Search results for: thyroid status

Authors: Faezeh Jahanpour, Shahin Dezhdar, Saeedeh Firouz Bakht, Afshin Ostovar

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Objective: The hospitalized premature babies often undergo various painful procedures such as venous sampling. The Kangaroo mother care (KMC) method is one of the pain reduction methods, but as mother’s presence is not always possible, this research was done to compare the effect of swaddling and KMC method on venous sampling pain on premature neonates. Methods: In this randomized clinical trial 90 premature infants selected and randomly alocated into three groups; Group A (swaddling), Group B (the kangaroo care), and group C (the control). From 10 minutes before blood sampling to 2 minutes after that in group A, the infant was wrapped in a thin sheet, and in group B, the infant was under Kangaroo care. In all three groups, the heart rate and arterial oxygen saturation in time intervals of 30 seconds before, during, 30-60-90, and 120 seconds after sampling were measured and recorded. The infant’s face was video recorded since sampling till 2 minutes and the videos were checked by a researcher who was unaware of the kind of intervention and the pain assessment tools for infants (PIPP) for time intervals of 30 seconds were completed. Data analyzed by t-test, Q square, Repeated Measure ANOVA, Kruskal-Wallis, Post-hoc and Bonferroni test. Results: Findings revealed that the pain was reduced to a great extent in swaddling and kangaroo method compared to that in control group. But there was not a significant difference between kangaroo and swaddling care method (P ≥ 0.05). In addition, the findings showed that the heart rate and arterial oxygen saturation was low and stable in swaddling and Kangaroo care method and returned to base status faster, whereas, the changes were severe in control group and did not return to base status even after 120 seconds. Discussion: The results of this study showed that there was not a meaningful difference between swaddling and kangaroo care method on physiological indexes and pain in infants. Therefore, swaddling method can be a good substitute for kangaroo care method in this regard.

Keywords: Kangaroo mother care, neonate, pain, premature, swaddling, venipuncture,

Procedia PDF Downloads 198

Authors: Dana Page, Erica McClure, Kate Snider, Jenni Pollard, Tim Landrum, Jeff Valentine

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Extensive research has been conducted on students with emotional and behavioral disorders (EBD) and their rates of challenging behavior. In the past, however, less attention has been given to their academic achievement and outcomes. Recent research examining outcomes for students with EBD has indicated that these students receive lower grades, are less likely to pass classes, and experience higher rates of school dropout than students without disabilities and students with other high incidence disabilities. Given that between 2% and 20% of the school-age population is likely to have EBD (though many may not be identified as such), this is no small problem. Despite the need for increased examination of this population’s academic achievement, research on the actual performance of students with EBD has been minimal. This study reports the results of a meta-analysis of the limited research examining academic achievement of students with EBD, including effect sizes of assessment scores and discussion of moderators potentially impacting academic outcomes. Researchers conducted a thorough literature search to identify potentially relevant documents before screening studies for inclusion in the systematic review. Screening identified 35 studies that reported results of academic assessment scores for students with EBD. These studies were then coded to extract descriptive data across multiple domains, including placement of students, participant demographics, and academic assessment scores. Results indicated possible collinearity between EBD disability status and lower academic assessment scores, despite a lack of association between EBD eligibility and lower cognitive ability. Quantitative analysis of assessment results yielded effect sizes for academic achievement of student participants, indicating lower performance levels and potential moderators (e.g., race, socioeconomic status, and gender) impacting student academic performance. In addition to discussing results of the meta-analysis, implications and areas for future research, policy, and practice are discussed.

Keywords: students with emotional behavioral disorders, academic achievement, systematic review, meta-analysis

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Authors: Mirjana Ilic, Dragan Zivotic, Aleksandra Perovic, Predrag Gavrilovic

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The service quality perception depends on many factors, such as the area in which the services are provided, socioeconomic status, educational status, experience, age and gender of consumers, as well as many others. For this reason, it is not possible to apply instrument for establishing the service quality perception that is developed in other areas and in other populations. The aim of the research was to form an instrument for assessing the quality perception in the field of fitness in Serbia. After analyzing the available literature and conducting a pilot research, there were 15 isolated areas in which it was possible to observe the service quality perception. The areas included: material and technical basis, secondary facilities, coaches, programs, reliability, credibility, security, rapid response, compassion, communication, prices, satisfaction, loyalty, quality outcomes and motives. These areas were covered by a questionnaire consisted of 100 items where the number of items varied from area to area from 3 up to 11. The questionnaire was administered to 350 subjects of both genders (174 men and 176 women) aged from 18 to 68 years, being beneficiaries of fitness services for at least 1 year. In each of the areas was conducted a factor analysis in its exploratory form by principal components method. The number of significant factors has been determined in accordance with the Kaiser Guttman criterion. The initial factor solutions were simplified using the Varimax rotation. Analyses per areas have produced from 1 to 4 factors. Afterward, the factor analysis of factor scores on the first principal component of each of the respondents in each of the analyzed area was performed, and the factor structure was obtained with four latent dimensions interpreted as offer, the relationship with the coaches, the experience of quality and the initial impression. This factor structure was analysed by hierarchical analysis of Oblique factors, which in the second order space produced single factor interpreted as a general factor of the service quality perception. The resulting questionnaire represents an instrument which can serve managers in the field of fitness to optimize the centers development, raising the quality of services in line with consumers needs and expectations.

Keywords: fitness, hierarchical model, quality perception, factor analysis

Procedia PDF Downloads 295

Authors: Yude Wu

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Mongolia, grappling with significant socio-economic challenges, faces pressing issues of inequality and poverty, as evidenced by a high Gini coefficient and the highest poverty rate among the top 20 largest Asian countries. Despite government efforts, Mongolia's poverty rate experienced only a slight reduction from 29.6 percent in 2016 to 27.8 percent in 2020. PEER countries, such as South Africa, Botswana, Kazakhstan, and Peru, share characteristics with Mongolia, including reliance on the mining industry and classification as lower middle-income countries. Successful transitions of these countries to upper middle-income status between 1994 and the 2010s provide valuable insights. Drawing on secondary analyses of existing research and PEER country profiles, the study evaluates past policies, identifies gaps in current approaches, and proposes recommendations to combat poverty sustainably. The hypothesis includes a reliance on the mining industry and a transition from lower to upper middle-income status. Policies from these countries, such as the GEAR policy in South Africa and economic diversification in Botswana, offer insights into Mongolia's development. This essay aims to illuminate the multidimensional nature of underdevelopment in Mongolia through a secondary analysis of existing research and PEER country profiles, evaluating past policies, identifying gaps in current approaches, and providing recommendations for sustainable progress. Drawing inspiration from PEER countries, Mongolia can implement policies such as economic diversification to reduce vulnerability and create stable job opportunities. Emphasis on infrastructure, human capital, and strategic partnerships for Foreign Direct Investment (FDI) aligns with successful strategies implemented by PEER countries, providing a roadmap for Mongolia's development objectives.

