Search results for: women living with HIV
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5160

Search results for: women living with HIV

3990 Living with Functional Movement Disorder: An Exploratory Study of the Lived Experience of Five Individuals with Functional Movement Disorder

Authors: Stephanie Zuba-Bates

Abstract:

Purpose: This qualitative research study explored the lived experience of people with functional movement disorder (FMD) including how it impacts their quality of life and participation in life activities. It aims to educate health care professionals about FMD from the perspective of those living with the disorder. Background: Functional movement disorder is characterized by abnormal motor movements including tremors, abnormal gait, paresis, and dystonia with no known underlying pathophysiological cause. Current research estimates that FMD may account for 2-20% of clients seen by neurologists. Getting a diagnosis of FMD is typically long and difficult. In addition, many healthcare professionals are unfamiliar with the disorder which may delay treatment. People living with FMD face great disruption in major areas of life including activities of daily living (ADLs), work, leisure, and community participation. OT practitioners have expertise in working with people with both physical disabilities as well as mental illness and this expertise has the potential to guide treatment and become part of the standard of care. In order for occupational therapists to provide these services, they must be aware of the disorder and must advocate for clients to be referred to OT services. In addition, referring physicians and other health professionals need to understand how having FMD impacts the daily functioning of people living with the disorder and how OT services can intervene to improve their quality of life. This study aimed to answer the following research questions: 1) What is the lived experience of individuals with FMD?; 2) How has FMD impacted their participation in major areas of life?; and, 3) What treatment have they found to be effective in improving their quality of life? Method: A naturalistic approach was used to collect qualitative data through semi-structured telephone interviews of five individuals living with FMD. Subjects were recruited from social media websites and resources for people with FMD. Data was analyzed for common themes among participants. Results: Common themes including the variability of symptoms of the disorder; challenges to receiving a diagnosis; frustrations with and distrust of health care professionals; the impact of FMD on the participant’s ability to perform daily activities; and, strategies for living with the symptoms of FMD. Conclusion: All of the participants in the study had to modify their daily activities, roles and routines as a result of the disorder. This is an area where occupational therapists may intervene to improve the quality of life of these individuals. Additionally, participants reported frustration with the medical community regarding the awareness of the disorder and how they were treated by medical professionals. Much more research and awareness of the disorder is in order.

Keywords: functional movement disorder, occupational therapy, participation, quality of life

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3989 Son Preference in Afghanistan and Its Impact on Fertility Outcomes

Authors: Saha Naseri

Abstract:

Introduction/Objective: Son preference, a preference for sons over daughters, is a practice deeply-rooted in gender inequality that is widespread in many societies and across different religions and cultures. In this study, we are aiming to study the effects of son preference on fertility outcomes (birth interval and current contraceptive use) in Afghanistan, where have been perceived with high rates of son preference. The objectives of the study are to examine the association between the sex of the previous child and the duration of the subsequent birth interval and to evaluate the effect of son preference on current contraceptive use. Methodology: Afghanistan Demographic and Health Survey (DHS) (2015) was used to study the impact of son preference on fertility outcomes among married women. The data collected from 28,661 on currently-married women, aged between 15 and 49 years who have at least one child, have used to conduct this quantitative study. Outcomes of interest are birth interval and current contraceptive use. Simple and multiple regression analysis have been conducted to assess the effect of son preference on these fertility outcomes. Results: The present study has highlighted that son preference somehow exists among married women in Afghanistan. It is indicated that the sex of the first birth is significantly associated with the succeeding birth interval. Having a female child as the first baby was associated with a shorter average succeeding birth interval by 1.8 months compared to a baby boy (p-value = 0.000). For the second model, the results identified that women who desire for more sons have 7% higher odds to be current contraceptive user compared to those who have no preference (p-value = 0.03). The latter results do not indicate the son preference. However, one limitation for this result was the timeliness of the questions asked since contraceptive use in the current time was asked along with a question on ‘future’ desired sex composition. Moreover, women may have just given birth and want to reach a certain time span of birth interval before planning for another child, even if it was a boy, which might have affected the results. Conclusion: Overall, this study has demonstrated that there is a positive relationship between son preference and one main fertility behaviors, birth interval. The second fertility outcome, current contraceptive use, was not a good indicator to measure son preference. Based on the finding, recommendations will be made for appropriate interventions addressing gender norms and related fertility decisions.

Keywords: Afghanistan, birth interval, contraceptive, son preference

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3988 Individual and Contextual Factors Associated with Modern Contraceptive Use among Sexually Active Adolescents and Young Women in Zambia: A Multilevel Analysis

Authors: Chinyama Lukama, Million Phiri, Namuunda Mutombo

Abstract:

Background: Improving access and utilization to high-quality sexual and reproductive health (SRH) information and services, including family planning (FP) commodities, is central to the global developmental agenda of sub-Saharan Africa (SSA). Despite the importance of family planning use in enhancing maternal health outcomes and fertility reduction, the prevalence of adolescents and young women using modern contraception is generally low in SSA. Zambia is one of the countries in Southern Africa with a high prevalence of teenage pregnancies and fertility rates. Despite many initiatives that have been implemented to improve access and demand for family planning commodities, utilization of FP, especially among adolescents and young women, has generally been low. The objective of this research agenda was to better understand the determinants of modern contraceptive use in adolescents and young women in Zambia. This analysis produced findings that will be critical for informing the strengthening of sexual and reproductive health policy strategies aimed at bolstering the provision and use of maternal health services in order to further improve maternal health outcomes in the country. Method: The study used the recent data from the Demographic and Health Survey of 2018. A sample of 3,513 adolescents and young women (ADYW) were included in the analysis. Multilevel logistic regression models were employed to examine the association of individual and contextual factors with modern contraceptive use among adolescents and young women. Results: The prevalence of modern contraception among sexually active ADYW in Zambia was 38.1% [95% CI, 35.9, 40.4]. ADYW who had secondary or higher level education [aOR = 2.16, 95% CI=1.35–3.47], those with exposure to listening to the radio or watching television [aOR = 1.26, 95% CI=1.01–1.57], and those who had decision-making power at household level [aOR = 2.18, 95% CI=1.71–2.77] were more likely to use modern contraceptives. Conversely, strong neighborhood desire for large family size among ADYW [aOR = 0.65 95% CI = 0.47–0.88] was associated with less likelihood to use modern contraceptives. Community access to family planning information through community health worker visits increased the likelihood [aOR = 1.48, 95% CI=1.16–1.91] of using modern contraception among ADYW. Conclusion: The study found that both individual and community factors were key in influencing modern contraceptive use among adolescents and young women in Zambia. Therefore, when designing family planning interventions, the Government of Zambia, through its policymakers and sexual reproductive health program implementers at the Ministry of Health, in collaboration with stakeholders, should consider the community context. There should also be deliberate actions to encourage family planning education through the media.

