Search results for: under 17 years
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10442

Search results for: under 17 years

9452 Erectile Dysfunction in A Middle Aged Man 6 Years After Bariatric Surgery: A Case Report

Authors: Thaminda Liyanage, Chamila Shamika Kurukulasuriya

Abstract:

Introduction: Morbid obesity has been successfully treated with bariatric surgery for over 60 years. Although operative procedures have improved and associated complications have reduced substantially, surgery still carries the risk of post-operative malabsorption, malnutrition and a range of gastrointestinal disorders. Overweight by itself can impair libido in both sexes and cause erectile dysfunction in males by inducing a state of hypogonadotropic hypogonadism, proportional to the degree of obesity. Impact of weight reduction on libido and sexual activity remains controversial, however it is broadly accepted that weight loss improves sexual drive. Zinc deficiency, subsequent to malabsorption, may lead to impaired testosterone synthesis in men while excessive and/or rapid weight loss in females may result in reversible amenorrhoea leading to sub-fertility. Methods: We describe a 37 year old male, 6 years post Roux-en-Y gastric bypass surgery, who presented with erectile dysfunction, loss of libido, worsening fatigue and generalized weakness for 4 months. He also complained of constipation and frequent muscle cramps but denied having headache, vomiting or visual disturbances. Patient had lost 38 kg of body weight post gastric bypass surgery over four years {135kg (BMI 42.6 kg/m2) to 97 kg (BMI 30.6 kg/m2)} and the weight had been stable for past two years. He had no recognised co-morbidities at the time of the surgery and noted marked improvement in general wellbeing, physical fitness and psychological confident post surgery, up until four months before presentation. Clinical examination revealed dry pale skin with normal body hair distribution, no thyroid nodules or goitre, normal size testicles and normal neurological examination with no visual field defects or diplopia. He had low serum testosterone, follicular stimulating hormone (FSH), luteinizing hormone (LH), T3, T4, thyroid stimulating hormone (TSH), insulin like growth factor 1 (IGF-1) and 24-hour urine cortisol levels. Serum cortisol demonstrated an appropriate rise to ACTH stimulation test but growth hormone (GH) failed increase on insulin tolerance test. Other biochemical and haematological studies were normal, except for low zinc and folate with minimally raised liver enzymes. MRI scan of the head confirmed a solid pituitary mass with no mass effect on optic chiasm. Results: In this patient clinical, biochemical and radiological findings were consistent with anterior pituitary dysfunction. However, there were no features of raised intracranial pressure or neurological compromise. He was commenced on appropriate home replacement therapy and referred for neurosurgical evaluation. Patient reported marked improvement in his symptoms, specially libido and erectile dysfunction, on subsequent follow up visits. Conclusion: Sexual dysfunction coupled with non specific constitutional symptoms has multiple aetiologies. Clinical symptoms out of proportion to nutritional deficiencies post bariatric surgery should be thoroughly investigated. Close long term follow up is crucial for overall success.

Keywords: obesity, bariatric surgery, erectile dysfunction, loss of libido

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9451 A C/T Polymorphism at the 5’ Untranslated Region of CD40 Gene in Patients Associated with Graves’ Disease in Kumaon Region

Authors: Sanjeev Kumar Shukla, Govind Singh, Prabhat Pant Shahzad Ahmad

Abstract:

Background: Graves’ disease is an autoimmune disorder with a genetic predisposition, and CD40 plays a pathogenic role in various autoimmune diseases. A single nucleotide polymorphism at position –1 of the Kozak sequence of the 5 untranslated regions of the CD40 gene of exon 1 has been reported to be associated with the development of Graves’ Disease. Objective: The aim of the present study was to investigate whether CD40 gene polymorphism confers susceptibility to Graves’ disease in the Kumaon region. CD40 gene polymorphisms were studied in Graves’ Disease patients (n=50) and healthy control subjects without anti-thyroid autoantibodies or a family history of autoimmune disorders (n=50). Material and Method: CD40 gene polymorphisms were studied in fifty Graves’ Disease patients and fifty healthy control subjects. All samples were collected from STG Hospital, Haldwani, Nainital. A C/T polymorphism at position –1 of the CD40 gene was measured using the polymerase chain reaction-restriction fragment length polymorphism. Results: There was no significant difference in allele or genotype frequency of the CD40 SNP between Graves’ Disease and control subjects. There was a significant decrease in the TT genotype frequency in the Graves’ Disease patients who developed Graves’ Disease after 40 years old than those under 40 years of age. These data suggest that the SNP of the CD40 gene is associated with susceptibility to the later onset of Graves’ Disease. Conclusion: The CD40 gene was a different susceptibility gene for Graves’ Disease within certain families because it was both linked and associated with Graves’ Disease.

Keywords: autoimmune diseases, pathogenesis, diagnosis, therapy

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9450 Farmers’ Use of Indigenous Knowledge System (IKS) for Selected Arable Crops Production in Ondo State

Authors: A. M. Omoare, E. O. Fakoya

Abstract:

This study sought to determine the use of indigenous knowledge for selected arable crops production in Ondo Sate. A multistage sampling method was used and 112 arable crops farmers were systematically selected. Data were analyzed using both descriptive and inferential statistics. The results showed that majority of the sampled farmers were male (75.90%) About 75% were married with children. Large proportion of them (62.61%) were within the ages of 30-49 years. Most of them have spent about 10 years in farming (58.92%). The highest raw scores of use of indigenous knowledge were found in planting on mound in yam production, use of native medicine and scare-crow method in controlling birds in rice production, timely planting of locally developed resistant varieties in cassava production and soaking of maize seeds in water to determine their viability with raw scores of 313, 310, 305, 303, and 300 respectively, while the lowest raw scores was obtained in use of bell method in controlling birds in rice production with raw scores of 210. The findings established that proverbs (59.8%) and taboos (55.36%) were the most commonly used media in transmitting indigenous knowledge by arable crop farmers. The multiple regression analysis result revealed that age of the farmers and farming experience had a significant relationship with the use of indigenous knowledge of the farmers which gave R2=0.83 for semi-log function form of equation which is the land equation. The policy implication is that indigenous knowledge should provide a basis for designing modern technologies to enhance sustainable agricultural development.

