Search results for: nutritional status
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3731

Search results for: nutritional status

3461 Management of Nutrition Education in Spa Resorts in Poland

Authors: Joanna Wozniak-Holecka, Sylwia Jaruga-Sekowska

Abstract:

There are 45 statutory spa and treatment areas in Poland, and the demand for spa and treatment services increases year by year. Within each type of spa treatment facilities, nutritional education services are provided. During spa treatment, the patient learns the principles of rational nutrition and applied diet therapy. It should help him develop proper eating habits, which will also follow at home. However, the nutrition education system of spa resort patients should be considered as very imperfect and requiring a definite systemic correction. It has, at the same time, a wide human and infrastructure base, which guarantees to obtain positive reinforcement in the scope of undertaken activities and management. Unfortunately, this advantage is not fully used. The aim of the project was to assess the quality of implemented nutritional education and to assess the diet of patients in spa treatment entities from a nationwide perspective. The material for the study was data obtained as part of an in-depth interview conducted among nutrition department managers (25 interviews) and a survey addressed to patients (600 questionnaires) of a selected group of spa resorts from across the country about the implementation of nutritional education in institutions. Also, decade menus for the basic diet, easily digestible diet and diet with limitation of easily digestible carbohydrates (a total of 1,120 menus) were obtained for the study. Almost 2/3 of respondents (73.2%) were overweight or obese, but only 32.8% decided on an easily digestible or low-energy diet during the treatment. Most of the surveyed patients rated the nutrition in spa resorts as satisfactory. Classes on nutrition education were carried out mainly by a dietitian (65% of meetings), the other educators were doctors and nurses. The meetings (95%) were of a group nature and lasted only 30 minutes on average. The subjects of the classes concerned the principles of proper nutrition and composition of meals, a nutrition pyramid and a diet adapted to a given disease. The assessed menus did not meet the nutrition standards and, therefore, did not provide patients with the correct quality of nutrition. The norm of protein, fat, vitamin A, B12, phosphorus, iron and sodium was exceeded, while vitamin D, folic acid, magnesium and zinc were not enough than recommended. The study allowed to conclude that there is a large discrepancy between the recommendations presented during the nutrition education classes and the quality of diet implemented in the examined institutions. The project may contribute to the development of effective educational tools in nutrition, especially about a specific group of chronically ill patients.

Keywords: diet, management, nutritional education, spa resort

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3460 Effect of Malnutrition at Admission on Length of Hospital Stay among Adult Surgical Patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia: Prospective Cohort Study, 2022

Authors: Yoseph Halala Handiso, Zewdi Gebregziabher

Abstract:

Background: Malnutrition in hospitalized patients remains a major public health problem in both developed and developing countries. Despite the fact that malnourished patients are more prone to stay longer in hospital, there is limited data regarding the magnitude of malnutrition and its effect on length of stay among surgical patients in Ethiopia, while nutritional assessment is also often a neglected component of the health service practice. Objective: This study aimed to assess the prevalence of malnutrition at admission and its effect on the length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, 2022. Methods: A facility-based prospective cohort study was conducted among 398 adult surgical patients admitted to the hospital. Participants in the study were chosen using a convenient sampling technique. Subjective global assessment was used to determine the nutritional status of patients with a minimum stay of 24 hours within 48 hours after admission (SGA). Data were collected using the open data kit (ODK) version 2022.3.3 software, while Stata version 14.1 software was employed for statistical analysis. The Cox regression model was used to determine the effect of malnutrition on the length of hospital stay (LOS) after adjusting for several potential confounders taken at admission. Adjusted hazard ratio (HR) with a 95% confidence interval was used to show the effect of malnutrition. Results: The prevalence of hospital malnutrition at admission was 64.32% (95% CI: 59%-69%) according to the SGA classification. Adult surgical patients who were malnourished at admission had higher median LOS (12 days: 95% CI: 11-13) as compared to well-nourished patients (8 days: 95% CI: 8-9), means adult surgical patients who were malnourished at admission were at higher risk of reduced chance of discharge with improvement (prolonged LOS) (AHR: 0.37, 95% CI: 0.29-0.47) as compared to well-nourished patients. Presence of comorbidity (AHR: 0.68, 95% CI: 0.50-90), poly medication (AHR: 0.69, 95% CI: 0.55-0.86), and history of admission (AHR: 0.70, 95% CI: 0.55-0.87) within the previous five years were found to be the significant covariates of the length of hospital stay (LOS). Conclusion: The magnitude of hospital malnutrition at admission was found to be high. Malnourished patients at admission had a higher risk of prolonged length of hospital stay as compared to well-nourished patients. The presence of comorbidity, polymedication, and history of admission were found to be the significant covariates of LOS. All stakeholders should give attention to reducing the magnitude of malnutrition and its covariates to improve the burden of LOS.

Keywords: effect of malnutrition, length of hospital stay, surgical patients, Ethiopia

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3459 The Sustainability of Farm Forestry Management in Bulukumba Regency, South Sulawesi, Indonesia

Authors: Nuraeni, Suryanti, Saida, Annas Boceng

Abstract:

Farm forestry is a forest where farmers or landowners do cultivation and farming activities on their land. This study aims to determine the dimensions of sustainable development of farm forestry and to analyze the leverage factors to improve the sustainability status of farm forestry management in Bulukumba Regency. This research was conducted in Kajang District, Bulukumba Regency. The analysis of the sustainability of farm forestry management applied Multi-Dimensional Scaling (MDS), a modification of the Rapid Appraisal of The Status of Farming (RAPFARM). The index value of farm forestry sustainability was by 62.01% for ecological dimension, 51.54% for economic dimension, 61.00% for the social and cultural dimension, and 63.24% for legal and institutional dimension with sustainable enough category status. Meanwhile, the index value for the technology and infrastructure was by 47.16% of less sustainable category status. The result of leverage analysis of attributes for the dimensions of ecological, economic, social and cultural, legal and institutional as well as infrastructure and technology afforded twenty-two (22) leverage sensitive factors that influence the sustainability of farm forestry.

