Search results for: opioid use in pregnant women

Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The use of the partograph is a well-known best practice for quality monitoring of labour and subsequent prevention of obstructed and prolonged labour. However, a number of cases of obstructed labour do happen in health facilities due to poor quality of intrapartum care. Methods: A cross-sectional quantitative study assessed knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia using a structured interviewer administered questionnaire. The collected data was analyzed using SPSS version 16.0. Logistic regression analysis was used to identify factors associated with knowledge and use of partograph among obstetric care givers. Results: Knowledge about the partograph was fair: 189 (96.6%) of all the respondents correctly mentioned at least one component of the partograph, 104 (53.3%) correctly explained the function of alert line and 161 (82.6%) correctly explained the function of action line. The study showed that 112 (57.3%) of the obstetric care givers at public health institutions reportedly utilized partograph to monitor mothers in labour. The utilization of the partograph was significantly higher among obstetric care givers working in health centres (67.9%) compared to those working in hospitals (34.4%) [Adjusted OR = 3.63(95%CI: 1.81, 7.28)]. Conclusions: A significant percentage of obstetric care givers had fair knowledge of the partograph and why it is necessary to use it in the management of labour and over half of obstetric care givers reported use of the partograph to monitor mothers in labour. Pre-service and on-job training of obstetric care givers on the use of the partograph should be given emphasis. Mandatory health facility policy is also recommended to ensure safety of women in labour in public health facilities in Addis Ababa, Ethiopia.

Keywords: partograph, knowledge, utilization, obstetric care givers, public health institutions

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Authors: Vicky Khasandi-Telewa, Sinfree Makoni

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This paper examines the lived experiences of Kenyans caught between the two main varieties of English and the communication challenges they often face. The paper aims to provide evidence for the challenges that Kenyan speakers of English have experienced as a result of the confluence between British English (BrE) and American English (AmE). The study is explorative thus, qualitative and a descriptive research design was used. The objectives were to describe the communication challenges Kenyans encounter due to the differences in grammar, pronunciation, vocabulary, and pragmatics between AmE and BrE and, to illuminate these variations to enable the Kenyan English learner to communicate appropriately. The purposive sample consisted of sixty five subjects, all who were from a top girls national high school in Kenya, therefore, many are in high-end positions nationally and internationally and well-travelled; in fact, seven are based in the USA, two in the United Kingdom and one lives in Australia. Using interviews, they were asked about their experiences with the different varieties of English, and their responses recorded. Autoethnography, a qualitative research method that involves introspection and cultural analysis, was also used. Thematic content analysis was used to extract the themes and group them for data analysis. The theoretical framework used is World Englishes by Kachru. The results indicate that there is indeed some communication breakdown due to linguistic varieties, but the differences are largely understood by speakers of the different varieties. Attitude plays a major role in communication challenges between the different Englishes, especially among teachers. The study urges acceptance of different varieties of English so long as communication takes place. This has implications for teaching English to Kenyan and speakers of other languages to whom English is taught as a Second Language or Foreign language.

Keywords: American english, british english, kenyan english, englishes, teaching of english to speakers of other languages (TeSOL)

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Authors: Tsoaledi D. Thobejane, Barnabas C. Okere

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Gender mainstreaming has been adopted as a strategy for promoting gender equality in institutions of higher learning Worldwide, not least in Africa. This study investigated Gender Mainstreaming at the University of Venda, in Limpopo Province, South Africa. The study was based on the Feminist Theoretical Framework. Both qualitative and quantitative approaches were used. A case study research design was adopted. The study involved a population of 60 participants and a sample of 25 male and female workers selected using the purposive sampling technique. Data were presented in pie charts, tables, themes and in textual forms. Data were analysed through descriptive statistics and thematic analysis. The major findings and conclusions of the study were that the University of Venda faces enormous challenges in mainstreaming gender in the university functions. There are perceptions that most strategic higher positions in the institution are dominated by men while women are marginalized. Although the University has policies on gender, staff members do not know about them while management does not implement its policies. University of Venda makes use of the Employment Equity Act of 1998, but it is not clear whether line managers are aware of its implementation and how. In addition, favouritism, nepotism, patronage, and patriarchy played a role in gender mainstreaming. The study recommended that there should be more gender awareness activities, such as workshops, conferences, and symposia for workers and staff members in order to sensitize them about gender towards understanding. The study also recommended that deserving female staff members should be promoted, and all employees should be encouraged to read and understand gender policies. In addition, management should implement the institutions and national gender policies without fear or favour.

Keywords: gender mainstreaming, gender equality, institutions, representation

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Authors: Shittu Bisi Agnes

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Studies on households’ willingness to pay for environmental and general health safety in the advent of Ebola virus Diseases in Nigeria was carried out. This is aimed at revealing the means by which the virus was eventually eradicated in Nigeria as widely claimed in the media. This study therefore attempted to determine the environmental and general health condition in the State Of Osun, how socio-economic characteristics of the people affected willingness to pay. And also provide platform for the reduction of environmental and general health problems. Data were collected with the aid of well-structured questionnaire and administer 150 randomly selected people of study area, and oral interview was also utilized. Data collected were analyzed using both descriptive tools and inferential statistics vis-a-viz regression analysis. Findings showed 92.5% of respondents was aware of ebola virus diseases outbreak in Nigeria, 8.5% was unaware of any disease outbreak. And 65.7% of respondents was strongly willing to pay for environmental and general health safety 27.1% was fairly willing, 5.7% was indifferent and 1.7% was unwilling to pay. 5% rated the level of environmental and general health condition in the area has been good, 53.6% rated theirs has been fair, 33.6% as been poor. The average willingness to pay per household per month were #500.00, #250.00, #150.00 and #100.00 respectively for the four categories. It was recommended that policy instruments to increase peoples' income will accelerate eradication of environmental and general health problems, environmental health education in form of talk shop, workshop, lectures and seminars could be organized at the political ward levels, churches, mosque, and at schools. Environmental and general health safety related information could be disseminated through mass media, market women, and functional unions.