Keywords: adolescents, young women, modern contraception use, fertility, family planning

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3987 Role of ASHA in Utilizing Maternal Health Care Services India, Evidences from National Rural Health Mission (NRHM)

Authors: Dolly Kumari, H. Lhungdim

Abstract:

Maternal health is one of the crucial health indicators for any country. 5th goal of Millennium Development Goals is also emphasising on improvement of maternal health. Soon after Independence government of India realizing the importance of maternal and child health care services, and took steps to strengthen in 1st and 2nd five year plans. In past decade the other health indicator which is life expectancy at birth has been observed remarkable improvement. But still maternal mortality is high in India and in some states it is observe much higher than national average. Government of India pour lots of fund and initiate National Rural Health Mission (NRHM) in 2005 to improve maternal health in country by providing affordable and accessible health care services. Accredited Social Heath Activist (ASHA) is one of the key components of the NRHM. Mainly ASHAs are selected female aged 25-45 years from village itself and accountable for the monitoring of maternal health care for the same village. ASHA are trained to works as an interface between the community and public health system. This study tries to assess the role of ASHA in utilizing maternal health care services and to see the level of awareness about benefits given under JSY scheme and utilization of those benefits by eligible women. For the study concurrent evaluation data from National Rural health Mission (NRHM), initiated by government of India in 2005 has been used. This study is based on 78205 currently married women from 70 different districts of India. Descriptive statistics, chi2 test and binary logistic regression have been used for analysis. The probability of institutional delivery increases by 2.03 times (p<0.001) while if ASHA arranged or helped in arranging transport facility the probability of institutional delivery is increased by 1.67 times (p<0.01) than if she is not arranging transport facility. Further if ASHA facilitated to get JSY card to the pregnant women probability of going for full ANC is increases by 1.36 times (p<0.05) than reference. However if ASHA discuses about institutional delivery and approaches to get register than probability of getting TT injection is 1.88 and 1.64 times (p<0.01) higher than that if she did not discus. Further, Probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 years. The probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 year of age than before 18 years, it is also 1.28 times (p<0.001) and 1.32 times (p<0.001) higher among women have 1 to 8 year of schooling and with 9 and above years of schooling respectively than the women who never attended school. Those women who are working have 1.13 times (p<0.001) higher probability of getting benefits from JSY scheme than not working women. Surprisingly women belongs to wealthiest quintile are .53times (P<0.001) less aware about JSY scheme. Results conclude that work done by ASHA has great influence on maternal health care utilization in India. But results also show that still substantial numbers of needed population are far from utilization of these services. Place of delivery is significantly influenced by referral and transport facility arranged by ASHA.

Keywords: institutional delivery, JSY beneficiaries, referral faculty, public health

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3986 Assessment of Healthy Lifestyle Behavior Needs for Older Adults Living with Hypertension

Authors: P. Sutipan, U. Intarakamhang

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The purpose of this study was to assess and prioritize the order of needs with regard to the healthy lifestyle behaviors for older adults living with hypertension. The participants involved 400 hypertensive elderly individuals in Chiang Mai, Thailand. The research instrument was a 26-item needs-assessment questionnaire in a dual response format on a four-level rating scale. The data was analyzed with the use of descriptive statistics and the needs were ranked using the Modified Priority Needs Index (PNIModified). The results indicated that the three priorities of healthy lifestyle behavior were healthy eating (PNImodified = 0.36), exercise (PNImodified = 0.35), and social contribution (PNImodified = 0.34), respectively. The implications of the findings for planning the intervention phase of the project are of particular interest.

Keywords: needs assessment, the modified priority needs index (PNIModified), healthy lifestyle behavior, older adults

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3985 Ghanaian Men and the Performance of Masculinity: Negotiating Gender-Based Violence in Contemporary Ghana

Authors: Isaac Dery

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Masculinity studies have gained much purchase globally in recent decades, especially the sense in which they have produced discursive space for interdisciplinary investigations. In the light of this, there is increasing consensus among commentators that different masculinities co-exist within a particular social space. There is also a growing recognition and awareness of the merits in examining the conceptual underpinnings of masculinity (especially hegemonic masculinity) its variously contested meanings, and values, and how it contributes to violent behaviours by men. The consequences of hegemonic masculinity and its violent and traumatic impacts on men and women have been evident. The emerging call to imagine more egalitarian and complex masculinities among men has been at the centre of various discussions on the fight against violence. Some theorists argue that this violence emanates from men’s drive to live up to impossible ideals of “masculinity.” Seeking to make the connections between masculinity and gender-based violence, this paper discusses the imperative and possibilities of engaging men/boys as key actors in the campaign against violence. It is worth re-examining the ways in which men’s embodiment and performance of dangerous masculinities contribute towards violence. This paper therefore argues that empowering men to understand the implications of certain behaviours is the key in an attempt to arrest violence and its traumatic cost. This paper is situated within the thesis that there is a relationship between men’s embodiment and performance of dominant forms of masculinities, on the one hand, and violence against women and other men, on the other. Based on research conducted in northern Ghana on domestic violence, it is the argument of this paper that in order to contain violence against women, conditions of gender construction need to be problematized in a manner that will transform fundamental understandings of gender relations in society.

Keywords: violence against women, masculinities, Ghana, gender

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3984 Conceptualising an Open Living Museum beyond Musealization in the Context of a Historic City: Study of Bhaktapur World Heritage Site, Nepal

Authors: Shyam Sunder Kawan

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Museums are enclosed buildings encompassing and displaying creative artworks, artefacts, and discoveries for people’s knowledge and observation. In the context of Nepal, museums and exhibition areas are either adaptive to small gallery spaces in residences or ‘neo-classical palatial complexes’ that evolved during the 19th century. This study accepts the sparse occurrence of a diverse range of artworks and expressions in the country's complex cultural manifestations within vivid ethnic groups. This study explores the immense potential of one such prevalence beyond the delimitation of physical boundaries. Taking Bhaktapur World Heritage Site as a case, the study perpetuates its investigation into real-time life activities that this city and its cultural landscapes ensemble. Seeking the ‘musealization’ as an urban process to induce museums into the city precinct, this study anticipates art space into urban spaces to offer a limitless experience for this contemporary world. Unveiling art as an experiential component, this study aims to conceptualize a living heritage as an infinite resource for museum interpretation beyond just educational institute purposes.

Keywords: living museum, site museum, museulization, contemporary arts, cultural heritage, historic cities

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3983 reconceptualizing the place of empire in european women’s travel writing through the lens of iberian texts

Authors: Gayle Nunley

Abstract:

Between the mid-nineteenth and early twentieth century, a number of Western European women broke with gender norms of their time and undertook to write and publish accounts of their own international journeys. In addition to contributing to their contemporaries’ progressive reimagining of the space and place of female experience within the public sphere, these often orientalism-tinged texts have come to provide key source material for the analysis of gendered voice in the narration of Empire, particularly with regard to works associated with Europe’s then-ascendant imperial powers, Britain and France. Incorporation of contemporaneous writings from the once-dominant Empires of Iberian Europe introduces an important additional lens onto this process. By bringing to bear geographic notions of placedness together with discourse analysis, the examination of works by Iberian Europe’s female travelers in conjunction with those of their more celebrated Northern European peers reveals a pervasive pattern of conjoined belonging and displacement traceable throughout the broader corpus, while also underscoring the insufficiency of binary paradigms of gendered voice. The re-situating of women travelers’ participation in the European imperial project to include voices from the Iberian south creates a more robust understanding of these writers’ complex, and often unexpectedly modern, engagement with notions of gender, mobility, ‘otherness’ and contact-zone encounter acted out both within and against the imperial paradigm.