Keywords: farm forestry, South Sulawesi, management, sustainability

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3458 Infant and Young Child-Feeding Practices in Mongolia

Authors: Otgonjargal Damdinbaljir

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Background: Infant feeding practices have a major role in determining the nutritional status of children and are associated with household socioeconomic and demographic factors. In 2010, Mongolia used WHO 2008 edition of Indicators for assessing infant and young child feeding practices for the first time. Objective: To evaluate the feeding status of infants and young children under 2 years old in Mongolia. Materials and Methods: The study was conducted by cluster random sampling. The data on breastfeeding and complementary food supplement of the 350 infants and young children aged 0-23 months in 21 provinces of the 4 economic regions of the country and capital Ulaanbaatar city were collected through questionnaires. The feeding status was analyzed according to the WHO 2008 edition of Indicators for assessing infant and young child feeding practices. Analysis of data: Survey data was analysed using the PASW statistics 18.0 and EPI INFO 2000 software. For calculation of overall measures for the entire survey sample, analyses were stratified by region. Age-specific feeding patterns were described using frequencies, proportions and survival analysis. Logistic regression was done with feeding practice as dependent and socio demographic factors as independent variables. Simple proportions were calculated for each IYCF indicator. The differences in the feeding practices between sexes and age-groups, if any, were noted using chi-square test. Ethics: The Ethics Committee under the auspices of the Ministry of Health approved the study. Results: A total of 350 children aged 0-23 months were investigated. The rate of ever breastfeeding of children aged 0-23 months reached up to 98.2%, while the percentage of early initiation of breastfeeding was only 85.5%. The rates of exclusive breastfeeding under 6 months, continued breastfeeding for 1 year, and continued breastfeeding for 2 years were 71.3%, 74% and 54.6%, respectively. The median time of giving complementary food was the 6th month and the weaning time was the 9th month. The rate of complementary food supplemented from 6th-8th month in time was 80.3%. The rates of minimum dietary diversity, minimum meal frequency, and consumption of iron-rich or iron-fortified foods among children aged 6-23 months were 52.1%, 80.8% (663/813) and 30.1%, respectively. Conclusions: The main problems revealed from the study were inadequate category and frequency of complementary food, and the low rate of consumption of iron-rich or iron-fortified foods were the main issues to be concerned on infant feeding in Mongolia. Our findings have highlighted the need to encourage mothers to enrich their traditional wheat- based complementary foods add more animal source foods and vegetables.

Keywords: complementary feeding, early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency

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3457 The Impact of Protein Content on Athletes’ Body Composition

Authors: G. Vici, L. Cesanelli, L. Belli, R. Ceci, V. Polzonetti

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Several factors contribute to success in sport and diet is one of them. Evidence-based sport nutrition guidelines underline the importance of macro- and micro-nutrients’ balance and timing in order to improve athlete’s physical status and performance. Nevertheless, a high content of proteins is commonly found in resistance training athletes’ diet with carbohydrate intake that is not enough or not well planned. The aim of the study was to evaluate the impact of different protein and carbohydrate diet contents on body composition and sport performance on a group of resistance training athletes. Subjects were divided as study group (n=16) and control group (n=14). For a period of 4 months, both groups were subjected to the same resistance training fitness program with study group following a specific diet and control group following an ab libitum diet. Body compositions were evaluated trough anthropometric measurement (weight, height, body circumferences and skinfolds) and Bioimpedence Analysis. Physical strength and training status of individuals were evaluated through the One Repetition Maximum test (RM1). Protein intake in studied group was found to be lower than in control group. There was a statistically significant increase of body weight, free fat mass and body mass cell of studied group respect to the control group. Fat mass remains almost constant. Statistically significant changes were observed in quadriceps and biceps circumferences, with an increase in studied group. The MR1 test showed improvement in study group’s strength but no changes in control group. Usually people consume hyper-proteic diet to achieve muscle mass development. Through this study, it was possible to show that protein intake fixed at 1,7 g/kg/d can meet the individual's needs. In parallel, the increased intake of carbohydrates, focusing on quality and timing of assumption, has enabled the obtainment of desired results with a training protocol supporting a hypertrophic strategy. Therefore, the key point seems related to the planning of a structured program both from a nutritional and training point of view.

Keywords: body composition, diet, exercise, protein

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3456 The Labor Participation–Fertility Trade-off: The Case of the Philippines

Authors: Daphne Ashley Sze, Kenneth Santos, Ariane Gabrielle Lim

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As women are now given more freedom and choice to pursue employment, the world’s over-all fertility has been decreasing mainly due to the shift in time allocation between working and child rearing. As such, we study the case of the Philippines, where there exists a decreasing fertility rate and increasing openness for women labor participation. We focused on the distinction between fertility and fecundity, the former being the manifestation of the latter and aim to trace and compare the effects of both fecundity and fertility to women’s employment status through the estimation of the reproduction function and multinomial logistic function. Findings suggest that the perception of women regarding employment opportunities in the Philippines links the negative relationship observed between fertility, fecundity and women’s employment status. Today, there has been a convergence in the traditional family roles of men and women, as both genders now have identical employment opportunities that continue to shape their preferences.

Keywords: multinomial logistic function, tobit, fertility, women employment status, fecundity

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3455 The Labor Participation-Fertility Trade-Off: Exploring Fecundity and Its Consequences to Women's Employment in the Philippines

Authors: Ariane C. Lim, Daphne Ashley L. Sze, Kenneth S. Santos

Abstract:

As women are now given more freedom and choice to pursue employment, the world’s over-all fertility has been decreasing mainly due to the shift in time allocation between working and child-rearing. As such, we study the case of the Philippines, where there exists a decreasing fertility rate and increasing openness for women labor participation. We focused on the distinction between fertility and fecundity, the former being the manifestation of the latter and aim to trace and compare the effects of both fecundity and fertility to women’s employment status through the estimation of the reproduction function and multinomial logistic function. Findings suggest that the perception of women regarding employment opportunities in the Philippines links the negative relationship observed between fertility, fecundity and women’s employment status. Today, there has been a convergence in the traditional family roles of men and women, as both genders now have identical employment opportunities that continue to shape their preferences.