Keywords: inequality, PEER countries, comparative analysis, nomadic animal husbandry, sustainable growth

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Authors: Rotem Mashkov, Noam Shoval

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In an age when a tourist’s gaze is more focused on the daily lives of locals, it is evident that local food markets are being rediscovered. Traditional urban markets succeed in reinventing themselves as a space for consumption, recreation, and culture, enabling authentic experiences and interpersonal interactions with the local culture. Alongside this, the pressure of tourism development may result in commercialization and retail gentrification to the point of losing the sense of local identity. The issue of finding a balance between tourism development and the preservation of unique local features is at the heart of this study and is being tested using the case of the Mahane Yehuda market in Jerusalem. The research question—how merchants respond to tourism development in the Mahane Yehuda food market— focuses on local traders, a group of players who are usually absent from the research arenas, although they influence tourism development as well as influenced by it. Three main research methods were integrated into this study. The first two methods, a survey of articles survey and comparative mapping of the business mix, were used to characterize the changes in the Mahane Yehuda market both consciously and physically. The third research method, involving in-depth interviews with merchants, was used to examine the traders' attitudes and responses to tourism development. The findings indicate that there has been a turnaround in the market image over the past decade and a half. Additionally, there has been a significant physical change in the business mix, reflected by a decline of 15% in the number of stalls selling food products and delicacies. The data from the interviews on the traders’ attitudes towards tourism development were inconclusive; there were disagreements among the traders about the economic contribution of tourism development in relation to their dependence on the tourism industry. However, there was a consensus on the need for authentic elements in the marketplace. The findings of the study also indicate a strong link between the merchants’ response to tourism development and their stall ownership status as the merchant could exercise their position in various ways depending on the possession type.

Keywords: business mix, Jerusalem, local food markets, Mahane Yehuda market, merchants’ attitude, ownership status, retail gentrification, tourism development, traditional urban markets

Procedia PDF Downloads 117

Authors: Rossukhon Makaramani, Supanan Sittilerd, Wipada Prasarnsaph

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The study aimed to 1) examine management status of a Program in Education at the Faculty of Education, Suan Sunandha Rajabhat University (SSRU); 2) determine main components, indicators and criteria for constructing quality assessment framework; 3) assess quality of a SSRU Program in Education; and 4) provide recommendations to promote academic excellence. The program to be assessed was Bachelor of Education Program in Education (5 years), Revised Version 2009. Population and samples were stakeholders involving implementation of this program during an academic year 2012. Results were: 1) Management status of the Program in Education showed that the Faculty of Education depicted good level (4.20) in the third cycle of external quality assessment by the Office for National Education Standards and Quality Assessment (ONESQA). There were 1,192 students enrolling in the program, divided into 5 major fields of study. There were 50 faculty members, 37 holding master’s degrees and 13 holding doctorate degrees. Their academic position consisted of 35 lecturers, 10 assistant professors, and 5 associate professors. For program management, there was a committee of 5 members for the program and also a committee of 4 or 5 members for each major field of study. Among the faculty members, 41 persons taught in this program. The ratio between faculty and student was 1:26. The result of 2013 internal quality assessment indicated that system and mechanism of the program development and management was at fair level. However, the overall result yielded good level either by criteria of the Office of Higher Education Commission (4.29) or the NESQA (4.37); 2) Framework for assessing the quality of the program consisted of 4 dimensions and 15 indicators; 3) Assessment of the program yielded Good level of quality (4.04); 4) Recommendations to promote academic excellence included management and development of the program focusing on teacher reform toward highly recognized profession; cultivation of values, moral, ethics, and spirits of being a teacher; construction of specialized programs; development of faculty potentials; enhancement of the demonstration school’s readiness level; and provision of dormitories for learning.

Keywords: quality assessment, education program, Suan Sunandha Rajabhat University, academic excellence

Procedia PDF Downloads 282

Authors: Samrawit Tamrat Gebretsadik

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Recurrent wheezing is a common respiratory symptom among children, often indicative of underlying airway inflammation and hyperreactivity. Understanding the prevalence and associated factors of recurrent wheezing in specific age groups is crucial for targeted interventions and improved respiratory health outcomes. This study aimed to investigate the prevalence and associated factors of recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College in Ethiopia. A cross-sectional study design was employed, involving structured interviews with parents/guardians, medical records review, and clinical examination of children. Data on demographic characteristics, environmental exposures, family history of respiratory diseases, and socioeconomic status were collected. Logistic regression analysis was used to identify factors associated with recurrent wheezing. The study included X 6-year-old children, with a prevalence of recurrent wheezing found to be Y%. Environmental exposures, including tobacco smoke exposure (OR = Z, 95% CI: X-Y), indoor air pollution (OR = Z, 95% CI: X-Y), and presence of pets at home (OR = Z, 95% CI: X-Y), were identified as significant risk factors for recurrent wheezing. Additionally, a family history of asthma or allergies (OR = Z, 95% CI: X-Y) and low socioeconomic status (OR = Z, 95% CI: X-Y) were associated with an increased likelihood of recurrent wheezing. The impact of recurrent wheezing on the quality of life of affected children and their families was also assessed. Children with recurrent wheezing experienced a higher frequency of respiratory symptoms, increased healthcare utilization, and decreased physical activity compared to their non-wheezing counterparts. In conclusion, recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College is associated with various environmental, genetic, and socioeconomic factors. These findings underscore the importance of targeted interventions aimed at reducing exposure to known triggers and improving respiratory health outcomes in this population. Future research should focus on longitudinal studies to further elucidate the causal relationships between risk factors and recurrent wheezing and evaluate the effectiveness of preventive strategies.

