Search results for: female healthcare

Authors: Liu Yuhong, Hussen Mansai, Mei Chunli

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Inflammatory discitis is a sterile inflammatary disease that typically presents with abnormalities in two adjacent vertebral bodies and the intervening disk. Diagnosis this disorder is usually difficult and ideal management remains controversial. In this report，we examine a case of inflammatory discitis in a 56 year old female in which treatment with adalimumab ameliorated symptoms. The 56-year-old female patient developed repeatedly inflammatory discitis in the past three years, presenting with severe back pain, an elevated C-reactive protein and erythrocyte sedimentation rate, radiological erosive changes in vertebral and intervertebral disk of the spine. Surgical treatment, antibiotics and non steroidal anti-inflammatory drugs(NSAIDs) were used, but the patient still suffered from recurrent onset of unbearable backache. Three years later from the patient’s first admission，adalimumab was prescribed due to the third occurrence of Anderson lesions, which she had been suffering from for years. Soon after the same day of adalimumab therapy, her symptoms had a dramatic improvement. On the following day she could stand and walk slowly, her CRP and ESR were decreased to nearly normal levels in 4 weeks. Human leukocyte antigen (HLA)-typing analysis revealed a positive result for HLA-B27, the patient’s inflammatory discitis was considered to be associated with spondyloarthropathy.

Keywords: adalimumab, inflammatory discitis, spondyloarthropathy, patient

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Authors: Chryssa Thermolia, Ekaterini S. Bei, Stelios Sotiriadis, Kostas Stravoskoufos, Euripides G. M. Petrakis

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Moving into a new era of healthcare, new tools and devices are developed to extend and improve health services, such as remote patient monitoring and risk prevention. In this concept, Internet of Things (IoT) and Cloud Computing present great advantages by providing remote and efficient services, as well as cooperation between patients, clinicians, researchers and other health professionals. This paper focuses on patients suffering from bipolar disorder, a brain disorder that belongs to a group of conditions called effective disorders, which is characterized by great mood swings.We exploit the advantages of Semantic Web and Cloud Technologies to develop a patient monitoring system to support clinicians. Based on intelligently filtering of evidence-knowledge and individual-specific information we aim to provide treatment notifications and recommended function tests at appropriate times or concluding into alerts for serious mood changes and patient’s non-response to treatment. We propose an architecture, as the back-end part of a cloud platform for IoT, intertwining intelligence devices with patients’ daily routine and clinicians’ support.

Keywords: bipolar disorder, intelligent systems patient monitoring, semantic web technologies, healthcare

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Authors: Vitor S. Mendonca, Maria Luisa S. Schmidt

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The Brazilian medical profession is viewed as being error-free, so healthcare professionals who commit an error are condemned there. Medical errors occur frequently in the Brazilian healthcare system, so identifying better options for handling this issue has become of interest primarily for physicians. The purpose of this study is to better understand the tensions involved in the fear of making an error due to the harm and risk this would represent for those involved. A qualitative study was performed by means of the narratives of the lived experiences of ten acting physicians in the State of Sao Paulo. The concept and characterization of errors were discussed, together with the fear of making an error, the near misses or error in itself, how to deal with errors and what to do to avoid them. The analysis indicates an excessive pressure in the medical profession for error-free practices, with a well-established physician-patient relationship to facilitate the management of medical errors. The error occurs, but a lack of information and discussion often leads to its concealment due to fear or possible judgment by society or peers. The establishment of programs that encourage appropriate medical conduct in the event of an error requires coherent answers for humanization in Brazilian medical science. It is necessary to improve the discussion about medical errors and disseminate models of communication and notification of errors in Brazil.

Keywords: medical error, narrative, physician-patient relationship, qualitative research

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Authors: Anita Kushwaha

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We propose a new evolutionary computational model called Artificial Reproduction System which is based on the complex process of meiotic reproduction occurring between male and female cells of the living organisms. Artificial Reproduction System is an attempt towards a new computational intelligence approach inspired by the theoretical reproduction mechanism, observed reproduction functions, principles and mechanisms. A reproductive organism is programmed by genes and can be viewed as an automaton, mapping and reducing so as to create copies of those genes in its off springs. In Artificial Reproduction System, the binding mechanism between male and female cells is studied, parameters are chosen and a network is constructed also a feedback system for self regularization is established. The model then applies Mendel’s law of inheritance, allele-allele associations and can be used to perform data analysis of imbalanced data, multivariate, multiclass and big data. In the experimental study Artificial Reproduction System is compared with other state of the art classifiers like SVM, Radial Basis Function, neural networks, K-Nearest Neighbor for some benchmark datasets and comparison results indicates a good performance.

Keywords: bio-inspired computation, nature- inspired computation, natural computing, data mining

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Authors: Aliyu Aminu Baba, Yahaya Danjuma, Ahmad Sule Liman-Katagum

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This paper examines the effects of the board of directors’ diversity on firm performance. We investigate the relationship between the number of women directors on the board and important board committees and financial performance measured as return on assets. Our statistical analysis supports the theoretical position of the effect diversity on financial performance. These studies enhanced the previous studies on the board of director’s gender diversity, board committees, and its impacts on firm financial performance. The study uses data from eighteen (18) Nigerian commercial banks. The study finds that banks with a higher number of females directors on board and board committees have higher Earning per share(EPS)) and Return on Assets (ROA). It also finds that some banks did not even have a single female on its corporate board. Evidence imply that decisions concerning the appointment of women to corporate boards should be on criteria and financial performance. It is recommended that banks can enhance their financial performance by having more female directors on their corporate board.