Keywords: Arable Crop Production, extent of use, indigenous knowledge, farming experience

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9449 Types of School Aggression Amongst Bulgarian Students in the Age Group of 12–18 Years-Old

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

Abstract:

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

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

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9448 Clinical Risk Score for Mortality and Predictors of Severe Disease in Adult Patients with Dengue

Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma

Abstract:

Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.

Keywords: dengue, mortality, predictors, severity

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9447 Knowledge, Attitude, and Practice Among Diabetic Patients About Diabetic Foot Disease in Khartoum State Primary Health Care Centers, November 2022

Authors: Abrar Noorain, Zeinab Amara, Sulaf Abdelaziz

Abstract:

Background: Diabetic foot disease imposes a financial burden on diabetic patients and healthcare services. In Sudan, diabetic foot ulcer prevalence reached 18.1%. This study aims to assess the knowledge, attitudes, and practices and the correlation between the level of foot care knowledge and self-care practices among diabetic patients in Sudan. Methodology: In a cross-sectional study involving 262 patients with type 1 and type 2 diabetes attending diabetic clinics in three primary care centers in Khartoum, Sudan, during September to November 2022, information regarding participants sociodemographic status, foot care knowledge, attitudes, and practices was gathered using a validated, structured questionnaire in a face-to-face interview method. These data were analyzed using the statistical package for the social sciences (SPSS) 22. Results: The patients’ mean age was 54.9 years, with a female predominance (56%). Of the participants, 37% had diabetes mellitus for over ten years. On the topic of foot care, 35.5% of patients showed good knowledge, and 76% were aware of the risk of reduced foot sensation. In relation to nail care, only 19% knew how to cut nails correctly. Conclusion: Knowledge, attitudes, and practices about diabetic foot care are substandard. There is a positive correlation between foot care knowledge and self-care practices. Hence, educating diabetic patients with foot care knowledge through an awareness program and the characteristics of diabetic shoes may improve self-care practices.

Keywords: DM, DFD, DFU, PHC, SPSS

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9446 Neuropsychological Testing in a Multi-Lingual Society: Normative Data for South African Adults in More Than Eight Languages

Authors: Sharon Truter, Ann B. Shuttleworth-Edwards

Abstract:

South Africa is a developing country with significant diversity in languages spoken and quality of education available, creating challenges for fair and accurate neuropsychological assessments when most available neuropsychological tests are obtained from English-speaking developed countries. The aim of this research was to compare normative data on a spectrum of commonly used neuropsychological tests for English- and Afrikaans-speaking South Africans with relatively high quality of education and South Africans with relatively low quality of education who speak Afrikaans, Sesotho, Setswana, Sepedi, Tsonga, Venda, Xhosa or Zulu. The participants were all healthy adults aged 18-60 years, with 8-12 years of education. All the participants were tested in their first language on the following tests: two non-verbal tests (Rey Osterrieth Complex Figure Test and Bell Cancellation Test), four verbal fluency tests (category, phonemic, verb and 'any words'), one verbal learning test (Rey Auditory Verbal Leaning Test) and three tests that have a verbal component (Trail Making Test A & B; Symbol Digit Modalities Test and Digit Span). Descriptive comparisons of mean scores and standard deviations across the language groups and between the groups with relatively high versus low quality of education highlight the importance of using normative data that takes into account language and quality of education.

Keywords: cross-cultural, language, multi-lingual, neuropsychological testing, quality of education

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9445 Identification of Vulnerable Zone Due to Cyclone-Induced Storm Surge in the Exposed Coast of Bangladesh

Authors: Mohiuddin Sakib, Fatin Nihal, Rabeya Akter, Anisul Haque, Munsur Rahman, Wasif-E-Elahi

Abstract:

Surge generating cyclones are one of the deadliest natural disasters that threaten the life of coastal environment and communities worldwide. Due to the geographic location, ‘low lying alluvial plain, geomorphologic characteristics and 710 kilometers exposed coastline, Bangladesh is considered as one of the greatest vulnerable country for storm surge flooding. Bay of Bengal is possessing the highest potential of creating storm surge inundation to the coastal areas. Bangladesh is the most exposed country to tropical cyclone with an average of four cyclone striking every years. Frequent cyclone landfall made the country one of the worst sufferer within the world for cyclone induced storm surge flooding and casualties. During the years from 1797 to 2009 Bangladesh has been hit by 63 severe cyclones with strengths of different magnitudes. Though detailed studies were done focusing on the specific cyclone like Sidr or Aila, no study was conducted where vulnerable areas of exposed coast were identified based on the strength of cyclones. This study classifies the vulnerable areas of the exposed coast based on storm surge inundation depth and area due to cyclones of varying strengths. Classification of the exposed coast based on hazard induced cyclonic vulnerability will help the decision makers to take appropriate policies for reducing damage and loss.