Keywords: wheezing, inflammation, respiratory, crucial

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Authors: Anna Rudzińska, Katarzyna Szklener, Pola Juchaniuk, Anna Rodzajweska, Katarzyna Machulska-Ciuraj, Monika Rychlik- Grabowska, Michał łOziński, Agnieszka Kolak-Bruks, SłAwomir Mańdziuk

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Introduction: Immune checkpoint inhibition (ICI) belongs to the modern forms of anti-cancer treatment. Due to the constant development and continuous research in the field of ICI, many aspects of the treatment are yet to be discovered. One of the less researched aspects of ICI treatment is the influence of the adverse effects on the treatment success rate. It is suspected that adverse events in the course of the ICI treatment indicate a better response rate and correlate with longer progression-free- survival. Methodology: The research was conducted with the usage of the documentation of the Department of Clinical Oncology and Chemotherapy. Data of the patients with a lung cancer diagnosis who were treated between 2019-2022 and received ICI treatment were analyzed. Results: Out of over 133 patients whose data was analyzed, the vast majority were diagnosed with non-small cell lung cancer. The majority of the patients did not experience adverse effects. Most adverse effects reported were classified as grade 1 or grade 2 according to CTCAE classification. Most adverse effects involved skin, thyroid and liver toxicity. Statistical significance was found for the adverse effect incidence and overall survival (OS) and progression-free survival (PFS) (p=0,0263) and for the time of toxicity onset and OS and PFS (p<0,001). The number of toxicity sites was statistically significant for prolonged PFS (p=0.0315). The highest OS was noted in the group presenting grade 1 and grade 2 adverse effects. Conclusions: Obtained results confirm the existence of the prolonged OS and PFS in the adverse-effects-charged patients, mostly in the group presenting mild to intermediate (Grade 1 and Grade 2) adverse effects and late toxicity onset. Simultaneously our results suggest a correlation between treatment response rate and the toxicity grade of the adverse effects and the time of the toxicity onset. Similar results were obtained in several similar research conducted - with the proven tendency of better survival in mild and moderate toxicity; meanwhile, other studies in the area suggested an advantage in patients with any toxicity regardless of the grade. The contradictory results strongly suggest the need for further research on this topic, with a focus on additional factors influencing the course of the treatment.

Keywords: adverse effects, immunotherapy, lung cancer, PD-1/PD-L1 inhibitors

Procedia PDF Downloads 74

Authors: Kamil Ganaev, Elina Vlasova, Andrei Shiryaev, Renat Akchurin

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De novo atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a common complication. To date, there are no data on the possible effect of diffuse lesions of coronary arteries on the incidence of postoperative AF complications. Methods. Patients operated on-pump under hypothermic conditions during the calendar year (2020) were studied. Inclusion criteria - isolated CABG and achievement of complete myocardial revascularization. Patients with a history of AF moderate and severe valve dysfunction, hormonal thyroid pathology, initial CHF(Congestive heart failure), as well as patients with developed perioperative complications (IM, acute heart failure, massive blood loss) and deceased were excluded. Thus 227 patients were included; mean age 65±9 years; 69% were men. 89% of patients had a 3-vessel lesion of the coronary artery; the remainder had a 2-vessel lesion. Mean LV size: 3.9±0.3 cm, indexed LV volume: 29.4±5.3 mL/m2. Two groups were considered: D (n=98), patients with diffuse coronary heart disease, and L (n=129), patients with local coronary heart disease. Clinical and demographic characteristics in the groups were comparable. Rhythm assessment: continuous bedside ECG monitoring up to 5 days; ECG CT at 5-7 days after CABG; daily routine ECG registration. Follow-up period - postoperative hospital period. Results. The Median follow-up period was 9 (7;11) days. POFP (Postoperative atrial fibrillation) was detected in 61/227 (27%) patients: 34/98 (35%) in group D versus 27/129 (21%) in group L; p<0.05. Moreover, the values of revascularization index in groups D and L (3.9±0.7 and 3.8±0.5, respectively) were equal, and the mean time Cardiopulmonary bypass (CPB) (107±27 and 80±13min), as well as the mean ischemic time (67±17 and 55±11min) were significantly longer in group D (p<0.05). However, a separate analysis of these parameters in patients with and without developed AF did not reveal any significant differences in group D (CPB time 99±21.2 min, ischemic time 63±12.2 min), or in group L (CPB time 88±13.1 min, ischemic time 58.7±13.2 min). Conclusion. With the diffuse nature of coronary lesions, the incidence of AF in the hospital period after isolated CABG definitely increases. To better understand the role of severe coronary atherosclerosis in the development of POAF, it is necessary to distinguish the influence of organic features of atrial and ventricular myocardium (as a consequence of chronic coronary disease) from the features of surgical correction in diffuse coronary lesions.

Keywords: atrial fibrillation, diffuse coronary artery disease, coronary artery bypass grafting, local coronary artery disease

Procedia PDF Downloads 198

Authors: Ibrahim Arslan

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Since 1984, Turkey has experienced a significant transformation in legal and economic matters. The most consequential examples of this transformation in recent years are the renewal of the Commercial Code and the Check Act. Nowadays, the commercial activity is not limited within the boundaries of the country; on the contrary, as required by the global economy, it has an international dimension. For this reason, unlike some other legal principles, the rules regulating the commercial life should be compatible with the international standards as much as possible. Otherwise the development possibility in the global markets will be limited. The Check Act has been adopted in 2009 and the Commercial Code has been adopted in 2011. The Commercial Code has been entered into force on 1 July 2012. The international dimension of check is in-disputable for it is based on the Geneva Convention. However, the Turkish business life has created a unique application of this legal tool. This application is called “post-date” checks. Indeed the majority of the checks being used in the market are post-dated checks. The holders of these checks have waited the date written on the check for presentation and collection. Thus, the actual situation has occurred. This actual situation has been legitimized via Check Act No. 5941 and post dated checks have gained a legal status. In the preparation of the new the Turkish Commercial Code one of the goals is "to ensure that the Turkish commercial law becomes a part of the international market". To achieve this goal, significant changes have been made especially concerning the independent external audition of the corporations, the board structure and public disclosure regulations. These changes aim to facilitate the internationalization of Turkish corporations as well as intensification of foreign direct investments through foreign capital. Although the target has been determined this way, after the adoption but five days before the entry into force of the Turkish Commercial Code No. 6102, a law made backward going alterations concerning independent external audition and public disclosure regulations. Turkish Commercial Code has been currently in force with its altered status. Both the regulations in the Check Act as well as the changes in the Commercial Code are not compatible with the goals introduced by rationale “to ensure Turkish commercial law to be a part of the international market” as such.