Keywords: board of directors, gender diversity, board committees, financial performance

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Authors: Leslie Beale

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Being a patient with a chronic disease is both a physical and emotional experience. The ability to recognize a patient’s emotional health is an important part of a health care provider’s skills. For the purposes of this paper, emotional health is viewed as the way that we feel, and the way that our feelings affect us. Understanding the patient’s emotional health leads to improved provider-patient relationships and health outcomes. For example, when a patient first hears his or her diagnosis from a provider, they might find it difficult to cope with their emotions. Struggling to cope with emotions interferes with the patient’s ability to read, understand, and act on health information and services. As a result, the patient becomes more frustrated and confused, creating barriers to accessing healthcare services. These barriers are challenging for both the patient and their healthcare providers. There are five basic emotions that are part of who we are and are always with us: fear, anger, sadness, joy, and compassion. Living with a chronic disease however can cause a patient to experience and express these emotions in new and unique ways. Within the provider-patient relationship, there needs to be an understanding that each patient experiences these five emotions and, experiences them at different times. In response to this need, the paper highlights a health promotion framework for patients with chronic disease. This framework emphasizes the emotional health of patients.

Keywords: health promotion, emotional health, patients with chronic disease, patient-centered care

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Authors: Velly Anatasia

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The worldwide annual expenditure for cosmetics is estimated at U.S. $18 billion and many players in the field are competing aggressively to capture more and more markets. Players in the cosmetics industry strive to be the foremost by establish customer loyalty. Furthermore, customer loyalty is portrayed by brand loyalty. Therefore, brand loyalty is the key determine of winning the competition in tight market. This study examines the influence of brand loyalty on cosmetics buying behavior of female consumers in Jakarta as capital of Indonesia. The seven factors of brand loyalty are brand name, Product quality, price, design, promotion, servicesquality and store environment. The paper adopted descriptive analysis, factor loading and multiple regression approach to test the hypotheses. The data has been collected by using questionnaires which were distributed and self-administered to 125female respondents accustomed using cosmetics. The findings of this study indicated that promotion has shown strong correlation with brand loyalty. The research results showed that there is positive and significant relationship between factors of brand loyalty (brand name, product quality, price, design, promotion, services quality and store environment) with cosmetics brand loyalty.

Keywords: brand loyalty, brand name, product quality, service quality, promotion

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Authors: Sai Shruthi Sridhar, A. Madhumidha, Kreethika Guru, Priyanka Sekar, Ananthi Malayappan

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Numerous changes in technology and its recent development are structuring long withstanding effect to our world, one among them is the emergence of “Internet of Things” (IoT). Similar to Technology world, one industry stands out in everyday life–healthcare. Attention to “quality of health care” is an increasingly important issue in a global economy and for every individual. As per WHO (World Health Organization) it is estimated to be less than 50% adhere to the medication provided and only about 20% get their medicine on time. Medication adherence is one of the top problems in healthcare which is fixable by use of technology. In recent past, there were minor provisions for elderly and specially-skilled to get motivated and to adhere medicines prescribed. This paper proposes a novel solution that uses IOT based RFID Medication Reminder Solution to provide personal health care services. This employs real time tracking which offer quick counter measures. The proposed solution builds on the recent digital advances in sensor technologies, smart phones and cloud services. This novel solution is easily adoptable and can benefit millions of people with a direct impact on the nation’s health care expenditure with innovative scenarios and pervasive connectivity.

Keywords: cloud services, IoT, RFID, sensors

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Authors: Aliyaa Zaidan, Rayan Bahabri

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The twenty-first century revealed an accelerating change and intensifying complexity of communication technology. Online social networking engines have gained astounding recognition worldwide. The influence of those social media platforms on dentistry and dental students is not well established. Therefore, this study aimed to evaluate the impact of using social media on professional and profile level among dental students in Saudi Arabia. A cross-sectional study developed via online questionnaire concerning on social media usage and its effect on professional and profile level of dental students and dental interns from several universities in Saudi Arabia. A total of 296 dental students and dental interns in Saudi Arabia responded to the questionnaire. Ninety-eight percent of the participants usually use the social media on a regular basis. Most social media sites used among the participants were Snapchat, Instagram, and YouTube by 85%, 81%, 77% respectively. Forty-one percent of the participants agreed that using social media in the dental field is a necessity nowadays. Thirty-eight percent of participants agreed that using social media is an easy way to gain a reliable knowledge, while 43% agreed that social media will improve the quality of healthcare. Furthermore, 65% of the students deemed using social media for academic purposes will improve their performance. Fifty-five percent of the respondents often use social media tools to obtain information about subject or procedures related to the dental field. Regarding profile reputation of dental students, 40% of the respondents agreed that their profile information published on social networking websites, could be used by others to judge their level of professionalism. Male and female dental students both agreed that their reputation would be adversely affected by 37%,63%, respectively, if their social networking activity were viewed by members of the public. The discrepancy among student levels reveals that social media profile positively influence the acceptance to postgraduate programs (P= 0.01).