Keywords: cyclone, landfall, storm surge, exposed coastline, vulnerability

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9444 Physics-Informed Machine Learning for Displacement Estimation in Solid Mechanics Problem

Authors: Feng Yang

Abstract:

Machine learning (ML), especially deep learning (DL), has been extensively applied to many applications in recently years and gained great success in solving different problems, including scientific problems. However, conventional ML/DL methodologies are purely data-driven which have the limitations, such as need of ample amount of labelled training data, lack of consistency to physical principles, and lack of generalizability to new problems/domains. Recently, there is a growing consensus that ML models need to further take advantage of prior knowledge to deal with these limitations. Physics-informed machine learning, aiming at integration of physics/domain knowledge into ML, has been recognized as an emerging area of research, especially in the recent 2 to 3 years. In this work, physics-informed ML, specifically physics-informed neural network (NN), is employed and implemented to estimate the displacements at x, y, z directions in a solid mechanics problem that is controlled by equilibrium equations with boundary conditions. By incorporating the physics (i.e. the equilibrium equations) into the learning process of NN, it is showed that the NN can be trained very efficiently with a small set of labelled training data. Experiments with different settings of the NN model and the amount of labelled training data were conducted, and the results show that very high accuracy can be achieved in fulfilling the equilibrium equations as well as in predicting the displacements, e.g. in setting the overall displacement of 0.1, a root mean square error (RMSE) of 2.09 × 10−4 was achieved.

Keywords: deep learning, neural network, physics-informed machine learning, solid mechanics

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9443 Nurses as Being Participants of Sexual Health of Women

Authors: Malika Turganova, Aigul Abduldayeva

Abstract:

Modern conditions require nursing innovations at the primary ambulatory stage in the health system of Kazakhstan. There is a growing need for nurses involved in before-doctor attendance for preventive interview with a female population about reproductive health. We conducted questionnaire survey of the population of Astana in 2015. Questionnaires were drawn up according to the criteria of sexual health of World Health Organization. 3593 respondents out of 8000 questionnaires agreed to answer the questions anonymously, mM=±2,1. The average age of women comprised 37,4±11,2, Ме=31,7 years of age. Analysis of awareness about marriage hygiene revealed that 72,7% of respondents did not receive information about marriage hygiene and 89,1% respondents consider it more advisable before marriage. 45,9% of respondents specified the internet as a source of information on marriage hygiene issues, 24,5% of respondents pointed out friends, and 21,5% specified doctor. Comparing female age groups under and after 40 years old we see that proportion of cases when parents provide information about marriage hygiene issues comprises 4.3% (χ2 =9.8, p<0.05). The most important factor of preservation of women reproductive health is handling a problem of unwanted pregnancy. The responsibility lies equally in men and women. Data analysis of contraceptive methods by ranking showed three most frequently used methods: contraception sheath – 29.3%, then coitus interruptus – 18.7% and hormonal preparations – 16.9%. The most important factor of women's reproductive health preservation is a solving of the problem of unwanted pregnancy, and in this respect, the responsibility lies equally in men and women. Analyzing obtained data on contraceptive methods by ranking three of the most frequently used methods are condoms – 29,3%, then coitus interruptus – 18,7% and hormonal preparations – 16,9%. Additional oral survey of the population showed a low level of informational support of female population by family physicians, health care professionals of educational organizations (schools, universities, and colleges) about hormonal contraceptive. Females of both age groups used to think that hormonal contraceptives cause collateral damage such as blastoma, cancer, increased body weight, varix dilatation of lower limbs. Satisfaction with the frequency of sexual relations of the respondents comprised 57,6%. At that, women under 40 years of age are the most satisfied women among age groups (χ2 =5,8, p<0,05).

Keywords: nurse, public health service of Kazakhstan, reproductive and sexual health, trust of population

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9442 Assessment of Incidence and Predictors of Mortality Among HIV Positive Children on Art in Public Hospitals of Harer Town Who Were Enrolled From 2011 to 2021

Authors: Getahun Nigusie Demise

Abstract:

Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: The aim of this study is to assess the incidence and predictors of mortality among HIV positive children on antiretroviral therapy (ART) in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, treatment, Ethiopia

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9441 The Study of Thai Consumer Behavior toward Buying Goods on the Internet

Authors: Pichamon Chansuchai

Abstract:

The study of Thai consumer behavior toward buying goods on the Internet is a survey research. The five-level rating scale and open-ended questionnaire are applied for this research procedure, which has more than 400 random sampling of Thai people aged between 15-40 years old. The summary findings are: The analysis of respondents profile were female 55.3% and male 44.8% , 35.3% aged between 20-30 years old, had been employed 29.5% with average income up to 11,000 baht/month 50.2% and expenditure more than 11,000 baht per month 29.3%. The internet usage behavior of respondents mostly found that objectives of the internet usage are: 1) Communication 93.3% 2) the categories of websites usage was trading 42.8% 3) The marketing mix effected to trading behavior via internet which can be analyzed in term of marketing factor as following: Product focused on product quality was the most influenced factor with average value 4.75. The cheaper price than overview market was the most effect factor to internet shopping with mean value 4.53. The average value 4.67 of the available place that could reduce spending time for shopping. The effective promotion of the buy 1 get 1 was the stimulus factor for internet shopping with mean value 4.60. For hypothesis testing, the different sex has relationship with buying decision. It presented that male and female have vary purchasing decision via internet with value of significant difference 0.05. Furthermore, the variety occupations of respondents related to the use of selected type of website. It also found that the vary of personal occupation effected to the type of website selection dissimilar with value of significant difference 0.05.