Keywords: ebola virus diseases (EVD), socio-economic, safety, pay, Osun

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Authors: M. Qorbani

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Neuromuscular control of posture as understood through studies of responses to mechanical sudden acceleration automatically has been previously demonstrated in individuals with chronic ankle instability (CAI), but the presence of acute condition has not been previously explored specially in a sudden acceleration. The aim of this study was to determine neuromuscular control pattern in those with and without unilateral acute ankle sprains. Design: Case - control. Setting: University research laboratory. The sinker–card protocol with surface translation was be used as a sudden acceleration protocol with study of EMG upon 4 posture stabilizer muscles in two sides of the body in response to sudden acceleration in forward and backward directions. 20 young adult women in two groups (10 LAS; 23.9 ± 2.03 yrs and 10 normal; 26.4 ± 3.2 yrs). The data of EMG were assessed by using multivariate test and one-way repeated measures 2×2×4 ANOVA (P< 0.05). The results showed a significant muscle by direction interaction. Higher TA activity of left and right side in LAS group than normal group in forward direction significantly be showed. Higher MGR activity in normal group than LAS group in backward direction significantly showed. These findings suggest that compared two sides of the body in two directions for 4 muscles EMG activities between and within group for neuromuscular control of posture in avoiding fall. EMG activations of two sides of the body in lateral ankle sprain (LAS) patients were symmetric significantly. Acute ankle instability following once ankle sprains caused to coordinated temporal spatial patterns and strategy selection.

Keywords: neuromuscular response, sEMG, lateral ankle sprain, posture.

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Authors: Shadia Al-Bahlani, Khadija Al-Bulushi, Zuweina Al-Hadidi, Buthaina Al-Dhahl, Nadia Al-Abri

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Breast cancer is the most common cancer in women worldwide. Triple-Negative Breast Cancer (TNBC) is an aggressive type of breast cancer, which is defined by the absence of Estrogen (ER), Progesterone (PR) and human epidermal growth factor (Her-2) receptors. The calpain system plays an important role in many cellular processes including apoptosis, necrosis, cell signaling and proliferation. However, the role of calpain in cisplatin (CDDP)-induced apoptosis in TNBC cells is not fully understood. Here, TNBC (MDA-MB231) cells were treated with different concentration of CDDP (0, 20 & 40 µM) and calpain activation and apoptosis were measured by western blot and Hoechst Stain respectively. In addition, calpain modulation by either activation and/or inhibition and its effect on CDDP-induced apoptosis were assessed by the same above approaches. Our findings showed that CDDP induced endoplasmic reticulum stress and thus Calcium release and subsequently activate calpain α-fodrin cleavage indicated by the increase in GRP78 and Calmodulin protein expression and respectively in MDA-MB231 cells. It also induced apoptosis as measured by Hoechst stain and caspase-12 cleavage. Calpain activation by both Cyclopiazonic acid and Thapsigargin showed similar effect and enhanced the sensitivity of these cells to CDDP treatment. On the other hand, calpain inhibition by either specific siRNA and/or exogenous inhibitor (Calpeptin) had an adverse effect where it attenuated calpain activation and thus CDDP- induced apoptosis in these cells. Altogether, these findings suggested that calpain activation play an essential role in sensitizing the TNBC cells to CDDP-induced apoptosis. This might lead to the discovery of novel treatment to over this aggressive type of breast cancer.

Keywords: calpain, cisplatin, apoptosis, breast cancer

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Authors: Antarip Bhattacharya, Dhritiman Maitra

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Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia due to autonomous production of parathormone (PTH) and the third most common endocrine disorder. Upto 2% of postmenopausal women could have this condition. Primary hyperparathyroidism is characterized by hypercalcemia with a high or insufficiently suppressed level of parathyroid hormone and is caused by a solitary parathyroid adenoma in 85-90% of patients. PHPT may also be caused by parathyroid hyperplasia (involving multiple glands) or parathyroid carcinoma. Associated morbidities and sequelae include decreased bone mineral density, fractures, kidney stones, hypertension, cardiac comorbidities and psychiatric disorder which entail huge costs for treatment. In the year 2021, by virtue of running a Breast and Endocrine Surgery clinic in a Tier 1 city at a tertiary care hospital, the opportunity to be associated with patients of hyperparathyroidism came our way. Here, we shall describe the spectrum of clinical presentations and customisation of treatment for parathyroid diseases with reference to the above patients. A retrospective analysis of the data of all patients presenting with symptoms of parathyroid diseases was made and classified according to the cause. 13 patients had presented with symptoms of hyperparathyroidism and each case presented with unique symptoms and necessitated detailed evaluation. The treatment or surgery offered to each patient was tailored to his/her individual disease and led to favourable outcomes. Diseases affecting parathyroid are not as rare as we believe. Each case merits detailed clinical evaluation, investigations and tailoring of suitable treatment with regard to medical management and extent of surgery. Intra-operative frozen section/iOPTH monitoring are really useful adjuncts for intra-operative decision making.

Keywords: hyperparathyroidism, parathyroid adenoma, parathyroid surgery, PTH

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Authors: R. Lekaviciene, D. Antiniene

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Attempts to split the construct of emotional intelligence (EI) into separate components – ability to understand own and others’ emotions and ability to control own and others’ emotions may be meaningful more theoretically than practically. In real life, a personality encounters various emotional situations that require exhibition of complex EI to solve them. Emotional situation solution tests enable measurement of such undivided EI. The object of the present study is to determine sociodemographic and other factors that are important for emotional situation solutions. The study involved 1,430 participants from various regions of Lithuania. The age of participants varied from 17 years to 27 years. Emotional social and interpersonal situation scale EI-DARL-V2 was used. Each situation had two mandatory answering formats: The first format contained assignments associated with hypothetical theoretical knowledge of how the situation should be solved, while the second format included the question of how the participant would personally resolve the given situation in reality. A questionnaire that contained various sociodemographic data of subjects was also presented. Factors, statistically significant for emotional situation solution, have been determined: gender, family structure, the subject’s relation with his or her mother, mother’s occupation, subjectively assessed financial situation of the family, level of education of the subjects and his or her parents, academic achievement, etc. The best solvers of emotional situations are women with high academic achievements. According to their chosen study profile/acquired profession, they are related to the fields in social sciences and humanities. The worst solvers of emotional situations are men raised in foster homes. They are/were bad students and mostly choose blue-collar professions.

