Search results for: obese people
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7299

Search results for: obese people

5499 Window Seat: Examining Public Space, Politics, and Social Identity through Urban Public Transportation

Authors: Sabrina Howard

Abstract:

'Window Seat' uses public transportation as an entry point for understanding the relationship between public space, politics, and social identity construction. This project argues that by bringing people of different races, classes, and genders in 'contact' with one another, public transit operates as a site of exposure, as people consciously and unconsciously perform social identity within these spaces. These performances offer a form of freedom that we associate with being in urban spaces while simultaneously rendering certain racialized, gendered, and classed bodies vulnerable to violence. Furthermore, due to its exposing function, public transit operates as a site through which we, as urbanites and scholars, can read social injustice and reflect on the work that is necessary to become a truly democratic society. The major questions guiding this research are: How does using public transit as the entry point provide unique insights into the relationship between social identity, politics, and public space? What ideas do Americans hold about public space and how might these ideas reflect a liberal yearning for a more democratic society? To address these research questions, 'Window Seat' critically examines ethnographic data collected on public buses and trains in Los Angeles, California, and online news media. It analyzes these sources through literature in socio-cultural psychology, sociology, and political science. It investigates the 'everyday urban hero' narrative or popular news stories that feature an individual or group of people acting against discriminatory or 'Anti-American' behavior on public buses and trains. 'Window Seat' studies these narratives to assert that by circulating stories of civility in news media, United Statsians construct and maintain ideas of the 'liberal city,' which is characterized by ideals of freedom and democracy. Furthermore, for those involved, these moments create an opportunity to perform the role of the Good Samaritan, an identity that is wrapped up in liberal beliefs in diversity and inclusion. This research expands conversations in urban studies by making a case for the political significance of urban public space. It demonstrates how these sites serve as spaces through which liberal beliefs are circulated and upheld through identity performance.

Keywords: social identity, public space, public transportation, liberalism

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5498 A New Smart Plug for Home Energy Management

Authors: G. E. Kiral, O. Elma, A. T. Ince, B. Vural, U. S. Selamogullari, M. Uzunoglu

Abstract:

Energy is an indispensable resource to meet the needs of people. Depending on the needs of people, the correct and efficient use of electrical energy has became important nowadays. Besides the need for the electrical energy is also increasing with the rapidly developing technology and continuously changing living standards. Due to the depletion of energy sources and increased demand for electricity, efficient energy use is an important research topic. Recently, ideas like smart cities, smart buildings and smart homes have been widely used under smart grid concept. With smart grid infrastructure, it will be possible to monitor electrical demand of a residential customer and control each electricity generation center for more efficient energy flow. The smallest component of the smart grid can be considered as smart homes. Better utilization of the electrical grid can be achieved through the communication of the smart home with both other customers in the grid and appliances in the house itself since generation can effectively be scheduled by having more precise demand data. Smart Plugs are used for the communication with the household appliances in the house. Smart Plug is an intermediate control element, which can be mounted on the existing outlet, and thus can be used to monitor the energy consumption of the plugged device and also can provide on/off control energy remotely. This study proposes a Smart Plug for energy monitoring and energy management. Proposed design is composed of five subsystems: micro controller embedded system with communication system, metering circuitry, power supply and switching circuitry. The developed smart plug offers efficient use of electrical energy.

Keywords: energy efficiency, home energy management, smart home, smart plug

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5497 The Current Crisis of Refugees and Contemporary Ethics

Authors: Leila Angélica de O. Castro, Thiago R. Pereira

Abstract:

The number of refugees currently is alarming, having overcome the numbers of World War II. The objective of this research will be to examine this refugee crisis the light of the main contemporary ethical theories, mainly by analyzing whether there is an ethical obligation to assist these refugees. Among the many existing theories like virtue ethics, Kantian ethics, utilitarian ethics, ethical egoism and psychological egoism, will be the ethical theories used to analyze the current refugee crisis. The ethics of virtue is the oldest of theories, an action can be considered correct if we are acting virtuously if we predisposition to act that virtuously, where the goal is always the eudaimonia, a good life, a happy life. The Kantian ethics of the works of the philosopher Immanuel Kant, where we apply the hypothetical and categorical imperatives to find universal truths, actions that we consider to be universally correct. Utilitarian ethics believes that action will be considered as correct to bring happiness to the greatest possible number of people, even if they somehow have to bring unhappiness to any number of people. Ethical egoism should be concerned first with our individual happiness, and then we can worry about the happiness of others, so long as it causes us some happiness. Thus, action is correct since it is causing us a greater degree of happiness than unhappiness. Finally, the psychological egoism does not seek to determine whether an action is right or not, but claims that all our actions, even if they seem altruistic, actually has another motivation, which will always be a selfish motivation, that is, concerned with the our well-being. From these initial concepts, the issue of refugees, especially the question of whether states and their citizens have or not any ethical obligation to help them and receive them in their territories will be analyzed .

Keywords: refugees, ethics, obligation to help, contemporary theories

Procedia PDF Downloads 357
5496 Architectural Robotics in Micro Living Spaces: An Approach to Enhancing Wellbeing

Authors: Timothy Antoniuk

Abstract:

This paper will demonstrate why the most successful and livable cities in the future will require multi-disciplinary designers to develop a deep understanding of peoples’ changing lifestyles, and why new generations of deeply integrated products, services and experiences need to be created. Disseminating research from the UNEP Creative Economy Reports and through a variety of other consumption and economic-based statistics, a compelling argument will be made that it is peoples’ living spaces that offer the easiest and most significant affordances for inducing positive changes to their wellbeing, and to a city’s economic and environmental prosperity. This idea, that leveraging happiness, wellbeing and prosperity through creating new concepts and typologies of ‘home’, puts people and their needs, wants, desires, aspirations and lifestyles at the beginning of the design process, not at the end, as so often occurs with current-day multi-unit housing construction. As an important part of the creative-reflective and statistical comparisons that are necessary for this on-going body of research and practice, Professor Antoniuk created the Micro Habitation Lab (mHabLab) in 2016. By focusing on testing the functional and economic feasibility of activating small spaces with different types of architectural robotics, a variety of movable, expandable and interactive objects have been hybridized and integrated into the architectural structure of the Lab. Allowing the team to test new ideas continually and accumulate thousands of points of feedback from everyday consumers, a series of on-going open houses is allowing the public-at-large to see, physically engage with, and give feedback on the items they find most and least valuable. This iterative approach of testing has exposed two key findings: Firstly, that there is a clear opportunity to improve the macro and micro functionality of small living spaces; and secondly, that allowing people to physically alter smaller elements of their living space lessens feelings of frustration and enhances feelings of pride and a deeper perception of “home”. Equally interesting to these findings is a grouping of new research questions that are being exposed which relate to: The duality of space; how people can be in two living spaces at one time; and how small living spaces is moving the Extended Home into the public realm.

