Search results for: female healthcare

Authors: Leen Al Kassab, Sarah Johns, Helen Noble, Nawal Nour, Elizabeth Janiak, Sarrah Shahawy

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Introduction: Immigrant and refugee women experience disparities in sexual and reproductive health (SRH) outcomes, partially as a result of barriers to SRH literacy and to regular healthcare access and engagement. Despite the existing data highlighting growing needs for culturally relevant and structurally competent care, interventions are scarce and not well-documented. Methods: In this IRB-approved study, we used a community-based participatory research approach, with the assistance of a community advisory board, to conduct a qualitative needs assessment of SRH knowledge and service engagement with immigrant and refugee women from Africa or the Middle East and currently residing in Boston. We conducted a total of nine focus group discussions (FGDs) in partnership with medical, community, and religious centers, in six languages: Arabic, English, French, Somali, Pashtu, and Dari. A total of 44 individuals participated. We explored migrant and refugee women’s current and evolving SRH care needs and gaps, specifically related to the development of interventions and clinical best practices targeting SRH literacy, healthcare engagement, and informed decision-making. Recordings of the FGDs were transcribed verbatim and translated by interpreter services. We used open coding with multiple coders who resolved discrepancies through consensus and iteratively refined our codebook while coding data in batches using Dedoose software. Results: Participants reported immigrant adaptation experiences, discrimination, and feelings of trust, autonomy, privacy, and connectedness to family, community, and the healthcare system as factors surrounding SRH knowledge and needs. The context of previously learned SRH knowledge was commonly noted to be in schools, at menstruation, before marriage, from family members, partners, friends, and online search engines. Common themes included empowering strength drawn from religious and cultural communities, difficulties bridging educational gaps with their US- born daughters, and a desire for more SRH education from multiple sources, including family, health care providers, and religious experts & communities. Regarding further SRH education, participants’ preferences varied regarding ideal platform (virtual vs. in-person), location (in religious and community centers or not), smaller group sizes, and the involvement of men. Conclusions: Based on these results, empowering SRH initiatives should include both community and religious center-based, as well as clinic-based, interventions. Interventions should be composed of frequent educational workshops in small groups involving age-grouped women, daughters, and (sometimes) men, tailored SRH messaging, and the promotion of culturally, religiously, and linguistically competent care.

Keywords: community, immigrant, religion, sexual & reproductive health, women's health

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Authors: Rachel Talbot, Nasuh Malas

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Stigma in child and adolescent psychiatry continues to be a significant barrier for youth to receive much needed psychiatric care. Parents misperceptions regarding mental health may interfere with their child’s care and negatively influence their child’s view of mental health. For some children, their first experience with psychiatry may occur during medical hospitalization when they are seen by the Psychiatry Consultation-Liaison (C/L) Service. Despite this unique role, there is limited data on how to address mental health stigma with patients and families within the context of Child and Adolescent C/L Psychiatry. This study explores the use of a brief introductory video with messages from the psychiatry C/L team, families who have accessed mental health consultation in the hospital, as well as clips of family and C/L team interactions to address parental stigma of psychiatry. Common stigmatized concerns shared by parents include concerns about confidentiality, later ramifications of mental healthcare, outsider status, and parental self-blame. There are also stigmatized concerns about psychiatric medication use including overmedication, sedation, long-term effects, medicating ‘real problems’ and personality blunting. Each of these are addressed during the video parents will see with the intent of reducing negative parental perceptions relating to mental healthcare. For this study, families are given a survey highlighting these concerns, prior to and after watching the video. Pre-and post-video responses are compared with the hypothesis that watching the video will effectively reduce parental stigma about psychiatric care. Data collection is currently underway and will be completed by the end of November 2017 with data analysis completed by January 2018. This study will also give vital information about the demographic differences in perceptions of stigma so future interventions can be targeted towards those with higher perceived stigma. This study posits that use of an introductory video is an effective strategy to combat stigma and help educate and empower families. In this way, we will be reducing further barriers for patients and families to seek out mental health resources and supports that are often desperately needed for these youths.

Keywords: child and adolescent psychiatry, consult-liaison psychiatry, media, stigma

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Authors: Diego F. Carrillo-González, Milena Osorio, Natalia M. Cerro, Yasser Y. Lenis

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Introduction: mortality during the implantation and early embryonic development periods reach around 30% in different mammalian species. It has been described that progesterone (P4) and Arginine (Arg) play a beneficial role in establishing and maintaining early pregnancy in mammals. The combined effect between Arg and P4 on reproductive parameters in the rabbit species is not yet elucidated, to our best knowledge. Objective: to assess the effect of L-arginine and progesterone during the post-breeding period in female rabbits on the composition of the amniotic fluid, the placental structure, and the bone growth in their fetuses. Methods: crossbred female rabbits (n=16) were randomly distributed into four experimental groups (Ctrl, Arg, P4, and Arg+P4). In the control group, 0.9% saline solution was administered as a placebo, the Arg group was administered arginine (50 mg/kg BW) from day 4.5 to day 19 post-breeding, the P4 group was administered progesterone (Gestavec®, 1.5 mg/kg BW) from 24 hours to day 4 post-breeding and for the Arg+P4 group, an administration was performed under the same time and dose guidelines as the Arg and P4 treatments. Four females were sacrificed, and the amniotic fluid was collected and analyzed with rapid urine test strips, while the placenta and fetuses were processed in the laboratory to obtain histological plates. The percentage of deciduous, labyrinthine, and junctional zones was determined, and the length of the femur for each fetus was measured as an indicator of growth. Descriptive statistics were applied to identify the success rates for each of the tests. Afterwards, A one-way analysis of variance (ANOVA) was performed, and a comparison of means was conducted by Tukey's test. Results: a higher density (p<0.05) was observed in the amniotic fluid for fetuses in the control group (1022±2.5g/mL) compared to the P4 (1015±5.3g/mL) and Arg+P4 (1016±4,9g/mL) groups. Additionally, the density of amniotic fluid in the Arg group (1021±2.5g/mL) was higher (p<0.05) than in the P4 group. The concentration of protein, glucose, and ascorbic acid had no statistical difference between treatments (p>0.05). The histological analysis of the uteroplacental regions, a statistical difference (p<0,05) in the proportion of deciduous zone was found between the P4 group (9.6±2.6%) when compared with the Ctrl (28.15±12.3%), and Arg+P4 (26.3±4.9) groups. In the analysis of the fetuses, the weight was higher for the Arg group (2.69±0.18), compared to the other groups (p<0.05), while a shorter length was observed (p<0.05) in the fetuses for the Arg+P4 group (25.97±1.17). However, no difference (p>0.05) was found when comparing the length of the developing femurs between the experimental groups. Conclusion: the combination of L-arginine and progesterone allows a reduction in the density of amniotic fluid, without affecting the protein, energy, and antioxidant components. However, the use of L-arginine stimulates weight gain in fetuses, without affecting size, which could be used to improve production parameters in rabbit production systems. In addition, the modification in the deciduous zone could show a placental adaptation based on the fetal growth process, however more specific studies on the placentation process are required.