Keywords: emotional intelligence, emotional situations, solution of situation, young people

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Authors: Takeshi Sato, Mizuki Nakajima, Macky Kato, Shoji Igawa

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The purpose of study was to investigate the effect of varying pole weights on energy expenditure, upper limb and lower limb muscle activity as Electromyogram during Nordic walking (NW). Four healthy men [age = 22.5 (±1.0) years, body mass = 61.4 (±3.6) kg, height = 170.3 (±4.3) cm] and three healthy women [age = 22.7 (±2.9) years, body mass = 53.0 (±1.7) kg, height = 156.7 (±4.5) cm] participated in the experiments after informed consent. Seven healthy subjects were tested on the treadmill, walking, walking (W) with Nordic Poles (NW) and walking with 1kg weight Nordic Poles (NW+1). Walking speed was 6 km per hours in all trials. Eight EMG activities were recorded by bipolar surface methods in biceps brachii, triceps brachii, trapezius, deltoideus, tibialis anterior, medial gastrocnemius, rectus femoris and biceps femoris muscles. And heart rate (HR), oxygen uptake (VO₂), and rate of perceived exertion (RPE) were measured. The level of significance was set at a = 0.05, with p < 0.05 regarded as statistically significant. Our results confirmed that use of NW poles increased HR at a given upper arm muscle activity but decreased lower limb EMGs in comparison with W. Moreover NW was able to increase more step lengths with hip joint extension during NW rather than W. Also, EMG revealed higher activation of upper limb for almost all NW and 1kgNW tests plus added masses compared to W (p < 0.05). Therefore, it was thought either of NW and 1kgNW were to have benefit as a physical exercise for safe, feasible, and readily training for a wide range of aged people in the quality of daily life. However, there was no significant effected in leg muscles activity by using 1kgNW except for upper arm muscle activity during Nordic pole walking.

Keywords: Nordic walking, electromyogram, heart rate, RPE

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Authors: Umugwaneza Francoise, Ntamazeze Janviere, Donghong Ding

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Entrepreneurship has been considered by majority people from developing world as “no other option” kind of career. Consequently, for a long time entrepreneurship in developing countries has been mainly practiced by people who have low or not at all formal education. Even today, to some extent, much of the actions taken by governments, donors and some societies have tendency to consider entrepreneurship as an instrument to lift up the most vulnerable population including uneducated women, school drop outers, people with disabilities and other groups who live with some sort of vulnerability. However, there is a shortage of knowledge based and know-how entrepreneurship in developing countries. Although, the entrepreneurship done with formal educated people would contribute indispensably and sustain the development, the low numbers of formal educated people become entrepreneurs in developing countries. Empirically, this paper investigated the influential factors affecting the entrepreneurial motivation, intentions and decision among African scientists and engineers postgraduate from china universities since 1995 to 2014. Results revealed that 39% are entrepreneurs, 43% work for private sectors and 18% work for governments. Only 6% of respondents are in technological entrepreneurship related to their field of graduation. Study location, mentors or research supervisors and life style are the major factors influenced their decisions to become entrepreneurs whereas complex financial systems and political instability pushed some to employments. Interestingly, significant number of entrepreneurs did not have any entrepreneurial intentions. This paper concludes with suggestions to policy makers and investors in order to encouraging technological entrepreneurs which will provide more opportunities, create jobs and improve people’s quality of life.

Keywords: technological entrepreneurship, entrepreneurial motivation, entrepreneurship decision making, entrepreneurship intentions, formal education

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Authors: Ian Omung'a

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Breast cancer remains to be one of the deadliest cancers for women worldwide, with the risk of developing tumors being as high as 50 percent in Sub-Saharan African countries like Kenya. With as many as 42 percent of these cases set to be diagnosed late when cancer has metastasized and or the prognosis has become terminal, Full Field Digital [FFD] Mammography remains an effective screening technique that leads to early detection where in most cases, successful interventions can be made to control or eliminate the tumors altogether. FFD Mammograms have been proven to multiply more effective when used together with Computer-Aided Detection and Diagnosis [CADe] systems, relying on algorithmic implementations of Deep Learning techniques in Computer Vision to carry out deep pattern recognition that is comparable to the level of a human radiologist and decipher whether specific areas of interest in the mammogram scan image portray abnormalities if any and whether these abnormalities are indicative of a benign or malignant tumor. Within this paper, we review emergent Deep Learning techniques that will prove relevant to the development of State-of-The-Art FFD Mammogram CADe systems. These techniques will span self-supervised learning for context-encoded occlusion, self-supervised learning for pre-processing and labeling automation, as well as the creation of a standardized large-scale mammography dataset as a benchmark for CADe systems' evaluation. Finally, comparisons are drawn between existing practices that pre-date these techniques and how the development of CADe systems that incorporate them will be different.

Keywords: breast cancer diagnosis, computer aided detection and diagnosis, deep learning, whole mammogram classfication, ultrasound classification, computer vision

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Authors: Fangfang Wang, Fan Qu

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Polycystic ovary syndrome (PCOS), the most common endocrinopathy among women of reproductive age, is characterized by ovarian dysfunction, hyperandrogenism and reduced fecundity. The aim of this study is to investigate whether the circadian disruption is involved in pathogenesis of PCOS in androgen-induced animal model. We established a rat model of PCOS using single subcutaneous injection with testosterone propionate on the ninth day after birth, and confirmed their PCOS-like phenotypes with vaginal smears, ovarian hematoxylin and eosin (HE) staining and serum androgen measurement. The control group rats received the vehicle only. Gene expression was detected by real-time quantitative PCR. (1) Compared with control group, PCOS model rats of 10-week group showed persistently keratinized vaginal cells, while all the control rats showed at least two consecutive estrous cycles. (2) Ovarian HE staining and histological examination showed that PCOS model rats of 10-week group presented many cystic follicles with decreased numbers of granulosa cells and corpora lutea in their ovaries, while the control rats had follicles with normal layers of granulosa cells at various stages of development and several generations of corpora lutea. (3) In the 10-week group, serum free androgen index was notably higher in PCOS model rats than controls. (4) Disturbed mRNA expression patterns of core clock genes were found in ovaries of PCOS model rats of 10-week group. Abnormal expression of key genes associated with circadian rhythm in ovary may be one of the mechanisms for ovarian dysfunction in PCOS model rats induced by androgen.

