Search results for: socio-economic inequality
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 965

Search results for: socio-economic inequality

305 Inclusive, Just and Effective Transition: Comparing Market-Based and Redistributive Approaches to Sustainability

Authors: Karen Bell

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While there is broad agreement among governments and civil society globally about the need to develop more sustainable societies, the best way to achieve this is still contested. In particular, there are differences regarding whether to continue to implement market-based approaches or to move to alternative redistributive-based approaches. In this paper, ‘Green Economy’ and ‘Living Well’ strategies are compared as examples of these two different strategies for achieving social, ecological and economic sustainability. The paper is based on a 3-year ESRC funded project on transitions to sustainability which examines the implementation of the ‘Green Economy’ paradigm in South Korea and the 'Living Well' paradigm in Bolivia. As well as outlining and analysing secondary data, the paper also draws on over 100 interviews with a range of local stakeholders in these countries carried out by the author between and including 2016 and 2018. The work indicates that the Living Well paradigm seems to better integrate social, ecological and economic concerns and may better deliver sustainability in the time frame necessary than the dominant Green Economy paradigm. This seems to be primarily because Living Well emphasises redistribution to reduce inequality and ensure human needs are met; living in harmony with nature, taking into account natural limits and cycles; respecting traditional values and practices where these support sustainability and human well-being; sovereignty and local control of natural resources; and participative decision-making, based on grassroots community organising. It is, therefore, argued that to achieve inclusive, just and effective transitions to sustainability we should aim to foster equality, respect planetary limits, build on local traditions, bring resources into public ownership and enhance participatory democracy. This will require a radically different approach to that offered within the market-based agenda currently dominating global sustainability debates and activities.

Keywords: environmental transition, green economy, inclusive sustainability, living well, sustainable transition

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304 The Effect of Second Language Listening Proficiency on Cognitive Control among Young Adult Bilinguals

Authors: Zhilong Xie, Jinwen Huang, Guofang Zeng

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The existing body of research on bilingualism has consistently linked the use of multiple languages to enhanced cognitive control. Numerous studies have demonstrated that bilingual individuals exhibit advantages in non-linguistic tasks demanding cognitive control. However, recent investigations have challenged these findings, leading to a debate regarding the extent and nature of bilingual advantages. The adaptive control hypothesis posits that variations in bilingual experiences hold the key to resolving these controversies. This study aims to contribute to this discussion by exploring the impact of second language (L2) listening experience on cognitive control among young Chinese-English bilinguals. By examining this specific aspect of bilingualism, the study offers a perspective on the origins of bilingual advantages. This study employed a range of cognitive tasks, including the Flanker task, Wisconsin Card Sorting Test (WCST), Operation Span Task (OSPAN), and a second language listening comprehension test. After controlling for potential confounding variables such as intelligence, socioeconomic status, and overall language proficiency, independent sample t-test analysis revealed significant differences in performance between groups with high and low L2 listening proficiency in the Flanker task and OSPAN. However, no significant differences emerged between the two groups in the WCST. These findings suggest that L2 listening proficiency has a significant impact on inhibitory control and working memory but not on conflict monitoring or mental set shifting. These specific findings provide a more nuanced understanding of the origins of bilingual advantages within a specific bilingual context, highlighting the importance of considering the nature of bilingual experience when exploring cognitive benefits.

Keywords: bilingual advantage, inhibitory control, L2 listening, working memory

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303 Food Insecurity and Mental Health among Adolescents in Southwest Ethiopia: Structural Equation Modeling Analysis

Authors: Mulusew G. Jebena, David Lindstrom, Tefera Belachew, Craig Hadley, Carl Lachat, Patrick Kolsteren

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Background: The biological and psychosocial consequence of food insecurity on physical health and nutritional status has been reported. But, its effect on mental health during adolescence remains unexplored. Thus, the main aim of this analysis is to examine the mechanism by which food insecurity is linked to mental health among adolescents living in Jimma, Southwest Ethiopia. Methods: We used data from third round observation of Jimma Longitudinal Family and Youth Survey (JLFSY). A total of 1,521 adolescents included for the main analysis. Food insecurity was measured using 5-items scale and The Self Reporting Questionnaire (SRQ-20) was used to measure mental distress. Structural equation modeling analysis was done using maximum likelihood estimation method. Model diagnostics test was reported. All p values were two tailed and P value ≤ 0.05 was used to determine statistical significance. Results: The prevalence of mental distress was 20.8%, 95% CI: (18.8, 22.9). After adjusted for covariates, the final model depicts food insecurity was associated with adolescent mental distress (β=.324). This analysis showed 94.1% of the effect of food insecurity on mental distress is direct. By contrast, 5.9% of the food insecurity effect is mediated by physical health. In addition, Self-rated health (β=.356), socioeconomic status (β=-.078) parental educational (β= .170), living in urban (β= .193) and female headed household (β=.205) were associated with adolescent mental distress. Conclusions: This finding highlights the direct effect of food insecurity on adolescent mental distress. Therefore, any intervention aimed to improve mental distress of adolescents should consider strategies to improve access to sufficient, safe, and nutritious food. Beside this, prevention of underlying factors such as psychosomatic health illness and improving socio economic status is also very critical. Furthermore longitudinal relationship of the long term effect of food insecurity on mental health should be investigated.

Keywords: adolescent, Ethiopia, food insecurity, mental health

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302 Application of Environmental Justice Concept in Urban Planning, The Peri-Urban Environment of Tehran as the Case Study

Authors: Zahra Khodaee

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Environmental Justice (EJ) concept consists of multifaceted movements, community struggles, and discourses in contemporary societies that seek to reduce environmental risks, increase environmental protections, and generally reduce environmental inequalities suffered by minority and poor communities; a term that incorporates ‘environmental racism’ and ‘environmental classism,’ captures the idea that different racial and socioeconomic groups experience differential access to environmental quality. This article explores environmental justice as an urban phenomenon in urban planning and applies it in peri-urban environment of a metropolis. Tehran peri-urban environments which are the result of meeting the city- village- nature systems or «city-village junction» have gradually faced effects such as accelerated environmental decline, changes without land-use plan, and severe service deficiencies. These problems are instances of environmental injustice which make the planners to adjust the problems and use and apply the appropriate strategies and policies by looking for solutions and resorting to theories, techniques and methods related to environmental justice. In order to access to this goal, try to define environmental justice through justice and determining environmental justice indices to analysis environmental injustice in case study. Then, make an effort to introduce some criteria to select case study in two micro and micro levels. Qiyamdasht town as the peri-urban environment of Tehran metropolis is chosen and examined to show the existence of environmental injustice by questionnaire analysis and SPSS software. Finally, use AIDA technique to design a strategic plan and reduce environmental injustice in case study by introducing the better scenario to be used in policy and decision making areas.