Keywords: colonialism, orientalism, Spain, travel writing, women travelers

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3982 Factors Associated with the Use of Long-Acting Reversible Contraceptive Methods among Women of Reproductive Age 15-49 Years in Jinja District

Authors: Helen Nelly Naiga, Christopher Garimoi Orach

Abstract:

Introduction: Long-acting reversible contraceptive (LARC) methods are highly effective. However, LARC use in Uganda is low (13%). We assessed the factors associated with the use of long-acting reversible contraceptives among women of reproductive age (15-49 yrs) in Jinja District. Methods: We conducted a facility-based cross-sectional study. A total of 314 women aged 15–49 years attending public health facilities (1 hospital and 3 health center IV) in Jinja district, were randomly selected. A total of 6 key informants and 6 in-depth interviews were conducted. Logistic regression analysis was conducted using Stata version 14. Qualitative data were analysed using thematic analysis. Results: The study found that 40.45% of the respondents had ever used LARC. The commonest LARC method used was implanting (38.22%). The factors significantly associated with use of LARC were employment (AOR =2.91; 95% CI (1.05-8.08), access to LARC methods (AOR =4.48; 95% CI (1.24-16.21), husband support (AOR =4.90; 95% CI (1.56-15.41), and experience of no side effects (AOR =3.48; 95% CI (1.00-12.19). Conclusion and recommendations: The study showed that 4 in 10 women of reproductive age in Jinja District were using LARC. The factors associated with LARC use were employment, husband support, access to LARC methods, and the lack of side effects. There is a need to strengthen client education, improve accessibility to LARC methods at all levels of health centers, improve male partner’s decision-making in LARC use and manage the side effects effectively.

Keywords: family planning, implants, intrauterine device, long-acting reversible contraceptives (LARC)

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3981 STEAM and Project-Based Learning: Equipping Young Women with 21st Century Skills

Authors: Sonia Saddiqui, Maya Marcus

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UTS STEAMpunk Girls is an educational program for young women (aged 12-16), to empower them to be more informed and active members of the 21st century workforce. With the number of STEM graduates on the decline, especially among young women, an additional aim of the program is to trial a STEAM (Science, Technology, Engineering, Arts/Humanities/Social Sciences, Mathematics), inter-disciplinary approach to improving STEM engagement. In-line with UNESCO’s recent focus on promoting ‘transversal competencies’ in future graduates, the program utilised co-design, project-based learning, entrepreneurial processes, and inter-disciplinary learning. The program consists of two phases. Taking a participatory design approach, the first phase (co-design workshops) provided valuable insight into student perspectives around engaging young women in STEM and inter-disciplinary thinking. The workshops positioned 26 young women from three schools as subject matter experts (SMEs), providing a platform for them to share their opinions, experiences and findings around the STEAM disciplines. The second (pilot) phase put the co-design phase findings into practice, with 64 students from four schools working in groups to articulate problems with real-world implications, and utilising design-thinking to solve them. The pilot phase utilised project-based learning to engage young women in entrepreneurial and STEAM frameworks and processes. Scalable program design and educational resources were trialed to determine appropriate mechanisms for engaging young women in STEM and in STEAM thinking. Across both phases, data was collected via longitudinal surveys to obtain pre-program, baseline attitudinal information, and compare that against post-program responses. Preliminary findings revealed students’ improved understanding of the STEM disciplines, industries and professions, improved awareness of STEAM as a concept, and improved understanding regarding inter-disciplinary and design thinking. Program outcomes will be of interest to high-school educators in both STEM and the Arts, Humanities and Social Sciences fields, and will hopefully inform future programmatic approaches to introducing inter-disciplinary STEAM learning in STEM curriculum.

Keywords: co-design, STEM, STEAM, project-based learning, inter-disciplinary

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3980 Changing the Biopower Hierarchy between Women’s Bodily Knowledge and the Medical Knowledge about the Body: The Case of Female Ejaculation and #Notpee

Authors: Lior B. Navon

Abstract:

The objective of this study is to investigate how technology, such as social media, can influence the biopower hierarchy between the medical knowledge about the body and women’s bodily knowledge through the case study of the hashtag 'notpee'. In January 2015, the hashtag #notpee, relating to a feminine physiological phenomenon called female ejaculation (FE) or squirting (SQ) started circulating on twitter. This hashtag, born as a reaction to a medical study claiming that SQ is essentially involuntary emission of urine during sexual activity, sparked an unusual public discourse about FE, a phenomenon that is usually not discussed or referred to in socio-legitimate public spheres. This unusual backlash got the attention of women’s magazines and blogs, as well as more mainstream large and respected outlets such as The Guardian and CNN. Both the tweets on twitter, as well as the media coverage of them, were mainly aimed at rejecting the research’s findings. While not offering an alternative and choosing to define the phenomenon by negation, women argued that the fluid extracted was not pee based on their personal experiences. Based on a critical discourse analysis of 742 tweets with the hashtag 'notpee' between January 2015 and January 2016, and of 15 articles covering the backlash, this study suggests that the #notpee backlash challenged the power balance between the medical knowledge about the feminine body and the feminine bodily knowledge through two different, yet related, forms of resistance to biopower. The first resistance is to the authority over knowledge production — who has the power to produce 'true' statements when it comes to the body? Is it the women who experience the phenomenon, or is it the medical institution? The second resistance to biopower has to do with what we regard as facts or veracity. A critical discourse analysis reveals that while both the scientific field, as well as the women arguing against its findings, use empirical information, they, nevertheless, rely on two dichotomic databases- while the scientific research relies on samples from the 'dead like body', these woman are relying on their lived subjective senses as a source for fact making. Nevertheless, while #notpee is asking to change the power relations between the feminine subjective bodily knowledge and the seemingly objective masculine medical knowledge about the body, it by no means dismisses it. These women are essentially asking the medical institution to take into consideration the subjective body as well as the objective one while acknowledging and accepting the power of the latter over knowledge production.

Keywords: biopower, female ejaculation, new media, bodily knowledge

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3979 The Benefits of Mountain Climbing in the Physical Well-Being of Young People

Authors: Zylfi Shehu, Rozeta Shatku

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The aim of this study is the identification of the goods and the consequences it brings up the mountain climbing to the youth, how mountain climbing influences in physical activity and the health of young people. Taken to study 37 young people aged 18-30 years, 25 males and 12 females. The selection was made at random and voluntary. Subjects were not professionals but amateurs climbing in the mountain. They were informed and instructed for the test to be carried out. The ascent was made in January 2016 in the Mount of Gjallica in Kukës, Albania, the height of the mountain is 2489 m above sea level. Backpack for each subject weighing 32 kg. Time of ascent, attitude and descent was 6 days. In 22 males, 2 of them did not afford the ascent on the first day and went back. Of the 12 women, 5 of them withdrew on the first day. During the descent on day six, 20 males 7 of them had minor injuries, three with serious injuries. While a total of 7 women, 4 of them had minor injuries and one with serious injuries. Most of the men and women who deal with physical activity throughout life faced the light and were not injured, and the rest that were not dealt with physical activity were more injured. Lack of experience and knowledge was one of the causes of injuries. The subjects had anxiety all the time, uncertainty and fear of avalanches of snow and difficult terrain.