Keywords: Turkish Commercial Code No. 6102, Turkish Check Act, “post-date” checks, legal changes

Procedia PDF Downloads 278

Authors: Akram Sadat Jafari Roodbandi, Farzaneh Akbari, Vafa Feyzi, Zahra Zare, Zohreh Foroozanfar

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Introduction: Circadian rhythm or sleep-awake cycle in 24 hours is one of the important factors affecting the physiological and psychological characteristics in humans that contribute to biochemical, physiological and behavioral processes and helps people to set up brain and body for sleep or active awakening during certain hours. The purpose of this study was to investigate the relationship between the characteristics of circadian rhythms on the sleep quality and sleepiness according to their demographic characteristics such as age. Methods: This cross-sectional descriptive-analytic study was carried out among the general population of Kerman, aged 15-84 years. After dividing the age groups into 10-year demographic characteristics questionnaire, the type of circadian questionnaire, Pittsburgh sleep quality questionnaire and Euporth sleepiness questionnaire were completed in equal numbers between men and women of that age group. Using cluster sampling with effect design equal 2, 1300 questionnaires were distributed during the various hours of 24 hours in public places in Kerman city. Data analysis was done using SPSS software and univariate tests and linear regressions at a significance level of 0.05. Results: In this study, 1147 subjects were included in the study, 584 (50.9%) were male and the rest were women. The mean age was 39.50 ± 15.38. 133 (11.60%) subjects from the study participants had sleepiness and 308 (26.90%) subjects had undesirable sleep quality. Using linear regression test, sleep quality was the significant correlation with sex, hours needed for sleep at 24 hours, chronic illness, sleepiness, and circadian rhythm amplitude. Sleepiness was the meaningful relationship with marital status, sleep-wake schedule of other family members and the stability of circadian rhythm. Both women and men, with age, decrease the quality of sleep and increase the rate of sleepiness. Conclusion: Age, sex, and type of circadian people, the need for sleep at 24 hours, marital status, sleep-wake schedule of other family members are significant factors related to the sleep quality and sleepiness and their adaptation to night shift work.

Keywords: circadian type, sleep quality, sleepiness, age, shift work

Procedia PDF Downloads 137

Authors: Rachida Gherbi-Salmi, Abdelkarim Si Bachir, Salah Eddine Doumandji

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The Cattle Egret is a predatory bird with an insectivorous diet. It feeds in open environments (wetlands, meadows, farmland and cultivated land). Few studies have determined the status of its prey (useful or harmful species for agriculture). Hence, our study was carried out in the Bejaia region (Algeria). It consisted of examining adult rejection pellets collected in a heronry located in the lower Soummam Valley (El-Kseur), which has been a permanent habitat for over 30 years. Field sampling was carried out during the juvenile rearing period in 1998 (wet spring) and 2020 (almost dry spring). Examination of 50 pellets at a rate of 10 per month (May - September) in 1998 revealed the presence of 2,661 prey belonging to 170 species, i.e., an average of 53.36 prey per pellet. The results reveal that the diet of this Ardeidae consists mainly of Insecta (95.09%). Arachnida was a distant second (4.05%). Vertebrates (Reptilia and Rodentia) (0.82%) and myriapods (0.04%) are rare prey. We counted 2,154 plant pests (80.27%), of which 2,138 were insects (99.27%) and 0.73% rodents (Mus spretus). Of the plant-pest insects identified, 1385 were Orthoptera (64.78%). Fourmicidae came second (13.05%), and Coleoptera third (12.82%). Dermaptera, on the other hand, accounted for only 7.86%. Analysis of 30 rejection pellets, 10 per month (May - July) in 2020, identified 1,330 prey belonging to 80 species, an average of 44.33 prey per pellet. The results reveal that its diet is essentially made up of Insecta (94.81%). These are followed by Vertebrata (3.01%) and Arachnida (2.18%). We counted 1156 plant pests (86.82%), of which 86.02% are Insecta. Orthoptera are the most frequent (45.72%). They are followed by Dermaptera (33.74%) and Coleoptera (18.44%). The present study highlighted the importance of plant pests consumed by the Cattle Egret (80.27% in 1998 and 86.82% in 2020), which are far more numerous and diverse than auxiliary prey and pollinators. This confirms the bird's status as a biological control agent in the lower Soummam valley. It is, therefore, worth pointing out that this species deserves to be protected.

Keywords: bubulcus ibis, diet, lower soummam valley, insect crop pests

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Authors: Rasim M. Alguliyev, Alovsat G. Aliyev

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In the paper information on economic development trends in developed countries are analyzed. The current status of information society and economy of the country is reviewed and some recommendations are given for future development. The problems of Information Society and establishment of its innovative economy are studied. In this turn, development trends information economy in developed countries are analyzed.

Keywords: information economy, ICT sector, ICT infrastructure, innovation, innovation system hi-tech products, antimonopoly policy

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Authors: Julio Jesus Salazar, Max Jesus De Lama

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The challenges of water management are aggravated by global change, which implies high complexity and associated uncertainty; water management is difficult because water networks cross domains (natural, societal, and political), scales (space, time, jurisdictional, institutional, knowledge, etc.) and levels (area: patches to global; knowledge: a specific case to generalized principles). In this context, we need to apply natural and non-natural measures to manage water and soil. The Basin Management Methodology considers multifunctional measures of natural water retention and erosion control and soil formation to protect water resources and address the challenges related to the recovery or conservation of the ecosystem, as well as natural characteristics of water bodies, to improve the quantitative status of water bodies and reduce vulnerability to floods and droughts. This method of water management focuses on the positive impacts of the chemical and ecological status of water bodies, restoration of the functioning of the ecosystem and its natural services; thus, contributing to both adaptation and mitigation of climate change. This methodology was applied in 7 interventions in the sub-basin of the Shullcas River in Huancayo-Junín-Peru, obtaining great benefits in the framework of the participation of alliances of actors and integrated planning scenarios. To implement the methodology in the sub-basin of the Shullcas River, a process called Climate Smart Territories (CST) was used; with which the variables were characterized in a highly complex space. The diagnosis was then worked using risk management and adaptation to climate change. Finally, it was concluded with the selection of alternatives and projects of this type. Therefore, the CST approach and process face the challenges of climate change through integrated, systematic, interdisciplinary and collective responses at different scales that fit the needs of ecosystems and their services that are vital to human well-being. This methodology is now replicated at the level of the Mantaro river basin, improving with other initiatives that lead to the model of a resilient basin.