Keywords: arginine, progesterone, rabbits, reproduction

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Authors: Carmen Maria Hernandez-Nicolas, Juan Francisco Martín-Ugedo, Antonio Mínguez-Vera

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This paper analyses the influence of gender of the mayors of Spanish local governments on different budget items using a sample of 8,243 town councils between 2002 and 2010 period and 64,361 observations. The system Generalized Method of Moments (GMM) technique was employed to examine this panel data. This powerful methodology allows controlling for the endogenity of the variables and the heterogeneity of the sample. Unlike previous works focused on the study of gender influence on firm decisions, the present work analyzes the influence of the gender of the major in the council’s decisions. Specifically, we examine the differences in financial liabilities, security, protection and social promotion expenses and income items relating to public management. In addition, the study focuses on the Spanish context, which is characterized by the presence of decentralization of public responsibility to a greater extent than in neighboring countries, feeding the debate on the operational efficiency of local government increased with an open debate on the importance of gender in public management. The results show that female mayors tend to have lower expenses in general without significant differences in incomes obtained for men and women majors. We also find that female majors incur fewer financial liabilities, one of the most important problems in the Spanish public sector. However, despite of cutting in the public sector, these councils have higher expenditure on security, protection and social promotion. According to these evidences, the presence of women in politics may serve to improve the councils’ economic situation and it is not only necessary for social justice but for economics efficiency. Besides, in councils with more inhabitants, women mayors are more common, but women who served for a very long time are less common.

Keywords: councils, gender, local budgets, public management, women mayors

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Authors: Zehra Buyuktuncer, Aylin H. Büyükkaragöz, Tuğçe N. Balcı, Nevin Ergun

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Background: Undergoing rigid dietary habits for enhancing athletic performance could lead to eating disorders. High prevalence of eating disorders among female athletes has been already reported. However, the risk of disordered eating among disabled athletes is not known. A better knowledge of the different eating behaviors and their prevalence in disabled athletes would be helpful to understand interactions between eating and health. This study aimed to examine the cognitive restraint, uncontrolled eating and emotional eating behaviors in a disabled athlete population. Method: A total of 70 disabled Turkish national athletes (33 female, 37 male) from 5 sport branches (soccer, weight lifting, shooting, table tennis and basketball) were involved in the study. The cognitive restraint, uncontrolled eating and emotional eating behaviors were assessed using the revised version of Three Factor Eating Questionnaire-R18 (TFEQ-R18). The questionnaires were conducted by dietitian during the preparation camps of athletes. Body weight, height and waist circumference (WC) were measured; and body composition was analyzed by bioelectrical impedance analysis method. Results: The TFEQ scales showed a cognitive dietary restraint score of 13.9±4.2, uncontrolled eating score of 17.7±5.8 and emotional eating score of 4.9±2.5. The mean score of total TFEQ-R18 was 36.5±8.62. Neither total TFEQ-R18 score nor subscale scores differed significantly by gender or sport branches (p>0.05, for each). The scores were also similar in BMI groups (n=63; p>0.05). Total TFEQ, uncontrolled eating and emotional eating scores were significantly higher among the athletes with congenital disabilities compared to the scores of the athletes with acquired disabilities (p<0.05, for each). Moreover, the cognitive dietary restraint score was significantly high in athletes who would like to lose weight (p=0.009). Conclusion: Disabled athletes might have a risk of disordered eating. The different eating behaviors among disabled athletes should be assessed using validated tools to develop personalized nutritional strategies for those athletes.

Keywords: disabled athletes, eating behaviour, three-factor eating questionnaire-r18, body composition

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Authors: Mohammed Agbali, Claudia Trillo, Yusuf Arayici, Terrence Fernando

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The wide-spread adoption of the Smart City concept has introduced a new era of computing paradigm with opportunities for city administrators and stakeholders in various sectors to re-think the concept of urbanization and development of healthy cities. With the world population rapidly becoming urban-centric especially amongst the emerging economies, social innovation will assist greatly in deploying emerging technologies to address the development challenges in core sectors of the future cities. In this context, sustainable health-care delivery and improved quality of life of the people is considered at the heart of the healthy city agenda. This paper examines the Boston innovation landscape from the perspective of smart services and innovation ecosystem for sustainable development, especially in transportation and healthcare. It investigates the policy implementation process of the Healthy City agenda and eHealth economy innovation based on the experience of Massachusetts’s City of Boston initiatives. For this purpose, three emerging areas are emphasized, namely the eHealth concept, the innovation hubs, and the emerging technologies that drive innovation. This was carried out through empirical analysis on results of public sector and industry-wide interviews/survey about Boston’s current initiatives and the enabling environment. The paper highlights few potential research directions for service integration and social innovation for deploying emerging technologies in the healthy city agenda. The study therefore suggests the need to prioritize social innovation as an overarching strategy to build sustainable Smart Cities in order to avoid technology lock-in. Finally, it concludes that the Boston example of innovation economy is unique in view of the existing platforms for innovation and proper understanding of its dynamics, which is imperative in building smart and healthy cities where quality of life of the citizenry can be improved.

Keywords: computing paradigm, emerging technologies, equitable healthcare, healthy cities, open data, smart city, social innovation

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Authors: Luksanaporn Krungkraipetch

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Currently, surgery is the only known effective treatment for pterygium. In certain groups, the probability of recurrence after basic sclera excision is very significant. Tissue grafting is substantially more time-consuming and challenging than keeping the sclera uncovered, but it reduces the chance of recurrence. Conjunctival autograft surgery is older than amniotic membrane graft surgery. The purpose of this study was to compare pterygium surgery with conjunctival autograft against an amniotic membrane transplant. In the study, a randomized controlled trial was used. Four cases were ruled out (two for failing to meet inclusion criteria and the other for refusing to participate). Group I (n = 40) received the intervention, whereas Group II (n = 40) served as the control. Both descriptive and inferential statistical approaches were used, including data analysis and data analysis statistics. The descriptive statistics analysis covered basic pterygium surgery information as well as the risk of recurrent pterygium. As an inferential statistic, the chi-square was used. A p-value of 0.05 is statistically significant. The findings of this investigation were the majority of patients in Group I were female (70.0%), aged 41–60 years, had no underlying disease (95.0%), and had nasal pterygium (97.5%). The majority of Group II patients were female (60.0%), aged 41–60 years, had no underlying disease (97.5%) and had nasal pterygium (97.5%). Group I had no recurrence of pterygium after surgery, but Group II had a 7.5% recurrence rate. Typically, the recurrence time is twelve months. The majority of pterygium recurrences occur in females (83.3%), between the ages of 41 and 60 (66.7%), with no underlying disease. The recurrence period is typically six months (60%) and a nasal pterygium site (83.3%). Pterygium recurrence after surgery is associated with nasal location (p =.002). 16.7% of pterygium surgeries result in complications; one woman with nasal pterygium underwent autograft surgery six months later. The presence of granulation tissue at the surgical site is a mild complication. A pterygium surgery recurrence rate comparison of conjunctival autograft and amniotic membrane transplantation revealed that conjunctival autograft had a higher recurrence rate than amniotic membrane transplantation (p =.013).

