Search results for: American Diabetic Association

Authors: Nayera E. Hassan, Sahar A. El-Masry, Rokia A. El Banna, Mones M. Abu Shady, Muhammad Al-Tohamy, Manal Mouhamed Ali, Mehrevan M. Abd El-Moniem, Mona Anwar

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Association between vitamin D, adiponectin and obesity is a matter of debate, as they play important role in linking obesity with different cardiometabolic risk factors. Objectives: Evaluation of the association between metabolic risk factors with both adiponectin and vitamin D levels and that between adiponectin and vitamin D among obese Egyptian children. Subjects and Methods: This case-control cross-sectional study consisted of 65 obese and 30 healthy children, aged 8-11 years. 25-hydroxy vitamin D (25(OH) D) level, serum adiponectin, total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) were measured. Results: The mean 25(OH) D levels in the obese and control groups were 29.9± 10.3 and 39.7 ± 12.7 ng/mL respectively (P < 0.001). The mean 25(OH) D and adiponectin levels in the obese were lower than that in the control group (P < 0.0001). 25(OH) D were inversely correlated with body mass index (BMI), triglyceride, total cholesterol and LDL-cholesterol (LDL-C), while adiponectin level were inversely correlated with systolic blood pressure (SBP), and diastolic blood pressure (DBP), and positively correlated with HDL-C. However, there is no relation between 25(OH) D and adiponectin levels among obese children and total sample. Conclusion: In spite of strong association between vitamin D and adiponectin levels with metabolic risk factors and obesity, there is no relation between 25(OH) D and adiponectin levels. In obese children, there are significant negative correlations between 25(OH) D with lipid profile, and between adiponectin levels with blood pressure. At certain adiponectin level, the relation between it and BMI disappears.

Keywords: 25-hydroxy vitamin D, adiponectin, lipid profile, blood pressure, children

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Authors: Mohsen Maraoui

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In the aim of natural language processing applications improvement, such as information retrieval, machine translation, lexical disambiguation, we focus on statistical approach to semantic indexing for multilingual text documents based on conceptual network formalism. We propose to use this formalism as an indexing language to represent the descriptive concepts and their weighting. These concepts represent the content of the document. Our contribution is based on two steps. In the first step, we propose the extraction of index terms using the multilingual lexical resource Euro WordNet (EWN). In the second step, we pass from the representation of index terms to the representation of index concepts through conceptual network formalism. This network is generated using the EWN resource and pass by a classification step based on association rules model (in attempt to discover the non-taxonomic relations or contextual relations between the concepts of a document). These relations are latent relations buried in the text and carried by the semantic context of the co-occurrence of concepts in the document. Our proposed indexing approach can be applied to text documents in various languages because it is based on a linguistic method adapted to the language through a multilingual thesaurus. Next, we apply the same statistical process regardless of the language in order to extract the significant concepts and their associated weights. We prove that the proposed indexing approach provides encouraging results.

Keywords: concept extraction, conceptual network formalism, fuzzy association rules, multilingual thesaurus, semantic indexing

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Authors: Kinjal H. Shah, Piyush M. Patel

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Diabetes mellitus is considered to be a serious endocrine syndrome. Synthetic hypoglycemic agents can produce serious side effects including hematological effects, coma, and disturbances of the liver and kidney. In addition, they are not suitable for use during pregnancy. In recent years, there have been relatively few reports of short-term side effects or toxicity due to sulphonylureas. Published figures and frequency of side effects in large series of patient range from about 1 to 5%, with symptoms severe enough to lead to the withdrawal of the drug in less than 1 to 2%. Adverse effects, in general, have been of the following type: allergic skin reactions, gastrointestinal disturbances, blood dyscrasias, hepatic dysfunction, and hypoglycemia. The associated disadvantages with insulin and oral hypoglycemic agents have led to stimulation in the research for locating natural resources showing antidiabetic activity and to explore the possibilities of using traditional medicines with proper chemical and pharmacological profiles. Literature survey reveals that the inhabitants of Abbottabad district of Pakistan use the dried leaf powder along with table salt and water orally for treating diabetes, skin allergy, wounds and as a blood purifier, where they pronounced the plant locally as ‘Nem.' The detailed phytochemical investigation of the Cedrela toona Roxb. leaves for antidiabetic activity has not been documented. Hence, there is a need for phytochemical investigation of the leaves for antidiabetic activity. The collection of fresh leaves and authentification followed by successive extraction, phytochemical screening, and testing of antidiabetic activity. The blood glucose level was reduced maximum in ethanol extract at 5th and 7th h after treatment. Blood glucose was depressed by 8.2% and 10.06% in alloxan – induced diabetic rats after treatment which was comparable to the standard drug, Glibenclamide. This may be due to the activation of the existing pancreatic cells in diabetic rats by the ethanolic extract.

Keywords: antidiabetic, Cedrela toona Roxb., phytochemical screening, blood glucose

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Authors: Tya M. Arthur

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Purpose: BIPOC (Black, Indigenous, and People of Color) adolescents face racism and discrimination at a young age. These early experiences have short- and long-term impacts on their health and overall well-being. The purpose of this study was to determine the relationships between perceived racial discrimination at school and health risk behaviors and experiences of BIPOC adolescents. Methods: Data from the 2021 Adolescent Behaviors and Experiences Survey (ABES) were analyzed. All demographic data were summarized using frequencies and chi-squared tests. A univariate and multivariate logistic regression model was used to test the relationship between perceived racial discrimination and selected health risk factors. All analyses were conducted using STATA SE 18. Results: A total of 42.2% of the BIPOC adolescents in the study indicated being treated unfairly at school due to their race. The majority of those who reported being discriminated against were Black/African American or Multiple Race-Hispanic. Asian adolescents were almost 5 times more likely to face racial discrimination at school compared to their American Indian/Alaska Native counterparts (OR = 4.86, 95% CI [2.69-8.77], p < 0.001). Other risk predictors of racial discrimination included being female (OR = 1.38, 95% CI [1.13-1.68], p = 0.002) and feeling disconnected at school (OR = 1.76, 95% CI [1.30-2.38], p < 0.001). After adjustment for health risk behaviors and experiences, BIPOC adolescents were still more likely to face racial discrimination with even higher odds. Conclusions: The results of this study highlight the depth of racial discrimination faced by BIPOC adolescents at school. Greater attention should be placed on racial discrimination as a social determinant of health and a public health crisis.