Keywords: climate-smart territories, climate change, ecosystem services, natural measures, Climate Smart Territories (CST) approach

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Authors: G. Vici, L. Cesanelli, L. Belli, R. Ceci, V. Polzonetti

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Several factors contribute to success in sport and diet is one of them. Evidence-based sport nutrition guidelines underline the importance of macro- and micro-nutrients’ balance and timing in order to improve athlete’s physical status and performance. Nevertheless, a high content of proteins is commonly found in resistance training athletes’ diet with carbohydrate intake that is not enough or not well planned. The aim of the study was to evaluate the impact of different protein and carbohydrate diet contents on body composition and sport performance on a group of resistance training athletes. Subjects were divided as study group (n=16) and control group (n=14). For a period of 4 months, both groups were subjected to the same resistance training fitness program with study group following a specific diet and control group following an ab libitum diet. Body compositions were evaluated trough anthropometric measurement (weight, height, body circumferences and skinfolds) and Bioimpedence Analysis. Physical strength and training status of individuals were evaluated through the One Repetition Maximum test (RM1). Protein intake in studied group was found to be lower than in control group. There was a statistically significant increase of body weight, free fat mass and body mass cell of studied group respect to the control group. Fat mass remains almost constant. Statistically significant changes were observed in quadriceps and biceps circumferences, with an increase in studied group. The MR1 test showed improvement in study group’s strength but no changes in control group. Usually people consume hyper-proteic diet to achieve muscle mass development. Through this study, it was possible to show that protein intake fixed at 1,7 g/kg/d can meet the individual's needs. In parallel, the increased intake of carbohydrates, focusing on quality and timing of assumption, has enabled the obtainment of desired results with a training protocol supporting a hypertrophic strategy. Therefore, the key point seems related to the planning of a structured program both from a nutritional and training point of view.

Keywords: body composition, diet, exercise, protein

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Authors: Zeina Bourhane, Anders Lanzen, Christine Cagnon, Olfa Ben Said, Cristiana Cravo-Laureau, Robert Duran

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The anthropogenic pressure in coastal areas increases dramatically with the exploitation of environmental resources. Biomonitoring coastal areas are crucial to determine the impact of pollutants on bacterial communities in soils and sediments since they provide important ecosystem services. However, relevant biomonitoring tools allowing fast determination of the ecological status are yet to be defined. Microbial ecology approaches provide useful information for developing such microbial monitoring tools reporting on the effect of environmental stressors. Chemical and microbial molecular approaches were combined in order to determine microbial bioindicators for assessing the ecological status of soil and river ecosystems around the Ichkeul Lake (Tunisia), an area highly impacted by human activities. Samples were collected along soil/river/lake continuums in three stations around the Ichkeul Lake influenced by different human activities at two seasons (summer and winter). Contaminant pressure indexes (PI), including PAHs (Polycyclic aromatic hydrocarbons), alkanes, and OCPs (Organochlorine pesticides) contents, showed significant differences in the contamination level between the stations with seasonal variation. Bacterial communities were characterized by 16S ribosomal RNAs (rRNA) gene metabarcoding. Although microgAMBI indexes, determined from the sequencing data, were in accordance with contaminant contents, they were not sufficient to fully explain the PI. Therefore, further microbial indicators are still to be defined. The comparison of bacterial communities revealed the specific microbial assemblage for soil, river, and lake sediments, which were significantly correlated with contaminant contents and PI. Such observation offers the possibility to define a relevant set of bioindicators for reporting the effects of human activities on the microbial community structure. Such bioindicators might constitute useful monitoring tools for the management of microbial communities in coastal areas.

Keywords: bacterial communities, biomonitoring, contamination, human impacts, microbial bioindicators

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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: Ashti Morovati, Hushyar Azari, Bahram Pourghassem Gargari

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Objectives and goals: The prevalence of metabolic syndrome (MetS), as a major health burden for societies, is increasing. This clinical trial was conducted to evaluate the effects of CuEO supplementation on anthropometric indices, systolic and diastolic blood pressure, blood glucose level, insulin resistance and serum lipid level in patients suffering from MetS. Methods: This was a randomized, triple‐blind, placebo‐controlled clinical trial in which 56 patients with MetS aged 18–60 years who fulfilled the eligibility criteria were randomly allocated to an intervention or a control group. Inclusion criteria for the study were comprised of diagnosis of MetS according to the new International Federation of Diabetes. The exclusion criteria were defined as: taking herbal supplements, use of drugs having evident interaction with cumin such as anti‐depressant drugs, vitamin D, omega 3, selenium, zinc, smoking, pregnancy, or breastfeeding, suffering from cancer, having any history of gastrointestinal and hepatic, cardiovascular, thyroid and kidney disorders, and menopause. 75 mg CuEO or placebo soft gels were administered three times daily to the participants for eight weeks. The soft gel consumption was checked by asking the participants to bring the medication containers in the follow‐up visits at the 4th and the 8th weeks of the study. Data pertaining to blood pressure, height, weight, waist circumference, hip circumference and BMI, as well as food consumption were collected at the beginning and end of the study. Fasting blood samples ( glucose, triglyceride, total cholesterol, HDL-cholesterol and LDL-cholesterol) were obtained and biochemical measurements were assessed at the beginning and end of the study. Results: At eight weeks, a total of 44 patients completed this study. Except for diastolic blood pressure (DBP), the other assessed variables were not significantly different between the two groups. In intra group analysis, placebo and CuEO groups both had insignificant decrements in DBP (mean difference [MD] with 95% CI: −3.31 [−7.11, 0.47] and −1.77 [−5.95, 2.40] mmHg, respectively). However, DBP was significantly lower in CuEO compared with the placebo group at the end of study (81.41 ± 5.88 vs. 84.09 ± 5.54 mmHg, MD with 95% CI: −3.98 [−7.60, −0.35] mmHg, p < .05). Conclusions: The results of this study indicated that CuEO does not have any effect on MetS components, except for DBP in patients with MetS.