Keywords: polycystic ovary syndrome, androgen, animal model, circadian disruption

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Authors: Deng Qiaoshan

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With the rise of feminism in the global film industry, feminist expressions in Chinese films have also evolved, reflecting societal focus on gender issues. This article focuses on young Chinese female directors such as Yang Lina, Teng Congcong, and Yang Mingming. Their films now present richer female perspectives and consciously incorporate unique female life experiences. They highlight women's real-life struggles, portraying ’struggling’ female identities—characters facing professional failures and desire identity issues, ultimately returning to family roles. These films commonly explore the ‘mother-daughter relationship’, with some using genre storytelling for commercial appeal and others deconstructing the ‘myth of motherhood’ to reflect reality, rewriting traditional maternal roles. The ‘struggling’ female identity in these directors' films shows an aesthetic of ‘pseudo-reality’, blending realistic situations with poetic, lyrical elements, reflecting their creative traits and internal conflicts. These contradictions are closely related to the unique creative context of Chinese cinema in which they operate. Emerging under China's strict film censorship system, film industrialization, consumerist culture, and internet environment, new-generation directors face multiple demands. How to ‘survive’ amidst complex commercial requirements while creating films with a clear feminist consciousness is the fundamental dilemma faced by young Chinese female directors.

Keywords: female directors, feminism film, female dilemma, film censorship system

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Authors: Eirini Arvanitaki

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Romance has incrementally grown in popularity over the last century. The first Mills & Boon romance novel was published in 1909 and since then romance has not only survived but it has become a long standing genre. There are several reasons behind its durability and success. First, its ability to please and appeal to a mass audience. Romance novels are products of commercial success situated in large scale production, especially if one takes into account the high volume of romance novels published, translated and distributed all around the world every month. Second, what has also contributed to keeping the romance genre alive is the content of the books and their effect on the reader. These are stories of two heterosexual individuals who meet, fall in love, face obstacles and successfully overcome them. Through the love plots, the books address anxieties, concerns and everyday troubles that the average reader can identify with. Additionally, the romance novel is a means of escapism from everyday life and responsibilities as well as a short-lived opportunity to enjoy personal time/space and focus on one’s self. Third, the genre’s ability to adapt to the periods and societies in which it is published has also assisted in prolonging its longevity. This paper discusses the ways in which popular romance authors write and engage with the body. Despite the claim that popular romance narratives adjust their contents in accordance with different time periods and social phenomena, the paper highlights the dissimilarities between writing the female and male body and suggests that women romance writers are yet to break free from phallogocentric law. The examination of the projections of the body and the language used to describe it indicates that these narratives are flexible enough to adjust to twenty-first century but only within the limits of their own conventionality.

Keywords: body, gender, language, literary representations, popular romance narratives, taboo

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Authors: Faiz Bakhsh, Tahira Yasmeen

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The Afghan refugee children in Pakistan are considered as the most vulnerable persons in danger of being abused and treated badly as compared to the minimum criteria of the protection of refugee children under 1951 refugee convention. This paper explores the impact of the 1951 refugee convention on the protection of refugee children, affected by the armed conflict in Afghanistan, residing in refugee camps in Pakistan. Despite, protection available under Refugee Convention, there exist millions of refugees in the world, including a huge portion of women and children, that remain unprotected, and their protection remains a challenging task for the world community. This study investigates the status and number of refugees in Pakistan, especially children; protection and assistance of refugees under Refugee Convention; protection of the rights of refugee children in Pakistan; and implementation of the rules of Refugee Convention relating refugee children in Pakistan and measures for the protection of refugee children in Pakistan. This socio-legal study utilizes a qualitative research approach and applies mixed methods of data collection. The primary data is collected through the interpretation of the legal framework available for the protection of refugees as well as domestic laws of Pakistan. The secondary data is collected through previous studies available on the same topic. The result of this study indicates that lack of proper implementation of the rules, of the Refugee Convention, relating protection of refugee children cause sufferings to refugee children including the provision of basic health, nutrition, family life, education and protection from child abuse. Pakistan needs a comprehensive domestic legal framework for the protection of refugees, especially refugee children. Moreover, the government of Pakistan with the help of the United Nations High Commissioner for Refugees (UNHCR) must prioritize the protection of Afghan refugee children as per standard criteria provided by the refugee convention 1951.

Keywords: refugee children, refugee convention, armed conflict, Pakistan

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Authors: Jiaqian Yin, Ruoling Chen, David Churchill, Huijuan Zou, Peipei Guo, Chunmei Liang, Xiaoqing Peng, Zhikang Zhang, Weiju Zhou, Yunxia Cao

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Purpose: This study aimed to explore the interaction of male and female age on implantation failure from in vitro fertilisation (IVF)/ intracytoplasmic sperm injection (ICSI) treatments in couples following their first cycles using the Anhui Maternal-Child Health Study (AMCHS). Methods: The AMCHS recruited 2042 infertile couples who were physically fit for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment at the Reproductive Centre of the First Affiliated Hospital of Anhui Medical University between May 2017 to April 2021. This prospective cohort study analysed the data from 1910 cohort couples for the current paper data analysis. The multivariate logistic regression model was used to identify the effect of male and female age on implantation failure after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40; female age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40) predictors. Results: Logistic regression indicated that advanced maternal age was associated with increased implantation failure (P<0.001). There was evidence of an interaction between maternal age (30-<35 and ≥ 35) and paternal age (≥35) on implantation failure. (p<0.05). Only when the male was ≥35 years of increased maternal age was associated with the risk of implantation failure. Conclusion: In conclusion, there was an additive effect on implantation failure with advanced parental age. The impact of advanced maternal age was only seen in the older paternal age group. The delay of childbearing in both men and women will be a serious public issue that may contribute to a higher risk of implantation failure in patients needing assisted reproductive technology (ART).