Keywords: racial discrimination, adolescents, heath risk factors, BIPOC

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Authors: Azizah M. Nahari, Peter Doerner

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Phosphate (Pi) is one of the essential macronutrients in plant growth and development, and it plays a central role in metabolic processes in plants, particularly photosynthesis and respiration. Limitation of crop productivity by Pi is widespread and is likely to increase in the future. Applications of Pi fertilizers have improved soil Pi fertility and crop production; however, they have also caused environmental damage. Therefore, in order to reduce dependence on unsustainable Pi fertilizers, a better understanding of phosphate use efficiency (PUE) is required for engineering nutrient-efficient crop plants. Enhanced Pi efficiency can be achieved by improved productivity per unit Pi taken up. We aim to identify, by using association mapping, general features of the most important loci that contribute to increased PUE to allow us to delineate the physiological pathways involved in defining this trait in the model plant Arabidopsis. As PUE is in part determined by the efficiency of uptake, we designed a hydroponic system to avoid confounding effects due to differences in root system architecture leading to differences in Pi uptake. In this system, 18 parental lines and 217 lines of the MAGIC population (a Multiparent Advanced Generation Inter-Cross) grown in high and low Pi availability conditions. The results showed revealed a large variation of PUE in the parental lines, indicating that the MAGIC population was well suited to identify PUE loci and pathways. 2 of 18 parental lines had the highest PUE in low Pi while some lines responded strongly and increased PUE with increased Pi. Having examined the 217 MAGIC population, considerable variance in PUE was found. A general feature was the trend of most lines to exhibit higher PUE when grown in low Pi conditions. Association mapping is currently in progress, but initial observations indicate that a wide variety of physiological processes are involved in influencing PUE in Arabidopsis. The combination of hydroponic growth methods and genome-wide association mapping is a powerful tool to identify the physiological pathways underpinning complex quantitative traits in plants.

Keywords: hydroponic system growth, phosphate use efficiency (PUE), Genome-wide association mapping, MAGIC population

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Authors: Ikram Mohamed Eltayeb, Ustina Saeed Barsoumbolice

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Cinnamomum zeylanicum belong to the family Lauraceae and Artemisia absinthium belong to the family Asteraceae. Both were traditionally used as antiemetic, anti-inflammatory and antidiabetic. In Sudan, the mixtures of the two plants were traditionally used for the treatment of diabetes. Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia. It is mainly classified into two major groups, type-1 and type-2. Type-2 is a combination of resistance to insulin action and an inadequate compensatory insulin secretory response. The treatment of type-2 diabetes mellitus (DM) with synthetic drugs have many side effects so many researches were conducted to overcome or reduce this side effects by using alternative medicine. The objective of this study is to investigate and compare the anti-diabetic activity of C. zeylanicum and A. absinthium and their combination with difference ratio. C. zeylanicum and A. absinthium were extracted by 96% ethanol using Soxhlet apparatus. Thirty-two rats were divided into eight groups; each group contains four rats. 1st group was administered with distilled water at dose of 10ml/kg, 2nd group had received glucose only at dose of 2g/kg intraperitoneal, the standard group (3rd group) had received Glibenclamide orally at dose of 0.45mg/kg, 4th group received 100 mg C. zeylanicum + 300 mg A. absinthium with a ratio of (25:75), 5th group received 300 mg C. zeylanicum + 100 mg A. absinthium with a ratio of (75:25), 6th group received 200 mg C. zeylanicum + 200 mg A. absinthiumwith a ratio of (50:50), 7th group received 400 mg of A. absinthium, 8th group received 400 mg of C. zeylanicum. Then the blood samples were taken Retro-orbitally at 0, 1, 2 and 4 hours and the glucose level was measured. Each plant alone and their combination with different ratios shows antidiabetic effect. The significant activity was shown by A. absinthium extract (400 mg/kg), combination of ratio of (75:25) A. absinthium: C. zeylanicum(400mg/kg) and then C. zeylanicum(400mg/kg) with p-value 0.001, 0.022, 0.030 respectively, the activity was found to be increased with time. The other combinations showed less activity with p-value > 0.05. The result concludes that the good antidiabetic activity was performed by A. absinthium alone and its activity decreased by increase combination ratio with C. zeylanicum. Which maybe explains by the antagonistic effect between the compounds of C. zeylanicum and A. absinthium.

Keywords: antidiabetic, Artemisia absinthium , cinnamomum zeylanicum, combination

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Authors: Yeliz Cakir Kocak, Hafize Ozturk Can, Sibel Icke, Ummahan Yucel, Esin Ceber Turfan

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Introduction: Midwifery organization in Turkey became official in 1954 with the foundation of Midwifery Association. Today there are two Professional organizations representing midwives: ‘Midwifery Association’ and ‘Association for Education, Research and Development in Midwifery (AERDM)’. In recent years, conjuction with the increase in the numbers of midwives, professional consciousness and professional organization conscious is increasing. The undergraduates of Midwifery Department of Ege University İzmir Ataturk School of Health have come together for their professions when they’re stil students, so they founded ‘Midwifery Community of Ege University (MCEU) (EGEBET in Turkish)’ in counseling within structors and the confirmation of the university in 2013. Objective: The aim of this presentation is to reveal the activities and grades of an undergraduate community in-three-years, founded by the undergraduates in order to raise awareness in pregraduate Professional organization. Thus it is aimed to be aware towards postgraduate Professional organization, and to reflect Professional unity and solidarity, alongside personal development to midwifery services by maintaining Professional development. In-the-presentation it is aimed to explain what dimension the organization of midwifery students in Turkey is, and to be a stimulus so that ICM can be more active on undergraduate communities. Findings: MCEU’s an activity that has launched in the scope of Social Responsibility Lecture instructed in curricula of second grade in the Midwifery Department. The community have performed lots activities to reach their objectives between the years of 2013-2016. MCEU have had 65 members in a very-soon period. Today the community that goes on its activities on social network in order to abolish the distances and reach more midwifery students’ve 444 members. MCEU aiming to make all the students of the Midwifery Department a member of this association also accepts the applications of national and international midwifery students. More over the community has published two student periodical magazine and carries out activities on Midwifery Day each year. Conclusion: In conjuction with the national introduction of MCEU in the student congress in 2013, it has received consultancy from the members of MCEU as a sample model in the student organization of midwifery department of other universities in Turkey, and stil remains receiving. Furthermore a student community has been founded under the roof of association with the demand of community’s members. Also academician has a responsibility to give direction to the future and shape the future. Therefore, it is thought that the study can be an instance for all branches of science students and academics. Acknowledgment: We thank to founder members of MCEU and all the other students remaining to perform activities because of their contributions to Professional organization.

