Search results for: pregnant women
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3099

Search results for: pregnant women

969 Concentrations of Leptin, C-Peptide and Insulin in Cord Blood as Fetal Origins of Insulin Resistance and Their Effect on the Birth Weight of the Newborn

Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

Abstract:

Obesity is associated with an increased risk of developing insulin resistance. Insulin resistance often progresses to type-2 diabetes mellitus and is linked to a wide variety of other pathophysiological features including hypertension, hyperlipidemia, atherosclerosis (metabolic syndrome) and polycystic ovarian syndrome. Macrosomia is common in infants born to not only women with gestational diabetes mellitus but also non-diabetic obese women. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age (LGA) are more likely to be obese in childhood. It is also established from previous studies that Asian populations have higher percentage body fat at a lower body mass index compared to Caucasians. High leptin levels in cord blood have been reported to correlate with fetal adiposity at birth. Previous studies have also shown that cord blood C-peptide and insulin levels are significantly and positively correlated with birth weight. Therefore, the objective of this preliminary study was to determine the relationship between parameters of fetal insulin resistance such as leptin, C-peptide and insulin and the birth weight of the newborn in a study population in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns and the concentration of insulin, leptin, and C-peptide were measured by ELISA technique. Birth weight, length, occipital frontal, chest, hip and calf circumferences of newborns were measured and characteristics of the mother such as age, height, weight before pregnancy and weight gain were collected. The relationship between insulin, leptin, C-peptide, and anthropometrics were assessed by Pearson’s correlation while the Mann-Whitney U test was used to assess the differences in cord blood leptin, C-peptide, and insulin levels between groups. A significant difference (p < 0.001) was observed between the insulin levels of infants born LGA (18.73 ± 0.64 µlU/ml) and AGA (13.08 ± 0.43 µlU/ml). Consistently, A significant increase in concentration (p < 0.001) was observed in C-peptide levels of infants born LGA (9.32 ± 0.77 ng/ml) compared to AGA (5.44 ± 0.19 ng/ml). Cord blood leptin concentration of LGA infants (12.67 ng/mL ± 1.62) was significantly higher (p < 0.001) compared to the AGA infants (7.10 ng/mL ± 0.97). Significant positive correlations (p < 0.05) were observed among cord leptin levels and the birth weight, pre-pregnancy maternal weight and BMI between the infants of AGA and LGA. Consistently, a significant positive correlation (p < 0.05) was observed between the birth weight and the C peptide concentration. Significantly high concentrations of leptin, C-peptide and insulin levels in the cord blood of LGA infants suggest that they may be involved in regulating fetal growth. Although previous studies suggest comparatively high levels of body fat in the Asian population, values obtained in this study are not significantly different from values previously reported from Caucasian populations. According to this preliminary study, maternal pre-pregnancy BMI and weight may contribute as significant indicators of cord blood parameters of insulin resistance and possibly the birth weight of the newborn.

Keywords: large for gestational age, leptin, C-peptide, insulin

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968 Implementing Quality Improvement Projects to Enhance Contraception and Abortion Care Service Provision and Pre-Service Training of Health Care Providers

Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie

Abstract:

Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.

Keywords: abortion, contraception, quality improvement, service provision

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967 Dental Implant Survival in Patients with Osteoporosis

Authors: Mohammad ASadian, Samira RajiAsadabadi

Abstract:

Osteoporosis is very common, particularly in post-menopausal women and is characterized by a decrease in bone mass and strength. Osteoporosis also affects the jawbone and it is considered a potential contraindication to the placement of dental implants. The present paper reviews the literature regarding the effect of osteoporosis on the osseointegration of implants. Experimental models have shown that osteoporosis affects the process of osseointegration, which can be reversed by treatment. However, studies in subjects with osteoporosis have shown no differences in the survival of the implants compared to healthy individuals. Therefore, osteoporosis cannot be considered a contraindication for implant placement. Oral bisphosphonates are the most commonly used pharmacological agents in the treatment of osteoporosis. Although there have been cases of osteonecrosis of the jaw in patients treated with bisphosphonates, they are very rare and it is more usually associated with intravenous bisphosphonates in patients with neoplasms or other serious diseases. Nevertheless, patients treated with bisphosphonates must be informed in writing about the possibility of this complication and must give informed consent. Ceasing to use of bisphosphonates before implant placement does not seem to be necessary.

Keywords: Osteoporosis, dental implant, bisphosphonates, survival

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966 An Analytical Exploration of the Gender-Corruption Thesis in the Nigerian Context

Authors: Francisca Anene

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Studies indicate that gender equality and corruption are negatively correlated. This has been attributed to two opposing arguments - 'fairer-sex' and 'fairer-system'. Though there is no agreement on the reason for the correlation, it has been suggested that gender equality can be actively pursued as a means of combating corruption and instituting good governance in countries perceived to be more corrupt. This paper explores the relationship between gender, corruption and good governance in Nigeria. With the aid of secondary empirical data from various sources including Transparency International Corruption Perceptions Index, World Values Survey, World Bank Enterprise Survey and Afrobarometer, a correlation is established between gender and corruption and the causative factors are explored in the Nigerian context. On the basis of the above, the paper demonstrates that though a numerical increase of women in leadership/influence may result in the achievement of gender equality in Nigeria, true equality must go beyond numbers if it is to be used as a means for instituting good governance.