Keywords: parental age, infertility, cohort study, IVF

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Authors: Katalin Gocze, Gabriella Kiss, Zsuzsanna Gurdan, Krisztian Kvell, Attila Trabert

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Introduction: On a worldwide scale running has become an increasingly popular leisure time activity during the past decade. Since the participation rate of women has risen significantly the aim of our study was to analyze the mental status, sleeping habits and the prevalence of depression among female runners. Methods: Cross-sectional analysis included the use of validated and globally used surveys for the comprehensive evaluation of insomnia (AIS), depression (BDI), exercise dependence (EDS) and exercise addiction (EAI). Recreational and amateur female runners participating at half-marathon events in Hungary were asked to take part in our pilot study. Results: Participants mean age was 42.03±9.03 years. The prevalence of imsomnia was 18.87%. 60.34% has worries regarding their weight and 43.1% think that they have an actual weight problem. 77.6% stated that their body weight has an influence on their mood. 2.7% displayed borderline clinical depression, the prevalence of mild mood disorders was 10.81%. 17.2% had previously problems with disordered eating. Participants had a mean total EDS score of 46.94±15.55 and a mean total of 13.49±3.80 on EAI. Component scores were the highest for tolerance (a need for increased amounts of exercise to achieve the desired effect or a diminished effect occurs with continued use of the same amount of exercise). Conclusion: Even tough running can help improve mental health, tackle depression and overcome adversity, athletes are at risk of experiencing psychological difficulties which have an impact on their physical perfomance as well. Further research can help initiate targeted educational and screening programs to ensure that female athletes find a path to emotional well-being.

Keywords: depression, eating disorder, exercise addiction, exercise dependence, insomnia, running

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Authors: Shaibu Baanni Azumah, Ignatius Tindjina, Stella Obanyi, Tara N. Wood

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This study examined the effect of Urea Deep Placement (UDP) technology on the output of irrigated rice farmers in the northern region of Ghana. Multi-stage sampling technique was used to select 142 rice farmers from the Golinga and Bontanga irrigation schemes, around Tamale. A treatment effect model was estimated at two stages; firstly, to determine the factors that influenced farmers’ decision to adopt the UDP technology and secondly, to determine the effect of the adoption of the UDP technology on the output of rice farmers. The significant variables that influenced rice farmers’ adoption of the UPD technology were sex of the farmer, land ownership, off-farm activity, extension service, farmer group participation and training. The results also revealed that farm size and the adoption of UDP technology significantly influenced the output of rice farmers in the northern region of Ghana. In addition to the potential of the technology to improve yields, it also presents an employment opportunity for women and youth, who are engaged in the deep placement of Urea Super Granules (USG), as well as in the transplantation of rice. It is recommended that the government of Ghana work closely with the IFDC to embed the UDP technology in the national agricultural programmes and policies. The study also recommends an effective collaboration between the government, through the Ministry of Food and Agriculture (MoFA) and the International Fertilizer Development Center (IFDC) to train agricultural extension agents on UDP technology in the rice producing areas of the country.

Keywords: Northern Ghana, output , irrigation rice farmers, treatment effect model, urea deep placement

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Authors: Aline Giardin, Maria Rosa Chitolina

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Our research conducted in 8 different schools in the city of Rio Grande do Sul, Brazil, we can clearly see that, even in modern times, where the search for equality between men and women is already over 60 years of struggle in this world where you show Much more than two genres and in this world that is proving that sex is not just biological, are confronted with sexist and phallocentric situations in our Schools, and among our students. The sample consisted of 503 students with a mean age between 13 and 21 years. 107 students identified themselves as gay, lesbian, bisexual or transgender. The remainder was identified as heterosexual or none at all. Compared to LGBT students, transgender students faced the school's more hostile climates, while non-transgender female students were less likely to experience anti-LGBT victimization. In addition, transgender students experienced more negative experiences at school compared to students whose gender expression adhered to traditional gender norms. Transgender students were more likely to feel insecure at school, with 80.0% of transgender students reporting that they felt insecure at school because of their gender identity. Female students in our research reported lower frequencies of victimization based on sexual orientation and gender identity and were less likely to feel insecure at school. In all indicators of discrimination in school, high school students have outperformed elementary school students and have had fewer resources and supports related to LGBT. High school students reported higher rates of victimization on sexual orientation and gender expression than elementary school students. For example, about one-third (35.5%) of high school students suffered regular physical Very often) based on their sexual orientation, compared to less than a quarter (21.4%) of primary school students. The whole premise here is to perceive the phallocentrism and sexism hidden in our schools. Opposition between the sexes is not reflexive or articulates a biological fact, but a social construction.

Keywords: transgender students, school, psychological implications, discrimination

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Authors: Sarah K. Basudan, Ragad I. Al Jazzar, Zeinah Sulaihim, Hanan M. Al-Kadri

