Search results for: older entrepreneur
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 861

Search results for: older entrepreneur

321 Hidden Populations and Women: New Political, Methodological and Ethical Challenges

Authors: Renée Fregosi

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The contribution presently proposed will report on the beginnings of a Franco-Chilean study to be launched in 2015 by a multidisciplinary team of Renée Fregosi Political Science University Paris 3 / CECIEC, Norma Muñoz Public Policies University of Santiago of Chile, Jean-Daniel Lelievre, Medicine Paris 11 University, Marcelo WOLFF Medicine University of Chile, Cecilia Blatrix Political Science University Paris-Tech, Ernesto OTTONE, Political Science University of Chile, Paul DENY Medicine Paris 13 University, Rafael Bugueno Medicine Hospital Urgencia Pública of Santiago, Eduardo CARRASCO Political Science Paris 3 University. The problem of hidden populations challenges some criteria and concepts to re-examine: in particular the concept of target population, sampling methods to "snowball" and the cost-effectiveness criterion that shows the connection of political and scientific fields. Furthermore, if the pattern of homosexual transmission still makes up the highest percentage of the modes of infection with HIV, there is a continuous increase in the number of people infected through heterosexual sex, including women and persons aged 50 years and older. This group can be described as " unknown risk people." Access to these populations is a major challenge and raises methodological, ethical and political issues of prevention, particularly on the issue of screening. This paper proposes an inventory of these types of problems and their articulation, to define a new phase in the prevention against HIV refocused on women.

Keywords: HIV testing, hidden populations, difficult to reach PLWHA, women, unknown risk people

Procedia PDF Downloads 494
320 Men of Congress in Today’s Brazil: Ethnographic Notes on Neoliberal Masculinities in Support of Bolsonaro

Authors: Joao Vicente Pereira Fernandez

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In the context of a democratic crisis, a new wave of authoritarianism prompts domineering male figures to leadership posts worldwide. Although the gendered aspect of this phenomenon has been reasonably documented, recent studies have focused on high-level commanding posts, such as those of president and prime-minister, leaving other positions of political power with limited attention. This natural focus of investigation, however powerful, seems to have restricted our understanding of the phenomenon by precluding a more thorough inquiry of its gendered aspects and its consequences for political representation as a whole. Trying to fill this gap, in recent research, we examined the election results of Jair Bolsonaro’s party for the Legislative Branch in 2018. We found that the party's proportion of non-male representatives was on average, showing it provided reasonable access of women to the legislature in a comparative perspective. However, and perhaps more intuitively, we also found that the elected members of Bolsonaro’s party performed very gendered roles, which allowed us to draw the first lines of the representative profiles gathered around the new-right in Brazil. These results unveiled new horizons for further research, addressing topics that range from the role of women for the new-right on Brazilian institutional politics to the relations between these profiles of representatives, their agendas, and political and electoral strategies. This article aims to deepen the understanding of some of these profiles in order to lay the groundwork for the development of the second research agenda mentioned above. More specifically, it focuses on two out of the three profiles that were grasped predominantly, if not entirely, from masculine subjects during our last research, with the objective of portraying the masculinity standards mobilized and promoted by them. These profiles –the entrepreneur and the army man – were chosen to be developed due to their proximity to both liberal and authoritarian views, and, moreover, because they can possibly represent two facets of the new-right that were integrated in a certain way around Bolsonaro in 2018, but that can be reworked in the future. After a brief introduction of the literature on masculinity and politics in times of democratic crisis, we succinctly present the relevant results of our previous research and then describe these two profiles and their masculinities in detail. We adopt a combination of ethnography and discourse analysis, methods that allow us to make sense of the data we collected on our previous research as well as of the data gathered for this article: social media posts and interactions between the elected members that inspired these profiles and their supporters. Finally, we discuss our results, presenting our main argument on how these descriptions provide a further understanding of the gendered aspect of liberal authoritarianism, from where to better apprehend its political implications in Brazil.

Keywords: Brazilian politics, gendered politics, masculinities, new-right

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319 Experiencing Scarred Body among Thai Women Living with Breast Cancer

Authors: Dusanee Suwankhong, Pranee Liamputtong

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Breast surgery leaves undesirable scars to all women who experienced mastectomy, despite the fact that this could be a principle approach to save one life. This paper explores how Thai women living with breast cancer perceived and experienced a scarred body after breast surgery. In-depth interviews and drawing methods were employed among 20 women diagnosed with breast cancer. The interviewed data were analysed using thematic analysis method. The results showed that all women with breast cancer who underwent breast surgery perceived and experienced scar as a persisting and visible side-effect. This disfigurement appearance presented a negative image of feminine identity and led to emotional burdens among women. They responded to being scarred in different ways relating to their perceptions of body and changes. The older group had less embarrassed feelings towards being scarred comparing to the younger one. All women tried to seek means to cope with such physical impairment and keep balance life related to their condition. For example, they relied on Buddhism practice and tried to heal the keloid using natural products. Scars appeared to be an unpleasant effect for women who underwent breast mastectomy. Nurses and health care professionals in the local health service sectors need to pay close attention to how the women see the scarred body and their experiences of living with the distorted feminine appearance, and to provide sensitive support that meets the needs of these vulnerable women. The suitable supports can reduce the sense of embarrassment and increase their sense of self-confidence about their social femininity.

Keywords: breast surgery, emotional response, qualitative study, scars, Thai women

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318 Inequality of Opportunities in the Health of the Adult Population of Russia

Authors: Marina Kartseva, Polina Kuznetsova

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In our work, we estimate the contribution of inequality of opportunity to inequality in the health of the Russian population aged 25 to 74 years. The empirical basis of the study is the nationally representative data of the RLMS for 2018. Individual health is measured using a self-reported status on five-point scale. The startconditions are characterized by parental education and place of birth (country, type of settlement). Personal efforts to maintain health include the level of education, smoking status, and physical activity. To understand how start opportunities affect an individual's health, we use the methodology proposed in (Trannoy et al., 2010), which takes into account both direct and indirect (through the influence on efforts) effects. Regression analysis shows that all other things being equal, the starting capabilities of individuals have a significant impact on their health. In particular, parental education has a positive effect on self-reported health. Birth in another country, in another settlement, and in an urban area, on the contrary, reduceself-reported health. This allows to conclude that there exists an unfair inequality in health, namely inequality caused by factors that are independent of a person's own efforts. We estimate the contribution of inequality of opportunity to inequality in health using a nonparametric approach (Checchi, Peragine, 2010; Lazar, 2013). According to the obtained results, the contribution of unfair inequality as 72-74% for the population as a whole, being slightly higher for women (62-74% and 60-69% for men and women, respectively) and for older age (59- 62% and 67-75% for groups 25-44 years old and 45-74 years old, respectively). The obtained estimates are comparable with the results for other countries and indicate the importance of the problem of inequality of opportunities in health in Russia.