Keywords: multinomial logistic function, tobit, fertility, women employment status, fecundity

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3454 Racial and Ethnic Health Disparities: An Investigation of the Relationship between Race, Ethnicity, Health Care Access, and Health Status

Authors: Dorcas Matowe

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Inequality in health care for racial and ethnic minorities continues to be a growing concern for many Americans. Some of the barriers hindering the elimination of health disparities include lack of insurance, socioeconomic status (SES), and racism. This study will specifically focus on the association between some of these factors- health care access, which includes insurance coverage and frequency of doctor visits, race, ethnicity, and health status. The purpose of this study will be to address the following questions: is having health insurance associated with increased doctor visits? Are racial and ethnic minorities with health insurance more or less likely to see a doctor? Is the association between having health insurance moderated by being an ethnic minority? Given the current implications of the 2010 Affordable Care Act, this study will highlight the need to prioritize health care access for minorities and confront institutional racism. Critical Race Theory (CRT) will demonstrate how racism has reinforced these health disparities. This quantitative study design will analyze secondary data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, a telephone survey conducted annually in all 50 states and three US territories by state health departments in conjunction with the Center for Disease Control (CDC). Non-identifying health-related data is gathered annually from over 400,000 adults 18 years and above about their health status and use of preventative services. Through Structural Equation Modeling (SEM), the relationship between the predictor variables of health care access, race, and ethnicity, the criterion variable of health status, and the latent variables of emotional support and life satisfaction will be examined. It is hypothesized that there will be an interaction between certain racial and ethnic minorities who went to see a doctor, had insurance coverage, experienced racism, and the quality of their health status, emotional support, and life satisfaction.

Keywords: ethnic minorities, health disparities, health access, racism

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3453 Effects of Microbiological and Physicochemical Processes on the Quality of Complementary Foods Based on Maize (Zea mays) Fortification with Bambara Groundnut (Vigna subterranea)

Authors: T. I. Mbata, M. J. Ikenebomeh

Abstract:

Background: The study was aim at formulating a complementary foods based on maize and bambara groundnut with a view of reducing malnutrition in low income families. Protein-energy malnutrition is a major health challenge attributed to the inappropriate complementary feeding practices, low nutritional quality of traditional complementary foods and high cost of quality protein-based complementary foods. Methods: The blends 70% maize, 30% bambara groundnut were evaluated for proximate analyses, minerals, amino acids profile, and antinutritional factors, using proprietary formula (‘Nutrend’) as standard. Antinutritional factors, amino acids, microbiological properties and sensory attributes were determined using standard methods. Results; For Protein, the results were 15.0% for roasted bambara groundnut maize germinated flour (RBMGF), 13.80% for cooked bambara groundnut maize germinated flour (CBMGF), 15.18% for soaked bambara groundnut maize germinated flour (SBMGF); values for maize flour and nutrend had 10.4% and 23.21% respectively. With respect to energy value, RBMGF, CBMGF, SBMGF, maize flour and nutrend had 494.9, 327.58, 356.49, 366.8 and 467.2 kcal respectively. The percentages of total essential amino acids in the composition of the blends were 36.9%, 40.7% and 38.9% for CBMGF, SBMGF and RBMGF, respectively, non-essential amino acids contents were 63.1%, 59.3% and 61.1% for CBMGF, SBMGF and RBMGF respectively. The mineral content, that is, calcium, potassium, magnesium and sodium, of formulated samples were higher than those obtained for maize flour and Nutrend. The antinutrient composition of RBMGF and CBMGF were lower than of SBMGF. The rats fed with the control diet exhibited better growth performance such as feed intake (1527 g) and body weight gain (93.8 g). For the microbial status, microflora gradually changed from gram negative enteric bacteria, molds, lactic acid bacteria and yeast to be dominated by gram positive lactic acid bacteria (LAB) and yeasts. Yeasts and LAB growth counts in the complementary food varied between 4.44 and 7.36 log cfu/ml. LAB number increased from 5.40 to 7.36 log cfu/ml during fermentation. Yeasts increased from 4.44 to 5.60 log cfu/ml. Organoleptic evaluation revealed that the foods were well accepted. Conclusion: Based on the findings the application of bambara groundnut fortification to traditional foods can promote the nutritional quality of African maize - based traditional foods with acceptable rheological and cooking qualities.

Keywords: bambara groundnut, maize, fortification, complementary food

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3452 Oat Bran Associated with Nutritional Counseling in Treating Obesity and Other Risk Factors for Cardiovascular Disease

Authors: Simone Raimondi De Souza, Glaucia Maria Moraes De Oliveira, Ronir Raggio Luiz, Glorimar Rosa

Abstract:

Introduction: Obesity is among the main risk factors for cardiovascular disease (CVD). Genesis is multifactorial, including genetic, hormonal and environmental factors disorders, among which inadequate feeding pattern, for which nutritional counseling strategies have proven effective. The consumption of beta-glucans (soluble fibers that reportedly promote satiety) present in oat bran can be an effective strategy for preventing and treating obesity. Other benefits have been observed with oat bran consumption, such as reduction of hypercholesterolemia and hyperglycemia, two other risk factors for CVD. Objectives: To analyze the effect of oat bran consumption associated with nutritional counseling in reducing body mass index (BMI), blood cholesterol, glucose profile, waist and neck circumference in obese individuals, and to evaluate the change in eating pattern. Methods: clinical trial, randomized, double-blind, placebo-controlled, lasting 90 days with adults of both genders, with BMI ≥30kg/m2. The study was approved by the Ethics in Research involving human beings in a public institute of cardiology, in Rio de Janeiro, Brazil. Individuals were invited to participate and accepted formally by signing the Terms of Consent. Participants were randomized into oat bran group (gOB) or placebo group (gPCB) and received, respectively: morning prepared consisting of 40g oat bran, 30g of skimmed milk powder and 1g sweetener sucralose; refined flour 40g rice, 30g of milk powder and 1g sweetener sucralose. The Ten Steps to Healthy Eating, of Brazilian Ministry of Health were used to support the nutritional counseling. Variables analyzed: gender; age; BMI, waist circumference (WC) neck circumference (NC); systolic blood pressure (SBP); diastolic blood pressure (DBP); food consumption, total cholesterol (TC), LDL-cholesterol (LDL-c), HDL-cholesterol (HDL-c), non-HDL cholesterol (nHDLc), triglycerides (TG), fasting glucose (FG), fasting insulin (FI) and HOMA-IR. Dietary intake was assessed by 24-hour dietary recall. The Diet Quality Index revised for the Brazilian population (IQD-R) assessed quality of feeding pattern. Statistical analyzes were performed using SPSS version 21, considering statistically significant p-value less than 0.05. Results: A total of 38 participants were included, age = 50 ± 7,6years, 63% women. 19 subjects were placed in gOB and 19 in gPCB. After intervention, statistically significant reductions were observed in the following parameters: in gOB: IQD-R, TC, LDL-c, nHDL-c, FI, SBP, DBP, BMI, WC, NC; in gPCB: IQD-R, LDL-c, SBP, DBP, BMI, WC, NC. No statistically significant differences were observed in the results between groups. Conclusion: Our results reinforce nutritional counseling as important strategy for prevention and treatment of obesity and suggest that inclusion of oat bran in daily diet can bring additional benefits controlling risk factors for CVD. More studies are needed to establish all benefits of oat bran to human health as well as the ideal daily dose for consumption.