Keywords: climbing, physical activity, young people

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3978 English Title Adaptive Comparison of Outdoor and Indoor Social Security in Damaged Area and New Residential Complex with Two-Way Anova Case Study: Qasr-Al-Dasht and Moalem District in Shiraz

Authors: Homa Parmoon, Narges Hamzeh

Abstract:

Since today's urban spaces are disposed towards behavioral disorders and lack of security, both qualitative and quantitative aspects of security especially social and physical security are considered as basic necessities in urban planning. This research focused on the variable of place of living, examined social security in the old and new textures, and investigated the amount of residents’ social security in Shiraz including safety, financial, emotional and moral security. To this end, two neighborhoods in region 1 of Shiraz- Qasr-Al-Dasht (old texture) and Moalem (new texture)- were examined through a comparative study of 60 samples lived in two neighborhoods. Data were gathered through two-way ANOVA between the variables of residential context and internal and external security. This analysis represents the significance or insignificance of the model as well as the individual effects of each independent variable on the dependent variable. It was tested by ANCOVA and F-test. Research findings indicated place of living has a significant effect on families’ social security. The safety, financial, emotional, and moral security also represented a great impact on social security. As a result, it can be concluded that social security changes with the changing in place of living.

Keywords: social security, damaged area, two-way ANOVA, Shiraz

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3977 Determinants of Maternal Near-Miss among Women in Public Hospital Maternity Wards in Northern Ethiopia: A Facility Based Case-Control Study

Authors: Dejene Ermias Mekango, Mussie Alemayehu, Gebremedhin Berhe Gebregergs, Araya Abrha Medhanye, Gelila Goba

Abstract:

Background: Maternal near miss (MNM) can be used as a proxy indicator of maternal mortality ratio. There is a huge gap in life time risk between Sub-Saharan Africa and developed countries. In Ethiopia, a significant number of women die each year from complications during pregnancy, childbirth and the post-partum period. Besides, a few studies have been performed on MNM, and little is known regarding determinant factors. This study aims to identify determinants of MNM among women in Tigray region, Northern Ethiopia. Methods: a case-control study in hospital found in Tigray region, Ethiopia was conducted from January 30 - March 30, 2016. The sample included 103 cases and 205 controls recruited from women seeking obstetric care at six public hospitals. Clients having a life-threatening obstetric complication including haemorrhage, hypertensive diseases of pregnancy, dystocia, infections, and anemia or clinical signs of severe anemia in women without haemorrhage were taken as cases and those with normal obstetric outcomes were considered as controls. Cases were selected based on proportional to size allocation while systematic sampling was employed for controls. Data were analyzed using SPSS version 20.0. Binary and multiple variable logistic regression (odds ratio) analyses were calculated with 95% CI. Results: The largest proportion of cases and controls was among the ages of20–29 years, accounting for37.9 %( 39) of cases and 31.7 %( 65) of controls. Roughly 90% of cases and controls were married. About two-thirds of controls and 45.6 %( 47) of cases had gestational age between 37-41 weeks. History of chronic medical conditions was reported in 55.3 %(57) of cases and 33.2%(68) of controls. Women with no formal education [AOR=3.2;95%CI:1.24, 8.12],being less than 16 years old at first pregnancy [AOR=2.5; 95%CI:1.12,5.63],induced labor[AOR=3; 95%CI:1.44, 6.17], history of Cesarean section (C-section) [AOR=4.6; 95%CI: 1.98, 7.61] or chronic medical disorder[AOR=3.5;95%CI:1.78, 6.93], and women who traveled more than 60 minutes before reaching their final place of care[AOR=2.8;95% CI: 1.19,6.35] all had higher odds of experiencing MNM. Conclusions: The Government of Ethiopia should continue its effort to address the lack of road and health facility access as well as education, which will help reduce MNM. Work should also be continued to educate women and providers about common predictors of MNM like the history of C-section, chronic illness, and teenage pregnancy. These efforts should be carried out at the facility, community, and individual levels. The targeted follow-up to women with a history of chronic disease and C-section could also be a practical way to reduce MNM.

Keywords: maternal near miss, severe obstetric hemorrhage, hypertensive disorder, c-section, Tigray, Ethiopia

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3976 Sildenafil Citrate (Viagra) Suppositories Are Promising Approach for Treatment of Unexplained Infertility

Authors: Shahinaz El-Shourbagy El-Shourbagy, Ahmed M. E Ossman Ossman, Ashraf El-Mohamady El-Mohamady

Abstract:

Objective: To investigate if there is a role of sildenafil citrate (Viagra) in the treatment of infertile couples for idiopathic cause. Design: An observational study. Setting: Infertility outpatient clinic of Tanta University Hospital Egypt. Patient(s): 50 unexplained infertility women {endometrial thickness (EM) and the mean resistance index (RI)} compared to 50 fertile control group attended for check-up in the same period and receiving no treatment. Intervention(s): unexplained infertility women were given 25 mg of sildenafil citrate suppositories four times per day for seven days starting from the 5th day of the menstrual cycle for three cycles. Main Outcome Measures: EM and RI of endometrial spiral artery were assessed by transvaginal color-pulsed Doppler ultrasound in unexplained infertility women before and after sildenafil citrate treatment and compared with control. The conception rate and pregnancy outcome were recorded in the two groups. Result(s): Women with unexplained infertility had significantly thinner endometrium and a higher spiral artery resistance index, meaning lower peri-implantation blood flow than the fertile controls. Sildenafil citrate treated women showed a statistically significant increase in endometrial thickness (p < 0.001) and a significant decrease in the mean spiral artery resistance index (p < 0.001) giving a better conception rate. Conclusion: Sildenafil citrate suppositories treatment enhance the endometrial blood flow through decreasing spiral artery resistance index 'RI' and consequently improve endometrial growth and receptivity in cases of unexplained infertility thus giving a better conception rate.