Keywords: pterygium, pterygium surgery, conjunctival autograft, amniotic membrane transplantation

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Authors: Dmitriy Syssoyev, Aslan Seitkamzin, Natalya Lim, Kamilla Mussina, Abduzhappar Gaipov, Dimitri Poddighe, Dinara Galiyeva

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Background: Data on the epidemiology of congenital heart defects (CHD) in Kazakhstan is scarce. Therefore, the aim of this study was to describe the incidence, prevalence and all-cause mortality of patients with CHD in Kazakhstan, using national large-scale registry data from the Unified National Electronic Healthcare System (UNEHS) for the period of 2014-2020. Methods: In this retrospective cohort study, the included data pertained to all patients diagnosed with CHD in Kazakhstan and registered in UNEHS between January 2014 and December 2020. CHD was defined based on International Classification of Diseases 10th Revision (ICD-10) codes Q20-Q26. Incidence, prevalence, and all-cause mortality rates were calculated per 100,000 population. Survival analysis was performed using Cox proportional hazards regression modeling and the Kaplan-Meier method. Results: In total, 66,512 patients were identified. Among them, 59,534 (89.5%) were diagnosed with a single CHD, while 6,978 (10.5%) had more than two CHDs. The median age at diagnosis was 0.08 years (interquartile range (IQR) 0.01 – 0.66) for people with multiple CHD types and 0.39 years (IQR 0.04 – 8.38) for those with a single CHD type. The most common CHD types were atrial septal defect (ASD) and ventricular septal defect (VSD), accounting for 25.8% and 21.2% of single CHD cases, respectively. The most common multiple types of CHD were ASD with VSD (23.4%), ASD with patent ductus arteriosus (PDA) (19.5%), and VSD with PDA (17.7%). The incidence rate of CHD decreased from 64.6 to 47.1 cases per 100,000 population among men and from 68.7 to 42.4 among women. The prevalence rose from 66.1 to 334.1 cases per 100,000 population among men and from 70.8 to 328.7 among women. Mortality rates showed a slight increase from 3.5 to 4.7 deaths per 100,000 in men and from 2.9 to 3.7 in women. Median follow-up was 5.21 years (IQR 2.47 – 11.69). Male sex (HR 1.60, 95% CI 1.45 - 1.77), having multiple CHDs (HR 2.45, 95% CI 2.01 - 2.97), and living in a rural area (HR 1.32, 95% CI 1.19 - 1.47) were associated with a higher risk of all-cause mortality. Conclusion: The incidence of CHD in Kazakhstan has shown a moderate decrease between 2014 and 2020, while prevalence and mortality have increased. Male sex, multiple CHD types, and rural residence were significantly associated with a higher risk of all-cause mortality.

Keywords: congenital heart defects (CHD), epidemiology, incidence, Kazakhstan, mortality, prevalence

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Authors: Victorine Mbong Shu

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Very little research exists on family sex and sexuality communication and identity formation and how communication is helping adolescents in forming their sexual identities in South Africa. This study is designed to explore the impact of sexual communication in African families and the dynamics that influence the openness or closedness of adolescent sexual identities. The primary objectives of this study are threefold; to understand how sexuality communication in African families impacts the closedness and/or openness of adolescent African identities; to explore the nature of African children's sexuality given the status of their families’ communications on sex; to describe how parental or adult sexual knowledge, attitudes, values of sex, etc. are translated to children in African families, if at all. This study seeks answers to challenges faced by African parents and caregivers of adolescent children in South Africa regarding sex-sexuality communication and their shifting identities in different spaces. Its outcome seeks to empower these families on how to continue to effectively communicate sex and sexuality at different stages and circumstances. Two sets of people are interviewed separately in order to explore issues of familial communication and how to understand how together with religion and culture, adolescents are socialised to form the social and gender identities that they take to adulthood. They were parents of adolescents and young adult children who spoke in retrospect on when they were adolescents. The results of this study will fill knowledge gaps considering the chosen theory of communication that gives clarity to the topic of sex and sexuality communication in African families in South Africa and the dynamics of privacy that influence identity formation. A subset of the 40 conversations, 5 female parents, 5 male parents, 5 young female adults, and 5 male young adults, was used for this analysis. The preliminary results revealed five emergent themes informed by research questions and the theoretical framework of this study: Open communication, Discomfort discussing sex and sexuality, The importance of sex communication to African parents, Factors influencing African families’ communication about sex and sexuality and Privacy and boundaries.

Keywords: sex, sexuality, communication, African families, adolescents

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Authors: Y. O’Connor, C. Heavin, S. O’ Connor, J. Gallagher, J. Wu, J. O’Donoghue

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Background: To improve the delivery of paediatric healthcare in resource-poor settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which outlines how (a) this process can be digitised and (b) adherence could be improved as a result. Aim: To explore how an electronic mobile version of CCM (eCCM) can overcome issues associated with the paper-based CCM protocol (poor adherence to guidelines) vis-à-vis service blueprinting. This service blueprint will outline how (a) the CCM process can be digitised using mobile Clinical Decision Support Systems software to support clinical decision-making and (b) adherence can be improved as a result. Method: Development of a single service blueprint for a standalone application which visually depicts the service processes (eCCM) when supporting the CHWs, using an application known as Supporting LIFE (Low cost Intervention For disEase control) as an exemplar. Results: A service blueprint is developed which illustrates how the eCCM solution can be utilised by CHWs to assist with the delivery of healthcare services to children. Leveraging smartphone technologies can (a) provide CHWs with just-in-time data to assist with their decision making at the point-of-care and (b) improve CHW adherence to CCM guidelines. Conclusions: The development of the eCCM opens up opportunities for the CHWs to leverage the inherent benefit of mobile devices to assist them with health service delivery in rural settings. To ensure that benefits are achieved, it is imperative to comprehend the functionality and form of the eCCM service process. By creating such a service blueprint for an eCCM approach, CHWs are provided with a clear picture regarding the role of the eCCM solution, often resulting in buy-in from the end-users.