Keywords: environmental justice, metropolis of Tehran, Qiyam, Dasht peri, urban settlement, analysis of interconnected decision area (AIDA)

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301 Health Ramifications of Workplace Bullying: Gender, Race and Sexual Orientation as Risk Factors

Authors: Kathleen Canul

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Bullying is on the rise according to several recent studies. Workplace bullying has garnered less attention than other forms yet incidence rates range from 35-45%. The consequences of being bullied at work are broad, ranging from physiological to psychological to occupational. As the bullying progresses, employees begin to exhibit physical and psychological symptoms. Blood pressure rises, along with other cardiac related concerns. For men, covert coping with job unfairness was associated with a four-fold risk of heart attack and death. Gastrointestinal distress, headaches, muscle tension, sleep disorders and exhaustion are also common. Workplace bullying appears to contribute to the risk of subsequent psychotropic medication, as well. Emotionally, anxiety and depression increase along with lowered self-esteem and problems concentrating on the duties of the job. In an attempt to cope, individuals may succumb to unhealthy practices involving food, alcohol and other drugs. Patterns of bullying vary by gender, race, and ethnicity, as well as sexual orientation, with women, ethnic minorities and LGBTQ employees reporting higher rates of bullying in the workplace. Not only is this an issue of inequity on the job, but also a problem of health disparities as there are few mental health professionals confident and competent in dealing with workplace bullying issues, and the lack of culturally competent clinicians exacerbates this inequality in receiving adequate care. Alone, the topic of workplace bullying is not unique; however, the diverse experiences of underrepresented groups who disproportionately are affected on the job and suffer untreated, health related concerns represent a significant and emerging problem requiring attention. Conference participants who have experienced, witnessed or help those bullied on the job would benefit most from this review of the literature on the consequences of bullying experienced by diverse and underrepresented groups in the workplace.

Keywords: bullying, ethnic minorities, health disparities, workplace conflict

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300 Clinical and Epidemiological Profile in Patients with Preeclampsia in a Private Institution in Medellin, Colombia 2015

Authors: Camilo Andrés Agudelo Vélez, Lina María Martínez Sánchez, Isabel Cristina Ortiz Trujillo, Evert Armando Jiménez Cotes, Natalia Perilla Hernández, María de los Ángeles Rodríguez Gázquez, Daniel Duque Restrepo, Felipe Hernández Restrepo, Dayana Andrea Quintero Moreno, Juan José Builes Gómez, Camilo Ruiz Mejía, Ana Lucia Arango Gómez

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Preeclampsia is a clinical complication during pregnancy with high incidence in Colombia; therefore, it is important to evaluate the influence of external conditions and medical interventions, in order to promote measures that encourage improvements in the quality of life. Objective: Determine clinical and sociodemographic variables in women with preeclampsia. Methods: This cross-sectional study enrolled 50 patients with the diagnosis of preeclampsia, from a private institution in Medellin, during 2015. We used the software SPSS ver.20 for statistical analysis. For the qualitative variables, we calculated the mean and standard deviation, while, for ordinal and nominal levels of quantitative variables, ratios were estimated. Results: The average age was 26.8±5.9 years. The predominant characteristics were socioeconomic stratum 2 (48%), students (55%), mixed race (46%) and middle school as level of education (38%). As for clinical features, 72% of the cases were mild preeclampsia, and 22% were severe forms. The most common clinical manifestations were edema (46%), headache (62%), and proteinuria (55%). As for the Gyneco-obstetric history, 8% reported previous episodes of this disease and it was the first pregnancy for 60% of the patients. Conclusions: Preeclampsia is a frequent condition in young women; on the other hand, headache and edema were the most common reasons for consultation, therefore, doctors need to be aware of these symptoms in pregnant women.

Keywords: pre-eclampsia, hypertension, pregnancy complications, pregnancy, abdominal, edema

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299 Community Perceptions on Honey Quality in Tobacco Growing Areas in Kigoma Region, Tanzania

Authors: Pilly Kagosi, Cherestino Balama

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Beekeeping plays major role in improving biodiversity, increasing household income, and crop production through pollination. Tobacco farming is also the main source of household income for smallholder farmers. In Kigoma, production of Tobacco has increased and is perceived to threaten honey quality. The study explored the perception of the community on quality of honey in tobacco and non tobacco growing areas. The study was conducted in Kigoma Region, Tanzania. District and Villages were purposively sampled based on large numbers of people dealing with beekeeping activities and tobacco farming. Socioeconomic data were collected and analysed using Statistical Package for Social Sciences and content analysis. The perception of stakeholders on honey quality was analysed using Likert scale. Majority of the respondents agreed that tobacco farming greatly affects honey quality because honey from beehives near tobacco farms test bitter and sometimes irritating, which was associated with nicotine content and agrochemicals applied to tobacco crops. Though they cannot differentiate honey bitterness from agrochemicals and bee fodders. Furthermore, it was revealed that chemicals applied to tobacco and vegetables have negative effect on the bees and honey quality. Respondents believe that setting bee hives near tobacco farms might contaminate honey and therefore affect its quality. Beekeepers are not aware of the nicotine content from other bee fodders like miombo of which do not have any effect on human beings. Actually, tobacco farming does not affect beekeeping activities in issue of quality when farmers follow proper management of tobacco flowers and proper handling of honey. Though, big challenge in tobacco farming is chemically applied to the crops and harvest bee fodders for curing tobacco. The study recommends training to community on proper management of tobacco and proper handling of bee products.

Keywords: community, honey, perceptions, tobacco

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298 Levels of Digital Health Literacy in Culturally and Linguistically Diverse Females in Regional Australia and its Association with Demographics

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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297 Factors That Influence Choice of Walking Mode in Work Trips: Case Study of Rasht, Iran

Authors: Nima Safaei, Arezoo Masoud, Babak Safaei

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In recent years, there has been a growing emphasis on the role of urban planning in walking capability and the effects of individual and socioeconomic factors on the physical activity levels of city dwellers. Although considerable number of studies are conducted about walkability and for identifying the effective factors in walking mode choice in developed countries, to our best knowledge, literature lacks in the study of factors affecting choice of walking mode in developing countries. Due to the high importance of health aspects of human societies and in order to make insights and incentives for reducing traffic during rush hours, many researchers and policy makers in the field of transportation planning have devoted much attention to walkability studies; they have tried to improve the effective factors in the choice of walking mode in city neighborhoods. In this study, effective factors in walkability that have proven to have significant impact on the choice of walking mode, are studied at the same time in work trips. The data for the study is collected from the employees in their workplaces by well-instructed people using questionnaires; the statistical population of the study consists of 117 employed people who commute daily from work to home in Rasht city of Iran during the beginning of spring 2015. Results of the study which are found through the linear regression modeling, show that people who do not have freedom of choice for choosing their living locations and need to be present at their workplaces in certain hours have lower levels of walking. Additionally, unlike some of the previous studies which were conducted in developed countries, coincidental effects of Body Mass Index (BMI) and the income level of employees, do not have a significant effect on the walking level in work travels.