Keywords: dental students, professional, reputation, social media

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Authors: Awdhesh Yadav, P. S. Saravanamurthy, Shaikh Tayyaba, Uma Shah, Ashok Agarwal

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Objectives: HIV interventions in India has leveraged Self-Help Group (SHG) as one of the key strategies under structural intervention to empower female sex workers (FSW) to reduce their risk exposure and vulnerability to STI/HIV. Understanding the role of SHGs in light of the evolving dynamics of sex work needs to be delved into to strategize HIV interventions among FSWs in India. This paper aims to study the HIV program outcome among the FSWs associated with SHGs and FSWs not associated with SHGs in Thane, Maharashtra. Study Design: This cross-sectional study, was undertaken from the Behavioral Tracking Survey (BTS) conducted among 503 FSWs in Thane in 2015. Two-stage probability based conventional sampling was done for selection of brothel and bar based FSWs, while Time Location Cluster (TLC) sampling was done for home, lodge and street-based sex workers. Methods: Bivariate and multivariate logistic regression were performed to compare and contrast between FSWs associated with SHG and those not associated with SHG with respect to the utilization of HIV related services by them. ‘Condom use’, ‘consistent condom use’, ‘contact with peer-educators’, ‘counseling sessions’ and ‘HIV testing’ were chosen as indicators on HIV service utilization. Results: 8% (38) of FSWs are registered with SHG; 92% aged ≥ 25 years, 47% illiterate, and 71% are currently married. The likelihood of utilizing HIV services including, knowledge on HIV/AIDS and its mode of transmission (OR:5.54; CI: 1.87-16.60; p < 0.05),accessed drop-in Centre (OR: 6.53; CI: 2.15-19.88; p < 0.10), heard about joint health camps (OR: 4.71; CI:2.12-10.46); p < 0.05), negotiated or stood up against police/broker/local goonda/clients (OR: 2.26; CI: 1.08-4.73; p < 0.05), turned away clients when they refused to use condom during sex (OR: 3.76; CI: 1.27-11.15; p < 0.05) and heard of ART (OR; 4.55; CI: 2.18-9.48; p < 0.01) were higher among FSWs associated with SHG in comparison to FSWs not associated with SHG. Conclusions: Considering the improved HIV program outcomes among FSWs associated with SHG; HIV interventions among FSWs could consider facilitating the formation of SHGs with FSWs as one of the key strategies to empower the community for ensuring better program outcomes.

Keywords: empowerment, female sex workers, HIV, Thane, self-help group

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Authors: Chithra A. V., Somoshree Datta, Sandeep Nithyanandan

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Sign Language Recognition (SLR) is the process of interpreting and translating sign language into spoken or written language using technological systems. It involves recognizing hand gestures, facial expressions, and body movements that makeup sign language communication. The primary goal of SLR is to facilitate communication between hearing- and speech-impaired communities and those who do not understand sign language. Due to the increased awareness and greater recognition of the rights and needs of the hearing- and speech-impaired community, sign language recognition has gained significant importance over the past 10 years. Technological advancements in the fields of Artificial Intelligence and Machine Learning have made it more practical and feasible to create accurate SLR systems. This paper presents a distinct approach to SLR by framing it as a video classification problem using Deep Learning (DL), whereby a combination of Convolutional Neural Networks (CNNs) and Recurrent Neural Networks (RNNs) has been used. This research targets the integration of sign language recognition into healthcare settings, aiming to improve communication between medical professionals and patients with hearing impairments. The spatial features from each video frame are extracted using a CNN, which captures essential elements such as hand shapes, movements, and facial expressions. These features are then fed into an RNN network that learns the temporal dependencies and patterns inherent in sign language sequences. The INCLUDE dataset has been enhanced with more videos from the healthcare domain and the model is evaluated on the same. Our model achieves 91% accuracy, representing state-of-the-art performance in this domain. The results highlight the effectiveness of treating SLR as a video classification task with the CNN-RNN architecture. This approach not only improves recognition accuracy but also offers a scalable solution for real-time SLR applications, significantly advancing the field of accessible communication technologies.

Keywords: sign language recognition, deep learning, convolution neural network, recurrent neural network

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Authors: Mohammad Julhas Sujan, Md. Ferdous Alam

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Maternal, neonatal, and child health (MNCH) holds one of the prime focuses in Bangladesh’s national healthcare system. To save the lives of mothers and children, knowing the stock of MNCH medicines in different healthcare facilities and when to replenish them are essential. A robust information system not only facilitates efficient management of the essential MNCH medicines but also helps effective allocation of scarce resources. In Bangladesh, Supply chain management of the 25-essential life-saving medicines are currently tracked and monitored via an electronic logistics management information system (eLMIS). Our aim was to conduct a cross-sectional study with a year (2020) worth of data from 24 districts of Bangladesh to evaluate how eLMIS is helping the Government and other stakeholders in efficient supply chain management. Data were collected from 4711 healthcare facilities ranging from primary to secondary levels within a district. About 90% (4143) are community clinics which are considered primary health care facilities in Bangladesh. After eLMIS implementation, the average reporting rate across the districts has been increased (> 97%). The month of stock (MOS) of zinc is an average 6 months compared to Inj. Magnesium Sulphate which will take 2.5 years to consume according to the current average monthly consumption (AMC). Due to first approaching expiry, Tab. Misoprostol, 7.1% Chlorhexidine and Inj. Oxytocin may become unusable. Moreover, Inj. Oxytocin is temperature sensitive and may reduce its efficacy if it is stocked for a longer period. In contrast, Zinc should be sufficiently stocked to prevent sporadic stockouts. To understand how data are collected, transmitted, processed, and aggregated for MNCH medicines in a faster and timely manner, an electronic logistics management information system (eLMIS) is necessary. We recommend the use of such a system in developing countries like Bangladesh for efficient supply chain management of essential MNCH medicines.