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Background: Cesarean section has been increasing in recent years, with a wide range of etiologies contributing to this rise. This study aimed to assess the indications, outcomes, and complications in Riyadh, Saudi Arabia. Methods: A Retrospective Cohort study was conducted at King Abdulaziz medical city. The study includes two cohorts: G1 (2009) and G2 (2020) groups who met the inclusion criteria. The data was transferred to the SPSS (statistical package for social sciences) version 24 for analysis. The initial descriptive statistics were run for all variables, including numerical and categorical data. The numerical data were reported as median, and standard deviation and categorical data were reported as frequencies and percentages. Results: The data were collected from 399 women who were divided into two groups, G1(199) and G2(200). The mean age of all participants is 32+-6​; G1 and G2 had significant differences in age means with 30+-6 and 34+-5, respectively, with a p-value of <0.001, which indicates delayed fertility by four years. Moreover, a breech presentation was less likely to occur in G2 (OR 0.64, CI: 0.21-0.62. P<0.001). Nonetheless, maternal causes such as repeated C-sections and maternal medical conditions were more likely to happen in G2 (OR 1.5, CI: 1.04-2.38, p=0.03) and (OR 5.4, CI: 1.12-23.9, P=0.01), respectively. Furthermore, postpartum hemorrhage showed an increase of 12% in G2 (OR 5.4, CI: 2.2-13.4, p<0.001). G2 was more likely to be admitted to the neonatal intensive care unit (NICU) (OR 16, CI: 7.4-38.7) and to special care baby (SCB) (OR 7.2, CI: 3.9-13.1), both with a p-value<0.001 compared to regular nursery admission. Conclusion: There are multiple factors that are contributing to the increase in c section rate in a Saudi tertiary hospitals. The factors were suggested to be previous c-sections, abnormal fetal heart rate, malpresentation, and maternal or fetal medical conditions.

Keywords: cesarean sections, maternal indications, maternal complications, neonatal condition

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Authors: Segen Asayehegn

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Introduction: In Tigray, Ethiopia, next to cervical cancer, breast cancer is one of the most common cancer health problems for women. Objectives: This article is proposed to identify the prospective and potential risk factors affecting the time-to-first-recurrence of breast cancer patients in Tigray, Ethiopia. Methods: The data were taken from the patient’s medical record that registered from January 2010 to January 2020. The study considered a sample size of 1842 breast cancer patients. Powerful non-parametric and parametric shared frailty survival regression models (FSRM) were applied, and model comparisons were performed. Results: Out of 1842 breast cancer patients, about 1290 (70.02%) recovered/cured the disease. The median cure time from breast cancer is found at 12.8 months. The model comparison suggested that the lognormal parametric shared a frailty survival regression model predicted that treatment, stage of breast cancer, smoking habit, and marital status significantly affects the first recurrence of breast cancer. Conclusion: Factors like treatment, stages of cancer, and marital status were improved while smoking habits worsened the time to cure breast cancer. Recommendation: Thus, the authors recommend reducing breast cancer health problems, the regional health sector facilities need to be improved. More importantly, concerned bodies and medical doctors should emphasize the identified factors during treatment. Furthermore, general awareness programs should be given to the community on the identified factors.

Keywords: acceleration factor, breast cancer, Ethiopia, shared frailty survival models, Tigray

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Authors: Leona Ondrejikova, Martin Hill, Antonin Parizek

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The incidence of gestational diabetes mellitus (GDM) is higher in women predisposed to developing intrahepatic cholestasis of pregnancy (ICP). Both diseases are associated with altered steroidogenesis when compared with none-ICP controls. However, the effect of GDM on circulating steroids in ICP patients remains unclear. The question remains, whether the levels of circulating steroids differ between ICP patients with and without GDM. In total 10 ICP patients without GDM (ICP+GDM-), 7 ICP patients with GDM (ICP+GDM+), and 15 controls (ICP-GDM-) were monitored during late gestation, at labor, and during three periods postpartum (day 5, week 3, and week 6 postpartum) (Šimják et al., 2018). The relationships between steroid profiles and patients’ status were evaluated using the ANOVA model consisting of subject factor, between-subject factors Group (ICP+GDM+, ICP+GDM-, ICP-GDM-), gestational age at the diagnosis of ICP and gestational age at labor, and within-subject factor Stage and ICP × Stage interaction. The levels of the C21 and C19 Δ5 steroids and 5α/β-reduced C19 steroids were highest in ICP+GDM+, while those for the ICP-GDM-, and ICP+GDM- groups were lower. In the C21 Δ4 steroids and their 5α/β-reduced metabolites, the steroid levels were highest in the ICP+GDM-, intermediate in the ICP-GDM- and lowest in the ICP+GDM+ group. This higher concentration in ICP+GDM- group may be of importance as the 5α-pregnane-3α,20α-diol disulfate, is considered as the substance inducing ICP. In general, these data show that the comorbidity with GDM substantially changes the steroidome in ICP patients towards the higher activity of steroid CYP17A1 lyase step in adrenal zona reticularis reduced CYP17A1 hydroxylase step in zona fasciculata. This is consistent with our previously published hypothesis about the critical role of maternal zona reticularis in the pathophysiology of ICP. Our present data also indicate that the comorbidity with GDM might moderate the gravity of the ICP in this way.

Keywords: CYP17A1, GC-MS, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy

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Authors: I. Ramalho, S. Campos, M. Dias

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Introduction: Endometriosis may play a role in the pathogenesis of ovarian cancer (OC), however, the risk and prognosis have not been well established. The association between these two pathologies could have an important impact on prevention and early diagnosis of OC. Objective: To analyze the prevalence of endometriosis associated ovarian cancer and related clinical, epidemiological and histopathological issues. Design: We conducted a retrospective case series analysis of patients diagnosed with endometriosis and ovarian cancer in the Gynecology Department of Coimbra University Hospital Center since 2006 to 2015. Methods: We collected data from women diagnosed with ovarian cancer, with anatomopathology records reporting findings of endometriosis in ovarian cancer patients. Patients were retrieved from the pathological records and appropriate medical records were retrospectively reviewed. Statistical analysis was performed using SPSS 22.0. Results: Histological evidence of endometriosis was found in 17 out of 261 patients diagnosed with ovarian cancer (OC) (6.51%). The most usual symptoms were pelvic pain, abdominal distension, asthenia, ascites, weight loss and nausea. Mean age at diagnosis was 61.2 ± 15.1, 41-86 years old, 33.3% were pre-menopausal patients and cancer stage distribution was predominantly stage I (31.3%) and stage III (56.3%). OC occurred unilaterally in 14 patients and 2 patients were diagnosed with a synchronous ovarian and endometrial cancer. Regarding histological type, 10 OC were classified as clear cell carcinoma (CCC), 4 endometrioid carcinomas (EC) and 3 mixed type (clear cell and endometrioid). Four ovarian carcinomas presumably arose from endometriomas: 3 CCC and 1 EC. Conclusions: In accordance with previous studies, clear cell was the most common pathological type in endometriotic patients, followed by endometrioid carcinomas, and two rare synchronous ovarian and endometrial carcinomas were registered. Although endometriosis association to OC is uncommon, endometriosis should be managed with special care in order to early diagnosis.

