Search results for: Arab women pain

Authors: Sevim Ugur, Cemile Kutmec Yilmaz, Omer Us, Sevdenur Koksaldi

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Aim: This study aims to investigate the effect of digital game playing and Internet addiction on perceived stress levels in university students. Method: The descriptive study was conducted through face-to-face interview method with a total of 364 university students studying at Aksaray University between November 15 and December 30, 2017. The research data were collected using personal information form, a questionnaire to determine the characteristics of playing digital game, the Internet addiction scale and the perceived stress scale. In the evaluation of the data, Mann-Whitney U test was used for two-group comparison of the sample with non-normal distribution, Kruskal-Wallis H-test was used in the comparison of more than two groups, and the Spearman correlation test was used to determine the relationship between Internet addiction and the perceived stress level. Results: It was determined that the mean age of the students participated in the study was 20.13 ± 1.7 years, 67.6% was female, 35.7% was sophomore, and 62.1% had an income 500 TL or less. It was found that 83.5% of the students use the Internet every day and 70.6% uses the Internet for 5 hours or less per day. Of the students, 12.4% prefers digital games instead of spending time outdoors, 8% plays a game as the first activity in leisure time, 12.4% plays all day, 15.7% feels anger when he/she is prevented from playing, 14.8% prefers playing games to get away from his/her problems, 23.4% had his/her school achievement affected negatively because of game playing, and 8% argues with family members due to the time spent for gaming. Students who play games on the computer for a long time were found to feel back pain (30.8%), headache (28.6%), insomnia (26.9%), dryness and pain in the eyes (26.6%), pain in the wrist (21.2%), feeling excessive tension and anger (16.2%), humpback (12.9), vision loss (9.6%) and pain in the wrist and fingers (7.4%). In our study, students' Internet addiction scale mean score was found to be 45.47 ± 16.1 and mean perceived stress scale score was 28.56 ± 2.7. A significant and negative correlation (p=0.037) was found between the total score of the Internet addiction scale and the total score of the perceived stress scale (r=-0.110). Conclusion: It was found in the study that Internet addiction and perceived stress of the students were at a moderate level and that there was a negative correlation between Internet addiction and perceived stress levels. Internet addiction was found to increase with the increasing perceived stress levels of students, and students were found to have health problems such as back pain, dryness in the eyes, pain, insomnia, headache, and humpback. Therefore, it is recommended to inform students about different coping methods other than spending time on the Internet to cope with the stress they perceive.

Keywords: digital game, internet addiction, student, stress level

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Authors: Ida Rosada, Nurliani

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Today, the number of women who seek additional income to help her husband is increasing. They do that in order to be able to express themselves in the midst of the family and society. Nonetheless, housewives are in charge of managing family’s income and prepare food for the family. The objective of this research is 1) to analyze the effect of the dual role of women to household income and 2) to analyze the effect of the dual role to consumption patterns. The study used a qualitative approach, data collection techniques are through observation, interviews, and documentation on farming households. The data was analysed qualitative descriptively. The results found that: 1) The revenue contribution of women who play double role in the informal sector amounted to 34.07% (less than 50%). 2) The main reason that the respondents worked in the informal sector is to be able to send their children to school (34%) and to improve household economy condition (28%). 3) After earning additional income, respondents said that they can contribute to increase the family’s income and to cover the family shortage (82%); 4) Respondents’ opinion to changes in food consumption after performing the dual role is the ability to purchase and provide the desired food (44%) and changing patterns of consumption per day (30%).

Keywords: dual role, the informal sector, consumption patterns, household income

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Authors: Yashvi Italiya

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Dysthymia (DD) is a much-overlooked soft mood disorder and mostly confused with other forms of chronic depression. This research paper gives a spotlight to the DD prevailing in men and women. It also focuses on one of the comorbidities of Dysthymia, i.e., Anxiety. The comorbidities, hurdles in diagnosis, the ubiquity of the disorder, and the relation of Anxiety and DD are briefly described. Gender was the main focus here because the researcher of this paper found it as a research gap while doing the literature review. The study was done through secondary data obtained primarily from a questionnaire having Alpha 0.891 reliability. T-test method of data analysis was used to test the hypotheses. The result shows that the researcher failed to accept alternative hypothesis 1 (M1 > M2), while the alternative hypothesis 2 (M1 > M2) was accepted. The ratio of DD in women (M1) is not higher than that of men (M2) (hypothesis 1). But, women are more anxious than men (hypothesis 2). It was found that comorbid Anxiety is more widespread in one gender. It further plays a significant role in mixing up the symptoms. It was concluded that the dividing line between Dysthymia and MDD is still unclear for an accurate diagnosis. There is an essential need for spreading knowledge concerning the differences between the symptoms of DD and MDD so that the actual disorder can be identified, and proper help can be received from/provided by professionals.

Keywords: anxiety, comorbidity, dysthymia, gender, MDD

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Authors: LaShawnda N. Fields, Valandra

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As part of a larger study, this particular line of inquiry focuses on experiences of tokenism and invisible labor expected of Black women within social work education. Black women faculty members and doctoral students participated in semi-formal, in-depth interviews. All participants were identified as members of schools of social work within Carnegie-designated R-1 institutions. Several participants believed that their race independently and the intersection of their race and gender was often misrepresented by their institution as an indication of a diverse and equitable environment. These women believed they were often solicited to participate in visual materials and make public appearances to benefit the school while feeling invisible. Most of the Black women interviewed, whether faculty members or doctoral students, were the sole Black person or one of very few Black women at these schools of social work. Similarly, the Black doctoral students spoke of being “paraded around” as a prized show horse while enduring a toxic culture that lacks inclusion. These women expressed frustration and disappointment as their images and scholarship were featured on websites and within marketing materials, not the pride and joy such exposure should elicit. These experiences of tokenism were taking place while the women constantly received messages of not being good enough or not a good fit at their institution. Invisible labor refers to work that is not compensated nor formally recognized. This labor is primarily committee work and student support. Representation of Black women faculty members is limited at these research-intensive schools of social work resulting in these women being sought out by students across disciplines. Similarly, the Black women doctoral students are informally recruited as peer mentors to support those students rising in the ranks behind them. Though this work is rooted in retention efforts, it is never identified as such. All participants identified committee work related to their identities as another way they find themselves engaged in work that often goes unrecognized and underappreciated. Committee work is usually tied to identity work, such as diversity, equity, and inclusion though it rarely translates to action and improvements. This qualitative study provides insight into the lived experiences of an at-risk and under-represented demographic. Institutions can better understand how they can support this demographic. These Black women scholars have been invited into these institutions but have not historically been granted full access. These women have survived unsavory conditions through sheer determination and support found mostly outside their schools of social work. Utilizing this data as a springboard for informed and action-oriented strategic planning would allow institutions to create inclusive and equity cultures that result in Black women thriving versus simply surviving.