Keywords: corruption, gender equality, good governance, Nigeria

Procedia PDF Downloads 504
965 The Lightener of Love: The World Peace Religion

Authors: Abdul Razzaq

Abstract:

It is known that every human society throughout the world and throughout history, the various religions and their theologies, ethics, and traditions influence everything in their life, shaping socio-economic and political ideas, attitudes and institutions. It is observed that religious teachings and traditions shape how people respond to each other in their daily social inter-course and interaction in the community at large. The majorities of us preserves and protect our own religious beliefs and traditions as generally they symbolize our essential identities, theologically, historically, culturally, socially, and even politically. Our religious faiths symbolize our dignity as persons and our very souls as communities and individuals. It thus goes without saying that in our multi-racial and multi-religious society, the only way for us to live in peace and harmony is for us to live in peaceful co-existence. It is important for us to recognize, understand, accept and respect each other regardless of our respective belief. The history of interfaith is as ancient as the religions since men and women when not at war with their neighbors have always made an effort to understand them (not least because understanding is a strategy for defense, but also because for as long as there is dialogue wars are delayed).

Keywords: Islam, religion, peace, society

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964 The Lightener of Love - The World Peace

Authors: Abdul Razzaq

Abstract:

It is known that every human society throughout the world and throughout history, the various religions and their theologies, ethics, and traditions influence everything in their life, shaping socio-economic and political ideas, attitudes and institutions. It is observed that religious teachings and traditions shape how people respond to each other in their daily social inter-course and interaction in the community at large. The majorities of us preserves and protect our own religious beliefs and traditions as generally they symbolize our essential identities, theologically, historically, culturally, socially, and even politically. Our religious faiths symbolize our dignity as persons and our very souls as communities and individuals. It thus goes without saying that in our multi-racial and multi-religious society, the only way for us to live in peace and harmony is for us to live in peaceful co-existence. It is important for us to recognize, understand, accept and respect each other regardless of our respective belief. The history of interfaith is as ancient as the religions since men and women when not at war with their neighbors have always made an effort to understand them (not least because understanding is a strategy for defense, but also because for as long as there is dialogue wars are delayed).

Keywords: Islam, interfaith, Sects, world, piece

Procedia PDF Downloads 653
963 Functionalization of Sanitary Pads with Probiotic Paste

Authors: O. Sauperl, L. Fras Zemljic

Abstract:

The textile industry is gaining increasing importance in the field of medical materials. Therefore, presented research is focused on textile materials for external (out-of-body) use. Such materials could be various hygienic textile products (diapers, tampons, sanitary napkins, incontinence products, etc.), protective textiles and various hospital linens (surgical covers, masks, gowns, cloths, bed linens, etc.) wound pillows, bandages, orthopedic socks, etc. Function of tampons and sanitary napkins is not only to provide protection during the menstrual cycle, but their function can be also to take care of physiological or pathological vaginal discharge. In general, women's intimate areas are against infection protected by a low pH value of the vaginal flora. High pH inhibits the development of harmful microorganisms, as it is difficult to be reproduced in an acidic environment. The normal vaginal flora in healthy women is highly colonized by lactobacilli. The lactic acid produced by these organisms maintains the constant acidity of the vagina. If the balance of natural protection breaks, infections can occur. In the market, there exist probiotic tampons as a medical product supplying the vagina with beneficial probiotic lactobacilli. But, many users have concerns about the use of tampons due to the possible dry-out of the vagina as well as the possible toxic shock syndrome, which is the reason that they use mainly sanitary napkins during the menstrual cycle. Functionalization of sanitary napkins with probiotics is, therefore, interesting in regard to maintain a healthy vaginal flora and to offer to users added value of the sanitary napkins in the sense of health- and environmentally-friendly products. For this reason, the presented research is oriented in functionalization of the sanitary napkins with the probiotic paste in order to activate the lactic acid bacteria presented in the core of the functionalized sanitary napkin at the time of the contact with the menstrual fluid. In this way, lactobacilli could penetrate into vagina and by maintaining healthy vaginal flora to reduce the risk of vaginal disorders. In regard to the targeted research problem, the influence of probiotic paste applied onto cotton hygienic napkins on selected properties was studied. The aim of the research was to determine whether the sanitary napkins with the applied probiotic paste may assure suitable vaginal pH to maintain a healthy vaginal flora during the use of this product. Together with this, sorption properties of probiotic functionalized sanitary napkins were evaluated and compared to the untreated one. The research itself was carried out on the basis of tracking and controlling the input parameters, currently defined by Slovenian producer (Tosama d.o.o.) as the most important. Successful functionalization of sanitary pads with the probiotic paste was confirmed by ATR-FTIR spectroscopy. Results of the methods used within the presented research show that the absorption of the pads treated with probiotic paste deteriorates compared to non-treated ones. The coating shows a 6-month stability. Functionalization of sanitary pads with probiotic paste is believed to have a commercial potential for lowering the probability of infection during the menstrual cycle.