Keywords: adherence, community health workers, developing countries, mobile clinical decision support systems, CDSS, service blueprint

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Authors: J. U. Santhosh Kumar, V. Krishna, Sebin Sebastian, G. S. Seethapathy, G. Ravikanth, R. Uma Shaanker

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Food is one of the basic needs of human beings. It requires the normal function of the body part and a healthy growth. Recently, food adulteration increases day by day to increase the quantity and make more benefit. Animal source foods can provide a variety of micronutrients that are difficult to obtain in adequate quantities from plant source foods alone. Particularly in the meat industry, products from animals are susceptible targets for fraudulent labeling due to the economic profit that results from selling cheaper meat as meat from more profitable and desirable species. This work presents an overview of the main PCR-based techniques applied to date to verify the authenticity of beef meat and meat products from beef species. We were analyzed 25 market beef samples in South India. We examined PCR methods based on the sequence of the cytochrome b gene for source species identification. We found all sample were sold as beef meat as Bos Taurus. However, interestingly Male meats are more valuable high price compare to female meat, due to this reason most of the markets samples are susceptible. We were used sex determination gene of cattle like TSPY(Y-encoded, testis-specific protein TSPY is a Y-specific gene). TSPY homologs exist in several mammalian species, including humans, horses, and cattle. This gene is Y coded testis protein genes, which only amplify the male. We used multiple PCR products form species-specific “fingerprints” on gel electrophoresis, which may be useful for meat authentication. Amplicons were obtained only by the Cattle -specific PCR. We found 13 market meat samples sold as female beef samples. These results suggest that the species-specific PCR methods established in this study would be useful for simple and easy detection of adulteration of meat products.

Keywords: authentication, meat products, species-specific, TSPY

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Authors: Delaram Hosseinioun

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In their collections, Shirin Neshat, Mitra Tabrizian, Gohar Dashti and Newsha Tavakolian adopt a hybrid form of narrative to confront the restrictions imposed on women in hegemonic public and private spaces. Focusing on motives such as social marginalisation, crisis of belonging, as well as lack of agency for women, the artists depict the regression of women’s rights in their respective generations. Based on the ideas of Michael Bakhtin, namely his concept of polyphony or the plurality of contradictory voices, the views of Judith Butler on giving an account to oneself and Henri Leverbre’s theories on social space, this study illustrates the artists’ concept of identity in crisis through time and space. The research explores how the artists took their art as a novel dimension to depict and confront the hardships imposed on Iranian women. Henri Lefebvre makes a distinction between complex social structures through which individuals situate, perceive and represent themselves. By adding Bakhtin’s polyphonic view to Lefebvre’s concepts of perceived and lived spaces, the study explores the sense of social fragmentation in the works of Dashti and Tavakolian. One argument is that as the representatives of the contemporary generation of female artists who spend their lives in Iran and faced a higher degree of restrictions, their hyperbolic and theatrical styles stand as a symbolic act of confrontation against restrictive socio-cultural norms imposed on women. Further, the research explores the possibility of reclaiming one's voice and sense of agency through art, corresponding with the Bakhtinian sense of polyphony and Butler’s concept of giving an account to oneself. Works of Neshat and Tabrizian as the representatives of the previous generation who faced exile and diaspora, encompass a higher degree of misplacement, violence and decay of women’s presence. In Their works, the women’s body encompasses Lefebvre’s dismantled temporal and special setting. Notably, the ongoing social conviction and gender-based dogma imposed on women frame some of the concurrent motives among the selected collections of the four artists. By applying an interdisciplinary lens and integrating the conducted interviews with the artists, the study illustrates how the artists seek a transcultural account for themselves and women in their generations. Further, the selected collections manifest the urgency for an authentic and liberal voice and setting for women, resonating with the concurrent Women, Life, Freedom movement in Iran.

Keywords: persian modern female photographers, transcultural studies, shirin neshat, mitra tabrizian, gohar dashti, newsha tavakolian, butler, bakhtin, lefebvre

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Authors: Anouar El Younssi

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This study seeks to shed some light on the political and social ramifications and implications of Haifaa al-Mansour’s 2012 film Wadjda. The film made international headlines following its release, and was touted as the first film ever to be shot in its entirety inside the Kingdom of Saudi Arabia, and also the first to be directed by a female (Haifaa al-Mansour). Wadjda revolves around a simple storyline: A teenage Saudi girl living in the capital city Riyadh—named Wadjda—wants to have a bicycle just like her male teenage neighbor and friend Abdullah, but her ultra-conservative Saudi society places so many constraints on its female population—including not allowing girls and women to ride bicycles. Wadjda, who displays a rebellious spirit, takes concrete steps to save money in order to realize her dream of buying a bicycle. For example, she starts making and selling sports bracelets to her school mates, and she decides to participate in a Qur’an competition in hopes of winning a sum of money that comes with the first prize. In the end, Wadjda could not beat the system on her own, but the film reverses course, and the audience gets a happy ending: Wadjda’s mother, whose husband has decided to take a second wife, defies the system and buys her daughter the very bicycle Wadjda has been dreaming of. It is quite significant that the mother takes her daughter’s side on the subject of the bicycle at the end of the film, for this shows that she finally came to the realization that she and her daughter are both oppressed by the cultural norms prevalent in Saudi society. It is no coincidence that this change of heart and action on the part of the mother takes place immediately after the wedding night celebrating her husband’s second marriage. Gender inequality is thus placed front and center in the film. Nevertheless, a major finding of this study is that the film carries out its social critique in a soft and almost covert manner. The female actors in the film never issue a direct criticism of Saudi society or government; the criticism is consistently implied and subtle throughout. It is a criticism that relies more on showing than telling. The film shows us—rather than tells us directly—what is wrong, and lets us, the audience, decide and make a judgment. In fact, showing could arguably be more powerful and impactful than telling. Regarding methodology, this study will focus on and analyze the visuals and a number of key utterances by the main actor Wadjda in order to corroborate the study’s argument about the film’s bent on critiquing patriarchy. This research will attempt to establish a link between the film as an art object and as a social text. Ultimately, Wadjda sends a message of hope, that change is possible and that it is already happening slowly inside the Kingdom. It also sends the message that an insurrectional approach regarding women’s rights in Saudi Arabia is perhaps not the right one, at least at this historical juncture.