Keywords: oat bran, cardiovascular disease, nutritional counseling, obesity

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3451 The Important of Nutritional Status in Rehabilitation of Children with CP: Saudi Perspective

Authors: Reem Al-Garni

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Malnutrition is a global epidemic, but the under-weight or Failure-To-Thrive risk is increasing in rehabilitation setting and considered one of the contribution factor for developmental delay. Beside the consequences of malnutrition on children growth and development, there are other side-effects that might delay or hold the progress of rehabilitation. The awareness for malnutrition must be raised and discussed by the rehabilitation team, to promote the treatment and to optimize the client care. The solution can start from food supplements intake and / or Enteral Nutrition plan, depending on the malnutrition level and to reach the goal, the medical team should to work together in order to provide comprehensive treatment and to help the family to be able to manage their child condition. We have explore the outcomes of rehabilitation between the children with CP whose diagnosed with malnutrition and children with normal body Wight Over a period of 4 months who received 4-6 weeks of rehabilitation two hours daily by using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings reported that children with normal body Wight has better outcomes and improvement comparing with children with malnutrition for the entire study sample.

Keywords: Cerebral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, malnutrition

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3450 Adequate Dietary Intake to Improve Outcome of Urine: Urea Nitrogen with Balance Nitrogen and Total Lymphocyte Count

Authors: Mardiana Madjid, Nurpudji Astuti Taslim, Suryani As'ad, Haerani Rasyid, Agussalim Bukhari

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The high level of Urine Urea Nitrogen (UUN) indicates hypercatabolism occurs in hospitalized patients. High levels of Total Lymphocyte Count (TLC) indicates the immune system condition, adequate wound healing, and limit complication. Adequate dietary intake affects to decrease of hypercatabolism status in treated patient’s hospitals. Nitrogen Balance (NB) is simply the difference between nitrogen (N₂) intake and output. If more N₂ intake than output, then positive NB or anabolic will occur. This study aims to evaluate the effect of dietary intake in influencing balance nitrogen and total lymphocyte count. Method: A total of 43 patients admitted to a Wahidin Sudirohusodo Hospital between 2018 and 2019 for 10 days' treats are included. The inclusion criteria were patients who were treated for 10 days and receives food from the hospital orally. Patients did not experience gastrointestinal disorders such as vomiting and diarrhea and experience impair kidney function and liver function and expressed approval to participate in this study. During hospitalization, food intake, UUN, albumin serum, balance nitrogen, and TLC was assessed twice on day 1 and day 10. There is no Physician Clinical Nutritional intervention to correct food intake. UUN is 24 hours of urine collected on the second day after admission and the tenth day. Statistical analysis uses SPSS 24 with observational cohort methods. Result: The Forty-three participants completed the follow-up (27 men and 18 women). The age of fewer than 4 years is 22 people, 45 to 60 years is 16 people, and over 60 years is 4 people. The result of the study on day 1 obtained SGA score A, SGA score B, SGA score C are 8, 32, 3 until day 10 are 8, 31, 4, respectively. According to 24h dietary recalls, the energy intake during observation was from 522.5 ± 400.4 to 1011.9 ± 545.1 kcal/day P < 0.05, protein intake from 20.07 ± 17.2 to 40.3 ± 27.3 g/day P < 0.05, carbohydrates from 92.5 ± 71.6 to 184.8 ± 87.4 g/day, and fat from 5.5 ± 3.86 to 13.9 ± 13.9 g/day. The UUN during the observation was from 6.6 ± 7.3 to 5.5 ± 3.9 g/day, TLC decreased from 1622.9 ± 897.2 to 1319.9 ± 636.3/mm³ value target 1800/mm³, albumin serum from 3.07 ± 0.76 to 2.9 ± 0.57 g/day, and BN from -7.5 ± 7.2 to -3.1 ± 4.86. Conclusion: The high level of UUN needs to correct adequate dietary intake to improve NB and TLC status on hospitalized patients.

Keywords: adequate dietary intake, balance nitrogen, total lymphocyte count, urine urea nitrogen

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3449 Maturity Status of Male Boys in Punjab - India

Authors: Parminder K. Laroiya, Sukhdeep S. Kang

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The Present cross-sectional study was conducted on 610 boys (ranging in age bracket of 11 to 17 years) to assess their developmental age to check percentage of early, normal and late maturity among them, and to check whether there is any significant difference in their calendar age and developmental age. Developmental age of these subjects has been accessed by TW2 method (using hand wrist X-rays) and their chronological age was checked from their date of birth certificate. Developmental status of subjects i.e. early, normal or late mature was considered with +2 years or -2 years from their calendar age. Results of this study shows that 50% boys were normal in their maturity status in all age brackets and rest of subjects were either early maturers 24.92% or late maturers 25.08%. When pattern of maturity was studied in each age group it has been found that till the age of 15 years, percentage of normal maturity was less than 50 % whereas in 16 and 17 years age groups, this percentage of normal maturity increased to 60% - 65 % ( this may be because at this age mostly boys attain adolescence) Further investigation of each age group showed that till the age of 14 years percentage of late maturity among these boys were approximately 35% to 40% whereas early maturity lies between 15% to 20%. It has been found from the present study that at the age of 15 years, there is a twist among percentage of late and early maturity among boys-early maturers are 38.61% and late maturers are 16.84%. At the age of 16 and 17 years percentage of late maturity has been decreased to 3% to 6%, whereas percentage of early maturity increased to 35.64 % and 30.69 % respectively.