Keywords: architectural robotics, extended home, interactivity, micro living spaces

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5495 Empirical Evidence to Beliefs and Perceptions on Mental Health Disorder and Substance Abuse: The Role of a Social Worker

Authors: Helena Baffoe

Abstract:

The US has developed numerous programs over the past 50 years to enhance the lives of those who suffer from mental health illnesses and substance abuse, as well as the effectiveness of their treatments. Despite these advances over the past 50 years, there hasn't been a corresponding improvement in American public attitudes and beliefs about mental health disorders and substance abuse. Highly publicized acts of violence frequently elicit comments that blame the perpetrator's perceived mental health disorder since such people are thought to be substance abusers. Despite these strong public beliefs and perception about mental disorder and substance abuse, concreate empirical evidence that entail this perception is lacking, and evidence of their effectiveness has not been integrated. A rich data was collected from Substance Abuse and Mental Health Services Administration (SAMHSA) with a hypothesis that people who are diagnosed with a mental health disorder are likely to be diagnosed with substance abuse using logit regression analysis and Instrumental Variable. It was found that depressive, anxiety, and trauma/stressor mental disorders constitute the most common mental disorder in the United States, and the study could not find statistically significant evidence that being diagnosed with these leading mental health disorders in the United States does necessarily imply that such a patient is diagnosed with substances abuse. Thus, the public has a misconception of mental health and substance abuse issues, and social workers' responsibilities are outlined in order to assist ameliorate this attitude and perception.

Keywords: mental health disorder, substance abuse, role of a social worker, evidence based research

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5494 Robots for the Elderly at Home: For Men Only

Authors: Christa Fricke, Sibylle Meyer, Gert G. Wagner

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Our research focuses on the question of whether assistive and social robotics could pose a promising strategy to support the independent living of elderly people and potentially relieve relatives of any anxieties. To answer the question of how elderly people perceive the potential of robotics, we analysed the data from the Berlin Aging Study BASE-II (https://www.base2.mpg.de/de) (N=1463) and data from the German SYMPARTNER study (http://www.sympartner.de) (N=120) and compared those to a control group made up of people younger than 30 years (BASE II: N=241; SYMPARTNER: N=30). BASE-II is a cohort study of people living in Berlin, Germany. The sample covers more than 2200 cases; a questionnaire on the use and acceptance of assistive and social robots was carried out with a sub-sample of 1463 respondents in 2015. The SYMPARTNER study was done by SIBIS institute of Social Research, Berlin and included a total of 120 persons between the ages of 60 and 87 in Berlin and the rural German federal state of Thuringia. Both studies included a control group of persons between the ages of 20 and 35 (BASE II: N=241; SYMPARTNER: N=30). Additional data, representative for the whole population in Germany, will be surveyed in fall 2017 (Survey “Technikradar” [technology radar] by the National Academy of Science and Engineering). Since this survey is including some identical questions as BASE-II/SYMPARTNER, comparative results can be presented at 20th International Conference on Social Robotics in New York 2018. The complexity of the data gathered in BASE-II and SYMPARTNER, encompassing detailed socio-economic background characteristics as well as personality traits such as the personal attitude to risk taking, locus of control and Big Five, proves highly valuable and beneficial. Results show that participants’ expressions of resentment against robots are comparatively low. Participants’ personality traits play a role, however the effect sizes are small. Only 15 percent of participants received domestic robots with great scepticism. Participants aged older than 70 years expressed greatest rejection of the robotic assistant. The effect sizes however account for only a few percentage points. Overall, participants were surprisingly open to the robot and its usefulness. The analysis also shows that men’s acceptance of the robot is generally greater than that of women (with odds ratios of about 0.6 to 0.7). This applies to both assistive robots in the private household and in care environments. Men expect greater benefits of the robot than women. Women tend to be more sceptical of their technical feasibility than men. Interview results prove our hypothesis that men, in particular of the age group 60+, are more accustomed to delegate household chores to women. A delegation to machines instead of humans, therefore, seems palpable. The answer to the title question of this planned presentation is: social and assistive robots at home robots are not only accepted by men – but by fewer women than men.

Keywords: acceptance, care, gender, household

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5493 Early Versus Delayed Antiretroviral Therapy in HIV‐positive People with Tuberculosis

Authors: Mohhamed El Habib Labdouni

Abstract:

Introduction: Co-infection with VIH and tuberculosis poses one of the major ongoing challenges for global TB and AIDS prevention and control. The objective of this study is to raise the issue of the resurgence of TB, in People living with VIH supported in a referent center in western Algeria. Its epidemiological, clinical, biological and radiological new trends, and to compare the mortality rate between early and delayed ART. Methods: It was a prospective study, during 36 months from the 01st/01/2012 to 31st/12/2014, by identifying and analyzing cases of TB-VIH co-infection. Our population was devised in two groups/ early ART and delayed ART. The primary and secondary endpoints were analyzed with Kaplan-Meier curves and log-rank test the period of follow up, which was fixed at 300 weeks. Results: Sixty cases of co-infection TB -VIH were enrolled in our study: 78.3% had pulmonary tuberculosis associated with extra-pulmonary, 13.3% had only pulmonary tuberculosis and 08.3% presented strictly extra-pulmonary TB. The clinical particularity of this co-infection is the frequency of serious localization such us: pleural 23.3%, peritoneal 31.7%, and meningeal suffusion 13.3%.y-.biologicaly we notice the predominance both of pancytopenia and leucoanemia, hyponatremia in 38,6% and hypokalemia in 19,3%. By analyzing Kaplan-Meier survival curves, we notice that early ART initiation is associated with a significant reduction of all-cause mortality (p = 0,000), and we have identified several prognostic factors such as hypokalemia hyponatremia, leukocytosis thrombopenemia leucothrombopenia (p = 0,005). Conclusion: Our study confirms most of the results reported in the literature. Early ART initiation reduces the rate of all-cause mortality, despite the probability of the occurrence of TB-IRIS.

Keywords: TB-HIV co-infection, early ART, hyponatremia, extrapulmonary tuberculosis

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5492 Emerging Cyber Threats and Cognitive Vulnerabilities: Cyberterrorism

Authors: Oludare Isaac Abiodun, Esther Omolara Abiodun

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The purpose of this paper is to demonstrate that cyberterrorism is existing and poses a threat to computer security and national security. Nowadays, people have become excitedly dependent upon computers, phones, the Internet, and the Internet of things systems to share information, communicate, conduct a search, etc. However, these network systems are at risk from a different source that is known and unknown. These network systems risk being caused by some malicious individuals, groups, organizations, or governments, they take advantage of vulnerabilities in the computer system to hawk sensitive information from people, organizations, or governments. In doing so, they are engaging themselves in computer threats, crime, and terrorism, thereby making the use of computers insecure for others. The threat of cyberterrorism is of various forms and ranges from one country to another country. These threats include disrupting communications and information, stealing data, destroying data, leaking, and breaching data, interfering with messages and networks, and in some cases, demanding financial rewards for stolen data. Hence, this study identifies many ways that cyberterrorists utilize the Internet as a tool to advance their malicious mission, which negatively affects computer security and safety. One could identify causes for disparate anomaly behaviors and the theoretical, ideological, and current forms of the likelihood of cyberterrorism. Therefore, for a countermeasure, this paper proposes the use of previous and current computer security models as found in the literature to help in countering cyberterrorism

