Search results for: pediatric gun violence

Authors: Windy Rakhmawati, Suryani Suryani, Sri Hendrawati, Nenden Nur Asriyani Maryam

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Tuberculosis (TB) is one of the leading causes of death in the world. Fear of COVID-19 has made people reluctant to visit health facilities, leading to disruptions to childhood TB control programs, which may increase household transmission and delay diagnosis and treatment. This study aimed to describe parents' knowledge, attitudes, and health-seeking behaviour towards childhood TB during the COVID-19 pandemic. This cross-sectional study was performed on 392 parents with TB children in three provinces with the highest proportion of TB cases in Indonesia. This study was conducted from February to December 2022. The inclusion criteria of respondents were parents with a child aged 0-14 years old with TB diagnosis who live with their parents. Data were collected using the Knowledge, Attitude, and Practice (KAP) survey guidelines from the World Health Organization and analyzed descriptively, as well as Spearman’s correlation. Overall, 392 parents of children with TB had poor knowledge (51.8%) including about causes, risk factors, transmission, symptoms, treatment, and prevention, which about 52.3%, 55.1%, 61.2%, 69.6%, 100%, 59.2%, respectively. Parents' health service-seeking behaviour towards Child TB was not normally distributed (P < 0.05) with knowledge test results (.000) and Seeking Health Services (.000). Health-seeking behaviour of parents in pediatric TB care was self-medication or self-treatment (86.2%), Traditional health seeking behaviour (4.8%), and modern health seeking behaviour (8.9%). The correlation between knowledge and seeking health services (Sig= .609) means there is no correlation between knowledge about TB and parents' health-seeking behaviour. Furthermore, 60.2% of the respondents would be shocked if their child had TB. More than half of the families in this study have poor knowledge and did self-medication or self-treatment regarding health-seeking behaviour for TB disease. Therefore, health workers, especially nurses, must provide TB-related education and health promotion and emphasize the importance of early detection. Health workers can also optimize their role in caring for and providing care to patients by increasing their trust in health workers, which will impact health-seeking behaviour in the future.

Keywords: attitude, child, health seeking behaviour, knowledge, tuberculosis

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Authors: Tania Camarillo Contreras, Yana Kuchirko

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Women’s sexuality, despite it being a core part of human functioning, has historically been stigmatized, silenced, and regulated and silenced across many cultures. The regulation of women’s bodies and desires has often been accomplished via gender ideologies and norms that ascribe power to men over women. Within Latino communities, gender ideologies like marianismo provide scripts by which women are expected to adhere submissiveness, purity, and putting others’ needs before their own. Prior work on sexuality-related topics among Latinas has almost exclusively examined the roles of risky behavior, partner violence, and gender roles on psychological and health outcomes. it know little about positive aspects of Latinas’ sexuality, such as their perspectives on sexual excitation and inhibition. Moreover, we know little about Latina’s sexuality in relation to marianismo. In this study, it ask the following questions (1) What are Latina’s perspectives on sexual excitation/inhibition? Do they vary by demographic variables (e.g., education, religiosity); (2) Does endorsement of marianismo among Latina women predict their perspectives on sexual excitation/sexual inhibition? and (3) Does endorsement of double standard (mediator variable) mediate the relation between marianismo (Independent) and sexual excitation/sexual inhibition? The results of this study shed light on effects of culturally specific gender ideologies like marianismo on women’s sexualities and have implications for culturally informed and gender-affirming policies seeking to better support Latinas’ sexual health.

Keywords: cultural beliefs, latinas, marianismo, sexuality, sexual inhibition

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Authors: Elizabeth Carthy

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There is growing recognition that sexual exploitation and abuse (SEA) perpetrated by humanitarian workers is widespread, most recently affirmed by allegations of high-ranking Oxfam officials paying women for sex in post-earthquake Haiti. SEA covers a range of gendered abuses, including rape, sexual assault, and ‘transactional’ or ‘survival’ sex. Holding individuals legally accountable for such behaviors is difficult in all contexts even more so in fragile and conflict-affected settings. Transactional sex, for the purposes of this paper, refers to situations where humanitarian workers exchange aid or assistance for sexual services. This paper explores existing organizational accountability measures relating to transactional sex engaged in by international humanitarian workers through a descriptive and interpretive case study approach-examining the situation in Haiti. It comparatively analyses steps the United Nations has taken to combat this problem. Then it examines the possibility of domestic legal accountability for such conduct in Haiti. Finally, the paper argues that international human rights law can fill in potential gaps in domestic legal frameworks to ensure states hold humanitarian workers and potentially organizations accountable for engaging in and/or perpetuating this gendered abuse of power.

Keywords: gender-based violence, humanitarian action, international human rights law, sexual exploitation

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Authors: Xiaoyu Stephanie Ren

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With the increase of massive migration, economic polarization, as well as increasing awareness and respects for religious freedom in the world, women have become unprecedentedly vulnerable to trafficking involving religious coercion. Such cases can also bring enormous challenges for prosecution in which the prosecutor bears the burden of proving that the victim acted, or not acted in a certain way due to the exploitation of her belief system: (1) Jurors who are nonbelievers tend not to be convinced that something of intangible nature can act as the force to get victim into women trafficking situation; (2) Court more often than not rules in favor of victims in women trafficking cases involving religious exploitation only when there is physical coercion in addition to religious coercion; (3) Female victims are often reluctant to testify at court due to their godly fear and loyalty to trafficker. Using case study methodology, this paper examines the unique characteristics of religious coercion as means of trafficking in women from a legal perspective and proposes multiple ways based on communal beliefs that faith communities, as victims for such crime themselves, can act in order to help to end religious exploitation. The purpose of this paper is threefold: to improve acknowledgment for the role of religious coercion as a sole force for women trafficking situation; to discuss legal hurdles in prosecuting women trafficking cases involving religious coercion; and to propose collaboration across borders among faith communities to end such exploitation.