Keywords: maturity status, developmental age, chronological age, X-rays

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3448 The Economic Benefits of Higher Education to the Graduates in the Philippines

Authors: Christia C. Baltar

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Everybody goes to primary education but not all proceed to secondary education because of poverty and it is evident in the Philippines. Moreover, the number goes down when they reach higher education. The researcher believes that higher education may improve the standard of living of the family looking at the economic benefits of it. Once one graduated from a particular degree, one may employ with higher wage than those who are non-degree holder. Every year the Philippines produce more than five hundred thousand graduates of higher education and it keeps on increasing every year. Thus, the competition in the employment is really high. It is then important to pursue higher education than settling to a high school graduate because a degree is what most of the employer is looking for. The Philippine government through the Department of Labor and Employment is offering job fairs to all cities as much as possible just to cater employment for those graduates away from urban areas like in Manila and even the privates sectors also proposing for job fairs. Researcher conducted a survey in her institution and she further used secondary information to strengthen the findings of her survey. Researcher used descriptive measures, chi-square test for independence, and the correlation coefficient to analyze the data in her survey. In the survey conducted results show that there was an increase on the income of the family of the graduates of higher education. The graduates believed that their standard of living improved because they were able to work in a better job. The data were analyzed and the results show that there was no significant relationship on sex, age and marital status of the graduates to their economic status but the degree program they enrolled in the tertiary education affects their economic status. The impact of earning higher education can be seen indirectly to the economic growth of the Philippines. Finally, researcher concludes that there is direct and indirect impact of the higher education to the economic status of the graduates.

Keywords: economic benefits, economic status, graduate, higher education

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3447 Developing an Intervention Program to Promote Healthy Eating in a Catering System Based on Qualitative Research Results

Authors: O. Katz-Shufan, T. Simon-Tuval, L. Sabag, L. Granek, D. R. Shahar

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Meals provided at catering systems are a common source of workers' nutrition and were found as contributing high amounts calories and fat. Thus, eating daily catering food can lead to overweight and chronic diseases. On the other hand, the institutional dining room may be an ideal environment for implementation of intervention programs that promote healthy eating. This may improve diners' lifestyle and reduce their prevalence of overweight, obesity and chronic diseases. The significance of this study is in developing an intervention program based on the diners’ dietary habits, preferences and their attitudes towards various intervention programs. In addition, a successful catering-based intervention program may have a significant effect simultaneously on a large group of diners, leading to improved nutrition, healthier lifestyle, and disease-prevention on a large scale. In order to develop the intervention program, we conducted a qualitative study. We interviewed 13 diners who eat regularly at catering systems, using a semi-structured interview. The interviews were recorded, transcribed and then analyzed by the thematic method, which identifies, analyzes and reports themes within the data. The interviews revealed several major themes, including expectation of diners to be provided with healthy food choices; their request for nutrition-expert involvement in planning the meals; the diners' feel that there is a conflict between sensory attractiveness of the food and its' nutritional quality. In the context of the catering-based intervention programs, the diners prefer scientific and clear messages focusing on labeling healthy dishes only, as opposed to the labeling of unhealthy dishes; they were interested in a nutritional education program to accompany the intervention program. Based on these findings, we have developed an intervention program that includes: changes in food served such as replacing several menu items and nutritional improvement of some of the recipes; as well as, environmental changes such as changing the location of some food items presented on the buffet, placing positive nutritional labels on healthy dishes and an ongoing healthy nutrition campaign, all accompanied by a nutrition education program. The intervention program is currently being tested for its impact on health outcomes and its cost-effectiveness.

Keywords: catering system, food services, intervention, nutrition policy, public health, qualitative research

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3446 Lifestyle Factors Associated With Overweight/obesity Status In Croatian Adolescents: A Population-Based Study

Authors: Lovro Štefan

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The main purpose of the present study was to investigate the associations between the overweight/obesity status and lifestyle factors. In this cross-sectional study, participants were 1950 urban secondary-school students (54.7% of female students) aged 17-18 years old. Dependent variable was body-mass index status derived from self-reported height and weight. The outcome was binarised, where participants with value <25 kg/m2 were collapsed into „normal“, while those ≥25 kg/m2 into „overweight/obesity“ category. Independent variables were gender, type of school, physical activity, sedentary behaviour, self-rated health, self-perceived socioeconomic status and psychological distress. The associations between the dependent and independent variables were analyzed by using multiple logistic regression analysis. In the univariate model, being overweight/obese was significantly associated with being a male student (OR 0.31; 95% CI 0.23 to 0.42), attending a vocational school (OR 1.87; 95% CI 1.42 to 2.48), not meeting the recommendations for moderate-to-vigorous physical activity (OR 0.44; 95% CI 0.22 to 0.88), more time spending in sedentary behaviour (OR 1.53; 95% CI 1.07 to 2.19), poor self-rated health (OR 0.35, 95% CI 0.20 to 0.56) and lower socioeconomic status (OR 0.63; 95% CI 0.48 to 0.84). In the multivariate model, the same associations occured between the dependent and independent variable. In both models, psychological distress was not associated with being overweight/obese. In conclusion, our findings suggest, that lifestyle factors are independently associated with body-mass index

Keywords: body mass index, secondary-school students, Croatia, physical activity, sedentary behaviour, logistic regression

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3445 Assessment of Proximate Composition and Heavy Metal in Vigna unguculata (White Beans) Sold in Kazaure Market, Jigawa State, Nigeria

Authors: Abdu Umar Adamu, Saidu Akun Abdullahi, Al-Hassan Muhammed, Hamisu Abdu

Abstract:

Leguminous plants such as beans have been considered as a source of protein in this present work. The proximate analysis on beans (Vigna unguiculata) were determined in order to identify the nutritional content as well as presence of some heavy metals accumulation in washed and unwashed beans (white Beans) sold in Kazaure market Jigawa State Nigeria. On the average comparative analysis, the result has indicated that, the Vigna unguiculata had protein content of 61.1%, fibre 4.5%, ash 10.4%, moisture 5%, carbohydrate 15.8% and total lipid 4.9%, therefore it could be suggested that beans has enough nutritional content that helps the people health. The heavy metal analysis of unwashed white beans showed that Fe (17.37 ± 6.71)mg/kg had the highest concentration followed by Zn (6.41 ± 3.09), Cu (5.69 ± 2.42), Cd (0.46 ± 0.65) and Pb (0.57 ± 0.94)mg/kg , while the washed beans shows that Zn (0.11 ± 0.17), Fe (0.01 ± 0.006), Cd (0.02 ± 0.01), Cu (0.03 ± 0.021), Pb (0.01 ± 0.006)mg/kg. The washed white beans are safe for consumption and also the concentration of heavy metal are negligible and of nontoxic effect to human health.