Keywords: adaption, eLMIS, MNCH, live-saving medicines

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Authors: Mubarak Jan Beebee Zeba Mahetaab, Sumera Bibi Keenoo

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Background: Covid-19 was first reported in Wuhan. On 13th March 2020, WHO declared Covid-19 as a pandemic disease with 140,936 cases globally. The outbreak of covid-19 occurred in over 184 countries, and it created a lot of medical and mental burdens. Aside from the physical problems, the mental health of the medical staff has been of critical concern. Aims and Objectives: To determine the prevalence of burnout among HCW dealing with COVID-19, identify the risk factors and find measures to support their mental health while dealing with the current and future pandemic. Methodology: A cross-sectional study was conducted among the HCW who fought against COVID-19 in SSRN Hospital in Mauritius. The HCWs were recruited using the snowballing sampling technique. Age, gender, job category, income, duration of vacation, working environment and importance of mental health were measured. Results: The prevalence of burnout was highest among HCA. Age had no significant association with pandemic-related burnout. In Mauritius, burnout during the pandemic is linked with lower income and having less vacation days. Conclusion: Burnout is prevalent among healthcare workers working during the Covid-19 Pandemic. Interventions such as psychological counselling, yoga and financial increments need to be implemented to help the healthcare workers.

Keywords: burnout, Covid-19, health care professionals, pandemic

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Authors: Laura Sapranaviciute-Zabazlajeva, Abdonas Tamosiunas, Dalia Luksiene, Dalia Virviciute

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The cardiovascular diseases (CVD) is the leading cause of death in the EU, especially in the middle aged and elderly population. Psychological wellbeing (PWB) has been linked with better cardiovascular health and survival in the elderly. The aim of the study is to evaluate associations between CVD risk and PWB in middle-aged and elderly population. 10,940 middle aged and older Lithuanians of age 45-74 years, were invited to participate in the study. A study sample was a random and stratified by gender and age. In 2006-2008 7,087 responders participated in the survey, so the response rate was 64.8%. A follow-up study was conducted from 2006 till 2015. New CVD cases and deaths from CVD were evaluated using the Kaunas population-based CVD register and death register of Kaunas. Study results revealed that good PWB predicts longer life in female participants (Log Rank = 13.7, p < 0.001). In the fully adjusted model for socio-demographic, social and CVD risk factors, hazard ratio for CVD mortality risk was lower amongst women with good PWB (HR = 0.28, 95% CI 0.11-0.72), but not significantly for men. Our study concludes, that lower CVD mortality rates is being associated with better PWB in female aged 45-74 years.

Keywords: psychological well-being, cardiovascular disease, elderly, survival

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Authors: G. I. Ozumba, V. A. Pam, V. A. Adejoh, S. A. Odey

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Intestinal parasitic infections are the most common parasitic infections of the man commonly resulting in morbidity and mortality in infected individuals. Two hundred (200) patients from two medical centers were randomly examined for intestinal parasites using normal saline wet mount and formol-ether concentration methods. One hundred patients each were examined from Plateau State Specialist Hospital (PSSH) and Vom Christian Hospital (VCH) respectively. Of the 100 patients examined at PSSH, (22.0%) tested positive for intestinal parasites, while only (6.0%) was reported for VCH. Ascaris lumbricoides and Taenia spp. were significantly (P value=0.0002726) the most prevalent intestinal parasites in PSSH with (31.8%) respectively. Balantidium coli and Entamoeba histolytica were the least prevalent at (4.5%) respectively. Hookworm (50.0%) was significantly (P<0.0001) the most prevalent intestinal parasite in VCH, followed by A. lumbricoides (33.3%), while Taenia spp. (16.7%) was the least. Female subjects 12(54.5%) were more infected than their male 10(45.4%) counterparts in PSSH. The difference (P value=0.3633) in the infection between female and male subjects at PSSH was not significant. Female subjects were significantly (P value=0.0008586) more infected 4(66.7%) than male subjects 2(33.3%) at VCH. The prevalence of intestinal parasite in relation to age in PSSH shows a significantly (P-value = 0.02573) high level among age group 11-20years 9(36.0%). On the contrary, the high prevalence of intestinal parasites among age groups 31-40 years 2(9.1%) at VCH was not significant (P value=0.1595). The result in relation to a water source in patients attending PSSH shows that the boreholes sources (66.7%) had a significantly (P<0.0001) high prevalence of intestinal parasites, while the least prevalence was observed in tap source (7.9%). Results from VCH shows that streams/rivers (16.7%) revealed high prevalence, while the tap source was least parasitized (10.0%). There was no significant difference (P value=0.436) in the prevalence of parasites in relation to the water source at VCH. This prevalence is directly related to the sanitary condition, socio-economic status, educational level, the age and hygienic habits of the patients. Thus, necessary sanitary policies, awareness, screening and de-worming exercises and occasional check of intestinal parasites are recommended.

Keywords: intestinal parasites, Jos, patients, prevalence

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Authors: Hamidreza Khodaei, Ali Daryabeigi Zand

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Ovulation is a physiologic process with an inflammatory response that depends on a coordinated activity of gonadotropins and steroid hormones, and inflammatory mediators such as cytokines, prostaglandins, leptin, nitric oxide (NO), etc. Conjugated linoleic acid (CLA) is composed of polyunsaturated fatty acids (PUFA) found in dairy products, beef, and lamb. There is strong evidence that dietary CLA affects mediators involved in ovulation. The objective of this study is to evaluate the impacts of various doses of dietary CLA on systemic and local hormones and parameters involved in ovulation. In this case-control research, 80 (50 ± 2-day old) female mice were randomly divided into 4 groups (C as control treatment and T1, T2 and T3 are considered as the treatment groups). There were four replicates in each group, and there were five mice in every replicate (20 mice, in total). The mice in the control group were fed with no CLA in their diet, but the ones in the treatment group received 0.1, 0.3 and 0.5g/kg of CLA (replacing corn oil in the diet), respectively for four months. After that, blood samples were obtained from the tails of animals that displayed estrus signs and estradiol (E2), progesterone (P4), LH, FSH, NO, leptin and TNFα were measured. In addition, the impacts of CLA on the ovarian production of prostaglandins (PGs) and NO were studied. The data were analyzed by SAS software. CLA considerably decreased serum levels of FSH (p < 0.05), LH, estradiol, NO, leptin and TNFα (p < 0.01). In addition, CLA decreased progesterone levels, but this effect was statistically not significant. The significantly adverse effects of CLA were observed in the ovarian production of PGE2 and PGF2α (p < 0.01). It seems that CLA may play an important role in reducing the ovulation rate in mice as CLA negatively affected female reproduction and it had adverse effects on systemic and local hormones involved in ovulation.