Keywords: women trafficking, sex violence, religious exploitation, faith community, prosecution, law

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Authors: Aneta Nitsch-Osuch, Sylwia Dyk, Izabela Gołebiak

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Background. Since 2014 the pertussis vaccine is recommended to Polish health care workers who have close contacts with infants. Although this recommendation is implemented into the National Immunization Programme, its realization has remained unknown. The Purpose: The aim of the study, conducted at the department of Social Medicine and Public Health (Medical University of Warsaw, Poland), was to describe a perception, knowledge and coverage rates regarding pertussis vaccination among nursing staff. According to the authors' knowledge, it was the first study related to this topic in our country. Material and Methods: A total number of 543 nurses who work at pediatric or neonatal wards was included into the study (501 women and 42 men), average age was 47 years. All nurses were asked to fulfill the anonymous survey, previously validated. Results: 1. Coverage rates: The analysis of results revealed that only 4% of responders reported they were vaccinated with Tdpa within past 10 years, while 8% declared they would plan the vaccine in the future. 35% of responders would consider the Tdpa vaccine whether there is some kind of the reimbursement. 2. Perception and knowledge of the disease and vaccination: The majority (82%) of nurses did not recognize pertussis as a re-emerging infectious disease. 54% of them believed that obligatory vaccinations in the childhood protect against the disease and the protection is a life-long one. Only 15% of nurses considered pertussis as a possible nosocomial infection. The current epidemiology of the disease was known to 6% of responders, while 24% of them were familiar with pertussis vaccination schedules for infants, children and adolescents, but only 9% of responders knew that adults older than 19 years are recommended to be vaccinated with Tdpa every 10 years. Many nurses (82%) would expect more educational activities related to pertussis and methods of its prophylaxis. Conclusions: The pertussis vaccine coverage rate among Polish nurses is extremely low. This is a result of not enough knowledge about the disease and its prevention. Educational activities addressed to health care workers and reimbursement of the pertussis vaccine are required to improve awareness and increase of vaccine coverage rates in the future.

Keywords: coverage, nurse, pertussis, vaccine

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Authors: Tabiti S. Tabiti, A. M. Jinadu, Daramola Japheth

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Urban insecurity is among the challenges militating against sustainable urban governance; in the first place it distorts the peace of urban areas making them unsafe. On the other hand it hinders the effective performance of urban functions. Urban security challenges manifest in different forms such as, street violence, theft and robbery, accidents of different types kidnapping, killings etc.. Efforts to address urban security challenges in Nigeria have been concentrated in legislative, law enforcement and the use of community vigilante groups. However in this study, the place of physical planning strategy through effective neighbourhood renewal as practiced in Mokola is presented as an effective complementary approach for addressing urban insecurity. On this backdrop, the paper recommends the need for gradual rehabilitation of urban slum neighborhoods by the state government in collaboration with World Bank and other development financiers. The local governments should be made autonomy in Nigeria so as to make them more responsible to the people. Other recommendations suggested in the paper include creating enabling environment that will promote economic empowerment and public enlightment on personal and community sanitation. It is certain that if these recommendations are adopted the challenge of urban insecurity will reduce significantly in Nigerian cities.

Keywords: neighbourhood renewal, pilot project, slum upgrading, urban security

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Authors: Sophie Laurence, Catherine Rivard

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The assessment of acquired language disorders in the adult population, whether for a bilingual or monolingual adult, is a complex process that requires the speech-language pathologist (SLP) to make a judicious choice when selecting the assessment method and tools. However, this task is even more complex with Ontario's bilingual population due to the lack of linguistically and culturally appropriate tools for this population. Numerous researches examined language assessment of the pediatric bilingual population; however, few studies have focused on assessing acquired language disorders in bilingual adults. This study's main objective is to identify the challenges that SLPs encounter when assessing language in the bilingual English-French adult population in Ontario to ultimately be able to serve this population in the future better. An online questionnaire was made available to 1325 members of the College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO) who work with the adult population. The answers to this questionnaire (n = 71) allowed us to identify the tools and strategies most commonly used by SLPs in current practice, identify the assessment challenges faced by SLPs, and determine the causes of these challenges as well as potential solutions. In an English and French assessment, the Western Aphasia Battery, the Boston Diagnostic Aphasia Examination, and the Boston Naming Test were the three tools that respondents deemed to be the most relevant for the assessment. Besides, the results revealed that limited access to SLPs and interpreters who speak the client's language and the lack of standardized and normalized assessment tools for Ontario's French-speaking and bilingual English-French clientele are at the heart of the challenges of current SLP practice. Consistent with these findings, respondents highlighted two potential solutions to address these challenges: SLPs have access to standardized/normalized tools for the population under study and better access to SLPs and interpreters who speak the client's language.

Keywords: assessment, acquired language disorders, bilingualism, speech-Language pathology, adult population

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Authors: Naum Simanovsky, Vladimir Goldman, Michael Zaidman

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Background: The optimal algorithm for the management of symptomatic tarsal coalition is still under discussion in pediatric literature. It's debatable what surgical steps are essential to achieve the best outcome. Method: The investigators retrospectively reviewed the records of twelve patients with symptomatic tarsal coalition that were treated operatively between 2017 and 2019. Only painful flat feet were operated. Two patients were excluded from the study due to lack of sufficient follow-up. Ten of eleven feet were treated with the combination of calcaneal lengthening osteotomy (CLO) and resection of coalition (RC). Only one foot was operated with CLO alone. In half of our patients, Achilles lengthening was performed. For two children, medial plication was added. Short leg cast was applied to all children for 6-8 weeks, and soft shoe insoles for medial arch support were prescribed after. Demographic, clinical, and radiographic records were reviewed. The outcome was evaluated using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results: There were seven boys and three girls. The mean age at the time of surgery was 13.9 (range 12 to 17) years, and the mean follow-up was 18 (range 8 to 34) months. The early complications included one superficial wound infection and dehiscence. Late complication includes two children with residual forefoot supination. None of our patients required additional operations during the follow-up period. All feet achieved complete deformity correction or dramatic improvement. In the last follow-up, seven feet were painless, and four children had some mild pain after intensive activities. All feet achieved excellent and good scoring on AOFAS. Conclusions: Many patients with talocalcaneal coalition also have rigid or stiff, painful, flat feet. For these patients, the resection of coalition with concomitant CLO can be safely recommended.