Keywords: education, equity, invisible labor, tokenism, intersectionality

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Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

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Background: In March 2020, the World Health Organization (WHO) declared the outbreak of a new coronavirus disease, COVID-19, as a public health concern and pandemic. This situation is generating psychological consequences such as stress, anxiety, depression, and intimate partner violence (IPV) throughout the population. This is a brief note on the magnitude of this threat and different ways for abused women to minimize the effects of it in their daily life. Methods: A literature review was conducted using the MEDLINE, PSYCHINFO, and SCIENCE DIRECT databases. The keywords used included intimate partner violence, abuse, victims, pandemic, quarantine, coronavirus, and COVID-19. A Google search was also conducted using these words to identify reports published in non-indexed health care and social science journals. The literature search was restricted to English language studies. Results: The prevalence of IPV and its consequences are rising during such a pandemic. Having sufficient support from healthcare workers and acquaintances is critical for women in such circumstances. Conclusion: Community members, healthcare providers, governments, and policymakers should be informed of the increased risk of IPV during such a pandemic. They should provide a supporting structure for abused women. Social networking is also a good approach that could help abusive women during this situation.

Keywords: covid-19, intimate partner violence, pandemic, women

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Authors: Shubeska Stratrova S., Muca A., Panovska S. Clinic of endocrinology, diabetes, metabolic disorders, Medical Faculty, Skopje, N. Macedonia

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Rationale: Obese subjects have a high energy density diet, low physical activity levels, a sedentary lifestyle, as well as eating disorders, which are considered important risk factors for the development of obesity. Methods: In order to discover the imbalance of energy intake and energy expenditure in obese women (W), two groups of examinees answered questionnaires regarding nutrition and physical activity: 1st group of women with normal body mass index (BMI <25 kg/m²) and 2nd group of obese women with BMI >30 kg/m². Results: 61.11% of obese W from the 2nd group reported good appetite, which was higher than the 1st group (45%). In 55.56% W, frustrations were a provocation for over nutrition. In the 2nd group, 38.89% W ate too much compared to 9.09% W from the 1st group. In the ²ⁿᵈ group, 35.29% W reported consuming food rarely and too much, while 29.41% W reported consuming food often and too much. All examinees from the ²ⁿᵈ group had consumed food in less than 5 hours, compared to only 8.33% W from the ¹ⁿᵈ group and had consumed hyper-caloric food. Consumption of fruits and vegetables was lower in the 2nd group compared to the 1st group. Half of the subjects in the 2nd group were physically inactive, compared to only 8% in the 1st group. All of the examinees in the 2nd group walked for less than 3 hours a day, compared to 54% in the 1st group. In the 2nd group, 67% W reported watching TV very often, 39% reported watching TV longer than 3 hours, which is significantly higher than 8.33% W in the 1st group. Overall, 81.25% of examinees from the 2nd group reported sitting for more than 3 hours a day, which is significantly more compared to the 1st group (45.45%). Conclusions: Obese women are less physically active, have a sedentary lifestyle, good appetite, and consume too much hyper-caloric food very often.

Keywords: (W) obese women, BMI(Body mass Index), nutrition, hyper-caloric food

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Authors: Abuzar Baloach

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Spinal cord stimulators (SCS) are increasingly used for managing chronic pain, but their presence requires careful anesthetic planning. This review explores critical anesthetic considerations for patients with SCS, encompassing preoperative, intraoperative, and acute pain management, as well as specific considerations for obstetric and out-of-operating-room procedures. Preoperative Evaluation: Thorough assessment is essential, including a detailed medical history of the SCS device, such as type, manufacturer, and settings. Additionally, a complete pain history and a physical exam are necessary to understand the patient’s baseline neurological function and assess mobility, which can impact anesthesia management. Intraoperative Considerations: Electrocautery poses a risk for patients with SCS due to potential interference. Monopolar electrocautery is discouraged, but if needed, the grounding pad should be positioned away from the device, and the device itself should be turned off. The SCS device can introduce ECG artifacts and potentially interfere with pacemakers and defibrillators (ICD), which may result in inappropriate pacing or shocks. Precautions, including baseline ECG and interrogation, are recommended if both devices are present. Furthermore, lithotripsy, though generally avoided, can be performed under certain conditions with caution. Obstetric Anesthesia: While SCS devices are generally turned off during pregnancy, they have shown no interference with fetal cardiotocography, and epidural placement can be safely achieved with a sterile technique below the SCS leads. Acute Pain Considerations: SCS placement is taken into account in pain management plans, especially with neuraxial anesthesia, as potential risks include infection, limited spread due to fibrous sheaths, and damage to the SCS leads. Out-of-Operating Room Procedures: MRI, previously contraindicated, is now conditionally safe with SCS devices, depending on manufacturer specifications. CT scans are generally safe, though radiation should be minimized to prevent device malfunction. For radiation therapy, specific safety measures are recommended, such as keeping the beam at least 1 cm away from the device and limiting the dose to prevent damage. In conclusion, anesthetic management for SCS patients requires meticulous planning across all stages of care. By understanding the unique interactions and potential risks associated with SCS and other devices, healthcare providers can enhance patient safety and improve outcomes. Further research and the establishment of standardized guidelines are essential to optimize perioperative care for this growing patient population.

