where 1 is the highest]. The Friedman test was used to compare the mean difficulty rating scores provided for the difficulty of each topic. The mean difficulty rating score ranges from 1 to 4, where the larger the mean rating score, the higher the difficulty. When considering the whole group of students, nine topics out of 21 were perceived as significantly more difficult than the other topics. Protein synthesis, DNA Replication and Biomolecules were the most difficult, in that order. The Mann-Whitney U test revealed that the perceived level of difficulty in comprehending Biomolecules is significantly lower for students taking Chemistry compared to those not choosing the subject (p = 0.018). Protein Synthesis was claimed as the most difficult by Chemistry students and Biomolecules by those not studying Chemistry. DNA Replication was the second most difficult topic perceived by both groups. The Mann-Whitney U test was used to examine the effect of gender on the perceived level of difficulty in comprehending various topics. It was found that females have significantly more difficulty in comprehending Biomolecules than males (p=0.039). Protein synthesis was perceived as the most difficult topic by males (mean difficulty rating score = 3.14), while Biomolecules, DNA Replication and Protein synthesis were of equal difficulty for females (mean difficulty rating score = 3.00). Males and females perceived DNA Replication as equally difficult (mean difficulty rating score = 3.00). Discovering the students’ study habits and perceived level of difficulty of specific topics is vital for the lecturer to offer guidance that leads to higher academic achievement.

Keywords: biology, perceived difficulty, post-secondary, study habits

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Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

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Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

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Authors: Abdullah Almilaibary, Jeremy Jolley, Mark Hayter

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Background: Despite recent progress in enhancing the accessibility of HIV-related health services worldwide, opportunities to diagnose patients are often missed due to genuine barriers at different levels. The aim of the study is to explore the factors that affect the utilization of HIV testing services by young people aged 17-25 in Saudi Arabia. Methods: A non-experimental descriptive cross-sectional design was used to predict factors that influenced HIV testing among Umm- Al Qura University students aged 17-25 years. A newly developed self-completed online questionnaire was used and the study sample was drawn using a convenience sampling technique. The questionnaire consisted of 52 items divided into three scales: 12 items for HIV/AIDS-related knowledge, 3 items for risk perception, and 37 items for attitudes toward HIV testing. Five experts in the field of HIV/AIDS validated the contents of the questionnaire and agreed that the items included were related to the construct being measured. The reliability of the questionnaire was also assessed using a test/re-test strategy with 27 participants recruited from the population under study. The reliability assessment revealed that the questionnaire was consistent as Cronbach’s Alpha was 0.80 for HIV/ADS knowledge, 0.88 for risk perception and 0.78 for attitudes towards HIV testing. The data were collected between 14th of July and 14th of October 2014. Results: 394 participants completed the questionnaires: 116 (29.4%) male and 278 (70%) female. 50.5% of the participants were aged 20 to 22 years, 34.8% were 17-19 years and 14.7% were aged between 23-25 years; about 93% of the participants were single. Only 20 (6%) participants had previously been tested for HIV. The main reasons for not being tested for HIV were: exposure to HIV was considered unlikely (48%), HIV test was not offered (36%) and unawareness of HIV testing centres (16%). On HIV/AIDS-related knowledge, the male participants scored higher than the females as the mean score for males was (M = 6.4, SD = 2.4) while for females it was (M 5.7, SD 2.5). In terms of risk perception, female participants appeared to have lower levels of risk perception than male participants, with the mean score for males being (M 11.7, SD 2.5) and (M 10.5, SD 2.4) for females. The female participants showed slightly more positive attitudes towards HIV testing than male participants: the mean score for males was (M = 108.14, SD = 17.9) and was (M = 111.32, SD = 17.3) for females. Conclusions: The data reveal that misconceptions about HIV/AIDS in Saudi Arabia are still a challenge. Although the attitudes towards HIV testing were reasonably positive, the utilization of the HIV test was low. Thus, tailoring HIV/AIDS preventive strategies in Saudi Arabia should focus on the needs of young people and other high risk groups in the country.