Keywords: current situation, midwifery, organization, student

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Authors: Soodabeh Shahid Sales, Azam Rastgar Moghadam, Mehrane Mehramiz, Malihe Entezari, Kazem Anvari, Mohammad Sadegh Khorrami, Saeideh Ahmadi Simab, Ali Moradi, Seyed Mahdi Hassanian, Majid Ghayour-Mobarhan, Gordon A. Ferns, Amir Avan

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Background Esophageal cancer has been reported as the eighth most common cancer universal and the seventh cause of cancer-related death in men .recent studies have revealed that cytochrome P450, family 1, subfamily B, polypeptide 1, which plays a role in metabolizing xenobiotics, is associated with different cancers. Therefore in the present study, we investigated the impact of CYP1B1-rs1056836 on esophagus squamous cell carcinoma (ESCC) patients. Method: 317 subjects, with and without ESCC were recruited. DNA was extracted and genotyped via Real-time PCR-Based Taq Man. Kaplan Meier curves were utilized to assess overall and progression-free survival. To evaluate the relationship between patients clinicopathological data, genotypic frequencies, disease prognosis, and patients survival, Pearson chi-square and t-test were used. Logistic regression was utilized to assess the association between the risk of ESCC and genotypes. Results: the genotypic frequency for GG, GC, and CC are respectively 58.6% , 29.8%, 11.5% in the healthy group and 51.8%, 36.14% and 12% in ESCC group. With respect to the recessive genetic inheritance model, an association between the GG genotype and stage of ESCC were found. Also, statistically significant results were not found for this variation and risk of ESCC. Patients with GG genotype had a decreased risk of nodal metastasis in comparison with patients with CC/CG genotype, although this link was not statistically significant. Conclusion: Our findings illustrated the correlation of CYP1B1-rs1056836 as a potential biomarker for ESCC patients, supporting further studies in larger populations in different ethnic groups. Moreover, further investigations are warranted to evaluate the association of emerging marker with dietary intake and lifestyle.

Keywords: Cytochrome P450, esophagus squamous cell carcinoma, dietary intake, lifestyle

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Authors: Ahlem Bouziri, Chiraz Latiri, Eric Gaussier

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The steady growth in the size of textual document collections is a key progress-driver for modern information retrieval techniques whose effectiveness and efficiency are constantly challenged. Given a user query, the number of retrieved documents can be overwhelmingly large, hampering their efficient exploitation by the user. In addition, retaining only relevant documents in a query answer is of paramount importance for an effective meeting of the user needs. In this situation, the query expansion technique offers an interesting solution for obtaining a complete answer while preserving the quality of retained documents. This mainly relies on an accurate choice of the added terms to an initial query. Interestingly enough, query expansion takes advantage of large text volumes by extracting statistical information about index terms co-occurrences and using it to make user queries better fit the real information needs. In this respect, a promising track consists in the application of data mining methods to extract dependencies between terms, namely a generic basis of association rules between terms. The key feature of our approach is a better trade off between the size of the mining result and the conveyed knowledge. Thus, face to the huge number of derived association rules and in order to select the optimal combination of query terms from the generic basis, we propose to model the problem as a classification problem and solve it using a supervised learning algorithm such as SVM or k-means. For this purpose, we first generate a training set using a genetic algorithm based approach that explores the association rules space in order to find an optimal set of expansion terms, improving the MAP of the search results. The experiments were performed on SDA 95 collection, a data collection for information retrieval. It was found that the results were better in both terms of MAP and NDCG. The main observation is that the hybridization of text mining techniques and query expansion in an intelligent way allows us to incorporate the good features of all of them. As this is a preliminary attempt in this direction, there is a large scope for enhancing the proposed method.

Keywords: supervised leaning, classification, query expansion, association rules

Procedia PDF Downloads 319

Authors: Bryana Woodard, Monica Mitchell, Kasey Harry, Ebony Washington, Megan Harris, Marcia Boyd, Regina Lynch, Daphene Baines, Surbi Bankar

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Introduction: African Americans experience mental health illnesses (i.e., depression, anxiety, etc.) at higher rates than their white counterparts. Despite this, they utilize mental health resources less and have lower mental health literacy, perhaps due to cultural barriers- including but not limited to mistrust. Research acknowledges African Americans’ close ties to community networks, identifying these linkages as key to establishing comfort and trust. Similarly, the church has historically been a space that creates unity and community among African Americans. Studies show that longstanding academic-community partnerships with organizations, such as churches and faith-based entities, have the capability to effectively address health and mental health barriers and needs in African Americans. The importance of implementing faith-based approaches is supported in the literature, however few empirical studies exist. This project describes the First Ladies for Health and Cincinnati Children's Hospital Medical Center (CCHMC) Partnership (FLFH-CCHMC Partnership) and the implementation and assessment of an annual Mental Health Symposium, the overall aim of which was to increase mental health awareness and decrease stigma in African American communities. Methods: The specific goals of the FLFH Mental Health Symposium were to (1) Collaborate with trusted partners to build trust with community participants; (2) Increase mental health literacy and decrease mental health stigma; (3) Understand the barriers to improving mental health and improving trust; (4) Assess the short-term outcomes two months following the symposium. Data were collected through post-event and follow-up surveys using a mixed methods approach. Results: More than 100 participants attended each year with over 350 total participants over three years. 98.7% of participants were African American, 86.67% female, 11.6% male, and 11.6% LGBTQ+/non-binary; 10.5% of participants were teens, with the remainder aged 20 to 80 plus. The event was successful in achieving its goals: (1a) Eleven different speakers from 8 community and church organizations presented; (1b) 93% of participants rated the overall symposium as very good or excellent (2a) Mental health literacy significantly increased each year with over 90% of participants reporting improvement in their “understanding” and “awareness of mental health (2b) Participants 'personal stigma surrounding mental health illness decreased each year with 92.3% of participants reporting changes in their “willingness to talk about and share” mental health challenges; (3) Barriers to mental health care were identified and included social stigma, lack of trust, and the cost of care. Data were used to develop priorities and an action plan for the FLFH-CCHMC Mental Health Partnership; (4) Follow-up data showed that participants sustained benefits of the FLFH Symposium and took actionable steps (e.g., meditation, referrals, etc.). Additional quantitative and qualitative data will be shared. Conclusions: Lower rates of mental health literacy and higher rates of stigma among participants in this initiative demonstrate the importance of mental health providers building trust and partnerships in communities. Working with faith-based entities provides an opportunity to mitigate and address mental health equity in African American communities.