Keywords: bicycle, gender inequality, social critique, Wadjda, women’s rights

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Authors: Reham Algheshairy, Khaled Tayeb, Christopher Smith, Rebecca Gregg, Haruna Musa

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Background: Diabetes is a medical condition that refers to the pancreas’ inability to secrete sufficient insulin levels, a hormone responsible for controlling glucose levels in the body. Any surplus glucose in the blood stream is excreted through the urinary system. Insulin resistance in blood cells can also cause this condition despite the fact that the pancreas is producing the required amount of insulin A number of researchers claim that the prevalence of diabetes in Saudi Arabia has reached epidemic proportions, although one study did observe one positive in the rise in the awareness of diabetes, possibly indicative of Saudi Arabia’s improving healthcare system. While a number of factors can cause diabetes, the ever-increasing incidence of the disease in Saudi Arabia has been blamed primarily on low levels of physical activity and high levels of obesity. Objectives: The project has two aims. The first aim of the project is to investigate the regulatory effects of consumption of Nigella seeds and Ajwah dates on blood glucose levels in diabetic patients with type 2 diabetes. The second aim of the project is to investigate whether these dietary factors may have potentially beneficial effects in controlling the complications that associated with type 2 diabetes. Methods: This use a random-cross intervention trail of 75 Saudi male and female with type 2 diabetes in Al-Noor hospital in Makkah ( KSA) aged between 18 and 70 years were divided into 3 groups. Group 1 will consume 2g of Nigella Sativa seeds daily along with a modified diet for 12 weeks, group 2 will be given Ajwah dates daily with a modified diet for 12 weeks and group 3 will follow a modified diet for 12 weeks. Anthropometric measurements were taken at baseline, along with bloods for HbA1c, fasting blood sugar and at the end of 12 weeks. Results: This study found significant decrease in blood level (FBG & 2PPBG) and HbA1c in the groups with diet and Nigella seeds) compared to Ajwa date. However, there is no significant change were found in HbA1c, FBG and 2hrpp regarding Ajwa group. Conclusion: This study illustrated a significant improvement in some markers of glycaemia following 2 g of Ns and diet for 12 weeks. The dose of 2g/day of consumed Nigella seeds was found to be more effective in controlling BGL and HbA1c than control and Ajwa groups. This suggests that Nigella seeds and following a diet may have a potential effect (a role in controlling outcomes for type 2 diabetes and controlling the disease). Further research is needed on a large scale to determine the optimum dose and duration of Nigella and Ajwa in order to achieve the desired results.

Keywords: type 2 diabetes, Nigella seeds, Ajwa dates, fasting blood glucose, control

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Authors: Amir A. Beltagi, Ahmed R. Abdelbaki

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Background: Core stability training has recently attracted attention for optimizing performance and improving muscle balance for healthy and unhealthy individuals. The purpose of this study was to investigate the effect of beginner’s core stability exercises on the trunk flexors’/extensors’ peak torque ratio and trunk flexors’ and extensors’ peak torques. Methods: Thirty five healthy individuals, randomly assigned into two groups; experimental (group I) and control (group II), participated in the study. Group I involved 20 participants (10 male & 10 female) with mean ±SD age, weight, and height of 20.7±2.4 years, 66.5±12.1 kg and 166.7±7.8 cm respectively. Group II involved 15 participants (6 male & 9 female) with mean ±SD age, weight, and height of 20.3±0.61 years, 68.57±12.2 kg and 164.28 ±7.59 cm respectively. Data were collected using the Biodex Isokinetic system. The participants were tested twice; before and after a 6-week period during which the experimental group performed a core stability training program. Findings: Statistical analysis using the 2x2 Mixed Design ANOVA revealed that there were no significant differences in the trunk flexors’/extensors’ peak torque ratio between the ‘pre’ and ‘post’ tests for either group (p > 0.025). Moreover, there were no significant differences in the trunk flexors’/extensors’ ratios between both groups at either test (p > 0.025). Meanwhile, the 2x2 Mixed Design MANOVA revealed that there were significant differences in the trunk flexors’ and extensors’ peak torques between the ‘pre’ and ‘post’ tests for group I (p < 0.025), while there were no significant differences inbetween for group II (p > 0.025). Moreover, there were no significant differences between both groups for the tested muscles’ peak torques at either test except for that of the trunk flexors at the ‘post’ test only (p < 0.025). Interpretation: The improvement in muscle performance indicated by the increase in the trunk flexors’ and extensors’ peak torques in the experimental group recommends including core stability training in the exercise programs that aim to improve muscle performance.

Keywords: core stability, isokinetic, trunk muscles, muscle balance

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Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Bookun

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Introduction: Dialysis access is a key component of the care of patients with end stage renal failure. In our institution, a combined service of vascular surgeons and nephrologists are responsible for the creation and maintenance of arteriovenous fisultas (AVF), tenckhoff cathethers and Hickman/permcath lines. This poster investigates the last 10 years of dialysis access surgery conducted at St. Vincent’s Hospital Melbourne. Method: A cross-sectional retrospective analysis was conducted of patients of St. Vincent’s Hospital Melbourne (Victoria, Australia) utilising data collection from the Australasian Vascular Audit (Australian and New Zealand Society for Vascular Surgery). Descriptive demographic analysis was carried out as well as operation type, length of hospital stays, postoperative deaths and need for reoperation. Results: 2085 patients with renal failure were operated on between the years of 2011 and 2020. 1315 were male (63.1%) and 770 were female (36.9%). The mean age was 58 (SD 13.8). 92% of patients scored three or greater on the American Society of Anesthiologiests classification system. Almost half had a history of ischaemic heart disease (48.4%), more than half had a history of diabetes (64%), and a majority had hypertension (88.4%). 1784 patients had a creatinine over 150mmol/L (85.6%), the rest were on dialysis (14.4%). The most common access procedure was AVF creation, with 474 autologous AVFs and 64 prosthetic AVFs. There were 263 Tenckhoff insertions. We performed 160 cadeveric renal transplants. The most common location for AVF formation was brachiocephalic (43.88%) followed by radiocephalic (36.7%) and brachiobasilic (16.67%). Fistulas that required re-intervention were most commonly angioplastied (n=163), followed by thrombectomy (n=136). There were 107 local fistula repairs. Average length of stay was 7.6 days, (SD 12). There were 106 unplanned returns to theatre, most commonly for fistula creation, insertion of tenckhoff or permacath removal (71.7%). There were 8 deaths in the immediately postoperative period. Discussion: Access to dialysis is vital for patients with end stage kidney disease, and requires a multidisciplinary approach from both nephrologists, vascular surgeons, and allied health practitioners. Our service provides a variety of dialysis access methods, predominately fistula creation and tenckhoff insertion. Patients with renal failure are heavily comorbid, and prolonged hospital admission following surgery is a source of significant healthcare expenditure. AVFs require careful monitoring and maintenance for ongoing utility, and our data reflects a multitude of operations required to maintain usable access. The requirement for dialysis is growing worldwide and our data demonstrates a local experience in access, with preferred methods, common complications and the associated surgical interventions.