Keywords: attitude toward hiv testing, hiv testing, hiv/aids related knowledge, risk perception

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Authors: Sujata Gupta Kedar, Fasiha Fayaz

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This paper presents various studies being carried out by various researchers globally on the attitude of lecturers towards the advent of information technology and e-learning. An effort has been made in this paper to study the various trends being presented by researchers and draw some general conclusions. These show the effect of the lecturer’s gender, age and educational background on their attitude towards the e-learning. Also the favorable attitude of teachers' towards using new technology in teaching will certainly make teachers use them in appropriate situations in teaching and thus measuring of teachers attitude towards using new technology in teaching is very much needed. The sample of 50 males and 50 females were studied from different colleges of Bangalore “Attitudes towards using new technology scale” by Dr. Rajasekar was used. It was seen that male and female had no significant difference in hardware and software use, whereas both had favorable attitude. And there was a significant difference at 1% level among female lecturers belonging to arts faculty. There is no significant difference between the gender and age, because higher the age lower the score is. Irrespective of teaching experience males had no significant difference, whereas females are significant at 1% level, which says that higher the teaching experience of lecturers less knowledge they have towards the use of ICT, as the younger generation is more expose to technology.

Keywords: e-learning, ICT, attitudes, lecturers, communication technology

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Authors: A. A. Betah

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This research was performed to evaluate the attitudes of rural women towards education, health and work outside the home. The study was based on a random sample of 147 rural women, Kafr-Rahmaniyah village was chosen for the study because its life expectancy at birth for females, education and percentage of females in the labor force, were the highest in the district. The study data were collected from rural female respondents, using a face-to-face questionnaire. In addition, the study estimated several factors like age, main occupation, family size, monthly household income, geographic cosmopolites, and degree of social participation for rural women respondents. Using Statistical Package for the Social Sciences (SPSS), data were analyzed by non-parametric statistical methods. The main finding in this study was a significant relationship between each of the previous variables and each of rural women’s attitudes toward education, health, and work outside home. The study concluded with some recommendations. The most important element is ensuring attention to rural women’s needs, requirements and rights via raising their health awareness, education and their contributions in their society.

Keywords: attitudes, education, health, rural women, work outside home

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Authors: Washaya Soul, Mupangwa John, Mapfumo Lizwell, Muchenje Voster

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Ruminant animals contribute a considerable amount of methane to the atmosphere, which is a cause of concern for global warming. Two studies were conducted in beef and goats where the studies aimed to determine the enteric CH₄ levels from a herd of beef cows raised on semi-arid rangelands and to evaluate the effect of supplementing goats with forage legumes: Vigna unguiculata and Lablab purpureus on enteric methane production. A total of 24 cows were selected from Boran and Nguni cows (n = 12 per breed) from two different farms; parity (P1 – P4) and season (dry vs. wet) were considered predictor variables in the first experiment. Eighteen goats (weaners, 9 males, 9 females) were used, in which sex and forage species were predictor variables in the second experiment. Three treatment diets were used in goats. Methane was measured using a Laser methane detector [LMD] for six consecutive days and repeated once after every three months in beef cows and once every week for 6 weeks in goats during the post-adaptation period. Parity and breed had no effects on CH₄ production in beef cows; however, season significantly influenced CH₄ outputs. Methane production was higher (P<0.05) in the dry compared to the wet season, 31.1CH₄/DMI(g/kg) and 28.8 CH₄/DMI(g/kg) for the dry and wet seasons, respectively. In goats, forage species and sex of the animal affected enteric methane production (P<0.05). Animals produce more gas when ruminating than feeding or just standing for all treatments. The control treatment exhibited higher (P<0.05) methane emissions per kg of DMI. Male goats produced more methane compared to females (17.40L/day; 12.46 g/kg DMI and 0.126g/day) versus (15.47L/day, 12.28 g/kg DMI, 0.0109g/day) respectively. It was concluded that cows produce more CH₄/DMI during the dry season, while forage legumes reduce enteric methane production in goats, and male goats produce more gas compared to females. It is recommended to introduce forage legumes, particularly during the dry season, to reduce the amount of gas produced.

Keywords: beef cows, extensive grazing system, forage legumes, greenhouse gases, goats Laser methane detector.