Keywords: community psychology, faith-based, african-american, culturally competent care, mental health equity

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Authors: Siti Rajaah Binti Sayed Sultan

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Managing the code blue event is stressful for nurses, the patient, and the patient's families. The rapid response from the first and second responders in the code blue event will improve patient outcomes and prevent tissue hypoxia that leads to brain injury and other organ failures. Providing 1 minute for the cardiac massage and 2 minutes for defibrillation will significantly improve patient outcomes. As we know, the American Heart Association came out with guidelines for managing cardiac arrest patients. The hospital must provide competent staff to manage this situation. It can be achieved when the staff is well equipped with the skill, attitude, and knowledge to manage this situation with well-planned strategies, i.e., clear guidelines for managing the code blue event, competent staff, and functional equipment. The code blue simulation (CBS) was chosen in the training program for code blue management because it can mimic real scenarios. Having the code blue simulation module will allow the staff to appreciate what they will face during the code blue event, especially since it rarely happens in that area. This CBS module training will help the staff familiarize themselves with the activities that happened during actual events and be able to operate the equipment accordingly. Being challenged and independent in managing the code blue in the early phase gives the patient a better outcome. The CBS module will help the assessor and the hospital management team with the proper tools and guidelines for managing the code blue drill accordingly. As we know, prompt action will benefit the patient and their family. It also indirectly increases the confidence and job satisfaction among the nurses, increasing the standard of care, reducing the complication and hospital burden, and enhancing cost-effective care.

Keywords: code blue simulation module, development of code blue simulation module, code blue response time, code blue drill, cardiorespiratory arrest, managing code blue

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Authors: Helena Maragou

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Introducing Toni Morrison’s fiction to a classroom overseas entails a significant pedagogical investment, from monitoring students’ uncertain journey through Morrison’s shifty semantics to filling in the gaps of cultural knowledge and understanding for the students to be able to relate text to context. A rewarding process, as Morrison’s works present a tremendous opportunity for transnational dialogue, an opportunity that hinges upon Toni Morrison’s bringing to the fore the untold and unspeakable lives of racial ‘Others’, but also, crucially, upon her broader critique of Western ideological hegemony. This critique is a fundamental aspect of Toni Morrison’s politics and one that appeals to young readers of Toni Morrison in Greece at a time when the questioning of institutions and ideological traditions is precipitated by regional and global change. It is more or less self-evident that to help a class of international students get aboard a Morrison novel, an instructor should begin by providing them with cultural context. These days, students’ exposure to Hollywood representations of the African American past and present, as well as the use of documentaries, photography, music videos, etc., as supplementary class material, provide a starting point, a workable historical and cultural framework for textual comprehension. The true challenge, however, lies ahead: it is one thing for students to intellectually grasp the historical hardships and traumas of Morrison’s characters and to even engage in aesthetic appreciation of Morrison’s writing; quite another to relate to her works as articulations of experiences akin to their own. The great challenge, then, is in facilitating students’ discovery of the universal Morrison, the author who speaks across cultures while voicing the untold tales of her own people; this process of discovery entails, on a pedagogical level, that students be guided through the works’ historical context, to plunge into the intricacies of Morrison’s discourse, itself an elaborate linguistic booby trap, so as to be finally brought to reconsider their own historical experiences using the lens of Morrison’s fiction. The paper will be based on experience of teaching a Toni Morrison seminar to a class of Greek students at the American College of Greece and will draw from students’ exposure and responses to Toni Morrison’s “Nobel Prize Lecture,” as well as her novels Song of Solomon and Home.

Keywords: toni morrison, international classroom, pedagogy, African American literature

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Authors: Muhammad Ashfaq, Muhammad Saleem Haider, Muhammad Ali, Muhammad Sajjad, Amna Ali, Urooj Mubashar

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Phenotypic diversity was confirmed by measuring different morphological traits i.e. seed traits (seed length, seed width, seed thickness, seed length-width ratio, 1000 grain weight) and root-shoot traits (shoot length, root length, shoot fresh weight, root fresh weight, root-shoot ratio, root numbers and root thickness). Variance and association study of desirable traits determine the genotypic differences among the rice germplasm. All the traits showed significant differences among the genotypes. The traits were studied in Randomized complete block design (RCBD) at different water levels. Some traits showed positive correlation with each other and beneficial for increasing the yield and production of the crop. Seed thickness has positive correlation with seed length and seed width (r= 0.104**, r=0.246**). On the other hand, various root shoot traits showed positive highly significant association at different water levels i.e. root length, fresh root weight, root thickness, shoot thickness and root numbers. Our main focus to study the performance/correlation of root shoots traits under stress condition. Fresh root weight, shoot thickness and root numbers showed positive significant association with shoot length, root length, fresh root and shoot weight (r=0.2530**, r=0.2891**, r=0.4626**, r=0.4515**, r=0.5781**, r=0.7164**, r=0.0603**, r= 0.5570**, r=0.5824**). Long root length genotypes favors and suitable for drought stress conditions and screening of diverse genotypes for the further development of new plant material that performing well under different environmental conditions. After screening genetic diversity of potential rice, lines were studied to check the polymorphism by using some SSR markers. DNA was extracted, and PCR analyses were done to study PIC values and allelic diversity of the genotypes. The main objective of this study is to screen out the genotypes on the basis of various genotypic and phenotypic traits.