Keywords: BMI, linear regression, transportation, walking, work trips

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296 Indigenous Understandings of Climate Vulnerability in Chile: A Qualitative Approach

Authors: Rosario Carmona

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This article aims to discuss the importance of indigenous people participation in climate change mitigation and adaptation. Specifically, it analyses different understandings of climate vulnerability among diverse actors involved in climate change policies in Chile: indigenous people, state officials, and academics. These data were collected through participant observation and interviews conducted during October 2017 and January 2019 in Chile. Following Karen O’Brien, there are two types of vulnerability, outcome vulnerability and contextual vulnerability. How vulnerability to climate change is understood determines the approach, which actors are involved and which knowledge is considered to address it. Because climate change is a very complex phenomenon, it is necessary to transform the institutions and their responses. To do so, it is fundamental to consider these two perspectives and different types of knowledge, particularly those of the most vulnerable, such as indigenous people. For centuries and thanks to a long coexistence with the environment, indigenous societies have elaborated coping strategies, and some of them are already adapting to climate change. Indigenous people from Chile are not an exception. But, indigenous people tend to be excluded from decision-making processes. And indigenous knowledge is frequently seen as subjective and arbitrary in relation to science. Nevertheless, last years indigenous knowledge has gained particular relevance in the academic world, and indigenous actors are getting prominence in international negotiations. There are some mechanisms that promote their participation (e.g., Cancun safeguards, World Bank operational policies, REDD+), which are not absent from difficulties. And since 2016 parties are working on a Local Communities and Indigenous Peoples Platform. This paper also explores the incidence of this process in Chile. Although there is progress in the participation of indigenous people, this participation responds to the operational policies of the funding agencies and not to a real commitment of the state with this sector. The State of Chile omits a review of the structure that promotes inequality and the exclusion of indigenous people. In this way, climate change policies could be configured as a new mechanism of coloniality that validates a single type of knowledge and leads to new territorial control strategies, which increases vulnerability.

Keywords: indigenous knowledge, climate change, vulnerability, Chile

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295 Exploring Health-Related Inequalities between Private, Public and Active Transport Users, Using Relative Importance Index: Case Study on Santiago de Chile

Authors: Beatriz Mella Lira, Karla Yohannessen, Robin Hickman

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The aim of the paper is recognising inequalities through the self-assessment of health-related factors, in the context of daily mobilities in Santiago de Chile. Human capabilities will be used as the theoretical basis for the recognition and assessment of these factors regarding the functioning (what people are currently able to do) and capabilities (what people want to achieve and what is valuable for them), reflecting differences across social groups and among types of transport users. The self-assessment of health-related factors considers perceptions of stress, physical effort, proximity to other transport users, pollution, safety, and comfort. The types of transport users are classified as: private (cars, taxis, colectivos, motos), public (buses and metro) and active (bicycles and walking). The methodology follows a capability-based questionnaire, which was applied in different areas of Santiago de Chile, considering concepts extracted from the human capabilities list. The self-assessment of these health-related factors examines the context of peoples’ mobilities for performing their daily activities, considering socioeconomic differences as income, age, gender, disabilities, residence location and primary mode choice. The paper uses Relative Importance Index (RII) for weighting the relative influence or valuation of the factors. The respondents were asked to rate the importance of each factor on a scale from 1 to 5, in an ascending order of importance. The results suggest that these health-related factors impact not just the perceptions of users, but their well-being and their propensity for achieving their capabilities and the things they value in life. The paper is focused on the development of an applicable approach, measuring factors that should be included in transport project appraisal, as a more comprehensive and complementary method.

Keywords: active transport, health, human capabilities, Santiago de Chile, transport inequalities, transportation planning, urban planning

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294 Impacts of Ibeju - Lekki New Town on Neighbouring Residents of Ibeju, Lagos Nigeria

Authors: Abolade Olajoke, Adigun Folasade Oyenike, Odunjo Oluronke Omolola Olaleye, Babajide Rotimi

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Against the shortfall associated with unprecedented urbanization in most cities of the world, coupled with rapid expansion of outer boundaries, is the resultant birth of the development of new towns. The paper therefore examines the impacts of Ibeju - Lekki New Town on Neighbouring communities of Ibeju Lekki. Random systematic sampling was employed elicit relevant information from a total number of 269 residents at interval of five buildings in four neighbouring communities. Descriptive statistics was employed to test for the socioeconomic characteristics of respondents, problems faced by government officials during the implementation and monitoring process. Likert scale was employed to ascertain respondents view on the impact of the new town on neighbouring communities. Result from the findings shows that male (56.9%) are the most dominant occupant in the study area of which most (68.1%) fall within the most the active age group (18-39 and 40-59 years). Results further shows that 36% of the total respondents are traders and majority (32%) earn below government salary wage cap of ₦18000 thus indicating that majority of the respondents are petty traders. Results of findings from development authority reveals that the major problem encountered during monitoring and implementation is harassment of government officials (35%). Result of likert scale further show that new town has brought increase in intensity of land use within neighbouring communities (RAI 3.65), provision of job opportunity (RAI 3.57). This have consequently improve standard of living of the neighbouring community (RAI 3.27). On the contrary some (RAI 1.97) opined that attention should paid to provision of power supply and provision of recreation facilities (RAI I.63). The study recommends that government should make adequate provisions for basic facilities such power supply, adequate health care system, basic education and provision of healthy portable water. This should be given utmost priority to enhance the living condition of residents. To forestall attack from residents’ adequate security measures should be provided as backup for Government official during implementation and monitoring. Appropriate sanction to illegal occupants and demolition of illegal structures should be fully implemented, This will indubitably prevent haphazard development and also promote a liveable environment. Against the shortfall associated with unprecedented urbanization in most cities of the world, coupled with rapid expansion of outer boundaries, is the resultant birth of the development of new towns. The paper therefore examines the impacts of Ibeju - Lekki New Town on Neighbouring communities of Ibeju Lekki. Random systematic sampling was employed elicit relevant information from a total number of 269 residents at interval of five buildings in four neighbouring communities. Descriptive statistics was employed to test for the socioeconomic characteristics of respondents, problems faced by government officials during the implementation and monitoring process. Likert scale was employed to ascertain respondents view on the impact of the new town on neighbouring communities. Result from the findings shows that male (56.9%) are the most dominant occupant in the study area of which most (68.1%) fall within the most the active age group (18-39 and 40-59 years). Results further shows that 36% of the total respondents are traders and majority (32%) earn below government salary wage cap of ₦18000 thus indicating that majority of the respondents are petty traders. Results of findings from development authority reveals that the major problem encountered during monitoring and implementation is harassment of government officials (35%) Result of likert scale further show that new town has brought increase in intensity of land use within neighbouring communities (RAI 3.65), provision of job opportunity (RAI 3.57). This have consequently improve standard of living of the neighbouring community (RAI 3.27). On the contrary some (RAI 1.97) opined that attention should paid to provision of power supply and provision of recreation facilities (RAI I.63). The study recommends that government should make adequate provisions for basic facilities such power supply, adequate health care system, basic education and provision of healthy portable water. This should be given utmost priority to enhance the living condition of residents. To forestall attack from residents’ adequate security measures should be provided as backup for Government official during implementation and monitoring. Appropriate sanction to illegal occupants and demolition of illegal structures should be fully implemented, This will indubitably prevent haphazard development and also promote a liveable environment.