Keywords: functionalization, probiotic paste, sanitary pads, textile materials

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962 Comparison of Cardiometabolic Risk Factors in Lean Versus Overweight/Obese Peri-Urban Female Adolescent School Learners in Mthatha, South Africa: A Pilot Case Control Study

Authors: Benedicta N. Nkeh-Chungag, Constance R. Sewani-Rusike, Isaac M. Malema, Daniel T. Goon, Oladele V. Adeniyi, Idowu A. Ajayi

Abstract:

Background: Childhood and adolescent obesity is an important predictor of adult cardiometabolic diseases. Current data on age- and gender-specific cardiometabolic risk factors are lacking in the peri-urban Eastern Cape Province, South Africa. However, such information is important in designing innovative strategies to promote healthy living among children and adolescents. The purpose of this pilot study was to compare and determine the extent of cardiometabolic risk factors between samples of lean and overweight/obese adolescent population in a peri-urban township of South Africa. Methods: In this case-control study, age-matched, non-pregnant and non-lactating female adolescents consisting of equal number of cases (50 overweight/obese) and control (50 lean) participated in the study. Fasting venous blood samples were obtained for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (Trig), highly sensitive C-reactive protein (hsCRP) and blood sugar. Anthropometric measurements included weight, height, waist and hip circumferences. Body mass index was calculated. Blood pressure was measured; and metabolic syndrome was assessed using appropriate diagnostic criteria for children and adolescents. Results: Of the 76 participants with complete data, 12/38 of the overweight/obese and 1/38 of the lean group met the criteria for adolescent metabolic syndrome. All cardiometabolic risk factors were elevated in the overweight/obese group compared with the lean group: low HDL-C (RR = 2.21), elevated TC (RR = 1.23), elevated LDL-C (RR = 1.42), elevated Trig (RR = 1.73), and elevated hsCRP (RR = 1.9). There were significant atherosclerotic indices among the overweight/obese group compared with the lean group: TC/HDL and LDL/HDL (2.99±0.91 vs 2.63±0.48; p=0.016 and 1.73±0.61 vs 1.41±0.46; p= 0.014, respectively). Conclusion: There are multiple cardiometabolic risk factors among the overweight/obese female adolescent group compared with lean adolescent group in the study. Female adolescent who are overweight and obese have higher relative risks of developing cardiometabolic diseases compared with their lean counterparts in the peri-urban Mthatha, South Africa. School health programme focusing on promoting physical exercise, healthy eating and keeping appropriate weight are needed in the country.

Keywords: adolescents, cardiometabolic risk factors, obesity, peri-urban South Africa

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961 Engaging with Security and State from a Gendered Lens in the South Asian Context: Indian State’s Construction of Internal Security and State Responses

Authors: Pooja Bakshi

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In the following paper, an attempt would be made to engage with the relationship between the state and the imperatives of security from a gendered lens. This will be juxtaposed with the feminist engagement with International Law. Theorizations from the literature on South Asian politics and Global politics would be applied to the manner in which the Indian state has defined and proposed to deal with concerns of internal security pertaining to the ‘Left Wing Extremism’ in 2010-2011. It would be argued that the state needs to be disaggregated into the legislature, executive and the judiciary; since there are times when some institutional parts of the state provide space for progressive democratic engagement whilst other institutions don’t. The specific contours of violence faced by women and children at the hands of the state, in the above-mentioned discourse would also be examined. In the end, implications of the security state discourse on debates in International Law would be elaborated.

Keywords: feminist engagement, human rights, state response to left extremism, security studies in South Asia

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960 Revisionism in Literature: Deconstructing Patriarchal Ideals in Margaret Atwood's The Penelopiad

Authors: Essam Abdelhamid Hegazy

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This paper aims to read Margaret Atwood's The Penelopiad (2005) via a revisionist and deconstructive approach. This novel is a postmodernist exploration of the grand-narrative myth The Odyssey (800 BC) by Homer, who portrayed the heroic warrior and the faithful wife as the epitome of perfect male and female models _examples whom all must follow and mimic. In Atwood's narrative, the same two hero models are the two great tricksters who are willing to perform any sort of obnoxious act for achieving their goals. This research tries to examine how Atwood tried to synthesize the change in character’s narratives leading to the humanization of the perfect hero and the ideal wife. The researcher has used a multidisciplinary approach where the feminist, revisionist and deconstructive theories were implemented to identify and find out the new interpretations of the myths that center the experiences and perspectives of women. Research findings are that revisionist approach was applied through giving an opportunity to the victimized and the voiceless to speak out and retaliate against their prosecutions.

Keywords: margret atwood, patriarchal, penelopiad, revisionism

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959 Combating the Practice of Open Defecation through Appropriate Communication Strategies in Rural India

Authors: Santiagomani Alex Parimalam

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Lack of awareness on the consequences of open defecation and myths and misconceptions related to use of toilets have led to the continued practice of open defecation in India. Government of India initiated a multi-pronged intensive communication campaign against the practice of open defecation in the last few years. The primary vision of this communication campaign was to provide increased demand for toilets and to ensure that all have access to safe sanitation. The campaign strategy included the use of mass media, group and folk media, and interpersonal communication to expedite achieving its objectives. The campaign included the use of various media such as posters, wall writings, slides in cinema theatres, kiosks, pamphlets, newsletters, flip charts and folk media to bring behavioural changes in the communities. The author did a concurrent monitoring and process documentation of the campaigns initiated by the state of Tamilnandu, India between 2013 and 2016 commissioned by UNICEF India. The study was carried out to assess the effectiveness of the communication campaigns in combating the practice of open defecation and promote construction of toilets in the state of Tamilnadu, India. Initial findings revealed the gap in understanding the audience and the use of appropriate media. The first phase of the communication campaign by name as Chi Chi Chollapa (bringing shame concept) also revealed that use of interpersonal communication, group and community media were the most effective strategy in reaching the rural masses. The failure of various other media used especially the print media (poster, handbills, newsletter, kiosks) provides insights as to where the government needs to invest its resources in bringing health-seeking behaviour in the community. The findings shared with the government enabled to strengthen the campaign resulting in improved response. Taking cues from the study, the government understood the potency of the women, school children, youth and community leaders as the effective carriers of the message. The government narrowed down its focus and invested on the voluntary workers (village poverty reduction committee workers VPRCs) in the community. The effectiveness of interpersonal communication and peer education by the credible community worker threw light on the need for localising the content and communicator. From this study, we could derive that only community and group media are preferred by the people in the rural community. Children, youth, women, and credible local leaders are proved to be ambassadors in behaviour change communication. This study discloses the lacunae involved in the communication campaign and points out that the state should have carried out a proper communication need analysis and piloting. The study used a survey method with random sampling. The study used both quantitative and qualitative tools such as interview schedules, in-depth interviews, and focus group discussions in rural areas of Tamilnadu in phases. The findings of the study would provide directions to future campaigns to any campaign concerning health and rural development.