Keywords: inequality of opportunity, inequality in health, self-reported health, efforts, health-related lifestyle, Russia, RLMS

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317 The Patterns and Levels of Physical Activity and Sedentary Behavior of Primary School Learners in Eastern Cape Province, South Africa

Authors: Howard Gomwe, Eunice Seekoe, Philemon Lyoka, Chioneso Show Marange, Dennyford Mafa

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Background: This study was designed to assess PA levels and sedentary behavior among primary school learners in the Eastern Cape province of South Africa. Methods: A cross-sectional study was adopted to assess the patterns and levels of PA and sedentary behavior using the Physical Activity Questionnaire for Older Children (PAQ-C). Results: Using complete case analysis, 870 randomly selected participants (boys = 351 and girls = 519) aged 9 to 14 years were retained. The sample comprised of primary school learners, both boys and girls; aged 9-14 years old, who were randomly selected from rural, urban and peri-urban areas in the Eastern Cape Province of South Africa. Overly, the sample had a mean PAQ-C score of 2.33 ± 0.43. The mean of PA in boys was significantly higher (p = 0.003) in comparison with the girls. The 13 to 14 age group had a significantly higher PA level (p = 0.014). Learners from urban areas (n = 136; 77.3%) engaged more in sedentary behaviour as compared to those from rural areas (n = 252; 54.9%). Conclusion: The findings demonstrated low levels of PA and high engagement of sedentary behavior, which have negative implications on the health, growth and development of children. The study, therefore, recommends relevant stakeholders to implement interventions aimed to promote the increase in PA and reduction in sedentary behaviors for primary school learners in the Eastern Cape province in South Africa.

Keywords: learners, physical activity, sedentary behavior, south Africa

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316 Physical and Physiological Characteristics of Young Soccer Players in Republic of Macedonia

Authors: Sanja Manchevska, Vaska Antevska, Lidija Todorovska, Beti Dejanova, Sunchica Petrovska, Ivanka Karagjozova, Elizabeta Sivevska, Jasmina Pluncevic Gligoroska

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Introduction: A number of positive effects on the player’s physical status, including the body mass components are attributed to training process. As young soccer players grow up qualitative and quantitative changes appear and contribute to better performance. Player’s anthropometric and physiologic characteristics are recognized as important determinants of performance. Material: A sample of 52 soccer players with an age span from 9 to 14 years were divided in two groups differentiated by age. The younger group consisted of 25 boys under 11 years (mean age 10.2) and second group consisted of 27 boys with mean age 12.64. Method: The set of basic anthropometric parameters was analyzed: height, weight, BMI (Body Mass Index) and body mass components. Maximal oxygen uptake was tested using the treadmill protocol by Brus. Results: The group aged under 11 years showed the following anthropometric and physiological features: average height= 143.39cm, average weight= 44.27 kg; BMI= 18.77; Err = 5.04; Hb= 13.78 g/l; VO2=37.72 mlO2/kg. Average values of analyzed parameters were as follows: height was 163.7 cm; weight= 56.3 kg; BMI = 19.6; VO2= 39.52 ml/kg; Err=5.01; Hb=14.3g/l for the participants aged 12 to14 years. Conclusion: Physiological parameters (maximal oxygen uptake, erythrocytes and Hb) were insignificantly higher in the older group compared to the younger group. There were no statistically significant differences between analyzed anthropometric parameters among the two groups except for the basic measurements (height and weight).

Keywords: body composition, young soccer players, BMI, physical status

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315 The Effect of Potassium Hydroxide on Fine Soil Treated with Olivine

Authors: Abdelmaoula Mahamoud Tahir, Sedat Sert

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The possibility of improving the shear strength of unsaturated clayey soil with the addition of olivine was investigated in this paper. Unconsolidated undrained triaxial tests (UU), under different cell pressures (namely: 100 kPa and 200 kPa), with varying percentages of olivine (10% and 20% by weight) and with one day, 28 days, and 56 days curing times, were performed to determine the shear strength of the soil. The increase in strength was observed as a function of the increase in olivine content. An olivine content of 25% was determined as the optimum value to achieve the targeted improvement for both cure times. A comparative study was also conducted between clay samples treated with only olivine and others in the presence of potassium hydroxide (KOH). Clay samples treated with olivine and activated with potassium hydroxide (KOH) had higher shear strength than non-activated olivine-treated samples. It was determined that the strength of the clay samples treated with only olivine did not increase over time and added resistance only with the high specific gravity of olivine. On the other hand, the samples activated with potassium hydroxide (KOH) added to the resistance with high specific gravity and the chemical bonds of olivine. Morphological and mineralogical analyzes were carried out in this study to see and analyze the chemical bonds formed after the reaction. The main components of this improvement were the formation of magnesium-aluminate-hydrate and magnesium-silicate-hydrate. Compared to older methods such as cement addition, these results show that in stabilizing clayey soils, olivine additive offers an energy-efficient alternative for reducing carbon dioxide emissions.

Keywords: ground stabilization, clay, olivine additive, KOH, microstructure

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314 The Use of Complementary and Alternative Medicine for Pain Relief in the Elderly: An Investigational Analysis of Seniors Residing in an Independent/Assisted Seniors’ Living Facility

Authors: Carol Cameletti

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The goal of this study was to perform a pilot survey to assess pain frequency and intensity in an elderly population and to assess treatment options for chronic pain that include complementary and alternative medicines (CAM). Ten participants were recruited from an independent and supportive living housing facility in Northern Ontario and asked to complete two questionnaires: 1) a self-assessment on pain, and 2) the use of CAM for pain. Results from our study show that 80% of the participants experienced pains other than the regular everyday pains such as minor headaches, sprains or toothaches. Although participants stated that on average the highest level of pain they experienced within the past 24 hours had a score of 6.5 (0=no pain, 10=worst pain imaginable) the level of pain they experienced moderately interfered with their daily activities. Unfortunately, participants stated that they were only able to attain minimal levels of pain relief using treatments or medications causing some of the participants to seek alternative therapies or self-help practices. The most commonly used CAMs were vitamins/minerals, herbs and supplements, and self-help practices such as meditation, prayer, visualization and relaxation techniques. Although some of the participants stated that they had received complementary treatments directly from their physician, four of the nine participants said that they had not disclosed CAM use to their physician thereby indicating a need to open the lines of communication between healthcare providers and patients with regards to CAM use. It is our hope that the data generated from this study will serve as the platform for a pain management clinic that is client-centered, consumer-driven and truly integrative and tailored in order to meet the unique needs of older adults in Great Sudbury, Ontario.