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Authors: A. Gazdzinska, P. Jagielski, E. Kaniewska, S. P. Gazdzinski, M. Wylezol

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Background: In the multi-factor etiology of obesity, an increasing degree of importance is attributed to behavioral factors. Lifestyle and health-oriented behaviors heavily influence the treatment of multiple diseases, including obesity. However, only a few studies evaluated health-related behaviors exhibited by patients qualified for bariatric surgery. None of them was performed in Polish population. Aim: Assessment of health behaviors of obese patients according to the degree of mood disorders. Method: The study involved 93 patients (66 females) who were qualified for bariatric surgery in the Department of Surgery of the Military Institute of Aviation Medicine in Warsaw. Diagnostic instrument was the Juczynski’s Inventory of Health Behavior (HBI), which evaluates health behavior in four categories, i.e. proper nutrition habits (PNH), preventive behavior (PH), health practices (HP) and positive mental attitude (PMA). The average HBI falls in the range between 24 and 120 points, for each category of health behaviors fall between 1 and 5 (higher score means higher severity declared healthy behaviors). The depressive symptoms in patients were assessed with Beck Depression Inventory (BDI). All analyses were conducted using STATISTICA 12. Results: The average age was 44.2 ± 11.5 years, mean BMI was 44.3 ± 10.5 kg/m2 and 46.8 ± 7.6 kg/m2, in females and males respectively. According to BDI, 32% patients had mild level of depression, 10% moderate and 14% severe depression. BDI scores were not different between females and males. Low results with regard to the health behaviors declared were obtained by 35.5 % of patients, medium by 44.0%, while high ones by only 20.5%. On average, patients gained 3.28 points in PNH, 3.37 points in PH, 3.29 points in HP, while 3.42 in the PMA category, showing average intensity of these behaviors. These health behaviors were practiced significantly more often by women (p = 0.04). The average HBI was 80.2; with average score of 81.5 for females and 76.6 for males, respectively (p = 0.03). Women were better in the PNH category (p = 0.02). A positive correlation was found between age and all categories of health behaviors, in particular PNH (R = 0.38; p = 0.001), PH (R = 0.26; p = 0.01), HP (R = 0.27; p = 0.01) and PMA (R = 0.24; p = 0.02), independent of gender. The severity of depression had a significant impact only on the behaviors associated with proper eating habits, which saw a negative correlation between BDI scores and the PNH (R = -0.21; p = 0.04). Conclusions: Majority of morbidly obese patients qualified for bariatric surgery obtained low to average scores in health behavior questionnaire. However, these results are similar in comparison with the Polish adult population. In accordance to these results, it seems that healthy behaviors, among them eating behaviors, do not appear to be a cause of obesity epidemic or they might be acquired when the disease is already underway. Female gender and age had a positive effect, and depression had a negative effect on the level of health behaviors among patients qualified for bariatric surgery.

Keywords: depression, habits, health behaviours, obesity

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Authors: Camille Plant, Katherine McGill, Pek Ang

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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.

Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry

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Authors: Usma Iftikhar, Khorshed Alam

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Background: Digital health platforms and digital health interventions are gaining increasing importance with the shift to online health-seeking behaviour, especially post-Covid. Subsequently, the importance of digital health literacy is increasingly being recognized. With the surge in culturally and linguistically diverse populations in First World countries, especially females, the predictors of digital health access in this population remain elusive. Keeping in view the inadequate digital infrastructure in rural and remote Australia, with lack of specialist services, the determinants of digital access gain even more importance. Objectives: The objective of this research are to measure the digital health literacy levels in this population, including the predictors of digital health literacy like sociodemographics and the correlation between the predictors and digital health literacy levels. Methods: A population-based quantitative survey was carried out in Regional Queensland from Jan 2022- Dec 2023 on culturally and linguistically diverse adult females. Sociodemographics like age, literacy levels, socioeconomic status, access to digital devices were recorded after informed consent. Digital health literacy levels were measured by specially designed questionnaires. The relationship between sociodemographics and digital health literacy levels was estimated by Pearson correlation. Results: Mean DHL was 2.66 + 0.35. There was a negative significant relationship (p<0.005) between demographics like age and access to a digital device with digital health literacy levels. Also observed was a positive significant relationship between literacy levels and proficiency in English. Conclusion: Age, literacy levels and English proficiency are some of the highest predictors of digital health access. This is important because remote areas rely on digital health access due to less developed health infrastructure, including specialist services. Guide for Policy makers to focus on the populations most in need.