Keywords: cyberterrorism, computer security, information, internet, terrorism, threat, digital forensic solution

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5491 A Conceptual Model of Social Entrepreneurial Intention Based on the Social Cognitive Career Theory

Authors: Anh T. P. Tran, Harald Von Korflesch

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Entrepreneurial intention play a major role in entrepreneurship academia and practice. The spectrum ranges from the first model of the so-called Entrepreneurial Event, then the Theory of Planned Behavior, the Theory of Planned Behavior Entrepreneurial Model, and the Social Cognitive Career Theory to some typical empirical studies with more or less diverse results. However, little is known so far about the intentions of entrepreneurs in the social areas of venture creation. It is surprising that, since social entrepreneurship is an emerging field with growing importance. Currently, all around the world, there is a big challenge with a lot of urgent soaring social and environmental problems such as poor households, people with disabilities, HIV/AIDS infected people, the lonely elderly, or neglected children, some of them even actual in the Western countries. In addition, the already existing literature on entrepreneurial intentions demonstrates a high level of theoretical diversity in general, especially the missing link to the social dimension of entrepreneurship. Seeking to fill the mentioned gaps in the social entrepreneurial intentions literature, this paper proposes a conceptual model of social entrepreneurial intentions based on the Social Cognitive Career Theory with two main factors influencing entrepreneurial intentions namely self-efficacy and outcome expectation. Moreover, motives, goals and plans do not arise from empty nothingness, but are shaped by interacting with the environment. Hence, personalities (i.e., agreeableness, conscientiousness, extraversion, neuroticism, openness) as well as contextual factors (e.g., role models, education, and perceived support) are also considered as the antecedents of social entrepreneurship intentions.

Keywords: entrepreneurial intention, social cognitive career theory, social entrepreneurial intention, social entrepreneurship

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5490 The Impact of the Length of Time Spent on the Street on Adjustment to Homelessness

Authors: Jakub Marek, Marie Vagnerova, Ladislav Csemy

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Background: The length of time spent on the street influences the degree of adjustment to homelessness. Over the years spent sleeping rough, homeless people gradually lose the ability to control their lives and their return to mainstream society becomes less and less likely. Goals: The aim of the study was to discover whether and how men who have been sleeping rough for more than ten years differ from those who have been homeless for four years or less. Methods: The research was based on a narrative analysis of in-depth interviews focused on the respondent’s entire life story, i.e. their childhood, adolescence, and the period of adulthood preceding homelessness. It also asked the respondents about how they envisaged the future. The group under examination comprised 51 homeless men aged 37 – 54. The first subgroup contained 29 men who have been sleeping rough for 10 – 21 years, the second group contained 22 men who have been homeless for four years or less. Results: Men who have been sleeping rough for more than ten years had problems adapting as children. They grew up in a problematic family or in an institution and acquired only a rudimentary education. From the start they had problems at work, found it difficult to apply themselves, and found it difficult to hold down a job. They tend to have high-risk personality traits and often a personality disorder. Early in life they had problems with alcohol or drugs and their relationships were unsuccessful. If they have children, they do not look after them. They are reckless even in respect of the law and often commit crime. They usually ended up on the street in their thirties. Most of this subgroup of homeless people lack motivation and the will to make any fundamental change to their lives. They identify with the homeless community and have no other contacts. Men who have been sleeping rough for four years or less form two subgroups. There are those who had a normal childhood, attended school and found work. They started a family but began to drink, and as a consequence lost their family and their job. Such men end up on the street between the ages of 35 and 40. And then there are men who become homeless after the age of 40 because of an inability to cope with a difficult situation, e.g. divorce or indebtedness. They are not substance abusers and do not have a criminal record. Such people can be offered effective assistance to return to mainstream society by the social services because they have not yet fully self-identified with the homeless community and most of them have retained the necessary abilities and skills. Conclusion: The length of time a person has been homeless is an important factor in respect of social prevention. It is clear that the longer a person is homeless, the worse are their chances of being reintegrated into mainstream society.

Keywords: risk factors, homelessness, chronicity, narrative analysis

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5489 Measuring Social Dimension of Sustainable Development in New Zealand Cities

Authors: Taimaz Larimian

Abstract:

During recent years, sustainable development has increasingly influenced urban policy, housing and planning in cities all over the world. Debates about sustainability no longer consider it solely as an environmental concern, but also incorporate social and economic dimensions. However, while a social dimension of sustainability is extensively accepted, the exact definition of the concept is still vague and unclear. This study is addressing this lack of specificity through a detailed exploration of social sustainability as the least studied pillar of sustainable development and sheds light on the debate over the definition of social sustainability through developing a measurement model of the constitutive dimensions of the concept. With this aim, a conceptual framework is developed based on the existing literature, determining seven main dimensions of the social sustainability concept namely: social interaction, safety and security, social equity, social participation, neighborhood satisfaction, housing satisfaction and sense of place. The validity and reliability of the model is then tested using exploratory and confirmatory factor analysis. In order to do so, five case study neighborhoods from Dunedin city with a range of urban forms and characters are investigated, to define social sustainability concept and its consisting dimensions from people’s perspective. The findings of this study present a clear definition of social sustainability at neighborhood scale and highlight all different dimensions of the concept in the context of New Zealand cities. According to the results, among the investigated dimensions, neighborhood satisfaction and safety and security had the most influence on people’s feeling of social sustainability in their neighborhood.

Keywords: social sustainability, factor analysis, neighborhood level, New Zealand cities

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5488 Impact of Homestay Tourism on the Traditional Lifestyle and Culture of the Indigenous Tharu People: A Case Study of Nepal

Authors: Durga Prasad Neupane

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This study investigates the impacts of homestay tourism on the traditional lifestyle and culture of the indigenous Tharu people in Nepal. It explores how this form of tourism has influenced the lives of Tharu individuals and their community as a whole. The study delves into the effects of tourism on various aspects, including language, socio-economic development, and cultural promotion and revival. Employing a qualitative approach and a case study design, the study gathers in-depth and comprehensive data on the impacts of homestay tourism on the Amaltari Tharu community. Building rapport with respondents, including homestay management committees, Tharu homestay owners, and non-Tharu residents, is achieved through various channels like personal interactions, phone conversations, and repeated visits. The research further combines document analysis with in-depth interviews to glean diverse perspectives and insights. The study's findings reveal that while homestay tourism presents challenges, it also holds significant potential for promoting and revitalizing the Tharu culture. Tourism has not only fostered the flourishing of Tharu traditions but has also contributed to improved educational opportunities within the community. However, the study recognizes the influence of globalization in driving changes to Tharu customs and rituals, potentially leading to a new form of cultural colonization. In this context, homestay tourism emerges as a crucial tool for preserving and revitalizing the unique ethnic identity and traditions of the Amaltari Tharu community.