Keywords: appropriate, communication, combating, open defecation

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958 Breast Cancer Prediction Using Score-Level Fusion of Machine Learning and Deep Learning Models

Authors: Sam Khozama, Ali M. Mayya

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Breast cancer is one of the most common types in women. Early prediction of breast cancer helps physicians detect cancer in its early stages. Big cancer data needs a very powerful tool to analyze and extract predictions. Machine learning and deep learning are two of the most efficient tools for predicting cancer based on textual data. In this study, we developed a fusion model of two machine learning and deep learning models. To obtain the final prediction, Long-Short Term Memory (LSTM) and ensemble learning with hyper parameters optimization are used, and score-level fusion is used. Experiments are done on the Breast Cancer Surveillance Consortium (BCSC) dataset after balancing and grouping the class categories. Five different training scenarios are used, and the tests show that the designed fusion model improved the performance by 3.3% compared to the individual models.

Keywords: machine learning, deep learning, cancer prediction, breast cancer, LSTM, fusion

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957 Dynamic Changes in NT-proBNP Levels in Unrelated Donors during Hematopoietic Stem Cells Mobilization

Authors: Natalia V. Minaeva, Natalia A. Zorina, Marina N. Khorobrikh, Philipp S. Sherstnev, Tatiana V. Krivokorytova, Alexander S. Luchinin, Maksim S. Minaev, Igor V. Paramonov

Abstract:

Background. Over the last few decades, the Center for International Blood and Marrow Transplant Research (CIBMTR) and the World Marrow Donor Association (WMDA) have been actively working to ensure the safety of the hematopoietic stem cell (HSC) donation process. Registration of adverse events that may occur during the donation period and establishing a relationship between donation and side effects are included in the WMDA international standards. The level of blood serum N-terminal pro-brain natriuretic peptide (NT-proBNP) is an early marker of myocardial stress. Due to the high analytical sensitivity and specificity, laboratory assessment of NT-proBNP makes it possible to objectively diagnose myocardial dysfunction. It is well known that the main stimulus for proBNP synthesis and secretion from atrial and ventricular cardiac myocytes is myocyte stretch and increasement of myocardial extensibility and pressure in the heart chambers. Аim. The aim of the study was to assess the dynamic changes in the levels of blood serum N-terminal pro-brain natriuretic peptide of unrelated donors at various stages of hematopoietic stem cell mobilization. Materials. We have examined 133 unrelated donors, including 92 men and 41 women, that have been included into the study. The NT-proBNP levels were measured before the start of mobilization, then on the day of apheresis, and after the donation of allogeneic HSC. The relationship between NT-proBNP levels and body mass index (BMI), ferritin, hemoglobin, and white blood cells (WBC) levels was assessed on the day of apheresis. The median age of donors was 34 years. Mobilization of HSCs was managed with filgrastim administration at a dose of 10 μg/kg daily for 4-5 days. The first leukocytapheresis was performed on day 4 from the start of filgrastim administration. Quantitative values of the blood serum NT-proBNP level are presented as a median (Me), first and third quartiles (Q1-Q3). Comparative analysis was carried out using the t-test and correlation analysis as well by Spearman method. Results. The baseline blood serum NT-proBNP levels in all 133 donors were within the reference values (<125 pg/ml) and equaled 21,6 (10,0; 43,3) pg/ml. At the same time, the level of NT-proBNP in women was significantly higher than that of men. On the day of the HSC apheresis, a significant increase of blood serum NT-proBNP levels was detected and equald 131,2 (72,6; 165,3) pg/ml (p<0,001), with higher rates in female donors. A statistically significant weak inverse correleation was established between the level of NT-proBNP and the BMI of donors (-0.18, p = 0,03), as well as the level of hemoglobin (-0.33, p <0,001), and ferritin levels (-0.19, p = 0,03). No relationship has been established between the magnitude of WBC levels achieved as a result of the mobilization of HSC on the day of leukocytapheresis. A day after the apheresis, the blood serum NT-proBNP levels still exceeded the reference values, but there was a decreasing tendency. Conclusion. An increase of the blood serum NT-proBNP level in unrelated donors during the mobilization of HSC was established. Future studies should clarify the reason for this phenomenon, as well as its effects on donors' long-term health.

Keywords: unrelated donors, mobilization, hematopoietic stem cells, N-terminal pro-brain natriuretic peptide

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956 Comparison of Incidence and Risk Factors of Early Onset and Late Onset Preeclampsia: A Population Based Cohort Study

Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

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Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

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955 American Slavery and the Consciousness of Play

Authors: Janaka B. Lewis

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“Narratives of Slavery and the Culture of Play” examines how play is discussed in early African American literature by both men and women to illustrate ways that they negotiated the hierarchy and oppression of enslavement. Reading narratives categorized as “slave narratives,” including those written by Frederick Douglass, Harriet Jacobs, and Olaudah Equiano, through the lens of play theory offers an illuminated analysis of the significance of play culture in these texts. It then reads late nineteenth-century play culture (or absence thereof) portrayed in literature as a lens for more contemporary African American oral and literary culture. These discussions of social constructions through literature bridge analyses of African American-authored texts and create a larger conversation about print media as a tool of activism and resistance. This essay also contributes to a larger body of analysis of nineteenth-century African American culture through literature.