Keywords: Tarsal coalition, calcaneal lengthening osteotomy., flat foot, coalition resection

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Authors: Shahla Rostamirad

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Purpose: Giardiasis is a widespread infection in humans caused by Giardia lamblia. The prevalence of this parasite among children in Isfahan of Iran is unknown. This study intended to estimate Giardia lamblia infection prevalence and identify possible associated risk factors in a healthy pediatric population living in the Isfahan, a metropolitan city of Iran. Methods: Between September 2010 and March 2012, 1448 stool sample from children with clinical manifestation that refer to clinical lab in Isfahan city for stool examination were collected and analyzed. About 1218 samples were positive for parasitic disease. All of samples were examined and diagnosed by direct examination and formalin-ether concentration of stools. Results: A total of 1218 positive cases were analyzed in this study. The findings showed that 92.5% of patients were infected by protozoa and 7.5 percent with helminth infection. The highest and lowest rate of infection belongs to Giardia lamblia and Entamoeba histolytica with 75% and 1.1%, respectively. Other infection cases were included of Blastocystys hominis 9.9%, E. coli 6.5%, H. nana 1.3%, Enterobious vermicolaris 4% and Ascaris lumbricoides 2.2% percent. The population studied revealed a gender distribution of 53.2% male and 46.8% female. Age distribution was 57.3% between 0-5 years and 42.7% between 6-15 years.The prevalence was higher among children aged 0-5 years (57.8%), than among older children (42.2%). Conclusion: The prevalence of protozoan parasite, especially Giardiasis, in children residing in the region of Isfahan is high. Several risk factors were associated with this prevalence and highlight the importance of parents' education and sanitation conditions in the children's well being. The association between Giardia lamblia and H. pylori seems an important issue deserving further investigation in order to promote prevention or treatment strategies. Other risk factor include presence of Helicobacter pylori infection, living in houses with own drainage system and reported household, pet contact, especially with cat and dog.

Keywords: Giardia duodenalis, prevalence, risk factors, children, Isfahan, Iran

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Authors: Michael Zaidman, Naum Simanovsky

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Introduction. Symptomatic tarsal coalition with rigid flat foot often demands operative solution. An isolated coalition resection does not guarantee pain relief; correction of co-existing foot deformity may be required. The objective of the study was to analyze the results of combination of tarsal coalition resection and arthroereisis. Patients and methods. We retrospectively reviewed medical records and radiographs of children operatively treated in our institution for symptomatic calcaneonavicular or talocalcaneal coalition between the years 2019 and 2022. Eight patients (twelve feet), 4 boys and 4 girls with mean age 11.2 years, were included in the study. In six patients (10 feet) calcaneonavicular coalition was diagnosed, two patients (two feet) sustained talonavicular coalition. To quantify degrees of foot deformity, we used calcaneal pitch angle, lateral talar-first metatarsal (Meary's) angle, and talonavicular coverage angle. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results. The mean follow-up was 28 month. The preoperative mean talonavicular coverage angle was 17,75º as compared with postoperative mean angle of 5.4º. The calcaneal pitch angle improved from mean 6,8º to 16,4º. The mean preoperative Meary’s angle of -11.3º improved to mean 2.8º. The preoperative mean AOFAS score improved from 54.7 to 93.1 points post-operatively. In nine of twelve feet, overall clinical outcome judged by AOFAS scale was excellent (90-100 points), in three feet was good (80-90 points). Six patients (ten feet) obviously improved their subtalar range of motion. Conclusion. For symptomatic stiff or rigid flat feet associated with tarsal coalition, the combination of coalition resection and arthroereisis leads to normalization of radiographic parameters, clinical and functional improvement with good patient’s satisfaction and likely to be more effective than the isolated procedures.

Keywords: rigid flat foot, tarsal coalition resection, arthroereisis, outcome

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Authors: Mustafa Metin Donma

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Obesity increases the risk of elevated blood pressure, which is a metabolic syndrome (MetS) component. Waist circumference (WC) is accepted as an indispensable parameter for the evaluation of these health problems. The close relationship of height with blood pressure values revealed the necessity of including height in tense indices. The association of tense indices with WC has also become an increasingly important topic. The purpose of this study was to develop a tense index that could contribute to differential diagnosis of MetS more than the indices previously introduced. One hundred and ninety-four children, aged 06-11 years, were considered to constitute four groups. The study was performed on normal weight (Group 1), overweight+obese (Group 2), morbid obese [without (Group 3) and with (Group 4) MetS findings] children. Children were included in the groups according to the recommendations of World Health Organization based on age- and gender dependent body mass index percentiles. For MetS group, MetS components well-established before were considered. Anthropometric measurements, as well as blood pressure values were taken. Tense indices were computed. The formula for the first tense index was (SP+DP)/2. The second index was Advanced Donma Tense Index (ADTI). The formula for this index was [(SP+DP)/2] * Height. Statistical calculations were performed. 0.05 was accepted as the p value indicating statistical significance. There were no statistically significant differences between the groups for pulse pressure, systolic-to-diastolic pressure ratio and tense index. Increasing values were observed from Group 1 to Group 4 in terms of mean arterial blood pressure and advanced Donma tense index (ADTI), which was highly correlated with WC in all groups except Group 1. Both tense index and ADTI exhibited significant correlations with WC in Group 3. However, in Group 4, ADTI, which includes height parameter in the equation, was unique in establishing a strong correlation with WC. In conclusion, ADTI was suggested as a tense index while investigating children with MetS.