Keywords: white beans, protein, proximate composition, heavy metal

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3444 Modification of the Risk for Incident Cancer with Changes in the Metabolic Syndrome Status: A Prospective Cohort Study in Taiwan

Authors: Yung-Feng Yen, Yun-Ju Lai

Abstract:

Background: Metabolic syndrome (MetS) is reversible; however, the effect of changes in MetS status on the risk of incident cancer has not been extensively studied. We aimed to investigate the effects of changes in MetS status on incident cancer risk. Methods: This prospective, longitudinal study used data from Taiwan’s MJ cohort of 157,915 adults recruited from 2002–2016 who had repeated MetS measurements 5.2 (±3.5) years apart and were followed up for the new onset of cancer over 8.2 (±4.5) years. A new diagnosis of incident cancer in study individuals was confirmed by their pathohistological reports. The participants’ MetS status included MetS-free (n=119,331), MetS-developed (n=14,272), MetS-recovered (n=7,914), and MetS-persistent (n=16,398). We used the Fine-Gray sub-distribution method, with death as the competing risk, to determine the association between MetS changes and the risk of incident cancer. Results: During the follow-up period, 7,486 individuals had new development of cancer. Compared with the MetS-free group, MetS-persistent individuals had a significantly higher risk of incident cancer (adjusted hazard ratio [aHR], 1.10; 95% confidence interval [CI], 1.03-1.18). Considering the effect of dynamic changes in MetS status on the risk of specific cancer types, MetS persistence was significantly associated with a higher risk of incident colon and rectum, kidney, pancreas, uterus, and thyroid cancer. The risk of kidney, uterus, and thyroid cancer in MetS-recovered individuals was higher than in those who remained MetS but lower than MetS-persistent individuals. Conclusions: Persistent MetS is associated with a higher risk of incident cancer, and recovery from MetS may reduce the risk. The findings of our study suggest that it is imperative for individuals with pre-existing MetS to seek treatment for this condition to reduce the cancer risk.

Keywords: metabolic syndrome change, cancer, risk factor, cohort study

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3443 Dynamics of Marital Status and Information Search through Consumer Generated Media: An Exploratory Study

Authors: Shivkumar Krishnamurti, Ruchi Agarwal

Abstract:

The study examines the influence of marital status on consumers of products and services using blogs as a source of information. A pre-designed questionnaire was used to collect the primary data from the respondents (experiences). Data were collected from one hundred and eighty seven respondents residing in and around the Emirates of Sharjah and Dubai of the United Arab Emirates. The collected data was analyzed with the help of statistical tools such as averages, percentages, factor analysis, student’s t-test and structural equation modeling technique. Objectives of the study are to know the reasons how married and unmarried or single consumers of products and services are motivated to use blogs as a source of information, to know whether the consumers of products and services irrespective of their marital status share their views and experiences with other bloggers and to know the respondents’ future intentions towards blogging. The study revealed the following: Majority of the respondents have the motivation to blog because they are willing to receive comments on what they post about services, convenience of blogs to search for information about services and products, by blogging respondents share information on the symptoms of a disease/ disorder that may be experienced by someone, helps to share information about ready to cook mix products and are keen to spend more time blogging in the future.

Keywords: blog, consumer, information, marital status

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3442 Nepal Himalaya: Status of Women, Politics, and Administration

Authors: Tulasi Acharya

Abstract:

The paper is a qualitative analysis of status of women and women in politics and administration in Nepal Himalaya. The paper reviews data of women in civil service and in administrative levels. Looking at the Nepali politics and administration from the social constructivist perspective, the paper highlights some social and cultural issues that have othered women as “second sex.” As the country is heading towards modernity, gender friendly approaches are being instituted. Although the data reflects on the progress on women’s status and on women’s political and administrative participation, the data is not enough to predict the democratic gender practices in political and administrative levels. The political and administrative culture of Nepal Himalaya should be changed by promoting gender practices and deconstructing gender images in administrative culture through representative bureaucracy and by introducing democratic policies.

Keywords: politics, policy, administration, culture, women, Nepal, democracy

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3441 Analysis of Productivity and Poverty Status among Users of Improved Sorghum Varieties in Kano State, Nigeria

Authors: Temitope Adefunsho Olatoye, Julius Olabode Elega

Abstract:

Raising agricultural productivity is an important policy goal for governments and development agencies, and this is central to growth, income distribution, improved food security, and poverty alleviation among practitioners. This study analyzed the productivity and poverty status among users of improved sorghum varieties in Kano State, Nigeria. A multistage sampling technique was adopted in the selection of 131 sorghum farmers who were users of improved sorghum varieties. Data collected were analyzed using both descriptive (frequency distribution and percentage) and inferential (productivity index and FGT model) statistics. The result of the socioeconomic characteristics of the sorghum farmers showed a mean age of 40 years, with about 93.13% of the sorghum farmers being male. Also, as indicated by the result, the majority (82.44%) of the farmers were married, with most of them having qur’anic education with a mean farm size of 3.6 ha, as reported in the study area. Furthermore, the result showed that the mean farming experience of the sorghum farmers in the study area was 19 years, with an average monthly income of about ₦48,794, as reported in the study area. The result of the productivity index showed a ratio of 192,977kg/ha, while the result of poverty status shows that 62.88% were in the non-poor category, 21.21% were poor, and 15.91% were very poor, respectively. The result also showed that the incidence of poverty for sorghum farmers was 16%, indicating that the incidence of poverty was prevalent in the study area. Based on the findings of this study, it was therefore recommended that seed companies should facilitate the spread of improved sorghum varieties as it has an impact on the productivity and poverty status of sorghum farmers in the study area.