Keywords: alternative, complementary, elderly, medicine

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313 Unstructured Learning: Development of Free Form Construction in Waldorf and Normative Preschools

Authors: Salam Kodsi

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In this research, we sought to focus on constructive play and examine its components in the context of two different educational approaches: Waldorf and normative schools. When they are free to choose, construction is one of the forms of play most favored by children. Its short-term and long-term cognitive contributions are apparent in various areas of development. The lack of empirical studies about play in Waldorf schools, which addresses the possibility of this incidental learning inspired the need to enrich the body of existing knowledge. 90 children (4-6 yrs.old) four preschools ( two normative, two Waldorf) participated in a small homogeneous city. Naturalistic observations documented the time frame, physical space, and construction materials related to the freeform building; processes of construction among focal representative children and its products. The study’s main finding with respect to the construction output points to a connection between educational approach and level of construction sophistication. Higher levels of sophistication were found at the Waldorf preschools than at the mainstream preschools. This finding emerged due to the differences in the level of sophistication among the older children in the two types of preschools, while practically no differences emerged among the younger children. Discussion of the research findings considered the differences between the play environments in terms of time, physical space, and construction materials. The construction processes were characterized according to the design model stages. The construction output was characterized according to the sophistication scale dimensions and the connections between approach, age and gender, and sophistication level.

Keywords: constructive play, preschool, design process model, complexity

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312 Perceived and Performed E-Health Literacy: Survey and Simulated Performance Test

Authors: Efrat Neter, Esther Brainin, Orna Baron-Epel

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Background: Connecting end-users to newly developed ICT technologies and channeling patients to new products requires an assessment of compatibility. End user’s assessment is conveyed in the concept of eHealth literacy. The study examined the association between perceived and performed eHealth literacy (EHL) in a heterogeneous age sample in Israel. Methods: Participants included 100 Israeli adults (mean age 43,SD 13.9) who were first phone interviewed and then tested on a computer simulation of health-related Internet tasks. Performed, perceived and evaluated EHL were assessed. Levels of successful completion of tasks represented EHL performance and evaluated EHL included observed motivation, confidence, and amount of help provided. Results: The skills of accessing, understanding, appraising, applying, and generating new information had a decreasing successful completion rate with increase in complexity of the task. Generating new information, though highly correlated with all other skills, was least correlated with the other skills. Perceived and performed EHL were correlated (r=.40, P=.001), while facets of performance (i.e, digital literacy and EHL) were highly correlated (r=.89, P<.001). Participants low and high in performed EHL were significantly different: low performers were older, had attained less education, used the Internet for less time and perceived themselves as less healthy. They also encountered more difficulties, required more assistance, were less confident in their conduct and exhibited less motivation than high performers. Conclusions: The association in this age-hetrogenous ample was larger than in previous age-homogenous samples. The moderate association between perceived and performed EHL indicates that the two are associated yet distinct, the latter requiring separate assessment. Features of future rapid performed EHL tools are discussed.

Keywords: eHealth, health literacy, performance, simulation

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311 Age-Stereotypes of Emerging Adults within the South African Work Environment

Authors: Bronwyn Bell, Lizelle Brink

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Workplaces of today are populated by employees from different generations; emerging adults being the most recent demographic group entering the workplace. These individuals form part of Generation Y and are between the ages of 18 to 25. Emerging adults bring unique and different characteristics to the workplace. These individuals also differ from other generations with regards to their employment desires and ways of working. Age-stereotypes of emerging adults is, therefore, a common occurrence within workplaces. The general objective of the study was therefore to explore age-related stereotypes experienced regarding emerging adults within the South African work context and to determine the influences thereof. A qualitative research design from the social constructivism paradigm was employed in order to reach the objectives of this research study. A phenomenological approach using a combination of purposive and snowball sampling was employed within this study. A sample of 25 employees (N = 25) from various South African organisations were interviewed for the purpose of this study and formed part of three generations namely Generation Y, Generation X and Baby Boomers. In order to analyse the collected data, the steps of thematic analysis were used. The main findings of this study indicated that emerging adults experience various positive and negative stereotypes within the workplace. Results further indicated that these stereotypes influence emerging adults in a behavioural, cognitive and emotional manner. These stereotypes also influence the way emerging adults are treated by older employees within the workplace. Recommendations based on the results of this study were made for future research and practice. This study creates awareness within organisations regarding age-stereotypes of emerging adults. By being aware, employees can manage the influences thereof within the workplace.

Keywords: age-stereotypes, baby boomers, emerging adults, generation x, generation y, South African work environment, stereotypes

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310 Nasopharyngeal Carriage of Streptococcus pneumoniae in Children under 5 Years of Age before Introduction of Pneumococcal Vaccine (PCV 10) in Urban and Rural Sindh

Authors: Muhammad Imran Nisar, Fyezah Jehan, Tauseef Akhund, Sadia Shakoor, Kanwal Nayani, Furqan Kabir, Asad Ali, Anita Zaidi

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Pneumococcal Vaccine -10 (PCV 10) was included in the Expanded Program of immunization (EPI) in Sindh, Pakistan in February 2013. This study was carried out immediately before the introduction of PCV 10 to establish baseline pneumococcal carriage and prevalent serotypes in naso-pharynx of children 3-11 months of age in an urban and rural community in Sindh, Pakistan. An additional sample of children aged 12 to 59 months was drawn from the urban community. Nasopharyngeal specimens were collected from a random sample of children. Samples were processed in a central laboratory in Karachi. Pneumococci were cultured on 5% Sheep Blood Agar and serotyping was performed using CDC standardized sequential multiplex PCR assay on bacterial colonies. Serotypes were then categorized into vaccine (PCV-10 and PCV-13) type and non-vaccine types. A total of 670 children were enrolled. Carriage rate for pneumococcus based on culture positivity was 74% and 79.5 % in the infant group in Karachi and Matiari respectively. Carriage rate was 78.2% for children aged 12 to 59 months in Karachi. Proportion of PCV 10 serotypes in infants was 38.8% and 33.5% in Karachi and Matiari respectively. In the older age group in Karachi, the proportion was 30.6%. Most common serotypes were 6A, 6B, 23F, 19A and 18C. This survey establishes vaccine and non-vaccine serotype carriage rate in a vaccine-naïve pediatric population among rural and urban communities in Sindh province. Annually planned surveys in the same communities will inform change in carriage rate after the introduction and uptake of PCV 10 in these communities.