Keywords: blood pressure, child, height, metabolic syndrome, waist circumference

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Authors: Maryam Esfandiari, Bohdan Fridrich

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On December 28, 2017, a wave of protests erupted in several Iranian cities. Protesters demonstrated against the president, Hasan Rohani, and theocratical nature of the regime. Iran has a recent history with protest movements, such as Green Movement responsible for demonstrations after 2009 Iranian presidential election. However, the 2017/2018 protests differ from the previous ones in terms of organization and agenda. The events show little to no central organization and seem as being sparked by grass root movements and by citizens’ fatigue of government corruption, authoritarianism, and economic problems of the country. Social media has played important role in communicating the protests to the outside world and also in general coordination. By using content analyses, this paper analyzes the visual content of Twitter posts published during the protests. It aims to find the correlation between their decentralized nature and nature of the tweets – either emotionally arousing or efficiency-elicit. Pictures are searched by hashtags and coded by their content, such as ‘crowds,’ ‘protest activities,’ ‘symbols of unity,’ ‘violence,’ ‘iconic figures,’ etc. The study determines what type of content prevails and what type is the most impactful in terms of reach. This study contributes to understanding the role of social media both as a tool and a space in protest organization and portrayal in countries with limited Internet access.

Keywords: twitter, Iran, collective action, protest

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Authors: Mahitab A. A. Mahmoud

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Despite the international community’s galvanized efforts to achieve gender equality, the Arab world still lags behind for their sustained suppression of diversity and freedoms. In Egypt, homosexuals are defamed and hunted not only by authorities but also by politicized religious institutions and media platforms. The resultant state-sponsored homophobia is reflected in media. This paper offers a critical discourse analysis of the representation of LGBTQs in Egypt’s local news articles and movies in an attempt to investigate the underlying ideology. The results reveal a clichéd portrayal of homosexuals as a social parasite that requires cleansing by the government. LGBTQs are depicted as an outcome of debauchery, unhappy marriage, sexual deviancy, deficiency of masculinity/femininity, absence of the mother and/or father figure(s), abject poverty, excessive wealth, psychiatric disorder, debased instincts, childhood sexual molestation, immorality, deviation from religion, chaos, treason, conspiracy against the regime, to name only a few. This image, which is imposed and sustained by the state, exposes homosexuals to a violation of their human rights by both the police and the society, endangers their lives, breeds intolerance, social inequality and violence, prevents healthy coexistence; and deprives them of living a normal life.

Keywords: critical discourse analysis, gender studies, homophobia, homosexuality, ideology, media studies

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Authors: Md Nur Uddin

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The Rohingya people are one of the world's most oppressed and persecuted refugee populations, having been stateless for over six generations and still are. In recent years, more than half-million Rohingya Muslims have fled Myanmar (Burma) for neighboring nations. This article discusses the Status and Rights of Rohingya Migrants in Bangladesh, with a focus on the living conditions of this vulnerable population. A lot of information has been studied about Rohingya refugees states that violence in Rakhine state has sent an estimated 615,500 Rohingya across the border into Bangladesh's Cox's Bazar since August 25, 2017. In Cox's Bazar, a total of 33,131 Rohingya refugees are housed in two registered camps, with an additional 854,024 living in informal settlements nearby. The living conditions of Rohingya refugees in overcrowded camps remain dismal. Mental health is bad, cleanliness is poor, malnutrition is common, and physical and sexual abuse is endemic. A coordinated diplomatic effort involving Bangladesh and Myanmar, as well as international mediators such as the Organization of Islamic Countries and the United Nations, is essential to adequately resolve this complex matter. Bangladeshi officials must ensure the safety of the Rohingyas in the camps and use available humanitarian aid to give the refugees basic amenities such as food, shelter, sanitation, and medical treatment. UNHCR officials should keep an eye on the actual repatriation process to ensure that refugees who have expressed a desire to stay in Bangladesh are not deported against their choice.

Keywords: international refugee laws, united nations, Rohingya, stateless, humanitarian

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Authors: Patrizia Bonaventura, Magda Di Renzo

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This project aims to measure and assess the voice quality in children with autism. Few previous studies exist which have analyzed the voice quality of individuals with autism: abnormal voice characteristics have been found, like a high pitch, great pitch range, and sing-song quality. Existing studies did not focus specifically on Italian-speaking children’s voices and provided analysis of a few acoustic parameters. The present study aimed to gather more data and to perform acoustic analysis of the voice of children with autism in order to identify patterns of abnormal voice features that might shed some light on the causes of the dysphonia and possibly be used to create a pediatric assessment tool for early identification of autism. The participants were five native Italian-speaking boys with autism between the age of 4 years and 10 years (mean 6.8 ± SD 1.4). The children had a diagnosis of autism, were verbal, and had no other comorbid conditions (like Down syndrome or ADHD). The voices of the autistic children were recorded in the production of sustained vowels [ah] and [ih] and of sentences from the Italian version of the CAPE-V voice assessment test. The following voice parameters, representative of normal quality, were analyzed by acoustic spectrography through Praat: Speaking Fundamental Frequency, F0 range, average intensity, and dynamic range. The results showed that the pitch parameters (Speaking Fundamental Frequency and F0 range), as well as the intensity parameters (average intensity and dynamic range), were significantly different from the relative normal reference thresholds. Also, variability among children was found, so confirming a tendency revealed in previous studies of individual variation in these aspects of voice quality. The results indicate a general pattern of abnormal voice quality characterized by a high pitch and large variations in pitch and intensity. These acoustic voice characteristics found in Italian-speaking autistic children match those found in children speaking other languages, indicating that autism symptoms affecting voice quality might be independent of the native language of the children.