Keywords: Foster Greer Thorbecke model, improved sorghum varieties, productivity, poverty status

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3440 Association Between Disability and Obesity Status Among US Adults: Findings From 2019-2021 National Health Interview Survey (NHIS)

Authors: Chimuanya Osuji, Kido Uyamasi, Morgan Bradley

Abstract:

Introduction: Obesity is a major risk factor for many chronic diseases, with higher rates occurring among certain populations. Even though disparities in obesity rates exist for those with disabilities, few studies have assessed the association between disability and obesity status. This study aims to examine the association between type of disability and obesity status among US adults during the Covid-19 pandemic (2019-2021). Methods: Data for this cross-sectional study was obtained from the 2019, 2020 and 2021 NHIS. Multinomial logistic regressions were used to assess the relationship between each type of disability and obesity status (reference= normal/underweight). Each model adjusted for demographic, health status and health-related quality of life variables. Statistical analyses were conducted using SAS version 9.4. Results: Of the 82,632 US adults who completed the NHIS in 2019, 2020, and 2021. 8.9% (n= 7,354) reported at least 1 disability-related condition. Respondents reported having a disability across vision (1.5%), hearing (1.5%), mobility (5.3%), communication (0.8%), cognition (2.4%) and self-care (1.1%) domains. After adjusting for covariates, adults with at least 1 disability-related condition were about 30% more likely to have moderate-severe obesity (AOR=1.3; 95% CI=1.11, 1.53). Mobility was the only disability category positively associated with mild obesity (AOR=1.16; 95% CI=1.01, 1.35) and moderate/severe obesity (AOR=1.6; 95% CI=1.35, 1.89). Individuals with vision disability were about 35% less likely to have mild obesity (AOR=0.66; 95% CI=0.51, 0.86) and moderate-severe obesity (AOR=0.66; 95% CI= 0.48, 0.9). Individuals with hearing disability were 28% less likely to have mild obesity (AOR=0.72; 95% CI= 0.56, 0.94). Individuals with communication disability were about 30% less likely to be overweight (AOR=0.66; 95% CI=0.47, 0.93) and 50% less likely to have mild obesity (AOR=0.45; 95% CI= 0.29, 0.71). Individuals with cognitive disability were about 25% less likely to have mild obesity and about 35% less likely to have moderate-severe obesity. Individuals with self-care disability were about 30% less likely to be overweight. Conclusion: Mobility-related disabilities are significantly associated with obesity status among adults residing in the United States. Researchers and policy makers should implement obesity intervention methods that can address the gap in obesity prevalence rates among those with and without disabilities.

Keywords: cognition, disability, mobility, obesity

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3439 Organizational Agility in 22 Districts of Tehran Municipality

Authors: Mehrnoosh Jafari, Zeinolabedin Amini Sabegh, Habibollah Azimian

Abstract:

Background: Today variable and dynamic environment doubles importance of using suitable solutions for confronting these changes in th4e organizations. One of the best ways for coping with environmental changes is directing the organization towards agility. Current research aims at investigating status of organizational agility in Tehran municipality (22 districts). Research Methodology: This research is applied research in terms of purpose of study and it is survey in terms of collection of descriptive data. A sample (n = 377) was selected from Tehran Municipality (22 districts) employees using multistage sampling method (cluster and regular). Data were collected using organizational agility standard questionnaire, and they were analyzed using statistical tests in SPSS software as well as inferential statistics such as one-sample t-test and Friedman test and descriptive statistics such as mean and median. Findings: Research findings showed organizational agility status in the organizations under study is in relatively optimal status and competence has highest priority in terms of ranking and priority of organizational agility indexes. Conclusion: It is necessary that managers provide suitable conditions for promoting organizational agility status in the organizations under study by identifying factors affecting change in the organizational environments and using available potentials for better coping with changes and higher flexibility and speed.

Keywords: organizational, municipality, employer, agility

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3438 Fighting for What’s Fair: Illegitimacy Appraisals as Drivers of Different Collective Action Responses to Economic Inequality

Authors: Finn Lannon, Jenny Roth, Roland Deutsch, Eric Igou

Abstract:

The world continues to be rife with economic inequality, which has an impact on how people think and behaves in response to large and often growing gaps in wealth. Large gaps in earnings between groups within a particular organization, area or society can create tension between groups. Collective action tendencies (to protest, sign a petition, vote on behalf of an ingroup etc.) are also a growing phenomenon globally. Research shows that economic inequality promotes social processes such as appraisals of illegitimacy, which are recognized antecedents of collective action. This paper examines different types of collective action intentions among middle-status group members in response to economic inequality in two studies. Study 1 (N = 72) demonstrates a causal link between high economic inequality and collective action intentions of middle-status group members both to reduce inequality and to improve group status. A second pre-registered study (N = 432) examines key drivers of these relationships, including illegitimacy appraisals and direction of intergroup comparison. Adding to the current understanding of the topic, distinctions between the illegitimacy of one’s group status and the illegitimacy of societal inequality are found to mediate key relationships between economic inequality and relevant collective action types. The direction of intergroup comparison (upwards vs. downwards) is also shown to have a significant impact on collective action intentions to improve group status. Findings add to the understanding of the consequences of economic inequality and drivers of collective action intentions.

Keywords: economic inequality, collective action, legitimacy, social psychology

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3437 Women Executives' Career Success in the Office of the Basic Education

Authors: Nipon Sasithornsaowapa

Abstract:

This research aims to study the impact of personality and family status on women executives’ career success of the primary education department of Thailand. The independent variable includes three factors, namely family status, personality, and knowledge-skill-experience, while the dependent variable is the career success. The population of this study includes 2,179 female management officials in the department of primary education. A total of 400 female managers is interviewed and utilized as a sample group. A questionnaire is developed and used as a research tool for data collection. Content analysis is performed to get the quantitative data. Descriptive statistics in this research is conducted by SPSS program. The findings revealed that personality and family status of samples have an influence on the overall career success of women executives in terms of their objective career success. However, in terms of specific factors of personality or family status, it is found that there is no relevance of each factor on the women executives’ career success. It can be concluded that the factor affecting the women executives’ career success is subjective career success including the happiness and enjoyment with the job not factor concerning materials. Their success is the result of each individual working experience. However, their personal characteristics do not affect their success.

Keywords: career success, women executives, primary education, knowledge-skill-experience

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3436 Social Integration of Visually Impaired Persons in Georgia

Authors: Vakhtang Nozadze, Luiza Arutinova, Khatuna Martskvishvili

Abstract:

The social empowerment of most needed individuals is a challenging issue, especially for developing countries. The current study explores the effects of visual impairment on individuals’ satisfaction with different aspects of life (i.e. education, job, income, family) and coping strategies. Furthermore, the difference between groups according to health status is revealed. Other demographic variables (education, employment, and marital status) is also considered. The cross-sectional design and self-reported questionnaires were adopted. Seventy-two visually impaired males and females (age range 13-66) and seventy healthy individuals participated in the study. The results reveal the importance of health status on the accessibility of social amenities, individuals’ satisfaction with life, and a diversity of coping strategies, irrespective of the age. The research has an important implication for social integration research and policy.