Keywords: Naso-Pharyngeal carriage, Pakistan, PCV10, Pneumococcus

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309 Levels of Loneliness and Quality of Life Among Retirees in Kuwait: Implication to Practice

Authors: Hamad Alhamad

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Introduction: The number of retirees in Kuwait is rising quickly, and this is causing more people to become concerned about their well-being. Despite the fact that loneliness and quality of life are significant indices of retiree wellbeing, little research has been done on the topic among retirees in Kuwait. The aim of this study is to explore the level of loneliness and quality of life among retirees in Kuwait. Methods: This is a a cross-sectional descriptive research targeting retirees who live in Kuwait. The UCLA loneliness scale (version 3) and the 36-Item Short Form Survey (36- SF) were utilized. Data was analyzed using SPSS. The ethical approval was obtained from Kuwait University and the Ministry of Health (286). Results: Total respondents in this research were 202 (N=202). The results indicate 77.7% (N=157) experience moderate level of loneliness, 19.8% (N=40) experience high level of loneliness, and only 205% (N=5) experience low level of loneliness. The results of the SF-36 health related questionnaire, participants scores in the eight domains: Physical functioning, general health, role limitations due to physical and emotional health, energy, social functioning, pain, and emotional wellbeing , scored low means. The average of the means was calculated and was (49.8), which indicated that all participants have moderately low Quality of life. Significant relationship with p value equal to ( p= 0.004), was found between a sociodemographic characteristic and level of loneliness in which retirees who were married indicated higher levels of loneliness compared to the single, divorced, and widowed retirees. Conclusion: The study revealed retirees in Kuwait feel moderate loneliness and have a low Quality of Time. The study indicates that retirees should be more considered emotionally and improved and help explore the negative effects on their quality of time In addition to exploring the leading factors to the feeling of loneliness.

Keywords: older adults, social isolation, work, retirement

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308 The Adoption and Use of Social Media as a Source of Information by Egyptian Government Journalists

Authors: Essam Mansour

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This study purposes to explore the adoption and use of social media as a source of information by Egyptian government journalists. It applied a survey with a total of 386 journalists representing the three official newspapers of Egypt. Findings showed that 27.2% of journalists were found to not use social media, mainly males (69.7%), older than 40 years (77.7%) and mostly with a BA degree (80.4%). On the other hand, 72.8% of them were found to use these platforms who were also males (59.1%), younger than 40 years (65.9%) and mostly with a BA degree (93.2%). More than two-thirds (69.9%) were somewhat old users whose experience ranged from seven to ten years, and more than two-thirds (73.5%) have been heavily using these platforms (four to more than six hours a day. Such results confirm that a large number (95.7%) of users were found to be at least advanced users. Social media users’ home and work were the most significant places to access these platforms, which were found to be easy and useful to use. Most types of social media used were social news, media sharing and micro blogging, blogs comments and forums, social networking sites and bookmarking sites to perform tasks, such as finding information, making communication, keeping up to date, checking materials, sharing information and making discussions. A large number of users tend to accept these media platforms to be a source of information since they are accessible, linked references updated sources, accurate, promote current work, convenient, secured, credible, reliable, stabled, easily identified, copyrighted, build confident and contain filtered information. However, lack of know-how to cite sources, followed by lack of credibility of the source of news, lack of quality of information sources and lack of time were at least significant to journalists when using social media platforms.

Keywords: social media, social networking sites, newspapers, journalists, Egypt

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307 Cigarette Smoking and Alcohol Use among Mauritian Adolescents: Analysis of 2017 WHO Global School-Based Student Health Survey

Authors: Iyanujesu Adereti, Tajudeen Basiru, Ayodamola Olanipekun

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Background: Substance abuse among adolescents is of public health concern globally. Despite being the most abused by adolescents, there are limited studies on the prevalence of alcohol use and cigarette smoking among adolescents in Mauritius. Objectives: To determine the prevalence of cigarette smoking, alcohol use and associated correlates among school-going adolescents in Mauritius. Methodology: Data obtained from 2017 WHO Global School-based Student Health Survey (GSHS) survey of 3,012 school-going adolescents in Mauritius was analyzed using STATA. Descriptive statistics were used to obtain prevalence. Bivariate and multivariate logistic regression analysis was used to evaluate predictors of cigarette smoking and alcohol use. Results: Prevalence of alcohol consumption and cigarette smoking were 26.0% and 17.1%, respectively. Smoking and alcohol use was more prevalent among males, younger adolescents, and those in higher school grades (p-value <.000). In multivariable logistic regression, male gender was associated with a higher risk of cigarette smoking (adjusted Odds Ratio (aOR) [95%Confidence Interval (CI)]= 1.51[1.06-2.14]) but lower risk of alcohol use (aOR[95%CI]= 0.69[0.53-0.90]) while older age (mid and late adolescence) and parental smoking were found to be associated with increased risk of alcohol use (aOR[95%CI]= 1.94[1.34-2.99] and 1.36[1.05-1.78] respectively). Marijuana use, truancy, being in a fight and suicide ideation were associated with increased odds of alcohol use (aOR[95%CI]= 3.82[3.39-6.09]; 2.15[1.62-2.87]; 1.83[1.34-2.49] and 1.93[1.38-2.69] respectively) and cigarette smoking (aOR[95%CI]= 17.28[10.4 - 28.51]; 1.73[1.21-2. 49]; 1.67[1.14-2.45] and 2.17[1.43-3.28] respectively) while involvement in sexual activity was associated with reduced risk of alcohol use (aOR[95%CI]= 0.50[0.37-0.68]) and cigarette smoking (aOR[95%CI]= 0.47[0.33-0.69]). Parental support and parental monitoring were uniquely associated with lower risk of cigarette smoking (aOR[95%CI]= 0.69[0.47-0.99] and 0.62[0.43-0.91] respectively). Conclusion: The high prevalence of alcohol use and cigarette smoking in this study shows the need for the government of Mauritius to enhance policies that will help address this issue putting into accounts the various risk and protective factors.