Keywords: Unexplained infertility, endometrial blood flow, endome¬trial receptivity, color-pulsed Doppler ultrasound; RI (resis¬tance index, Sildenafil citrate (Viagra)

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3975 Clinical Efficacy and Tolerability of Dropsordry™ in Spanish Perimenopausal Women with Urgency Urinary Incontinence (UUI)

Authors: J. A. Marañón, L. Lozano C. De Los Santos, L. Martínez-Campesino, E. Caballero-Garrido, F. Galán-Estella

Abstract:

Urinary incontinence (UI) is a significant health problem with considerable social and economic impact. An estimated 30% of women aged 30 to 60 years old have urinary incontinence (UI), while more than 50% of community-dwelling older women have the condition. Stress urinary incontinence and overactive bladder are the common types of incontinence The prevalence of stress and mixed (stress and urge) incontinence is higher than urge incontinence, but the latter is more likely to require treatment. In women, moderate and severe have a prevalence ranging from about 12% to 17% The objectives of this study was to examine the effect of the supplementation of tablets containing Dropsordry in women with urge urinary incontinence (UUI). Dropsordry is a novel active containing phytoestrogens from SOLGEN, the high genistin soy bean extract and pyrogallol plus polyphenols from standarized pumpkin seed extract,. The study was a single-center, not randomiized open prospective, study. 28 women with urinary incontinence ≥45 years were enrolled in this study (45-62 y. old age . Mean 52 y old). Items related to UI symptoms, were previously collected (T0) and these ítems were reviewed at the final of the study – 8 weeks. (T2). The presence of UI was previously diagnosed using the International Continence Society standards (ICS). Relationships between presence of UI and potential related factors as diabetes were also explored. Daily urinary test control was performed during the 8 weeks of treatment. Daily dosage was 1 g/ day (500 mg twice per day) from 0 to 4 week (T1), following a 500 mg/day daily intake from 4 to 8 week (T2). After eight weeks of treatment, the urgency grade score was reduced a 24,7%. The total urge episodes was reduced a 46%. Surprisingly there was no a significant change in daytime urinations (< 5%), however nocturia was reduced a 69,35%. Strenght Urinary Incontinence (SUI) was also tested showing a remarkably 52,17% reduction. Moreover the use of daily pantyliners was reduced a 66,25%. In addition, it was performed a panel test survey with quests when subjects of the study were enrolled (T0) and the same quests was performed after 8 weeks of supplementation (T2). 100% of the enrolled women fullfilled the ICIQ-SF quest (Spanish versión) and they were also questioned about the effects they noticed in response to taking the supplement and the change in quality of life. Interestingly no side effects were reported. There was a 96,2% of subjective satisfaction and a 85,8% objective score in the improvement of quality of life. CONCLUSION: the combination of High genistin isoflavones and pumpkin seed pyrogallol in Dropsordry tablets seems to be a safe and highly effective supplementation for the relieve of the urinary incontinence symptoms and a better quality of life in perimenopause women .

Keywords: isoflavones, pumpkin, menopause, incontinence, genistin

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3974 The 10-year Risk of Major Osteoporotic and Hip Fractures Among Indonesian People Living with HIV

Authors: Iqbal Pramukti, Mamat Lukman, Hasniatisari Harun, Kusman Ibrahim

Abstract:

Introduction: People living with HIV had a higher risk of osteoporotic fracture than the general population. The purpose of this study was to predict the 10-year risk of fracture among people living with HIV (PLWH) using FRAX™ and to identify characteristics related to the fracture risk. Methodology: This study consisted of 75 subjects. The ten-year probability of major osteoporotic fractures (MOF) and hip fractures was assessed using the FRAX™ algorithm. A cross-tabulation was used to identify the participant’s characteristics related to fracture risk. Results: The overall mean 10-year probability of fracture was 2.4% (1.7) for MOF and 0.4% (0.3) for hip fractures. For MOF score, participants with parents’ hip fracture history, smoking behavior and glucocorticoid use showed a higher MOF score than those who were not (3.1 vs. 2.5; 4.6 vs 2.5; and 3.4 vs 2.5, respectively). For HF score, participants with parents’ hip fracture history, smoking behavior and glucocorticoid use also showed a higher HF score than those who were not (0.5 vs. 0.3; 0.8 vs. 0.3; and 0.5 vs. 0.3, respectively). Conclusions: The 10-year risk of fracture was higher among PLWH with several factors, including the parent’s hip. Fracture history, smoking behavior and glucocorticoid used. Further analysis on determining factors using multivariate regression analysis with a larger sample size is required to confirm the factors associated with the high fracture risk.

Keywords: HIV, PLWH, osteoporotic fractures, hip fractures, 10-year risk of fracture, FRAX

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3973 Evaluating the Factors That Influence Caries Reduction During Pregnancy

Authors: Mimoza Canga, Irene Malagnino, Vergjini Mulo, Alketa Qafmolla, Vito Antonio Malagnino

Abstract:

Background: Dental caries is the most common dental disease and pregnancy represents a special process of physical, hormonal and metabolic changes in pregnant women, which is accompanied by an imbalance in the oral cavity. Objective: The objective of this study is to evaluate caries reduction after dental visits, the scaling of teeth, fluoridated water, brushing of the teeth and using fluoride toothpaste before and during pregnancy. Materials and methods: This study was conducted in the time period March 2018- September 2021, the age range of the participants was: 18-41 years old. The sample taken under observation was composed of 84 pregnant women. The questionnaire included the demographic characteristics of the sample, such as age, women's education level was primary, secondary, and higher education. Based on women's education level, our analysis found that 25.9% of pregnant women had completed primary education, 35.2% of them had secondary education and 38.9% of pregnant women had higher education. The descriptive and analytical research analysis is formulated as a longitudinal study. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: In the present study, it was observed that there is a strong relationship between dental visits and the scaling of the teeth with the value of P˂ .0001. While the number of teeth with caries before pregnancy and fluoridated water have a P-value=0.002. If we compare the same factor with the number of teeth with dental caries during pregnancy, the correlation is P-value = 0.0001. The number of teeth with caries before pregnancy and carbohydrates consumption has a strong relation with P-value=0.05. According to the present research, the number of teeth with dental caries before pregnancy in relation to brushing the teeth has a P-value ˂ 0.05. Furthermore, in the actual research, it was established that using fluoride toothpaste doesn’t affect the number of teeth with caries before pregnancy with a P-value= .314. Conclusion: According to the results of the present study performed in Albania, it was found out that the periodical dental visits, scaling of the teeth, fluoridated water, brushing of the teeth influenced caries reduction before and during pregnancy. In comparison, the usage of fluoride toothpaste did not have any effect on dental caries reduction in the same time period. The recommendations are as follows: maintaining oral hygiene, using fluoridated water and brushing the teeth regularly. Healthcare providers should inform pregnant women about the importance of oral health and the implementation of measures to manage dental caries.

Keywords: brushing of the teeth, dental visits, dental scaling, fluoridated water, pregnancy

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3972 Quality of Life and Willingness to Take Treatment and the Importance of the Disease in the Lives of Patients with Eating Disorders

Authors: Marzena Trojanczyk, Mariusz Jaworski, Ewa Dmoch Gajzlerska

Abstract:

Purpose: The purpose of this paper is to assess the relationship between the level of quality of life and willingness to take treatment in patients with eating disorders as anorexia, bulimia and compulsive bingeing. Material and methods: The subjects consisted of 99 women with eating disorders: anorexia, n = 33; bulimia, n = 35; compulsive overeating, n = 31 and 35 women in the control group. The study used an original questionnaire to assess the overall quality of life, as well as selected areas of the physical, mental, social and spiritual satisfaction. The subjects were also asked about the level of motivation for treatment, and the importance of the disease in the lives of patients. Statistical analyses were performed using the statistical program SPSS 18.0. Results: Women with eating disorders in particular groups did not differ with respect to each other in the aspect of overall quality of life, satisfaction with the development of the spiritual, social functioning and mental health. The severity level of the disease in the lives of patients showed a negative correlation with social functioning in women with anorexia nervosa. In the case of patients with compulsive bingeing a positive relationship between the level of importance of the disease and the satisfaction of spiritual development is reported. Conclusions: Concerning the inferior quality of life, there is no relationship between a willingness to take treatment and the importance of the disease in the lives of patients with anorexia, bulimia and compulsive bingeing.