Keywords: homestay, tourism, Tharu culture, cultural revival, linguistic variations

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5487 Animation: A Footpath for Enhanced Awareness Creation on Malaria Prevention in Rural Communities

Authors: Stephen Osei Akyiaw, Divine Kwabena Atta Kyere-Owusu

Abstract:

Malaria has been a worldwide menace of a health condition to human beings for several decades with majority of people on the African continent with most causalities where Ghana is no exception. Therefore, this study employed the use of animation to enhance awareness creation on the spread and prevention of Malaria in Effutu Communities in the Central Region of Ghana. Working with the interpretivist paradigm, this study adopted Art-Based Research, where the AIDA Model and Cognitive Theory of Multimedia Learning (CTML) served as the theories underpinning the study. Purposive and convenience sampling techniques were employed in selecting sample for the study. The data collection instruments included document review and interviews. Besides, the study developed an animation using the local language of the people as the voice over to foster proper understanding by the rural community folks. Also, indigenous characters were used for the animation for the purpose of familiarization with the local folks. The animation was publicized at Health Town Halls within the communities. The outcomes of the study demonstrated that the use of animation was effective in enhancing the awareness creation for preventing and controlling malaria disease in rural communities in Effutu Communities in the Central Region of Ghana. Health officers and community folks expressed interest and desire to practice the preventive measures outlined in the animation to help reduce the spread of Malaria in their communities. The study, therefore, recommended that animation could be used to curtail the spread and enhanced the prevention of Malaria.

Keywords: malaria, animation, prevention, communities

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5486 Assessing Psycho-Social Stressors for Chronically Infected Hepatitis C Virus Patients in Egypt

Authors: Ammal M. Metwally, Dalia M. Elmosalami, Walaa A. Fouad, Abla G. Khalifa, Lobna A. El Etreby, Mohamed AbdelRahman

Abstract:

People with hepatitis C are likely to experience psychological distress related to adjustment issues following diagnosis. Objective: The study was conducted to determine the psycho-social stressors accompanying Hepatitis C virus (HCV) chronic infection. The study focused on immediate and later on reactions to being diagnosed as infected HCV patients. Effect of HCV on disruption of patients’ relationships in term of family relationship and friendship, employment and financial status was assessed. The magnitude and causes of the social stigma and its relation to awareness about illness, level of education were also assessed. Methods: During this study the subjective experiences of people having HCV was explored through a designed questionnaire targeted 540 cases; 359 males and 181 females from ten out of 21 National Treatment Reference Centers of National Hepatology and Tropical Medicine Research Institutes of Ministry of Health (MOH) hospitals. The study was conducted along a period of six months from September 2011 to March 2012. Results: The study revealed that the financial problems are the commonest problems faced by 75.5 % of the cases. More than 70% of the cases suffered from immediate sadness versus 67.4% suffered from worry. Social stigma was reported by 13 % of HCV +patients, the majority of which were females. Conclusions: Exploring the psychosocial consequences of HCV infection can act as pressing motivators for behavior change needed for limiting HCV endemicity in Egypt.

Keywords: Egypt, HCV infection, psycho-social adjustment, stigma

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5485 The Incidence of Obesity among Adult Women in Pekanbaru City, Indonesia, Related to High Fat Consumption, Stress Level, and Physical Activity

Authors: Yudia Mailani Putri, Martalena Purba, B. J. Istiti Kandarina

Abstract:

Background: Obesity has been recognized as a global health problem. Individuals classified as overweight and obese are increasing at an alarming rate. This condition is associated with psychological and physiological problems. as a person reaches adulthood, somatic growth ceases. At this stage, the human body has developed fully, to a stable state. As the capital of Riau Province in Indonesia, Pekanbaru is dominated by Malay ethnic population habitually consuming cholesterol-rich fatty foods as a daily menu, a trigger to the onset of obesity resulting in high prevalence of degenerative diseases. Research objectives: The aim of this study is elaborating the relationship between high-fat consumption pattern, stress level, physical activity and the incidence of obesity in adult women in Pekanbaru city. Research Methods: Among the combined research methods applied in this study, the first stage is quantitative observational, analytical cross-sectional research design with adult women aged 20-40 living in Pekanbaru city. The sample consists of 200 women with BMI≥25. Sample data is processed with univariate, bivariate (correlation and simple linear regression) and multivariate (multiple linear regression) analysis. The second phase is qualitative descriptive study purposive sampling by in-depth interviews. six participants withdrew from the study. Results: According to the results of the bivariate analysis, there are relationships between the incidence of obesity and the pattern of high fat foods consumption (energy intake (p≤0.000; r = 0.536), protein intake (p≤0.000; r=0.307), fat intake (p≤0.000; r=0.416), carbohydrate intake (p≤0.000; r=0.430), frequency of fatty food consumption (p≤0.000; r=0.506) and frequency of viscera foods consumption (p≤0.000; r=0.535). There is a relationship between physical activity and incidence of obesity (p≤0.000; r=-0.631). However, there is no relationship between the level of stress (p=0.741; r=0.019-) and the incidence of obesity. Physical activity is a predominant factor in the incidence of obesity in adult women in Pekanbaru city. Conclusion: There are relationships between high-fat food consumption pattern, physical activity and the incidence of obesity in Pekanbaru city whereas physical activity is a predominant factor in the occurrence of obesity, supported by the unchangeable pattern of high-fat foods consumption.

Keywords: obesity, adult, high in fat, stress, physical activity, consumption pattern

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5484 Mediterranean Diet-Driven Changes in Gut Microbiota Decrease the Infiltration of Inflammatory Myeloid Cells into the Intestinal Tissue

Authors: Gema Gómez-Casado, Alba Rodríguez-Muñoz, Virginia Mela-Rivas, Pallavi Kompella, Francisco José Tinahones-Madueña, Isabel Moreno-Indias, Almudena Ortega-Gómez

Abstract:

Obesity is a high-priority health problem worldwide due to its high prevalence. The proportion of obese and overweight subjects in industrialized countries exceeds half of the population in most cases. Beyond the metabolic problem, obesity boosts inflammation levels in the organism. The gut microbiota, considered an organ by itself, controls a high variety of processes at a systemic level. In fact, the microbiota interacts closely with the immune system, being crucial in determining the maturation state of neutrophils, key effectors of the innate immune response. It is known that changes in the diet exert strong effects on the variety and activity of the gut microbiota. The effect that those changes have on the axis microbiota-immune response is an unexplored field. In this study, 10 patients with obesity (weight 114,3 ± 14,5Kg, BMI 40,47±3,66) followed a Mediterranean-hypocaloric diet for 3 months, reducing their initial weight by 12,71 ± 3%. A transplant of microbiota from these patients before and after the diet was performed into wild type “germ-free” mice (n=10/group), treated with antibiotics. Six weeks after the transplant, mice were euthanized, and the presence of cells from the innate immune system were analysed in different organs (bone marrow, blood, spleen, visceral adipose tissue, and intestine) by flow cytometry. No differences were observed in the number of myeloid cells in bone marrow, blood, spleen, or visceral adipose tissue of mice transplanted with patient’s microbiota before and after following the Mediterranean diet. However, the intestine of mice that received post-diet microbiota presented a marked decrease in the number of neutrophils (whose presence is associated with tissue inflammation), as well as macrophages. In line with these findings, intestine monocytes from mice with post-diet microbiota showed a less inflammatory profile (lower Ly6Gˡᵒʷ proportion of cells). These results point toward a decrease in the inflammatory state of the intestinal tissue, derived from changes in the gut microbiota, which occurred after a 3-month Mediterranean diet.