Keywords: adolescent health, alcohol use, cigarette smoking, global school-based student health survey

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306 Callous-Unemotional Traits in Preschoolers: Distinct Associations with Empathy Subcomponents

Authors: E. Stylianopoulou, A. K. Fanti

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Object: Children scoring high on Callous-Unemotional traits (CU traits) exhibit lack of empathy. More specifically, children scoring high on CU traits appear to exhibit deficits on affective empathy or deficits in other constructs. However, little is known about cognitive empathy, and it's relation with CU traits in preschoolers. Despite the fact that empathy is measurable at a very young age, relatively less study has focused on empathy in preschoolers than older children with CU traits. The present study examines the cognitive and affective empathy in preschoolers with CU traits. The aim was to examine the differences between cognitive and affective empathy in those individuals. Based on previous research in children with CU traits, it was hypothesized that preschoolers scoring high in CU traits will show deficits in both cognitive and affective empathy; however, more deficits will be detected in affective empathy rather than cognitive empathy. Method: The sample size was 209 children, of which 109 were male, and 100 were female between the ages of 3 and 7 (M=4.73, SD=0.71). From those participants, only 175 completed all the items. The Inventory of Callous-Unemotional traits was used to measure CU traits. Moreover, the Griffith Empathy Measure (GEM) Affective Scale and the Griffith Empathy Measure (GEM) Cognitive Scale was used to measure Affective and Cognitive empathy, respectively. Results: Linear Regression was applied to examine the preceding hypotheses. The results showed that generally, there was a moderate negative association between CU traits and empathy, which was significant. More specifically, it has been found that there was a significant and negative moderate relation between CU traits and cognitive empathy. Surprisingly, results indicated that there was no significant relation between CU traits and affective empathy. Conclusion: The current findings support that preschoolers show deficits in understanding others emotions, indicating a significant association between CU traits and cognitive empathy. However, such a relation was not found between CU traits and affective empathy. The current results raised the importance that there is a need for focusing more on cognitive empathy in preschoolers with CU traits, a component that seems to be underestimated till now.

Keywords: affective empathy, callous-unemotional traits, cognitive empathy, preschoolers

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305 Relationship and Associated Factors of Breastfeeding Self-efficacy among Postpartum Couples in Malawi: A Cross-sectional Study

Authors: Roselyn Chipojola, Shu-yu Kuo

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Background: Breastfeeding self-efficacy in both mothers and fathers play a crucial role in improving exclusive breastfeeding rates. However, less is known on the relationship and predictors of paternal and maternal breastfeeding self-efficacy. This study aimed to examine the relationship and associated factors of breastfeeding self-efficacy (BSE) among mothers and fathers in Malawi. Methods: A cross-sectional study was conducted on 180 pairs of postpartum mothers and fathers at a tertiary maternity facility in central Malawi. BSE was measured using the Breastfeeding Self-Efficacy Scale Short-Form. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale. A structured questionnaire was used to collect demographic and health variables. Data were analyzed using multivariable logistic regression and multinomial logistic regression. Results: A higher score of self-efficacy was found in mothers (mean=55.7, Standard Deviation (SD) =6.5) compared to fathers (mean=50.2, SD=11.9). A significant association between paternal and maternal breastfeeding self-efficacy was found (r= 0. 32). Age, employment status, mode of birth was significantly related to maternal and paternal BSE, respectively. Older age and caesarean section delivery were significant factors of combined BSE scores in couples. A higher BSE score in either the mother or her partner predicted higher exclusive breastfeeding rates. BSE scores were lower when couples’ depressive symptoms were high. Conclusion: BSE are highly correlated between Malawian mothers and fathers, with a relatively higher score in maternal BSE. Importantly, a high BSE in couples predicted higher odds of exclusive breastfeeding, which highlights the need to include both mothers and fathers in future breastfeeding promotion strategies.

Keywords: paternal, maternal, exclusive breastfeeding, breastfeeding self‑efficacy, malawi

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304 Influence of Travel Time Reliability on Elderly Drivers Crash Severity

Authors: Ren Moses, Emmanuel Kidando, Eren Ozguven, Yassir Abdelrazig

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Although older drivers (defined as those of age 65 and above) are less involved with speeding, alcohol use as well as night driving, they are more vulnerable to severe crashes. The major contributing factors for severe crashes include frailty and medical complications. Several studies have evaluated the contributing factors on severity of crashes. However, few studies have established the impact of travel time reliability (TTR) on road safety. In particular, the impact of TTR on senior adults who face several challenges including hearing difficulties, decreasing of the processing skills and cognitive problems in driving is not well established. Therefore, this study focuses on determining possible impacts of TTR on the traffic safety with focus on elderly drivers. Historical travel speed data from freeway links in the study area were used to calculate travel time and the associated TTR metrics that is, planning time index, the buffer index, the standard deviation of the travel time and the probability of congestion. Four-year information on crashes occurring on these freeway links was acquired. The binary logit model estimated using the Markov Chain Monte Carlo (MCMC) sampling technique was used to evaluate variables that could be influencing elderly crash severity. Preliminary results of the analysis suggest that TTR is statistically significant in affecting the severity of a crash involving an elderly driver. The result suggests that one unit increase in the probability of congestion reduces the likelihood of the elderly severe crash by nearly 22%. These findings will enhance the understanding of TTR and its impact on the elderly crash severity.