Keywords: autism, voice disorders, speech science, acoustic analysis of voice

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Authors: Leman Korkmaz, Bahar Bahtiyar-Saygan

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Objective: The COVID-19 pandemic has been affecting the whole world since the beginning of 2020. In addition to health-related and financial effects, there seem to be significant psychological effects as well, among them those related to people’s views and representations of marriage and divorce. Background: Although various impacts of COVID-19 have been investigated since the beginning of the pandemic, there is a limited number of studies on its effects concerning relationships. This research aims to understand how the COVID-19 pandemic affects the views on and representations of marriage and divorce by conducting two studies. Method: In the first study, one-to-one semi-structured interviews were conducted with 31 participants (20 single and 11 married individuals) to investigate their evaluations regarding the effect of COVID-19 on people’s views of marriage in general and their own views of marriage in particular. In the second study, 298 entries on the most frequently used online social platform in Turkey (EkşiSözlük) under two separate headings for COVID-19 impact on marriage and divorce were analyzed, and meaningful thematic units were formed. Results: The findings of the thematic analysis indicated that participants mostly mentioned both the positive and negative effects of COVID-19 on the views and representations of marriage. There were both common (e.g., loneliness, violence, etc.) and distinct (e.g., sexuality, positive and negative effects on attitudes towards marriage, etc.) thematic units between the results of the two studies. Implications: There are considerable implications discussed in light of the literature on Terror Management Theory, Attachment Theory, stress research, and growth perspective.

Keywords: COVID-19 pandemic, divorce, marriage, relationships, representations, views

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Authors: Uhde Serenay Sunay, Alev Yalçınkaya

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Emotional abuse is one of the most challenging forms of violence to define, and many individuals often unknowingly experience emotional abuse. Existing literature has found that individuals who have experienced psychological abuse tend to suffer from depression, low self-esteem, a decreased sense of autonomy, fear, and an increased risk of suicide. Current research indicates that physical abuse in romantic relationships is often accompanied by emotional abuse, supporting the idea that identifying emotional abuse is an essential factor in romantic relationships. On the other hand, studies on emotional abuse between partners in romantic relationships are limited. This study investigated attitudes towards emotional abuse among Turkish university students. Gender differences were investigated.Additionally, the study examined whether the degree of emotional abuse was related to attitudes towards emotional abuse. A total of 243 university students participated in the research, with 156 female and 87 male participants. Participants' attitudes toward emotional abuse were measured using the Turkish adaptation of Follingstad Psychological Aggression Scale and hypothetical scenarios created by the researchers. The results revealed that attitudes of women and men vary significantly in attack looks/sexuality, fidelity, gender roles, and jealousy subscales of Follingstad Psychological Aggression Scale. Furthermore, attitudes towards moderate-level and severe-level emotional abuse exhibit statistically significant variability by gender, while attitudes towards mild-level emotional abuse do not.

Keywords: emotional abuse, gender differences, Turkish culture, university students

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Authors: Yolanda Zografova, Ekaterina Dimitrova, Tsvetelina Panchelieva, Victoria Nedeva-Atanasova

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Aggression and violence amongst school-aged children are widely spread phenomenon, which is expanding both on a global level and in Bulgaria. The purpose of the paper is to reveal the overall range of different types and manifestations of school aggression in a specific age group (12 to 18 years old students) from the 5th to the 12th grade according to the Bulgarian education system. In addition, the research investigates the dynamics of aggressive behaviour in two parallel lines – a horizontal one (with students from the same age) and a vertical one (with students from different grade). In the current study based on the original authors’ inventory (School Aggression Questionnaire), the three main types of aggression are measured – physical, verbal and indirect. The sample consists of 300 students from schools in a big metropolitan city, a mid-sized town, and a small town. Results show that the predominant aggression type is the verbal one, but this is the predominant type for the girls in the sample, not for the boys. Another result is that the higher the school grade, the lower levels of overall aggression is shown by the students. The study of such a multi-dimensional phenomenon as the aggression will provide up-to-date scientific knowledge, important both for the development of science on these topics, and useful for public interests in relation to the balanced development of children and adolescents at school. The results provide an excellent base for the development of prevention and intervention programs in order to reduce school aggression.

Keywords: educational psychology, School aggression, interpersonal relations, school aggression questionnaire, types of aggression

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Authors: Arash Sharghi, Irina Dotu

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The developments in the Middle East region have activated the involvement of a numerous diverse state and non-state actors in the regional affairs. The goals, positions, ideologies, different, and even contrast policy behaviors had procured the spreading and continuity of crisis. Non-state actors varying from Islamic organizations to takfiri-terrorist movements on one hand and regional and trans- regional actors, from another side, seek to reach their interests in the power struggle. Here, a research worthy question comes on the agenda: taking into consideration actors’ contradictory interests and constraints what are the regional peace and stability perspectives? Therein, different actors’ aims definition, their actions and behaviors, which affect instability, can be regarded as independent variables; whereas, on the contrary, Middle East peace and stability perspective analysis is a dependent variable. Though, this regional peace and war theory based research admits the significant influence of trans-regional actors, it asserts the roots of violence to derive from region itself. Consequently, hot war and conflict prevention and hot peace assurance in the Middle East region cannot be attained only by demands and approaches of trans-regional actors. Moreover, capacity of trans-regional actors is sufficient only for a cold war or cold peace to be reached in the region. Furthermore, within the framework of current conflict (struggle) between regional actors it seems to be difficult and even impossible to turn the cold war into a cold peace in the region.

Keywords: cold peace, cold war, hot war, Middle East, non-state actors, regional and Great powers, war theory

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Authors: Onaza Ajmal

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The purpose of the study is to explore the power relations linguistically and visually with reference to the representation of gender, race, violence, and empowerment through male characters and female superheroes from the two selected Marvel comics, Ms. Marvel (2014) and Captain Marvel (2019-). The study also aims to elaborate on the different cultural backgrounds of female superheroes and their choices and behaviors concerning the male characters. Moreover, it also seeks to explore whether the female superheroes reassert or resists the established gender roles. Using the tenets of critical discourse analysis (CDA) and feminist critical discourse analysis (FCDA) by Lazar (2005), the study analyzed the power relations from a feminist viewpoint. The linguistic analysis of textual features such as ‘adjectives’, ‘lexical items’, ‘metaphors’, and ‘use of pronouns’, etc., found in the selected comics is carried out under the framework of CDA given by Fairclough (1989). Kress and van Leeuwen's model of reading images (2006) are used to analyze the visual images in this study. The findings of the study show that despite the empowering nature of female superheroes, the unequal power relations between male and female characters are established linguistically and visually, which further sustains and reinforces the racial and patriarchal gender ideologies in the selected comics. Moreover, it is recommended that the female representations in the feminist themes of empowerment with respect to the Pakistani female superheroes should also be explored for further research.