Keywords: behavior, internet, consumer, goods

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9440 Identifying the Source of Stress and Coping Strategies of Undergraduate Occupational Therapy Students' of BHPI in Bangladesh

Authors: Md. Toufiq Hasan

Abstract:

This research set out to explore the source of stress and coping strategies of undergraduate Occupational Therapy students’ of Bangladesh Health Professions Institute (BHPI) in Bangladesh. For that reason, a quantitative and prospective type survey has been conducted by the researcher with 27 student participants of BHPI Occupational Therapy department whose stress scores were ≥40 according to Zung’s self-rating depression scale. Data was collected by using Bengali and English joined questionnaire of Inventory of College Students’ Recent Life Experience and Ways of Coping Scale. The researcher followed ‘Comprehensive sampling’ procedure to study the entire group of population. From the in-depth analysis to data found some source of stress and coping strategies of the students’. Stress was found significantly more in 2nd year students rather than other years. Female students were more vulnerable for stress rather than male. The age ranges 18-20 years of students are more vulnerable for stress. The main sources of stresses are found that, a lot of responsibilities and too many things to do at once and not enough time to meet their obligation or duties. The important coping strategies are found that, they criticized or lectured their selves, tried not to burn their bridges, but leave things open somewhat and inspired to do something creative. Findings of the study highlighted the need for teachers-students interactive relationship for better academic performance. The study also discloses some important recommendations for the students and teachers. At last the findings of the study will help the Occupational Therapy students and teachers of BHPI.

Keywords: BHPI undergraduate occupational therapy students, stress, source of stress, coping strategies

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9439 Understanding the Nexus between Dengue and Climate Variability

Authors: Edilene Mercedes Mauer Machado, Carolina Hadassa Marques Karoly, Amanda Britz, Claudineia Brazil

Abstract:

The El Niño phenomenon, characterized by the anomalous warming of surface waters in the Equatorial Pacific Ocean, can influence weather patterns in various parts of the world, including the occurrence of extreme events such as droughts or heavy rainfall. Studies have suggested a relationship between El Niño and an increase in the incidence of dengue in certain areas. During El Niño periods, there can be changes in climatic conditions, such as increased temperatures and reduced rainfall in certain tropical and subtropical regions. These conditions can favor the reproduction of the Aedes aegypti mosquito, the vector for dengue transmission. Research aims to investigate how climate events like El Niño and La Niña can influence the incidence and transmission of dengue. The results have shown that, on average, there was a significant increase in dengue cases during La Niña years compared to years of climatic neutrality, contradicting the findings of Hopp et al. (2015). The study also highlighted that regions affected by El Niño exhibited greater variability in dengue incidence. However, it is important to emphasize that the effects of El Niño on dengue transmission can vary depending on the region and local factors, such as socioeconomic context and implemented control measures, as described by Johansson et al. (2009). Not all areas affected by El Niño will necessarily experience an increase in dengue incidence, and the interaction between climate and disease transmission is complex.

Keywords: anomalous warming, climatic patterns, dengue incidence, extreme events

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9438 Effect of Nutrition and Rehabilitation Programs in Treating High Blood Cholesterol For Ages (30-40) Years

Authors: Luma Hameed Abd, Ammar Hamza Hadi, Amjed Abid Ali Mahdi

Abstract:

Context: The study focused on treating high blood cholesterol in individuals aged 30-40 years using rehabilitation and nutrition programs compared to medical drugs. Research aim: To compare the effectiveness of exercise rehabilitation and nutrition programs with medical drugs in reducing high blood cholesterol levels. Methodology: An experimental method with equal groups was utilized, involving 160 patients from Najaf Hospital. SPSS was used for data analysis. Findings: The study showed that both the exercise and nutrition program, as well as medical drugs, contributed to lowering cholesterol levels, with the first group showing better results. Theoretical importance: The research highlights the significance of a holistic approach combining exercise, nutrition, and medical treatment in managing high cholesterol. Data collection: Blood cholesterol tests were conducted before and after the programs to assess improvements. Analysis procedures: Statistical methods such as arithmetic mean, standard deviation, Torsion coefficient, and T-test for correlated samples were employed to analyze the results. Questions addressed: The study addressed the effectiveness of rehabilitation and nutrition programs compared to medical drugs in treating high blood cholesterol. Conclusion: The research concluded that the combination of exercise rehabilitation and nutrition programs was more effective in reducing blood cholesterol levels compared to medical drugs.

Keywords: nutrition, rehabilitation, programs, high blood cholesterol

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9437 Impact Analysis of a School-Based Oral Health Program in Brazil

Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

Abstract:

Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

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9436 Role of Vitamin D in Osseointegration of Dental Implant

Authors: Pouya Khaleghi

Abstract:

Dental implants are a successful treatment modality for restoring both function and aesthetics. Dental implant treatment has predictive results in the replacement of the lost teeth and has a high success rate even in the long term. The most important factor which is responsible for the positive course of implant treatment is the process of osseointegration between the implant structure and the host’s bone tissue. During recent years, many studies have focused on surgical and prosthetic factors, as well as the implant-related factors. However, implant failure still occurs despite the improvements that have led to the increased survival rate of dental implants, which suggests the possible role of some host-related risk factors. Vitamin D is a fat-soluble vitamin regulating calcium and phosphorus metabolism in tissues. The role of vitamin D in bone healing has been under investigation for several years. Vitamin D deficiency has also been associated with impaired and delayed callus formation and fractures healing; however, the role of vitamin D has not been clarified. Therefore, it is extremely important to study the phenomenon of a connection formed between bone tissue and the surface of a titanium implant and find correlations between the 25- hydroxycholecalciferol concentration in blood serum and the course of osseointegration. Because the processes of bone remodeling are very dynamic in the period of actual osseointegration, it is necessary to obtain the correct concentration of vitamin D3 metabolites in blood serum. In conclusion, the correct level of 25-hydroxycholecalciferol on the day of surgery and vitamin D deficiency treatment have a significant influence on the increase in the bone level at the implant site during the process of osseointegration assessed radiologically.