Keywords: highway safety, travel time reliability, elderly drivers, traffic modeling

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303 The Origin and Development of Entrepreneurial Cognition: The Impact of Entrepreneurship Education on Cognitive Style and Subsequent Entrepreneurial Intention

Authors: Salma Hussein, Hadia Aziz

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Entrepreneurship plays a significant and imperative role in economic and social growth, and therefore, is stimulated and encouraged by governments and academics as a mean of creating job opportunities, innovation, and wealth. Indicative of its importance, it is essential to identify factors that encourage and promote entrepreneurial behavior. This is particularly true for developing countries where the need for entrepreneurial development is high and the resources are scarce, thus, there is a need to maximize the outcomes of investing in entrepreneurial development. Entrepreneurial education has been the center of attention and interest among researchers as it is believed to be one of the most critical factors in promoting entrepreneurship over the long run. Accordingly, the urgency to encourage entrepreneurship education and develop an enterprise culture is now a main concern in Egypt. Researchers have postulated that cognition has the potential to make a significant contribution to the study of entrepreneurship. One such contribution that future studies need to consider in entrepreneurship research is the cognitive processes that occur within the individual such as cognitive style. During the past decade, there has been an increasing interest in cognitive style among researchers and practitioners specifically in innovation and entrepreneurship field. Limited studies pay attention to study the antecedent dynamics that fuel entrepreneurial cognition to better understand its role in entrepreneurship. Moreover, while many studies were conducted on entrepreneurship education, scholars are still hesitant regarding the teachability of entrepreneurship due to the lack of clear evidence of its impact. Furthermore, the relation between cognitive style and entrepreneurial intentions, has yet to be discovered. Hence, this research aims to test the impact of entrepreneurship education on cognitive style and subsequent intention in order to evaluate whether student’s and potential entrepreneur’s cognitive styles are affected by entrepreneurial education and in turn affect their intentions. Understanding the impact of Entrepreneurship Education on ways of thinking and intention is critical for the development of effective education and training in entrepreneurship field. It is proposed that students who are exposed to entrepreneurship education programs will have a more balanced thinking style compared to those students who are not exposed. Moreover, it is hypothesized that students having a balanced cognitive style will exhibit higher levels of entrepreneurial intentions than students having an intuitive or analytical cognitive style. Finally, it is proposed that non-formal entrepreneurship education will be more positively associated with entrepreneurial intentions than will formal entrepreneurship education. The proposed methodology is a pre and post Experimental Design. The sample will include young adults, their age range from 18 till 35 years old including both students enrolled in formal entrepreneurship education programs in private universities as well as young adults who are willing to participate in a Non-Formal entrepreneurship education programs in Egypt. Attention is now given on how far individuals are analytical or intuitive in their cognitive style, to what extent it is possible to have a balanced thinking style and whether or not this can be aided by training or education. Therefore, there is an urge need for further research on entrepreneurial cognition in educational contexts.

Keywords: cognitive style, entrepreneurial intention, entrepreneurship education, experimental design

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302 Exploring Sense of Belonging in Toronto: A Multigenerational Perspective and Social Sustainability

Authors: Homa Hedayat

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In the dynamic urban landscape of Toronto, the concept of belonging assumes paramount importance. As global challenges—such as the pandemic, financial instability, and geopolitical shifts—reshape our world, understanding how different generations of immigrants establish connections within this multicultural metropolis becomes increasingly vital. Our research delves into forming a sense of belonging in urban spaces, specifically focusing on the experiences of Iranian immigrants residing in Toronto. By examining their perceptions of public places, attachment to residential neighborhoods, and the impact of the urban environment, we contribute to a more holistic understanding of social sustainability and community well-being. We unravel the intricate interplay between individual characteristics, housing context, and neighborhood dynamics through qualitative interviews and a quantitative survey. This research presents a study of the perception of public places and sense of belonging in residential neighbourhoods by younger and older Iranian immigrants living in the Toronto metropolitan area. Few works in the existing literature have investigated the relationship immigrants develop with the shared spaces of the city and their residential environment and how that relationship can impact the development of a ‘sense of belonging’ in the city. Ultimately, our findings pave the way for inclusive and cohesive urban environments, fostering connections across generations and enhancing Toronto’s resilience and harmony. As Toronto continues to evolve, nurturing a sense of belonging becomes paramount. Our research emphasizes the importance of social cohesion and community well-being. By fostering connections across generations, we pave the way for a more resilient and harmonious city.

Keywords: sense of belonging, multigenerational, urban spaces, social sustainability

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301 Histopathological Spectrum of Skin Lesions in the Elderly: Experience from a Tertiary Hospital in Southeast Nigeria

Authors: Ndukwe, Chinedu O.

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Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in the geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Material and methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1 and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1±9.5 years. In the female patients, it was 70.1±7.5 years. The commonest disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. Commonest was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms and papulosquamous disorders are the three commonest histologically diagnosed skin lesions in our geriatric population. The commonest skin malignancies in this group of patients are squamous cell carcinoma and malignant melanoma.

Keywords: geriatric, skin, Nigeria, histopathology

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300 Cognitive Impairment in Chronic Renal Patients on Hemodialysis

Authors: Fabiana Souza Orlandi, Juliana Gomes Duarte, Gabriela Dutra Gesualdo

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Chronic renal disease (CKD), accompanied by hemodialysis, causes chronic renal failure in a number of situations that compromises not only physical, personal and environmental aspects, but also psychological, social and family aspects. Objective: To verify the level of cognitive impairment of chronic renal patients on hemodialysis. Methodology: This is a descriptive, cross-sectional study. The present study was performed in a Dialysis Center of a city in the interior of the State of São Paulo. The inclusion criteria were: being 18 years or older; have a medical diagnosis of CKD; being in hemodialysis treatment in this unit; and agree to participate in the research, with the signature of the Informed Consent (TCLE). A total of 115 participants were evaluated through the Participant Characterization Instrument and the Addenbrooke Cognitive Exam - Revised Version (ACE-R), being scored from 0 to 100, stipulating the cut-off note for the complete battery <78 and subdivided into five domains: attention and guidance; memory; fluency; language; (66.9%) and caucasian (54.7%), 53.7 (±14.8) years old. Most of the participants were retired (74.7%), with incomplete elementary schooling (36.5%) and the average time of treatment was 46 months. Most of the participants (61.3%) presented impairment in the area of attention and orientation, 80.4% in the spatial visual domain. Regarding the total ACE-R score, 75.7% of the participants presented scores below the established cut grade. Conclusion: There was a high percentage (75.7%) below the cut-off score established for ACE-R, suggesting that there may be some cognitive impairment among these participants, since the instrument only performs a screening on cognitive health. The results of the study are extremely important so that possible interventions can be traced in order to minimize impairment, thus improving the quality of life of chronic renal patients.