Keywords: new town, urbanization, infrastructure boundary

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293 Immediate Effect of Transcutaneous Electrical Nerves Stimulation on Flexibility and Health Status in Patients with Chronic Nonspecific Low Back Pain (A Pilot Study)

Authors: Narupon Kunbootsri, Patpiya Sirasaporn

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Low back pain is the most common of chief complaints in chronic pain. Low back pain directly affect to activities daily living and also has high socioeconomic costs. The prevalence of low back pain is high in both genders in all populations. The symptoms of low back pain including, pain at low back area, muscle spasm, tenderness points and stiff back. Trancutanous Electrical Nerve Stimulation (TENS) is one of modalities mainly use for control pain. There was indicated that TENS is wildly use in low back pain, but no scientific data about the flexibility of muscle after TENS in low back pain. Thus the aim of this study was to investigate immediate effect of TENS on flexibility and health status in patients with chronic nonspecific low back pain. Eight chronic nonspecific low back pain patients 1 male and 7 female employed in this study. Participants were diagnosed by a doctor based on history and physical examination. Each participant received treatment at physiotherapy unit. Participants completed Roland Morris Disability Questionnaire (RMDQ), numeric rating scale (NRS) and trunk flexibility before treatment. Each participant received low frequency TENS set at asymmetrical, 10 Hz, 20 minutes per point. Immediately after treatment, participants completed RNS, RMDQ and trunk flexibility again. All participants were treated by only one physiotherapist. There was a statistically significant increased in flexibility immediately after low frequency TENS [mean difference -6.37 with 95%CI were (-8.35)-(-4.39)]. There was a statistically significant decreased in numeric rating scale [mean difference 2.13 with 95%CI were 1.08-3.16]. Roland Morris Disability Questionnaire showed improvement of health status average 44.8% immediately after treatment. In conclusion, the results of the present study indicate that immediately effect after low frequency TENS can decrease pain and improve flexibility of back muscle in chronic nonspecific low back pain patients.

Keywords: low back pain, flexibility, TENS, chronic

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292 Risk Factors for Diabetic Foot: Upper Egypt Experience

Authors: Ali Kassem, Mohamed Alsenbasy, Ahmed Nagaah

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Background: Diabetic foot is one of the often neglected complications of diabetes mellitus It was reported that patients of diabetic foot ulcer (DFU) have considerable morbidity and mortality. Due to arterial abnormalities, diabetic neuropathy, as well as the tendency to delayed wound healing, foot infection and or gangrene is relatively common in diabetic patients. Foot related problems are responsible for up to 50% of diabetic related hospital admissions. Aim of work: The aim of the present study is to assess the risk factors for DFU in diabetic patients attending Sohag University Hospitals (Upper Egypt) Material and methods: The present study includes 100 diabetic foot patients attending the diabetic outpatient clinic of Sohag University Hospitals. For all of the studied patients the following were done: Full medical history and clinical examination; thorough foot examination; Laboratory tests including: Blood glucose level, HBA1c, serum lipids and renal function tests, ECG and Echocardiography, Doppler study on the lower limbs. Results: Sixty eight percent of the affected patients were males versus 32 % female patients. All male patients and none of the female were smoker. Seventy nine percent of patients were living in rural areas versus 14 % in urban areas. Duration of diabetes was more than 12 years in 74%, less than 12 years in 26% of patients. Fifty percent of patients have associated hypertension, 46% have dyslipidemia, 18% have ischemic heart disease or old myocardial infarction and 8% have impaired renal function. History of previous foot ulcers was reported in 11 % and foot amputation in 2% of patients. Conclusion: Male gender, low socioeconomic status, smoking, long duration of diabetes, other cardiovascular risk factors particularly hypertension and previous history of foot ulceration are the major risk factors for diabetic foot in our locality.

Keywords: diabetic foot, diabetic neuropathy, foot gangrene, risk factors for diabetic complications

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291 The Psychological Impact of War Trauma on Refugees

Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis

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The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.

Keywords: psychiatric disorders, refugees, war survivors, war trauma

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290 Empowerment Means Decision-Making: How Does It Empower Women: Case of Slum Areas of Dhaka City, Bangladesh

Authors: Nurunnaher Nurunnaher

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This paper examines the impact of women’s participation in microcredit on women’s decision making in the slum areas of Dhaka city, Bangladesh. There is confusion in the literature about whether women’s empowerment is or is not a trickle down impact of poverty alleviation or household well-being, and the studies use more or less similar indicators to measure the status of household and the status of women. Studies very rarely conceptualize and operationalize the term ‘empowerment’ as the word is often used without proper care by policy makers and development practitioners instead of household wellbeing. Currently, decision making in many studies has been used as an indicator of women’s empowerment when assessing the impact of microcredit programs on women. Based on a qualitative and feminist study this paper operationalizes women’s empowerment through the development of a conceptual framework, the identification of assessment criteria and the development of proper indicators that guided the whole study. The testimonies of participants, both men and women, were the basis of exploration of women’s lived experiences, which is the most appropriate method to explore the impact of such programs on women’s empowerment. The study considers empowerment as a process that affects various levels of life and gender relationships. The study found that there is a positive change in women’s position in decision making when women have developed an independent economic base with credit money. However, predominantly, women’s decision making is shared with men with the final decision still in the men’s hands. It can be said that women’s microcredit participation has not significantly challenged the social norms, therefore it is not surprising that women who hand over credit to their husband rarely have any power in intra-household bargaining process. Nevertheless, overall it is evident that women are continuously struggling toward the freedom to have the authority over household, economic and personal matters. It is concluded that while making strategic choices or gaining empowerment requires several steps, women’s participation in decision-making has several implications on their lives and potentially challenges patriarchy.