Keywords: dialysis, fistula, nephrology, vascular surgery

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Authors: Saeed Anwar

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Foreign aid has long been a prominent tool in the pursuit of economic development in recipient countries. This research paper aims to analyze the impact of foreign aid on economic development and explore the effectiveness of aid in promoting sustainable growth, poverty reduction, and improvements in human development indicators. Drawing upon a comprehensive review of existing literature, both theoretical frameworks and empirical evidence are synthesized to provide insights into the complex relationship between foreign aid and economic development. The paper examines various channels through which foreign aid influences economic development, including infrastructure development, education and healthcare investments, technology transfer, and institutional capacity building. It explores the potential positive effects of aid in stimulating economic growth, reducing poverty, and enhancing human capital formation. Additionally, it investigates the potential challenges and limitations associated with aid, such as aid dependency, governance issues, and the potential crowding out of domestic resources. Furthermore, the study assesses the heterogeneity of aid effectiveness across different types of aid modalities, recipient country characteristics, and aid allocation mechanisms. It considers the role of aid conditionality, aid fragmentation, and aid targeting in influencing the effectiveness of aid in promoting economic development. The findings of this research contribute to the ongoing discourse on foreign aid and economic development by providing a comprehensive analysis of the existing literature. The study highlights the importance of context-specific factors, recipient country policies, and aid effectiveness frameworks in determining the impact of foreign aid on economic development outcomes. The insights derived from this research can inform policymakers, donor agencies, and practitioners in designing and implementing effective aid strategies to maximize the positive impact of foreign aid on economic development.

Keywords: foreign aid, economic development, sustainable growth, poverty reduction, human development indicators, infrastructure development, education, healthcare, technology transfer, institutional capacity building, aid effectiveness, aid dependency, governance, crowding out, aid conditionality, aid fragmentation, aid targeting, recipient country policies, aid strategies, donor agencies, policymaking

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Authors: Carlos Riobo

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This paper analyzes literature and art in Argentina from the nineteenth to the twenty-first centuries as these media used the figure of the white female captive to define a developing national identity. This identity excluded the Indians whose lands the whites were taking and who appeared as the aggressors and captors in writing and paintings. The paper identifies the complicit relationship between art and history in crafting national memory. It also identifies a movement toward purity (as defined by separation of entities) and away from mestizaje (racial and cultural mixtures).

Keywords: Argentina, borders, captives, literature, painting

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Authors: Nelomi Anandagoda, Leanne J. Eveson

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During the COVID-19 pandemic, the surge in in-patient admissions across the medical directorate of a district general hospital necessitated the implementation of an incident rota. Conscious of the impact on training and professional development, the idea of developing a virtual teaching programme was conceived. The programme initially aimed to provide junior doctors, specialist nurses, pharmacists, and allied healthcare professionals from medical specialties and those re-deployed from other specialties (e.g., ophthalmology, GP, surgery, psychiatry) the knowledge and skills to manage the deteriorating patient with COVID-19. The programme was later developed to incorporate the general internal medicine curriculum. To facilitate continuing medical education whilst maintaining social distancing during this period, a virtual platform was used to deliver teaching to junior doctors across two large district general hospitals and two community hospitals. Teaching sessions were recorded and uploaded to a common platform, providing a resource for participants to catch up on and re-watch teaching sessions, making strides towards reducing discrimination against the professional development of less than full-time trainees. Thus, creating a learning environment, which is inclusive and accessible to adult learners in a self-directed manner. The negative impact of the pandemic on the well-being of healthcare professionals is well documented. To support the multi-disciplinary team, the virtual teaching programme evolved to included sessions on well-being, resilience, and work-life balance. Providing teaching for learners across the multi-disciplinary team (MDT) has been an eye-opening experience. By challenging the concept that learners should only be taught within their own peer groups, the authors have fostered a greater appreciation of the strengths of the MDT and showcased the immense wealth of expertise available within the trust. The inclusive nature of the teaching and the ease of joining a virtual teaching session has facilitated the dissemination of knowledge across the MDT, thus improving patient care on the frontline. The weekly teaching programme has been running for over eight months, with ongoing engagement, interest, and participation. As described above, the teaching programme has evolved to accommodate the needs of its learners. It has received excellent feedback with an appreciation of its inclusive, multi-disciplinary, and holistic nature. The COVID-19 pandemic provided a catalyst to rapidly develop novel methods of working and training and widened access/exposure to the virtual technologies available to large organisations. By merging pedagogical expertise and technology, the authors have created an effective online learning environment. Although the authors do not propose to replace face-to-face teaching altogether, this model of virtual multidisciplinary team, cross-site teaching has proven to be a great leveler. It has made high-quality teaching accessible to learners of different confidence levels, grades, specialties, and working patterns.

Keywords: cross-site, cross-speciality, inter-disciplinary, multidisciplinary, virtual teaching

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Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng

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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.

Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work

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Authors: Pascal U. Onu, Doris A. Ogbang, Emmanuel Okechukwu.

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Background: Plastics in their various forms have become ubiquitous in a very short space of time. This ubiquitous nature has plagued and daunted nations globally, overwhelming their ability to manage the environmental impact, especially its linkages to climate change. This has mobilized nations globally and triggered debates on the best approaches to ensure sustainability in terms of its production and utilization, as total elimination seems unrealistic. Objective: This study undertook to understand the pattern of plastic waste management, and its pollution awareness levels by the residents of the study area. Methods: Data were obtained through questionnaires designed specifically for plastic waste and qualitatively via journals and articles. Simple descriptive survey techniques with a survey population size of 300 respondents using kobo collect were employed. Results: Analysis based on disaggregated data indicated a proportionate distribution among male and female respondents (53% male and 47% female, respectively). Overall awareness levels on plastic waste's contribution to climate change, compared to its environmental impact, are reflective of a dire need for increased efforts in strengthening awareness creation, especially across gender populations and religious backgrounds. Drainage blockage topped the ranks among common problems caused by plastic waste within the area. Various plastic waste disposal methods were ranked, while pro-environmental measures for reducing the waste menace showed more willingness from males at 52%. Conclusion: These outcomes are instructive and suggest the need for renewed and increased awareness/education on the nexus of plastic pollution to climate change and also appropriate synergies/collaboration between government, private sector, and local communities, especially in the area of recycling to improve sustainability in plastic waste management.