Keywords: cognition, chronic renal insufficiency, adult health, dialysis

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299 Cold Tomato Paste as an Alternative Therapy for Elderly Clients with Exacerbation of Arthritis

Authors: Mary Therese G. Caluna, Mark Justin B. Campanero, Erlin Maris T. Cantiller, Claudine Mae A. Cantillo, Nerissa L. Caño

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Objective: The study determined the effectiveness of cold tomato paste in relieving pain caused by exacerbation of arthritis in the elderly, specifically on clients 60 years old and above. The study focused on alternative, cost-effective and non-pharmacological techniques in relieving pain experienced by the older people with osteoarthritis and rheumatoid arthritis. Methods: Using purposive non-probability sampling, the researchers gathered a total number of 40 subjects that passed the inclusion criteria provided by the researchers. The subjects were divided into two groups, experimental group (20 subjects) and control groups (20 subjects). The Numeric Rating 11-point Scale (NRS-11) was utilized to assess the pain level of the subject prior the application of the treatment and after the application of the treatment. Key findings: There is a significant difference in the pain levels of the experimental group before and after the application of cold tomato paste. This indicates that that the application of cold tomato paste alleviates the pain experienced by elderly clients with exacerbation of arthritis. Conclusion: The effectiveness of cold tomato paste in relieving pain experienced by elderly clients who are in exacerbation of arthritis was proven to be evidence-based. The cold tomato paste application has significant impact in the field of nursing and therefore, can be used in both clinical trials and practices. The effectiveness of cold tomato application promotes innovation in the field of nursing, thus encouraging further researches regarding other uses of tomato and other herbal interventions to relieve the pain caused by osteoarthritis and rheumatoid arthritis.

Keywords: alternative therapy, arthritis, cold tomato paste, elderly clients, exacerbation

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298 Clustering for Detection of the Population at Risk of Anticholinergic Medication

Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

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Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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297 The Experiences of First-Generation Afro/Black Caribbean-American Women Navigating Sexual Pleasure and Their Bicultural Identity as a Result of Immigration

Authors: Jessie André

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In the past 10 years, more studies have begun exploring the psychological impact of those who have been subjected to and have adopted two different cultures. Currently, there is no existing literature regarding how individuals with a bicultural identity navigate their often-conflicting cultures on topics such as sexual pleasure and sexual scripts. The purpose of this study was to explore how first-generation Afro/Black Caribbean-American women navigate their multiple cultural identities with regards to sexual pleasure and sexual scripts. This study contains an exploration of participants self-described challenges, attitudes, and beliefs associated to how they navigate and experience their sexuality. This research study uses an explanatory, qualitative method design with semi structured interviews to answer the primary and secondary research question. Research findings indicate that the later the age of immigration, the stronger their ties were to the culture from their country of origin, which affected their self-assessments of sexual desirability and sexual self-esteem. Findings also suggest that even though women who immigrated at a younger age had higher rates of difficulty navigating and identifying with their adopted culture’s sexual mores. These women also reported lower ratings of comfort voicing sexual desires and concerns to their partner and had lower self-ratings of feeling connected to their cultural identity. These participants had challenges utilizing the dual and conflicting sexual mores and rules they received from U.S. society and their country of origin, resulting in less pleasurable sexual experiences. Whereas women who immigrated at an older age reported having more pleasurable sexual experiences.

Keywords: bicultural identity, sexual pleasure, first-generation immigrants, afro/black caribbean-American

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296 Nurse´s Interventions in Patients with Dementia During Clinical Practice: A Literature Review

Authors: Helga Martins, Idália Matias

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Background: Dementia is an important research topic since that life expectancy worldwide is increasing, so people are getting older. The aging of populations has a major impact on the increase in dementia, and nurses play a major role in taking care of these patients. Therefore, the implementation of nursing interventions based on evidence is vital so that we are aware of what we can do in clinical practice in order to provide patient cantered care to patients with dementia. Aim: To identify the nurse´s interventions in patients with dementia during clinical practice. Method: Literature review grounded on an electronic search in the EBSCOhost platform (CINAHL Plus with Full Text, MEDLINE with Full Text, and Nursing & Allied Health Collection), using the search terms of "dementia" AND "nurs*" AND “interventions” in the abstracts. The inclusion criteria were: original papers published up to June 2021. A total of 153 results after de duplicate removal we kept 104. After the application of the inclusion criteria, we included 15 studies This literature review was performed by two independent researchers. Results: A total of 15 results about nurses’ interventions in patients with dementia were included in the study. The major interventions are therapeutic communication strategies, environmental management of stressors involving family/caregivers; strategies to promote patient safety, and assistance in activities of daily living in patients who are clinically deteriorated. Conclusion: Taking care of people with dementia is a complex and demanding task. Nurses are required to have a set of skills and competences in order to provide nursing interventions. We highlight that is necessary an awareness in nursing education regarding providing nursing care to patients with dementia.

Keywords: dementia, interventions, nursing, review

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295 Pharmacodynamic Interaction between Tamsulosin and Finasteride Treatment on Induced Benign Prostate Hyperplasia in Mice by Using Chou-Talalay Method

Authors: Firas Rashad Al-Samarai

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Introduction: Benign prostatic hyperplasia (BPH) is a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract, or kidney problems. Objective: to evaluate the efficacy and interaction of tamsulosin with finasteride treatment on induced benign prostate hyperplasia (BPH) in mice. Methods: BPH was induced by subcutaneous injection of testosterone propionate (20 mg/kg) for 30 days. Eighty-five mice were divided into five groups. The first group (G1): twenty-five mice induced BPH treated with tamsulosin orally and divided into five equal subgroups with doses (0.017, 0.052, 0.087, 0. 123, and 0.158) mg/kg, the second group (G2): twenty-five mice induced BPH treated with finasteride orally and divided into five equal subgroups with doses (0.175, 0.527, 0.878, 1.23, and 1.580) mg/kg. the third group (G3): twenty-five mice induced BPH treated with a combination of tamsulosin with finasteride orally, and divided into five equal subgroups with doses (0.0085, 0.0875), (0.026, 0.2635), (0.0435, 0.439) , (0.0615, 0.615) and ( 0.079 , 0.790 ) mg/kg respectively. Fourth group (G4): five mice induced BPH and treated distilled water. Fifth group (G5): five mice were not inducing BPH and without any treatment. Results: The results showed a gradual significant increase in prostate weight % and prostate index % Inhibitions until reached saturation in the last two doses of tamsulosin, finasteride, and combination groups, the maximum effective dose of tamsulosin and finasteride were (0.156) and (1.495) mg/kg respectively. Moreover, the effective dose of the combination (tamsulosin and finasteride) was estimated (0.06876, 0.6876) mg/kg, respectively, as well as the type of interaction was synergism and the value of the combination index was 0.046. Conclusions: We concluded that the combination of tamsulosin with finasteride showed a synergistic effect in BPH treatment by minimizing the side effect of each drug as s result of decreasing the dose of each one.