Keywords: childhood, slavery, consciousness of play, 19th century African American culture

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954 Gendered Perceptions in Maize Supply Chains: Evidence from Uganda

Authors: Anusha De, Bjorn Van Campenhout

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Faced with imperfect information, economic actors use judgment and perceptions in decision-making. Inaccurate perceptions or false beliefs may result in inefficient value chains, and systematic bias in perceptions may affect inclusiveness. In this paper, perceptions in Ugandan maize supply chains are studied. A random sample of maize farmers where they were asked to rate other value chain actors—agro-input dealers, assembly traders and maize millers—on a set of important attributes such as service quality, price competitiveness, ease of access, and overall reputation. These other value chain actors are tracked and asked to assess themselves on the same attributes. It is observed that input dealers, traders and millers assess themselves more favorably than farmers do. Zooming in on heterogeneity in perceptions related to gender, it is evident that women rate higher than men. The sex of the actor being rated does not affect the rating.

Keywords: gender, input dealers, maize supply chain, perceptions, processors

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953 Anterior Uveitis Caused by Infection with Cytomegalovirus and Herpes Simplex Virus Type I at Cicendo Eye Hospital Bandung

Authors: Shinta Stri Ayuda Nur Setyaningsih

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Anterior uveitis is often triggered by viral infections such as herpes simplex virus (HSV) and cytomegalovirus (CMV). This study aims to provide an overview of the demographic and clinical characteristics of patients with anterior uveitis caused by CMV and HSV infection at PMN Cicendo Eye Hospital Bandung. This study used a retrospective observational method. Data were collected from the medical records of patients who visited the PMN Infection and Immunology Polyclinic at Cicendo Eye Hospital between February and July 2023. The results showed that anterior uveitis associated with HSV and CMV viruses often occurs in the elderly and more in women. The most common clinical symptoms are red eyes and decreased visual acuity, with a gradual onset of symptoms. Complications that often arise are cataracts and glaucoma. This study provides a deeper understanding of anterior uveitis caused by infection with HSV and CMV viruses.

Keywords: uveitis anterior, cytomegavirus, herpes simplex virus type I ELISA

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952 Training in Communicational Skills in Students of Medicine: Differences in Bilingualism

Authors: Naiara Ozamiz Etcebarria, Sonia Ruiz De Azua Garcia, Agurtzane Ortiz Jauregi, Virginia Guillen Cañas

Abstract:

Introduction: The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes´ improvement and efficiency of health services. The ability of Active listening , empathy, assertiveness and social skills, are important abilities to develop in all professions in which there is a relationship with other people. In the field of health, it is even more important to have adequate qualities so that the treatment with the patient will be adequate and satisfactory. We conducted a research with students of third year in the Degree of Medicine with the objectives: - to know how the active listening, empathy, assertiveness and social skills of students are. - to know if there are differences according to different demographic variables, such as sex, language, age, number of siblings and interest in the subject. Material and Methods: The students of the Third year in the Degree of Medicine (N = 212) participated voluntarily. Sociodemographic data were collected. Descriptive and comparative analysis of the averages of the students with respect to active listening, empathy, assertiveness and social skills were performed. Once the questionnaires were collected, they were entered into the SPSS 21 database. Four communicational aspects were evaluated: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. The active listening questionnaire assesses these factors: Listening without interruption and less contradiction, Listening with 100% attention, Listening beyond words, Listening encouraging the other to go deeper. The TECA questionnaire of cognitive and affective empathy evaluates: Adoption of perspectives, Emotional Comprehension, Emphasizing stress, Empathic joy. The EHS questionnaire Social Skills Scale: Self-expression in social situations, Defending one's own rights as a consumer, Expressing anger or dissatisfaction, Refusing to do and cutting interactions off, Making requests, Initiating positive interactions with the other sex. The ACDA questionnaire Assertiveness Assessment Scale evaluates self-assertiveness and heteroaservitivity. Applicability: To train these skills is so important for clinical practice of medical students and these capabilities that can be measured in a longitudinal way time. Ethical-legal aspects: The data were anonymous. The study was approved by the Ethics Committee. Results: The students of the Third year in the Degree of Medicine (34.4% Basque speakers and 65.6% Spanish speakers) with average age 20.93, (27.8% men and 72.2% women). There are no differences in social skills between men and women. The Basque speaker students of are more heteroactive (ACDA) than Spanish students. Active listening has a high correlation with social skills, especially with self-expression in social situations. Listening without interruption has a high correlation with self-expression in social situations and initiating positive interactions with the opposite sex. Adoption of perspectives presents a high correlation with auto- assertiveness. Emotional understanding presents a high correlation with positive interactions with the opposite sex. Empathic joy correlates with self-assertiveness, self-expression in social situations, and initiating positive interactions with the opposite sex.