Keywords: plastic waste, KAP, climate change, Nigeria

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Authors: Kristin Thooft

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— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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Authors: Truong H. Le, Ngoc M. To, Quang N. Tran, Luu T. Cao, Chi V. Le

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Introduction: In Vietnam, the current monitoring and treatment for ordinary diabetic patient mostly based on glucose monitoring with HbA1c test for every three months (recommended goal is HbA1c < 6.5%~7%). For diabetes in pregnant women or Gestational diabetes mellitus (GDM), glycemic control until the time of delivery is extremly important because it could reduce significantly medical implications for both the mother and the child. Besides, GDM requires continuos glucose monitoring at least every two weeks and therefore an alternative marker of glycemia for short-term control is considering a potential tool for the healthcare providers. There are published studies have indicated that the glycosylated serum protein is a better indicator than glycosylated hemoglobin in GDM monitoring. Based on the actual practice in Vietnam, this study was designed to evaluate the role of serum fructosamine as a monitoring tool in GDM treament and its correlations with fasting blood glucose (G0), 2-hour postprandial glucose (G2) and glycosylated hemoglobin (HbA1c). Methods: A cohort study on pregnant women diagnosed with GDM by the 75-gram oralglucose tolerance test was conducted at Endocrinology Department, Cho Ray hospital, Vietnam from June 2014 to March 2015. Cho Ray hospital is the final destination for GDM patient in the southern of Vietnam, the study population has many sources from other pronvinces and therefore researchers belive that this demographic characteristic can help to provide the study result as a reflection for the whole area. In this study, diabetic patients received a continuos glucose monitoring method which consists of bi-weekly on-site visit every 2 weeks with glycosylated serum protein test, fasting blood glucose test and 2-hour postprandial glucose test; HbA1c test for every 3 months; and nutritious consultance for daily diet program. The subjects still received routine treatment at the hospital, with tight follow-up from their healthcare providers. Researchers recorded bi-weekly health conditions, serum fructosamine level and delivery outcome from the pregnant women, using Stata 13 programme for the analysis. Results: A total of 500 pregnant women was enrolled and follow-up in this study. Serum fructosamine level was found to have a light correlation with G0 ( r=0.3458, p < 0.001) and HbA1c ( r=0.3544, p < 0.001), and moderately correlated with G2 ( r=0.4379, p < 0.001). During study timeline, the delivery outcome of 287 women were recorded with the average age of 38.5 ± 1.5 weeks, 9% of them have macrosomia, 2.8% have premature birth before week 35th and 9.8% have premature birth before week 37th; 64.8% of cesarean section and none of them have perinatal or neonatal mortality. The study provides a reference interval of serum fructosamine for GDM patient was 112.9 ± 20.7 μmol/dL. Conclusion: The present results suggests that serum fructosamine is as effective as HbA1c as a reflection of blood glucose control in GDM patient, with a positive result in delivery outcome (0% perinatal or neonatal mortality). The reference value of serum fructosamine measurement provided a potential monitoring utility in GDM treatment for hospitals in Vietnam. Healthcare providers in Cho Ray hospital is considering to conduct more studies to test this reference as a target value in their GDM treatment and monitoring.

Keywords: gestational diabetes mellitus, monitoring tool, serum fructosamine, Vietnam

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Authors: Odenigbo Veronica Ngozi, Lorreta Chika Ukwuaba

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This study focuses on how the strengthening adult literacy program can help accelerate transformative strategies to end female genital mutilation (FGM) in Nigeria, specifically in Nsukka Local Government Area. The research delves into the definition of FGM, adult literacy programs, and how to achieve ending FGM to attain Sustainable Development Goals (SDGs) in 2030. It further discusses the practice of FGM in Nigeria and emphasizes the statement of the problem. The main aim of the study is to investigate how strengthening adult literacy programs can help accelerate transformative strategies to end FGM in Nigeria and achieve SDGs in 2030. The researchers utilized a survey research design to conduct the study in Nsukka L.G.A. The population was composed of 26 facilitators and adult learners in five adult learning centers in the area. The entire population was used as a sample, and structured questionnaires were employed to elicit information. The items on the questionnaire were face-validated by three experts, and the reliability of the instrument was verified using Cronbach Alpha Reliability Technique. The research questions were analyzed using means and standard deviation while the hypothesis was tested at 0.05 level of degree of significance using a t-test. The findings show that through adult literacy program acceleration of transformative strategies, the practices of FGM can be ended. Strengthening adult literacy programs is a good channel to end or stop FGM through the knowledge and skill acquired from the learning centers. The theoretical importance of the study lies in the fact that it highlights the role of adult literacy programs in accelerating transformative strategies to combat harmful cultural practices such as FGM. It further supports the importance of education and knowledge in achieving sustainable development goals by 2030. Structured questionnaires were distributed to an entire population of 26 facilitators and adult learners in five adult learning centers in Nsukka L.G.A. The questionnaire items were face–validated by three experts, and the reliability of the instrument was verified using Cronbach Alpha Reliability Technique. The research questions were analyzed using means and standard deviation, while the hypothesis was tested using a t-test at 0.05 level of degree of significance. The study addressed the question of how strengthening adult literacy programs can help accelerate transformative strategies to end FGM in Nigeria and achieve SDGs by 2030. In conclusion, the study found that adult literacy is a good tool to end FGM in Nigeria. The recommendations were that government, non-governmental organizations (NGOs), Community-based organizations (CBOs), and individuals should support the funding and establishment of adult literacy centers in communities so as to reach every illiterate parent or individual and acquire the knowledge and skill needed to understand the negative effect of FGM in the life of a girl child.

Keywords: adult literacy, female genital mutilation, learning centers, SDGs, strengthening

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Authors: Yi Huang

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Background: For the development of children, it is important for parents to encourage children not only on academic competence but also on children’s social competence. In the western cultural context, parents emphasize more heavily on female children’s social-behavioral development. However, whether the conclusion is correct in eastern culture and whether the parent’s gender affects such an emphasis remains unclear. And, more valuably, from the perspective of intervention, except for the nature factors - child’s gender and parent’s gender, it is also worth to probe whether the improvable factors, such as parent’s perspective taking, influence parent’s emphasis on child’s social competence. Aim: This study was aimed to investigate the impact of parent’s gender, child’s gender, and parent’s perspective-taking on parent’s attitudes of encouragement of the child’s social competence under the Chinese cultural context. Method: 461 Chinese parents whose children were in the first year of middle school during the research time participated in this study. Among all participants, there were 155 fathers and 306 mothers. The research adopted the self-report of perspective-taking, which is the sub-scale of the Interpersonal Reactivity Index and the self-report of the encouragement on a child’s social communication, which is the sub-scale of the Chinese version of The Children Rearing Practice Report. In this study, 291 parents reported regarding male children, and 170 parents reported regarding female children. Results: Contrary to the traditional western theory, which usually suggests parent puts more attention on social development and competence to girl the instead of the boy, in the Chinese context, parent emphasizes social competence more on the male child. Analogically, in China, compared to mother, father underscores the child’s social competence more heavily. By constructing the hierarchical regression model, the result indicated that after controlling the variables of the gender of child and the gender of parent, parent’s perspective-taking still explains for the variance of parent’s encouragement on child’s social competence, which means, parent’s perspective-taking predicts parent’s encouragement on child’s social competence after excluding the impact of the gender of parent and child. Conclusion: For Chinese parents, the ability of perspective-taking is beneficial to enhance their awareness of encouraging children’s social competence.