Keywords: anesthesia, chronic pain, spinal cord stimulator, SCS

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Authors: Kadhim Alabady

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Purpose: Mental health problems affect women and men equally, but some are more common among women. To Provide a baseline of the current picture of major mental health challenges among women in Dubai. which can then be used to measure the impact of interventions or service development. Method: We have used mixed methods evaluation approaches. This was used to increase the validity of findings by using a variety of data collection techniques. We have integrated qualitative and quantitative methods in this piece of work. Conducting the two approaches is to explore issues that might not be highlighted enough through one method. Results: The key findings are: The prevalence of people who suffer from different types of mental disorders remains largely unknown, many women are unwilling to seek professional help because of lack of awareness or the stigma attached to it. -It is estimated there were around 2,928–4,392 mothers in Dubai (2014) suffering from postnatal depression of which 858–1,287, early intervention can be effective. -The system for managing health care for women with mental illness is fragmented and contains gaps and duplications. -It is estimated 1,029 girl aged 13–19 years affected with anorexia nervosa and there would be an estimated 1,029 girl aged 13–19 years affected with anorexia nervosa. Recommendations: -Work is required with primary health care in order to identify women with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. -It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions that are not routinely collected to get a clear sense of what is needed and to assist decision and policy making in getting a complete picture on what services are required. -Emergency Mental Health Care – there is a need for a crisis response team to respond to emergencies in the community. -Continuum of care – a significant gap in the services for women once they diagnosed with mental disorder.

Keywords: mental health, depression, schizophrenia, women

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Authors: Magdalena Korytowska, Gunnar Lengstrand, Cecilia Larsson Wexell

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Background: Breast cancer (BC) is the most common cancer among women worldwide, and cases are continuing to increase in Sweden. Bone is the most common metastatic site in breast cancer patients, where > 65-75% of women with advanced breast cancer develop bone metastases during their disease. To prevent the skeletal-related events of metastases (e.g., pathological fractures, bone loss, cancer-induced bone pain, and hypercalcemia bone), two different classes of antiresorptive medications (AR), bisphosphonate and denosumab are typically administered every 3 to 4 weeks. Since 2015, adjuvant bisphosphonate treatment has been used every six months for three to five years in postmenopausal women for the prevention of skeletal metastases and improved survival. Methods: A case-control study was conducted to test the hypotheses that patients treated with high-dose AR are at higher risk of developing MRONJ than breast cancer patients with adjuvant bisphosphonate treatment at a lower dose. Medical and odontological data was collected between 2015-2020. Assessment of oral health and dental care before and during oncological treatment took place at the specialist clinic for Orofacial medicine linked to the specific hospital. Results: In total, 220 patients were included, 101 patients in the high-dose group and 119 patients in the adjuvant BP-treatment group. MRONJ was diagnosed in 13 patients (14%) in the high-dose group. The mandible was affected in most of the cases (84.6%), with a mean duration of high-dose treatment of 19.7 months. In 46.2% of cases, no dental cause of MRONJ could be identified. Overall, estrogen receptor-positive (ER+) BC was the most representative type in 172 patients (78.2%). However, this was 83.9% in the high-dose cases group. The most used drug was denosumab. Twenty-five patients (26.9%) switched their medication from ZOL to denosumab during their oncological treatment. Patients with ER+ breast cancer were reported in 88 patients (87.8%) in the adjuvant group that was treated with ZOL. Conclusions: MRONJ was diagnosed only in the high-dose AR group. Dental assessment and care of patients in the adjuvant group should be considered, with a recommendation to potentially prolong ZOL treatment from 3 to 5 years, with concomitant use of hormonal therapy in patients diagnosed with ER+ breast cancer to prevent bone loss induced by oncological treatment. A new referral for dental assessment is very important in the case of bone metastases when treatment with high dose AR will be required since it is associated with a higher risk of MRONJ.

Keywords: antiresorptive therapy, breast cancer, dental care, MRONJ

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Authors: Paul E. Olsen

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Researchers, businesses, and governments study the glass ceiling faced by women and members of minority groups at work, but the experiences of gay men, lesbians, and bisexual men and women with the lavender ceiling have not received similar attention. This qualitative research traces similarities between the lavender ceiling and the glass ceiling. More specifically, it presents a study designed to elucidate the experiences of gay men at work and compare them with those of women and minority group members, as reported in research literature on the glass ceiling. This research asked: 1) What have gay men experienced in the workplace? 2) What experiences have they had with recruitment, mentors, corporate climate, advancement opportunities, performance evaluation, social activities, harassment, and task force and committee assignments? 3) How do these experiences compare with those of women and minorities who have described their experiences with the glass ceiling? Purposeful and convenience sampling were used as participant selection strategies. Participants were diverse in terms of age, education, and industry. Data for this study were collected through semi-structured individual interviews with eight self-identified gay men working in human services, manufacturing, marketing, finance, government, the nonprofit sector, and retail. The gay men in the study described workplace experiences similar to descriptions of the glass ceiling faced by women and minorities. The lavender ceiling parallels the glass ceiling in corporate climates, harassment, mentors, social activities, promotions and performance appraisal, and task force and committee assignments at work. Women and most minorities do not, however, face the disclosure dilemma: Should one reveal his sexual orientation at work?

Keywords: discrimination, diversity, gay and lesbian, human resource

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Authors: Gülçin Akbas Uslu

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Honor cultures put importance on the sexual purity of women. Women are expected to avoid acts that may spoil their honor. The emphasis on honor leads to the subordination of women and the dominance of men. In order to protect and clean honor, women are exposed to physical and psychological violence. Therefore, understanding the motivations driving people to endorse honor bears importance. For this purpose, this study aims to explore honor endorsement from the joint perspective of System Justification Theory (SJT) and Regulatory Focus Theory (RFT). SJT asserts that people have a tendency to support and rationalize the system. The motivation to maintain the system may be a factor in the endorsement of honor. RFT proposes two distinct regulatory processes, namely promotion and prevention focus. Having a dominant prevention focus, such as a deep concern for responsibilities, risk avoidance, and minimizing negative outcomes, may have a role in honor. Data were collected conveniently from 366 participants (216 women; 150 men). Participants filled out Honor Endorsement Index, Honor Based System Justification Scale and Regulatory Focus Orientation Scale Results revealed that both regulatory focus and system justification play a role in understanding honor. One-way ANOVA findings showed that individuals with a dominant prevention focus endorse honor beliefs more than individuals with a dominant promotion focus. Besides, regression analysis revealed that prevention focus and system justification significantly and positively predict honor. Results provide clarifications for why honor has an important meaning in individuals’ life and why honor-based violence is approved. These findings bear great importance in Turkey, where emphasis on honor is high and can be used in reducing people’s adherence to honor, which is based on women’s sexuality and men’s power over women.