Keywords: anorexia, bulimia, compulsive overeating, quality of life

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3971 Time to Cure from Obstetric Fistula and Its Associated Factors among Women Admitted to Addis Ababa Hamlin Fistula Hospital, Addis Ababa Ethiopia: A Survival Analysis

Authors: Chernet Mulugeta, Girma Seyoum, Yeshineh Demrew, Kehabtimer Shiferaw

Abstract:

Background: Obstetric fistula (OF) is a serious medical condition that includes an abnormal opening between the vagina and bladder (vesico-vaginal fistula) or the vagina and rectum (recto-vaginal fistula). It is usually caused by prolonged obstructed labour. Despite its serious health and psychosocial consequences, there is a paucity of evidence regarding the time it takes to heal from OF. Objective: The aim of this study was to assess the time to cure from obstetric fistula and its predictors among women admitted to Addis Ababa Hamlin Fistula Hospital, Addis Ababa, Ethiopia. Methodology: An institution-based retrospective cohort study was conducted from January 2015 to December 2020 among a randomly selected 434 women with OF in Addis Ababa Hamlin Fistula Hospital. Data was collected using a structured checklist adapted from a similar study. The open data kit (ODK) collected data was exported and analyzed by using STATA (14.2). Kaplan Meir was used to compare the recovery time from OF. To identify the predictors of OF, a Cox regression model was fitted, and an adjusted hazard ratio with a 95% confidence interval was used to estimate the strength of the associations. Results: The average time to recover from obstetric fistula was 3.95 (95% CI: 3.0-4.6) weeks. About ¾ of the women [72.8% (95% CI - 0.65-1.2)] were physically cured of obstetric fistula. Having secondary education and above [AHR=3.52; 95% CI (1.98, 6.25)] compared to no formal education, having a live birth [AHR=1.64; 95% CI (1.22, 2.21)], having an intact bladder [AHR=2.47; 95% CI (1.1, 5.54)] compared to totally destructed, and having a grade 1 fistula [AHR=1.98; 95% CI (1.19, 3.31)] compared to grade 3 were the significant predictors of shorter time to cure from an obstetric fistula. Conclusion and recommendation: Overall, the proportion of women with OF who were not being cured was unacceptably high. The time it takes for them to recover from the fistula was also extended. It connotes us to work on the identified predictors to improve the time to recovery from OF.

Keywords: time to recovery, obstetric fistula, predictors, Ethiopia

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3970 Nature of Body Image Distortion in Eating Disorders

Authors: Katri K. Cornelissen, Lise Gulli Brokjob, Kristofor McCarty, Jiri Gumancik, Martin J. Tovee, Piers L. Cornelissen

Abstract:

Recent research has shown that body size estimation of healthy women is driven by independent attitudinal and perceptual components. The attitudinal component represents psychological concerns about body, coupled to low self-esteem and a tendency towards depressive symptomatology, leading to over-estimation of body size, independent of the Body Mass Index (BMI) someone actually has. The perceptual component is a normal bias known as contraction bias, which, for bodies is dependent on actual BMI. Women with a BMI less than the population norm tend to overestimate their size, while women with a BMI greater than the population norm tend to underestimate their size. Women whose BMI is close to the population mean are most accurate. This is indexed by a regression of estimated BMI on actual BMI with a slope less than one. It is well established that body dissatisfaction, i.e. an attitudinal distortion, leads to body size overestimation in eating disordered individuals. However, debate persists as to whether women with eating disorders may also suffer a perceptual body distortion. Therefore, the current study was set to ask whether women with eating disorders exhibit the normal contraction bias when they estimate their own body size. If they do not, this would suggest differences in the way that women with eating disorders process the perceptual aspects of body shape and size in comparison to healthy controls. 100 healthy controls and 33 women with a history of eating disorders were recruited. Critically, it was ensured that both groups of participants represented comparable and adequate ranges of actual BMI (e.g. ~18 to ~40). Of those with eating disorders, 19 had a history of anorexia nervosa, 6 bulimia nervosa, and 8 OSFED. 87.5% of the women with a history of eating disorders self-reported that they were either recovered or recovering, and 89.7% of them self-reported that they had had one or more instances of relapse. The mean time lapsed since first diagnosis was 5 years and on average participants had experienced two relapses. Participants were asked to fill number of psychometric measures (EDE-Q, BSQ, RSE, BDI) to establish the attitudinal component of their body image as well as their tendency to internalize socio-cultural body ideals. Additionally, participants completed a method of adjustment psychophysical task, using photorealistic avatars calibrated for BMI, in order to provide an estimate of their own body size and shape. The data from the healthy controls replicate previous findings, revealing independent contributions to body size estimation from both attitudinal and perceptual (i.e. contraction bias) body image components, as described above. For the eating disorder group, once the adequacy of their actual BMI ranges was established, a regression of estimated BMI on actual BMI had a slope greater than 1, significantly different to that from controls. This suggests that (some) eating disordered individuals process the perceptual aspects of body image differently from healthy controls. It therefore is necessary to develop interventions which are specific to the perceptual processing of body shape and size for the management of (some) individuals with eating disorders.

Keywords: body image distortion, perception, recovery, relapse, BMI, eating disorders

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3969 Epidemiological and Clinical Profile of Patients with Chorioamnionitis

Authors: Isabel Cristina Ortiz Trujillo, Lina Maria Martinez Sanchez, Felipe Hernández Restrepo, Daniel Gallego Gonzalez, Natalia Vargas Grisales, Camilo Andrés Agudelo Vélez

Abstract:

Chorioamnionitis, is a pregnancy infection, causes different fetal and maternal symptoms. Streptococcus agalactiae present in the normal vaginal microflora of some women, favouring its abnormal multiplication during pregnancy, causing perinatal morbidity and mortality. Objective. Describe the clinical and epidemiological profile of the patients with diagnosis of clinical chorioanmionitis. Methodology. Descriptive, cross-sectional study. The population was patients with diagnosis of clinical chorioanmionitis. The information was taken from the medical records. The research was approved by the Ethics Committee. We used the program SPSS ® version 17.0 (SPSS Inc; Chicago, Illinois, USA) for the information analysis, descriptive statistics were used. Results. 78 patients in total with clinical chorioamnionitis, with a mean age of 26.3 ±5, 8 years old, the 69.2% primigravid women. 2.6% of women had positive culture for Streptococcus agalactiae in urine sample during current pregnancy and 30.7% had received some kind of antibiotics during current pregnancy. The 57.7% had 37 to 40 weeks of gestation in the current pregnancy it was calculated more frequently by ultrasound (66.7% in first quarter, 11.5% in the second and 1.9% in the third). In a 60.3% way of termination of pregnancy was vaginal and a 35.9 percent were caesarean section. Among the women in the study, a 30.8% had premature rupture of membranes. Conclusion. The chorioamnionitis continues to be an important cause of antibiotic use during pregnancy or labour and the decision to do a caesarean, with highest percentage in pregnancies-preterm and preterm premature rupture of membranes.