Keywords: implant, osseointegration, vitamin d, dental

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9435 A Fuzzy Control System for Reducing Urban Stormwater Runoff by a Stormwater Storage Tank

Authors: Pingping Zhang, Yanpeng Cai, Jianlong Wang

Abstract:

Stormwater storage tank (SST) is a popular low impact development technology for reducing stormwater runoff in the construction of sponge city. At present, it is difficult to perform the automatic control of SST for reducing peak flow. In this paper, fuzzy control was introduced into the peak control of SST to improve the efficiency of reducing stormwater runoff. Firstly, the design of SST was investigated. A catchment area and a return period were assumed, a SST model was manufactured, and then the storage capacity of the SST was verified. Secondly, the control parameters of the SST based on reducing stormwater runoff were analyzed, and a schematic diagram of real-time control (RTC) system based on peak control SST was established. Finally, fuzzy control system of a double input (flow and water level) and double output (inlet and outlet valve) was designed. The results showed that 1) under the different return periods (one year, three years, five years), the SST had the effect of delayed peak control and storage by increasing the detention time, 2) rainfall, pipeline flow, the influent time and the water level in the SST could be used as RTC parameters, and 3) the response curves of flow velocity and water level fluctuated very little and reached equilibrium in a short time. The combination of online monitoring and fuzzy control was feasible to control the SST automatically. This paper provides a theoretical reference for reducing stormwater runoff and improving the operation efficiency of SST.

Keywords: stormwater runoff, stormwater storage tank, real-time control, fuzzy control

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9434 Storage of Organic Carbon in Chemical Fractions in Acid Soil as Influenced by Different Liming

Authors: Ieva Jokubauskaite, Alvyra Slepetiene, Danute Karcauskiene, Inga Liaudanskiene, Kristina Amaleviciute

Abstract:

Soil organic carbon (SOC) is the key soil quality and ecological stability indicator, therefore, carbon accumulation in stable forms not only supports and increases the organic matter content in the soil, but also has a positive effect on the quality of soil and the whole ecosystem. Soil liming is one of the most common ways to improve the carbon sequestration in the soil. Determination of the optimum intensity and combinations of liming in order to ensure the optimal carbon quantitative and qualitative parameters is one of the most important tasks of this work. The field experiments were carried out at the Vezaiciai Branch of Lithuanian Research Centre for Agriculture and Forestry (LRCAF) during the 2011–2013 period. The effect of liming with different intensity (at a rate 0.5 every 7 years and 2.0 every 3-4 years) was investigated in the topsoil of acid moraine loam Bathygleyic Dystric Glossic Retisol. Chemical analyses were carried out at the Chemical Research Laboratory of Institute of Agriculture, LRCAF. Soil samples for chemical analyses were taken from the topsoil after harvesting. SOC was determined by the Tyurin method modified by Nikitin, measuring with spectrometer Cary 50 (VARIAN) at 590 nm wavelength using glucose standards. SOC fractional composition was determined by Ponomareva and Plotnikova version of classical Tyurin method. Dissolved organic carbon (DOC) was analyzed using an ion chromatograph SKALAR in water extract at soil-water ratio 1:5. Spectral properties (E4/E6 ratio) of humic acids were determined by measuring the absorbance of humic and fulvic acids solutions at 465 and 665 nm. Our study showed a negative statistically significant effect of periodical liming (at 0.5 and 2.0 liming rates) on SOC content in the soil. The content of SOC was 1.45% in the unlimed treatment, while in periodically limed at 2.0 liming rate every 3–4 years it was approximately by 0.18 percentage points lower. It was revealed that liming significantly decreased the DOC concentration in the soil. The lowest concentration of DOC (0.156 g kg-1) was established in the most intensively limed (2.0 liming rate every 3–4 years) treatment. Soil liming exerted an increase of all humic acids and fulvic acid bounded with calcium fractions content in the topsoil. Soil liming resulted in the accumulation of valuable humic acids. Due to the applied liming, the HR/FR ratio, indicating the quality of humus increased to 1.08 compared with that in unlimed soil (0.81). Intensive soil liming promoted the formation of humic acids in which groups of carboxylic and phenolic compounds predominated. These humic acids are characterized by a higher degree of condensation of aromatic compounds and in this way determine the intensive organic matter humification processes in the soil. The results of this research provide us with the clear information on the characteristics of SOC change, which could be very useful to guide the climate policy and sustainable soil management.