Keywords: digital health literacy, eHealth literacy, culturally and linguistically diverse, ethnic minorities, regional areas, rural and remote areas

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Authors: Tessa Verhallen, Mama Africa

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

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

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Authors: Marybec Griffin

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Purpose: The purpose of this cross-sectional study was to get a better understanding of healthcare usage and satisfaction among young adult gay men (YAGM), including the facility used as the usual source of healthcare, preference for coordinated healthcare, and if their primary care provider (PCP) adequately addressed the health needs of gay men. Methods: Interviews were conducted among n=800 YAGM in New York City (NYC). Participants were surveyed about their sociodemographic characteristics and healthcare usage and satisfaction access using multivariable logistic regression models. The surveys were conducted between November 2015 and June 2016. Results: The mean age of the sample was 24.22 years old (SD=4.26). The racial and ethnic background of the participants is as follows: 35.8% (n=286) Black Non-Hispanic, 31.9% (n=225) Hispanic/Latino, 20.5% (n=164) White Non-Hispanic, 4.4% (n=35) Asian/Pacific Islander, and 6.9% (n=55) reporting some other racial or ethnic background. 31.1% (n=249) of the sample had an income below $14,999. 86.7% (n=694) report having either public or private health insurance. For usual source of healthcare, 44.6% (n=357) of the sample reported a private doctor’s office, 16.3% (n=130) reported a community health center, and 7.4% (n=59) reported an urgent care facility, and 7.6% (n=61) reported not having a usual source of healthcare. 56.4% (n=451) of the sample indicated a preference for coordinated healthcare. 54% (n=334) of the sample were very satisfied with their healthcare. Findings from multivariable logistical regression models indicate that participants with higher incomes (AOR=0.54, 95% CI 0.36-0.81, p < 0.01) and participants with a PCP (AOR=0.12, 95% CI 0.07-0.20, p < 0.001) were less likely to use a walk-in facility as their usual source of healthcare. Results from the second multivariable logistic regression model indicated that participants who experienced discrimination in a healthcare setting were less likely to prefer coordinated healthcare (AOR=0.63, 95% CI 0.42-0.96, p < 0.05). In the final multivariable logistic model, results indicated that participants who had disclosed their sexual orientation to their PCP (AOR=2.57, 95% CI 1.25-5.21, p < 0.01) and were comfortable discussing their sexual activity with their PCP (AOR=8.04, 95% CI 4.76-13.58, p < 0.001) were more likely to agree that their PCP adequately addressed the healthcare needs of gay men. Conclusion: Understanding healthcare usage and satisfaction among YAGM is necessary as the healthcare landscape changes, especially given the relatively recent addition of urgent care facilities. The type of healthcare facility used as a usual source of care influences the ability to seek comprehensive and coordinated healthcare services. While coordinated primary and sexual healthcare may be ideal, individual preference for this coordination among YAGM is desired but may be limited due to experiences of discrimination in primary care settings.

Keywords: healthcare policy, gay men, healthcare access, Affordable Care Act

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Authors: Bedilu A. Ejigu, Eshetu Wencheko, Kiros Berhane

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Anaemia is a condition in which the haemoglobin concentration falls below an established cut-off value due to a decrease in the number and size of red blood cells. The current study aimed to assess the spatial pattern and identify predictors related to anaemia using the third Ethiopian demographic health survey which was conducted in 2010. To achieve this objective, this study took into account the clustered nature of the data. As a result, multilevel modeling has been used in the statistical analysis. For analysis purpose, only complete cases from 15,909 females, and 13,903 males were considered. Among all subjects who agreed for haemoglobin test, 5.49 %males, and 19.86% females were anaemic. In both binary and ordinal outcome modeling approaches, educational level, age, wealth index, BMI and HIV status were identified to be significant predictors for anaemia prevalence. Furthermore, it was noted that pregnant women were more anaemic than non-pregnant women. As revealed by Moran's I test, significant spatial autocorrelation was noted across clusters. The risk of anaemia was found to vary across different regions, and higher prevalence was observed in Somali and Affar region.