Keywords: honor, system justification theory, regulatory focus theory, prevention focus

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Authors: Hanady Hamdallah, H. Elyse Ireland, John H. H. Williams

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Conjugated linoleic acid (CLA) is a food supplement that is reported to have multiple beneficial health effects, including being anti-carcinogenic, anti-inflammatory and anti-obesity. Animal studies have shown a significant anti-obesity effect of CLA, but results in humans were inconsistent, where some of the studies found an anti-obesity effect while other studies failed to find any decline in obesity markers after CLA supplementation. This meta-analysis aimed to determine if oral CLA supplementation has been shown to reduce obesity related markers in women. Pub Med, Cochrane Library, and Google Scholar were used to identify the eligible trials using two main searching strategies: the first one was to search eligible trials using keywords 'Conjugated linoleic acid', 'CLA', 'Women', and the second strategy was to extract the eligible trials from previously published systematic reviews and meta-analyses. The eligible trials were placebo control trials where women supplemented with CLA mixture in the form of oral capsules for 6 months or less. Also, these trials provided information about body composition expressed as body weight (BW), body mass index (BMI), total body fat (TBF), percentage body fat (BF %), and/ or lean body mass (LBM). The quality of each included study was assessed using both JADAD scale and an adapted CONSERT checklist. Meta-analysis of 8 eligible trials showed that CLA supplementation was significantly associated with reduced BW (Mean ± SD, 1.2 ± 0.26 kg, p < 0.001), BMI (0.6 ± 0.13kg/m², p < 0.001) and TBF (0.76 ± 0.26 kg, p= 0.003) in women, when supplemented over 6-16 weeks. Subgroup meta-analysis demonstrated a significant reduction in BW (1.29 ± 0.31 kg, p < 0.001), BMI (0.60 ± 0.14 kg/m², p < 0.001) and TBF (0.82 ± 0.28 kg, p= 0.003) in the trials that had recruited overweight-obese women. The second subgroup meta-analysis, that considered the menopausal status of the participants, found that CLA was significantly associated with reduced BW (1.35 ± 0.37 kg, p < 0.001; 1.05 ± 0.36 kg, p= 0.003) and BMI (0.50 ± 0.17 kg/m², p= 0.003; 0.75 ± 0.2 kg/m², p < 0.001) in both pre and post-menopausal age women, respectively. A reduction in TBF (1.09 ± 0.37 kg, p= 0.003) was only significant in post-menopausal women. Interestingly, CLA supplementation was associated with a significant reduction in BW (1.05 ± 0.35 kg, p< 0.003), BMI (0.73 ± 0.2 kg/m², p < 0.001) and TBF (1.07 ± 0.36 kg, p= 0.003) in the trials without lifestyle monitoring or interventions. No significant effect of CLA on LBM was detected in this meta-analysis. This meta-analysis suggests a moderate anti-obesity effect of CLA on BW, BMI and TBF reduction in women, when supplemented over 6-16 weeks, particularly in overweight-obese women and post-menopausal women. However, this finding requires careful interpretation due to several issues in the designs of available CLA supplementation trials. More well-designed trials are required to confirm this meta-analysis results.

Keywords: body composition, body mass index, body weight, conjugated linoleic acid

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Authors: Memnun Seven, Mine Bahar, Aygül Akyüz, Hatice Erdoğan

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Background: The workplace has been deemed a suitable location for educating many women at once about cancer screening. Objective: To determine how group education about early diagnostic methods for breast and cervical cancer affects women’s behavior and readiness to receive mammography and Pap smears. Methods: This semi-interventional study was conducted at a textile factory in Istanbul, Turkey. Female workers (n = 125) were included in the study. A participant identification form and knowledge evaluation form developed for this study, along with the trans-theoretical model, were used to collect data. A 45-min interactive group education was given to the participants. Results: Upon contacting participants 3 months after group education, 15.4% (n = 11) stated that they had since received a mammogram and 9.8% (n = 7) a Pap smear. As suggested by the trans-theoretical model, group education increased participants’ readiness to receive cancer screening, along with their knowledge of breast and cervical cancer. Conclusions: Group education positively impacted women’s knowledge of cancer and their readiness to receive mammography and Pap smears. Group education can therefore potentially create awareness of cancer screening tests among women and improve their readiness to receive such tests.

Keywords: cancer screening, educational intervention, participation, women

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Authors: Mary Abigail T. Ty, Mary Jocelyn Yu-Laygo, Jocelyn Z. Mariano

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This is a case of L.S.T., a 61 year old, G6P4 (3124) who presented with a one month history of intermittent, brownish, watery, non foul smelling vaginal discharge. There were no other accompanying symptoms. On rectovaginal examination, a palpable adnexal mass on the left was appreciated, with the lower border measuring 3 cm. The mass was non-tender, had irregular borders and solid areas. On transvaginal sonography, it revealed a left pelvic mass measuring 3 x 4 x 2 cm, with a Sassone score of 9. It had vascularization. The primary consideration was Ovarian Newgrowth, probably malignant in nature. CA-125 results were slightly elevated at 43.2 u/ml (NV: 0-35 u/ml). After intraoperative evaluation, the left fallopian tube was converted into a 9 x 4.5 x 3 cm bulbous cystic mass with solid areas. On cut section, the ampullary portion of the fallopian tube contained necrotic and friable looking tissues. Specimen was sent for frozen section and results revealed adenocarcinoma of the left fallopian tube. Patient subsequently underwent complete surgical staging with unremarkable post-operative course. The Surg Ico pathologic diagnosis was G6P4 (3124) Fallopian tube serous cystadenocarcinoma stage 1. The mean incidence of PFTC is 3.6 per million women yearly. This is associated with a generally low survival rate. The primary diagnosis is very difficult to establish because only 0–10% of patients suffering from PFTC are diagnosed pre-operatively. Symptoms play a very important role in the discovery of this disease, because there will be no presentation to the hospital without symptoms. The most common of which may be vaginal bleeding, abdominal pain, a palpable mass and ascites. A conglomerate of manifestations may be encountered, but not at all times. This is termed hydrops tubae profluens where there is presence of colicky pain with relief from intermittent passage of serosanguinous vaginal discharge. The significance of this report is to emphasize the rarity of the case and how the dilemma in the diagnosis is almost always present despite ancillary procedures.