Keywords: active listening, assertiveness, communicational skills, empathy, students of medicine

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951 Job Satisfaction and Career Choices: A Study Using Schein´s Career Anchor Model

Authors: Rosana Silvina Codaro, Patricia Amelia Tomei

Abstract:

This study explores the relationship between job satisfaction and alignment between the individual´s current occupation and his talents, needs and values, namely his 'career anchors'. With this purpose in mind, a quantitative survey was performed for a non- graduate probabilistic sample of management business students of a private university in Rio de Janeiro. The results of the survey showed there is no significant association between satisfaction at work and alignment with the individual’s career anchor. The most frequent career anchor found for both genders was lifestyle, showing a trend towards finding a career that allows some balance between professional and personal life. The study also showed that self-employed individuals are more satisfied with their work than the individuals employed by a company are, and men are more satisfied at work than women are, Individuals aligned and not satisfied tend to be the ones who have fewer years of work experience and individuals not aligned and satisfied tend to be older.

Keywords: careers, career anchors, job satisfaction, Schein´s career anchor model

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950 The Relationship between Exercise Attitude and Performance with Self-Image in Elderly Men in Iran

Authors: Hadis Mahmoodsalehi, Elham Shakoor, Maryam Koushkie Jahromi

Abstract:

Background and aims: Given the importance of health promotion in elderly and attention to health factors including physical activity and self-image reinforcing, this study aimed to investigate the relationship between exercise attitude and performance with self-image concept in elderly men. Methods: In this descriptive–correlational study, 50 different daily exercise activities of the elderly men living in Iran (mean age: 60.94 years) were selected through simple sampling method. Participants completed a questionnaire regarding exercise attitude and performance and Beck self-image concept. Pearson correlation test was used for analysis of the data. Results: The results showed the significant correlation between optimism and exercise performance (p = 0.012) and exercise attitude (p = 0.005). Conclusion: Findings show that exercise performance and attitude are associated positively with optimism in elderly women. So, increasing exercise or improving attitude toward exercise can lead to improving optimism.

Keywords: elderly, exercise performance and attitude, self-image, descriptive–correlational study

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949 The Perspective of Using Maiden Name: A Sample of Konya-Turkey

Authors: Manar Aslan, Ayfer Karaaslan

Abstract:

Purpose: The aim of this study was to determine the attitude towards the use of the maiden name of the Turkish people. Methods: For the study group who lives in the center of Konya/Turkey and people aged 16-65 years, as the sample identified 1,000 people with simple random between the months of February to May 2013. The survey created by the researchers, for investigating the perception of using the maiden name of the people of Konya consists of 25 questions with demographic characteristics. For statistical analysis of the obtained data made using SPSS 20, chi-square test and one-way analysis of variance methods of frequency, average, were evaluated as percentage distribution. Results: The traditional view of Konya increasing age increases, decreases the desire to use her maiden name. So look favorably than younger generations to use maiden name. In parallel with the level of educational levels are increasing utilization rates maiden name. Thus, individuals with higher levels of education are more positive look at the use of her maiden name. Looking at the marital status; compared to individuals with a single against the use of her maiden name of individuals who are married are more negative attitude.

Keywords: Maiden name, public viewpoint, utilization, women

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948 Automated Prediction of HIV-associated Cervical Cancer Patients Using Data Mining Techniques for Survival Analysis

Authors: O. J. Akinsola, Yinan Zheng, Rose Anorlu, F. T. Ogunsola, Lifang Hou, Robert Leo-Murphy

Abstract:

Cervical Cancer (CC) is the 2nd most common cancer among women living in low and middle-income countries, with no associated symptoms during formative periods. With the advancement and innovative medical research, there are numerous preventive measures being utilized, but the incidence of cervical cancer cannot be truncated with the application of only screening tests. The mortality associated with this invasive cervical cancer can be nipped in the bud through the important role of early-stage detection. This study research selected an array of different top features selection techniques which was aimed at developing a model that could validly diagnose the risk factors of cervical cancer. A retrospective clinic-based cohort study was conducted on 178 HIV-associated cervical cancer patients in Lagos University teaching Hospital, Nigeria (U54 data repository) in April 2022. The outcome measure was the automated prediction of the HIV-associated cervical cancer cases, while the predictor variables include: demographic information, reproductive history, birth control, sexual history, cervical cancer screening history for invasive cervical cancer. The proposed technique was assessed with R and Python programming software to produce the model by utilizing the classification algorithms for the detection and diagnosis of cervical cancer disease. Four machine learning classification algorithms used are: the machine learning model was split into training and testing dataset into ratio 80:20. The numerical features were also standardized while hyperparameter tuning was carried out on the machine learning to train and test the data. Logistic Regression (LR), Decision Tree (DT), Random Forest (RF), and K-Nearest Neighbor (KNN). Some fitting features were selected for the detection and diagnosis of cervical cancer diseases from selected characteristics in the dataset using the contribution of various selection methods for the classification cervical cancer into healthy or diseased status. The mean age of patients was 49.7±12.1 years, mean age at pregnancy was 23.3±5.5 years, mean age at first sexual experience was 19.4±3.2 years, while the mean BMI was 27.1±5.6 kg/m2. A larger percentage of the patients are Married (62.9%), while most of them have at least two sexual partners (72.5%). Age of patients (OR=1.065, p<0.001**), marital status (OR=0.375, p=0.011**), number of pregnancy live-births (OR=1.317, p=0.007**), and use of birth control pills (OR=0.291, p=0.015**) were found to be significantly associated with HIV-associated cervical cancer. On top ten 10 features (variables) considered in the analysis, RF claims the overall model performance, which include: accuracy of (72.0%), the precision of (84.6%), a recall of (84.6%) and F1-score of (74.0%) while LR has: an accuracy of (74.0%), precision of (70.0%), recall of (70.0%) and F1-score of (70.0%). The RF model identified 10 features predictive of developing cervical cancer. The age of patients was considered as the most important risk factor, followed by the number of pregnancy livebirths, marital status, and use of birth control pills, The study shows that data mining techniques could be used to identify women living with HIV at high risk of developing cervical cancer in Nigeria and other sub-Saharan African countries.