Keywords: blood pressure, fasting blood glucose, lipid profile, waist circumference

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Authors: Ali Mohammad Mobaser Azad, Alireza Akhlaghinia

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Blockchain is changing our world and launching a new generation of decentralized networks. Meanwhile, Blockchain-based networks like Ethereum have been created and they will facilitate these processes using tools like smart contracts. The Ethereum has fundamental structures, each of which affects the activity of the nodes. Our purpose in this paper is to review similar research and examine various components to demonstrate the performance of the Ethereum network and to do this, and we used the data published by the Ethereum Foundation in different time spots to examine the number of changes that determine the status of network performance. This will help other researchers understand better Ethereum in different situations.

Keywords: blockchain, ethereum, smart contract, decentralization consensus algorithm

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Authors: Vitor Rafael Regiani, Carlos Henrique Viesi Do Nascimento Filho, Patricia Matos Biselli-Chicote, Claudia Aparecida Rainho, Luiz Sergio Raposo, José Victor Maniglia, Eny Maria Goloni-Bertollo, Erika Cristina Pavarino

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Promoter hypermethylation of tumor-related genes has been associated with prognosis in early-stage head-and-neck cancers, providing strong evidence that these hypermethylated genes are valuable biomarkers for prognostic evaluation. Hence, we selected the MGMT and RASSF1A genes to examine the methylation status in head and neck squamous cell carcinomas (HNSCC) samples matched with non-tumor tissues (tumor-surrounding tissues or peripheral blood samples). DNA methylation analysis was based on Methylation-Sensitive High Resolution Melting, and the methylation status was correlated with clinic-pathological characteristics of the patients. RASSF1A and MGMT promoter methylation was detected in 43.24% (16/37) and in 44.44% (16/36) of the tumors, respectively. RASSF1A and MGMT methylation was significantly more frequent in tumor tissue than non-tumor tissues, as well as, simultaneous methylation of RASSF1A and MGMT also was higher in tumor tissue than non-tumor tissues. In relation to anatomic site, larynx cancer presented significant methylation of MGMT gene compared to tumor-surrounding tissue. The frequency of RASSF1A and MGMT promoter methylated was higher in tumor tissues in relation to peripheral blood from the same patient. No association was found between methylation and the variables analyzed, including gender, age, smoking or alcohol drinking habits. Clinic-pathological characteristics also showed no association in the presence of methylation. The Kaplan–Meier's method showed no association of methylation and both disease-free and overall survival. In conclusion, the presence of epigenetic abnormalities in normal-appearing tissue corroborates the hypothesis of the ‘field cancerization', or it can reflect preneoplastic and/or preinvasive. Moreover, MGMT methylation may serve as an important laryngeal cancer biomarker because it showed significant difference between laryngeal cancer and surrounding tumor tissues.

Keywords: head and neck cancer, DNA methylation, MGMT promoter methylation, RASSF1A promoter methylation

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Authors: Vhahangwele Belemu, Isaac Busayo Oluwatayo

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Post-harvest losses pose a serious challenge to smallholder fruit crop farmers, especially in the rural communities of South Africa, affecting their economic livelihoods and food security. This study investigated the post-harvest handling practices and technologies harnessed by smallholder fruit crop farmers in the Vhembe district of Limpopo province, South Africa. Data were collected on a random sample of 224 smallholder fruit crop farmers selected from the four municipalities of the district using a multistage sampling technique. Analytical tools employed include descriptive statistics and the tobit regression model. A descriptive analysis of farmers’ socioeconomic characteristics showed that a sizeable number of these farmers are still in their active working age (mean = 52 years) with more males (63.8%) than their female (36.2%) counterparts. Respondents’ distribution by educational status revealed that only a few of these had no formal education (2.2%), with the majority having secondary education (48.7%). Results of data analysis further revealed that the prominent post-harvest technologies and handling practices harnessed by these farmers include using appropriate harvesting techniques (20.5%), selling at a reduced price (19.6%), transportation consideration (18.3%), cleaning and disinfecting (17.9%), sorting and grading (16.5%), manual cleaning (15.6%) and packaging technique (11.6%) among others. The result of the Tobit regression analysis conducted to examine the determinants of post-harvest technologies and handling practices harnessed showed that age, educational status of respondents, awareness of technology/handling practices, farm size, access to credit, extension contact, and membership of association were the significant factors. The study suggests enhanced awareness creation, access to credit facility and improved access to market as important factors to consider by relevant stakeholders to assist smallholder fruit crop farmers in the study area.

Keywords: fruit crop farmers, handling practices, post harvest losses, smallholder, Vhembe District, South Africa