Keywords: conjugated linoleic acid, nitric oxide, ovary, ovulation, prostaglandin, gonadotropin

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Authors: Weldegerima Gebremedhin Hagos

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Background: The Coronavirus disease of 2019 (COVID-19) is a catastrophic emerging global health threat caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 has a wide range of complications and sequels. It is devastating in developing countries, causing serious health and socioeconomic crises as a result of the increasingly overburdened healthcare system. Ethiopia reported the first case of SARS-CoV-2 on 13th March 2020, with community transmission ensuing by mid-May. The aim of this study was conducted to determine the prevalence of SARS-CoV-2 infection in Tigray, Ethiopia. Methods: Facility-based correctional study designs were used on a total of 380 study participants from March 2023 up to May 2023 in two general hospitals and one comprehensive specialized hospital in Tigray, Ethiopia. A pre-structured questionnaire was used to assess information regarding the socio-demographic, clinical data and other risk factors. A nasal swap was taken by trained health professionals, and the laboratory analysis was done by RT-PCR (quant studio 7-flex, applied biosystems) in Tigrai Health Research Institute and Mekelle University Medical Microbiology Research Laboratory. Result: The mean age of the study participants was 31 (SD+/-3.5) years, with 65% being male and 35% female. The overall seropositivity of sars-cov-2 among the study participants was 5.5%. The prevalence was higher in males (6.2%) than females which were (4.7%). Sars-cov-2 infection was significantly associated with a history of lack of vaccination (p-value 0.002). There was no significant association between seropositivity and demographic factors (P > 0.05). Conclusion: The seroprevalence of SARS-CoV-2 among the study participants is high. Those study participants with a previous history of vaccination have a low probability of developing COVID-19 infection. A low SARS-CoV-2 infection rate was recorded in those who frequently use masks.

Keywords: prevalence, SARS-CoV-2, infection, risk factors

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Authors: Khadiza Akter, Tammy Greer, Raegan Bishop

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An in-depth study of the psycho-social effects of gynecological health disparities among immigrant women in the USA is the goal of this integrative review paper. Immigrant women frequently encounter unique obstacles that have severe psycho-social repercussions when it comes to receiving high-quality gynecological treatment. The review investigates the interaction of psychological, sociological, and health factors that affect the psycho-social effects that immigrant women experience in recognition of the significance of addressing these imbalances. The difficulties that immigrant women face in providing high-quality gynecological treatment in the USA are examined in this study. These difficulties are caused by a variety of psychological issues, including acculturation stress and stigma, as well as by social problems like prejudice, language hurdles, and cultural norms. Additionally, variations in healthcare access and affordability have a role. This study highlights the particular challenges that immigrant women have in receiving high-quality gynecological treatment in the United States. These difficulties are caused by both social problems like language obstacles, cultural norms, and biases, as well as psychological ones like acculturation stress and stigma. Additionally, variations in gynecological care for immigrant women are greatly influenced by variances in healthcare availability and price. To find pertinent research looking at the psychological effects of gynecological health disparities among immigrant women in the USA, a thorough search of numerous databases was done. Numerous approaches, including mixed, quantitative, and qualitative ones, were used in the studies. The important findings from various investigations were extracted and synthesized after they underwent a careful evaluation. In order to lessen these discrepancies and enhance the overall well-being of immigrant women, healthcare professionals, legislators, and researchers must collaborate to create specialized treatments, regulations, and health system reforms.

Keywords: cultural barriers, gynecological health disparities, health care access, immigrant women, mental health, psycho-social consequences, social stigma

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Authors: G. Bruno, A. Ciavarella, N. Linciano

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The proportion of women in boardroom has traditionally been low around the world. Over the last decades, several jurisdictions opted for active intervention, which triggered a tangible progress in female representation. In Europe, many countries have implemented boardroom diversity policies in the form of legal quotas (Norway, Italy, France, Germany) or governance code amendments (United Kingdom, Finland). Policy actions rest, among other things, on the assumption that gender balanced boards result in improved corporate governance and performance. The investigation of the relationship between female boardroom representation and firm value is therefore key on policy grounds. The evidence gathered so far, however, has not produced conclusive results also because empirical studies on the impact of voluntary female board representation had to tackle with endogeneity, due to either differences in unobservable characteristics across firms that may affect their gender policies and governance choices, or potential reverse causality. In this paper, we study the relationship between the presence of female directors and corporate performance in Italy, where the Law 120/2011 envisaging mandatory quotas has introduced an exogenous shock in board composition which may enable to overcome reverse causality. Our sample comprises Italian firms listed on the Italian Stock Exchange and the members of their board of directors over the period 2008-2016. The study relies on two different databases, both drawn from CONSOB, referring respectively to directors and companies’ characteristics. On methodological grounds, information on directors is treated at the individual level, by matching each company with its directors every year. This allows identifying all time-invariant, possibly correlated, elements of latent heterogeneity that vary across firms and board members, such as the firm immaterial assets and the directors’ skills and commitment. Moreover, we estimate dynamic panel data specifications, so accommodating non-instantaneous adjustments of firm performance and gender diversity to institutional and economic changes. In all cases, robust inference is carried out taking into account the bidimensional clustering of observations over companies and over directors. The study shows the existence of a U-shaped impact of the percentage of women in the boardroom on profitability, as measured by Return On Equity (ROE) and Return On Assets. Female representation yields a positive impact when it exceeds a certain threshold, ranging between about 18% and 21% of the board members, depending on the specification. Given the average board size, i.e., around ten members over the time period considered, this would imply that a significant effect of gender diversity on corporate performance starts to emerge when at least two women hold a seat. This evidence supports the idea underpinning the critical mass theory, i.e., the hypothesis that women may influence.