Keywords: women, gender inequality/equality, decision making, empowerment, microcredit, slums, Dhaka, Bangladesh

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289 Assessing the Impact of Construction Projects on Disabled Accessibility and Inclusion

Authors: Yasser Aboel-Magd

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This research addresses the critical issue of accessibility for individuals with special needs and the broader implications of disability on one's ability to lead an independent and integrated life within society. It highlights the consequences of injury, illness, or disability not only on the physical level but also on psychological, social, educational, economic, and functional aspects of life. The study emphasizes the importance of inclusive design in urban spaces, reflecting on how a society's treatment of individuals with disabilities serves as a measure of its progress. The research delves into the challenges faced by people with special needs in the Kingdom, where, despite advancements in various sectors, there is a noticeable lack of accommodating public opportunities for this significant demographic. It argues for the necessity of a Saudi building code that considers the needs of a diverse population during the design phase. The paper discusses the role of urban space as a fundamental element in urban formation and its impact on the societal integration of individuals with special needs. The study explores a variety of inclusive design principles, ranging from physical features like ramps and tactile paving to digital and cognitive accessibility measures such as screen readers, closed captions, plain language, and visual aids. It also considers the impact of wayfinding and appropriate lighting design on the orientation and assistance of individuals within urban spaces at the lowest cost. The researchers connect inclusive design with sustainable practices, advocating for environments that are not only environmentally friendly but also adaptable and lasting. The paper concludes with the assertion that the integration of accessibility, universal design, and sustainability signifies a society's commitment to inclusivity and the empowerment of all individuals, paving the way for a future where everyone can participate fully and independently in society.

Keywords: accessibility, inclusive design, Saudi building code, disability inclusion, socioeconomic progress

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288 Effect of Agricultural Extension Services on Technical Efficiency of Smallholder Cassava Farmers in Ghana: A Stochastic Meta-Frontier Analysis

Authors: Arnold Missiame

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In Ghana, rural dwellers who depend primarily on agriculture for their livelihood constitute about 60% of the country’s population. This shows the critical role and potentials of the agricultural sector in helping to achieve Ghana’s vision 2030. With the current threat of climate change and advancements in technology, agricultural extension is not just about technology transfer and improvements in productivity, but it is also about improving the managerial and technical skills of farmers. In Ghana, the government of Ghana as well as other players in the sector like; non-governmental organizations, NGOs, local and international funding agencies, for decades now, have made capacity-building-investments in smallholder farmers by way of extension services delivery. This study sought to compare the technical efficiency of farmers who have access to agricultural extension and farmers who do not in Ghana. The study employed the stochastic meta-frontier model to analyze household survey data comprising 300 smallholder cassava farmers from the Fanteakwa district of Ghana. The farmers were selected through a two-stage sampling technique where 5 communities were purposively selected in the first stage and then 60 smallholder cassava farmers were randomly selected from each of the 5 communities. Semi-structured questionnaires were used to collect data on farmers’ socioeconomic and farm-level characteristics. The results showed that farmers who have access to agricultural extensions services have higher technical efficiencies (TE) and produce much closer to their meta-production frontiers (higher technology gap ratios (TGR) than farmers who do not have access to such extension services. Furthermore, experience in cassava cultivation and formal education significantly improves the technical efficiencies of farmers. The study recommends that the mode and scope of agricultural extension service delivery in the country should be enhanced to ensure that smallholder farmers have easy access to extension agents.

Keywords: agricultural extension, Ghana, smallholder farmers, stochastic meta-frontier model, technical efficiency

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287 Detection of Bcl2 Polymorphism in Patient with Hepatocellular carcinoma

Authors: Mohamed Abdel-Hamid, Olfat Gamil Shaker, Doha El-Sayed Ellakwa, Eman Fathy Abdel-Maksoud

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Introduction: Despite advances in the knowledge of the molecular virology of hepatitis C virus (HCV), the mechanisms of hepatocellular injury in HCV infection are not completely understood. Hepatitis C viral infection (HCV) influences the susceptibility to apoptosis. This could lead to insufficient antiviral immune response and persistent viral infection. Aim of this study: was to examine whether BCL-2 gene polymorphism at codon 43 (+127G/A or Ala43Thr) has an impact on development of hepatocellular carcinoma caused by chronic hepatitis C Egyptian patients. Subjects and Methods: The study included three groups; group 1: composing of 30 patients with hepatocellular carcinoma (HCC), group 2 composing of 30 patients with HCV, group 3 composing of 30 healthy subjects matching the same age and socioeconomic status were taken as a control group. Gene polymorphism of BCL2 (Ala43Thr) were evaluated by PCR-RFLP technique and measured for all patients and controls. Results: The summed 43Thr genotype was more frequent and statistically significant in HCC patients as compared to control group. This genotype of BCL2 gene may inhibit the programmed cell death which leads to disturbance in tissue and cells homeostasis and reduction in immune regulation. This result leads to viral replication and HCV persistence. Moreover, virus produces variety of mechanisms to block genes participated in apoptosis. This mechanism proves that HCV patients who have 43Thr genotype are more susceptible to HCC. Conclusion: The data suggest for the first time that the BCL2 polymorphism is associated with the susceptibility to HCC in Egyptian populations and might be used as molecular markers for evaluating HCC risk. This study clearly demonstrated that Chronic HCV exhibit a deregulation of apoptosis with the disease progression. This provides an insight into the pathogenesis of chronic HCV infection, and may contribute to the therapy.