Keywords: obesity, nutrition, Mediterranean diet, gut microbiota, immune system

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5483 European Project Meter Matters in Sports: Fostering Criteria for Inclusion through Sport

Authors: Maria Campos, Alain Massart, Hugo Sarmento

Abstract:

The Meter Matters Erasmus Sport European Project (ID: 101050372) explores the field of social inclusion in and through sports with the aim of a) proposing appropriate criteria for co-funding sports programs involving people with intellectual and developmental disabilities and other more vulnerable people, primarily in mainstream sports organizations and b) proposing a model for co-funding social inclusion in and through sports at the national level. This European project (2022-2024) involves 6 partners from 3 countries: Univerza V Ljubljani – coordinator and Drustvo Specialna Olimpiada Slovenije (Slovenia); Magyar Specialis Olimpia Szovetseg and Magyar Testnevelesi Es Sporttudomanyi Egyetem (Hungary) and APPDA Coimbra - Associação Portuguesa para as Perturbações do Desenvolvimento e Autismo and Universidade De Coimbra, Faculty of Sport Sciences and Physical Education (Portugal). Equal involvement of all people in sports activities is, in terms of national and international guidelines, enshrined in some conventions and strategies in the field of sports, as well as human rights, social security, physical and mental health, architecture, environment and public administration. However, there is a gap between the practice and EU guidelines in terms of sustainable support for socially inclusive sports programs in the form of co-funding by state and local (municipal) resources. We observe considerable opacity in the regulation of the field. Given that there are both relevant programs and inclusive legislation and policies, we believe that the reason for the missing article is reflected in the undeveloped criteria for measuring social inclusion in sports. Major sports programs are usually co-funded based on crowds (number of involved athletes) and performance (sports score). In the field of social inclusion in sports, the criteria cannot be the same, as it is a smaller population. Therefore, the goals of inclusion in sports should not be the focused on competitive results but on opening equal opportunities for all, regardless of their psychophysical abilities. In the Meter Matters program, we are searching for criteria for co-funding social inclusion in sports through focus groups with coaches, social workers, psychologists and others professionals involved in inclusive sports programs in regular sports clubs and with athletes and their parents or guardians. Moreover, experts in the field of social inclusion in sports were also interviewed. Based on the proposals for measuring social inclusion in sports, we developed a model for co-funding socially inclusive sports programs.

Keywords: European project, meter matters, inclusion, sport

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5482 Therapeutic Effect of 12 Weeks of Sensorimotor Exercise on Pain, Functionality and Quality of Life in Non-athlete Women With Patellofemoral Pain Syndrome

Authors: Kasbparast Mehdi, Hassani Zainab

Abstract:

Aim: The purpose of this research was to investigate the effectiveness of therapeutical sensorimotor exercise. The statistical population of women who were diagnosed with patellofemoral pain syndrome by a doctor and were between the ages of 35 and 45 and registered for the first time in a sports club in the 4th district of Tehran, 30 people by random sampling and according to The include and exclude criteria were selected and divided into 2 equal control and experimental and homogeneous groups (in terms of height, weight and BMI).In both control and experimental groups, the pain was measured using a Visual Analog Scale(VAS) functionality was measured using the step-down test and quality of life was measured using a World Health Organization Quality of Life Scale (WHOQOL-BREF) (pre-test). Then, only the experimental group performed sensorimotor exercises for 12 weeks and 3 sessions each week, a total of 24 sessions and each session for 1 hour, and during this period, the control group only continued their daily activities. After the end of the training period, the desired factors were evaluated again (post-test) in the same way as the pre-test was done for them (experimental group and control group), with the same quality. Findings: The statistical results showed that in the experimental group, the amount of pain, function and quality of life had a statistical improvement (P≤0.05). Conclusion: In general conclusion, it can be stated that using sensorimotor exercises not only improved functionality and quality of life but also reduced the amount of pain in people with patellofemoral pain syndrome.

Keywords: pain, PFPS, sensori motor training, functionality

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5481 Uptake of Hepatitis B Vaccine among Hepatitis C Positive Patients and Their Vaccine Response in Myanmar

Authors: Zaw Z Aung

Abstract:

Background: High-risk groups for hepatitis B infection (HBV) are people who injected drugs (PWID), men who have sex with men (MSM), people living with HIV (PLHIV) and persons with hepatitis C (HCV), etc. HBV/HCV coinfected patients are at increased risk of cirrhosis, hepatic decompensation and hepatocellular carcinoma. To the best of author’s knowledge, there is currently no data for hepatitis B vaccine utilization in HCV positive patients and their antibody response. Methodology: From February 2018 to May 2018, consented participants at or above 18 years who came to the clinic in Mandalay were tested with the anti-HCV rapid test. Those who tested HCV positive (n=168) were further tested with hepatitis B profile and asked about their previous hepatitis B vaccination history and risk factors. Results: Out of 168 HCV positive participants, three were excluded for active HBV infections. The remaining 165 were categorized into previously vaccinated 64% (n=106) and unvaccinated 36% (n=59) There were three characteristics groups- PWID monoinfected (n=77), General Population (GP) monoinfected (n=22) and HIV/HCV coinfected participants (n=66). Unvaccinated participants were highest in HIV/HCV, with 68%(n=45) followed by GP (23%, n=5) and PWID (12%, n=9). Among previously vaccinated participants, the highest percentage was PWID (88%, n=68), the second highest was GP (77%, n=17) and lowest in HIV/HCV patients (32%, n=21). 63 participants completed third doses of vaccination (PWID=36, GP=13, HIV/HCV=14). 53% of participants who completed 3 dose of hepatitis B were non-responders (n=34): HIV/HCV (86%, n=12), PWID (44%, n=16), and GP (46%, n=6) Conclusion: Even in the presence of effective and safe hepatitis B vaccine, uptake is low among high risk groups especially PLHIV that needs to be improved. Integration or collaboration of hepatitis B vaccination program, HIV/AIDS and hepatitis C treatment centers is desirable. About half of vaccinated participants were non-responders so that optimal doses, schedule and follow-up testing need to be addressed carefully for those groups.