Keywords: gender diversity, quotas, firms performance, corporate governance

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Authors: Sharmila Dahal Paudel

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Background: There are around twenty-four thousand to twenty-eight thousand Female Sex Workers in Nepal. FSWs are the vulnerable groups for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) infections which directly and indirectly ease to reduce the quality of life of such groups. Due to their highly marginalized status, FSWs in Nepal have limited access to information about reproductive health and safe sex practices. The objectives of the study are to assess the quality of life of female sex workers and the factors affecting them. Materials and Methods: A descriptive cross-sectional study with methodological triangulation was conducted among 108 FSWs on the basis of service record of selected organization of Pokhara valley. The complete enumerative sampling was used to select FSWs. Structured interview schedule, WHOQOL-BREF and in-depth questionnaire were used to collect the data. The descriptive and inferential statistics were used to interpret the result. Results: The mean age of participants were 23.44 years and the mean quality of life score was 174.06 ranging from 56.54 to 370.78. Among the domain scores, the mean score is highest in social domain (55.89) followed by physical (45.42), psychological (39.27) and the environmental (34.23). Regarding the association of QOL with socio-demographic, occupation and health-related variables, the multi-linear regression suggests that the satisfaction with occupation was highly significant with the total QOL score (B=-50.50, SE=10.46; p= <0.001) and there is negative relation between QOL and feeling of exploitation and facing STI problems. This means those who feels exploited have significantly less QOL comparing with those who did not feel the same. In correlation analysis, all the domains are positively co-related with each domain which is found to be significant at 1% level of significance. Conclusion: The highest mean score was in social domain, and the lowest is in environmental domain which suggests that the items included in environmental domains could not be utilized or hindrance were there.

Keywords: FSWs, HIV, QOL, WHOQOL-BREF

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Authors: Ala Rakhshandeh, Zahra Ashkar, Solmaz Dehghani Dolatabadi, Hossein Bayat

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The present study has been conducted to investigate the role of family emotional climate and emotional expression style in the academic well-being of students with military parents. Children, including 280 female students of Shahriar police officers, were selected by random sampling method, and they have been investigated through Alfred B. Hillburn's family emotional climate questionnaire (1964), King and Ammon's emotional expression questionnaire (1990), and Pitrinen, Sweeney, and Falto's academic well-being questionnaire (2014). The data were analyzed using statistical methods of correlation coefficient and stepwise multiple regression under the SPSS23 program. The results reveal that the variables of family emotional climate and emotional expression can explain 36.4% of the variance in academic well-being. This finding reveals that with an increase of standard deviation on the scores of family emotional climate and emotional expression, 0.513 and 0.155 standard deviations are added to the scores of academic well-being, respectively. The emotional climate of the family has a superior distinctive role in predicting the educational well-being of female students. Thus, the emotional climate of the family and the style of emotional expression play a meaningful role in the academic well-being of students with the military parent.

Keywords: emotional climate, family, emotional expression style, academic well-being

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Authors: Osuagwu Justine Ugochukwu

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Investigating the effects of transformational and transactional leadership styles on the performance of healthcare employees at the University Teaching Hospital (UNTH) in Enugu, Nigeria, was the goal of the research. The respondents were asked to fill out a structured questionnaire. The respondents were chosen using a straightforward random sampling technique and consisted of 370 health workers at the hospital. The result of the analysis revealed that transactional and transformational leadership style has a positive while ambidextrous leadership has a negative effect on healthcare workers' performance in UNTH, Enugu. Therefore, the management of public hospitals that have the capacity to change their top management approach to leadership styles will gain substantial support from their employees’ thereby increasing organizational commitment and performance among health workers. This will have remarkable social implications, one of which is a change in the work culture and attitude of medical personnel from the seemingly anti-community of patients to friendly engagement and treatment of patients leading to a harmonious coexistence among these individuals in society. Investigating ambidextrous leadership and the use of nonparametric analysis is unique and has brought brand-new knowledge to leadership literature.