Keywords: BCL2 gene, Hepatitis C Virus, Hepatocellular carcinoma, sensitivity, specificity, apoptosis

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286 A Scoping Review of Psychosocial Interventions for the Survivors and/or Victims of Intimate Partner Violence in Low- and Middle-Income Countries

Authors: Mukondi Nethavhakone

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The high prevalence of violence against women is a global public health problem. Our societies have become dangerous places for women. Women during their child-bearing ages are at a higher risk of experiencing emotional, physical, and sexual violence. What makes it more concerning is that these violent acts are perpetrated by family members or partners, or ex-partners. Intimate Partner Violence (IPV) is associated with long-lasting physical, reproductive, sexual, mental, and maternal health implications. Expectedly women’s mental health would dimmish as a result of experiencing IPV. The burden of violence against women is seen to be heavier in low- and middle-income countries (LMICs) compared to the rest of the world. Countries have committed to eliminating all forms of violence against women through the sustainable development goal, aiming to see changes by the year 2030. As such, various countries have implemented psychosocial interventions of different levels of impact. However, little is known, especially in low- and middle-income countries, with regard to the potential of psychosocial interventions for IPV to improve the mental health outcomes for the survivors and/or victims of IPV. Analysing the risk for IPV through a social-ecological theoretical approach, low- and middle-income countries still readdressing gender inequality which is the cause of intimate partner violence. That is why it is taking time for these countries to shift psychosocial interventions to focus more on the improvement of the mental health of the survivors. It is, therefore, against this backdrop that the researcher intends to undertake a scoping review to understand the nature and characteristics of psychosocial interventions that have been implemented in low- and middle-income countries. With the findings from the scoping review, the researcher aims to develop a conceptual framework that may be a useful resource for healthcare practitioners and researchers in low- and middle-income countries. As this area of research has not been thoroughly reviewed, the results from this scoping will determine whether a systematic review will be justifiable. Additionally, the researcher will identify gaps and opportunities for future research in this area.

Keywords: mental health improvement, psychosocial interventions, intimate partner violence, LMICs

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285 Tribal Food Security Assessment and Its Measurement Index: A Study of Tribes and Particularly Vulnerable Tribal Groups in Jharkhand, India

Authors: Ambika Prasad Gupta, Harshit Sosan Lakra

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Food security is an important issue that has been widely discussed in literature. However, there is a lack of research on the specific food security challenges faced by tribal communities. Tribal food security refers to the ability of indigenous or tribal communities to consistently access and afford an adequate and nutritious supply of food. These communities often have unique cultural, social, and economic contexts that can impact their food security. The study aims to assess the food security status of all thirty-two major tribes, including Particularly Vulnerable Tribal Groups (PVTG) people living in various blocks of Jharkhand State. The methodology of this study focuses on measuring the food security index of indigenous people by developing and redefining a new Tribal Food Security Index (TFSI) as per the indigenous community-level indicators identified by the Global Food Security Index and other indicators relevant to food security. Affordability, availability, quality and safety, and natural resources were the dimensions used to calculate the overall Tribal Food Security Index. A survey was conducted for primary data collection of tribes and PVTGs at the household level in various districts of Jharkhand with a considerable tribal population. The result shows that due to the transition from rural to urban areas, there is a considerable change in TFSI and a decrease in forest dependency of tribal communities. Socioeconomic factors like occupation and household size had a significant correlation with TFSI. Tribal households living in forests have a higher food security index than tribal households residing in urban transition areas. The study also shows that alternative methodology adopted to measure specific community-level food security creates high significant impact than using commonly used indices.

Keywords: indigenous people, tribal food security, particularly vulnerable tribal groups, Jharkhand

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284 Assessment of the Effects of Water Harvesting Technology on Downstream Water Availability Using SWAT Model

Authors: Ayalkibet Mekonnen, Adane Abebe

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In hydrological cycle there are many water-related human interventions that modify the natural systems. Rainwater harvesting is one such intervention that involves harnessing of water in the upstream. Water harvesting used in upstream prevents water runoff on downstream mainly disturbance on biodiversity and ecosystems. The main objectives of the study are to assess the effects of water harvesting technologies on downstream water availability in the Woreda. To address the above problem, SWAT model, cost-benefit ratio and optimal control approach was used to analyse the hydrological and socioeconomic impact and tradeoffs on water availability of the community, respectively. The downstream impacts of increasing water consumption in the upstream rain-fed areas of the Bilate and Shala Catchment are simulated using the semi-distributed SWAT model. The two land use scenarios tested at sub basin levels (1) conventional land use represents the current land use practice (Agri-CON) and (2) in-field rainwater harvesting (IRWH), improving soil water availability through rainwater harvesting land use scenario. The simulated water balance results showed that the highest peak mean monthly direct flow obtained from Agri-CON land use (127.1 m3/ha), followed by Agri-IRWH land use (11.5 mm) and LULC 2005 (90.1 m3/ha). The Agri-IRWH scenario reduced direct flow by 10% compared to Agri-CON and more groundwater flow contributed by Agri-IRWH (190 m3/ha) than Agri-CON (125 m3/ha). The overall result suggests that the water yield of the Woreda may not be negatively affected by the Agri-IRWH land use scenario. The technology in the Woreda benefited positively having an average benefit cost ratio of 4.2. Water harvesting for domestic use was not optimal that the value of the water per demand harvested was less than the amount of water needed. Storage tanks, series of check dams, gravel filled dams are an alternative solutions for water harvesting.

Keywords: water harvesting, SWAT model, land use scenario, Agri-CON, Agri-IRWH, trade off, benefit cost ratio

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283 Long-Term Otitis Media with Effusion and Related Hearing Loss and Its Impact on Developmental Outcomes

Authors: Aleema Rahman

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Introduction: This study aims to estimate the prevalence of long-term otitis media with effusion (OME) and hearing loss in a prospective longitudinal cohort studyand to study the relationship between the condition and educational and psychosocial outcomes. Methods: Analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) will be undertaken. ALSPAC is a longitudinal birth cohort study carried out in the UK, which has collected detailed measures of hearing on ~7000 children from the age of seven. A descriptive analysis of the data will be undertaken to estimate the prevalence of OME and hearing loss (defined as having average hearing levels > 20dB and type B tympanogram) at 7, 9, 11, and 15 years as well as that of long-term OME and hearing loss. Logistic and linear regression analyses will be conducted to examine associations between long-term OME and hearing loss and educational outcomes (grades obtained from standardised national attainment tests) and psychosocial outcomes such as anxiety, social fears, and depression at ages 10-11 and 15-16 years. Results: Results will be presented in terms of the prevalence of OME and hearing loss in the population at each age. The prevalence of long-term OME and hearing loss, defined as having OME and hearing loss at two or more time points, will also be reported. Furthermore, any associations between long-term OME and hearing loss and the educational and psychosocial outcomes will be presented. Analyses will take into account demographic factors such as sex and social deprivation and relevant confounders, including socioeconomic status, ethnicity, and IQ. Discussion: Findings from this study will provide new epidemiological information on the prevalence of long-term OME and hearing loss. The research will provide new knowledge on the impact of OME for the small group of children who do not grow out of condition by age 7 but continue to have hearing loss and need clinical care through later childhood. The study could have clinical implications and may influence service delivery for this group of children.