Keywords: acid soil, carbon sequestration, long–term liming, soil organic carbon

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9433 Risk Factors for High Resistance of Ciprofloxacin Against Escherichia coli in Complicated Urinary Tract Infection

Authors: Liaqat Ali, Khalid Farooq, Shafieullah Khan, Nasir Orakzai, Qudratullah

Abstract:

Objectives: To determine the risk factors for high resistance of ciprofloxacin in complicated urinary tract infections. Materials and Methods: It is an analytical study that was conducted in the department of Urology (Team ‘C’) at Institute of Kidney Diseases Hayatabad Peshawar from 1st June 2012 till 31st December 2012. Total numbers of 100 patients with complicated UTI was selected in the study. Multivariate analysis and linear regression were performed for the detection of risk factors. All the data was recorded on structured Proforma and was analyzed on SPSS version 17. Results: The mean age of the patient was 55.6 years (Range 3-82 years). 62 patients were male while 38 patients were female. 66 isolates of E-Coli were found sensitive to ciprofloxacin while 34 isolates were found Resistant for ciprofloxacin. Using multivariate analysis and linear regression, an increasing age above 50 (p=0.002) History of urinary catheterization especially for bladder outflow obstruction (p=0.001) and previous multiple use of ciprofloxacin (p=0.001) and poor brand of ciprofloxacin were found to be independent risk factors for high resistance of ciprofloxacin. Conclusion: UTI is common illness across the globe with increasing trend of antimicrobial resistance for ciprofloxacin against E Coli in complicated UTI. The risk factors for emerging resistance are increasing age, urinary catheterization and multiple use and poor brand of ciprofloxacin.

Keywords: urinary tract infection, ciprofloxacin, urethral catheterization, antimicrobial resistance

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9432 Phonological Characteristics of Severe to Profound Hearing Impaired Children

Authors: Akbar Darouie, Mamak Joulaie

Abstract:

In regard of phonological skills development importance and its influence on other aspects of language, this study has been performed. Determination of some phonological indexes in children with hearing impairment and comparison with hearing children was the objective. A sample of convenience was selected from a rehabilitation center and a kindergarten in Karaj, Iran. Participants consisted of 12 hearing impaired and 12 hearing children (age range: 5 years and 6 months to 6 years and 6 months old). Hearing impaired children suffered from severe to profound hearing loss while three of them were cochlear implanted and the others were wearing hearing aids. Conversational speech of these children was recorded and 50 first utterances were selected to analyze. Percentage of consonant correct (PCC) and vowel correct (PVC), initial and final consonant omission error, cluster consonant omission error and syllabic structure variety were compared in two groups. Data were analyzed with t test (version 16th SPSS). Comparison between PCC and PVC averages in two groups showed a significant difference (P< 0/01). There was a significant difference about final consonant emission error (P<0/001) and initial consonant emission error (P<0/01) too. Also, the differences between two groups on cluster consonant omission were significant (P<0/001). Therefore, some changes were seen in syllabic structures in children with hearing impairment compared to typical group. This study demonstrates some phonological differences in Farsi language between two groups of children. Therefore, it seems, in clinical practices we must notice this issue.

Keywords: hearing impairment, phonology, vowel, consonant

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9431 Human Rabies Survivors in India: Epidemiological, Immunological and Virological Studies

Authors: Madhusudana S. N., Reeta Mani, Ashwini S. Satishchandra P., Netravati, Udhani V., Fiaz A., Karande S.

Abstract:

Rabies is an acute encephalitis which is considered 100% fatal despite occasional reports of survivors. However, in recent times more cases of human rabies survivors are being reported. In the last 5 years, there are six laboratories confirmed human rabies survivors in India alone. All cases were children below 15 years and all contracted the disease by dog bites. All of them also had received the full or partial course of rabies vaccination and 4 out of 6 had also received rabies immunoglobulin. All cases were treated in intensive care units in hospitals at Bangalore, Mumbai, Chandigarh, Lucknow and Goa. We report here the results of immunological and virological studies conducted at our laboratory on these patients. The clinical samples that were obtained from these patients were Serum, CSF, nuchal skin biopsy and saliva. Serum and CSF samples were subjected to standard RFFIT for estimation of rabies neutralizing antibodies. Skin biopsy, CSF and saliva were processed by TaqMan real-time PCR for detection of viral RNA. CSF, saliva and skin homogenates were also processed for virus isolation by inoculation of suckling mice. The PBMCs isolated from fresh blood was subjected to ELISPOT assay to determine the type of immune response (Th1/Th2). Both CSF and serum were also investigated for selected cytokines by Luminex assay. The level of antibodies to virus G protein and N protein were determined by ELISA. All survivors had very high titers of RVNA in serum and CSF 100 fold higher than non-survivors and vaccine controls. A five-fold rise in titer could be demonstrated in 4 out of 6 patients. All survivors had a significant increase in antibodies to G protein in both CSF and serum when compared to non-survivors. There was a profound and robust Th1 response in all survivors indicating that interferon gamma could play an important factor in virus clearance. We could isolate viral RNA in only one patient four years after he had developed symptoms. The partial N gene sequencing revealed 99% homology to species I strain prevalent in India. Levels of selected cytokines in CSF and serum did not reveal any difference between survivors and non-survivors. To conclude, survival from rabies is mediated by virus-specific immune responses of the host and clearance of rabies virus from CNS may involve the participation of both Th2 and Th1 immune responses.