Keywords: rice, morphological traits, association, germplasm, genetic diversity, water levels, variation

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Authors: Jenan Shakoor

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Obesity prevalence is increasing worldwide. University life is a challenging period especially for students who have to leave their familiar surroundings and settle in a new environment. The current study aimed to assess the diet and exercise habits and their association with body mass index (BMI) among nursing college students living at Kirkuk University residence. This was a descriptive study. A non-probability (purposive) sample of 101 students living in Kirkuk University residence was recruited during the period from the 15^th November 2015 to the 5^th May 2016. A questionnaire was constructed for the purpose of the study which consisted of four parts: the demographic characteristics of the study sample, eating habits, eating at college and healthy habits. The data were collected by interviewing the study sample and the weight and height were measured by a trained researcher at the college. Descriptive statistical analysis was undertaken. Data were prepared, organized and entered into the computer file; the Statistical Package for Social Science (SPSS 20) was used for data analysis. A p value≤ 0.05 was accepted as statistical significant. A total of 63 (62.4%) of the sample were aged20-21with a mean age of 22.1 (SD±0.653). A third of the sample 38 (37.6%) were from level four at college, 67 (66.3%) were female and 46 45.5% of participants were from a middle socio-economic status. 14 (13.9%) of the study sample were overweight (BMI =25-29.9kg/m²) and 6 (5.9%) were obese (BMI≥30kg/m²) compared to 73 (72.3%) were of normal weight (BMI =18.5-24.9kg/m²). With regard to eating habits and exercise, 42 (41.6%) of the students rarely ate breakfast, 79 (78.2%) eat lunch at university residence, 77 (78.2%) of the students reported rarely doing exercise and 62 (61.4%) of them were sleeping for less than eight hours. No significant association was found between the variables age, sex, level of college and socio-economic status and BMI, while there was a significant association between eating lunch at university and BMI (p =0.03). No significant association was found between eating habits, healthy habits and BMI. The prevalence of overweight and obesity among the study sample was 19.8% with female students being more obese than males. Further studies are needed to identify BMI among residence students in other colleges and increasing the awareness of undergraduate students to healthy food habits.

Keywords: body mass index, diet, obesity, university residence

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Authors: Saeedeh Salimi, Farzaneh Farajian- Mashhadi, Ehsan Tabatabaei, Mahnaz Shahrakipoor, Minoo Yaghmaei, Mojgan Mokhtari

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Purpose: Estrogen receptor-α (ERα) plays an essential role in the adaptation of increased uterine blood flow during gestation. Therefore ERα gene could be a possible candidate for preeclampsia(PE) susceptibility. In the current study, we aimed to investigate the association of the ERα gene polymorphisms and PE in an Iranian population. Methods: One hundred ninety-two pregnant women with PE and 186 normotensive women were genotyped for ERα gene (PvuII and XbaI) polymorphisms by PCR-RFLP method. Results: The frequency of alleles and genotypes of ERα PvuII and XbaI polymorphisms were not different between PE and normotensive control women. However, higher frequency of GG genotype was observed in women with severe PE compared to mild PE (OR, 1.8 [95% CI, 1.1 to 3]; P = 0.02) and in severe PE compared to normotensive women [OR= 1.8(1.1-3), P=0.02] after adjusting for age, ethnicity and primiparity. Conclusions: The GG genotype of ERα XbaI polymorphism could be a genetic risk factor for PE predisposition.

Keywords: estrogen receptor-α, polymorphism, gene, preeclampsia

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Authors: Adesola Odole, Nse Odunaiya, Samuel Adewale

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Chronic Mechanical Low Back Pain (CMLBP) is prevalent in the aging population; some studies have documented the association among pain intensity, functional disability and physical activity in the general population but very few studies in the elderly. This study was designed to investigate the association among pain intensity, functional disability and physical activity of elderly individuals with CMLBP in the University College Hospital (UCH), Ibadan, Nigeria and also to determine the difference in physical activity, pain intensity and functional disability between males and females. A total of 96 participants diagnosed with CMLBP participated in this cross-sectional survey. They were conveniently sampled from selected units in the UCH, Ibadan, Nigeria. Data on sex, marital status, occupation and duration of onset of pain of participants were obtained from the participants. The Physical Activity Scale for the Elderly, Visual Analogue Scale and Oswestry Disability Questionnaire were used to measure the physical activity, pain intensity and functional disability of the participants respectively. Data was analysed using Spearman correlation, independent t-test; and α was set at 0.05. Participants (25 males, 71 females) were aged 69.64±7.43 years. The majority (76.0%) of the participants were married, and over half (55.2%) were retirees. Participants’ mean pain intensity score was 5.21±2.03 and mean duration of onset of low back pain was 63.63 ± 90.01 months. The majority (67.6%) of the participants reported severe to crippled functional disability. Their mean functional disability was 46.91 ± 13.99. Participants’ mean physical activity score was 97.47 ± 82.55. There was significant association between physical activity and pain intensity (r = -0.21, p = 0.04). There was significant association between physical activity and functional disability (r = -0.47, p = 0.00). Male (87.26 ± 79.94) and female (101.07 ± 83.71) participants did not differ significantly in physical activity (t = 0.00, p = 0.48). In addition, male (5.48 ± 2.06) and female (5.11 ± 2.02) participants’ pain intensity were comparable (t = 0.26, p = 0.44). There was also no significant difference in functional disability (t = 0.05, p = 0.07) between male (42.56 ±13.85) and female (48.45 ± 13.81) participants. It can be concluded from this study that majority of the elderly individuals with chronic mechanical low back pain had a severe to crippled functional disability. Those who reported increased physical activity had reduced pain intensity and functional disability. Male and female elderly individuals with chronic mechanical low back pain are comparable in their pain intensity, functional disability, and physical activity. Elderly individuals with CMLBP should be educated on the importance of participating in physical activity which could reduce their pain symptoms and improve functional disability.

Keywords: elderly, functional disability, mechanical low back pain, pain intensity, physical activity

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Authors: Amin Pashaye Amiri

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Freedom of information, according to which the public has a right to have access to government-held information, is largely considered as a tool for improving transparency and accountability in governments, and as a requirement of self-governance and good governance. So far, more than ninety countries have recognized citizens’ right to have access to public information. This recognition often took place through the adoption of an act referred to as “freedom of information act”, “access to public records act”, and so on. A freedom of information act typically imposes a positive obligation on a government to initially and regularly release certain public information, and also obliges it to provide individuals with information they request. Such an act usually allows governmental bodies to withhold information only when it falls within a limited number of exemptions enumerated in the act such as exemptions for protecting privacy of individuals and protecting national security. Some steps have been taken at the national and international level towards the recognition of freedom of information as a human right. Freedom of information was recognized in a few countries as a part of freedom of expression, and therefore, as a human right. Freedom of information was also recognized by some international bodies as a human right. The Inter-American Court of Human Rights ruled in 2006 that Article 13 of the American Convention on Human Rights, which concerns the human right to freedom of expression, protects the right of all people to request access to government information. The European Court of Human Rights has recently taken a considerable step towards recognizing freedom of information as a human right. However, in spite of the measures that have been taken, public access to government information is not yet widely accepted as an international human right. The paper will consider the degree to which freedom of information has been recognized as a human right, and study the possibility of widespread recognition of such a human right in the future. It will also examine the possible benefits of such recognition for the development of the human right to free expression.