Keywords: chorioamnionitis, Streptococcus agalactiae, pregnancy complications, infectious

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3968 Gender and Older People: Reframing Gender Analysis through Lifecycle Lens

Authors: Supriya Akerkar

Abstract:

The UN Decade on Healthy Ageing (2021-2030) provides a new opportunity to address ageing and gender issues in different societies. The concept of gender has been used to unpack and analyse the power and constructions of gender relations in different societies. Such analysis has been employed and used to inform policy and practices of governments and non-governmental organisations to further gender equalities in their work. Yet, experiences of older women and men are often left out of such mainstream gender analysis, marginalising their existence and issues. This paper argues that new critical analytical tools are needed to capture the realities and issues of interest to older women and men. In particular, it argues that gender analysis needs to integrate analytical concepts of ageing and lifecycle approach in its framework. The paper develops such a framework by critical interrogation of the gender analysis tools that are currently applied for framing gender issues in international development and humanitarian work. Informed by the realities and experiences of older women and men, developed through a synthesis of available literature, the paper will develop a new framework for gender analysis that can be used by governments and non-government organisations in their work to further gender justice across the life cycle.

Keywords: ageing, gender, older people, social inclusion

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3967 Gender Inequality on Marine Tourism Development in Small Island

Authors: Khodijah Ismail, Elfindri

Abstract:

Tourism development have many environmental, economically and sociocultural benefits. Small islands have a lot of potential for marine tourism development. But, stereotype gender issues still dominate the social and cultural life of rural communities that have an impact on the gap in benefits of local development. The purpose of this study is to found development strategy concept of marine tourism in small islands gender-based. This study found in the marine tourism development of small islands not involved women, from planning to monitor marine tourism development in small islands. It's affects to the low of socio-economic of women in the coastal village and small islands. This condition is not advantage for sustainable development of marine tourism in small islands. Therefore, strengthening of livelihood assets by gender based through the marine tourism development in small islands is very important to attention, that women can contributed to household welfare, bargaining positioned in social culture was better and increase broad access to local government development policies. To realize it requires the full support of the government and relevant stakeholders through gender empowerment and strengthening of accessibility, connectivity, regulation, and design institution.

Keywords: gender inequality, marine tourism, development, tourism management

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3966 Occult Haemolacria Paradigm in the Study of Tears

Authors: Yuliya Huseva

Abstract:

To investigate the contents of tears to determine latent blood. Methods: Tear samples from 72 women were studied with the microscopy of tears aspirated with a capillary and stained by Nocht and with a chemical method of test strips with chromogen. Statistical data processing was carried out using statistical packages Statistica 10.0 for Windows, calculation of Pearson's chi-square test, Yule association coefficient, the method of determining sensitivity and specificity. Results:, In 30.6% (22) of tear samples erythrocytes were revealed microscopically. Correlations between the presence of erythrocytes in the tear and the phase of the menstrual cycle has been discovered. In the follicular phase of the cycle, erythrocytes were found in 59.1% (13) people, which is significantly more (x2=4.2, p=0.041) compared to the luteal phase - in 40.9% (9) women. In the first seven days of the follicular phase of the menstrual cycle the erythrocytes were predominanted of in the tears of women examined testifies in favour of the vicarious bleeding from the mucous membranes of extragenital organs in sync with menstruation. Of the other cellular elements in tear samples with latent haemolacria, neutrophils prevailed - in 45.5% (10), while lymphocytes were less common - in 27.3% (6), because neutrophil exudation is accompanied by vasodilatation of the conjunctiva and the release of erythrocytes into the conjunctival cavity. It was found that the prognostic significance of the chemical method was 0.53 of the microscopic method. In contrast to microscopy, which detected blood in tear samples from 30.6% (22) of women, blood was detected chemically in tears of 16.7% (12). An association between latent haemolacria and endometriosis was found (k=0.75, p≤0.05). Microscopically, in the tears of patients with endometriosis, erythrocytes were detected in 70% of cases, while in healthy women without endometriosis - in 25% of cases. The proportion of women with erythrocytes in tears, determined by a chemical method, was 41.7% among patients with endometriosis, which is significantly more (x2=6.5, p=0.011) than 11.7% among women without endometriosis. The data obtained can be explained by the etiopathogenesis of the extragenital endometriosis which is caused by hematogenous spread of endometrial tissue into the orbit. In endometriosis, erythrocytes are found against the background of accumulations of epithelial cells. In the tear samples of 4 women with endometriosis, glandular cuboidal epithelial cells, morphologically similar to endometrial cells, were found, which may indicate a generalization of the disease. Conclusions: Single erythrocytes can normally be found in the tears, their number depends on the phase of the menstrual cycle, increasing in the follicular phase. Erythrocytes found in tears against the background of accumulations of epitheliocytes and their glandular atypia may indicate a manifestation of extragenital endometriosis. Both used methods (microscopic and chemical) are informative in revealing latent haemolacria. The microscopic method is more sensitive, reveals intact erythrocytes, and besides, it provides information about other cells. At the same time, the chemical method is faster and technically simpler, it determines the presence of haemoglobin and its metabolic products, and can be used as a screening.

Keywords: tear, blood, microscopy, epitheliocytes

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3965 The Iranian Law and Refugee Survivors of Sexual and Gender-Based Violence

Authors: Aminreza Koohestani

Abstract:

This paper intends to explore the existing safeguards available within the Iranian law in protecting refugees affected by Sexual and Gender-Based Violence (SGBV). The Iranian law afforded protection for women and girls against SGBV is scattered across various bodies of law. Moreover, the degree of protection provided by the law varies greatly from one type of SGBV to another. The paper discusses the scope of applicability of Iranian laws to refugees affected by SGBV as well as substantive and procedural laws afforded protection for survivors of SGBV.