Keywords: endometriosis, histology, observational study, ovarian cancer

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Authors: Mohsen Shati, Seyede Salehe Mortazavi, Seyed Kazem Malakouti, Hamidreza Khanke Fazlollah Ahmadi

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Taking unnecessary or excessive medication or using drugs with no indication (polypharmacy) by people of all ages, especially the elderly, is associated with increased adverse drug reactions (ADR), medical errors, hospitalization and escalating the costs. It may be facilitated or impeded by the healthcare system. In this study, we are going to describe the role of the health system in the practice of polypharmacy in Iranian elderly. In this Inductive qualitative content analysis using Graneheim and Lundman methods, purposeful sample selection until saturation has been made. Participants have been selected from doctors, pharmacists, policy-makers and the elderly. A total of 25 persons (9 men and 16 women) have participated in this study. Data analysis after incorporating codes with similar characteristics revealed 14 subcategories and six main categories of the referral system, physicians’ accessibility, health data management, drug market, laws enforcement, and social protection. Some of the conditions of the healthcare system have given rise to polypharmacy in the elderly. In the absence of a comprehensive specialty and subspecialty referral system, patients may go to any physician office so may well be confused about numerous doctors' prescriptions. Electronic records not being prepared for the patients, failure to comply with laws, lack of robust enforcement for the existing laws and close surveillance are among the contributing factors. Inadequate insurance and supportive services are also evident. Age-specific care providing has not yet been institutionalized, while, inadequate specialist workforce playing a major role. So, one may not ignore the health system as contributing factor in designing effective interventions to fix the problem.

Keywords: elderly, polypharmacy, health system, qualitative study

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Authors: Bernard Eze Orji

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The masquerade, which is the most popular indigenous art form in Africa, is obviously identified by its elaborate, weird, and opulent costumes. The costume is the major essential accouterments in the art of the masquerade. From time past, masquerades have performed and enjoyed the freedom associated with its inscrutability and mystification solely because of its costumes. Noninitiates and women watched masquerades from a distance due to the reverence attached to its costumes and performances. In fact, whether in performance or as an item of art, the masquerade costume was seen as an embodiment of a tradition of liveliness, showiness, secrecy, and sacredness. This liveliness and showiness transformed masked characters who are believed to be possessed by spirits of ancestors and animals that inhabited the costumes. However, with the translocation of masquerade in new festivals such as carnival and state-sponsored cultural days, its costumes have been reduced to a mere item of entertainment and aesthetic values. The sacredness and reverence which hitherto elevated masquerade art to the point of wonderment have given way to an aesthetic appreciation of ingenious and individual creativity deployed in these festivals. This is as a result of the realistic and artistic creations that pervade masquerade costumes and masks in these festivals. It is a common sight to see such masquerades of animal and human genera like a lion, elephant, hippopotamus, and antelope; Agbogho Mmuo, Adamma, and Nchiekwa, respectively. This creative flair has emerged to expunge the ritual narratives associated with masquerades in the past. The study utilized performance analysis and aesthetic theory to establish that the creative ingenuity deployed by fine artists and mask designers who combine traditional artifacts to achieve modern masterpieces for the masquerades of the new festivals have reduced the ritual trappings and hype ascribed to masquerades in indigenous societies.

Keywords: costume and mask designs, entertainment, masquerade, ritual

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Authors: Chiara De Amicis, Sonia Falconieri, Mesut Tastan

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In this study, we analyze the language employed by Chief Executive Officers (CEOs) and Chief Financial Officers (CFOs) during earnings conference calls from a gender perspective. We find evidences that conference calls held by female CEOs and/or CFOs exhibit a higher level of optimism compared to conference calls held by male CEOs and/or CFOs. Moreover, female managers tend to present and discuss firm performances with less vagueness as compared to their male colleagues. We then observe the market reaction around each earnings conference call: while manager optimism is perceived as a good signal by investors, manager vagueness significantly dampens the market reaction around the call. Whether the gender of the CEO and/or the CFO delivering the conference call affects investors’ perceptions about the firm performance is still an open question. Some evidences show that the language employed by female managers conveys more valuable information for market participants as compared to the language employed by their male counterparts. This study contributes to a growing literature in finance and accounting that uses textual analysis to assess the informativeness of corporate disclosure. To our knowledge, this is the first paper that aims at answering the question whether the gender of firm’s top managers does matter when it comes to assess the informativeness of corporate spoken communication. We believe that our results will be of relevance for future research in the field. Moreover, our evidence may be used in support of the debate if a larger participation by women in the management of companies should be encouraged or not.

Keywords: conference calls, even study, gender, market reaction, textual analysis

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Authors: C. M. Williams, R. English, P. King, I. M. Brown

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Introduction: Pseudoangiomatous Stromal Hyperplasia (PASH) is a benign fibrous proliferation of breast stroma affecting predominantly premenopausal women with no significant increased risk of breast cancer. Informal recommendations for management have continued to evolve over recent years from surgical excision to observation, although there are no specific national guidelines. This study assesses the safety of a non-surgical approach to PASH management by review of cases at a single centre. Methods: Retrospective case series review (January 2011 – August 2016) was conducted on consecutive PASH cases. Diagnostic classification (clinical, radiological and histological), management outcomes, and breast cancer incidence were recorded. Results: 43 patients were followed up for median of 25 months (3-64) with 75% symptomatic at presentation. 12% of cases (n=5) had a radiological score (BIRADS MMG or US) ≥ 4 of which 3 were confirmed malignant. One further malignancy was detected and proven radiologically occult and contralateral. No patients were diagnosed with a malignancy during follow-up. Treatment evolved from 67% surgical in 2011 to 33% in 2016. Conclusions: The management of PASH has transitioned in line with other published experience. The preliminary findings suggest this appears safe with no evidence of missed malignancies; however, longer follow up is required to confirm long-term safety. Recommendations: PASH with suspicious radiological findings ( ≥ U4/R4) warrants multidisciplinary discussion for excision. In the absence of histological or radiological suspicion of malignancy, PASH can be safely managed without surgery.