Keywords: coping strategies, life satisfaction, social integration, visual impairment

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3435 Klotho Level as a Marker of Low Bone Mineral Density in Egyptian Sickle Cell Disease Patients

Authors: Mona Hamdy, Iman Shaheen, Hadeel Seif Eldin, Basma Ali, Omnia Abdeldayem

Abstract:

Summary: Bone involvement of sickle cell disease (SCD) patients varies from acute clinical manifestations of painful vaso-occlusive crises or osteomyelitis to more chronic affection of bone mineral density (BMD) and debilitating osteonecrosis and osteoporosis. Secreted klotho protein is involved in calcium (Ca) reabsorption in the kidney. This study aimed to measure serum klotho levels in children with SCD to determine the possibility of using it as a marker of low BMD in children with SCD in correlation with a dual-energy radiograph absorptiometry scan. This study included 60 sickle disease patients and 30 age-matched and sex-matched control participants without SCD. A highly statistically significant difference was found between patients with normal BMD and those with low BMD, with serum Ca and klotho levels being lower in the latter group. Klotho serum level correlated positively with both serum Ca and BMD. Serum klotho level showed 94.9% sensitivity and 95.2% specificity in the detection of low BMD. Both serum Ca and klotho serum levels may be useful markers for detection of low BMD related to SCD with high sensitivity and specificity; however, klotho may be a better indicator as it is less affected by the nutritional and endocrinal status of patients or by intake of Ca supplements.

Keywords: sickle cell disease, BMD, osteoporosis, DEXA, klotho

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3434 Avoiding Packet Drop for Improved through Put in the Multi-Hop Wireless N/W

Authors: Manish Kumar Rajak, Sanjay Gupta

Abstract:

Mobile ad hoc networks (MANETs) are infrastructure less and intercommunicate using single-hop and multi-hop paths. Network based congestion avoidance which involves managing the queues in the network devices is an integral part of any network. QoS: A set of service requirements that are met by the network while transferring a packet stream from a source to a destination. Especially in MANETs, packet loss results in increased overheads. This paper presents a new algorithm to avoid congestion using one or more queue on nodes and corresponding flow rate decided in advance for each node. When any node attains an initial value of queue then it sends this status to its downstream nodes which in turn uses the pre-decided flow rate of packet transfer to its upstream nodes. The flow rate on each node is adjusted according to the status received from its upstream nodes. This proposed algorithm uses the existing infrastructure to inform to other nodes about its current queue status.

Keywords: mesh networks, MANET, packet count, threshold, throughput

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3433 An Exploratory Research on Awareness towards Human Rights among Public Representatives of Bihar, India

Authors: Saba Farheen, Uday Shankar

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Background- Attaining equality among all humans and eliminating all forms of discrimination against them are fundamental human rights. These rights are based on the belief that all human beings are born free with equal dignity, esteem, and honour. In India, more than 30 percent politicians are having criminal background. They are also illiterate, which obstacle them in governing the system. They do not know the basic human rights. Because of this, they cannot decide what to do for the sake of the nation. Bihar is the third largest populated state of India and is characterized by corrupt politicians and poor literacy rate. If the politicians can aware about the human rights, then they will show positive attitude towards these. Aim- The main goal of the present research was to study the subjects’ knowledge or awareness towards their human rights. It was an attempt to identify social-psychological conditions that inhibit or facilitate awareness among public representatives towards their human rights in the special context of Bihar, India. Thus the main variable awareness towards human rights has been treated as the main dependent variable. The other two variables-socio economic status and Educational status, have been treated as independent variables. Method- The subjects were 400 public representatives in the age group of 35 to 50 years. They were from High socio economic status (N=150), Middle socio economic status (N=150), and Low socio economic status (N=100). The subjects were either educated (N=200) or Uneducated (N=200). The subjects were selected randomly from the different districts of Bihar, India. “Human Rights Awareness Scale” by Dr. Iftekhar Hossain, Dr. Saba Farheen, and Dr. Uday Shankar was applied in this study. Results- Results have shown that the public representatives have very low level of awareness towards the human rights. Also, the subjects from Middle SES have highest awareness in comparison with subjects of High and Low SES. Uneducated public representatives have less awareness than the educated one about human rights. Conclusion- Conclusively, it can be stated that human rights awareness among the public representatives of India is very low, and it is being affected by their Socio economic status and literacy level.

Keywords: human rights, awareness, public representatives, bihar, India

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3432 The Influence of Career Optimism and Relationship Status on University Students’ Wellbeing

Authors: Didem Kepir Savoly, Selen Demirtas Zorbaz

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University students are at such a developmental stage that they are in between adolescence and adulthood, which is called emerging adulthood. And this developmental stage can be stressful due to its own nature. The potential stressor can be related to their academic life, career thoughts or beliefs, and the quality of their relationships with their peers, friends, and partners. University life is also a time that they explore and navigate their career goals and relationships. These life events may contribute to their wellbeing and mental health positively or negatively. Also, relationship status can have an impact on individuals’ mental health, whether they feel satisfied or not, and can play a role in university students’ wellbeing. The relationships between career, relationship, and wellbeing can be multifaceted and complex, and more research is required in this area. Therefore, this study aims to fill this gap in the literature by exploring the influence of career optimism and relationship status on university students’ wellbeing. According to the purpose of the research, the following hypotheses are established: 1. University students with higher career optimism will exhibit a higher level of wellbeing. 2. University students in relationships will report a higher level of wellbeing. This research is based on a quantitative method. The scale implementation, correlational, and group comparison analysis were utilized to analyze data. The data was collected from university students in Turkiye by utilizing the Career Optimism Scale and a questionnaire to identify participants’ relationship status and demographic variables. The findings and their implications may inspire researchers and practitioners, especially practitioners at counseling centers and career services of universities, in order to tailor psychoeducational and intervention programs to promote university students’ mental health.

Keywords: career optimism, relationship status, university students, wellbeing

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