Keywords: associated cervical cancer, data mining, random forest, logistic regression

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947 Debunking Sexual Myths in Bangladesh through an Intervention on the Internet

Authors: E. Rommes, Els Toonen, Rahil Roodsaz, Suborna Camellia, Farhana Alam, Saad Khan, Jhalok Ranjon Talukder, Tanveer Hassan, Syeda Farjana Ahmed, Sabina Faiz Rashid

Abstract:

In Bangladesh, a country in which adults (both parents and teachers) find it particularly hard to speak with youth about sexuality, adolescents seem to struggle with various insecurities about their sexual feelings, thoughts, behavior and physical characteristics. On the basis of a large number of interviews and focus groups with rural and urban Bangla adolescent girls and boys of lower and middle class as part of the large-scale three-year project ‘Breaking the Shame’, we have identified ten sexual themes or ‘myths’ that youth struggle with most. These encompass amongst others beliefs and insecurities on masturbation, discharge, same-sex behavior and feelings, the effects of watching porn and gender norms. We argue that the Internet is a particularly suitable medium to ‘debunk’ those myths, as youth can consult it anonymously and privately and so avoid social shame. Moreover, amongst the myths, we have identified two kinds which may need different debunking techniques. One kind of myth concerns scientifically uncontested, generally biological related information, such as the effects of having sex with a pregnant woman, questions on the effects of a penile or vaginal discharge or questions on the effects of masturbation. The second kind of myths concerns more diverse information sources and deals with e.g. religious or culturally specific norms, such as on the meaning and existence of homosexuality or gender appropriate norms of behavior in Bangladesh. For addressing both kinds of myths, expert information including a wealth of references to information resources needs to be provided, which the Internet is very suitable for. For the second kind of myths, adolescents also need to learn how to deal with sometimes conflicting norms and information sources, and they need to develop and reflect on their own opinions as part of their identity formation. On the basis of a literature review, we thus distinguish general information needs from identity formation needs, which includes the need to be able to relate information and opinions to one’s own opinions and situation. Hence, we argue that youth not only need abstract expert information to be able to debunk sexual myths, but also the option to discuss this information with other adolescents and compare their own situation and opinions with other peers, who in that way serve as ‘warm experts’ for each other. In this paper, we will describe the outcomes of our qualitative study above. In addition, we will present our findings of an intervention by presenting youth with general, uncontested information on the Internet with additional peer discussion options to compare the debunking effects on different kinds of myths.

Keywords: peer discussion, intervention, sexual myths, shame

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946 Welfare State and Income Distribution to School-Age Children

Authors: Kanyarat Bussaban, Siriporn Poolsuwan

Abstract:

This study is conducted with the objective to prove how the distorted distribution of welfare affects the quality of school-age children lives differently in the case of an urban community in Bangkok. 334 samples are households from Suan Oi and Ratchapatubtim communities. The study of sample communities found the difference between two community areas that are close. The people of Suan Oi community are economically better off people than the people of the Ratchapatubtim community. They share the benefits of using most services except the welfare of a child’s education. The resulting analysis of the variability in quality of life of the school age children indicate that heads of the households are women looking for quality of life benefits when the compulsory school age is less. A study of the two communities suggests that the inequality in income distribution currently affects the quality of life of school-age children.

Keywords: inequality, income distribution, quality of school-age children lives, welfare state

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945 Assessing Spatial Associations of Mortality Patterns in Municipalities of the Czech Republic

Authors: Jitka Rychtarikova

Abstract:

Regional differences in mortality in the Czech Republic (CR) may be moderate from a broader European perspective, but important discrepancies in life expectancy can be found between smaller territorial units. In this study territorial units are based on Administrative Districts of Municipalities with Extended Powers (MEP). This definition came into force January 1, 2003. There are 205 units and the city of Prague. MEP represents the smallest unit for which mortality patterns based on life tables can be investigated and the Czech Statistical Office has been calculating such life tables (every five-years) since 2004. MEP life tables from 2009-2013 for males and females allowed the investigation of three main life cycles with the use of temporary life expectancies between the exact ages of 0 and 35; 35 and 65; and the life expectancy at exact age 65. The results showed regional survival inequalities primarily in adult and older ages. Consequently, only mortality indicators for adult and elderly population were related to census 2011 unlinked data for the same age groups. The most relevant socio-economic factors taken from the census are: having a partner, educational level and unemployment rate. The unemployment rate was measured for adults aged 35-64 completed years. Exploratory spatial data analysis methods were used to detect regional patterns in spatially contiguous units of MEP. The presence of spatial non-stationarity (spatial autocorrelation) of mortality levels for male and female adults (35-64), and elderly males and females (65+) was tested using global Moran’s I. Spatial autocorrelation of mortality patterns was mapped using local Moran’s I with the intention to depict clusters of low or high mortality and spatial outliers for two age groups (35-64 and 65+). The highest Moran’s I was observed for male temporary life expectancy between exact ages 35 and 65 (0.52) and the lowest was among women with life expectancy of 65 (0.26). Generally, men showed stronger spatial autocorrelation compared to women. The relationship between mortality indicators such as life expectancies and socio-economic factors like the percentage of males/females having a partner; percentage of males/females with at least higher secondary education; and percentage of unemployed males/females from economically active population aged 35-64 years, was evaluated using multiple regression (OLS). The results were then compared to outputs from geographically weighted regression (GWR). In the Czech Republic, there are two broader territories North-West Bohemia (NWB) and North Moravia (NM), in which excess mortality is well established. Results of the t-test of spatial regression showed that for males aged 30-64 the association between mortality and unemployment (when adjusted for education and partnership) was stronger in NM compared to NWB, while educational level impacted the length of survival more in NWB. Geographic variation and relationships in mortality of the CR MEP will also be tested using the spatial Durbin approach. The calculations were conducted by means of ArcGIS 10.6 and SAS 9.4.