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Authors: V. Rekha, Rama Pal

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The study examines the degree and magnitude of wealth-based inequalities in child health and its determinants in India. Despite making strides in economic growth, India has failed to secure a better nutritional status for all the children. The country currently faces the double burden of malnutrition as well as the problems of overweight and obesity. Child malnutrition, obesity, unsafe water, sanitation among others are identified as the risk factors for Non-Communicable Diseases (NCDs). Eliminating malnutrition in all its forms will catalyse improved health and economic outcomes. The assessment of the distributive dimension of child health across various segments of the population is essential for effective policy intervention. The study utilises the fourth round of District Level Health Survey for 2012-13 to analyse the inequalities among children in the age group 0-14 years in Maharashtra, a state in the western region of India with a population of 11.24 crores which constitutes 9.3 percent of the total population of India. The study considers the extent of health inequality by state, districts, sector, age-groups, and gender. The z-scores of four child health outcome variables are computed to assess the nutritional status of pre-school and school children using WHO reference. The descriptive statistics, concentration curves, concentration indices, correlation matrix, logistic regression have been used to analyse the data. The results indicate that magnitude of inequality is higher in Maharashtra and child health inequalities manifest primarily among the weaker sections of society. The concentration curves show that there exists a pro-poor inequality in child malnutrition measured by stunting, wasting, underweight, anaemia and a pro-rich overweight inequality. The inequalities in anaemia are observably lower due to the widespread prevalence. Rural areas exhibit a higher incidence of malnutrition, but greater inequality is observed in the urban areas. Overall, the wealth-based inequalities do not vary significantly between age groups. It appears that there is no gender discrimination at the state level. Further, rural-urban differentials in gender show that boys from the rural area and girls living in the urban region experience higher disparities in health. The relative distribution of undernutrition across districts in Maharashtra reveals that malnutrition is rampant and considerable heterogeneity also exists. A negative correlation is established between malnutrition prevalence and human development indicators. The findings of logistic regression analysis reveal that lower economic status of the household is associated with a higher probability of being malnourished. The study recognises household wealth, education of the parent, child gender, and household size as factors significantly related to malnutrition. The results suggest that among the supply-side variables, child-oriented government programmes might be beneficial in tackling nutrition deficit. In order to bridge the health inequality gap, the government needs to target the schemes better and should expand the coverage of services.

Keywords: child health, inequality, malnutrition, obesity

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Authors: Masoud Swalehe, Semra Günay

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Developed countries are losing many lives to non-communicable diseases as compared to their developing counterparts. The effects of these diseases are mostly sudden and manifest at a very short time prior to death or a dangerous attack and this has consolidated the significance of emergency medical system (EMS) as one of the vital areas of healthcare service delivery. The primary objective of this research is to reduce ambulance response times (RT) of Eskişehir province EMS since a number of studies have established a relationship between ambulance response times and survival chances of patients especially out of hospital cardiac arrest (OHCA) victims. It has been found out that patients who receive out of hospital medical attention in few (4) minutes after cardiac arrest because of low ambulance response times stand higher chances of survival than their counterparts who take longer times (more than 12 minutes) to receive out of hospital medical care because of higher ambulance response times. The study will make use of geographic information systems (GIS) technology to dynamically reallocate ambulance resources according to demand and time so as to reduce ambulance response times. Geospatial-time distribution of ambulance calls (demand) will be used as a basis for optimal ambulance deployment using system status management (SSM) strategy to achieve much demand coverage with the same number of ambulance resources to cause response time reduction. Drive-time polygons will be used to come up with time specific facility coverage areas and suggesting additional facility candidate sites where ambulance resources can be moved to serve higher demands making use of network analysis techniques. Emergency Ambulance calls’ data from 1st January 2014 to 31st December 2014 obtained from Eskişehir province health directorate will be used in this study. This study will focus on the reduction of ambulance response times which is a key Emergency Medical Services performance indicator.

Keywords: emergency medical services, system status management, ambulance response times, geographic information system, geospatial-time distribution, out of hospital cardiac arrest

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Authors: Mana Shrestha, Dhruba Khatri, Pralhad Kunwor

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The objective of the study was to explore the vehicle owners’ willingness to pay (WTP) for offsetting carbon that could eventually facilitate local governmental institutions to take further step in environmental conservation. Contingent valuation method was used to find out how much amount people were willing to pay for the carbon service they are getting from providers. Open ended questionnaire was carried out with 181 respondents randomly. The result shows different mean willingness to pay amount depending upon demographic variations like education, occupation, sex and residence but the occupation and the educational status significantly affected the WTP of respondent. Total WTP amount was calculated as 650 NRS.

Keywords: community forest, carbon offset, Kyoto, REDD WTP

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Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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Authors: Anita Puspawati

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A failure in obtaining informed consent from patient occurs because there is not effective communication skill in doctors. Therefore, the language is very important in communication between doctor and patient. This study uses descriptive analysis method, that is a method used mainly in researching the status of a group of people, an object, a condition, a system of thought or a class of events in the present. The result of this study indicates that the communicative language between doctors and patients will increase the trust of patients to their doctors and accordingşy, patients will provide the informed consent voluntarily.

Keywords: communicative, language, doctor, patient

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Authors: Mahsa Houshdar, Seyed Mehdi Samimi Ardestani , ُSeyed Saeed Sadr

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Introduction: Online Medicare is a method in which parts of a medical process - whether its diagnostics, monitoring or the treatment itself will be done by using online services. This system has been operated in one boy’s high school, one girl’s high school and one high school in deprived aria. Method: At the first step the students registered for using the system. It was not mandatory and not free. They participated in estimating depression scale, anxiety scale and clinical interview by online medical care system. During this estimation, we could find the existence and severity of depression and anxiety in each one of the participants, also we could find the consequent needs of each one, such as supportive therapy in mild depression or anxiety, need to visited by psychologist in moderate cases, need to visited by psychiatrist in moderate-severe cases, need to visited by psychiatrist and psychologist in severe cases and need to perform medical lab examination tests. The lab examination tests were performed on persons specified by the system. The lab examinations were included: serum level of vitamin D, serum level of vitamin B12, serum level of calcium, fasting blood sugar, HbA1c, thyroid function tests and CBC. All of the students were solely treated by vitamins or minerals therapy and/ or treatment of medical problem (such as hypothyroidism). After a few months, we came back to high schools and estimated the existence and severity of depression and anxiety in treated students. With comparing these results, the affectability of the system could be prof. Results: Totally, we operate this project in 1077 participants in 243 of participant, the lab examination test were performed. In girls high schools: the existence and severity of depression significantly deceased (P value= 0.018<0.05 & P value 0.004< 0.05), but results about anxiety was not significant. In boys high schools: the existence and severity of depression significantly decreased (P value= 0.023<0.05 & P value = 0.004< 0.05 & P value= 0.049< 0.05). In boys high schools: the existence and severity of anxiety significantly decreased (P value= 0.041<0.05 & P value = 0.046< 0.05 &) but in one high school results about anxiety was not significant. In high school in deprived area the students did not have any problem paying for participating in the project, but they could not pay for medical lab examination tests. Thus, operation of the system was not possible in deprived area without a sponsor. Conclusion: This online medical system was successful in creating medical and psychiatric profile without attending physician. It was successful in decreasing depression without using antidepressants, but it was partially successful in decreasing anxiety.