Keywords: Hepatitis B vaccine, Hepatitis C, HIV, Myanmar

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5480 Prediction of the Factors Influencing the Utilization of HIV Testing among Young People Aged between 17-25 Years in Saudi Arabia

Authors: Abdullah Almilaibary, Jeremy Jolley, Mark Hayter

Abstract:

Background: Despite recent progress in enhancing the accessibility of HIV-related health services worldwide, opportunities to diagnose patients are often missed due to genuine barriers at different levels. The aim of the study is to explore the factors that affect the utilization of HIV testing services by young people aged 17-25 in Saudi Arabia. Methods: A non-experimental descriptive cross-sectional design was used to predict factors that influenced HIV testing among Umm- Al Qura University students aged 17-25 years. A newly developed self-completed online questionnaire was used and the study sample was drawn using a convenience sampling technique. The questionnaire consisted of 52 items divided into three scales: 12 items for HIV/AIDS-related knowledge, 3 items for risk perception, and 37 items for attitudes toward HIV testing. Five experts in the field of HIV/AIDS validated the contents of the questionnaire and agreed that the items included were related to the construct being measured. The reliability of the questionnaire was also assessed using a test/re-test strategy with 27 participants recruited from the population under study. The reliability assessment revealed that the questionnaire was consistent as Cronbach’s Alpha was 0.80 for HIV/ADS knowledge, 0.88 for risk perception and 0.78 for attitudes towards HIV testing. The data were collected between 14th of July and 14th of October 2014. Results: 394 participants completed the questionnaires: 116 (29.4%) male and 278 (70%) female. 50.5% of the participants were aged 20 to 22 years, 34.8% were 17-19 years and 14.7% were aged between 23-25 years; about 93% of the participants were single. Only 20 (6%) participants had previously been tested for HIV. The main reasons for not being tested for HIV were: exposure to HIV was considered unlikely (48%), HIV test was not offered (36%) and unawareness of HIV testing centres (16%). On HIV/AIDS-related knowledge, the male participants scored higher than the females as the mean score for males was (M = 6.4, SD = 2.4) while for females it was (M 5.7, SD 2.5). In terms of risk perception, female participants appeared to have lower levels of risk perception than male participants, with the mean score for males being (M 11.7, SD 2.5) and (M 10.5, SD 2.4) for females. The female participants showed slightly more positive attitudes towards HIV testing than male participants: the mean score for males was (M = 108.14, SD = 17.9) and was (M = 111.32, SD = 17.3) for females. Conclusions: The data reveal that misconceptions about HIV/AIDS in Saudi Arabia are still a challenge. Although the attitudes towards HIV testing were reasonably positive, the utilization of the HIV test was low. Thus, tailoring HIV/AIDS preventive strategies in Saudi Arabia should focus on the needs of young people and other high risk groups in the country.

Keywords: attitude toward hiv testing, hiv testing, hiv/aids related knowledge, risk perception

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5479 The Role of Public Management Development in Enhancing Public Service Delivery in the South African Local Government

Authors: Andrew Enaifoghe

Abstract:

The study examined the role of public management development in enhancing public service delivery in the South African local government. The study believes that the ultimate empowerment of the third tier sphere of governments in South Africa remains the instrument required to enhance both national and continental development. This over the year has been overwhelmed with problems and imbalance related to ethical practice, accountability and the functional local government system and the machinery itself. The study finds that imbalances are being strengthened by a lack of understanding and unanimity as to what a public management development in a democratic system is and how it should work to achieve the dividends of democracy in delivering public goods. Studies indicated that the magnitudes are widespread corruption and misrepresentations of government priorities; both of which weaken the ability of governments to enhance broad-based economic growth and social well-being of the people. This study addressed the problem of public management and accountable local government. The study indicates the need for citizens’ participation in the decision-making process in delivering public service in South Africa and how its accountability mechanism supports good governance. The study concludes that good and ethical watersheds in South Africa have since reached such proportions that social pressure, the pressure from the government and various institutions have to re-consider where they stand regarding ethics, ethical behaviour, accountability and professionalism in delivering public goods to the people at the local municipal government.

Keywords: accountability, development, democratic system, South Africa

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5478 Psychosocial Risks and Occupational Health in a Mexican Small and Medium-Sized Enterprises

Authors: Magdalena Escamilla Quintal, Thelma Cetina Canto, Cecilia Aguilar Ortega

Abstract:

Due to the importance that people represent for companies, the setting of a clear control of the risks that threaten the health and the material and financial resources of workers is essential. It is irrelevant if the company is a small and medium-sized enterprise (SME) or a large multinational, or if it is in the construction or service sector. The risk prevention importance is related to a constitutional and human right that all people have; working in a risk-free environment to prevent accidents or illnesses that may influence their quality of life and the tranquility of their family. Therefore, the objective of this study was to determine the level of psychosocial risks (physical and emotional) of the employees of an SME. The participants of this study were 186 employees of a productive sector SME; 151 men and 35 women, all with an average age of 31.77 years. Their seniority inside the SME was between one month and 19.91 years. Ninety-six workers were from the production area, 28 from the management area, as well as 25 from the sales area and 40 from the supplies area. Ninety-three workers were found in Uman, 78 in Playa del Carmen, 11 in Cancun and seven in Cd. del Carmen. We found a statistically significant relationship between the burnout variable and the engagement and psychosomatic complaints as well as between the variables of sex, burnout and psychosomatic complaints. We can conclude that, for benefit of the SME, that there are low levels of burnout and psychosomatic complaints, the women experience major levels of burnout and the men show major levels of psychosomatic complaints. The findings, contributions, limitations and future proposals will be analyzed.

Keywords: psychosocial risks, SME, burnout, engagement, psychosomatic complaints

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5477 Loss of Control Eating as a Key Factor of the Psychological Symptomatology Related to Childhood Obesity

Authors: L. Beltran, S. Solano, T. Lacruz, M. Blanco, M. Rojo, M. Graell, A. R. Sepulveda

Abstract:

Introduction and Objective: Given the difficulties of assessing Binge Eating Disorder during childhood, episodes of Loss of Control (LOC) eating can be a key symptom. The objective is to know the prevalence of food psychopathology depending on the type of evaluation and find out which psychological characteristics differentiate overweight or obese children who present LOC from those who do not. Material and Methods: 170 children from 8 to 12 years of age with overweight or obesity (P > 85) were evaluated through the Primary Care Centers of Madrid. Sociodemographic data and psychological measures were collected through the Kiddie-Schedule for Affective Disorders & Schizophrenia, Present & Lifetime Version (K-SADS-PL) diagnostic interview and self-applied questionnaires: Children's eating attitudes (ChEAT), depressive symptomatology (CDI), anxiety (STAIC), general self-esteem (LAWSEQ), body self-esteem (BES), perceived teasing (POTS) and perfectionism (CAPS). Results: 15.2% of the sample exceeded the ChEAT cut-off point, presenting a risk of pathological eating; 5.88% presented an Eating Disorder through the diagnostic interview (2.35% Binge Eating disorder), and 33.53% had LOC episodes. No relationship was found between the presence of LOC and clinical diagnosis of eating disorders according to DSM-V; however, the group with LOC presented a higher risk of eating psychopathology using the ChEAT (p < .02). Significant differences were found in the group with LOC (p < .02): higher z-BMI, lower body self-esteem, greater anxious symptomatology, greater frequency of teasing towards weight, and greater effect of teasing both towards weight and competitions; compared to their peers without LOC. Conclusion: According to previous studies in samples with overweight children, in this Spanish sample of children with obesity, we found a prevalence of moderate eating disorder and a high presence of LOC episodes, which is related to both eating and general psychopathology. These findings confirm that the exclusion of LOC episodes as a diagnostic criterion can underestimate the presence of eating psychopathology during this developmental stage. According to these results, it is highly recommended to promote school context programs that approach LOC episodes in order to reduce associated symptoms. This study is included in a Project funded by the Ministry of Innovation and Science (PSI2011-23127).