Keywords: anaemia, Moran's I test, multilevel models, spatial pattern

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Authors: Gianne Bianca P. Manalo, Ernesto A. Martin, Vanessa V. Velasco

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The laying performance, egg quality, egg classification, and income over feed cost of Improved Philippine Mallard duck (Itik Pinas) were examined as influenced by garlic powder in drinking water. A total of 48 ducks (42 females and 6 males) were used in the study. The ducks were allocated into two treatments - with garlic powder (GP) and without garlic powder (control) in drinking water. Each treatment had three replicates with eight ducks (7 females and 1 male) per replication. The results showed that there was a significant (P = 0.03) difference in average egg weight where higher values were attained by ducks with GP (77.67 g ± 0.64) than the control (75.64 g ± 0.43). The supplementation of garlic powder in drinking water, however, did not affect the egg production, feed intake, FCR, egg mass, livability, egg quality and egg classification. The Itik Pinas with GP in drinking water had numerically higher income over feed cost than those without. GP in drinking water can be considered in raising Itik Pinas. Further studies on increasing level of GP and long feeding duration also merit consideration to substantiate the findings.

Keywords: phytogenic, garlic powder, Itik-Pinas, egg weight, egg production

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Authors: Jonathan Hinton Westover, Maureen S. Andrade, Doug Miller

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Research has been inconclusive in determining if men or women experience more job satisfaction. A global comparison examining extrinsic and intrinsic factors, work relations, and work-life balance determinants found few differences; however, work relations and work-life balance factors were more significant for male than female workers across occupations. The current study uses International Social Survey Program data representing 37 countries to explore gender differences in job satisfaction in the hospitality industry. Findings demonstrate that mean job satisfaction scores for females are lower across hospitality occupations except for hotel receptionists, housekeeping supervisors, and hotel cleaners. Regression results revealed additional differences such as the significance of co-worker relations, the negative impact of being discriminated against and harassed at work, working weekends, marital status, and supervisory status for women with autonomy, work stress, education, and employment relationship being more salient for men. Interesting work, work being useful to society, job security, pay, relations with management, and work interfering with family were significant for both males and females.

Keywords: job satisfaction, gender, hospitality, global comparisons

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Authors: Bagweneza Vedaste, Rugema Joselyne, Twagirayezu Innocent, Nikuze Bellancille, Nyirazigama Alice, Ishimwe Bazakare Marie Laetitia, Kaberuka Gerard, Mukeshimana Madeleine

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Background: Teen pregnancies have dramatically increased across the country in the past few years. Teen mothers usually face difficulties accessing the reproductive health (RH) services due to different reasons that include fear of getting discriminated or seen by other people. Some teen mothers do not also know their rights regarding the RH services, and they sometimes get discriminated. Little is known in Rwanda regarding how these teen mothers access the RH services compared to the general population, and views of teen mothers on their rights to access these services have not been clearly documented in the country. Specific Aims: To explore baseline information about SRH services among teen mothers; to explore factors that contribute to the use of SRH services among teen mothers; to identify strategies to increase awareness on SRHR (Sexual and Reproductive Health and Rights) among teen mothers in targeted area; and to explore views of teen mothers on rights for SRH services. Research design/Methodology: The qualitative exploratory descriptive research will be used among the teen mothers in five selected health centers of Rwamagana district. The study will use the qualitative descriptive study design. Setting: The study will be conducted in five selected health centers of Rwamagana district, which has been chosen due to a higher number of adolescent pregnancies in Eastern Province according to the DHS 2019-2020. Participants: The participants in this study will be teenage mothers who conceived after turning 11 but have delivered before turning 19. As the upper age for teenage is 19 years, this means that the researchers anticipated that those conceiving at 19 years may deliver in their twenties, which was the upper age limit in this study. Data collection measures: A semi-structured interview guide will be used to gather information from the respondents in focus group discussions. Significance: The findings of this study will provide a picture regarding the access of teen mothers to SRHS and their rights to SRH services. They will increase their awareness regarding SRH services and rights. Finally, the findings may help to address barriers faced by teen mothers to reach, pay and utilize SRHS.