Keywords: educational attainment, hearing loss, otitis media with effusion, psychosocial development

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282 Remedying the Scourge of Poverty as a Social Problem: The Islamic Perspective

Authors: Maryam Umar Ladan, Arshad Munir

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Poverty has always been a constant feature of society throughout history. It has existed in the lives of people and it is a fact that although the majority of people lives in poverty, the remaining minority lives in luxury. While some countries called the first World countries lives in luxury, the third World countries lives in poverty. It remains an undesirable phenomenon affecting a vast number of people across the globe despite governmental, institutional and private organizations’ interventions with measures aimed at cushioning its adverse effects. Unequal distribution of societal resources, accumulated wealth in the hands of few, lack of access to education and employment, individual responsibility among others, were highlighted as factors associated with poverty. Poverty predisposes the poor individual to malnutrition and starvation, exposure to disease, thereby resulting to violence, crimes, and experiencing lifelong problems. Evidence show that about 50 percent of the world population lives on less than 2.50 dollar a day, 90 percent of whom are from Sub-Saharan Africa and South Asia including countries where Islam is the major if not one adherent religion. As a solution to poverty, Islam prescribes a system of annual Zakat (charity). The Islamic law prescribes that every person who has a saving that reaches a certain limit should give out 2.5 percent of the total annual earning (as in income, money, farm produce) to deserving and prescribed citizens. This is to, among others; reduce the level of inequality through distribution of wealth among the Muslim Ummah (community). Furthermore, Islam encourages the rich in several places in the Qur’an to spend their wealth on poor people other than the compulsory 2.5%. Therefore, it is inarguable that the Islamic system of distribution of resources (as zakat) is the best strategy to poverty eradication. Thus, strongly recommended for desired results in poverty eradication efforts. If every rich person gives Zakat sincerely, poverty will be eradicated in the world, and not a single person will die of want of food or material things.

Keywords: Islam, charity, poverty, zakat

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281 Main Tendencies of Youth Unemployment and the Regulation Mechanisms for Decreasing Its Rate in Georgia

Authors: Nino Paresashvili, Nino Abesadze

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The modern world faces huge challenges. Globalization changed the socio-economic conditions of many countries. The current processes in the global environment have a different impact on countries with different cultures. However, an alleviation of poverty and improvement of living conditions is still the basic challenge for the majority of countries, because much of the population still lives under the official threshold of poverty. It is very important to stimulate youth employment. In order to prepare young people for the labour market, it is essential to provide them with the appropriate professional skills and knowledge. It is necessary to plan efficient activities for decreasing an unemployment rate and for developing the perfect mechanisms for regulation of a labour market. Such planning requires thorough study and analysis of existing reality, as well as development of corresponding mechanisms. Statistical analysis of unemployment is one of the main platforms for regulation of the labour market key mechanisms. The corresponding statistical methods should be used in the study process. Such methods are observation, gathering, grouping, and calculation of the generalized indicators. Unemployment is one of the most severe socioeconomic problems in Georgia. According to the past as well as the current statistics, unemployment rates always have been the most problematic issue to resolve for policy makers. Analytical works towards to the above-mentioned problem will be the basis for the next sustainable steps to solve the main problem. The results of the study showed that the choice of young people is not often due to their inclinations, their interests and the labour market demand. That is why the wrong professional orientation of young people in most cases leads to their unemployment. At the same time, it was shown that there are a number of professions in the labour market with a high demand because of the deficit the appropriate specialties. To achieve healthy competitiveness in youth employment, it is necessary to formulate regional employment programs with taking into account the regional infrastructure specifications.

Keywords: unemployment, analysis, methods, tendencies, regulation mechanisms

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280 Chinese on the Move: Residential Mobility and Evolution of People's Republic of China-Born Migrants in Australia

Authors: Siqin Wang, Jonathan Corcoran, Yan Liu, Thomas Sigler

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Australia is a quintessentially immigrant nation with 28 percent of its residents being foreign-born. By 2011, People’s Republic of China (PRC) overtook the United Kingdom to become the largest source country in Australia. Significantly, the profile of PRC-born migrants has changed to mirror broader global shifts towards high-skilled labour, education-related, and investment-focussed migration, all of which reflect an increasing trend in the mobility of wealthy and/or educated cohorts. Together, these coalesce to form a more complex pattern of migrant settlement –both spatially and socio-economically. This paper focuses on the PRC-born migration, redresses these lacunae, with regard to the settlement outcomes of PRC migrants to Australia, with a particular focus on spatial evolution and residential mobility at both the metropolitan and national scales. By drawing on Census Data and migration Micro Datasets, the aim of this paper is to examine the shifting dynamics of PRC-born migrants in Australian capital cities to unveil their socioeconomic characteristics, residential patterns and change of spatial concentrations during their transition into the new host society. This paper finds out three general patterns in the residential evolution of PRC-born migrants depending on the size of capital cities where they settle down, as well as the association of socio-economic characters with the formation of enclaves. It also examines the residential mobility across states and cities from 2001 to 2011 indicating the rising status of median-size Australian capital cities for receiving PRC-born migrants. The paper concludes with a discussion of evidences for policy formation, facilitates the effective transition of PRC-born populations into the mainstream of host society and enhances social harmony to help Australia become a more successful multicultural nation.

Keywords: Australia, Chinese migrants, residential mobility, spatial evolution

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279 Seroprevalence and Determinants of Toxoplasmosis in Pregnant Women Attending Antenatal Clinic at the University Teaching Hospital, Lusaka, Zambia: A Cross-Sectional Study

Authors: Christiana Frimpong, Mpundu Makasa, Lungowe Sitali, Charles Michelo

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Background: Toxoplasmosis is a neglected zoonotic disease which is prevalent among pregnant women especially in Africa. This study aimed to determine the seroprevalence and determinants of the disease among pregnant women attending the antenatal clinic at the University Teaching Hospital (UTH). Method: A cross-sectional study was employed where 411 pregnant women attending the antenatal clinic at UTH were interviewed using closed-ended questionnaires. Their blood was also tested for Toxoplasma gondii IgG and IgM antibodies using the OnSite Toxo IgG/IgM Combo Rapid Test cassettes by CTK Biotech, Inc, USA. Result: The overall seroprevalence of the infection (IgG) was 5.87%. There was no seropositive IgM result. Contact with cats showed 7.81 times the risk of contracting the infection in the pregnant women and being a farmer/being involved in construction work showed 15.5 times likelihood of contracting the infection. Socio-economic status of the pregnant women also presented an inverse relationship (showed association) with the infection graphically. However, though there were indications of the association between contact with cats, employment type as well as the socioeconomic status of the pregnant women with the infection, there was not enough evidence to suggest these factors as significant determining factors of Toxoplasma gondii infection in our study population. Conclusion: There is a low prevalence of Toxoplasma gondii infection among pregnant women in Lusaka, Zambia. Screening for the infection among pregnant women can be done once or twice during pregnancy to help protect both mother and child from the disease. Health promotion among women of child bearing age on the subject is of immense importance in order to help curb the situation. Further studies especially that of case-control and cohort studies should be carried out in the country in order to better ascertain the extent of the condition nationwide.