Keywords: fallopian tube carcinoma, prognosis, rare, risk factors

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Authors: Pepur Sandra, Bulog Ivana, Rimac Smiljanić Ana

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During the COVID-19 pandemic, stress and family financial fragility arose worldwide. Economic and health uncertainty created new pressure on the everyday life of families. The work from home, homeschooling, and care of other family members caused an increase in unpaid work and generated a new division of intrahousehold. As many times before, women have taken the higher burden. This paper analyzes family stress and finance during the COVID-19 pandemic. We propose that women's inclusion in paid and unpaid work and their financial literacy influence family finances. We build up our assumptions according to the two theories that explain intrahousehold family decision-making: traditional and barging models. The traditional model assumes that partners specialize in their roles in line with time availability. Consequently, partners less engaged in payable working activities will spend more time on domestic activities and vice versa. According to the bargaining model, each individual has their preferences, and the one with more household bargaining power, e.g., higher income, higher level of education, better employment, or higher financial knowledge, is likely to make family decisions and avoid unpaid work. Our results are based on an anonymous and voluntary survey of 869 valid responses from women older than 18 conducted in Croatia at the beginning of 2021. We found that families who experienced delays in settling current obligations before the pandemic were in a worse financial situation during the pandemic. However, all families reported problems settling current obligations during pandemic times regardless of their financial condition before the crisis. Women from families with financial issues reported higher levels of family and personal stress during the pandemic. Furthermore, we provide evidence that more women's unpaid work negatively affects the family's financial fragility during the pandemic. In addition, in families where women have better financial literacy and are more financially independent, families cope better with finance before and during pandemics.

Keywords: family financial fragility, stress, unpaid work, women's financial literacy

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Authors: Zairunisha

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This paper is concerned with the ways in which Assisted Reproductive Technologies (ARTs) affect women’s lives and perceptions regarding their infertility, contraception and reproductive health. Like other female animals, nature has ordained human female with the biological potential of procreation and becoming mother. However, during the last few decades, this phenomenal disposition of women has become a technological affair to achieve fertility and contraception. Medical practices in patriarchal societies are governed by male scientists, technical and medical professionals who try to control women as procreator instead of providing them choices. The use of ARTs presents innumerable waxed ethical questions and issues such as: the place and role of a child in a woman’s life, freedom of women to make their choices related to use of ARTs, challenges and complexities women face at social and personal levels regarding use of ARTs, effect of ARTs on their life as mothers and other relationships. The paper is based on a survey study to explore and analyze the above ethical issues arising from the use of Assisted Reproductive Technologies (ARTs) by women in New Delhi, the capital of India. A rapid rate of increase in fertility clinics has been noticed recently. It is claimed that these clinics serve women by using ARTs procedures for infertile couples and individuals who want to have child or terminate a pregnancy. The study is an attempt to articulate a critique of ARTs from a feminist perspective. A qualitative feminist research methodology has been adopted for conducting the survey study. An attempt has been made to identify the ways in which a woman’s life is affected in terms of her perceptions, apprehensions, choices and decisions regarding new reproductive technologies. A sample of 18 women of New Delhi was taken to conduct in-depth interviews to investigate their perception and response concerning the use of ARTs with a focus on (i) successful use of ARTs, (ii) unsuccessful use of ARTs, (iii) use of ARTs in progress with results yet to be known. The survey was done to investigate the impact of ARTs on women’s physical, emotional, psychological conditions as well as on their social relations and choices. The complexities and challenges faced by women in the voluntary and involuntary (forced) use of ARTs in Delhi have been illustrated. A critical analysis of interviews revealed that these technologies are used and developed for making profits at the cost of women’s lives through which economically privileged women and individuals are able to purchase services from lesser ones. In this way, the amalgamation of technology and cultural traditions are redefining and re-conceptualising the traditional patterns of motherhood, fatherhood, kinship and family relations within the realm of new ways of reproduction introduced through the use of ARTs.

Keywords: reproductive technologies, infertilities, voluntary, involuntary

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Authors: Andrew Hwang

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The average American worker sits for thirteen hours a day, often with poor posture and infrequent breaks, which can lead to health issues and back problems. The Smart Cushion was created to alert individuals of their poor postures, and may potentially alleviate back problems and correct poor posture. The Smart Cushion is a portable, rectangular, foam cushion, with five strategically placed pressure sensors, that utilizes an Arduino Uno circuit board and specifically designed software, allowing it to collect data from the five pressure sensors and store the data on an SD card. The data is then compiled into graphs and compared to controlled postures. Before volunteers sat on the cushion, their levels of back pain were recorded on a scale from 1-10. Data was recorded for an hour during sitting, and then a new, corrected posture was suggested. After using the suggested posture for an hour, the volunteers described their level of discomfort on a scale from 1-10. Different patterns of sitting postures were generated that were able to serve as early warnings of potential back problems. By using the Smart Cushion, the areas where different volunteers were applying the most pressure while sitting could be identified, and the sitting postures could be corrected. Further studies regarding the relationships between posture and specific regions of the body are necessary to better understand the origins of back pain; however, the Smart Cushion is sufficient for correcting sitting posture and preventing the development of additional back pain.