Keywords: sexual and reproductive health services, inclusiveness, qualitative study, adolescent mothers

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Authors: Jocelyne Uwibambe, Ange Thaina Ndizeye, Dinah Ishimwe, Emmanuel Mugabo Byakagaba

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Background: In low- and middle-income countries (LMICs), the use of modern contraceptive methods among women, including adolescents, is still low despite the desire to avoid pregnancy. In addition, countries have set a minimum age for marriage, which is 21 years for most countries, including Rwanda. The Rwandan culture, to a certain extent, and religion, to a greater extent, however, limit the freedom of young women to use contraceptive services because it is wrongly perceived as an encouragement for premarital sexual intercourse. In the end, what doesn’t change is that denying access to contraceptives to either male or female adolescents does not translate into preventing them from sexual activities, hence leading to an ever-increasing number of unwanted pregnancies, possible STIs, HIV, Human Papilloma Virus, and subsequent unsafe abortion followed by avoidable expensive complications. The purpose of this study is to evaluate the perception of healthcare providers regarding contraceptive use among adolescents. Methodology: This was a qualitative study. Interviews were done with different healthcare providers, including doctors, nurses, midwives, and pharmacists, through focused group discussions and in-depth interviews, then the audio was transcribed, translated and thematic coding was done. Results: This study explored the perceptions of healthcare workers regarding the provision of modern contraception to adolescents in Rwanda. The findings revealed that while healthcare providers had a good understanding of family planning and contraception, they were hesitant to provide contraception to adolescents. Sociocultural beliefs played a significant role in shaping their attitudes, as many healthcare workers believed that providing contraception to adolescents would encourage promiscuous behavior and go against cultural norms. Religious beliefs also influenced their reluctance, with some healthcare providers considering premarital sex and contraception as sinful. Lack of knowledge among parents and adolescents themselves was identified as a contributing factor to unwanted pregnancies, as inaccurate information from peers and social media influenced risky sexual behavior. Conditional policies, such as the requirement for parental consent, further hindered adolescents' access to contraception. The study suggested several solutions, including comprehensive sexual and reproductive health education, involving multiple stakeholders, ensuring easy access to contraception, and involving adolescents in policymaking. Overall, this research highlights the need for addressing sociocultural beliefs, improving healthcare providers' knowledge, and revisiting policies to ensure adolescents' reproductive health rights are met in Rwanda. Conclusion: The study highlights the importance of enhancing healthcare provider training, expanding access to modern contraception, implementing community-based interventions, and strengthening policy and programmatic support for adolescent contraception. Addressing these challenges is crucial for improving the provision of family planning services to adolescents in Rwanda and achieving the Sustainable Development Goals related to sexual and reproductive health. Collaborative efforts involving various stakeholders and organizations can contribute to overcoming these barriers and promoting the well-being of adolescents in Rwanda.

Keywords: adolescent, health care providers, contraception, reproductive health

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Authors: Mohammad Jalali Varnamkhasti

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The genetic algorithms have been very successful in handling difficult optimization problems. The fundamental problem in genetic algorithms is premature convergence. This paper, present a new fuzzy genetic algorithm based on chaotic values instead of the random values in genetic algorithm processes. In this algorithm, for initial population is used chaotic sequences and then a new sexual selection proposed for selection mechanism. In this technique, the population is divided such that the male and female would be selected in an alternate way. The layout of the male and female chromosomes in each generation is different. A female chromosome is selected by tournament selection size from the female group. Then, the male chromosome is selected, in order of preference based on the maximum Hamming distance between the male chromosome and the female chromosome or The highest fitness value of male chromosome (if more than one male chromosome is having the maximum Hamming distance existed), or Random selection. The selections of crossover and mutation operators are achieved by running the fuzzy logic controllers, the crossover and mutation probabilities are varied on the basis of the phenotype and genotype characteristics of the chromosome population. Computational experiments are conducted on the proposed techniques and the results are compared with some other operators, heuristic and local search algorithms commonly used for solving p-median problems published in the literature.

Keywords: genetic algorithm, fuzzy system, chaos, sexual selection

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