Keywords: workers performance, transformational leadership, transactional leadership, governance quality, ambidextrous leadership

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Authors: Harriet Bothwell, Lowri Evans, Kevin Jones

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Background: The University of Bristol provides all medical students the opportunity to undertake student selected components (SSCs) at multiple stages of the undergraduate programme. SSCs enable students to explore areas of interest that are not necessarily covered by the curriculum. Students are required to produce a written report and most use SSCs as an opportunity to undertake an audit or small research project. In 2013 Swindon Academy, based at the Great Western Hospital, offered eight students the opportunity of a global health SSC which included a two week trip to rural hospital in Uganda. This SSC has since expanded and in 2017 a total of 20 students had the opportunity to undertake small research projects at two hospitals in rural Uganda. 'Tomorrows Doctors' highlights the importance of understanding healthcare from a 'global perspective' and student feedback from previous SSCs suggests that self-assessed knowledge of global health increases as a result of this SSC. Through the most recent version of this SSC students had the opportunity to undertake projects in a wide range of specialties including paediatrics, palliative care, surgery and medical education. Methods: An anonymous online questionnaire was made available to students following the SSC. There was a response rate of 80% representing 16 out of the 20 students. This questionnaire surveyed students’ satisfaction and experience of the SSC including the level of academic, project and spiritual support provided as well as perceived challenges in completing the project and barriers to healthcare delivery in the low resource setting. This survey had multiple open questions allowing the collection of qualitative data. Further qualitative data was collected from the students’ project report. The suggested format included a reflection and all students completed these. All qualitative data underwent thematic analysis. Results: All respondents rated the overall experience of the SSC as 'good' or 'excellent'. Preliminary data suggest that students’ confidence in their knowledge of global health, diagnosis of tropical diseases and management of tropical diseases improved after completing this SSC. Thematic analysis of students' reflection is ongoing but suggests that students gain far more than improved knowledge of tropical diseases. Students reflect positively on having the opportunity to research in a low resource setting and feel that by completing these projects they will be 'useful' to the hospital. Several students reflect the stark contrast to healthcare delivery in the UK and recognise the 'privilege' of having a healthcare system that is free at the point of access. Some students noted the different approaches that clinicians in Uganda had to train in 'taking ownership' of their own learning. Conclusions: Students completing this SSC report increased knowledge of global health and tropical medicine. However, their reflections reveal much broader learning outcomes and demonstrate considerable insight in multiple topics including conducting research in the low resource setting, training and healthcare inequality.

Keywords: global health, medical education, student feedback, undergraduate

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Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

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Authors: Charlotte Bach, Albrecht Jahn, Mahnaz Motamedi, Maryam Karimi-Ghahfarokhi

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Background: Maternal and infant deaths are most prevalent in the first month after birth, emphasizing the critical need for quality healthcare services during this period. Immigrant women, who are more susceptible to adverse pregnancy outcomes, often face neglect in accessing proper healthcare. The lack of adequate postpartum care significantly contributes to mortality rates. Therefore, utilizing maternal health care services and implementing postpartum care is crucial in reducing maternal and child mortality. Aims: This study aims to evaluate the assessment of pre- and postnatal care among women with and without migration background. In addition, the study explores the impact of COVID-19 procedures on women's experiences during pregnancy, birth, and the postpartum period. Methods: This research employs a cross-sectional Mixed-Method design. Data collection was facilitated through structured questionnaires administered to participants, alongside the utilization of patient bases, including Maternity and child medical records. Following the assumption that the investigator aimed to gain comprehensive insights, qualitative sampling focused on individuals with substantial experiences related to COVID-19, regarded as rich cases. Results: our study highlighted the influence of educational level, marital status, and consensual partnerships on the likelihood of Cesarean deliveries. Regarding breastfeeding practices, migrant women exhibited higher rates of breastfeeding initiation and continuation. Contraception utilization revealed interesting patterns, with non-migrants displaying higher odds of contraceptive use. The qualitative component of our research adds depth to the exploration of women's experiences during the COVID-19 pandemic, revealing nuanced challenges related to anxiety, hospital restrictions, breastfeeding support, and postnatal ward routines. Conclusion: Dissimilarity among studies toward cesarean rate between migrants and non-migrants underscores the importance of targeted interventions considering the diverse needs of distinct population groups. It also acknowledges potential cultural, contextual, and healthcare system influences on the association between mode of delivery and infant feeding practices. Studies acknowledge the influence of contextual variables on contraceptive preferences among migrants and non-migrants, emphasizing the need for tailored healthcare policies. The findings contribute to existing research, highlighting the need for a nuanced understanding of the impact of birth preparation courses on maternal and infant outcomes. Furthermore, they emphasize the universality of certain maternity care experiences, regardless of pandemic contexts, reinforcing the importance of patient-centred approaches in healthcare delivery.

Keywords: migration background, pregnancy outcome, covid-19, postpartum

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Authors: Min-Tao Hsu

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This study aims to explore the lived experiences of women with breast cancer, including their life world of illness and their adaptation to breast cancer. Breast cancer is not only a potentially lethal disease, but also a disease that may lead to many irreversible changes for female patients. Especially, in a culture where the wholeness is pursuit as an essential value, the sickness and/or broken body bring great challenge of life. Based on holism and symbolic interactionism, this study used interpretive ethnography including in-depth interviews and participant observations to collect the narrative of women with breast cancer concerning their illness experience. In addition, this study used Agar’s hermeneutic cycle to analyze data. The average age of 35 participants was 54.2. A total of 15 patients were within 2 years of onset, 5 patients were within 2-5 years of the treatment observation period, and 15 patients suffered from breast cancer for more than 5 years. The average age of onset was 50.4. Result: The main storyline of the life world of illness is ‘breast cancer is a turning point of life.’ Loss of breast was in terms of ‘no more a woman’ in Taiwanese culture. Two young women, one in her newly wedded and another right before marry, were divorced and cancelled wedding right after being diagnosed. All of them addressed that they have a ‘broken body.’ Single women accounted that they won’t marry for not being humiliated and most of married women said they never show female body in front of her husband or partner even in intimacy encounter. Three common themes were discovered: 1) new self and new identity; 2) new social relationships and new me; 3) new body and new life. The intertwining bodies, illness, selves, suffering, and medical treatments of female patients were observed. More, the recovery, of cause, was happened when new self, relationship, and new body were generated. Their identity to be a woman and a wife is shattered and their life is urged into another facet. For helping them to recovery from such situation, building a new identity and new social fabric on the new body need to be included in nursing care plan.