Keywords: Czech Republic, mortality, municipality, socio-economic factors, spatial analysis

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944 An Analysis into Global Suicide Trends and Their Relation to Current Events Through a Socio-Cultural Lens

Authors: Lyndsey Kim

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We utilized country-level data on suicide rates from 1985 through 2015 provided by the WHO to explore global trends as well as country-specific trends. First, we find that up until 1995, there was an increase in suicide rates globally, followed by a steep decline in deaths. This observation is largely driven by the data from Europe, where suicides are prominent but steadily declining. Second, men are more likely to commit suicide than women across the world over the years. Third, the older generation is more likely to commit suicide than youth and adults. Finally, we turn to Durkheim’s theory and use it as a lens to understand trends in suicide across time and countries and attempt to identify social and economic events that might explain patterns that we observe. For example, we discovered a drastically different pattern in suicide rates in the US, with a steep increase in suicides in the early 2000s. We hypothesize this might be driven by both the 9/11 attacks and the recession of 2008.

Keywords: suicide trends, current events, data analysis, world health organization, durkheim theory

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943 Preoperative Anxiety Evaluation: Comparing the Visual Facial Anxiety Scale/Yumul Faces Anxiety Scale, Numerical Verbal Rating Scale, Categorization Scale, and the State-Trait Anxiety Inventory

Authors: Roya Yumul, Chse, Ofelia Loani Elvir Lazo, David Chernobylsky, Omar Durra

Abstract:

Background: Preoperative anxiety has been shown to be caused by the fear associated with surgical and anesthetic complications; however, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting given the duration and concentration required to complete the 40-item extensive questionnaire. Our primary aim in the study is to investigate the correlation of the Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparison analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusions: Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul FACES Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul FACES Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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942 A Scoping Review of Trends in Climate Change Research in Ghana

Authors: Emmanuel Bintaayi Jeil, Kabila Abass, David Forkuor, Divine Odame Appiah

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In Ghana, the nature and trends of climate change-related research are not clear. This study synthesises various research evidence on climate change published in Ghana between 1999 and 2018. Data for the review was gathered using a set of search words performed in Google Scholar, Web of Science, ProQuest, and ScienceDirect following scoping review guidelines stipulated by the Joanna Briggs Institute. Data were analysed using a scoping review. A total of 114 eligible articles were identified and included in the synthesis. Findings revealed that research on climate change in Ghana is growing steadily, and most of the studies were conducted in 2018. Trends in climate change research in Ghana relate to agriculture and development. There is a lack of attention on climate change issues related to women, water availability and management, and health. Future research should therefore focus on addressing these issues in addition to alternative livelihoods for vulnerable people.

Keywords: scoping review, trends, climate change, research, Ghana

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941 A Study on Pre and Post Competitive State Anxiety among the Athletes

Authors: Vinay Choudhary, Ibakordor Patlong

Abstract:

This study investigates and evaluates pre and post competitive anxiety, self-confidence, and performance of the athletes. The Cognitive State Anxiety Inventory-2 was administered to collect data from 73 athletes, both men, and women, before and after the competition, who participated in the Reliance Foundation Youth Sports (RFYS)-Athletics, held at Gachibowli Stadium, Hyderabad. A paired t-test was used to find the significant difference between the pre and post-competition. Results showed that the levels of cognitive state anxiety before the competition was low as compared after the competition and the levels of somatic state anxiety before the competition was high as compared after the competition whereas the levels of self-confidence before the competition was high as compared after the competition. This study concludes that the levels of cognitive state anxiety increases after the competition as athletes could not perform according to the performance expectations, on the contrary, the levels of somatic anxiety decrease as there was no pressure of performance on the athletes after the competition and the levels of self-confidence decreases after the competition as athletes could not reach their desired performance levels.

Keywords: anxiety, athletes, pre and post, CSAI-2, self-confidence, performance

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940 Fighting for Equality in Early Buddhism

Authors: Kenneth Lee

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During Buddha’s time in the 5th century BCE, the Indian society was organized by a social stratification system called “the caste system” (Skt. varna), which still exists today. The origination of the caste system can be traced back to 1500 BCE within the ancient Vedic texts of the Aryans, the Indo-European nomadic people who migrated and settled in the Indus Valley region. However, the four-tiered hierarchical nature of the caste system created inequality, privilege, and discrimination based on hereditary transmission. After renouncing his royal status as a prince, Siddhartha Gautama spent six years in the forest, practiced austerities, mastered meditation, and eventually realized enlightenment. Thereupon, now referred to as “Shakyamuni Buddha” or “sage from the tribe of Shakya who has become awake,” the Buddha founded the Sangha, a community of monks, nuns, and lay followers, where everyone was equal and treated equally. After providing a brief overview of Buddha’s time, this talk will examine Buddha’s Dharma or teachings on equality and his creation of the Sangha as “society within a society, which had a dissolving effect on society.

Keywords: equality, women, buddhism, discrimination

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