Keywords: feminist critical discourse analysis, patriarchal gender ideology, power relations, superhero comics

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Authors: Amir Bastani

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The result of the research in the field of human behavioural genetics demonstrates a genetic contribution of behavioural differences in aggression, violence, drug and substance abuse, antisocial personality disorder and other related traits. As the field of human behavioural genetics progresses and achieves credibility, the criminal accused continue to use its types of evidence into the criminal law. One of the most important genetic factors which controls certain neurotransmitters like dopamine and serotonin is the Monoamine Oxidase Acid A (MAOA) gene, known as the 'warrior gene'. The high-profile study by Caspi and colleagues in 2002 showed that the combination between one type of variation of the MAOA gene and childhood maltreatment noticeably predisposes a person to antisocial behaviour. Moreover, further scientific research shows that individuals with the MAOA gene have to some degree difficulties in controlling their impulses. Based on the evidence of MAOA, some criminal accused claimed difficulties in self-control. In the first case – the famous case of Mobley – the court rejected the MAOA evidence on the ground of the lack of scientific support. In contrast, in other cases after the Mobley trial, courts accepted the evidence of MAOA. In this paper, the issue of lack of impulse control produced by the MAOA gene and cases which relied on the MAOA evidence and successfully being accepted will be reviewed in detail. Finally, the anticipation of the paper for the future use of the MAOA evidence in criminal cases will be presented.

Keywords: genetic defence, criminal responsibility, MAOA, self-control

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Authors: Pablo Cid Galache, Laura Zamorano Bonilla

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Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is rela-ted to low insulin concentrations. Therefore is a complication mainly found in developing countries. The main clinical features are hepatomegaly, edema, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The MS incidence is de-creasing due to the new types of insulin and intensive glycemic control. Therefore is a rare diagnosis in Europe nowadays, being described mainly in developing countries or with so-cioeconomic limitations to guarantee an adequate management of diabetes. Edema secondary to fluid retention is a rare complication of insulin treatment, especially in young patients. Its severity is variable and is mainly related to the start of a proper treatment and the improvement in glycemic control after diagnosis or after periods of poor metabolic control. Edema resolves spontaneously without requiring treatment in most cases. The Pediatric Endocrinology Unit of Hospital Motril could diagnose a 14-year-old girl who presented very poor metabolic control during the last 3 years as a consequence of the socioeconomic conditions of the country of origin during the last years. Presents up to 4 admissions for ketoacidosis during the last 12 months. After the family moved to Spain our patient began to be followed up in our Hospital. Initially presented glycated hemoglobin figures of 11%. One week after the start of treatment, the patient was admitted in the emergency room due to the appearance of generalized edema and pain in the limbs. The main laboratory abnormalities include: blood glucose 225mg/dl; HbA1C 10.8% triglycerides 543 mg/dl, total cholesterol 339 mg/dl (LDL 225) GOT 124 U/l, GPT 89U/l. Abdominal ultrasound shows mild hepatomegaly and no signs of ascites were shown. The patient presented a progressive improvement with resolution of the edema and analitical abnormalities during the next two weeks. During admission, the family received diabetes education, achieving adequate glycemic control at discharge. Nowadays the patient has a good glycemic control having glycated hemoglobin levels around 7%.

Keywords: Mauriac, diabetes, complication, developing countries

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Authors: Noura El-Ahmady El-Naggar

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Among the antitumour drugs, bacterial enzyme L-asparaginase has been employed as the most effective chemotherapeutic agent in pediatric oncotherapy especially for acute lymphoblastic leukemia. Glutaminase free L-asparaginase producing actinomycetes were isolated from soil samples collected from Egypt. Among them, a potential culture, strain NEAE-119, was selected and identified on the basis of morphological, cultural, physiological and biochemical properties, together with 16S rDNA sequence as Streptomyces olivaceus NEAE-119 and sequencing product(1509 bp) was deposited in the GenBank database under accession number KJ200342. The optimization of different process parameters for L-asparaginase production by Streptomyces olivaceus NEAE-119 using Plackett–Burman experimental design and response surface methodology was carried out. Fifteen nutritional variables (temperature, pH, incubation time, inoculum size, inoculum age, agitation speed, dextrose, starch, L-asparagine, KNO3, yeast extract, K2HPO4, MgSO4.7H2O, NaCl and FeSO4. 7H2O) were screened using Plackett–Burman experimental design. The most positive significant independent variables affecting enzyme production (temperature, inoculum age and agitation speed) were further optimized by the central composite face-centered design -response surface methodology. As a result, a medium of the following formula is the optimum for producing an extracellular L-asparaginase in the culture filtrate of Streptomyces olivaceus NEAE-119: Dextrose 3g, starch 20g, L-asparagine 10g, KNO3 1g, K2HPO4 1g, MgSO4.7H2O 0.1g, NaCl 0.1g, pH 7, temperature 37°C, agitation speed 200 rpm/min, inoculum size 4%, v/v, inoculum age 72 h and fermentation period 5 days.