Keywords: freedom of information, freedom of expression, human rights, government information

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Authors: Saqib Amina, Waqas Mehmoodb, Iftikhar Yasinc

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This study analyzes the robust association between ethnic violence and mental health from a global perspective (201-countries across the world) by using the panel data for the period 1970 to 2020. Mental health has been determined through various dimensions such as mental disorders, anxiety disorder, depressive disorder, schizophrenia, and bipolar disorder. The empirical findings show that ethnic violence has a significant positive association with all types of mental health indicators, including mental disorders, anxiety disorder, depressive disorder, schizophrenia, and bipolar disorder. The study also reveals that institutional quality may reduce the effect of mental health disorders in a better way than promoting democracy. This study suggests the non-stigmatizing social form of community-based support services instead of a stigmatizing the concept of mental illnesses that promotes hospitalization and drug treatment.

Keywords: ethnic violence, unemployment, mental health, violence

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Authors: Christopher G. Harris, Guy D. Eslick

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Purpose: Lobular carcinoma in situ (LCIS) is a known risk factor for breast cancer of unclear significance when detected in association with invasive carcinoma. This meta-analysis aims to determine the impact of LCIS on local recurrence risk for individuals with breast cancer treated with breast conservation therapy to help guide appropriate treatment strategies. Methods: We identified relevant studies from five electronic databases. Studies were deemed suitable for inclusion where they compared patients with invasive breast cancer and concurrent LCIS to those with breast cancer alone, all patients underwent breast conservation therapy (lumpectomy with adjuvant radiation therapy), and local recurrence was evaluated. Recurrence data were pooled by use of a random effects model. Results: From 1488 citations screened by our search, 8 studies were deemed suitable for inclusion. These studies comprised of 908 cases and 10638 controls. Median follow-up time was 90 months. There was a significantly increased overall risk of local breast cancer recurrence for individuals with LCIS in association with breast cancer following breast conservation therapy [pOR 1.87; 95% CI 1.14-3.04; p = 0.012]. The risk of local recurrence was non-significantly increased at 5 [pOR 1.09; 95% CI 0.48-2.48; p = 0.828] and 10 years [pOR 1.90; 95% CI 0.89-4.06; p = 0.096]. Conclusions: Individuals with LCIS in association with invasive breast cancer have an increased risk of local recurrence following breast conservation therapy. This supports consideration of aggressive local control of LCIS by way of completion mastectomy or re-excision for certain high-risk patients.

Keywords: breast cancer, breast conservation therapy, lobular carcinoma in situ, lobular neoplasia, local recurrence, meta-analysis

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Authors: Angela Fabris, Joerg Helbig

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Our paper deals with feature films set in Venice which focus on the influence of Italian life style on anglophone characters. Usually, these films emphasize the different cultures and mentalities of Italian and British (or American) people. More often than not, these encounters result in a profound change of the anglophone characters' attitude towards romance and sensuality. A case in point is David Lean's Summer Madness (UK 1955). This film recounts the love affair between the American tourist Jane Hudson (Katherine Hepburn) and the Venetian antique shop owner Renato de Rossi (Rossano Brazzi). Jane is a spinster in her mid-forties who longs for love and romance. The chance arrives when she meets Renato who feels attracted to her. Jane's immediate reaction, however, is to reject Renato's advances. What follows is a struggle between the strict morality of a puritan upbringing and the irresitable charm of Mediterranean temptations. Similar conflicts can be found in many other movies. Apart from Summer Madness we will discuss Aldo Lado's Chi l'ha vista morire? (It 1972), Nicolas Roeg's Don't Look Now (UK/It 1973) and Paul Schrader's The Comfort of Strangers (It/UK/USA 1990). Our paper raises the question whether or not these and other films present false stereotypes and chlichés. The paper is part of our large-scale research project which explores the history of erotic cinema in Italy and England.

Keywords: culture clash, erotic cinema, film, Venice

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Authors: Jeanne Grace, Jacqueline Naiker

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Background: Longevity is increasing, accompanied by a rise in disability and chronic diseases with physical activity (PA) delaying disability, ensuring successful aging (SA) and independent living in older adults. Aim: This study aimed to determine objectively measured PA levels, health-related quality of life (HRQoL), life-space mobility, and successful aging (SA) of older adults in KwaZulu-Natal province, South Africa, as well as their mutual associations. Methods: A total of 210 older adults aged 65–92 years were purposively sampled and completed the Medical Outcomes Study 36-Item Short-Form Health Survey, the Life-Space Mobility, and Successful Aging questionnaires. PA levels were measured using an Omron Pedometer, which the participants wore for seven consecutive days. Results: The average number of steps taken per day for the seven days was 2025, with 98.6% of the entire study population classified as sedentary. The Vitality domain (one of 8 categorized) reflected the best health status (M = 59.9, SD ± 18.8), with a significant 93% of the participants indicating that they had not visited places outside their immediate neighborhood (P < 0.0005). A significant, negative association between the average number of steps taken in 7 days and all three SA variables – namely, the physical (r = –0.152, P = 0.027), sociological (r = –0.148, P = 0.032) and psychological (r = –0.176, P = 0.010), and a significant, positive association with life-space mobility (r = 0.224, P = 0.001) was noted. Conclusion: The majority of the elderly were sedentary, affecting their HRQoL, life-space mobility, and SA negatively.