Keywords: Arduino Sketch Algorithm, biomedical technology, pressure sensors, Smart Cushion

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Authors: Orly Sela

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The lecture discusses a Language Teaching program in a Teacher Education College in northern Israel. An on-line course was added to the program in order to keep on-campus attendance at a minimum, thus allowing the students to keep their full-time jobs in school. In addition, the use of educational technology to allow students to study anytime anywhere, in keeping with 21st-century innovative teaching-learning practices, was also an issue, as was the wish for this course to serve as a model which the students could then possibly use in their K-12 teaching. On the other hand, there were strong considerations against including an online course in the program. The students in the program were mostly Israeli-Arab married women with young children, living in a traditional society which places a strong emphasis on the place of the woman as a wife, mother, and home-maker. In addition, as teachers, they used much of their free time on school-related tasks. Having careers at the same time as studying was ground-breaking for these women, and using their time at home for studying rather than taking care of their families may have been simply too much to ask of them. At the end of the course, feedback was collected through an online questionnaire including both open and closed questions. The data collected shows that the students believed in online teaching-learning in principle, but had trouble implementing it in practice. This evidence raised the question of whether or not such a course should be included in a graduate program for mature, professional students, particular women with families living in a traditional society. This issue is not relevant to Israel alone, but also to academic institutions worldwide serving such populations. The lecture discusses this issue, sharing the researcher’s conclusions with the audience. Based on the evidence offered, it is the researcher’s conclusion that online education should, indeed, be offered to such audiences. However, the courses should be designed with the students’ special needs in mind, with emphasis placed on initial planning and course organization based on acknowledgment of the teaching context; modeling of online teaching/learning suited for in-service teacher education, and special attention paid to social-constructivist aspects of learning.

Keywords: course design, in-service teacher-education, mature students, online teaching/learning

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Authors: Yose Rizal, Nuraini, Mirnawati, Maria Endo Mahata, Rio Darman, Dendi Kurniawan

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An experiment had been conducted to determine the effects of several levels of Neurospora crassa- fermented palm kernel cake in the diet on the production performance and egg-yolk quality of Arab laying-hens, and to obtain the appropriate level of this fermented palm kernel cake for reducing the utilization of concentrated feed in the diet. Three hundred Arab laying-hens of 72 weeks old were employed in this experiment, and randomly assigned to four treatments (0, 7.25, 10.15, and 13.05% fermented palm kernel cake in diets) in a completely randomized design with five replicates. Measured variables were production performance (feed consumption, egg-mass production, feed conversion, egg weight and hen-day egg production), and egg-yolk quality (ether extract and cholesterol contents, and egg-yolk color index). Results of experiment indicated that feed consumption, egg-mass production, feed conversion, egg weight, hen-day egg production and egg-yolk color index were not influenced (P>0.05) by diets. However, the ether extract and cholesterol contents of egg-yolk were very significantly reduced (P<0.01) by diets. In conclusion, Neurospora crassa-fermented palm kernel cake could be included up to 13.05% to effectively replace 45% concentrated feed in Arab laying-hens diet without adverse effect on the production performance.

Keywords: neurospora crassa-fermented palm kernel cake, Arab laying-hens, production performance, ether extract, cholesterol, egg-yolk color index

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Authors: Avigail Moor

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Sexual violence against women occurs at alarmingly high rates, which have remained steady irrespective of the increased societal awareness of this problem, affecting an upward of 20% of women. It appears that all the public discourse on this topic, including research, prevention programs, and public campaigns have not made a noticeable dent in this prevalence. This calls for new course of action. Raising awareness regarding the preventive role of bystanders might be it. To that end, the present study sought to establish what promotes bystander intervention and what hinders it. Three hundred and twenty-four men and women, ranging in age from 20-40, participated in this study, completing self-report questionnaires on the topics under investigation. Results indicated that the proclivity to intervene as a bystander is impacted by various factors. The most consequential among them is gender, with twice as many women as men, 70% vs 38% respectively, being positively inclined to take action in such cases. Other significant factors included belief in rape myths and having empathy towards perpetrators, which reduced the likelihood of bystander intervention. Holding the attitude that it is possible to freely consent to sex while intoxicated had a similar impact. The discussion addresses various preventive implications.

Keywords: bystander intervention, sexual assault, rape prevention, rape myths

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Authors: Trinh Hoang Hong Hue

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Citizen Participation has been largely considered as an important objective of improving democracy and government decision-making in Vietnam recently. The Public Administration Performance Index Survey data (PAPI) indicated that citizens in provinces that have a higher proportion of male often less participate in local governance than those in provinces that have lower proportion of male. That means Vietnamese women more actively participate at the local governance rather than men. Thus this study will explore factors involving gender differences that impact on citizen participation at the local level. Applying qualitative approach, mainly in-depth interview, this study explores four diverse perspectives on enhancing citizen participation for both women and men at the local governance including civic knowledge; the trust of citizens; suitable policies of local government; and the role of NGOs. Furthermore, this study also points out two crucial reasons that are leading to the gender differences of citizen participation at the local level. Firstly, because Vietnamese women play the main role in family financial management; then they are willing to highly contribute to ‘voluntary contributions’; one of the four sub-dimensions of the concept ‘citizen participation’ of PAPI. Secondly, in Vietnam, women are deeply prone to be interested in the small issues at the local governance; whereas men are much keen on the bigger issues at national and international governance.

Keywords: citizen participation, gender, women, local governance, PAPI, Vietnam

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Authors: Ramesh Bhat, Ammu Somanath, A. K. Nayanatara

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Background: The increasing prevalence of overweight and obesity is a critical public health problem for women. The negative effect of stress on memory and cognitive functions has been widely explored for decades in numerous research projects using a wide range of methodology. Deterioration of memory and other brain functions are hallmarks of Alzheimer’s disease. Estrogen fluctuations and withdrawal have myriad direct effects on the central nervous system that have the potential to influence cognitive functions. Aim: The present study aims to compare the effect of stress on the cognitive functions in overweight/obese women before and after menopause. Material and Methods: A total of 142 female subjects constituting women before menopause between the age group of 18–44 years and women after menopause between the age group of 45–60 years were included in the sample. Participants were categorized into overweight/obese groups based on the body mass index. The Perceived Stress Scale (PSS) the major tool was used for measuring the perception of stress. Based on the stress scale measurement each group was classified into with stress and without stress. Addenbrooke’s cognitive Examination-III was used for measuring the cognitive functions. Results: Premenopausal women with stress showed a significant (P<0.05) decrease in the cognitive parameters such as attention and orientation Fluency, language and visuospatial ability. Memory did not show any significant change in this group. Whereas, in the postmenopausal stressed women all the cognitive functions except fluency showed a significant (P<0.05) decrease after menopause stressed group. Conclusion: Stress is a significant factor on the cognitive functions of obese and overweight women before and after menopause. Practice of Yoga, Encouragement in activities like gardening, embroidery, games and relaxation techniques should be recommended to prevent stress. Insights into the neurobiology before and after menopause can be gained from future studies examining the effect on the HPA axis in relation to cognition and stress.