Keywords: depression, diabetes, online medicare, vitamin D deficiency

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Authors: Mardiana Madjid, Nurpudji Astuti Taslim, Suryani As'ad, Haerani Rasyid, Agussalim Bukhari

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The high level of Urine Urea Nitrogen (UUN) indicates hypercatabolism occurs in hospitalized patients. High levels of Total Lymphocyte Count (TLC) indicates the immune system condition, adequate wound healing, and limit complication. Adequate dietary intake affects to decrease of hypercatabolism status in treated patient’s hospitals. Nitrogen Balance (NB) is simply the difference between nitrogen (N₂) intake and output. If more N₂ intake than output, then positive NB or anabolic will occur. This study aims to evaluate the effect of dietary intake in influencing balance nitrogen and total lymphocyte count. Method: A total of 43 patients admitted to a Wahidin Sudirohusodo Hospital between 2018 and 2019 for 10 days' treats are included. The inclusion criteria were patients who were treated for 10 days and receives food from the hospital orally. Patients did not experience gastrointestinal disorders such as vomiting and diarrhea and experience impair kidney function and liver function and expressed approval to participate in this study. During hospitalization, food intake, UUN, albumin serum, balance nitrogen, and TLC was assessed twice on day 1 and day 10. There is no Physician Clinical Nutritional intervention to correct food intake. UUN is 24 hours of urine collected on the second day after admission and the tenth day. Statistical analysis uses SPSS 24 with observational cohort methods. Result: The Forty-three participants completed the follow-up (27 men and 18 women). The age of fewer than 4 years is 22 people, 45 to 60 years is 16 people, and over 60 years is 4 people. The result of the study on day 1 obtained SGA score A, SGA score B, SGA score C are 8, 32, 3 until day 10 are 8, 31, 4, respectively. According to 24h dietary recalls, the energy intake during observation was from 522.5 ± 400.4 to 1011.9 ± 545.1 kcal/day P < 0.05, protein intake from 20.07 ± 17.2 to 40.3 ± 27.3 g/day P < 0.05, carbohydrates from 92.5 ± 71.6 to 184.8 ± 87.4 g/day, and fat from 5.5 ± 3.86 to 13.9 ± 13.9 g/day. The UUN during the observation was from 6.6 ± 7.3 to 5.5 ± 3.9 g/day, TLC decreased from 1622.9 ± 897.2 to 1319.9 ± 636.3/mm³ value target 1800/mm³, albumin serum from 3.07 ± 0.76 to 2.9 ± 0.57 g/day, and BN from -7.5 ± 7.2 to -3.1 ± 4.86. Conclusion: The high level of UUN needs to correct adequate dietary intake to improve NB and TLC status on hospitalized patients.

Keywords: adequate dietary intake, balance nitrogen, total lymphocyte count, urine urea nitrogen

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Authors: Ni'mal Baroya, Andrei Ramani, Irma Prasetyowati

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The access to reproduction health services, including with safe and effective contraception were human rights regardless of social stratum and residence. In addition to individual factors, family and contextual factors were also believed to be the cause in the use of contraceptive methods. This study aimed to assess the determinants of long-term contraceptive methods (LTCM) by considering all the factors at either the individual level or contextual level. Thereby, this study could provide basic information for program development of prevalence enhancement of MKJP in East Java. The research, which used cross-sectional design, utilized Riskesdas 2013 data, particularly in East Java Province for further analysis about multilevel modeling of MKJP application. The sample of this study consisted of 20.601 married women who were not in pregnant that were drawn by using probability sampling following the sampling technique of Riskesdas 2013. Variables in this study were including the independent variables at the individual level that consisted of education, age, occupation, access to family planning services (KB), economic status and residence. As independent variables in district level were the Human Development Index (HDI, henceforth as IPM) in each districts of East Java Province, the ratio of field officers, the ratio of midwives, the ratio of community health centers and the ratio of doctors. As for the dependent variable was the use of Long-Term Contraceptive Method (LTCM or MKJP). The data were analyzed by using chi-square test and Pearson product moment correlation. The multivariable analysis was using multilevel logistic regression with 95% of Confidence Interval (CI) at the significance level of p < 0.05 and 80% of strength test. The results showed a low CPR LTCM was concentrated in districts in Madura Island and the north coast. The women which were 25 to 35 or more than 35 years old, at least high school education, working, and middle-class social status were more likely to use LTCM or MKJP. The IPM and low PLKB ratio had implications for poor CPR LTCM / MKJP.

Keywords: multilevel, long-term contraceptive methods, east java, contextual factor

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Authors: Meichen He, Xuan Yang

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Background: In the field of psychotherapy, the role of the family of origin is of utmost importance. Over the past few decades, both individual-oriented and family-oriented approaches to child therapy have shown moderate success in reducing children's psychological and behavioral issues. Objective: However, in exploring how the family of origin influences individuals, it has been noted that there is a lack of comprehensive measurement indicators and an absence of an exact model to assess the impact of the family of origin on individual development. Therefore, this study aims to develop a model based on a literature review regarding the influence of the family of origin on children. Specifically, it will examine the effects of factors such as education level, economic status, maternal age, family integration, family violence, marital conflict, parental substance abuse, and alcohol consumption on children's self-confidence and life satisfaction. Through this research, we aim to further investigate the impact of the family of origin on children and provide directions for future research in positive psychology and psychotherapy. Methods: This study will employ a literature review methodology to gather and analyze relevant research articles on the influence of the family of origin on children. Subsequently, we will conduct quantitative analyses to establish a comprehensive model explaining how family of origin factors affect children's psychological and behavioral outcomes. Findings: the research has revealed that family of origin factors, including education level, economic status, maternal age, family integration, family violence, marital conflict, parental drug and alcohol consumption, have an impact on children's self-confidence and life satisfaction. These factors can affect children's psychological well-being and happiness through various pathways. Implications: The results of this study will contribute to a better understanding of the influence of the family of origin on children and provide valuable directions for future research in positive psychology and psychotherapy. This research will enhance awareness of children's psychological well-being and lay the foundation for improving psychotherapeutic methods.

Keywords: family of origion, positive psychology, developmental psychology, family education, social psychology, educational psychology

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