Keywords: Streptomyces olivaceus NEAE-119, glutaminase free L-asparaginase, production, Plackett-Burman design, central composite face-centered design, 16S rRNA, scanning electron microscope

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Authors: Elyce Cardonick, Shistri Dhar, Linsdey Seidman

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Background: When breast cancer is diagnosed during pregnancy, the prognosis is comparable to non-pregnant women matched for prognostic indicators when pregnant women receive treatment without delay. Chemotherapy, including taxanes, can be given during pregnancy with normal neonatal development in exposed fetuses. Methods: Cases of primary breast cancer were extracted from the Cancer and Pregnancy Registry and longitudinal study at Cooper Medical School, which collects cases of pregnant women diagnosed and treated for cancer into a single database. Obstetrical, oncology and pediatric records were reviewed, including annual neonatal developmental, behavioral and medical assessments. Results: 270 pregnant women were diagnosed with primary breast cancer at a mean gestational age of 14.7+9weeks. Mean maternal age at diagnosis 34.5+4.5 years. Receptor status is comparable to non-pregnant women of reproductive age. Forty-nine women were advised to terminate. Two hundred two women underwent surgery;244 women received chemotherapy in pregnancy after the first trimester; the majority of Doxorubucin/Cytoxan; 81 of the cases included a taxane. At a mean of 90 months, follow up obtained on 255 newborns.192/255 newborns are meeting developmental milestones. Respiratory illnesses, including asthma, and bronchiolitis, were reported in 64 newborns, the most common medical condition reported. Thirty-one children are undergoing treatment for GERD, 11 for urinary tract infections, and 7 are undergoing treatment for anemia. Twenty-six children with expressive or articulation language delays, 21/26 are mild. Eleven children with gross/ 7 with fine motor delays. Eight children are treated for ADHD, 4 for anxiety and 4 have social skill impairment. The majority of children with developmental, language or motor delays were born preterm. Conclusion: After chemotherapy exposure in utero for breast cancer, the majority of newborns are meeting developmental milestones and are medically healthy. The goal for treating pregnant women with breast cancer is to aim for delivery close to the term.

Keywords: breast cancer, pregnancy, chemotherapy, newborn

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Authors: Nibedita Priyadarsini

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It is said that Ethics has a wide range of application which mainly deals with human life and human behavior. All ethical decisions are ultimately concerned with life and death. Both life and death must be considered dignified. Medical ethics with its different topics mostly deals with life and death concepts among which euthanasia is one. Various types of debates continue over Euthanasia long since. The question of putting an end to someone’s life has aroused controversial in legal sphere as well as in moral sphere. To permit or not to permit has remained an enigma the world over. Modern medicine is in the stage of transcending limits that cannot be set aside. The morality of allowing people to die without treatment has become more important as methods of treatment have become more sophisticated. Allowing someone to die states an essential recognition that there is some point in any terminal illness when further curative treatment has no purpose and the patient in such situation should allow dying a natural death in comfort, peace, and dignity, without any interference from medical science and technology. But taking a human life is in general sense is illogical in itself. It can be said that when we kill someone, we cause the death; whereas if we merely let someone die, then we will not be responsible for anyone’s death. This point is often made in connection with the euthanasia cases and which is often debatable. Euthanasia in the pediatric age group involves some important issues that are different from those of adult issues. The main distinction that occurs is that the infants and newborns and young children are not able to decide about their future as the adult does. In certain cases, where the child born with some serious deformities with no hope of recovery, in that cases doctor decide not to perform surgery in order to remove the blockage, and let the baby die. Our aim in this paper is to examine, whether it is ethically justified to withhold or to apply euthanasia on the part of the defective infant. What to do with severely defective infants from earliest time if got to know that they are not going to survive at all? Here, it will deal mostly with the ethics in deciding the relevant ethical concerns in the practice of euthanasia with the defective newborns issues. Some cases in relation to disabled infants and newborn baby will be taken in order to show what to do in a critical condition, that the patient and family members undergoes and under which condition those could be eradicated, if not all but some. The final choice must be with the benefit of the patient.

Keywords: ethics, medical ethics, euthanasia, defective newborns

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Authors: Otuu O. Obasi, Jude C. Ajaraogu, Happiness C. Anthony-Ikpe

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Women in Igbo land generally experience culture-related mistreatment in the event of the death of their husbands. The mistreatment ranges from scraping of widows’ hair to denial of the right to see their husbands’ corpses. The objectives of the study were to determine the forms and prevalence of widowhood practice in the studied communities, the effects of the socio-cultural attributes of the people on the practice, and the perceived effect of the practice on the victims. Data for the study were collected from 64 randomly selected communities out of 640 communities in Imo State, Nigeria. 450 copies of the researcher-made-questionnaire were distributed across the three senatorial zones of the State. A total of 418 or 92.8% were completely filled and returned. The result of the study showed, among other things, that the majority of males and females recognized widowhood practice as dehumanizing, but opined that it cannot be stopped because it is rooted in culture. However, 30.2% of the female population did not agree that the practice is dehumanizing to women since it was their cultural practice. The study also revealed that scrapping of widows’ hair was the commonest practice while sleeping alone with the husband’s corpse was the least practice. Regarding the effect which this practice has on widows, emotional trauma topped the list; and was followed by economic hardship and health deterioration. Also shown by the study was that the level of education and religion did not have a notable effect on widowhood practice. With regard to possible stoppage measures, greater number of the respondents (38%) indicated that a synergy of efforts was needed to curb the social scourge.

Keywords: widowhood practice, socio-cultural attributes, violence, impact

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Authors: Abubakar Samaila

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Pastoralism has been an old practice in the Sahel region of west Africa. In recent years, pastoralists in Nigeria have increasingly been migrating on seasonal transhumance southward from the neighboring countries, especially Niger Republic, in search of better grazing conditions due to mainly, climate change. This has increased pressure on farm lands which instigate farmer-herder conflicts. These conflicts occur mainly between farmers and pastoralists but also between pastoralist groups themselves. However, there has been a shift in these conflicts recently to involve traditional institutions and, in some cases, the local authorities along the borderlands. The involvement of local institutions in the conflict has created an incentive to local actors, particularly pastoralcommunity-based groups, in responding to these violent threats. As pastoralists are mobile, these conflicts became difficult to contain and, thus, spill across borders. Consequently, the conflict has now transformed into an urbanized regional conflicts that involve some major cities along the Nigeria-Niger borderlands; Sokoto, Zamfara, and Katsina on the Nigerian side andDosso, Tahoa andMaradi in Niger republic. These areas are now experiencing unprecedented growing wave of violence that have become complex and escalates into a hydra-social conflict. The aim of this research is to investigate how the fluidities of Nigeria-Niger borderland intensified armed conflicts between the local pastoral organizations and sedentary populationspreading to some urban cities along the borderlands. The paper further suggests alternative approaches towards addressing the perennial crisis in African borderlands.