Keywords: rabies, rabies treatment, rabies survivors, immune reponse in rabies encephalitis

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9430 The out of Proportion - Pulmonary Hypertension in Indians with Chronic Lung Disease

Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

Abstract:

Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

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9429 Trusting the Eyes: The Changing Landscape of Eyewitness Testimony

Authors: Manveen Singh

Abstract:

Since the very advent of law enforcement, eyewitness testimony has played a pivotal role in identifying, arresting and convicting suspects. Reliant heavily on the accuracy of human memory, nothing seems to carry more weight with the judiciary than the testimony of an actual witness. The acceptance of eyewitness testimony as a substantive piece of evidence lies embedded in the assumption that the human mind is adept at recording and storing events. Research though, has proven otherwise. Having carried out extensive study in the field of eyewitness testimony for the past 40 years, psychologists have concluded that human memory is fragile and needs to be treated carefully. The question that arises then, is how reliable is eyewitness testimony? The credibility of eyewitness testimony, simply put, depends on several factors leaving it reliable at times while not so much at others. This is further substantiated by the fact that as per scientific research, over 75 percent of all eyewitness testimonies may stand in error; quite a few of these cases resulting in life sentences. Although the advancement of scientific techniques, especially DNA testing, helped overturn many of these eyewitness testimony-based convictions, yet eyewitness identifications continue to form the backbone of most police investigations and courtroom decisions till date. What then is the solution to this long standing concern regarding the accuracy of eyewitness accounts? The present paper shall analyze the linkage between human memory and eyewitness identification as well as look at the various factors governing the credibility of eyewitness testimonies. Furthermore, it shall elaborate upon some best practices developed over the years to help reduce mistaken identifications. Thus, in the process, trace out the changing landscape of eyewitness testimony amidst the evolution of DNA and trace evidence.

Keywords: DNA, eyewitness, identification, testimony, evidence

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9428 Biogas as a Renewable Energy Fuel: A Review of Biogas Upgrading, Utilization and Storage

Authors: Imran Ullah Khana, Mohd Hafiz Dzarfan Othmanb, Haslenda Hashima, Takeshi Matsuurad, A. F. Ismailb, M. Rezaei-DashtArzhandib, I. Wan Azelee

Abstract:

Biogas upgrading is a widely studied and discussed topic, and its utilization as a natural gas substitute has gained significant attention in recent years. The production of biomethane provides a versatile application in both heat and power generation and as a vehicular fuel. This paper systematically reviews the state of the art of biogas upgrading technologies with upgrading efficiency, methane (CH4) loss, environmental effect, development and commercialization, and challenges in terms of energy consumption and economic assessment. The market situation for biogas upgrading has changed rapidly in recent years, giving membrane separation a significant market share with traditional biogas upgrading technologies. In addition, the potential utilization of biogas, efficient conversion into bio-compressed natural gas (bio-CNG), and storage systems are investigated in depth. Two storing systems for bio-CNG at filling stations, namely buffer and cascade storage systems are used. The best storage system should be selected on the basis of the advantages of both systems. Also, the fuel economy and mass emissions for bio-CNG and CNG-filled vehicles are studied. There is the same fuel economy and less carbon dioxide (CO2) emission for bio-CNG. Based on the results of comparisons between the technical features of upgrading technologies, various specific requirements for biogas utilization and the relevant investment, and operating and maintenance costs, future recommendations are made for biogas upgrading.

Keywords: biogas upgrading, cost, utilization, bio-CNG, storage, energy

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9427 Demographic Characteristics of the Atlas Barbary Sheep in Amassine Nature Reserve, Atlas Range, Morocco: Implications For Conservation and Management

Authors: Hakim Bachiri, Mohammed Znari, Moulay Abdeljalil Ait Baamranne

Abstract:

Population characteristics of Atlas Barbary sheep (Ammotragus lervia lervia) were investigated 20 years following the 1999 introduction of 10 individuals into the fenced nature reserve of Amassine, High Atlas range, Morocco, for promoting wildlife watching and tourism. Population age-sex structure and density were determined in late winter-early spring during four consecutive years (2016-2019) by direct observation before the dispersal of the herd. In this latter case, the line transect distance sampling was successfully applied. Population size increased from 37 to 62 animals during the four-year study period; the maximal population size being 82 individuals recorded in 2006. An estimated population density ranged from 0.25 to 0.41 Barbary sheep/ha during the study period. The adult sex ratio varied from 91 to 67 per 100 females. The apparent birth rate was 14 to 73/100 females. Juveniles and subadults comprised 27-43% of the population, adult males 26-31% and adult females 29-45%. The survival rate from birth to 1 year of age approximated 35%, for adult males was estimated to average 69%/year. The obtained results would be helpful for developing sustainable population management and habitat restoration plan and assessing the feasibility of potential reintroduction/restocking in other areas of the Atlas range.

Keywords: atlas mountains, barbary sheep, demography, management

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9426 Usage the Point Analysis Algorithm (SANN) on Drought Analysis

Authors: Khosro Shafie Motlaghi, Amir Reza Salemian

Abstract:

In arid and semi-arid regions like our country Evapotranspiration is the greatestportion of water resource. Therefor knowlege of its changing and other climate parameters plays an important role for planning, development, and management of water resource. In this search the Trend of long changing of Evapotranspiration (ET0), average temprature, monthly rainfall were tested. To dose, all synoptic station s in iran were divided according to the climate with Domarton climate. The present research was done in semi-arid climate of Iran, and in which 14 synoptic with 30 years period of statistics were investigated with 3 methods of minimum square error, Mann Kendoll, and Vald-Volfoytz Evapotranspiration was calculated by using the method of FAO-Penman. The results of investigation in periods of statistic has shown that the process Evapotranspiration parameter of 24 percent of stations is positive, and for 2 percent is negative, and for 47 percent. It was without any Trend. Similary for 22 percent of stations was positive the Trend of parameter of temperature for 19 percent , the trend was negative and for 64 percent, it was without any Trend. The results of rainfall trend has shown that the amount of rainfall in most stations was not considered as a meaningful trend. The result of Mann-kendoll method similar to minimum square error method. regarding the acquired result was can admit that in future years Some regions will face increase of temperature and Evapotranspiration.