Keywords: determinants, pregnant women, seroprevalence, toxoplasmosis, University Teaching Hospital (UTH), Zambia

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278 Implementation of Algorithm K-Means for Grouping District/City in Central Java Based on Macro Economic Indicators

Authors: Nur Aziza Luxfiati

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Clustering is partitioning data sets into sub-sets or groups in such a way that elements certain properties have shared property settings with a high level of similarity within one group and a low level of similarity between groups. . The K-Means algorithm is one of thealgorithmsclustering as a grouping tool that is most widely used in scientific and industrial applications because the basic idea of the kalgorithm is-means very simple. In this research, applying the technique of clustering using the k-means algorithm as a method of solving the problem of national development imbalances between regions in Central Java Province based on macroeconomic indicators. The data sample used is secondary data obtained from the Central Java Provincial Statistics Agency regarding macroeconomic indicator data which is part of the publication of the 2019 National Socio-Economic Survey (Susenas) data. score and determine the number of clusters (k) using the elbow method. After the clustering process is carried out, the validation is tested using themethodsBetween-Class Variation (BCV) and Within-Class Variation (WCV). The results showed that detection outlier using z-score normalization showed no outliers. In addition, the results of the clustering test obtained a ratio value that was not high, namely 0.011%. There are two district/city clusters in Central Java Province which have economic similarities based on the variables used, namely the first cluster with a high economic level consisting of 13 districts/cities and theclustersecondwith a low economic level consisting of 22 districts/cities. And in the cluster second, namely, between low economies, the authors grouped districts/cities based on similarities to macroeconomic indicators such as 20 districts of Gross Regional Domestic Product, with a Poverty Depth Index of 19 districts, with 5 districts in Human Development, and as many as Open Unemployment Rate. 10 districts.

Keywords: clustering, K-Means algorithm, macroeconomic indicators, inequality, national development

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277 Use of Alternative and Complementary Therapies in Patients with Chronic Pain in a Medical Institution in Medellin, Colombia, 2014

Authors: Lina María Martínez Sánchez, Juliana Molina Valencia, Esteban Vallejo Agudelo, Daniel Gallego González, María Isabel Pérez Palacio, Juan Ricardo Gaviria García, María De Los Ángeles Rodríguez Gázquez, Gloria Inés Martínez Domínguez

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Alternative and complementary therapies constitute a vast and complex combination of interventions, philosophies, approaches, and therapies that acquire a holistic healthcare point of view, becoming an alternative for the treatment of patients with chronic pain. Objective: determine the characteristics of the use of alternative and complementary therapies in patients with chronic pain who consulted in a medical institution. Methodology: cross-sectional and descriptive study, with a population of patients that assisted to the outpatient consultation and met the eligibility criteria. Sampling was not conducted. A form was used for the collection of demographic and clinical variables and the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) was validated. The analysis and processing of information was carried out using the SPSS program vr.19. Results: 220 people with chronic pain were included. The average age was 54.7±16.2 years, 78.2% were women, and 75.5% belonged to the socioeconomic strata 1 to 3. Musculoskeletal pain (77.7%), migraine (15%) and neuralgia (9.1%) were the most frequently types of chronic pain. 33.6% of participants have used some kind of alternative and complementary therapy; the most frequent were: homeopathy (14.5%), phytotherapy (12.7%), and acupuncture (11.4%). The total average HCAMQ score for the study group was 30.2±7.0 points, which shows a moderate attitude toward the use of complementary and alternative medicine. The highest scores according to the type of pain were: neuralgia (32.4±5.8), musculoskeletal pain (30.5±6.7), fibromyalgia (29.6±7.3) and migraine (28.5±8.8). The reliability of the HCAMQ was acceptable (Cronbach's α: 0.6). Conclusion: it was noted that the types of chronic pain and the clinical or therapeutic management of patients correspond to the data available in current literature. Despite the moderate attitude toward the use of these alternative and complementary therapies, one of every three patients uses them.

Keywords: chronic pain, complementary therapies, homeopathy, acupuncture analgesia

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276 Major Dietary Patterns in Relationship with Anthropometric Indices in North West of Iran

Authors: Arezou Rezazadeh, Nasrin Omidvar, Hassan Eini-Zinab, Mahmoud Ghazi-Tabatabaie, Reza Majdzadeh, Saeid Ghavamzadeh, Sakineh Nouri-Saeidlou

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Dietary pattern analysis method can reflect more information about the nutritional etiology of chronic diseases such as obesity. The aim of this study was to determine the relationship between major dietary patterns and anthropometric measures in men and women living in the city of Urmia. In this cross-sectional study, 723 participants (427 women and 296 men), aged 20–64 in Urmia city were selected from all four zones of Urmia city, in the north-west of Iran. Anthropometrics (weight, height, waist and hip circumference) were measured with standard methods. Body Mass Index (BMI) was calculated by dividing weight (in kilograms) by the square of height (in meter). Dietary intake information was collected by a semi-quantitative food frequency questionnaire in the last year. Dietary patterns were determined using principal component analysis. The relationship between dietary patterns and obesity was analyzed by logistic regression. Three major dietary patterns (DPs) were identified that were named ‘Traditional Higher SES (THS)’, ‘Traditional Low SES (TLS)’ and ‘Transitional’. THS DP was positively and Transitional DP was negatively associated with BMI and waist circumference (W.C), however, after adjusting for confounding variables (age, gender, ethnicity, energy intake, physical activity and SES), the associations were not significant. The TLS was not significantly associated with BMI, but after adjusting for confounders, a significant positive association was detected with W.C and Waist to hip ratio (WHR). Findings showed that both traditional patterns were positively and the western type transitional pattern was reversely associated with anthropometric indices. But this relationship was highly affected by demographic, socioeconomic and energy input and output determinants. The results indicate the inevitable effect of environmental factors on the relationship between dietary patterns and anthropometric indices.

Keywords: anthropometric indices, dietary pattern, Iran, North-west

Procedia PDF Downloads 165