Keywords: childhood obesity, eating psychopathology, loss-of-control eating, psychological symptomatology

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5476 Islamic Perception of Modern Democratic System

Authors: Muhammad Khubaib

Abstract:

The Holy Quran purport is to establish a democratic system in which Allah has the right to special authority and He who has the supreme power or sovereignty. The supreme leader, Allah ceded the right to govern to his prophet and whoever would ever rule he would have to govern as a deputy of Prophet of Allah and he will not have the right to deviate from the basic rules of law and constitution. Centuries before the birth of prevailing democracy, Muslim scholars and researchers continuously keep using the term of “Jamhür” (majority) in their books. Islam gives the basic importance to the public opinion to establish a government and make the public confidence necessary for the government. The most effective way to gain the trust of the people in the present to build national institutions is through the vote. Vote testifies in favor of the candidate and majority tells us who is more honest and talented. Each voter stands at the position of trustworthy. To vote a cruel person would be tantamount to treason and even not to vote would be considered as a national offence. After transparent process, the selected member of government would be seemed a fine example of the saying of Muhammad (S.A.W) in which he said; the majority of my people will never be agreed at misleading. In short in this article, there would be discussed democracy in the Islamic perception, while elaborating the western democracy so that it can be cleared that in which way the Holy Quran supported the democracy and what gestures Muhammad (S.A.W) made to spread the democracy and on the basis of those gestures, and how come those gestures are being followed to choose the sacred caliphate. It's hoped that this research would be helpful to refine the democratic system and support to meet the challenges Muslim world are facing.

Keywords: democracy, modern democratic system, respect of majority opinion, vote casting

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5475 Poverty: The Risk to Children’s Mental Health

Authors: Steven Walker

Abstract:

This paper assesses recent data on the prevalence of poverty among children and young people diagnosed with mental health problems. The paper will demonstrate that the current hierarchy of risk factors for developing mental health problems needs adjusting to place poverty among the highest risk factors. Globally poverty is calculated to keep rising especially among less developed countries, and the post-Covid 19 economic recession in developed countries is set to rise. The experience of young people enduring Pandemic isolation is already being quantified and is expected to increase referrals for specialist intervention. Searches on several medical/psychological/social databases using keywords: poverty, children, mental illness were undertaken between 2018 and 2021. Worldwide, 700 million people still live in extreme poverty, half of whom are children. Children are physically and mentally disproportionately affected. Children who grow up impoverished lack the basic necessities they need to survive and thrive. 150 million children have been plunged into multidimensional poverty due to COVID-19. The poorest children are twice as likely to die in childhood than their wealthier peers. For those growing up in humanitarian crises such as Ukraine, the risks of deprivation and exclusion are magnified. In the world’s richest countries, one in seven children still live in poverty. Currently, one in four children in the European Union are at risk of falling into poverty. In Europe the impact of Brexit on the UK economy is predicted to reduce GDP by 5% in 2021 with a corresponding rise in poverty. According to the global charity Oxfam wealth inequality impacts levels of child abuse and affects women and girls worse and is a contributory factor in the risk of developing childhood mental illness. In the UK 2000 Foodbanks have opened since 2010, handing out 2 million food parcels annually, where there are currently 4 million children officially living in poverty. This research demonstrates that there is a strong association between families’ socio-economic circumstances and the chances that their children will experience mental illness. Evidence of this association is found repeatedly across developed countries. The paper will conclude by arguing that psychologists, psychiatrists, psychotherapists, social workers and CAMHS specialists need to place more importance on this critical socio-economic variable when assessing referred children and also advocate for political priorities in governments to reduce poverty and lower the risk of childhood mental illness.

Keywords: poverty, resilience, risk factor, socio economic, susceptibility

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5474 A Review of Type 2 Diabetes and Diabetes-Related Cardiovascular Disease in Zambia

Authors: Mwenya Mubanga, Sula Mazimba

Abstract:

Background: In Zambia, much of the focus on nutrition and health has been on reducing micronutrient deficiencies, wasting and underweight malnutrition and not on the rising global projections of trends in obesity and type 2 diabetes. The aim of this review was to identify and collate studies on the prevalence of obesity, diabetes and diabetes-related cardiovascular disease conducted in Zambia, to summarize their findings and to identify areas that need further research. Methods: The Medical Literature Analysis and Retrieval System (MEDLINE) database was searched for peer-reviewed articles on the prevalence of, and factors associated with obesity, type 2 diabetes, and diabetes-related cardiovascular disease amongst Zambian residents using a combination of search terms. The period of search was from 1 January 2000 to 31 December 2016. We expanded the search terms to include all possible synonyms and spellings obtained in the search strategy. Additionally, we performed a manual search for other articles and references of peer-reviewed articles. Results: In Zambia, the current prevalence of Obesity and Type 2 diabetes is estimated at 13%-16% and 2.0 – 3.0% respectively. Risk factors such as the adoption of western dietary habits, the social stigmatization associated with rapid weight loss due to Tuberculosis and/ or the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and rapid urbanization have all been blamed for fueling the increased risk of obesity and type 2 diabetes. However, unlike traditional Western populations, those with no formal education were less likely to be obese than those who attained secondary or tertiary level education. Approximately 30% of those surveyed were unaware of their diabetes diagnosis and more than 60% were not on treatment despite a known diabetic status. Socio-demographic factors such as older age, female sex, urban dwelling, lack of tobacco use and marital status were associated with an increased risk of obesity, impaired glucose tolerance and type 2 diabetes. We were unable to identify studies that specifically looked at diabetes-related cardiovascular disease. Conclusion: Although the prevalence of Obesity and Type 2 diabetes in Zambia appears low, more representative studies focusing on parts of the country outside of the main industrial zone need to be conducted. There also needs to be research on diabetes-related cardiovascular disease. National surveillance, monitoring and evaluation on all non-communicable diseases need to be prioritized and policies that address underweight, obesity and type 2 diabetes developed.

Keywords: type 2 diabetes, Zambia, obesity, cardiovascular disease

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5473 Presentation of Transgender identities

Authors: Tony Chapman-Wilson

Abstract:

Applied theatre is not an ultimate vehicle to create social change; but is more an opportunity of hope that the production material might affect this. Theatre-makers are able to deconstruct socially and politically challenging themes to encourage their audience to witness lived experiences as they consider themes of concern and injustice. This allows writers to (re) present the lived experiences of trans people, and for social injustice, continued transphobia, and lack of equity to be presented to an audience for debate. There needs to be a stronger position and presence of trans voices and active participation presented of these rather than just that of the cisgender-lens and standpoint. This research examines the relationship between human rights and theatre and considers global examples of this practice, as well as exploring the negatives formed from this relationship, and how this may be developed in the future. This focusses on the ability of theatre to denounce the violations of human rights and considers the power of theatre to support the importance of the awareness of violations to human rights for the raised awareness and potential for action of the audience – who may themselves be part of the oppressed, or indeed an oppressor. The fundamental assertion here is not one of evidenced social change, but of awareness raising of the audience and the potential for social activism and action. The practice of applied theatre is one that is experienced by the audience and the project participants alike, with the intention that theatre may consider how people interact with one another. This paper examines the opportunity of verbatim theatre techniques to allow for a cis-led trans-collaborative research project to (re) present intergenerational trans identities.