Keywords: analysis, algorithm, SANN, ET0

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9425 Access to Apprenticeships and the Impact of Individual and School Level Characteristics

Authors: Marianne Dæhlen

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Periods of apprenticeships are characteristic of many vocational educational training (VET) systems. In many countries, becoming a skilled worker implies that the journey starts with an application for apprenticeships at a company or another relevant training establishment. In Norway, where this study is conducted, VET students start their journey with two years of school-based training before applying for two years of apprenticeship. Previous research has shown that access to apprenticeships differs by family background (socio-economic, immigrant, etc.), gender, school grades, and region. The question we raise in this study is whether the status, reputation, or position of the vocational school contributes to VET students’ access to apprenticeships. Data and methods: Register data containing information about schools’ and VET students’ characteristics will be analyzed in multilevel regression analyses. At the school level, the data will contain information on school size, shares of immigrants and/or share of male/female students, and grade requirements for admission. At the VET-student level, the register contains information on e.g., gender, school grades, educational program/trade, obtaining apprenticeship or not. The data set comprises about 3,000 students. Results: The register data is expected to be received in November 2024 and consequently, any results are not present at the point of this call. The planned article is part of a larger research project granted from the Norwegian Research Council and will, accordingly to the plan, start up in December 2024.

Keywords: apprenticeships, VET-students’ characteristics, vocational schools, quantitative methods

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9424 The School-to-Work Transition: The Case of NEET Youths from Rural Areas

Authors: Anđelka Stojanović, Ivan Mihajlović, Ivica Nikolić

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In the past years, due to the financial crisis and the tightening of conditions on the labor market, young people are facing great challenges in achieving financial independence and finding their place in society. Higher unemployment rates, poorer living conditions, separation from the labor market, and longer school-to-work transitions particularly affect rural youth and make significant differences between youth groups in rural and urban areas. Improving employability skills and development of instruments for further learning among young people “Not in Education, Employment, or Training” (NEET) should not be only the concerns of these people, already adequately be directed and supported by the institutions. According to the World Bank data, the share of youth not in education, employment or training (NEET), in the European Union in the past few years decreases but still shows a significant share in the total percentage of the youth population. In 2017 rate was 10.96% while in 2018 that value was 10.38%. When observing individual countries in Europe, especially those with lower incomes, this rate is much higher. It was concluded that this topic was not sufficiently elaborated and presented in the social and scientific environment. Therefore, the aim of this paper is to identify and systematize the problems of school-to-work transition among young NEETs living in rural areas as well as the initiatives for addressing their problems.

Keywords: NEET youth, risks and initiatives, rural youth, school-to-work transition

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9423 Dietary Intake and Nutritional Inadequacy Leading to Malnutrition among Children Residing in Shelter Home, Rural Tamil Nadu, India

Authors: Niraimathi Kesavan, Sangeeta Sharma, Deepa Jagan, Sridhar Sukumar, Mohan Ramachandran, Vidhubala Elangovan

Abstract:

Background: Childhood is a dynamic period for growth and development. Optimum nutrition during this period forms a strong foundation for growth, development, resistance to infections, long-term good health, cognition, educational achievements, and work productivity in a later phase of life. Underprivileged children living in a resource constraint settings like shelter homes are at high risk of malnutrition due to poor quality diet and nutritional inadequacy. In low-income countries, underprivileged children are vulnerable to being deprived of nutritious food, which stands as a major challenge in the health sector. The present aims to assess the dietary intake, nutritional status, and nutritional inadequacy and their association with malnutrition among children residing in shelter homes in rural Tamil Nadu. Methods: The study was a descriptive survey conducted among all the children aged between 8-18 years residing in two selected shelter homes (Anbu illam, a home for female children, and Amaidhi illam, a home for male children), rural Tirunelveli, Tamil Nadu, India. A total of 57 children were recruited, including 18 boys and 39 girls, for the study. Dietary intake was measured using seven days 24 hours recall. The average nutrient intake was considered for further analysis. Results: Of the 57 children, about 60% (n=35) were undernutrition. The mean daily energy intake was 1298 (SD 180) kcal for boys and 952 (SD155) kcal for girls. The total calorie intake was 55-60% below the estimated average requirement (EAR) for adolescent boys and girls in the age group 13-15 years and 16-18 years. Carbohydrates were the major source of energy (boys 53% and girls 51%), followed by fat (boys 31.5% and girls 34.5%) and protein (boys 14% and girls 12.9%). Dairy intake (<200ml/day) was less than the recommendation (500ml/day). Micro-nutrient-rich foods such as fruits, vegetables, and green leafy vegetables in the diet were <200g/day, which was far less than the recommended dietary guidelines of 400g- 600g/day for the age group of 7-18 years. Nearly 26% of girls reported experiencing menstrual problems. The majority (76.9%) of the children exhibited nutrient deficiency-related signs and symptoms. Conclusion: The total energy, minerals, and micro-nutrient intake were inadequate and below the Recommended Dietary Allowance for children and adolescents. The diet predominantly consists of refined cereals, rice, semolina, and vermicelli. Consumption of whole grains, milk, fruits, vegetables, and leafy vegetables was far below the recommended dietary guidelines. Dietary inadequacies among these children pose a serious concern for their overall health status and its consequences in the later phase of life.

Keywords: adolescents, children, dietary intake, malnutrition, nutritional inadequacy, shelter home

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