Keywords: active life expectancy, geriatrics, nursing homes, well-being

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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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Authors: Sunil Kumar, Uday C. Ghoshal

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Background and aims: Serotonin (5-hydroxtryptamine, 5-HT) is an important factor in gut function, playing key roles in intestinal peristalsis and secretion, and in sensory signaling in the brain-gut axis. Removal from its sites of action is mediated by a specific protein called the serotonin reuptake transporter (SERT). Polymorphisms in the promoter region of the SERT gene have effects on transcriptional activity, resulting in altered 5-HT reuptake efficiency. Functional polymorphisms may underlie disturbance in gut function in individuals suffering with disorders such as irritable bowel syndrome (IBS). The aim of this study was to assess the potential association between SERT polymorphisms and the diarrhea predominant IBS (D-IBS) phenotype Subjects: A total of 36 northern Indian female patients and 55 female northern Indian healthy controls (HC) were subjected to genotyping. Methods: Leucocyte DNA of all subjects was analyzed by polymerase chain reaction based technologies for SERT polymorphisms, specifically the insertion/deletion polymorphism in the promoter (SERT-P). Statistical analysis was performed to assess association of SERT polymorphism allele with the D-IBS phenotype. Results: The frequency of distribution of SERT-P gene was comparable between female patients with IBS and HC (p = 0.086). However, frequency of SERT-P deletion/deletion genotype was significantly higher in female patients with D-IBS compared to C-IBS and A-IBS [17/19 (89.5%) vs. 4/12 (33.3%) vs. 1/5 (20%), p=0.001, respectively]. The mucosal level of serotonin was higher in D-IBS compared to C-IBS and A-IBS [Median, range (159.26, 98.78–212.1) vs. 110.4, 67.87–143.53 vs. 92.34, 78.8–166.3 pmol/mL, p=0.001, respectively]. The mucosal level of serotonin was higher in female patients with IBS with SERT-P deletion/deletion genotype compared deletion/insertion and insertion/insertion [157.65, 67.87–212.1 vs. 110.4, 78.1–143.32 vs. 100.5, 69.1–132.03 pmol/mL, p=0.001, respectively]. Patients with D-IBS with deletion/deletion genotype more often reported symptoms of abdominal pain, discomfort (p=0.025) and bloating (p=0.039). Symptoms development following lactose ingestion was strongly associated with D-IBS and SERT-P deletion/deletion genotype (p=0.004). Conclusions: Significant association was observed between D-IBS and the SERT-P deletion/deletion genotype, suggesting that the serotonin transporter is a potential candidate gene for D-IBS in women.

Keywords: serotonin, SERT, inflammatory bowel disease, genetic polymorphism

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Authors: Thinakar Mani Balusamy, Ratnakar S. Kini, Bharat Narasimhan, Venkateswaran A. R, Pugazhendi Thangavelu, Mohammed Ali, Prem Kumar K., Kani Sheikh M., Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal

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Introduction: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury in a tertiary care center. Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and 2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed. Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining nine presenting due to penetrating injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16 managed nonoperatively. Nine patients had a severe injury ( > grade 3) – of which four underwent endotherapy, three had stents placed and one underwent an endoscopic pseudocyst drainage. Among those managed nonoperatively, three underwent a radiological drainage procedure. Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However we would like to emphasize that endoscopic intervention definitely remains the preferred treatment modality when the clinical setting permits. This is especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.

Keywords: endotherapy, non-operative management, surgery, traumatic pancreatic injury

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Authors: Kwang Yeon Kim

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This paper will explore the directly proportional relationship between the influence of Hispanophone media in U.S. markets and Hispanic population growth. Though this growth has origins across south and central America, in U.S. media markets Mexican and Cuban immigrants, have traditionally been considered the most influential. Having endured significant historical discrimination, disparagement, and ethnic framing from conventional Anglophone media, such groups have sought to form their own identities as media consuming and producing Americans of Latin American origin. Although immigrants to the U.S. have traditionally faced obstacles in access to education, children of Mexican-Americans (Chicanos) and Cuban-Americans have made significant progress in overcoming these obstacles, partly explaining their media dominance. This is particularly true in the case of Cuban-Americans, for whom such media presence is not predicted by share of population. By conducting comparative studies of Chicano media and Cuban-Americans media, common ground was found in strategies of reliance on media-driven identity formation. In contrast to the mainstream media portrayal of Latino/as with limiting, negative stereotypes, Spanish-language media’s goal is to form the identity of being Latino for those living in the United States. Providing both news from countries of origin and local news within the United States, Chicano and Cuban-American media performs rituals of recollection while rooting such populations in more proximate media paradigms.

Keywords: Chicano identity, Cuban-Americans, Hispanophone media, Latino/a community

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Authors: Nebila Lichiheb, LaToya Myles, William Pendergrass, Bruce Hicks, Dawson Cagle

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Atmospheric transport of hazardous materials in urban areas is increasingly under investigation due to the potential impact on human health and the environment. In response to health and safety concerns, several dispersion models have been developed to analyze and predict the dispersion of hazardous contaminants. The models of interest usually rely on meteorological information obtained from the meteorological models of NOAA’s National Weather Service (NWS). However, due to the complexity of the urban environment, NWS forecasts provide an inadequate basis for dispersion computation in urban areas. A dense meteorological network in Washington, DC, called DCNet, has been operated by NOAA since 2003 to support the development of urban monitoring methodologies and provide the driving meteorological observations for atmospheric transport and dispersion models. This study focuses on the comparison of wind observations from the DCNet station on the U.S. Department of Commerce Herbert C. Hoover Building against the North American Mesoscale (NAM) model outputs for the period 2017-2019. The goal is to develop a simple methodology for modifying NAM outputs so that the dispersion requirements of the city and its urban area can be satisfied. This methodology will allow us to quantify the prediction errors of the NAM model and propose adjustments of key variables controlling dispersion model calculation.

Keywords: meteorological data, Washington D.C., DCNet data, NAM model

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Authors: Susmiati, Ingrid S. Surono, Jamsari, Nur Indrawati Lipoeto

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There are two contradicting opinions on the relationship between fat mass obesity associated (FTO) rs 9939609 variants and obesity on various ethnics and races. The first opinion agrees that there is an association between the two variables, yet another one disagree. Minangkabau ethnic had a different dietary pattern with other ethnics in Indonesia. They had higher fat and low fiber intakes compared to the other ethnics groups. There is little research in genetic factors that influence eating behavior (food preference or food selection). The objective of this study was to investigate the association between FTO rs 9939609 variants with obesity and eating behavior in adolescent girls of Minangkabau Ethnic. The research design was case control study. A total of 275 adolescent girls aged 12-15 years old (130 obese and 145 normal) were randomly chosen from four districts at West Sumatera (Padang, Padang Pariaman, Padang Panjang and Tanah Datar). Genetic variants of FTO rs 9939609 were analyzed with Tetra-primer Amplification Refractory Mutation System-Polimerase Chain Reaction (AMRS PCR), eating behavior were gathered using eating habits questionnaire, and Body Mass Index (BMI) was calculated according to BMI Z-score (WHO). The result showed that genetic variants of FTO rs 9939609 (TT, TA and AA genotype) had associated with obesity (p = 0,013), whereas subject with An Allele was significantly associated with obesity (odds ratio 1,62 [95% confidential interval, 1,00-2,60]). Subjects with An Allele carrier reported a higher consumption of fried food (p < 0.05) as compared to TT genotypes carriers. There is no association between genetic variants and meal frequency, fruit and fiber intakes p > 0.05. The genetic variants of FTO rs 9939609 are associated with obesity and eating behavior in adolescent of Minangkabau Ethics.