Keywords: cognition, stress, premenopausal, body mass index

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Authors: Meseret Gebeyehu Yehuala

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Women represent the majority of urban farmers engaged in vegetable and fruit production in Bahir Dar, Ethiopia. We examine urban agriculture in Bahir Dar city in the context of disruptions caused by the civil war and COVID-19. The Sustainable Livelihoods Framework serves as a conceptual frame to explore the vulnerability context, the structural and institutional challenges faced by women, and how this impacts their livelihoods. A total of 25 urban women farmers and 6 key informants were involved in the study through explorative and structured interviews conducted in 2021. Observations and informal conversations during repeated visits provided deeper insights. In addition, key informants employed in civil service institutions and experts were interviewed. Data were analysed by applying qualitative content analysis by using Atlas tia software. Women report that they experience a lack of access to land, insecurity of tenure, irregular technical support and input provision by agricultural extension services, and lack of access to credit and formal marketplaces. The COVID-19 pandemic restrictions aggravated this situation by delaying agricultural extension offices’ provision of necessary inputs and disrupting food handling and storage leading to the loss of perishable products. Bombing in relation to the civil war has destroyed harvests and left women in fear of returning to their fields. Women stated that vegetable and fruit production could contribute to their incomes, household food supplies, and more diversified diets. However, the city municipal office has, so far, not committed to supporting urban agriculture as a livelihood strategy.

Keywords: urban agriculture, institutional challenges, Bahir Dar, sustainable livelihood framework

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Authors: Halimatus Sakdiah Minhat, Hamizah Sulaiman

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Introduction: Old age is commonly link with menopause among women. The main purpose of this study is to explore the views of middle-aged women and its association with menopause. Methods: Qualitative interviews in the form of focus group discussions (FGD) were conducted among women aged between 35 and 59 years old living in urban localities in two different states in Malaysia. Selection of respondents were conducted using the maximum variation sampling, focussing on five age categories which are between 35 to 39, 40 to 44, 45 to 49, 50 to 54 and 55 to 59 years old. Each FGD involved 5 to 7 respondents and lasted for 1 to 2 hours each. The content of the interviews were recorded, transcribed verbatim after each interview before the next focus group discussion is conducted. Field notes of reflexive observations were recorded by the rapporteur. Individual transcripts were analysed using standard methods of qualitative thematic analysis. The material was read through twice and later coded. The codes were further collapsed into several key themes related to perceptions towards menopause among the respondents. Results: A total number of 36 middle-aged women were consented for the interviews. The contents of the interviews revealed that younger women tend to associate menopause with being old, which were dominated by the younger aged categories of less than 50 years old. Majority of the respondents linked menopause with end of woman’s reproductive capacity or inability to give birth, lethargic or endless feeling of tiredness and insomnia, emotional instability or having more sensitive feelings and also the beginning of many health problems such as osteoarthritis which they perceived very synonyms with being old. Conclusion: The findings of this study indirectly reflect the negative views towards menopause among the middle-aged women in Malaysia. Being residents in the urban areas equipped with advanced technology and health information, do not exclude them from having negative views about menopause. However, this is a qualitative study which only focussing on age ranges, regardless of their socioeconomic and demographic background, which make further studies on related issues are necessaries. The fact that it was a qualitative interview, the findings could not be generalised and only specific to the targeted population.

Keywords: Menopause, Middle-aged women, old, Malaysia

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Authors: Redha M. Elhuni

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The critical key success factors, which have to be targeted with appropriate change management, are the user acceptance and support of a new Enterprise Resource Planning (ERP) system at the early implementation stages. This becomes even more important in Arab context where national and organisational culture with a different value and belief system, resulting in different management styles, might not complement with Western business culture embedded in the predefined standard business processes of existing ERP packages. This study explains and critically evaluates research into national and organizational culture and the influence of different national cultures on the implementation and reengineering process of ERP packages in an Arab context. Using a case study, realized through a quantitative survey testing five of Martinsons’s and Davison’s propositions in a Libyan sample company, confirmed the expected results from the literature review that culture has an impact on the implementation process and that employee empowerment is an unavoidable consequence of an ERP implementation.

Keywords: enterprise resource planning, ERP systems, organisational culture, Arab context

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Authors: Mirjana Dokmanovic

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The main topic of this paper is the analysis of the presence of gender stereotypes in the media content in the Republic of Serbia with respect to the state commitments to eliminate discrimination against women. The research methodology included the analysis of the media content of six daily newspapers and two magazines on the date of 28 December 2015 and the analysis of the reality TV show programs in 2015 from gender perspective. The methods of the research has also included a desk research and a qualitative analysis of the available data, statistics, policy papers, studies, and reports produced by the government, the Ministry of Culture and Information, the Regulatory Body for Electronic Media, the Press Council, the associations of media professionals, the independent human rights bodies, and civil society organizations (CSOs). As a State Signatory to the Convention on the Elimination of All Forms of Discrimination against Women, the Republic of Serbia has adopted numerous measures in this field, including the Law on Equality between Sexes and the national gender equality strategies. Special attention has been paid to eliminating gender stereotypes and prejudices in the media content and portraying of women. This practice has been forbidden by the Law on Electronic Media, the Law on Public Information and Media, the Law on Public Service Broadcasting and the Bylaw on the Protection of Human Rights in the Provision of Media Services. Despite these commitments, there has not been achieved progress regarding eliminating gender stereotypes in the media content. The research indicates that the media perpetuate traditional gender roles and patriarchal patterns. Female politicians, entrepreneurs, academics, scientists, and engineers have been very rarely portrayed in the media. On the other side, women are in their focus as celebrities, singers, and actresses. Women are underrepresented in the pages related to politics and economy, while they are mostly present in the cover stories related to show-business, health care, family and household matters. Women are three times more than men identified on the basis of their family status, as mothers, wives, daughters, etc. Hate speech, misogyny, and violence against women are often present in the reality TV shows. The abuse of women and their bodies in advertising is still widely present. The cases of domestic violence are still presented with sensationalism, although there has been achieved progress in portraying victims of domestic violence with respect and dignity. The issues related to gender equality and the position of the vulnerable groups of women, such as Roma women or rural women, are not visible in the media. This research, as well as warnings of women’s CSOs and independent human rights bodies, indicates the necessity to implement legal and policy measures in this field consistently and with due diligence. The aim of the paper is to contribute eliminating gender stereotypes in the media content and advancing gender equality.