Keywords: parent; child, gender differences, perspective-taking, social development

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Authors: Anita Puspawati

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

Keywords: communicative, language, doctor, patient

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Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: Rudra Prasad Khanal

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Introduction: Non-communicable disease, such as cancer, has spread all over the world for some last decades. However, every nation has experienced a burden from the development of technology. In the context of Nepal, 10 to 15 thousand new cancer incidences are being registered in different hospitals for treatment. Since the date of starting nuclear medicine at Bir Hospital in 1998, cancer patients have been getting treatment regularly. According to the data of the population-based cancer registry, approximately 60% of the population having a middle-class income is being affected by cancer in Nepal. Methods and Materials: The study is aimed to find out the particular place where the population density of new cancer incidence is highest in Nepal and to inform the concerned regulatory body that is working on cancer screening and early detection for the proper treatment from the beginning. In order to identify the areas with the highest population density of new cancer incidence, all the data of cancer patients were collected from five different renowned hospitals and also from the population-based cancer registry center and then analyzed the data. The history of cancer patients was studied from 2003 to 2020, but here the data are analyzed from 2015 to 2020 only to find the latest trend in cancer incidence. Results: In the five major hospitals in Nepal, the total new cancer incidence was 61783 from 2015 to 2020. Out of those, 34617 were female, and 27176 were male. This research shows that female cancer patients were more every year. In the male, lung cancer patients more than cancer of other organs, but in females, the number of breast cancer patients was greatest. The age-adjusted mortality rate for males in Kathmandu valley was 36.3, and for females was 27.0 per 100,000 population. The cancer incidence and mortality rate were slightly lesser in other districts of Nepal. This rate increased with the increase in the age of people. Over 60 years, cancer incidence and mortality rates have been found to increase rapidly. Conclusion: This research supports conducting the program of cancer screening and early detection at Kathmandu valley with high priority and then Morang, Rukum, SSDM, etc., to control cancer.

Keywords: cancer incidence, research scholar, Tribhuvan University, Bhaktapur Cancer Hospital, Nepal

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Authors: Xue Li, Hui Xu

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Mild cognitive impairment (MCI) is a clinical stage that occurs between normal aging and dementia. Although MCI increases the risk of developing dementia, individuals with MCI may maintain stable cognitive function and even recover to a typical cognitive state. An intervention to prevent or delay the progression to dementia in individuals with MCI may involve promoting social engagement. Social participation is the engagement in socially relevant social exchanges and meaningful activities. Older adults with MCI may encounter restricted cognitive abilities, mood changes, and behavioral difficulties during social participation, influencing their willingness to engage. Therefore, this study aims to employ qualitative research methods to gain an in-depth comprehension of the authentic social participation experiences of older adults with mild cognitive impairment, which will establish a foundation for designing appropriate intervention programs. A phenomenological research was conducted. The study participants were selected using the purposive sampling method in combination with the maximum differentiation sampling strategy. Face-to-face semistructured interviews were conducted among 12 elderly individuals suffering from mild cognitive impairment in a community in Zhengzhou City from May to July 2023. Colaizzi 7-step method was used to analyze the data and extract the theme. The real experience of social participation in older adults with mild cognitive impairment can be summarized into 3 themes: (1) a single social relationship but a strong desire to participate, (2) a dual experience of social participation with both positive and negative aspects, (3) multiple barriers to social participation, including impaired memory capacity, heavy family responsibilities and lack of infrastructure. The study found that elderly individuals with mild cognitive impairment and one social interaction display an increased desire to engage in society. To improve social participation levels and reduce cognitive function decline, healthcare providers should work with relevant government agencies and the community to create a comprehensive social participation system. It is important for healthcare providers to note the social participation status of the elderly with mild cognitive impairment.

Keywords: mild cognitive impairment, the elderly, social participation, qualitative research

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Authors: Aisha Musaazi Sebunya Nakitto, Anika E. Wagner, Yusuf B. Byaruhanga, John H. Muyonga

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The prevalence and burden of diabetes are rapidly increasing globally, stemming from changes in lifestyle and dietary habits. Although several drugs are available to treat type 2 diabetes mellitus (T2DM), many are accompanied by several side effects and are often costly. Solanum anguivi Lam. fruits (SALF) are bitter berries that commonly grow in the wild and are traditionally cultivated by many globally as a remedy for T2DM. This effect is likely attributable to the presence of bioactive compounds such as phenolics, flavonoids, saponins, alkaloids, and vitamin C in SALF. In this study, we investigated the morphological characteristics of different SALF accessions and the effect of ripeness stages and thermal treatments on the bioactive compounds contents (BCC) and antioxidant activity (AA) of SALF accessions. Using the fruit fly Drosophila melanogaster (D. melanogaster) model, we explored the potential impact of dietary SALF in preventing and treating T2DM phenotypes. Morphological characterization was conducted based on descriptors of Solanum species. The BCC and AA of SALF at different ripeness stages (unripe, yellow, orange, and red) and after thermal treatments were determined using spectrophotometry, HPLC, and gravimetry. Male and female fruit flies were fed a high-sugar diet (HSD) to induce a T2DM-like phenotype, while control flies were fed on SY10 medium for up to 24 days. Experimental flies were exposed to HSD supplemented with 5 or 10 mg/ml SALF. The therapeutic and prevention effect of SALF in T2DM-like phenotype was investigated on weight, climbing activity, glucose and triglyceride contents, survival, and gene expression of PPARγ co-activator 1α fly homolog Srl and Drosophila insulin-like peptides. Methods in fly studies included Gustatory assay, Climbing assay, Glucose GOD-PAP assay, Triglyceride GPO-PAP assay, Roti-Quant®, and Real Time-PCR analysis. The ripeness stage significantly influenced SALF BCC and AA, and this was dependent on the accession. The unripe stage had the highest AA and total phenolics and flavonoids; the orange stage was rich in saponins, while the red stage had the highest alkaloid contents. Boiling and steaming increased the total phenolics and AA up to 4-fold and 3-fold, respectively. Drying at low temperatures resulted in higher phenolics and AA than the control. In the therapeutic model, the HSD-fed female flies exhibited elevated glucose levels, which exhibited a dose-dependent reduction upon exposure to a SALF-supplemented diet. Female flies fed on a SALF+ HSD exhibited a significant increase in survival compared to HSD-fed and control diet-fed flies. SALF supplementation did not alter the weights, fitness, and triglyceride levels of female flies in comparison with HSD-only-fed flies. The mRNA levels of Srl decreased in HSD-fed flies compared to the control-fed, with no effect observed in females exposed to HSD+SALF. Similarly, in the preventative model, the SALF diet resulted in higher survival of supplemented flies compared to controls. Consumption of boiled unripe SALF may result in the highest health benefits due to the high phenolic contents and antioxidant activity observed. Dietary intake of SALF significantly lowered glucose levels and increased survival of the D. melanogaster model. Additional studies in higher organisms are needed to explore the preventative and therapeutic potential of SALF in T2DM.

Keywords: antioxidant activity, bioactive compounds, bitter berries, Drosophila melanogaster, Solanum anguivi, type 2 diabetes mellitus, survival

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