Keywords: breast cancer, illness narrative, world of illness, self-healing, interpretive ethnography

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Authors: Lamis Kattan, Joanne Haddad

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This paper examines the impact of gender focused labor legislation on women's labor force participation and economic empowerment. We rely on historical legislative acts passed by state legislatures and exploit whether or not states passed regulatory laws regulating overall and industry specific employment and work conditions for women, night work laws and labor laws requiring provision of seats for working women. We exploit the fact that not all states enacted these laws as well as the variation in the timing of enactment of such laws. Our results show that women in comparison to men in treated states are more likely to be in the labor force post introduction of night work laws in comparison to control states. We also document the effect of industry-specific labor policies on women's likelihood to be employed in the affected industry and in higher-wage occupations within the industry of interest. Policy implications of our findings endorse the adoption of labor laws in favor of women to advocate their empowerment through a higher involvement in the labor market and financial independence.

Keywords: female employment, labor laws, marriage, fertility

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Authors: Saul Ngarava, Leocadia Zhou, Nomakhaya Monde

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Water crises have the fourth most significant societal impact after weapons of mass destruction, climate change, and extreme weather conditions, ahead of natural disasters. Intricacies between women and water are central to achieving the 2030 Sustainable Development Goals (SDGs). The majority of the 1.2 billion poor people worldwide, with two-thirds being women, and mostly located in Sub Sahara Africa (SSA) and South Asia, do not have access to safe and reliable sources of water. There exist gendered differences in water security based on the division of labour associating women with water. Globally, women and girls are responsible for water collection in 80% of the households which have no water on their premises. Women spend 16 million hours a day collecting water, while men and children spend 6 million and 4 million per day, respectively, which is time foregone in the pursuit of other livelihood activities. Due to their proximity and activities concerning water, women are vulnerable to water insecurity through exposures to water-borne diseases, fatigue from physically carrying water, and exposure to sexual and physical harassment, amongst others. Proximity to treated water and their wellbeing also has an effect on their sensitivity and adaptive capacity to water insecurity. The great distances, difficult terrain and heavy lifting expose women to vulnerabilities of water insecurity. However, few studies have quantified the vulnerabilities and burdens on women, with a few taking a phenomenological qualitative approach. Vulnerability studies have also been scanty in the water security realm, with most studies taking linear forms of either quantifying exposures, sensitivities or adaptive capacities in climate change studies. The current study argues for the need for a water insecurity vulnerability assessment, especially for women into research agendas as well as policy interventions, monitoring, and evaluation. The study sought to identify and provide pathways through which female-headed households were water insecure in South Africa, the 30th driest country in the world. This was through linking the drinking water decision as well as the vulnerability frameworks. Secondary data collected during the 2016 General Household Survey (GHS) was utilised, with a sample of 5928 female-headed households. Principal Component Analysis and Structural Equation Modelling were used to analyse the data. The results show dynamic relationships between water characteristics and water treatment. There were also associations between water access and wealth status of the female-headed households. Association was also found between water access and water treatment as well as between wealth status and water treatment. The study concludes that there are dynamic relationships in water insecurity (exposure, sensitivity, and adaptive capacity) for female-headed households in South Africa. The study recommends that a multi-prong approach is required in tackling exposures, sensitivities, and adaptive capacities to water insecurity. This should include capacitating and empowering women for wealth generation, improve access to water treatment equipment as well as prioritising the improvement of infrastructure that brings piped and safe water to female-headed households.

Keywords: gender, principal component analysis, structural equation modelling, vulnerability, water insecurity

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Authors: Xiaofei Zhu

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As a 'weapon of the weak', the Public Interest Law can provide a better perspective for the cause of gender justice. In recent years, the legal practice of single female reproductive rights in China has already possessed the elements of public interest law activities and the possibility of public interest law operation. Through the general operating procedures of public interest law practice, that is, from the choice of subject, the planning of the case, the operation of the strategy and the later development, the paper analyzes the gains and losses of the legal practice of single female reproductive rights in China, and puts forward some ideas on its possible operation path. On this basis, it is believed that the cause of women's rights should be carried out under the broad human rights perspective; it is necessary to realize the particularity of different types of women's rights protection practice; the practice of public interest law needs to accurately grasp the constituent elements of all aspects of the case, and strive to find the opportunities of institutional and social change; the practice of public welfare law of gender justice should be carried out from a long-term perspective.

Keywords: single women’s reproductive rights, public interest law, gender justice, legal strategies, legal change

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Authors: Rubab Z. Kahlon, Ibtisam Butt, Isma Younis, Aamer G. Mufti

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Worldwide lung cancer 1.61 million cases were seen in both genders. Lung carcinoma is the major cause of both morbidity and mortality in the world. Purpose of the present study was to describe the spatio- temporal trends of lung cancer in both genders. A retrospective study was conducted. Total 1498 patients of lung carcinoma were examined. Only lung cancer patients from all over the Punjab were included in the present study. MS Excel 2010 was used for data tabulation and calculation while the Arc GIS version 9.3 was used for geographical representation of the data. 1498 cases of Lung cancer were found from 2008-2012. The number of male patients was 1236 and female was 262. Majority of the patients were from Lahore districts with 807 patients. Lung cancer was more prevalent in male as compared to female in our region. Increase in the prevalence of lung cancer was prominently seen in the most populated and industrial areas of the Punjab province. Time trend of five years showed fluctuation in the lung cancer incidence during the study period.

Keywords: districts, gender, lung cancer trends, Punjab province of Pakistan

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