Keywords: FTO rs9939609, obesity, eating behavior, adolescents

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Authors: Laïd Boukraâ

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Complementary and Alternative Medicine is an inclusive term that describes treatments, therapies, and modalities that are not accepted as components of mainstream education or practice, but that are performed on patients by some practitioners. While these treatments and therapies often form part of post-graduate education, study and writing, they are generally viewed as alternatives or complementary to more universally accepted treatments. Ancient civilizations used bee products and medicinal plants, but modern civilization and ‘education’ have seriously lessened our natural instinctive ability and capability. Despite the fact that the modern Western establishment appears to like to relegate apitherapy and aromatherapy to the status of 'folklore' or 'old wives' tales', they contain a vast spread of pharmacologically-active ingredients and each one has its own unique combination and properties. They are classified in modern herbal medicine according to their spheres of action. Bee products and medicinal plants are well-known natural product for their healing properties and their increasing popularity recently as they are widely used in wound healing. Honey not only has antibacterial properties which can help as an antibacterial agent but also has chemical properties which may further help in the wound healing process. A formulation with honey as its main component was produced into a honey gel. This new formulation has enhanced texture and is more user friendly for usage as well. This new formulation would be better than other formulas as it is hundred percent consisting of natural products and has been made into a better formulation. In vitro assay, animal model study and clinical trials have shown the effectiveness of LEADERMAX for the treatment of diabetic foot, burns, leg ulcer and bed sores. This one hundred percent natural product could be the best alternative to conventional products for wound and burn management. The advantages of the formulation are: 100% natural, affordable, easy to use, strong power of absorption, dry surface on the wound making a film, will not stick to the wound bed; helps relieve wound pain, inflammation, edema and bruising while improving comfort.

Keywords: bed sore bee products, burns, diabetic foot, medicinal plants, leg ulcer, wounds

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Authors: Iram Zahair, Tanith Rose, Oyinlola Oyebode, Stephen Clayton, Iman Ghosh, Michelle Maden, Ben Barr

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Background: Gastrointestinal infections exert a significant public health burden on UK healthcare services and the community. However, there are conflicting findings on where ethnic inequalities are likely to persist. This systematic review aimed to identify studies that ascertain differences in the incidence and prevalence of gastrointestinal infections within and between UK ethnic groups and explore possible explanations for heterogeneity observed within the literature. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance, a systematic review methodology was used. Medline, Web of Science, CINAHL Plus, and grey literature were searched from 1980 to 2021 for studies reporting an association between ethnicity and gastrointestinal infections in UK population samples. Two reviewers independently screened the articles and conducted quality appraisals; data extraction was undertaken by one reviewer and verified by two reviewers (PROSPERO CRD 42021240714). A narrative synthesis was undertaken to synthesise the study findings. Results: The searches identified 8134 studies; 13 met the inclusion criteria. 12 out of 13 studies found a difference in the prevalence of gastrointestinal infections between different ethnic groups. UK ethnic minorities, predominantly men and children of Asian ethnicity, had an increased risk of infection than the white British majority in 12 studies; the Pakistani ethnic group had a higher risk of infection in three out of 13 studies. Studies reported that age and sex confounded the relationship between ethnicity and gastrointestinal infections. At the same time, the country of birth, socioeconomic status, and geographical location of ethnic groups mediated this association and significantly explained the heterogeneity observed across the studies. Harvest plots supported the textual synthesis. Conclusion: This systematic review elucidates the lack of extensive UK quantitative evidence examining the association between ethnicity and gastrointestinal infections. Insights into gastrointestinal infections and ethnicity's association can help address policy actions to mitigate the inequalities identified within and between UK ethnic groups.

Keywords: ethnic and racial populations, public health, public health policy, systematic review

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Authors: Salima Kerai, Muhammad Islam, Uzma Khan, Nargis Asad, Junaid Razzak, Omrana Pasha

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Background: Pre-hospital care providers are exposed to various kinds of stressors. Their daily exposure to diverse critical and traumatic incidents can lead to stress reactions like Post-Traumatic Stress Disorder (PTSD). Consequences of PTSD in terms of work loss can be catastrophic because of its compound effect on families, which affect them economically, socially and emotionally. Therefore, it is critical to assess the association between PTSD and Work performance in Emergency Medical Service (EMS) if exist any. Methods: This prospective observational study was carried out at AMAN EMS in Karachi, Pakistan. EMS personnel were screened for potential PTSD using impact of event scale-revised (IES-R). Work performance was assessed on basis of five variables; number of late arrivals to work, number of days absent, number of days sick, adherence to protocol and patient satisfaction survey over the period of 3 months. In order to model outcomes like number of late arrivals to work, days absent and days late; negative binomial regression was used whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. Results: Out of 536 EMS personnel, 525 were found to be eligible, of them 518 consented. However data on 507 were included because 7 left the job during study period. The mean score of PTSD was found to be 24.0 ± 12.2. However, weak and insignificant association was found between PTSD and work performance measures: number of late arrivals (RRadj 0.99; 95% CI 0.98-1.00), days absent (RRadj 0.98; 95% CI 0.96-0.99), days sick (Rradj 0.99; 95% CI 0.98 to 1.00), adherence to protocol (ORadj 1.01: 95% CI 0.99 to 1.04) and patient satisfaction (0.001% score; 95% CI -0.03% to 0.03%). Conclusion: No association was found between PTSD and Work performance in the selected EMS population in Karachi Pakistan. Further studies are needed to explore the phenomenon of resiliency in these populations. Moreover, qualitative work is required to explore perceptions and feelings like willingness to go to work, readiness to carry out job responsibilities.

Keywords: trauma, emergency medical service, stress, pakistan

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