Keywords: discrimination against women, gender roles, gender stereotypes, media, misogyny, portraying women in the media, prejudices against women, Republic of Serbia

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Authors: Deirdre Mc Grath, Joanne Reid

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Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has in relation to this study enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying program theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving program theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: ovarian cancer, exercise intervention, implementation, Co-design

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Authors: A. Lubis, S. S. Pasulu, Z. Hikmah, A. Endaryanto, A. Harsono

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Infection by group A streptococci (GAS) can trigger an autoantibody that cause a poststreptococcal reactive arthritis (PSRA). Four patients with PSRA aged 10 years to 14 years old with the main complaint of joint pain for five days to 10 days after suffering a fever and sore throat. The joint pain was persistent, additive, and non migratory. All patients revealed an increase in erythrocyte sedimentation rate (ESR) and anti-streptolysin O (ASLO), but the chest x-ray, electrocardiography, and echocardiography were normal. Bone imaging showed no destruction on the affected joint. Jones Criteria were not fulfilled in all patients. Erythromycin and ibuprofen were given in all patients and an improvement was shown. Erythromycin was continued for one year and routine controls were conducted for cardiac evaluation. The prognosis of all the patients was good.

Keywords: arthritis, group a streptococcus, autoantibody, Jones criteria

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Authors: Arezoo Fallahi, Siamak Derakhshan, Parvaneh Taymoori, Babak Nematshahrbabaki

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Background: Osteoporosis, the most common metabolic bone disease, is an important health care issue. Not only the cost of disease is high but also is one of the causes of disability and mortality and effect on quality of life. Although self-care is effective on disease, s control and treatment but still effective factors on self-care of patient, s viewpoint have not been survey. The aim of this study was to explore effective factors on self-care in women with osteoporosis. Materials and methods: This study was done by conventional content analysis approach in year 2014. Through purposeful sampling 15 women referred to bone mass densitometry centers participated in this study. Inclusion criteria were: Women older than 50 years old with osteoporosis, final diagnosis of osteoporosis for over six –month period, T-score index below -2.5 (lower back or hip), drug use by patients with a physician’s prescription, ability in speaking and attending to participate in the study. Data was collected by face to face and group semi-structure deep interviews and analyzed via content analysis method. To support of rigor of data, criteria credibility, confirmability and transferability were used. Results: during data analysis five categories developed: “hope and disability in the face of illness”, “mutual roles of physician”, “role of family” and “administrative centers and organizations”. To perform self-care behaviors, the participations of this study emphasized on pay attention to their own healthy, regarding patients' rights by physician, pay attention to women's health by men, and the role of media especially radio and television. Conclusion: the finding of the study showed that women’s responsibility with osteoporosis for their health is not a factor but it is multifactorial. Increasing life expectancy in patients, attention to patients needs by physician, increasing health promotion programs in the media and enhancing role of family may provide conditions and infrastructure to empowerment women in doing self-care behavior.

Keywords: women, osteoporosis, self-care, content analysis

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Authors: Yu Chen Su

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Introduction: Gestational diabetes mellitus (GDM) refers to impaired glucose tolerance in pregnant women, impacting both the mother and newborn with short and long-term effects. It increases risks of preeclampsia, hypertension, type 2 diabetes, cesarean section, and preterm birth. GDM is associated with fetal macrosomia, shoulder dystocia, neonatal hypoglycemia, and future type 2 diabetes risk. A study on 6,421 pregnant women found 12% experienced high stress, linked to maladaptive coping and depressive emotions. Women with high-risk pregnancies may experience greater stress and depression. Research suggests GDM increases depression prevalence. A study on 632 Hispanic women with GDM showed severe stress and depression tendencies. Involving 95 women with GDM, 33.4% exhibited depression symptoms. Another study compared 180 GDM women to 186 with normal glucose levels, revealing higher depression levels in GDM women. They found GDM women were 1.85 times more likely to receive antidepressants during pregnancy and 1.69 times more likely to experience postpartum depression. Maternal stress and depressive symptoms during pregnancy are significant factors. Early identification by healthcare professionals can greatly benefit GDM women, their infants, and their families. Objectives: The purpose of this study was to investigate the association between gestational diabetes mellitus (GDM) and the risk of depression. Methods: This study reviewed and analyzed relevant literature on gestational diabetes mellitus (GDM) and depression in 6,876 patients. The literature search followed PRISMA guidelines and included databases like Embase, PubMed, MEDLINE, CINAHL, and Cochrane Library. Prospective or retrospective studies with relevant risk ratios and estimates were included, using a random-effects model for the analysis of depression risk correlation. Studies without depression data or relevant risks were excluded. The search period extended until October 2022. Results: Systematic review of 7 studies (6,876 participants) found a significant association (OR = 8.77, CI: 7.98-9.64, p < 0.05) between gestational diabetes mellitus (GDM) and higher depression risk compared to healthy pregnant women. Conclusions: Pregnancy is a significant life transition involving physiological, psychological, and social changes. Gestational diabetes poses challenges to women's physical and mental well-being. Sensitive healthcare professionals identifying issues early can greatly benefit women, babies, and the family.

Keywords: gestational diabetes, depression, systematic review, neta-analysis

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