Keywords: Tamsulosin, Finasteride, combination, BPH

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294 Exploring Identity of Female British Pakistani Student with Shifting and Re-shifting of Cultures

Authors: Haleema Sadia

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The study is aimed at exploring the identity construction of female British born Pakistani postgraduate student who shifted to Pakistan at the age of 12, stayed there for 8 years and re-shifted to UK for Higher Education. Research questions are: 1. What is the academic and socio-cultural background of the participant prior to joining the UoM as a postgrad student? 2. How the participant talk, see herself and act in relation to cultural and social norms and practices? Participant’ identity is explored through positioning theory of Holland et al. (1998), referring to the ways people understand and enact their social positions in the figured world. The research is a case study based on narrative interview of Shabana, a British-born Pakistani female postgraduate student, who has recently joined the university of Manchester. Shabana received her primary education in UK during the first twelve years of her life. She is the youngest among the three sisters, with only one brother younger to her. Her father, although not well educated is a successful entrepreneur, maintaining offices in UK and Pakistan. Her mother is a housewife with no formal education. Shabana’s elder sister got involved in a relationship with a Pakistani boy against cultural norms of arranged marriage. Resultantly the three sisters were shifted to Pakistan to be equated with socio-religious norms. Shabana termed her first year in Pakistan as disgusting and she hated her father for the decision. However after a year’s time and shifting from an orthodox city to the provincial capital Lahore, she developed liking for the Pakistani culture. She gradually developed a new socio-religious identity during her stay, which she expressed as a turning point in her life. After completing O level Shabana returned back to UK and joined the University of Hull as undergraduate Student. At Hull she remained isolated, missed the religious environment and relished the memories of Lahore. She would visit Pakistan almost three times a year. After obtaining her BSc degree from Hull she went back to Pakistan. Soon after she decided to improve her academic qualification. She came to UK to join her parents and got admission in the MSc chemistry program at UoM. Presently Shabana talks about the dominant role of male members in the family culture in decision-making. She strongly feels to struggle hard and attain equal status with males in education, employment, earning, authority and freedom. She sees herself in a position to share the authority with her (would be) husband in important family and other matters. Shabana has developed a new identity of a mix of both Pakistani and UK culture. She is appreciative of the socio-cultural values of UK while still regarding the cultural and religious values of Pakistan in high esteem.

Keywords: postgraduate students, identity construction, cultural shifts, female british pakistani student

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293 Factors Associated with Non-Adherence to Antiretroviral Treatment among HIV Infected Patients in Ukraine

Authors: Larissa Burruano, Sergey Grabovyj, Irina Nguen

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The study aimed to assess the level of adherence to anti retroviral therapy (ART) and to examine the relationship between adherence and risk behavior factor (drug use) among patients infected with HIV. The patients with newly diagnosed or established HIV infection under follow-up at the Sumskij Regional Centre for AIDS Prevention in Ukraine were eligible for this study. Medical records were used to measure the patient’s adherence to medication. Measurements were obtained at month 6 and at month 12 to calculate the number of medication omission during the past 30 days: (on a 2-point scale – once until three in a month – were considered adherent, three and more in a month – were considered non-adherent). Of the 50 study participants, 27 (54.0%) were men and 23 (46.0%) women. The mean age is 35.2 years (SD= 5.1). A majority of the patients (82.0%) is in the age group of 25-30 years. The main level of adherence was 74.0% and 66.0% at 6 and 12 months, respectively. The main routes of HIV transmission were drug injection among men 12 (44.4%) and sexual contact among women 11 (47.8%). Univariate analyses indicated that patients who had lower level of education were more likely to have been non-adherent at month 6- (X2 =5.1, n=50, p < .05) and at month 12 (X2 = 4.34, n=50, p < .05). Multivariate tests showed that only age (OR= 1.163 [95% CI 0.98–1.370]) was significant independent predictor of treatment adherence, while gender, education, employment status were not predictive for the risk of developing non-compliance. There was not a significant interaction between non-adherence and intravenous drug use. Consistent with these findings, younger people were more likely to have missed a dose of their medication because they had a greater sense of invulnerability than older patients. The study indicates that the socio demographic characteristic should be taken into an account in the future research regarding adherence in the case of HIV infection. If the patient anti retroviral adherence can be improved by qualitatively better medical care in all regions of the Ukraine, behavioral changes in the population can to be expected in the long term.

Keywords: HIV, antiretroviral therapy, adherence, Ukraine, Eastern Europe

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292 Factors Influencing Antipsychotic Drug Usage and Substitution among Nigerian Schizophrenic Patients

Authors: Ubaka Chukwuemeka Michael, Ukwe Chinwe Victoria

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Background: The use of antipsychotic monotherapy remains the standard for schizophrenic disorders so also a prescription switch from older typical to newer atypical classes of antipsychotics on the basis of better efficacy and tolerability. However, surveys on the quality of antipsychotic drug use and substitution in developing countries are very scarce. This study was intended to evaluate quality and factors that drive the prescription and substitution of antipsychotic drugs among schizophrenic patients visiting a regional psychiatric hospital. Methods: Case files of patients visiting a federal government funded Neuropsychiatric Hospital between July 2012 and July 2014 were systematically retrieved. Patient demographic characteristics, clinical details and drug management data were collected and subjected to descriptive and inferential data analysis to determine quality and predictors of utilization. Results: Of the 600 case files used, there were more male patients (55.3%) with an overall mean age of 33.7±14.4 years. Typical antipsychotic agents accounted for over 85% of prescriptions, with majority of the patients receiving more than 2 drugs in at least a visit (80.9%). Fluphenazine (25.2%) and Haloperidol (18.8%) were mostly given as antipsychotics for treatment initiation while Olazenpine (23.0%) and Benzhexol (18.3%) were the most currently prescribed antipsychotics. Nearly half (42%, 252/600) of these patients were switched from one class to another, with 34.5% (207/600) of them switched from typical to atypical drug classes. No demographic or clinical factors influenced drug substitutions but a younger age and being married influenced being prescribed a polypharmacy regimen (more than 2 drugs) and an injectable antipsychotic agent. Conclusion: The prevalence of antipsychotic polypharmacy and use of typical agents among these patients was high. However, only age and marital status affected the quality of antipsychotic prescriptions among these patients.

Keywords: antipsychotics, drug substitution, pharmacoepidemiology, polypharmacy

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