Keywords: benign breast disease, conservative management, malignancy, pseudoangiomatous stromal hyperplasia, surgical excision

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Authors: Abara Onu, Augustine Mina Ephraim, Emmanuel Teidi

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Terrorism has been a major challenge and is so dare to the Nigerian government in recent times. The actions and activities of the Islamic sect known as Boko Haram had led to enormous loss of lives and properties in the country, mostly the Northern part of Nigeria. Some of these activities entails bombings, suicide attacks, intimidations, sporadic gunfire of the unarmed, blameless and innocent Nigerians, burning of police stations and churches, kidnappings, raping of school girls and women. Nigeria has also been included amongst one of the terrorist countries of the world. This has serious implications for the development of Nigerian economy. Although, Nigeria had made several worried hard work to deal with these challenges masqueraded by terrorism and insecurity in the country but the rate of insurgency and insecurity is still worrisome. The study looks at exploring the determinants of Boko Haram terrorism in Nigerian security systems and economy. Data used for the study work was from questionnaire administered, using Analysis of Variance (ANOVA) method to analyse the data. The result shows that Ideology and funding are significant basic factors that propelled the Boko Haram group in Nigeria. The Boko Haram disaster poses a significant threat to Nigeria’s economy and the military is the best option and solution in tackling the Boko Haram menace in Nigeria. The work x-rayed the following recommendations; government should declare war on terrorism and as well seek support and cooperation from international communities who in time or the other might have faced with this kind ugly experience and challenge and were able to tackle it. Nigerian Military needs to be more empowered with high dangerous weapons to combat the insurgency as well as beef up security across the Country to curb the threats.

Keywords: terrorism, economy, Boko Haram, Nigeria

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Authors: Surabhi Agrawal Kohli, Sunita Gupta, Esha Khanuja, Parul Garg, P. Gupta

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Background: Adenomyosis is a common gynaecological condition that affects the menstruating women. Uterine enlargement, dysmenorrhoea, and menorrhagia are regarded as the cardinal clinical symptoms of adenomyosis. Classically it was thought, compared with ultrasonography, when adenomyosis is suspected, MRI enables more accurate diagnosis of the disease. Materials and Methods: 172 subjects were enrolled after an informed consent that had complaints of HMB, dyspareunia, dysmenorrhea, and chronic pelvic pain. Detailed history of the enrolled subjects was taken, followed by a clinical examination. These patients were then subjected to TVS where myometrial echo texture, presence of myometrial cysts, blurring of endomyometrial junction was noted. MRI was followed which noted the presence of junctional zone thickness and myometrial cysts. After hysterectomy, histopathological diagnosis was obtained. Results: 78 participants were analysed. The mean age was 44.2 years. 43.5% had parity of 4 or more. heavy menstrual bleeding (HMB) was present in 97.8% and dysmenorrhea in 93.48 % of HPE positive patient. Transvaginal sonography (TVS) and MRI had a sensitivity of 89.13% and 80.43%, specificity of 90.62% and 84.37%, positive likelihood ratio of 9.51 and 5.15, negative likelihood ratio of 0.12 and 0.23, positive predictive value of 93.18% and 88.1%, negative predictive value of 85.29% and 75% and a diagnostic accuracy of 89.74% and 82.5%. Comparison of sensitivity (p=0.289) and specificity (p=0.625) showed no statistically significant difference between TVS and MRI. Conclusion: Prevalence of 30.23%. HMB with dysmenorrhoea and chronic pelvic pain helps in diagnosis. TVS (Endomyometrial junction blurring) is both sensitive and specific in diagnosing adenomyosis without need for additional diagnostic tool. Both TVS and MRI are equally efficient, however because of certain additional advantages of TVS over MRI, it may be used as the first choice of imaging. MRI may be used additionally in difficult cases as well as in patients with existing co-pathologies.

Keywords: adenomyosis, heavy menstrual bleeding, MRI, TVS

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Authors: Lapatrada Numkham, Saowaluk Khakhong, Jeeraporn Kummabutr

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Non-communicable diseases (NCDs) are the leading cause of death in worldwide. Thailand also concerns and focuses on reduction a new case of these diseases. Community Health Volunteers (CHV) is important health personnel in primary health care and performs as a health leader in the community. If the health of CHV changes, it would impact on the performance to promote health of families and community. This cross-sectional study aimed to 1) describe the health status of community health volunteers and 2) examine the factors associated with health status among community health volunteers. The sample included 360 community health volunteers in a province in central Thailand during September-December 2014. Data were collected using questionnaires on health information, knowledge of health behaviors, and health behaviors. Body weight, height, waist circumference (WC), blood pressure (BP), and blood glucose (BS) (fingertip) were assessed. Data were analyzed using descriptive statistics and chi-square test. There were three hundred and sixty participants with 82.5% being women. The mean age was 54 + 8.9 years. Forty-seven percent of the participants had co-morbidities. Hypertension was the most common co-morbidity (26.7%). The results revealed that the health status of the volunteers included: no underlying disease, having risk of hypertension (HT) & diabetes mellitus (DM), and having HT&DM at 38.3%, 30.0%, and 31.7% respectively. The chi-square test revealed that the factors associated with health status among the volunteers were gender, age, WC and body mass index (BMI). The results suggested that community health nurses should; 1) implement interventions to decrease waist circumference and lose weight through education programs, especially females; 2) monitor people that have a risk of HT&DM and that have HT&DM by meeting and recording BP level, BS level, WC and BMI; and 3) collaborate with a district public health officer to initiate a campaign to raise awareness of the risks of chronic diseases among community health volunteers.

Keywords: community health volunteers, health status, risk of non-communicable disease, Thailand

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