Keywords: pastoralism, climate change, conflict, nigeria, niger, borderlands

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Authors: Helena Baffoe

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The US has developed numerous programs over the past 50 years to enhance the lives of those who suffer from mental health illnesses and substance abuse, as well as the effectiveness of their treatments. Despite these advances over the past 50 years, there hasn't been a corresponding improvement in American public attitudes and beliefs about mental health disorders and substance abuse. Highly publicized acts of violence frequently elicit comments that blame the perpetrator's perceived mental health disorder since such people are thought to be substance abusers. Despite these strong public beliefs and perception about mental disorder and substance abuse, concreate empirical evidence that entail this perception is lacking, and evidence of their effectiveness has not been integrated. A rich data was collected from Substance Abuse and Mental Health Services Administration (SAMHSA) with a hypothesis that people who are diagnosed with a mental health disorder are likely to be diagnosed with substance abuse using logit regression analysis and Instrumental Variable. It was found that depressive, anxiety, and trauma/stressor mental disorders constitute the most common mental disorder in the United States, and the study could not find statistically significant evidence that being diagnosed with these leading mental health disorders in the United States does necessarily imply that such a patient is diagnosed with substances abuse. Thus, the public has a misconception of mental health and substance abuse issues, and social workers' responsibilities are outlined in order to assist ameliorate this attitude and perception.

Keywords: mental health disorder, substance use, empirical evidence, logistic regression

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Authors: Soumaya Mrabet, Taieb Ach, Imen Akkari, Amira Atig, Neirouz Ghannouchi, Koussay Ach, Elhem Ben Jazia

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Introduction: Celiac disease (CD) and type 1 diabetes mellitus (T1D) are complex disorders with shared genetic components. The association between CD and T1D has been reported in many pediatric series. The aim of our study is to describe the epidemiological, clinical and evolutive characteristics of adult patients presenting this association. Material and Methods: This is a retrospective study including patients diagnosed with CD and T1D, explored in Internal Medicine, Gastroenterology and Endocrinology and Diabetology Departments of the Farhat Hached University Hospital, between January 2005 and June 2016. Results: Among 57 patients with CD, 15 patients had also T1D (26.3%). There are 11 women and 4 men with a median age of 27 years (16-48). All patients developed T1D prior to the diagnosis of CD with an average duration of 47 months between the two diagnosis (6 months-5 years). CD was revealed by recurrent abdominal pain in 11 cases, diarrhea in 10 cases, bloating in 8 cases, constipation in 6 cases and vomiting in 2 cases. Three patients presented cycle disorders with secondary amenorrhea in 2 patients. Anti-Endomysium, anti-transglutaminase and Anti-gliadin antibodies were positive respectively in 57, 54 and 11 cases. The biological tests revealed anemia in 10 cases, secondary to iron deficiency in 6 cases and folate and vitamin B12 deficiency in 4 cases, hypoalbuminaemia in 4 cases, hypocalcemia in 3 cases and hypocholesterolemia in 1 patient. Upper gastrointestinal endoscopy showed an effacement of the folds of the duodenal mucosa in 6 cases and a congestive duodenal mucosa in 3 cases. The macroscopic appearance was normal in the others cases. Microscopic examination showed an aspect of villous atrophy in 57 cases, which was partial in 10 cases and total in 47 cases. After an average follow-up of 3 years 2 months, the evolution was favorable in all patients under gluten-free diet with the necessity of less important doses of insulin in 10 patients. Conclusion: In our study, the prevalence of T1D in adult patients with CD was 26.3%. This association can be attributed to overlapping genetic HLA risk loci. In recent studies, the role of gluten as an important player in the pathogenesis of CD and T1D has been also suggested.

Keywords: celiac disease, gluten, prevalence, type 1 diabetes

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Authors: Bassma A. Abdel Haleem, Ehab K. Emam, George E. Yacoub, Ashraf M. Salem

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Background: Obesity is an increasingly common problem in childhood. Childhood obesity is considered the main risk factor for the development of metabolic syndrome (MetS) (diabetes type 2, dyslipidemia, and hypertension). Recent studies estimated that among children with obesity 30-60% will develop MetS. Visceral fat thickness is a valuable predictor of the development of MetS. Computed tomography and dual-energy X-ray absorptiometry are the main techniques to assess visceral fat. However, they carry the risk of radiation exposure and are expensive procedures. Consequently, they are seldom used in the assessment of visceral fat in children. Some studies explored the potential of ultrasound as a substitute to assess visceral fat in the elderly and found promising results. Given the vulnerability of children to radiation exposure, we sought to evaluate ultrasound as a safer and more cost-efficient alternative for measuring visceral fat in obese children. Additionally, we assessed the correlation between visceral fat and obesity indicators such as insulin resistance. Methods: A cross-sectional study was conducted on 46 children with obesity (aged 6–16 years). Their visceral fat was evaluated by ultrasound. Subcutaneous fat thickness (SFT), i.e., the measurement from the skin-fat interface to the linea alba, and visceral fat thickness (VFT), i.e., the thickness from the linea alba to the aorta, were measured and correlated with anthropometric measures, fasting lipid profile, homeostatic model assessment for insulin resistance (HOMA-IR) and liver enzymes (ALT). Results: VFT assessed via ultrasound was found to strongly correlate with the BMI, HOMA-IR with AUC for VFT as a predictor of insulin resistance of 0.858 and cut off point of >2.98. VFT also correlates positively with serum triglycerides and serum ALT. VFT correlates negatively with HDL. Conclusions: Ultrasound, a safe and cost-efficient technique, could be a useful tool for measuring the abdominal fat thickness in children with obesity. Ultrasound-measured VFT could be an appropriate prognostic factor for insulin resistance, hypertriglyceridemia, and elevated liver enzymes in obese children.

Keywords: metabolic syndrome, pediatric obesity, sonography, visceral fat

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