Keywords: Iran, law, violence, women

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3964 Tree Dress and the Internet of Living Things

Authors: Vibeke Sorensen, Nagaraju Thummanapalli, J. Stephen Lansing

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Inspired by the indigenous people of Borneo, Indonesia and their traditional bark cloth, artist and professor Vibeke Sorensen executed a “digital unwrapping” of several trees in Southeast Asia using a digital panorama camera and digitally “stitched” them together for printing onto sustainable silk and fashioning into the “Tree Dress”. This dress is a symbolic “un-wrapping” and “re-wrapping” of the tree’s bark onto a person as a second skin. The “digital bark” is directly responsive to the real tree through embedded and networked electronics that connect in real-time to sensors at the physical site of the living tree. LEDs and circuits inserted into the dress display the continuous measurement of the O2 / CO2, temperature, humidity, and light conditions at the tree. It is an “Internet of Living Things” (IOLT) textile that can be worn to track and interact with it. The computer system connecting the dress and the tree converts the gas emission data at the site of the real tree into sound and music as sonification. This communicates not only the scientific data but also translates it into a poetic representation. The wearer of the garment can symbolically identify with the tree, or “become one” with it by adorning its “skin.” In this way, the wearer also becomes a human agent for the tree, bringing its actual condition to direct perception of the wearer and others who may engage it. This project is an attempt to bring greater awareness to issues of deforestation by providing a direct access to living things separated by physical distance, and hopefully, to increase empathy for them by providing a way to sense individual trees and their daily existential condition through remote monitoring of data. Further extensions to this project and related issues of sustainability include the use of recycled and alternative plant materials such as bamboo and air plants, among others.

Keywords: IOLT, sonification, sustainability, tree, wearable technology

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3963 Induction of Labor Using Misoprostol with or without Mifepristone in Intrauterine Death: A Randomized Controlled Study

Authors: Ajay Agrawal, Pritha Basnet, Achala Thakur, Pappu Rizal, Rubina Rai

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Context: Rapid expulsion of fetus in intrauterine fetal death (IUFD) is usually requested without any medical grounds for it. So; an efficient, safe method for induction of labor (IOL) is required. Objective: To determine if pre-treatment with mifepristone followed by IOL with misoprostol in late IUFD is more efficacious. Methods: We conducted a randomized controlled trial in 100 patients. Group-A women received single oral dose of 200 mg mifepristone, followed by induction with vaginal misoprostol after 24-hour. Group-B women were induced only with vaginal misoprostol. In each group 5 dose of misoprostol was used 4 hourly. If first cycle was unsuccessful, after break of 12 hour, second course of misoprostol was started. The primary outcome was a measure of induction to delivery time and vaginal delivery within 24 hours. Secondary outcome was to measure need of oxytocin and complications. Results: Maternal age, parity and period of gestation were comparable between groups. Number of misoprostol dose needed in group A was significantly less than group B. Mann Whitney U test showed, women in group A had significantly earlier onset of labor, however total induction to delivery interval was not significant. In group-A, 85.7% delivered within 24 hours of first dose of misoprostol while in group-B 70% delivered within 24 hour (p=0.07). More women in Group B required oxytocin. Conclusion: Pretreatment with mifepristone before IOL following late IUFD is an effective and safe regimen. It appears to shorten the duration of induction to onset of labor.

Keywords: induction of labor, intrauterine fetal death, mifepristone, misoprostol

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3962 The Development of Local-Global Perceptual Bias across Cultures: Examining the Effects of Gender, Education, and Urbanisation

Authors: Helen J. Spray, Karina J. Linnell

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Local-global bias in adulthood is strongly dependent on environmental factors and a global bias is not the universal characteristic of adult perception it was once thought to be: whilst Western adults typically demonstrate a global bias, Namibian adults living in traditional villages possess a strong local bias. Furthermore, environmental effects on local-global bias have been shown to be highly gender-specific; whereas urbanisation promoted a global bias in urbanised Namibian women but not men, education promoted a global bias in urbanised Namibian men but not women. Adult populations, however, provide only a snapshot of the gene-environment interactions which shape perceptual bias. Yet, to date, there has been little work on the development of local-global bias across environmental settings. In the current study, local-global bias was assessed using a similarity-matching task with Navon figures in children aged between 4 and 15 years from across three populations: traditional Namibians, urban Namibians, and urban British. For the two Namibian groups, measures of urbanisation and education were obtained. Data were subjected to both between-group and within-group analyses. Between-group analyses compared developmental trajectories across population and gender. These analyses revealed a global bias from even as early as 4 in the British sample, and showed that the developmental onset of a global bias is not fixed. Urbanised Namibian children ultimately developed a global bias that was indistinguishable from British children; however, a global bias did not emerge until much later in development. For all populations, the greatest developmental effects were observed directly following the onset of formal education. No overall gender effects were observed; however, there was a significant gender by age interaction which was difficult to reconcile with existing biological-level accounts of gender differences in the development of local-global bias. Within-group analyses compared the effects of urbanisation and education on local-global bias for traditional and urban Namibian boys and girls separately. For both traditional and urban boys, education mediated all effects of age and urbanisation; however, this was not the case for girls. Traditional Namibian girls retained a local bias regardless of age, education, or urbanisation, and in urbanised girls, the development of a global bias was not attributable to any one factor specifically. These results are broadly consistent with aforementioned findings that education promoted a global bias in urbanised Namibian men but not women. The development of local-global bias does not follow a fixed trajectory but is subject to environmental control. Understanding how variability in the development of local-global bias might arise, particularly in the context of gender, may have far-reaching implications. For example, a number of educationally important cognitive functions (e.g., spatial ability) are known to show consistent gender differences in childhood and local-global bias may mediate some of these effects. With education becoming an increasingly prevalent force across much of the developing world it will be important to understand the processes that underpin its effects and their implications.

Keywords: cross-cultural, development, education, gender, local-global bias, perception, urbanisation, urbanization

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3961 An Educational Program Based on Health Belief Model to Prevent Non-Alcoholic Fatty Liver Disease among Iranian Women

Authors: Babak Nemat

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Background and Purpose: Non-alcoholic fatty liver is one of the most common liver disorders, which, as the most important cause of death from liver disease, has unpleasant consequences and complications. The aim of this study was to investigate the effect of an educational intervention based on a health belief model to prevent non-alcoholic fatty liver among women. Materials and Methods: This experimental study was performed among 110 women referring to comprehensive health service centers in Malayer City, west of Iran, in 2023. Using the available sampling method, 110 participants were divided into experimental and control groups. The data collection tool included demographic characteristics and a questionnaire based on the health belief model. In the experimental group, three one-hour training sessions were conducted in the form of pamphlets, lectures, and group discussions. Data were analyzed using SPSS software version 21, by correlation tests, paired t-tests, and independent t-tests. Results: The mean age of participants was 38.07±6.28 years, and most of the participants were middle-aged, married, housewives with academic education, middle-income, and overweight. After the educational intervention, the mean scores of the constructs include perceived sensitivity (p=0.01), perceived severity (p=0.01), perceived benefits (p=0.01), guidance for internal (p=0.01), and external action (p=0.01), and perceived self-efficacy (p=0.01) in the experimental group were significantly higher than the control group. The score of perceived barriers in the experimental group decreased after training. The perceived obstacles score in the test group decreased after the training (15.2 ± 3.9 v.s 11.2 ± 3.3, (p<0.01). Conclusion: The findings of the study showed that the design and implementation of educational programs based on the constructs of the health belief model can be effective in preventing women from developing higher levels of non-alcoholic fatty liver.

Keywords: non-alcoholic fatty liver, health belief model, education, women

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