Keywords: applied theatre, verbatim, transgender, social justice

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5472 Concealing Breast Cancer Status: A Qualitative Study in India

Authors: Shradha Parsekar, Suma Nair, Ajay Bailey, Binu V. S.

Abstract:

Background: Concealing of cancer-related information is seen in many low-and-middle-income countries and may be associated with multiple factors. Comparatively, there is lack of information about, how breast cancers diagnosed women disclose cancer-related information to their social contacts and vice versa. To get more insights on the participant’s experience, opinions, expectations, and attitudes, a qualitative study is a suitable approach. Therefore, this study involving in-depth interviews was planned to lessen this gap. Methods: Interviews were conducted separately among breast cancer patients and their caregivers with semi-structured qualitative interview guide. Purposive and convenient sampling was being used to recruit patients and caregivers, respectively. Ethical clearance and permission from the tertiary hospital were obtained and participants were selected from the Udupi district, Karnataka, India. After obtaining a list of breast cancer diagnosed cases, participants were contacted in person and their willingness to take part in the study was taken. About 39 caregivers and 35 patients belonging to different breast cancer stages were recruited. Interviews were recorded with prior permission. Data was managed by Atlas.ti 8 software. The recordings were transcribed, translated and coded in two cycles. Most of the patients belonged to stage II and III cancer. Codes were grouped together into to whom breast cancer status was concealed to and underneath reason for the same. Main findings: followings are the codes and code families which emerged from the data. 1) Concealing the breast cancer status from social contacts other than close family members (such as extended family, neighbor and friends). Participants perceived the reasons as, a) to avoid questions which people probe (which doesn’t have answers), b) to avoid people paying courtesy visit (to inquire about the health as it is Indian culture to visit the sick person) making it inconvenient for patient and caregivers have to offer something and talk to them, c) to avoid people getting shocked (react as if cancer is different from other diseases) or getting emotional/sad, or getting fear of death d) to avoid getting negative suggestion or talking anything in front of patient as it may affect patient negatively, e) to avoid getting stigmatized, f) to avoid getting obstacle in child’s marriage. 2) Participant concealed the breast cancer status of young children as they perceived that it may a) affect studies, b) affect emotionally, c) children may get scared. 3) Concealing the breast cancer status from patients as the caregivers perceived that they have fear of a) worsening patient’s health, b) patient getting tensed, c) patient getting shocked, and d) patient getting scared. However, some participants stressed important in disclosing the cancer status to social contact/patient to make the people aware of the disease. Conclusion: The news of breast cancer spreads like electricity in the wire, therefore, patient or family avoid it for many reasons. Although, globally, due to physicians’ ethical obligations, there is an inclination towards more disclosure of cancer diagnosis and status of prognosis to the patient. However, it is an ongoing argument whether patient/social contacts should know the status especially in a country like India.

Keywords: breast cancer, concealing cancer status, India, qualitative study

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5471 Communication of Expected Survival Time to Cancer Patients: How It Is Done and How It Should Be Done

Authors: Geir Kirkebøen

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Most patients with serious diagnoses want to know their prognosis, in particular their expected survival time. As part of the informed consent process, physicians are legally obligated to communicate such information to patients. However, there is no established (evidence based) ‘best practice’ for how to do this. The two questions explored in this study are: How do physicians communicate expected survival time to patients, and how should it be done? We explored the first, descriptive question in a study with Norwegian oncologists as participants. The study had a scenario and a survey part. In the scenario part, the doctors should imagine that a patient, recently diagnosed with a serious cancer diagnosis, has asked them: ‘How long can I expect to live with such a diagnosis? I want an honest answer from you!’ The doctors should assume that the diagnosis is certain, and that from an extensive recent study they had optimal statistical knowledge, described in detail as a right-skewed survival curve, about how long such patients with this kind of diagnosis could be expected to live. The main finding was that very few of the oncologists would explain to the patient the variation in survival time as described by the survival curve. The majority would not give the patient an answer at all. Of those who gave an answer, the typical answer was that survival time varies a lot, that it is hard to say in a specific case, that we will come back to it later etc. The survey part of the study clearly indicates that the main reason why the oncologists would not deliver the mortality prognosis was discomfort with its uncertainty. The scenario part of the study confirmed this finding. The majority of the oncologists explicitly used the uncertainty, the variation in survival time, as a reason to not give the patient an answer. Many studies show that patients want realistic information about their mortality prognosis, and that they should be given hope. The question then is how to communicate the uncertainty of the prognosis in a realistic and optimistic – hopeful – way. Based on psychological research, our hypothesis is that the best way to do this is by explicitly describing the variation in survival time, the (usually) right skewed survival curve of the prognosis, and emphasize to the patient the (small) possibility of being a ‘lucky outlier’. We tested this hypothesis in two scenario studies with lay people as participants. The data clearly show that people prefer to receive expected survival time as a median value together with explicit information about the survival curve’s right skewedness (e.g., concrete examples of ‘positive outliers’), and that communicating expected survival time this way not only provides people with hope, but also gives them a more realistic understanding compared with the typical way expected survival time is communicated. Our data indicate that it is not the existence of the uncertainty regarding the mortality prognosis that is the problem for patients, but how this uncertainty is, or is not, communicated and explained.

Keywords: cancer patients, decision psychology, doctor-patient communication, mortality prognosis

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5470 Social Discourses on Lone Motherhood in South Korea: Social Prejudice and Process of Resistance, Adaptation and Negotiation

Authors: Thi Thu Van Nguyen

Abstract:

In South Korea, Confucianism has not only played a crucial position in Korean traditional culture but also deeply rooted in people’s mind. Confucianism bears a special emphasis on the traditional family pattern characterized by paternalism. Therefore, non-paternity families are barely recognized and unwed mothers are faced with numerous prejudices in their life. Prejudice to unwed mothers in Korea is believed to stem from social discourses against lone motherhood which is the way how people look and talk about unwed mothers and from the early time these social discourses have big impacts on their daily lives. However, after the 1990s, along with the rapid transformation of family pattern and support from social welfare organizations, unwed mothers have gradually got to escape from the social prejudice then established themselves as a new family form. This study is aimed at researching social discourses on lone motherhood in Korea and the process of resistance, adaptation and negotiation of unwed mothers in three different stages: the antenatal, postnatal stages and social inclusion. The anthropological method is employed. Twenty single young mothers of the Korean Unwed Mothers Families' Association were engaged in the author’s detailed interviews. The study’s frame analysis is based on the theoretical framework on social discourses on lone motherhood by Simon Duncan and Rosalind Edwards (1999). This study is an effort to comprehend and investigate the difficulties experienced by unwed mothers living in negative social discourses and the way they overcome the difficulties.

Keywords: unwed mothers, gender, social discourses, social prejudice, Confucianism

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